1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services 
1.3 	budget; making changes to children and family services, Department of Health, 
1.4 	miscellaneous provisions, health licensing fees, health care, and continuing 
1.5 	care; redesigning service delivery; making changes to chemical and mental 
1.6 	health; modifying fee schedules; modifying program eligibility requirements; 
1.7 	authorizing rulemaking; imposing criminal penalties; requiring reports; 
1.8 	appropriating money for the Departments of Health and Human Services and 
1.9 	other health-related boards and councils; making forecast adjustments;amending 
1.10 	Minnesota Statutes 2010, sections 8.31, subdivisions 1, 3a; 62D.08, subdivision 
1.11 	7; 62E.08, subdivision 1; 62E.14, by adding a subdivision; 62J.04, subdivisions 
1.12 	3, 9; 62J.17, subdivision 4a; 62J.495, by adding a subdivision; 62J.692; 62Q.32; 
1.13 	62U.04, subdivisions 3, 9; 62U.06, subdivision 2; 119B.011, subdivision 13; 
1.14 	119B.035, subdivision 4; 119B.09, subdivision 10, by adding subdivisions; 
1.15 	119B.125, by adding a subdivision; 119B.13, subdivisions 1, 1a, 7; 144.1501, 
1.16 	subdivision 1; 144.396, subdivisions 5, 6; 144.98, subdivisions 2a, 7, by adding 
1.17 	subdivisions; 144A.102; 144A.61, by adding a subdivision; 144E.123; 145.925, 
1.18 	subdivisions 1, 2; 145.928, subdivisions 7, 8; 145A.17, subdivision 3; 148.07, 
1.19 	subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2; 
1.20 	148.212, subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52; 
1.21 	150A.091, subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101; 
1.22 	151.102, by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; 
1.23 	151.47, subdivision 1; 151.48; 152.12, subdivision 3; 157.15, by adding a 
1.24 	subdivision; 157.20, by adding a subdivision; 245A.14, subdivision 4; 245C.03, 
1.25 	by adding a subdivision; 245C.10, by adding a subdivision; 246B.10; 252.025, 
1.26 	subdivision 7; 252.27, subdivision 2a; 253B.212; 254B.03, subdivisions 1, 4; 
1.27 	254B.04, subdivision 1, by adding a subdivision; 254B.06, subdivision 2; 256.01, 
1.28 	subdivisions 2b, 14, 14b, 24, 29, by adding a subdivision; 256.969, subdivision 
1.29 	2b; 256B.04, subdivisions 14a, 18, by adding a subdivision; 256B.05, by 
1.30 	adding a subdivision; 256B.056, subdivisions 3, 4; 256B.057, subdivision 9; 
1.31 	256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 8e, 13e, 13h, 
1.32 	17, 17a, 18, 31a, 41, by adding subdivisions; 256B.0631, subdivisions 1, 2, 
1.33 	3; 256B.0644; 256B.0659, subdivisions 11, 28; 256B.0751, subdivision 4, by 
1.34 	adding a subdivision; 256B.0911, subdivisions 1a, 3a; 256B.0913, subdivision 
1.35 	4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 10; 256B.0916, subdivision 6a; 
1.36 	256B.092, subdivisions 1b, 1e, 1g, 3, 8; 256B.0943, by adding a subdivision; 
1.37 	256B.0945, subdivision 4; 256B.14, by adding a subdivision; 256B.431, 
1.38 	subdivisions 2r, 32; 256B.434, subdivision 4; 256B.437, subdivision 6; 
1.39 	256B.441, subdivision 50a, by adding a subdivision; 256B.48, subdivision 
2.1 	1; 256B.49, subdivisions 13, 14, 15; 256B.5012, by adding subdivisions; 
2.2 	256B.69, subdivisions 5a, 5c, 28, by adding subdivisions; 256B.76, subdivision 
2.3 	4; 256D.02, subdivision 12a; 256D.03, subdivision 3; 256D.031, subdivisions 
2.4 	1, 6, 7, 9, 10; 256D.05, subdivision 1; 256D.06, subdivision 2; 256D.09, 
2.5 	subdivision 6; 256D.44, subdivision 5; 256D.46, subdivision 1; 256D.47; 
2.6 	256D.49, subdivision 3; 256E.35, subdivisions 5, 6; 256G.02, subdivision 
2.7 	6; 256I.03, by adding a subdivision; 256I.04, subdivisions 1, 2b; 256I.05, 
2.8 	subdivision 1a; 256J.12, subdivisions 1a, 2; 256J.20, subdivision 3; 256J.37, by 
2.9 	adding a subdivision; 256J.38, subdivision 1; 256J.49, subdivision 13; 256J.53, 
2.10 	subdivision 2; 256L.01, subdivision 4a; 256L.02, subdivision 3; 256L.03, 
2.11 	subdivision 5; 256L.04, subdivisions 1, 7, 10; 256L.05, subdivisions 2, 3a, by 
2.12 	adding a subdivision; 256L.07, subdivision 1; 256L.11, subdivision 7; 256L.12, 
2.13 	subdivision 9; 256L.15, subdivision 1a; 260C.157, subdivision 3; 260D.01; 
2.14 	297F.10, subdivision 1; 326B.175; 393.07, subdivisions 10, 10a; 402A.10, 
2.15 	subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 518A.51; Laws 2009, chapter 
2.16 	79, article 13, section 3, subdivision 8, as amended; Laws 2010, First Special 
2.17 	Session chapter 1, article 15, section 3, subdivision 6; article 25, section 3, 
2.18 	subdivision 6; proposing coding for new law in Minnesota Statutes, chapters 1; 
2.19 	15; 62E; 62J; 62U; 145; 148; 151; 214; 256; 256B; 256L; 326B; 402A; proposing 
2.20 	coding for new law as Minnesota Statutes, chapter 256N; repealing Minnesota 
2.21 	Statutes 2010, sections 62J.07, subdivisions 1, 2, 3; 62J.17, subdivisions 1, 3, 
2.22 	5a, 6a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1464; 
2.23 	144.147; 144.1499; 256.979, subdivisions 5, 6, 7, 10; 256.9791; 256.9862, 
2.24 	subdivision 2; 256B.055, subdivision 15; 256B.057, subdivision 2c; 256B.0756; 
2.25 	256D.01, subdivisions 1, 1a, 1b, 1e, 2; 256D.03, subdivisions 1, 2, 2a; 256D.05, 
2.26 	subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2, 5, 7, 8; 
2.27 	256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 256D.10; 256D.13; 256D.15; 256D.16; 
2.28 	256D.35, subdivision 8b; 256D.46; 256L.07, subdivision 7; 402A.30; 402A.45; 
2.29 	Laws 2008, chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 3, 
2.30 	section 18, as amended; article 5, sections 55, as amended; 56; 57; 60; 61; 62; 63; 
2.31 	64; 65; 66; 68; 69; 79; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100, 
2.32 	subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 
2.33 	22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140; 
2.34 	4651.0150; 9500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5.
2.35 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.36 	ARTICLE 1
2.37 	CHILDREN AND FAMILY SERVICES

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

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

3.9 	Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:
3.10 		Subd. 4.Assistance. (a) A family is limited to a lifetime total of 12 months of 
3.11 	assistance under subdivision 2. The maximum rate of assistance is equal to 90 68 percent 
3.12 	of the rate established under section 119B.13 for care of infants in licensed family child 
3.13 	care in the applicant's county of residence.
3.14 	(b) A participating family must report income and other family changes as specified 
3.15 	in the county's plan under section 119B.08, subdivision 3.
3.16 	(c) Persons who are admitted to the at-home infant child care program retain their 
3.17 	position in any basic sliding fee program. Persons leaving the at-home infant child care 
3.18 	program reenter the basic sliding fee program at the position they would have occupied.
3.19 	(d) Assistance under this section does not establish an employer-employee 
3.20 	relationship between any member of the assisted family and the county or state.

3.21 	EFFECTIVE DATE. This section is effective October 31, 2011.

3.22 	Sec. 3. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
3.23 	to read:
3.24 		Subd. 9a.Child care centers; assistance. (a) For the purposes of this subdivision, 
3.25 	"qualifying child" means a child who satisfies both of the following:
3.26 	(1) is not a child or dependent of an employee of the child care provider; and
3.27 	(2) does not reside with an employee of the child care provider.
3.28 	(b) Funds distributed under this chapter must not be paid for child care services 
3.29 	that are provided for a child by a child care provider who employs either the parent of 
3.30 	the child or a person who resides with the child, unless at all times at least 50 percent of 
3.31 	the children for whom the child care provider is providing care are qualifying children 
3.32 	under paragraph (a).
4.1 	(c) If a child care provider satisfies the requirements for payment under paragraph 
4.2 	(b), but the percentage of qualifying children under paragraph (a) for whom the provider 
4.3 	is providing care falls below 50 percent, the provider shall have four weeks to raise the 
4.4 	percentage of qualifying children for whom the provider is providing care to at least 50 
4.5 	percent before payments to the provider are discontinued for child care services provided 
4.6 	for a child who is not a qualifying child.

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

4.8 	Sec. 4. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
4.9 		Subd. 10.Payment of funds. All federal, state, and local child care funds must 
4.10 	be paid directly to the parent when a provider cares for children in the children's own 
4.11 	home. In all other cases, all federal, state, and local child care funds must be paid directly 
4.12 	to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible 
4.13 	family. Funds distributed under this chapter must not be used for child care services that 
4.14 	are provided for a child by a child care provider who resides in the same household or 
4.15 	occupies the same residence as the child.

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

4.17 	Sec. 5. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 
4.18 	to read:
4.19 		Subd. 13.Child care in the child's home. Child care assistance must only be 
4.20 	authorized in the child's home if the child's parents have authorized activities outside of 
4.21 	the home and if one or more of the following circumstances are met:
4.22 	(1) the parents' qualifying activity occurs during times when out-of-home care is 
4.23 	not available. If child care is needed during any period when out-of-home care is not 
4.24 	available, in-home care can be approved for the entire time care is needed;
4.25 	(2) the family lives in an area where out-of-home care is not available; or
4.26 	(3) a child has a verified illness or disability that would place the child or other 
4.27 	children in an out-of-home facility at risk or creates a hardship for the child and the family 
4.28 	to take the child out of the home to a child care home or center.

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

4.30 	Sec. 6. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision 
4.31 	to read:
5.1 		Subd. 1b.Training required. (a) Effective November 1, 2011, prior to initial 
5.2 	authorization as required in subdivision 1, a legal nonlicensed family child care provider 
5.3 	must complete first aid and CPR training and provide the verification of first aid and CPR 
5.4 	training to the county. The training documentation must have valid effective dates as of 
5.5 	the date the registration request is submitted to the county and the training must have been 
5.6 	provided by an individual approved to provide first aid and CPR instruction.
5.7 	(b) Legal nonlicensed family child care providers with an authorization effective 
5.8 	before November 1, 2011, must be notified of the requirements before October 1, 2011, or 
5.9 	at authorization, and must meet the requirements upon renewal of an authorization that 
5.10 	occurs on or after January 1, 2012.
5.11 	(c) Upon each reauthorization after the authorization period when the initial first aid 
5.12 	and CPR training requirements are met, a legal nonlicensed family child care provider 
5.13 	must provide verification of at least eight hours of additional training listed in the 
5.14 	Minnesota Center for Professional Development Registry.
5.15 	(d) This subdivision only applies to legal nonlicensed family child care providers.

5.16 	Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
5.17 		Subdivision 1.Subsidy restrictions. (a) Beginning July 1, 2006 October 31, 2011, 
5.18 	the maximum rate paid for child care assistance in any county or multicounty region under 
5.19 	the child care fund shall be the rate for like-care arrangements in the county effective 
5.20 	JanuaryJuly 1, 2006, increaseddecreased by sixfive percent.
5.21 	(b) Rate changes shall be implemented for services provided in September 2006 
5.22 	unless a participant eligibility redetermination or a new provider agreement is completed 
5.23 	between July 1, 2006, and August 31, 2006.
5.24 	As necessary, appropriate notice of adverse action must be made according to 
5.25 	Minnesota Rules, part 3400.0185, subparts 3 and 4.
5.26 	New cases approved on or after July 1, 2006, shall have the maximum rates under 
5.27 	paragraph (a), implemented immediately.
5.28 	(c)(b) Every year, the commissioner shall survey rates charged by child care 
5.29 	providers in Minnesota to determine the 75th percentile for like-care arrangements in 
5.30 	counties. When the commissioner determines that, using the commissioner's established 
5.31 	protocol, the number of providers responding to the survey is too small to determine 
5.32 	the 75th percentile rate for like-care arrangements in a county or multicounty region, 
5.33 	the commissioner may establish the 75th percentile maximum rate based on like-care 
5.34 	arrangements in a county, region, or category that the commissioner deems to be similar.
6.1 	(d)(c) A rate which includes a special needs rate paid under subdivision 3 or under a 
6.2 	school readiness service agreement paid under section 119B.231, may be in excess of the 
6.3 	maximum rate allowed under this subdivision.
6.4 	(e)(d) The department shall monitor the effect of this paragraph on provider rates. 
6.5 	The county shall pay the provider's full charges for every child in care up to the maximum 
6.6 	established. The commissioner shall determine the maximum rate for each type of care 
6.7 	on an hourly, full-day, and weekly basis, including special needs and disability care. The 
6.8 	maximum payment to a provider for one day of care must not exceed the daily rate. The 
6.9 	maximum payment to a provider for one week of care must not exceed the weekly rate.
6.10 	(e) Child care providers receiving reimbursement under this chapter must not be 
6.11 	paid activity fees or an additional amount above the maximum rates for care provided 
6.12 	during nonstandard hours for families receiving assistance.
6.13 	(f) When the provider charge is greater than the maximum provider rate allowed, 
6.14 	the parent is responsible for payment of the difference in the rates in addition to any 
6.15 	family co-payment fee.
6.16 	(g) All maximum provider rates changes shall be implemented on the Monday 
6.17 	following the effective date of the maximum provider rate.

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

6.20 	Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
6.21 		Subd. 1a.Legal nonlicensed family child care provider rates. (a) Legal 
6.22 	nonlicensed family child care providers receiving reimbursement under this chapter must 
6.23 	be paid on an hourly basis for care provided to families receiving assistance.
6.24 	(b) The maximum rate paid to legal nonlicensed family child care providers must be 
6.25 	80 68 percent of the county maximum hourly rate for licensed family child care providers. 
6.26 	In counties where the maximum hourly rate for licensed family child care providers is 
6.27 	higher than the maximum weekly rate for those providers divided by 50, the maximum 
6.28 	hourly rate that may be paid to legal nonlicensed family child care providers is the rate 
6.29 	equal to the maximum weekly rate for licensed family child care providers divided by 50 
6.30 	and then multiplied by 0.80 0.68. The maximum payment to a provider for one day of care 
6.31 	must not exceed the maximum hourly rate times ten. The maximum payment to a provider 
6.32 	for one week of care must not exceed the maximum hourly rate times 50.
6.33 	(c) A rate which includes a special needs rate paid under subdivision 3 may be in 
6.34 	excess of the maximum rate allowed under this subdivision.
7.1 	(d) Legal nonlicensed family child care providers receiving reimbursement under 
7.2 	this chapter may not be paid registration fees for families receiving assistance.

7.3 	EFFECTIVE DATE. This section is effective April 16, 2012, except the 
7.4 	amendment changing 80 to 68 and 0.80 to 0.68 is effective October 31, 2011.

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

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

8.19 	Sec. 10. [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
8.20 		Subdivision 1.Electronic benefit transfer (EBT) card. Cash benefits for the 
8.21 	general assistance and Minnesota supplemental aid programs under chapter 256D and 
8.22 	programs under chapter 256J must be issued on a separate EBT card with the name of the 
8.23 	head of household printed on the card. The card must include the following statement: "It 
8.24 	is unlawful to use this card to purchase tobacco products or alcoholic beverages." This 
8.25 	card must be issued within 30 calendar days of an eligibility determination. During the 
8.26 	initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT 
8.27 	card without a name printed on the card. This card may be the same card on which food 
8.28 	support benefits are issued and does not need to meet the requirements of this section.
8.29 		Subd. 2.EBT card use restricted to Minnesota vendors. EBT cardholders 
8.30 	receiving cash benefits under the general assistance and Minnesota supplemental aid 
8.31 	programs under chapter 256D or programs under chapter 256J are prohibited from using 
8.32 	their EBT cards at vendors located outside of Minnesota. This subdivision does not apply 
8.33 	to food support benefits.
8.34 		Subd. 3.Prohibited purchases. EBT debit cardholders in programs listed under 
8.35 	subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products 
9.1 	and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for 
9.2 	an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic 
9.3 	beverages with the cardholder's EBT card. Violation of this subdivision is a petty 
9.4 	misdemeanor. A retailer must not be held liable for the crime of another under section 
9.5 	609.05, for actions taken under this subdivision.

9.6 	EFFECTIVE DATE. Subdivisions 1 and 2 of this section are effective June 1, 2012.

9.7 	Sec. 11. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to 
9.8 	read:
9.9 		Subd. 12a.Resident; general assistance medical care. (a) For purposes of 
9.10 	eligibility for general assistance and general assistance medical care, a person must be a 
9.11 	resident of this state.
9.12 	(b) A "resident" is a person living in the state for at least 30 days with the intention of 
9.13 	making the person's home here and not for any temporary purpose. Time spent in a shelter 
9.14 	for battered women shall count toward satisfying the 30-day residency requirement. All 
9.15 	applicants for these programs are required to demonstrate the requisite intent and can do 
9.16 	so in any of the following ways:
9.17 	(1) by showing that the applicant maintains a residence at a verified address, other 
9.18 	than a place of public accommodation. An applicant may verify a residence address by 
9.19 	presenting a valid state driver's license,; a state identification card,; a voter registration 
9.20 	card,; a rent receipt,; a statement by the landlord, apartment manager, or homeowner 
9.21 	verifying that the individual is residing at the address,; or other form of verification 
9.22 	approved by the commissioner; or
9.23 	(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 
9.24 	3, item C.
9.25 	(c) For general assistance medical care, a county agency shall waive the 30-day 
9.26 	residency requirement in cases of medical emergencies. For general assistance, a county 
9.27 	shall waive the 30-day residency requirement where unusual hardship would result from 
9.28 	denial of general assistance. For purposes of this subdivision, "unusual hardship" means 
9.29 	the applicant is without shelter or is without available resources for food.
9.30 	The county agency must report to the commissioner within 30 days on any waiver 
9.31 	granted under this section. The county shall not deny an application solely because the 
9.32 	applicant does not meet at least one of the criteria in this subdivision, but shall continue to 
9.33 	process the application and leave the application pending until the residency requirement 
9.34 	is met or until eligibility or ineligibility is established.
10.1 	(d) For purposes of paragraph (c), the following definitions apply (1) "metropolitan 
10.2 	statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes 
10.3 	any shelter that is located within the metropolitan statistical area containing the county 
10.4 	and for which the applicant is eligible, provided the applicant does not have to travel more 
10.5 	than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2) 
10.6 	does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
10.7 	(e) Migrant workers as defined in section 256J.08 and, until March 31, 1998, their 
10.8 	immediate families are exempt from the residency requirements of this section, provided 
10.9 	the migrant worker provides verification that the migrant family worked in this state 
10.10 	within the last 12 months and earned at least $1,000 in gross wages during the time the 
10.11 	migrant worker worked in this state. 
10.12 	(f) For purposes of eligibility for emergency general assistance, the 30-day residency 
10.13 	requirement under this section shall not be waived.
10.14 	(g) (e) If any provision of this subdivision is enjoined from implementation or found 
10.15 	unconstitutional by any court of competent jurisdiction, the remaining provisions shall 
10.16 	remain valid and shall be given full effect.

10.17 	EFFECTIVE DATE. This section is effective October 1, 2012.

10.18 	Sec. 12. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:
10.19 		Subdivision 1.Eligibility. (a) Each assistance unit with income and resources 
10.20 	less than the standard of assistance established by the commissioner and with a member 
10.21 	who is a resident of the state shall be eligible for and entitled to general assistance if 
10.22 	the assistance unit is:
10.23 	(1) a person who is suffering from a professionally certified permanent or temporary 
10.24 	illness, injury, or incapacity which is expected to continue for more than 30 90 days and 
10.25 	which prevents the person from obtaining or retaining employment;
10.26 	(2) a person whose presence in the home on a substantially continuous basis is 
10.27 	required because of the professionally certified illness, injury, incapacity, or the age of 
10.28 	another member of the household;
10.29 	(3) (2) a person who has been placed in, and is residing in, a licensed or certified 
10.30 	facility for purposes of physical or mental health or rehabilitation, or in an approved 
10.31 	chemical dependency domiciliary facility, if the placement is based on illness or incapacity 
10.32 	and is according to a plan developed or approved by the county agency through its 
10.33 	director or designated representative;
10.34 	(4) (3) a person who resides in a shelter facility described in subdivision 3;
11.1 	(5) (4) a person not described in clause (1) or (3) (2) who is diagnosed by a licensed 
11.2 	physician, psychological practitioner, or other qualified professional, as developmentally 
11.3 	disabled or mentally ill, and that condition prevents the person from obtaining or retaining 
11.4 	employment;
11.5 	(6) a person who has an application pending for, or is appealing termination of 
11.6 	benefits from, the Social Security disability program or the program of supplemental 
11.7 	security income for the aged, blind, and disabled, provided the person has a professionally 
11.8 	certified permanent or temporary illness, injury, or incapacity which is expected to 
11.9 	continue for more than 30 days and which prevents the person from obtaining or retaining 
11.10 	employment;
11.11 	(7) a person who is unable to obtain or retain employment because advanced age 
11.12 	significantly affects the person's ability to seek or engage in substantial work;
11.13 	(8) (5) a person who has been assessed by a vocational specialist and, in consultation 
11.14 	with the county agency, has been determined to be unemployable for purposes of this 
11.15 	clause; a person is considered employable if there exist positions of employment in the 
11.16 	local labor market, regardless of the current availability of openings for those positions, 
11.17 	that the person is capable of performing. The person's eligibility under this category must 
11.18 	be reassessed at least annually. The county agency must provide notice to the person not 
11.19 	later than 30 days before annual eligibility under this item ends, informing the person of the 
11.20 	date annual eligibility will end and the need for vocational assessment if the person wishes 
11.21 	to continue eligibility under this clause. For purposes of establishing eligibility under this 
11.22 	clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
11.23 	(9) (6) a person who is determined by the county agency, according to permanent 
11.24 	rules adopted by the commissioner, to be learning disabled have a condition that qualifies 
11.25 	under Minnesota's special education rules as a specific learning disability, provided that if
11.26 	a rehabilitation plan for the person is developed or approved by the county agency, and
11.27 	the person is following the plan;
11.28 	(10) (7) a child under the age of 18 who is not living with a parent, stepparent, or 
11.29 	legal custodian, and only if: the child is legally emancipated or living with an adult with 
11.30 	the consent of an agency acting as a legal custodian; the child is at least 16 years of age 
11.31 	and the general assistance grant is approved by the director of the county agency or a 
11.32 	designated representative as a component of a social services case plan for the child; or the 
11.33 	child is living with an adult with the consent of the child's legal custodian and the county 
11.34 	agency. For purposes of this clause, "legally emancipated" means a person under the age 
11.35 	of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of 
11.36 	the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv) 
12.1 	is otherwise considered emancipated under Minnesota law, and for whom county social 
12.2 	services has not determined that a social services case plan is necessary, for reasons other 
12.3 	than the child has failed or refuses to cooperate with the county agency in developing 
12.4 	the plan;
12.5 	(11) (8) a person who is eligible for displaced homemaker services, programs, or 
12.6 	assistance under section 116L.96, but only if that person is enrolled as a full-time student;
12.7 	(12) a person who lives more than four hours round-trip traveling time from any 
12.8 	potential suitable employment;
12.9 	(13) (9) a person who is involved with protective or court-ordered services that 
12.10 	prevent the applicant or recipient from working at least four hours per day; or
12.11 	(14) a person over age 18 whose primary language is not English and who is 
12.12 	attending high school at least half time; or
12.13 	(15) (10) a person whose alcohol and drug addiction is a material factor that 
12.14 	contributes to the person's disability; applicants who assert this clause as a basis for 
12.15 	eligibility must be assessed by the county agency to determine if they are amenable 
12.16 	to treatment; if the applicant is determined to be not amenable to treatment, but is 
12.17 	otherwise eligible for benefits, then general assistance must be paid in vendor form, for 
12.18 	the individual's shelter costs up to the limit of the grant amount, with the residual, if 
12.19 	any, paid according to section 256D.09, subdivision 2a; if the applicant is determined 
12.20 	to be amenable to treatment, then in order to receive benefits, the applicant must be in 
12.21 	a treatment program or on a waiting list and the benefits must be paid in vendor form, 
12.22 	for the individual's shelter costs, up to the limit of the grant amount, with the residual, if 
12.23 	any, paid according to section 256D.09, subdivision 2a.
12.24 	(b) As a condition of eligibility under paragraph (a), clauses (1), (3) (2), (5) (4), 
12.25 	(8) (5), and (9) (6), the recipient must complete an interim assistance agreement and 
12.26 	must apply for other maintenance benefits as specified in section 256D.06, subdivision 
12.27 	5, and must comply with efforts to determine the recipient's eligibility for those other 
12.28 	maintenance benefits.
12.29 	(c) The burden of providing documentation for a county agency to use to verify 
12.30 	eligibility for general assistance or for exemption from the food stamp employment 
12.31 	and training program is upon the applicant or recipient. The county agency shall use 
12.32 	documents already in its possession to verify eligibility, and shall help the applicant or 
12.33 	recipient obtain other existing verification necessary to determine eligibility which the 
12.34 	applicant or recipient does not have and is unable to obtain.

12.35 	EFFECTIVE DATE. This section is effective May 1, 2012.

13.1 	Sec. 13. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:
13.2 		Subd. 2.Emergency need. (a) Notwithstanding the provisions of subdivision 1, a 
13.3 	grant of emergency general assistance shall, to the extent funds are available, be made to 
13.4 	an eligible single adult, married couple, or family for an emergency need, as defined in 
13.5 	rules promulgated by the commissioner, where the recipient requests temporary assistance 
13.6 	not exceeding 30 days if an emergency situation appears to exist and the individual or 
13.7 	family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP under 
13.8 	written criteria adopted by the county agency. If an applicant or recipient relates facts 
13.9 	to the county agency which may be sufficient to constitute an emergency situation, the 
13.10 	county agency shall, to the extent funds are available, advise the person of the procedure 
13.11 	for applying for assistance according to this subdivision. 
13.12 	(b) The applicant must be ineligible for assistance under chapter 256J, must have 
13.13 	annual net income no greater than 200 percent of the federal poverty guidelines for the 
13.14 	previous calendar year, and may receive an emergency general assistance grant is available 
13.15 	to a recipient not more than once in any 12-month period. 
13.16 	(c) Funding for an emergency general assistance program is limited to the 
13.17 	appropriation. Each fiscal year, the commissioner shall allocate to counties the money 
13.18 	appropriated for emergency general assistance grants based on each county agency's 
13.19 	average share of state's emergency general expenditures for the immediate past three fiscal 
13.20 	years as determined by the commissioner, and may reallocate any unspent amounts to 
13.21 	other counties. No county shall be allocated less than $1,000 for a fiscal year.
13.22 	(d) Any emergency general assistance expenditures by a county above the amount of 
13.23 	the commissioner's allocation to the county must be made from county funds.

13.24 	EFFECTIVE DATE. This section is effective November 1, 2011.

13.25 	Sec. 14. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
13.26 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
13.27 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
13.28 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
13.29 	center, or a group residential housing facility.
13.30 	(a) The county agency shall pay a monthly allowance for medically prescribed 
13.31 	diets if the cost of those additional dietary needs cannot be met through some other 
13.32 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
13.33 	a licensed physician. Costs for special diets shall be determined as percentages of the 
13.34 	allotment for a one-person household under the thrifty food plan as defined by the United 
14.1 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
14.2 	food plan that are covered are as follows:
14.3 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
14.4 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
14.5 	of thrifty food plan;
14.6 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
14.7 	percent of thrifty food plan;
14.8 	(4) low cholesterol diet, 25 percent of thrifty food plan;
14.9 	(5) high residue diet, 20 percent of thrifty food plan;
14.10 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
14.11 	(7) gluten-free diet, 25 percent of thrifty food plan;
14.12 	(8) lactose-free diet, 25 percent of thrifty food plan;
14.13 	(9) antidumping diet, 15 percent of thrifty food plan;
14.14 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
14.15 	(11) ketogenic diet, 25 percent of thrifty food plan.
14.16 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
14.17 	repairs or necessary repairs or replacement of household furniture and appliances using 
14.18 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
14.19 	as long as other funding sources are not available.
14.20 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
14.21 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
14.22 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
14.23 	guardian or conservator is a member of the county agency staff, no fee is allowed.
14.24 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
14.25 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
14.26 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
14.27 	until the person has not received Minnesota supplemental aid for one full calendar month 
14.28 	or until the person's living arrangement changes and the person no longer meets the criteria 
14.29 	for the restaurant meal allowance, whichever occurs first.
14.30 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
14.31 	is allowed for representative payee services provided by an agency that meets the 
14.32 	requirements under SSI regulations to charge a fee for representative payee services. This 
14.33 	special need is available to all recipients of Minnesota supplemental aid regardless of 
14.34 	their living arrangement.
14.35 	(f) (a)(1) Notwithstanding the language in this subdivision, An amount equal to the 
14.36 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
15.1 	which is in effect on the first day of July of each year will be added to the standards of 
15.2 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
15.3 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
15.4 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
15.5 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
15.6 	community-based waiver recipients living in their own home or rented or leased apartment 
15.7 	which is not owned, operated, or controlled by a provider of service not related by blood 
15.8 	or marriage, unless allowed under paragraph (g) (b).
15.9 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
15.10 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
15.11 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
15.12 	after the age of 65.
15.13 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
15.14 	exceed 40 percent of the assistance unit's gross income before the application of this 
15.15 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
15.16 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
15.17 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
15.18 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
15.19 	considered shelter needy for purposes of this paragraph.
15.20 	(g) Notwithstanding this subdivision,(b) To access housing and services as provided 
15.21 	in paragraph (f) (a), the recipient may choose housing that may be owned, operated, or 
15.22 	controlled by the recipient's service provider. In a multifamily building of four or more 
15.23 	units, the maximum number of apartments that may be used by recipients of this program 
15.24 	shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.

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

15.26 	Sec. 15. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:
15.27 		Subdivision 1.Eligibility. A county agency must grant emergency Minnesota 
15.28 	supplemental aid, to the extent funds are available, if the recipient is without adequate 
15.29 	resources to resolve an emergency that, if unresolved, will threaten the health or safety of 
15.30 	the recipient. For the purposes of this section, the term "recipient" includes persons for 
15.31 	whom a group residential housing benefit is being paid under sections 256I.01 to 256I.06.
15.32 	Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency 
15.33 	need may apply for emergency general assistance under section 256D.06, subdivision 2.

15.34 	EFFECTIVE DATE. This section is effective November 1, 2011.

16.1 	Sec. 16. Minnesota Statutes 2010, section 256D.47, is amended to read:
16.2 	256D.47 PAYMENT METHODS.
16.3 	Minnesota supplemental aid payments must be issued to the recipient, a protective 
16.4 	payee, or a conservator or guardian of the recipient's estate in the form of county warrants 
16.5 	immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the 
16.6 	recipient's account in a financial institution. Minnesota supplemental aid payments must 
16.7 	be issued regularly on the first day of the month. The supplemental aid warrants must be 
16.8 	mailed only to the address at which the recipient resides, unless another address has been 
16.9 	approved in advance by the county agency. Vendor payments must not be issued by the 
16.10 	county agency except for nonrecurring emergency need payments; at the request of the 
16.11 	recipient; for special needs, other than special diets; or when the agency determines the 
16.12 	need for protective payments exist.

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

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

16.25 	Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
16.26 		Subd. 6.Withdrawal; matching; permissible uses. (a) To receive a match, a 
16.27 	participating household must transfer funds withdrawn from a family asset account to its 
16.28 	matching fund custodial account held by the fiscal agent, according to the family asset 
16.29 	agreement. The fiscal agent must determine if the match request is for a permissible use 
16.30 	consistent with the household's family asset agreement.
16.31 	The fiscal agent must ensure the household's custodial account contains the 
16.32 	applicable matching funds to match the balance in the household's account, including 
17.1 	interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches 
17.2 	must be provided as follows:
17.3 	(1) from state grant and TANF funds a matching contribution of $1.50 for every $1 
17.4 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or a 
17.5 	$3,000 lifetime limit; and
17.6 	(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1 
17.7 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or 
17.8 	a $3,000 lifetime limit.
17.9 	(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a 
17.10 	direct payment to the vendor of the goods or services for the permissible use.

17.11 	Sec. 19. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision 
17.12 	to read:
17.13 		Subd. 8.Supplementary services. "Supplementary services" means services 
17.14 	provided to residents of group residential housing providers in addition to room and 
17.15 	board including, but not limited to, oversight and up to 24-hour supervision, medication 
17.16 	reminders, assistance with transportation, arranging for meetings and appointments, and 
17.17 	arranging for medical and social services.

17.18 	Sec. 20. Minnesota Statutes 2010, section 256I.04, subdivision 1, is amended to read:
17.19 		Subdivision 1.Individual eligibility requirements. An individual is eligible for 
17.20 	and entitled to a group residential housing payment to be made on the individual's behalf 
17.21 	if the county agency has approved the individual's residence in a group residential housing 
17.22 	setting and the individual meets the requirements in paragraph (a) or (b) this section.
17.23 	(a) The individual is aged, blind, or is over 18 years of age and disabled as 
17.24 	determined under the criteria used by the title II program of the Social Security Act, 
17.25 	and meets the resource restrictions and standards of the supplemental security income 
17.26 	program, and the individual's countable income after deducting the (1) exclusions and 
17.27 	disregards of the SSI program, (2) the medical assistance personal needs allowance 
17.28 	under section 256B.35, and (3) an amount equal to the income actually made available 
17.29 	to a community spouse by an elderly waiver recipient under the provisions of sections 
17.30 	256B.0575, paragraph (a), clause (4), and 256B.058, subdivision 2, is less than the 
17.31 	monthly rate specified in the county agency's agreement with the provider of group 
17.32 	residential housing in which the individual resides.
17.33 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 
17.34 	1, paragraph (a), and the individual's resources are less than the standards specified by 
18.1 	section 256D.08, and the individual's countable income as determined under sections 
18.2 	256D.01 to 256D.21, less the medical assistance personal needs allowance under section 
18.3 	256B.35 is less than the monthly rate specified in the county agency's agreement with the 
18.4 	provider of group residential housing in which the individual resides.
18.5 	(b) Each individual with income and resources less than the standard of assistance 
18.6 	established by the commissioner and who is a resident of the state shall be eligible for and 
18.7 	entitled to group residential housing if the assistance unit is:
18.8 	(1) a person who is suffering from a professionally certified permanent or temporary 
18.9 	illness, injury, or incapacity which is expected to continue for more than 90 days and 
18.10 	which prevents the person from obtaining or retaining employment;
18.11 	(2) a person who has been placed in, and is residing in, a licensed or certified facility 
18.12 	for purposes of physical or mental health or rehabilitation, or in an approved chemical 
18.13 	dependency domiciliary facility, if the placement is based on illness or incapacity and is 
18.14 	according to a plan developed or approved by the county agency through its director or 
18.15 	designated representative;
18.16 	(3) a person not described in clause (1) or (2) who is diagnosed by a licensed 
18.17 	physician, psychological practitioner, or other qualified professional, as developmentally 
18.18 	disabled or mentally ill, and that condition prevents the person from obtaining or retaining 
18.19 	employment;
18.20 	(4) a person who has been assessed by a vocational specialist and, in consultation 
18.21 	with the county agency, has been determined to be unemployable for purposes of this 
18.22 	clause; a person is considered employable if there exist positions of employment in the 
18.23 	local labor market, regardless of the current availability of openings for those positions, 
18.24 	that the person is capable of performing. The person's eligibility under this category must 
18.25 	be reassessed at least annually. The county agency must provide notice to the person not 
18.26 	later than 30 days before annual eligibility under this item ends, informing the person of the 
18.27 	date annual eligibility will end and the need for vocational assessment if the person wishes 
18.28 	to continue eligibility under this clause. For purposes of establishing eligibility under this 
18.29 	clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
18.30 	(5) a person who is determined by the county agency, according to permanent rules 
18.31 	adopted by the commissioner, to have a condition that qualifies under Minnesota's special 
18.32 	education rules as a specific learning disability, provided that a rehabilitation plan for 
18.33 	the person is developed or approved by the county agency, and the person is following 
18.34 	the plan; or
18.35 	(6) a person whose alcohol and drug addiction is a material factor that contributes 
18.36 	to the person's disability.
19.1 	(c) As a condition of eligibility under paragraph (b), the recipient must complete an 
19.2 	interim assistance agreement and must apply for other maintenance benefits as specified in 
19.3 	section 256N.35, and must comply with efforts to determine the recipient's eligibility for 
19.4 	those other maintenance benefits.
19.5 	(d) As a condition of eligibility under this section, the recipient must complete 
19.6 	at least 20 hours per month of volunteer or paid work. The county of residence shall 
19.7 	determine what may be included as volunteer work. Recipients must provide monthly 
19.8 	proof of volunteer work on the forms established by the county. A person who is unable 
19.9 	to obtain or retain 20 hours per month of volunteer or paid work due to a professionally 
19.10 	certified illness, injury, disability, or incapacity must not be made ineligible for group 
19.11 	residential housing under this section.
19.12 	(e) The burden of providing documentation for a county agency to use to verify 
19.13 	eligibility under this section is upon the applicant or recipient. The county agency shall 
19.14 	use documents already in its possession to verify eligibility, and shall help the applicant or 
19.15 	recipient obtain other existing verification necessary to determine eligibility which the 
19.16 	applicant or recipient does not have and is unable to obtain.

19.17 	EFFECTIVE DATE. This section is effective October 1, 2012.

19.18 	Sec. 21. Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read:
19.19 		Subd. 2b.Group residential housing agreements. (a) Agreements between county 
19.20 	agencies and providers of group residential housing must be in writing and must specify 
19.21 	the name and address under which the establishment subject to the agreement does 
19.22 	business and under which the establishment, or service provider, if different from the 
19.23 	group residential housing establishment, is licensed by the Department of Health or the 
19.24 	Department of Human Services; the specific license or registration from the Department 
19.25 	of Health or the Department of Human Services held by the provider and the number 
19.26 	of beds subject to that license; the address of the location or locations at which group 
19.27 	residential housing is provided under this agreement; the per diem and monthly rates that 
19.28 	are to be paid from group residential housing funds for each eligible resident at each 
19.29 	location; the number of beds at each location which are subject to the group residential 
19.30 	housing agreement; whether the license holder is a not-for-profit corporation under section 
19.31 	501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to 
19.32 	the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections. 
19.33 	Group residential housing agreements may be terminated with or without cause by either 
19.34 	the county or the provider with two calendar months prior notice.
20.1 	(b) Counties must not enter into agreements with providers of group residential 
20.2 	housing that are licensed as board and lodging with special services and that do not include 
20.3 	a residency requirement of at least 20 hours per month of volunteer or paid work. A person 
20.4 	who is unable to obtain or retain 20 hours per month of volunteer or paid work due to a 
20.5 	professionally certified illness, injury, disability, or incapacity must not be made ineligible 
20.6 	for group residential housing under this section. This paragraph does not apply to group 
20.7 	residential housing providers who serve people aged 21 or younger if the residents are 
20.8 	required to attend school or improve independent living skills.

20.9 	EFFECTIVE DATE. This section is effective May 1, 2012.

20.10 	Sec. 22. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:
20.11 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 
20.12 	256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37 
20.13 	for other services necessary to provide room and board provided by the group residence 
20.14 	if the residence is licensed by or registered by the Department of Health, or licensed by 
20.15 	the Department of Human Services to provide services in addition to room and board, 
20.16 	and if the provider of services is not also concurrently receiving funding for services for 
20.17 	a recipient under a home and community-based waiver under title XIX of the Social 
20.18 	Security Act; or funding from the medical assistance program under section 256B.0659, 
20.19 	for personal care services for residents in the setting; or residing in a setting which 
20.20 	receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is 
20.21 	available for other necessary services through a home and community-based waiver, or 
20.22 	personal care services under section 256B.0659, then the GRH rate is limited to the rate 
20.23 	set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary 
20.24 	service rate exceed $426.37. The registration and licensure requirement does not apply to 
20.25 	establishments which are exempt from state licensure because they are located on Indian 
20.26 	reservations and for which the tribe has prescribed health and safety requirements. Service 
20.27 	payments under this section may be prohibited under rules to prevent the supplanting of 
20.28 	federal funds with state funds. The commissioner shall pursue the feasibility of obtaining 
20.29 	the approval of the Secretary of Health and Human Services to provide home and 
20.30 	community-based waiver services under title XIX of the Social Security Act for residents 
20.31 	who are not eligible for an existing home and community-based waiver due to a primary 
20.32 	diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is 
20.33 	determined to be cost-effective.
20.34 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH 
20.35 	fund for beds under this section to other funding programs administered by the department 
21.1 	after consultation with the county or counties in which the affected beds are located. 
21.2 	The commissioner may also make cost-neutral transfers from the GRH fund to county 
21.3 	human service agencies for beds permanently removed from the GRH census under a plan 
21.4 	submitted by the county agency and approved by the commissioner. The commissioner 
21.5 	shall report the amount of any transfers under this provision annually to the legislature.
21.6 	(c) The provisions of paragraph (b) do not apply to a facility that has its 
21.7 	reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).
21.8 	(d) Counties must not negotiate supplementary service rates with providers of group 
21.9 	residential housing that are licensed as board and lodging with special services and that 
21.10 	do not encourage a policy of sobriety on their premises.

21.11 	EFFECTIVE DATE. This section is effective May 1, 2012.

21.12 	Sec. 23. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:
21.13 		Subd. 1a.30-day 60-day residency requirement. An assistance unit is considered 
21.14 	to have established residency in this state only when a child or caregiver has resided in this 
21.15 	state for at least 30 60 consecutive days with the intention of making the person's home 
21.16 	here and not for any temporary purpose. The birth of a child in Minnesota to a member 
21.17 	of the assistance unit does not automatically establish the residency in this state under 
21.18 	this subdivision of the other members of the assistance unit. Time spent in a shelter for 
21.19 	battered women shall count toward satisfying the 30-day 60-day residency requirement.

21.20 	Sec. 24. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
21.21 		Subd. 2.Exceptions. (a) A county shall waive the 30-day residency requirement 
21.22 	where unusual hardship would result from denial of assistance.
21.23 	(b) For purposes of this section, unusual hardship means an assistance unit:
21.24 	(1) is without alternative shelter; or
21.25 	(2) is without available resources for food.
21.26 	(c) For purposes of this subdivision, the following definitions apply (1) "metropolitan 
21.27 	statistical area" is as defined by the U.S. Census Bureau; (2) "alternative shelter" includes 
21.28 	any shelter that is located within the metropolitan statistical area containing the county and 
21.29 	for which the family is eligible, provided the assistance unit does not have to travel more 
21.30 	than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2) 
21.31 	does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
21.32 	(d) Applicants are considered to meet the residency requirement under subdivision 
21.33 	1a if they once resided in Minnesota and:
22.1 	(1) joined the United States armed services, returned to Minnesota within 30 days of 
22.2 	leaving the armed services, and intend to remain in Minnesota; or
22.3 	(2) left to attend school in another state, paid nonresident tuition or Minnesota 
22.4 	tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of 
22.5 	graduation with the intent to remain in Minnesota.
22.6 	(e) (b) The 30-day 60-day residence requirement is met when:
22.7 	(1) a minor child or a minor caregiver moves from another state to the residence of 
22.8 	a relative caregiver; and
22.9 	(2) the relative caregiver has resided in Minnesota for at least 30 60 consecutive 
22.10 	days and:
22.11 	(i) the minor caregiver applies for and receives MFIP; or
22.12 	(ii) the relative caregiver applies for assistance for the minor child but does not 
22.13 	choose to be a member of the MFIP assistance unit.

22.14 	Sec. 25. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:
22.15 		Subd. 3.Other property limitations. To be eligible for MFIP, the equity value of 
22.16 	all nonexcluded real and personal property of the assistance unit must not exceed $2,000 
22.17 	for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 
22.18 	(19) must be excluded when determining the equity value of real and personal property:
22.19 	(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $10,000. If 
22.20 	the assistance unit owns more than one licensed vehicle, the county agency shall determine 
22.21 	the loan value of all additional vehicles and exclude the combined loan value of less than 
22.22 	or equal to $7,500. The county agency shall apply any excess loan value as if it were 
22.23 	equity value to the asset limit described in this section, excluding: (i) the value of one 
22.24 	vehicle per physically disabled person when the vehicle is needed to transport the disabled 
22.25 	unit member; this exclusion does not apply to mentally disabled people; (ii) the value of 
22.26 	special equipment for a disabled member of the assistance unit; and (iii) any vehicle used 
22.27 	for long-distance travel, other than daily commuting, for the employment of a unit member.
22.28 	To establish the loan value of vehicles, a county agency must use the N.A.D.A. 
22.29 	Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not 
22.30 	listed in the guidebook, or when the applicant or participant disputes the loan value listed 
22.31 	in the guidebook as unreasonable given the condition of the particular vehicle, the county 
22.32 	agency may require the applicant or participant document the loan value by securing a 
22.33 	written statement from a motor vehicle dealer licensed under section 168.27, stating 
22.34 	the amount that the dealer would pay to purchase the vehicle. The county agency shall 
23.1 	reimburse the applicant or participant for the cost of a written statement that documents 
23.2 	a lower loan value;
23.3 	(2) the value of life insurance policies for members of the assistance unit;
23.4 	(3) one burial plot per member of an assistance unit;
23.5 	(4) the value of personal property needed to produce earned income, including 
23.6 	tools, implements, farm animals, inventory, business loans, business checking and 
23.7 	savings accounts used at least annually and used exclusively for the operation of a 
23.8 	self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 
23.9 	is to produce income and if the vehicles are essential for the self-employment business;
23.10 	(5) the value of personal property not otherwise specified which is commonly 
23.11 	used by household members in day-to-day living such as clothing, necessary household 
23.12 	furniture, equipment, and other basic maintenance items essential for daily living;
23.13 	(6) the value of real and personal property owned by a recipient of Supplemental 
23.14 	Security Income or Minnesota supplemental aid;
23.15 	(7) the value of corrective payments, but only for the month in which the payment 
23.16 	is received and for the following month;
23.17 	(8) a mobile home or other vehicle used by an applicant or participant as the 
23.18 	applicant's or participant's home;
23.19 	(9) money in a separate escrow account that is needed to pay real estate taxes or 
23.20 	insurance and that is used for this purpose;
23.21 	(10) money held in escrow to cover employee FICA, employee tax withholding, 
23.22 	sales tax withholding, employee worker compensation, business insurance, property rental, 
23.23 	property taxes, and other costs that are paid at least annually, but less often than monthly;
23.24 	(11) monthly assistance payments for the current month's or short-term emergency 
23.25 	needs under section 256J.626, subdivision 2;
23.26 	(12) the value of school loans, grants, or scholarships for the period they are 
23.27 	intended to cover;
23.28 	(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 
23.29 	in escrow for a period not to exceed three months to replace or repair personal or real 
23.30 	property;
23.31 	(14) income received in a budget month through the end of the payment month;
23.32 	(15) savings from earned income of a minor child or a minor parent that are set aside 
23.33 	in a separate account designated specifically for future education or employment costs;
23.34 	(16) the federal earned income credit, Minnesota working family credit, state and 
23.35 	federal income tax refunds, state homeowners and renters credits under chapter 290A, 
24.1 	property tax rebates and other federal or state tax rebates in the month received and the 
24.2 	following month;
24.3 	(17) payments excluded under federal law as long as those payments are held in a 
24.4 	separate account from any nonexcluded funds;
24.5 	(18) the assets of children ineligible to receive MFIP benefits because foster care or 
24.6 	adoption assistance payments are made on their behalf; and
24.7 	(19) the assets of persons whose income is excluded under section 256J.21, 
24.8 	subdivision 2, clause (43).

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

24.10 	Sec. 26. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision 
24.11 	to read:
24.12 		Subd. 3c.Treatment of Supplemental Security Income. The county shall reduce 
24.13 	the cash portion of the MFIP grant by $50 per adult SSI recipient who resides in the 
24.14 	household, and who would otherwise be included in the MFIP assistance unit under 
24.15 	section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient status under 
24.16 	section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient receives less 
24.17 	than $50 of SSI, only the amount received shall be used in calculating the MFIP cash 
24.18 	assistance payment. This provision does not apply to relative caregivers who could elect 
24.19 	to be included in the MFIP assistance unit under section 256J.24, subdivision 4, unless the 
24.20 	caregiver's children or stepchildren are included in the MFIP assistance unit.

24.21 	EFFECTIVE DATE. This section is effective May 1, 2012.

24.22 	Sec. 27. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:
24.23 		Subd. 13. Work activity. (a) "Work activity" means any activity in a participant's 
24.24 	approved employment plan that leads to employment. For purposes of the MFIP program, 
24.25 	this includes activities that meet the definition of work activity under the participation 
24.26 	requirements of TANF. Work activity includes: 
24.27 	(1) unsubsidized employment, including work study and paid apprenticeships or 
24.28 	internships; 
24.29 	(2) subsidized private sector or public sector employment, including grant diversion 
24.30 	as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid 
24.31 	work experience, and supported work when a wage subsidy is provided; 
24.32 	(3) unpaid work experience, including community service, volunteer work, 
24.33 	the community work experience program as specified in section 256J.67, unpaid 
25.1 	apprenticeships or internships, and supported work when a wage subsidy is not provided. 
25.2 	Unpaid work experience is only an option if the participant has been unable to obtain or 
25.3 	maintain paid employment in the competitive labor market, and no paid work experience 
25.4 	programs are available to the participant. Prior to placing a participant in unpaid work, 
25.5 	the county must inform the participant that the participant will be notified if a paid work 
25.6 	experience or supported work position becomes available. Unless a participant consents in 
25.7 	writing to participate in unpaid work experience, the participant's employment plan may 
25.8 	only include unpaid work experience if including the unpaid work experience in the plan 
25.9 	will meet the following criteria: 
25.10 	(i) the unpaid work experience will provide the participant specific skills or 
25.11 	experience that cannot be obtained through other work activity options where the 
25.12 	participant resides or is willing to reside; and 
25.13 	(ii) the skills or experience gained through the unpaid work experience will result 
25.14 	in higher wages for the participant than the participant could earn without the unpaid 
25.15 	work experience; 
25.16 	(4) job search including job readiness assistance, job clubs, job placement, 
25.17 	job-related counseling, and job retention services; 
25.18 	(5) job readiness education, including English as a second language (ESL) or 
25.19 	functional work literacy classes as limited by the provisions of section 256J.531, 
25.20 	subdivision 2, general educational development (GED) course work, high school 
25.21 	completion, and adult basic education as limited by the provisions of section 256J.531, 
25.22 	subdivision 1; 
25.23 	(6) job skills training directly related to employment, including education and 
25.24 	training that can reasonably be expected to lead to employment, as limited by the 
25.25 	provisions of section 256J.53; 
25.26 	(7) providing child care services to a participant who is working in a community 
25.27 	service program; 
25.28 	(8) activities included in the employment plan that is developed under section 
25.29 	256J.521, subdivision 3; and 
25.30 	(9) preemployment activities including chemical and mental health assessments, 
25.31 	treatment, and services; learning disabilities services; child protective services; family 
25.32 	stabilization services; or other programs designed to enhance employability. 
25.33 	(b) "Work activity" does not include activities done for political purposes as defined 
25.34 	in section 211B.01, subdivision 6.

25.35 	Sec. 28. Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read:
26.1 		Subd. 2.Approval of postsecondary education or training. (a) In order for a 
26.2 	postsecondary education or training program to be an approved activity in an employment 
26.3 	plan, the plan must include additional work activities if the education and training 
26.4 	activities do not meet the minimum hours required to meet the federal work participation 
26.5 	rate under Code of Federal Regulations, title 45, sections 261.31 and 261.35 participant 
26.6 	must be working in unsubsidized employment at least 10 hours per week.
26.7 	(b) Participants seeking approval of a postsecondary education or training plan 
26.8 	must provide documentation that:
26.9 	(1) the employment goal can only be met with the additional education or training;
26.10 	(2) there are suitable employment opportunities that require the specific education or 
26.11 	training in the area in which the participant resides or is willing to reside;
26.12 	(3) the education or training will result in significantly higher wages for the 
26.13 	participant than the participant could earn without the education or training;
26.14 	(4) the participant can meet the requirements for admission into the program; and
26.15 	(5) there is a reasonable expectation that the participant will complete the training 
26.16 	program based on such factors as the participant's MFIP assessment, previous education, 
26.17 	training, and work history; current motivation; and changes in previous circumstances.
26.18 	(c) The hourly unsubsidized employment requirement does not apply for intensive 
26.19 	education or training programs lasting 12 weeks or less when full-time attendance is 
26.20 	required.

26.21 	Sec. 29. [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
26.22 	The adult assistance grant program is a capped allocation to counties that can be 
26.23 	spent in a flexible manner, to the extent funds are available, for adult assistance.

26.24 	EFFECTIVE DATE. This section is effective October 1, 2012.

26.25 	Sec. 30. [256N.20] DEFINITIONS.
26.26 		Subdivision 1.Scope. For the purposes of sections 256N.01 to 256N.80, the terms 
26.27 	defined in this section have the meanings given them.
26.28 		Subd. 2.Adult assistance. "Adult assistance" means a capped allocation provided 
26.29 	or arranged for by county boards for ongoing emergency needs, special diets, or special 
26.30 	needs as determined by the county.
26.31 		Subd. 3.Commissioner. "Commissioner" means the commissioner of human 
26.32 	services.
26.33 		Subd. 4.County board. "County board" means the board of county commissioners 
26.34 	in each county.
27.1 		Subd. 5.Eligible participant. "Eligible participant" means low-income adults who 
27.2 	meet the residency requirements under section 256N.22, and who were previously eligible 
27.3 	for programs under subdivision 6 are eligible for adult assistance. The commissioner may 
27.4 	develop more specific eligibility criteria.
27.5 		Subd. 6.Former programs. "Former programs" means funding for:
27.6 	(1) general assistance;
27.7 	(2) emergency general assistance;
27.8 	(3) emergency supplemental aid; and
27.9 	(4) Minnesota supplemental aid special needs and special diets.

27.10 	EFFECTIVE DATE. This section is effective October 1, 2012.

27.11 	Sec. 31. [256N.22] RESIDENCY.
27.12 	(a) For purposes of eligibility for adult assistance, a person must be a resident of 
27.13 	this state.
27.14 	(b) A "resident" is a person living in the state for at least 60 days with the intention of 
27.15 	making the person's home here and not for any temporary purpose. Time spent in a shelter 
27.16 	for battered women shall count toward satisfying the 60-day residency requirement. All 
27.17 	applicants for these programs are required to demonstrate the requisite intent and may do 
27.18 	so in any of the following ways:
27.19 	(1) by showing that the applicant maintains a residence at a verified address, other 
27.20 	than a place of public accommodation. An applicant may verify a residence address by 
27.21 	presenting a valid state driver's license, a state identification card, a voter registration 
27.22 	card, or a rent receipt; or
27.23 	(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 
27.24 	3, item C. 
27.25 	(c) The county shall not deny an application solely because the applicant does not 
27.26 	meet at least one of the criteria in this subdivision, but shall continue to process the 
27.27 	application and leave the application pending until the residency requirement is met or 
27.28 	until eligibility or ineligibility is established. 
27.29 	(d) If any provision of this subdivision is enjoined from implementation or found 
27.30 	unconstitutional by any court of competent jurisdiction, the remaining provisions shall 
27.31 	remain valid and shall be given full effect. 

27.32 	EFFECTIVE DATE. This section is effective October 1, 2012.

27.33 	Sec. 32. [256N.25] PROGRAM EVALUATION.
28.1 		Subdivision 1.County evaluation. Each county shall submit to the commissioner 
28.2 	data from the past calendar year on the outcomes and performance indicators, and 
28.3 	information as to how grant funds are being spent on the target population. The 
28.4 	commissioner shall prescribe standard methods to be used by the counties in providing 
28.5 	the data. The data shall be submitted no later than March 1 of each year, beginning with 
28.6 	March 1, 2013. The commissioner shall define outcomes and performance indicators.
28.7 		Subd. 2.Statewide evaluation. Six months after the end of the first full calendar 
28.8 	year and biennially thereafter, the commissioner shall prepare a report on the counties' 
28.9 	progress in improving the outcomes of adults related to safety and well-being. This report 
28.10 	shall be disseminated electronically throughout the state.

28.11 	EFFECTIVE DATE. This section is effective October 1, 2012.

28.12 	Sec. 33. [256N.30] FUNDING.
28.13 		Subdivision 1.Assistance. (a) Counties may use the capped allocation for adult 
28.14 	assistance for individuals under section 256N.20, subdivision 2.
28.15 	(b) The county agency shall, within available appropriations, provide a personal 
28.16 	needs allowance to individuals eligible for group residential housing under section 
28.17 	256I.04, subdivision 1, paragraph (b), and to other individuals who reside in licensed 
28.18 	residential facilities other than group residential housing. The county may determine the 
28.19 	amount of the personal needs allowance based on the individual's net income and need.
28.20 	(c) In determining the amount of assistance, the county shall disregard the first 
28.21 	$150 of earned income per month. In addition, the county shall disregard additional 
28.22 	earned income up to a maximum of $500 per month for individuals residing in facilities or 
28.23 	group residential housing for whom the county agency has approved a discharge plan that 
28.24 	includes work. The additional amount disregarded must be placed in a separate savings 
28.25 	account by the eligible individual, to be used upon discharge from the residential facility 
28.26 	into the community, up to a maximum of $2,000.
28.27 	(d) The county shall give priority to eligible individuals who are enrolled in a 
28.28 	12-month residential chemical dependency treatment program.
28.29 		Subd. 2.Allocation. Funding for the adult assistance grant program is limited to the 
28.30 	appropriation. The commissioner shall allocate to counties the money appropriated for the 
28.31 	program based on each county agency's average share of the state's former programs under 
28.32 	section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts 
28.33 	to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any 
28.34 	adult assistance aid expenditures by a county above the amount of the commissioner's 
28.35 	allocation to the county must be made from county funds.

29.1 	EFFECTIVE DATE. This section is effective October 1, 2012.

29.2 	Sec. 34. [256N.35] APPLICANT REQUIREMENTS.
29.3 	(a) Any applicant, otherwise eligible for adult assistance and possibly eligible for 
29.4 	federal maintenance benefits from any other source shall: (1) make application for those 
29.5 	benefits within 30 days of the adult assistance application; and (2) execute an interim 
29.6 	assistance authorization on a form as directed by the commissioner.
29.7 	(b) The commissioner shall review a denial of an application for other federal 
29.8 	maintenance benefits and may require a recipient of adult assistance to file an appeal of 
29.9 	the denial if appropriate.
29.10 	(c) If found eligible for maintenance benefits, and maintenance benefits were 
29.11 	received during the period in which adult assistance was also being received, the recipient 
29.12 	shall be required to reimburse the state for the interim assistance paid. Reimbursement 
29.13 	shall not exceed the amount of adult assistance paid during the time period to which the 
29.14 	other maintenance benefits apply.
29.15 	(d) The commissioner may contract with the county agencies, qualified agencies, 
29.16 	organizations, or persons to provide advocacy and support services to process claims for 
29.17 	federal disability benefits for applicants or recipients of services or benefits supervised by 
29.18 	the commissioner using money retained under this section.
29.19 	(e) The commissioner may provide methods by which county agencies shall identify, 
29.20 	refer, and assist recipients who may be eligible for benefits under federal programs for the 
29.21 	disabled.
29.22 	(f) The total amount of interim assistance recoveries retained under this section 
29.23 	for advocacy, support, and claim processing services shall not exceed 35 percent of the 
29.24 	interim assistance recoveries in the prior fiscal year.

29.25 	EFFECTIVE DATE. This section is effective October 1, 2012.

29.26 	Sec. 35. Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read:
29.27 		Subd. 3.Juvenile treatment screening team. (a) The responsible social services 
29.28 	agency shall establish a juvenile treatment screening team to conduct screenings and 
29.29 	prepare case plans under this subdivision section 245.487, subdivision 3, and chapters 
29.30 	260C and 260D. Screenings shall be conducted within 15 days of a request for a screening. 
29.31 	The team, which may be the team constituted under section 245.4885 or 256B.092 or 
29.32 	Minnesota Rules, parts 9530.6600 to 9530.6655, shall consist of social workers, juvenile 
29.33 	justice professionals, and persons with expertise in the treatment of juveniles who are 
29.34 	emotionally disabled, chemically dependent, or have a developmental disability. The team 
30.1 	shall involve parents or guardians in the screening process as appropriate, and the child's 
30.2 	parent, guardian, or permanent legal custodian under section 260C.201, subdivision 11. 
30.3 	The team may be the same team as defined in section 260B.157, subdivision 3.
30.4 	(b) The social services agency shall determine whether a child brought to its 
30.5 	attention for the purposes described in this section is an Indian child, as defined in section 
30.6 	260C.007, subdivision 21, and shall determine the identity of the Indian child's tribe, as 
30.7 	defined in section 260.755, subdivision 9. When a child to be evaluated is an Indian child, 
30.8 	the team provided in paragraph (a) shall include a designated representative of the Indian 
30.9 	child's tribe, unless the child's tribal authority declines to appoint a representative. The 
30.10 	Indian child's tribe may delegate its authority to represent the child to any other federally 
30.11 	recognized Indian tribe, as defined in section 260.755, subdivision 12.
30.12 	(c) If the court, prior to, or as part of, a final disposition, proposes to place a child:
30.13 	(1) for the primary purpose of treatment for an emotional disturbance, a 
30.14 	developmental disability, or chemical dependency in a residential treatment facility out 
30.15 	of state or in one which is within the state and licensed by the commissioner of human 
30.16 	services under chapter 245A; or
30.17 	(2) in any out-of-home setting potentially exceeding 30 days in duration, including a 
30.18 	postdispositional placement in a facility licensed by the commissioner of corrections or 
30.19 	human services, the court shall ascertain whether the child is an Indian child and shall 
30.20 	notify the county welfare agency and, if the child is an Indian child, shall notify the Indian 
30.21 	child's tribe. The county's juvenile treatment screening team must either: (i) screen and 
30.22 	evaluate the child and file its recommendations with the court within 14 days of receipt 
30.23 	of the notice; or (ii) elect not to screen a given case and notify the court of that decision 
30.24 	within three working days.
30.25 	(d) If the screening team has elected to screen and evaluate the child, The child 
30.26 	may not be placed for the primary purpose of treatment for an emotional disturbance, a 
30.27 	developmental disability, or chemical dependency, in a residential treatment facility out of 
30.28 	state nor in a residential treatment facility within the state that is licensed under chapter 
30.29 	245A, unless one of the following conditions applies:
30.30 	(1) a treatment professional certifies that an emergency requires the placement 
30.31 	of the child in a facility within the state;
30.32 	(2) the screening team has evaluated the child and recommended that a residential 
30.33 	placement is necessary to meet the child's treatment needs and the safety needs of the 
30.34 	community, that it is a cost-effective means of meeting the treatment needs, and that it 
30.35 	will be of therapeutic value to the child; or
31.1 	(3) the court, having reviewed a screening team recommendation against placement, 
31.2 	determines to the contrary that a residential placement is necessary. The court shall state 
31.3 	the reasons for its determination in writing, on the record, and shall respond specifically 
31.4 	to the findings and recommendation of the screening team in explaining why the 
31.5 	recommendation was rejected. The attorney representing the child and the prosecuting 
31.6 	attorney shall be afforded an opportunity to be heard on the matter.
31.7 	(e) When the county's juvenile treatment screening team has elected to screen and 
31.8 	evaluate a child determined to be an Indian child, the team shall provide notice to the 
31.9 	tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a 
31.10 	member of the tribe or as a person eligible for membership in the tribe, and permit the 
31.11 	tribe's representative to participate in the screening team.
31.12 	(f) When the Indian child's tribe or tribal health care services provider or Indian 
31.13 	Health Services provider proposes to place a child for the primary purpose of treatment 
31.14 	for an emotional disturbance, a developmental disability, or co-occurring emotional 
31.15 	disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by 
31.16 	the child's tribe shall submit necessary documentation to the county juvenile treatment 
31.17 	screening team, which must invite the Indian child's tribe to designate a representative to 
31.18 	the screening team.

31.19 	Sec. 36. Minnesota Statutes 2010, section 260D.01, is amended to read:
31.20 	260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
31.21 	(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care 
31.22 	for treatment" provisions of the Juvenile Court Act.
31.23 	(b) The juvenile court has original and exclusive jurisdiction over a child in 
31.24 	voluntary foster care for treatment upon the filing of a report or petition required under 
31.25 	this chapter. All obligations of the agency to a child and family in foster care contained in 
31.26 	chapter 260C not inconsistent with this chapter are also obligations of the agency with 
31.27 	regard to a child in foster care for treatment under this chapter.
31.28 	(c) This chapter shall be construed consistently with the mission of the children's 
31.29 	mental health service system as set out in section 245.487, subdivision 3, and the duties 
31.30 	of an agency under section 256B.092, 260C.157, and Minnesota Rules, parts 9525.0004 
31.31 	to 9525.0016, to meet the needs of a child with a developmental disability or related 
31.32 	condition. This chapter:
31.33 	(1) establishes voluntary foster care through a voluntary foster care agreement as the 
31.34 	means for an agency and a parent to provide needed treatment when the child must be in 
32.1 	foster care to receive necessary treatment for an emotional disturbance or developmental 
32.2 	disability or related condition;
32.3 	(2) establishes court review requirements for a child in voluntary foster care for 
32.4 	treatment due to emotional disturbance or developmental disability or a related condition;
32.5 	(3) establishes the ongoing responsibility of the parent as legal custodian to visit the 
32.6 	child, to plan together with the agency for the child's treatment needs, to be available and 
32.7 	accessible to the agency to make treatment decisions, and to obtain necessary medical, 
32.8 	dental, and other care for the child; and
32.9 	(4) applies to voluntary foster care when the child's parent and the agency agree that 
32.10 	the child's treatment needs require foster care either:
32.11 	(i) due to a level of care determination by the agency's screening team informed by 
32.12 	the diagnostic and functional assessment under section 245.4885; or
32.13 	(ii) due to a determination regarding the level of services needed by the responsible 
32.14 	social services' screening team under section 256B.092, and Minnesota Rules, parts 
32.15 	9525.0004 to 9525.0016.
32.16 	(d) This chapter does not apply when there is a current determination under section 
32.17 	626.556 that the child requires child protective services or when the child is in foster care 
32.18 	for any reason other than treatment for the child's emotional disturbance or developmental 
32.19 	disability or related condition. When there is a determination under section 626.556 that 
32.20 	the child requires child protective services based on an assessment that there are safety 
32.21 	and risk issues for the child that have not been mitigated through the parent's engagement 
32.22 	in services or otherwise, or when the child is in foster care for any reason other than 
32.23 	the child's emotional disturbance or developmental disability or related condition, the 
32.24 	provisions of chapter 260C apply.
32.25 	(e) The paramount consideration in all proceedings concerning a child in voluntary 
32.26 	foster care for treatment is the safety, health, and the best interests of the child. The 
32.27 	purpose of this chapter is:
32.28 	(1) to ensure a child with a disability is provided the services necessary to treat or 
32.29 	ameliorate the symptoms of the child's disability;
32.30 	(2) to preserve and strengthen the child's family ties whenever possible and in the 
32.31 	child's best interests, approving the child's placement away from the child's parents only 
32.32 	when the child's need for care or treatment requires it and the child cannot be maintained 
32.33 	in the home of the parent; and
32.34 	(3) to ensure the child's parent retains legal custody of the child and associated 
32.35 	decision-making authority unless the child's parent willfully fails or is unable to make 
32.36 	decisions that meet the child's safety, health, and best interests. The court may not find 
33.1 	that the parent willfully fails or is unable to make decisions that meet the child's needs 
33.2 	solely because the parent disagrees with the agency's choice of foster care facility, unless 
33.3 	the agency files a petition under chapter 260C, and establishes by clear and convincing 
33.4 	evidence that the child is in need of protection or services.
33.5 	(f) The legal parent-child relationship shall be supported under this chapter by 
33.6 	maintaining the parent's legal authority and responsibility for ongoing planning for the 
33.7 	child and by the agency's assisting the parent, where necessary, to exercise the parent's 
33.8 	ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing 
33.9 	planning means:
33.10 	(1) actively participating in the planning and provision of educational services, 
33.11 	medical, and dental care for the child;
33.12 	(2) actively planning and participating with the agency and the foster care facility 
33.13 	for the child's treatment needs; and
33.14 	(3) planning to meet the child's need for safety, stability, and permanency, and the 
33.15 	child's need to stay connected to the child's family and community.
33.16 	(g) The provisions of section 260.012 to ensure placement prevention, family 
33.17 	reunification, and all active and reasonable effort requirements of that section apply. This 
33.18 	chapter shall be construed consistently with the requirements of the Indian Child Welfare 
33.19 	Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the 
33.20 	Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

33.21 	Sec. 37. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:
33.22 		Subd. 10a.Expedited issuance of food stamps. The commissioner of human 
33.23 	services shall continually monitor the expedited issuance of food stamp benefits to ensure 
33.24 	that each county complies with federal regulations and that households eligible for 
33.25 	expedited issuance of food stamps are identified, processed, and certified within the time 
33.26 	frames prescribed in federal regulations.
33.27 	County food stamp offices shall screen and issue food stamps to applicants on the 
33.28 	day of application. Applicants who meet the federal criteria for expedited issuance and 
33.29 	have an immediate need for food assistance shall receive either: within five working days
33.30 	(1) a manual Authorization to Participate (ATP) card; or
33.31 	(2) the immediate issuance of food stamp coupons benefits.
33.32 	The local food stamp agency shall conspicuously post in each food stamp office a 
33.33 	notice of the availability of and the procedure for applying for expedited issuance and 
33.34 	verbally advise each applicant of the availability of the expedited process.

34.1 	Sec. 38. Minnesota Statutes 2010, section 518A.51, is amended to read:
34.2 	518A.51 FEES FOR IV-D SERVICES.
34.3 	(a) When a recipient of IV-D services is no longer receiving assistance under the 
34.4 	state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the 
34.5 	public authority responsible for child support enforcement must notify the recipient, 
34.6 	within five working days of the notification of ineligibility, that IV-D services will be 
34.7 	continued unless the public authority is notified to the contrary by the recipient. The 
34.8 	notice must include the implications of continuing to receive IV-D services, including the 
34.9 	available services and fees, cost recovery fees, and distribution policies relating to fees.
34.10 	(b) An application fee of $25 shall be paid by the person who applies for child 
34.11 	support and maintenance collection services, except persons who are receiving public 
34.12 	assistance as defined in section 256.741 and the diversionary work program under section 
34.13 	256J.95, persons who transfer from public assistance to nonpublic assistance status, and 
34.14 	minor parents and parents enrolled in a public secondary school, area learning center, or 
34.15 	alternative learning program approved by the commissioner of education.
34.16 	(c) In the case of an individual who has never received assistance under a state 
34.17 	program funded under Title IV-A of the Social Security Act and for whom the public 
34.18 	authority has collected at least $500 of support, the public authority must impose an 
34.19 	annual federal collections fee of $25 for each case in which services are furnished. This 
34.20 	fee must be retained by the public authority from support collected on behalf of the 
34.21 	individual, but not from the first $500 collected.
34.22 	(d) When the public authority provides full IV-D services to an obligee who has 
34.23 	applied for those services, upon written notice to the obligee, the public authority must 
34.24 	charge a cost recovery fee of one percent of the amount collected. This fee must be 
34.25 	deducted from the amount of the child support and maintenance collected and not assigned 
34.26 	under section 256.741 before disbursement to the obligee. This fee does not apply to an 
34.27 	obligee who:
34.28 	(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, 
34.29 	medical assistance, or MinnesotaCare programs; or
34.30 	(2) has received assistance under the state's title IV-A or IV-E foster care programs, 
34.31 	until the person has not received this assistance for 24 consecutive months.
34.32 	 (e) When the public authority provides full IV-D services to an obligor who has 
34.33 	applied for such services, upon written notice to the obligor, the public authority must 
34.34 	charge a cost recovery fee of one percent of the monthly court-ordered child support and 
34.35 	maintenance obligation. The fee may be collected through income withholding, as well 
35.1 	as by any other enforcement remedy available to the public authority responsible for 
35.2 	child support enforcement.
35.3 	 (f) Fees assessed by state and federal tax agencies for collection of overdue support 
35.4 	owed to or on behalf of a person not receiving public assistance must be imposed on the 
35.5 	person for whom these services are provided. The public authority upon written notice to 
35.6 	the obligee shall assess a fee of $25 to the person not receiving public assistance for each 
35.7 	successful federal tax interception. The fee must be withheld prior to the release of the 
35.8 	funds received from each interception and deposited in the general fund.
35.9 	 (g) Federal collections fees collected under paragraph (c) and cost recovery 
35.10 	fees collected under paragraphs (d) and (e), retained by the commissioner of human 
35.11 	services, shall be considered child support program income according to Code of Federal 
35.12 	Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund 
35.13 	account established under paragraph (i). The commissioner of human services must elect 
35.14 	to recover costs based on either actual or standardized costs.
35.15 	 (h) The limitations of this section on the assessment of fees shall not apply to 
35.16 	the extent inconsistent with the requirements of federal law for receiving funds for the 
35.17 	programs under Title IV-A and Title IV-D of the Social Security Act, United States Code, 
35.18 	title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
35.19 	 (i) The commissioner of human services is authorized to establish a special revenue 
35.20 	fund account to receive the federal collections fees collected under paragraph (c) and cost 
35.21 	recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of 
35.22 	these fees may be retained for expenditures necessary to administer the fees and must be 
35.23 	transferred to the child support system special revenue account. The remaining nonfederal 
35.24 	share of the federal collections fees and cost recovery fees must be retained by the 
35.25 	commissioner and dedicated to the child support general fund county performance-based 
35.26 	grant account authorized under sections 256.979 and 256.9791. The commissioner shall 
35.27 	distribute the remaining nonfederal share of these fees to the counties quarterly using the 
35.28 	methodology specified in section 256.979, subdivision 11. The funds received by the 
35.29 	counties must be reinvested in the child support enforcement program, and the counties 
35.30 	shall not reduce the funding of their child support programs by the amount of funding 
35.31 	distributed.

35.32 	Sec. 39. REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES, 
35.33 	GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.
 35.34 	Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must 
35.35 	negotiate with their third-party processors to block EBT card cash transactions at their 
36.1 	places of business and withdrawals of cash at automatic teller machines located in their 
36.2 	places of business.

36.3 	Sec. 40. MINNESOTA EBT BUSINESS TASK FORCE.
 36.4 		Subdivision 1.Members. The Minnesota EBT Business Task Force includes seven 
36.5 	members, appointed as follows:
36.6 	(1) two members of the Minnesota house of representatives appointed by the speaker 
36.7 	of the house;
36.8 	(2) two members of the Minnesota senate appointed by the senate majority leader;
36.9 	(3) the commissioner of human services, or designee;
36.10 	(4) an appointee of the Minnesota Grocers Association; and
36.11 	(5) a credit card processor, appointed by the commissioner of human services.
36.12 		Subd. 2.Duties. The Minnesota EBT Business Task Force shall create a workable 
36.13 	strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the 
36.14 	general assistance program and Minnesota supplemental aid program under Minnesota 
36.15 	Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT 
36.16 	cards. The task force will consider cost to the state, feasibility of execution at retail, and 
36.17 	ease of use and privacy for EBT cardholders.
36.18 		Subd. 3.Report. The task force will report back to the legislative committees with 
36.19 	jurisdiction over health and human services policy and finance by April 1, 2012, with 
36.20 	recommendations related to the task force duties under subdivision 2.
36.21 		Subd. 4.Expiration. The task force expires on June 30, 2012.

36.22 	Sec. 41. STREAMLINING CHILDREN AND COMMUNITY SERVICES ACT 
36.23 	REPORTING REQUIREMENTS.
 36.24 	The commissioner of human services and county human services representatives, in 
36.25 	consultation with other interested parties, shall develop a streamlined alternative to current 
36.26 	reporting requirements related to the Children and Community Services Act service plan. 
36.27 	The commissioner shall submit recommendations and draft legislation to the chairs and 
36.28 	ranking minority members of the committees having jurisdiction over human services no 
36.29 	later than November 15, 2012.

36.30 	Sec. 42. REVISOR'S INSTRUCTION.
 36.31 	The revisor of statutes shall make conforming amendments and correct statutory 
36.32 	cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and 
36.33 	related repealers in this article.

37.1 	Sec. 43.  REPEALER.
 37.2 	(a) Minnesota Statutes 2010, section 256.9862, subdivision 2, is repealed effective 
37.3 	February 1, 2012.
37.4 	(b) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; 
37.5 	256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a; 
37.6 	256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2, 
37.7 	5, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, and 6; 256D.10; 256D.13; 256D.15; 
37.8 	256D.16; 256D.35, subdivision 8b; and 256D.46, are repealed effective October 1, 2012.
37.9 	(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September 
37.10 	3, 2012.
37.11 	(d) Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, are 
37.12 	repealed effective November 1, 2011.

37.13 	ARTICLE 2
37.14 	DEPARTMENT OF HEALTH

37.15 	Section 1. Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended to read:
37.16 		Subd. 7.Consistent administrative expenses and investment income reporting.
 37.17 	(a) Every health maintenance organization must directly allocate administrative expenses 
37.18 	to specific lines of business or products when such information is available. The definition 
37.19 	of administrative expenses must be consistent with that of the National Association of 
37.20 	Insurance Commissioners (NAIC) as provided in the most current NAIC blank. Remaining 
37.21 	expenses that cannot be directly allocated must be allocated based on other methods, as 
37.22 	recommended by the Advisory Group on Administrative Expenses. Health maintenance 
37.23 	organizations must submit this information, including administrative expenses for dental 
37.24 	services, using the reporting template provided by the commissioner of health.
37.25 	(b) Every health maintenance organization must allocate investment income based 
37.26 	on cumulative net income over time by business line or product and must submit this 
37.27 	information, including investment income for dental services, using the reporting template 
37.28 	provided by the commissioner of health.

37.29 	Sec. 2. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
37.30 		Subd. 3.Cost containment duties. The commissioner shall:
37.31 	(1) establish statewide and regional cost containment goals for total health care 
37.32 	spending under this section and collect data as described in sections 62J.38to 62J.41 and 
37.33 	62J.40 to monitor statewide achievement of the cost containment goals; 
38.1 	(2) divide the state into no fewer than four regions, with one of those regions being 
38.2 	the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 
38.3 	Wright, and Sherburne Counties, for purposes of fostering the development of regional 
38.4 	health planning and coordination of health care delivery among regional health care 
38.5 	systems and working to achieve the cost containment goals;
38.6 	(3) monitor the quality of health care throughout the state and take action as 
38.7 	necessary to ensure an appropriate level of quality;
38.8 	(4) issue recommendations regarding uniform billing forms, uniform electronic 
38.9 	billing procedures and data interchanges, patient identification cards, and other uniform 
38.10 	claims and administrative procedures for health care providers and private and public 
38.11 	sector payers. In developing the recommendations, the commissioner shall review the 
38.12 	work of the work group on electronic data interchange (WEDI) and the American National 
38.13 	Standards Institute (ANSI) at the national level, and the work being done at the state and 
38.14 	local level. The commissioner may adopt rules requiring the use of the Uniform Bill 
38.15 	82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 
38.16 	version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 
38.17 	forms or procedures;
38.18 	(5) undertake health planning responsibilities;
38.19 	(6) authorize, fund, or promote research and experimentation on new technologies 
38.20 	and health care procedures;
38.21 	(7) within the limits of appropriations for these purposes, administer or contract for 
38.22 	statewide consumer education and wellness programs that will improve the health of 
38.23 	Minnesotans and increase individual responsibility relating to personal health and the 
38.24 	delivery of health care services, undertake prevention programs including initiatives to 
38.25 	improve birth outcomes, expand childhood immunization efforts, and provide start-up 
38.26 	grants for worksite wellness programs;
38.27 	(8) undertake other activities to monitor and oversee the delivery of health care 
38.28 	services in Minnesota with the goal of improving affordability, quality, and accessibility of 
38.29 	health care for all Minnesotans; and
38.30 	(9) make the cost containment goal data available to the public in a 
38.31 	consumer-oriented manner.

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

38.33 	Sec. 3. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
38.34 		Subd. 4a.Expenditure reporting. Each hospital, outpatient surgical center, 
38.35 	diagnostic imaging center, and physician clinic shall report annually to the commissioner 
39.1 	on all major spending commitments, in the form and manner specified by the 
39.2 	commissioner. The report shall include the following information:
39.3 	(a) a description of major spending commitments made during the previous year, 
39.4 	including the total dollar amount of major spending commitments and purpose of the 
39.5 	expenditures;
39.6 	(b) the cost of land acquisition, construction of new facilities, and renovation of 
39.7 	existing facilities;
39.8 	(c) the cost of purchased or leased medical equipment, by type of equipment;
39.9 	(d) expenditures by type for specialty care and new specialized services;
39.10 	(e) information on the amount and types of added capacity for diagnostic imaging 
39.11 	services, outpatient surgical services, and new specialized services; and
39.12 	(f) information on investments in electronic medical records systems.
39.13 	For hospitals and outpatient surgical centers, this information shall be included in reports 
39.14 	to the commissioner that are required under section 144.698. For diagnostic imaging 
39.15 	centers, this information shall be included in reports to the commissioner that are required 
39.16 	under section 144.565. For physician clinics, this information shall be included in reports 
39.17 	to the commissioner that are required under section 62J.41. For all other health care 
39.18 	providers that are subject to this reporting requirement, reports must be submitted to the 
39.19 	commissioner by March 1 each year for the preceding calendar year.

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

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

39.27 	Sec. 5. Minnesota Statutes 2010, section 62J.692, is amended to read:
39.28 	62J.692 MEDICAL EDUCATION.
39.29 		Subdivision 1.Definitions. For purposes of this section, the following definitions 
39.30 	apply:
39.31 	(a) "Accredited clinical training" means the clinical training provided by a 
39.32 	medical education program that is accredited through an organization recognized by the 
39.33 	Department of Education, the Centers for Medicare and Medicaid Services, or another 
40.1 	national body who reviews the accrediting organizations for multiple disciplines and 
40.2 	whose standards for recognizing accrediting organizations are reviewed and approved by 
40.3 	the commissioner of health in consultation with the Medical Education and Research 
40.4 	Advisory Committee.
40.5 	(b) "Commissioner" means the commissioner of health.
40.6 	(c) "Clinical medical education program" means the accredited clinical training of 
40.7 	physicians (medical students and residents), doctor of pharmacy practitioners, doctors 
40.8 	of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 
40.9 	registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 
40.10 	physician assistants.
40.11 	(d) "Sponsoring institution" means a hospital, school, or consortium located in 
40.12 	Minnesota that sponsors and maintains primary organizational and financial responsibility 
40.13 	for a clinical medical education program in Minnesota and which is accountable to the 
40.14 	accrediting body.
40.15 	(e) "Teaching institution" means a hospital, medical center, clinic, or other 
40.16 	organization that conducts a clinical medical education program in Minnesota.
40.17 	(f) "Trainee" means a student or resident involved in a clinical medical education 
40.18 	program.
40.19 	(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time 
40.20 	equivalent counts, that are at training sites located in Minnesota with currently active 
40.21 	medical assistance enrollment status and a National Provider Identification (NPI) number 
40.22 	where training occurs in either an inpatient or ambulatory patient care setting and where 
40.23 	the training is funded, in part, by patient care revenues. Training that occurs in nursing 
40.24 	facility settings is not eligible for funding under this section.
40.25 		Subd. 3.Application process. (a) A clinical medical education program 
40.26 	conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy 
40.27 	practitioners, dentists, chiropractors, or physician assistants is eligible for funds under 
40.28 	subdivision 4 or 11, as appropriate, if the program:
40.29 	(1) is funded, in part, by patient care revenues;
40.30 	(2) occurs in patient care settings that face increased financial pressure as a result 
40.31 	of competition with nonteaching patient care entities; and
40.32 	(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
40.33 	A clinical medical education program that trains pediatricians is requested to include 
40.34 	in its program curriculum training in case management and medication management for 
40.35 	children suffering from mental illness to be eligible for funds under subdivision 4.
41.1 	(b) A clinical medical education program for advanced practice nursing is eligible 
41.2 	for funds under subdivision 4 or 11, as appropriate, if the program meets the eligibility 
41.3 	requirements in paragraph (a), clauses (1) to (3), and is sponsored by the University of 
41.4 	Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part 
41.5 	of the Minnesota State Colleges and Universities system or members of the Minnesota 
41.6 	Private College Council.
41.7 	(c) Applications must be submitted to the commissioner by a sponsoring institution 
41.8 	on behalf of an eligible clinical medical education program and must be received by 
41.9 	October 31 of each year for distribution in the following year. An application for funds 
41.10 	must contain the following information:
41.11 	(1) the official name and address of the sponsoring institution and the official 
41.12 	name and site address of the clinical medical education programs on whose behalf the 
41.13 	sponsoring institution is applying;
41.14 	(2) the name, title, and business address of those persons responsible for 
41.15 	administering the funds;
41.16 	(3) for each clinical medical education program for which funds are being sought; 
41.17 	the type and specialty orientation of trainees in the program; the name, site address, and 
41.18 	medical assistance provider number and national provider identification number of each 
41.19 	training site used in the program; the federal tax identification number of each training site 
41.20 	used in the program, where available; the total number of trainees at each training site; and 
41.21 	the total number of eligible trainee FTEs at each site; and
41.22 	(4) other supporting information the commissioner deems necessary to determine 
41.23 	program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the 
41.24 	equitable distribution of funds.
41.25 	(d) An application must include the information specified in clauses (1) to (3) for 
41.26 	each clinical medical education program on an annual basis for three consecutive years. 
41.27 	After that time, an application must include the information specified in clauses (1) to (3) 
41.28 	when requested, at the discretion of the commissioner:
41.29 	(1) audited clinical training costs per trainee for each clinical medical education 
41.30 	program when available or estimates of clinical training costs based on audited financial 
41.31 	data;
41.32 	(2) a description of current sources of funding for clinical medical education costs, 
41.33 	including a description and dollar amount of all state and federal financial support, 
41.34 	including Medicare direct and indirect payments; and
41.35 	(3) other revenue received for the purposes of clinical training.
42.1 	(e) An applicant that does not provide information requested by the commissioner 
42.2 	shall not be eligible for funds for the current funding cycle.
42.3 		Subd. 4.Distribution of funds. (a) Following the distribution described under 
42.4 	paragraph (b), the commissioner shall annually distribute the available medical education 
42.5 	funds to all qualifying applicants based on a distribution formula that reflects a summation 
42.6 	of two factors:
42.7 	(1) a public program volume factor, which is determined by the total volume of 
42.8 	public program revenue received by each training site as a percentage of all public 
42.9 	program revenue received by all training sites in the fund pool; and
42.10 	(2) a supplemental public program volume factor, which is determined by providing 
42.11 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
42.12 	public program revenue accounted for at least 0.98 percent of the total public program 
42.13 	revenue received by all eligible training sites. Grants to training sites whose public 
42.14 	program revenue accounted for less than 0.98 percent of the total public program revenue 
42.15 	received by all eligible training sites shall be reduced by an amount equal to the total 
42.16 	value of the supplemental payment.
42.17 	Public program revenue for the distribution formula includes revenue from medical 
42.18 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
42.19 	general assistance medical care. Training sites that receive no public program revenue 
42.20 	are ineligible for funds available under this subdivision. For purposes of determining 
42.21 	training-site level grants to be distributed under paragraph (a), total statewide average 
42.22 	costs per trainee for medical residents is based on audited clinical training costs per trainee 
42.23 	in primary care clinical medical education programs for medical residents. Total statewide 
42.24 	average costs per trainee for dental residents is based on audited clinical training costs 
42.25 	per trainee in clinical medical education programs for dental students. Total statewide 
42.26 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
42.27 	per trainee in clinical medical education programs for pharmacy students. Training sites 
42.28 	whose training site level grant is less than $1,000, based on the formula described in this 
42.29 	paragraph, are ineligible for funds available under this subdivision.
42.30 	(b) $5,350,000 $2,680,000 of the available medical education funds shall be 
42.31 	distributed as follows:
42.32 	(1) $1,475,000 $740,000 to the University of Minnesota Medical Center-Fairview;
42.33 	(2) $2,075,000 $970,000 to the University of Minnesota School of Dentistry; and
42.34 	(3) $1,800,000 $970,000 to the Academic Health Center. $150,000 of the funds 
42.35 	distributed to the Academic Health Center under this paragraph shall be used for a 
42.36 	program to assist internationally trained physicians who are legal residents and who 
43.1 	commit to serving underserved Minnesota communities in a health professional shortage 
43.2 	area to successfully compete for family medicine residency programs at the University 
43.3 	of Minnesota.
43.4 	(c) Funds distributed shall not be used to displace current funding appropriations 
43.5 	from federal or state sources.
43.6 	(d) Funds shall be distributed to the sponsoring institutions indicating the amount 
43.7 	to be distributed to each of the sponsor's clinical medical education programs based on 
43.8 	the criteria in this subdivision and in accordance with the commissioner's approval letter. 
43.9 	Each clinical medical education program must distribute funds allocated under paragraph 
43.10 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
43.11 	institutions, which are accredited through an organization recognized by the Department 
43.12 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
43.13 	with training sites to provide clinical training. To ensure the quality of clinical training, 
43.14 	those accredited sponsoring institutions must:
43.15 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
43.16 	training conducted at sites; and
43.17 	(2) take necessary action if the contract requirements are not met. Action may 
43.18 	include the withholding of payments under this section or the removal of students from 
43.19 	the site.
43.20 	(e) Any funds not distributed in accordance with the commissioner's approval letter 
43.21 	must be returned to the medical education and research fund within 30 days of receiving 
43.22 	notice from the commissioner. The commissioner shall distribute returned funds to the 
43.23 	appropriate training sites in accordance with the commissioner's approval letter.
43.24 	(f) A maximum of $150,000 of the funds dedicated to the commissioner under 
43.25 	section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
43.26 	administrative expenses associated with implementing this section.
43.27 		Subd. 5.Report. (a) Sponsoring institutions receiving funds under this section 
43.28 	must sign and submit a medical education grant verification report (GVR) to verify that 
43.29 	the correct grant amount was forwarded to each eligible training site. If the sponsoring 
43.30 	institution fails to submit the GVR by the stated deadline, or to request and meet 
43.31 	the deadline for an extension, the sponsoring institution is required to return the full 
43.32 	amount of funds received to the commissioner within 30 days of receiving notice from 
43.33 	the commissioner. The commissioner shall distribute returned funds to the appropriate 
43.34 	training sites in accordance with the commissioner's approval letter.
43.35 	(b) The reports must provide verification of the distribution of the funds and must 
43.36 	include:
44.1 	(1) the total number of eligible trainee FTEs in each clinical medical education 
44.2 	program;
44.3 	(2) the name of each funded program and, for each program, the dollar amount 
44.4 	distributed to each training site;
44.5 	(3) documentation of any discrepancies between the initial grant distribution notice 
44.6 	included in the commissioner's approval letter and the actual distribution;
44.7 	(4) a statement by the sponsoring institution stating that the completed grant 
44.8 	verification report is valid and accurate; and
44.9 	(5) other information the commissioner, with advice from the advisory committee, 
44.10 	deems appropriate to evaluate the effectiveness of the use of funds for medical education.
44.11 	(c) By February 15 of each year, the commissioner, with advice from the 
44.12 	advisory committee, shall provide an annual summary report to the legislature on the 
44.13 	implementation of this section.
44.14 		Subd. 6.Other available funds. The commissioner is authorized to distribute, in 
44.15 	accordance with subdivision 4 or 11, as appropriate, funds made available through:
44.16 	(1) voluntary contributions by employers or other entities;
44.17 	(2) allocations for the commissioner of human services to support medical education 
44.18 	and research; and
44.19 	(3) other sources as identified and deemed appropriate by the legislature for 
44.20 	inclusion in the fund.
44.21 		Subd. 7.Transfers from the commissioner of human services. Of the amount 
44.22 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), 
44.23 	$21,714,000 shall be distributed as follows:
44.24 	(1) $2,157,000 shall be distributed by the commissioner to the University of 
44.25 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
44.26 	(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 
44.27 	Medical Center for clinical medical education;
44.28 	(3) $17,400,000 shall be distributed by the commissioner to the University of 
44.29 	Minnesota Board of Regents for purposes of medical education;
44.30 	(4) $1,121,640 shall be distributed by the commissioner to clinical medical education 
44.31 	dental innovation grants in accordance with subdivision 7a; and
44.32 	(5) the remainder of the amount transferred according to section 256B.69, 
44.33 	subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 
44.34 	clinical medical education programs that meet the qualifications of subdivision 3 based on 
44.35 	the formula in subdivision 4, paragraph (a), or 11, as appropriate.
45.1 		Subd. 7a.Clinical medical education innovations grants. (a) The commissioner 
45.2 	shall award grants to teaching institutions and clinical training sites for projects that 
45.3 	increase dental access for underserved populations and promote innovative clinical 
45.4 	training of dental professionals. In awarding the grants, the commissioner, in consultation 
45.5 	with the commissioner of human services, shall consider the following:
45.6 	(1) potential to successfully increase access to an underserved population;
45.7 	(2) the long-term viability of the project to improve access beyond the period 
45.8 	of initial funding;
45.9 	(3) evidence of collaboration between the applicant and local communities;
45.10 	(4) the efficiency in the use of the funding; and
45.11 	(5) the priority level of the project in relation to state clinical education, access, 
45.12 	and workforce goals.
45.13 	(b) The commissioner shall periodically evaluate the priorities in awarding the 
45.14 	innovations grants in order to ensure that the priorities meet the changing workforce 
45.15 	needs of the state.
45.16 		Subd. 8.Federal financial participation.  The commissioner of human services 
45.17 	shall seek to maximize federal financial participation in payments for medical education 
45.18 	and research costs.
45.19 	The commissioner shall use physician clinic rates where possible to maximize 
45.20 	federal financial participation. Any additional funds that become available must be 
45.21 	distributed under subdivision 4, paragraph (a), or 11, as appropriate.
45.22 		Subd. 9.Review of eligible providers. The commissioner and the Medical 
45.23 	Education and Research Costs Advisory Committee may review provider groups included 
45.24 	in the definition of a clinical medical education program to assure that the distribution of 
45.25 	the funds continue to be consistent with the purpose of this section. The results of any 
45.26 	such reviews must be reported to the Legislative Commission on Health Care Access.
45.27 		Subd. 11.Distribution of funds. (a) Upon receiving federal approval, the 
45.28 	commissioner shall annually distribute the available medical education funds to all 
45.29 	qualifying applicants based on the distribution formula provided in this subdivision, which 
45.30 	supersedes the formula described in subdivision 4, paragraph (a).
45.31 	(1) Following the distribution of funds described under subdivision 4, paragraph 
45.32 	(b), the commissioner shall annually distribute the available medical education funds 
45.33 	to all qualifying applicants based on a distribution formula that reflects a summation 
45.34 	of two factors:
46.1 	(i) a public program volume factor, which is determined by the total volume of 
46.2 	public program revenue received by each training site as a percentage of all public 
46.3 	program revenue received by all training sites in the fund pool; and 
46.4 	(ii) a supplemental public program volume factor, which is determined by providing 
46.5 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
46.6 	public program revenue accounted for at least 0.98 percent of the total public program 
46.7 	revenue received by all eligible training sites. Grants to training sites whose public 
46.8 	program revenue accounted for less than 0.98 percent of the total public program revenue 
46.9 	received by all eligible training sites shall be reduced by an amount equal to the total 
46.10 	value of the supplemental payment. 
46.11 	Public program revenue for the distribution formula includes revenue from medical 
46.12 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
46.13 	general assistance medical care. Training sites that receive no public program revenue are 
46.14 	ineligible for funds available under this subdivision. For purposes of determining training 
46.15 	site level grants to be distributed under paragraph (a), total statewide average costs per 
46.16 	trainee for medical residents is based on audited clinical training costs per trainee in 
46.17 	primary care clinical medical education programs for medical residents. Total statewide 
46.18 	average costs per trainee for dental residents is based on audited clinical training costs 
46.19 	per trainee in clinical medical education programs for dental students. Total statewide 
46.20 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
46.21 	per trainee in clinical medical education programs for pharmacy students.
46.22 	(2) Ten percent of available medical education funds shall be used to create a primary 
46.23 	care bonus pool.  Grants to eligible training sites under this clause shall be determined by 
46.24 	dividing the total number of eligible FTE trainees from primary care medicine, advanced 
46.25 	practice nursing, or physician assistant programs at all eligible training sites by the amount 
46.26 	of funds available in the primary care bonus pool to determine a grant per primary care 
46.27 	FTE; each eligible training site shall receive a grant equal to the grant per primary care 
46.28 	FTE multiplied by the number of eligible primary care FTE's at the training site. 
46.29 	(3) After determining the grant amount for each training site under clause (1), items 
46.30 	(i) and (ii), and clause (2), the commissioner shall calculate a grant per eligible trainee for 
46.31 	each training site.  Any training site whose grant per eligible trainee is greater than the 
46.32 	95th percentile grant per eligible trainee shall have the grant amount reduced to the 95th 
46.33 	percentile grant per eligible trainee.  Grants in excess of this amount for any training site 
46.34 	shall be redistributed based on the criteria in clause (4).
46.35 	Any training site with fewer than 0.1 FTE eligible trainees from all programs or a 
46.36 	calculated grant less than $1,000 based on the formula described in clauses (1) and (2) 
47.1 	shall be eliminated from the distribution; the calculated grants for these training sites shall 
47.2 	be redistributed based on the criteria in clause (4).
47.3 	(4) The commissioner shall award from available funds appropriated for this purpose 
47.4 	and equally divided between the following programs: 
47.5 	(i) the community mental health center grants program under section 145.9272; and
47.6 	(ii) the community health centers development grants program under section 
47.7 	145.987.
47.8 	If federal approval for this funding mechanism is not received for either of the grant 
47.9 	programs described in this paragraph, available funds will be provided to the remaining 
47.10 	grant program described in this paragraph. If none of the grant programs described in this 
47.11 	paragraph receive federal approval, available funds will be distributed to eligible training 
47.12 	sites based on the formula in clauses (1) to (3).
47.13 	(b) Funds distributed shall not be used to displace current funding appropriations 
47.14 	from federal or state sources. 
47.15 	(c) Funds shall be distributed to the sponsoring institutions indicating the amount 
47.16 	to be distributed to each of the sponsor's clinical medical education programs based on 
47.17 	the criteria in this subdivision and according to the commissioner's approval letter. Each 
47.18 	clinical medical education program must distribute funds allocated under paragraph 
47.19 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
47.20 	institutions, which are accredited through an organization recognized by the Department 
47.21 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
47.22 	with training sites to provide clinical training. To ensure the quality of clinical training, 
47.23 	those accredited sponsoring institutions must:
47.24 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
47.25 	training conducted at sites; and 
47.26 	(2) take necessary action if the contract requirements are not met. Action may 
47.27 	include the withholding of payments under this section or the removal of students from 
47.28 	the site. 
47.29 	(d) Any funds not distributed according to the commissioner's approval letter must 
47.30 	be returned to the medical education and research fund within 30 days of receiving 
47.31 	notice from the commissioner. The commissioner shall distribute returned funds to the 
47.32 	appropriate training sites according to the commissioner's approval letter. 
47.33 	(e) A maximum of $150,000 of the funds dedicated to the commissioner under 
47.34 	section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
47.35 	administrative expenses associated with implementing this section.

48.1 	Sec. 6. [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING 
48.2 	MEASURES.
48.3 		Subdivision 1.Data from providers. (a) By July 1, 2012, the commissioner 
48.4 	shall review currently available quality measures and make recommendations for future 
48.5 	measurement aimed at improving assessment and care related to Alzheimer's disease and 
48.6 	other dementia diagnoses, including improved rates and results of cognitive screening, 
48.7 	rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment 
48.8 	plans.
48.9 	(b) The commissioner may contract with a private entity to complete the 
48.10 	requirements in this subdivision. If the commissioner contracts with a private entity 
48.11 	already under contract through section 62U.02, then the commissioner may use a sole 
48.12 	source contract and is exempt from competitive procurement processes.
48.13 		Subd. 2.Learning collaborative. By July 1, 2012, the commissioner shall 
48.14 	develop a health care home learning collaborative curriculum that includes screening and 
48.15 	education on best practices regarding identification and management of Alzheimer's and 
48.16 	other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, 
48.17 	care coordinators, clinic administrators, patient partners and families, and community 
48.18 	resources including public health.
48.19 		Subd. 3.Comparison data. The commissioner, with the commissioner of human 
48.20 	services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly 
48.21 	review existing and forthcoming literature in order to estimate differences in the outcomes 
48.22 	and costs of current practices for caring for those with Alzheimer's disease and other 
48.23 	dementias, compared to the outcomes and costs resulting from:
48.24 	(1) earlier identification of Alzheimer's and other dementias;
48.25 	(2) improved support of family caregivers; and
48.26 	(3) improved collaboration between medical care management and community-based 
48.27 	supports.
48.28 		Subd. 4.Reporting. By January 15, 2013, the commissioner must report to the 
48.29 	legislature on progress toward establishment and collection of quality measures required 
48.30 	under this section.

48.31 	Sec. 7. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:
48.32 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
48.33 	apply.
48.34 	(b) "Dentist" means an individual who is licensed to practice dentistry.
48.35 	(c) "Designated rural area" means:
49.1 	(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, 
49.2 	Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, 
49.3 	Rochester, and St. Cloud; or
49.4 	(2) a municipal corporation, as defined under section 471.634, that is physically 
49.5 	located, in whole or in part, in an area defined as a designated rural area under clause (1).
49.6 	an area defined as a small rural area or isolated rural area according to the four category 
49.7 	classifications of the Rural Urban Commuting Area system developed for the United 
49.8 	States Health Resources and Services Administration.
49.9 	(d) "Emergency circumstances" means those conditions that make it impossible for 
49.10 	the participant to fulfill the service commitment, including death, total and permanent 
49.11 	disability, or temporary disability lasting more than two years.
49.12 	(e) "Medical resident" means an individual participating in a medical residency in 
49.13 	family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
49.14 	(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse 
49.15 	anesthetist, advanced clinical nurse specialist, or physician assistant.
49.16 	(g) "Nurse" means an individual who has completed training and received all 
49.17 	licensing or certification necessary to perform duties as a licensed practical nurse or 
49.18 	registered nurse.
49.19 	(h) "Nurse-midwife" means a registered nurse who has graduated from a program of 
49.20 	study designed to prepare registered nurses for advanced practice as nurse-midwives.
49.21 	(i) "Nurse practitioner" means a registered nurse who has graduated from a program 
49.22 	of study designed to prepare registered nurses for advanced practice as nurse practitioners.
49.23 	(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
49.24 	(k) "Physician" means an individual who is licensed to practice medicine in the areas 
49.25 	of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
49.26 	(l) "Physician assistant" means a person licensed under chapter 147A.
49.27 	(m) "Qualified educational loan" means a government, commercial, or foundation 
49.28 	loan for actual costs paid for tuition, reasonable education expenses, and reasonable living 
49.29 	expenses related to the graduate or undergraduate education of a health care professional.
49.30 	(n) "Underserved urban community" means a Minnesota urban area or population 
49.31 	included in the list of designated primary medical care health professional shortage areas 
49.32 	(HPSAs), medically underserved areas (MUAs), or medically underserved populations 
49.33 	(MUPs) maintained and updated by the United States Department of Health and Human 
49.34 	Services.

49.35 	Sec. 8. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
50.1 		Subd. 5.Statewide tobacco prevention grants. (a) To the extent funds are 
50.2 	appropriated for the purposes of this subdivision, the commissioner of health shall, within 
50.3 	available appropriations, award competitive grants to eligible applicants for projects and 
50.4 	initiatives directed at the prevention of tobacco use. The project areas for grants include:
50.5 	(1) statewide public education and information campaigns which include 
50.6 	implementation at the local level; and
50.7 	(2) coordinated special projects, including training and technical assistance, a 
50.8 	resource clearinghouse, and contracts with ethnic and minority communities.
50.9 	(b) Eligible applicants may include, but are not limited to, nonprofit organizations, 
50.10 	colleges and universities, professional health associations, community health boards, and 
50.11 	other health care organizations. Applicants must submit proposals to the commissioner. 
50.12 	The proposals must specify the strategies to be implemented to target tobacco use among 
50.13 	youth, and must take into account the need for a coordinated statewide tobacco prevention 
50.14 	effort.
50.15 	(c) The commissioner must give priority to applicants who demonstrate that the 
50.16 	proposed project:
50.17 	(1) is research based or based on proven effective strategies;
50.18 	(2) is designed to coordinate with other activities and education messages related 
50.19 	to other health initiatives;
50.20 	(3) utilizes and enhances existing prevention activities and resources; or
50.21 	(4) involves innovative approaches preventing tobacco use among youth.

50.22 	Sec. 9. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:
50.23 		Subd. 6.Local tobacco prevention grants. (a) The commissioner shall award 
50.24 	grants, within available appropriations, to eligible applicants for local and regional 
50.25 	projects and initiatives directed at tobacco prevention in coordination with other health 
50.26 	areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related 
50.27 	problems. The project areas for grants include:
50.28 	(1) school-based tobacco prevention programs aimed at youth and parents;
50.29 	(2) local public awareness and education projects aimed at tobacco prevention in 
50.30 	coordination with locally assessed community public health needs pursuant to chapter 
50.31 	145A; or
50.32 	(3) local initiatives aimed at reducing high-risk behavior in youth associated with 
50.33 	tobacco use and the health consequences of these behaviors.
50.34 	(b) Eligible applicants may include, but are not limited to, community health boards, 
50.35 	school districts, community clinics, Indian tribes, nonprofit organizations, and other health 
51.1 	care organizations. Applicants must submit proposals to the commissioner. The proposals 
51.2 	must specify the strategies to be implemented to target tobacco use among youth, and must 
51.3 	be targeted to achieve the outcomes established in subdivision 2.
51.4 	(c) The commissioner must give priority to applicants who demonstrate that the 
51.5 	proposed project or initiative is:
51.6 	(1) supported by the community in which the applicant serves;
51.7 	(2) is based on research or on proven effective strategies;
51.8 	(3) is designed to coordinate with other community activities related to other health 
51.9 	initiatives;
51.10 	(4) incorporates an understanding of the role of community in influencing behavioral 
51.11 	changes among youth regarding tobacco use and other high-risk health-related behaviors; 
51.12 	or
51.13 	(5) addresses disparities among populations of color related to tobacco use and 
51.14 	other high-risk health-related behaviors.
51.15 	(d) The commissioner shall divide the state into specific geographic regions and 
51.16 	allocate a percentage of the money available for distribution to projects or initiatives 
51.17 	aimed at that geographic region. If the commissioner does not receive a sufficient number 
51.18 	of grant proposals from applicants that serve a particular region or the proposals submitted 
51.19 	do not meet the criteria developed by the commissioner, the commissioner shall provide 
51.20 	technical assistance and expertise to ensure the development of adequate proposals 
51.21 	aimed at addressing the public health needs of that region. In awarding the grants, the 
51.22 	commissioner shall consider locally assessed community public health needs pursuant to 
51.23 	chapter 145A.

51.24 	Sec. 10. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:
51.25 		Subd. 2a.Standards. Notwithstanding the exemptions in subdivisions 8 and 9, the 
51.26 	commissioner shall accredit laboratories according to the most current environmental 
51.27 	laboratory accreditation standards under subdivision 1 and as accepted by the accreditation 
51.28 	bodies recognized by the National Environmental Laboratory Accreditation Program 
51.29 	(NELAP) of the NELAC Institute.

51.30 	Sec. 11. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:
51.31 		Subd. 7.Initial accreditation and annual accreditation renewal. (a) The 
51.32 	commissioner shall issue or renew accreditation after receipt of the completed application 
51.33 	and documentation required in this section, provided the laboratory maintains compliance 
52.1 	with the standards specified in subdivision 2a, notwithstanding any exemptions under 
52.2 	subdivisions 8 and 9, and attests to the compliance on the application form.
52.3 	(b) The commissioner shall prorate the fees in subdivision 3 for laboratories 
52.4 	applying for accreditation after December 31. The fees are prorated on a quarterly basis 
52.5 	beginning with the quarter in which the commissioner receives the completed application 
52.6 	from the laboratory.
52.7 	(c) Applications for renewal of accreditation must be received by November 1 and 
52.8 	no earlier than October 1 of each year. The commissioner shall send annual renewal 
52.9 	notices to laboratories 90 days before expiration. Failure to receive a renewal notice does 
52.10 	not exempt laboratories from meeting the annual November 1 renewal date.
52.11 	(d) The commissioner shall issue all accreditations for the calendar year for which 
52.12 	the application is made, and the accreditation shall expire on December 31 of that year.
52.13 	(e) The accreditation of any laboratory that fails to submit a renewal application 
52.14 	and fees to the commissioner expires automatically on December 31 without notice or 
52.15 	further proceeding. Any person who operates a laboratory as accredited after expiration of 
52.16 	accreditation or without having submitted an application and paid the fees is in violation 
52.17 	of the provisions of this section and is subject to enforcement action under sections 
52.18 	144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired 
52.19 	accreditation may reapply under subdivision 6.

52.20 	Sec. 12. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 
52.21 	to read:
52.22 		Subd. 8.Exemption from national standards for quality control and personnel 
52.23 	requirements. Effective January 1, 2012, a laboratory that analyzes samples for 
52.24 	compliance with a permit issued under section 115.03, subdivision 5, may request 
52.25 	exemption from the personnel requirements and specific quality control provisions for 
52.26 	microbiology and chemistry stated in the national standards as incorporated by reference 
52.27 	in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
52.28 	(1) complies with the methodology and quality control requirements, where 
52.29 	available, in the most recent, approved edition of the Standard Methods for the 
52.30 	Examination of Water and Wastewater as published by the Water Environment Federation; 
52.31 	and
52.32 	(2) supplies the name of the person meeting the requirements in section 115.73, or 
52.33 	the personnel requirements in the national standard pursuant to subdivision 2a.
52.34 	A laboratory applying for this exemption shall not apply for simultaneous 
52.35 	accreditation under the national standard.

53.1 	Sec. 13. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 
53.2 	to read:
53.3 		Subd. 9.Exemption from national standards for proficiency testing frequency.
 53.4 	(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under 
53.5 	the exemption in subdivision 8 must obtain an acceptable proficiency test result for each 
53.6 	of the laboratory's accredited or requested fields of testing. The laboratory must analyze 
53.7 	proficiency samples selected from one of two annual proficiency testing studies scheduled 
53.8 	by the commissioner.
53.9 	(b) If a laboratory fails to successfully complete the first scheduled proficiency 
53.10 	study, the laboratory shall:
53.11 	(1) obtain and analyze a supplemental test sample within 15 days of receiving the 
53.12 	test report for the initial failed attempt; and
53.13 	(2) participate in the second annual study as scheduled by the commissioner.
53.14 	(c) If a laboratory does not submit results or fails two consecutive proficiency 
53.15 	samples, the commissioner will revoke the laboratory's accreditation for the affected 
53.16 	fields of testing.
53.17 	(d) The commissioner may require a laboratory to analyze additional proficiency 
53.18 	testing samples beyond what is required in this subdivision if information available to 
53.19 	the commissioner indicates that the laboratory's analysis for the field of testing does not 
53.20 	meet the requirements for accreditation.
53.21 	(e) The commissioner may collect from laboratories accredited under the exemption 
53.22 	in subdivision 8 any additional costs required to administer this subdivision and 
53.23 	subdivision 8.

53.24 	Sec. 14. Minnesota Statutes 2010, section 144A.102, is amended to read:
53.25 	144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS; 
53.26 	PENALTIES.
53.27 	(a) By January 2000, the commissioner of health shall work with providers to 
53.28 	examine state and federal rules and regulations governing the provision of care in licensed 
53.29 	nursing facilities and apply for federal waivers and identify necessary changes in state 
53.30 	law to:
53.31 	(1) allow the use of civil money penalties imposed upon nursing facilities to abate 
53.32 	any deficiencies identified in a nursing facility's plan of correction; and
53.33 	(2) stop the accrual of any fine imposed by the Health Department when a follow-up 
53.34 	inspection survey is not conducted by the department within the regulatory deadline.
54.1 	(b) By January 2012, the commissioner of health shall work with providers and 
54.2 	the ombudsman for long-term care to examine state and federal rules and regulations 
54.3 	governing the provision of care in licensed nursing facilities and apply for federal waivers 
54.4 	and identify necessary changes in state law to:
54.5 	(1) eliminate the requirement for written plans of correction from nursing homes for 
54.6 	federal deficiencies issued at a scope and severity that is not widespread, harmful, or in 
54.7 	immediate jeopardy; and
54.8 	(2) issue the federal survey form electronically to nursing homes.
54.9 	The commissioner shall issue a report to the legislative chairs of the committees 
54.10 	with jurisdiction over health and human services by January 31, 2012, on the status of 
54.11 	implementation of this paragraph.

54.12 	Sec. 15. Minnesota Statutes 2010, section 144A.61, is amended by adding a 
54.13 	subdivision to read:
54.14 		Subd. 9.Electronic transmission. The commissioner of health must accept 
54.15 	electronic transmission of applications and supporting documentation for interstate 
54.16 	endorsement for the nursing assistant registry.

54.17 	Sec. 16. Minnesota Statutes 2010, section 144E.123, is amended to read:
54.18 	144E.123 PREHOSPITAL CARE DATA.
54.19 		Subdivision 1.Collection and maintenance. A licensee shall collect and provide 
54.20 	prehospital care data to the board in a manner prescribed by the board. At a minimum, 
54.21 	the data must include items identified by the board that are part of the National Uniform 
54.22 	Emergency Medical Services Data Set. A licensee shall maintain prehospital care data 
54.23 	for every response.
54.24 		Subd. 2.Copy to receiving hospital. If a patient is transported to a hospital, a copy 
54.25 	of the ambulance report delineating prehospital medical care given shall be provided 
54.26 	to the receiving hospital.
54.27 		Subd. 3.Review. Prehospital care data may be reviewed by the board or its 
54.28 	designees. The data shall be classified as private data on individuals under chapter 13, the 
54.29 	Minnesota Government Data Practices Act.
54.30 		Subd. 4.Penalty. Failure to report all information required by the board under this 
54.31 	section shall constitute grounds for license revocation.
54.32 		Subd. 5.Working group. By October 1, 2011, the board must convene a working 
54.33 	group composed of six members, three of which must be appointed by the board and three 
54.34 	of which must be appointed by the Minnesota Ambulance Association, to redesign the 
55.1 	board's policies related to collection of data from licenses. The issues to be considered 
55.2 	include, but are not limited to, the following: user-friendly reporting requirements; data 
55.3 	sets; improved accuracy of reported information; appropriate use of information gathered 
55.4 	through the reporting system; and methods for minimizing the financial impact of data 
55.5 	reporting on licenses, particularly for rural volunteer services. The working group must 
55.6 	report its findings and recommendations to the board no later than July 1, 2012.

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

55.8 	Sec. 17. [145.4221] HUMAN CLONING PROHIBITED.
55.9 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms 
55.10 	have the meanings given.
55.11 	(b) "Human cloning" means human asexual reproduction accomplished by 
55.12 	introducing nuclear material from one or more human somatic cells into a fertilized 
55.13 	or unfertilized oocyte whose nuclear material has been removed or inactivated so as 
55.14 	to produce a living organism at any stage of development that is genetically virtually 
55.15 	identical to an existing or previously existing human organism.
55.16 	(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes, 
55.17 	obtained or derived from a living or deceased human body at any stage of development.
55.18 		Subd. 2.Prohibition on cloning. No person or entity, whether public or private, 
55.19 	may:
55.20 	(1) perform or attempt to perform human cloning;
55.21 	(2) participate in an attempt to perform human cloning;
55.22 	(3) ship, import, or receive for any purpose an embryo produced by human cloning 
55.23 	or any product derived from such an embryo; or 
55.24 	(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic 
55.25 	cell, for the purpose of human cloning.
55.26 		Subd. 3.Scientific research. Nothing in this section shall restrict areas of scientific 
55.27 	research not specifically prohibited by this section, including research in the use of nuclear 
55.28 	transfer or other cloning techniques to produce molecules, DNA, cells other than human 
55.29 	embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this 
55.30 	section shall restrict, inhibit, or make unlawful the scientific field of stem cell research, 
55.31 	unless explicitly prohibited.
55.32 		Subd. 4.Penalties. Any person or entity that knowingly or recklessly violates 
55.33 	subdivision 2 is guilty of a misdemeanor.
55.34 		Subd. 5.Severability. If any provision, section, subdivision, sentence, clause, 
55.35 	phrase, or word in this section or the application thereof to any person or circumstance is 
56.1 	found to be unconstitutional, the same is hereby declared to be severable and the remainder 
56.2 	of this section shall remain effective notwithstanding such unconstitutional provision. The 
56.3 	legislature declares that it would have passed this section and each provision, subdivision, 
56.4 	sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section, 
56.5 	subdivision, sentence, clause, phrase, or word is declared unconstitutional.

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

56.8 	Sec. 18. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:
56.9 		Subdivision 1.Eligible organizations; purpose. The commissioner of health may, 
56.10 	within available appropriations, make special grants to cities, counties, groups of cities or 
56.11 	counties, or nonprofit corporations to provide prepregnancy family planning services.

56.12 	Sec. 19. Minnesota Statutes 2010, section 145.925, subdivision 2, is amended to read:
56.13 		Subd. 2.Prohibition. The commissioner shall not make special grants pursuant to 
56.14 	this section to any nonprofit corporation which performs abortions eligible organization 
56.15 	that performs abortions or provides referrals for abortion services. No state funds shall be 
56.16 	used under contract from a grantee to any nonprofit corporation which performs abortions. 
56.17 	This provision shall not apply to hospitals licensed pursuant to sections 144.50 to 144.56, 
56.18 	or health maintenance organizations certified pursuant to chapter 62D eligible organization 
56.19 	that performs abortions or provides referrals for abortion services. 

56.20 	Sec. 20. [145.9271] WHITE EARTH BAND URBAN CLINIC.
56.21 		Subdivision 1.Establish urban clinic. The White Earth Band of Ojibwe Indians 
56.22 	shall establish and operate one or more health care clinics in the Minneapolis area or 
56.23 	greater Minnesota to serve members of the White Earth Tribe and may use funds received 
56.24 	under this section for application to qualify as a federally qualified health center.
56.25 		Subd. 2.Grant agreements. Before receiving the funds under this section, the 
56.26 	White Earth Band of Ojibwe Indians is requested to submit to the commissioner of health 
56.27 	a work plan and budget that describes its annual plan for the funds. The commissioner will 
56.28 	incorporate the work plan and budget into a grant agreement between the commissioner 
56.29 	and the White Earth Band of Ojibwe Indians. Before each successive disbursement, the 
56.30 	White Earth Band of Ojibwe Indians is requested to submit a narrative progress report and 
56.31 	an expenditure report to the commissioner.

56.32 	Sec. 21. [145.9272] COMMUNITY MENTAL HEALTH CENTER GRANTS.
57.1 		Subdivision 1.Definitions. For purposes of this section, "community mental 
57.2 	health center" means an entity that is eligible for payment under section 256B.0625, 
57.3 	subdivision 5.
57.4 		Subd. 2.Allocation of subsidies. The commissioner of health shall distribute, from 
57.5 	money appropriated for this purpose, grants to community mental health centers operating 
57.6 	in the state on July 1 of the year 2011 and each subsequent year for community mental 
57.7 	health center services to low-income consumers and patients with mental illness. The 
57.8 	amount of each grant shall be in proportion to each community mental health center's 
57.9 	revenues received from state health care programs in the most recent calendar year for 
57.10 	which data is available.

57.11 	EFFECTIVE DATE. This section is effective July 1, 2011, or upon federal 
57.12 	approval of the funding mechanism set out in Minnesota Statutes, section 62J.692, 
57.13 	subdivision 11, whichever is later.

57.14 	Sec. 22. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
57.15 		Subd. 7.Community grant program; immunization rates and infant mortality 
57.16 	rates. (a) The commissioner shall, within available appropriations, award grants to 
57.17 	eligible applicants for local or regional projects and initiatives directed at reducing health 
57.18 	disparities in one or both of the following priority areas:
57.19 	(1) decreasing racial and ethnic disparities in infant mortality rates; or
57.20 	(2) increasing adult and child immunization rates in nonwhite racial and ethnic 
57.21 	populations.
57.22 	(b) The commissioner may award up to 20 percent of the funds available as planning 
57.23 	grants. Planning grants must be used to address such areas as community assessment, 
57.24 	coordination activities, and development of community supported strategies.
57.25 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
57.26 	social service organizations, community nonprofit organizations, community health 
57.27 	boards, tribal governments, and community clinics. Applicants must submit proposals to 
57.28 	the commissioner. A proposal must specify the strategies to be implemented to address 
57.29 	one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the 
57.30 	outcomes established according to subdivision 3.
57.31 	(d) The commissioner shall give priority to applicants who demonstrate that their 
57.32 	proposed project or initiative:
57.33 	(1) is supported by the community the applicant will serve;
57.34 	(2) is research-based or based on promising strategies;
57.35 	(3) is designed to complement other related community activities;
58.1 	(4) utilizes strategies that positively impact both priority areas;
58.2 	(5) reflects racially and ethnically appropriate approaches; and
58.3 	(6) will be implemented through or with community-based organizations that reflect 
58.4 	the race or ethnicity of the population to be reached.

58.5 	Sec. 23. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
58.6 		Subd. 8.Community grant program; other health disparities. (a) The 
58.7 	commissioner shall, within available appropriations, award grants to eligible applicants 
58.8 	for local or regional projects and initiatives directed at reducing health disparities in 
58.9 	one or more of the following priority areas:
58.10 	(1) decreasing racial and ethnic disparities in morbidity and mortality rates from 
58.11 	breast and cervical cancer;
58.12 	(2) decreasing racial and ethnic disparities in morbidity and mortality rates from 
58.13 	HIV/AIDS and sexually transmitted infections;
58.14 	(3) decreasing racial and ethnic disparities in morbidity and mortality rates from 
58.15 	cardiovascular disease;
58.16 	(4) decreasing racial and ethnic disparities in morbidity and mortality rates from 
58.17 	diabetes; or
58.18 	(5) decreasing racial and ethnic disparities in morbidity and mortality rates from 
58.19 	accidental injuries or violence.
58.20 	(b) The commissioner may award up to 20 percent of the funds available as planning 
58.21 	grants. Planning grants must be used to address such areas as community assessment, 
58.22 	determining community priority areas, coordination activities, and development of 
58.23 	community supported strategies.
58.24 	(c) Eligible applicants may include, but are not limited to, faith-based organizations, 
58.25 	social service organizations, community nonprofit organizations, community health 
58.26 	boards, and community clinics. Applicants shall submit proposals to the commissioner. 
58.27 	A proposal must specify the strategies to be implemented to address one or more of 
58.28 	the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes 
58.29 	established according to subdivision 3.
58.30 	(d) The commissioner shall give priority to applicants who demonstrate that their 
58.31 	proposed project or initiative:
58.32 	(1) is supported by the community the applicant will serve;
58.33 	(2) is research-based or based on promising strategies;
58.34 	(3) is designed to complement other related community activities;
58.35 	(4) utilizes strategies that positively impact more than one priority area;
59.1 	(5) reflects racially and ethnically appropriate approaches; and
59.2 	(6) will be implemented through or with community-based organizations that reflect 
59.3 	the race or ethnicity of the population to be reached.

59.4 	Sec. 24. [145.987] COMMUNITY HEALTH CENTERS DEVELOPMENT 
59.5 	GRANTS.
59.6 	(a) The commissioner of health shall award grants from money appropriated for this 
59.7 	purpose to expand community health centers, as defined in section 145.9269, subdivision 
59.8 	1, in the state through the establishment of new community health centers or sites in 
59.9 	areas defined as small rural areas or isolated rural areas according to the four category 
59.10 	classification of the Rural Urban Commuting Area system developed for the United States 
59.11 	Health Resources and Services Administration or serving underserved patient populations.
59.12 	(b) Grant funds may be used to pay for:
59.13 	(1) costs for an organization to develop and submit a proposal to the federal 
59.14 	government for the designation of a new community health center or site; and
59.15 	(2) costs of planning, designing, remodeling, constructing, or purchasing equipment 
59.16 	for a new center or site.
59.17 	Funds may not be used for operating costs.
59.18 	(c) The commissioner shall award grants on a competitive basis.

59.19 	EFFECTIVE DATE. This section is effective July 1, 2011, or upon federal 
59.20 	approval of the funding mechanism set out in Minnesota Statutes, section 62J.692, 
59.21 	subdivision 11, whichever is later.

59.22 	Sec. 25. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:
59.23 		Subd. 3.Requirements for programs; process. (a) Community health boards 
59.24 	and tribal governments that receive funding under this section must submit a plan to 
59.25 	the commissioner describing a multidisciplinary approach to targeted home visiting for 
59.26 	families. The plan must be submitted on forms provided by the commissioner. At a 
59.27 	minimum, the plan must include the following:
59.28 	(1) a description of outreach strategies to families prenatally or at birth;
59.29 	(2) provisions for the seamless delivery of health, safety, and early learning services;
59.30 	(3) methods to promote continuity of services when families move within the state;
59.31 	(4) a description of the community demographics;
59.32 	(5) a plan for meeting outcome measures; and
59.33 	(6) a proposed work plan that includes:
59.34 	(i) coordination to ensure nonduplication of services for children and families;
60.1 	(ii) a description of the strategies to ensure that children and families at greatest risk 
60.2 	receive appropriate services; and
60.3 	(iii) collaboration with multidisciplinary partners including public health, 
60.4 	ECFE, Head Start, community health workers, social workers, community home 
60.5 	visiting programs, school districts, and other relevant partners. Letters of intent from 
60.6 	multidisciplinary partners must be submitted with the plan.
60.7 	(b) Each program that receives funds must accomplish the following program 
60.8 	requirements:
60.9 	(1) use a community-based strategy to provide preventive and early intervention 
60.10 	home visiting services;
60.11 	(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 
60.12 	home visit must occur prenatally or as soon after birth as possible and must include a 
60.13 	public health nursing assessment by a public health nurse;
60.14 	(3) offer, at a minimum, information on infant care, child growth and development, 
60.15 	positive parenting, preventing diseases, preventing exposure to environmental hazards, 
60.16 	and support services available in the community;
60.17 	(4) provide information on and referrals to health care services, if needed, including 
60.18 	information on and assistance in applying for health care coverage for which the child or 
60.19 	family may be eligible; and provide information on preventive services, developmental 
60.20 	assessments, and the availability of public assistance programs as appropriate;
60.21 	(5) provide youth development programs when appropriate;
60.22 	(6) recruit home visitors who will represent, to the extent possible, the races, 
60.23 	cultures, and languages spoken by families that may be served;
60.24 	(7) train and supervise home visitors in accordance with the requirements established 
60.25 	under subdivision 4;
60.26 	(8) maximize resources and minimize duplication by coordinating or contracting 
60.27 	with local social and human services organizations, education organizations, and other 
60.28 	appropriate governmental entities and community-based organizations and agencies;
60.29 	(9) utilize appropriate racial and ethnic approaches to providing home visiting 
60.30 	services; and
60.31 	(10) connect eligible families, as needed, to additional resources available in the 
60.32 	community, including, but not limited to, early care and education programs, health or 
60.33 	mental health services, family literacy programs, employment agencies, social services, 
60.34 	and child care resources and referral agencies.
60.35 	(c) When available, programs that receive funds under this section must offer or 
60.36 	provide the family with a referral to center-based or group meetings that meet at least 
61.1 	once per month for those families identified with additional needs. The meetings must 
61.2 	focus on further enhancing the information, activities, and skill-building addressed during 
61.3 	home visitation; offering opportunities for parents to meet with and support each other; 
61.4 	and offering infants and toddlers a safe, nurturing, and stimulating environment for 
61.5 	socialization and supervised play with qualified teachers.
61.6 	(d) Funds available under this section shall not be used for medical services. The 
61.7 	commissioner shall establish an administrative cost limit for recipients of funds. The 
61.8 	outcome measures established under subdivision 6 must be specified to recipients of 
61.9 	funds at the time the funds are distributed.
61.10 	(e) Data collected on individuals served by the home visiting programs must remain 
61.11 	confidential and must not be disclosed by providers of home visiting services without a 
61.12 	specific informed written consent that identifies disclosures to be made. Upon request, 
61.13 	agencies providing home visiting services must provide recipients with information on 
61.14 	disclosures, including the names of entities and individuals receiving the information and 
61.15 	the general purpose of the disclosure. Prospective and current recipients of home visiting 
61.16 	services must be told and informed in writing that written consent for disclosure of data is 
61.17 	not required for access to home visiting services.
61.18 	(f) Upon initial contact with a family, programs that receive funding under this 
61.19 	section must receive permission from the family to share with other family service 
61.20 	providers information about services the family is receiving and unmet needs of the family 
61.21 	in order to select a lead agency for the family and coordinate available resources. For 
61.22 	purposes of this paragraph, the term "family service providers" includes local public 
61.23 	health, social services, school districts, Head Start programs, health care providers, and 
61.24 	other public agencies.

61.25 	Sec. 26. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision 
61.26 	to read:
61.27 		Subd. 7a.Limited food establishment. "Limited food establishment" means a food 
61.28 	and beverage service establishment that primarily provides beverages that consist of 
61.29 	combining dry mixes and water or ice for immediate service to the consumer. Limited 
61.30 	food establishments must use equipment and utensils that are nontoxic, durable, and retain 
61.31 	their characteristic qualities under normal use conditions and may request a variance for 
61.32 	plumbing requirements from the commissioner.

61.33 	EFFECTIVE DATE. This section is effective July 1, 2011, and applies to 
61.34 	applications for licensure submitted on or after that date.

62.1 	Sec. 27. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision 
62.2 	to read:
62.3 		Subd. 5.Variance requests. (a) A person may request a variance from all parts of 
62.4 	Minnesota Rules, chapter 4626, except as provided in paragraph (b) or Minnesota Rules, 
62.5 	chapter 4626. At the time of application for plan review, the person, operator, or submitter 
62.6 	must be notified of the right to request variances.
62.7 	(b) No variance may be requested or approved for the following parts of Minnesota 
62.8 	Rules, chapter 4626:
62.9 	(1) Minnesota Rules, part 4626.0020, subpart 35;
62.10 	(2) Minnesota Rules, parts 4626.0040 to 4626.0060;
62.11 	(3) Minnesota Rules, parts 4626.0065 to 4626.0100;
62.12 	(4) Minnesota Rules, parts 4626.0105 to 4626.0120;
62.13 	(5) Minnesota Rules, part 4626.1565;
62.14 	(6) Minnesota Rules, parts 4626.1590 and 4626.1595; and 
62.15 	(7) Minnesota Rules, parts 4626.1600 to 4626.1675.

62.16 	Sec. 28. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
62.17 		Subdivision 1.Tax and use tax on cigarettes. Revenue received from cigarette 
62.18 	taxes, as well as related penalties, interest, license fees, and miscellaneous sources of 
62.19 	revenue shall be deposited by the commissioner in the state treasury and credited as 
62.20 	follows:
62.21 	(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each 
62.22 	year thereafter must be credited to the Academic Health Center special revenue fund 
62.23 	hereby created and is annually appropriated to the Board of Regents at the University of 
62.24 	Minnesota for Academic Health Center funding at the University of Minnesota; and
62.25 	(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal yearyears 2007 and 
62.26 	each year thereafterthrough fiscal year 2011 and $6,244,000 each fiscal year thereafter 
62.27 	must be credited to the medical education and research costs account hereby created in 
62.28 	the special revenue fund and is annually appropriated to the commissioner of health for 
62.29 	distribution under section 62J.692, subdivision 4 or 11, as appropriate; and
62.30 	(3) the balance of the revenues derived from taxes, penalties, and interest (under 
62.31 	this chapter) and from license fees and miscellaneous sources of revenue shall be credited 
62.32 	to the general fund.

62.33 	Sec. 29. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY 
62.34 	RESPONSIBILITIES.
 63.1 	(a) The commissioner of health, in consultation with the commissioner of human 
63.2 	services, shall evaluate and recommend options for reorganizing health and human 
63.3 	services regulatory responsibilities in both agencies to provide better efficiency and 
63.4 	operational cost savings while maintaining the protection of the health, safety, and welfare 
63.5 	of the public. Regulatory responsibilities that are to be evaluated are those found in 
63.6 	Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B, 
63.7 	149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50, 
63.8 	144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
63.9 	(b) The evaluation and recommendations shall be submitted in a report to the 
63.10 	legislative committees with jurisdiction over health and human services no later than 
63.11 	February 15, 2012, and shall include, at a minimum, the following:
63.12 	(1) whether the regulatory responsibilities of each agency should be combined into 
63.13 	a separate agency;
63.14 	(2) whether the regulatory responsibilities of each agency should be merged into 
63.15 	an existing agency;
63.16 	(3) what cost savings would result by merging the activities regardless of where 
63.17 	they are located;
63.18 	(4) what additional costs would result if the activities were merged;
63.19 	(5) whether there are additional regulatory responsibilities in both agencies that 
63.20 	should be considered in any reorganization; and
63.21 	(6) for each option recommended, projected cost and a timetable and identification 
63.22 	of the necessary steps and requirements for a successful transition period.

63.23 	Sec. 30. STUDY OF FOR-PROFIT HEALTH MAINTENANCE 
63.24 	ORGANIZATIONS.
 63.25 	The commissioner of health shall contract with an entity with expertise in health 
63.26 	economics and health care delivery and quality to study the efficiency, costs, service 
63.27 	quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to 
63.28 	not-for-profit health maintenance organizations operating in Minnesota and other states. 
63.29 	The study findings must address whether the state of Minnesota could: (1) reduce medical 
63.30 	assistance and MinnesotaCare costs and costs of providing coverage to state employees; 
63.31 	and (2) maintain or improve the quality of care provided to state health care program 
63.32 	enrollees and state employees if for-profit health maintenance organizations were allowed 
63.33 	to operate in the state. The commissioner shall require the entity under contract to report 
63.34 	study findings to the commissioner and the legislature by January 15, 2012.

64.1 	Sec. 31. MINNESOTA TASK FORCE ON PREMATURITY.
 64.2 		Subdivision 1.Establishment. The Minnesota Task Force on Prematurity is 
64.3 	established to evaluate and make recommendations on methods for reducing prematurity 
64.4 	and improving premature infant health care in the state.
64.5 		Subd. 2.Membership; meetings; staff. (a) The task force shall be composed of at 
64.6 	least the following members, who serve at the pleasure of their appointing authority:
64.7 	(1) 15 representatives of the Minnesota Prematurity Coalition including, but not 
64.8 	limited to, health care providers who treat pregnant women or neonates, organizations 
64.9 	focused on preterm births, early childhood education and development professionals, and 
64.10 	families affected by prematurity;
64.11 	(2) one representative appointed by the commissioner of human services;
64.12 	(3) two representatives appointed by the commissioner of health;
64.13 	(4) one representative appointed by the commissioner of education; 
64.14 	(5) two members of the house of representatives, one appointed by the speaker of 
64.15 	the house and one appointed by the minority leader; and
64.16 	(6) two members of the senate, appointed according to the rules of the senate.
64.17 	(b) Members of the task force serve without compensation or payment of expenses.
64.18 	(c) The commissioner of health must convene the first meeting of the Minnesota 
64.19 	Task Force on Prematurity by July 31, 2011. The task force must continue to meet at 
64.20 	least quarterly. Staffing and technical assistance shall be provided by the Minnesota 
64.21 	Perinatal Coalition.
64.22 		Subd. 3.Duties. The task force must report the current state of prematurity in 
64.23 	Minnesota and develop recommendations on strategies for reducing prematurity and 
64.24 	improving premature infant health care in the state by considering the following:
64.25 	(1) standards of care for premature infants born less than 37 weeks gestational age, 
64.26 	including recommendations to improve hospital discharge and follow-up care procedures;
64.27 	(2) coordination of information among appropriate professional and advocacy 
64.28 	organizations on measures to improve health care for infants born prematurely;
64.29 	(3) identification and centralization of available resources to improve access and 
64.30 	awareness for caregivers of premature infants;
64.31 	(4) development and dissemination of evidence-based practices through networking 
64.32 	and educational opportunities; 
64.33 	(5) a review of relevant evidence-based research regarding the causes and effects of 
64.34 	premature births in Minnesota;
64.35 	(6) a review of relevant evidence-based research regarding premature infant health 
64.36 	care, including methods for improving quality of and access to care for premature infants;
65.1 	(7) a review of the potential improvements in health status related to the use of 
65.2 	health care homes to provide and coordinate pregnancy-related services; and
65.3 	(8) identification of gaps in public reporting measures and possible effects of these 
65.4 	measures on prematurity rates.
65.5 		Subd. 4.Report; expiration. (a) By November 30, 2011, the task force must submit 
65.6 	a report on the current state of prematurity in Minnesota to the chairs of the legislative 
65.7 	policy committees on health and human services.
65.8 	(b) By January 15, 2013, the task force must report its final recommendations, 
65.9 	including any draft legislation necessary for implementation, to the chairs of the legislative 
65.10 	policy committees on health and human services.
65.11 	(c) This task force expires on January 31, 2013, or upon submission of the final 
65.12 	report required in paragraph (b), whichever is earlier.

65.13 	Sec. 32. NURSING HOME REGULATORY EFFICIENCY.
 65.14 	The commissioner of health must work with long-term care providers, provider 
65.15 	associations, and consumer advocates to clarify for the benefit of providers, survey 
65.16 	teams, and investigators from the office of health facility complaints all of the situations 
65.17 	that providers must report and are required to report to the department under federal 
65.18 	certification regulations and to the common entry point under the Minnesota Vulnerable 
65.19 	Adults Act. The commissioner must produce decision trees, flow sheets, or other 
65.20 	reproducible materials to guide the parties and to reduce the number of unnecessary 
65.21 	reports.

65.22 	Sec. 33.  REPEALER.
 65.23 	(a) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; 
65.24 	62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; 144.1464; 144.147; and 
65.25 	144.1499, are repealed.
65.26 	(b) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 
65.27 	14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; 
65.28 	4651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.

65.29 	ARTICLE 3
65.30 	MISCELLANEOUS

65.31 	Section 1. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to 
65.32 	read:
66.1 		Subd. 4.Special family day care homes. Nonresidential child care programs 
66.2 	serving 14 or fewer children that are conducted at a location other than the license holder's 
66.3 	own residence shall be licensed under this section and the rules governing family day 
66.4 	care or group family day care if:
66.5 	(a) the license holder is the primary provider of care and the nonresidential child 
66.6 	care program is conducted in a dwelling that is located on a residential lot;
66.7 	(b) the license holder is an employer who may or may not be the primary provider 
66.8 	of care, and the purpose for the child care program is to provide child care services to 
66.9 	children of the license holder's employees;
66.10 	(c) the license holder is a church or religious organization;
66.11 	(d) the license holder is a community collaborative child care provider. For 
66.12 	purposes of this subdivision, a community collaborative child care provider is a provider 
66.13 	participating in a cooperative agreement with a community action agency as defined in 
66.14 	section 256E.31; or
66.15 	(e) the license holder is a not-for-profit agency that provides child care in a dwelling 
66.16 	located on a residential lot and the license holder maintains two or more contracts with 
66.17 	community employers or other community organizations to provide child care services. 
66.18 	The county licensing agency may grant a capacity variance to a license holder licensed 
66.19 	under this paragraph to exceed the licensed capacity of 14 children by no more than five 
66.20 	children during transition periods related to the work schedules of parents, if the license 
66.21 	holder meets the following requirements:
66.22 	(1) the program does not exceed a capacity of 14 children more than a cumulative 
66.23 	total of four hours per day;
66.24 	(2) the program meets a one to seven staff-to-child ratio during the variance period;
66.25 	(3) all employees receive at least an extra four hours of training per year than 
66.26 	required in the rules governing family child care each year;
66.27 	(4) the facility has square footage required per child under Minnesota Rules, part 
66.28 	9502.0425;
66.29 	(5) the program is in compliance with local zoning regulations;
66.30 	(6) the program is in compliance with the applicable fire code as follows:
66.31 	(i) if the program serves more than five children older than 2-1/2 years of age, 
66.32 	but no more than five children 2-1/2 years of age or less, the applicable fire code is 
66.33 	educational occupancy, as provided in Group E Occupancy under the Minnesota State 
66.34 	Fire Code 2003, Section 202; or
67.1 	(ii) if the program serves more than five children 2-1/2 years of age or less, the 
67.2 	applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire 
67.3 	Code 2003, Section 202; and
67.4 	(7) any age and capacity limitations required by the fire code inspection and square 
67.5 	footage determinations shall be printed on the license.; or
67.6 	(f) the license holder is the primary provider of care and has located the licensed 
67.7 	child care program in a commercial space, if the license holder meets the following 
67.8 	requirements:
67.9 	(1) the program is in compliance with local zoning regulations;
67.10 	(2) the program is in compliance with the applicable fire code as follows:
67.11 	(i) if the program serves more than five children older than 2-1/2 years of age, 
67.12 	but no more than five children 2-1/2 years of age or less, the applicable fire code is 
67.13 	educational occupancy, as provided in Group E Occupancy under the Minnesota State 
67.14 	Fire Code 2003, Section 202; or
67.15 	(ii) if the program serves more than five children 2-1/2 years of age or less, the 
67.16 	applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire 
67.17 	Code 2003, Section 202;
67.18 	(3) any age and capacity limitations required by the fire code inspection and square 
67.19 	footage determinations are printed on the license; and
67.20 	(4) the license holder prominently displays the license issued by the commissioner 
67.21 	which contains the statement "This special family child care provider is not licensed as a 
67.22 	child care center."

67.23 	Sec. 2. Minnesota Statutes 2010, section 245C.03, is amended by adding a subdivision 
67.24 	to read:
67.25 		Subd. 7.Children's therapeutic services and supports providers. The 
67.26 	commissioner shall conduct background studies according to this chapter when initiated 
67.27 	by a children's therapeutic services and supports provider under section 256B.0943.

67.28 	Sec. 3. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision 
67.29 	to read:
67.30 		Subd. 8.Children's therapeutic services and supports providers. The 
67.31 	commissioner shall recover the cost of background studies required under section 
67.32 	245C.03, subdivision 7, for the purposes of children's therapeutic services and supports 
67.33 	under section 256B.0943, through a fee of no more than $20 per study charged to 
68.1 	the license holder. The fees collected under this subdivision are appropriated to the 
68.2 	commissioner for the purpose of conducting background studies.

68.3 	Sec. 4. Minnesota Statutes 2010, section 256B.04, subdivision 14a, is amended to read:
68.4 		Subd. 14a.Level of need determination. Nonemergency medical transportation 
68.5 	level of need determinations must be performed by a physician, a registered nurse working 
68.6 	under direct supervision of a physician, a physician's assistant, a nurse practitioner, a 
68.7 	licensed practical nurse, or a discharge planner.
68.8 	 Nonemergency medical transportation level of need determinations must not be 
68.9 	performed more than annually on any individual, unless the individual's circumstances 
68.10 	have sufficiently changed so as to require a new level of need determination. No entity 
68.11 	shall charge, and the commissioner shall pay, no more than $25 for performing a level of 
68.12 	need determination regarding any person receiving nonemergency medical transportation, 
68.13 	including special transportation.
68.14 	Special transportation services to eligible persons who need a stretcher-accessible 
68.15 	vehicle from an inpatient or outpatient hospital are exempt from a level of need 
68.16 	determination if the special transportation services have been ordered by the eligible 
68.17 	person's physician, registered nurse working under direct supervision of a physician, 
68.18 	physician's assistant, nurse practitioner, licensed practical nurse, or discharge planner 
68.19 	pursuant to Medicare guidelines.
68.20 	 Individuals transported to or residing in licensed nursing facilities are exempt from a 
68.21 	level of need determination and are eligible for special transportation services until the 
68.22 	individual no longer resides in a licensed nursing facility. If a person authorized by this 
68.23 	subdivision to perform a level of need determination determines that an individual requires 
68.24 	stretcher transportation, the individual is presumed to maintain that level of need until 
68.25 	otherwise determined by a person authorized to perform a level of need determination, or 
68.26 	for six months, whichever is sooner.

68.27 	Sec. 5. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 
68.28 	read:
68.29 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
68.30 	transportation costs incurred solely for obtaining emergency medical care or transportation 
68.31 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
68.32 	care when paid directly to an ambulance company, common carrier, or other recognized 
68.33 	providers of transportation services. Medical transportation must be provided by:
68.34 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
69.1 	(2) special transportation; or
69.2 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
69.3 	carrier, or private automobile.
69.4 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
69.5 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
69.6 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
69.7 	transportation, or private automobile.
69.8 	The commissioner may use an order by the recipient's attending physician to certify that 
69.9 	the recipient requires special transportation services. Special transportation providers 
69.10 	shall perform driver-assisted services for eligible individuals. Driver-assisted service 
69.11 	includes passenger pickup at and return to the individual's residence or place of business, 
69.12 	assistance with admittance of the individual to the medical facility, and assistance in 
69.13 	passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special 
69.14 	transportation providers must obtain written documentation from the health care service 
69.15 	provider who is serving the recipient being transported, identifying the time that the 
69.16 	recipient arrived. Special transportation providers may not bill for separate base rates for 
69.17 	the continuation of a trip beyond the original destination. Special transportation providers 
69.18 	must take recipients to the nearest appropriate health care provider, using the most direct 
69.19 	route as determined by a commercially available mileage software program approved by 
69.20 	the commissioner. The minimum medical assistance reimbursement rates for special 
69.21 	transportation services are:
69.22 	(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 
69.23 	eligible persons who need a wheelchair-accessible van;
69.24 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
69.25 	eligible persons who do not need a wheelchair-accessible van; and
69.26 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
69.27 	special transportation services to eligible persons who need a stretcher-accessible vehicle;
69.28 	(2) the base rates for special transportation services in areas defined under RUCA 
69.29 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
69.30 	11.3 percent; and
69.31 	(3) for special transportation services in areas defined under RUCA to be rural 
69.32 	or super rural areas:
69.33 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
69.34 	percent of the respective mileage rate in clause (1); and
69.35 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
69.36 	112.5 percent of the respective mileage rate in clause (1).
70.1 	(c) For purposes of reimbursement rates for special transportation services under 
70.2 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
70.3 	the urban, rural, or super rural reimbursement rate applies.
70.4 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
70.5 	means a census-tract based classification system under which a geographical area is 
70.6 	determined to be urban, rural, or super rural.

70.7 	Sec. 6. Minnesota Statutes 2010, section 256B.0943, is amended by adding a 
70.8 	subdivision to read:
70.9 		Subd. 5a.Background studies. The requirements for background studies under 
70.10 	this section may be met by a children's therapeutic services and supports services agency 
70.11 	through the commissioner's NETStudy system as provided under sections 245C.03, 
70.12 	subdivision 7, and 245C.10, subdivision 8.

70.13 	Sec. 7. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision 
70.14 	to read:
70.15 		Subd. 3a.Spousal contribution. (a) For purposes of this subdivision, the following 
70.16 	terms have the meanings given:
70.17 	(1) "commissioner" means the commissioner of human services;
70.18 	(2) "community spouse" means the spouse, who lives in the community, of an 
70.19 	individual receiving long-term care services in a long-term care facility or home care 
70.20 	services pursuant to the Medicaid waiver for elderly services under section 256B.0915 
70.21 	or the alternative care program under section 256B.0913. A community spouse does not 
70.22 	include a spouse living in the community who receives a monthly income allowance under 
70.23 	section 256B.058, subdivision 2, or who receives home and community-based services 
70.24 	under section 256B.0915, 256B.092, or 256B.49, or the alternative care program under 
70.25 	section 256B.0913;
70.26 	(3) "cost of care" means the actual fee-for-service costs or capitated payments for 
70.27 	the long-term care spouse;
70.28 	(4) "department" means the Department of Human Services;
70.29 	(5) "disabled child" means a blind or permanently and totally disabled son or 
70.30 	daughter of any age based on the Social Security Administration disability standards;
70.31 	(6) "income" means earned and unearned income, attributable to the community 
70.32 	spouse, used to calculate the adjusted gross income on the prior year's income tax return. 
70.33 	Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
71.1 	(7) "long-term care spouse" means the spouse who is receiving long-term care 
71.2 	services in a long-term care facility or home and community based services pursuant 
71.3 	to the Medicaid waiver for elderly services under section 256B.0915 or the alternative 
71.4 	care program under section 256B.0913.
71.5 	(b) The community spouse of a long-term care spouse who receives medical 
71.6 	assistance or alternative care services has an obligation to contribute to the cost of care. 
71.7 	The community spouse must pay a monthly fee on a sliding fee scale based on the 
71.8 	community spouse's income. If a minor or disabled child resides with and receives care 
71.9 	from the community spouse, then no fee shall be assessed.
71.10 	(c) For a community spouse with an income equal to or greater than 250 percent of 
71.11 	the federal poverty guidelines for a family of two and less than 545 percent of the federal 
71.12 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
71.13 	a sliding fee scale established by the commissioner that begins at 7.5 percent of the 
71.14 	community spouse's income and increases to 15 percent for those with an income of up to 
71.15 	545 percent of the federal poverty guidelines for a family of two.
71.16 	(d) For a community spouse with an income equal to or greater than 545 percent of 
71.17 	the federal poverty guidelines for a family of two and less than 750 percent of the federal 
71.18 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
71.19 	a sliding fee scale established by the commissioner that begins at 15 percent of the 
71.20 	community spouse's income and increases to 25 percent for those with an income of up to 
71.21 	750 percent of the federal poverty guidelines for a family of two.
71.22 	(e) For a community spouse with an income equal to or greater than 750 percent of 
71.23 	the federal poverty guidelines for a family of two and less than 975 percent of the federal 
71.24 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
71.25 	a sliding fee scale established by the commissioner that begins at 25 percent of the 
71.26 	community spouse's income and increases to 33 percent for those with an income of up to 
71.27 	975 percent of the federal poverty guidelines for a family of two.
71.28 	(f) For a community spouse with an income equal to or greater than 975 percent of 
71.29 	the federal poverty guidelines for a family of two, the spousal contribution shall be 33 
71.30 	percent of the community spouse's income.
71.31 	(g) The spousal contribution shall be explained in writing at the time eligibility 
71.32 	for medical assistance or alternative care is being determined. In addition to explaining 
71.33 	the formula used to determine the fee, the county or tribal agency shall provide written 
71.34 	information describing how to request a variance for undue hardship, how a contribution 
71.35 	may be reviewed or redetermined, the right to appeal a contribution determination, and 
71.36 	that the consequences for not complying with a request to provide information shall be 
72.1 	an assessment against the community spouse for the full cost of care for the long-term 
72.2 	care spouse.
72.3 	(h) The contribution shall be assessed for each month the long-term care spouse 
72.4 	has a community spouse and is eligible for medical assistance payment of long-term 
72.5 	care services or alternative care.
72.6 	(i) The spousal contribution shall be reviewed at least once every 12 months and 
72.7 	when there is a loss or gain in income in excess of ten percent. Thirty days prior to a 
72.8 	review or redetermination, written notice must be provided to the community spouse 
72.9 	and must contain the amount the spouse is required to contribute, notice of the right to 
72.10 	redetermination and appeal, and the telephone number of the division at the agency that is 
72.11 	responsible for redetermination and review. If, after review, the contribution amount is to 
72.12 	be adjusted, the county or tribal agency shall mail a written notice to the community spouse 
72.13 	30 days in advance of the effective date of the change in the amount of the contribution.
72.14 	(1) The spouse shall notify the county or tribal agency within 30 days of a gain or 
72.15 	loss in income in excess of ten percent and provide the agency supporting documentation 
72.16 	to verify the need for redetermination of the fee.
72.17 	(2) When a spouse requests a review or redetermination of the contribution amount, 
72.18 	a request for information shall be sent to the spouse within ten calendar days after the 
72.19 	county or tribal agency receives the request for review.
72.20 	(3) No action shall be taken on a review or redetermination until the required 
72.21 	information is received by the county or tribal agency.
72.22 	(4) The review of the spousal contribution shall be completed within ten days after 
72.23 	the county or tribal agency receives completed information that verifies a loss or gain in 
72.24 	income in excess of ten percent.
72.25 	(5) An increase in the contribution amount is effective in the month in which the 
72.26 	increase in income occurs.
72.27 	(6) A decrease in the contribution amount is effective in the month the spouse 
72.28 	verifies the reduction in income, retroactive to no longer than six months.
72.29 	(j) In no case shall the spousal contribution exceed the amount of medical assistance 
72.30 	expended or the cost of alternative care services for the care of the long-term care spouse. 
72.31 	Annually, upon redetermination, or at termination of eligibility, the total amount of 
72.32 	medical assistance paid or costs of alternative care for the care of the long-term care spouse 
72.33 	and the total amount of the spousal contribution shall be compared. If the total amount 
72.34 	of the spousal contribution exceeds the total amount of medical assistance expended or 
72.35 	cost of alternative care, then the agency shall reimburse the community spouse the excess 
73.1 	amount if the long-term care spouse is no longer receiving services, or apply the excess 
73.2 	amount to the spousal contribution due until the excess amount is exhausted.
73.3 	(k) A community spouse may request a variance by submitting a written request 
73.4 	and supporting documentation that payment of the calculated contribution would cause 
73.5 	an undue hardship. An undue hardship is defined as the inability to pay the calculated 
73.6 	contribution due to medical expenses incurred by the community spouse. Documentation 
73.7 	must include proof of medical expenses incurred by the community spouse since the last 
73.8 	annual redetermination of the contribution amount that are not reimbursable by any public 
73.9 	or private source, and are a type, regardless of amount, that would be allowable as a 
73.10 	federal tax deduction under the Internal Revenue Code.
73.11 	(1) A spouse who requests a variance from a notice of an increase in the amount 
73.12 	of spousal contribution shall continue to make monthly payments at the lower amount 
73.13 	pending determination of the variance request. A spouse who requests a variance from 
73.14 	the initial determination shall not be required to make a payment pending determination 
73.15 	of the variance request. Payments made pending outcome of the variance request that 
73.16 	result in overpayment must be returned to the spouse, if the long-term care spouse is no 
73.17 	longer receiving services, or applied to the spousal contribution in the current year. If the 
73.18 	variance is denied, the spouse shall pay the additional amount due from the effective date 
73.19 	of the increase or the total amount due from the effective date of the original notice of 
73.20 	determination of the spousal contribution.
73.21 	(2) A spouse who is granted a variance shall sign a written agreement in which the 
73.22 	spouse agrees to report to the county or tribal agency any changes in circumstances that 
73.23 	gave rise to the undue hardship variance.
73.24 	(3) When the county or tribal agency receives a request for a variance, written notice 
73.25 	of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days 
73.26 	after the county or tribal agency receives the financial information required in this clause. 
73.27 	The granting of a variance will necessitate a written agreement between the spouse and the 
73.28 	county or tribal agency with regard to the specific terms of the variance. The variance 
73.29 	will not become effective until the written agreement is signed by the spouse. If the 
73.30 	county or tribal agency denies in whole or in part the request for a variance, the denial 
73.31 	notice shall set forth in writing the reasons for the denial that address the specific hardship 
73.32 	and right to appeal.
73.33 	(4) If a variance is granted, the term of the variance shall not exceed 12 months 
73.34 	unless otherwise determined by the county or tribal agency.
73.35 	(5) Undue hardship does not include action taken by a spouse which divested or 
73.36 	diverted income in order to avoid being assessed a spousal contribution.
74.1 	(l) A spouse aggrieved by an action under this subdivision has the right to appeal 
74.2 	under subdivision 4. If the spouse appeals on or before the effective date of an increase 
74.3 	in the spousal fee, the spouse shall continue to make payments to the county or tribal 
74.4 	agency in the lower amount while the appeal is pending. A spouse appealing an initial 
74.5 	determination of a spousal contribution shall not be required to make monthly payments 
74.6 	pending an appeal decision. Payments made that result in an overpayment shall be 
74.7 	reimbursed to the spouse if the long-term care spouse is no longer receiving services, or 
74.8 	applied to the spousal contribution remaining in the current year. If the county or tribal 
74.9 	agency's determination is affirmed, the community spouse shall pay within 90 calendar 
74.10 	days of the order the total amount due from the effective date of the original notice of 
74.11 	determination of the spousal contribution. The commissioner's order is binding on the 
74.12 	spouse and the agency and shall be implemented subject to section 256.045, subdivision 7. 
74.13 	No additional notice is required to enforce the commissioner's order.
74.14 	(m) If the county or tribal agency finds that notice of the payment obligation was 
74.15 	given to the community spouse and the spouse was determined to be able to pay, but that 
74.16 	the spouse failed or refused to pay, a cause of action exists against the community spouse 
74.17 	for that portion of medical assistance payment of long-term care services or alternative 
74.18 	care services granted after notice was given to the community spouse. The action may be 
74.19 	brought by the county or tribal agency in the county where assistance was granted for the 
74.20 	assistance together with the costs of disbursements incurred due to the action. In addition 
74.21 	to granting the county or tribal agency a money judgment, the court may, upon a motion or 
74.22 	order to show cause, order continuing contributions by a community spouse found able to 
74.23 	repay the county or tribal agency. The order shall be effective only for the period of time 
74.24 	during which a contribution shall be assessed.
74.25 	(n) Counties and tribes are entitled to one-half of the nonfederal share of 
74.26 	contributions made under this section for long-term care spouses on medical assistance 
74.27 	that are directly attributed to county or tribal efforts. Counties and tribes are entitled to 
74.28 	25 percent of the contributions made under this section for long-term care spouses on 
74.29 	alternative care directly attributed to county or tribal efforts.

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

74.31 	Sec. 8. Minnesota Statutes 2010, section 326B.175, is amended to read:
74.32 	326B.175 ELEVATORS, ENTRANCES SEALED.
74.33 	Except as provided in section 326B.188, it shall be the duty of the department and 
74.34 	the licensing authority of any municipality which adopts any such ordinance whenever 
75.1 	it finds any such elevator under its jurisdiction in use in violation of any provision of 
75.2 	sections 326B.163 to 326B.178 to seal the entrances of such elevator and attach a notice 
75.3 	forbidding the use of such elevator until the provisions thereof are complied with.

75.4 	Sec. 9. [326B.188] COMPLIANCE WITH ELEVATOR CODE CHANGES.
75.5 	(a) This section applies to code requirements for existing elevators and related 
75.6 	devices under Minnesota Rules, chapter 1307, where the deadline set by law for meeting 
75.7 	the code requirements is January 29, 2012, or later.
75.8 	(b) If the department or municipality conducting elevator inspections within its 
75.9 	jurisdiction notifies the owner of an existing elevator or related device of the code 
75.10 	requirements before the effective date of this section, the owner may submit a compliance 
75.11 	plan by December 30, 2011. If the department or municipality does not notify the owner 
75.12 	of an existing elevator or related device of the code requirements before the effective 
75.13 	date of this section, the department or municipality shall notify the owner of the code 
75.14 	requirements and permit the owner to submit a compliance plan by December 30, 2011, or 
75.15 	within 60 days after the date of notification, whichever is later.
75.16 	(c) Any compliance plan submitted under this section must result in compliance with 
75.17 	the code requirements by the later of January 29, 2012, or three years after submission of 
75.18 	the compliance plan. Elevators and related devices that are not in compliance with the 
75.19 	code requirements by the later of January 29, 2012, or three years after the submission of 
75.20 	the compliance plan may be taken out of service as provided in section 326B.175.

75.21 	Sec. 10. NONEMERGENCY MEDICAL TRANSPORTATION SINGLE 
75.22 	ADMINISTRATIVE STRUCTURE PROPOSAL.
 75.23 	(a) The commissioner of human services shall develop a proposal to create a single 
75.24 	administrative structure for providing nonemergency medical transportation services to 
75.25 	fee-for-service medical assistance recipients. This proposal must consolidate access and 
75.26 	special transportation into one administrative structure with the goal of standardizing 
75.27 	eligibility determination processes, scheduling arrangements, billing procedures, data 
75.28 	collection, and oversight mechanisms in order to enhance coordination, improve 
75.29 	accountability, and lessen confusion.
75.30 	(b) In developing the proposal, the commissioner shall:
75.31 	(1) examine the current responsibilities performed by the counties and the 
75.32 	Department of Human Services and consider the shift in costs if these responsibilities are 
75.33 	changed;
76.1 	(2) identify key performance measures to assess the cost effectiveness of 
76.2 	nonemergency medical transportation statewide, including a process to collect, audit, 
76.3 	and report data;
76.4 	(3) develop a statewide complaint system for medical assistance recipients using 
76.5 	special transportation;
76.6 	(4) establish a standardized billing process;
76.7 	(5) establish a process that provides public input from interested parties before 
76.8 	special transportation eligibility policies are implemented or significantly changed;
76.9 	(6) establish specific eligibility criteria that include the frequency of eligibility 
76.10 	assessments and the length of time a recipient remains eligible for special transportation;
76.11 	(7) develop a reimbursement method to compensate volunteers for no-load miles 
76.12 	when transporting recipients to or from health-related appointments; and
76.13 	(8) establish specific eligibility criteria to maximize the use of public transportation 
76.14 	by recipients who are without a physical, mental, or other impairment that would prohibit 
76.15 	safely accessing and using public transportation.
76.16 	(c) In developing the proposal, the commissioner shall consult with the 
76.17 	nonemergency medical transportation advisory council established under paragraph (d).
76.18 	(d) The commissioner shall establish the nonemergency medical transportation 
76.19 	advisory council to assist the commissioner in developing a single administrative structure 
76.20 	for providing nonemergency medical transportation services. The council shall be 
76.21 	comprised of: 
76.22 	(1) one representative each from the departments of human services and 
76.23 	transportation; 
76.24 	(2) one representative each from the following organizations: the Minnesota State 
76.25 	Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC 
76.26 	of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County 
76.27 	Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit 
76.28 	Association, legal aid, the Minnesota Ambulance Association, the National Alliance on 
76.29 	Mental Illness, Medical Transportation Management, and other transportation providers; 
76.30 	and
76.31 	(3) four members from the house of representatives, two from the majority party 
76.32 	and two from the minority party, appointed by the speaker, and four members from the 
76.33 	senate, two from the majority party and two from the minority party, appointed by the 
76.34 	Subcommittee on Committees of the Committee on Rules and Administration.
77.1 	The council is governed by Minnesota Statutes, section 15.509, except that members 
77.2 	shall not receive per diems. The commissioner of human services shall fund all costs 
77.3 	related to the council from existing resources.
77.4 	(e) The commissioner shall submit the proposal and draft legislation necessary for 
77.5 	implementation to the chairs and ranking minority members of the senate and house of 
77.6 	representatives committees or divisions with jurisdiction over health care policy and 
77.7 	finance by January 15, 2012.

77.8 	ARTICLE 4
77.9 	HEALTH RELATED LICENSING

77.10 	Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:
77.11 		Subdivision 1.Renewal fees. All persons practicing chiropractic within this state, 
77.12 	or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the 
77.13 	Board of Chiropractic Examiners a renewal fee set by the board in accordance with section 
77.14 	16A.1283, with a penalty set by the board for each month or portion thereof for which a 
77.15 	license fee is in arrears and upon payment of the renewal and upon compliance with all the 
77.16 	rules of the board, shall be entitled to renewal of their license.

77.17 	Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision 
77.18 	to read:
77.19 		Subd. 4.Animal chiropractic. (a) Animal chiropractic registration fee is $125.
77.20 	(b) Animal chiropractic registration renewal fee is $75.
77.21 	(c) Animal chiropractic inactive renewal fee is $25.

77.22 	Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
77.23 		Subd. 2.Powers. (a) The board is authorized to adopt and, from time to time, revise 
77.24 	rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 
77.25 	provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula 
77.26 	and standards for schools and courses preparing persons for licensure under sections 
77.27 	148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses 
77.28 	at such times as it may deem necessary. It shall approve such schools and courses as 
77.29 	meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine, 
77.30 	license, and renew the license of duly qualified applicants. It shall hold examinations 
77.31 	at least once in each year at such time and place as it may determine. It shall by rule 
77.32 	adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for 
77.33 	registration and renewal of registration as defined in section 148.231. It shall maintain a 
78.1 	record of all persons licensed by the board to practice professional or practical nursing and 
78.2 	all registered nurses who hold Minnesota licensure and registration and are certified as 
78.3 	advanced practice registered nurses. It shall cause the prosecution of all persons violating 
78.4 	sections 148.171 to 148.285 and have power to incur such necessary expense therefor. 
78.5 	It shall register public health nurses who meet educational and other requirements 
78.6 	established by the board by rule, including payment of a fee. Prior to the adoption of rules, 
78.7 	the board shall use the same procedures used by the Department of Health to certify public 
78.8 	health nurses. It shall have power to issue subpoenas, and to compel the attendance of 
78.9 	witnesses and the production of all necessary documents and other evidentiary material. 
78.10 	Any board member may administer oaths to witnesses, or take their affirmation. It shall 
78.11 	keep a record of all its proceedings. 
78.12 	(b) The board shall have access to hospital, nursing home, and other medical records 
78.13 	of a patient cared for by a nurse under review. If the board does not have a written consent 
78.14 	from a patient permitting access to the patient's records, the nurse or facility shall delete 
78.15 	any data in the record that identifies the patient before providing it to the board. The board 
78.16 	shall have access to such other records as reasonably requested by the board to assist the 
78.17 	board in its investigation. Nothing herein may be construed to allow access to any records 
78.18 	protected by section 145.64. The board shall maintain any records obtained pursuant to 
78.19 	this paragraph as investigative data under chapter 13. 
78.20 	(c) The board may accept and expend grants or gifts of money or in-kind services 
78.21 	from a person, a public or private entity, or any other source for purposes consistent with 
78.22 	the board's role and within the scope of its statutory authority.
78.23 	(d) The board may accept registration fees for meetings and conferences conducted 
78.24 	for the purposes of board activities that are within the scope of its authority.

78.25 	Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
78.26 		Subdivision 1.Issuance. Upon receipt of the applicable licensure or reregistration 
78.27 	fee and permit fee, and in accordance with rules of the board, the board may issue 
78.28 	a nonrenewable temporary permit to practice professional or practical nursing to an 
78.29 	applicant for licensure or reregistration who is not the subject of a pending investigation 
78.30 	or disciplinary action, nor disqualified for any other reason, under the following 
78.31 	circumstances:
78.32 	(a) The applicant for licensure by examination under section 148.211, subdivision 
78.33 	1, has graduated from an approved nursing program within the 60 days preceding board 
78.34 	receipt of an affidavit of graduation or transcript and has been authorized by the board to 
78.35 	write the licensure examination for the first time in the United States. The permit holder 
79.1 	must practice professional or practical nursing under the direct supervision of a registered 
79.2 	nurse. The permit is valid from the date of issue until the date the board takes action on 
79.3 	the application or for 60 days whichever occurs first. 
79.4 	(b) The applicant for licensure by endorsement under section 148.211, subdivision 2, 
79.5 	is currently licensed to practice professional or practical nursing in another state, territory, 
79.6 	or Canadian province. The permit is valid from submission of a proper request until the 
79.7 	date of board action on the application or for 60 days, whichever comes first. 
79.8 	(c) (b) The applicant for licensure by endorsement under section 148.211, 
79.9 	subdivision 2, or for reregistration under section 148.231, subdivision 5, is currently 
79.10 	registered in a formal, structured refresher course or its equivalent for nurses that includes 
79.11 	clinical practice. 
79.12 	(d) The applicant for licensure by examination under section 148.211, subdivision 
79.13 	1, who graduated from a nursing program in a country other than the United States or 
79.14 	Canada has completed all requirements for licensure except registering for and taking the 
79.15 	nurse licensure examination for the first time in the United States. The permit holder must 
79.16 	practice professional nursing under the direct supervision of a registered nurse. The permit 
79.17 	is valid from the date of issue until the date the board takes action on the application or for 
79.18 	60 days, whichever occurs first. 

79.19 	Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:
79.20 	148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 
79.21 	VERIFICATION.
79.22 		Subdivision 1.Registration. Every person licensed to practice professional or 
79.23 	practical nursing must maintain with the board a current registration for practice as a 
79.24 	registered nurse or licensed practical nurse which must be renewed at regular intervals 
79.25 	established by the board by rule. No certificate of registration shall be issued by the board 
79.26 	to a nurse until the nurse has submitted satisfactory evidence of compliance with the 
79.27 	procedures and minimum requirements established by the board.
79.28 	The fee for periodic registration for practice as a nurse shall be determined by the 
79.29 	board by rule law. A penalty fee shall be added for any application received after the 
79.30 	required date as specified by the board by rule. Upon receipt of the application and the 
79.31 	required fees, the board shall verify the application and the evidence of completion of 
79.32 	continuing education requirements in effect, and thereupon issue to the nurse a certificate 
79.33 	of registration for the next renewal period.
80.1 		Subd. 4.Failure to register. Any person licensed under the provisions of sections 
80.2 	148.171 to 148.285 who fails to register within the required period shall not be entitled to 
80.3 	practice nursing in this state as a registered nurse or licensed practical nurse. 
80.4 		Subd. 5.Reregistration. A person whose registration has lapsed desiring to 
80.5 	resume practice shall make application for reregistration, submit satisfactory evidence of 
80.6 	compliance with the procedures and requirements established by the board, and pay the 
80.7 	registration reregistration fee for the current period to the board. A penalty fee shall be 
80.8 	required from a person who practiced nursing without current registration. Thereupon, the
80.9 	registration certificate shall be issued to the person who shall immediately be placed on 
80.10 	the practicing list as a registered nurse or licensed practical nurse.
80.11 		Subd. 6.Verification. A person licensed under the provisions of sections 148.171 to 
80.12 	148.285 who requests the board to verify a Minnesota license to another state, territory, 
80.13 	or country or to an agency, facility, school, or institution shall pay a fee to the board
80.14 	for each verification. 

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

80.18 	Sec. 7. [148.243] FEE AMOUNTS.
80.19 		Subdivision 1.Licensure by examination. The fee for licensure by examination is 
80.20 	$105.
80.21 		Subd. 2.Reexamination fee. The reexamination fee is $60.
80.22 		Subd. 3.Licensure by endorsement. The fee for licensure by endorsement is $105.
80.23 		Subd. 4.Registration renewal. The fee for registration renewal is $85.
80.24 		Subd. 5.Reregistration. The fee for reregistration is $105.
80.25 		Subd. 6.Replacement license. The fee for a replacement license is $20.
80.26 		Subd. 7.Public health nurse certification. The fee for public health nurse 
80.27 	certification is $30.
80.28 		Subd. 8.Drug Enforcement Administration verification for Advanced Practice 
80.29 	Registered Nurse (APRN). The Drug Enforcement Administration verification for 
80.30 	APRN is $50.
80.31 		Subd. 9.Licensure verification other than through Nursys. The fee for 
80.32 	verification of licensure status other than through Nursys verification is $20.
80.33 		Subd. 10.Verification of examination scores. The fee for verification of 
80.34 	examination scores is $20.
81.1 		Subd. 11.Microfilmed licensure application materials. The fee for a copy of 
81.2 	microfilmed licensure application materials is $20.
81.3 		Subd. 12.Nursing business registration; initial application. The fee for the initial 
81.4 	application for nursing business registration is $100.
81.5 		Subd. 13.Nursing business registration; annual application. The fee for the 
81.6 	annual application for nursing business registration is $25.
81.7 		Subd. 14.Practicing without current registration. The fee for practicing without 
81.8 	current registration is two times the amount of the current registration renewal fee for any 
81.9 	part of the first calendar month, plus the current registration renewal fee for any part of 
81.10 	any subsequent month up to 24 months.
81.11 		Subd. 15.Practicing without current APRN certification. The fee for practicing 
81.12 	without current APRN certification is $200 for the first month or any part thereof, plus 
81.13 	$100 for each subsequent month or part thereof.
81.14 		Subd. 16.Dishonored check fee. The service fee for a dishonored check is as 
81.15 	provided in section 604.113.
81.16 		Subd. 17.Border state registry fee. The initial application fee for border state 
81.17 	registration is $50. Any subsequent notice of employment change to remain or be 
81.18 	reinstated on the registry is $50.

81.19 	Sec. 8. [148.2855] NURSE LICENSURE COMPACT.
81.20 	The Nurse Licensure Compact is enacted into law and entered into with all other 
81.21 	jurisdictions legally joining in it, in the form substantially as follows:
81.22 	ARTICLE 1
81.23 	DEFINITIONS
81.24 	As used in this compact:
81.25 	(a) "Adverse action" means a home or remote state action.
81.26 	(b) "Alternative program" means a voluntary, nondisciplinary monitoring program 
81.27 	approved by a nurse licensing board.
81.28 	(c) "Coordinated licensure information system" means an integrated process for 
81.29 	collecting, storing, and sharing information on nurse licensure and enforcement activities 
81.30 	related to nurse licensure laws, which is administered by a nonprofit organization 
81.31 	composed of and controlled by state nurse licensing boards.
81.32 	(d) "Current significant investigative information" means:
81.33 	(1) investigative information that a licensing board, after a preliminary inquiry that 
81.34 	includes notification and an opportunity for the nurse to respond if required by state law, 
82.1 	has reason to believe is not groundless and, if proved true, would indicate more than a 
82.2 	minor infraction; or
82.3 	(2) investigative information that indicates that the nurse represents an immediate 
82.4 	threat to public health and safety regardless of whether the nurse has been notified and 
82.5 	had an opportunity to respond.
82.6 	(e) "Home state" means the party state which is the nurse's primary state of residence.
82.7 	(f) "Home state action" means any administrative, civil, equitable, or criminal 
82.8 	action permitted by the home state's laws which are imposed on a nurse by the home 
82.9 	state's licensing board or other authority including actions against an individual's license 
82.10 	such as revocation, suspension, probation, or any other action which affects a nurse's 
82.11 	authorization to practice.
82.12 	(g) "Licensing board" means a party state's regulatory body responsible for issuing 
82.13 	nurse licenses.
82.14 	(h) "Multistate licensure privilege" means current, official authority from a 
82.15 	remote state permitting the practice of nursing as either a registered nurse or a licensed 
82.16 	practical/vocational nurse in the party state. All party states have the authority, according 
82.17 	to existing state due process law, to take actions against the nurse's privilege such as 
82.18 	revocation, suspension, probation, or any other action which affects a nurse's authorization 
82.19 	to practice.
82.20 	(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those 
82.21 	terms are defined by each party state's practice laws.
82.22 	(j) "Party state" means any state that has adopted this compact.
82.23 	(k) "Remote state" means a party state other than the home state:
82.24 	(1) where the patient is located at the time nursing care is provided; or
82.25 	(2) in the case of the practice of nursing not involving a patient, in the party state 
82.26 	where the recipient of nursing practice is located.
82.27 	(l) "Remote state action" means:
82.28 	(1) any administrative, civil, equitable, or criminal action permitted by a remote 
82.29 	state's laws which are imposed on a nurse by the remote state's licensing board or other 
82.30 	authority including actions against an individual's multistate licensure privilege to practice 
82.31 	in the remote state; and
82.32 	(2) cease and desist and other injunctive or equitable orders issued by remote states 
82.33 	or the licensing boards of those states.
82.34 	(m) "State" means a state, territory, or possession of the United States, the District of 
82.35 	Columbia, or the Commonwealth of Puerto Rico.
83.1 	(n) "State practice laws" means individual party state laws and regulations that 
83.2 	govern the practice of nursing, define the scope of nursing practice, and create the 
83.3 	methods and grounds for imposing discipline. State practice laws does not include the 
83.4 	initial qualifications for licensure or requirements necessary to obtain and retain a license, 
83.5 	except for qualifications or requirements of the home state.
83.6 	ARTICLE 2
83.7 	GENERAL PROVISIONS AND JURISDICTION
83.8 	(a) A license to practice registered nursing issued by a home state to a resident in 
83.9 	that state will be recognized by each party state as authorizing a multistate licensure 
83.10 	privilege to practice as a registered nurse in the party state. A license to practice licensed 
83.11 	practical/vocational nursing issued by a home state to a resident in that state will be 
83.12 	recognized by each party state as authorizing a multistate licensure privilege to practice 
83.13 	as a licensed practical/vocational nurse in the party state. In order to obtain or retain a 
83.14 	license, an applicant must meet the home state's qualifications for licensure and license 
83.15 	renewal as well as all other applicable state laws.
83.16 	(b) Party states may, according to state due process laws, limit or revoke the 
83.17 	multistate licensure privilege of any nurse to practice in their state and may take any other 
83.18 	actions under their applicable state laws necessary to protect the health and safety of 
83.19 	their citizens. If a party state takes such action, it shall promptly notify the administrator 
83.20 	of the coordinated licensure information system. The administrator of the coordinated 
83.21 	licensure information system shall promptly notify the home state of any such actions by 
83.22 	remote states.
83.23 	(c) Every nurse practicing in a party state must comply with the state practice laws of 
83.24 	the state in which the patient is located at the time care is rendered. In addition, the practice 
83.25 	of nursing is not limited to patient care, but shall include all nursing practice as defined by 
83.26 	the state practice laws of the party state. The practice of nursing will subject a nurse to the 
83.27 	jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
83.28 	(d) This compact does not affect additional requirements imposed by states for 
83.29 	advanced practice registered nursing. However, a multistate licensure privilege to practice 
83.30 	registered nursing granted by a party state shall be recognized by other party states as a 
83.31 	license to practice registered nursing if one is required by state law as a precondition for 
83.32 	qualifying for advanced practice registered nurse authorization.
83.33 	(e) Individuals not residing in a party state shall continue to be able to apply for 
83.34 	nurse licensure as provided for under the laws of each party state. However, the license 
83.35 	granted to these individuals will not be recognized as granting the privilege to practice 
83.36 	nursing in any other party state unless explicitly agreed to by that party state.
84.1 	ARTICLE 3
84.2 	APPLICATIONS FOR LICENSURE IN A PARTY STATE
84.3 	(a) Upon application for a license, the licensing board in a party state shall ascertain, 
84.4 	through the coordinated licensure information system, whether the applicant has ever held 
84.5 	or is the holder of a license issued by any other state, whether there are any restrictions 
84.6 	on the multistate licensure privilege, and whether any other adverse action by a state 
84.7 	has been taken against the license.
84.8 	(b) A nurse in a party state shall hold licensure in only one party state at a time, 
84.9 	issued by the home state.
84.10 	(c) A nurse who intends to change primary state of residence may apply for licensure 
84.11 	in the new home state in advance of the change. However, new licenses will not be 
84.12 	issued by a party state until after a nurse provides evidence of change in primary state of 
84.13 	residence satisfactory to the new home state's licensing board.
84.14 	(d) When a nurse changes primary state of residence by:
84.15 	(1) moving between two party states, and obtains a license from the new home state, 
84.16 	the license from the former home state is no longer valid;
84.17 	(2) moving from a nonparty state to a party state, and obtains a license from the new 
84.18 	home state, the individual state license issued by the nonparty state is not affected and will 
84.19 	remain in full force if so provided by the laws of the nonparty state; or
84.20 	(3) moving from a party state to a nonparty state, the license issued by the prior 
84.21 	home state converts to an individual state license, valid only in the former home state, 
84.22 	without the multistate licensure privilege to practice in other party states.
84.23 	ARTICLE 4
84.24 	ADVERSE ACTIONS
84.25 	In addition to the general provisions described in article 2, the provisions in this 
84.26 	article apply.
84.27 	(a) The licensing board of a remote state shall promptly report to the administrator 
84.28 	of the coordinated licensure information system any remote state actions including the 
84.29 	factual and legal basis for the action, if known. The licensing board of a remote state shall 
84.30 	also promptly report any significant current investigative information yet to result in a 
84.31 	remote state action. The administrator of the coordinated licensure information system 
84.32 	shall promptly notify the home state of any reports.
84.33 	(b) The licensing board of a party state shall have the authority to complete any 
84.34 	pending investigation for a nurse who changes primary state of residence during the 
84.35 	course of the investigation. The board shall also have the authority to take appropriate 
84.36 	action, and shall promptly report the conclusion of the investigation to the administrator 
85.1 	of the coordinated licensure information system. The administrator of the coordinated 
85.2 	licensure information system shall promptly notify the new home state of any action.
85.3 	(c) A remote state may take adverse action affecting the multistate licensure 
85.4 	privilege to practice within that party state. However, only the home state shall have the 
85.5 	power to impose adverse action against the license issued by the home state.
85.6 	(d) For purposes of imposing adverse actions, the licensing board of the home state 
85.7 	shall give the same priority and effect to reported conduct received from a remote state as 
85.8 	it would if the conduct had occurred within the home state. In so doing, it shall apply its 
85.9 	own state laws to determine appropriate action.
85.10 	(e) The home state may take adverse action based on the factual findings of the 
85.11 	remote state, provided each state follows its own procedures for imposing the adverse 
85.12 	action.
85.13 	(f) Nothing in this compact shall override a party state's decision that participation 
85.14 	in an alternative program may be used in lieu of licensure action and that participation 
85.15 	shall remain nonpublic if required by the party state's laws.
85.16 	Party states must require nurses who enter any alternative programs to agree not to 
85.17 	practice in any other party state during the term of the alternative program without prior 
85.18 	authorization from the other party state.
85.19 	ARTICLE 5
85.20 	ADDITIONAL AUTHORITIES INVESTED IN 
85.21 	PARTY STATE NURSE LICENSING BOARDS
85.22 	Notwithstanding any other laws, party state nurse licensing boards shall have the 
85.23 	authority to:
85.24 	(1) if otherwise permitted by state law, recover from the affected nurse the costs of 
85.25 	investigation and disposition of cases resulting from any adverse action taken against 
85.26 	that nurse;
85.27 	(2) issue subpoenas for both hearings and investigations which require the attendance 
85.28 	and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse 
85.29 	licensing board in a party state for the attendance and testimony of witnesses, and the 
85.30 	production of evidence from another party state, shall be enforced in the latter state by 
85.31 	any court of competent jurisdiction according to the practice and procedure of that court 
85.32 	applicable to subpoenas issued in proceedings pending before it. The issuing authority 
85.33 	shall pay any witness fees, travel expenses, mileage, and other fees required by the service 
85.34 	statutes of the state where the witnesses and evidence are located;
85.35 	(3) issue cease and desist orders to limit or revoke a nurse's authority to practice 
85.36 	in the nurse's state; and
86.1 	(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).
86.2 	ARTICLE 6
86.3 	COORDINATED LICENSURE INFORMATION SYSTEM
86.4 	(a) All party states shall participate in a cooperative effort to create a coordinated 
86.5 	database of all licensed registered nurses and licensed practical/vocational nurses. This 
86.6 	system shall include information on the licensure and disciplinary history of each 
86.7 	nurse, as contributed by party states, to assist in the coordination of nurse licensure and 
86.8 	enforcement efforts.
86.9 	(b) Notwithstanding any other provision of law, all party states' licensing boards shall 
86.10 	promptly report adverse actions, actions against multistate licensure privileges, any current 
86.11 	significant investigative information yet to result in adverse action, denials of applications, 
86.12 	and the reasons for the denials to the coordinated licensure information system.
86.13 	(c) Current significant investigative information shall be transmitted through the 
86.14 	coordinated licensure information system only to party state licensing boards.
86.15 	(d) Notwithstanding any other provision of law, all party states' licensing boards 
86.16 	contributing information to the coordinated licensure information system may designate 
86.17 	information that may not be shared with nonparty states or disclosed to other entities or 
86.18 	individuals without the express permission of the contributing state.
86.19 	(e) Any personally identifiable information obtained by a party state's licensing 
86.20 	board from the coordinated licensure information system may not be shared with nonparty 
86.21 	states or disclosed to other entities or individuals except to the extent permitted by the 
86.22 	laws of the party state contributing the information.
86.23 	(f) Any information contributed to the coordinated licensure information system that 
86.24 	is subsequently required to be expunged by the laws of the party state contributing that 
86.25 	information shall also be expunged from the coordinated licensure information system.
86.26 	(g) The compact administrators, acting jointly with each other and in consultation 
86.27 	with the administrator of the coordinated licensure information system, shall formulate 
86.28 	necessary and proper procedures for the identification, collection, and exchange of 
86.29 	information under this compact.
86.30 	ARTICLE 7
86.31 	COMPACT ADMINISTRATION AND
86.32 	INTERCHANGE OF INFORMATION
86.33 	(a) The head or designee of the nurse licensing board of each party state shall be the 
86.34 	administrator of this compact for that state.
86.35 	(b) The compact administrator of each party state shall furnish to the compact 
86.36 	administrator of each other party state any information and documents including, but not 
87.1 	limited to, a uniform data set of investigations, identifying information, licensure data, and 
87.2 	disclosable alternative program participation information to facilitate the administration of 
87.3 	this compact.
87.4 	(c) Compact administrators shall have the authority to develop uniform rules to 
87.5 	facilitate and coordinate implementation of this compact. These uniform rules shall be 
87.6 	adopted by party states under the authority in article 5, clause (4).
87.7 	ARTICLE 8
87.8 	IMMUNITY
87.9 	A party state or the officers, employees, or agents of a party state's nurse licensing 
87.10 	board who acts in good faith according to the provisions of this compact shall not be 
87.11 	liable for any act or omission while engaged in the performance of their duties under 
87.12 	this compact. Good faith shall not include willful misconduct, gross negligence, or 
87.13 	recklessness.
87.14 	ARTICLE 9
87.15 	ENACTMENT, WITHDRAWAL, AND AMENDMENT
87.16 	(a) This compact shall become effective for each state when it has been enacted by 
87.17 	that state. Any party state may withdraw from this compact by repealing the nurse licensure 
87.18 	compact, but no withdrawal shall take effect until six months after the withdrawing state 
87.19 	has given notice of the withdrawal to the executive heads of all other party states.
87.20 	(b) No withdrawal shall affect the validity or applicability by the licensing boards 
87.21 	of states remaining party to the compact of any report of adverse action occurring prior 
87.22 	to the withdrawal.
87.23 	(c) Nothing contained in this compact shall be construed to invalidate or prevent any 
87.24 	nurse licensure agreement or other cooperative arrangement between a party state and a 
87.25 	nonparty state that is made according to the other provisions of this compact.
87.26 	(d) This compact may be amended by the party states. No amendment to this 
87.27 	compact shall become effective and binding upon the party states until it is enacted into 
87.28 	the laws of all party states.
87.29 	ARTICLE 10
87.30 	CONSTRUCTION AND SEVERABILITY
87.31 	(a) This compact shall be liberally construed to effectuate the purposes of the 
87.32 	compact. The provisions of this compact shall be severable and if any phrase, clause, 
87.33 	sentence, or provision of this compact is declared to be contrary to the constitution of any 
87.34 	party state or of the United States or the applicability thereof to any government, agency, 
87.35 	person, or circumstance is held invalid, the validity of the remainder of this compact and 
87.36 	the applicability of it to any government, agency, person, or circumstance shall not be 
88.1 	affected by it. If this compact is held contrary to the constitution of any party state, the 
88.2 	compact shall remain in full force and effect for the remaining party states and in full force 
88.3 	and effect for the party state affected as to all severable matters.
88.4 	(b) In the event party states find a need for settling disputes arising under this 
88.5 	compact:
88.6 	(1) the party states may submit the issues in dispute to an arbitration panel which 
88.7 	shall be comprised of an individual appointed by the compact administrator in the home 
88.8 	state, an individual appointed by the compact administrator in the remote states involved, 
88.9 	and an individual mutually agreed upon by the compact administrators of the party states 
88.10 	involved in the dispute; and
88.11 	(2) the decision of a majority of the arbitrators shall be final and binding.

88.12 	Sec. 9. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO 
88.13 	EXISTING LAWS.
88.14 	(a) A nurse practicing professional or practical nursing in Minnesota under the 
88.15 	authority of section 148.2855 shall have the same obligations, privileges, and rights as if 
88.16 	the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section 
88.17 	148.2855, the Board of Nursing shall comply with and follow all laws and rules with 
88.18 	respect to registered and licensed practical nurses practicing professional or practical 
88.19 	nursing in Minnesota under the authority of section 148.2855, and all such individuals 
88.20 	shall be governed and regulated as if they were licensed by the board.
88.21 	(b) Section 148.2855 does not relieve employers of nurses from complying with 
88.22 	statutorily imposed obligations.
88.23 	(c) Section 148.2855 does not supersede existing state labor laws.
88.24 	(d) For purposes of the Minnesota Government Data Practices Act, chapter 13, 
88.25 	an individual not licensed as a nurse under sections 148.171 to 148.285 who practices 
88.26 	professional or practical nursing in Minnesota under the authority of section 148.2855 is 
88.27 	considered to be a licensee of the board.
88.28 	(e) Uniform rules developed by the compact administrators shall not be subject 
88.29 	to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101, 
88.30 	14.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
88.31 	(f) Proceedings brought against an individual's multistate privilege shall be 
88.32 	adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject 
88.33 	to judicial review as provided for in sections 14.63 to 14.69.
88.34 	(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4; 
88.35 	144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917, 
89.1 	subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40, 
89.2 	subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are 
89.3 	licensed as registered or licensed practical nurses in the home state shall be considered 
89.4 	to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to 
89.5 	registered nurses or the practice of professional nursing, then only holders of a multistate 
89.6 	privilege who are licensed as registered nurses in the home state shall be considered 
89.7 	licensees.
89.8 	(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557 
89.9 	apply to individuals not licensed as registered or licensed practical nurses under sections 
89.10 	148.171 to 148.285 who practice professional or practical nursing in Minnesota under 
89.11 	the authority of section 148.2855.
89.12 	(i) The board may take action against an individual's multistate privilege based on 
89.13 	the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or 
89.14 	requiring the board to take corrective or disciplinary action.
89.15 	(j) The board may take all forms of disciplinary action provided for in section 
89.16 	148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision 
89.17 	6, against an individual's multistate privilege.
89.18 	(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals 
89.19 	who practice professional or practical nursing in Minnesota under the authority of section 
89.20 	148.2855.
89.21 	(l) The cooperation requirements of section 148.265 apply to individuals who 
89.22 	practice professional or practical nursing in Minnesota under the authority of section 
89.23 	148.2855.
89.24 	(m) The provisions of section 148.283 shall not apply to individuals who practice 
89.25 	professional or practical nursing in Minnesota under the authority of section 148.2855.
89.26 	(n) Complaints against individuals who practice professional or practical nursing 
89.27 	in Minnesota under the authority of section 148.2855 shall be handled as provided in 
89.28 	sections 214.10 and 214.103.
89.29 	(o) All provisions of section 148.2855 authorizing or requiring the board to provide 
89.30 	data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
89.31 	(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a 
89.32 	remote state any active investigative data regarding a complaint investigation against a 
89.33 	nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable 
89.34 	assurances from the remote state that the data will be maintained with the same protections 
89.35 	as provided in Minnesota law.
90.1 	(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice 
90.2 	professional or practical nursing in Minnesota under the authority of section 148.2855 
90.3 	when the practice involves direct physical contact between the nurse and a patient.
90.4 	(r) A nurse practicing professional or practical nursing in Minnesota under the 
90.5 	authority of section 148.2855 must comply with any criminal background check required 
90.6 	under Minnesota law.

90.7 	Sec. 10. [148.2857] WITHDRAWAL FROM COMPACT.
90.8 	The governor may withdraw the state from the compact in section 148.2855 if 
90.9 	the Board of Nursing notifies the governor that a party state to the compact changed 
90.10 	the party state's requirements for nurse licensure after July 1, 2009, and that the party 
90.11 	state's requirements, as changed, are substantially lower than the requirements for nurse 
90.12 	licensure in this state.

90.13 	Sec. 11. [148.2858] MISCELLANEOUS PROVISIONS.
90.14 	(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board" 
90.15 	means the executive director of the board.
90.16 	(b) The Board of Nursing shall have the authority to recover from a nurse practicing 
90.17 	professional or practical nursing in Minnesota under the authority of section 148.2855 
90.18 	the costs of investigation and disposition of cases resulting from any adverse action 
90.19 	taken against the nurse.
90.20 	(c) The board may implement a system of identifying individuals who practice 
90.21 	professional or practical nursing in Minnesota under the authority of section 148.2855.

90.22 	Sec. 12. [148.2859] NURSE LICENSURE COMPACT ADVISORY 
90.23 	COMMITTEE.
90.24 		Subdivision 1.Establishment; membership. A Nurse Licensure Compact Advisory 
90.25 	Committee is established to advise the compact administrator in the implementation of 
90.26 	section 148.2855. Members of the advisory committee shall be appointed by the board 
90.27 	and shall be composed of representatives of Minnesota nursing organizations, Minnesota 
90.28 	licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses 
90.29 	who provide home care, Minnesota licensed advanced practice registered nurses, and 
90.30 	public members as defined in section 214.02.
90.31 		Subd. 2.Duties. The advisory committee shall advise the compact administrator in 
90.32 	the implementation of section 148.2855.
91.1 		Subd. 3.Organization. The advisory committee shall be organized and 
91.2 	administered under section 15.059.

91.3 	Sec. 13. Minnesota Statutes 2010, section 148B.17, is amended to read:
91.4 	148B.17 FEES.
91.5 		Subdivision. 1.Fees; Board of Marriage and Family Therapy. Each board shall 
91.6 	by rule establish The board's fees, including late fees, for licenses and renewals are 
91.7 	established so that the total fees collected by the board will as closely as possible equal 
91.8 	anticipated expenditures during the fiscal biennium, as provided in section 16A.1285. 
91.9 	Fees must be credited to accounts the board's account in the state government special 
91.10 	revenue fund. 
91.11 		Subd. 2.Licensure and application fees. Nonrefundable licensure and application 
91.12 	fees charged by the board are as follows:
91.13 	(1) application fee for national examination is $220;
91.14 	(2) application fee for Licensed Marriage and Family Therapist (LMFT) state 
91.15 	examination is $110;
91.16 	(3) initial LMFT license fee is prorated, but cannot exceed $125;
91.17 	(4) annual renewal fee for LMFT license is $125;
91.18 	(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT 
91.19 	license renewal is $50;
91.20 	(6) application fee for LMFT licensure by reciprocity is $340;
91.21 	(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) 
91.22 	license is $75;
91.23 	(8) annual renewal fee for LAMFT license is $75;
91.24 	(9) late fee for LAMFT renewal is $50;
91.25 	(10) fee for reinstatement of license is $150; and 
91.26 	(11) fee for emeritus status is $125.
91.27 		Subd. 3.Other fees. Other fees charged by the board are as follows:
91.28 	(1) sponsor application fee for approval of a continuing education course is $60;
91.29 	(2) fee for license verification by mail is $10;
91.30 	(3) duplicate license fee is $25;
91.31 	(4) duplicate renewal card fee is $10;
91.32 	(5) fee for licensee mailing list is $60;
91.33 	(6) fee for a rule book is $10; and
91.34 	(7) fees as authorized by section 148B.175, subdivision 6, clause (7).

92.1 	Sec. 14. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:
92.2 		Subd. 2.Fee. Each applicant shall pay a nonrefundable application fee set by 
92.3 	the board under section 148B.17.

92.4 	Sec. 15. Minnesota Statutes 2010, section 148B.52, is amended to read:
92.5 	148B.52 DUTIES OF THE BOARD.
92.6 	(a) The Board of Behavioral Health and Therapy shall:
92.7 	(1) establish by rule appropriate techniques, including examinations and other 
92.8 	methods, for determining whether applicants and licensees are qualified under sections 
92.9 	148B.50 to 148B.593; 
92.10 	(2) establish by rule standards for professional conduct, including adoption of a 
92.11 	Code of Professional Ethics and requirements for continuing education and supervision;
92.12 	(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593; 
92.13 	(4) establish by rule standards for initial education including coursework for 
92.14 	licensure and content of professional education;
92.15 	(5) establish, maintain, and publish annually a register of current licensees and 
92.16 	approved supervisors;
92.17 	(6) establish initial and renewal application and examination fees sufficient to cover 
92.18 	operating expenses of the board and its agents in accordance with section 16A.1283;
92.19 	(7) educate the public about the existence and content of the laws and rules for 
92.20 	licensed professional counselors to enable consumers to file complaints against licensees 
92.21 	who may have violated the rules; and
92.22 	(8) periodically evaluate its rules in order to refine the standards for licensing 
92.23 	professional counselors and to improve the methods used to enforce the board's standards.
92.24 	(b) The board may appoint a professional discipline committee for each occupational 
92.25 	licensure regulated by the board, and may appoint a board member as chair. The 
92.26 	professional discipline committee shall consist of five members representative of the 
92.27 	licensed occupation and shall provide recommendations to the board with regard to rule 
92.28 	techniques, standards, procedures, and related issues specific to the licensed occupation.

92.29 	Sec. 16. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:
92.30 		Subd. 2.Application fees. Each applicant shall submit with a license, advanced 
92.31 	dental therapist certificate, or permit application a nonrefundable fee in the following 
92.32 	amounts in order to administratively process an application:
92.33 	(1) dentist, $140;
92.34 	(2) full faculty dentist, $140;
93.1 	(2) (3) limited faculty dentist, $140;
93.2 	(3) (4) resident dentist or dental provider, $55;
93.3 	(5) advanced dental therapist, $100;
93.4 	(4) (6) dental therapist, $100;
93.5 	(5) (7) dental hygienist, $55;
93.6 	(6) (8) licensed dental assistant, $55; and
93.7 	(7) (9) dental assistant with a permit as described in Minnesota Rules, part 
93.8 	3100.8500, subpart 3, $15.

93.9 	Sec. 17. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:
93.10 		Subd. 3.Initial license or permit fees. Along with the application fee, each of the 
93.11 	following applicants shall submit a separate prorated initial license or permit fee. The 
93.12 	prorated initial fee shall be established by the board based on the number of months of the 
93.13 	applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to 
93.14 	exceed the following monthly fee amounts:
93.15 	(1) dentist or full faculty dentist, $14 times the number of months of the initial term;
93.16 	(2) dental therapist, $10 times the number of months of the initial term;
93.17 	(3) dental hygienist, $5 times the number of months of the initial term;
93.18 	(4) licensed dental assistant, $3 times the number of months of the initial term; and
93.19 	(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 
93.20 	subpart 3, $1 times the number of months of the initial term.

93.21 	Sec. 18. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:
93.22 		Subd. 4.Annual license fees. Each limited faculty or resident dentist shall submit 
93.23 	with an annual license renewal application a fee established by the board not to exceed 
93.24 	the following amounts:
93.25 	(1) limited faculty dentist, $168; and
93.26 	(2) resident dentist or dental provider, $59.

93.27 	Sec. 19. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:
93.28 		Subd. 5.Biennial license or permit fees. Each of the following applicants shall 
93.29 	submit with a biennial license or permit renewal application a fee as established by the 
93.30 	board, not to exceed the following amounts:
93.31 	(1) dentist or full faculty dentist, $336;
93.32 	(2) dental therapist, $180;
93.33 	(3) dental hygienist, $118;
94.1 	(4) licensed dental assistant, $80; and
94.2 	(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 
94.3 	subpart 3, $24.

94.4 	Sec. 20. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:
94.5 		Subd. 8.Duplicate license or certificate fee. Each applicant shall submit, with 
94.6 	a request for issuance of a duplicate of the original license, or of an annual or biennial 
94.7 	renewal certificate for a license or permit, a fee in the following amounts:
94.8 	(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental 
94.9 	assistant license, $35; and
94.10 	(2) annual or biennial renewal certificates, $10.

94.11 	Sec. 21. Minnesota Statutes 2010, section 150A.091, is amended by adding a 
94.12 	subdivision to read:
94.13 		Subd. 16.Failure of professional development portfolio audit. A licensee shall 
94.14 	submit a fee as established by the board not to exceed the amount of $250 after failing 
94.15 	two consecutive professional development portfolio audits and, thereafter, for each failed 
94.16 	professional development portfolio audit under Minnesota Rules, part 3100.5300.

94.17 	Sec. 22. [151.065] FEE AMOUNTS.
94.18 		Subdivision 1.Application fees. Application fees for licensure and registration 
94.19 	are as follows:
94.20 	(1) pharmacist licensed by examination, $130;
94.21 	(2) pharmacist licensed by reciprocity, $225;
94.22 	(3) pharmacy intern, $30;
94.23 	(4) pharmacy technician, $30;
94.24 	(5) pharmacy, $190;
94.25 	(6) drug wholesaler, legend drugs only, $200;
94.26 	(7) drug wholesaler, legend and nonlegend drugs, $200;
94.27 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
94.28 	(9) drug wholesaler, medical gases, $150;
94.29 	(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
94.30 	(11) drug manufacturer, legend drugs only, $200;
94.31 	(12) drug manufacturer, legend and nonlegend drugs, $200;
94.32 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
94.33 	(14) drug manufacturer, medical gases, $150;
95.1 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
95.2 	(16) medical gas distributor, $75;
95.3 	(17) controlled substance researcher, $50; and
95.4 	(18) pharmacy professional corporation, $100.
95.5 		Subd. 2.Original license fee. The pharmacist original licensure fee, $130.
95.6 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees 
95.7 	are as follows:
95.8 	(1) pharmacist, $130;
95.9 	(2) pharmacy technician, $30;
95.10 	(3) pharmacy, $190;
95.11 	(4) drug wholesaler, legend drugs only, $200;
95.12 	(5) drug wholesaler, legend and nonlegend drugs, $200;
95.13 	(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
95.14 	(7) drug wholesaler, medical gases, $150;
95.15 	(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
95.16 	(9) drug manufacturer, legend drugs only, $200;
95.17 	(10) drug manufacturer, legend and nonlegend drugs, $200;
95.18 	(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;
95.19 	(12) drug manufacturer, medical gases, $150;
95.20 	(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
95.21 	(14) medical gas distributor, $75;
95.22 	(15) controlled substance researcher, $50; and
95.23 	(16) pharmacy professional corporation, $45.
95.24 		Subd. 4.Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses 
95.25 	and certificates are as follows:
95.26 	(1) intern affidavit, $15;
95.27 	(2) duplicate small license, $15; and
95.28 	(3) duplicate large certificate, $25.
95.29 		Subd. 5.Late fees. All annual renewal fees are subject to a 50 percent late fee if 
95.30 	the renewal fee and application are not received by the board prior to the date specified 
95.31 	by the board.
95.32 		Subd. 6.Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's 
95.33 	license to lapse may reinstate the license with board approval and upon payment of any 
95.34 	fees and late fees in arrears, up to a maximum of $1,000.
96.1 	(b) A pharmacy technician who has allowed the technician's registration to lapse 
96.2 	may reinstate the registration with board approval and upon payment of any fees and late 
96.3 	fees in arrears, up to a maximum of $90.
96.4 	(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical 
96.5 	gas distributor who has allowed the license of the establishment to lapse may reinstate the 
96.6 	license with board approval and upon payment of any fees and late fees in arrears.
96.7 	(d) A controlled substance researcher who has allowed the researcher's registration 
96.8 	to lapse may reinstate the registration with board approval and upon payment of any fees 
96.9 	and late fees in arrears.
96.10 	(e) A pharmacist owner of a professional corporation who has allowed the 
96.11 	corporation's registration to lapse may reinstate the registration with board approval and 
96.12 	upon payment of any fees and late fees in arrears.

96.13 	Sec. 23. Minnesota Statutes 2010, section 151.07, is amended to read:
96.14 	151.07 MEETINGS; EXAMINATION FEE.
96.15 	The board shall meet at times as may be necessary and as it may determine to 
96.16 	examine applicants for licensure and to transact its other business, giving reasonable 
96.17 	notice of all examinations by mail to known applicants therefor. The secretary shall record 
96.18 	the names of all persons licensed by the board, together with the grounds upon which 
96.19 	the right of each to licensure was claimed. The fee for examination shall be in such the 
96.20 	 amount as the board may determine specified in section 151.065, which fee may in the 
96.21 	discretion of the board be returned to applicants not taking the examination.

96.22 	Sec. 24. Minnesota Statutes 2010, section 151.101, is amended to read:
96.23 	151.101 INTERNSHIP.
96.24 	Upon payment of the fee specified in section 151.065, the board may license register
96.25 	as an intern any natural persons who have satisfied the board that they are of good moral 
96.26 	character, not physically or mentally unfit, and who have successfully completed the 
96.27 	educational requirements for intern licensure registration prescribed by the board. The 
96.28 	board shall prescribe standards and requirements for interns, pharmacist-preceptors, and 
96.29 	internship training but may not require more than one year of such training.
96.30 	The board in its discretion may accept internship experience obtained in another 
96.31 	state provided the internship requirements in such other state are in the opinion of the 
96.32 	board equivalent to those herein provided.

97.1 	Sec. 25. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision 
97.2 	to read:
97.3 		Subd. 3.Registration fee. The board shall not register an individual as a pharmacy 
97.4 	technician unless all applicable fees specified in section 151.065 have been paid.

97.5 	Sec. 26. Minnesota Statutes 2010, section 151.12, is amended to read:
97.6 	151.12 RECIPROCITY; LICENSURE.
97.7 	The board may in its discretion grant licensure without examination to any 
97.8 	pharmacist licensed by the Board of Pharmacy or a similar board of another state which 
97.9 	accords similar recognition to licensees of this state; provided, the requirements for 
97.10 	licensure in such other state are in the opinion of the board equivalent to those herein 
97.11 	provided. The fee for licensure shall be in such the amount as the board may determine by 
97.12 	rule specified in section 151.065.

97.13 	Sec. 27. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
97.14 		Subdivision 1.Renewal fee. Every person licensed by the board as a pharmacist 
97.15 	shall pay to the board a the annual renewal fee to be fixed by it specified in section 
97.16 	151.065. The board may promulgate by rule a charge to be assessed for the delinquent 
97.17 	payment of a fee. the late fee specified in section 151.065 if the renewal fee and 
97.18 	application are not received by the board prior to the date specified by the board. It shall 
97.19 	be unlawful for any person licensed as a pharmacist who refuses or fails to pay such any 
97.20 	applicable  renewal or late fee to practice pharmacy in this state. Every certificate and 
97.21 	license shall expire at the time therein prescribed.

97.22 	Sec. 28. Minnesota Statutes 2010, section 151.19, is amended to read:
97.23 	151.19 REGISTRATION; FEES.
97.24 		Subdivision 1.Pharmacy registration. The board shall require and provide for the 
97.25 	annual registration of every pharmacy now or hereafter doing business within this state. 
97.26 	Upon the payment of a any applicable  fee to be set by the board specified in section 
97.27 	151.065, the board shall issue a registration certificate in such form as it may prescribe to 
97.28 	such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be 
97.29 	displayed in a conspicuous place in the pharmacy for which it is issued and expire on the 
97.30 	30th day of June following the date of issue. It shall be unlawful for any person to conduct 
97.31 	a pharmacy unless such certificate has been issued to the person by the board.
97.32 		Subd. 2.Nonresident pharmacies. The board shall require and provide for an 
97.33 	annual nonresident special pharmacy registration for all pharmacies located outside of this 
98.1 	state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 
98.2 	prescription medications into this state. Nonresident special pharmacy registration shall 
98.3 	be granted by the board upon payment of any applicable fee specified in section 151.065 
98.4 	and the disclosure and certification by a pharmacy:
98.5 	(1) that it is licensed in the state in which the dispensing facility is located and from 
98.6 	which the drugs are dispensed;
98.7 	(2) the location, names, and titles of all principal corporate officers and all 
98.8 	pharmacists who are dispensing drugs to residents of this state;
98.9 	(3) that it complies with all lawful directions and requests for information from 
98.10 	the Board of Pharmacy of all states in which it is licensed or registered, except that it 
98.11 	shall respond directly to all communications from the board concerning emergency 
98.12 	circumstances arising from the dispensing of drugs to residents of this state;
98.13 	(4) that it maintains its records of drugs dispensed to residents of this state so that the 
98.14 	records are readily retrievable from the records of other drugs dispensed;
98.15 	(5) that it cooperates with the board in providing information to the Board of 
98.16 	Pharmacy of the state in which it is licensed concerning matters related to the dispensing 
98.17 	of drugs to residents of this state;
98.18 	(6) that during its regular hours of operation, but not less than six days per week, for 
98.19 	a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 
98.20 	communication between patients in this state and a pharmacist at the pharmacy who has 
98.21 	access to the patients' records; the toll-free number must be disclosed on the label affixed 
98.22 	to each container of drugs dispensed to residents of this state; and
98.23 	(7) that, upon request of a resident of a long-term care facility located within the 
98.24 	state of Minnesota, the resident's authorized representative, or a contract pharmacy or 
98.25 	licensed health care facility acting on behalf of the resident, the pharmacy will dispense 
98.26 	medications prescribed for the resident in unit-dose packaging or, alternatively, comply 
98.27 	with the provisions of section 151.415, subdivision 5.
98.28 		Subd. 3.Sale of federally restricted medical gases. The board shall require and 
98.29 	provide for the annual registration of every person or establishment not licensed as a 
98.30 	pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 
98.31 	medical gases. Upon the payment of a any applicable  fee to be set by the board specified 
98.32 	in section 151.065, the board shall issue a registration certificate in such form as it may 
98.33 	prescribe to those persons or places that may be qualified to sell or distribute federally 
98.34 	restricted medical gases. The certificate shall be displayed in a conspicuous place in the 
98.35 	business for which it is issued and expire on the date set by the board. It is unlawful for 
99.1 	a person to sell or distribute federally restricted medical gases unless a certificate has 
99.2 	been issued to that person by the board.

99.3 	Sec. 29. Minnesota Statutes 2010, section 151.25, is amended to read:
99.4 	151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
99.5 	The board shall require and provide for the annual registration of every person 
99.6 	engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, 
99.7 	now or hereafter doing business with accounts in this state. Upon a payment of a any 
99.8 	applicable fee as set by the board specified in section 151.065, the board shall issue a 
99.9 	registration certificate in such form as it may prescribe to such manufacturer. Such 
99.10 	registration certificate shall be displayed in a conspicuous place in such manufacturer's 
99.11 	or wholesaler's place of business for which it is issued and expire on the date set by the 
99.12 	board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals, 
99.13 	or poisons for medicinal purposes unless such a certificate has been issued to the person 
99.14 	by the board. It shall be unlawful for any person engaged in the manufacture of drugs, 
99.15 	medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell 
99.16 	legend drugs to other than a pharmacy, except as provided in this chapter.

99.17 	Sec. 30. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
99.18 		Subdivision 1.Requirements. All wholesale drug distributors are subject to the 
99.19 	requirements in paragraphs (a) to (f).
99.20 	(a) No person or distribution outlet shall act as a wholesale drug distributor without 
99.21 	first obtaining a license from the board and paying the required any applicable  fee
99.22 	specified in section 151.065.
99.23 	(b) No license shall be issued or renewed for a wholesale drug distributor to operate 
99.24 	unless the applicant agrees to operate in a manner prescribed by federal and state law and 
99.25 	according to the rules adopted by the board.
99.26 	(c) The board may require a separate license for each facility directly or indirectly 
99.27 	owned or operated by the same business entity within the state, or for a parent entity 
99.28 	with divisions, subsidiaries, or affiliate companies within the state, when operations 
99.29 	are conducted at more than one location and joint ownership and control exists among 
99.30 	all the entities.
99.31 	(d) As a condition for receiving and retaining a wholesale drug distributor license 
99.32 	issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has 
99.33 	and will continuously maintain: 
99.34 	(1) adequate storage conditions and facilities;
100.1 	(2) minimum liability and other insurance as may be required under any applicable 
100.2 	federal or state law;
100.3 	(3) a viable security system that includes an after hours central alarm, or comparable 
100.4 	entry detection capability; restricted access to the premises; comprehensive employment 
100.5 	applicant screening; and safeguards against all forms of employee theft;
100.6 	(4) a system of records describing all wholesale drug distributor activities set forth 
100.7 	in section 151.44 for at least the most recent two-year period, which shall be reasonably 
100.8 	accessible as defined by board regulations in any inspection authorized by the board; 
100.9 	(5) principals and persons, including officers, directors, primary shareholders, 
100.10 	and key management executives, who must at all times demonstrate and maintain their 
100.11 	capability of conducting business in conformity with sound financial practices as well 
100.12 	as state and federal law;
100.13 	(6) complete, updated information, to be provided to the board as a condition for 
100.14 	obtaining and retaining a license, about each wholesale drug distributor to be licensed, 
100.15 	including all pertinent corporate licensee information, if applicable, or other ownership, 
100.16 	principal, key personnel, and facilities information found to be necessary by the board;
100.17 	(7) written policies and procedures that assure reasonable wholesale drug distributor 
100.18 	preparation for, protection against, and handling of any facility security or operation 
100.19 	problems, including, but not limited to, those caused by natural disaster or government 
100.20 	emergency, inventory inaccuracies or product shipping and receiving, outdated product 
100.21 	or other unauthorized product control, appropriate disposition of returned goods, and 
100.22 	product recalls;
100.23 	(8) sufficient inspection procedures for all incoming and outgoing product 
100.24 	shipments; and
100.25 	(9) operations in compliance with all federal requirements applicable to wholesale 
100.26 	drug distribution.
100.27 	(e) An agent or employee of any licensed wholesale drug distributor need not seek 
100.28 	licensure under this section.
100.29 	(f) A wholesale drug distributor shall file with the board an annual report, in a 
100.30 	form and on the date prescribed by the board, identifying all payments, honoraria, 
100.31 	reimbursement or other compensation authorized under section 151.461, clauses (3) to 
100.32 	(5), paid to practitioners in Minnesota during the preceding calendar year. The report 
100.33 	shall identify the nature and value of any payments totaling $100 or more, to a particular 
100.34 	practitioner during the year, and shall identify the practitioner. Reports filed under this 
100.35 	provision are public data. 

101.1 	Sec. 31. Minnesota Statutes 2010, section 151.48, is amended to read:
101.2 	151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
101.3 	(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business 
101.4 	in the state without first obtaining a license from the board and paying the required any 
101.5 	applicable fee specified in section 151.065.
101.6 	(b) Application for an out-of-state wholesale drug distributor license under this 
101.7 	section shall be made on a form furnished by the board.
101.8 	(c) No person acting as principal or agent for any out-of-state wholesale drug 
101.9 	distributor may sell or distribute drugs in the state unless the distributor has obtained 
101.10 	a license.
101.11 	(d) The board may adopt regulations that permit out-of-state wholesale drug 
101.12 	distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state 
101.13 	wholesale drug distributor:
101.14 	(1) possesses a valid license granted by another state under legal standards 
101.15 	comparable to those that must be met by a wholesale drug distributor of this state as 
101.16 	prerequisites for obtaining a license under the laws of this state; and
101.17 	(2) can show that the other state would extend reciprocal treatment under its own 
101.18 	laws to a wholesale drug distributor of this state.

101.19 	Sec. 32. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
101.20 		Subd. 3.Research project use of controlled substances. Any qualified person 
101.21 	may use controlled substances in the course of a bona fide research project but cannot 
101.22 	administer or dispense such drugs to human beings unless such drugs are prescribed, 
101.23 	dispensed and administered by a person lawfully authorized to do so. Every person 
101.24 	who engages in research involving the use of such substances shall apply annually for 
101.25 	registration by the state Board of Pharmacy and shall pay any applicable fee specified in 
101.26 	section 151.065, provided that such registration shall not be required if the person is 
101.27 	covered by and has complied with federal laws covering such research projects.

101.28 	Sec. 33. [214.107] HEALTH-RELATED LICENSING BOARDS 
101.29 	ADMINISTRATIVE SERVICES UNIT.
101.30 		Subdivision 1.Establishment. An administrative services unit is established 
101.31 	for the health-related licensing boards in section 214.01, subdivision 2, to perform 
101.32 	administrative, financial, and management functions common to all the boards in a manner 
101.33 	that streamlines services, reduces expenditures, targets the use of state resources, and 
101.34 	meets the mission of public protection.
102.1 		Subd. 2.Authority. The administrative services unit shall act as an agent of the 
102.2 	boards.
102.3 		Subd. 3.Funding. (a) The administrative service unit shall apportion among the 
102.4 	health-related licensing boards an amount to be allocated to each health-related licensing 
102.5 	board. The amount apportioned to each board shall equal each board's share of the annual 
102.6 	operating costs for the unit and shall be deposited into the state government special 
102.7 	revenue fund.
102.8 	(b) The administrative services unit may receive and expend reimbursements for 
102.9 	services performed for other agencies.

102.10 	Sec. 34. EFFECTIVE DATE.
 102.11 	Sections 8 to 12 are effective upon implementation of the coordinated licensure 
102.12 	information system defined in Minnesota Statutes, section 148.2855, but no sooner than 
102.13 	July 1, 2012.

102.14 	ARTICLE 5
102.15 	HEALTH CARE

102.16 	Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
102.17 		Subdivision 1.Citation. This section shall be known as and may be cited as the 
102.18 	"Freedom of Choice in Health Care Act."
102.19 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have 
102.20 	the meaning given them.
102.21 	(b) "Health care service" means any service, treatment, or provision of a product for 
102.22 	the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise 
102.23 	maintain or improve physical or mental health, subject to all laws and rules regulating 
102.24 	health service providers and products within the state of Minnesota.
102.25 	(c) "Mode of securing" means to purchase directly or on credit or by trade, or to 
102.26 	contract for third-party payment by insurance or other legal means as authorized by the 
102.27 	state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored 
102.28 	health care benefits under such conditions as may legally be required as a condition of 
102.29 	such benefits, or any combination of the same.
102.30 	(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding, 
102.31 	surcharge, fee, or any other imposed consequence established by law or rule of a 
102.32 	government or its subdivision or agency that is used to punish or discourage the exercise 
102.33 	of rights protected under this section.
103.1 		Subd. 3.Statement of public policy. (a) The power to require or regulate a person's 
103.2 	choice in the mode of securing health care services, or to impose a penalty related to that 
103.3 	choice, is not found in the Constitution of the United States of America, and is therefore a 
103.4 	power reserved to the people pursuant to the Ninth Amendment, and to the several states 
103.5 	pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign 
103.6 	power to declare the public policy of the state of Minnesota regarding the right of all 
103.7 	persons residing in the state in choosing the mode of securing health care services.
103.8 	(b) It is hereby declared that the public policy of the state of Minnesota, consistent 
103.9 	with our constitutionally recognized and inalienable rights of liberty, is that every person 
103.10 	within the state of Minnesota is and shall be free to choose or decline to choose any mode 
103.11 	of securing health care services without penalty or threat of penalty.
103.12 	(c) The policy stated under this section shall not be applied to impair any right of 
103.13 	contract related to the provision of health care services to any person or group.
103.14 		Subd. 4.Enforcement. (a) No public official, employee, or agent of the state of 
103.15 	Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or 
103.16 	effectuate any penalty in the state of Minnesota that violates the public policy set forth 
103.17 	in this section.
103.18 	(b) The attorney general shall take any action as is provided in this section or section 
103.19 	8.31 in the defense or prosecution of rights protected under this section.

103.20 	Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
103.21 		Subdivision 1.Investigate offenses against provisions of certain designated 
103.22 	sections; assist in enforcement. (a) The attorney general shall investigate violations of the 
103.23 	law of this state respecting unfair, discriminatory, and other unlawful practices in business, 
103.24 	commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act 
103.25 	(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition 
103.26 	(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to 
103.27 	325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other 
103.28 	laws against false or fraudulent advertising, the antidiscrimination acts contained in 
103.29 	section 325D.67, the act against monopolization of food products (section 325D.68), 
103.30 	the act regulating telephone advertising services (section 325E.39), the Prevention of 
103.31 	Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency 
103.32 	exchanges and assist in the enforcement of those laws as in this section provided. 
103.33 	(b) The attorney general shall seek injunctive and any other appropriate relief as 
103.34 	expeditiously as possible to preserve the rights and property of the residents of Minnesota, 
103.35 	and to defend as necessary the state of Minnesota, its officials, employees, and agents in 
104.1 	the event that any law or regulation violating the public policy set forth in the Freedom 
104.2 	of Choice in Health Care Act in this section is enacted by any government, subdivision, 
104.3 	or agency thereof.
104.4 	(c) The attorney general shall seek injunctive and any other appropriate relief 
104.5 	as expeditiously as possible in the event that any law or regulation violating the public 
104.6 	policy set forth in the Freedom of Choice in Health Care Act in this section is enacted 
104.7 	without adequate federal funding to the state to ensure affordable health care coverage 
104.8 	is available to the residents of Minnesota.

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

104.19 	Sec. 4. Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read:
104.20 		Subdivision 1.Establishment. The association shall establish the following 
104.21 	maximum premiums to be charged for membership in the comprehensive health insurance 
104.22 	plan:
104.23 	(a) the premium for the number one qualified plan shall range from a minimum of 
104.24 	101 percent to a maximum of 125 percent of the weighted average of rates charged by 
104.25 	those insurers and health maintenance organizations with individuals enrolled in:
104.26 	(1) $1,000 annual deductible individual plans of insurance in force in Minnesota;
104.27 	(2) individual health maintenance organization contracts of coverage with a $1,000 
104.28 	annual deductible which are in force in Minnesota; and
104.29 	(3) other plans of coverage similar to plans offered by the association based on 
104.30 	generally accepted actuarial principles;
104.31 	(b) the premium for the number two qualified plan shall range from a minimum of 
104.32 	101 percent to a maximum of 125 percent of the weighted average of rates charged by 
104.33 	those insurers and health maintenance organizations with individuals enrolled in:
104.34 	(1) $500 annual deductible individual plans of insurance in force in Minnesota;
105.1 	(2) individual health maintenance organization contracts of coverage with a $500 
105.2 	annual deductible which are in force in Minnesota; and
105.3 	(3) other plans of coverage similar to plans offered by the association based on 
105.4 	generally accepted actuarial principles;
105.5 	(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible 
105.6 	shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted 
105.7 	average of rates charged by those insurers and health maintenance organizations with 
105.8 	individuals enrolled in:
105.9 	(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in 
105.10 	force in Minnesota; and
105.11 	(2) individual health maintenance organization contracts of coverage with a $2,000, 
105.12 	$5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or
105.13 	(3) other plans of coverage similar to plans offered by the association based on 
105.14 	generally accepted actuarial principles;
105.15 	(d) the premium for each type of Medicare supplement plan required to be offered 
105.16 	by the association pursuant to section 62E.12 shall range from a minimum of 101 percent 
105.17 	to a maximum of 125 percent of the weighted average of rates charged by those insurers 
105.18 	and health maintenance organizations with individuals enrolled in: 
105.19 	(1) Medicare supplement plans in force in Minnesota;
105.20 	(2) health maintenance organization Medicare supplement contracts of coverage 
105.21 	which are in force in Minnesota; and
105.22 	(3) other plans of coverage similar to plans offered by the association based on 
105.23 	generally accepted actuarial principles; and
105.24 	(e) the charge for health maintenance organization coverage shall be based on 
105.25 	generally accepted actuarial principles.; and
105.26 	(f) the premium for a high-deductible, basic plan offered under section 62E.121 shall 
105.27 	range from a minimum of 101 percent to a maximum of 125 percent of the weighted 
105.28 	average of rates charged by those insurers and health maintenance organizations offering 
105.29 	comparable plans outside of the Minnesota Comprehensive Health Association.
105.30 	The list of insurers and health maintenance organizations whose rates are used to 
105.31 	establish the premium for coverage offered by the association pursuant to paragraphs (a) 
105.32 	to (d) and (f) shall be established by the commissioner on the basis of information which 
105.33 	shall be provided to the association by all insurers and health maintenance organizations 
105.34 	annually at the commissioner's request. This information shall include the number of 
105.35 	individuals covered by each type of plan or contract specified in paragraphs (a) to (d) and 
105.36 	(f) that is sold, issued, and renewed by the insurers and health maintenance organizations, 
106.1 	including those plans or contracts available only on a renewal basis. The information shall 
106.2 	also include the rates charged for each type of plan or contract.
106.3 	In establishing premiums pursuant to this section, the association shall utilize 
106.4 	generally accepted actuarial principles, provided that the association shall not discriminate 
106.5 	in charging premiums based upon sex. In order to compute a weighted average for each 
106.6 	type of plan or contract specified under paragraphs (a) to (d) and (f), the association 
106.7 	shall, using the information collected pursuant to this subdivision, list insurers and health 
106.8 	maintenance organizations in rank order of the total number of individuals covered by 
106.9 	each insurer or health maintenance organization. The association shall then compute 
106.10 	a weighted average of the rates charged for coverage by all the insurers and health 
106.11 	maintenance organizations by:
106.12 	(1) multiplying the numbers of individuals covered by each insurer or health 
106.13 	maintenance organization by the rates charged for coverage;
106.14 	(2) separately summing both the number of individuals covered by all the insurers 
106.15 	and health maintenance organizations and all the products computed under clause (1); and
106.16 	(3) dividing the total of the products computed under clause (1) by the total number 
106.17 	of individuals covered.
106.18 	The association may elect to use a sample of information from the insurers and 
106.19 	health maintenance organizations for purposes of computing a weighted average. In no 
106.20 	case, however, may a sample used by the association to compute a weighted average 
106.21 	include information from fewer than the two insurers or health maintenance organizations 
106.22 	highest in rank order.

106.23 	Sec. 5. [62E.121] HIGH-DEDUCTIBLE, BASIC PLAN.
106.24 		Subdivision 1.Required offering. The Minnesota Comprehensive Health 
106.25 	Association shall offer a high-deductible, basic plan that meets the requirements specified 
106.26 	in this section. The high-deductible, basic plan is a one-person plan. Any dependents 
106.27 	must be covered separately.
106.28 		Subd. 2.Annual deductible; out-of-pocket maximum. (a) The plan shall provide 
106.29 	the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000. 
106.30 	The in-network annual out-of-pocket maximum for each annual deductible option shall be 
106.31 	$1,000 greater than the amount of the annual deductible.
106.32 	(b) The deductible is subject to an annual increase based on the change in the 
106.33 	Consumer Price Index (CPI).
106.34 		Subd. 3.Office visits for nonpreventive care. The following co-payments shall 
106.35 	apply for each of the first three office visits per calendar year for nonpreventive care:
107.1 	(1) $30 per visit for the $3,000 annual deductible option;
107.2 	(2) $40 per visit for the $6,000 annual deductible option;
107.3 	(3) $50 per visit for the $9,000 annual deductible option; and
107.4 	(4) $60 per visit for the $12,000 annual deductible option.
107.5 	For the fourth and subsequent visits during the calendar year, 80 percent coverage is 
107.6 	provided under all deductible options, after the deductible is met.
107.7 		Subd. 4.Preventive care. One hundred percent coverage is provided for preventive 
107.8 	care, and no co-payment, coinsurance, or deductible requirements apply.
107.9 		Subd. 5.Prescription drugs. A $10 co-payment applies to preferred generic drugs. 
107.10 	Preferred brand-name drugs require an enrollee payment of 100 percent of the health 
107.11 	plan's discounted rate.
107.12 		Subd. 6.Convenience care center visits. A $20 co-payment applies for the first 
107.13 	three convenience care center visits during a calendar year. For the fourth and subsequent 
107.14 	visits during a calendar year, 80 percent coverage is provided after the deductible is met.
107.15 		Subd. 7.Urgent care center visits. A $100 co-payment applies for the first urgent 
107.16 	care center visit during a calendar year. For the second and subsequent visits during a 
107.17 	calendar year, 80 percent coverage is provided after the deductible is met.
107.18 		Subd. 8.Emergency room visits. A $200 co-payment applies for the first 
107.19 	emergency room visit during a calendar year. For the second and subsequent visits during 
107.20 	a calendar year, 80 percent coverage is provided after the deductible is met.
107.21 		Subd. 9.Lab and x-ray; hospital services; ambulance; surgery. Lab and x-ray 
107.22 	services, hospital services, ambulance services, and surgery are covered at 80 percent 
107.23 	after the deductible is met.
107.24 		Subd. 10.Eyewear. The health plan pays up to $50 per calendar year for eyewear.
107.25 		Subd. 11.Maternity. Maternity, labor and delivery, and postpartum care are not 
107.26 	covered. One hundred percent coverage is provided for prenatal care and no deductible 
107.27 	applies.
107.28 		Subd. 12.Other eligible health care services. Other eligible health care services 
107.29 	are covered at 80 percent after the deductible is met.
107.30 		Subd. 13.Option to remove mental health and substance abuse coverage.
 107.31 	Enrollees have the option of removing mental health and substance abuse coverage in 
107.32 	exchange for a reduced premium.
107.33 		Subd. 14.Option to upgrade prescription drug coverage. Enrollees have 
107.34 	the option to upgrade prescription drug coverage to include coverage for preferred 
107.35 	brand-name drugs with a $50 co-payment and coverage for nonpreferred drugs with a 
107.36 	$100 co-payment in exchange for an increased premium.
108.1 		Subd. 15.Out-of-network services. (a) The out-of-network annual deductible is 
108.2 	double the in-network annual deductible.
108.3 	(b) There is no out-of-pocket maximum for out-of-network services.
108.4 	(c) Benefits for out-of-network services are covered at 60 percent after the deductible 
108.5 	is met.
108.6 	(d) The lifetime maximum benefit for out-of-network services is $1,000,000.
108.7 		Subd. 16.Services not covered. Services not covered include: custodial care 
108.8 	or rest care; most dental services; cosmetic services; refractive eye surgery; infertility 
108.9 	services; and services that are investigational, not medically necessary, or received while 
108.10 	on military duty.

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

108.18 	Sec. 7. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:
108.19 		Subd. 9.Growth limits; federal programs. The commissioners of health and 
108.20 	human services shall establish a rate methodology for Medicare and Medicaid risk-based 
108.21 	contracting with health plan companies that is consistent with statewide growth limits. 
108.22 	The methodology shall be presented for review by the Minnesota Health Care Commission 
108.23 	and the Legislative Commission on Health Care Access prior to the submission of a 
108.24 	waiver request to the Centers for Medicare and Medicaid Services and subsequent 
108.25 	implementation of the methodology.

108.26 	Sec. 8. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
108.27 		Subd. 7.Transfers from the commissioner of human services. Of the amount 
108.28 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), 
108.29 	$21,714,000 shall be distributed as follows:
108.30 	(1) $2,157,000 shall be distributed by the commissioner to the University of 
108.31 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
108.32 	(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 
108.33 	Medical Center for clinical medical education;
109.1 	(3) $17,400,000 shall be distributed by the commissioner to the University of 
109.2 	Minnesota Board of Regents for purposes of medical education;
109.3 	(4) $1,121,640 shall be distributed by the commissioner to clinical medical education 
109.4 	dental innovation grants in accordance with subdivision 7a; and
109.5 	(5) the remainder of the amount transferred according to section 256B.69, 
109.6 	subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 
109.7 	clinical medical education programs that meet the qualifications of subdivision 3 based on 
109.8 	the formula in subdivision 4, paragraph (a), or subdivision 11, as appropriate.

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

109.17 	Sec. 10. [62J.824] BILLING FOR PROCEDURES TO CORRECT MEDICAL 
109.18 	ERRORS PROHIBITED.
109.19 	A health care provider shall not bill a patient, and shall not be reimbursed, for 
109.20 	any operation, treatment, or other care that is provided to reverse, correct, or otherwise 
109.21 	minimize the affects of an adverse health care event, as described in section 144.7065, 
109.22 	subdivisions 2 to 7, for which that health care provider is responsible.

109.23 	Sec. 11. Minnesota Statutes 2010, section 62Q.32, is amended to read:
109.24 	62Q.32 LOCAL OMBUDSPERSON.
109.25 	County board or community health service agencies may establish an office of 
109.26 	ombudsperson to provide a system of consumer advocacy for persons receiving health 
109.27 	care services through a health plan company. The ombudsperson's functions may include, 
109.28 	but are not limited to:
109.29 	(a) mediation or advocacy on behalf of a person accessing the complaint and appeal 
109.30 	procedures to ensure that necessary medical services are provided by the health plan 
109.31 	company; and
109.32 	(b) investigation of the quality of services provided to a person and determine the 
109.33 	extent to which quality assurance mechanisms are needed or any other system change 
110.1 	may be needed. The commissioner of health shall make recommendations for funding 
110.2 	these functions including the amount of funding needed and a plan for distribution. The 
110.3 	commissioner shall submit these recommendations to the Legislative Commission on 
110.4 	Health Care Access by January 15, 1996.

110.5 	Sec. 12. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:
110.6 		Subd. 3.Provider peer grouping. (a) The commissioner shall develop a peer 
110.7 	grouping system for providers based on a combined measure that incorporates both 
110.8 	provider risk-adjusted cost of care and quality of care, and for specific conditions as 
110.9 	determined by the commissioner. In developing this system, the commissioner shall 
110.10 	consult and coordinate with health care providers, health plan companies, state agencies, 
110.11 	and organizations that work to improve health care quality in Minnesota. For purposes of 
110.12 	the final establishment of the peer grouping system, the commissioner shall not contract 
110.13 	with any private entity, organization, or consortium of entities that has or will have a direct 
110.14 	financial interest in the outcome of the system.
110.15 	(b) By no later than October 15, 2010, the commissioner shall disseminate 
110.16 	information to providers on their total cost of care, total resource use, total quality of care, 
110.17 	and the total care results of the grouping developed under this subdivision in comparison 
110.18 	to an appropriate peer group. Any analyses or reports that identify providers may only be 
110.19 	published after the provider has been provided the opportunity by the commissioner to 
110.20 	review the underlying data and submit comments. Providers may be given any data for 
110.21 	which they are the subject of the data. The provider shall have 30 days to review the data 
110.22 	for accuracy and initiate an appeal as specified in paragraph (d).
110.23 	(c) By no later than January 1, 2011, the commissioner shall disseminate information 
110.24 	to providers on their condition-specific cost of care, condition-specific resource use, 
110.25 	condition-specific quality of care, and the condition-specific results of the grouping 
110.26 	developed under this subdivision in comparison to an appropriate peer group. Any 
110.27 	analyses or reports that identify providers may only be published after the provider has 
110.28 	been provided the opportunity by the commissioner to review the underlying data and 
110.29 	submit comments. Providers may be given any data for which they are the subject of the 
110.30 	data. The provider shall have 30 days to review the data for accuracy and initiate an 
110.31 	appeal as specified in paragraph (d).
110.32 	(d) The commissioner shall establish an appeals process to resolve disputes from 
110.33 	providers regarding the accuracy of the data used to develop analyses or reports. When 
110.34 	a provider appeals the accuracy of the data used to calculate the peer grouping system 
110.35 	results, the provider shall:
111.1 	(1) clearly indicate the reason they believe the data used to calculate the peer group 
111.2 	system results are not accurate;
111.3 	(2) provide evidence and documentation to support the reason that data was not 
111.4 	accurate; and
111.5 	(3) cooperate with the commissioner, including allowing the commissioner access to 
111.6 	data necessary and relevant to resolving the dispute.
111.7 	If a provider does not meet the requirements of this paragraph, a provider's appeal shall be 
111.8 	considered withdrawn. The commissioner shall not publish results for a specific provider 
111.9 	under paragraph (e) or (f) while that provider has an unresolved appeal.
111.10 	(e) Beginning January 1, 2011, the commissioner shall, no less than annually, 
111.11 	publish information on providers' total cost, total resource use, total quality, and the results 
111.12 	of the total care portion of the peer grouping process. The results that are published must 
111.13 	be on a risk-adjusted basis.
111.14 	(f) Beginning March 30, 2011, the commissioner shall no less than annually publish 
111.15 	information on providers' condition-specific cost, condition-specific resource use, and 
111.16 	condition-specific quality, and the results of the condition-specific portion of the peer 
111.17 	grouping process. The results that are published must be on a risk-adjusted basis.
111.18 	(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing 
111.19 	information under paragraph (e) or (f), the commissioner shall ensure the scientific 
111.20 	validity and reliability of the results according to the standards described in paragraph (h). 
111.21 	If additional time is needed to establish the scientific validity and reliability of the results, 
111.22 	the commissioner may delay the dissemination of data to providers under paragraph (b) 
111.23 	or (c), or the publication of information under paragraph (e) or (f). If the delay is more 
111.24 	than 60 days, the commissioner shall report in writing to the Legislative Commission on 
111.25 	Health Care Access chairs and ranking minority members of the legislative committees 
111.26 	with jurisdiction over health care policy and finance the following information:
111.27 	(1) the reason for the delay;
111.28 	(2) the actions being taken to resolve the delay and establish the scientific validity 
111.29 	and reliability of the results; and
111.30 	(3) the new dates by which the results shall be disseminated.
111.31 	If there is a delay under this paragraph, the commissioner must disseminate the 
111.32 	information to providers under paragraph (b) or (c) at least 90 days before publishing 
111.33 	results under paragraph (e) or (f).
111.34 	(h) The commissioner's assurance of valid and reliable clinic and hospital peer 
111.35 	grouping performance results shall include, at a minimum, the following:
111.36 	(1) use of the best available evidence, research, and methodologies; and
112.1 	(2) establishment of an explicit minimum reliability threshold developed in 
112.2 	collaboration with the subjects of the data and the users of the data, at a level not below 
112.3 	nationally accepted standards where such standards exist.
112.4 	In achieving these thresholds, the commissioner shall not aggregate clinics that are not 
112.5 	part of the same system or practice group. The commissioner shall consult with and solicit 
112.6 	feedback from representatives of physician clinics and hospitals during the peer grouping 
112.7 	data analysis process to obtain input on the methodological options prior to final analysis 
112.8 	and on the design, development, and testing of provider reports.

112.9 	Sec. 13. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:
112.10 		Subd. 9.Uses of information. (a) By no later than 12 months after the commissioner 
112.11 	publishes the information in subdivision 3, paragraph (e): For product renewals or for 
112.12 	new products that are offered, after 12 months have elapsed from publication by the 
112.13 	commissioner of the information in subdivision 3, paragraph (e):
112.14 	(1) the commissioner of management and budget shall use the information and 
112.15 	methods developed under subdivision 3 to strengthen incentives for members of the state 
112.16 	employee group insurance program to use high-quality, low-cost providers;
112.17 	(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer 
112.18 	health benefits to their employees must offer plans that differentiate providers on their 
112.19 	cost and quality performance and create incentives for members to use better-performing 
112.20 	providers;
112.21 	(3) all health plan companies shall use the information and methods developed 
112.22 	under subdivision 3 to develop products that encourage consumers to use high-quality, 
112.23 	low-cost providers; and
112.24 	(4) health plan companies that issue health plans in the individual market or the 
112.25 	small employer market must offer at least one health plan that uses the information 
112.26 	developed under subdivision 3 to establish financial incentives for consumers to choose 
112.27 	higher-quality, lower-cost providers through enrollee cost-sharing or selective provider 
112.28 	networks.
112.29 	(b) By January 1, 2011, the commissioner of health shall report to the governor 
112.30 	and the legislature on recommendations to encourage health plan companies to promote 
112.31 	widespread adoption of products that encourage the use of high-quality, low-cost providers. 
112.32 	The commissioner's recommendations may include tax incentives, public reporting of 
112.33 	health plan performance, regulatory incentives or changes, and other strategies.

112.34 	Sec. 14. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:
113.1 		Subd. 2.Legislative oversight. Beginning January 15, 2009, the commissioner 
113.2 	of health shall submit to the Legislative Commission on Health Care Access chairs and 
113.3 	ranking minority members of the legislative committees with jurisdiction over health care 
113.4 	policy and finance periodic progress reports on the implementation of this chapter and 
113.5 	sections 256B.0751 to 256B.0754.

113.6 	Sec. 15. Minnesota Statutes 2010, section 256.01, subdivision 2b, is amended to read:
113.7 		Subd. 2b.Performance payments. The commissioner shall develop and implement 
113.8 	a pay-for-performance system to provide performance payments to eligible medical 
113.9 	groups and clinics that demonstrate optimum care in serving individuals with chronic 
113.10 	diseases who are enrolled in health care programs administered by the commissioner under 
113.11 	chapters 256B, 256D, and 256L. The commissioner may receive any federal matching 
113.12 	money that is made available through the medical assistance program for managed care 
113.13 	oversight contracted through vendors, including consumer surveys, studies, and external 
113.14 	quality reviews as required by the federal Balanced Budget Act of 1997, Code of Federal 
113.15 	Regulations, title 42, part 438-managed care, subpart E-external quality review. Any 
113.16 	federal money received for managed care oversight is appropriated to the commissioner 
113.17 	for this purpose. The commissioner may expend the federal money received in either 
113.18 	year of the biennium.

113.19 	Sec. 16. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
113.20 	to read:
113.21 		Subd. 33.Contingency contract fees. (a) When the commissioner enters into 
113.22 	a contingency-based contract for the purpose of recovering medical assistance or 
113.23 	MinnesotaCare funds, the commissioner may retain that portion of the recovered funds 
113.24 	equal to the amount of the contingency fee.
113.25 	(b) Amounts attributed to new recoveries under this subdivision are appropriated 
113.26 	to the commissioner to the extent they fulfill the payment terms of the contract with the 
113.27 	vendor and shall be deposited into an account in a fund other than the general fund for 
113.28 	purposes of fulfilling the terms of the vendor contract. 

113.29 	Sec. 17. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
113.30 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
113.31 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
113.32 	years after, or more frequently as determined by the commissioner, the commissioner 
113.33 	shall obtain operating data from an updated base year and establish operating payment 
114.1 	rates per admission for each hospital based on the cost-finding methods and allowable 
114.2 	costs of the Medicare program in effect during the base year. Rates under the general 
114.3 	assistance medical care, medical assistance, and MinnesotaCare programs shall not be 
114.4 	rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months 
114.5 	of the rebased period beginning January 1, 2009. For the first 24 months of the rebased 
114.6 	period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota 
114.7 	long-term hospital shall be rebased effective January 1, 2011, based on its most recent 
114.8 	Medicare cost report ending on or before September 1, 2008, with the provisions under 
114.9 	subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent 
114.10 	rate setting periods in which the base years are updated, a Minnesota long-term hospital's 
114.11 	base year shall remain within the same period as other hospitals. Effective January 1, 
114.12 	2013, rates shall be rebased at full value Rates must not be rebased to more current data 
114.13 	for the first six months of the rebased period beginning January 1, 2013. The base year 
114.14 	operating payment rate per admission is standardized by the case mix index and adjusted 
114.15 	by the hospital cost index, relative values, and disproportionate population adjustment. 
114.16 	The cost and charge data used to establish operating rates shall only reflect inpatient 
114.17 	services covered by medical assistance and shall not include property cost information 
114.18 	and costs recognized in outlier payments.

114.19 	Sec. 18. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
114.20 		Subd. 18.Applications for medical assistance. (a) The state agency may 
114.21 	take applications for medical assistance and conduct eligibility determinations for 
114.22 	MinnesotaCare enrollees.
114.23 	(b) The commissioner of human services shall modify the Minnesota health care 
114.24 	programs application form to add a question asking applicants whether they have ever 
114.25 	served in the United States military.

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

114.27 	Sec. 19. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
114.28 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
114.29 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
114.30 	member of a household with two family members, husband and wife, or parent and child, 
114.31 	the household must not own more than $6,000 in assets, plus $200 for each additional 
114.32 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
114.33 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
114.34 	time of an eligibility redetermination. The accumulation of the clothing and personal 
115.1 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
115.2 	the time of the eligibility redetermination. The value of assets that are not considered in 
115.3 	determining eligibility for medical assistance is the value of those assets excluded under 
115.4 	the supplemental security income program for aged, blind, and disabled persons, with 
115.5 	the following exceptions:
115.6 	(1) household goods and personal effects are not considered;
115.7 	(2) capital and operating assets of a trade or business that the local agency determines 
115.8 	are necessary to the person's ability to earn an income are not considered;
115.9 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
115.10 	security income program;
115.11 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
115.12 	the supplemental security income program. Burial expenses funded by annuity contracts 
115.13 	or life insurance policies must irrevocably designate the individual's estate as contingent 
115.14 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
115.15 	(5) effective upon federal approval, for a person who no longer qualifies as an 
115.16 	employed person with a disability due to loss of earnings, assets allowed while eligible 
115.17 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
115.18 	months, beginning with the first month of ineligibility as an employed person with a 
115.19 	disability, to the extent that the person's total assets remain within the allowed limits of 
115.20 	section 256B.057, subdivision 9, paragraph (c).
115.21 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
115.22 	15.

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

115.24 	Sec. 20. Minnesota Statutes 2010, section 256B.056, subdivision 4, is amended to read:
115.25 		Subd. 4.Income. (a) To be eligible for medical assistance, a person eligible under 
115.26 	section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of 
115.27 	the federal poverty guidelines. Effective January 1, 2000, and each successive January, 
115.28 	recipients of supplemental security income may have an income up to the supplemental 
115.29 	security income standard in effect on that date.
115.30 	(b) To be eligible for medical assistance, families and children may have an income 
115.31 	up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, 
115.32 	AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 
115.33 	1996, shall be increased by three percent.
115.34 	(c) Effective July 1, 2002, to be eligible for medical assistance, families and children 
115.35 	may have an income up to 100 percent of the federal poverty guidelines for the family size.
116.1 	(d) To be eligible for medical assistance under section 256B.055, subdivision 15, a 
116.2 	person may have an income up to 75 percent of federal poverty guidelines for the family 
116.3 	size.
116.4 	(e) (d) In computing income to determine eligibility of persons under paragraphs 
116.5 	(a) to (d) (c) who are not residents of long-term care facilities, the commissioner shall 
116.6 	disregard increases in income as required by Public Law Numbers 94-566, section 503; 
116.7 	99-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration 
116.8 	unusual medical expense payments are considered income to the recipient.

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

116.10 	Sec. 21. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
116.11 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
116.12 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
116.13 	other persons residing lawfully in the United States. Citizens or nationals of the United 
116.14 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
116.15 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
116.16 	Public Law 109-171.
116.17 	(b) "Qualified noncitizen" means a person who meets one of the following 
116.18 	immigration criteria:
116.19 	(1) admitted for lawful permanent residence according to United States Code, title 8;
116.20 	(2) admitted to the United States as a refugee according to United States Code, 
116.21 	title 8, section 1157;
116.22 	(3) granted asylum according to United States Code, title 8, section 1158;
116.23 	(4) granted withholding of deportation according to United States Code, title 8, 
116.24 	section 1253(h);
116.25 	(5) paroled for a period of at least one year according to United States Code, title 8, 
116.26 	section 1182(d)(5);
116.27 	(6) granted conditional entrant status according to United States Code, title 8, 
116.28 	section 1153(a)(7);
116.29 	(7) determined to be a battered noncitizen by the United States Attorney General 
116.30 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
116.31 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
116.32 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
116.33 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
116.34 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
116.35 	Public Law 104-200; or
117.1 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
117.2 	Law 96-422, the Refugee Education Assistance Act of 1980.
117.3 	(c) All qualified noncitizens who were residing in the United States before August 
117.4 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
117.5 	medical assistance with federal financial participation.
117.6 	(d) All qualified noncitizens who entered the United States on or after August 22, 
117.7 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
117.8 	medical assistance with federal financial participation through November 30, 1996.
117.9 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
117.10 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
117.11 	chapter are eligible for medical assistance with federal participation for five years if they 
117.12 	meet one of the following criteria:
117.13 	(i) refugees admitted to the United States according to United States Code, title 8, 
117.14 	section 1157;
117.15 	(ii) persons granted asylum according to United States Code, title 8, section 1158;
117.16 	(iii) persons granted withholding of deportation according to United States Code, 
117.17 	title 8, section 1253(h);
117.18 	(iv) veterans of the United States armed forces with an honorable discharge for 
117.19 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
117.20 	children; or
117.21 	(v) persons on active duty in the United States armed forces, other than for training, 
117.22 	their spouses and unmarried minor dependent children.
117.23 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
117.24 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
117.25 	participation as described in paragraph (j).
117.26 	Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant 
117.27 	women who are noncitizens described in paragraph (b) or (e) who are lawfully in the 
117.28 	United States as defined in Code of Federal Regulations, title 8, section 103.12, and who 
117.29 	otherwise meet eligibility requirements of this chapter, are eligible for medical assistance 
117.30 	with federal financial participation as provided by the federal Children's Health Insurance 
117.31 	Program Reauthorization Act of 2009, Public Law 111-3.
117.32 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
117.33 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
117.34 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
117.35 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
117.36 	with the United States Citizenship and Immigration Services to pursue any applicable 
118.1 	immigration status, including citizenship, that would qualify them for medical assistance 
118.2 	with federal financial participation.
118.3 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
118.4 	for medical assistance with federal financial participation through December 31, 1996.
118.5 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
118.6 	medical assistance without federal financial participation as described in paragraph (j).
118.7 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
118.8 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
118.9 	or after August 22, 1996, are eligible for medical assistance without federal financial 
118.10 	participation as described in paragraph (j).
118.11 	(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this 
118.12 	chapter are eligible for the benefits as provided in paragraphs (g)(f) to (i) (h). For purposes 
118.13 	of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United 
118.14 	States Code, title 8, section 1101(a)(15).
118.15 	(g) (f) Payment shall also be made for care and services that are furnished to 
118.16 	noncitizens, regardless of immigration status, who otherwise meet the eligibility 
118.17 	requirements of this chapter, if such care and services are necessary for the treatment of an 
118.18 	emergency medical condition, except for organ transplants and related care and services 
118.19 	and routine prenatal care.
118.20 	(h) (g) For purposes of this subdivision, the term "emergency medical condition" 
118.21 	means a medical condition that meets the requirements of United States Code, title 42, 
118.22 	section 1396b(v).
118.23 	(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment 
118.24 	of an emergency medical condition are limited to the following:
118.25 	(i) services delivered in an emergency room or by an ambulance service licensed 
118.26 	under chapter 144E that are directly related to the treatment of an emergency medical 
118.27 	condition;
118.28 	(ii) services delivered in an inpatient hospital setting following admission from an 
118.29 	emergency room or clinic for an acute emergency condition; and
118.30 	(iii) follow-up services that are directly related to the original service provided 
118.31 	to treat the emergency medical condition and are covered by the global payment made 
118.32 	to the provider.
118.33 	(2) Services for the treatment of emergency medical conditions do not include:
118.34 	(i) services delivered in an emergency room or inpatient setting to treat a 
118.35 	nonemergency condition;
118.36 	(ii) organ transplants and related care;
119.1 	(iii) services for routine prenatal care;
119.2 	(iv) continuing care, including long-term care, nursing facility services, home health 
119.3 	care, adult day care, day training, or supportive living services;
119.4 	(v) elective surgery;
119.5 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as 
119.6 	part of an emergency room visit;
119.7 	(vii) preventative health care and family planning services;
119.8 	(viii) dialysis;
119.9 	(ix) chemotherapy or therapeutic radiation services;
119.10 	(x) rehabilitation services;
119.11 	(xi) physical, occupational, or speech therapy;
119.12 	(xii) transportation services;
119.13 	(xiii) case management;
119.14 	(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
119.15 	(xv) dental services;
119.16 	(xvi) hospice care;
119.17 	(xvii) audiology services and hearing aids;
119.18 	(xviii) podiatry services;
119.19 	(xix) chiropractic services;
119.20 	(xx) immunizations;
119.21 	(xxi) vision services and eyeglasses;
119.22 	(xxii) waiver services;
119.23 	(xxiii) individualized education programs; or
119.24 	(xxiv) chemical dependency treatment.
119.25 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
119.26 	nonimmigrants, or lawfully present as designated in paragraph (e) and whoin the United 
119.27 	States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by 
119.28 	a group health plan or health insurance coverage according to Code of Federal Regulations, 
119.29 	title 42, section 457.310, and who otherwise meet the eligibility requirements of this 
119.30 	chapter, are eligible for medical assistance through the period of pregnancy, including 
119.31 	labor and delivery, and 60 days postpartum, to the extent federal funds are available under 
119.32 	title XXI of the Social Security Act, and the state children's health insurance program.
119.33 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
119.34 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
119.35 	for medical assistance with federal financial participation and who otherwise meet the 
119.36 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
120.1 	assistance without federal financial participation. Qualified noncitizens as described 
120.2 	in paragraph (d) are only eligible for medical assistance without federal financial 
120.3 	participation for five years from their date of entry into the United States.
120.4 	(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
120.5 	services from a nonprofit center established to serve victims of torture and are otherwise 
120.6 	ineligible for medical assistance under this chapter are eligible for medical assistance 
120.7 	without federal financial participation. These individuals are eligible only for the period 
120.8 	during which they are receiving services from the center. Individuals eligible under this 
120.9 	paragraph shall not be required to participate in prepaid medical assistance.

120.10 	Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
120.11 	subdivision to read:
120.12 		Subd. 3q.Evidence-based childbirth program. (a) The commissioner shall 
120.13 	implement a program to reduce the number of elective inductions of labor prior to 39 
120.14 	weeks' gestation. In this subdivision, the term "elective induction of labor" means the 
120.15 	use of artificial means to stimulate labor in a woman without the presence of a medical 
120.16 	condition affecting the woman or the child that makes the onset of labor a medical 
120.17 	necessity. The program must promote the implementation of policies within hospitals 
120.18 	providing services to recipients of medical assistance or MinnesotaCare that prohibit the 
120.19 	use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by 
120.20 	the attending providers.
120.21 	(b) For all births covered by medical assistance or MinnesotaCare on or after 
120.22 	January 1, 2012, a payment for professional services associated with the delivery of a 
120.23 	child in a hospital must not be made unless the provider has submitted information about 
120.24 	the nature of the labor and delivery including any induction of labor that was performed 
120.25 	in conjunction with that specific birth. The information must be on a form prescribed by 
120.26 	the commissioner.
120.27 	(c) The requirements in paragraph (b) must not apply to deliveries performed 
120.28 	at a hospital that has policies and processes in place that have been approved by the 
120.29 	commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process 
120.30 	for review of hospital induction policies must be established by the commissioner and 
120.31 	review of policies must occur at the discretion of the commissioner. The commissioner's 
120.32 	decision to approve or rescind approval must include verification and review of items 
120.33 	including, but not limited to:
120.34 	(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
121.1 	(2) policies that encourage providers to document and communicate with patients a 
121.2 	final expected date of delivery by 20 weeks' gestation that includes data from ultrasound 
121.3 	measurements as applicable;
121.4 	(3) policies that encourage patient education regarding elective inductions, and 
121.5 	requires documentation of the processes used to educate patients;
121.6 	(4) ongoing quality improvement review as determined by the commissioner; and
121.7 	(5) any data that has been collected by the commissioner.
121.8 	(d) All hospitals must report annually to the commissioner induction information 
121.9 	for all births that were covered by medical assistance or MinnesotaCare in a format and 
121.10 	manner to be established by the commissioner.
121.11 	(e) The commissioner at any time may choose not to implement or may discontinue 
121.12 	any or all aspects of the program if the commissioner is able to determine that hospitals 
121.13 	representing at least 90 percent of births covered by medical assistance or MinnesotaCare 
121.14 	have approved policies in place.

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

121.16 	Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to 
121.17 	read:
121.18 		Subd. 8.Physical therapy. (a) Medical assistance covers physical therapy and 
121.19 	related services, including specialized maintenance therapy. Specialized maintenance 
121.20 	therapy is covered for recipients age 20 and under.
121.21 	(b) Authorization by the commissioner is required to provide medically necessary 
121.22 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
121.23 	threshold where one has been established by the commissioner for a specified service: (1) 
121.24 	80 units of any approved CPT code other than modalities; (2) 20 modality sessions; and 
121.25 	(3) three evaluations or reevaluations. Services provided by a physical therapy assistant 
121.26 	shall be reimbursed at the same rate as services performed by a physical therapist when 
121.27 	the services of the physical therapy assistant are provided under the direction of a physical 
121.28 	therapist who is on the premises. Services provided by a physical therapy assistant that 
121.29 	are provided under the direction of a physical therapist who is not on the premises shall 
121.30 	be reimbursed at 65 percent of the physical therapist rate.

121.31 	EFFECTIVE DATE. This section is effective July 1, 2011, for services provided 
121.32 	on a fee-for-service basis, and January 1, 2012, for services provided by a managed care 
121.33 	plan or county-based purchasing plan.

122.1 	Sec. 24. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to 
122.2 	read:
122.3 		Subd. 8a.Occupational therapy. (a) Medical assistance covers occupational 
122.4 	therapy and related services, including specialized maintenance therapy. Specialized 
122.5 	maintenance therapy is covered for recipients age 20 and under.
122.6 	(b) Authorization by the commissioner is required to provide medically necessary 
122.7 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
122.8 	threshold where one has been established by the commissioner for a specified service: 
122.9 	(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or 
122.10 	reevaluations. Services provided by an occupational therapy assistant shall be reimbursed 
122.11 	at the same rate as services performed by an occupational therapist when the services of 
122.12 	the occupational therapy assistant are provided under the direction of the occupational 
122.13 	therapist who is on the premises. Services provided by an occupational therapy assistant 
122.14 	that are provided under the direction of an occupational therapist who is not on the 
122.15 	premises shall be reimbursed at 65 percent of the occupational therapist rate.

122.16 	EFFECTIVE DATE. This section is effective July 1, 2011, for services provided 
122.17 	on a fee-for-service basis, and January 1, 2012, for services provided by a managed care 
122.18 	plan or county-based purchasing plan.

122.19 	Sec. 25. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to 
122.20 	read:
122.21 		Subd. 8b.Speech-language pathology and audiology services. (a) Medical 
122.22 	assistance covers speech-language pathology and related services, including specialized 
122.23 	maintenance therapy. Specialized maintenance therapy is covered for recipients age 
122.24 	20 and under.
122.25 	(b) Authorization by the commissioner is required to provide medically necessary
122.26 	speech-language pathology services to a recipient beyond any of the following 
122.27 	onetime service thresholds, or a lower threshold where one has been established by the 
122.28 	commissioner for a specified service: (1) 50 treatment sessions with any combination of 
122.29 	approved CPT codes; and (2) one evaluation. 
122.30 	(c) Medical assistance covers audiology services and related services. Services 
122.31 	provided by a person who has been issued a temporary registration under section 
122.32 	148.5161 shall be reimbursed at the same rate as services performed by a speech-language 
122.33 	pathologist or audiologist as long as the requirements of section 148.5161, subdivision 
122.34 	3, are met.

123.1 	EFFECTIVE DATE. This section is effective July 1, 2011, for services provided 
123.2 	on a fee-for-service basis, and January 1, 2012, for services provided by a managed care 
123.3 	plan or county-based purchasing plan.

123.4 	Sec. 26. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to 
123.5 	read:
123.6 		Subd. 8c.Care management; rehabilitation services. (a) Effective July 1, 1999, 
123.7 	onetime thresholds shall replace annual thresholds for provision of rehabilitation services 
123.8 	described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in 
123.9 	amount and description as the thresholds prescribed by the Department of Human Services 
123.10 	health care programs provider manual for calendar year 1997, except they will not be 
123.11 	renewed annually, and they will include sensory skills and cognitive training skills.
123.12 	(b) A care management approach for authorization of rehabilitation services beyond 
123.13 	the threshold described in subdivisions 8, 8a, and 8b  shall be instituted in conjunction 
123.14 	with the onetime thresholds. The care management approach shall require the provider 
123.15 	and the department rehabilitation reviewer to work together directly through written 
123.16 	communication, or telephone communication when appropriate, to establish a medically 
123.17 	necessary care management plan. Authorization for rehabilitation services shall include 
123.18 	approval for up to 12 months of services at a time without additional documentation from 
123.19 	the provider during the extended period, when the rehabilitation services are medically 
123.20 	necessary due to an ongoing health condition.
123.21 	(c) The commissioner shall implement an expedited five-day turnaround time to 
123.22 	review authorization requests for recipients who need emergency rehabilitation services 
123.23 	and who have exhausted their onetime threshold limit for those services.

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

123.25 	Sec. 27. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to 
123.26 	read:
123.27 		Subd. 8e.Chiropractic services. Payment for chiropractic services is limited to 
123.28 	one annual evaluation and 12 24 visits per year unless prior authorization of a greater 
123.29 	number of visits is obtained.

123.30 	Sec. 28. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
123.31 	subdivision to read:
123.32 		Subd. 8f.Acupuncture services. Medical assistance covers acupuncture, as defined 
123.33 	in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by 
124.1 	another Minnesota licensed practitioner for whom acupuncture is within the practitioner's 
124.2 	scope of practice and who has specific acupuncture training or credentialing.

124.3 	Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to 
124.4 	read:
124.5 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
124.6 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
124.7 	or the maximum allowable cost set by the federal government or by the commissioner 
124.8 	plus the fixed dispensing fee; or the usual and customary price charged to the public. The 
124.9 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
124.10 	charge by any provider/insurer agreement or contract for submitted charges to medical 
124.11 	assistance programs. The net submitted charge may not be greater than the patient liability 
124.12 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
124.13 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
124.14 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
124.15 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
124.16 	nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 
124.17 	includes quantity and other special discounts except time and cash discounts. Effective 
124.18 	July 1, 2009, The actual acquisition cost of a drug shall be estimated by the commissioner,
124.19 	at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic 
124.20 	factor drugs shall be estimated at the average wholesale price minus 30 percent. wholesale 
124.21 	acquisition cost plus four percent for independently owned pharmacies located in a 
124.22 	designated rural area within Minnesota, and at wholesale acquisition cost plus two percent 
124.23 	for all other pharmacies. A pharmacy is "independently owned" if it is one of four or 
124.24 	fewer pharmacies under the same ownership nationally. A "designated rural area" means 
124.25 	an area defined as a small rural area or isolated rural area according to the four-category 
124.26 	classification of the Rural Urban Commuting Area system developed for the United States 
124.27 	Health Resources and Services Administration. Wholesale acquisition cost is defined as 
124.28 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers 
124.29 	in the United States, not including prompt pay or other discounts, rebates, or reductions 
124.30 	in price, for the most recent month for which information is available, as reported in 
124.31 	wholesale price guides or other publications of drug or biological pricing data. The 
124.32 	maximum allowable cost of a multisource drug may be set by the commissioner and it 
124.33 	shall be comparable to, but no higher than, the maximum amount paid by other third-party 
124.34 	payors in this state who have maximum allowable cost programs. Establishment of the 
125.1 	amount of payment for drugs shall not be subject to the requirements of the Administrative 
125.2 	Procedure Act.
125.3 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
125.4 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
125.5 	facilities when a unit dose blister card system, approved by the department, is used. Under 
125.6 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
125.7 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
125.8 	be identified on the claim to the department. The unit dose blister card containing the 
125.9 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
125.10 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
125.11 	will be required to credit the department for the actual acquisition cost of all unused 
125.12 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
125.13 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
125.14 	dispensed in a quantity that is less than a 30-day supply.
125.15 	(c) Whenever a maximum allowable cost has been set for a multisource drug, 
125.16 	payment shall be on the basis of the lower of the usual and customary price charged 
125.17 	to the public or the maximum allowable cost established by the commissioner unless 
125.18 	prior authorization for the brand name product has been granted according to the criteria 
125.19 	established by the Drug Formulary Committee as required by subdivision 13f, paragraph 
125.20 	(a), and the prescriber has indicated "dispense as written" on the prescription in a manner 
125.21 	consistent with section 151.21, subdivision 2.
125.22 	(d) The basis for determining the amount of payment for drugs administered in an 
125.23 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
125.24 	provider or the amount established for Medicare by the106 percent of the average sales 
125.25 	price as determined by the United States Department of Health and Human Services 
125.26 	pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales 
125.27 	price is unavailable, the amount of payment must be lower of the usual and customary cost 
125.28 	submitted by the provider or the wholesale acquisition cost.
125.29 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
125.30 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
125.31 	require individuals enrolled in the health care programs administered by the department 
125.32 	to obtain specialty pharmacy products from providers with whom the commissioner has 
125.33 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
125.34 	used by a small number of recipients or recipients with complex and chronic diseases 
125.35 	that require expensive and challenging drug regimens. Examples of these conditions 
125.36 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
126.1 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
126.2 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
126.3 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 
126.4 	that require complex care. The commissioner shall consult with the formulary committee 
126.5 	to develop a list of specialty pharmacy products subject to this paragraph. In consulting 
126.6 	with the formulary committee in developing this list, the commissioner shall take into 
126.7 	consideration the population served by specialty pharmacy products, the current delivery 
126.8 	system and standard of care in the state, and access to care issues. The commissioner shall 
126.9 	have the discretion to adjust the reimbursement rate to prevent access to care issues.
126.10 	(f) Home infusion therapy services provided by home infusion therapy pharmacies 
126.11 	must be paid at rates according to subdivision 8d.

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

126.14 	Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to 
126.15 	read:
126.16 		Subd. 13h.Medication therapy management services. (a) Medical assistance 
126.17 	and general assistance medical care cover medication therapy management services for 
126.18 	a recipient taking four three or more prescriptions to treat or prevent two one or more 
126.19 	chronic medical conditions, or; a recipient with a drug therapy problem that is identified
126.20 	by the commissioner or identified by a pharmacist and approved by the commissioner; or 
126.21 	prior authorized by the commissioner that has resulted or is likely to result in significant 
126.22 	nondrug program costs. The commissioner may cover medical therapy management 
126.23 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
126.24 	purposes of this subdivision, "medication therapy management" means the provision 
126.25 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
126.26 	therapeutic outcomes of the patient's medications:
126.27 	(1) performing or obtaining necessary assessments of the patient's health status;
126.28 	(2) formulating a medication treatment plan;
126.29 	(3) monitoring and evaluating the patient's response to therapy, including safety 
126.30 	and effectiveness;
126.31 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
126.32 	medication-related problems, including adverse drug events;
126.33 	(5) documenting the care delivered and communicating essential information to 
126.34 	the patient's other primary care providers;
127.1 	(6) providing verbal education and training designed to enhance patient 
127.2 	understanding and appropriate use of the patient's medications;
127.3 	(7) providing information, support services, and resources designed to enhance 
127.4 	patient adherence with the patient's therapeutic regimens; and
127.5 	(8) coordinating and integrating medication therapy management services within the 
127.6 	broader health care management services being provided to the patient.
127.7 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
127.8 	the pharmacist as defined in section 151.01, subdivision 27.
127.9 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
127.10 	must meet the following requirements:
127.11 	(1) have a valid license issued under chapter 151;
127.12 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
127.13 	completed a structured and comprehensive education program approved by the Board of 
127.14 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
127.15 	documentation of pharmaceutical care management services that has both clinical and 
127.16 	didactic elements;
127.17 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
127.18 	have developed a structured patient care process that is offered in a private or semiprivate 
127.19 	patient care area that is separate from the commercial business that also occurs in the 
127.20 	setting, or in home settings, excluding including long-term care and settings, group homes, 
127.21 	if the service is ordered by the provider-directed care coordination team and facilities 
127.22 	providing assisted living services, but excluding skilled nursing facilities; and
127.23 	(4) make use of an electronic patient record system that meets state standards.
127.24 	(c) For purposes of reimbursement for medication therapy management services, 
127.25 	the commissioner may enroll individual pharmacists as medical assistance and general 
127.26 	assistance medical care providers. The commissioner may also establish contact 
127.27 	requirements between the pharmacist and recipient, including limiting the number of 
127.28 	reimbursable consultations per recipient.
127.29 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
127.30 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
127.31 	requirements may provide the services via two-way interactive video. Reimbursement 
127.32 	shall be at the same rates and under the same conditions that would otherwise apply to 
127.33 	the services provided. To qualify for reimbursement under this paragraph, the pharmacist 
127.34 	providing the services must meet the requirements of paragraph (b), and must be located 
127.35 	within an ambulatory care setting approved by the commissioner. The patient must also 
128.1 	be located within an ambulatory care setting approved by the commissioner. Services 
128.2 	provided under this paragraph may not be transmitted into the patient's residence.
128.3 	(e) The commissioner shall establish a pilot project for an intensive medication 
128.4 	therapy management program for patients identified by the commissioner with multiple 
128.5 	chronic conditions and a high number of medications who are at high risk of preventable 
128.6 	hospitalizations, emergency room use, medication complications, and suboptimal 
128.7 	treatment outcomes due to medication-related problems. For purposes of the pilot 
128.8 	project, medication therapy management services may be provided in a patient's home 
128.9 	or community setting, in addition to other authorized settings. The commissioner may 
128.10 	waive existing payment policies and establish special payment rates for the pilot project. 
128.11 	The pilot project must be designed to produce a net savings to the state compared to the 
128.12 	estimated costs that would otherwise be incurred for similar patients without the program. 
128.13 	The pilot project must begin by January 1, 2010, and end June 30, 2012.

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

128.15 	Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 
128.16 	read:
128.17 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
128.18 	transportation costs incurred solely for obtaining emergency medical care or transportation 
128.19 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
128.20 	care when paid directly to an ambulance company, common carrier, or other recognized 
128.21 	providers of transportation services. Medical transportation must be provided by:
128.22 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
128.23 	(2) special transportation; or
128.24 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
128.25 	carrier, or private automobile.
128.26 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
128.27 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
128.28 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
128.29 	transportation, or private automobile.
128.30 	The commissioner may use an order by the recipient's attending physician to certify that 
128.31 	the recipient requires special transportation services. Special transportation providers shall 
128.32 	perform driver-assisted services for eligible individuals. Driver-assisted service includes 
128.33 	passenger pickup at and return to the individual's residence or place of business, assistance 
128.34 	with admittance of the individual to the medical facility, and assistance in passenger 
129.1 	securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 
129.2 	providers must obtain written documentation from the health care service provider who 
129.3 	is serving the recipient being transported, identifying the time that the recipient arrived. 
129.4 	Special transportation providers may not bill for separate base rates for the continuation of 
129.5 	a trip beyond the original destination. Special transportation providers must take recipients 
129.6 	to the nearest appropriate health care provider, using the most direct route. The minimum 
129.7 	medical assistance reimbursement rates for special transportation services are:
129.8 	(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 
129.9 	eligible persons who need a wheelchair-accessible van;
129.10 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
129.11 	eligible persons who do not need a wheelchair-accessible van; and
129.12 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
129.13 	special transportation services to eligible persons who need a stretcher-accessible vehicle;
129.14 	(2) the base rates for special transportation services in areas defined under RUCA 
129.15 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
129.16 	11.3 percent; and
129.17 	(3) for special transportation services in areas defined under RUCA to be rural 
129.18 	or super rural areas:
129.19 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
129.20 	percent of the respective mileage rate in clause (1); and
129.21 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
129.22 	112.5 percent of the respective mileage rate in clause (1).
129.23 	(c) For purposes of reimbursement rates for special transportation services under 
129.24 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
129.25 	the urban, rural, or super rural reimbursement rate applies.
129.26 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
129.27 	means a census-tract based classification system under which a geographical area is 
129.28 	determined to be urban, rural, or super rural.
129.29 	(e) Effective for services provided on or after July 1, 2011, nonemergency 
129.30 	transportation rates, including special transportation, taxi, and other commercial carriers, 
129.31 	are reduced 4.5 percent. Payments made to managed care plans and county-based 
129.32 	purchasing plans must be reduced for services provided on or after January 1, 2012, 
129.33 	to reflect this reduction.

129.34 	Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to 
129.35 	read:
130.1 		Subd. 17a.Payment for ambulance services. (a) Medical assistance covers 
130.2 	ambulance services. Providers shall bill ambulance services according to Medicare 
130.3 	criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 
130.4 	for services rendered on or after July 1, 2001, medical assistance payments for ambulance 
130.5 	services shall be paid at the Medicare reimbursement rate or at the medical assistance 
130.6 	payment rate in effect on July 1, 2000, whichever is greater.
130.7 	(b) Effective for services provided on or after July 1, 2011, ambulance services 
130.8 	payment rates are reduced 4.5 percent. Payments made to managed care plans and 
130.9 	county-based purchasing plans must be reduced for services provided on or after January 
130.10 	1, 2012, to reflect this reduction.

130.11 	Sec. 33. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to 
130.12 	read:
130.13 		Subd. 18.Bus or taxicab transportation. To the extent authorized by rule of the 
130.14 	state agency, medical assistance covers costs of the most appropriate and cost-effective 
130.15 	form of transportation incurred by any ambulatory eligible person for obtaining 
130.16 	nonemergency medical care.

130.17 	Sec. 34. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
130.18 	subdivision to read:
130.19 		Subd. 25b.Authorization with third-party liability. (a) Except as otherwise 
130.20 	allowed under this subdivision or required under federal or state regulations, the 
130.21 	commissioner must not consider a request for authorization of a service when the recipient 
130.22 	has coverage from a third-party payer unless the provider requesting authorization has 
130.23 	made a good faith effort to receive payment or authorization from the third-party payer. 
130.24 	A good faith effort is established by supplying with the authorization request to the 
130.25 	commissioner the following:
130.26 	(1) a determination of payment for the service from the third-party payer, a 
130.27 	determination of authorization for the service from the third-party payer, or a verification 
130.28 	of noncoverage of the service by the third-party payer; and
130.29 	(2) the information or records required by the department to document the reason for 
130.30 	the determination or to validate noncoverage from the third-party payer.
130.31 	(b) A provider requesting authorization for services covered by Medicare is not 
130.32 	required to bill Medicare before requesting authorization from the commissioner if the 
130.33 	provider has reason to believe that a service covered by Medicare is not eligible for 
130.34 	payment. The provider must document that, because of recent claim experiences with 
131.1 	Medicare or because of written communication from Medicare, coverage is not available 
131.2 	for the service.
131.3 	(c) Authorization is not required if a third-party payer has made payment that is 
131.4 	equal to or greater than 60 percent of the maximum payment amount for the service 
131.5 	allowed under medical assistance.

131.6 	Sec. 35. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to 
131.7 	read:
131.8 		Subd. 31a.Augmentative and alternative communication systems. (a) Medical 
131.9 	assistance covers augmentative and alternative communication systems consisting of 
131.10 	electronic or nonelectronic devices and the related components necessary to enable a 
131.11 	person with severe expressive communication limitations to produce or transmit messages 
131.12 	or symbols in a manner that compensates for that disability.
131.13 	(b) Until the volume of systems purchased increases to allow a discount price, the 
131.14 	commissioner shall reimburse augmentative and alternative communication manufacturers 
131.15 	and vendors at the manufacturer's suggested retail price for augmentative and alternative 
131.16 	communication systems and related components. The commissioner shall separately 
131.17 	reimburse providers for purchasing and integrating individual communication systems 
131.18 	which are unavailable as a package from an augmentative and alternative communication 
131.19 	vendor. Augmentative and alternative communication systems must be paid the lower 
131.20 	of the: 
131.21 	(1) submitted charge; or
131.22 	(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are 
131.23 	manufacturers of augmentative and alternative communication systems; or
131.24 	(ii) manufacturer's invoice charge plus 20 percent for providers that are not 
131.25 	manufacturers of augmentative and alternative communication systems.
131.26 	(c) Reimbursement rates established by this purchasing program are not subject to 
131.27 	Minnesota Rules, part 9505.0445, item S or T.

131.28 	Sec. 36. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
131.29 	subdivision to read:
131.30 		Subd. 55.Payment for noncovered services. (a) Except when specifically 
131.31 	prohibited by the commissioner or federal law, a provider may seek payment from the 
131.32 	recipient for services not eligible for payment under the medical assistance program when 
131.33 	the provider, prior to delivering the service, reviews and considers all other available 
131.34 	covered alternatives with the recipient and obtains a signed acknowledgment from the 
132.1 	recipient of the potential of the recipient's liability. The signed acknowledgment must be 
132.2 	in a form approved by the commissioner.
132.3 	(b) Conditions under which a provider must not request payment from the recipient 
132.4 	include, but are not limited to:
132.5 	(1) a service that requires prior authorization, unless authorization has been denied 
132.6 	as not medically necessary and all other therapeutic alternatives have been reviewed;
132.7 	(2) a service for which payment has been denied for reasons relating to billing 
132.8 	requirements;
132.9 	(3) standard shipping or delivery and setup of medical equipment or medical 
132.10 	supplies;
132.11 	(4) services that are included in the recipient's long term care per diem;
132.12 	(5) the recipient is enrolled in the Restricted Recipient Program and the provider is 
132.13 	one of a provider type designated for the recipient's health care services; and
132.14 	(6) the noncovered service is a prescriptive drug identified by the commissioner as 
132.15 	having the potential for abuse and overuse, except where payment by the recipient is 
132.16 	specifically approved by the commissioner on the date of service based upon compelling 
132.17 	evidence supplied by the prescribing provider that establishes medical necessity for that 
132.18 	particular drug.
132.19 	(c) The payment requested from recipients for noncovered services under this 
132.20 	subdivision must not exceed the provider's usual and customary charge for the actual 
132.21 	service received by the recipient. A recipient must not be billed for the difference between 
132.22 	what medical assistance paid for the service or would pay for a less costly alternative 
132.23 	service.

132.24 	Sec. 37. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
132.25 	subdivision to read:
132.26 		Subd. 56.Medical service coordination. (a) Medical assistance covers in-reach 
132.27 	community-based service coordination that is performed in a hospital emergency 
132.28 	department as an eligible procedure under a state healthcare program or private insurance 
132.29 	for a frequent user. A frequent user is defined as an individual who has frequented the 
132.30 	hospital emergency department for services three or more times in the previous four 
132.31 	consecutive months. In-reach community-based service coordination includes navigating 
132.32 	services to address a client's mental health, chemical health, social, economic, and housing 
132.33 	needs, or any other activity targeted at reducing the incidence of emergency room and 
132.34 	other nonmedically necessary health care utilization.
133.1 	(b) Reimbursement must be made in 15-minute increments under current Medicaid 
133.2 	mental health social work reimbursement methodology and allowed for up to 60 days 
133.3 	posthospital discharge based upon the specific identified emergency department visit or 
133.4 	inpatient admitting event. A frequent user who is participating in care coordination within 
133.5 	a health care home framework is ineligible for reimbursement under this subdivision. 
133.6 	Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in 
133.7 	social work, public health, corrections, or a related field. The commissioner shall submit 
133.8 	any necessary application for waivers to the Centers for Medicare and Medicaid Services 
133.9 	to implement this subdivision.
133.10 	(c) For the purposes of this subdivision, "in-reach community-based service 
133.11 	coordination" means the practice of a community-based worker with training, knowledge, 
133.12 	skills, and ability to access a continuum of services, including housing, transportation, 
133.13 	chemical and mental health treatment, employment, and peer support services, by working 
133.14 	with an organization's staff to transition an individual back into the individual's living 
133.15 	environment. In-reach community-based service coordination includes working with the 
133.16 	individual during their discharge and for up to a defined amount of time in the individual's 
133.17 	living environment, reducing the individual's need for readmittance.

133.18 	Sec. 38. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
133.19 	subdivision to read:
133.20 		Subd. 57.Payment for Part B Medicare crossover claims. Effective for services 
133.21 	provided on or after January 1, 2012, medical assistance payment for an enrollee's cost 
133.22 	sharing associated with Medicare Part B is limited to an amount up to the medical 
133.23 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
133.24 	Medicare.

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

133.26 	Sec. 39. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
133.27 	subdivision to read:
133.28 		Subd. 58.Early and periodic screening, diagnosis, and treatment services.
 133.29 	Medical assistance covers early and periodic screening, diagnosis, and treatment services 
133.30 	(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate 
133.31 	established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

133.32 	Sec. 40. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
133.33 	subdivision to read:
134.1 		Subd. 59.Services provided by advanced dental therapists and dental 
134.2 	therapists. Medical assistance covers services provided by advanced dental therapists 
134.3 	and dental therapists when provided within the scope of practice identified in sections 
134.4 	150A.105 and 150A.106.

134.5 	Sec. 41. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to 
134.6 	read:
134.7 		Subdivision 1.Co-payments Cost-sharing. (a) Except as provided in subdivision 
134.8 	2, the medical assistance benefit plan shall include the following co-payments cost-sharing
134.9 	for all recipients, effective for services provided on or after October 1, 2003, and before 
134.10 	January 1, 2009 July 1, 2011:
134.11 	(1) $3 per nonpreventive visit, except as provided in paragraph (c). For purposes 
134.12 	of this subdivision, a visit means an episode of service which is required because of 
134.13 	a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 
134.14 	ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 
134.15 	midwife, advanced practice nurse, audiologist, optician, or optometrist;
134.16 	(2) $3 for eyeglasses;
134.17 	(3) $6 $3.50 for nonemergency visits to a hospital-based emergency room, except 
134.18 	that this co-payment shall be increased to $20 upon federal approval; and
134.19 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
134.20 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
134.21 	shall apply to antipsychotic drugs when used for the treatment of mental illness.;
134.22 	(5) a family deductible equal to the maximum amount allowed under Code of 
134.23 	Federal Regulations, title 42, part 447.54; and
134.24 	(b) Except as provided in subdivision 2, the medical assistance benefit plan shall 
134.25 	include the following co-payments for all recipients, effective for services provided on 
134.26 	or after January 1, 2009:
134.27 	(1) $3.50 for nonemergency visits to a hospital-based emergency room;
134.28 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
134.29 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
134.30 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
134.31 	(3) (6) for individuals identified by the commissioner with income at or below 100 
134.32 	percent of the federal poverty guidelines, total monthly co-payments cost-sharing must 
134.33 	not exceed five percent of family income. For purposes of this paragraph, family income 
134.34 	is the total earned and unearned income of the individual and the individual's spouse, if 
135.1 	the spouse is enrolled in medical assistance and also subject to the five percent limit on 
135.2 	co-payments cost-sharing.
135.3 	(c) (b) Recipients of medical assistance are responsible for all co-payments  and 
135.4 	deductibles in this subdivision.
135.5 	(c) Effective January 1, 2012, or upon federal approval, whichever is later, the 
135.6 	following co-payments for nonpreventive visits shall apply to providers included in 
135.7 	provider peer grouping:
135.8 	(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of 
135.9 	care per medical assistance enrollee is at the 60th percentile or lower for providers of 
135.10 	the same type;
135.11 	(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care 
135.12 	per medical assistance enrollee is greater than the 60th percentile but does not exceed the 
135.13 	80th percentile for providers of the same type; and
135.14 	(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of 
135.15 	care per medical assistance enrollee is greater than the 80th percentile for providers of 
135.16 	the same type.
135.17 	Each managed care and county-based purchasing plan shall calculate the average, 
135.18 	risk-adjusted, total annual cost of care for providers under this paragraph using a 
135.19 	methodology approved by the commissioner. The commissioner shall develop a 
135.20 	methodology for calculating the average, risk-adjusted, total annual cost of care for 
135.21 	fee-for-service providers.
135.22 	(d) The commissioner shall seek any federal waivers and approvals necessary to 
135.23 	increase the co-payment for nonemergency visits to a hospital-based emergency room 
135.24 	under paragraph (a), clause (3), and to implement paragraph (c).

135.25 	Sec. 42. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to 
135.26 	read:
135.27 		Subd. 2.Exceptions. Co-payments and deductibles shall be subject to the following 
135.28 	exceptions:
135.29 	(1) children under the age of 21;
135.30 	(2) pregnant women for services that relate to the pregnancy or any other medical 
135.31 	condition that may complicate the pregnancy;
135.32 	(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or 
135.33 	intermediate care facility for the developmentally disabled;
135.34 	(4) recipients receiving hospice care;
135.35 	(5) 100 percent federally funded services provided by an Indian health service;
136.1 	(6) emergency services;
136.2 	(7) family planning services;
136.3 	(8) services that are paid by Medicare, resulting in the medical assistance program 
136.4 	paying for the coinsurance and deductible; and
136.5 	(9) co-payments that exceed one per day per provider for nonpreventive visits, 
136.6 	eyeglasses, and nonemergency visits to a hospital-based emergency room.

136.7 	Sec. 43. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to 
136.8 	read:
136.9 		Subd. 3.Collection. (a) The medical assistance reimbursement to the provider shall 
136.10 	be reduced by the amount of the co-payment or deductible, except that reimbursements 
136.11 	shall not be reduced:
136.12 	(1) once a recipient has reached the $12 per month maximum or the $7 per month 
136.13 	maximum effective January 1, 2009, for prescription drug co-payments; or
136.14 	(2) for a recipient identified by the commissioner under 100 percent of the federal 
136.15 	poverty guidelines who has met their monthly five percent co-payment cost-sharing limit.
136.16 	(b) The provider collects the co-payment or deductible from the recipient. Providers 
136.17 	may not deny services to recipients who are unable to pay the co-payment or deductible.
136.18 	(c) Medical assistance reimbursement to fee-for-service providers and payments to 
136.19 	managed care plans shall not be increased as a result of the removal of co-payments or 
136.20 	deductibles effective on or after January 1, 2009.

136.21 	Sec. 44. Minnesota Statutes 2010, section 256B.0644, is amended to read:
136.22 	256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 
136.23 	PROGRAMS.
136.24 	(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a 
136.25 	health maintenance organization, as defined in chapter 62D, must participate as a provider 
136.26 	or contractor in the medical assistance program, general assistance medical care program, 
136.27 	and MinnesotaCare as a condition of participating as a provider in health insurance plans 
136.28 	and programs or contractor for state employees established under section 43A.18, the 
136.29 	public employees insurance program under section 43A.316, for health insurance plans 
136.30 	offered to local statutory or home rule charter city, county, and school district employees, 
136.31 	the workers' compensation system under section 176.135, and insurance plans provided 
136.32 	through the Minnesota Comprehensive Health Association under sections 62E.01 to 
136.33 	62E.19. The limitations on insurance plans offered to local government employees shall 
137.1 	not be applicable in geographic areas where provider participation is limited by managed 
137.2 	care contracts with the Department of Human Services.
137.3 	(b) For providers other than health maintenance organizations, participation in the 
137.4 	medical assistance program means that:
137.5 	 (1) the provider accepts new medical assistance, general assistance medical care, 
137.6 	and MinnesotaCare patients;
137.7 	(2) for providers other than dental service providers, at least 20 percent of the 
137.8 	provider's patients are covered by medical assistance, general assistance medical care, 
137.9 	and MinnesotaCare as their primary source of coverage; or
137.10 	(3) for dental service providers, at least ten percent of the provider's patients are 
137.11 	covered by medical assistance, general assistance medical care, and MinnesotaCare as 
137.12 	their primary source of coverage, or the provider accepts new medical assistance and 
137.13 	MinnesotaCare patients who are children with special health care needs. For purposes 
137.14 	of this section, "children with special health care needs" means children up to age 18 
137.15 	who: (i) require health and related services beyond that required by children generally; 
137.16 	and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 
137.17 	condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 
137.18 	cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 
137.19 	neurological diseases; visual impairment or deafness; Down syndrome and other genetic 
137.20 	disorders; autism; fetal alcohol syndrome; and other conditions designated by the 
137.21 	commissioner after consultation with representatives of pediatric dental providers and 
137.22 	consumers.
137.23 	(c) Patients seen on a volunteer basis by the provider at a location other than 
137.24 	the provider's usual place of practice may be considered in meeting the participation 
137.25 	requirement in this section. The commissioner shall establish participation requirements 
137.26 	for health maintenance organizations. The commissioner shall provide lists of participating 
137.27 	medical assistance providers on a quarterly basis to the commissioner of management and 
137.28 	budget, the commissioner of labor and industry, and the commissioner of commerce. Each 
137.29 	of the commissioners shall develop and implement procedures to exclude as participating 
137.30 	providers in the program or programs under their jurisdiction those providers who do 
137.31 	not participate in the medical assistance program. The commissioner of management 
137.32 	and budget shall implement this section through contracts with participating health and 
137.33 	dental carriers.
137.34 	(d) For purposes of paragraphs (a) and (b), participation in the general assistance 
137.35 	medical care program applies only to pharmacy providers.
138.1 	(e) A provider described in section 256B.76, subdivision 5, may limit the eligibility 
138.2 	of new medical assistance, general assistance medical care, and MinnesotaCare patients 
138.3 	for specific categories of rehabilitative services, if medical assistance, general assistance 
138.4 	medical care, and MinnesotaCare patients served by the provider in the aggregate exceed 
138.5 	30 percent of the provider's overall patient population.

138.6 	Sec. 45. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to 
138.7 	read:
138.8 		Subd. 4.Alternative models and waivers of requirements. (a) Nothing in this 
138.9 	section shall preclude the continued development of existing medical or health care 
138.10 	home projects currently operating or under development by the commissioner of human 
138.11 	services or preclude the commissioner from establishing alternative models and payment 
138.12 	mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs 
138.13 	under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term 
138.14 	care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and 
138.15 	medical assistance, are in the waiting period for Medicare, or who have other primary 
138.16 	coverage.
138.17 	(b) The commissioner of health shall waive health care home certification 
138.18 	requirements if an applicant demonstrates that compliance with a certification requirement 
138.19 	will create a major financial hardship or is not feasible, and the applicant establishes an 
138.20 	alternative way to accomplish the objectives of the certification requirement.

138.21 	Sec. 46. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 
138.22 	subdivision to read:
138.23 		Subd. 8.Coordination with local services. The health care home and the county 
138.24 	shall coordinate care and services provided to patients enrolled with a health care home 
138.25 	who have complex medical needs or a disability, and who need and are eligible for 
138.26 	additional local services administered by counties, including but not limited to waivered 
138.27 	services, mental health services, social services, public health services, transportation, and 
138.28 	housing.  The coordination of care and services must be as provided in the plan established 
138.29 	by the patient and health care home.

138.30 	Sec. 47. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
138.31 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
138.32 	and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 
138.33 	January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 
139.1 	renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 
139.2 	31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 
139.3 	issue separate contracts with requirements specific to services to medical assistance 
139.4 	recipients age 65 and older.
139.5 	(b) A prepaid health plan providing covered health services for eligible persons 
139.6 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
139.7 	contract with the commissioner. Requirements applicable to managed care programs 
139.8 	under chapters 256B and 256L established after the effective date of a contract with the 
139.9 	commissioner take effect when the contract is next issued or renewed.
139.10 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
139.11 	shall withhold five percent of managed care plan payments under this section and 
139.12 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
139.13 	assistance program pending completion of performance targets. Each performance target 
139.14 	must be quantifiable, objective, measurable, and reasonably attainable, except in the case 
139.15 	of a performance target based on a federal or state law or rule. Criteria for assessment 
139.16 	of each performance target must be outlined in writing prior to the contract effective 
139.17 	date. The managed care plan must demonstrate, to the commissioner's satisfaction, 
139.18 	that the data submitted regarding attainment of the performance target is accurate. The 
139.19 	commissioner shall periodically change the administrative measures used as performance 
139.20 	targets in order to improve plan performance across a broader range of administrative 
139.21 	services. The performance targets must include measurement of plan efforts to contain 
139.22 	spending on health care services and administrative activities. The commissioner may 
139.23 	adopt plan-specific performance targets that take into account factors affecting only one 
139.24 	plan, including characteristics of the plan's enrollee population. The withheld funds 
139.25 	must be returned no sooner than July of the following year if performance targets in the 
139.26 	contract are achieved. The commissioner may exclude special demonstration projects 
139.27 	under subdivision 23.
139.28 	(d) Effective for services rendered on or after January 1, 2009, through December 
139.29 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
139.30 	under this section and county-based purchasing plan payments under section 256B.692 
139.31 	for the prepaid medical assistance program. The withheld funds must be returned no 
139.32 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
139.33 	exclude special demonstration projects under subdivision 23.
139.34 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
139.35 	shall require that managed care plans use the assessment and authorization processes, 
139.36 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
140.1 	billing processes, and policies consistent with medical assistance fee-for-service or the 
140.2 	Department of Human Services contract requirements consistent with medical assistance 
140.3 	fee-for-service or the Department of Human Services contract requirements for all 
140.4 	personal care assistance services under section 256B.0659.
140.5 	(f) Effective for services rendered on or after January 1, 2010, through December 
140.6 	31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 
140.7 	under this section and county-based purchasing plan payments under section 256B.692 
140.8 	for the prepaid medical assistance program. The withheld funds must be returned no 
140.9 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
140.10 	exclude special demonstration projects under subdivision 23.
140.11 	(g) Effective for services rendered on or after January 1, 2011, the commissioner 
140.12 	shall include as part of the performance targets described in paragraph (c) a reduction in 
140.13 	the health plan's emergency room utilization rate for state health care program enrollees 
140.14 	by a measurable rate of five percent from the plan's utilization rate for state health care 
140.15 	program enrollees for the previous calendar year.
140.16 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
140.17 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
140.18 	the commissioner that a reduction in the utilization rate was achieved.
140.19 	The withhold described in this paragraph shall continue for each consecutive 
140.20 	contract period until the plan's emergency room utilization rate for state health care 
140.21 	program enrollees is reduced by 25 percent of the plan's emergency room utilization 
140.22 	rate for state health care program enrollees for calendar year 2009. Hospitals shall 
140.23 	cooperate with the health plans in meeting this performance target and shall accept 
140.24 	payment withholds that may be returned to the hospitals if the performance target is 
140.25 	achieved. The commissioner shall structure the withhold so that the commissioner returns 
140.26 	a portion of the withheld funds in amounts commensurate with achieved reductions in 
140.27 	utilization less than the targeted amount. The withhold in this paragraph does not apply to 
140.28 	county-based purchasing plans.
140.29 	(h) Effective for services rendered on or after January 1, 2012, the commissioner 
140.30 	shall include as part of the performance targets described in paragraph (c) a reduction in 
140.31 	the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous 
140.32 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
140.33 	care program enrollees by a measurable rate of five percent from the plan's utilization rate 
140.34 	for state health care program enrollees for the previous calendar year.
140.35 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
140.36 	of the following calendar year if the managed care plan or county-based purchasing plan 
141.1 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
141.2 	rate was achieved.
141.3 	The withhold described in this paragraph must continue for each consecutive 
141.4 	contract period until the plan's subsequent hospitalization rate for state health care 
141.5 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
141.6 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
141.7 	with the plans in meeting this performance target and shall accept payment withholds that 
141.8 	must be returned to the hospitals if the performance target is achieved. The commissioner 
141.9 	shall structure the withhold so that the commissioner returns a portion of the withheld 
141.10 	funds in amounts commensurate with achieved reductions in utilization less than the 
141.11 	targeted amount.
141.12 	(h) (i) Effective for services rendered on or after January 1, 2011, through December 
141.13 	31, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments 
141.14 	under this section and county-based purchasing plan payments under section 256B.692 
141.15 	for the prepaid medical assistance program. The withheld funds must be returned no 
141.16 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
141.17 	exclude special demonstration projects under subdivision 23.
141.18 	(i) (j) Effective for services rendered on or after January 1, 2012, through December 
141.19 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
141.20 	under this section and county-based purchasing plan payments under section 256B.692 
141.21 	for the prepaid medical assistance program. The withheld funds must be returned no 
141.22 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
141.23 	exclude special demonstration projects under subdivision 23.
141.24 	(j) (k) Effective for services rendered on or after January 1, 2013, through December 
141.25 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
141.26 	under this section and county-based purchasing plan payments under section 256B.692 
141.27 	for the prepaid medical assistance program. The withheld funds must be returned no 
141.28 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
141.29 	exclude special demonstration projects under subdivision 23.
141.30 	(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner 
141.31 	shall withhold three percent of managed care plan payments under this section and 
141.32 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
141.33 	assistance program. The withheld funds must be returned no sooner than July 1 and 
141.34 	no later than July 31 of the following year. The commissioner may exclude special 
141.35 	demonstration projects under subdivision 23.
142.1 	(l) (m) A managed care plan or a county-based purchasing plan under section 
142.2 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
142.3 	under this section that is reasonably expected to be returned.
142.4 	(m) (n) Contracts between the commissioner and a prepaid health plan are exempt 
142.5 	from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
142.6 	(a), and 7.
142.7 	(n) (o) The return of the withhold under paragraphs (d), (f), and (h) to (k) is not 
142.8 	subject to the requirements of paragraph (c).

142.9 	Sec. 48. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:
142.10 		Subd. 5c.Medical education and research fund. (a) The commissioner of human 
142.11 	services shall transfer each year to the medical education and research fund established 
142.12 	under section 62J.692, an amount specified in this subdivision. The commissioner shall 
142.13 	calculate the following:
142.14 	(1) an amount equal to the reduction in the prepaid medical assistance payments as 
142.15 	specified in this clause. Until January 1, 2002, the county medical assistance capitation 
142.16 	base rate prior to plan specific adjustments and after the regional rate adjustments under 
142.17 	subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining 
142.18 	metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after 
142.19 	January 1, 2002, the county medical assistance capitation base rate prior to plan specific 
142.20 	adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining 
142.21 	metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing 
142.22 	facility and elderly waiver payments and demonstration project payments operating 
142.23 	under subdivision 23 are excluded from this reduction. The amount calculated under 
142.24 	this clause shall not be adjusted for periods already paid due to subsequent changes to 
142.25 	the capitation payments;
142.26 	(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this 
142.27 	section;
142.28 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
142.29 	paid under this section; and
142.30 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
142.31 	under this section.
142.32 	(b) This subdivision shall be effective upon approval of a federal waiver which 
142.33 	allows federal financial participation in the medical education and research fund. Effective 
142.34 	July 1, 2009, and thereafter, The transfers required byamount specified under paragraph 
142.35 	(a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009. 
143.1 	Any excess shall first reduce the amounts otherwise required to be transferredspecified 
143.2 	under paragraph (a), clauses (2) to (4). Any excess following this reduction shall 
143.3 	proportionally reduce the transfersamount specified under paragraph (a), clause (1).
143.4 	(c) Beginning July 1, 2009 2011, of the amounts amount in paragraph (a), the 
143.5 	commissioner shall transfer $21,714,000 each fiscal year to the medical education and 
143.6 	research fund. The balance of the transfers under paragraph (a) shall be transferred to the 
143.7 	medical education and research fund no earlier than July 1 of the following fiscal year.
143.8 	(d) Beginning July 1, 2011, of the amount in paragraph (a), following the transfer 
143.9 	under paragraph (c), the commissioner shall transfer to the medical education research 
143.10 	fund $4,024,000 in fiscal year 2012 and $4,626,000 in fiscal year 2013 and thereafter.

143.11 	Sec. 49. Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:
143.12 		Subd. 28.Medicare special needs plans; medical assistance basic health care.
 143.13 	(a) The commissioner may contract with qualified Medicare-approved special needs 
143.14 	plans to provide medical assistance basic health care services to persons with disabilities, 
143.15 	including those with developmental disabilities. Basic health care services include:
143.16 	(1) those services covered by the medical assistance state plan except for ICF/MR 
143.17 	services, home and community-based waiver services, case management for persons with 
143.18 	developmental disabilities under section 256B.0625, subdivision 20a, and personal care 
143.19 	and certain home care services defined by the commissioner in consultation with the 
143.20 	stakeholder group established under paragraph (d); and
143.21 	(2) basic health care services may also include risk for up to 100 days of nursing 
143.22 	facility services for persons who reside in a noninstitutional setting and home health 
143.23 	services related to rehabilitation as defined by the commissioner after consultation with 
143.24 	the stakeholder group.
143.25 	The commissioner may exclude other medical assistance services from the basic 
143.26 	health care benefit set. Enrollees in these plans can access any excluded services on the 
143.27 	same basis as other medical assistance recipients who have not enrolled.
143.28 	Unless a person is otherwise required to enroll in managed care, enrollment in these 
143.29 	plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 
143.30 	enrollment with an option to opt out is not voluntary enrollment.
143.31 	(b) Beginning January 1, 2007, the commissioner may contract with qualified 
143.32 	Medicare special needs plans to provide basic health care services under medical 
143.33 	assistance to persons who are dually eligible for both Medicare and Medicaid and those 
143.34 	Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 
143.35 	The commissioner shall consult with the stakeholder group under paragraph (d) in 
144.1 	developing program specifications for these services. The commissioner shall report to 
144.2 	the chairs of the house of representatives and senate committees with jurisdiction over 
144.3 	health and human services policy and finance by February 1, 2007, on implementation 
144.4 	of these programs and the need for increased funding for the ombudsman for managed 
144.5 	care and other consumer assistance and protections needed due to enrollment in managed 
144.6 	care of persons with disabilities. Payment for Medicaid services provided under this 
144.7 	subdivision for the months of May and June will be made no earlier than July 1 of the 
144.8 	same calendar year.
144.9 	(c) Notwithstanding subdivision 4, beginning January 1, 2008 2012, the 
144.10 	commissioner may expand contracting under this subdivision to all shall enroll persons 
144.11 	with disabilities not otherwise required to enroll in managed care under this section, 
144.12 	unless the individual chooses to opt out of enrollment. The commissioner shall establish 
144.13 	enrollment and opt out procedures consistent with applicable enrollment procedures under 
144.14 	this subdivision.
144.15 	(d) The commissioner shall establish a state-level stakeholder group to provide 
144.16 	advice on managed care programs for persons with disabilities, including both MnDHO 
144.17 	and contracts with special needs plans that provide basic health care services as described 
144.18 	in paragraphs (a) and (b). The stakeholder group shall provide advice on program 
144.19 	expansions under this subdivision and subdivision 23, including:
144.20 	(1) implementation efforts;
144.21 	(2) consumer protections; and
144.22 	(3) program specifications such as quality assurance measures, data collection and 
144.23 	reporting, and evaluation of costs, quality, and results.
144.24 	(e) Each plan under contract to provide medical assistance basic health care services 
144.25 	shall establish a local or regional stakeholder group, including representatives of the 
144.26 	counties covered by the plan, members, consumer advocates, and providers, for advice on 
144.27 	issues that arise in the local or regional area.
144.28 	(f) The commissioner is prohibited from providing the names of potential enrollees 
144.29 	to health plans for marketing purposes. The commissioner may shall mail no more than 
144.30 	two sets of marketing materials per contract year to potential enrollees on behalf of health 
144.31 	plans, in which case at the health plan's request. The marketing materials shall be mailed 
144.32 	by the commissioner within 30 days of receipt of these materials from the health plan. The 
144.33 	health plans shall cover any costs incurred by the commissioner for mailing marketing 
144.34 	materials.

145.1 	Sec. 50. Minnesota Statutes 2010, section 256B.69, is amended by adding a 
145.2 	subdivision to read:
145.3 		Subd. 30.Provider payment rates. (a) Each managed care and county-based plan 
145.4 	shall, by October 1, 2011, array all providers within each provider type, employed by or 
145.5 	under contract with the plan, by their average total annual cost of care for serving medical 
145.6 	assistance and MinnesotaCare enrollees for the most recent reporting year for which data 
145.7 	is available, risk-adjusted for enrollee demographics and health status.
145.8 	(b) Beginning January 1, 2012, and each contract year thereafter, each managed 
145.9 	care and county-based purchasing plan shall implement a progressive payment withhold 
145.10 	methodology for each provider type, under which the withhold for a provider increases 
145.11 	proportionally as the provider's risk-adjusted total annual cost increases, relative to other 
145.12 	providers of the same type. For purposes of this paragraph, the risk-adjusted total annual 
145.13 	cost of care is the dollar amount calculated under paragraph (a).
145.14 	(c) At the end of each contract year, each plan shall array all providers within each 
145.15 	provider type by their average total annual cost of care for serving medical assistance and 
145.16 	MinnesotaCare enrollees for that contract year, risk-adjusted for enrollee demographics 
145.17 	and health status. For each provider whose risk-adjusted total annual cost of care is at or 
145.18 	below the 70th percentile of providers of the same type or specialty, the plan shall return 
145.19 	the full amount of any withhold. For each provider whose risk-adjusted total annual cost 
145.20 	of care is above the 70th percentile, the plan shall return only the portion of the withhold 
145.21 	sufficient to bring the provider's payment rate to the average for providers within the 
145.22 	provider type whose risk-adjusted total annual cost of care is at the 70th percentile. Each 
145.23 	plan shall reduce provider payments only as allowed under paragraph (f).
145.24 	(d) Each managed care and county-based purchasing plan must establish an appeals 
145.25 	process to allow providers to appeal determinations of risk-adjusted total annual cost of 
145.26 	care. Each plan's appeals process must be approved by the commissioner.
145.27 	(e) The commissioner shall require each plan to submit to the commissioner, in 
145.28 	the form and manner specified by the commissioner, all provider payment data and 
145.29 	information on the withhold methodology that the commissioner determines is necessary 
145.30 	to verify compliance with this subdivision.
145.31 	(f) The commissioner, for the contract year beginning January 1, 2012, shall reduce 
145.32 	plan capitation rates by ten percent from the rates that would otherwise apply, absent 
145.33 	application of this subdivision. The reduced rate shall be the historical base rate for 
145.34 	negotiating capitation rates for future contract years. The commissioner may recommend 
145.35 	additional reductions in capitation rates for future contract years to the legislature, if the 
145.36 	commissioner determines this is necessary to ensure that health care providers under 
146.1 	contract with managed care and county-based purchasing plans practice in an efficient 
146.2 	manner. Effective for services rendered on or after January 1, 2012, managed care plans 
146.3 	and county-based purchasing plans contracted with the state to administer the health 
146.4 	care programs provided under sections 256B.69, 256B.692, and 256L.12, may reduce 
146.5 	payments made to providers employed or under contract with the plan. However, a 
146.6 	managed care or county-based purchasing plan is prohibited from: (1) reducing payments 
146.7 	made to providers whose risk-adjusted total annual cost of care is at or below the 70th 
146.8 	percentile of providers of the same type or specialty, or at or below the 80th percentile 
146.9 	for provider types or specialties currently subject to plan care management requirements 
146.10 	that in the aggregate are more extensive than those that apply to other provider types or 
146.11 	specialties, or for which a majority of services are currently subject to prior authorization 
146.12 	by the plan and (2) reducing payments to hospitals described under the Social Security 
146.13 	Act, title 18, section 1886, subsection (d), paragraph (l), and subparagraph (B), clause (iii).
146.14 	(g) The commissioner of human services, in consultation with the commissioner of 
146.15 	health, shall develop and provide to managed care and county-based purchasing plans, by 
146.16 	September 1, 2011, standard criteria and definitions necessary for consistent calculation 
146.17 	of the total annual risk-adjusted cost of care across plans. The commissioner may use 
146.18 	encounter data to implement this subdivision, and may provide encounter data or analyses 
146.19 	to plans.
146.20 	(h) For purposes of this subdivision, "provider" means a vendor of medical care 
146.21 	as defined in section 256B.02, subdivision 7, for which sufficient encounter data on 
146.22 	utilization and costs is available to implement this subdivision.
146.23 	(i) A managed care or county-based purchasing plan must use the methodology 
146.24 	described in paragraphs (a) to (e), unless the plan develops an alternative model consistent 
146.25 	with the purpose of this subdivision.

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

146.27 	Sec. 51. Minnesota Statutes 2010, section 256B.69, is amended by adding a 
146.28 	subdivision to read:
146.29 		Subd. 32.Health education. The commissioner shall require managed care and 
146.30 	county-based purchasing plans, as a condition of contract, to provide health education, 
146.31 	wellness training, and information about the availability and benefits of preventive 
146.32 	services to all medical assistance and MinnesotaCare enrollees, beginning January 1, 
146.33 	2012. Plan initiatives developed or implemented to comply with this requirement must be 
146.34 	approved by the commissioner.

147.1 	Sec. 52. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
147.2 		Subd. 4.Critical access dental providers.  (a) Effective for dental services 
147.3 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
147.4 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
147.5 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
147.6 	increase reimbursement by 30 percent above the reimbursement rate that would otherwise 
147.7 	be paid to the critical access dental provider. The commissioner shall pay the managed 
147.8 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
147.9 	reimbursements to critical access dental providers as approved by the commissioner.
147.10 	(b) The commissioner shall designate the following dentists and dental clinics as 
147.11 	critical access dental providers:
147.12 	(1) nonprofit community clinics that:
147.13 	(i) have nonprofit status in accordance with chapter 317A;
147.14 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
147.15 	501(c)(3);
147.16 	(iii) are established to provide oral health services to patients who are low income, 
147.17 	uninsured, have special needs, and are underserved;
147.18 	(iv) have professional staff familiar with the cultural background of the clinic's 
147.19 	patients;
147.20 	(v) charge for services on a sliding fee scale designed to provide assistance to 
147.21 	low-income patients based on current poverty income guidelines and family size;
147.22 	(vi) do not restrict access or services because of a patient's financial limitations 
147.23 	or public assistance status; and
147.24 	(vii) have free care available as needed;
147.25 	(2) federally qualified health centers, rural health clinics, and public health clinics;
147.26 	(3) county owned and operated hospital-based dental clinics;
147.27 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
147.28 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
147.29 	patients who are uninsured or covered by medical assistance, general assistance medical 
147.30 	care, or MinnesotaCare; and
147.31 	(5) a dental clinic associated with an oral health or dental education program owned 
147.32 	and operated by the University of Minnesota or an institution within the Minnesota State 
147.33 	Colleges and Universities system.
147.34 	 (c) The commissioner may designate a dentist or dental clinic as a critical access 
147.35 	dental provider if the dentist or dental clinic is willing to provide care to patients covered 
148.1 	by medical assistance, general assistance medical care, or MinnesotaCare at a level which 
148.2 	significantly increases access to dental care in the service area.
148.3 	(d) Notwithstanding paragraph (a), critical access payments must not be made for 
148.4 	dental services provided from April 1, 2010, through June 30, 2010.
148.5 	(e) Notwithstanding section 256B.04, subdivision 2, the commissioner of human 
148.6 	services shall not adopt rules governing this section or section 256L.11, subdivision 7.

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

148.8 	Sec. 53. [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE 
148.9 	DEMONSTRATION PROJECT.
148.10 		Subdivision 1.Establishment and implementation. The commissioner of 
148.11 	human services, in consultation with the commissioner of health, shall contract 
148.12 	with a Minnesota-based academic and research institution specializing in providing 
148.13 	complementary and alternative medicine education and clinical services to establish and 
148.14 	implement a five-year demonstration project in conjunction with federally qualified health 
148.15 	centers and federally qualified health center look-alikes as defined in section 145.9269, to 
148.16 	improve the quality and cost-effectiveness of care provided under medical assistance to 
148.17 	enrollees with neck and back problems.  The demonstration project must maximize the use 
148.18 	of complementary and alternative medicine-oriented primary care providers, including but 
148.19 	not limited to physicians and chiropractors.  The demonstration project must be designed 
148.20 	to significantly improve physical and mental health for enrollees who present with 
148.21 	neck and back problems while decreasing medical treatment costs. The commissioner, 
148.22 	in consultation with the commissioner of health, shall deliver services through the 
148.23 	demonstration project beginning July 1, 2011, or upon federal approval, whichever is later.
148.24 		Subd. 2.RFP and project criteria. The commissioner, in consultation with the 
148.25 	commissioner of health, shall develop and issue a request for proposal (RFP) for the 
148.26 	demonstration project. The RFP must require the academic and research institution 
148.27 	selected to demonstrate a proven track record over at least five years of conducting 
148.28 	high-quality, federally funded clinical research. The RFP shall specify the state costs 
148.29 	directly related to the requirements of this section and shall require that the selected 
148.30 	institution pay those costs to the state. The institution and the federally qualified health 
148.31 	centers and federally qualified health center look-alikes shall also:
148.32 	(1) provide patient education, provider education, and enrollment training 
148.33 	components on health and lifestyle issues in order to promote enrollee responsibility for 
148.34 	health care decisions, enhance productivity, prepare enrollees to reenter the workforce, 
148.35 	and reduce future health care expenditures;
149.1 	(2) use high-quality and cost-effective integrated disease management that includes 
149.2 	the best practices of traditional and complementary and alternative medicine;
149.3 	(3) incorporate holistic medical care, appropriate nutrition, exercise, medications, 
149.4 	and conflict resolution techniques;
149.5 	(4) include a provider education component that makes use of professional 
149.6 	organizations representing chiropractors, nurses, and other primary care providers 
149.7 	and provides appropriate educational materials and activities in order to improve the 
149.8 	integration of traditional medical care with licensed chiropractic services and other 
149.9 	alternative health care services and achieve program enrollment objectives; and
149.10 	(5) provide to the commissioner the information and data necessary for the 
149.11 	commissioner to prepare the annual reports required under subdivision 6.
149.12 		Subd. 3.Enrollment. Enrollees from the program shall be selected by the 
149.13 	commissioner from current enrollees in the prepaid medical assistance program who 
149.14 	have, or are determined to be at significant risk of developing, neck and back problems. 
149.15 	Participation in the demonstration project shall be voluntary.  The commissioner shall 
149.16 	seek to enroll, over the term of the demonstration project, ten percent of current and 
149.17 	future medical assistance enrollees who have, or are determined to be at significant risk 
149.18 	of developing, neck and back problems.
149.19 		Subd. 4.Federal approval. The commissioner shall seek any federal waivers and 
149.20 	approvals necessary to implement the demonstration project.
149.21 		Subd. 5.Project costs. The commissioner shall require the academic and research 
149.22 	institution selected, federally qualified health centers, and federally qualified health center 
149.23 	look-alikes to fund all costs of the demonstration project. Amounts received under 
149.24 	subdivision 2 are appropriated to the commissioner for the purposes of this section.
149.25 		Subd. 6.Annual reports. The commissioner, in consultation with the commissioner 
149.26 	of health, beginning December 15, 2011, and each December 15 thereafter through 
149.27 	December 15, 2015, shall report annually to the legislature on the functional and mental 
149.28 	improvements of the populations served by the demonstration project, patient satisfaction, 
149.29 	and the cost-effectiveness of the program. The reports must also include data on hospital 
149.30 	admissions, days in hospital, rates of outpatient surgery and other services, and drug 
149.31 	utilization. The report, due December 15, 2015, must include recommendations on 
149.32 	whether the demonstration project should be continued and expanded.

149.33 	Sec. 54. [256B.841] MINNESOTA CHOICE WAIVER APPLICATION AND 
149.34 	PROCESS.
149.35 		Subdivision 1.Intent. It is the intent of the legislature that medical assistance be:
150.1 	(1) a sustainable, cost-effective, person-centered, and opportunity-driven program 
150.2 	utilizing competitive and value-based purchasing to maximize available service options; 
150.3 	and
150.4 	(2) a results-oriented system of coordinated care that focuses on independence 
150.5 	and choice, promotes accountability and transparency, encourages and rewards healthy 
150.6 	outcomes and responsible choices, and promotes efficiency.
150.7 		Subd. 2.Waiver application. (a) By September 1, 2011, the commissioner of 
150.8 	human services shall apply for a waiver and any necessary state plan amendments from 
150.9 	the secretary of the United States Department of Health and Human Services, including, 
150.10 	but not limited to, a waiver of the appropriate sections of title XIX of the federal Social 
150.11 	Security Act, United States Code, title 42, section 1396 et seq., or other provisions of 
150.12 	federal law that provide program flexibility and under which Minnesota will operate 
150.13 	all facets of the state's medical assistance program. For purposes of this section, and 
150.14 	256B.842, and 256B.843, this waiver shall be known as the Minnesota Consumer Health 
150.15 	Opportunities and Innovative Care Excellence (CHOICE) waiver.
150.16 	(b) The commissioner of human services shall provide the legislative committees 
150.17 	with jurisdiction over health and human services finance and policy with the CHOICE 
150.18 	waiver application and financial and other related materials, at least ten days prior to 
150.19 	submitting the application and materials to the federal Centers for Medicare and Medicaid 
150.20 	Services.
150.21 	(c) If the state's CHOICE waiver application is approved, the commissioner of 
150.22 	human services shall:
150.23 	(1) notify the chairs of the legislative committees with jurisdiction over health and 
150.24 	human services finance and policy and allow the legislative committees with jurisdiction 
150.25 	over health and human services finance and policy to review the terms of the CHOICE 
150.26 	waiver; and
150.27 	(2) not implement the CHOICE waiver until ten legislative days have passed 
150.28 	following notification of the chairs.
150.29 		Subd. 3.Rulemaking; legislative proposals. Upon acceptance of the terms of the 
150.30 	CHOICE waiver, the commissioner of human services shall:
150.31 	(1) adopt rules to implement the CHOICE waiver; and
150.32 	(2) propose any legislative changes necessary to implement the terms of the 
150.33 	CHOICE waiver.
150.34 		Subd. 4.Joint commission on waiver implementation. (a) After acceptance of the 
150.35 	terms of the CHOICE waiver, the governor shall establish a joint commission on CHOICE 
150.36 	waiver implementation. The commission shall consist of eight members; four of whom 
151.1 	shall be members of the senate, not more than three from the same political party, to be 
151.2 	appointed by the Subcommittee on Committees of the senate Committee on Rules and 
151.3 	Administration, and four of whom shall be members of the house of representatives, not 
151.4 	more than three from the same political party, to be appointed by the speaker of the house.
151.5 	(b) The commission shall:
151.6 	(1) oversee implementation of the CHOICE waiver;
151.7 	(2) confer as necessary with state agency commissioners;
151.8 	(3) make recommendations on services covered under the medical assistance 
151.9 	program;
151.10 	(4) monitor and make recommendations on quality and access to care under the 
151.11 	CHOICE  waiver; and
151.12 	(5) make recommendations for the efficient and cost-effective administration of the 
151.13 	medical assistance program under the terms of the CHOICE waiver.

151.14 	Sec. 55. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE 
151.15 	REFORM.
151.16 		Subdivision 1.Goals for reform.  In developing the CHOICE waiver application 
151.17 	and implementing the CHOICE waiver, the commissioner of human services shall ensure 
151.18 	that the reformed medical assistance program is a person-centered, financially sustainable, 
151.19 	and cost-effective program.
151.20 		Subd. 2.Reformed medical assistance criteria. The reformed medical assistance 
151.21 	program established through the CHOICE waiver must:
151.22 	(1) empower consumers to make informed and cost-effective choices about their 
151.23 	health and offer consumers rewards for healthy decisions;
151.24 	(2) ensure adequate access to needed services;
151.25 	(3) enable consumers to receive individualized health care that is outcome-oriented 
151.26 	and focused on prevention, disease management, recovery, and maintaining independence;
151.27 	(4) promote competition between health care providers to ensure best value 
151.28 	purchasing, leverage resources, and to create opportunities for improving service quality 
151.29 	and performance;
151.30 	(5) redesign purchasing and payment methods and encourage and reward 
151.31 	high-quality and cost-effective care by incorporating and expanding upon current payment 
151.32 	reform and quality of care initiatives including, but not limited to, those initiatives 
151.33 	authorized under chapter 62U; and
152.1 	(6) continually improve technology to take advantage of recent innovations and 
152.2 	advances that help decision makers, consumers, and providers make informed and 
152.3 	cost-effective decisions regarding health care.
152.4 		Subd. 3.Annual report. The commissioner of human services shall annually 
152.5 	submit a report to the governor and the legislature, beginning December 1, 2012, and each 
152.6 	December 1 thereafter, describing the status of the administration and implementation 
152.7 	of the CHOICE waiver.

152.8 	Sec. 56. [256B.843] CHOICE WAIVER APPLICATION REQUIREMENTS.
152.9 		Subdivision 1.Requirements for CHOICE waiver request. The commissioner 
152.10 	shall seek federal approval to:
152.11 	(1) enter into a five-year agreement with the United States Department of Health and 
152.12 	Human Services and Centers for Medicaid and Medicare Services (CMS) under section 
152.13 	1115a to waive, as part of the CHOICE waiver, provisions of title XIX of the federal 
152.14 	Social Security Act, United States Code, title 42, section 1396 et seq., requiring:
152.15 	(i) statewideness to allow for the provision of different services in different areas or 
152.16 	regions of the state;
152.17 	(ii) comparability of services to allow for the provision of different services to 
152.18 	members of the same or different coverage groups;
152.19 	(iii) no prohibitions restricting the amount, duration, and scope of services included 
152.20 	in the medical assistance state plan;
152.21 	(iv) no prohibitions limiting freedom of choice of providers; and
152.22 	(v) retroactive payment for medical assistance, at the state's discretion;
152.23 	(2) waive the applicable provisions of title XIX of the federal Social Security Act, 
152.24 	United States Code, title 42, section 1396 et seq., in order to:
152.25 	(i) expand cost sharing requirements above the five percent of income threshold for 
152.26 	beneficiaries in certain populations;
152.27 	(ii) establish health savings or power accounts that encourage and reward 
152.28 	beneficiaries who reach certain prevention and wellness targets; and
152.29 	(iii) implement a tiered set of parameters to use as the basis for determining 
152.30 	long-term service care and setting needs;
152.31 	(3) modify income and resource rules in a manner consistent with the goals of the 
152.32 	reformed program;
152.33 	(4) provide enrollees with a choice of appropriate private sector health coverage 
152.34 	options, with full federal financial participation;
153.1 	(5) treat payments made toward the cost of care as a monthly premium for 
153.2 	beneficiaries receiving home and community-based services when applicable;
153.3 	(6) provide health coverage and services to individuals over the age of 65 that are 
153.4 	limited in scope and are available only in the home and community-based setting;
153.5 	(7) consolidate all home and community-based services currently provided under 
153.6 	title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c), 
153.7 	into a single program of home and community-based services that include options for 
153.8 	consumer direction and shared living;
153.9 	(8) expand disease management, care coordination, and wellness programs for all 
153.10 	medical assistance recipients; and
153.11 	(9) empower and encourage able-bodied medical assistance recipients to work, 
153.12 	whenever possible.
153.13 		Subd. 2.Agency coordination. The commissioner shall establish an intraagency 
153.14 	assessment and coordination unit to ensure that decision making and program planning for 
153.15 	recipients who may need long-term care, residential placement, and community support 
153.16 	services are coordinated. The assessment and coordination unit shall determine level of 
153.17 	care, develop service plans and a service budget, make referrals to appropriate settings, 
153.18 	provide education and choice counseling to consumers and providers, track utilization, 
153.19 	and monitor outcomes. 

153.20 	Sec. 57. Minnesota Statutes 2010, section 256D.03, subdivision 3, is amended to read:
153.21 		Subd. 3.General assistance medical care; eligibility. (a) Beginning April 1, 
153.22 	2010 October 1, 2011, the general assistance medical care program shall be administered 
153.23 	according to section 256D.031, unless otherwise stated, except for outpatient prescription 
153.24 	drug coverage, which shall continue to be administered under this section and funded 
153.25 	under section 256D.031, subdivision 9, beginning June 1, 2010.
153.26 	(b) Outpatient prescription drug coverage under general assistance medical care is 
153.27 	limited to prescription drugs that:
153.28 	(1) are covered under the medical assistance program as described in section 
153.29 	256B.0625, subdivisions 13 and 13d; and
153.30 	(2) are provided by manufacturers that have fully executed general assistance 
153.31 	medical care rebate agreements with the commissioner and comply with the agreements. 
153.32 	Outpatient prescription drug coverage under general assistance medical care must conform 
153.33 	to coverage under the medical assistance program according to section 256B.0625, 
153.34 	subdivisions 13 to 13h.
154.1 	(c) Outpatient prescription drug coverage does not include drugs administered in a 
154.2 	clinic or other outpatient setting.
154.3 	(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance 
154.4 	medical care covers the services listed in subdivision 4.

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

154.6 	Sec. 58. Minnesota Statutes 2010, section 256D.031, subdivision 1, is amended to read:
154.7 		Subdivision 1.Eligibility. (a) Except as provided under subdivision 2, general 
154.8 	assistance medical care may be paid for any individual who is not eligible for medical 
154.9 	assistance under chapter 256B, including eligibility for medical assistance based on a 
154.10 	spenddown of excess income according to section 256B.056, subdivision 5, and who:
154.11 	(1) is receiving assistance under section 256D.05, except for families with children 
154.12 	who are eligible under the Minnesota family investment program (MFIP), or who is 
154.13 	having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
154.14 	(2) is a resident of Minnesota and has gross countable income not in excess of 75 
154.15 	percent of federal poverty guidelines for the family size, using a six-month budget period, 
154.16 	and whose equity in assets is not in excess of $1,000 per assistance unit.
154.17 	(2) is a resident of Minnesota and has gross countable income that is equal to or less 
154.18 	than 125 percent of the federal poverty guidelines for the family size, using a six-month 
154.19 	budget period, and who meets the asset limit specified in section 256L.17, subdivision 2.
154.20 	Exempt assets, the reduction of excess assets, and the waiver of excess assets must 
154.21 	conform to the medical assistance program in section 256B.056, subdivisions 3 and 3d, 
154.22 	except that the maximum amount of undistributed funds in a trust that could be distributed 
154.23 	to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's 
154.24 	discretion under the terms of the trust, must be applied toward the asset maximum.
154.25 	(b) The commissioner shall adjust the income standards under this section each July 
154.26 	1 by the annual update of the federal poverty guidelines following publication by the 
154.27 	United States Department of Health and Human Services.

154.28 	Sec. 59. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
154.29 		Subd. 6.Coordinated care delivery systems. (a) Effective June 1, 2010 October 
154.30 	1, 2011, the commissioner shall contract with hospitals or groups of hospitals, or 
154.31 	county-based purchasing plans, that qualify under paragraph (b) and agree to deliver 
154.32 	services according to this subdivision. Contracting hospitals or plans shall develop 
154.33 	and implement a coordinated care delivery system to provide health care services to 
155.1 	individuals who are eligible for general assistance medical care under this section and who 
155.2 	either choose to receive services through the coordinated care delivery system or who are 
155.3 	enrolled by the commissioner under paragraph (c). The health care services provided by 
155.4 	the system must include: (1) the services described in subdivision 4 with the exception 
155.5 	of outpatient prescription drug coverage but shall include drugs administered in a clinic 
155.6 	or other outpatient setting; or (2) a set of comprehensive and medically necessary health 
155.7 	services that the recipients might reasonably require to be maintained in good health and 
155.8 	that has been approved by the commissioner, including at a minimum, but not limited 
155.9 	to, emergency care, medical transportation services, inpatient hospital and physician 
155.10 	care, outpatient health services, preventive health services, mental health services, 
155.11 	and prescription drugs administered in a clinic or other outpatient setting. Outpatient 
155.12 	prescription drug coverage is covered on a fee-for-service basis in accordance with section 
155.13 	256D.03, subdivision 3, and funded under subdivision 9. A hospital or plan establishing a 
155.14 	coordinated care delivery system under this subdivision must ensure that the requirements 
155.15 	of this subdivision are met.
155.16 	(b) A hospital or group of hospitals, or a county-based purchasing plan established 
155.17 	under section 256B.692, may contract with the commissioner to develop and implement a 
155.18 	coordinated care delivery system as follows: if the hospital or group of hospitals or plan 
155.19 	agrees to satisfy the requirements of this subdivision.
155.20 	(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during 
155.21 	calendar year 2008, it received fee-for-service payments for services to general assistance 
155.22 	medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater 
155.23 	than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to 
155.24 	provide geographic access or to ensure that at least 80 percent of enrollees have access to 
155.25 	a coordinated care delivery system; and
155.26 	(2) effective December 1, 2010, a Minnesota hospital not qualified under clause 
155.27 	(1) may contract with the commissioner under this subdivision if it agrees to satisfy the 
155.28 	requirements of this subdivision.
155.29 	Participation by hospitals or plans shall become effective quarterly on June 1, September 
155.30 	1, December 1, or March 1 October 1, January 1, April 1, or July 1. Hospital or plan 
155.31 	participation is effective for a period of 12 months and may be renewed for successive 
155.32 	12-month periods.
155.33 	(c) Applicants and recipients may enroll in any available coordinated care delivery 
155.34 	system statewide. If more than one coordinated care delivery system is available, the 
155.35 	applicant or recipient shall be allowed to choose among the systems. The commissioner 
155.36 	may assign an applicant or recipient to a coordinated care delivery system if no choice 
156.1 	is made by the applicant or recipient. The commissioner shall consider a recipient's zip 
156.2 	code, city of residence, county of residence, or distance from a participating coordinated 
156.3 	care delivery system when determining default assignment. An applicant or recipient 
156.4 	may decline enrollment in a coordinated care delivery system but services excluding 
156.5 	outpatient prescription drug coverage are only available through a coordinated care 
156.6 	delivery system. Upon enrollment into a coordinated care delivery system, the recipient 
156.7 	must agree to receive all nonemergency services through the coordinated care delivery 
156.8 	system. Enrollment in a coordinated care delivery system is for six months and may be 
156.9 	renewed for additional six-month periods, except that initial enrollment is for six months 
156.10 	or until the end of a recipient's period of general assistance medical care eligibility, 
156.11 	whichever occurs first. A recipient who continues to meet the eligibility requirements of 
156.12 	this section is not eligible to enroll in MinnesotaCare during a period of enrollment in a 
156.13 	coordinated care delivery system. From June 1, 2010, to February 28, 2011, applicants 
156.14 	and recipients not enrolled in a coordinated care delivery system may seek services from 
156.15 	a hospital eligible for reimbursement under the temporary uncompensated care pool 
156.16 	established under subdivision 8. After February 28, 2011, services are available only 
156.17 	through a coordinated care delivery system.
156.18 	(d) The hospital or plan may contract and coordinate with providers and clinics 
156.19 	for the delivery of services and shall contract with essential community providers as 
156.20 	defined under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the 
156.21 	extent practicable. When contracting with providers and clinics, the hospital or plan 
156.22 	shall give preference to providers and clinics certified as health care homes under section 
156.23 	256B.0751. The hospital or plan must contract with federally qualified health centers or 
156.24 	federally qualified health center look-alikes, as defined in section 145.9269, subdivision 1, 
156.25 	and essential community providers as defined in section 62Q.19, that agree to accept the 
156.26 	terms, conditions, and payment rates offered by the hospital or plan to similarly situated 
156.27 	providers, except that reimbursement to federally qualified health centers and federally 
156.28 	qualified health center look-alikes must comply with federal law. If a provider or clinic or 
156.29 	health center contracts with a hospital or plan to provide services through the coordinated 
156.30 	care delivery system, the provider may not refuse to provide services to any recipient 
156.31 	enrolled in the system, and payment for services shall be negotiated with the hospital or 
156.32 	plan and paid by the hospital or plan from the system's allocation under subdivision 7.
156.33 	(e) A coordinated care delivery system must:
156.34 	(1) provide the covered services required under paragraph (a) to recipients enrolled 
156.35 	in the coordinated care delivery system, and comply with the requirements of subdivision 
156.36 	4, paragraphs (b) to (g);
157.1 	(2) establish a process to monitor enrollment and ensure the quality of care provided;
157.2 	(3) in cooperation with counties, coordinate the delivery of health care services with 
157.3 	existing homeless prevention, supportive housing, and rent subsidy programs and funding 
157.4 	administered by the Minnesota Housing Finance Agency under chapter 462A; and
157.5 	(4) adopt innovative and cost-effective methods of care delivery and coordination, 
157.6 	which may include the use of allied health professionals, telemedicine, patient educators, 
157.7 	care coordinators, and community health workers.
157.8 	(f) The hospital or plan may require a recipient to designate a primary care provider 
157.9 	or a primary care clinic. The hospital or plan may limit the delivery of services to a 
157.10 	network of providers who have contracted with the hospital or plan to deliver services in 
157.11 	accordance with this subdivision, and require a recipient to seek services only within this 
157.12 	network. The hospital or plan may also require a referral to a provider before the service 
157.13 	is eligible for payment. A coordinated care delivery system is not required to provide 
157.14 	payment to a provider who is not employed by or under contract with the system for 
157.15 	services provided to a recipient enrolled in the system, except in cases of an emergency. 
157.16 	For purposes of this section, emergency services are defined in accordance with Code of 
157.17 	Federal Regulations, title 42, section 438.114 (a).
157.18 	(g) A recipient enrolled in a coordinated care delivery system has the right to appeal 
157.19 	to the commissioner according to section 256.045.
157.20 	(h) The state shall not be liable for the payment of any cost or obligation incurred 
157.21 	by the coordinated care delivery system.
157.22 	(i) The hospital or plan must provide the commissioner with data necessary for 
157.23 	assessing enrollment, quality of care, cost, and utilization of services. Each hospital or 
157.24 	plan must provide, on a quarterly basis on a form prescribed by the commissioner for each 
157.25 	recipient served by the coordinated care delivery system, the services provided, the cost of 
157.26 	services provided, and the actual payment amount for the services provided and any other 
157.27 	information the commissioner deems necessary to claim federal Medicaid match. The 
157.28 	commissioner must provide this data to the legislature on a quarterly basis.
157.29 	(j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2, 
157.30 	paragraph (b), do not apply to general assistance medical care provided under this section.
157.31 	(k) Notwithstanding any other provision in this section to the contrary, for 
157.32 	participation beginning September 1, 2010, the commissioner shall offer the same contract 
157.33 	terms related toshall negotiate an enrollment threshold formula and financial liability 
157.34 	protections to with a hospital or group of hospitals or plan qualified under this subdivision 
157.35 	to develop and implement a coordinated care delivery system as those contained in the 
157.36 	coordinated care delivery system contracts effective June 1, 2010.
158.1 	(l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are 
158.2 	implemented effective July 1, 2010, this subdivision must not be implemented.

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

158.4 	Sec. 60. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
158.5 		Subd. 7.Payments; rate setting for the hospital coordinated care delivery 
158.6 	system. (a) Effective for general assistance medical care services, with the exception 
158.7 	of outpatient prescription drug coverage, provided on or after June 1, 2010, through a 
158.8 	coordinated care delivery system, the commissioner shall allocate the annual appropriation 
158.9 	for the coordinated care delivery system to hospitals or plans participating under 
158.10 	subdivision 6 in quarterly payments, beginning on the first scheduled warrant on or after 
158.11 	June 1, 2010 October 1, 2011. The payment shall be allocated among all hospitals or 
158.12 	plans qualified to participate on the allocation date as follows: based upon the enrollment 
158.13 	thresholds negotiated with the commissioner.
158.14 	(1) each hospital or group of hospitals shall be allocated an initial amount based on 
158.15 	the hospital's or group of hospitals' pro rata share of calendar year 2008 payments for 
158.16 	general assistance medical care services to all participating hospitals;
158.17 	(2) the initial allocations to Hennepin County Medical Center; Regions Hospital; 
158.18 	Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview, 
158.19 	shall be increased to 110 percent of the value determined in clause (1);
158.20 	(3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata 
158.21 	amount in order to keep the allocations within the limit of available appropriations; and
158.22 	(4) the amounts determined under clauses (1) to (3) shall be allocated to participating 
158.23 	hospitals.
158.24 	The commissioner may prospectively reallocate payments to participating hospitals 
158.25 	or plans on a biannual basis to ensure that final allocations reflect actual coordinated 
158.26 	care delivery system enrollment. The 2008 base year shall be updated by one calendar 
158.27 	year each June 1, beginning June 1, 2011.
158.28 	(b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the 
158.29 	commissioner shall make one-third of the quarterly payment in June and the remaining 
158.30 	two-thirds of the quarterly payment in July to each participating hospital or group of 
158.31 	hospitals.
158.32 	(c) (b) In order to be reimbursed under this section, nonhospital providers of health 
158.33 	care services shall contract with one or more hospitals or plans described in paragraph (a) 
158.34 	to provide services to general assistance medical care recipients through the coordinated 
158.35 	care delivery system established by the hospital or plan. The hospital or plan shall 
159.1 	reimburse bills submitted by nonhospital providers participating under this paragraph at a 
159.2 	rate negotiated between the hospital or plan and the nonhospital provider.
159.3 	(d) (c) The commissioner shall apply for federal matching funds under section 
159.4 	256B.199, paragraphs (a) to (d), for expenditures under this subdivision.
159.5 	(e) (d) Outpatient prescription drug coverage is provided in accordance with section 
159.6 	256D.03, subdivision 3, and paid on a fee-for-service basis under subdivision 9.

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

159.8 	Sec. 61. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:
159.9 		Subd. 9.Prescription drug pool. (a) The commissioner shall establish an outpatient 
159.10 	prescription drug pool, effective June 1, 2010 October 1, 2011. Money in the pool must 
159.11 	be used to reimburse pharmacies and other pharmacy service providers as defined in 
159.12 	Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed 
159.13 	to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates 
159.14 	established in section 256B.0625, subdivision 13e. Outpatient prescription drug coverage 
159.15 	is subject to the availability of funds in the pool. If the commissioner forecasts that 
159.16 	expenditures under this subdivision will exceed the appropriation for this purpose, the 
159.17 	commissioner may bring recommendations to the Legislative Advisory Commission on 
159.18 	methods to resolve the shortfall.
159.19 	(b) Effective June 1, 2010 January 1, 2012, coordinated care delivery systems 
159.20 	established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an 
159.21 	assessment equal to 20 percent of payments for the prescribed drugs for recipients of 
159.22 	services through that coordinated care delivery system, as calculated by the commissioner 
159.23 	based on the most recent available data.

159.24 	Sec. 62. Minnesota Statutes 2010, section 256D.031, subdivision 10, is amended to 
159.25 	read:
159.26 		Subd. 10.Assistance for veterans. Hospitals and plans participating in the 
159.27 	coordinated care delivery system under subdivision 6 shall consult with counties, county 
159.28 	veterans service officers, and the Veterans Administration to identify other programs for 
159.29 	which general assistance medical care recipients enrolled in their system are qualified.

159.30 	Sec. 63. Minnesota Statutes 2010, section 256L.01, subdivision 4a, is amended to read:
159.31 		Subd. 4a.Gross individual or gross family income. (a) "Gross individual or gross 
159.32 	family income" for nonfarm self-employed means income calculated for the 12-month
159.33 	six-month period of eligibility using as a baseline the adjusted gross income reported 
160.1 	on the applicant's federal income tax form for the previous year and adding back in 
160.2 	depreciation, and carryover net operating loss amounts that apply to the business in which 
160.3 	the family is currently engaged.
160.4 	(b) "Gross individual or gross family income" for farm self-employed means 
160.5 	income calculated for the 12-month six-month period of eligibility using as the baseline 
160.6 	the adjusted gross income reported on the applicant's federal income tax form for the 
160.7 	previous year.
160.8 	(c) "Gross individual or gross family income" means the total income for all family 
160.9 	members, calculated for the 12-month six-month period of eligibility.

160.10 	Sec. 64. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:
160.11 		Subd. 3.Financial management. (a) The commissioner shall manage spending for 
160.12 	the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 
160.13 	each state revenue and expenditure forecast, the commissioner must make an assessment 
160.14 	of the expected expenditures for the covered services for the remainder of the current 
160.15 	biennium and for the following biennium. The estimated expenditure, including the 
160.16 	reserve, shall be compared to an estimate of the revenues that will be available in the health 
160.17 	care access fund. Based on this comparison, and after consulting with the chairs of the 
160.18 	house of representatives Ways and Means Committee and the senate Finance Committee, 
160.19 	and the Legislative Commission on Health Care Access, the commissioner shall, as 
160.20 	necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 
160.21 	remain within the limits of available revenues for the remainder of the current biennium 
160.22 	and for the following biennium. The commissioner shall not hire additional staff using 
160.23 	appropriations from the health care access fund until the commissioner of management 
160.24 	and budget makes a determination that the adjustments implemented under paragraph (b) 
160.25 	are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 
160.26 	revenues for the remainder of the current biennium and for the following biennium.
160.27 	(b) The adjustments the commissioner shall use must be implemented in this order: 
160.28 	first, stop enrollment of single adults and households without children; second, upon 45 
160.29 	days' notice, stop coverage of single adults and households without children already 
160.30 	enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium 
160.31 	subsidy amounts by ten percent for families with gross annual income above 200 percent 
160.32 	of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium 
160.33 	subsidy amounts by ten percent for families with gross annual income at or below 200 
160.34 	percent; and fifth, require applicants to be uninsured for at least six months prior to 
160.35 	eligibility in the MinnesotaCare program. If these measures are insufficient to limit the 
161.1 	expenditures to the estimated amount of revenue, the commissioner shall further limit 
161.2 	enrollment or decrease premium subsidies.

161.3 	Sec. 65. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:
161.4 		Subd. 5.Co-payments and coinsurance Cost-sharing. (a) Except as provided in 
161.5 	paragraphs (b) and, (c), and (h), the MinnesotaCare benefit plan shall include the following 
161.6 	co-payments and coinsurance cost-sharing requirements for all enrollees:
161.7 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
161.8 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
161.9 	(2) $3 per prescription for adult enrollees;
161.10 	(3) $25 for eyeglasses for adult enrollees;
161.11 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
161.12 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
161.13 	established illness, and which is delivered in an ambulatory setting by a physician or 
161.14 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
161.15 	audiologist, optician, or optometrist; and
161.16 	(5) $6 for nonemergency visits to a hospital-based emergency room for services 
161.17 	provided through December 31, 2010, and $3.50 effective January 1, 2011; and
161.18 	(6) a family deductible equal to the maximum amount allowed under Code of 
161.19 	Federal Regulations, title 42, part 447.54.
161.20 	(b) Paragraph (a), clause (1), does and paragraph (e) do not apply to parents and 
161.21 	relative caretakers of children under the age of 21.
161.22 	(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
161.23 	(d) Paragraph (a), clause (4), does not apply to mental health services.
161.24 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
161.25 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
161.26 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
161.27 	applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
161.28 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
161.29 	or changes from one prepaid health plan to another during a calendar year, any charges 
161.30 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
161.31 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
161.32 	prior to enrollment, or prior to the change in health plans, shall be disregarded.
161.33 	(g) MinnesotaCare reimbursements to fee-for-service providers and payments to 
161.34 	managed care plans or county-based purchasing plans shall not be increased as a result of 
161.35 	the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
162.1 	(h) Effective January 1, 2012, the following co-payments for nonpreventive visits 
162.2 	shall apply to enrollees who are adults without children eligible under section 256L.04, 
162.3 	subdivision 7:
162.4 	(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of care 
162.5 	per MinnesotaCare enrollee is at the 60th percentile or lower for providers of the same 
162.6 	type;
162.7 	(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care 
162.8 	per MinnesotaCare enrollee is greater than the 60th percentile but does not exceed the 
162.9 	80th percentile for providers of the same type; and
162.10 	(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of 
162.11 	care per MinnesotaCare enrollee is greater than the 80th percentile for providers of the 
162.12 	same type.
162.13 	Each managed care and county-based purchasing plan shall calculate the average, 
162.14 	risk-adjusted, total annual cost of care for providers under this paragraph using a 
162.15 	methodology that has been approved by the commissioner.

162.16 	Sec. 66. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
162.17 		Subdivision 1.Defined contributions to enrollees. (a) Beginning January 1, 2012, 
162.18 	the commissioner shall provide each MinnesotaCare enrollee eligible under section 
162.19 	256L.04, subdivision 7, with family income greater than 125 percent of the federal poverty 
162.20 	guidelines with a monthly defined contribution to purchase health coverage under a health 
162.21 	plan as defined in section 62A.011, subdivision 3.
162.22 	(b) Beginning January 1, 2012, the commissioner shall provide each MinnesotaCare 
162.23 	adult enrollee eligible under section 256L.04, subdivision 1, with family income greater 
162.24 	than 133 percent of the federal poverty guidelines with a monthly defined contribution to 
162.25 	purchase health coverage under a health plan as defined in section 62A.011, subdivision 3, 
162.26 	offered by a health plan company as defined in section 62Q.01, subdivision 4.
162.27 	(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums 
162.28 	under section 256L.15 and are exempt from the managed care enrollment requirement 
162.29 	of section 256L.12.
162.30 	(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees 
162.31 	eligible under paragraph (a) or (b) unless otherwise provided in this section. Covered 
162.32 	services, cost sharing, disenrollment for nonpayment of premium, enrollee appeal rights 
162.33 	and complaint procedures, and the effective date of coverage for enrollees eligible under 
162.34 	paragraph (a) shall be as provided under the terms of the health plan purchased by the 
162.35 	enrollee.
163.1 	(e) Unless otherwise provided in this section, all MinnesotaCare requirements 
163.2 	related to eligibility, income and asset methodology, income reporting, and program 
163.3 	administration, continue to apply to enrollees obtaining coverage under this section.
163.4 		Subd. 2.Use of defined contribution; health plan requirements. (a) An enrollee 
163.5 	may use up to the monthly defined contribution to pay premiums for coverage under a 
163.6 	health plan as defined in section 62A.011, subdivision 3.
163.7 	(b) An enrollee must select a health plan within three calendar months of approval of 
163.8 	MinnesotaCare eligibility. If a health plan is not selected and purchased within this time 
163.9 	period, the enrollee must reapply and must meet all eligibility criteria.
163.10 	(c) A health plan purchased under this section must:
163.11 	(1) provide coverage for mental health and chemical dependency treatment services; 
163.12 	and
163.13 	(2) comply with the coverage limitations specified in section 256L.03, subdivision 
163.14 	1, the second paragraph.
163.15 		Subd. 3.Determination of defined contribution amount. (a) The commissioner 
163.16 	shall determine the defined contribution sliding scale using the base contribution specified 
163.17 	in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 
163.18 	for defined contributions that provides:
163.19 	(1) persons with the lowest eligible household income with a defined contribution 
163.20 	of 110 percent of the base contribution;
163.21 	(2) persons with household incomes equal to 175 percent of the federal poverty 
163.22 	guidelines with a defined contribution of 100 percent of the base contribution;
163.23 	(3) persons with household incomes equal to or greater than 250 percent of 
163.24 	the federal poverty guidelines with a defined contribution of 80 percent of the base 
163.25 	contribution; and
163.26 	(4) persons with household incomes in evenly spaced increments between the 
163.27 	percentages of the federal poverty guideline or income level specified in clauses (1) to (3) 
163.28 	with a base contribution that is a percentage interpolated from the defined contribution 
163.29 	percentages specified in clauses (1) to (3).

163.30	Under 19
	$105
	
163.31	19-29
	$125
	
163.32	30-34
	$135
	
163.33	35-39
	$140
	
163.34	40-44
	$175
	
163.35	45-49
	$215
	
163.36	50-54
	$295
	
164.1	55-59
	$345
	
164.2	60+
	$360
	
164.3 	(b) The commissioner shall multiply the defined contribution amounts developed 
164.4 	under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 
164.5 	health plan by a health plan company and who purchase coverage through the Minnesota 
164.6 	Comprehensive Health Association.
164.7 		Subd. 4.Administration by commissioner. (a) The commissioner shall administer 
164.8 	the defined contributions. The commissioner shall:
164.9 	(1) calculate and process defined contributions for enrollees; and
164.10 	(2) pay the defined contribution amount to health plan companies or the Minnesota 
164.11 	Comprehensive Health Association, as applicable, for enrollee health plan coverage.
164.12 	(b) Nonpayment of a health plan premium shall result in disenrollment from 
164.13 	MinnesotaCare effective the first day of the calendar month following the calendar month 
164.14 	for which the premium was due. Persons disenrolled for nonpayment or who voluntarily 
164.15 	terminate coverage may not reenroll until four calendar months have elapsed.
164.16 		Subd. 5.Assistance to enrollees. The commissioner of human services, in 
164.17 	consultation with the commissioner of commerce, shall develop an efficient and 
164.18 	cost-effective method of referring eligible applicants to professional insurance agent 
164.19 	associations.
164.20 		Subd. 6.Minnesota Comprehensive Health Association (MCHA). Beginning 
164.21 	January 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual 
164.22 	health market by a health plan company in accordance with section 62A.65 are eligible 
164.23 	for coverage through a health plan offered by the Minnesota Comprehensive Health 
164.24 	Association and may enroll in MCHA in accordance with section 62E.14. Any difference 
164.25 	between the revenue and covered losses to the MCHA related to implementation of this 
164.26 	section shall be paid to the MCHA from the health care access fund.
164.27 		Subd. 7.Federal approval. The commissioner shall seek all federal waivers and 
164.28 	approvals necessary to implement coverage under this section for MinnesotaCare enrollees 
164.29 	eligible under subdivision 1. The commissioner shall seek the continuation of federal 
164.30 	financial participation for the adult enrollees eligible under section 256L.04, subdivision 1.

164.31 	Sec. 67. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:
164.32 		Subdivision 1.Families with children. (a) Families with children with family 
164.33 	income equal to or less than 275 percent of the federal poverty guidelines for the 
164.34 	applicable family size shall be eligible for MinnesotaCare according to this section. All 
165.1 	other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers 
165.2 	to enrollment under section 256L.07, shall apply unless otherwise specified.
165.3 	(b) Parents who enroll in the MinnesotaCare program must also enroll their children, 
165.4 	if the children are eligible. Children may be enrolled separately without enrollment by 
165.5 	parents. However, if one parent in the household enrolls, both parents must enroll, unless 
165.6 	other insurance is available. If one child from a family is enrolled, all children must 
165.7 	be enrolled, unless other insurance is available. If one spouse in a household enrolls, 
165.8 	the other spouse in the household must also enroll, unless other insurance is available. 
165.9 	Families cannot choose to enroll only certain uninsured members.
165.10 	(c) Beginning October 1, 2003, the dependent sibling definition no longer applies 
165.11 	to the MinnesotaCare program. These persons are no longer counted in the parental 
165.12 	household and may apply as a separate household.
165.13 	(d) Beginning July 1, 2010, or upon federal approval, whichever is later, Parents are 
165.14 	not eligible for MinnesotaCare if their gross income exceeds $57,500 $50,000.
165.15 	(e) Children formerly enrolled in medical assistance and automatically deemed 
165.16 	eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 
165.17 	from the requirements of this section until renewal.
165.18 	(f) [Reserved.]

165.19 	Sec. 68. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
165.20 		Subd. 7.Single adults and households with no children. (a) The definition of 
165.21 	eligible persons, through September 30, 2011,  includes all individuals and households 
165.22 	with no children who have gross family incomes that are equal to or less than 200250 
165.23 	percent of the federal poverty guidelines.
165.24 	(b) Effective July 1, 2009 October 1, 2011, the definition of eligible persons includes 
165.25 	all individuals and households with no children who have gross family incomes that are 
165.26 	greater than 125 percent of the federal poverty guidelines and equal to or less than 250 
165.27 	percent of the federal poverty guidelines.

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

165.29 	Sec. 69. Minnesota Statutes 2010, section 256L.04, subdivision 10, is amended to read:
165.30 		Subd. 10.Citizenship requirements. Eligibility for MinnesotaCare is limited to 
165.31 	citizens or nationals of the United States, qualified noncitizens, and other persons residing 
165.32 	lawfully in the United States as described in section 256B.06, subdivision 4, paragraphs 
165.33 	(a) to (e) and (j) who are eligible for medical assistance with federal participation 
165.34 	according to United States Code, title 8, section 1612. Undocumented noncitizens and 
166.1 	nonimmigrants are ineligible for MinnesotaCare. For purposes of this subdivision, a 
166.2 	nonimmigrant is an individual in one or more of the classes listed in United States Code, 
166.3 	title 8, section 1101(a)(15), and an undocumented noncitizen is an individual who resides 
166.4 	in the United States without the approval or acquiescence of the United States Citizenship 
166.5 	and Immigration Services. Families with children who are citizens or nationals of 
166.6 	the United States must cooperate in obtaining satisfactory documentary evidence of 
166.7 	citizenship or nationality according to the requirements of the federal Deficit Reduction 
166.8 	Act of 2005, Public Law 109-171.

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

166.10 	Sec. 70. Minnesota Statutes 2010, section 256L.05, subdivision 2, is amended to read:
166.11 		Subd. 2.Commissioner's duties. (a) The commissioner or county agency shall 
166.12 	use electronic verification as the primary method of income verification. If there is a 
166.13 	discrepancy between reported income and electronically verified income, an individual 
166.14 	may be required to submit additional verification. In addition, the commissioner shall 
166.15 	perform random audits to verify reported income and eligibility. The commissioner 
166.16 	may execute data sharing arrangements with the Department of Revenue and any other 
166.17 	governmental agency in order to perform income verification related to eligibility and 
166.18 	premium payment under the MinnesotaCare program.
166.19 	(b) In determining eligibility for MinnesotaCare, the commissioner shall require 
166.20 	applicants and enrollees seeking renewal of eligibility to verify both earned and unearned 
166.21 	income. The commissioner shall also require applicants and enrollees , and their spouses 
166.22 	or parents, who are age 21 and over and employed 20 or more hours per week by any one 
166.23 	employer, to verify that they do not have access to employer-subsidized coverage as 
166.24 	described in section 256L.07, subdivision 2. Data collected is nonpublic data as defined 
166.25 	in section 13.02, subdivision 9.

166.26 	Sec. 71. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:
166.27 		Subd. 3a.Renewal of eligibility. (a) Beginning July 1, 2007 2011, an enrollee's 
166.28 	eligibility must be renewed every 12 six months. The 12-month period begins in the 
166.29 	month after the month the application is approved.
166.30 	(b) Each new period of eligibility must take into account any changes in 
166.31 	circumstances that impact eligibility and premium amount. An enrollee must provide all 
166.32 	the information needed to redetermine eligibility by the first day of the month that ends 
166.33 	the eligibility period. If there is no change in circumstances, the enrollee may renew 
166.34 	eligibility at designated locations that include community clinics and health care providers' 
167.1 	offices. The designated sites shall forward the renewal forms to the commissioner. The 
167.2 	commissioner may establish criteria and timelines for sites to forward applications to the 
167.3 	commissioner or county agencies. The premium for the new period of eligibility must be 
167.4 	received as provided in section 256L.06 in order for eligibility to continue.
167.5 	(c) An enrollee who fails to submit renewal forms and related documentation 
167.6 	necessary for verification of continued eligibility in a timely manner shall remain eligible 
167.7 	for one additional month beyond the end of the current eligibility period before being 
167.8 	disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the 
167.9 	additional month.

167.10 	Sec. 72. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision 
167.11 	to read:
167.12 		Subd. 6.Referral of veterans. The commissioner shall ensure that all applicants 
167.13 	for MinnesotaCare who identify themselves as veterans are referred to a county veterans 
167.14 	service officer for assistance in applying to the United States Department of Veterans 
167.15 	Affairs for any veterans benefits for which they may be eligible.

167.16 	Sec. 73. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:
167.17 		Subdivision 1.General requirements. (a) Children enrolled in the original 
167.18 	children's health plan as of September 30, 1992, children who enrolled in the 
167.19 	MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 
167.20 	article 4, section 17, and children who have family gross incomes that are equal to or 
167.21 	less than 150 percent of the federal poverty guidelines are eligible without meeting 
167.22 	the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 
167.23 	long as they maintain continuous coverage in the MinnesotaCare program or medical 
167.24 	assistance. Children who apply for MinnesotaCare on or after the implementation date 
167.25 	of the employer-subsidized health coverage program as described in Laws 1998, chapter 
167.26 	407, article 5, section 45, who have family gross incomes that are equal to or less than 150 
167.27 	percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 
167.28 	be eligible for MinnesotaCare.
167.29 	(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose 
167.30 	income increases above 275 percent of the federal poverty guidelines the limits described 
167.31 	in section 256L.04, subdivision 1, are no longer eligible for the program and shall be 
167.32 	disenrolled by the commissioner. Beginning January 1, 2008,
167.33 	(c) Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, 
167.34 	whose income increases above 200 percent of the federal poverty guidelines or 250 
168.1 	percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for 
168.2 	the program and shall be disenrolled by the commissioner.
168.3 	(d) For persons disenrolled under this subdivision, MinnesotaCare coverage 
168.4 	terminates the last day of the calendar month following the month in which the 
168.5 	commissioner determines that the income of a family or individual exceeds program 
168.6 	income limits.
168.7 	(b) (e) Notwithstanding paragraph (a) (b), children may remain enrolled in 
168.8 	MinnesotaCare if ten percent of their gross individual or gross family income as defined 
168.9 	in section 256L.01, subdivision 4, is less than the annual premium for a six-month 
168.10 	policy with a $500 deductible available through the Minnesota Comprehensive Health 
168.11 	Association. Children who are no longer eligible for MinnesotaCare under this clause shall 
168.12 	be given a 12-month notice period from the date that ineligibility is determined before 
168.13 	disenrollment. The premium for children remaining eligible under this clause shall be the 
168.14 	maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
168.15 	(c) (f) Notwithstanding paragraphs (a) and (b) (e), parents are not eligible for 
168.16 	MinnesotaCare if gross household income exceeds $57,500 for the 12-month $25,000 for 
168.17 	the six-month period of eligibility.

168.18 	Sec. 74. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
168.19 		Subd. 7.Critical access dental providers. Effective for dental services provided to 
168.20 	MinnesotaCare enrollees on or after January 1, 2007, July 1, 2011, the commissioner shall 
168.21 	increase payment rates to dentists and dental clinics deemed by the commissioner to be 
168.22 	critical access providers under section 256B.76, subdivision 4, by 50 30 percent above 
168.23 	the payment rate that would otherwise be paid to the provider. The commissioner shall 
168.24 	pay the prepaid health plans under contract with the commissioner amounts sufficient to 
168.25 	reflect this rate increase. The prepaid health plan must pass this rate increase to providers 
168.26 	who have been identified by the commissioner as critical access dental providers under 
168.27 	section 256B.76, subdivision 4.

168.28 	Sec. 75. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
168.29 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
168.30 	per capita, where possible. The commissioner may allow health plans to arrange for 
168.31 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
168.32 	an independent actuary to determine appropriate rates.
168.33 	(b) For services rendered on or after January 1, 2004, the commissioner shall 
168.34 	withhold five percent of managed care plan payments and county-based purchasing 
169.1 	plan payments under this section pending completion of performance targets. Each 
169.2 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
169.3 	except in the case of a performance target based on a federal or state law or rule. Criteria 
169.4 	for assessment of each performance target must be outlined in writing prior to the 
169.5 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
169.6 	satisfaction, that the data submitted regarding attainment of the performance target is 
169.7 	accurate. The commissioner shall periodically change the administrative measures used 
169.8 	as performance targets in order to improve plan performance across a broader range of 
169.9 	administrative services. The performance targets must include measurement of plan 
169.10 	efforts to contain spending on health care services and administrative activities. The 
169.11 	commissioner may adopt plan-specific performance targets that take into account factors 
169.12 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
169.13 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
169.14 	following calendar year if performance targets in the contract are achieved.
169.15 	(c) For services rendered on or after January 1, 2011, the commissioner shall 
169.16 	withhold an additional three percent of managed care plan or county-based purchasing 
169.17 	plan payments under this section. The withheld funds must be returned no sooner than 
169.18 	July 1 and no later than July 31 of the following calendar year. The return of the withhold 
169.19 	under this paragraph is not subject to the requirements of paragraph (b).
169.20 	(d) Effective for services rendered on or after January 1, 2011, the commissioner 
169.21 	shall include as part of the performance targets described in paragraph (b) a reduction in 
169.22 	the plan's emergency room utilization rate for state health care program enrollees by a 
169.23 	measurable rate of five percent from the plan's utilization rate for the previous calendar 
169.24 	year.
169.25 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
169.26 	of the following calendar year if the managed care plan demonstrates to the satisfaction of 
169.27 	the commissioner that a reduction in the utilization rate was achieved.
169.28 	The withhold described in this paragraph shall continue for each consecutive 
169.29 	contract period until the plan's emergency room utilization rate for state health care 
169.30 	program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 
169.31 	for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 
169.32 	with the health plans in meeting this performance target and shall accept payment 
169.33 	withholds that may be returned to the hospitals if the performance target is achieved. The 
169.34 	commissioner shall structure the withhold so that the commissioner returns a portion of 
169.35 	the withheld funds in amounts commensurate with achieved reductions in utilization less 
170.1 	than the targeted amount. The withhold described in this paragraph does not apply to 
170.2 	county-based purchasing plans.
170.3 	(e) Effective for services provided on or after January 1, 2012, the commissioner 
170.4 	shall include as part of the performance targets described in paragraph (b) a reduction in 
170.5 	the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous 
170.6 	hospitalization of a patient regardless of the reason for the hospitalization for state health 
170.7 	care program enrollees by a measurable rate of five percent from the plan's hospitalization 
170.8 	rate for the previous calendar year.
170.9 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
170.10 	of the following calendar year if the managed care plan or county-based purchasing plan 
170.11 	demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization 
170.12 	rate was achieved.
170.13 	The withhold described in this paragraph must continue for each consecutive 
170.14 	contract period until the plan's subsequent hospitalization rate for state health care 
170.15 	program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate 
170.16 	for state health care program enrollees for calendar year 2010. Hospitals shall cooperate 
170.17 	with the plans in meeting this performance target and shall accept payment withholds that 
170.18 	must be returned to the hospitals if the performance target is achieved. The commissioner 
170.19 	shall structure the withhold so that the commissioner returns a portion of the withheld 
170.20 	funds in amounts commensurate with achieved reductions in utilizations less than the 
170.21 	targeted amount. The withhold described in this paragraph does not apply to county-based 
170.22 	purchasing plans.
170.23 	(e) (f) A managed care plan or a county-based purchasing plan under section 
170.24 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
170.25 	under this section that is reasonably expected to be returned.

170.26 	Sec. 76. Minnesota Statutes 2010, section 256L.15, subdivision 1a, is amended to read:
170.27 		Subd. 1a.Payment options. The commissioner may offer the following payment 
170.28 	options to an enrollee:
170.29 	(1) payment by check;
170.30 	(2) payment by credit card;
170.31 	(3) payment by recurring automatic checking withdrawal;
170.32 	(4) payment by onetime electronic transfer of funds;
170.33 	(5) payment by wage withholding with the consent of the employer and the 
170.34 	employee; or
170.35 	(6) payment by using state tax refund payments.
171.1 	The commissioner shall include information about the payment options on each 
171.2 	premium notice. At application or reapplication, a MinnesotaCare applicant or enrollee 
171.3 	may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to 
171.4 	collect funds from the applicant's or enrollee's refund for the purposes of meeting all or 
171.5 	part of the applicant's or enrollee's MinnesotaCare premium obligation. The applicant or 
171.6 	enrollee may authorize the commissioner to apply for the state working family tax credit 
171.7 	on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be 
171.8 	subject to the $10 fee under section 270A.07, subdivision 1.

171.9 	Sec. 77. PLAN TO COORDINATE CARE FOR CHILDREN WITH HIGH-COST 
171.10 	MENTAL HEALTH CONDITIONS.
 171.11 	The commissioner of human services shall develop and submit to the legislature 
171.12 	by December 15, 2011, a plan to provide care coordination to medical assistance and 
171.13 	MinnesotaCare enrollees who are children with high-cost mental health conditions. For 
171.14 	purposes of this section, a child has a "high-cost mental health condition" if mental health 
171.15 	and medical expenses over the past year totalled $100,000 or more. For purposes of this 
171.16 	section, "care coordination" means collaboration between an advanced practice nurse and 
171.17 	primary care physicians and specialists to manage care; development of mental health 
171.18 	management plans for recurrent mental health issues; oversight and coordination of all 
171.19 	aspects of care in partnership with families; organization of medical, treatment, and 
171.20 	therapy information into a summary of critical information; coordination and appropriate 
171.21 	sequencing of evaluations and multiple appointments; information and assistance with 
171.22 	accessing resources; and telephone triage for behavior or other problems.

171.23 	Sec. 78. REGULATORY SIMPLIFICATION AND REDUCTION OF 
171.24 	PROVIDER REPORTING AND DATA SUBMITTAL REQUIREMENTS.
 171.25 		Subdivision 1.Regulatory simplification and report reduction work group. The 
171.26 	commissioner of management and budget shall convene a regulatory simplification and 
171.27 	report reduction work group of persons designated by the commissioners of health, human 
171.28 	services, and commerce to eliminate redundant, unnecessary, and obsolete state mandated 
171.29 	reporting or data submittal requirements for health care providers or group purchasers 
171.30 	related to health care costs, quality, utilization, access, or patient encounters or related to 
171.31 	provider or group purchaser, monitoring, finances, and regulation.  For purposes of this 
171.32 	section, the term "health care providers or group purchasers" has the meaning provided 
171.33 	in Minnesota Statutes, section 62J.03, subdivisions 6 and 8, except that it also includes 
171.34 	nursing homes.
172.1 		Subd. 2.Plan development and other duties. (a) The commissioner of 
172.2 	management and budget, in consultation with the work group, shall develop a plan for 
172.3 	regulatory simplification and report reduction activities of the commissioners of health, 
172.4 	human services, and commerce that considers collection and regulation of the following 
172.5 	in a coordinated manner:
172.6 	(1) encounter data;
172.7 	(2) group purchaser provider network data;
172.8 	(3) financial reporting;
172.9 	(4) reporting and documentation requirements relating to member communications 
172.10 	and marketing materials;
172.11 	(5) state regulation and oversight of group purchasers;
172.12 	(6) requirements and procedures for denial, termination, or reduction of services 
172.13 	and member appeals and grievances; and
172.14 	(7) state performance improvement projects, requirements, and procedures.
172.15 	(b) The commissioners of health, human services, and commerce, following 
172.16 	consultation with the work group, shall present to the legislature by January 1, 2012, 
172.17 	proposals to implement their recommendations.
172.18 		Subd. 3.New reporting and other duties. (a) The commissioner of management 
172.19 	and budget, in consultation with the work group and the commissioners of health, human 
172.20 	services, and commerce, shall develop criteria to be used by the commissioners in 
172.21 	determining whether to establish new reporting and data submittal requirements. These 
172.22 	criteria must support the establishment of new reporting and data submittal requirements 
172.23 	only:
172.24 	(1) if required by a federal agency or state statute;
172.25 	(2) if needed for a state regulatory audit or corrective action plan;
172.26 	(3) if needed to monitor or protect public health;
172.27 	(4) if needed to manage the cost and quality of Minnesota's public health insurance 
172.28 	programs; or
172.29 	(5) if a review and analysis by the commissioner of the relevant agency has 
172.30 	documented the necessity, importance, and administrative cost of the requirement, and 
172.31 	has determined that the information sought cannot be efficiently obtained through another 
172.32 	state or federal report.
172.33 	(b) The commissioners of health, human services, and commerce, following 
172.34 	consultation with the work group, may propose to the legislature new provider and group 
172.35 	purchaser reporting and data submittal requirements to take effect on or after July 1, 2012. 
173.1 	These proposals shall include an analysis of the extent to which the requirements meet 
173.2 	the criteria developed under paragraph (a).

173.3 	Sec. 79. SPECIALIZED MAINTENANCE THERAPY.
 173.4 	The commissioner of human services shall evaluate whether providing medical 
173.5 	assistance coverage for specialized maintenance therapy for enrollees with serious and 
173.6 	persistent mental illness who are at risk of hospitalization will improve the quality of 
173.7 	care and lower medical assistance spending by reducing rates of hospitalization. The 
173.8 	commissioner shall present findings and recommendations to the chairs and ranking 
173.9 	minority members of the legislative committees with jurisdiction over health and human 
173.10 	services finance and policy by December 15, 2011.

173.11 	Sec. 80. BENEFIT SET OPTIONS.
 173.12 	The commissioner of human services shall analyze and provide recommendations 
173.13 	for state plan amendments that would provide different benefits for different demographic 
173.14 	populations under the medical assistance program as permitted under federal law, with the 
173.15 	goal of tailoring more cost-effective coverage based on unique needs of the demographic 
173.16 	population. The commissioner shall report these recommendations to the chairs and 
173.17 	ranking minority members of the senate and house health and human services committees 
173.18 	by January 15, 2012.

173.19 	Sec. 81. REDUCING HOSPITALIZATION RATES.
 173.20 	The commissioner of human services, by January 15, 2012, shall present 
173.21 	recommendations to the legislature to reduce hospitalization rates for state health care 
173.22 	program enrollees who are children with high-cost medical conditions.

173.23 	Sec. 82. MEDICAID FRAUD PREVENTION AND DETECTION.
 173.24 		Subdivision 1.Request for proposals. By October 31, 2011, the commissioner 
173.25 	of human services shall issue a request for proposals to prevent and detect Medicaid 
173.26 	fraud and mispayment. The request for proposals shall require the vendor to provide 
173.27 	data analytics capabilities, including, but not limited to, predictive modeling techniques 
173.28 	and other forms of advanced analytics, technical assistance, claims review, and medical 
173.29 	record and documentation investigations, to detect and investigate improper payments 
173.30 	both before and after payments are made.
174.1 		Subd. 2.Proof of concept phase. The selected vendor, at no cost to the state, shall 
174.2 	be required to apply its analytics and investigations on a subset of data provided by the 
174.3 	commissioner to demonstrate the direct recoveries of the solution.
174.4 		Subd. 3.Data confidentiality. Data provided by the commissioner to the vendor 
174.5 	under this section must maintain the confidentiality of the information.
174.6 		Subd. 4.Full implementation phase. The request for proposal must require the 
174.7 	commissioner to implement the recommendations provided by the vendor if the work 
174.8 	done under the requirements of subdivision 2 provides recoveries directly related to the 
174.9 	investigations to the state. After full implementation, the vendor shall be paid from 
174.10 	recoveries directly attributable to the work done by the vendor, according to the terms and 
174.11 	performance measures negotiated in the contract.
174.12 		Subd. 5.Selection of vendor. The commissioner of human services shall select a 
174.13 	vendor from the responses to the request for proposal by January 31, 2012.
174.14 		Subd. 6.Progress report. The commissioner shall provide a report describing the 
174.15 	progress made under this section to the governor and the chairs and ranking minority 
174.16 	members of the legislative committees with jurisdiction over the Department of Human 
174.17 	Services by June 15, 2012. The report shall provide a dynamic scoring analysis of the 
174.18 	work described in the report.

174.19 	Sec. 83. WOUND CARE TREATMENT.
 174.20 	The commissioner of human services, through the health services policy committee 
174.21 	established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall study 
174.22 	the effectiveness of new strategies for wound care treatment for medical assistance and 
174.23 	MinnesotaCare enrollees with diabetes, including but not limited to the use of new wound 
174.24 	care technologies, assessment tools, and reporting programs. The commissioner shall 
174.25 	present recommendations by December 15, 2011, to the legislature on whether these 
174.26 	new strategies for wound care treatment should be covered under medical assistance 
174.27 	and MinnesotaCare.

174.28 	Sec. 84. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN 
174.29 	FEDERAL HEALTH CARE REFORMS.
 174.30 	State funds must not be expended in the planning or implementation of the Patient 
174.31 	Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care 
174.32 	and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no 
174.33 	provisions of the act may be implemented, until the constitutionality of the act has been 
174.34 	affirmed by the United States Supreme Court.

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

175.2 	Sec. 85. COMMISSIONER'S ACTIONS; REPEAL OF EARLY MEDICAL 
175.3 	ASSISTANCE EXPANSION.
 175.4 	(a) Effective October 1, 2011, the commissioner of human services shall suspend 
175.5 	implementation and administration of Minnesota Statutes 2010, sections 256B.055, 
175.6 	subdivision 15; 256B.056, subdivision 3, paragraph (b); and 256B.056, subdivision 4, 
175.7 	paragraph (d). The commissioner shall refer persons enrolled under these provisions, and 
175.8 	applicants for coverage under these provisions, to the general assistance medical care 
175.9 	program established under Minnesota Statutes, section 256D.031.
175.10 	(b) The commissioner shall seek all federal approvals and waivers necessary 
175.11 	to implement Minnesota Statutes, section 256D.031, and to ensure federal financial 
175.12 	participation for the population covered under Minnesota Statutes, section 256D.031.

175.13 	Sec. 86. GENERAL ASSISTANCE MEDICAL CARE PROGRAM; 
175.14 	PROVISIONS REVIVED.
 175.15 	Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter 
175.16 	1, article 16, section 47, the following statutes are revived and have the force of law 
175.17 	effective October 1, 2011:
175.18 	(1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 6, 7, and 8;
175.19 	(2) Minnesota Statutes 2010, section 256D.031, subdivisions 1, 2, 3, 4, 6, 7, 9, 
175.20 	and 10; and
175.21 	(3) Laws 2010, chapter 200, article 1, section 18.

175.22 	Sec. 87.  REPEALER.
 175.23 	(a) Minnesota Statutes 2010, section 62J.07, subdivisions 1, 2, and 3, are repealed.
175.24 	(b) Minnesota Statutes 2010, section 256L.07, subdivision 7, exempting eligibility 
175.25 	for children formally under medical assistance, is repealed retroactively from October 
175.26 	1, 2008, and federal approval is no longer necessary.
175.27 	(c) The amendment in Laws 2009, chapter 79, article 5, section 55, as amended by 
175.28 	Laws 2009, chapter 173, article 1, section 36, (256L.04, subdivision 1, children deemed 
175.29 	eligible are exempt from eligibility requirements) is repealed retroactively from January 
175.30 	1, 2009, and federal approval is no longer necessary.
175.31 	(d) Laws 2009, chapter 79, article 5, section 56,  (256L.04, subdivision 1b, 
175.32 	exemption from income limit for children) is repealed retroactively from July 1, 2009, 
175.33 	and federal approval is no longer necessary.
176.1 	(e) Laws 2009, chapter 79, article 5, section 60, (256L.05, subdivision 1c, open 
176.2 	enrollment and streamlined application) is repealed retroactively from July 1, 2009, 
176.3 	and federal approval is no longer necessary.
176.4 	(f) Laws 2009, chapter 79, article 5, section 66, (256L.07, subdivision 8, automatic 
176.5 	eligibility certain children) is repealed retroactively from July 1, 2009, and federal 
176.6 	approval is no longer necessary.
176.7 	(g) The amendment in Laws 2009, chapter 79, article 5, section 57, (256L.04, 
176.8 	subdivision 7a, ineligibility for adults with certain income) is repealed retroactively 
176.9 	from July 1, 2009, and federal approval is no longer necessary.
176.10 	(h) The amendment in Laws 2009, chapter 79, article 5, section 61,  (256L.05, 
176.11 	subdivision 3, children eligibility following termination from foster care) is repealed 
176.12 	retroactively from July 1, 2009, and federal approval is no longer necessary.
176.13 	(i) The amendment in Laws 2009, chapter 79, article 5, section 62,  (256L.05, 
176.14 	subdivision 3a, exemption from cancellation for nonrenewal for children) is repealed 
176.15 	retroactively from July 1, 2009, and federal approval is no longer necessary.
176.16 	(j) The amendment in Laws 2009, chapter 79, article 5, section 63,  (256L.07, 
176.17 	subdivision 1, children whose gross family income is greater than 275 percent FPG 
176.18 	may remain enrolled) is repealed retroactively from July 1, 2009, and federal approval is 
176.19 	no longer necessary.
176.20 	(k) The amendment in Laws 2009, chapter 79, article 5, section 64,  (256L.07, 
176.21 	subdivision 2, exempts children from requirement not to have employer-subsidized 
176.22 	coverage) is repealed retroactively from July 1, 2009, and federal approval is no longer 
176.23 	necessary.
176.24 	(l) The amendment in Laws 2009, chapter 79, article 5, section 65,  (256L.07, 
176.25 	subdivision 3, requires children with family gross income over 200 percent of FPG 
176.26 	to have had no health coverage for four months prior to application) is repealed 
176.27 	retroactively from July 1, 2009, and federal approval is no longer necessary.
176.28 	(m) The amendment in Laws 2009, chapter 79, article 5, section 68,  (256L.15, 
176.29 	subdivision 2, children in families with income less than 200 percent FPG pay no 
176.30 	premium) is repealed retroactively from July 1, 2009, and federal approval is no longer 
176.31 	necessary.
176.32 	(n) The amendment in Laws 2009, chapter 79, article 5, section 69,  (256L.15, 
176.33 	subdivision 3, exempts children with family income below 200 percent FPG from 
176.34 	sliding fee scale) is repealed retroactively from July 1, 2009, and federal approval is 
176.35 	no longer necessary.
177.1 	(o) Laws 2009, chapter 79, article 5, section 79,  (uncoded federal approval) is 
177.2 	repealed the day following final enactment.
177.3 	(p) Minnesota Statutes 2010, section 256B.057, subdivision 2c, (extended medical 
177.4 	assistance for certain children) is repealed.
177.5 	(q) The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9, 
177.6 	(renewal rolling month and premium grace month) are repealed.

177.7 	Sec. 88.  REPEALER.
 177.8 	Minnesota Statutes 2010, sections 256B.055, subdivision 15; and 256B.0756, are 
177.9 	repealed effective October 1, 2011.

177.10 	ARTICLE 6
177.11 	CONTINUING CARE

177.12 	Section 1. [15.996] PERFORMANCE-BASED ORGANIZATIONS.
177.13 		Subdivision 1.Designation. The governor may designate one or more programs 
177.14 	within the Department of Human Services and within up to two other executive branch 
177.15 	state agencies whose missions involve people with disabilities as performance-based 
177.16 	organizations. The goal of the performance-based organization designation is to provide 
177.17 	the best services in the most cost-effective manner to people with disabilities.  For a 
177.18 	program that is designated as a performance-based organization, the agency providing 
177.19 	services or another governmental or private organization under contract with the agency 
177.20 	may enter into a performance-based agreement that allows the agency or the entity under 
177.21 	contract with the agency more flexibility in its operations in exchange for a greater level of 
177.22 	accountability. With any required legislative approval, a performance-based organization 
177.23 	agreement may exempt an agency or an outside entity providing services from one or 
177.24 	more procedural laws, rules, or policies that otherwise would govern the program.
177.25 		Subd. 2.Performance-based organization agreement. Designation of a 
177.26 	performance-based organization must be implemented through a performance-based 
177.27 	organization agreement. A performance-based organization agreement may be between 
177.28 	the governor and an agency, if an agency is to provide services under the agreement, or 
177.29 	between an agency and an outside entity, if the outside entity is to provide the services. A 
177.30 	performance-based organization agreement must:
177.31 	(1) describe the programs subject to the agreement;
177.32 	(2) specify the procedural laws, rules, or policies that will not apply to the 
177.33 	performance-based organization, why waiver or variance from these laws, rules, or 
178.1 	policies is necessary to achieve desired outcomes, and a description of alternative means 
178.2 	of accomplishing the purposes of those laws, rules, or policies;
178.3 	(3) contain procedures for oversight of the performance-based organization, 
178.4 	including requirements and procedures for program and financial audits;
178.5 	(4) if the performance-based organization involves a nonstate entity, contain 
178.6 	provisions governing assumption of liability, and types and amounts of insurance coverage 
178.7 	to be obtained;
178.8 	(5) specify the duration of the agreement; and
178.9 	(6) specify measurable performance-based outcomes for achieving program 
178.10 	goals, time periods during which these outcomes will be measured and reported, and 
178.11 	consequences for not meeting the performance-based outcomes.
178.12 		Subd. 3.Duration; legislative approval; reporting. (a) A performance-based 
178.13 	organization agreement may be up to three years and may be renewed.
178.14 	(b) The chief executive of the state agency whose program is subject to a 
178.15 	performance-based organization must report to the chairs and ranking minority members 
178.16 	of legislative policy and finance committees with jurisdiction over the program on the 
178.17 	proposed content of the performance-based organization, and specifically describing 
178.18 	any procedural laws, rules, and policies that will not apply. The legislature must 
178.19 	approve a performance-based organization before the state agency may enter into a 
178.20 	performance-based agreement.

178.21 	Sec. 2. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:
178.22 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor 
178.23 	child, including a child determined eligible for medical assistance without consideration of 
178.24 	parental income, must contribute to the cost of services used by making monthly payments 
178.25 	on a sliding scale based on income, unless the child is married or has been married, 
178.26 	parental rights have been terminated, or the child's adoption is subsidized according to 
178.27 	section 259.67 or through title IV-E of the Social Security Act. The parental contribution 
178.28 	is a partial or full payment for medical services provided for diagnostic, therapeutic, 
178.29 	curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 
178.30 	defined in United States Code, title 26, section 213, needed by the child with a chronic 
178.31 	illness or disability.
178.32 	(b) For households with adjusted gross income equal to or greater than 100 percent 
178.33 	of federal poverty guidelines, the parental contribution shall be computed by applying the 
178.34 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
179.1 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
179.2 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
179.3 	contribution is $4 per month;
179.4 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
179.5 	poverty guidelines and less than or equal to 545 525 percent of federal poverty guidelines, 
179.6 	the parental contribution shall be determined using a sliding fee scale established by the 
179.7 	commissioner of human services which begins at one percent of adjusted gross income at 
179.8 	175 percent of federal poverty guidelines and increases to 7.5 eight percent of adjusted 
179.9 	gross income for those with adjusted gross income up to 545 525 percent of federal 
179.10 	poverty guidelines;
179.11 	(3) if the adjusted gross income is greater than 545 525 percent of federal 
179.12 	poverty guidelines and less than 675 percent of federal poverty guidelines, the parental 
179.13 	contribution shall be 7.5 9.5 percent of adjusted gross income;
179.14 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
179.15 	poverty guidelines and less than 975 900 percent of federal poverty guidelines, the parental 
179.16 	contribution shall be determined using a sliding fee scale established by the commissioner 
179.17 	of human services which begins at 7.5 9.5 percent of adjusted gross income at 675 percent 
179.18 	of federal poverty guidelines and increases to ten 12 percent of adjusted gross income for 
179.19 	those with adjusted gross income up to 975 900 percent of federal poverty guidelines; and
179.20 	(5) if the adjusted gross income is equal to or greater than 975 900 percent of 
179.21 	federal poverty guidelines, the parental contribution shall be 12.5 13.5 percent of adjusted 
179.22 	gross income.
179.23 	If the child lives with the parent, the annual adjusted gross income is reduced by 
179.24 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
179.25 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
179.26 	specified under that section in addition to the parental contribution determined under this 
179.27 	section. The parental contribution is reduced by any amount required to be paid directly to 
179.28 	the child pursuant to a court order, but only if actually paid.
179.29 	(c) The household size to be used in determining the amount of contribution under 
179.30 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
179.31 	child receiving services. Adjustments in the contribution amount due to annual changes 
179.32 	in the federal poverty guidelines shall be implemented on the first day of July following 
179.33 	publication of the changes.
179.34 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
179.35 	natural or adoptive parents determined according to the previous year's federal tax form, 
180.1 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
180.2 	have been used to purchase a home shall not be counted as income.
180.3 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
180.4 	for services is being determined. The contribution shall be made on a monthly basis 
180.5 	effective with the first month in which the child receives services. Annually upon 
180.6 	redetermination or at termination of eligibility, if the contribution exceeded the cost of 
180.7 	services provided, the local agency or the state shall reimburse that excess amount to 
180.8 	the parents, either by direct reimbursement if the parent is no longer required to pay a 
180.9 	contribution, or by a reduction in or waiver of parental fees until the excess amount is 
180.10 	exhausted. All reimbursements must include a notice that the amount reimbursed may be 
180.11 	taxable income if the parent paid for the parent's fees through an employer's health care 
180.12 	flexible spending account under the Internal Revenue Code, section 125, and that the 
180.13 	parent is responsible for paying the taxes owed on the amount reimbursed.
180.14 	(f) The monthly contribution amount must be reviewed at least every 12 months; 
180.15 	when there is a change in household size; and when there is a loss of or gain in income 
180.16 	from one month to another in excess of ten percent. The local agency shall mail a written 
180.17 	notice 30 days in advance of the effective date of a change in the contribution amount. 
180.18 	A decrease in the contribution amount is effective in the month that the parent verifies a 
180.19 	reduction in income or change in household size.
180.20 	(g) Parents of a minor child who do not live with each other shall each pay the 
180.21 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
180.22 	child support payment actually paid on behalf of the child receiving services shall be 
180.23 	deducted from the adjusted gross income of the parent making the payment prior to 
180.24 	calculating the parental contribution under paragraph (b).
180.25 	(h) The contribution under paragraph (b) shall be increased by an additional five 
180.26 	percent if the local agency determines that insurance coverage is available but not 
180.27 	obtained for the child. For purposes of this section, "available" means the insurance is a 
180.28 	benefit of employment for a family member at an annual cost of no more than five percent 
180.29 	of the family's annual income. For purposes of this section, "insurance" means health 
180.30 	and accident insurance coverage, enrollment in a nonprofit health service plan, health 
180.31 	maintenance organization, self-insured plan, or preferred provider organization.
180.32 	Parents who have more than one child receiving services shall not be required 
180.33 	to pay more than the amount for the child with the highest expenditures. There shall 
180.34 	be no resource contribution from the parents. The parent shall not be required to pay 
180.35 	a contribution in excess of the cost of the services provided to the child, not counting 
181.1 	payments made to school districts for education-related services. Notice of an increase in 
181.2 	fee payment must be given at least 30 days before the increased fee is due.
181.3 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 
181.4 	in the 12 months prior to July 1:
181.5 	(1) the parent applied for insurance for the child;
181.6 	(2) the insurer denied insurance;
181.7 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 
181.8 	a complaint or appeal, in writing, to the commissioner of health or the commissioner of 
181.9 	commerce, or litigated the complaint or appeal; and
181.10 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
181.11 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
181.12 	A parent who has requested a reduction in the contribution amount under this 
181.13 	paragraph shall submit proof in the form and manner prescribed by the commissioner or 
181.14 	county agency, including, but not limited to, the insurer's denial of insurance, the written 
181.15 	letter or complaint of the parents, court documents, and the written response of the insurer 
181.16 	approving insurance. The determinations of the commissioner or county agency under this 
181.17 	paragraph are not rules subject to chapter 14.
181.18 	(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 
181.19 	2013, the parental contribution shall be computed by applying the following contribution 
181.20 	schedule to the adjusted gross income of the natural or adoptive parents:
181.21 	(1) if the adjusted gross income is equal to or greater than 100 percent of federal 
181.22 	poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 
181.23 	contribution is $4 per month;
181.24 	(2) if the adjusted gross income is equal to or greater than 175 percent of federal 
181.25 	poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, 
181.26 	the parental contribution shall be determined using a sliding fee scale established by the 
181.27 	commissioner of human services which begins at one percent of adjusted gross income 
181.28 	at 175 percent of federal poverty guidelines and increases to eight percent of adjusted 
181.29 	gross income for those with adjusted gross income up to 525 percent of federal poverty 
181.30 	guidelines;
181.31 	(3) if the adjusted gross income is greater than 525 percent of federal poverty 
181.32 	guidelines and less than 675 percent of federal poverty guidelines, the parental contribution 
181.33 	shall be 9.5 percent of adjusted gross income;
181.34 	(4) if the adjusted gross income is equal to or greater than 675 percent of federal 
181.35 	poverty guidelines and less than 900 percent of federal poverty guidelines, the parental 
181.36 	contribution shall be determined using a sliding fee scale established by the commissioner 
182.1 	of human services which begins at 9.5 percent of adjusted gross income at 675 percent of 
182.2 	federal poverty guidelines and increases to 12 percent of adjusted gross income for those 
182.3 	with adjusted gross income up to 900 percent of federal poverty guidelines; and
182.4 	(5) if the adjusted gross income is equal to or greater than 900 percent of federal 
182.5 	poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross 
182.6 	income. If the child lives with the parent, the annual adjusted gross income is reduced by 
182.7 	$2,400 prior to calculating the parental contribution. If the child resides in an institution 
182.8 	specified in section 256B.35, the parent is responsible for the personal needs allowance 
182.9 	specified under that section in addition to the parental contribution determined under this 
182.10 	section. The parental contribution is reduced by any amount required to be paid directly to 
182.11 	the child pursuant to a court order, but only if actually paid.

182.12 	Sec. 3. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
182.13 		Subd. 24.Disability Linkage Line. The commissioner shall establish the Disability 
182.14 	Linkage Line, ato serve as Minnesota's neutral access point for statewide consumer
182.15 	disability information, referral, and assistance system for people with disabilities and 
182.16 	chronic illnesses that. The Disability Linkage Line shall:
182.17 	(1) deliver information and assistance based on national and state standards;
182.18 	(1) provides (2) provide information about state and federal eligibility requirements, 
182.19 	benefits, and service options;
182.20 	(3) provide benefits and options counseling;
182.21 	(2) makes (4) make referrals to appropriate support entities;
182.22 	(3) delivers information and assistance based on national and state standards;
182.23 	(4) assists (5) educate people to on their options so they can make well-informed 
182.24 	decisions choices; and
182.25 	(5) supports (6) help support the timely resolution of service access and benefit 
182.26 	issues.;
182.27 	(7) inform people of their long-term community services and supports;
182.28 	(8) provide necessary resources and supports that can lead to employment and 
182.29 	increased economic stability of people with disabilities; and
182.30 	(9) serve as the technical assistance and help center for the Web-based tool, 
182.31 	Minnesota's Disability Benefits 101.org.

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

182.33 	Sec. 4. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
183.1 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
183.2 	determinations of disability by the commissioner's state medical review team under 
183.3 	sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph 
183.4 	(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence 
183.5 	submitted by county agencies with a referral and seek additional information from 
183.6 	providers, applicants, and enrollees to support the determination of disability where 
183.7 	necessary. Disability shall be determined according to the rules of title XVI and title 
183.8 	XIX of the Social Security Act and pertinent rules and policies of the Social Security 
183.9 	Administration.
183.10 	(b) Prior to a denial or withdrawal of a requested determination of disability due 
183.11 	to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 
183.12 	necessary and appropriate to a determination of disability, and (2) assist applicants and 
183.13 	enrollees to obtain the evidence, including, but not limited to, medical examinations 
183.14 	and electronic medical records.
183.15 	(c) The commissioner shall provide the chairs of the legislative committees with 
183.16 	jurisdiction over health and human services finance and budget the following information 
183.17 	on the activities of the state medical review team by February 1 of each year:
183.18 	(1) the number of applications to the state medical review team that were denied, 
183.19 	approved, or withdrawn;
183.20 	(2) the average length of time from receipt of the application to a decision;
183.21 	(3) the number of appeals, appeal results, and the length of time taken from the date 
183.22 	the person involved requested an appeal for a written decision to be made on each appeal;
183.23 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
183.24 	history within three months of application, and whether an application for Social Security 
183.25 	or Supplemental Security Income benefits is pending; and
183.26 	(5) specific information on the medical certification, licensure, or other credentials 
183.27 	of the person or persons performing the medical review determinations and length of 
183.28 	time in that position.
183.29 	(d) Any appeal made under section 256.045, subdivision 3, of a disability 
183.30 	determination made by the state medical review team must be decided according to the 
183.31 	timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is 
183.32 	not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the 
183.33 	appeal must be immediately reviewed by the chief appeals referee.

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

184.1 	Sec. 5. Minnesota Statutes 2010, section 256B.04, is amended by adding a subdivision 
184.2 	to read:
184.3 		Subd. 20.Money Follows the Person Rebalancing demonstration project. In 
184.4 	accordance with federal law governing Money Follows the Person Rebalancing funds, 
184.5 	amounts equal to the value of enhanced federal funding resulting from the operation of the 
184.6 	demonstration project grant must be transferred from the medical assistance account in 
184.7 	the general fund to an account in the special revenue fund. Funds in the special revenue 
184.8 	fund account do not cancel and are appropriated to the commissioner to carry out the 
184.9 	goals of the Money Follows the Person Rebalancing demonstration project as required 
184.10 	under the approved federal plan for the use of the funds, and may be transferred to the 
184.11 	medical assistance account if applicable.

184.12 	Sec. 6. Minnesota Statutes 2010, section 256B.05, is amended by adding a subdivision 
184.13 	to read:
184.14 		Subd. 5.Obligation of local agency to process medical assistance applications 
184.15 	within established timelines. The local agency must act on an application for medical 
184.16 	assistance within ten working days of receipt of all information needed to act on the 
184.17 	application but no later than required under Minnesota Rules, part 9505.0090, subparts 
184.18 	2 and 3.

184.19 	Sec. 7. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
184.20 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
184.21 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
184.22 	member of a household with two family members, husband and wife, or parent and child, 
184.23 	the household must not own more than $6,000 in assets, plus $200 for each additional 
184.24 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
184.25 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
184.26 	time of an eligibility redetermination. The accumulation of the clothing and personal 
184.27 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
184.28 	the time of the eligibility redetermination. The value of assets that are not considered in 
184.29 	determining eligibility for medical assistance is the value of those assets excluded under 
184.30 	the supplemental security income program for aged, blind, and disabled persons, with 
184.31 	the following exceptions:
184.32 	(1) household goods and personal effects are not considered;
184.33 	(2) capital and operating assets of a trade or business that the local agency determines 
184.34 	are necessary to the person's ability to earn an income are not considered;
185.1 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
185.2 	security income program;
185.3 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
185.4 	the supplemental security income program. Burial expenses funded by annuity contracts 
185.5 	or life insurance policies must irrevocably designate the individual's estate as contingent 
185.6 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
185.7 	(5) effective upon federal approval, for a person who no longer qualifies as an 
185.8 	employed person with a disability due to loss of earnings, assets allowed while eligible 
185.9 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
185.10 	months, beginning with the first month of ineligibility as an employed person with a 
185.11 	disability, to the extent that the person's total assets remain within the allowed limits of 
185.12 	section 256B.057, subdivision 9, paragraph (c) (d).
185.13 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
185.14 	15.

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

185.16 	Sec. 8. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
185.17 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
185.18 	for a person who is employed and who:
185.19 	(1) but for excess earnings or assets, meets the definition of disabled under the 
185.20 	Supplemental Security Income program;
185.21 	(2) is at least 16 but less than 65 years of age;
185.22 	(3) meets the asset limits in paragraph (c) (d); and
185.23 	(4) pays a premium and other obligations under paragraph (e).
185.24 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
185.25 	for medical assistance under this subdivision, a person must have more than $65 of earned 
185.26 	income. Earned income must have Medicare, Social Security, and applicable state and 
185.27 	federal taxes withheld. The person must document earned income tax withholding. Any 
185.28 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
185.29 	determinations.
185.30 	(b) (c) After the month of enrollment, a person enrolled in medical assistance under 
185.31 	this subdivision who:
185.32 	(1) is temporarily unable to work and without receipt of earned income due to a 
185.33 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
185.34 	months; or
186.1 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
186.2 	enrollee, and is without receipt of earned income may retain eligibility for up to four 
186.3 	consecutive months after the month of job loss. To receive a four-month extension, 
186.4 	enrollees must verify the medical condition or provide notification of job loss. All other 
186.5 	eligibility requirements must be met and the enrollee must pay all calculated premium 
186.6 	costs for continued eligibility.
186.7 	(c) (d) For purposes of determining eligibility under this subdivision, a person's 
186.8 	assets must not exceed $20,000, excluding:
186.9 	(1) all assets excluded under section 256B.056;
186.10 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
186.11 	Keogh plans, and pension plans; and
186.12 	(3) medical expense accounts set up through the person's employer.; and
186.13 	(4) spousal assets, including spouse's share of jointly held assets.
186.14 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
186.15 	earned income disregard. To be eligible, a person applying for medical assistance under 
186.16 	this subdivision must have earned income above the disregard level.
186.17 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
186.18 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
186.19 	a person must document earned income tax withholding.
186.20 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
186.21 	percent of federal poverty guidelines for the applicable family size must pay a premium 
186.22 	to be eligible for medical assistance under this subdivision. (e) All enrollees must pay a 
186.23 	premium to be eligible for medical assistance under this subdivision, except as provided 
186.24 	under section 256.01, subdivision 18b.
186.25 	(1) An enrollee must pay the greater of a $65 premium or the premium shall be
186.26 	calculated based on the person's gross earned and unearned income and the applicable 
186.27 	family size using a sliding fee scale established by the commissioner, which begins at 
186.28 	one percent of income at 100 percent of the federal poverty guidelines and increases 
186.29 	to 7.5 percent of income for those with incomes at or above 300 percent of the federal 
186.30 	poverty guidelines. 
186.31 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
186.32 	poverty guidelines shall be effective for premiums due in July of each year.
186.33 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
186.34 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35 
186.35 	premium or the premium calculated in clause (1).
187.1 	(3) Effective November 1, 2003, All enrollees who receive unearned income must 
187.2 	pay one-half of one five percent of unearned income in addition to the premium amount, 
187.3 	except as provided under section 256.01, subdivision 18b.
187.4 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
187.5 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
187.6 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
187.7 	256B.0625, subdivision 15, paragraph (a).
187.8 	(5) (4) Increases in benefits under title II of the Social Security Act shall not be 
187.9 	counted as income for purposes of this subdivision until July 1 of each year.
187.10 	(f) A person's eligibility and premium shall be determined by the local county 
187.11 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
187.12 	the commissioner.
187.13 	(g) Any required premium shall be determined at application and redetermined at 
187.14 	the enrollee's six-month income review or when a change in income or household size is 
187.15 	reported. Enrollees must report any change in income or household size within ten days 
187.16 	of when the change occurs. A decreased premium resulting from a reported change in 
187.17 	income or household size shall be effective the first day of the next available billing month 
187.18 	after the change is reported. Except for changes occurring from annual cost-of-living 
187.19 	increases, a change resulting in an increased premium shall not affect the premium amount 
187.20 	until the next six-month review.
187.21 	(h) Premium payment is due upon notification from the commissioner of the 
187.22 	premium amount required. Premiums may be paid in installments at the discretion of 
187.23 	the commissioner.
187.24 	(i) Nonpayment of the premium shall result in denial or termination of medical 
187.25 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
187.26 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
187.27 	D, are met. Except when an installment agreement is accepted by the commissioner, 
187.28 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
187.29 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
187.30 	payment with a returned, refused, or dishonored instrument. The commissioner may 
187.31 	require a guaranteed form of payment as the only means to replace a returned, refused, 
187.32 	or dishonored instrument.
187.33 	(j) The commissioner shall notify enrollees annually beginning at least 24 months 
187.34 	before the person's 65th birthday of the medical assistance eligibility rules affecting 
187.35 	income, assets, and treatment of a spouse's income and assets that will be applied upon 
187.36 	reaching age 65.
188.1 	(k) For enrollees whose income does not exceed 200 percent of the federal poverty 
188.2 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse 
188.3 	the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, 
188.4 	paragraph (a).

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

188.7 	Sec. 9. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to 
188.8 	read:
188.9 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
188.10 	must meet the following requirements:
188.11 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
188.12 	of age with these additional requirements:
188.13 	(i) supervision by a qualified professional every 60 days; and
188.14 	(ii) employment by only one personal care assistance provider agency responsible 
188.15 	for compliance with current labor laws;
188.16 	(2) be employed by a personal care assistance provider agency;
188.17 	(3) enroll with the department as a personal care assistant after clearing a background 
188.18 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
188.19 	services, the personal care assistance provider agency must initiate a background study on 
188.20 	the personal care assistant under chapter 245C, and the personal care assistance provider 
188.21 	agency must have received a notice from the commissioner that the personal care assistant 
188.22 	is:
188.23 	(i) not disqualified under section 245C.14; or
188.24 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
188.25 	disqualification under section 245C.22;
188.26 	(4) be able to effectively communicate with the recipient and personal care 
188.27 	assistance provider agency;
188.28 	(5) be able to provide covered personal care assistance services according to the 
188.29 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
188.30 	and report changes in the recipient's condition to the supervising qualified professional 
188.31 	or physician;
188.32 	(6) not be a consumer of personal care assistance services;
188.33 	(7) maintain daily written records including, but not limited to, time sheets under 
188.34 	subdivision 12;
189.1 	(8) effective January 1, 2010, complete standardized training as determined 
189.2 	by the commissioner before completing enrollment. The training must be available 
189.3 	in languages other than English and to those who need accommodations due to 
189.4 	disabilities. Personal care assistant training must include successful completion of the 
189.5 	following training components: basic first aid, vulnerable adult, child maltreatment, 
189.6 	OSHA universal precautions, basic roles and responsibilities of personal care assistants 
189.7 	including information about assistance with lifting and transfers for recipients, emergency 
189.8 	preparedness, orientation to positive behavioral practices, fraud issues, and completion of 
189.9 	time sheets. Upon completion of the training components, the personal care assistant must 
189.10 	demonstrate the competency to provide assistance to recipients;
189.11 	(9) complete training and orientation on the needs of the recipient within the first 
189.12 	seven days after the services begin; and
189.13 	(10) be limited to providing and being paid for up to 275 hours per month, except 
189.14 	that this limit shall be 275 hours per month for the period July 1, 2009, through June 30, 
189.15 	2011, of personal care assistance services regardless of the number of recipients being 
189.16 	served or the number of personal care assistance provider agencies enrolled with. The 
189.17 	number of hours worked per day shall not be disallowed by the department unless in 
189.18 	violation of the law.
189.19 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
189.20 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
189.21 	(c) Effective January 1, 2010, Persons who do not qualify as a personal care assistant 
189.22 	include parents and stepparents of minors, spouses, paid legal guardians, family foster 
189.23 	care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 
189.24 	staff of a residential setting. When the personal care assistant is a relative of the recipient, 
189.25 	the commissioner shall pay 80 percent of the provider rate. For purposes of this section, 
189.26 	relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or 
189.27 	older, an adult child, a grandparent, or a grandchild. 

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

189.29 	Sec. 10. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to 
189.30 	read:
189.31 		Subd. 28.Personal care assistance provider agency; required documentation.
 189.32 	(a) Required documentation must be completed and kept in the personal care assistance 
189.33 	provider agency file or the recipient's home residence. The required documentation 
189.34 	consists of:
189.35 	(1) employee files, including:
190.1 	(i) applications for employment;
190.2 	(ii) background study requests and results;
190.3 	(iii) orientation records about the agency policies;
190.4 	(iv) trainings completed with demonstration of competence;
190.5 	(v) supervisory visits;
190.6 	(vi) evaluations of employment; and
190.7 	(vii) signature on fraud statement;
190.8 	(2) recipient files, including:
190.9 	(i) demographics;
190.10 	(ii) emergency contact information and emergency backup plan;
190.11 	(iii) personal care assistance service plan;
190.12 	(iv) personal care assistance care plan;
190.13 	(v) month-to-month service use plan;
190.14 	(vi) all communication records;
190.15 	(vii) start of service information, including the written agreement with recipient; and
190.16 	(viii) date the home care bill of rights was given to the recipient;
190.17 	(3) agency policy manual, including:
190.18 	(i) policies for employment and termination;
190.19 	(ii) grievance policies with resolution of consumer grievances;
190.20 	(iii) staff and consumer safety;
190.21 	(iv) staff misconduct; and
190.22 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
190.23 	resolution of consumer grievances;
190.24 	(4) time sheets for each personal care assistant along with completed activity sheets 
190.25 	for each recipient served; and
190.26 	(5) agency marketing and advertising materials and documentation of marketing 
190.27 	activities and costs; and
190.28 	(6) for each personal care assistant, whether or not the personal care assistant is 
190.29 	providing care to a relative as defined in subdivision 11.
190.30 	(b) The commissioner may assess a fine of up to $500 on provider agencies that do 
190.31 	not consistently comply with the requirements of this subdivision.

190.32 	Sec. 11. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to 
190.33 	read:
190.34 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
190.35 	(a) "Long-term care consultation services" means:
191.1 	(1) assistance in identifying services needed to maintain an individual in the most 
191.2 	inclusive environment;
191.3 	(2) providing recommendations on cost-effective community services that are 
191.4 	available to the individual;
191.5 	(3) development of an individual's person-centered community support plan;
191.6 	(4) providing information regarding eligibility for Minnesota health care programs;
191.7 	(5) face-to-face long-term care consultation assessments, which may be completed 
191.8 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
191.9 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
191.10 	residence;
191.11 	(6) federally mandated screening to determine the need for an institutional level of 
191.12 	care under subdivision 4a;
191.13 	(7) determination of home and community-based waiver service eligibility 
191.14 	including level of care determination for individuals who need an institutional level of 
191.15 	care as defined under section 144.0724, subdivision 11, or 256B.092, service eligibility 
191.16 	including state plan home care services identified in sections 256B.0625, subdivisions 
191.17 	6, 7, and 19, paragraphs (a) and (c), and 256B.0657, based on assessment and support 
191.18 	plan development with appropriate referrals, including the option for consumer-directed 
191.19 	communityself-directed supports;
191.20 	(8) providing recommendations for nursing facility placement when there are no 
191.21 	cost-effective community services available; and
191.22 	(9) assistance to transition people back to community settings after facility 
191.23 	admission; and
191.24 	(10) providing notice to the individual or legal representative of the annual and 
191.25 	monthly average authorized amount for traditional agency services and self-directed 
191.26 	services under section 256B.0657 for which the recipient is found eligible.
191.27 	(b) "Long-term care options counseling" means the services provided by the linkage 
191.28 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
191.29 	telephone assistance and follow up once a long-term care consultation assessment has 
191.30 	been completed.
191.31 	(c) "Minnesota health care programs" means the medical assistance program under 
191.32 	chapter 256B and the alternative care program under section 256B.0913.
191.33 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
191.34 	plans administering long-term care consultation assessment and support planning services.

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

192.1 	Sec. 12. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to 
192.2 	read:
192.3 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
192.4 	services planning, or other assistance intended to support community-based living, 
192.5 	including persons who need assessment in order to determine waiver or alternative 
192.6 	care program eligibility, must be visited by a long-term care consultation team within 
192.7 	15 calendar 20 calendar days after the date on which an assessment was requested or 
192.8 	recommended. After January 1, 2011, these requirements also apply to personal care 
192.9 	assistance services, private duty nursing, and home health agency services, on timelines 
192.10 	established in subdivision 5. Face-to-face assessments must be conducted according 
192.11 	to paragraphs (b) to (i).
192.12 	(b) The county may utilize a team of either the social worker or public health nurse, 
192.13 	or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 
192.14 	assessment in a face-to-face interview. The consultation team members must confer 
192.15 	regarding the most appropriate care for each individual screened or assessed.
192.16 	(c) The assessment must be comprehensive and include a person-centered 
192.17 	assessment of the health, psychological, functional, environmental, and social needs of 
192.18 	referred individuals and provide information necessary to develop a support plan that 
192.19 	meets the consumers needs, using an assessment form provided by the commissioner.
192.20 	(d) The assessment must be conducted in a face-to-face interview with the person 
192.21 	being assessed and the person's legal representative, as required by legally executed 
192.22 	documents, and other individuals as requested by the person, who can provide information 
192.23 	on the needs, strengths, and preferences of the person necessary to develop a support 
192.24 	plan that ensures the person's health and safety, but who is not a provider of service or 
192.25 	has any financial interest in the provision of services. For persons who are to be assessed 
192.26 	for elderly waiver customized living services under section 256B.0915, and with the 
192.27 	permission of the person being assessed or the persons' designated or legal representative, 
192.28 	the client's current or proposed provider of services may submit a copy of the provider's 
192.29 	nursing assessment or written report outlining their recommendations regarding the 
192.30 	client's care needs. The person conducting the assessment will notify the provider of the 
192.31 	date by which this information is to be submitted. This information shall be provided to 
192.32 	the person conducting the assessment prior to the assessment.
192.33 	(e) The person, or the person's legal representative, must be provided with 
192.34 	written recommendations for community-based services, including consumer-directed
192.35 	self-directed  options, or institutional care that include documentation that the most 
192.36 	cost-effective alternatives available were offered to the individual. For purposes of 
193.1 	this requirement, "cost-effective alternatives" means community services and living 
193.2 	arrangements that cost the same as or less than institutional care. For persons determined 
193.3 	eligible for services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the 
193.4 	community support plan must also include the estimated annual and monthly average 
193.5 	authorized budget amount for those services.
193.6 	(f)(1) If the person chooses to use community-based services, the person or the 
193.7 	person's legal representative must be provided with a written community support plan, 
193.8 	regardless of whether the individual is eligible for Minnesota health care programs. The 
193.9 	written community support plan must include:
193.10 	(i) a summary of assessed needs as defined in paragraphs (c) and (d);
193.11 	(ii) the individual's options and choices to meet identified needs, including all 
193.12 	available options for case management services and providers;
193.13 	(iii) identification of health and safety risks and how those risks will be addressed, 
193.14 	including personal risk management strategies;
193.15 	(iv) referral information; and 
193.16 	(v) informal caregiver supports, if applicable.
193.17 	(2) For persons determined eligible for services defined under subdivision 1a, 
193.18 	paragraph (a), clauses (7) to (10), the community support plan must also include:
193.19 	(i) identification of individual goals;
193.20 	(ii) identification of short-term and long-term service outcomes. Short-term service 
193.21 	outcomes are defined as achievable within six months; 
193.22 	(iii) a recommended schedule for case management visits. When achievement of 
193.23 	short-term service outcomes may affect the amount of service required, the schedule must 
193.24 	be at least every six months and must reflect evaluation and progress toward identified 
193.25 	short-term service outcomes; and
193.26 	(iv) the estimated annual and monthly budget amount for services.
193.27 	(3) In addition, for persons determined eligible for state plan home care under 
193.28 	subdivision 1a, paragraph (a), clause (8), the person or person's representative must also 
193.29 	receive a copy of the home care service plan developed by a certified assessor.
193.30 	(4) A person may request assistance in identifying community supports without 
193.31 	participating in a complete assessment. Upon a request for assistance identifying 
193.32 	community support, the person must be transferred or referred to the services available 
193.33 	under sections 256.975, subdivision 7, and 256.01, subdivision 24, for telephone 
193.34 	assistance and follow up.
194.1 	(g) The person has the right to make the final decision between institutional 
194.2 	placement and community placement after the recommendations have been provided, 
194.3 	except as provided in subdivision 4a, paragraph (c).
194.4 	(h) The team must give the person receiving assessment or support planning, or 
194.5 	the person's legal representative, materials, and forms supplied by the commissioner 
194.6 	containing the following information:
194.7 	(1) the need for and purpose of preadmission screening if the person selects nursing 
194.8 	facility placement;
194.9 	(2) the role of the long-term care consultation assessment and support planning in 
194.10 	waiver and alternative care program eligibility determination;
194.11 	(3) information about Minnesota health care programs;
194.12 	(4) the person's freedom to accept or reject the recommendations of the team;
194.13 	(5) the person's right to confidentiality under the Minnesota Government Data 
194.14 	Practices Act, chapter 13;
194.15 	(6) the long-term care consultant's decision regarding the person's need for 
194.16 	institutional level of care as determined under criteria established in section 144.0724, 
194.17 	subdivision 11, or 256B.092; and
194.18 	(7) the person's right to appeal the decision regarding the need for nursing facility 
194.19 	level of care or the county's final decisions regarding public programs eligibility according 
194.20 	to section 256.045, subdivision 3.
194.21 	(i) Face-to-face assessment completed as part of eligibility determination for 
194.22 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
194.23 	community alternative care, and traumatic brain injury waiver programs under sections 
194.24 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
194.25 	than 60 calendar days after the date of assessment. The effective eligibility start date 
194.26 	for these programs can never be prior to the date of assessment. If an assessment was 
194.27 	completed more than 60 days before the effective waiver or alternative care program 
194.28 	eligibility start date, assessment and support plan information must be updated in a
194.29 	face-to-face visit and documented in the department's Medicaid Management Information 
194.30 	System (MMIS). The updated assessment may be completed by face-to-face visit, written 
194.31 	communication, or telephone as determined by the commissioner to establish statewide 
194.32 	consistency. The effective date of program eligibility in this case cannot be prior to the 
194.33 	date the updated assessment is completed.

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

195.1 	Sec. 13. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to 
195.2 	read:
195.3 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 195.4 	(a) Funding for services under the alternative care program is available to persons who 
195.5 	meet the following criteria:
195.6 	(1) the person has been determined by a community assessment under section 
195.7 	256B.0911 to be a person who would require the level of care provided in a nursing 
195.8 	facility, but for the provision of services under the alternative care program. Effective 
195.9 	January 1, 2011, this determination must be made according to the criteria established in 
195.10 	section 144.0724, subdivision 11;
195.11 	(2) the person is age 65 or older;
195.12 	(3) the person would be eligible for medical assistance within 135 days of admission 
195.13 	to a nursing facility;
195.14 	(4) the person is not ineligible for the payment of long-term care services by the 
195.15 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
195.16 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
195.17 	(5) the person needs long-term care services that are not funded through other 
195.18 	state or federal funding, or other health insurance or other third-party insurance such as 
195.19 	long-term care insurance;
195.20 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
195.21 	care services funded by the program for this person does not exceed 75 percent of the 
195.22 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
195.23 	does not prohibit the alternative care client from payment for additional services, but in no 
195.24 	case may the cost of additional services purchased under this section exceed the difference 
195.25 	between the client's monthly service limit defined under section 256B.0915, subdivision 
195.26 	3, and the alternative care program monthly service limit defined in this paragraph. If 
195.27 	care-related supplies and equipment or environmental modifications and adaptations are or 
195.28 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
195.29 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
195.30 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
195.31 	limit established in this paragraph, the annual cost of the alternative care services shall be 
195.32 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
195.33 	times the monthly limit described in this paragraph;
195.34 	(7) for individuals assigned a case mix classification A as described under section 
195.35 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
195.36 	living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming, 
196.1 	or walking, or (iii) a dependency score of less than three if eating is the only dependency
196.2 	and eating when the dependency score in eating is three or greater as determined by 
196.3 	an assessment performed under section 256B.0911, the monthly cost of alternative 
196.4 	care services funded by the program cannot exceed $600 $593 per month for all new 
196.5 	participants enrolled in the program on or after July 1, 2009 2011. This monthly limit 
196.6 	shall be applied to all other participants who meet this criteria at reassessment. This 
196.7 	monthly limit shall be increased annually as described in section 256B.0915, subdivision 
196.8 	3a, paragraph (a). This monthly limit does not prohibit the alternative care client from 
196.9 	payment for additional services, but in no case may the cost of additional services 
196.10 	purchased exceed the difference between the client's monthly service limit defined in this 
196.11 	clause and the limit described in clause (6) for case mix classification A; and
196.12 	(8) the person is making timely payments of the assessed monthly fee.
196.13 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
196.14 	agrees to:
196.15 	(i) the appointment of a representative payee;
196.16 	(ii) automatic payment from a financial account;
196.17 	(iii) the establishment of greater family involvement in the financial management of 
196.18 	payments; or
196.19 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
196.20 	The lead agency may extend the client's eligibility as necessary while making 
196.21 	arrangements to facilitate payment of past-due amounts and future premium payments. 
196.22 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
196.23 	reinstated for a period of 30 days.
196.24 	(b) Alternative care funding under this subdivision is not available for a person 
196.25 	who is a medical assistance recipient or who would be eligible for medical assistance 
196.26 	without a spenddown or waiver obligation. A person whose initial application for medical 
196.27 	assistance and the elderly waiver program is being processed may be served under the 
196.28 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
196.29 	for medical assistance, medical assistance must be billed for services payable under the 
196.30 	federally approved elderly waiver plan and delivered from the date the individual was 
196.31 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
196.32 	provision, alternative care funds may not be used to pay for any service the cost of which: 
196.33 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
196.34 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
196.35 	to participate in the federally approved elderly waiver program under the special income 
196.36 	standard provision.
197.1 	(c) Alternative care funding is not available for a person who resides in a licensed 
197.2 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
197.3 	for case management services which are provided in support of the discharge planning 
197.4 	process for a nursing home resident or certified boarding care home resident to assist with 
197.5 	a relocation process to a community-based setting.
197.6 	(d) Alternative care funding is not available for a person whose income is greater 
197.7 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
197.8 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
197.9 	year for which alternative care eligibility is determined, who would be eligible for the 
197.10 	elderly waiver with a waiver obligation.

197.11 	Sec. 14. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to 
197.12 	read:
197.13 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
197.14 	waivered services to an individual elderly waiver client except for individuals described 
197.15 	in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 
197.16 	mix resident class to which the elderly waiver client would be assigned under Minnesota 
197.17 	Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 
197.18 	as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 
197.19 	which the resident assessment system as described in section 256B.438 for nursing home 
197.20 	rate determination is implemented. Effective on the first day of the state fiscal year in 
197.21 	which the resident assessment system as described in section 256B.438 for nursing home 
197.22 	rate determination is implemented and the first day of each subsequent state fiscal year, the 
197.23 	monthly limit for the cost of waivered services to an individual elderly waiver client shall 
197.24 	be the rate of the case mix resident class to which the waiver client would be assigned 
197.25 	under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 
197.26 	previous state fiscal year, adjusted by the greater of any legislatively adopted home and 
197.27 	community-based services percentage rate increase or the average statewide percentage 
197.28 	increase in nursing facility payment rates adjustment.
197.29 	(b) The monthly limit for the cost of waivered services to an individual elderly 
197.30 	waiver client assigned to a case mix classification A under paragraph (a) with:
197.31 	(1) no dependencies in activities of daily living,; or
197.32 	(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
197.33 	walking, or (3) a dependency score of less than three if eating is the only dependency,
197.34 	and eating when the dependency score in eating is three or greater as determined by an 
197.35 	assessment performed under section 256B.0911
198.1 	 shall be the lower of the case mix classification amount for case mix A as determined 
198.2 	under paragraph (a) or the case mix classification amount for case mix A$1,750 per 
198.3 	month effective on October July 1, 2008 2011, per month for all new participants enrolled 
198.4 	in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all 
198.5 	other participants who meet this criteria at reassessment. This monthly limit shall be 
198.6 	increased annually as described in paragraph (a).
198.7 	(c) If extended medical supplies and equipment or environmental modifications are 
198.8 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
198.9 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
198.10 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
198.11 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
198.12 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
198.13 	services as described in paragraph (a) or (b).

198.14 	Sec. 15. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to 
198.15 	read:
198.16 		Subd. 3b.Cost limits for elderly waiver applicants who reside in a nursing 
198.17 	facility. (a) For a person who is a nursing facility resident at the time of requesting a 
198.18 	determination of eligibility for elderly waivered services, a monthly conversion budget 
198.19 	limit for the cost of elderly waivered services may be requested. The monthly conversion 
198.20 	budget limit for the cost of elderly waiver services shall be the resident class assigned 
198.21 	under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing 
198.22 	facility where the resident currently resides until July 1 of the state fiscal year in which 
198.23 	the resident assessment system as described in section 256B.438 for nursing home rate 
198.24 	determination is implemented. Effective on July 1 of the state fiscal year in which the 
198.25 	resident assessment system as described in section 256B.438 for nursing home rate 
198.26 	determination is implemented, the monthly conversion budget limit for the cost of elderly 
198.27 	waiver services shall be based on the per diem nursing facility rate as determined by the 
198.28 	resident assessment system as described in section 256B.438 for that resident residents
198.29 	in the nursing facility where the resident elderly waiver applicant currently resides 
198.30 	multiplied. The monthly conversion budget limit shall be calculated by multiplying the 
198.31 	per diem by 365 and,  divided by 12, less and reduced by  the recipient's maintenance needs 
198.32 	allowance as described in subdivision 1d. The initially approved monthly conversion rate 
198.33 	may budget limit shall be adjusted by the greater of any subsequent legislatively adopted 
198.34 	home and community-based services percentage rate increase or the average statewide 
198.35 	percentage increase in nursing facility payment rates annually as described in subdivision 
199.1 	3a, paragraph (a). The limit under this subdivision only applies to persons discharged from 
199.2 	a nursing facility after a minimum 30-day stay and found eligible for waivered services 
199.3 	on or after July 1, 1997. For conversions from the nursing home to the elderly waiver 
199.4 	with consumer directed community support services, the conversion rate limit is equal to 
199.5 	the nursing facility rate per diem used to calculate the monthly conversion budget limit 
199.6 	must be reduced by a percentage equal to the percentage difference between the consumer 
199.7 	directed services budget limit that would be assigned according to the federally approved 
199.8 	waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
199.9 	(b) The following costs must be included in determining the total monthly costs 
199.10 	for the waiver client:
199.11 	(1) cost of all waivered services, including extended medical specialized supplies 
199.12 	and equipment and environmental modifications and accessibility adaptations; and
199.13 	(2) cost of skilled nursing, home health aide, and personal care services reimbursable 
199.14 	by medical assistance.

199.15 	Sec. 16. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to 
199.16 	read:
199.17 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
199.18 	services shall be a monthly rate authorized by the lead agency within the parameters 
199.19 	established by the commissioner. The payment agreement must delineate the amount of 
199.20 	each component service included in the recipient's customized living service plan. The 
199.21 	lead agency shall ensure that there is a documented need within the parameters established 
199.22 	by the commissioner for all component customized living services authorized.
199.23 	(b) The payment rate must be based on the amount of component services to be 
199.24 	provided utilizing component rates established by the commissioner. Counties and tribes 
199.25 	shall use tools issued by the commissioner to develop and document customized living 
199.26 	service plans and rates.
199.27 	(c) Component service rates must not exceed payment rates for comparable elderly 
199.28 	waiver or medical assistance services and must reflect economies of scale. Customized 
199.29 	living services must not include rent or raw food costs.
199.30 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
199.31 	individualized monthly authorized payment for the customized living service plan shall 
199.32 	not exceed 50 percent of the greater of either the statewide or any of the geographic 
199.33 	groups' weighted average monthly nursing facility rate of the case mix resident class 
199.34 	to which the elderly waiver eligible client would be assigned under Minnesota Rules, 
199.35 	parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 
200.1 	in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 
200.2 	resident assessment system as described in section 256B.438 for nursing home rate 
200.3 	determination is implemented. Effective on July 1 of the state fiscal year in which 
200.4 	the resident assessment system as described in section 256B.438 for nursing home 
200.5 	rate determination is implemented and July 1 of each subsequent state fiscal year, the 
200.6 	individualized monthly authorized payment for the services described in this clause shall 
200.7 	not exceed the limit which was in effect on June 30 of the previous state fiscal year 
200.8 	updated annually based on legislatively adopted changes to all service rate maximums for 
200.9 	home and community-based service providers.
200.10 	(e) Effective July 1, 2011, the individualized monthly payment for the customized 
200.11 	living service plan for individuals described in subdivision 3a, paragraph (b), must be the 
200.12 	monthly authorized payment limit for customized living for individuals classified as case 
200.13 	mix A, reduced by 25 percent. This rate limit must be applied to all new participants 
200.14 	enrolled in the program on or after July 1, 2011, who meet the criteria described in 
200.15 	subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 
200.16 	meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
200.17 	(e) (f) Customized living services are delivered by a provider licensed by the 
200.18 	Department of Health as a class A or class F home care provider and provided in a 
200.19 	building that is registered as a housing with services establishment under chapter 144D.
200.20 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
200.21 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
200.22 	family for additional units of any allowable component service beyond those available 
200.23 	under the service rate limits described in paragraph (d), nor for additional units of any 
200.24 	allowable component service beyond those approved in the service plan by the lead agency.

200.25 	Sec. 17. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to 
200.26 	read:
200.27 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
200.28 	payment rate for 24-hour customized living services is a monthly rate authorized by the 
200.29 	lead agency within the parameters established by the commissioner of human services. 
200.30 	The payment agreement must delineate the amount of each component service included in 
200.31 	each recipient's customized living service plan. The lead agency shall ensure that there is a 
200.32 	documented need within the parameters established by the commissioner for all component 
200.33 	customized living services authorized. The lead agency shall not authorize 24-hour 
200.34 	customized living services unless there is a documented need for 24-hour supervision.
201.1 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
201.2 	requires assistance due to needs related to one or more of the following:
201.3 	(1) intermittent assistance with toileting, positioning, or transferring;
201.4 	(2) cognitive or behavioral issues;
201.5 	(3) a medical condition that requires clinical monitoring; or
201.6 	(4) for all new participants enrolled in the program on or after January July 1, 2011, 
201.7 	and all other participants at their first reassessment after January July 1, 2011, dependency 
201.8 	in at least two three of the following activities of daily living as determined by assessment 
201.9 	under section 256B.0911: bathing; dressing; grooming; walking; or eating when the 
201.10 	dependency score in eating is three or greater; and needs medication management and at 
201.11 	least 50 hours of service per month. The lead agency shall ensure that the frequency and 
201.12 	mode of supervision of the recipient and the qualifications of staff providing supervision 
201.13 	are described and meet the needs of the recipient.
201.14 	(c) The payment rate for 24-hour customized living services must be based on the 
201.15 	amount of component services to be provided utilizing component rates established by the 
201.16 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
201.17 	and document customized living plans and authorize rates.
201.18 	(d) Component service rates must not exceed payment rates for comparable elderly 
201.19 	waiver or medical assistance services and must reflect economies of scale.
201.20 	(e) The individually authorized 24-hour customized living payments, in combination 
201.21 	with the payment for other elderly waiver services, including case management, must not 
201.22 	exceed the recipient's community budget cap specified in subdivision 3a. Customized 
201.23 	living services must not include rent or raw food costs.
201.24 	(f) The individually authorized 24-hour customized living payment rates shall not 
201.25 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
201.26 	living services in effect and in the Medicaid management information systems on March 
201.27 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
201.28 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
201.29 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
201.30 	shall multiply the calculated service payment rate maximum for the A classification by 
201.31 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
201.32 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
201.33 	maximums shall be updated annually based on legislatively adopted changes to all service 
201.34 	rates for home and community-based service providers.
201.35 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
201.36 	may establish alternative payment rate systems for 24-hour customized living services in 
202.1 	housing with services establishments which are freestanding buildings with a capacity of 
202.2 	16 or fewer, by applying a single hourly rate for covered component services provided 
202.3 	in either:
202.4 	(1) licensed corporate adult foster homes; or
202.5 	(2) specialized dementia care units which meet the requirements of section 144D.065 
202.6 	and in which:
202.7 	(i) each resident is offered the option of having their own apartment; or
202.8 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
202.9 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
202.10 	subparts 1, 2, 3, and 4, item A.
202.11 	(h) A provider may not bill or otherwise charge an elderly waiver participant or their 
202.12 	family for additional units of any allowable component service beyond those available 
202.13 	under the service rate limits described in paragraph (e), nor for additional units of any 
202.14 	allowable component service beyond those approved in the service plan by the lead agency.

202.15 	Sec. 18. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to 
202.16 	read:
202.17 		Subd. 10.Waiver payment rates; managed care organizations. The 
202.18 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
202.19 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
202.20 	service rate limits for customized living services and 24-hour customized living services 
202.21 	under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 
202.22 	assistance rates paid to customized living providers by managed care organizations under 
202.23 	this section shall not exceed the maximum service rate limits and component rates as 
202.24 	determined by the commissioner under subdivisions 3e and 3h.

202.25 	Sec. 19. Minnesota Statutes 2010, section 256B.0916, subdivision 6a, is amended to 
202.26 	read:
202.27 		Subd. 6a.Statewide availability of consumer-directed community self-directed 
202.28 	 support services. (a) The commissioner shall submit to the federal Health Care Financing 
202.29 	Administration by August 1, 2001, an amendment to the home and community-based 
202.30 	waiver for persons with developmental disabilities under section 256B.092 and by April 1, 
202.31 	2005, for waivers under sections 256B.0915 and 256B.49,  to make consumer-directed 
202.32 	community self-directed support services available in every county of the state by January 
202.33 	1, 2002.
203.1 	(b) Until the waiver amendment for self-directed community supports is effective, if 
203.2 	a county declines to meet the requirements for provision of consumer-directed community
203.3 	self-directed supports, the commissioner shall contract with another county, a group of 
203.4 	counties, or a private agency to plan for and administer consumer-directed community
203.5 	self-directed  supports in that county.
203.6 	(c) The state of Minnesota, county agencies, tribal governments, or administrative 
203.7 	entities under contract to participate in the implementation and administration of the home 
203.8 	and community-based waiver for persons with developmental disabilities, shall not be 
203.9 	liable for damages, injuries, or liabilities sustained through the purchase of support by the 
203.10 	individual, the individual's family, legal representative, or the authorized representative 
203.11 	with funds received through the consumer-directed community self-directed support 
203.12 	service under this section. Liabilities include but are not limited to: workers' compensation 
203.13 	liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment 
203.14 	Tax Act (FUTA).

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

203.16 	Sec. 20. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to 
203.17 	read:
203.18 		Subd. 1b.Individual service Coordinated services and support plan. The 
203.19 	individual service Each recipient of case management services and any legal representative 
203.20 	shall be provided a written copy of the coordinated services and support plan must, which:
203.21 	(1) includeis developed within ten working days after the case manager receives the 
203.22 	community support plan from the certified assessor under section 256B.0911;
203.23 	(2) includes the results of the assessment information on the person's need for 
203.24 	service, including identification of service needs that will be or that are met by the person's 
203.25 	relatives, friends, and others, as well as community services used by the general public;
203.26 	(3) reasonably assures the health, safety, and welfare of the recipient;
203.27 	(2) identify(4) identifies the person's preferences for services as stated by the person, 
203.28 	the person's legal guardian or conservator, or the parent if the person is a minor;
203.29 	(5) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
203.30 	paragraph (o), of service and support providers;
203.31 	(3) identify(6) identifies long- and short-range goals for the person;
203.32 	(4) identify (7) identifies specific services and the amount and frequency of the 
203.33 	services to be provided to the person based on assessed needs, preferences, and available 
203.34 	resources. The individual service plan shall also specify other services the person needs 
203.35 	that are not available, and other services the person needs that are not available. The 
204.1 	individual coordinated services and support plan shall also specify service outcomes and 
204.2 	the provider's responsibility to monitor the achievement of the service outcomes;
204.3 	(5) identify (8) identifies the need for an individual programindividual's provider 
204.4 	plan to be developed by the provider according to the respective state and federal licensing 
204.5 	and certification standards, and additional assessments to be completed or arranged by the 
204.6 	provider after service initiation;
204.7 	(6) identify (9) identifies provider responsibilities to implement and make 
204.8 	recommendations for modification to the individual service coordinated services and 
204.9 	support  plan;
204.10 	(7) include(10) includes notice of the right to have assessments completed and 
204.11 	service plans developed within specified time periods, the right to appeal action or 
204.12 	inaction, and the right to request a conciliation conference or a hearing an appeal under 
204.13 	section 256.045;
204.14 	(8) be (11) is agreed upon and signed by the person, the person's legal guardian 
204.15 	or conservator, or the parent if the person is a minor, and the authorized county 
204.16 	representative; and
204.17 	(9) be (12) is reviewed by a health professional if the person has overriding medical 
204.18 	needs that impact the delivery of services.
204.19 	Service planning formats developed for interagency planning such as transition, 
204.20 	vocational, and individual family service plans may be substituted for service planning 
204.21 	formats developed by county agencies.

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

204.23 	Sec. 21. Minnesota Statutes 2010, section 256B.092, subdivision 1e, is amended to 
204.24 	read:
204.25 		Subd. 1e.Case management service monitoring, coordination, and evaluation, 
204.26 	and monitoring of services duties. (a) If the individual service coordinated services and 
204.27 	support  plan identifies the need for individual programprovider plans for authorized 
204.28 	services, the case managermanagement service provider shall assure that individual 
204.29 	programthe individual provider plans are developed by the providers according to clauses 
204.30 	(2) to (5). The providers shall assure that the individual programprovider plans:
204.31 	(1) are developed according to the respective state and federal licensing and 
204.32 	certification requirements;
204.33 	(2) are designed to achieve the goals of the individual service plan;
204.34 	(3) are consistent with other aspects of the individual service coordinated services 
204.35 	and support plan;
205.1 	(4) assure the health and safety of the person; and
205.2 	(5) are developed with consistent and coordinated approaches to services and service 
205.3 	outcomes among the various service providers.
205.4 	(b) The case managermanagement service provider shall monitor the provision of 
205.5 	services:
205.6 	(1) to assure that the individual service coordinated services and support plan is 
205.7 	being followed according to paragraph (a);
205.8 	(2) to identify any changes or modifications that might be needed in the individual 
205.9 	service coordinated services and support plan, including changes resulting from 
205.10 	recommendations of current service providers;
205.11 	(3) to determine if the person's legal rights are protected, and if not, notify the 
205.12 	person's legal guardian or conservator, or the parent if the person is a minor, protection 
205.13 	services, or licensing agencies as appropriate; and
205.14 	(4) to determine if the person, the person's legal guardian or conservator, or the 
205.15 	parent if the person is a minor, is satisfied with the services provided.
205.16 	(c) If the provider fails to develop or carry out the individual program provider plan 
205.17 	according to paragraph (a), the case manager shall notify the person's legal guardian or 
205.18 	conservator, or the parent if the person is a minor, the provider, the respective licensing 
205.19 	and certification agencies, and the county board where the services are being provided. In 
205.20 	addition, the case manager shall identify other steps needed to assure the person receives 
205.21 	the services identified in the individual service coordinated services and support plan.

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

205.23 	Sec. 22. Minnesota Statutes 2010, section 256B.092, subdivision 1g, is amended to 
205.24 	read:
205.25 		Subd. 1g.Conditions not requiring development of individual service a 
205.26 	coordinated services and support plan. Unless otherwise required by federal law, the 
205.27 	county agency is not required to complete an individual service a coordinated services and 
205.28 	support plan as defined in subdivision 1b for:
205.29 	(1) persons whose families are requesting respite care for their family member who 
205.30 	resides with them, or whose families are requesting a family support grant and are not 
205.31 	requesting purchase or arrangement of habilitative services; and
205.32 	(2) persons with developmental disabilities, living independently without authorized 
205.33 	services or receiving funding for services at a rehabilitation facility as defined in section 
205.34 	268A.01, subdivision 6, and not in need of or requesting additional services.

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

206.2 	Sec. 23. Minnesota Statutes 2010, section 256B.092, subdivision 3, is amended to read:
206.3 		Subd. 3.Authorization and termination of services. County agency case managers
206.4 	Lead agencies, under rules of the commissioner, shall authorize and terminate services 
206.5 	of community and regional treatment center providers according to individual service
206.6 	coordinated services and support plans. Services provided to persons with developmental 
206.7 	disabilities may only be authorized and terminated by case managers according to (1) 
206.8 	rules of the commissioner and (2) the individual service coordinated services and support
206.9 	plan as defined in subdivision 1b. Medical assistance services not needed shall not be 
206.10 	authorized by county lead agencies or funded by the commissioner. When purchasing or 
206.11 	arranging for unlicensed respite care services for persons with overriding health needs, the 
206.12 	county agency shall seek the advice of a health care professional in assessing provider 
206.13 	staff training needs and skills necessary to meet the medical needs of the person.

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

206.15 	Sec. 24. Minnesota Statutes 2010, section 256B.092, subdivision 8, is amended to read:
206.16 		Subd. 8.Screening teamAdditional certified assessor duties. The screening team
206.17 	certified assessor shall:
206.18 	(1) review diagnostic data;
206.19 	(2) review health, social, and developmental assessment data using a uniform 
206.20 	screeningcomprehensive assessment tool specified by the commissioner;
206.21 	(3) identify the level of services appropriate to maintain the person in the most 
206.22 	normal and least restrictive setting that is consistent with the person's treatment needs;
206.23 	(4) identify other noninstitutional public assistance or social service that may prevent 
206.24 	or delay long-term residential placement;
206.25 	(5) assess whether a person is in need of long-term residential care;
206.26 	(6) make recommendations regarding placementservices and payment for: (i) social 
206.27 	service or public assistance support, or both, to maintain a person in the person's own home 
206.28 	or other place of residence; (ii) training and habilitation service, vocational rehabilitation, 
206.29 	and employment training activities; (iii) community residential placement services; (iv) 
206.30 	regional treatment center placement; or (v) (iv)  a home and community-based service 
206.31 	alternative to community residential placement or regional treatment center placement;
206.32 	(7) evaluate the availability, location, and quality of the services listed in clause 
206.33 	(6), including the impact of placement alternativesservices and supports options on the 
207.1 	person's ability to maintain or improve existing patterns of contact and involvement with 
207.2 	parents and other family members;
207.3 	(8) identify the cost implications of recommendations in clause (6) and provide 
207.4 	written notice of the annual and monthly average authorized amount to be spent for 
207.5 	services for the recipient;
207.6 	(9) make recommendations to a court as may be needed to assist the court in making 
207.7 	decisions regarding commitment of persons with developmental disabilities; and
207.8 	(10) inform the person and the person's legal guardian or conservator, or the parent if 
207.9 	the person is a minor, that appeal may be made to the commissioner pursuant to section 
207.10 	256.045.

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

207.12 	Sec. 25. [256B.0961] STATE QUALITY ASSURANCE, QUALITY 
207.13 	IMPROVEMENT, AND LICENSING SYSTEM.
207.14 		Subdivision 1.Scope. (a) In order to improve the quality of services provided to 
207.15 	Minnesotans with disabilities and to meet the requirements of the federally approved 
207.16 	home and community-based waivers under section 1915c of the Social Security Act, a 
207.17 	State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans 
207.18 	receiving disability services is enacted. This system is a partnership between the 
207.19 	Department of Human Services and the State Quality Council established under 
207.20 	subdivision 3.
207.21 	(b) This system is a result of the recommendations from the Department of Human 
207.22 	Services' licensing and alternative quality assurance study mandated under Laws 2005, 
207.23 	First Special Session chapter 4, article 7, section 57, and presented to the legislature 
207.24 	in February 2007.
207.25 	(c) The disability services eligible under this section include:
207.26 	(1) the home and community-based services waiver programs for persons with 
207.27 	developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, 
207.28 	including traumatic brain injuries and services for those who qualify for nursing facility 
207.29 	level of care or hospital facility level of care;
207.30 	(2) home care services under section 256B.0651;
207.31 	(3) family support grants under section 252.32;
207.32 	(4) consumer support grants under section 256.476;
207.33 	(5) semi-independent living services under section 252.275; and
207.34 	(6) services provided through an intermediate care facility for the developmentally 
207.35 	disabled.
208.1 	(d) For purposes of this section, the following definitions apply:
208.2 	(1) "commissioner" means the commissioner of human services;
208.3 	(2) "council" means the State Quality Council under subdivision 3;
208.4 	(3) "Quality Assurance Commission" means the commission under section 
208.5 	256B.0951; and
208.6 	(4) "system" means the State Quality Assurance, Quality Improvement and 
208.7 	Licensing System under this section.
208.8 		Subd. 2.Duties of the commissioner of human services. (a) The commissioner of 
208.9 	human services shall establish the State Quality Council under subdivision 3.
208.10 	(b) The commissioner shall initially delegate authority to perform licensing 
208.11 	functions and activities according to section 245A.16 to a host county in Region 10. The 
208.12 	commissioner must not license or reimburse a participating facility, program, or service 
208.13 	located in Region 10 if the commissioner has received notification from the host county 
208.14 	that the facility, program, or service has failed to qualify for licensure.
208.15 	(c) The commissioner may conduct random licensing inspections based on outcomes 
208.16 	adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services 
208.17 	eligible under this section. The role of the random inspections is to verify that the system 
208.18 	protects the safety and well-being of persons served and maintains the availability of 
208.19 	high-quality services for persons with disabilities.
208.20 	(d) The commissioner shall ensure that the federal home and community-based 
208.21 	waiver requirements are met and that incidents that may have jeopardized safety and health 
208.22 	or violated services-related assurances, civil and human rights, and other protections 
208.23 	designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and 
208.24 	acted upon in a timely manner.
208.25 	(e) The commissioner shall seek a federal waiver by July 1, 2012 to allow 
208.26 	intermediate care facilities for persons with developmental disabilities to participate in 
208.27 	this system.
208.28 		Subd. 3.State Quality Council. (a) There is hereby created a State Quality 
208.29 	Council which must define regional quality councils, and carry out a community-based, 
208.30 	person-directed quality review component, and a comprehensive system for effective 
208.31 	incident reporting, investigation, analysis, and follow-up.
208.32 	(b) By August 1, 2011, the commissioner of human services shall appoint the 
208.33 	members of the initial State Quality Council. Members shall include representatives 
208.34 	from the following groups:
208.35 	(1) disability service recipients and their family members; 
209.1 	(2) during the first two years of the State Quality Council, there must be at least three 
209.2 	members from the Region 10 stakeholders. As regional quality councils are formed under 
209.3 	subdivision 4, each regional quality council shall appoint one member;
209.4 	(3) disability service providers;
209.5 	(4) disability advocacy groups; and
209.6 	(5) county human services agencies and staff from the Department of Human 
209.7 	Services and Ombudsman for Mental Health and Developmental Disabilities.
209.8 	(c) Members of the council who do not receive a salary or wages from an employer 
209.9 	for time spent on council duties may receive a per diem payment when performing council 
209.10 	duties and functions.
209.11 	(d) The State Quality Council shall:
209.12 	(1) assist the Department of Human Services in fulfilling federally mandated 
209.13 	obligations by monitoring disability service quality and quality assurance and 
209.14 	improvement practices in Minnesota; and
209.15 	(2) establish state quality improvement priorities with methods for achieving results 
209.16 	and provide an annual report to the legislative committees with jurisdiction over policy 
209.17 	and funding of disability services on the outcomes, improvement priorities, and activities 
209.18 	undertaken by the commission during the previous state fiscal year.
209.19 	(e) The State Quality Council, in partnership with the commissioner, shall:
209.20 	(1) approve and direct implementation of the community-based, person-directed 
209.21 	system established in this section;
209.22 	(2) recommend an appropriate method of funding this system, and determine the 
209.23 	feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
209.24 	(3) approve measurable outcomes in the areas of health and safety, consumer 
209.25 	evaluation, education and training, providers, and systems;
209.26 	(4) establish variable licensure periods not to exceed three years based on outcomes 
209.27 	achieved; and
209.28 	(5) in cooperation with the Quality Assurance Commission, design a transition plan 
209.29 	for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
209.30 	(f) The State Quality Council shall notify the commissioner of human services that a 
209.31 	facility, program, or service has been reviewed by quality assurance team members under 
209.32 	subdivision 4, paragraph (b), clause (13), and qualifies for a license.
209.33 	(g) The State Quality Council, in partnership with the commissioner, shall establish 
209.34 	an ongoing review process for the system. The review shall take into account the 
209.35 	comprehensive nature of the system which is designed to evaluate the broad spectrum of 
210.1 	licensed and unlicensed entities that provide services to persons with disabilities. The 
210.2 	review shall address efficiencies and effectiveness of the system.
210.3 	(h) The State Quality Council may recommend to the commissioner certain 
210.4 	variances from the standards governing licensure of programs for persons with disabilities 
210.5 	in order to improve the quality of services so long as the recommended variances do 
210.6 	not adversely affect the health or safety of persons being served or compromise the 
210.7 	qualifications of staff to provide services.
210.8 	(i) The safety standards, rights, or procedural protections referenced under 
210.9 	subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make 
210.10 	recommendations to the commissioner or to the legislature in the report required under 
210.11 	paragraph (c) regarding alternatives or modifications to the safety standards, rights, or 
210.12 	procedural protections referenced under subdivision 2, paragraph (c).
210.13 	(j) The State Quality Council may hire staff to perform the duties assigned in this 
210.14 	subdivision.
210.15 		Subd. 4.Regional quality councils. (a) The commissioner shall establish, as 
210.16 	selected by the State Quality Council, regional quality councils of key stakeholders, 
210.17 	including regional representatives of:
210.18 	(1) disability service recipients and their family members;
210.19 	(2) disability service providers;
210.20 	(3) disability advocacy groups; and
210.21 	(4) county human services agencies and staff from the Department of Human 
210.22 	Services and Ombudsman for Mental Health and Developmental Disabilities.
210.23 	(b) Each regional quality council shall:
210.24 	(1) direct and monitor the community-based, person-directed quality assurance 
210.25 	system in this section;
210.26 	(2) approve a training program for quality assurance team members under clause 
210.27 	(13);
210.28 	(3) review summary reports from quality assurance team reviews and make 
210.29 	recommendations to the State Quality Council regarding program licensure;
210.30 	(4) make recommendations to the State Quality Council regarding the system;
210.31 	(5) resolve complaints between the quality assurance teams, counties, providers, 
210.32 	persons receiving services, their families, and legal representatives;
210.33 	(6) analyze and review quality outcomes and critical incident data reporting 
210.34 	incidents of life safety concerns immediately to the Department of Human Services 
210.35 	licensing division;
211.1 	(7) provide information and training programs for persons with disabilities and their 
211.2 	families and legal representatives on service options and quality expectations;
211.3 	(8) disseminate information and resources developed to other regional quality 
211.4 	councils;
211.5 	(9) respond to state-level priorities;
211.6 	(10) establish regional priorities for quality improvement;
211.7 	(11) submit an annual report to the State Quality Council on the status, outcomes, 
211.8 	improvement priorities, and activities in the region;
211.9 	(12) choose a representative to participate on the State Quality Council and assume 
211.10 	other responsibilities consistent with the priorities of the State Quality Council; and
211.11 	(13) recruit, train, and assign duties to members of quality assurance teams, taking 
211.12 	into account the size of the service provider, the number of services to be reviewed, 
211.13 	the skills necessary for the team members to complete the process, and ensure that no 
211.14 	team member has a financial, personal, or family relationship with the facility, program, 
211.15 	or service being reviewed or with anyone served at the facility, program, or service. 
211.16 	Quality assurance teams must be comprised of county staff, persons receiving services 
211.17 	or the person's families, legal representatives, members of advocacy organizations, 
211.18 	providers, and other involved community members. Team members must complete 
211.19 	the training program approved by the regional quality council and must demonstrate 
211.20 	performance-based competency. Team members may be paid a per diem and reimbursed 
211.21 	for expenses related to their participation in the quality assurance process.
211.22 	(c) The commissioner shall monitor the safety standards, rights, and procedural 
211.23 	protections for the monitoring of psychotropic medications and those identified under 
211.24 	sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) 
211.25 	and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause 
211.26 	(7); 626.556; and 626.557.
211.27 	(d) The regional quality councils may hire staff to perform the duties assigned in 
211.28 	this subdivision.
211.29 	(e) The regional quality councils may charge fees for their services.
211.30 	(f) The quality assurance process undertaken by a regional quality council consists of 
211.31 	an evaluation by a quality assurance team of the facility, program, or service. The process 
211.32 	must include an evaluation of a random sample of persons served. The sample must be 
211.33 	representative of each service provided. The sample size must be at least five percent but 
211.34 	not less than two persons served. All persons must be given the opportunity to be included 
211.35 	in the quality assurance process in addition to those chosen for the random sample.
212.1 	(g) A facility, program, or service may contest a licensing decision of the regional 
212.2 	quality council as permitted under chapter 245A.
212.3 		Subd. 5.Annual survey of service recipients. The commissioner, in consultation 
212.4 	with the State Quality Council, shall conduct an annual independent statewide survey 
212.5 	of service recipients, randomly selected, to determine the effectiveness and quality 
212.6 	of disability services. The survey must be consistent with the system performance 
212.7 	expectations of the Centers for Medicare and Medicaid Services (CMS) Quality 
212.8 	Framework. The survey must analyze whether desired outcomes for persons with different 
212.9 	demographic, diagnostic, health, and functional needs, who are receiving different types 
212.10 	of services in different settings and with different costs, have been achieved. Annual 
212.11 	statewide and regional reports of the results must be published and used to assist regions, 
212.12 	counties, and providers to plan and measure the impact of quality improvement activities.
212.13 		Subd. 6.Mandated reporters. Members of the State Quality Council under 
212.14 	subdivision 3, the regional quality councils under subdivision 4, and quality assurance 
212.15 	team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as 
212.16 	defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16.

212.17 	EFFECTIVE DATE. (a) Subdivisions 1 to 6 are effective July 1, 2011.
212.18 	(b) The jurisdictions of the regional quality councils in subdivision 4 must be 
212.19 	defined, with implementation dates, by July 1, 2012. During the biennium beginning July 
212.20 	1, 2011, the Quality Assurance Commission shall continue to implement the alternative 
212.21 	licensing system under this section.

212.22 	Sec. 26. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to 
212.23 	read:
212.24 		Subd. 2r.Payment restrictions on leave days. (a) Effective July 1, 1993, the 
212.25 	commissioner shall limit payment for leave days in a nursing facility to 79 percent of that 
212.26 	nursing facility's total payment rate for the involved resident. 
212.27 	(b) For services rendered on or after July 1, 2003, for facilities reimbursed under this 
212.28 	section or section 256B.434, the commissioner shall limit payment for leave days in a 
212.29 	nursing facility to 60 percent of that nursing facility's total payment rate for the involved 
212.30 	resident.
212.31 	(c) For services rendered on or after July 1, 2011, for facilities reimbursed under 
212.32 	this chapter, the commissioner shall limit payment for leave days in a nursing facility 
212.33 	to 30 percent of that nursing facility's total payment rate for the involved resident, and 
212.34 	shall allow this payment only when the occupancy of the nursing facility, inclusive of 
213.1 	bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules, 
213.2 	part 9505.0415.

213.3 	Sec. 27. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to 
213.4 	read:
213.5 		Subd. 32.Payment during first 90 30 days. (a) For rate years beginning on or after 
213.6 	July 1, 2001, the total payment rate for a facility reimbursed under this section, section 
213.7 	256B.434, or any other section for the first 90 paid days after admission shall be:
213.8 	(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical 
213.9 	assistance rate for each case mix class;
213.10 	(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent 
213.11 	of the facility's medical assistance rate for each case mix class;
213.12 	(3) beginning with the 91st paid day after admission, the payment rate shall be the 
213.13 	rate otherwise determined under this section, section 256B.434, or any other section; and
213.14 	(4) payments under this paragraph apply to admissions occurring on or after July 1, 
213.15 	2001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
213.16 	(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for 
213.17 	a facility reimbursed under this section, section 256B.434, or any other section shall be:
213.18 	(1) for the first 30 calendar days after admission, the rate shall be 120 percent of 
213.19 	the facility's medical assistance rate for each RUG class;
213.20 	(2) beginning with the 31st calendar day after admission, the payment rate shall be 
213.21 	the rate otherwise determined under this section, section 256B.434, or any other section; 
213.22 	and
213.23 	(3) payments under this paragraph apply to admissions occurring on or after July 
213.24 	1, 2003 2011.
213.25 	(c) Effective January 1, 2004, (b)  The enhanced rates under this subdivision shall not 
213.26 	be allowed if a resident has resided during the previous 30 calendar days in:
213.27 	(1) the same nursing facility;
213.28 	(2) a nursing facility owned or operated by a related party; or
213.29 	(3) a nursing facility or part of a facility that closed or was in the process of closing.

213.30 	Sec. 28. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:
213.31 		Subd. 4.Alternate rates for nursing facilities. (a) For nursing facilities which 
213.32 	have their payment rates determined under this section rather than section 256B.431, the 
213.33 	commissioner shall establish a rate under this subdivision. The nursing facility must enter 
213.34 	into a written contract with the commissioner.
214.1 	(b) A nursing facility's case mix payment rate for the first rate year of a facility's 
214.2 	contract under this section is the payment rate the facility would have received under 
214.3 	section 256B.431.
214.4 	(c) A nursing facility's case mix payment rates for the second and subsequent years 
214.5 	of a facility's contract under this section are the previous rate year's contract payment 
214.6 	rates plus an inflation adjustment and, for facilities reimbursed under this section or 
214.7 	section 256B.431, an adjustment to include the cost of any increase in Health Department 
214.8 	licensing fees for the facility taking effect on or after July 1, 2001. The index for the 
214.9 	inflation adjustment must be based on the change in the Consumer Price Index-All Items 
214.10 	(United States City average) (CPI-U) forecasted by the commissioner of management and 
214.11 	budget's national economic consultant, as forecasted in the fourth quarter of the calendar 
214.12 	year preceding the rate year. The inflation adjustment must be based on the 12-month 
214.13 	period from the midpoint of the previous rate year to the midpoint of the rate year for 
214.14 	which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 
214.15 	2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, 
214.16 	July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, October 1, 2011, and 
214.17 	October 1, 2012. this paragraph shall apply only to the property-related payment rate, 
214.18 	except that adjustments to include the cost of any increase in Health Department licensing 
214.19 	fees taking effect on or after July 1, 2001, shall be provided. For the rate years beginning 
214.20 	on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall 
214.21 	be suspended. Beginning in 2005, adjustment to the property payment rate under this 
214.22 	section and section 256B.431 shall be effective on October 1. In determining the amount 
214.23 	of the property-related payment rate adjustment under this paragraph, the commissioner 
214.24 	shall determine the proportion of the facility's rates that are property-related based on the 
214.25 	facility's most recent cost report.
214.26 	(d) The commissioner shall develop additional incentive-based payments of up to 
214.27 	five percent above a facility's operating payment rate for achieving outcomes specified 
214.28 	in a contract. The commissioner may solicit contract amendments and implement those 
214.29 	which, on a competitive basis, best meet the state's policy objectives. The commissioner 
214.30 	shall limit the amount of any incentive payment and the number of contract amendments 
214.31 	under this paragraph to operate the incentive payments within funds appropriated for this 
214.32 	purpose. The contract amendments may specify various levels of payment for various 
214.33 	levels of performance. Incentive payments to facilities under this paragraph may be in the 
214.34 	form of time-limited rate adjustments or onetime supplemental payments. In establishing 
214.35 	the specified outcomes and related criteria, the commissioner shall consider the following 
214.36 	state policy objectives:
215.1 	(1) successful diversion or discharge of residents to the residents' prior home or other 
215.2 	community-based alternatives;
215.3 	(2) adoption of new technology to improve quality or efficiency;
215.4 	(3) improved quality as measured in the Nursing Home Report Card;
215.5 	(4) reduced acute care costs; and
215.6 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
215.7 	finds desirable.
215.8 	(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 
215.9 	take action to come into compliance with existing or pending requirements of the life 
215.10 	safety code provisions or federal regulations governing sprinkler systems must receive 
215.11 	reimbursement for the costs associated with compliance if all of the following conditions 
215.12 	are met:
215.13 	(1) the expenses associated with compliance occurred on or after January 1, 2005, 
215.14 	and before December 31, 2008;
215.15 	(2) the costs were not otherwise reimbursed under subdivision 4f or section 
215.16 	144A.071 or 144A.073; and
215.17 	(3) the total allowable costs reported under this paragraph are less than the minimum 
215.18 	threshold established under section 256B.431, subdivision 15, paragraph (e), and 
215.19 	subdivision 16.
215.20 	The commissioner shall use money appropriated for this purpose to provide to qualifying 
215.21 	nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 
215.22 	2008. Nursing facilities that have spent money or anticipate the need to spend money 
215.23 	to satisfy the most recent life safety code requirements by (1) installing a sprinkler 
215.24 	system or (2) replacing all or portions of an existing sprinkler system may submit to the 
215.25 	commissioner by June 30, 2007, on a form provided by the commissioner the actual 
215.26 	costs of a completed project or the estimated costs, based on a project bid, of a planned 
215.27 	project. The commissioner shall calculate a rate adjustment equal to the allowable 
215.28 	costs of the project divided by the resident days reported for the report year ending 
215.29 	September 30, 2006. If the costs from all projects exceed the appropriation for this 
215.30 	purpose, the commissioner shall allocate the money appropriated on a pro rata basis 
215.31 	to the qualifying facilities by reducing the rate adjustment determined for each facility 
215.32 	by an equal percentage. Facilities that used estimated costs when requesting the rate 
215.33 	adjustment shall report to the commissioner by January 31, 2009, on the use of this 
215.34 	money on a form provided by the commissioner. If the nursing facility fails to provide 
215.35 	the report, the commissioner shall recoup the money paid to the facility for this purpose. 
215.36 	If the facility reports expenditures allowable under this subdivision that are less than 
216.1 	the amount received in the facility's annualized rate adjustment, the commissioner shall 
216.2 	recoup the difference.

216.3 	Sec. 29. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
216.4 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
216.5 	services shall calculate the amount of the planned closure rate adjustment available under 
216.6 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
216.7 	(1) the amount available is the net reduction of nursing facility beds multiplied 
216.8 	by $2,080;
216.9 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
216.10 	closure rate adjustment must be identified;
216.11 	(3) capacity days are determined by multiplying the number determined under 
216.12 	clause (2) by 365; and
216.13 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
216.14 	by capacity days determined under clause (3).
216.15 	(b) A planned closure rate adjustment under this section is effective on the first day 
216.16 	of the month following completion of closure of the facility designated for closure in the 
216.17 	application and becomes part of the nursing facility's total operating payment rate.
216.18 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
216.19 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
216.20 	operating payment rate adjustment. Applications approved under this subdivision are 
216.21 	exempt from other requirements for moratorium exceptions under section 144A.073, 
216.22 	subdivisions 2 and 3.
216.23 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
216.24 	closure rate adjustment as provided under section 144A.161, subdivision 10.
216.25 	(e) A facility that has received a planned closure rate adjustment may reassign it 
216.26 	to another facility that is under the same ownership at any time within three years of its 
216.27 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
216.28 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
216.29 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
216.30 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
216.31 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
216.32 	from the date the per bed dollar amount is increased.
216.33 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
216.34 	services shall calculate the amount of the planned closure rate adjustment available under 
216.35 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
217.1 	(h) Beginning July 16, 2011, the commissioner shall no longer accept applications 
217.2 	for planned closure rate adjustments under subdivision 3.

217.3 	Sec. 30. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to 
217.4 	read:
217.5 		Subd. 50a.Determination of proximity adjustments. (a) For a nursing facility 
217.6 	located in close proximity to another nursing facility of the same facility group type but in 
217.7 	a different peer group and that has higher limits for care-related or other operating costs, 
217.8 	the commissioner shall adjust the limits in accordance with clauses (1) to (4):
217.9 	(1) determine the difference between the limits;
217.10 	(2) determine the distance between the two facilities, by the shortest driving route. If 
217.11 	the distance exceeds 20 miles, no adjustment shall be made;
217.12 	(3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a 
217.13 	percentage; and
217.14 	(4) increase the limits for the nursing facility with the lower limits by the value 
217.15 	determined in clause (1) multiplied by the value determined in clause (3).
217.16 	(b) Effective October 1, 2011, nursing facilities located no more than one-quarter 
217.17 	mile from a peer group with higher limits under either subdivision 50 or 51, may receive 
217.18 	an operating rate adjustment. The operating payment rates of a lower-limit peer group 
217.19 	facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer 
217.20 	group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer 
217.21 	group facility. Peer groups are those defined in subdivision 30. The nearest facility must 
217.22 	be determined by the most direct driving route.

217.23 	Sec. 31. Minnesota Statutes 2010, section 256B.441, is amended by adding a 
217.24 	subdivision to read:
217.25 		Subd. 61.Rate increase for low-rate facilities. Effective October 1, 2011, 
217.26 	operating payment rates of all nursing facilities that are reimbursed under this section or 
217.27 	section 256B.434 shall be increased for a resource utilization group rate with a weight 
217.28 	of 1.00 by up to 2.45 percent, but not to exceed for the same resource utilization group 
217.29 	weight the rate of the facility at the 18th percentile of all nursing facilities in the state. The 
217.30 	percentage of the operating payment rate for each facility to be case-mix adjusted shall be 
217.31 	equal to the percentage that is case-mix adjusted in that facility's operating payment rate 
217.32 	on the preceding September 30.

217.33 	Sec. 32. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:
218.1 		Subdivision 1.Prohibited practices. A nursing facility is not eligible to receive 
218.2 	medical assistance payments unless it refrains from all of the following:.
218.3 	(a) Charging private paying residents rates for similar services which exceed those 
218.4 	which are approved by the state agency for medical assistance recipients as determined by 
218.5 	the prospective desk audit rate, except under the following circumstances: 
218.6 	(1) the nursing facility may:
218.7 	(1) (i) charge private paying residents a higher rate for a private room,; and 
218.8 	(2) (ii) charge for special services which are not included in the daily rate if medical 
218.9 	assistance residents are charged separately at the same rate for the same services in 
218.10 	addition to the daily rate paid by the commissioner;
218.11 	(2) effective July 1, 2011, through September 30, 2012, nursing facilities may 
218.12 	charge private paying residents rates up to two percent higher than the allowable medical 
218.13 	assistance payment rate determined by the commissioner for the RUGS group currently 
218.14 	assigned to the resident; and
218.15 	(3) effective for rate years beginning October 1, 2012, and after, nursing facilities 
218.16 	may charge private paying residents rates greater than the allowable medical assistance 
218.17 	payment rate determined by the commissioner for the RUGS group currently assigned 
218.18 	to the resident by up to two percent more than the differential in effect on the prior 
218.19 	September 30. Nothing in this section precludes a nursing facility from charging a rate 
218.20 	allowable under the facility's single room election option under Minnesota Rules, part 
218.21 	9549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32. 
218.22 	Services covered by the payment rate must be the same regardless of payment source. 
218.23 	Special services, if offered, must be available to all residents in all areas of the nursing 
218.24 	facility and charged separately at the same rate. Residents are free to select or decline 
218.25 	special services. Special services must not include services which must be provided by 
218.26 	the nursing facility in order to comply with licensure or certification standards and that 
218.27 	if not provided would result in a deficiency or violation by the nursing facility. Services 
218.28 	beyond those required to comply with licensure or certification standards must not be 
218.29 	charged separately as a special service if they were included in the payment rate for the 
218.30 	previous reporting year. A nursing facility that charges a private paying resident a rate in 
218.31 	violation of this clause paragraph is subject to an action by the state of Minnesota or any of 
218.32 	its subdivisions or agencies for civil damages. A private paying resident or the resident's 
218.33 	legal representative has a cause of action for civil damages against a nursing facility that 
218.34 	charges the resident rates in violation of this clause paragraph. The damages awarded shall 
218.35 	include three times the payments that result from the violation, together with costs and 
218.36 	disbursements, including reasonable attorneys' attorney fees or their equivalent. A private 
219.1 	paying resident or the resident's legal representative, the state, subdivision or agency, or a 
219.2 	nursing facility may request a hearing to determine the allowed rate or rates at issue in 
219.3 	the cause of action. Within 15 calendar days after receiving a request for such a hearing, 
219.4 	the commissioner shall request assignment of an administrative law judge under sections 
219.5 	14.48 to 14.56 to conduct the hearing as soon as possible or according to agreement by 
219.6 	the parties. The administrative law judge shall issue a report within 15 calendar days 
219.7 	following the close of the hearing. The prohibition set forth in this clause paragraph shall 
219.8 	not apply to facilities licensed as boarding care facilities which are not certified as skilled 
219.9 	or intermediate care facilities level I or II for reimbursement through medical assistance.
219.10 	(b)(1) Charging, soliciting, accepting, or receiving from an applicant for admission 
219.11 	to the facility, or from anyone acting in behalf of the applicant, as a condition of admission, 
219.12 	expediting the admission, or as a requirement for the individual's continued stay, any fee, 
219.13 	deposit, gift, money, donation, or other consideration not otherwise required as payment 
219.14 	under the state plan. For residents on medical assistance, medical assistance payments 
219.15 	according to the state plan must be accepted as payment in full for continued stay, except 
219.16 	where otherwise provided for under statute;
219.17 	(2) requiring an individual, or anyone acting in behalf of the individual, to loan 
219.18 	any money to the nursing facility;
219.19 	(3) requiring an individual, or anyone acting in behalf of the individual, to promise 
219.20 	to leave all or part of the individual's estate to the facility; or
219.21 	(4) requiring a third-party guarantee of payment to the facility as a condition of 
219.22 	admission, expedited admission, or continued stay in the facility.
219.23 	Nothing in this paragraph would prohibit discharge for nonpayment of services in 
219.24 	accordance with state and federal regulations.
219.25 	(c) Requiring any resident of the nursing facility to utilize a vendor of health care 
219.26 	services chosen by the nursing facility. A nursing facility may require a resident to use 
219.27 	pharmacies that utilize unit dose packing systems approved by the Minnesota Board of 
219.28 	Pharmacy, and may require a resident to use pharmacies that are able to meet the federal 
219.29 	regulations for safe and timely administration of medications such as systems with specific 
219.30 	number of doses, prompt delivery of medications, or access to medications on a 24-hour 
219.31 	basis. Notwithstanding the provisions of this paragraph, nursing facilities shall not restrict 
219.32 	a resident's choice of pharmacy because the pharmacy utilizes a specific system of unit 
219.33 	dose drug packing.
219.34 	(d) Providing differential treatment on the basis of status with regard to public 
219.35 	assistance.
220.1 	(e) Discriminating in admissions, services offered, or room assignment on the 
220.2 	basis of status with regard to public assistance or refusal to purchase special services. 
220.3 	Discrimination in admissions discrimination, services offered, or room assignment shall 
220.4 	include, but is not limited to:
220.5 	(1) basing admissions decisions upon assurance by the applicant to the nursing 
220.6 	facility, or the applicant's guardian or conservator, that the applicant is neither eligible for 
220.7 	nor will seek information or assurances regarding current or future eligibility for public 
220.8 	assistance for payment of nursing facility care costs; and
220.9 	(2) engaging in preferential selection from waiting lists based on an applicant's 
220.10 	ability to pay privately or an applicant's refusal to pay for a special service.
220.11 	The collection and use by a nursing facility of financial information of any applicant 
220.12 	pursuant to a preadmission screening program established by law shall not raise an 
220.13 	inference that the nursing facility is utilizing that information for any purpose prohibited 
220.14 	by this paragraph.
220.15 	(f) Requiring any vendor of medical care as defined by section 256B.02, subdivision 
220.16 	7, who is reimbursed by medical assistance under a separate fee schedule, to pay any 
220.17 	amount based on utilization or service levels or any portion of the vendor's fee to the 
220.18 	nursing facility except as payment for renting or leasing space or equipment or purchasing 
220.19 	support services from the nursing facility as limited by section 256B.433. All agreements 
220.20 	must be disclosed to the commissioner upon request of the commissioner. Nursing 
220.21 	facilities and vendors of ancillary services that are found to be in violation of this provision 
220.22 	shall each be subject to an action by the state of Minnesota or any of its subdivisions or 
220.23 	agencies for treble civil damages on the portion of the fee in excess of that allowed by 
220.24 	this provision and section 256B.433. Damages awarded must include three times the 
220.25 	excess payments together with costs and disbursements including reasonable attorney's 
220.26 	fees or their equivalent.
220.27 	(g) Refusing, for more than 24 hours, to accept a resident returning to the same 
220.28 	bed or a bed certified for the same level of care, in accordance with a physician's order 
220.29 	authorizing transfer, after receiving inpatient hospital services.
220.30 	(h) For a period not to exceed 180 days, the commissioner may continue to make 
220.31 	medical assistance payments to a nursing facility or boarding care home which is in 
220.32 	violation of this section if extreme hardship to the residents would result. In these cases 
220.33 	the commissioner shall issue an order requiring the nursing facility to correct the violation. 
220.34 	The nursing facility shall have 20 days from its receipt of the order to correct the violation. 
220.35 	If the violation is not corrected within the 20-day period the commissioner may reduce 
220.36 	the payment rate to the nursing facility by up to 20 percent. The amount of the payment 
221.1 	rate reduction shall be related to the severity of the violation and shall remain in effect 
221.2 	until the violation is corrected. The nursing facility or boarding care home may appeal the 
221.3 	commissioner's action pursuant to the provisions of chapter 14 pertaining to contested 
221.4 	cases. An appeal shall be considered timely if written notice of appeal is received by the 
221.5 	commissioner within 20 days of notice of the commissioner's proposed action.
221.6 	In the event that the commissioner determines that a nursing facility is not eligible 
221.7 	for reimbursement for a resident who is eligible for medical assistance, the commissioner 
221.8 	may authorize the nursing facility to receive reimbursement on a temporary basis until the 
221.9 	resident can be relocated to a participating nursing facility.
221.10 	Certified beds in facilities which do not allow medical assistance intake on July 1, 
221.11 	1984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

221.12 	Sec. 33. Minnesota Statutes 2010, section 256B.49, subdivision 13, is amended to read:
221.13 		Subd. 13.Case management. (a) Each recipient of a home and community-based 
221.14 	waiver under this section shall be provided case management services according to 
221.15 	section 256B.092, subdivisions 1a, 1b, and 1e, by qualified vendors as described in the 
221.16 	federally approved waiver application. The case management service activities provided 
221.17 	will include:
221.18 	(1) assessing the needs of the individual within 20 working days of a recipient's 
221.19 	request;
221.20 	(2) developing the written individual service plan within ten working days after the 
221.21 	assessment is completed;
221.22 	(3) informing the recipient or the recipient's legal guardian or conservator of service 
221.23 	options;
221.24 	(4) assisting the recipient in the identification of potential service providers;
221.25 	(5) assisting the recipient to access services;
221.26 	(6) coordinating, evaluating, and monitoring of the services identified in the service 
221.27 	plan;
221.28 	(7) completing the annual reviews of the service plan; and
221.29 	(8) informing the recipient or legal representative of the right to have assessments 
221.30 	completed and service plans developed within specified time periods, and to appeal county 
221.31 	action or inaction under section 256.045, subdivision 3, including the determination of 
221.32 	nursing facility level of care.
221.33 	(b) The case manager may delegate certain aspects of the case management service 
221.34 	activities to another individual provided there is oversight by the case manager. The case 
222.1 	manager may not delegate those aspects which require professional judgment including 
222.2 	assessments, reassessments, and care plan development.

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

222.4 	Sec. 34. Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read:
222.5 		Subd. 14.Assessment and reassessment. (a) Assessments of each recipient's 
222.6 	strengths, informal support systems, and need for services shall be completed within 20 
222.7 	working days of the recipient's request as provided in section 256B.0911. Reassessment 
222.8 	of each recipient's strengths, support systems, and need for services shall be conducted 
222.9 	at least every 12 months and at other times when there has been a significant change in 
222.10 	the recipient's functioning.
222.11 	(b) There must be a determination that the client requires a hospital level of care or a 
222.12 	nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and 
222.13 	subsequent assessments to initiate and maintain participation in the waiver program.
222.14 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
222.15 	appropriate to determine nursing facility level of care for purposes of medical assistance 
222.16 	payment for nursing facility services, only face-to-face assessments conducted according 
222.17 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
222.18 	determination or a nursing facility level of care determination must be accepted for 
222.19 	purposes of initial and ongoing access to waiver services payment.
222.20 	(d) Persons with developmental disabilities who apply for services under the nursing 
222.21 	facility level waiver programs shall be screened for the appropriate level of care according 
222.22 	to section 256B.092.
222.23 	(e) Recipients who are found eligible for home and community-based services under 
222.24 	this section before their 65th birthday may remain eligible for these services after their 
222.25 	65th birthday if they continue to meet all other eligibility factors.
222.26 	(f) The commissioner shall develop criteria to identify recipients whose level of 
222.27 	functioning is reasonably expected to improve and reassess these recipients to establish 
222.28 	a baseline assessment. Recipients who meet these criteria must have a comprehensive 
222.29 	transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be 
222.30 	reassessed every six months until there has been no significant change in the recipient's 
222.31 	functioning for at least 12 months. After there has been no significant change in the 
222.32 	recipient's functioning for at least 12 months, reassessments of the recipient's strengths, 
222.33 	informal support systems, and need for services shall be conducted at least every 12 
222.34 	months and at other times when there has been a significant change in the recipient's 
223.1 	functioning. Counties, case managers, and service providers are responsible for conducting 
223.2 	these reassessments and shall complete the reassessments out of existing funds.

223.3 	EFFECTIVE DATE. This section is effective January 1, 2012, except for paragraph 
223.4 	(f), which is effective July 1, 2013.

223.5 	Sec. 35. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:
223.6 		Subd. 15.Individualized service Coordinated services and support plan; 
223.7 	comprehensive transitional service plan; maintenance service plan. (a) Each recipient 
223.8 	of home and community-based waivered services shall be provided a copy of the written 
223.9 	service coordinated services and support plan which: that complies with the requirements 
223.10 	of section 256B.092, subdivisions 1b and 1e.
223.11 	(1) is developed and signed by the recipient within ten working days of the 
223.12 	completion of the assessment;
223.13 	(2) meets the assessed needs of the recipient;
223.14 	(3) reasonably ensures the health and safety of the recipient;
223.15 	(4) promotes independence;
223.16 	(5) allows for services to be provided in the most integrated settings; and
223.17 	(6) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
223.18 	paragraph (p), of service and support providers.
223.19 	(b) In developing the comprehensive transitional service plan, the individual 
223.20 	receiving services, the case manager, and the guardian, if applicable, will identify 
223.21 	the transitional service plan fundamental service outcome and anticipated timeline to 
223.22 	achieve this outcome. Within the first 20 days following a recipient's request for an 
223.23 	assessment or reassessment, the transitional service planning team must be identified. A 
223.24 	team leader must be identified who will be responsible for assigning responsibility and 
223.25 	communicating with team members to ensure implementation of the transition plan and 
223.26 	ongoing assessment and communication process. The team leader should be an individual, 
223.27 	such as the case manager or guardian, who has the opportunity to follow the recipient to 
223.28 	the next level of service.
223.29 	Within ten days following an assessment, a comprehensive transitional service plan 
223.30 	must be developed incorporating elements of a comprehensive functional assessment and 
223.31 	including short-term measurable outcomes and timelines for achievement of and reporting 
223.32 	on these outcomes. Functional milestones must also be identified and reported according 
223.33 	to the timelines agreed upon by the transitional service planning team. In addition, the 
223.34 	comprehensive transitional service plan must identify additional supports that may assist 
223.35 	in the achievement of the fundamental service outcome such as the development of greater 
224.1 	natural community support, increased collaboration among agencies, and technological 
224.2 	supports.
224.3 	The timelines for reporting on functional milestones will prompt a reassessment of 
224.4 	services provided, the units of services, rates, and appropriate service providers. It is 
224.5 	the responsibility of the transitional service planning team leader to review functional 
224.6 	milestone reporting to determine if the milestones are consistent with observable skills 
224.7 	and that milestone achievement prompts any needed changes to the comprehensive 
224.8 	transitional service plan.
224.9 	For those whose fundamental transitional service outcome involves the need to 
224.10 	procure housing, a plan for the recipient to seek the resources necessary to secure the least 
224.11 	restrictive housing possible should be incorporated into the plan, including employment 
224.12 	and public supports such as housing access and shelter needy funding.
224.13 	(c) Counties and other agencies responsible for funding community placement and 
224.14 	ongoing community supportive services are responsible for the implementation of the 
224.15 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
224.16 	effective transitional service delivery and efficient utilization of funding resources.
224.17 	(d) Following one year of transitional services, the transitional services planning 
224.18 	team will make a determination as to whether or not the individual receiving services 
224.19 	requires the current level of continuous and consistent support in order to maintain the 
224.20 	recipient's current level of functioning. Recipients who are determined to have not had 
224.21 	a significant change in functioning for 12 months must move from a transitional to a 
224.22 	maintenance service plan. Recipients on a maintenance service plan must be reassessed 
224.23 	to determine if the recipient would benefit from a transitional service plan at least every 
224.24 	12 months and at other times when there has been a significant change in the recipient's 
224.25 	functioning. This assessment should consider any changes to technological or natural 
224.26 	community supports.
224.27 	(b) (e) When a county is evaluating denials, reductions, or terminations of home 
224.28 	and community-based services under section 256B.49 for an individual, the case manager 
224.29 	shall offer to meet with the individual or the individual's guardian in order to discuss the 
224.30 	prioritization of service needs within the individualized service plan, comprehensive 
224.31 	transitional service plan, or maintenance service plan. The reduction in the authorized 
224.32 	services for an individual due to changes in funding for waivered services may not exceed 
224.33 	the amount needed to ensure medically necessary services to meet the individual's health, 
224.34 	safety, and welfare.

224.35 	EFFECTIVE DATE. This section is effective January 1, 2012, except for 
224.36 	paragraphs (b), (c), and (d), which are effective July 1, 2013.

225.1 	Sec. 36. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
225.2 	subdivision to read:
225.3 		Subd. 9.ICF/MR rate increase. Effective July 1, 2011, the commissioner shall 
225.4 	increase the daily rate to $138.23 at an intermediate care facility for the developmentally 
225.5 	disabled located in Clearwater County and classified as a class A facility with 15 beds.

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

225.7 	Sec. 37. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
225.8 	subdivision to read:
225.9 		Subd. 10.ICF/MR rate adjustment. For each facility reimbursed under this 
225.10 	section, except for a facility located in Clearwater County and classified as a class A 
225.11 	facility with 15 beds, the commissioner shall decrease operating payment rates equal 
225.12 	to 0.095 percent of the operating payment rates in effect on June 30, 2011. For each 
225.13 	facility, the commissioner shall apply the rate reduction, based on occupied beds, using the 
225.14 	percentage specified in this subdivision multiplied by the total payment rate, including the 
225.15 	variable rate but excluding the property-related payment rate, in effect on the preceding 
225.16 	date. The total rate reduction shall include the adjustment provided in section 256B.501, 
225.17 	subdivision 12.

225.18 	Sec. 38. Minnesota Statutes 2010, section 256G.02, subdivision 6, is amended to read:
225.19 		Subd. 6.Excluded time. "Excluded time" means:
225.20 	(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter 
225.21 	other than an emergency shelter, halfway house, foster home, semi-independent living 
225.22 	domicile or services program, residential facility offering care, board and lodging facility 
225.23 	or other institution for the hospitalization or care of human beings, as defined in section 
225.24 	144.50, 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter, 
225.25 	or correctional facility; or any facility based on an emergency hold under sections 
225.26 	253B.05, subdivisions 1 and 2, and 253B.07, subdivision 6;
225.27 	(b) any period an applicant spends on a placement basis in a training and habilitation 
225.28 	program, including a rehabilitation facility or work or employment program as defined 
225.29 	in section 268A.01; or receiving personal care assistance services pursuant to section 
225.30 	256B.0659; semi-independent living services provided under section 252.275, and 
225.31 	Minnesota Rules, parts 9525.0500 to 9525.0660; or day training and habilitation programs 
225.32 	and assisted living services; and
225.33 	(c) any placement for a person with an indeterminate commitment, including 
225.34 	independent living.

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

226.2 	Sec. 39. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 
226.3 	Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special 
226.4 	Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read:

226.5	Subd. 8.Continuing Care Grants
 					
226.6 	The amounts that may be spent from the 
226.7 	appropriation for each purpose are as follows:

226.8	(a) Aging and Adult Services Grants
		13,499,000
		15,805,000
	
226.9 	Base Adjustment. The general fund base is 
226.10 	increased by $5,751,000 in fiscal year 2012 
226.11 	and $6,705,000 in fiscal year 2013.
226.12 	Information and Assistance 
226.13 	Reimbursement. Federal administrative 
226.14 	reimbursement obtained from information 
226.15 	and assistance services provided by the 
226.16 	Senior LinkAge or Disability Linkage lines 
226.17 	to people who are identified as eligible for 
226.18 	medical assistance shall be appropriated to 
226.19 	the commissioner for this activity.
226.20 	Community Service Development Grant 
226.21 	Reduction. Funding for community service 
226.22 	development grants must be reduced by 
226.23 	$260,000 for fiscal year 2010; $284,000 in 
226.24 	fiscal year 2011; $43,000 in fiscal year 2012; 
226.25 	and $43,000 in fiscal year 2013. Base level 
226.26 	funding shall be restored in fiscal year 2014.
226.27 	Community Service Development Grant 
226.28 	Community Initiative. Funding for 
226.29 	community service development grants shall 
226.30 	be used to offset the cost of aging support 
226.31 	grants. Base level funding shall be restored 
226.32 	in fiscal year 2014.
227.1 	Senior Nutrition Use of Federal Funds.
227.2 	For fiscal year 2010, general fund grants 
227.3 	for home-delivered meals and congregate 
227.4 	dining shall be reduced by $500,000. The 
227.5 	commissioner must replace these general 
227.6 	fund reductions with equal amounts from 
227.7 	federal funding for senior nutrition from the 
227.8 	American Recovery and Reinvestment Act 
227.9 	of 2009.

227.10	(b) Alternative Care Grants
		50,234,000
		48,576,000
	
227.11 	Base Adjustment. The general fund base is 
227.12 	decreased by $3,598,000 in fiscal year 2012 
227.13 	and $3,470,000 in fiscal year 2013.
227.14 	Alternative Care Transfer. Any money 
227.15 	allocated to the alternative care program that 
227.16 	is not spent for the purposes indicated does 
227.17 	not cancel but must be transferred to the 
227.18 	medical assistance account.

227.19
227.20	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		367,444,000
		419,749,000

227.21
227.22	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		853,567,000
		1,039,517,000
	
227.23 	Manage Growth in TBI and CADI 
227.24 	Waivers. During the fiscal years beginning 
227.25 	on July 1, 2009, and July 1, 2010, the 
227.26 	commissioner shall allocate money for home 
227.27 	and community-based waiver programs 
227.28 	under Minnesota Statutes, section 256B.49, 
227.29 	to ensure a reduction in state spending that is 
227.30 	equivalent to limiting the caseload growth of 
227.31 	the TBI waiver to 12.5 allocations per month 
227.32 	each year of the biennium and the CADI 
227.33 	waiver to 95 allocations per month each year 
227.34 	of the biennium. Limits do not apply: (1) 
227.35 	when there is an approved plan for nursing 
228.1 	facility bed closures for individuals under 
228.2 	age 65 who require relocation due to the 
228.3 	bed closure; (2) to fiscal year 2009 waiver 
228.4 	allocations delayed due to unallotment; or (3) 
228.5 	to transfers authorized by the commissioner 
228.6 	from the personal care assistance program 
228.7 	of individuals having a home care rating 
228.8 	of "CS," "MT," or "HL." Priorities for the 
228.9 	allocation of funds must be for individuals 
228.10 	anticipated to be discharged from institutional 
228.11 	settings or who are at imminent risk of a 
228.12 	placement in an institutional setting.
228.13 	Manage Growth in DD Waiver. The 
228.14 	commissioner shall manage the growth in 
228.15 	the DD waiver by limiting the allocations 
228.16 	included in the February 2009 forecast to 15 
228.17 	additional diversion allocations each month 
228.18 	for the calendar years that begin on January 
228.19 	1, 2010, and January 1, 2011. Additional 
228.20 	allocations must be made available for 
228.21 	transfers authorized by the commissioner 
228.22 	from the personal care program of individuals 
228.23 	having a home care rating of "CS," "MT," 
228.24 	or "HL."
228.25 	Adjustment to Lead Agency Waiver 
228.26 	Allocations. Prior to the availability of the 
228.27 	alternative license defined in Minnesota 
228.28 	Statutes, section 245A.11, subdivision 8, 
228.29 	the commissioner shall reduce lead agency 
228.30 	waiver allocations for the purposes of 
228.31 	implementing a moratorium on corporate 
228.32 	foster care.
228.33 	Alternatives to Personal Care Assistance 
228.34 	Services. Base level funding of $3,237,000 
228.35 	in fiscal year 2012 and $4,856,000 in 
229.1 	fiscal year 2013 is to implement alternative 
229.2 	services to personal care assistance services 
229.3 	for persons with mental health and other 
229.4 	behavioral challenges who can benefit 
229.5 	from other services that more appropriately 
229.6 	meet their needs and assist them in living 
229.7 	independently in the community. These 
229.8 	services may include, but not be limited to, a 
229.9 	1915(i) state plan option.

229.10	(e) Mental Health Grants

229.11	Appropriations by Fund
	
229.12	General
	77,739,000
	77,739,000
	
229.13	Health Care Access
	750,000
	750,000
	
229.14	Lottery Prize
	1,508,000
	1,508,000
	
229.15 	Funding Usage. Up to 75 percent of a fiscal 
229.16 	year's appropriation for adult mental health 
229.17 	grants may be used to fund allocations in that 
229.18 	portion of the fiscal year ending December 
229.19 	31.

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

229.21	(g) Chemical Dependency Entitlement Grants
		111,303,000
		122,822,000
	
229.22 	Payments for Substance Abuse Treatment.
229.23 	For placements beginning during fiscal years 
229.24 	2010 and 2011, county-negotiated rates and 
229.25 	provider claims to the consolidated chemical 
229.26 	dependency fund must not exceed the lesser 
229.27 	of:
229.28 	(1) rates charged for these services on 
229.29 	January 1, 2009; or
229.30 	(2) 160 percent of the average rate on January 
229.31 	1, 2009, for each group of vendors with 
229.32 	similar attributes.
229.33 	Rates for fiscal years 2010 and 2011 must 
229.34 	not exceed 160 percent of the average rate on 
230.1 	January 1, 2009, for each group of vendors 
230.2 	with similar attributes.
230.3 	Effective July 1, 2010, rates that were above 
230.4 	the average rate on January 1, 2009, are 
230.5 	reduced by five percent from the rates in 
230.6 	effect on June 1, 2010. Rates below the 
230.7 	average rate on January 1, 2009, are reduced 
230.8 	by 1.8 percent from the rates in effect on 
230.9 	June 1, 2010. Services provided under 
230.10 	this section by state-operated services are 
230.11 	exempt from the rate reduction. For services 
230.12 	provided in fiscal years 2012 and 2013, the 
230.13 	statewide aggregate payment under the new 
230.14 	rate methodology to be developed under 
230.15 	Minnesota Statutes, section 254B.12, must 
230.16 	not exceed the projected aggregate payment 
230.17 	under the rates in effect for fiscal year 2011 
230.18 	excluding the rate reduction for rates that 
230.19 	were below the average on January 1, 2009, 
230.20 	plus a state share increase of $3,787,000 for 
230.21 	fiscal year 2012 and $5,023,000 for fiscal 
230.22 	year 2013. Notwithstanding any provision 
230.23 	to the contrary in this article, this provision 
230.24 	expires on June 30, 2013.
230.25 	Chemical Dependency Special Revenue 
230.26 	Account. For fiscal year 2010, $750,000 
230.27 	must be transferred from the consolidated 
230.28 	chemical dependency treatment fund 
230.29 	administrative account and deposited into the 
230.30 	general fund.
230.31 	County CD Share of MA Costs for 
230.32 	ARRA Compliance. Notwithstanding the 
230.33 	provisions of Minnesota Statutes, chapter 
230.34 	254B, for chemical dependency services 
230.35 	provided during the period October 1, 2008, 
231.1 	to December 31, 2010, and reimbursed by 
231.2 	medical assistance at the enhanced federal 
231.3 	matching rate provided under the American 
231.4 	Recovery and Reinvestment Act of 2009, the 
231.5 	county share is 30 percent of the nonfederal 
231.6 	share. This provision is effective the day 
231.7 	following final enactment.

231.8
231.9	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000

231.10	(i) Other Continuing Care Grants
		19,201,000
		17,528,000
	
231.11 	Base Adjustment. The general fund base is 
231.12 	increased by $2,639,000 in fiscal year 2012 
231.13 	and increased by $3,854,000 in fiscal year 
231.14 	2013.
231.15 	Technology Grants. $650,000 in fiscal 
231.16 	year 2010 and $1,000,000 in fiscal year 
231.17 	2011 are for technology grants, case 
231.18 	consultation, evaluation, and consumer 
231.19 	information grants related to developing and 
231.20 	supporting alternatives to shift-staff foster 
231.21 	care residential service models.
231.22 	Other Continuing Care Grants; HIV 
231.23 	Grants. Money appropriated for the HIV 
231.24 	drug and insurance grant program in fiscal 
231.25 	year 2010 may be used in either year of the 
231.26 	biennium.
231.27 	Quality Assurance Commission. Effective 
231.28 	July 1, 2009, state funding for the quality 
231.29 	assurance commission under Minnesota 
231.30 	Statutes, section 256B.0951, is canceled.

231.31 	Sec. 40. ESTABLISHMENT OF RATES FOR SHARED HOME AND 
231.32 	COMMUNITY-BASED WAIVER SERVICES.
 231.33 	By January 1, 2012, the commissioner shall establish rates to begin paying for 
231.34 	in-home services and personal supports under all of the home and community-based 
232.1 	waiver services programs consistent with the standards in Minnesota Statutes, section 
232.2 	256B.4912, subdivision 2.

232.3 	Sec. 41. ESTABLISHMENT OF RATE FOR CASE MANAGEMENT 
232.4 	SERVICES.
 232.5 	By July 1, 2012, the commissioner shall establish the rate to be paid for case 
232.6 	management services under Minnesota Statutes, sections 256B.0621, subdivision 2, clause 
232.7 	(4), 256B.092, and 256B.49, consistent with the standards in Minnesota Statutes, section 
232.8 	256B.4912, subdivision 2.

232.9 	Sec. 42. RECOMMENDATIONS FOR FURTHER CASE MANAGEMENT 
232.10 	REDESIGN.
 232.11 	By February 1, 2012, the commissioner of human services shall develop a legislative 
232.12 	report with specific recommendations and language for proposed legislation to be effective 
232.13 	July 1, 2012, for the following:
232.14 	(1) definitions of service and consolidation of standards and rates to the extent 
232.15 	appropriate for all types of medical assistance case management services, including 
232.16 	targeted case management under Minnesota Statutes, sections 256B.0621; 256B.0625, 
232.17 	subdivision 20; and 256B.0924; mental health case management services for children 
232.18 	and adults, all types of home and community-based waiver case management, and case 
232.19 	management under Minnesota Rules, parts 9525.0004 to 9525.0036. This work shall be 
232.20 	completed in collaboration with efforts under Minnesota Statutes, section 256B.4912;
232.21 	(2) recommendations on county of financial responsibility requirements and quality 
232.22 	assurance measures for case management; 
232.23 	(3) identification of county administrative functions that may remain entwined in 
232.24 	case management service delivery models; and
232.25 	(4) implementation of a methodology to fully fund county case management 
232.26 	administrative functions. 

232.27 	Sec. 43. MY LIFE, MY CHOICES TASK FORCE.
 232.28 		Subdivision 1.Establishment. The My Life, My Choices Task Force is established 
232.29 	to create a system of supports and services for people with disabilities governed by the 
232.30 	following principles:
232.31 	(1) freedom to act as a consumer of services in the marketplace;
232.32 	(2) freedom to choose to take as much risk as any other citizen;
232.33 	(3) more choices in levels of service that may vary throughout life;
233.1 	(4) opportunity to work with a trusted advocate and fiscal support entity to manage a 
233.2 	personal budget and to be accountable for reporting spending and personal outcomes;
233.3 	(5) opportunity to live with minimal constraints instead of minimal freedoms; and
233.4 	(6) ability to consolidate funding streams into an individualized budget.
233.5 		Subd. 2.Membership. The My Life, My Choices Task Force shall consist of:
233.6 	(1) the lieutenant governor; 
233.7 	(2) the commissioner of human services, or the commissioner's designee;
233.8 	(3) a representative of the Minnesota Chamber of Commerce;
233.9 	(4) a county representative appointed by the Association of Minnesota Counties;
233.10 	(5) seven members appointed by the governor as follows: one administrative law 
233.11 	judge, one labor representative, two family members of people with disabilities, and three 
233.12 	individual members with different disabilities;
233.13 	(6)  two members appointed by the speaker of the house as follows: a representative 
233.14 	of a disability advocacy organization, and a representative of a disability legal services 
233.15 	advocacy organization; and
233.16 	(7) three members appointed by the majority leader of the senate, including two 
233.17 	representatives from nonprofit organizations, one of which serves all 87 counties and 
233.18 	one that serves persons with disabilities and employs fewer than 50 people, and a 
233.19 	representative of a philanthropic organization.
233.20 	Appointed nongovernmental members of the task force shall serve as staff for the 
233.21 	task force and take on responsibilities of coordinating meetings, reporting on committee 
233.22 	recommendations, and providing other staff support as needed to meet the responsibilities 
233.23 	of the task force as described in subdivision 3. The chairs and ranking minority members 
233.24 	of the legislative committees with jurisdiction over health and human services policy and 
233.25 	finance shall serve as ex officio members.
233.26 		Subd. 3.Duties. The task force shall make recommendations, including proposed 
233.27 	legislation, and report to the legislative committees with jurisdiction over health and 
233.28 	human services policy and finance by November 15, 2011, on creating a system of 
233.29 	supports and services for people with disabilities by July 1, 2012, as governed by the 
233.30 	principles under subdivision 1. In making recommendations and proposed legislation, the 
233.31 	council shall work in conjunction with the Consumer-Directed Community Supports Task 
233.32 	Force and shall include self-directed planning, individual budgeting, choice of trusted 
233.33 	partner, self-directed purchasing of services and supports, reporting of outcomes, ability to 
233.34 	share in any savings, and any additional rules or laws that may need to be waived. 
233.35 		Subd. 4.Expense reimbursement. The members of the task force shall not be 
233.36 	reimbursed by the state for expenses related to the duties of the task force. The task force 
234.1 	shall be independently staffed and coordinated by nongovernmental appointees who 
234.2 	serve on the task force, and no state dollars shall be appropriated for expenses related to 
234.3 	the task force under this section.
234.4 		Subd. 5.Expiration. The task force expires on July 1, 2013.

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

234.6 	Sec. 44. DIRECTION TO OMBUDSMAN FOR LONG-TERM CARE.
 234.7 	The Office of Ombudsman for Long-Term Care shall develop a work group to 
234.8 	address issues about, but not limited to: housing with services fees, staffing, and quality 
234.9 	assurance. The work group shall include, but not be limited to: consumers, relatives of 
234.10 	consumers, advocates, and providers.  The Office of Ombudsman for Long-Term Care 
234.11 	shall present a report with recommendations related to housing with services fees, staffing, 
234.12 	and quality assurance to the legislative committees with jurisdiction over health and 
234.13 	human services policy and finance by January 15, 2012. 

234.14 	Sec. 45. DIRECTION TO COUNTIES.
 234.15 	Counties must inform individuals who have had a level of service reduction of 
234.16 	their right to request an informal review conference with their case worker and any other 
234.17 	relevant county staff.

234.18 	Sec. 46. NURSING FACILITY PILOT PROJECT.
 234.19 		Subdivision 1.Report. The commissioner of human services, in consultation with 
234.20 	the commissioner of health, stakeholders, and experts, shall provide to the legislature 
234.21 	recommendations by November 15, 2011, on how to develop a project to demonstrate a 
234.22 	new approach to caring for certain individuals in nursing facilities.
234.23 		Subd. 2.Contents of report. The recommendations shall address the:
234.24 	(1) nature of the demonstration in terms of timing, size, qualifications to participate, 
234.25 	participation selection criteria and postdemonstration options for the demonstration and 
234.26 	for participating facilities;
234.27 	(2) nature of needed new form of licensure;
234.28 	(3) characteristics of the individuals the new model is intended to serve and 
234.29 	comparison of these characteristics with those individuals served by existing models of 
234.30 	care;
234.31 	(4) quality standards for licensure addressing management, types and amounts of 
234.32 	staffing, safety, infection control, care processes, quality improvement, and resident rights;
234.33 	(5) characteristics of inspection process;
235.1 	(6) funding for inspection process;
235.2 	(7) enforcement authorities;
235.3 	(8) role of Medicare;
235.4 	(9) participation in the elderly waiver program, including rate setting;
235.5 	(10) nature of any federal approval or waiver requirements and the method and 
235.6 	timing of obtaining them;
235.7 	(11) consumer rights; and
235.8 	(12) methods and resources needed to evaluate the effectiveness of the model with 
235.9 	regards to cost and quality.

235.10 	ARTICLE 7
235.11 	CHEMICAL AND MENTAL HEALTH

235.12 	Section 1. Minnesota Statutes 2010, section 246B.10, is amended to read:
235.13 	246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.
235.14 	The civilly committed sex offender's county shall pay to the state a portion of the 
235.15 	cost of care provided in the Minnesota sex offender program to a civilly committed sex 
235.16 	offender who has legally settled in that county. A county's payment must be made from 
235.17 	the county's own sources of revenue and payments must equal ten 25 percent of the cost of 
235.18 	care, as determined by the commissioner, for each day or portion of a day, that the civilly 
235.19 	committed sex offender spends at the facility. If payments received by the state under this 
235.20 	chapter exceed 90 75 percent of the cost of care, the county is responsible for paying the 
235.21 	state the remaining amount. The county is not entitled to reimbursement from the civilly 
235.22 	committed sex offender, the civilly committed sex offender's estate, or from the civilly 
235.23 	committed sex offender's relatives, except as provided in section 246B.07.

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

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

236.5 	Sec. 3. Minnesota Statutes 2010, section 253B.212, is amended to read:
236.6 	253B.212 COMMITMENT; RED LAKE BAND OF CHIPPEWA INDIANS; 
236.7 	WHITE EARTH BAND OF OJIBWE.
236.8 		Subdivision 1.Cost of care; commitment by tribal court order; Red Lake 
236.9 	Band of Chippewa Indians. The commissioner of human services may contract with 
236.10 	and receive payment from the Indian Health Service of the United States Department of 
236.11 	Health and Human Services for the care and treatment of those members of the Red 
236.12 	Lake Band of Chippewa Indians who have been committed by tribal court order to the 
236.13 	Indian Health Service for care and treatment of mental illness, developmental disability, or 
236.14 	chemical dependency. The contract shall provide that the Indian Health Service may not 
236.15 	transfer any person for admission to a regional center unless the commitment procedure 
236.16 	utilized by the tribal court provided due process protections similar to those afforded 
236.17 	by sections 253B.05 to 253B.10.
236.18 		Subd. 1a.Cost of care; commitment by tribal court order; White Earth Band of 
236.19 	Ojibwe Indians. The commissioner of human services may contract with and receive 
236.20 	payment from the Indian Health Service of the United States Department of Health and 
236.21 	Human Services for the care and treatment of those members of the White Earth Band 
236.22 	of Ojibwe Indians who have been committed by tribal court order to the Indian Health 
236.23 	Service for care and treatment of mental illness, developmental disability, or chemical 
236.24 	dependency. The tribe may also contract directly with the commissioner for treatment 
236.25 	of those members of the White Earth Band who have been committed by tribal court 
236.26 	order to the White Earth Department of Health for care and treatment of mental illness, 
236.27 	developmental disability, or chemical dependency. The contract shall provide that the 
236.28 	Indian Health Service and the White Earth Band shall not transfer any person for admission 
236.29 	to a regional center unless the commitment procedure utilized by the tribal court provided 
236.30 	due process protections similar to those afforded by sections 253B.05 to 253B.10.
236.31 		Subd. 2.Effect given to tribal commitment order. When, under an agreement 
236.32 	entered into pursuant to subdivision 1 subdivisions 1 or 1a, the Indian Health Service 
236.33 	applies to a regional center for admission of a person committed to the jurisdiction of the 
236.34 	health service by the tribal court as a person who is mentally ill, developmentally disabled, 
237.1 	or chemically dependent, the commissioner may treat the patient with the consent of 
237.2 	the Indian Health Service.
237.3 	A person admitted to a regional center pursuant to this section has all the rights 
237.4 	accorded by section 253B.03. In addition, treatment reports, prepared in accordance with 
237.5 	the requirements of section 253B.12, subdivision 1, shall be filed with the Indian Health 
237.6 	Service within 60 days of commencement of the patient's stay at the facility. A subsequent 
237.7 	treatment report shall be filed with the Indian Health Service within six months of the 
237.8 	patient's admission to the facility or prior to discharge, whichever comes first. Provisional 
237.9 	discharge or transfer of the patient may be authorized by the head of the treatment facility 
237.10 	only with the consent of the Indian Health Service. Discharge from the facility to the 
237.11 	Indian Health Service may be authorized by the head of the treatment facility after notice 
237.12 	to and consultation with the Indian Health Service.

237.13 	Sec. 4. Minnesota Statutes 2010, section 254B.03, subdivision 1, is amended to read:
237.14 		Subdivision 1.Local agency duties. (a) Every local agency shall provide chemical 
237.15 	dependency services to persons residing within its jurisdiction who meet criteria 
237.16 	established by the commissioner for placement in a chemical dependency residential 
237.17 	or nonresidential treatment service subject to the limitations on residential chemical 
237.18 	dependency treatment in section 254B.04, subdivision 1. Chemical dependency money 
237.19 	must be administered by the local agencies according to law and rules adopted by the 
237.20 	commissioner under sections 14.001 to 14.69.
237.21 	(b) In order to contain costs, the commissioner of human services shall select eligible 
237.22 	vendors of chemical dependency services who can provide economical and appropriate 
237.23 	treatment. Unless the local agency is a social services department directly administered by 
237.24 	a county or human services board, the local agency shall not be an eligible vendor under 
237.25 	section 254B.05. The commissioner may approve proposals from county boards to provide 
237.26 	services in an economical manner or to control utilization, with safeguards to ensure that 
237.27 	necessary services are provided. If a county implements a demonstration or experimental 
237.28 	medical services funding plan, the commissioner shall transfer the money as appropriate.
237.29 	(c) A culturally specific vendor that provides assessments under a variance under 
237.30 	Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 
237.31 	persons not covered by the variance.

237.32 	Sec. 5. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
237.33 		Subd. 4.Division of costs. Except for services provided by a county under 
237.34 	section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 
238.1 	subdivision 4, paragraph (b), the county shall, out of local money, pay the state for 
238.2 	16.14 22.95 percent of the cost of chemical dependency services, including those services 
238.3 	provided to persons eligible for medical assistance under chapter 256B and general 
238.4 	assistance medical care under chapter 256D. Counties may use the indigent hospitalization 
238.5 	levy for treatment and hospital payments made under this section. 16.14 22.95 percent 
238.6 	of any state collections from private or third-party pay, less 15 percent for the cost of 
238.7 	payment and collections, must be distributed to the county that paid for a portion of the 
238.8 	treatment under this section.

238.9 	EFFECTIVE DATE. This section is effective for claims processed beginning 
238.10 	July 1, 2011.

238.11 	Sec. 6. Minnesota Statutes 2010, section 254B.04, subdivision 1, is amended to read:
238.12 		Subdivision 1.Eligibility. (a) Persons eligible for benefits under Code of Federal 
238.13 	Regulations, title 25, part 20, persons eligible for medical assistance benefits under 
238.14 	sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet 
238.15 	the income standards of section 256B.056, subdivision 4, and persons eligible for general 
238.16 	assistance medical care under section 256D.03, subdivision 3, are entitled to chemical 
238.17 	dependency fund services subject to the following limitations: (1) no more than three 
238.18 	residential chemical dependency treatment episodes for the same person in a four-year 
238.19 	period of time unless the person meets the criteria established by the commissioner of 
238.20 	human services; and (2) no more than four residential chemical dependency treatment 
238.21 	episodes in a lifetime unless the person meets the criteria established by the commissioner 
238.22 	of human services. For purposes of this section, "episode" means a span of treatment 
238.23 	without interruption of 30 days or more. State money appropriated for this paragraph must 
238.24 	be placed in a separate account established for this purpose. 
238.25 	Persons with dependent children who are determined to be in need of chemical 
238.26 	dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 
238.27 	a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 
238.28 	local agency to access needed treatment services. Treatment services must be appropriate 
238.29 	for the individual or family, which may include long-term care treatment or treatment in a 
238.30 	facility that allows the dependent children to stay in the treatment facility. The county 
238.31 	shall pay for out-of-home placement costs, if applicable. 
238.32 	(b) A person not entitled to services under paragraph (a), but with family income 
238.33 	that is less than 215 percent of the federal poverty guidelines for the applicable family 
238.34 	size, shall be eligible to receive chemical dependency fund services within the limit 
238.35 	of funds appropriated for this group for the fiscal year. If notified by the state agency 
239.1 	of limited funds, a county must give preferential treatment to persons with dependent 
239.2 	children who are in need of chemical dependency treatment pursuant to an assessment 
239.3 	under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision 
239.4 	6, or 260C.212. A county may spend money from its own sources to serve persons under 
239.5 	this paragraph. State money appropriated for this paragraph must be placed in a separate 
239.6 	account established for this purpose. 
239.7 	(c) Persons whose income is between 215 percent and 412 percent of the federal 
239.8 	poverty guidelines for the applicable family size shall be eligible for chemical dependency 
239.9 	services on a sliding fee basis, within the limit of funds appropriated for this group for the 
239.10 	fiscal year. Persons eligible under this paragraph must contribute to the cost of services 
239.11 	according to the sliding fee scale established under subdivision 3. A county may spend 
239.12 	money from its own sources to provide services to persons under this paragraph. State 
239.13 	money appropriated for this paragraph must be placed in a separate account established 
239.14 	for this purpose.

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

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

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

239.31 	EFFECTIVE DATE. This section is effective for claims processed beginning 
239.32 	July 1, 2011.

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

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

240.9 	Sec. 10. Minnesota Statutes 2010, section 256B.0945, subdivision 4, is amended to 
240.10 	read:
240.11 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, 
240.12 	payments to counties for residential services provided by a residential facility shall only 
240.13 	be made of federal earnings for services provided under this section, and the nonfederal 
240.14 	share of costs for services provided under this section shall be paid by the county from 
240.15 	sources other than federal funds or funds used to match other federal funds. Payment to 
240.16 	counties for services provided according to this section shall be a proportion of the per 
240.17 	day contract rate that relates to rehabilitative mental health services and shall not include 
240.18 	payment for costs or services that are billed to the IV-E program as room and board.
240.19 	(b) Per diem rates paid to providers under this section by prepaid plans shall be 
240.20 	the proportion of the per-day contract rate that relates to rehabilitative mental health 
240.21 	services and shall not include payment for group foster care costs or services that are 
240.22 	billed to the county of financial responsibility. Services provided in facilities located in 
240.23 	bordering states are eligible for reimbursement on a fee-for-service basis only as described 
240.24 	in paragraph (a) and are not covered under prepaid health plans.
240.25 	(c) Payment for mental health rehabilitative services provided under this section by 
240.26 	or under contract with an American Indian tribe or tribal organization or by agencies 
240.27 	operated by or under contract with an American Indian tribe or tribal organization must 
240.28 	be made according to section 256B.0625, subdivision 34, or other relevant federally 
240.29 	approved rate-setting methodology.
240.30 	(d) The commissioner shall set aside a portion not to exceed five percent of the 
240.31 	federal funds earned for county expenditures under this section to cover the state costs of 
240.32 	administering this section. Any unexpended funds from the set-aside shall be distributed 
240.33 	to the counties in proportion to their earnings under this section.

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

241.1 	Sec. 11. COMMUNITY MENTAL HEALTH SERVICES; USE OF 
241.2 	BEHAVIORAL HEALTH HOSPITALS.
 241.3 	The commissioner shall issue a written report to the chairs and ranking minority 
241.4 	members of the house and senate committees with jurisdiction of health and human 
241.5 	services by December 31, 2011, on how the community behavioral health hospital 
241.6 	facilities will be fully utilized to meet the mental health needs of regions in which the 
241.7 	hospitals are located. The commissioner must consult with the regional planning work 
241.8 	groups for adult mental health and must include the recommendations of the work groups 
241.9 	in the legislative report. The report must address future use of community behavioral 
241.10 	health hospitals that are not certified as Medicaid eligible by CMS or have a less than 65 
241.11 	percent licensed bed occupancy rate, and using the facilities for another purpose that will 
241.12 	meet the mental health needs of residents of the region. The regional planning work 
241.13 	groups shall work with the commissioner to prioritize the needs of their regions. These 
241.14 	priorities, by region, must be included in the commissioner's report to the legislature.

241.15 	Sec. 12. INTEGRATED DUAL DIAGNOSIS TREATMENT.
 241.16 	(a) The commissioner shall require individuals who perform chemical dependency 
241.17 	assessments or mental health diagnostic assessments to use screening tools approved 
241.18 	by the commissioner in order to identify whether an individual who is the subject of 
241.19 	the assessment screens positive for co-occurring mental health or chemical dependency 
241.20 	disorders. Screening for co-occurring disorders must begin no later than December 31, 
241.21 	2011.
241.22 	(b) The commissioner shall adopt rules as necessary to implement this section. The 
241.23 	commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing 
241.24 	a certification process for integrated dual disorder treatment providers and a system 
241.25 	through which individuals receive integrated dual diagnosis treatment if assessed as having 
241.26 	both a substance use disorder and either a serious mental illness or emotional disturbance.
241.27 	(c) The commissioner shall apply for any federal waivers necessary to secure, to the 
241.28 	extent allowed by law, federal financial participation for the provision of integrated dual 
241.29 	diagnosis treatment to persons with co-occurring disorders. 

241.30 	Sec. 13. REGIONAL TREATMENT CENTERS; EMPLOYEES; REPORT.
 241.31 	The commissioner shall issue a report to the legislative committees with jurisdiction 
241.32 	over health and human services finance no later than December 31, 2011, which provides 
241.33 	the number of employees in management positions at the Anoka-Metro Regional 
242.1 	Treatment Center and the Minnesota Security Hospital at St. Peter and the ratio of 
242.2 	management to direct-care staff for each facility.

242.3 	Sec. 14. COMMISSIONER'S CRITERIA FOR RESIDENTIAL TREATMENT.
 242.4 	The commissioner shall develop specific criteria to approve treatment for individuals 
242.5 	who require residential chemical dependency treatment in excess of the maximum allowed 
242.6 	in section 254B.04, subdivision 1, due to co-occurring disorders, including disorders 
242.7 	related to cognition, traumatic brain injury, or documented disability. Criteria shall be 
242.8 	developed for use no later than October 1, 2011.

242.9 	Sec. 15.  REPEALER.
 242.10 	Laws 2009, chapter 79, article 3, section 18, as amended by Laws 2010, First Special 
242.11 	Session chapter 1, article 19, section 19, is repealed.

242.12 	ARTICLE 8
242.13 	REDESIGNING SERVICE DELIVERY

242.14 	Section 1. Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read:
242.15 		Subd. 14.Child welfare reform pilots. The commissioner of human services 
242.16 	shall encourage local reforms in the delivery of child welfare services, within available 
242.17 	appropriations, and is authorized to approve local pilot programs which focus on reforming 
242.18 	the child protection and child welfare systems in Minnesota. Authority to approve pilots 
242.19 	includes authority to waive existing state rules as needed to accomplish reform efforts. 
242.20 	Notwithstanding section 626.556, subdivision 10, 10b, or 10d, the commissioner may 
242.21 	authorize programs to use alternative methods of investigating and assessing reports of 
242.22 	child maltreatment, provided that the programs comply with the provisions of section 
242.23 	626.556 dealing with the rights of individuals who are subjects of reports or investigations, 
242.24 	including notice and appeal rights and data practices requirements. Pilot programs must 
242.25 	be required to address responsibility for safety and protection of children, be time limited, 
242.26 	and include evaluation of the pilot program.

242.27 	Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 14b, is amended to read:
242.28 		Subd. 14b.American Indian child welfare projects. (a) The commissioner of 
242.29 	human services may authorize projects to test tribal delivery of child welfare services to 
242.30 	American Indian children and their parents and custodians living on the reservation. 
242.31 	The commissioner has authority to solicit and determine which tribes may participate 
242.32 	in a project. Grants may be issued to Minnesota Indian tribes to support the projects. 
243.1 	The commissioner may waive existing state rules as needed to accomplish the projects. 
243.2 	Notwithstanding section 626.556, the commissioner may authorize projects to use 
243.3 	alternative methods of investigating and assessing reports of child maltreatment, provided 
243.4 	that the projects comply with the provisions of section 626.556 dealing with the rights 
243.5 	of individuals who are subjects of reports or investigations, including notice and appeal 
243.6 	rights and data practices requirements. The commissioner may seek any federal approvals 
243.7 	necessary to carry out the projects as well as seek and use any funds available to the 
243.8 	commissioner, including use of federal funds, foundation funds, existing grant funds, 
243.9 	and other funds. The commissioner is authorized to advance state funds as necessary to 
243.10 	operate the projects. Federal reimbursement applicable to the projects is appropriated 
243.11 	to the commissioner for the purposes of the projects. The projects must be required to 
243.12 	address responsibility for safety, permanency, and well-being of children.
243.13 	(b) For the purposes of this section, "American Indian child" means a person under 
243.14 	18 years of age who is a tribal member or eligible for membership in one of the tribes 
243.15 	chosen for a project under this subdivision and who is residing on the reservation of 
243.16 	that tribe.
243.17 	(c) In order to qualify for an American Indian child welfare project, a tribe must:
243.18 	(1) be one of the existing tribes with reservation land in Minnesota;
243.19 	(2) have a tribal court with jurisdiction over child custody proceedings;
243.20 	(3) have a substantial number of children for whom determinations of maltreatment 
243.21 	have occurred;
243.22 	(4) have capacity to respond to reports of abuse and neglect under section 626.556;
243.23 	(5) provide a wide range of services to families in need of child welfare services; and
243.24 	(6) have a tribal-state title IV-E agreement in effect.
243.25 	(d) Grants awarded under this section may be used for the nonfederal costs of 
243.26 	providing child welfare services to American Indian children on the tribe's reservation, 
243.27 	including costs associated with:
243.28 	(1) assessment and prevention of child abuse and neglect;
243.29 	(2) family preservation;
243.30 	(3) facilitative, supportive, and reunification services;
243.31 	(4) out-of-home placement for children removed from the home for child protective 
243.32 	purposes; and
243.33 	(5) other activities and services approved by the commissioner that further the goals 
243.34 	of providing safety, permanency, and well-being of American Indian children.
243.35 	(e) When a tribe has initiated a project and has been approved by the commissioner 
243.36 	to assume child welfare responsibilities for American Indian children of that tribe under 
244.1 	this section, the affected county social service agency is relieved of responsibility for 
244.2 	responding to reports of abuse and neglect under section 626.556 for those children 
244.3 	during the time within which the tribal project is in effect and funded. The commissioner 
244.4 	shall work with tribes and affected counties to develop procedures for data collection, 
244.5 	evaluation, and clarification of ongoing role and financial responsibilities of the county 
244.6 	and tribe for child welfare services prior to initiation of the project. Children who have not 
244.7 	been identified by the tribe as participating in the project shall remain the responsibility 
244.8 	of the county. Nothing in this section shall alter responsibilities of the county for law 
244.9 	enforcement or court services.
244.10 	(f) Participating tribes may conduct children's mental health screenings under section 
244.11 	245.4874, subdivision 1, paragraph (a), clause (14), for children who are eligible for the 
244.12 	initiative and living on the reservation and who meet one of the following criteria:
244.13 	(1) the child must be receiving child protective services;
244.14 	(2) the child must be in foster care; or
244.15 	(3) the child's parents must have had parental rights suspended or terminated.
244.16 	Tribes may access reimbursement from available state funds for conducting the screenings. 
244.17 	Nothing in this section shall alter responsibilities of the county for providing services 
244.18 	under section 245.487.
244.19 	(g) Participating tribes may establish a local child mortality review panel. In 
244.20 	establishing a local child mortality review panel, the tribe agrees to conduct local child 
244.21 	mortality reviews for child deaths or near-fatalities occurring on the reservation under 
244.22 	subdivision 12. Tribes with established child mortality review panels shall have access 
244.23 	to nonpublic data and shall protect nonpublic data under subdivision 12, paragraphs (c) 
244.24 	to (e). The tribe shall provide written notice to the commissioner and affected counties 
244.25 	when a local child mortality review panel has been established and shall provide data upon 
244.26 	request of the commissioner for purposes of sharing nonpublic data with members of the 
244.27 	state child mortality review panel in connection to an individual case.
244.28 	(h) The commissioner shall collect information on outcomes relating to child safety, 
244.29 	permanency, and well-being of American Indian children who are served in the projects. 
244.30 	Participating tribes must provide information to the state in a format and completeness 
244.31 	deemed acceptable by the state to meet state and federal reporting requirements.
244.32 	(i) In consultation with the White Earth Band, the commissioner shall develop 
244.33 	and submit to the chairs and ranking minority members of the legislative committees 
244.34 	with jurisdiction over health and human services a plan to transfer legal responsibility 
244.35 	for providing child protective services to White Earth Band member children residing in 
244.36 	Hennepin County to the White Earth Band. The plan shall include a financing proposal, 
245.1 	definitions of key terms, statutory amendments required, and other provisions required to 
245.2 	implement the plan. The commissioner shall submit the plan by January 15, 2012.

245.3 	Sec. 3. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 
245.4 	to read:
245.5 		Subd. 30.Provision of required materials in alternative formats. (a) For the 
245.6 	purposes of this subdivision, "alternative format" means a medium other than paper and 
245.7 	"prepaid health plan" means managed care plans and county-based purchasing plans.
245.8 	(b) A prepaid health plan may provide in an alternative format a provider directory 
245.9 	and certificate of coverage, or materials otherwise required to be available in writing 
245.10 	under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's 
245.11 	contract with the prepaid health plan, if the following conditions are met:
245.12 	(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the 
245.13 	enrollee that:
245.14 	(i) an alternative format is available and the enrollee affirmatively requests of 
245.15 	the prepaid health plan that the provider directory, certificate of coverage, or materials 
245.16 	otherwise required under Code of Federal Regulations, title 42, section 438.10, or under 
245.17 	the commissioner's contract with the prepaid health plan be provided in an alternative 
245.18 	format; and
245.19 	(ii) a record of the enrollee request is retained by the prepaid health plan in the 
245.20 	form of written direction from the enrollee or a documented telephone call followed by a 
245.21 	confirmation letter to the enrollee from the prepaid health plan that explains that the 
245.22 	enrollee may change the request at any time;
245.23 	(2) the materials are sent to a secure electronic mailbox and are made available at a 
245.24 	password-protected secure electronic Web site or on a data storage device if the materials 
245.25 	contain enrollee data that is individually identifiable;
245.26 	(3) the enrollee is provided a customer service number on the enrollee's membership 
245.27 	card that may be called to request a paper version of the materials provided in an 
245.28 	alternative format; and
245.29 	(4) the materials provided in an alternative format meets all other requirements of 
245.30 	the commissioner regarding content, size of the typeface, and any required time frames 
245.31 	for distribution. "Required time frames for distribution" must permit sufficient time for 
245.32 	prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' 
245.33 	requests for the materials.
245.34 	(c) A prepaid health plan may provide in an alternative format its primary care 
245.35 	network list to the commissioner and to local agencies within its service area. The 
246.1 	commissioner or local agency, as applicable, shall inform a potential enrollee of the 
246.2 	availability of a prepaid health plan's primary care network list in an alternative format. If 
246.3 	the potential enrollee requests an alternative format of the prepaid health plan's primary 
246.4 	care network list, a record of that request shall be retained by the commissioner or local 
246.5 	agency. The potential enrollee is permitted to withdraw the request at any time.
246.6 	The prepaid health plan shall submit sufficient paper versions of the primary 
246.7 	care network list to the commissioner and to local agencies within its service area to 
246.8 	accommodate potential enrollee requests for paper versions of the primary care network 
246.9 	list.
246.10 	(d) A prepaid health plan may provide in an alternative format materials otherwise 
246.11 	required to be available in writing under Code of Federal Regulations, title 42, section 
246.12 	438.10, or under the commissioner's contract with the prepaid health plan, if the conditions 
246.13 	of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in 
246.14 	managed care.
246.15 	(e) The commissioner shall seek any federal Medicaid waivers within 90 days after 
246.16 	the effective date of this subdivision that are necessary to provide alternative formats of 
246.17 	required material to enrollees of prepaid health plans as authorized under this subdivision.
246.18 	(f) The commissioner shall consult with managed care plans, county-based 
246.19 	purchasing plans, counties, and other interested parties to determine how materials 
246.20 	required to be made available to enrollees under Code of Federal Regulations, title 42, 
246.21 	section 438.10, or under the commissioner's contract with a prepaid health plan may 
246.22 	be provided in an alternative format on the basis that the enrollee has not opted in to 
246.23 	receive the alternative format. The commissioner shall consult with managed care 
246.24 	plans, county-based purchasing plans, counties, and other interested parties to develop 
246.25 	recommendations relating to the conditions that must be met for an opt-out process 
246.26 	to be granted.

246.27 	Sec. 4. Minnesota Statutes 2010, section 256D.09, subdivision 6, is amended to read:
246.28 		Subd. 6.Recovery of overpayments. (a) If an amount of general assistance or 
246.29 	family general assistance is paid to a recipient in excess of the payment due, it shall be 
246.30 	recoverable by the county agency. The agency shall give written notice to the recipient of 
246.31 	its intention to recover the overpayment.
246.32 	(b) Except as provided for interim assistance in section 256D.06, subdivision 
246.33 	5, when an overpayment occurs, the county agency shall recover the overpayment 
246.34 	from a current recipient by reducing the amount of aid payable to the assistance unit of 
246.35 	which the recipient is a member, for one or more monthly assistance payments, until 
247.1 	the overpayment is repaid. All county agencies in the state shall reduce the assistance 
247.2 	payment by three percent of the assistance unit's standard of need in nonfraud cases and 
247.3 	ten percent where fraud has occurred, or the amount of the monthly payment, whichever is 
247.4 	less, for all overpayments.
247.5 	(c) In cases when there is both an overpayment and underpayment, the county 
247.6 	agency shall offset one against the other in correcting the payment.
247.7 	(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual, 
247.8 	in addition to the aid reductions provided in this subdivision, to include further voluntary 
247.9 	reductions in the grant level agreed to in writing by the individual, until the total amount 
247.10 	of the overpayment is repaid.
247.11 	(e) The county agency shall make reasonable efforts to recover overpayments to 
247.12 	persons no longer on assistance under standards adopted in rule by the commissioner 
247.13 	of human services. The county agency need not attempt to recover overpayments of 
247.14 	less than $35 paid to an individual no longer on assistance if the individual does not 
247.15 	receive assistance again within three years, unless the individual has been convicted of 
247.16 	violating section 256.98.
247.17 	(f) Establishment of an overpayment is limited to 12 months prior to the month of 
247.18 	discovery due to agency error and six years prior to the month of discovery due to client 
247.19 	error or an intentional program violation determined under section 256.046.

247.20 	Sec. 5. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
247.21 		Subd. 3.Overpayment of monthly grants and recovery of ATM errors. (a) When 
247.22 	the county agency determines that an overpayment of the recipient's monthly payment 
247.23 	of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 
247.24 	to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 
247.25 	county agency may request voluntary repayment or pursue civil recovery. If the person is 
247.26 	receiving Minnesota supplemental aid, the county agency shall recover the overpayment 
247.27 	by withholding an amount equal to three percent of the standard of assistance for the 
247.28 	recipient or the total amount of the monthly grant, whichever is less. 
247.29 	(b) Establishment of an overpayment is limited to 12 months from the date of 
247.30 	discovery due to agency error. Establishment of an overpayment is limited to six years 
247.31 	prior to the month of discovery due to client error or an intentional program violation 
247.32 	determined under section 256.046.
247.33 	(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 
247.34 	is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 
248.1 	the agency may recover the ATM error by immediately withdrawing funds from the 
248.2 	recipient's electronic benefit transfer account, up to the amount of the error. 
248.3 	(d) Residents of nursing homes, regional treatment centers, andlicensed residential 
248.4 	facilities with negotiated rates shall not have overpayments recovered from their personal 
248.5 	needs allowance.

248.6 	Sec. 6. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
248.7 		Subdivision 1.Scope of overpayment. (a) When a participant or former participant 
248.8 	receives an overpayment due to agency, client, or ATM error, or due to assistance received 
248.9 	while an appeal is pending and the participant or former participant is determined 
248.10 	ineligible for assistance or for less assistance than was received, the county agency must 
248.11 	recoup or recover the overpayment using the following methods:
248.12 	(1) reconstruct each affected budget month and corresponding payment month;
248.13 	(2) use the policies and procedures that were in effect for the payment month; and
248.14 	(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 
248.15 	calculation of the overpayment when the unit has not reported within two calendar months 
248.16 	following the end of the month in which the income was received. 
248.17 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
248.18 	discovery due to agency error. Establishment of an overpayment is limited to six years 
248.19 	prior to the month of discovery due to client error or an intentional program violation 
248.20 	determined under section 256.046.

248.21 	Sec. 7. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
248.22 		Subd. 10.Food stamp program; Maternal and Child Nutrition Act. (a) The local 
248.23 	social services agency shall establish and administer the food stamp program according 
248.24 	to rules of the commissioner of human services, the supervision of the commissioner as 
248.25 	specified in section 256.01, and all federal laws and regulations. The commissioner of 
248.26 	human services shall monitor food stamp program delivery on an ongoing basis to ensure 
248.27 	that each county complies with federal laws and regulations. Program requirements to be 
248.28 	monitored include, but are not limited to, number of applications, number of approvals, 
248.29 	number of cases pending, length of time required to process each application and deliver 
248.30 	benefits, number of applicants eligible for expedited issuance, length of time required 
248.31 	to process and deliver expedited issuance, number of terminations and reasons for 
248.32 	terminations, client profiles by age, household composition and income level and sources, 
248.33 	and the use of phone certification and home visits. The commissioner shall determine the 
248.34 	county-by-county and statewide participation rate.
249.1 	(b) On July 1 of each year, the commissioner of human services shall determine a 
249.2 	statewide and county-by-county food stamp program participation rate. The commissioner 
249.3 	may designate a different agency to administer the food stamp program in a county if the 
249.4 	agency administering the program fails to increase the food stamp program participation 
249.5 	rate among families or eligible individuals, or comply with all federal laws and regulations 
249.6 	governing the food stamp program. The commissioner shall review agency performance 
249.7 	annually to determine compliance with this paragraph.
249.8 	(c) A person who commits any of the following acts has violated section 256.98 or 
249.9 	609.821, or both, and is subject to both the criminal and civil penalties provided under 
249.10 	those sections:
249.11 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
249.12 	willful statement or misrepresentation, or intentional concealment of a material fact, food 
249.13 	stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 
249.14 	is not entitled or in an amount greater than that to which that person is entitled or which 
249.15 	specify nutritional supplements to which that person is not entitled; or
249.16 	(2) presents or causes to be presented, coupons or vouchers issued according to 
249.17 	sections 145.891 to 145.897 for payment or redemption knowing them to have been 
249.18 	received, transferred or used in a manner contrary to existing state or federal law; or
249.19 	(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 
249.20 	purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 
249.21 	contrary to existing state or federal law, rules, or regulations; or
249.22 	(4) buys or sells food stamp coupons, authorization to purchase cards, other 
249.23 	assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 
249.24 	or any food obtained through the redemption of vouchers issued according to sections 
249.25 	145.891 to 145.897 for cash or consideration other than eligible food.
249.26 	(d) A peace officer or welfare fraud investigator may confiscate food stamps, 
249.27 	authorization to purchase cards, or other assistance transaction devices found in the 
249.28 	possession of any person who is neither a recipient of the food stamp program nor 
249.29 	otherwise authorized to possess and use such materials. Confiscated property shall be 
249.30 	disposed of as the commissioner may direct and consistent with state and federal food 
249.31 	stamp law. The confiscated property must be retained for a period of not less than 30 days 
249.32 	to allow any affected person to appeal the confiscation under section 256.045.
249.33 	(e) Food stamp overpayment claims which are due in whole or in part to client error 
249.34 	shall be established by the county agency for a period of six years from the date of any 
249.35 	resultant overpayment Establishment of an overpayment is limited to 12 months prior to 
249.36 	the month of discovery due to agency error. Establishment of an overpayment is limited 
250.1 	to six years prior to the month of discovery due to client error or an intentional program 
250.2 	violation determined under section 256.046.
250.3 	(f) With regard to the federal tax revenue offset program only, recovery incentives 
250.4 	authorized by the federal food and consumer service shall be retained at the rate of 50 
250.5 	percent by the state agency and 50 percent by the certifying county agency.
250.6 	(g) A peace officer, welfare fraud investigator, federal law enforcement official, 
250.7 	or the commissioner of health may confiscate vouchers found in the possession of any 
250.8 	person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 
250.9 	authorized to possess and use such vouchers. Confiscated property shall be disposed of 
250.10 	as the commissioner of health may direct and consistent with state and federal law. The 
250.11 	confiscated property must be retained for a period of not less than 30 days.
250.12 	(h) The commissioner of human services may seek a waiver from the United States 
250.13 	Department of Agriculture to allow the state to specify foods that may and may not be 
250.14 	purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 
250.15 	commissioner shall consult with the members of the house of representatives and senate 
250.16 	policy committees having jurisdiction over food support issues in developing the waiver. 
250.17 	The commissioner, in consultation with the commissioners of health and education, shall 
250.18 	develop a broad public health policy related to improved nutrition and health status. The 
250.19 	commissioner must seek legislative approval prior to implementing the waiver.

250.20 	Sec. 8. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:
250.21 		Subd. 4.Essential human services or essential services. "Essential human 
250.22 	services" or "essential services" means assistance and services to recipients or potential 
250.23 	recipients of public welfare and other services delivered by counties or tribes that are 
250.24 	mandated in federal and state law that are to be available in all counties of the state.

250.25 	Sec. 9. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:
250.26 		Subd. 5.Service delivery authority. "Service delivery authority" means a single 
250.27 	county, or group consortium of counties operating by execution of a joint powers 
250.28 	agreement under section 471.59 or other contractual agreement, that has voluntarily 
250.29 	chosen by resolution of the county board of commissioners to participate in the redesign 
250.30 	under this chapter or has been assigned by the commissioner pursuant to section 402A.18. 
250.31 	A service delivery authority includes an Indian tribe or group of tribes that have voluntarily 
250.32 	chosen by resolution of tribal government to participate in redesign under this chapter.

251.1 	Sec. 10. Minnesota Statutes 2010, section 402A.15, is amended to read:
251.2 	402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME 
251.3 	REFORMS.
251.4 		Subdivision 1.Duties. (a) The Steering Committee on Performance and Outcome 
251.5 	Reforms shall develop a uniform process to establish and review performance and outcome 
251.6 	standards for all essential human services based on the current level of resources available, 
251.7 	and to shall develop appropriate reporting measures and a uniform accountability process 
251.8 	for responding to a county's or human service delivery authority's failure to make adequate 
251.9 	progress on achieving performance measures. The accountability process shall focus on 
251.10 	the performance measures rather than inflexible implementation requirements.
251.11 	(b) The steering committee shall:
251.12 	(1) by November 1, 2009, establish an agreed-upon list of essential services;
251.13 	(2) by February 15, 2010, develop and recommend to the legislature a uniform, 
251.14 	graduated process, in addition to the remedies identified in section 402A.18, for responding 
251.15 	to a county's failure to make adequate progress on achieving performance measures; and
251.16 	(3) by December 15, 2012, for each essential service, make recommendations 
251.17 	to the legislature regarding (1) (i) performance measures and goals based on those 
251.18 	measures for each essential service, (2) and (ii) a system for reporting on the performance 
251.19 	measures and goals, and (3) appropriate resources, including funding, needed to achieve 
251.20 	those performance measures and goals. The resource recommendations shall take into 
251.21 	consideration program demand and the unique differences of local areas in geography and 
251.22 	the populations served. Priority shall be given to services with the greatest variation in 
251.23 	availability and greatest administrative demands. By January 15 of each year starting 
251.24 	January 15, 2011, the steering committee shall report its recommendations to the governor 
251.25 	and legislative committees with jurisdiction over health and human services. As part of its 
251.26 	report, the steering committee shall, as appropriate, recommend statutory provisions, rules 
251.27 	and requirements, and reports that should be repealed or eliminated.
251.28 	(c) As far as possible, the performance measures, reporting system, and funding 
251.29 	shall be consistent across program areas. The development of performance measures shall 
251.30 	consider the manner in which data will be collected and performance will be reported. 
251.31 	The steering committee shall consider state and local administrative costs related to 
251.32 	collecting data and reporting outcomes when developing performance measures. The 
251.33 	steering committee shall correlate the performance measures and goals to available levels 
251.34 	of resources, including state and local funding. The steering committee shall also identify 
251.35 	and incorporate federal performance measures in its recommendations for those program 
251.36 	areas where federal funding is contingent on meeting federal performance standards. The 
252.1 	steering committee shall take into consideration that the goal of implementing changes 
252.2 	to program monitoring and reporting the progress toward achieving outcomes is to 
252.3 	significantly minimize the cost of administrative requirements and to allow funds freed 
252.4 	by reduced administrative expenditures to be used to provide additional services, allow 
252.5 	flexibility in service design and management, and focus energies on achieving program 
252.6 	and client outcomes.
252.7 	(d) In making its recommendations, the steering committee shall consider input from 
252.8 	the council established in section 402A.20. The steering committee shall review the 
252.9 	measurable goals established in a memorandum of understanding entered into under 
252.10 	section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied 
252.11 	as statewide performance outcomes.
252.12 	(e) The steering committee shall form work groups that include persons who provide 
252.13 	or receive essential services and representatives of organizations who advocate on behalf 
252.14 	of those persons.
252.15 	(f) By December 15, 2009, the steering committee shall establish a three-year 
252.16 	schedule for completion of its work. The schedule shall be published on the Department of 
252.17 	Human Services Web site and reported to the legislative committees with jurisdiction over 
252.18 	health and human services. In addition, the commissioner shall post quarterly updates on 
252.19 	the progress of the steering committee on the Department of Human Services Web site.
252.20 		Subd. 2.Composition. (a) The steering committee shall include:
252.21 	(1) the commissioner of human services, or designee, and two additional 
252.22 	representatives of the department;
252.23 	(2) two county commissioners, representative of rural and urban counties, selected 
252.24 	by the Association of Minnesota Counties;
252.25 	(3) two county directors of human services, representative of rural and urban 
252.26 	counties, selected by the Minnesota Association of County Social Service Administrators; 
252.27 	and
252.28 	(4) three clients or client advocates representing different populations receiving 
252.29 	services from the Department of Human Services, who are appointed by the commissioner.
252.30 	(b) The commissioner, or designee, and a county commissioner shall serve as 
252.31 	cochairs of the committee. The committee shall be convened within 60 days of May 
252.32 	15, 2009.
252.33 	(c) State agency staff shall serve as informational resources and staff to the steering 
252.34 	committee. Statewide county associations may assemble county program data as required.
252.35 	(d) To promote information sharing and coordination between the steering committee 
252.36 	and council, one of the county representatives from paragraph (a), clause (2), and one of the 
253.1 	county representatives from paragraph (a), clause (3), must also serve as a representative 
253.2 	on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

253.3 	Sec. 11. Minnesota Statutes 2010, section 402A.18, is amended to read:
253.4 	402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET 
253.5 	PERFORMANCE OUTCOMES.
253.6 		Subdivision 1.Underperforming county; specific service. If the commissioner 
253.7 	determines that a county or service delivery authority is deficient in achieving minimum 
253.8 	performance outcomes for a specific essential service, the commissioner may impose the 
253.9 	following remedies and adjust state and federal program allocations accordingly:
253.10 	(1) voluntary incorporation of the administration and operation of the specific 
253.11 	essential service with an existing service delivery authority or another county. A 
253.12 	service delivery authority or county incorporating an underperforming county shall 
253.13 	not be financially liable for the costs associated with remedying performance outcome 
253.14 	deficiencies;
253.15 	(2) mandatory incorporation of the administration and operation of the specific 
253.16 	essential service with an existing service delivery authority or another county. A 
253.17 	service delivery authority or county incorporating an underperforming county shall 
253.18 	not be financially liable for the costs associated with remedying performance outcome 
253.19 	deficiencies; or 
253.20 	(3) transfer of authority for program administration and operation of the specific 
253.21 	essential service to the commissioner.
253.22 		Subd. 2.Underperforming county; more than one-half of service services. If 
253.23 	the commissioner determines that a county or service delivery authority is deficient in 
253.24 	achieving minimum performance outcomes for more than one-half of the defined essential 
253.25 	service services, the commissioner may impose the following remedies:
253.26 	(1) voluntary incorporation of the administration and operation of the specific
253.27 	essential service services with an existing service delivery authority or another county. 
253.28 	A service delivery authority or county incorporating an underperforming county shall 
253.29 	not be financially liable for the costs associated with remedying performance outcome 
253.30 	deficiencies;
253.31 	(2) mandatory incorporation of the administration and operation of the specific
253.32 	essential service services with an existing service delivery authority or another county. 
253.33 	A service delivery authority or county incorporating an underperforming county shall 
253.34 	not be financially liable for the costs associated with remedying performance outcome 
253.35 	deficiencies; or 
254.1 	(3) transfer of authority for program administration and operation of the specific
254.2 	essential service services to the commissioner.
254.3 		Subd. 2a.Financial responsibility of underperforming county. A county subject 
254.4 	to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of 
254.5 	the essential service or essential services the amount of nonfederal and nonstate funding 
254.6 	needed to remedy performance outcome deficiencies.
254.7 		Subd. 3.Conditions prior to imposing remedies. Before the commissioner may 
254.8 	impose the remedies authorized under this section, the following conditions must be met:
254.9 	(1) the county or service delivery authority determined by the commissioner 
254.10 	to be deficient in achieving minimum performance outcomes has the opportunity, in 
254.11 	coordination with the council, to develop a program outcome improvement plan. The 
254.12 	program outcome improvement plan must be developed no later than six months from the 
254.13 	date of the deficiency determination; and
254.14 	(2) the council has conducted an assessment of the program outcome improvement 
254.15 	plan to determine if the county or service delivery authority has made satisfactory 
254.16 	progress toward performance outcomes and has made a recommendation about remedies 
254.17 	to the commissioner. The review assessment and recommendation must be made to the 
254.18 	commissioner within 12 months from the date of the deficiency determination.

254.19 	Sec. 12. Minnesota Statutes 2010, section 402A.20, is amended to read:
254.20 	402A.20 COUNCIL.
254.21 		Subdivision 1.Council. (a) The State-County Results, Accountability, and Service 
254.22 	Delivery Redesign Council is established. Appointed council members must be appointed 
254.23 	by their respective agencies, associations, or governmental units by November 1, 2009. 
254.24 	The council shall be cochaired by the commissioner of human services, or designee, and a 
254.25 	county representative from paragraph (b), clause (4) or (5), appointed by the Association 
254.26 	of Minnesota Counties. Recommendations of the council must be approved by a majority 
254.27 	of the voting council members. The provisions of section 15.059 do not apply to this 
254.28 	council, and this council does not expire.
254.29 	(b) The council must consist of the following members:
254.30 	(1) two legislators appointed by the speaker of the house, one from the minority 
254.31 	and one from the majority;
254.32 	(2) two legislators appointed by the Senate Rules Committee, one from the majority 
254.33 	and one from the minority;
254.34 	(3) the commissioner of human services, or designee, and three employees from 
254.35 	the department;
255.1 	(4) two county commissioners appointed by the Association of Minnesota Counties;
255.2 	(5) two county representatives appointed by the Minnesota Association of County 
255.3 	Social Service Administrators; 
255.4 	(6) one representative appointed by AFSCME as a nonvoting member; and
255.5 	(7) one representative appointed by the Teamsters as a nonvoting member.
255.6 	(c) Administrative support to the council may be provided by the Association of 
255.7 	Minnesota Counties and affiliates.
255.8 	(d) Member agencies and associations are responsible for initial and subsequent 
255.9 	appointments to the council.
255.10 		Subd. 2.Council duties. The council shall:
255.11 	(1) provide review of the service delivery redesign process, including proposed 
255.12 	memoranda of understanding to establish a service delivery authority to conduct and 
255.13 	administer experimental projects to test new methods and procedures of delivering 
255.14 	services;
255.15 	(2) certify, in accordance with section 402A.30, subdivision 4, the formation of 
255.16 	a service delivery authority, including the memorandum of understanding in section 
255.17 	402A.30, subdivision 2, paragraph (b);
255.18 	(3) ensure the consistency of the memorandum of understanding entered into 
255.19 	under section 402A.30, subdivision 2, paragraph (b), with the performance standards 
255.20 	recommended by the steering committee and enacted by the legislature;
255.21 	(4) (2) ensure the consistency of the memorandum of understanding, to the extent 
255.22 	appropriate, or with other memorandum of understanding entered into by other service 
255.23 	delivery authorities; 
255.24 	(3) review and make recommendations on applications from a service delivery 
255.25 	authority for waivers of statutory or rule program requirements that are needed for 
255.26 	flexibility to determine the most cost-effective means of achieving specified measurable 
255.27 	goals in a redesign of human services delivery;
255.28 	(5) (4) establish a process to take public input on the service delivery framework 
255.29 	specified in the memorandum of understanding in section 402A.30, subdivision 2, 
255.30 	paragraph (b) scope of essential services over which a service delivery authority has 
255.31 	jurisdiction;
255.32 	(6) (5) form work groups as necessary to carry out the duties of the council under the 
255.33 	redesign;
255.34 	(7) (6) serve as a forum for resolving conflicts among participating counties and 
255.35 	tribes or between participating counties or tribes and the commissioner of human services, 
255.36 	provided nothing in this section is intended to create a formal binding legal process;
256.1 	(8) (7) engage in the program improvement process established in section 402A.18, 
256.2 	subdivision 3; and
256.3 	(9) (8) identify and recommend incentives for counties and tribes to participate in 
256.4 	human services service delivery authorities.
256.5 		Subd. 3.Program evaluation. By December 15, 2014, the council shall request 
256.6 	consideration by the legislative auditor for a reevaluation under section 3.971, subdivision 
256.7 	7, of those aspects of the program evaluation of human services administration reported 
256.8 	in January 2007 affected by this chapter.

256.9 	Sec. 13. [402A.35] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
256.10 		Subdivision 1.Requirements for establishing a service delivery authority.
 256.11 	(a) A county, tribe, or consortium of counties is eligible to establish a service delivery 
256.12 	authority if:
256.13 	(1) the county, tribe, or consortium of counties is:
256.14 	(i) a single county with a population of 55,000 or more;
256.15 	(ii) a consortium of counties with a total combined population of 55,000 or more;
256.16 	(iii) a consortium of four or more counties in reasonable geographic proximity 
256.17 	without regard to population; or
256.18 	(iv) one or more tribes with a total combined population of 25,000 or more.
256.19 	The council may recommend that the commissioner of human services exempt a 
256.20 	single county, tribe, or consortium of counties from the minimum population standard if 
256.21 	the county, tribe, or consortium of counties can demonstrate that it can otherwise meet 
256.22 	the requirements of this chapter.
256.23 	(b) A service delivery authority shall:
256.24 	(1) comply with current state and federal law, including any existing federal or state 
256.25 	performance measures and performance measures under section 402A.15 when they are 
256.26 	enacted into law, except where waivers are approved by the commissioner. Nothing 
256.27 	in this subdivision requires the establishment of performance measures under section 
256.28 	402A.15 prior to a service delivery authority participating in the service delivery redesign 
256.29 	under this chapter;
256.30 	(2) define the scope of essential services over which the service delivery authority 
256.31 	has jurisdiction;
256.32 	(3) designate a single administrative structure to oversee the delivery of those 
256.33 	services included in a proposal for a redesigned service or services and identify a single 
256.34 	administrative agent for purposes of contact and communication with the department;
257.1 	(4) identify the waivers from statutory or rule program requirements that are needed 
257.2 	to ensure greater local control and flexibility to determine the most cost-effective means of 
257.3 	achieving specified measurable goals that the participating service delivery authority is 
257.4 	expected to achieve;
257.5 	(5) set forth a reasonable level of targeted reductions in overhead and administrative 
257.6 	costs for each service delivery authority participating in the service delivery redesign;
257.7 	(6) set forth the terms under which a county, tribe, or consortium of counties 
257.8 	may withdraw from participation. In the case of withdrawal of any or all parties or 
257.9 	the dissolution of the service delivery authority, the employees shall continue to be 
257.10 	represented by the same exclusive representative or representatives and continue to be 
257.11 	covered by the same collective bargaining union agreement until a new agreement is 
257.12 	negotiated or the collective bargaining agreement term ends; and
257.13 	(7) set forth a structure for managing the terms and conditions of employment of the 
257.14 	employees as provided in section 402A.40.
257.15 	(c) Once a county, tribe, or consortium of counties establishes a service delivery 
257.16 	authority, no county, tribe, or consortium of counties that is a member of the service 
257.17 	delivery authority may participate as a member of any other service delivery authority. 
257.18 	The service delivery authority may allow an additional county, a tribe, or a consortium of 
257.19 	counties to join the service delivery authority subject to the approval of the council and 
257.20 	the commissioner.
257.21 	(d) Nothing in this chapter precludes local governments from using sections 465.81 
257.22 	and 465.82 to establish procedures for local governments to merge, with the consent 
257.23 	of the voters. Nothing in this chapter limits the authority of a county board or tribal 
257.24 	council to enter into contractual agreements for services not covered by the provisions 
257.25 	of a memorandum of understanding establishing a service delivery authority with other 
257.26 	agencies or with other units of government.
257.27 		Subd. 2.Relief from statutory requirements. (a) Unless otherwise identified in 
257.28 	the memorandum of understanding, any county, tribe, or consortium of counties forming a 
257.29 	service delivery authority is exempt from the provisions of sections 245.465; 245.4835; 
257.30 	245.4874; 245.492, subdivision 2; 245.4932; 256F.13; 256J.626, subdivision 2, paragraph 
257.31 	(b); and 256M.30.
257.32 	(b) This subdivision does not preclude any county, tribe, or consortium of counties 
257.33 	forming a service delivery authority from requesting additional waivers from statutory and 
257.34 	rule requirements to ensure greater local control and flexibility.
257.35 		Subd. 3.Duties. The service delivery authority shall:
258.1 	(1) within the scope of essential services set forth in the memorandum of 
258.2 	understanding establishing the authority, carry out the responsibilities required of local 
258.3 	agencies under chapter 393 and human services boards under chapter 402;
258.4 	(2) manage the public resources devoted to human services and other public services 
258.5 	delivered or purchased by the counties or tribes that are subsidized or regulated by the 
258.6 	Department of Human Services under chapters 245 to 261;
258.7 	(3) employ staff to assist in carrying out its duties;
258.8 	(4) develop and maintain a continuity of operations plan to ensure the continued 
258.9 	operation or resumption of essential human services functions in the event of any business 
258.10 	interruption according to local, state, and federal emergency planning requirements;
258.11 	(5) receive and expend funds received for the redesign process under the 
258.12 	memorandum of understanding;
258.13 	(6) plan and deliver services directly or through contract with other governmental, 
258.14 	tribal, or nongovernmental providers;
258.15 	(7) rent, purchase, sell, and otherwise dispose of real and personal property as 
258.16 	necessary to carry out the redesign; and
258.17 	(8) carry out any other service designated as a responsibility of a county.
258.18 		Subd. 4.Process for establishing a service delivery authority. (a) The county, 
258.19 	tribe, or consortium of counties meeting the requirements of section 402A.30 and 
258.20 	proposing to establish a service delivery authority shall present to the council:
258.21 	(1) in conjunction with the commissioner, a proposed memorandum of understanding 
258.22 	meeting the requirements of subdivision 1, paragraph (b), and outlining:
258.23 	(i) the details of the proposal;
258.24 	(ii) the state, tribal, and local resources, which may include, but are not limited to, 
258.25 	funding, administrative and technology support, and other requirements necessary for 
258.26 	the service delivery authority; and
258.27 	(iii) the relief available to the service delivery authority if the resource commitments 
258.28 	identified in item (ii) are not met; and
258.29 	(2) a board resolution from the board of commissioners of each participating county 
258.30 	stating the county's intent to participate, or in the case of a tribe, a resolution from tribal 
258.31 	government, stating the tribe's intent to participate.
258.32 	(b) After the council has considered and recommended approval of a proposed 
258.33 	memorandum of understanding, the commissioner may finalize and execute the 
258.34 	memorandum of understanding.
258.35 		Subd. 5.Commissioner authority to seek waivers. The commissioner may use the 
258.36 	authority under section 256.01, subdivision 2, paragraph (l), to grant waivers identified as 
259.1 	part of a proposed service delivery authority under subdivision 1, paragraph (b), clause 
259.2 	(4), except that waivers granted under this section must be approved by the council under 
259.3 	section 402A.20 rather than the Legislative Advisory Committee.

259.4 	Sec. 14. [402A.40] TRANSITION TO NEW BARGAINING UNIT STRUCTURE.
259.5 		Subdivision 1.Application of section. Notwithstanding the provisions of section 
259.6 	179A.12 or any other law, this section governs, where contrary to other law, the initial 
259.7 	certification and decertification, if any, of exclusive representatives for service delivery 
259.8 	authorities. Employees of a service delivery authority are public employees under section 
259.9 	179A.03, subdivision 14. Service delivery authorities are public employers under section 
259.10 	179A.03, subdivision 15.
259.11 		Subd. 2.Existing majority. The commissioner of the Minnesota Bureau of 
259.12 	Mediation Services shall certify an employee organization for employees of a service 
259.13 	delivery authority as exclusive representative for an appropriate unit upon a petition 
259.14 	filed with the commissioner by the organization demonstrating that the petitioner is 
259.15 	certified pursuant to section 179A.12 as the exclusive representative of a majority of the 
259.16 	employees included within the unit as of that date. Two or more employee organizations 
259.17 	that represent the employees in a unit may petition jointly under this subdivision, provided 
259.18 	that any organization may withdraw from a joint certification in favor of the remaining 
259.19 	organizations on 30 days' notice to the remaining organizations, the employer, and the 
259.20 	commissioner, without affecting the rights and obligations of the remaining organizations 
259.21 	or the employer. The commissioner shall make a determination on a timely petition within 
259.22 	45 days of its receipt.
259.23 		Subd. 3.No existing majority. (a) If no exclusive representative is certified under 
259.24 	subdivision 2, the commissioner shall certify an employee organization as exclusive 
259.25 	representative for an appropriate unit established upon a petition filed by the organization 
259.26 	within the time period provided in subdivision 2 demonstrating that the petitioner is 
259.27 	certified under section 179A.12 as the exclusive representative of fewer than a majority 
259.28 	of the employees included within the unit if no other employee organization so certified 
259.29 	has filed a petition within the time period provided in subdivision 2 and a majority of the 
259.30 	employees in the unit are represented by employee organizations under section 179A.12 
259.31 	on the date of the petition. Two or more employee organizations, each of which represents 
259.32 	employees included in the unit may petition jointly under this paragraph, provided that 
259.33 	any organization may withdraw from a joint certification in favor of the remaining 
259.34 	organizations on 30 days' notice to the remaining organizations, the employer, and the 
259.35 	commissioner without affecting the rights and obligations of the remaining organizations 
260.1 	or the employer. The commissioner shall make a determination on a timely petition within 
260.2 	45 days of its receipt.
260.3 	(b) If no exclusive representative is certified under paragraph (a) or subdivision 2, 
260.4 	and an employee organization petitions the commissioner within 90 days of the creation of 
260.5 	the service delivery authority demonstrating that a majority of the employees included 
260.6 	within an appropriate unit wish to be represented by the petitioner, where this majority 
260.7 	is evidenced by current dues deduction rights, signed statements from employees in 
260.8 	counties within the service delivery authority that are not currently represented by any 
260.9 	employee organization plainly indicating that the signatories wish to be represented for 
260.10 	collective bargaining purposes by the petitioner rather than by any other organization, 
260.11 	or a combination of those, the commissioner shall certify the petitioner as exclusive 
260.12 	representative of the employees in the unit. The commissioner shall make a determination 
260.13 	on a timely petition within 45 days of its receipt.
260.14 	(c) If no exclusive representative is certified under paragraph (a) or (b) or subdivision 
260.15 	2, and an employee organization petitions the commissioner subsequent to the creation 
260.16 	of the service delivery authority demonstrating that at least 30 percent of the employees 
260.17 	included within an appropriate unit wish to be represented by the petitioner, where this 30 
260.18 	percent is evidenced by current dues deduction rights, signed statements from employees 
260.19 	in counties within the service delivery authority that are not currently represented by any 
260.20 	employee organization plainly indicating that the signatories wish to be represented for 
260.21 	collective bargaining purposes by the petitioner rather than by any other organization, or a 
260.22 	combination of those, the commissioner shall conduct a secret ballot election to determine 
260.23 	the wishes of the majority. The election must be conducted within 45 days of receipt or 
260.24 	final decision on any petitions filed pursuant to subdivision 2, whichever is later. The 
260.25 	election is governed by section 179A.12, where not inconsistent with other provisions 
260.26 	of this section.
260.27 		Subd. 4.Decertification. The commissioner may not consider a petition for 
260.28 	decertification of an exclusive representative certified under this section for one year after 
260.29 	certification, unless section 179A.20, subdivision 6, applies.
260.30 		Subd. 5.Continuing contract. (a) The terms and conditions of collective 
260.31 	bargaining agreements covering the employees of service delivery authorities remain in 
260.32 	effect until a successor agreement becomes effective or, if no employee organization 
260.33 	petitions to represent the employees of the service delivery authority, until six months 
260.34 	after the establishment of the service delivery authority.
260.35 	(b) Any accrued leave, including but not limited to sick leave, vacation time, 
260.36 	compensatory leave or paid time off, or severance pay benefits accumulated under policies 
261.1 	of the previously employing county or a collective bargaining agreement between the 
261.2 	previously employing county and an exclusive representative shall continue to apply in the 
261.3 	newly created service delivery authority for the employees of the previously employing 
261.4 	county. An employee who was eligible for the benefits of the Family and Medical Leave 
261.5 	Act at the previously employing county shall continue to be eligible at the newly created 
261.6 	service delivery authority.
261.7 	(c) If it is necessary, prior to the negotiation of a new collective bargaining 
261.8 	agreement, to lay off an employee of a service delivery authority and if two or more 
261.9 	employees previously performed the work, seniority based on continuous length of 
261.10 	service with a service delivery authority member county shall be the determining factor 
261.11 	in determining which qualified employee shall be offered the job by the service delivery 
261.12 	authority. An employee whose work is being transferred to the service delivery authority 
261.13 	shall have the option of being laid off.
261.14 		Subd. 6.Contract and representation responsibilities. (a) The exclusive 
261.15 	representatives of units of employees certified prior to the creation of the service delivery 
261.16 	authority remain responsible for administration of their contracts and for other contractual 
261.17 	duties and have the right to dues and fair share fee deduction and other contractual 
261.18 	privileges and rights until a contract is agreed upon with the service delivery authority. 
261.19 	Exclusive representatives of service delivery authority employees certified after the 
261.20 	creation of the service delivery authority are immediately upon certification responsible 
261.21 	for bargaining on behalf of employees within the unit. They are also responsible for 
261.22 	administering grievances arising under previous contracts covering employees included 
261.23 	within the unit that remain unresolved upon agreement with the service delivery authority 
261.24 	on a contract. Where the employer does not object, these responsibilities may be varied by 
261.25 	agreement between the outgoing and incoming exclusive representatives. All other rights 
261.26 	and duties of representation begin upon the creation of a service delivery authority, except 
261.27 	that exclusive representatives certified upon or after the creation of the service delivery 
261.28 	authority shall immediately, upon certification, have the right to all employer information 
261.29 	and all forms of access to employees within the bargaining unit which would be permitted 
261.30 	to the current contract holder, including the rights in section 179A.07, subdivision 6. This 
261.31 	section does not affect an existing collective bargaining contract. Incoming exclusive 
261.32 	representatives are immediately, upon certification, responsible for bargaining on behalf of 
261.33 	all previously unrepresented employees assigned to their units.
261.34 	(b) Nothing in this section prevents an exclusive representative certified after 
261.35 	the effective dates of these provisions from assessing fair share or dues deductions 
262.1 	immediately upon certification if the employees were unrepresented for collective 
262.2 	bargaining purposes before that certification.

262.3 	Sec. 15. COUNTY ELECTRONIC VERIFICATION PROCEDURES.
 262.4 	The commissioner of human services shall define which public assistance program 
262.5 	requirements may be electronically verified for the purposes of determining eligibility, 
262.6 	and shall also define procedures for electronic verification. The commissioner of human 
262.7 	services shall report back to the chairs and ranking minority members of the legislative 
262.8 	committees with jurisdiction over these issues by January 15, 2012, with draft legislation 
262.9 	to implement the procedures if legislation is necessary for purposes of implementation.

262.10 	Sec. 16. ALIGNMENT OF PROGRAM POLICY AND PROCEDURES.
 262.11 	The commissioner of human services, in consultation with counties and other key 
262.12 	stakeholders, shall analyze and develop recommendations to align program policy and 
262.13 	procedures across all public assistance programs to simplify and streamline program 
262.14 	eligibility and access. The commissioner shall report back to the chairs and ranking 
262.15 	minority members of the legislative committees with jurisdiction over these issues by 
262.16 	January 15, 2013, with draft legislation to implement the recommendations.

262.17 	Sec. 17. ALTERNATIVE STRATEGIES FOR CERTAIN 
262.18 	REDETERMINATIONS.
 262.19 	The commissioner of human services shall develop and implement by January 15, 
262.20 	2012, a simplified process to redetermine eligibility for recipient populations in the medical 
262.21 	assistance, Minnesota supplemental aid, food support, and group residential housing 
262.22 	programs who are eligible based upon disability, age, or chronic medical conditions, and 
262.23 	who are expected to experience minimal change in income or assets from month to month. 
262.24 	The commissioner shall apply for any federal waivers needed to implement this section.

262.25 	Sec. 18. SIMPLIFICATION OF ELIGIBILITY AND ENROLLMENT 
262.26 	PROCESS.
 262.27 	(a) The commissioner of human services shall issue a request for information for an 
262.28 	integrated service delivery system for health care programs, food support, cash assistance, 
262.29 	and child care. The commissioner shall determine, in consultation with partners in 
262.30 	paragraph (c), if the products meet departments' and counties' functions. The request for 
262.31 	information may incorporate a performance-based vendor financing option in which the 
262.32 	vendor shares the risk of the project's success. The health care system must be developed 
263.1 	in phases with the capacity to integrate food support, cash assistance, and child care 
263.2 	programs as funds are available. The request for information must require that the system:
263.3 	(1) streamline eligibility determinations and case processing to support statewide 
263.4 	eligibility processing;
263.5 	(2) enable interested persons to determine eligibility for each program, and to apply 
263.6 	for programs online in a manner that the applicant will be asked only those questions 
263.7 	relevant to the programs for which the person is applying;
263.8 	(3) leverage technology that has been operational in other state environments with 
263.9 	similar requirements; and
263.10 	(4) include Web-based application, worker application processing support, and the 
263.11 	opportunity for expansion.
263.12 	(b) The commissioner shall issue a final report, including the implementation plan, 
263.13 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
263.14 	over health and human services no later than October 31, 2011.
263.15 	(c) The commissioner shall partner with counties, a service delivery authority 
263.16 	established under Minnesota Statutes, chapter 402A, the Office of Enterprise Technology, 
263.17 	other state agencies, and service partners to develop an integrated service delivery 
263.18 	framework, which will simplify and streamline human services eligibility and enrollment 
263.19 	processes. The primary objectives for the simplification effort include significantly 
263.20 	improved eligibility processing productivity resulting in reduced time for eligibility 
263.21 	determination and enrollment, increased customer service for applicants and recipients of 
263.22 	services, increased program integrity, and greater administrative flexibility.
263.23 	(d) The commissioner, along with a county representative appointed by the 
263.24 	Association of Minnesota Counties, shall report specific implementation progress to the 
263.25 	legislature annually beginning May 15, 2012.
263.26 	(e) The commissioner shall work with the Minnesota Association of County Social 
263.27 	Service Administrators and the Office of Enterprise Technology to develop collaborative 
263.28 	task forces, as necessary, to support implementation of the service delivery components 
263.29 	under this paragraph. The commissioner must evaluate, develop, and include as part 
263.30 	of the integrated eligibility and enrollment service delivery framework, the following 
263.31 	minimum components:
263.32 	(1) screening tools for applicants to determine potential eligibility as part of an 
263.33 	online application process;
263.34 	(2) the capacity to use databases to electronically verify application and renewal 
263.35 	data as required by law;
263.36 	(3) online accounts accessible by applicants and enrollees;
264.1 	(4) an interactive voice response system, available statewide, that provides case 
264.2 	information for applicants, enrollees, and authorized third parties;
264.3 	(5) an electronic document management system that provides electronic transfer of 
264.4 	all documents required for eligibility and enrollment processes; and
264.5 	(6) a centralized customer contact center that applicants, enrollees, and authorized 
264.6 	third parties can use statewide to receive program information, application assistance, 
264.7 	and case information, report changes, make cost-sharing payments, and conduct other 
264.8 	eligibility and enrollment transactions.
264.9 	(f) Subject to a legislative appropriation, the commissioner of human services shall 
264.10 	issue a request for proposal for the appropriate phase of an integrated service delivery 
264.11 	system for health care programs, food support, cash assistance, and child care.

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

264.13 	Sec. 19. WHITE EARTH BAND OF OJIBWE HUMAN SERVICES PROJECT.
 264.14 	(a) The commissioner of human services, in consultation with the White Earth Band 
264.15 	of Ojibwe, shall transfer legal responsibility to the tribe for providing human services to 
264.16 	tribal members and their families who reside on or off the reservation in Mahnomen 
264.17 	County. The transfer shall include:
264.18 	(1) financing, including federal and state funds, grants, and foundation funds; and
264.19 	(2) services to eligible tribal members and families defined as it applies to state 
264.20 	programs being transferred to the tribe.
264.21 	(b) The determination as to which programs will be transferred to the tribe and 
264.22 	the timing of the transfer of the programs shall be made by a consensus decision of the 
264.23 	governing body of the tribe and the commissioner. The commissioner shall waive existing 
264.24 	rules and seek all federal approvals and waivers as needed to carry out the transfer.
264.25 	(c) When the commissioner approves transfer of programs and the tribe assumes 
264.26 	responsibility under this section, Mahnomen County is relieved of responsibility for 
264.27 	providing program services to tribal members and their families who live on or off the 
264.28 	reservation while the tribal project is in effect and funded, except that a family member 
264.29 	who is not a White Earth member may choose to receive services through the tribe or the 
264.30 	county. The commissioner shall have authority to redirect funds provided to Mahnomen 
264.31 	County for these services, including administrative expenses, to the White Earth Band 
264.32 	of Ojibwe Indians.
264.33 	(d) Upon the successful transfer of legal responsibility for providing human services 
264.34 	for tribal members and their families who reside on and off the reservation in Mahnomen 
264.35 	County, the commissioner and the White Earth Band of Ojibwe shall develop a plan to 
265.1 	transfer legal responsibility for providing human services for tribal members and their 
265.2 	families who reside on or off reservation in Clearwater and Becker Counties.
265.3 	(e) No later than January 15, 2012, the commissioner shall submit a written 
265.4 	report detailing the transfer progress to the chairs and ranking minority members of the 
265.5 	legislative committees with jurisdiction over health and human services. If legislation is 
265.6 	needed to fully complete the transfer of legal responsibility for providing human services, 
265.7 	the commissioner shall submit proposed legislation along with the written report.

265.8 	Sec. 20.  REPEALER.
 265.9 	(a) Minnesota Statutes 2010, sections 402A.30; and 402A.45, are repealed.
265.10 	(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.

265.11 	ARTICLE 9
265.12 	HUMAN SERVICES FORECAST ADJUSTMENTS

265.13
265.14	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT 
APPROPRIATIONS.
 	
265.15 	The sums shown are added to, or if shown in parentheses, are subtracted from the 
265.16 	appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter 
265.17 	173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and 
265.18 	Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human 
265.19 	services and for the purposes specified in this article. The appropriations are from the 
265.20 	general fund or another named fund and are available for the fiscal year indicated for 
265.21 	each purpose. The figure "2011" used in this article means that the appropriation or 
265.22 	appropriations listed are available for the fiscal year ending June 30, 2011.

265.23
265.24	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

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

265.26	Appropriations by Fund
	
265.27			2011
	
265.28	General
		(381,869,000)
	
265.29	Health Care Access
		169,514,000
	
265.30	Federal TANF
		(23,108,000)
	
265.31 	The amounts that may be spent for each 
265.32 	purpose are specified in the following 
265.33 	subdivisions.

265.34	Subd. 2.Revenue and Pass-through
 				732,000
	
266.1 	This appropriation is from the federal TANF 
266.2 	fund.

266.3
266.4	Subd. 3.Children and Economic Assistance 
Grants

266.5	Appropriations by Fund
	
266.6	General
		(7,098,000)
	
266.7	Federal TANF
		(23,840,000)

266.8	(a) MFIP/DWP Grants

266.9	Appropriations by Fund
	
266.10	General
		18,715,000
	
266.11	Federal TANF
		(23,840,000)

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

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

266.14	(d) Minnesota Supplemental Aid Grants
				793,000

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

266.16	Subd. 4.Basic Health Care Grants

266.17	Appropriations by Fund
	
266.18	General
		(335,050,000)
	
266.19	Health Care Access
		169,514,000

266.20	(a) MinnesotaCare Grants
				169,514,000
	
266.21 	This appropriation is from the health care 
266.22 	access fund.

266.23
266.24	(b) Medical Assistance Basic Health Care - 
Families and Children
				(49,368,000)

266.25
266.26	(c) Medical Assistance Basic Health Care - 
Elderly and Disabled
				(43,258,000)

266.27
266.28	(d) Medical Assistance Basic Health Care - 
Adults without Children
				(242,424,000)

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

266.30
266.31	(a) Medical Assistance Long-Term Care 
Facilities
				(14,627,000)

266.32
266.33	(b) Medical Assistance Long-Term Care 
Waivers
				(44,718,000)

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

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

267.4	Subd. 6.Health Care Grants

267.5	(a) MinnesotaCare Grants
		998,000
		(13,376,000)
	
267.6 	This appropriation is from the health care 
267.7 	access fund.
267.8 	Health Care Access Fund Transfer to 
267.9 	General Fund. The commissioner of 
267.10 	management and budget shall transfer the 
267.11 	following amounts in the following years 
267.12 	from the health care access fund to the 
267.13 	general fund: $998,000 $0 in fiscal year 
267.14 	2010; $176,704,000 $59,901,000 in fiscal 
267.15 	year 2011; $141,041,000 in fiscal year 2012; 
267.16 	and $286,150,000 in fiscal year 2013. If at 
267.17 	any time the governor issues an executive 
267.18 	order not to participate in early medical 
267.19 	assistance expansion, no funds shall be 
267.20 	transferred from the health care access 
267.21 	fund to the general fund until early medical 
267.22 	assistance expansion takes effect. This 
267.23 	paragraph is effective the day following final 
267.24 	enactment.
267.25 	MinnesotaCare Ratable Reduction.
267.26 	Effective for services rendered on or after 
267.27 	July 1, 2010, to December 31, 2013, 
267.28 	MinnesotaCare payments to managed care 
267.29 	plans under Minnesota Statutes, section 
267.30 	256L.12, for single adults and households 
267.31 	without children whose income is greater 
267.32 	than 75 percent of federal poverty guidelines 
267.33 	shall be reduced by 15 percent. Effective 
268.1 	for services provided from July 1, 2010, to 
268.2 	June 30, 2011, this reduction shall apply to 
268.3 	all services. Effective for services provided 
268.4 	from July 1, 2011, to December 31, 2013, this 
268.5 	reduction shall apply to all services except 
268.6 	inpatient hospital services. Notwithstanding 
268.7 	any contrary provision of this article, this 
268.8 	paragraph shall expire on December 31, 
268.9 	2013.

268.10
268.11	(b) Medical Assistance Basic Health Care 
Grants - Families and Children
		-0-
		295,512,000
	
268.12 	Critical Access Dental. Of the general 
268.13 	fund appropriation, $731,000 in fiscal year 
268.14 	2011 is to the commissioner for critical 
268.15 	access dental provider reimbursement 
268.16 	payments under Minnesota Statutes, section 
268.17 	256B.76 subdivision 4. This is a onetime 
268.18 	appropriation.
268.19 	Nonadministrative Rate Reduction. For 
268.20 	services rendered on or after July 1, 2010, 
268.21 	to December 31, 2013, the commissioner 
268.22 	shall reduce contract rates paid to managed 
268.23 	care plans under Minnesota Statutes, 
268.24 	sections 256B.69 and 256L.12, and to 
268.25 	county-based purchasing plans under 
268.26 	Minnesota Statutes, section 256B.692, by 
268.27 	three percent of the contract rate attributable 
268.28 	to nonadministrative services in effect on 
268.29 	June 30, 2010. Notwithstanding any contrary 
268.30 	provision in this article, this rider expires on 
268.31 	December 31, 2013.

268.32
268.33	(c) Medical Assistance Basic Health Care 
Grants - Elderly and Disabled
		-0-
		(30,265,000)

268.34
268.35	(d) General Assistance Medical Care Grants
		-0-
		(75,389,000)
(59,583,000)
	
269.1 	The reduction to general assistance medical 
269.2 	care grants is contingent upon the effective 
269.3 	date in Laws 2010, First Special Session 
269.4 	chapter 1, article 16, section 48. The 
269.5 	reduction shall be reestimated based upon 
269.6 	the actual effective date of the law. The 
269.7 	commissioner of management and budget 
269.8 	shall make adjustments in fiscal year 
269.9 	2011 to general assistance medical care 
269.10 	appropriations to conform to the total 
269.11 	expected expenditure reductions specified in 
269.12 	this section.

269.13	(e)  Other Health Care Grants
		-0-
		(7,000,000)
	
269.14 	Cobra Carryforward. Unexpended funds 
269.15 	appropriated in fiscal year 2010 for COBRA 
269.16 	grants under Laws 2009, chapter 79, article 
269.17 	5, section 78, do not cancel and are available 
269.18 	to the commissioner for fiscal year 2011 
269.19 	COBRA grant expenditures. Up to $111,000 
269.20 	of the fiscal year 2011 appropriation for 
269.21 	COBRA grants provided in Laws 2009, 
269.22 	chapter 79, article 13, section 3, subdivision 
269.23 	6, may be used by the commissioner for costs 
269.24 	related to administration of the COBRA 
269.25 	grants.

269.26 	Sec. 4. EFFECTIVE DATE.
 269.27 	This article is effective the day following final enactment.

269.28 	ARTICLE 10
269.29 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

269.30	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
269.31 	The amounts shown in this section summarize direct appropriations, by fund, made 
269.32 	in this article.

270.1			2012
		2013
		Total
	
270.2	General
	$
	5,564,457,000
	$
	5,407,093,000
	$
	10,971,550,000
	
270.3
270.4	State Government Special 
Revenue
		63,700,000
		63,475,000
		127,175,000
	
270.5	Health Care Access
		317,467,000
		306,733,000
		624,200,000
	
270.6	Federal TANF
		286,744,000
		258,466,000
		545,210,000
	
270.7	Lottery Prize Fund
		1,665,000
		1,665,000
		3,330,000
	
270.8	Total
	$
	6,234,032,000
	$
	6,037,432,000
	$
	12,271,464,000

270.9	Sec. 2. HUMAN SERVICES APPROPRIATIONS.
 	
270.10 	The sums shown in the columns marked "Appropriations" are appropriated to the 
270.11 	agencies and for the purposes specified in this article. The appropriations are from the 
270.12 	general fund, or another named fund, and are available for the fiscal years indicated 
270.13 	for each purpose. The figures "2012" and "2013" used in this article mean that the 
270.14 	appropriations listed under them are available for the fiscal year ending June 30, 2012, or 
270.15 	June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal 
270.16 	year 2013. "The biennium" is fiscal years 2012 and 2013.

270.17				APPROPRIATIONS
	
270.18				Available for the Year
	
270.19				Ending June 30
	
270.20					2012
		2013

270.21
270.22	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

270.23	Subdivision 1.Total Appropriation
 	$
	6,078,510,000
	$
	5,891,475,000

270.24	Appropriations by Fund
	
270.25		2012
	2013
	
270.26	General
	5,489,816,000
	5,337,566,000
	
270.27
270.28	State Government 
Special Revenue
	565,000
	565,000
	
270.29	Health Care Access
	306,086,000
	299,578,000
	
270.30	Federal TANF
	280,378,000
	252,101,000
	
270.31	Lottery Prize Fund
	1,665,000
	1,665,000
	
270.32 	Receipts for Systems Projects. 
270.33 	Appropriations and federal receipts for 
270.34 	information systems projects for MAXIS, 
270.35 	PRISM, MMIS, and SSIS must be deposited 
270.36 	in the state systems account authorized in 
270.37 	Minnesota Statutes, section 256.014. Money 
271.1 	appropriated for computer projects approved 
271.2 	by the Minnesota Office of Enterprise 
271.3 	Technology, funded by the legislature, 
271.4 	and approved by the commissioner 
271.5 	of management and budget, may be 
271.6 	transferred from one project to another 
271.7 	and from development to operations as the 
271.8 	commissioner of human services considers 
271.9 	necessary. Any unexpended balance in 
271.10 	the appropriation for these projects does 
271.11 	not cancel but is available for ongoing 
271.12 	development and operations.
271.13 	Nonfederal Share Transfers. The 
271.14 	nonfederal share of activities for which 
271.15 	federal administrative reimbursement is 
271.16 	appropriated to the commissioner may be 
271.17 	transferred to the special revenue fund.
271.18 	TANF Maintenance of Effort.
271.19 	(a) In order to meet the basic maintenance 
271.20 	of effort (MOE) requirements of the TANF 
271.21 	block grant specified under Code of Federal 
271.22 	Regulations, title 45, section 263.1, the 
271.23 	commissioner may only report nonfederal 
271.24 	money expended for allowable activities 
271.25 	listed in the following clauses as TANF/MOE 
271.26 	expenditures:
271.27 	(1) MFIP cash, diversionary work program, 
271.28 	and food assistance benefits under Minnesota 
271.29 	Statutes, chapter 256J;
271.30 	(2) the child care assistance programs 
271.31 	under Minnesota Statutes, sections 119B.03 
271.32 	and 119B.05, and county child care 
271.33 	administrative costs under Minnesota 
271.34 	Statutes, section 119B.15;
272.1 	(3) state and county MFIP administrative 
272.2 	costs under Minnesota Statutes, chapters 
272.3 	256J and 256K;
272.4 	(4) state, county, and tribal MFIP 
272.5 	employment services under Minnesota 
272.6 	Statutes, chapters 256J and 256K;
272.7 	(5) qualifying working family credit 
272.8 	expenditures under Minnesota Statutes, 
272.9 	section 290.0671; and
272.10 	(6) qualifying Minnesota education credit 
272.11 	expenditures under Minnesota Statutes, 
272.12 	section 290.0674.
272.13 	(b) The commissioner shall ensure that 
272.14 	sufficient qualified nonfederal expenditures 
272.15 	are made each year to meet the state's 
272.16 	TANF/MOE requirements. For the activities 
272.17 	listed in paragraph (a), clauses (2) to 
272.18 	(6), the commissioner may only report 
272.19 	expenditures that are excluded from the 
272.20 	definition of assistance under Code of 
272.21 	Federal Regulations, title 45, section 260.31.
272.22 	(c) For fiscal years beginning with state fiscal 
272.23 	year 2003, the commissioner shall assure 
272.24 	that the maintenance of effort used by the 
272.25 	commissioner of management and budget 
272.26 	for the February and November forecasts 
272.27 	required under Minnesota Statutes, section 
272.28 	16A.103, contains expenditures under 
272.29 	paragraph (a), clause (1), equal to at least 16 
272.30 	percent of the total required under Code of 
272.31 	Federal Regulations, title 45, section 263.1.
272.32 	(d) Minnesota Statutes, section 256.011, 
272.33 	subdivision 3, which requires that federal 
272.34 	grants or aids secured or obtained under that 
272.35 	subdivision be used to reduce any direct 
273.1 	appropriations provided by law, do not apply 
273.2 	if the grants or aids are federal TANF funds.
273.3 	(e) For the federal fiscal years beginning on 
273.4 	or after October 1, 2007, the commissioner 
273.5 	may not claim an amount of TANF/MOE in 
273.6 	excess of the 75 percent standard in Code 
273.7 	of Federal Regulations, title 45, section 
273.8 	263.1(a)(2), except:
273.9 	(1) to the extent necessary to meet the 80 
273.10 	percent standard under Code of Federal 
273.11 	Regulations, title 45, section 263.1(a)(1), 
273.12 	if it is determined by the commissioner 
273.13 	that the state will not meet the TANF work 
273.14 	participation target rate for the current year; 
273.15 	(2) to provide any additional amounts 
273.16 	under Code of Federal Regulations, title 45, 
273.17 	section 264.5, that relate to replacement of 
273.18 	TANF funds due to the operation of TANF 
273.19 	penalties; and
273.20 	(3) to provide any additional amounts that 
273.21 	may contribute to avoiding or reducing 
273.22 	TANF work participation penalties through 
273.23 	the operation of the excess MOE provisions 
273.24 	of Code of Federal Regulations, title 45, 
273.25 	section 261.43(a)(2). 
273.26 	For the purposes of clauses (1) to (3), 
273.27 	the commissioner may supplement the 
273.28 	MOE claim with working family credit 
273.29 	expenditures or other qualified expenditures 
273.30 	to the extent such expenditures are otherwise 
273.31 	available after considering the expenditures 
273.32 	allowed in this subdivision. 
273.33 	(f) Notwithstanding any contrary provision 
273.34 	in this article, paragraphs (a) to (e) expire 
273.35 	June 30, 2015.
274.1 	Working Family Credit Expenditures 
274.2 	as TANF/MOE. The commissioner may 
274.3 	claim as TANF maintenance of effort up to 
274.4 	$6,707,000 per year of working family credit 
274.5 	expenditures for fiscal years 2012 and 2013.
274.6 	Working Family Credit Expenditures 
274.7 	to be Claimed for TANF/MOE. The 
274.8 	commissioner may count the following 
274.9 	amounts of working family credit 
274.10 	expenditures as TANF/MOE:
274.11 	(1) fiscal year 2012, $37,517,000;
274.12 	(2) fiscal year 2013, $28,171,000;
274.13 	(3) fiscal year 2014, $34,097,000; and
274.14 	(4) fiscal year 2015, $34,100,000.
274.15 	Notwithstanding any contrary provision in 
274.16 	this article, this rider expires June 30, 2015.
274.17 	TANF Transfer to Federal Child Care 
274.18 	and Development Fund. (a) The following 
274.19 	TANF fund amounts are appropriated 
274.20 	to the commissioner for purposes of 
274.21 	MFIP/Transition Year Child Care Assistance 
274.22 	under Minnesota Statutes, section 119B.05:
274.23 	(1) fiscal year 2012, $25,020,000;
274.24 	(2) fiscal year 2013, $12,020,000;
274.25 	(3) fiscal year 2014, $15,818,000; and
274.26 	(4) fiscal year 2015, $15,818,000.
274.27 	(b) The commissioner shall authorize the 
274.28 	transfer of sufficient TANF funds to the 
274.29 	federal child care and development fund to 
274.30 	meet this appropriation and shall ensure that 
274.31 	all transferred funds are expended according 
274.32 	to federal child care and development fund 
274.33 	regulations.
275.1 	Food Stamps Employment and Training 
275.2 	Funds. (a) Notwithstanding Minnesota 
275.3 	Statutes, sections 256D.051, subdivisions 1a, 
275.4 	6b, and 6c, and 256J.626, federal food stamps 
275.5 	employment and training funds received 
275.6 	as reimbursement for child care assistance 
275.7 	program expenditures must be deposited in 
275.8 	the general fund. The amount of funds must 
275.9 	be limited to $500,000 per year in fiscal 
275.10 	years 2012 through 2015, contingent upon 
275.11 	approval by the federal Food and Nutrition 
275.12 	Service.
275.13 	(b) Consistent with the receipt of these 
275.14 	federal funds, the commissioner may 
275.15 	adjust the level of working family credit 
275.16 	expenditures claimed as TANF maintenance 
275.17 	of effort. Notwithstanding any contrary 
275.18 	provision in this article, this rider expires 
275.19 	June 30, 2015.
275.20 	ARRA Food Support Benefit Increases. 
275.21 	The funds provided for food support benefit 
275.22 	increases under the Supplemental Nutrition 
275.23 	Assistance Program provisions of the 
275.24 	American Recovery and Reinvestment Act 
275.25 	(ARRA) of 2009 must be used for benefit 
275.26 	increases beginning July 1, 2009.
275.27 	Supplemental Security Interim Assistance 
275.28 	Reimbursement Funds. $2,800,000 of 
275.29 	uncommitted revenue available to the 
275.30 	commissioner of human services for SSI 
275.31 	advocacy and outreach services must be 
275.32 	transferred to and deposited into the general 
275.33 	fund by October 1, 2011.
275.34 	Transfer.  By June 30, 2012, the 
275.35 	commissioner of management and budget 
276.1 	must transfer $49,694,000 from the health 
276.2 	care access fund to the general fund. By June 
276.3 	30, 2013, the commissioner of management 
276.4 	and budget must transfer $5,000,000 from the 
276.5 	health care access fund to the general fund.

276.6	Subd. 2.Central Office Operations
 					
276.7 	The amounts that may be spent from this 
276.8 	appropriation for each purpose are as follows:

276.9	(a) Operations

276.10	Appropriations by Fund
	
276.11	General
	72,547,000
	71,077,000
	
276.12	Health Care Access
	11,508,000
	11,508,000
	
276.13
276.14	State Government 
Special Revenue
	440,000
	440,000
	
276.15	Federal TANF
	222,000
	222,000
	
276.16 	DHS Receipt Center Accounting. The 
276.17 	commissioner is authorized to transfer 
276.18 	appropriations to, and account for DHS 
276.19 	receipt center operations in, the special 
276.20 	revenue fund.
276.21 	Administrative Recovery; Set-Aside. The 
276.22 	commissioner may invoice local entities 
276.23 	through the SWIFT accounting system as an 
276.24 	alternative means to recover the actual cost 
276.25 	of administering the following provisions:
276.26 	(1) Minnesota Statutes, section 125A.744, 
276.27 	subdivision 3;
276.28 	(2) Minnesota Statutes, section 245.495, 
276.29 	paragraph (b);
276.30 	(3) Minnesota Statutes, section 256B.0625, 
276.31 	subdivision 20, paragraph (k);
276.32 	(4) Minnesota Statutes, section 256B.0924, 
276.33 	subdivision 6, paragraph (g);
277.1 	(5) Minnesota Statutes, section 256B.0945, 
277.2 	subdivision 4, paragraph (d); and
277.3 	(6) Minnesota Statutes, section 256F.10, 
277.4 	subdivision 6, paragraph (b).
277.5 	Payments for Cost Settlements. The 
277.6 	commissioner is authorized to use amounts 
277.7 	repaid to the general assistance medical care 
277.8 	program under Minnesota Statutes 2009 
277.9 	Supplement, section 256D.03, subdivision 
277.10 	3, to pay cost settlements for claims for 
277.11 	services provided prior to June 1, 2010. 
277.12 	Notwithstanding any contrary provision in 
277.13 	this article, this provision does not expire.
277.14 	Base Adjustment. The general fund base 
277.15 	for fiscal year 2014 shall be increased by 
277.16 	$68,000 and decreased by $11,000 in fiscal 
277.17 	year 2015.

277.18	(b) Children and Families

277.19	Appropriations by Fund
	
277.20	General
	9,457,000
	9,337,000
	
277.21	Federal TANF
	2,160,000
	2,160,000
	
277.22 	Financial Institution Data Match and 
277.23 	Payment of Fees. The commissioner is 
277.24 	authorized to allocate up to $310,000 each 
277.25 	year in fiscal years 2012 and 2013 from the 
277.26 	PRISM special revenue account to make 
277.27 	payments to financial institutions in exchange 
277.28 	for performing data matches between account 
277.29 	information held by financial institutions 
277.30 	and the public authority's database of child 
277.31 	support obligors as authorized by Minnesota 
277.32 	Statutes, section 13B.06, subdivision 7.
277.33 	Base Adjustment. The general fund base 
277.34 	is decreased by $47,000 in fiscal years 2014 
277.35 	and 2015.

278.1	(c) Health Care

278.2	Appropriations by Fund
	
278.3	General
	16,376,000
	16,278,000
	
278.4	Health Care Access
	22,623,000
	26,926,000
	
278.5 	Minnesota Senior Health Options 
278.6 	Reimbursement. Federal administrative 
278.7 	reimbursement resulting from the Minnesota 
278.8 	senior health options project is appropriated 
278.9 	to the commissioner for this activity.
278.10 	Utilization Review. Federal administrative 
278.11 	reimbursement resulting from prior 
278.12 	authorization and inpatient admission 
278.13 	certification by a professional review 
278.14 	organization shall be dedicated to the 
278.15 	commissioner for these purposes. A portion 
278.16 	of these funds must be used for activities to 
278.17 	decrease unnecessary pharmaceutical costs 
278.18 	in medical assistance.
278.19 	Base Adjustment. The general fund base 
278.20 	shall be decreased by $2,000 in fiscal year 
278.21 	2014 and $114,000 in fiscal year 2015.
278.22 	The health care access fund base is decreased 
278.23 	by $411,000 in fiscal year 2014 and $880,000 
278.24 	in fiscal year 2015.

278.25	(d) Continuing Care

278.26	Appropriations by Fund
	
278.27	General
	18,078,000
	17,864,000
	
278.28
278.29	State Government 
Special Revenue
	125,000
	125,000
	
278.30 	Region 10 Administrative Expenses.
278.31 	$100,000 is appropriated each fiscal 
278.32 	year, beginning in fiscal year 2012, for 
278.33 	the administration of the State Quality 
278.34 	Improvement and Licensing System under 
278.35 	Minnesota Statutes, section 256B.0961.
279.1 	Base Adjustment. The general fund base is 
279.2 	decreased by $662,000 in fiscal year 2014 
279.3 	and $762,000 in fiscal year 2015.

279.4	(e) Chemical and Mental Health

279.5	Appropriations by Fund
	
279.6	General
	4,194,000
	4,194,000
	
279.7	Lottery Prize
	157,000
	157,000

279.8	Subd. 3.Forecasted Programs
 					
279.9 	The amounts that may be spent from this 
279.10 	appropriation for each purpose are as follows:

279.11	(a) MFIP/DWP Grants

279.12	Appropriations by Fund
	
279.13	General
	83,986,000
	88,187,000
	
279.14	Federal TANF
	84,425,000
	75,417,000

279.15	(b) MFIP Child Care Assistance Grants
		39,012,000
		44,805,000

279.16
279.17	(c) General Assistance Grants and Adult 
Assistance
		48,774,000
		44,003,000
	
279.18 	General Assistance Standard. The 
279.19 	commissioner shall set the monthly standard 
279.20 	of assistance for general assistance units 
279.21 	consisting of an adult recipient who is 
279.22 	childless and unmarried or living apart 
279.23 	from parents or a legal guardian at $203. 
279.24 	The commissioner may reduce this amount 
279.25 	according to Laws 1997, chapter 85, article 
279.26 	3, section 54. This paragraph expires 
279.27 	September 30, 2012.
279.28 	Emergency General Assistance. The 
279.29 	amount appropriated for emergency general 
279.30 	assistance funds is limited to no more 
279.31 	than $7,089,812 in fiscal year 2012 and 
279.32 	$1,682,453 in fiscal year 2013. Funds 
279.33 	to counties shall be allocated by the 
279.34 	commissioner using the allocation method 
280.1 	specified in Minnesota Statutes, section 
280.2 	256D.06. This paragraph expires September 
280.3 	30, 2012.
280.4 	Base Adjustment. The general fund base 
280.5 	for adult assistance is $44,512,000 in fiscal 
280.6 	years 2014 and 2015.

280.7	(d) Minnesota Supplemental Aid Grants
		34,460,000
		33,532,000
	
280.8 	Emergency Minnesota Supplemental 
280.9 	Aid Funds. The amount appropriated for 
280.10 	emergency Minnesota supplemental aid 
280.11 	funds is limited to no more than $367,000 
280.12 	in fiscal year 2012. Funds to counties shall 
280.13 	be allocated by the commissioner using the 
280.14 	allocation method specified in Minnesota 
280.15 	Statutes, section 256D.46. This paragraph 
280.16 	expires September 30, 2012.

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

280.18	(f) MinnesotaCare Grants
		271,430,000
		260,619,000
	
280.19 	This appropriation is from the health care 
280.20 	access fund.

280.21	(g) GAMC Grants
		174,150,000
		232,200,000
	
280.22 	General Assistance Medical Care 
280.23 	Payments. For general assistance medical 
280.24 	care payments under Minnesota Statutes, 
280.25 	section 256D.031:
280.26 	$120,150,000 in fiscal year 2012 and 
280.27 	$160,200,000 in fiscal year 2013 are for 
280.28 	payments to coordinated care delivery 
280.29 	systems under Minnesota Statutes, section 
280.30 	256D.031, subdivision 7; and
280.31 	$54,000,000 in fiscal year 2012 and 
280.32 	$72,000,000 in fiscal year 2013 are for 
280.33 	payments for prescription drugs under 
281.1 	Minnesota Statutes, section 256D.031, 
281.2 	subdivision 9.
281.3 	Any amount under paragraph (g) that is not 
281.4 	spent in the first year does not cancel and is 
281.5 	available for payments in the second year.
281.6 	The commissioner may transfer any 
281.7 	unexpended amount under Minnesota 
281.8 	Statutes, section 256D.031, subdivision 9, 
281.9 	after the final allocation in fiscal year 2011 to 
281.10 	make payments under Minnesota Statutes, 
281.11 	section 256D.031, subdivision 7.

281.12	(h) Medical Assistance Grants
		4,175,592,000
		3,938,873,000
	
281.13 	Managed Care Incentive Payments. The 
281.14 	commissioner shall not make managed care 
281.15 	incentive payments for expanding preventive 
281.16 	services. This provision does not expire.
281.17 	Capitation Payment Delay. The 
281.18 	commissioner shall delay 71 percent of the 
281.19 	medical assistance capitation payment for 
281.20 	families with children to managed care plans 
281.21 	and county-based purchasing plans due in 
281.22 	May of 2013 until July of 2013.
281.23 	Reduction of Rates for Congregate 
281.24 	Living for Individuals with Lower Needs. 
281.25 	Beginning October 1, 2011, lead agencies 
281.26 	must reduce rates in effect on January 1, 
281.27 	2011, by ten percent for individuals with 
281.28 	lower needs living in foster care settings 
281.29 	where the license holder does not share the 
281.30 	residence with recipients on the CADI, DD, 
281.31 	and TBI waivers and customized living 
281.32 	settings for CADI and TBI. Lead agencies 
281.33 	must adjust contracts within 60 days of the 
281.34 	effective date.
282.1 	Reduction of Lead Agency Waiver 
282.2 	Allocations to Implement Rate Reductions 
282.3 	for Congregate Living for Individuals 
282.4 	with Lower Needs. Beginning October 1, 
282.5 	2011, the commissioner shall reduce lead 
282.6 	agency waiver allocations to implement the 
282.7 	reduction of rates for individuals with lower 
282.8 	needs living in foster care settings where the 
282.9 	license holder does not share the residence 
282.10 	with recipients on the CADI, DD, and TBI 
282.11 	waivers and customized living settings for 
282.12 	CADI and TBI.
282.13 	Manage Elderly Waiver Growth. 
282.14 	Beginning July 1, 2011, and ending on June 
282.15 	30, 2013, the commissioner shall manage 
282.16 	the elderly waiver so that the number of 
282.17 	people does not exceed the number on June 
282.18 	30, 2011.
282.19 	Reduce customized living and 24-hour 
282.20 	customized living component rates.
282.21 	Effective July 1, 2011, the commissioner 
282.22 	shall reduce elderly waiver customized living 
282.23 	and 24-hour customized living component 
282.24 	service spending by ten percent through 
282.25 	reductions in component rates and service 
282.26 	rate limits. The commissioner shall adjust 
282.27 	the elderly waiver capitation payment 
282.28 	rates for managed care organizations paid 
282.29 	under Minnesota Statutes, section 256B.69, 
282.30 	subdivisions 6a and 23, to reflect reductions 
282.31 	in component spending for customized living 
282.32 	services and 24-hour customized living 
282.33 	services under Minnesota Statutes, section 
282.34 	256B.0915, subdivisions 3e and 3h, for the 
282.35 	contract period beginning January 1, 2012. 
282.36 	To implement the reduction specified in 
283.1 	this provision, capitation rates paid by the 
283.2 	commissioner to managed care organizations 
283.3 	under Minnesota Statutes, section 256B.69, 
283.4 	shall reflect a 20 percent reduction for the 
283.5 	specified services for the period January 1, 
283.6 	2012, to June 30, 2012, and a ten percent 
283.7 	reduction for those services on or after July 
283.8 	1, 2012.
283.9 	Limit Growth in the Developmental 
283.10 	Disability Waiver. For the biennium 
283.11 	beginning July 1, 2011, the commissioner 
283.12 	shall limit the developmental disability 
283.13 	waiver to the number of recipients served 
283.14 	in March 2010. If necessary to achieve 
283.15 	this level, the commissioner shall not 
283.16 	refill waiver openings until the number of 
283.17 	waiver recipients reaches the March 2010 
283.18 	level. Once the March 2010 enrollment 
283.19 	level is reached, the commissioner shall 
283.20 	refill vacated openings to maintain the 
283.21 	March 2010 enrollment level. To the 
283.22 	extent possible, waiver allocations shall 
283.23 	be available to individuals who meet the 
283.24 	priorities for accessing waiver services 
283.25 	described in Minnesota Statutes, section 
283.26 	256B.092, subdivision 12. The limits do not 
283.27 	include conversions from intermediate care 
283.28 	facilities for persons with developmental 
283.29 	disabilities. When implementing the waiver 
283.30 	enrollment limits under this provision, it 
283.31 	is an absolute defense to an appeal under 
283.32 	Minnesota Statutes, section 256.045, if 
283.33 	the commissioner or lead agency proves 
283.34 	that it followed the established written 
283.35 	procedures and criteria and determined that 
283.36 	home and community-based services could 
284.1 	not be provided to the person within the 
284.2 	appropriations or lead agency's allocation of 
284.3 	home and community-based services money.
284.4 	Limit Growth in the Community 
284.5 	Alternatives for Disabled Individuals 
284.6 	Waiver. For the biennium beginning 
284.7 	July 1, 2011, the commissioner shall limit 
284.8 	the community alternatives for disabled 
284.9 	individuals waiver to the number of 
284.10 	recipients served in March 2010. If necessary 
284.11 	to achieve this level, the commissioner shall 
284.12 	not refill waiver openings until the number 
284.13 	of waiver recipients reaches the March 2010 
284.14 	level. Once the March 2010 enrollment 
284.15 	level is reached, the commissioner shall 
284.16 	refill vacated openings to maintain the 
284.17 	March 2010 enrollment level. To the 
284.18 	extent possible, waiver allocations shall 
284.19 	be available to individuals who meet the 
284.20 	priorities for accessing waiver services 
284.21 	described in Minnesota Statutes, section 
284.22 	256B.49, subdivision 11a. The limits include 
284.23 	conversions and diversions, unless the 
284.24 	commissioner has approved a plan to convert 
284.25 	funding due to the closure or downsizing 
284.26 	of a residential facility or nursing facility 
284.27 	to serve directly affected individuals on 
284.28 	the community alternatives for disabled 
284.29 	individuals waiver. When implementing 
284.30 	the waiver enrollment limits under this 
284.31 	provision, it is an absolute defense to an 
284.32 	appeal under Minnesota Statutes, section 
284.33 	256.045, if the commissioner or lead agency 
284.34 	proves that it followed the established written 
284.35 	procedures and criteria and determined that 
284.36 	home and community-based services could 
285.1 	not be provided to the person within the 
285.2 	appropriations or lead agency's allocation of 
285.3 	home and community-based services money. 
285.4 	Limit Growth in the Waiver for 
285.5 	Individuals with Traumatic Brain Injury.
285.6 	For the biennium beginning July 1, 2011, the 
285.7 	commissioner shall limit the traumatic brain 
285.8 	injury waiver to the number of recipients 
285.9 	served in March 2010. If necessary to 
285.10 	achieve this level, the commissioner shall 
285.11 	not refill waiver openings until the number 
285.12 	of waiver recipients reaches the March 2010 
285.13 	level. Once the March 2010 enrollment 
285.14 	level is reached, the commissioner shall 
285.15 	refill vacated openings to maintain the 
285.16 	March 2010 enrollment level. To the 
285.17 	extent possible, waiver allocations shall 
285.18 	be available to individuals who meet the 
285.19 	priorities for accessing waiver services 
285.20 	described in Minnesota Statutes, section 
285.21 	256B.49, subdivision 11a. The limits include 
285.22 	conversions and diversions, unless the 
285.23 	commissioner has approved a plan to convert 
285.24 	funding due to the closure or downsizing of a 
285.25 	residential facility or nursing facility to serve 
285.26 	directly affected individuals on the traumatic 
285.27 	brain injury waiver. When implementing 
285.28 	the waiver enrollment limits under this 
285.29 	provision, it is an absolute defense to an 
285.30 	appeal under Minnesota Statutes, section 
285.31 	256.045, if the commissioner or lead agency 
285.32 	proves that it followed the established written 
285.33 	procedures and criteria and determined that 
285.34 	home and community-based services could 
285.35 	not be provided to the person within the 
286.1 	appropriations or lead agency's allocation of 
286.2 	home and community-based services money.
286.3 	Personal Care Assistance Relative 
286.4 	Care. The commissioner shall adjust the 
286.5 	capitation payment rates for managed care 
286.6 	organizations paid under Minnesota Statutes, 
286.7 	section 256B.69, to reflect the rate reductions 
286.8 	for personal care assistance provided by 
286.9 	a relative pursuant to Minnesota Statutes, 
286.10 	section 256B.0659, subdivision 11.

286.11	(i) Alternative Care Grants
		45,727,000
		47,877,000
	
286.12 	Alternative Care Transfer. Any money 
286.13 	allocated to the alternative care program that 
286.14 	is not spent for the purposes indicated does 
286.15 	not cancel but shall be transferred to the 
286.16 	medical assistance account.

286.17	(j) Chemical Dependency Entitlement Grants
		108,568,000
		123,095,000

286.18	Subd. 4.Grant Programs
 					
286.19 	The amounts that may be spent from this 
286.20 	appropriation for each purpose are as follows:

286.21	(a) Support Services Grants

286.22	Appropriations by Fund
	
286.23	General
	8,715,000
	8,715,000
	
286.24	Federal TANF
	100,525,000
	94,611,000
	
286.25 	MFIP Consolidated Fund Grants. The 
286.26 	TANF fund base is reduced by $10,000,000 
286.27 	each year beginning in fiscal year 2012.
286.28 	Subsidized Employment Funding Through 
286.29 	ARRA. The commissioner is authorized to 
286.30 	apply for TANF emergency fund grants for 
286.31 	subsidized employment activities. Growth 
286.32 	in expenditures for subsidized employment 
286.33 	within the supported work program and the 
286.34 	MFIP consolidated fund over the amount 
287.1 	expended in the calendar year quarters in 
287.2 	the TANF emergency fund base year shall 
287.3 	be used to leverage the TANF emergency 
287.4 	fund grants for subsidized employment and 
287.5 	to fund supported work. The commissioner 
287.6 	shall develop procedures to maximize 
287.7 	reimbursement of these expenditures over the 
287.8 	TANF emergency fund base year quarters, 
287.9 	and may contract directly with employers 
287.10 	and providers to maximize these TANF 
287.11 	emergency fund grants.

287.12
287.13	(b) Basic Sliding Fee Child Care Assistance 
Grants
		36,067,000
		37,342,000
	
287.14 	Base Adjustment. The general fund base is 
287.15 	decreased by $1,490,000 in fiscal year 2014 
287.16 	and $867,000 in fiscal year 2015.
287.17 	Child Care and Development Fund 
287.18 	Unexpended Balance. In addition to 
287.19 	the amount provided in this section, the 
287.20 	commissioner shall expend $5,000,000 
287.21 	in fiscal year 2012 from the federal child 
287.22 	care and development fund unexpended 
287.23 	balance for basic sliding fee child care under 
287.24 	Minnesota Statutes, section 119B.03. The 
287.25 	commissioner shall ensure that all child 
287.26 	care and development funds are expended 
287.27 	according to the federal child care and 
287.28 	development fund regulations.

287.29	(c) Child Care Development Grants
		232,000
		232,000
	
287.30 	Base Adjustment. The general fund base is 
287.31 	increased by $1,255,000 is fiscal years 2014 
287.32 	and 2015.

287.33	(d) Child Support Enforcement Grants
		50,000
		50,000
	
287.34 	Federal Child Support Demonstration 
287.35 	Grants. Federal administrative 
288.1 	reimbursement resulting from the federal 
288.2 	child support grant expenditures authorized 
288.3 	under section 1115a of the Social Security 
288.4 	Act is appropriated to the commissioner for 
288.5 	this activity.

288.6	(e) Children's Services Grants

288.7	Appropriations by Fund
	
288.8	General
	45,654,000
	45,654,000
	
288.9	Federal TANF
	140,000
	140,000
	
288.10 	Adoption Assistance and Relative Custody 
288.11 	Assistance Payments. $1,661,000 each 
288.12 	year is for continuation of current payments 
288.13 	for adoption assistance and relative custody 
288.14 	assistance.
288.15 	Adoption Assistance and Relative Custody 
288.16 	Assistance Transfer.  The commissioner 
288.17 	may transfer unencumbered appropriation 
288.18 	balances for adoption assistance and relative 
288.19 	custody assistance between fiscal years and 
288.20 	between programs.
288.21 	Privatized Adoption Grants. Federal 
288.22 	reimbursement for privatized adoption grant 
288.23 	and foster care recruitment grant expenditures 
288.24 	is appropriated to the commissioner for 
288.25 	adoption grants and foster care and adoption 
288.26 	administrative purposes.
288.27 	Adoption Assistance Incentive Grants.
288.28 	Federal funds available during fiscal year 
288.29 	2012 and fiscal year 2013 for adoption 
288.30 	incentive grants are appropriated to the 
288.31 	commissioner for these purposes.
288.32 	Base Adjustment. The general fund base is 
288.33 	increased by $1,134,000 is fiscal years 2014 
288.34 	and 2015.

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

289.2	(g) Children and Economic Support Grants

289.3	Appropriations by Fund
	
289.4	General
	15,770,000
	15,772,000
	
289.5	Federal TANF
	700,000
	0
	
289.6 	Long-Term Homeless Services. $700,000 
289.7 	is appropriated from the federal TANF 
289.8 	fund for the biennium beginning July 
289.9 	1, 2011, to the commissioner of human 
289.10 	services for long-term homeless services 
289.11 	for low-income homeless families under 
289.12 	Minnesota Statutes, section 256K.26. This 
289.13 	is a onetime appropriation and is not added 
289.14 	to the base.
289.15 	Base Adjustment. The general fund base is 
289.16 	increased by $42,000 in fiscal year 2014 and 
289.17 	$43,000 in fiscal year 2015.

289.18	(h) Health Care Grants
		150,000
		150,000
	
289.19 	This appropriation is from the health care 
289.20 	access fund.
289.21 	Surplus Appropriation Canceled. Of the 
289.22 	health care access fund appropriation in 
289.23 	Laws 2009, chapter 79, article 13, section 3, 
289.24 	subdivision 6, paragraph (e), for the COBRA 
289.25 	premium state subsidy program, $11,750,000 
289.26 	must be canceled in fiscal year 2011. This 
289.27 	provision is effective the day following final 
289.28 	enactment.

289.29	(i) Aging and Adult Services Grants
		18,734,000
		18,910,000
	
289.30 	Aging Grants Reduction. Effective July 
289.31 	1, 2011, funding for grants made under 
289.32 	Minnesota Statutes, sections 256.9754 and 
289.33 	256B.0917, subdivision 13, is reduced by 
289.34 	$3,600,000 for each year of the biennium. 
290.1 	These reductions are onetime and do 
290.2 	not affect base funding for the 2014-2015 
290.3 	biennium. Grants made during the 2012-2013 
290.4 	biennium under Minnesota Statutes, section 
290.5 	256B.9754, must not be used for new 
290.6 	construction or building renovation.
290.7 	Base Level Adjustment.  The general fund 
290.8 	base is increased by $3,600,000 in fiscal year 
290.9 	2014 and increased by $3,600,000 in fiscal 
290.10 	year 2015.

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

290.12	(k) Disabilities Grants
		15,438,000
		18,432,000
	
290.13 	HIV Grants. The general fund appropriation 
290.14 	for the HIV drug and insurance grant 
290.15 	program shall be reduced by $2,425,000 in 
290.16 	fiscal year 2012 and increased by $2,425,000 
290.17 	in fiscal year 2014. These adjustments are 
290.18 	onetime and shall not be applied to the base. 
290.19 	Notwithstanding any contrary provision, this 
290.20 	provision expires June 30, 2014. Money 
290.21 	appropriated for the HIV drug and insurance 
290.22 	grant program in fiscal year 2014 may be 
290.23 	used in either year of the biennium.
290.24 	Region 10. Any unspent allocation for 
290.25 	Region 10 Quality Assurance from the 
290.26 	biennium beginning on July 1, 2009, may be 
290.27 	carried over into the biennium beginning on 
290.28 	July 1, 2011.
290.29 	Base Level Adjustment.  The general fund 
290.30 	base is increased by $2,425,000 in fiscal year 
290.31 	2014 only.
290.32 	Local Planning Grants for Creating 
290.33 	Alternatives to Congregate Living for 
290.34 	Individuals with Lower Needs. The 
291.1 	commissioner shall make available a total 
291.2 	of $250,000 per year in local planning 
291.3 	grants, beginning July 1, 2011, to assist 
291.4 	lead agencies and provider organizations in 
291.5 	developing alternatives to congregate living 
291.6 	within the available level of resources for the 
291.7 	home and community-based services waivers 
291.8 	for persons with disabilities.

291.9	(l) Adult Mental Health Grants

291.10	Appropriations by Fund
	
291.11	General
	69,957,000
	69,957,000
	
291.12	Health Care Access
	375,000
	375,000
	
291.13	Lottery Prize Fund
	1,508,000
	1,508,000
	
291.14 	Funding Usage. Up to 75 percent of a fiscal 
291.15 	year's appropriation for adult mental health 
291.16 	grants may be used to fund allocations in that 
291.17 	portion of the fiscal year ending December 
291.18 	31.
291.19 	Base Adjustment. The general fund base is 
291.20 	increased by $813,000 in fiscal years 2014 
291.21 	and 2015. The health care access fund base 
291.22 	is increased by $375,000 in fiscal years 2014 
291.23 	and 2015.

291.24	(m) Children's Mental Health Grants
		14,251,000
		14,251,000
	
291.25 	Funding Usage. Up to 75 percent of a fiscal 
291.26 	year's appropriation for children's mental 
291.27 	health grants may be used to fund allocations 
291.28 	in that portion of the fiscal year ending 
291.29 	December 31.
291.30 	Base Adjustment. The general fund base is 
291.31 	increased by $2,431,000 in fiscal years 2014 
291.32 	and 2015.

291.33
291.34	(n) Chemical Dependency Nonentitlement 
Grants
		1,336,000
		1,336,000

291.35	Subd. 5.State-Operated Services
 					
292.1 	Transfer Authority Related to 
292.2 	State-Operated Services. Money 
292.3 	appropriated for state-operated services 
292.4 	may be transferred between fiscal years 
292.5 	of the biennium with the approval of the 
292.6 	commissioner of management and budget.

292.7	(a) State-Operated Services Mental Health
		115,286,000
		115,135,000
	
292.8 	The commissioner shall close the Community 
292.9 	Behavioral Health Hospital-Willmar on or 
292.10 	before June 30, 2011. The commissioner 
292.11 	shall relocate the Child and Adolescent 
292.12 	Behavioral Health Hospital located in 
292.13 	the former Willmar Regional Treatment 
292.14 	Center to the facility previously housing 
292.15 	the Community Behavioral Health 
292.16 	Hospital-Willmar.

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

292.18	Subd. 6.Sex Offender Program
 		70,416,000
		67,570,000
	
292.19 	Transfer Authority Related to Minnesota 
292.20 	Sex Offender Program. Money 
292.21 	appropriated for the Minnesota sex offender 
292.22 	program may be transferred between fiscal 
292.23 	years of the biennium with the approval 
292.24 	of the commissioner of management and 
292.25 	budget.
292.26 	Minnesota Sex Offender Program 
292.27 	Reduction.  The fiscal year 2011 general 
292.28 	fund appropriation for Minnesota sex 
292.29 	offender services under Laws 2009, chapter 
292.30 	79, article 13, section 3, subdivision 10, 
292.31 	paragraph (b), is reduced by $3,000,000. 
292.32 	This paragraph is effective the day following 
292.33 	final enactment.

292.34	Subd. 7.Technical Activities
 		92,206,000
		79,551,000
	
293.1 	This appropriation is from the federal TANF 
293.2 	fund.
293.3 	Base Level Adjustment.  The TANF fund 
293.4 	base is increased by $4,155,000 in fiscal year 
293.5 	2014 and increased by $4,582,000 in fiscal 
293.6 	year 2015.

293.7	Sec. 4. COMMISSIONER OF HEALTH

293.8	Subdivision 1.Total Appropriation
 	$
	132,589,000
	$
	123,237,000

293.9	Appropriations by Fund
	
293.10		2012
	2013
	
293.11	General
	69,455,000
	64,341,000
	
293.12
293.13	State Government 
Special Revenue
	45,387,000
	45,376,000
	
293.14	Health Care Access
	11,381,000
	7,155,000
	
293.15	Federal TANF
	6,366,000
	6,365,000
	
293.16 	The amounts that may be spent for each 
293.17 	purpose are specified in the following 
293.18 	subdivisions.

293.19
293.20	Subd. 2.Community and Family Health 
Promotion

293.21	Appropriations by Fund
	
293.22	General
	43,539,000
	38,799,000
	
293.23
293.24	State Government 
Special Revenue
	1,033,000
	1,033,000
	
293.25	Health Care Access
	1,719,000
	1,719,000
	
293.26	Federal TANF
	6,366,000
	6,365,000
	
293.27 	TANF Appropriations. (1) $578,000 of the 
293.28 	TANF funds is appropriated each year to the 
293.29 	commissioner for family planning grants 
293.30 	under Minnesota Statutes, section 145.925.
293.31 	(2) $1,790,000 of the TANF funds is 
293.32 	appropriated each year to the commissioner 
293.33 	for home visiting and nutritional services 
293.34 	listed under Minnesota Statutes, section 
293.35 	145.882, subdivision 7, clauses (6) and (7). 
293.36 	Funds must be distributed to community 
294.1 	health boards according to Minnesota 
294.2 	Statutes, section 145A.131, subdivision 1.
294.3 	(3) $1,000,000 of the TANF funds is 
294.4 	appropriated each year to the commissioner 
294.5 	for decreasing infant mortality rates under 
294.6 	Minnesota Statutes, section 145.928, 
294.7 	subdivision 7.
294.8 	(4) $2,998,000 of the TANF funds is 
294.9 	appropriated each year to the commissioner 
294.10 	for the family home visiting grant program 
294.11 	according to Minnesota Statutes, section 
294.12 	145A.17. $2,000,000 of the funding must 
294.13 	be distributed to community health boards 
294.14 	according to Minnesota Statutes, section 
294.15 	145A.131, subdivision 1. $998,000 of 
294.16 	the funding must be distributed to tribal 
294.17 	governments based on Minnesota Statutes, 
294.18 	section 145A.14, subdivision 2a.
294.19 	(5) The commissioner may use up to 7.06 
294.20 	percent of the funds appropriated each fiscal 
294.21 	year to conduct the ongoing evaluations 
294.22 	required under Minnesota Statutes, section 
294.23 	145A.17, subdivision 7, and training and 
294.24 	technical assistance as required under 
294.25 	Minnesota Statutes, section 145A.17, 
294.26 	subdivisions 4 and 5.
294.27 	TANF Carryforward. Any unexpended 
294.28 	balance of the TANF appropriation in the 
294.29 	first year of the biennium does not cancel but 
294.30 	is available for the second year.
294.31 	Base Level Adjustment. The general fund 
294.32 	base is decreased by $5,000 in fiscal years 
294.33 	2014 and 2015.

294.34	Subd. 3.Policy Quality and Compliance

295.1	Appropriations by Fund
	
295.2	General
	10,395,000
	10,023,000
	
295.3
295.4	State Government 
Special Revenue
	14,026,000
	14,083,000
	
295.5	Health Care Access
	9,662,000
	5,436,000
	
295.6 	Medical Education and Research 
295.7 	Costs (MERC) Fund Transfers. The 
295.8 	commissioner of management and budget 
295.9 	shall transfer $9,800,000 from the MERC 
295.10 	fund to the general fund by October 1, 2011.
295.11 	White Earth Clinic. Of the general fund 
295.12 	appropriation, $500,000 in the first year and 
295.13 	$200,000 in the second year is for a grant 
295.14 	to the White Earth Band of Ojibwe Indians. 
295.15 	If the White Earth Band of Ojibwe Indians 
295.16 	accepts this grant, funds must be used for 
295.17 	the White Earth Clinic under Minnesota 
295.18 	Statutes, section 145.9271. The base for this 
295.19 	program is $200,000 for each of fiscal years 
295.20 	2014 and 2015.
295.21 	Comprehensive Advanced Life Support.
295.22 	Of the general fund appropriation, $31,000 
295.23 	each year is added to the base of the 
295.24 	comprehensive advanced life support 
295.25 	(CALS) program under Minnesota Statutes, 
295.26 	section 144.6062.
295.27 	Unused Federal Match Funds. Of the 
295.28 	funds appropriated in Laws 2009, chapter 
295.29 	79, article 13, section 4, subdivision 3, for 
295.30 	state matching funds for the federal Health 
295.31 	Information Technology for Economic and 
295.32 	Clinical Health Act, $2,800,000 is transferred 
295.33 	to the health care access fund by October 1, 
295.34 	2011.
296.1 	Loan Forgiveness. $1,014,000 is 
296.2 	appropriated from the health care access 
296.3 	fund in fiscal year 2012 for the department to 
296.4 	fulfill existing obligations of loan forgiveness 
296.5 	agreements. This funding is available 
296.6 	through fiscal year 2014. In addition, prior 
296.7 	year funds appropriated for loan forgiveness 
296.8 	and required to fulfill existing obligations do 
296.9 	not expire and are available until expended.
296.10 	Administrative Reports. Of the general 
296.11 	fund appropriation, $82,000 in fiscal year 
296.12 	2012 and $10,000 in fiscal year 2013 
296.13 	are for transfer to the commissioner of 
296.14 	management and budget for the reduction of 
296.15 	the administrative report study.
296.16 	Base Level Adjustment. The state 
296.17 	government special revenue fund base shall 
296.18 	be reduced by $141,000 in fiscal years 2014 
296.19 	and 2015. The health care access base shall 
296.20 	be increased by $600,000 in fiscal year 2014.

296.21	Subd. 4.Health Protection

296.22	Appropriations by Fund
	
296.23	General
	9,370,000
	9,370,000
	
296.24
296.25	State Government 
Special Revenue
	30,328,000
	30,260,000

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

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

296.28
296.29
296.30	Sec. 6. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,655,000
	
296.31 	Funds appropriated for fiscal year 2011 are 
296.32 	available until expended.

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

297.1	Sec. 8. HEALTH-RELATED BOARDS

297.2	Subdivision 1.Total Appropriation
 	$
	17,748,000
	$
	17,534,000
	
297.3 	This appropriation is from the state 
297.4 	government special revenue fund. The 
297.5 	amounts that may be spent for each  purpose 
297.6 	are specified in the following subdivisions.

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

297.8	Subd. 3.Board of Dentistry
 		1,829,000
		1,814,000
	
297.9 	Health Professional Services Program. Of 
297.10 	this appropriation, $704,000 in fiscal year 
297.11 	2012 and $704,000 in fiscal year 2013 from 
297.12 	the state government special revenue fund are 
297.13 	for the health professional services program.

297.14
297.15	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		110,000
		110,000

297.16
297.17	Subd. 5.Board of Marriage and Family 
Therapy
 		192,000
		167,000
	
297.18 	Rulemaking. Of this appropriation, $25,000 
297.19 	in fiscal year 2012 is for rulemaking. This is 
297.20 	a onetime appropriation.

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

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

297.23
297.24	Subd. 8.Board of Nursing Home 
Administrators
 		2,153,000
		2,145,000
	
297.25 	Rulemaking. Of this appropriation, $44,000 
297.26 	in fiscal year 2012 is for rulemaking. This is 
297.27 	a onetime appropriation.
297.28 	Electronic Licensing System Adaptors.
297.29 	Of this appropriation, $761,000 in fiscal 
297.30 	year 2013 from the state government special 
297.31 	revenue fund is to the administrative services 
297.32 	unit to cover the costs to connect to the 
297.33 	e-licensing system. Minnesota Statutes, 
298.1 	section 16E.22. Base level funding  for this 
298.2 	activity in fiscal year 2014 shall be  $100,000. 
298.3 	Base level funding for this activity in fiscal 
298.4 	year 2015 shall be $50,000.
298.5 	Development and Implementation of a 
298.6 	Disciplinary, Regulatory, Licensing and 
298.7 	Information Management System. Of this 
298.8 	appropriation, $800,000 in fiscal  year 2012 
298.9 	and $300,000 in fiscal year 2013 are  for the 
298.10 	development of a shared system. Base level 
298.11 	funding for this activity in fiscal year 2014 
298.12 	shall be $50,000.
298.13 	Administrative Services Unit - Operating 
298.14 	Costs. Of this appropriation, $526,000 
298.15 	in fiscal year 2012 and $526,000 in 
298.16 	fiscal year 2013 are for operating costs 
298.17 	of the administrative services unit. The 
298.18 	administrative services unit may receive 
298.19 	and expend reimbursements for services 
298.20 	performed by other agencies.
298.21 	Administrative Services Unit - Retirement 
298.22 	Costs. Of this appropriation in fiscal year 
298.23 	2012, $225,000 is for onetime retirement 
298.24 	costs in the health-related boards. This 
298.25 	funding may be transferred to the health 
298.26 	boards incurring those costs for their 
298.27 	payment. These funds are available either 
298.28 	year of the biennium.
298.29 	Administrative Services Unit - Volunteer 
298.30 	Health Care Provider Program. Of this 
298.31 	appropriation, $150,000 in fiscal year 2012 
298.32 	and $150,000 in fiscal year 2013 are to pay 
298.33 	for medical professional liability coverage 
298.34 	required under Minnesota Statutes, section 
298.35 	214.40.
299.1 	Administrative Services Unit - Contested 
299.2 	Cases and Other Legal Proceedings. Of 
299.3 	this appropriation, $200,000 in fiscal year 
299.4 	2012 and $200,000 in fiscal year 2013 are 
299.5 	for costs of contested case hearings and other 
299.6 	unanticipated costs of legal proceedings 
299.7 	involving health-related boards funded 
299.8 	under this section. Upon certification of a 
299.9 	health-related board to the administrative 
299.10 	services unit that the costs will be incurred 
299.11 	and that there is insufficient money available 
299.12 	to pay for the costs out of money currently 
299.13 	available to that board, the administrative 
299.14 	services unit is authorized to transfer money 
299.15 	from this appropriation to the board for 
299.16 	payment of those costs with the approval 
299.17 	of the commissioner of management and 
299.18 	budget. This appropriation does not cancel. 
299.19 	Any unencumbered and unspent balances 
299.20 	remain available for these expenditures in 
299.21 	subsequent fiscal years.
299.22 	Base Adjustment. The State Government 
299.23 	Special Revenue Fund base is decreased by 
299.24 	$911,000 in fiscal year 2014 and $1,011,000 
299.25 	in fiscal year 2015.

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

299.27	Subd. 10.Board of Pharmacy
 		2,341,000
		2,344,000
	
299.28 	Prescription Electronic Reporting. Of 
299.29 	this appropriation, $356,000 in fiscal year 
299.30 	2012 and $356,000 in fiscal year 2013 from 
299.31 	the state government special revenue fund 
299.32 	are to the board to operate the prescription 
299.33 	electronic reporting system in Minnesota 
299.34 	Statutes, section 152.126. Base level funding 
300.1 	for this activity in fiscal year 2014 shall be 
300.2 	$356,000.

300.3	Subd. 11.Board of Physical Therapy
 		389,000
		345,000
	
300.4 	Rulemaking. Of this appropriation, $44,000 
300.5 	in fiscal year 2012 is for rulemaking. This is 
300.6 	a onetime appropriation.

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

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

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

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

300.11
300.12	Subd. 16.Board of Behavioral Health and 
Therapy
 		414,000
		414,000

300.13
300.14	Sec. 9. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	2,742,000
	$
	2,742,000
	
300.15 	Regional Grants. $585,000 in fiscal year 
300.16 	2012 and $585,000 in fiscal year 2013 are 
300.17 	for regional emergency medical services 
300.18 	programs, to be distributed equally to the 
300.19 	eight emergency medical service regions. 
300.20 	Notwithstanding Minnesota Statutes, section 
300.21 	144E.50, 100 percent of the appropriation 
300.22 	shall be granted to the emergency medical 
300.23 	service regions.
300.24 	Cooper/Sams Volunteer Ambulance 
300.25 	Program. $700,000 in fiscal year 2012 and 
300.26 	$700,000 in fiscal year 2013 are for the 
300.27 	Cooper/Sams volunteer ambulance program 
300.28 	under Minnesota Statutes, section 144E.40.
300.29 	(a) Of this amount, $611,000 in fiscal year 
300.30 	2012 and $611,000 in fiscal year 2013 
300.31 	are for the ambulance service personnel 
300.32 	longevity award and incentive program, 
300.33 	under Minnesota Statutes, section 144E.40. 
301.1 	(b) Of this amount, $89,000 in fiscal year 
301.2 	2012 and $89,000 in fiscal year 2013 are 
301.3 	for the operations of the ambulance service 
301.4 	personnel longevity award and incentive 
301.5 	program, under Minnesota Statutes, section 
301.6 	144E.40. 
301.7 	Ambulance Training Grant. $361,000 in 
301.8 	fiscal year 2012 and $361,000 in fiscal year 
301.9 	2013 are for training grants.
301.10 	EMSRB Board Operations. $1,096,000 in 
301.11 	fiscal year 2012 and $1,096,000 in fiscal year 
301.12 	2013 are for operations.

301.13 	Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
301.14 	to read:
301.15 		Subd. 33.Federal administrative reimbursement dedicated. Federal 
301.16 	administrative reimbursement resulting from the following activities is appropriated to the 
301.17 	commissioner for the designated purposes:
301.18 	(1) reimbursement for the Minnesota senior health options project; and
301.19 	(2) reimbursement related to prior authorization and inpatient admission certification 
301.20 	by a professional review organization. A portion of these funds must be used for activities 
301.21 	to decrease unnecessary pharmaceutical costs in medical assistance.

301.22 	Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 
301.23 	6, is amended to read:

301.24	Subd. 6.Continuing Care Grants

301.25	(a) Aging and Adult Services Grants
		(3,600,000)
		(3,600,000)
	
301.26 	Community Service/Service Development 
301.27 	Grants Reduction. Effective retroactively 
301.28 	from July 1, 2009, funding for grants made 
301.29 	under Minnesota Statutes, sections 256.9754
301.30 	and 256B.0917, subdivision 13, is reduced by 
301.31 	$5,807,000 $3,600,000 for each year of the 
301.32 	biennium. Grants made during the biennium 
301.33 	under Minnesota Statutes, section 256.9754, 
302.1 	shall not be used for new construction or 
302.2 	building renovation.
302.3 	Aging Grants Delay. Aging grants must be 
302.4 	reduced by $917,000 in fiscal year 2011 and 
302.5 	increased by $917,000 in fiscal year 2012. 
302.6 	These adjustments are onetime and must not 
302.7 	be applied to the base. This provision expires 
302.8 	June 30, 2012.

302.9302.10
	(b) Medical Assistance Long-Term Care 
Facilities Grants
		(3,827,000)
		(2,745,000)
	
302.11 	ICF/MR Variable Rates Suspension.
302.12 	Effective retroactively from July 1, 2009, 
302.13 	to June 30, 2010, no new variable rates 
302.14 	shall be authorized for intermediate care 
302.15 	facilities for persons with developmental 
302.16 	disabilities under Minnesota Statutes, section 
302.17 	256B.5013, subdivision 1.
302.18 	ICF/MR Occupancy Rate Adjustment 
302.19 	Suspension. Effective retroactively from 
302.20 	July 1, 2009, to June 30, 2011, approval 
302.21 	of new applications for occupancy rate 
302.22 	adjustments for unoccupied short-term 
302.23 	beds under Minnesota Statutes, section 
302.24 	256B.5013, subdivision 7, is suspended.

302.25
302.26	(c) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		(2,318,000)
		(5,807,000)
	
302.27 	Developmental Disability Waiver Acuity 
302.28 	Factor. Effective retroactively from January 
302.29 	1, 2010, the January 1, 2010, one percent 
302.30 	growth factor in the developmental disability 
302.31 	waiver allocations under Minnesota Statutes, 
302.32 	section 256B.092, subdivisions 4 and 5, 
302.33 	that is attributable to changes in acuity,
302.34 	is suspended to June 30, 2011 eliminated. 
302.35 	Effective January 1, 2012, the one percent 
303.1 	growth factor in the developmental 
303.2 	disability waiver allocations is eliminated. 
303.3 	Notwithstanding any law to the contrary, this 
303.4 	provision does not expire.

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

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

303.7
303.8	(f) Chemical Dependency Nonentitlement 
Grants
		(393,000)
		(393,000)

303.9303.10
	(g) Other Continuing Care Grants
		-0-
		(2,500,000)
(1,414,000)
	
303.11 	Other Continuing Care Grants Delay.
303.12 	Other continuing care grants must be reduced 
303.13 	by $1,414,000 in fiscal year 2011 and 
303.14 	increased by $1,414,000 in fiscal year 2012. 
303.15 	These adjustments are onetime and must not 
303.16 	be applied to the base. This provision expires 
303.17 	June 30, 2012.

303.18	(h) Deaf and Hard-of-Hearing Grants
		-0-
		(169,000)
	
303.19 	Deaf and Hard-of-Hearing Grants Delay.
303.20 	Effective retroactively from July 1, 2010, 
303.21 	deaf and hard-of-hearing grants must be 
303.22 	reduced by $169,000 in fiscal year 2011 and 
303.23 	increased by $169,000 in fiscal year 2012. 
303.24 	These adjustments are onetime and must not 
303.25 	be applied to the base. This provision expires 
303.26 	June 30, 2012.

303.27 	Sec. 12. TRANSFERS.
 303.28 		Subdivision 1.Grants. The commissioner of human services, with the approval 
303.29 	of the commissioner of management and budget, and after notification of the chairs of 
303.30 	the senate health and human services budget and policy committee and the house of 
303.31 	representatives health and human services finance committee, may transfer unencumbered 
303.32 	appropriation balances for the biennium ending June 30, 2013, within fiscal years among 
303.33 	the MFIP; general assistance; general assistance medical care under Minnesota Statutes, 
303.34 	section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under 
304.1 	Minnesota Statutes, section 119B.05; Minnesota supplemental aid; MinnesotaCare, 
304.2 	and group residential housing programs, and the entitlement portion of the chemical 
304.3 	dependency consolidated treatment fund, and between fiscal years of the biennium.
304.4 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
304.5 	money may be transferred within the Departments of Health and Human Services as the 
304.6 	commissioners consider necessary, with the advance approval of the commissioner of 
304.7 	management and budget. The commissioner shall inform the chairs of the senate health 
304.8 	and human services budget and policy committee and the house of representatives health 
304.9 	and human services finance committee quarterly about transfers made under this provision.

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

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

304.16 	Sec. 15. EFFECTIVE DATE.
 304.17 	The provisions in this article are effective July 1, 2011, unless a different effective 
304.18 	date is specified.