SF 760

2nd Unofficial Engrossment - 87th Legislature (2011 - 2012)

Posted on 04/07/2011 12:44 p.m.

1.1A bill for an act 1.2relating to state government; establishing the health and human services 1.3budget; making changes to children and family services, Department of Health, 1.4miscellaneous provisions, health licensing fees, health care, and continuing 1.5care; redesigning service delivery; making changes to chemical and mental 1.6health; modifying fee schedules; modifying program eligibility requirements; 1.7authorizing rulemaking; imposing criminal penalties; requiring reports; 1.8appropriating money for the Departments of Health and Human Services and 1.9other health-related boards and councils; making forecast adjustments;amending 1.10Minnesota Statutes 2010, sections 3.98, by adding a subdivision; 62D.08, 1.11subdivision 7; 62E.08, subdivision 1; 62E.14, by adding a subdivision; 62J.04, 1.12subdivisions 3, 9; 62J.17, subdivision 4a; 62J.495, by adding a subdivision; 1.1362J.497, by adding a subdivision; 62J.692; 62Q.32; 62U.04, subdivisions 3, 9; 1.1462U.06, subdivision 2; 119B.011, subdivision 13; 119B.035, subdivisions 1, 1.154; 119B.09, subdivision 10, by adding subdivisions; 119B.13, subdivisions 1, 1.161a, 7; 144.05, by adding a subdivision; 144.1499; 144.1501, subdivisions 1, 1.174; 144.98, subdivisions 2a, 7, by adding subdivisions; 144A.071, by adding a 1.18subdivision; 144A.102; 144A.61, by adding a subdivision; 144E.123; 145.928, 1.19subdivision 2; 145.986, by adding subdivisions; 145A.17, subdivision 3; 148.07, 1.20subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2; 1.21148.212, subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52; 1.22150A.091, subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101; 1.23151.102, by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; 1.24151.47, subdivision 1; 151.48; 152.027, by adding a subdivision; 152.12, 1.25subdivision 3; 157.15, by adding a subdivision; 157.20, by adding a subdivision; 1.26169A.20, subdivisions 1, 1a, 1b, 1c; 245.50; 245A.14, subdivision 4; 246B.10; 1.27252.025, subdivision 7; 252.27, subdivision 2a; 253B.212; 254B.03, subdivisions 1.281, 4; 254B.04, subdivision 1, by adding a subdivision; 254B.06, subdivision 1.292; 256.01, subdivisions 2b, 14b, 24, 29, by adding subdivisions; 256.045, 1.30subdivision 4a; 256.9657, subdivision 1; 256.969, subdivision 2b, by adding a 1.31subdivision; 256B.04, subdivisions 14a, 18; 256B.05, by adding a subdivision; 1.32256B.055, subdivision 15; 256B.056, subdivisions 3, 4, by adding a subdivision; 1.33256B.057, subdivision 9; 256B.06, subdivision 4; 256B.0625, subdivisions 1.348e, 13e, 13h, 17, 17a, 18, 31a, 41, by adding subdivisions; 256B.0631, 1.35subdivisions 1, 2, 3; 256B.0644; 256B.0657; 256B.0659, subdivisions 11, 1.3628; 256B.0751, subdivisions 1, 2, 3, 4, by adding subdivisions; 256B.0753, 1.37by adding a subdivision; 256B.0754, by adding a subdivision; 256B.0755, 1.38subdivision 4, by adding subdivisions; 256B.0756; 256B.0911, subdivisions 1a, 1.393a, 4a, 6; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 5, 2.110; 256B.0916, subdivision 6a; 256B.092, subdivisions 1a, 1b, 1e, 1g, 3, 8; 2.2256B.0945, subdivision 4; 256B.14, by adding a subdivision; 256B.19, by adding 2.3a subdivision; 256B.37, subdivision 5; 256B.431, subdivision 2r, by adding 2.4a subdivision; 256B.434, subdivision 4; 256B.437, subdivision 6; 256B.441, 2.5by adding a subdivision; 256B.48, subdivision 1; 256B.49, subdivisions 12, 2.613, 14, 15; 256B.5012, by adding subdivisions; 256B.69, subdivisions 3a, 4, 2.75a, 5c, 6, by adding subdivisions; 256B.692, subdivisions 2, 5, 7, by adding 2.8a subdivision; 256B.694; 256B.76, subdivision 4; 256D.03, subdivision 3; 2.9256D.031, subdivisions 6, 7, 10; 256D.05, subdivision 1; 256D.06, subdivisions 2.101, 1b, 2; 256D.09, subdivision 6; 256D.44, subdivision 5; 256D.46, subdivision 2.111; 256D.49, subdivision 3; 256G.02, subdivision 6; 256I.03, by adding a 2.12subdivision; 256I.04, subdivision 2b; 256I.05, subdivisions 1a, 1e, by adding a 2.13subdivision; 256J.20, subdivision 3; 256J.38, subdivision 1; 256J.49, subdivision 2.1413; 256J.53, subdivision 2; 256L.01, subdivision 4a; 256L.02, subdivision 3; 2.15256L.03, subdivisions 3, 5; 256L.04, subdivisions 1, 7; 256L.05, subdivisions 2.162, 3a, 5, by adding a subdivision; 256L.07, subdivision 1; 256L.09, subdivision 2.174; 256L.11, subdivision 7; 256L.12, subdivision 9; 256L.15, subdivision 1a; 2.18260C.157, subdivision 3; 260D.01; 297F.10, subdivision 1; 326B.175; 393.07, 2.19subdivisions 10, 10a; 402A.10, subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 2.20518A.51; Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws 2.212009, chapter 79, article 8, sections 4, as amended; 51, as amended; article 13, 2.22section 3, subdivision 8, as amended; Laws 2010, First Special Session chapter 1, 2.23article 15, section 3, subdivision 6; article 25, section 3, subdivision 6; proposing 2.24coding for new law in Minnesota Statutes, chapters 1; 62E; 62J; 62Q; 62U; 137; 2.25144; 145; 148; 151; 256; 256B; 256L; 326B; 402A; repealing Minnesota Statutes 2.262010, sections 62J.07, subdivisions 1, 2, 3; 62J.17, subdivisions 1, 3, 5a, 6a, 8; 2.2762J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1464; 145A.14, 2.28subdivisions 1, 2; 256.979, subdivisions 5, 6, 7, 10; 256.9791; 256.9862, 2.29subdivision 2; 256B.055, subdivision 15; 256B.057, subdivision 2c; 256D.46, 2.30subdivisions 2, 3; 256L.07, subdivision 7; 402A.30; 402A.45; Laws 2008, 2.31chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 3, section 2.3218, as amended; article 5, sections 55, as amended; 56; 57; 60; 61; 62; 63; 64; 2.3365; 66; 68; 69; 79; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100, 2.34subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 2.3522, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140; 2.364651.0150; 9500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5. 2.37BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.38ARTICLE 1 2.39CHILDREN AND FAMILY SERVICES 2.40    Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to 2.41read: 2.42    Subd. 13. Family. "Family" means parents, stepparents, guardians and their spouses, 2.43or other eligible relative caregivers and their spouses, and their blood related dependent 2.44children and adoptive siblings under the age of 18 years living in the same home including 2.45children temporarily absent from the household in settings such as schools, foster care, and 2.46residential treatment facilities or parents, stepparents, guardians and their spouses, or other 2.47relative caregivers and their spouses temporarily absent from the household in settings 2.48such as schools, military service, or rehabilitation programs. new text begin An adult family member who new text end 3.1 new text begin is not in an authorized activity under this chapter may be temporarily absent for up to 60 new text end 3.2 new text begin days. new text end When a minor parent or parents and his, her, or their child or children are living with 3.3other relatives, and the minor parent or parents apply for a child care subsidy, "family" 3.4means only the minor parent or parents and their child or children. An adult age 18 or 3.5older who meets this definition of family and is a full-time high school or postsecondary 3.6student may be considered a dependent member of the family unit if 50 percent or more of 3.7the adult's support is provided by the parents, stepparents, guardians, and their spouses or 3.8eligible relative caregivers and their spouses residing in the same household. 3.9 new text begin EFFECTIVE DATE. new text end new text begin This section is effective April 16, 2012. new text end 3.10    Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 1, is amended to read: 3.11    Subdivision 1. Establishment. A family in which a parent provides care for the 3.12family's infant child may receive a subsidy in lieu of assistance if the family is eligible for 3.13or is receiving assistance under the basic sliding fee program. An eligible family must 3.14meet the eligibility factors under section 119B.09, except as provided in subdivision 4, 3.15and the requirements of this section. Subject to federal match and maintenance of effort 3.16requirements for the child care and development fund, and up to available appropriations, 3.17the commissioner shall provide assistance under the at-home infant child care program and 3.18for administrative costs associated with the program. new text begin The commissioner shall set aside new text end 3.19 new text begin two percent of the basic sliding fee child care appropriation under section 119B.03, for new text end 3.20 new text begin purposes of this section. new text end At the end of a fiscal year, the commissioner may carry forward 3.21any unspent funds under this section to the next fiscal year within the same biennium for 3.22assistance under the basic sliding fee program. 3.23    Sec. 3. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read: 3.24    Subd. 4. Assistance. (a) A family is limited to a lifetime total of 12 months of 3.25assistance under subdivision 2. The maximum rate of assistance is equal to 90 new text begin 64 new text end percent 3.26of the rate established under section 119B.13 for care of infants in licensed family child 3.27care in the applicant's county of residence. 3.28(b) A participating family must report income and other family changes as specified 3.29in the county's plan under section 119B.08, subdivision 3. 3.30(c) Persons who are admitted to the at-home infant child care program retain their 3.31position in any basic sliding fee program. Persons leaving the at-home infant child care 3.32program reenter the basic sliding fee program at the position they would have occupied. 3.33(d) Assistance under this section does not establish an employer-employee 3.34relationship between any member of the assisted family and the county or state. 4.1    Sec. 4. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 4.2to read: 4.3     new text begin Subd. 9a. new text end new text begin Child care centers; assistance. new text end new text begin (a) For the purposes of this subdivision, new text end 4.4 new text begin "qualifying child" means a child who satisfies both of the following: new text end 4.5 new text begin (1) is not a child or dependent of an employee of the child care provider; and new text end 4.6 new text begin (2) does not reside with an employee of the child care provider. new text end 4.7 new text begin (b) Funds distributed under this chapter must not be paid for child care services new text end 4.8 new text begin that are provided for a child by a child care provider who employs either the parent of new text end 4.9 new text begin the child or a person who resides with the child, unless at all times at least 50 percent of new text end 4.10 new text begin the children for whom the child care provider is providing care are qualifying children new text end 4.11 new text begin under paragraph (a). new text end 4.12 new text begin (c) If a child care provider satisfies the requirements for payment under paragraph new text end 4.13 new text begin (b), but the percentage of qualifying children under paragraph (a) for whom the provider new text end 4.14 new text begin is providing care falls below 50 percent, the provider shall have four weeks to raise the new text end 4.15 new text begin percentage of qualifying children for whom the provider is providing care to at least 50 new text end 4.16 new text begin percent before payments to the provider are discontinued for child care services provided new text end 4.17 new text begin for a child who is not a qualifying child. new text end 4.18 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2013. new text end 4.19    Sec. 5. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read: 4.20    Subd. 10. Payment of funds. All federal, state, and local child care funds must 4.21be paid directly to the parent when a provider cares for children in the children's own 4.22home. In all other cases, all federal, state, and local child care funds must be paid directly 4.23to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible 4.24family. new text begin Funds distributed under this chapter must not be used for child care services that new text end 4.25 new text begin are provided for a child by a child care provider who resides in the same household or new text end 4.26 new text begin occupies the same residence as the child. new text end 4.27 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 5, 2012. new text end 4.28    Sec. 6. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision 4.29to read: 4.30     new text begin Subd. 13. new text end new text begin Child care in the child's home. new text end new text begin Child care assistance must only be new text end 4.31 new text begin authorized in the child's home if the child's parents have authorized activities outside of new text end 4.32 new text begin the home and if one or more of the following circumstances are met: new text end 5.1 new text begin (1) the parents' qualifying activity occurs during times when out-of-home care is new text end 5.2 new text begin not available. If child care is needed during any period when out-of-home care is not new text end 5.3 new text begin available, in-home care can be approved for the entire time care is needed; new text end 5.4 new text begin (2) the family lives in an area where out-of-home care is not available; or new text end 5.5 new text begin (3) a child has a verified illness or disability that would place the child or other new text end 5.6 new text begin children in an out-of-home facility at risk or creates a hardship for the child and the family new text end 5.7 new text begin to take the child out of the home to a child care home or center. new text end 5.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective March 5, 2012. new text end 5.9    Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read: 5.10    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006, the maximum rate 5.11paid for child care assistance in any county or multicounty region under the child care 5.12fund shall be the rate for like-care arrangements in the county effective January 1, 2006, 5.13increased by six percent. 5.14    (b) Rate changes shall be implemented for services provided in September 2006 5.15unless a participant eligibility redetermination or a new provider agreement is completed 5.16between July 1, 2006, and August 31, 2006. 5.17    As necessary, appropriate notice of adverse action must be made according to 5.18Minnesota Rules, part 3400.0185, subparts 3 and 4. 5.19    New cases approved on or after July 1, 2006, shall have the maximum rates under 5.20paragraph (a), implemented immediately. 5.21    (c) Every year, the commissioner shall survey rates charged by child care providers in 5.22Minnesota to determine the 75th percentile for like-care arrangements in counties. When 5.23the commissioner determines that, using the commissioner's established protocol, the 5.24number of providers responding to the survey is too small to determine the 75th percentile 5.25rate for like-care arrangements in a county or multicounty region, the commissioner may 5.26establish the 75th percentile maximum rate based on like-care arrangements in a county, 5.27region, or category that the commissioner deems to be similar. 5.28    (d) A rate which includes a special needs rate paid under subdivision 3 or under a 5.29school readiness service agreement paid under section 119B.231, may be in excess of the 5.30maximum rate allowed under this subdivision. 5.31    (e) The department shall monitor the effect of this paragraph on provider rates. The 5.32county shall pay the provider's full charges for every child in care up to the maximum 5.33established. The commissioner shall determine the maximum rate for each type of care 5.34on an hourly, full-day, and weekly basis, including special needs and disability care. new text begin The new text end 6.1 new text begin maximum payment to a provider for one day of care must not exceed the daily rate. The new text end 6.2 new text begin maximum payment to a provider for one week of care must not exceed the weekly rate. new text end 6.3 new text begin (f) Child care providers receiving reimbursement under this chapter must not be paid new text end 6.4 new text begin activity fees or an additional amount above the maximum rates for care provided during new text end 6.5 new text begin nonstandard hours for families receiving assistance. new text end 6.6    (f) new text begin (g) new text end When the provider charge is greater than the maximum provider rate allowed, 6.7the parent is responsible for payment of the difference in the rates in addition to any 6.8family co-payment fee. 6.9    (g) new text begin (h) new text end All maximum provider rates changes shall be implemented on the Monday 6.10following the effective date of the maximum provider rate. 6.11 new text begin EFFECTIVE DATE. new text end new text begin This section is effective September 3, 2012, except the new text end 6.12 new text begin amendments to paragraph (e) are effective April 16, 2012. new text end 6.13    Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read: 6.14    Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal 6.15nonlicensed family child care providers receiving reimbursement under this chapter must 6.16be paid on an hourly basis for care provided to families receiving assistance. 6.17(b) The maximum rate paid to legal nonlicensed family child care providers must be 6.1880 new text begin 64 new text end percent of the county maximum hourly rate for licensed family child care providers. 6.19In counties where the maximum hourly rate for licensed family child care providers is 6.20higher than the maximum weekly rate for those providers divided by 50, the maximum 6.21hourly rate that may be paid to legal nonlicensed family child care providers is the rate 6.22equal to the maximum weekly rate for licensed family child care providers divided by 50 6.23and then multiplied by 0.80 new text begin 0.64. The maximum payment to a provider for one day of care new text end 6.24 new text begin must not exceed the maximum hourly rate times ten. The maximum payment to a provider new text end 6.25 new text begin for one week of care must not exceed the maximum hourly rate times 50 new text end . 6.26(c) A rate which includes a special needs rate paid under subdivision 3 may be in 6.27excess of the maximum rate allowed under this subdivision. 6.28(d) Legal nonlicensed family child care providers receiving reimbursement under 6.29this chapter may not be paid registration fees for families receiving assistance. 6.30 new text begin EFFECTIVE DATE. new text end new text begin This section is effective April 16, 2012, except the new text end 6.31 new text begin amendment changing 80 to 64 and 0.80 to 0.64 is effective July 1, 2011. new text end 6.32    Sec. 9. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read: 7.1    Subd. 7. Absent days. (a) new text begin Licensed new text end child care providers may new text begin and license-exempt new text end 7.2 new text begin centers must new text end not be reimbursed for more than 25 new text begin ten new text end full-day absent days per child, 7.3excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days, 7.4unless the child has a documented medical condition that causes more frequent absences. 7.5Absences due to a documented medical condition of a parent or sibling who lives in the 7.6same residence as the child receiving child care assistance do not count against the 25-day 7.7absent day limit in a fiscal year. Documentation of medical conditions must be on the 7.8forms and submitted according to the timelines established by the commissioner. A public 7.9health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a 7.10provider sends a child home early due to a medical reason, including, but not limited to, 7.11fever or contagious illness, the child care center director or lead teacher may verify the 7.12illness in lieu of a medical practitioner. new text begin Legal nonlicensed family child care providers new text end 7.13 new text begin must not be reimbursed for absent days. new text end If a child attends for part of the time authorized to 7.14be in care in a day, but is absent for part of the time authorized to be in care in that same 7.15day, the absent time will new text begin must new text end be reimbursed but the time will new text begin must new text end not count toward the 7.16ten consecutive or 25 cumulative absent day limits new text begin limit new text end . Children in families where at 7.17least one parent is under the age of 21, does not have a high school or general equivalency 7.18diploma, and is a student in a school district or another similar program that provides or 7.19arranges for child care, as well as parenting, social services, career and employment 7.20supports, and academic support to achieve high school graduation, may be exempt from 7.21the absent day limits upon request of the program and approval of the county. If a child 7.22attends part of an authorized day, payment to the provider must be for the full amount 7.23of care authorized for that day. Child care providers may new text begin must new text end only be reimbursed for 7.24absent days if the provider has a written policy for child absences and charges all other 7.25families in care for similar absences. 7.26    (b) Child care providers must be reimbursed for up to ten federal or state holidays 7.27or designated holidays per year when the provider charges all families for these days 7.28and the holiday or designated holiday falls on a day when the child is authorized to be 7.29in attendance. Parents may substitute other cultural or religious holidays for the ten 7.30recognized state and federal holidays. Holidays do not count toward the ten consecutive 7.31or 25 cumulative absent day limits new text begin limit new text end . 7.32    (c) A family or child care provider may new text begin must new text end not be assessed an overpayment for an 7.33absent day payment unless (1) there was an error in the amount of care authorized for the 7.34family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 7.35the family or provider did not timely report a change as required under law. 8.1    (d) The provider and family must receive notification of the number of absent days 8.2used upon initial provider authorization for a family and when the family has used 15 8.3cumulative absent days. Upon statewide implementation of the Minnesota Electronic 8.4Child Care System, the provider and family shall receive notification of the number of 8.5absent days used upon initial provider authorization for a family and ongoing notification 8.6of the number of absent days used as of the date of the notification. 8.7    (e) A county may pay for more absent days than the statewide absent day policy 8.8established under this subdivision if current market practice in the county justifies payment 8.9for those additional days. County policies for payment of absent days in excess of the 8.10statewide absent day policy and justification for these county policies must be included in 8.11the county's child care fund plan under section , subdivision 3. 8.12 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2013. new text end 8.13    Sec. 10. new text begin [256.987] ELECTRONIC BENEFIT TRANSFER CARD. new text end 8.14     new text begin Subdivision 1. new text end new text begin Electronic benefit transfer (EBT) card. new text end new text begin Beginning July 1, 2011, new text end 8.15 new text begin cash benefits for the general assistance and Minnesota supplemental aid programs under new text end 8.16 new text begin chapter 256D and programs under chapter 256J must be issued on a separate EBT card new text end 8.17 new text begin with the name of the head of household printed on the card. The card must include the new text end 8.18 new text begin following statement: "It is unlawful to use this card to purchase tobacco products or new text end 8.19 new text begin alcoholic beverages." This card must be issued within 30 calendar days of an eligibility new text end 8.20 new text begin determination. During the initial 30 calendar days of eligibility, a recipient may have new text end 8.21 new text begin cash benefits issued on an EBT card without a name printed on the card. This card may new text end 8.22 new text begin be the same card on which food support benefits are issued and does not need to meet new text end 8.23 new text begin the requirements of this section. new text end 8.24     new text begin Subd. 2. new text end new text begin EBT card use restricted to Minnesota vendors. new text end new text begin EBT cardholders new text end 8.25 new text begin receiving cash benefits under the general assistance and Minnesota supplemental aid new text end 8.26 new text begin programs under chapter 256D or programs under chapter 256J are prohibited from using new text end 8.27 new text begin their EBT cards at vendors located outside of Minnesota. This subdivision does not apply new text end 8.28 new text begin to food support benefits. new text end 8.29     new text begin Subd. 3. new text end new text begin Prohibited purchases. new text end new text begin EBT debit cardholders in programs listed under new text end 8.30 new text begin subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products new text end 8.31 new text begin and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for new text end 8.32 new text begin an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic new text end 8.33 new text begin beverages with the cardholder's EBT card. Violation of this subdivision is a petty new text end 8.34 new text begin misdemeanor. new text end 9.1    Sec. 11. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read: 9.2    Subdivision 1. Eligibility. (a) Each assistance unit with income and resources 9.3less than the standard of assistance established by the commissioner and with a member 9.4who is a resident of the state shall be eligible for and entitled to general assistance if 9.5the assistance unit is: 9.6(1) a person who is suffering from a professionally certified permanent or temporary 9.7illness, injury, or incapacity which is expected to continue for more than 30 new text begin 90 new text end days and 9.8which prevents the person from obtaining or retaining employment; 9.9(2) a person whose presence in the home on a substantially continuous basis is 9.10required because of the professionally certified illness, injury, incapacity, or the age of 9.11another member of the household; 9.12(3) new text begin (2) new text end a person who has been placed in, and is residing in, a licensed or certified 9.13facility for purposes of physical or mental health or rehabilitation, or in an approved 9.14chemical dependency domiciliary facility, if the placement is based on illness or incapacity 9.15and is according to a plan developed or approved by the county agency through its 9.16director or designated representative; 9.17(4) new text begin (3) new text end a person who resides in a shelter facility described in subdivision 3; 9.18(5) new text begin (4) new text end a person not described in clause (1) or (3) new text begin (2) new text end who is diagnosed by a licensed 9.19physician, psychological practitioner, or other qualified professional, as developmentally 9.20disabled or mentally ill, and that condition prevents the person from obtaining or retaining 9.21employment; 9.22(6) a person who has an application pending for, or is appealing termination of 9.23benefits from, the Social Security disability program or the program of supplemental 9.24security income for the aged, blind, and disabled, provided the person has a professionally 9.25certified permanent or temporary illness, injury, or incapacity which is expected to 9.26continue for more than 30 days and which prevents the person from obtaining or retaining 9.27employment; 9.28(7) a person who is unable to obtain or retain employment because advanced age 9.29significantly affects the person's ability to seek or engage in substantial work; 9.30(8) new text begin (5) new text end a person who has been assessed by a vocational specialist and, in consultation 9.31with the county agency, has been determined to be unemployable for purposes of this 9.32clause; a person is considered employable if there exist positions of employment in the 9.33local labor market, regardless of the current availability of openings for those positions, 9.34that the person is capable of performing. The person's eligibility under this category must 9.35be reassessed at least annually. The county agency must provide notice to the person not 9.36later than 30 days before annual eligibility under this item ends, informing the person of the 10.1date annual eligibility will end and the need for vocational assessment if the person wishes 10.2to continue eligibility under this clause. For purposes of establishing eligibility under this 10.3clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment; 10.4(9) new text begin (6) new text end a person who is determined by the county agency, according to permanent 10.5rules adopted by the commissioner, to be learning disabled new text begin have a condition that qualifies new text end 10.6 new text begin under Minnesota's special education rules as a specific learning disability new text end , provided that if 10.7a rehabilitation plan for the person is developed or approved by the county agency, new text begin and new text end 10.8the person is following the plan; 10.9(10) a child under the age of 18 who is not living with a parent, stepparent, or legal 10.10custodian, and only if: the child is legally emancipated or living with an adult with the 10.11consent of an agency acting as a legal custodian; the child is at least 16 years of age 10.12and the general assistance grant is approved by the director of the county agency or a 10.13designated representative as a component of a social services case plan for the child; or the 10.14child is living with an adult with the consent of the child's legal custodian and the county 10.15agency. For purposes of this clause, "legally emancipated" means a person under the age 10.16of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of 10.17the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv) 10.18is otherwise considered emancipated under Minnesota law, and for whom county social 10.19services has not determined that a social services case plan is necessary, for reasons other 10.20than the child has failed or refuses to cooperate with the county agency in developing 10.21the plan; 10.22(11) new text begin (7) new text end a person who is eligible for displaced homemaker services, programs, or 10.23assistance under section 116L.96, but only if that person is enrolled as a full-time student; 10.24(12) a person who lives more than four hours round-trip traveling time from any 10.25potential suitable employment; 10.26(13) new text begin (8) new text end a person who is involved with protective or court-ordered services that 10.27prevent the applicant or recipient from working at least four hours per day; new text begin or new text end 10.28(14) a person over age 18 whose primary language is not English and who is 10.29attending high school at least half time; or 10.30(15) new text begin (9) new text end a person whose alcohol and drug addiction is a material factor that 10.31contributes to the person's disability; applicants who assert this clause as a basis for 10.32eligibility must be assessed by the county agency to determine if they are amenable 10.33to treatment; if the applicant is determined to be not amenable to treatment, but is 10.34otherwise eligible for benefits, then general assistance must be paid in vendor form, for 10.35the individual's shelter costs up to the limit of the grant amount, with the residual, if 10.36any, paid according to section 256D.09, subdivision 2a; if the applicant is determined 11.1to be amenable to treatment, then in order to receive benefits, the applicant must be in 11.2a treatment program or on a waiting list and the benefits must be paid in vendor form, 11.3for the individual's shelter costs, up to the limit of the grant amount, with the residual, if 11.4any, paid according to section 256D.09, subdivision 2a. 11.5(b) As a condition of eligibility under paragraph (a), clauses (1), (3) new text begin (2) new text end , (5) new text begin (4) new text end , 11.6(8) new text begin (5) new text end , and (9) new text begin (6) new text end , the recipient must complete an interim assistance agreement and 11.7must apply for other maintenance benefits as specified in section 256D.06, subdivision 11.85 , and must comply with efforts to determine the recipient's eligibility for those other 11.9maintenance benefits. 11.10 new text begin (c) As a condition of eligibility under this section, the recipient must complete new text end 11.11 new text begin at least 20 hours per month of volunteer or paid work. The county of residence shall new text end 11.12 new text begin determine what may be included as volunteer work. Recipients must provide monthly new text end 11.13 new text begin proof of volunteer work on the forms established by the county. A person who is unable new text end 11.14 new text begin to obtain or retain 20 hours per month of volunteer or paid work due to a professionally new text end 11.15 new text begin certified illness, injury, disability, or incapacity must not be made ineligible for general new text end 11.16 new text begin assistance under this section. new text end 11.17(c) new text begin (d) new text end The burden of providing documentation for a county agency to use to verify 11.18eligibility for general assistance or for exemption from the food stamp employment 11.19and training program is upon the applicant or recipient. The county agency shall use 11.20documents already in its possession to verify eligibility, and shall help the applicant or 11.21recipient obtain other existing verification necessary to determine eligibility which the 11.22applicant or recipient does not have and is unable to obtain. 11.23    Sec. 12. Minnesota Statutes 2010, section 256D.06, subdivision 1, is amended to read: 11.24    Subdivision 1. Eligibility; amount of assistance. General assistance shall be 11.25granted in an amount that when added to the nonexempt income actually available to the 11.26assistance unit, the total amount equals the applicable standard of assistance for general 11.27assistance. In determining eligibility for and the amount of assistance for an individual or 11.28married couple, the county agency shall disregard the first $50 new text begin $150 new text end of earned income 11.29per month. 11.30    Sec. 13. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read: 11.31    Subd. 1b. Earned income savings account. In addition to the $50 new text begin $150 new text end disregard 11.32required under subdivision 1, the county agency shall disregard an additional earned 11.33income up to a maximum of $150 new text begin $500 new text end per month for: (1) persons residing in facilities 11.34licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to 12.19530.4000, and for whom discharge and work are part of a treatment plan; new text begin and new text end (2) 12.2persons living in supervised apartments with services funded under Minnesota Rules, 12.3parts 9535.0100 to 9535.1600, and for whom discharge and work are part of a treatment 12.4plan; and (3) persons residing in group residential housing, as that term is defined in 12.5section 256I.03, subdivision 3, for whom the county agency has approved a discharge plan 12.6which includes work. The additional amount disregarded must be placed in a separate 12.7savings account by the eligible individual, to be used upon discharge from the residential 12.8facility into the community. For individuals residing in a chemical dependency program 12.9licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from 12.10the savings account require the signature of the individual and for those individuals with 12.11an authorized representative payee, the signature of the payee. A maximum of $1,000 new text begin new text end 12.12 new text begin $2,000 new text end , including interest, of the money in the savings account must be excluded from 12.13the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in 12.14that account in excess of $1,000 new text begin $2,000 new text end must be applied to the resident's cost of care. If 12.15excluded money is removed from the savings account by the eligible individual at any 12.16time before the individual is discharged from the facility into the community, the money is 12.17income to the individual in the month of receipt and a resource in subsequent months. If 12.18an eligible individual moves from a community facility to an inpatient hospital setting, 12.19the separate savings account is an excluded asset for up to 18 months. During that time, 12.20amounts that accumulate in excess of the $1,000 new text begin $2,000 new text end savings limit must be applied to 12.21the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the 12.2218-month period, the entire account must be applied to the patient's cost of care. 12.23    Sec. 14. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read: 12.24    Subd. 2. Emergency need. new text begin (a) new text end Notwithstanding the provisions of subdivision 1, a 12.25grant of emergency general assistance shall, to the extent funds are available, be made to 12.26an eligible single adult, married couple, or family for an emergency need, as defined in 12.27rules promulgated by the commissioner, where the recipient requests temporary assistance 12.28not exceeding 30 days if an emergency situation appears to exist and the individual or 12.29family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP new text begin under new text end 12.30 new text begin written criteria adopted by the county agency new text end . If an applicant or recipient relates facts 12.31to the county agency which may be sufficient to constitute an emergency situation, the 12.32county agency shall, to the extent funds are available, advise the person of the procedure 12.33for applying for assistance according to this subdivision. 12.34     new text begin (b) The applicant must be ineligible for assistance under chapter 256J, must have new text end 12.35 new text begin annual net income no greater than 200 percent of the federal poverty guidelines for the new text end 13.1 new text begin previous calendar year, and may receive new text end an emergency general assistance grant is available 13.2to a recipient not more than once in any 12-month period. 13.3     new text begin (c) new text end Funding for an emergency general assistance program is limited to the 13.4appropriation. Each fiscal year, the commissioner shall allocate to counties the money 13.5appropriated for emergency general assistance grants based on each county agency's 13.6average share of state's emergency general expenditures for the immediate past three fiscal 13.7years as determined by the commissioner, and may reallocate any unspent amounts to 13.8other counties. new text begin No county shall be allocated less than $1,000 for a fiscal year. new text end 13.9     new text begin (d) new text end Any emergency general assistance expenditures by a county above the amount of 13.10the commissioner's allocation to the county must be made from county funds. 13.11    Sec. 15. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read: 13.12    Subd. 5. Special needs. In addition to the state standards of assistance established in 13.13subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 13.14Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 13.15center, or a group residential housing facility. 13.16    (a) The county agency shall pay a monthly allowance for medically prescribed 13.17diets if the cost of those additional dietary needs cannot be met through some other 13.18maintenance benefit. The need for special diets or dietary items must be prescribed by 13.19a licensed physician. Costs for special diets shall be determined as percentages of the 13.20allotment for a one-person household under the thrifty food plan as defined by the United 13.21States Department of Agriculture. The types of diets and the percentages of the thrifty 13.22food plan that are covered are as follows: 13.23    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan; 13.24    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 13.25of thrifty food plan; 13.26    (3) controlled protein diet, less than 40 grams and requires special products, 125 13.27percent of thrifty food plan; 13.28    (4) low cholesterol diet, 25 percent of thrifty food plan; 13.29    (5) high residue diet, 20 percent of thrifty food plan; 13.30    (6) pregnancy and lactation diet, 35 percent of thrifty food plan; 13.31    (7) gluten-free diet, 25 percent of thrifty food plan; 13.32    (8) lactose-free diet, 25 percent of thrifty food plan; 13.33    (9) antidumping diet, 15 percent of thrifty food plan; 13.34    (10) hypoglycemic diet, 15 percent of thrifty food plan; or 13.35    (11) ketogenic diet, 25 percent of thrifty food plan. 14.1    (b) Payment for nonrecurring special needs must be allowed for necessary home 14.2repairs or necessary repairs or replacement of household furniture and appliances using 14.3the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 14.4as long as other funding sources are not available. 14.5    (c) A fee for guardian or conservator service is allowed at a reasonable rate 14.6negotiated by the county or approved by the court. This rate shall not exceed five percent 14.7of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 14.8guardian or conservator is a member of the county agency staff, no fee is allowed. 14.9    (d) The county agency shall continue to pay a monthly allowance of $68 for 14.10restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 14.111990, and who eats two or more meals in a restaurant daily. The allowance must continue 14.12until the person has not received Minnesota supplemental aid for one full calendar month 14.13or until the person's living arrangement changes and the person no longer meets the criteria 14.14for the restaurant meal allowance, whichever occurs first. 14.15    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 14.16is allowed for representative payee services provided by an agency that meets the 14.17requirements under SSI regulations to charge a fee for representative payee services. This 14.18special need is available to all recipients of Minnesota supplemental aid regardless of 14.19their living arrangement. 14.20    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the 14.21maximum allotment authorized by the federal Food Stamp Program for a single individual 14.22which is in effect on the first day of July of each year will be added to the standards of 14.23assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 14.24as shelter needy and are: (i) relocating from an institution, or an adult mental health 14.25residential treatment program under section 256B.0622; (ii) eligible for the self-directed 14.26supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 14.27community-based waiver recipients living in their own home or rented or leased apartment 14.28which is not owned, operated, or controlled by a provider of service not related by blood 14.29or marriage, unless allowed under paragraph (g). 14.30    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 14.31shelter needy benefit under this paragraph is considered a household of one. An eligible 14.32individual who receives this benefit prior to age 65 may continue to receive the benefit 14.33after the age of 65. 14.34    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 14.35exceed 40 percent of the assistance unit's gross income before the application of this 14.36special needs standard. "Gross income" for the purposes of this section is the applicant's or 15.1recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 15.2in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 15.3state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 15.4considered shelter needy for purposes of this paragraph. 15.5(g) Notwithstanding this subdivision, to access housing and services as provided 15.6in paragraph (f), the recipient may choose housing that may be owned, operated, or 15.7controlled by the recipient's service provider. In a multifamily building of new text begin more than new text end four 15.8or more units, the maximum number of apartments new text begin at one address new text end that may be used by 15.9recipients of this program shall be 50 percent of the units in a building. This paragraph 15.10expires on June 30, 2012 new text begin 2014 new text end . 15.11    Sec. 16. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read: 15.12    Subdivision 1. Eligibility. A county agency must grant emergency Minnesota 15.13supplemental aid, to the extent funds are available, if the recipient is without adequate 15.14resources to resolve an emergency that, if unresolved, will threaten the health or safety of 15.15the recipient. For the purposes of this section, the term "recipient" includes persons for 15.16whom a group residential housing benefit is being paid under sections to . new text begin new text end 15.17 new text begin Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency new text end 15.18 new text begin need may apply for emergency general assistance under section 256D.06, subdivision 2. new text end 15.19    Sec. 17. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision 15.20to read: 15.21     new text begin Subd. 8. new text end new text begin Supplementary services. new text end new text begin "Supplementary services" means services new text end 15.22 new text begin provided to residents of group residential housing providers in addition to room and new text end 15.23 new text begin board including, but not limited to, oversight and up to 24-hour supervision, medication new text end 15.24 new text begin reminders, assistance with transportation, arranging for meetings and appointments, and new text end 15.25 new text begin arranging for medical and social services. new text end 15.26    Sec. 18. Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read: 15.27    Subd. 2b. Group residential housing agreements. new text begin (a) new text end Agreements between county 15.28agencies and providers of group residential housing must be in writing and must specify 15.29the name and address under which the establishment subject to the agreement does 15.30business and under which the establishment, or service provider, if different from the 15.31group residential housing establishment, is licensed by the Department of Health or the 15.32Department of Human Services; the specific license or registration from the Department 15.33of Health or the Department of Human Services held by the provider and the number 16.1of beds subject to that license; the address of the location or locations at which group 16.2residential housing is provided under this agreement; the per diem and monthly rates that 16.3are to be paid from group residential housing funds for each eligible resident at each 16.4location; the number of beds at each location which are subject to the group residential 16.5housing agreement; whether the license holder is a not-for-profit corporation under section 16.6501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to 16.7the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections. 16.8Group residential housing agreements may be terminated with or without cause by either 16.9the county or the provider with two calendar months prior notice. 16.10 new text begin (b) Beginning July 1, 2011, counties must not enter into agreements with providers new text end 16.11 new text begin of group residential housing that are licensed as board and lodging with special services new text end 16.12 new text begin and that do not include a residency requirement of at least 20 hours per month of volunteer new text end 16.13 new text begin or paid work. A person who is unable to obtain or retain 20 hours per month of volunteer new text end 16.14 new text begin or paid work due to a professionally certified illness, injury, disability, or incapacity must new text end 16.15 new text begin not be made ineligible for group residential housing under this section. new text end 16.16    Sec. 19. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read: 16.17    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section 16.18256I.04, subdivision 3 , the county agency may negotiate a payment not to exceed $426.37 16.19for other services necessary to provide room and board provided by the group residence 16.20if the residence is licensed by or registered by the Department of Health, or licensed by 16.21the Department of Human Services to provide services in addition to room and board, 16.22and if the provider of services is not also concurrently receiving funding for services for 16.23a recipient under a home and community-based waiver under title XIX of the Social 16.24Security Act; or funding from the medical assistance program under section 256B.0659, 16.25for personal care services for residents in the setting; or residing in a setting which 16.26receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is 16.27available for other necessary services through a home and community-based waiver, or 16.28personal care services under section 256B.0659, then the GRH rate is limited to the rate 16.29set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary 16.30service rate exceed $426.37. The registration and licensure requirement does not apply to 16.31establishments which are exempt from state licensure because they are located on Indian 16.32reservations and for which the tribe has prescribed health and safety requirements. Service 16.33payments under this section may be prohibited under rules to prevent the supplanting of 16.34federal funds with state funds. The commissioner shall pursue the feasibility of obtaining 16.35the approval of the Secretary of Health and Human Services to provide home and 17.1community-based waiver services under title XIX of the Social Security Act for residents 17.2who are not eligible for an existing home and community-based waiver due to a primary 17.3diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is 17.4determined to be cost-effective. 17.5(b) The commissioner is authorized to make cost-neutral transfers from the GRH 17.6fund for beds under this section to other funding programs administered by the department 17.7after consultation with the county or counties in which the affected beds are located. 17.8The commissioner may also make cost-neutral transfers from the GRH fund to county 17.9human service agencies for beds permanently removed from the GRH census under a plan 17.10submitted by the county agency and approved by the commissioner. The commissioner 17.11shall report the amount of any transfers under this provision annually to the legislature. 17.12(c) The provisions of paragraph (b) do not apply to a facility that has its 17.13reimbursement rate established under section 256B.431, subdivision 4, paragraph (c). 17.14     new text begin (d) Beginning July 1, 2011, counties must not negotiate supplementary service rates new text end 17.15 new text begin with providers of group residential housing that are licensed as board and lodging with new text end 17.16 new text begin special services and that do not enforce a policy of sobriety on their premises. new text end 17.17    Sec. 20. Minnesota Statutes 2010, section 256I.05, subdivision 1e, is amended to read: 17.18    Subd. 1e. Supplementary rate for certain facilities. new text begin (a) new text end Notwithstanding the 17.19provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall 17.20negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to 17.21exceed $700 per month, including any legislatively authorized inflationary adjustments, 17.22for a group residential housing provider that: 17.23(1) is located in Hennepin County and has had a group residential housing contract 17.24with the county since June 1996; 17.25(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 17.2626-bed facility; and 17.27(3) serves a chemically dependent clientele, providing 24 hours per day supervision 17.28and limiting a resident's maximum length of stay to 13 months out of a consecutive 17.2924-month period. 17.30 new text begin (b) Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, new text end 17.31 new text begin 2011, a county agency shall negotiate a supplementary rate in addition to the rate specified new text end 17.32 new text begin in subdivision 1, not to exceed $700 per month, including any legislatively authorized new text end 17.33 new text begin inflationary adjustments, for the group residential provider described under paragraph new text end 17.34 new text begin (a), not to exceed an additional 175 beds. new text end 18.1    Sec. 21. Minnesota Statutes 2010, section 256I.05, is amended by adding a subdivision 18.2to read: 18.3     new text begin Subd. 1o. new text end new text begin Supplemental rate adjustment. new text end new text begin Notwithstanding any other provision to new text end 18.4 new text begin the contrary, board and lodging with services providers that receive a supplemental service new text end 18.5 new text begin rate in excess of the supplemental service rate established under subdivision 1, shall be new text end 18.6 new text begin reduced no more than $10.42 per bed per month. new text end 18.7    Sec. 22. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read: 18.8    Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of 18.9all nonexcluded real and personal property of the assistance unit must not exceed $2,000 18.10for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 18.11(19) must be excluded when determining the equity value of real and personal property: 18.12    (1) a licensed vehicle up to a loan value of less than or equal to $15,000 new text begin $10,000 new text end . If 18.13the assistance unit owns more than one licensed vehicle, the county agency shall determine 18.14the loan value of all additional vehicles and exclude the combined loan value of less than 18.15or equal to $7,500. The county agency shall apply any excess loan value as if it were 18.16equity value to the asset limit described in this section, excluding: (i) the value of one 18.17vehicle per physically disabled person when the vehicle is needed to transport the disabled 18.18unit member; this exclusion does not apply to mentally disabled people; (ii) the value of 18.19special equipment for a disabled member of the assistance unit; and (iii) any vehicle used 18.20for long-distance travel, other than daily commuting, for the employment of a unit member. 18.21    To establish the loan value of vehicles, a county agency must use the N.A.D.A. 18.22Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not 18.23listed in the guidebook, or when the applicant or participant disputes the loan value listed 18.24in the guidebook as unreasonable given the condition of the particular vehicle, the county 18.25agency may require the applicant or participant document the loan value by securing a 18.26written statement from a motor vehicle dealer licensed under section 168.27, stating 18.27the amount that the dealer would pay to purchase the vehicle. The county agency shall 18.28reimburse the applicant or participant for the cost of a written statement that documents 18.29a lower loan value; 18.30    (2) the value of life insurance policies for members of the assistance unit; 18.31    (3) one burial plot per member of an assistance unit; 18.32    (4) the value of personal property needed to produce earned income, including 18.33tools, implements, farm animals, inventory, business loans, business checking and 18.34savings accounts used at least annually and used exclusively for the operation of a 19.1self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 19.2is to produce income and if the vehicles are essential for the self-employment business; 19.3    (5) the value of personal property not otherwise specified which is commonly 19.4used by household members in day-to-day living such as clothing, necessary household 19.5furniture, equipment, and other basic maintenance items essential for daily living; 19.6    (6) the value of real and personal property owned by a recipient of Supplemental 19.7Security Income or Minnesota supplemental aid; 19.8    (7) the value of corrective payments, but only for the month in which the payment 19.9is received and for the following month; 19.10    (8) a mobile home or other vehicle used by an applicant or participant as the 19.11applicant's or participant's home; 19.12    (9) money in a separate escrow account that is needed to pay real estate taxes or 19.13insurance and that is used for this purpose; 19.14    (10) money held in escrow to cover employee FICA, employee tax withholding, 19.15sales tax withholding, employee worker compensation, business insurance, property rental, 19.16property taxes, and other costs that are paid at least annually, but less often than monthly; 19.17    (11) monthly assistance payments for the current month's or short-term emergency 19.18needs under section 256J.626, subdivision 2; 19.19    (12) the value of school loans, grants, or scholarships for the period they are 19.20intended to cover; 19.21    (13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 19.22in escrow for a period not to exceed three months to replace or repair personal or real 19.23property; 19.24    (14) income received in a budget month through the end of the payment month; 19.25    (15) savings from earned income of a minor child or a minor parent that are set aside 19.26in a separate account designated specifically for future education or employment costs; 19.27    (16) the federal earned income credit, Minnesota working family credit, state and 19.28federal income tax refunds, state homeowners and renters credits under chapter 290A, 19.29property tax rebates and other federal or state tax rebates in the month received and the 19.30following month; 19.31    (17) payments excluded under federal law as long as those payments are held in a 19.32separate account from any nonexcluded funds; 19.33    (18) the assets of children ineligible to receive MFIP benefits because foster care or 19.34adoption assistance payments are made on their behalf; and 19.35    (19) the assets of persons whose income is excluded under section 256J.21, 19.36subdivision 2 , clause (43). 20.1    Sec. 23. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read: 20.2    Subd. 13. Work activity. new text begin (a) new text end "Work activity" means any activity in a participant's 20.3approved employment plan that leads to employment. For purposes of the MFIP program, 20.4this includes activities that meet the definition of work activity under the participation 20.5requirements of TANF. Work activity includes: 20.6    (1) unsubsidized employment, including work study and paid apprenticeships or 20.7internships; 20.8    (2) subsidized private sector or public sector employment, including grant diversion 20.9as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid 20.10work experience, and supported work when a wage subsidy is provided; 20.11    (3) unpaid work experience, including community service, volunteer work, 20.12the community work experience program as specified in section 256J.67, unpaid 20.13apprenticeships or internships, and supported work when a wage subsidy is not provided. 20.14Unpaid work experience is only an option if the participant has been unable to obtain or 20.15maintain paid employment in the competitive labor market, and no paid work experience 20.16programs are available to the participant. Prior to placing a participant in unpaid work, 20.17the county must inform the participant that the participant will be notified if a paid work 20.18experience or supported work position becomes available. Unless a participant consents in 20.19writing to participate in unpaid work experience, the participant's employment plan may 20.20only include unpaid work experience if including the unpaid work experience in the plan 20.21will meet the following criteria: 20.22    (i) the unpaid work experience will provide the participant specific skills or 20.23experience that cannot be obtained through other work activity options where the 20.24participant resides or is willing to reside; and 20.25    (ii) the skills or experience gained through the unpaid work experience will result 20.26in higher wages for the participant than the participant could earn without the unpaid 20.27work experience; 20.28    (4) job search including job readiness assistance, job clubs, job placement, 20.29job-related counseling, and job retention services; 20.30    (5) job readiness education, including English as a second language (ESL) or 20.31functional work literacy classes as limited by the provisions of section 256J.531, 20.32subdivision 2 , general educational development (GED) course work, high school 20.33completion, and adult basic education as limited by the provisions of section 256J.531, 20.34subdivision 1 ; 21.1    (6) job skills training directly related to employment, including education and 21.2training that can reasonably be expected to lead to employment, as limited by the 21.3provisions of section 256J.53; 21.4    (7) providing child care services to a participant who is working in a community 21.5service program; 21.6    (8) activities included in the employment plan that is developed under section 21.7256J.521, subdivision 3 ; and 21.8    (9) preemployment activities including chemical and mental health assessments, 21.9treatment, and services; learning disabilities services; child protective services; family 21.10stabilization services; or other programs designed to enhance employability. 21.11 new text begin (b) "Work activity" does not include activities done for political purposes as defined new text end 21.12 new text begin in section 211B.01, subdivision 6. new text end 21.13    Sec. 24. Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read: 21.14    Subd. 2. Approval of postsecondary education or training. (a) In order for a 21.15postsecondary education or training program to be an approved activity in an employment 21.16plan, the plan must include additional work activities if the education and training 21.17activities do not meet the minimum hours required to meet the federal work participation 21.18rate under Code of Federal Regulations, title 45, sections and new text begin participant new text end 21.19 new text begin must be working in unsubsidized employment at least 20 hours per week new text end . 21.20    (b) Participants seeking approval of a postsecondary education or training plan 21.21must provide documentation that: 21.22    (1) the employment goal can only be met with the additional education or training; 21.23    (2) there are suitable employment opportunities that require the specific education or 21.24training in the area in which the participant resides or is willing to reside; 21.25    (3) the education or training will result in significantly higher wages for the 21.26participant than the participant could earn without the education or training; 21.27    (4) the participant can meet the requirements for admission into the program; and 21.28    (5) there is a reasonable expectation that the participant will complete the training 21.29program based on such factors as the participant's MFIP assessment, previous education, 21.30training, and work history; current motivation; and changes in previous circumstances. 21.31 new text begin (c) The hourly unsubsidized employment requirement does not apply for intensive new text end 21.32 new text begin education or training programs lasting 12 weeks or less when full-time attendance is new text end 21.33 new text begin required. new text end 21.34    Sec. 25. Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read: 22.1    Subd. 3. Juvenile treatment screening team. (a) The responsible social services 22.2agency shall establish a juvenile treatment screening team to conduct screenings and 22.3prepare case plans under this subdivision new text begin section 245.487, subdivision 3, and chapters new text end 22.4 new text begin 260C and 260D. Screenings shall be conducted within 15 days of a request for a screening new text end . 22.5The team, which may be the team constituted under section 245.4885 or 256B.092 or 22.6Minnesota Rules, parts 9530.6600 to 9530.6655, shall consist of social workers, juvenile 22.7justice professionals, and persons with expertise in the treatment of juveniles who are 22.8emotionally disabled, chemically dependent, or have a developmental disability. The team 22.9shall involve parents or guardians in the screening process as appropriate new text begin , and the child's new text end 22.10 new text begin parent, guardian, or permanent legal custodian under section 260C.201, subdivision 11 new text end . 22.11The team may be the same team as defined in section 260B.157, subdivision 3. 22.12(b) The social services agency shall determine whether a child brought to its 22.13attention for the purposes described in this section is an Indian child, as defined in section 22.14260C.007, subdivision 21 , and shall determine the identity of the Indian child's tribe, as 22.15defined in section 260.755, subdivision 9. When a child to be evaluated is an Indian child, 22.16the team provided in paragraph (a) shall include a designated representative of the Indian 22.17child's tribe, unless the child's tribal authority declines to appoint a representative. The 22.18Indian child's tribe may delegate its authority to represent the child to any other federally 22.19recognized Indian tribe, as defined in section 260.755, subdivision 12. 22.20(c) If the court, prior to, or as part of, a final disposition, proposes to place a child: 22.21(1) for the primary purpose of treatment for an emotional disturbance, a 22.22developmental disability, or chemical dependency in a residential treatment facility out 22.23of state or in one which is within the state and licensed by the commissioner of human 22.24services under chapter 245A; or 22.25(2) in any out-of-home setting potentially exceeding 30 days in duration, including a 22.26postdispositional placement in a facility licensed by the commissioner of corrections or 22.27human services, the court shall ascertain whether the child is an Indian child and shall 22.28notify the county welfare agency and, if the child is an Indian child, shall notify the Indian 22.29child's tribe. The county's juvenile treatment screening team must either: (i) screen and 22.30evaluate the child and file its recommendations with the court within 14 days of receipt 22.31of the notice; or (ii) elect not to screen a given case and notify the court of that decision 22.32within three working days. 22.33(d) If the screening team has elected to screen and evaluate the child, The child 22.34may not be placed for the primary purpose of treatment for an emotional disturbance, a 22.35developmental disability, or chemical dependency, in a residential treatment facility out of 23.1state nor in a residential treatment facility within the state that is licensed under chapter 23.2245A, unless one of the following conditions applies: 23.3(1) a treatment professional certifies that an emergency requires the placement 23.4of the child in a facility within the state; 23.5(2) the screening team has evaluated the child and recommended that a residential 23.6placement is necessary to meet the child's treatment needs and the safety needs of the 23.7community, that it is a cost-effective means of meeting the treatment needs, and that it 23.8will be of therapeutic value to the child; or 23.9(3) the court, having reviewed a screening team recommendation against placement, 23.10determines to the contrary that a residential placement is necessary. The court shall state 23.11the reasons for its determination in writing, on the record, and shall respond specifically 23.12to the findings and recommendation of the screening team in explaining why the 23.13recommendation was rejected. The attorney representing the child and the prosecuting 23.14attorney shall be afforded an opportunity to be heard on the matter. 23.15(e) When the county's juvenile treatment screening team has elected to screen and 23.16evaluate a child determined to be an Indian child, the team shall provide notice to the 23.17tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a 23.18member of the tribe or as a person eligible for membership in the tribe, and permit the 23.19tribe's representative to participate in the screening team. 23.20(f) When the Indian child's tribe or tribal health care services provider or Indian 23.21Health Services provider proposes to place a child for the primary purpose of treatment 23.22for an emotional disturbance, a developmental disability, or co-occurring emotional 23.23disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by 23.24the child's tribe shall submit necessary documentation to the county juvenile treatment 23.25screening team, which must invite the Indian child's tribe to designate a representative to 23.26the screening team. 23.27    Sec. 26. Minnesota Statutes 2010, section 260D.01, is amended to read: 23.28260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT. 23.29    (a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care 23.30for treatment" provisions of the Juvenile Court Act. 23.31    (b) The juvenile court has original and exclusive jurisdiction over a child in 23.32voluntary foster care for treatment upon the filing of a report or petition required under 23.33this chapter. All obligations of the agency to a child and family in foster care contained in 23.34chapter 260C not inconsistent with this chapter are also obligations of the agency with 23.35regard to a child in foster care for treatment under this chapter. 24.1    (c) This chapter shall be construed consistently with the mission of the children's 24.2mental health service system as set out in section 245.487, subdivision 3, and the duties 24.3of an agency under section 256B.092, new text begin 260C.157, new text end and Minnesota Rules, parts 9525.0004 24.4to 9525.0016, to meet the needs of a child with a developmental disability or related 24.5condition. This chapter: 24.6    (1) establishes voluntary foster care through a voluntary foster care agreement as the 24.7means for an agency and a parent to provide needed treatment when the child must be in 24.8foster care to receive necessary treatment for an emotional disturbance or developmental 24.9disability or related condition; 24.10    (2) establishes court review requirements for a child in voluntary foster care for 24.11treatment due to emotional disturbance or developmental disability or a related condition; 24.12    (3) establishes the ongoing responsibility of the parent as legal custodian to visit the 24.13child, to plan together with the agency for the child's treatment needs, to be available and 24.14accessible to the agency to make treatment decisions, and to obtain necessary medical, 24.15dental, and other care for the child; and 24.16    (4) applies to voluntary foster care when the child's parent and the agency agree that 24.17the child's treatment needs require foster care either: 24.18    (i) due to a level of care determination by the agency's screening team informed by 24.19the diagnostic and functional assessment under section 245.4885; or 24.20    (ii) due to a determination regarding the level of services needed by the responsible 24.21social services' screening team under section 256B.092, and Minnesota Rules, parts 24.229525.0004 to 9525.0016. 24.23    (d) This chapter does not apply when there is a current determination under section 24.24626.556 that the child requires child protective services or when the child is in foster care 24.25for any reason other than treatment for the child's emotional disturbance or developmental 24.26disability or related condition. When there is a determination under section 626.556 that 24.27the child requires child protective services based on an assessment that there are safety 24.28and risk issues for the child that have not been mitigated through the parent's engagement 24.29in services or otherwise, or when the child is in foster care for any reason other than 24.30the child's emotional disturbance or developmental disability or related condition, the 24.31provisions of chapter 260C apply. 24.32    (e) The paramount consideration in all proceedings concerning a child in voluntary 24.33foster care for treatment is the safety, health, and the best interests of the child. The 24.34purpose of this chapter is: 24.35    (1) to ensure a child with a disability is provided the services necessary to treat or 24.36ameliorate the symptoms of the child's disability; 25.1    (2) to preserve and strengthen the child's family ties whenever possible and in the 25.2child's best interests, approving the child's placement away from the child's parents only 25.3when the child's need for care or treatment requires it and the child cannot be maintained 25.4in the home of the parent; and 25.5    (3) to ensure the child's parent retains legal custody of the child and associated 25.6decision-making authority unless the child's parent willfully fails or is unable to make 25.7decisions that meet the child's safety, health, and best interests. The court may not find 25.8that the parent willfully fails or is unable to make decisions that meet the child's needs 25.9solely because the parent disagrees with the agency's choice of foster care facility, unless 25.10the agency files a petition under chapter 260C, and establishes by clear and convincing 25.11evidence that the child is in need of protection or services. 25.12    (f) The legal parent-child relationship shall be supported under this chapter by 25.13maintaining the parent's legal authority and responsibility for ongoing planning for the 25.14child and by the agency's assisting the parent, where necessary, to exercise the parent's 25.15ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing 25.16planning means: 25.17    (1) actively participating in the planning and provision of educational services, 25.18medical, and dental care for the child; 25.19    (2) actively planning and participating with the agency and the foster care facility 25.20for the child's treatment needs; and 25.21    (3) planning to meet the child's need for safety, stability, and permanency, and the 25.22child's need to stay connected to the child's family and community. 25.23    (g) The provisions of section 260.012 to ensure placement prevention, family 25.24reunification, and all active and reasonable effort requirements of that section apply. This 25.25chapter shall be construed consistently with the requirements of the Indian Child Welfare 25.26Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the 25.27Minnesota Indian Family Preservation Act, sections 260.751 to 260.835. 25.28    Sec. 27. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read: 25.29    Subd. 10a. Expedited issuance of food stamps. The commissioner of human 25.30services shall continually monitor the expedited issuance of food stamp benefits to ensure 25.31that each county complies with federal regulations and that households eligible for 25.32expedited issuance of food stamps are identified, processed, and certified within the time 25.33frames prescribed in federal regulations. 26.1County food stamp offices shall screen and issue food stamps to applicants on the 26.2day of application. Applicants who meet the federal criteria for expedited issuance and 26.3have an immediate need for food assistance shall receive new text begin within two working days new text end either: 26.4(1) a manual Authorization to Participate (ATP) card; or 26.5(2) the immediate issuance of food stamp coupons new text begin benefits new text end . 26.6The local food stamp agency shall conspicuously post in each food stamp office a 26.7notice of the availability of and the procedure for applying for expedited issuance and 26.8verbally advise each applicant of the availability of the expedited process. 26.9    Sec. 28. Minnesota Statutes 2010, section 518A.51, is amended to read: 26.10518A.51 FEES FOR IV-D SERVICES. 26.11    (a) When a recipient of IV-D services is no longer receiving assistance under the 26.12state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the 26.13public authority responsible for child support enforcement must notify the recipient, 26.14within five working days of the notification of ineligibility, that IV-D services will be 26.15continued unless the public authority is notified to the contrary by the recipient. The 26.16notice must include the implications of continuing to receive IV-D services, including the 26.17available services and fees, cost recovery fees, and distribution policies relating to fees. 26.18    (b) An application fee of $25 shall be paid by the person who applies for child 26.19support and maintenance collection services, except persons who are receiving public 26.20assistance as defined in section 256.741 and the diversionary work program under section 26.21256J.95 , persons who transfer from public assistance to nonpublic assistance status, and 26.22minor parents and parents enrolled in a public secondary school, area learning center, or 26.23alternative learning program approved by the commissioner of education. 26.24    (c) In the case of an individual who has never received assistance under a state 26.25program funded under Title IV-A of the Social Security Act and for whom the public 26.26authority has collected at least $500 of support, the public authority must impose an 26.27annual federal collections fee of $25 for each case in which services are furnished. This 26.28fee must be retained by the public authority from support collected on behalf of the 26.29individual, but not from the first $500 collected. 26.30    (d) When the public authority provides full IV-D services to an obligee who has 26.31applied for those services, upon written notice to the obligee, the public authority must 26.32charge a cost recovery fee of one percent of the amount collected. This fee must be 26.33deducted from the amount of the child support and maintenance collected and not assigned 26.34under section 256.741 before disbursement to the obligee. This fee does not apply to an 26.35obligee who: 27.1    (1) is currently receiving assistance under the state's title IV-A, IV-E foster care, 27.2medical assistance, or MinnesotaCare programs; or 27.3    (2) has received assistance under the state's title IV-A or IV-E foster care programs, 27.4until the person has not received this assistance for 24 consecutive months. 27.5     (e) When the public authority provides full IV-D services to an obligor who has 27.6applied for such services, upon written notice to the obligor, the public authority must 27.7charge a cost recovery fee of one percent of the monthly court-ordered child support and 27.8maintenance obligation. The fee may be collected through income withholding, as well 27.9as by any other enforcement remedy available to the public authority responsible for 27.10child support enforcement. 27.11     (f) Fees assessed by state and federal tax agencies for collection of overdue support 27.12owed to or on behalf of a person not receiving public assistance must be imposed on the 27.13person for whom these services are provided. The public authority upon written notice to 27.14the obligee shall assess a fee of $25 to the person not receiving public assistance for each 27.15successful federal tax interception. The fee must be withheld prior to the release of the 27.16funds received from each interception and deposited in the general fund. 27.17     (g) Federal collections fees collected under paragraph (c) and cost recovery 27.18fees collected under paragraphs (d) and (e) new text begin , retained by the commissioner of human new text end 27.19 new text begin services, new text end shall be considered child support program income according to Code of Federal 27.20Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund 27.21account established under paragraph (i). The commissioner of human services must elect 27.22to recover costs based on either actual or standardized costs. 27.23     (h) The limitations of this section on the assessment of fees shall not apply to 27.24the extent inconsistent with the requirements of federal law for receiving funds for the 27.25programs under Title IV-A and Title IV-D of the Social Security Act, United States Code, 27.26title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662. 27.27     (i) The commissioner of human services is authorized to establish a special revenue 27.28fund account to receive the federal collections fees collected under paragraph (c) and cost 27.29recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of 27.30these fees may be retained for expenditures necessary to administer the fees and must be 27.31transferred to the child support system special revenue account. The remaining nonfederal 27.32share of the federal collections fees and cost recovery fees must be retained by the 27.33commissioner and dedicated to the child support general fund county performance-based 27.34grant account authorized under sections and . new text begin The commissioner shall new text end 27.35 new text begin distribute the remaining nonfederal share of these fees to the counties quarterly using the new text end 27.36 new text begin methodology specified in section 256.979, subdivision 11. The funds received by the new text end 28.1 new text begin counties must be reinvested in the child support enforcement program, and the counties new text end 28.2 new text begin shall not reduce the funding of their child support programs by the amount of funding new text end 28.3 new text begin distributed. new text end 28.4    Sec. 29. new text begin GRANT PROGRAM TO PROMOTE HEALTHY COMMUNITY new text end 28.5 new text begin INITIATIVES. new text end 28.6     new text begin (a) The commissioner of human services must contract with the Search Institute to new text end 28.7 new text begin help local communities develop, expand, and maintain the tools, training, and resources new text end 28.8 new text begin needed to foster positive community development and effectively engage people in their new text end 28.9 new text begin community. The Search Institute must: (1) provide training in community mobilization, new text end 28.10 new text begin youth development, and assets getting to outcomes; (2) provide ongoing technical new text end 28.11 new text begin assistance to communities receiving grants under this section; (3) use best practices to new text end 28.12 new text begin promote community development; (4) share best program practices with other interested new text end 28.13 new text begin communities; (5) create electronic and other opportunities for communities to share new text end 28.14 new text begin experiences in and resources for promoting healthy community development; and (6) new text end 28.15 new text begin provide an annual report of the strong communities project. new text end 28.16     new text begin (b) Specifically, the Search Institute must use a competitive grant process to select new text end 28.17 new text begin four interested communities throughout Minnesota to undertake strong community new text end 28.18 new text begin mobilization initiatives to support communities wishing to catalyze multiple sectors to new text end 28.19 new text begin create or strengthen a community collaboration to address issues of poverty in their new text end 28.20 new text begin communities. The Search Institute must provide the selected communities with the new text end 28.21 new text begin tools, training, and resources they need for successfully implementing initiatives focused new text end 28.22 new text begin on strengthening the community. The Search Institute also must use a competitive new text end 28.23 new text begin grant process to provide four strong community innovation grants to encourage current new text end 28.24 new text begin community initiatives to bring new innovation approaches to their work to reduce poverty. new text end 28.25 new text begin Finally, the Search Institute must work to strengthen networking and information sharing new text end 28.26 new text begin activities among all healthy community initiatives throughout Minnesota, including new text end 28.27 new text begin sharing best program practices and providing personal and electronic opportunities for new text end 28.28 new text begin peer learning and ongoing program support. new text end 28.29 new text begin (c) In order to receive a grant under paragraph (b), a community must show new text end 28.30 new text begin involvement of at least three sectors of their community and the active leadership of both new text end 28.31 new text begin youth and adults. Sectors may include, but are not limited to, local government, schools, new text end 28.32 new text begin community action agencies, faith communities, businesses, higher education institutions, new text end 28.33 new text begin and the medical community. In addition, communities must agree to: (1) attend training new text end 28.34 new text begin on community mobilization processes and strength-based approaches; (2) apply the assets new text end 28.35 new text begin getting to outcomes process in their initiative; (3) meet at least two times during the new text end 29.1 new text begin grant period to share successes and challenges with other grantees; (4) participate on an new text end 29.2 new text begin electronic listserv to share information throughout the period on their work; and (5) all new text end 29.3 new text begin communication requirements and reporting processes. new text end 29.4     new text begin (d) The commissioner of human services must evaluate the effectiveness of this new text end 29.5 new text begin program and must recommend to the committees of the legislature with jurisdiction over new text end 29.6 new text begin health and human services reform and finance by February 15, 2013, whether or not new text end 29.7 new text begin to make the program available statewide. The Search Institute annually must report to new text end 29.8 new text begin the commissioner of human services on the services it provided and the grant money new text end 29.9 new text begin it expended under this section. new text end 29.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 29.11    Sec. 30. new text begin CIRCLES OF SUPPORT GRANTS. new text end 29.12 new text begin The commissioner of human services must provide grants to community action new text end 29.13 new text begin agencies to help local communities develop, expand, and maintain the tools, training, and new text end 29.14 new text begin resources needed to foster social assets to assist people out of poverty through circles of new text end 29.15 new text begin support. The circles of support model must provide a framework for a community to build new text end 29.16 new text begin relationships across class and race lines so that people can work together to advocate for new text end 29.17 new text begin change in their communities and move individuals toward self-sufficiency. new text end 29.18 new text begin Specifically, circles of support initiatives must focus on increasing social capital, new text end 29.19 new text begin income, educational attainment, and individual accountability, while reducing debt, new text end 29.20 new text begin service dependency, and addressing systemic disparities that hold poverty in place. The new text end 29.21 new text begin effort must support the development of local guiding coalitions as the link between the new text end 29.22 new text begin community and circles of support for resource development and funding leverage. new text end 29.23 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 29.24    Sec. 31. new text begin HOMELESS SHELTERS; SCHOOL DISTRICTS. new text end 29.25 new text begin School districts may coordinate with local units of government and homeless new text end 29.26 new text begin services providers to use empty school buildings as homeless shelters. new text end 29.27    Sec. 32. new text begin REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES, new text end 29.28 new text begin GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS. new text end 29.29 new text begin Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must new text end 29.30 new text begin negotiate with their third-party processors to block EBT card cash transactions at their new text end 29.31 new text begin places of business and withdrawals of cash at automatic teller machines located in their new text end 29.32 new text begin places of business. new text end 30.1    Sec. 33. new text begin MINNESOTA EBT BUSINESS TASK FORCE. new text end 30.2     new text begin Subdivision 1. new text end new text begin Members. new text end new text begin The Minnesota EBT Business Task Force includes seven new text end 30.3 new text begin members, appointed as follows: new text end 30.4 new text begin (1) two members of the Minnesota house of representatives, one appointed by the new text end 30.5 new text begin speaker of the house and one appointed by the minority leader; new text end 30.6 new text begin (2) two members of the Minnesota senate, one appointed by the senate majority new text end 30.7 new text begin leader and one appointed by the senate minority leader; new text end 30.8 new text begin (3) the commissioner of human services, or designee; new text end 30.9 new text begin (4) an appointee of the Minnesota Grocers Association; and new text end 30.10 new text begin (5) a credit card processor, appointed by the commissioner of human services. new text end 30.11     new text begin Subd. 2. new text end new text begin Duties. new text end new text begin The Minnesota EBT Business Task Force shall create a workable new text end 30.12 new text begin strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the new text end 30.13 new text begin general assistance program and Minnesota supplemental aid program under Minnesota new text end 30.14 new text begin Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT new text end 30.15 new text begin cards. The task force will consider cost to the state, feasibility of execution at retail, and new text end 30.16 new text begin ease of use and privacy for EBT cardholders. new text end 30.17     new text begin Subd. 3. new text end new text begin Report. new text end new text begin The task force will report back to the legislative committees with new text end 30.18 new text begin jurisdiction over health and human services policy and finance by April 1, 2012, with new text end 30.19 new text begin recommendations related to the task force duties under subdivision 2. new text end 30.20     new text begin Subd. 4. new text end new text begin Expiration. new text end new text begin The task force expires on June 30, 2012. new text end 30.21    Sec. 34. new text begin STREAMLINING CHILDREN AND COMMUNITY SERVICES ACT new text end 30.22 new text begin REPORTING REQUIREMENTS. new text end 30.23     new text begin The commissioner of human services and county human services representatives, in new text end 30.24 new text begin consultation with other interested parties, shall develop a streamlined alternative to current new text end 30.25 new text begin reporting requirements related to the Children and Community Services Act service plan. new text end 30.26 new text begin The commissioner shall submit recommendations and draft legislation to the chairs and new text end 30.27 new text begin ranking minority members of the committees having jurisdiction over human services no new text end 30.28 new text begin later than November 15, 2012. new text end 30.29    Sec. 35. new text begin REPEALER. new text end 30.30 new text begin (a) new text end new text begin Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; new text end 30.31 new text begin 256.9791; 256.9862, subdivision 2; and 256D.46, subdivisions 2 and 3, new text end new text begin are repealed. new text end 30.32 new text begin (b) new text end new text begin Minnesota Rules, parts 3400.0130, subpart 8; and 9500.1261, subparts 3, items D new text end 30.33 new text begin and E, 4, and 5, new text end new text begin are repealed effective September 3, 2012. new text end 31.1ARTICLE 2 31.2DEPARTMENT OF HEALTH 31.3    Section 1. Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended to read: 31.4    Subd. 7. Consistent administrative expenses and investment income reporting. 31.5(a) Every health maintenance organization must directly allocate administrative expenses 31.6to specific lines of business or products when such information is available. new text begin The definition new text end 31.7 new text begin of administrative expenses must be consistent with that of the National Association of new text end 31.8 new text begin Insurance Commissioners (NAIC) as provided in the most current NAIC blank. new text end Remaining 31.9expenses that cannot be directly allocated must be allocated based on other methods, as 31.10recommended by the Advisory Group on Administrative Expenses. Health maintenance 31.11organizations must submit this information, including administrative expenses for dental 31.12services, using the reporting template provided by the commissioner of health. 31.13(b) Every health maintenance organization must allocate investment income based 31.14on cumulative net income over time by business line or product and must submit this 31.15information, including investment income for dental services, using the reporting template 31.16provided by the commissioner of health. 31.17    Sec. 2. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read: 31.18    Subd. 3. Cost containment duties. The commissioner shall: 31.19(1) establish statewide and regional cost containment goals for total health care 31.20spending under this section and collect data as described in sections 62J.38 to new text begin and new text end 31.21 new text begin 62J.40 new text end to monitor statewide achievement of the cost containment goals; 31.22(2) divide the state into no fewer than four regions, with one of those regions being 31.23the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 31.24Wright, and Sherburne Counties, for purposes of fostering the development of regional 31.25health planning and coordination of health care delivery among regional health care 31.26systems and working to achieve the cost containment goals; 31.27(3) monitor the quality of health care throughout the state and take action as 31.28necessary to ensure an appropriate level of quality; 31.29(4) issue recommendations regarding uniform billing forms, uniform electronic 31.30billing procedures and data interchanges, patient identification cards, and other uniform 31.31claims and administrative procedures for health care providers and private and public 31.32sector payers. In developing the recommendations, the commissioner shall review the 31.33work of the work group on electronic data interchange (WEDI) and the American National 31.34Standards Institute (ANSI) at the national level, and the work being done at the state and 32.1local level. The commissioner may adopt rules requiring the use of the Uniform Bill 32.282/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 32.3version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 32.4forms or procedures; 32.5(5) undertake health planning responsibilities; 32.6(6) authorize, fund, or promote research and experimentation on new technologies 32.7and health care procedures; 32.8(7) within the limits of appropriations for these purposes, administer or contract for 32.9statewide consumer education and wellness programs that will improve the health of 32.10Minnesotans and increase individual responsibility relating to personal health and the 32.11delivery of health care services, undertake prevention programs including initiatives to 32.12improve birth outcomes, expand childhood immunization efforts, and provide start-up 32.13grants for worksite wellness programs; 32.14(8) undertake other activities to monitor and oversee the delivery of health care 32.15services in Minnesota with the goal of improving affordability, quality, and accessibility of 32.16health care for all Minnesotans; and 32.17(9) make the cost containment goal data available to the public in a 32.18consumer-oriented manner. 32.19 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 32.20    Sec. 3. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read: 32.21    Subd. 4a. Expenditure reporting. Each hospital, outpatient surgical center, 32.22diagnostic imaging center, and physician clinic shall report annually to the commissioner 32.23on all major spending commitments, in the form and manner specified by the 32.24commissioner. The report shall include the following information: 32.25    (a) a description of major spending commitments made during the previous year, 32.26including the total dollar amount of major spending commitments and purpose of the 32.27expenditures; 32.28    (b) the cost of land acquisition, construction of new facilities, and renovation of 32.29existing facilities; 32.30    (c) the cost of purchased or leased medical equipment, by type of equipment; 32.31    (d) expenditures by type for specialty care and new specialized services; 32.32    (e) information on the amount and types of added capacity for diagnostic imaging 32.33services, outpatient surgical services, and new specialized services; and 32.34    (f) information on investments in electronic medical records systems. 33.1For hospitals and outpatient surgical centers, this information shall be included in reports 33.2to the commissioner that are required under section 144.698. For diagnostic imaging 33.3centers, this information shall be included in reports to the commissioner that are required 33.4under section 144.565. For physician clinics, this information shall be included in reports 33.5to the commissioner that are required under section . For all other health care 33.6providers that are subject to this reporting requirement, reports must be submitted to the 33.7commissioner by March 1 each year for the preceding calendar year. 33.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 33.9    Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 33.10to read: 33.11     new text begin Subd. 7. new text end new text begin Exemption. new text end new text begin Any clinical practice with a total annual net revenue of less new text end 33.12 new text begin than $500,000, and that has not received a state or federal grant for implementation new text end 33.13 new text begin of electronic health records, is exempt from the requirements of subdivision 1. This new text end 33.14 new text begin subdivision expires December 31, 2020. new text end 33.15    Sec. 5. Minnesota Statutes 2010, section 62J.497, is amended by adding a subdivision 33.16to read: 33.17     new text begin Subd. 6. new text end new text begin Additional standards for electronic prescribing. new text end new text begin By January 1, 2012, new text end 33.18 new text begin the commissioner of health, in consultation with the Minnesota e-Health Advisory new text end 33.19 new text begin Committee, must develop a method for incorporation of the following transactions into the new text end 33.20 new text begin requirements and standards for electronic prescribing provided in subdivisions 2 and 3: new text end 33.21 new text begin (1) submission of requests for a formulary exception based on information required new text end 33.22 new text begin on the form developed according to subdivision 4; and new text end 33.23 new text begin (2) submission of prior authorization requests based on information required on the new text end 33.24 new text begin form developed according to subdivision 5. new text end 33.25    Sec. 6. Minnesota Statutes 2010, section 62J.692, is amended to read: 33.2662J.692 MEDICAL EDUCATION. 33.27    Subdivision 1. Definitions. For purposes of this section, the following definitions 33.28apply: 33.29    (a) "Accredited clinical training" means the clinical training provided by a 33.30medical education program that is accredited through an organization recognized by the 33.31Department of Education, the Centers for Medicare and Medicaid Services, or another 33.32national body who reviews the accrediting organizations for multiple disciplines and 34.1whose standards for recognizing accrediting organizations are reviewed and approved by 34.2the commissioner of health in consultation with the Medical Education and Research 34.3Advisory Committee. 34.4    (b) "Commissioner" means the commissioner of health. 34.5    (c) "Clinical medical education program" means the accredited clinical training of 34.6physicians (medical students and residents), doctor of pharmacy practitioners, doctors 34.7of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 34.8registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 34.9physician assistants. 34.10    (d) "Sponsoring institution" means a hospital, school, or consortium located in 34.11Minnesota that sponsors and maintains primary organizational and financial responsibility 34.12for a clinical medical education program in Minnesota and which is accountable to the 34.13accrediting body. 34.14    (e) "Teaching institution" means a hospital, medical center, clinic, or other 34.15organization that conducts a clinical medical education program in Minnesota. 34.16    (f) "Trainee" means a student or resident involved in a clinical medical education 34.17program. 34.18    (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time 34.19equivalent counts, that are at training sites located in Minnesota with currently active 34.20medical assistance enrollment status and a National Provider Identification (NPI) number 34.21where training occurs in either an inpatient or ambulatory patient care setting and where 34.22the training is funded, in part, by patient care revenues. Training that occurs in nursing 34.23facility settings is not eligible for funding under this section. 34.24    Subd. 3. Application process. (a) A clinical medical education program conducted 34.25in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, 34.26dentists, new text begin advanced dental therapists, new text end chiropractors, or physician assistants is eligible for 34.27funds under subdivision 4 new text begin or 11, as appropriate, new text end if the program: 34.28(1) is funded, in part, by patient care revenues; 34.29(2) occurs in patient care settings that face increased financial pressure as a result of 34.30competition with nonteaching patient care entities new text begin training activities new text end ; and 34.31(3) emphasizes primary care or specialties that are in undersupply in Minnesota new text begin in new text end 34.32 new text begin rural areas or for racial, ethnic, or cultural populations in the state experiencing health new text end 34.33 new text begin disparities new text end . 34.34A clinical medical education program that trains pediatricians is requested to include 34.35in its program curriculum training in case management and medication management for 34.36children suffering from mental illness to be eligible for funds under subdivision 4. 35.1(b) A clinical medical education program for advanced practice nursing new text begin , registered new text end 35.2 new text begin nurses, or licensed practical nurses new text end is eligible for funds under subdivision 4 new text begin or 11, as new text end 35.3 new text begin appropriate, new text end if the program meets the eligibility requirements in paragraph (a), clauses 35.4(1) to (3), and is sponsored by the University of Minnesota Academic Health Center, 35.5the Mayo Foundation, or institutions that are part of the Minnesota State Colleges and 35.6Universities system or members of the Minnesota Private College Council. 35.7(c) Applications must be submitted to the commissioner by a sponsoring institution 35.8on behalf of an eligible clinical medical education program and must be received by 35.9October 31 of each year for distribution in the following year. An application for funds 35.10must contain the following information: 35.11(1) the official name and address of the sponsoring institution and the official 35.12name and site address of the clinical medical education programs on whose behalf the 35.13sponsoring institution is applying; 35.14(2) the name, title, and business address of those persons responsible for 35.15administering the funds; 35.16(3) for each clinical medical education program for which funds are being sought; 35.17the type and specialty orientation of trainees in the program; the name, site address, and 35.18medical assistance provider number new text begin or National Provider Identification number (NPI) new text end of 35.19each training site used in the program; the total number of trainees at each training site; 35.20and the total number of eligible trainee FTEs at each site; and 35.21(4) other supporting information the commissioner deems necessary to determine 35.22program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the 35.23equitable new text begin appropriate new text end distribution of funds. 35.24(d) An application must include the information specified in clauses (1) to (3) for 35.25each clinical medical education program on an annual basis for three consecutive years. 35.26After that time, an application must include the information specified in clauses (1) to (3) 35.27when requested, at the discretion of the commissioner: 35.28(1) audited clinical training costs per trainee for each clinical medical education 35.29program when available or estimates of clinical training costs based on audited financial 35.30data; 35.31(2) a description of current sources of funding for clinical medical education costs, 35.32including a description and dollar amount of all state and federal financial support, 35.33including Medicare direct and indirect payments; and 35.34(3) other revenue received for the purposes of clinical training. 35.35(e) An applicant that does not provide information requested by the commissioner 35.36shall not be eligible for funds for the current funding cycle. 36.1    Subd. 4. Distribution of funds. (a) Following the distribution described under 36.2paragraph (b), the commissioner shall annually distribute the available medical education 36.3funds to all qualifying applicants based on a distribution formula that reflects a summation 36.4of two factors: 36.5    (1) a public program volume factor, which is determined by the total volume of 36.6public program revenue received by each training site as a percentage of all public 36.7program revenue received by all training sites in the fund pool; and new text begin . new text end 36.8    (2) a supplemental public program volume factor, which is determined by providing 36.9a supplemental payment of 20 percent of each training site's grant to training sites whose 36.10public program revenue accounted for at least 0.98 percent of the total public program 36.11revenue received by all eligible training sites. Grants to training sites whose public 36.12program revenue accounted for less than 0.98 percent of the total public program revenue 36.13received by all eligible training sites shall be reduced by an amount equal to the total 36.14value of the supplemental payment. 36.15    Public program revenue for the distribution formula includes revenue from medical 36.16assistance, prepaid medical assistance, general assistance medical care, and prepaid 36.17general assistance medical care. Training sites that receive no public program revenue 36.18are ineligible for funds available under this subdivision. For purposes of determining 36.19training-site level grants to be distributed under paragraph (a), total statewide average 36.20costs per trainee for medical residents is based on audited clinical training costs per trainee 36.21in primary care clinical medical education programs for medical residents. Total statewide 36.22average costs per trainee for dental residents is based on audited clinical training costs 36.23per trainee in clinical medical education programs for dental students. Total statewide 36.24average costs per trainee for pharmacy residents is based on audited clinical training costs 36.25per trainee in clinical medical education programs for pharmacy students. new text begin Training sites new text end 36.26 new text begin whose training-site level grant is less than $1,000, based on the formula described in this new text end 36.27 new text begin paragraph, are ineligible for funds available under this subdivision. new text end 36.28    (b) $5,350,000 new text begin $4,900,000 new text end of the available medical education funds new text begin in fiscal year new text end 36.29 new text begin 2012 and $3,044,000 beginning in fiscal year 2013 new text end shall be distributed new text begin to fund training new text end 36.30 new text begin designed to address health disparities new text end as follows: 36.31    (1) $1,475,000 new text begin $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year new text end 36.32 new text begin 2013 new text end to the University of Minnesota Medical Center-Fairview new text begin the White Earth Band of new text end 36.33 new text begin Ojibwe Indians according to section 145.9271 new text end ; 36.34    (2) $2,075,000 new text begin $600,000 in fiscal year 2012 and $200,000 beginning in fiscal new text end 36.35 new text begin year 2013 new text end to the University of Minnesota School of Dentistry new text begin University of Minnesota new text end 36.36 new text begin according to section 137.395 new text end ; and 37.1 new text begin (3) $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year 2013 shall new text end 37.2 new text begin be distributed to the community health centers development grants program according new text end 37.3 new text begin to section 145.987; new text end 37.4 new text begin (4) $500,000 in fiscal year 2012 and $200,000 beginning in fiscal year 2013 shall be new text end 37.5 new text begin distributed to the community mental health centers grant program according to section new text end 37.6 new text begin 145.9272; new text end 37.7 new text begin (5) $1,000,000 in fiscal year 2012 and $444,000 beginning in fiscal year 2013 shall new text end 37.8 new text begin be distributed to the health careers opportunities grant program according to section new text end 37.9 new text begin 144.1499; and new text end 37.10    (3) new text begin (6) new text end $1,800,000 to the Academic Health Center. $150,000 of the funds distributed 37.11to the Academic Health Center under this paragraph shall be used for a program to assist 37.12internationally trained physicians who are legal residents and who commit to serving 37.13underserved Minnesota communities in a health professional shortage area to successfully 37.14compete for family medicine residency programs at the University of Minnesota. 37.15    (c) Funds distributed shall not be used to displace current funding appropriations 37.16from federal or state sources. 37.17    (d) Funds shall be distributed to the sponsoring institutions indicating the amount 37.18to be distributed to each of the sponsor's clinical medical education programs based on 37.19the criteria in this subdivision and in accordance with the commissioner's approval letter. 37.20Each clinical medical education program must distribute funds allocated under paragraph 37.21(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 37.22institutions, which are accredited through an organization recognized by the Department 37.23of Education or the Centers for Medicare and Medicaid Services, may contract directly 37.24with training sites to provide clinical training. To ensure the quality of clinical training, 37.25those accredited sponsoring institutions must: 37.26    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical 37.27training conducted at sites; and 37.28    (2) take necessary action if the contract requirements are not met. Action may 37.29include the withholding of payments under this section or the removal of students from 37.30the site. 37.31    (e) Any funds not distributed in accordance with the commissioner's approval letter 37.32must be returned to the medical education and research fund within 30 days of receiving 37.33notice from the commissioner. The commissioner shall distribute returned funds to the 37.34appropriate training sites in accordance with the commissioner's approval letter. 38.1    (f) A maximum of $150,000 of the funds dedicated to the commissioner under 38.2section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 38.3administrative expenses associated with implementing this section. 38.4    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section 38.5must sign and submit a medical education grant verification report (GVR) to verify that 38.6the correct grant amount was forwarded to each eligible training site. If the sponsoring 38.7institution fails to submit the GVR by the stated deadline, or to request and meet 38.8the deadline for an extension, the sponsoring institution is required to return the full 38.9amount of funds received to the commissioner within 30 days of receiving notice from 38.10the commissioner. The commissioner shall distribute returned funds to the appropriate 38.11training sites in accordance with the commissioner's approval letter. 38.12    (b) The reports must provide verification of the distribution of the funds and must 38.13include: 38.14    (1) the total number of eligible trainee FTEs in each clinical medical education 38.15program; 38.16    (2) the name of each funded program and, for each program, the dollar amount 38.17distributed to each training site; 38.18    (3) documentation of any discrepancies between the initial grant distribution notice 38.19included in the commissioner's approval letter and the actual distribution; 38.20    (4) a statement by the sponsoring institution stating that the completed grant 38.21verification report is valid and accurate; and 38.22    (5) other information the commissioner, with advice from the advisory committee, 38.23deems appropriate to evaluate the effectiveness of the use of funds for medical education. 38.24    (c) By February 15 of each year, the commissioner, with advice from the 38.25advisory committee, shall provide an annual summary report to the legislature on the 38.26implementation of this section. 38.27    Subd. 6. Other available funds. The commissioner is authorized to distribute, in 38.28accordance with subdivision 4, funds made available through: 38.29(1) voluntary contributions by employers or other entities; 38.30(2) allocations for the commissioner of human services to support medical education 38.31and research; and 38.32(3) other sources as identified and deemed appropriate by the legislature for 38.33inclusion in the fund. 38.34    Subd. 7. Transfers from the commissioner of human services. Of the amount 38.35transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), 38.36$21,714,000 shall be distributed as follows: 39.1(1) $2,157,000 shall be distributed by the commissioner to the University of 39.2Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40; 39.3(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 39.4Medical Center for clinical medical education; 39.5(3) $17,400,000 shall be distributed by the commissioner to the University of 39.6Minnesota Board of Regents for purposes of medical education; 39.7(4) $1,121,640 new text begin $1,021,640 new text end shall be distributed by the commissioner to clinical 39.8medical education dental innovation grants in accordance with subdivision 7a; and 39.9(5) new text begin $100,000 shall be distributed to the health careers opportunities grant program new text end 39.10 new text begin according to section 144.1499; and new text end 39.11 new text begin (6) new text end the remainder of the amount transferred according to section 256B.69, 39.12subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 39.13clinical medical education programs that meet the qualifications of subdivision 3 based on 39.14the formula in subdivision 4, paragraph (a) new text begin , or subdivision 11, as appropriate new text end . 39.15    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner 39.16shall award grants to teaching institutions and clinical training sites for projects that new text begin new text end 39.17 new text begin provide training to new text end increase dental access for underserved populations and promote 39.18innovative clinical training of dental professionals new text begin and for racial, ethnic, or cultural new text end 39.19 new text begin populations in the state experiencing health disparities new text end . In awarding the grants, the 39.20commissioner, in consultation with the commissioner of human services, shall consider 39.21the following: 39.22(1) potential to successfully increase access to an underserved population; 39.23(2) the long-term viability of the project to improve access beyond the period 39.24of initial funding; 39.25(3) evidence of collaboration between the applicant and local communities; new text begin and new text end 39.26(4) the efficiency in the use of the funding; and 39.27(5) new text begin (3) new text end the priority level of the project in relation to state clinical education, access, 39.28and new text begin health disparity new text end workforce goals. 39.29(b) The commissioner shall periodically evaluate the priorities in awarding the 39.30innovations grants in order to ensure that the priorities meet the changing workforce 39.31needs of the state. 39.32    Subd. 8. Federal financial participation. The commissioner of human services 39.33shall seek to maximize federal financial participation in payments for medical education 39.34and research costs. 40.1    The commissioner shall use physician clinic rates where possible to maximize 40.2federal financial participation. Any additional funds that become available must be 40.3distributed under subdivision 4, paragraph (a) new text begin , or 11, as appropriate new text end . 40.4    Subd. 9. Review of eligible providers. The commissioner and the Medical 40.5Education and Research Costs Advisory Committee may review provider groups included 40.6in the definition of a clinical medical education program to assure that the distribution of 40.7the funds continue to be consistent with the purpose of this section. The results of any 40.8such reviews must be reported to the Legislative Commission on Health Care Access. 40.9     new text begin Subd. 11. new text end new text begin Distribution of funds. new text end new text begin (a) Upon receiving federal approval, the new text end 40.10 new text begin commissioner shall annually distribute the available medical education funds to all new text end 40.11 new text begin qualifying applicants based on the following distribution formula, which supersedes the new text end 40.12 new text begin formula described in subdivision 4, paragraphs (a) and (b): new text end 40.13 new text begin (1) funds received pursuant to section 297F.10 shall be distributed to eligible clinical new text end 40.14 new text begin training sites using a public program volume factor, which is determined by the total new text end 40.15 new text begin volume of public program revenue received by each eligible training site as a percentage new text end 40.16 new text begin of all public program revenue received by all eligible training sites in the fund pool. Only new text end 40.17 new text begin clinical training that occurs in a hospital that reports financial, utilization, and services new text end 40.18 new text begin data to the commissioner of health, pursuant to sections 144.564 and 144.695 to 144.703 new text end 40.19 new text begin and Minnesota Rules, chapter 4650, is eligible for funding under this clause; and new text end 40.20 new text begin (2) funds transferred according to section 256B.69, subdivision 5c, paragraph (a), new text end 40.21 new text begin clauses (1) to (4), shall be distributed to eligible training sites based on the total number of new text end 40.22 new text begin eligible trainee FTEs and the total statewide average costs per FTE, by type of trainee, in new text end 40.23 new text begin each clinical medical education program. The number of eligible trainee FTEs for funds new text end 40.24 new text begin distributed under this clause is determined using the following steps: new text end 40.25 new text begin (i) each FTE trainee from an advanced practice nursing, physician assistant, family new text end 40.26 new text begin medicine, internal medicine, general pediatrics, or psychiatry program is weighted at 1.25. new text end 40.27 new text begin Each FTE trainee from any other eligible training program is weighted at 1.0; new text end 40.28 new text begin (ii) each FTE trainee at a clinical training site located in an isolated rural area new text end 40.29 new text begin according to the four category classification of the Rural Urban Commuting Area (RUCA) new text end 40.30 new text begin system developed for the United States Health Resources and Services Administration new text end 40.31 new text begin shall be weighted at the weight in item (i) multiplied by 1.5; each FTE trainee at a clinical new text end 40.32 new text begin training site located in a small rural area according to the RUCA system shall be weighted new text end 40.33 new text begin at the weight in item (i) multiplied by 1.25; each FTE trainee at a clinical training site new text end 40.34 new text begin located in a large rural area according to the RUCA system shall be weighted at the weight new text end 40.35 new text begin in item (i) multiplied by 1.1; and each FTE trainee at a clinical training site located in an new text end 41.1 new text begin urban area according to the RUCA system shall be weighted at the weight in item (i) new text end 41.2 new text begin multiplied by 1.0; new text end 41.3 new text begin (iii) each FTE trainee at a clinical training site that is a hospital eligible for funding new text end 41.4 new text begin under clause (1) shall be weighted at the weight in item (ii) multiplied by 0.85; and each new text end 41.5 new text begin FTE trainee at a clinical training site that is an ambulatory, nursing home, or other eligible new text end 41.6 new text begin nonhospital setting shall be weighted at the weight in item (ii) multiplied by 1.15; and new text end 41.7 new text begin (iv) grants to hospitals under this item are limited to a percentage share of the total new text end 41.8 new text begin pool of funds available under this item that is no more than 1.5 times the percentage of the new text end 41.9 new text begin hospital's total revenue that comes from public programs. Grants to hospitals in excess of new text end 41.10 new text begin this amount will be redistributed to other sites eligible for funding under this item. Each new text end 41.11 new text begin eligible clinical training site's grant under this item will be calculated by multiplying the new text end 41.12 new text begin training site's adjusted FTE count upon completion of items (i) to (iv) by the statewide new text end 41.13 new text begin average cost per trainee for each provider type to determine an adjusted clinical training new text end 41.14 new text begin cost for each site. The grant to each eligible clinical training site under this item shall new text end 41.15 new text begin equal that site's share of total adjusted clinical training costs for all eligible training sites new text end 41.16 new text begin receiving funding under this item. Any clinical training site with fewer than 0.1 FTE new text end 41.17 new text begin eligible trainees from all programs upon completion of items (i) to (iv) and any clinical new text end 41.18 new text begin training site that would receive less than a cumulative $1,000 under clauses (1) and (2) new text end 41.19 new text begin will be eliminated from the distribution. new text end 41.20 new text begin (b) Public program revenue for the distribution formula includes revenue for the new text end 41.21 new text begin relevant MERC reporting period from medical assistance, prepaid medical assistance, new text end 41.22 new text begin general assistance medical care, MinnesotaCare, and prepaid general assistance medical new text end 41.23 new text begin care, as reported to the Department of Health pursuant to sections 144.562, 144.564, new text end 41.24 new text begin and 144.695 to 144.703 and Minnesota Rules, chapter 4650, by December 31 of the new text end 41.25 new text begin year in which the MERC application is submitted. Training sites that receive no public new text end 41.26 new text begin program revenue are ineligible for funds available under this subdivision. For purposes new text end 41.27 new text begin of determining training-site level grants to be distributed under paragraph (a), clause new text end 41.28 new text begin (2), total statewide average costs per trainee for medical residents is based on audited new text end 41.29 new text begin clinical training costs per trainee in primary care clinical medical education programs for new text end 41.30 new text begin medical residents. Total statewide average costs per trainee for dental residents is based new text end 41.31 new text begin on audited clinical training costs per trainee in clinical medical education programs for new text end 41.32 new text begin dental students. Total statewide average costs per trainee for pharmacy residents is based new text end 41.33 new text begin on audited clinical training costs per trainee in clinical medical education programs for new text end 41.34 new text begin pharmacy students. new text end 42.1    Sec. 7. new text begin [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING new text end 42.2 new text begin MEASURES. new text end 42.3     new text begin Subdivision 1. new text end new text begin Data from providers. new text end new text begin (a) By July 1, 2012, the commissioner new text end 42.4 new text begin shall review currently available quality measures and make recommendations for future new text end 42.5 new text begin measurement aimed at improving assessment and care related to Alzheimer's disease and new text end 42.6 new text begin other dementia diagnoses, including improved rates and results of cognitive screening, new text end 42.7 new text begin rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment new text end 42.8 new text begin plans. new text end 42.9 new text begin (b) The commissioner may contract with a private entity to complete the new text end 42.10 new text begin requirements in this subdivision. If the commissioner contracts with a private entity new text end 42.11 new text begin already under contract through section 62U.02, then the commissioner may use a sole new text end 42.12 new text begin source contract and is exempt from competitive procurement processes. new text end 42.13     new text begin Subd. 2. new text end new text begin Learning collaborative. new text end new text begin By July 1, 2012, the commissioner shall new text end 42.14 new text begin develop a health care home learning collaborative curriculum that includes screening and new text end 42.15 new text begin education on best practices regarding identification and management of Alzheimer's and new text end 42.16 new text begin other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, new text end 42.17 new text begin care coordinators, clinic administrators, patient partners and families, and community new text end 42.18 new text begin resources including public health. new text end 42.19     new text begin Subd. 3. new text end new text begin Comparison data. new text end new text begin The commissioner, with the commissioner of human new text end 42.20 new text begin services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly new text end 42.21 new text begin review existing and forthcoming literature in order to estimate differences in the outcomes new text end 42.22 new text begin and costs of current practices for caring for those with Alzheimer's disease and other new text end 42.23 new text begin dementias, compared to the outcomes and costs resulting from: new text end 42.24 new text begin (1) earlier identification of Alzheimer's and other dementias; new text end 42.25 new text begin (2) improved support of family caregivers; and new text end 42.26 new text begin (3) improved collaboration between medical care management and community-based new text end 42.27 new text begin supports. new text end 42.28     new text begin Subd. 4. new text end new text begin Reporting. new text end new text begin By January 15, 2013, the commissioner must report to the new text end 42.29 new text begin legislature on progress toward establishment and collection of quality measures required new text end 42.30 new text begin under this section. new text end 42.31    Sec. 8. new text begin [137.395] EDUCATION AND TRAINING FOR HEALTH DISPARITY new text end 42.32 new text begin POPULATIONS. new text end 42.33     new text begin Subdivision 1. new text end new text begin Condition. new text end new text begin If the Board of Regents accepts the amount transferred new text end 42.34 new text begin under section 62J.692, subdivision 4, paragraph (b), clause (2), then it must be used for the new text end 42.35 new text begin purposes provided in this section. new text end 43.1     new text begin Subd. 2. new text end new text begin Purpose. new text end new text begin The Board of Regents, through the Academic Health Center, new text end 43.2 new text begin is required to implement a scholarship program in order to increase the number of new text end 43.3 new text begin graduates of the Academic Health Center programs who are from racial, ethnic, or cultural new text end 43.4 new text begin populations in the state that experience health disparities. new text end 43.5     new text begin Subd. 3. new text end new text begin Scholarships. new text end new text begin The Board of Regents is required to provide full new text end 43.6 new text begin scholarships to Academic Health Center programs for students who are from racial, ethnic, new text end 43.7 new text begin or cultural populations that experience health disparities. One-third of the scholarship new text end 43.8 new text begin funding available under this program must go to students at the University of Minnesota, new text end 43.9 new text begin Medical School, Duluth. new text end 43.10    Sec. 9. Minnesota Statutes 2010, section 144.05, is amended by adding a subdivision 43.11to read: 43.12     new text begin Subd. 6. new text end new text begin Elimination of certain provider reporting requirements; sunset of new new text end 43.13 new text begin requirements. new text end new text begin (a) Notwithstanding any other law, rule, or provision to the contrary, new text end 43.14 new text begin effective July 1, 2012, the commissioner shall cease collecting from health care providers new text end 43.15 new text begin and purchasers all reports and data related to health care costs, quality, utilization, access, new text end 43.16 new text begin patient encounters, and disease surveillance and public health, and related to provider new text end 43.17 new text begin licensure, monitoring, finances, and regulation, unless the reports or data are necessary for new text end 43.18 new text begin federal compliance. For purposes of this subdivision, the term "health care providers and new text end 43.19 new text begin purchasers" has the meaning provided in section 62J.03, subdivision 8, except that it also new text end 43.20 new text begin includes nursing homes, health plan companies as defined in section 62Q.01, subdivision new text end 43.21 new text begin 4, and managed care and county-based purchasing plans delivering services under sections new text end 43.22 new text begin 256B.69 and 256B.692. new text end 43.23 new text begin (b) The commissioner shall present to the 2012 legislature draft legislation to repeal, new text end 43.24 new text begin effective July 1, 2012, the provider reporting requirements identified under paragraph (a) new text end 43.25 new text begin that are not necessary for federal compliance. new text end 43.26 new text begin (c) The commissioner may establish new provider reporting requirements to take new text end 43.27 new text begin effect on or after July 1, 2012. These new reporting requirements must sunset five years new text end 43.28 new text begin from their effective date, unless they are renewed by the commissioner. All new provider new text end 43.29 new text begin reporting requirements and requests for their renewal shall not take effect unless they new text end 43.30 new text begin are enacted in state law. new text end 43.31    Sec. 10. Minnesota Statutes 2010, section 144.1499, is amended to read: 43.32144.1499 PROMOTION OF HEALTH CARE AND LONG-TERM CARE 43.33CAREERS new text begin HEALTH CAREERS OPPORTUNITIES GRANT PROGRAM new text end . 44.1     new text begin Subdivision. 1. new text end new text begin Program. new text end The commissioner of health, in consultation with 44.2an organization representing health care employers, long-term care employers, and 44.3educational institutions, may make grants to qualifying consortia as defined in section 44.4116L.11, subdivision 4, for intergenerational programs to encourage middle and high 44.5school students to work and volunteer in health care and long-term care settings. 44.6To qualify for a grant under this section, a consortium shall: new text begin health care employers, new text end 44.7 new text begin educational institutions, and related organizations for eligible activities intended to new text end 44.8 new text begin increase the number of people from racial, ethnic, or cultural populations that experience new text end 44.9 new text begin health disparities who are entering health careers in Minnesota. new text end 44.10(1) develop a health and long-term care careers curriculum that provides career 44.11exploration and training in national skill standards for health care and long-term care and 44.12that is consistent with Minnesota graduation standards and other related requirements; 44.13(2) offer programs for high school students that provide training in health and 44.14long-term care careers with credits that articulate into postsecondary programs; and 44.15(3) provide technical support to the participating health care and long-term care 44.16employer to enable the use of the employer's facilities and programs for kindergarten to 44.17grade 12 health and long-term care careers education. 44.18     new text begin Subd. 2. new text end new text begin Eligible activities. new text end new text begin Eligible activities must focus on students from racial, new text end 44.19 new text begin ethnic, or cultural populations experiencing health disparities. Eligible activities include new text end 44.20 new text begin the following: new text end 44.21 new text begin (1) health careers exploration activities for students from racial, ethnic, or cultural new text end 44.22 new text begin populations experiencing health disparities; new text end 44.23 new text begin (2) elementary, secondary, and postsecondary education activities to improve the new text end 44.24 new text begin academic readiness to enter health professions education programs for students from new text end 44.25 new text begin racial, ethnic, or cultural populations experiencing health disparities; new text end 44.26 new text begin (3) health careers mentoring for students from racial, ethnic, or cultural populations new text end 44.27 new text begin experiencing health disparities, including support for faculty involved in mentoring these new text end 44.28 new text begin students enrolled in or interested in entering health professions education programs; new text end 44.29 new text begin (4) secondary and postsecondary summer health care internships that provide new text end 44.30 new text begin students from racial, ethnic, or cultural populations experiencing health disparities with new text end 44.31 new text begin formal exposure to a health care profession in an employment setting; new text end 44.32 new text begin (5) health careers preparation, guidance, and support for students from racial, ethnic, new text end 44.33 new text begin or cultural populations experiencing health disparities who are interested in entering health new text end 44.34 new text begin professions education programs; new text end 44.35 new text begin (6) health careers preparation, guidance, and support for students from racial, new text end 44.36 new text begin ethnic, or cultural populations experiencing health disparities who are enrolled in health new text end 45.1 new text begin professions education programs and other activities to improve retention of these students new text end 45.2 new text begin in health professions education programs; or new text end 45.3 new text begin (7) other activities the commissioner has reason to believe will prepare, attract, and new text end 45.4 new text begin educate for health careers students from racial, ethnic, or cultural populations experiencing new text end 45.5 new text begin health disparities. new text end 45.6     new text begin Subd. 3. new text end new text begin Applications. new text end new text begin Applicants seeking a grant must apply to the commissioner. new text end 45.7 new text begin Applications must include the following: new text end 45.8 new text begin (1) a description of the need, challenges, or barriers that the proposed project will new text end 45.9 new text begin address; new text end 45.10 new text begin (2) a detailed description of the project and how it proposes to address the challenges new text end 45.11 new text begin or barriers; new text end 45.12 new text begin (3) a budget detailing all sources of funds for the project and how project funds new text end 45.13 new text begin will be used; new text end 45.14 new text begin (4) baseline data showing the current percentage of program applicants and current new text end 45.15 new text begin students who are from racial, ethnic, or cultural populations experiencing health disparities; new text end 45.16 new text begin (5) a description of achievable objectives that demonstrate how the project will new text end 45.17 new text begin contribute to increasing the number of students from racial, ethnic, or cultural populations new text end 45.18 new text begin experiencing health disparities who are entering health professions in Minnesota; new text end 45.19 new text begin (6) a timeline for completion of the project; new text end 45.20 new text begin (7) roles and capabilities of responsible individuals and organizations, including new text end 45.21 new text begin partner organizations; new text end 45.22 new text begin (8) a plan to evaluate project outcomes; and new text end 45.23 new text begin (9) other information the commissioner believes necessary to evaluate the new text end 45.24 new text begin application. new text end 45.25     new text begin Subd. 4. new text end new text begin Consideration of applications. new text end new text begin The commissioner must review each new text end 45.26 new text begin application to determine whether or not the application is complete and whether new text end 45.27 new text begin the applicant and the project are eligible for a grant. In evaluating applications, the new text end 45.28 new text begin commissioner must evaluate each application based on the following: new text end 45.29 new text begin (1) the extent to which the applicant has demonstrated that its project is likely new text end 45.30 new text begin to contribute to increasing the number of American Indians and underrepresented new text end 45.31 new text begin populations of color entering health professions in Minnesota; new text end 45.32 new text begin (2) the application's clarity and thoroughness in describing the challenges and new text end 45.33 new text begin barriers it is addressing; new text end 45.34 new text begin (3) the extent to which the applicant appears likely to coordinate project efforts new text end 45.35 new text begin with other organizations; new text end 45.36 new text begin (4) the reasonableness of the project budget; and new text end 46.1 new text begin (5) the organizational capacity of the applicant and its partners. new text end 46.2 new text begin The commissioner may also take into account other relevant factors. During new text end 46.3 new text begin application review the commissioner may request additional information about a proposed new text end 46.4 new text begin project, including information on project cost. Failure to provide the information requested new text end 46.5 new text begin disqualifies an applicant. new text end 46.6     new text begin Subd. 5. new text end new text begin Program oversight. new text end new text begin The commissioner shall determine the amount of a new text end 46.7 new text begin grant to be given to an eligible applicant based on the relative strength of each eligible new text end 46.8 new text begin application and the funds available to the commissioner. The commissioner may collect new text end 46.9 new text begin from grantees any information necessary to evaluate the program. new text end 46.10    Sec. 11. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read: 46.11    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions 46.12apply. 46.13(b) "Dentist" means an individual who is licensed to practice dentistry. 46.14(c) "Designated rural area" means: 46.15(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, 46.16Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, 46.17Rochester, and St. Cloud; or 46.18(2) a municipal corporation, as defined under section , that is physically 46.19located, in whole or in part, in an area defined as a designated rural area under clause (1). new text begin new text end 46.20 new text begin an area defined as a small rural area or isolated rural area according to the four category new text end 46.21 new text begin classifications of the Rural Urban Commuting Area system developed for the United new text end 46.22 new text begin States Health Resources and Services Administration. new text end 46.23(d) "Emergency circumstances" means those conditions that make it impossible for 46.24the participant to fulfill the service commitment, including death, total and permanent 46.25disability, or temporary disability lasting more than two years. 46.26(e) "Medical resident" means an individual participating in a medical residency in 46.27family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry. 46.28(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse 46.29anesthetist, advanced clinical nurse specialist, or physician assistant. 46.30(g) "Nurse" means an individual who has completed training and received all 46.31licensing or certification necessary to perform duties as a licensed practical nurse or 46.32registered nurse. 46.33(h) "Nurse-midwife" means a registered nurse who has graduated from a program of 46.34study designed to prepare registered nurses for advanced practice as nurse-midwives. 47.1(i) "Nurse practitioner" means a registered nurse who has graduated from a program 47.2of study designed to prepare registered nurses for advanced practice as nurse practitioners. 47.3(j) "Pharmacist" means an individual with a valid license issued under chapter 151. 47.4(k) "Physician" means an individual who is licensed to practice medicine in the areas 47.5of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry. 47.6(l) "Physician assistant" means a person licensed under chapter 147A. 47.7(m) "Qualified educational loan" means a government, commercial, or foundation 47.8loan for actual costs paid for tuition, reasonable education expenses, and reasonable living 47.9expenses related to the graduate or undergraduate education of a health care professional. 47.10(n) "Underserved urban community" means a Minnesota urban area or population 47.11included in the list of designated primary medical care health professional shortage areas 47.12(HPSAs), medically underserved areas (MUAs), or medically underserved populations 47.13(MUPs) maintained and updated by the United States Department of Health and Human 47.14Services. 47.15    Sec. 12. Minnesota Statutes 2010, section 144.1501, subdivision 4, is amended to read: 47.16    Subd. 4. Loan forgiveness. The commissioner of health may select applicants 47.17each year for participation in the loan forgiveness program, within the limits of available 47.18funding. The commissioner shall distribute available funds for loan forgiveness 47.19proportionally among the eligible professions according to the vacancy rate for each 47.20profession in the required geographic area, facility type, teaching area, patient group, 47.21or specialty type specified in subdivision 2. The commissioner shall allocate funds for 47.22physician loan forgiveness so that 75 percent of the funds available are used for rural 47.23physician loan forgiveness and 25 percent of the funds available are used for underserved 47.24urban communities and pediatric psychiatry loan forgiveness. If the commissioner does 47.25not receive enough qualified applicants each year to use the entire allocation of funds for 47.26any eligible profession, the remaining funds may be allocated proportionally among the 47.27other eligible professions according to the vacancy rate for each profession in the required 47.28geographic area, patient group, or facility type specified in subdivision 2. Applicants are 47.29responsible for securing their own qualified educational loans. The commissioner shall 47.30select participants based on their suitability for practice serving the required geographic 47.31area or facility type specified in subdivision 2, as indicated by experience or training. 47.32The commissioner shall give preference to applicants new text begin from racial, ethnic, or cultural new text end 47.33 new text begin populations experiencing health disparities who are new text end closest to completing their training new text begin new text end 47.34 new text begin and who agree to serve in settings in Minnesota that provide health care services to at least new text end 47.35 new text begin 50 percent American Indian or other populations of color, such as a federally recognized new text end 48.1 new text begin Native American reservation new text end . For each year that a participant meets the service obligation 48.2required under subdivision 3, up to a maximum of four years, the commissioner shall make 48.3annual disbursements directly to the participant equivalent to 15 percent of the average 48.4educational debt for indebted graduates in their profession in the year closest to the 48.5applicant's selection for which information is available, not to exceed the balance of the 48.6participant's qualifying educational loans. Before receiving loan repayment disbursements 48.7and as requested, the participant must complete and return to the commissioner an affidavit 48.8of practice form provided by the commissioner verifying that the participant is practicing 48.9as required under subdivisions 2 and 3. The participant must provide the commissioner 48.10with verification that the full amount of loan repayment disbursement received by the 48.11participant has been applied toward the designated loans. After each disbursement, 48.12verification must be received by the commissioner and approved before the next loan 48.13repayment disbursement is made. Participants who move their practice remain eligible for 48.14loan repayment as long as they practice as required under subdivision 2. 48.15    Sec. 13. new text begin [144.1503] HEALTH PROFESSIONS OPPORTUNITIES new text end 48.16 new text begin SCHOLARSHIP PROGRAM. new text end 48.17     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin For purposes of this section, the following definitions new text end 48.18 new text begin apply: new text end 48.19 new text begin (a) "Certified clinical nurse specialist" means an individual licensed in Minnesota as new text end 48.20 new text begin a registered nurse and certified by a national nurse certification organization acceptable to new text end 48.21 new text begin the Minnesota Board of Nursing to practice as a clinical nurse specialist. new text end 48.22 new text begin (b) "Certified nurse midwife" means an individual licensed in Minnesota as a new text end 48.23 new text begin registered nurse and certified by a national nurse certification organization acceptable to new text end 48.24 new text begin the Minnesota Board of Nursing to practice as a nurse midwife. new text end 48.25 new text begin (c) "Certified nurse practitioner" means an individual licensed in Minnesota as a new text end 48.26 new text begin registered nurse and certified by a national nurse certification organization acceptable to new text end 48.27 new text begin the Minnesota Board of Nursing to practice as a nurse practitioner. new text end 48.28 new text begin (d) "Chiropractor" means an individual licensed and regulated under sections 148.02 new text end 48.29 new text begin to 148.108. new text end 48.30 new text begin (e) "Dental therapist" means an individual licensed in the state and includes new text end 48.31 new text begin advanced dental therapists certified under section 150A.106. new text end 48.32 new text begin (f) "Dentist" means an individual licensed in Minnesota as a dentist under chapter new text end 48.33 new text begin 150A. new text end 48.34 new text begin (g) "Eligible scholarship placement site" means a nonprofit, private, or public new text end 48.35 new text begin entity located in Minnesota that provides at least 50 percent of its health care services to new text end 49.1 new text begin American Indian or other populations of color, such as federally recognized American new text end 49.2 new text begin Indian reservations. new text end 49.3 new text begin (h) "Emergency circumstances" means those conditions that make it impossible for new text end 49.4 new text begin the participant to fulfill the contractual requirements, including death, total and permanent new text end 49.5 new text begin disability, or temporary disability lasting more than two years. new text end 49.6 new text begin (i) "Participant" means an individual receiving a scholarship under this program. new text end 49.7 new text begin (j) "Physician assistant" means a person licensed in Minnesota under chapter 147A. new text end 49.8 new text begin (k) "Primary care physician" means an individual licensed in Minnesota as a new text end 49.9 new text begin physician and board-certified in family practice, internal medicine, obstetrics and new text end 49.10 new text begin gynecology, pediatrics, geriatrics, emergency medicine, hospital medicine, or psychiatry. new text end 49.11 new text begin (l) "Registered nurse" means an individual licensed by the Minnesota Board of new text end 49.12 new text begin Nursing to practice professional nursing. new text end 49.13     new text begin Subd. 2. new text end new text begin Establishment and purpose. new text end new text begin The commissioner shall establish a health new text end 49.14 new text begin professions opportunities scholarship program. The purpose of the program is to increase new text end 49.15 new text begin the number of students from racial, ethnic, or cultural populations experiencing health new text end 49.16 new text begin disparities who enter health professions. new text end 49.17     new text begin Subd. 3. new text end new text begin Eligible students. new text end new text begin To be eligible to apply to the commissioner for the new text end 49.18 new text begin scholarship program, an applicant must be: new text end 49.19 new text begin (1) accepted for full-time study in a program of study that will result in licensure as new text end 49.20 new text begin a primary care physician, certified nurse practitioner, certified nurse midwife, certified new text end 49.21 new text begin clinical nurse specialist, chiropractor, physician assistant, registered nurse, dentist, or new text end 49.22 new text begin dental therapist; new text end 49.23 new text begin (2) a Minnesota resident; and new text end 49.24 new text begin (3) an individual from a racial, ethnic, or cultural population experiencing health new text end 49.25 new text begin disparities in the state. new text end 49.26     new text begin Subd. 4. new text end new text begin Scholarship. new text end new text begin The commissioner may award a scholarship for the cost of new text end 49.27 new text begin full tuition, fees, and living expenses up to $40,000 per year to eligible students. The new text end 49.28 new text begin commissioner will subtract the amount of other scholarship, grant, and gift awards to the new text end 49.29 new text begin participant from the award made by this program. Scholarship awards will be limited to new text end 49.30 new text begin the number of years for full-time enrollment in the applicant's program of study but will new text end 49.31 new text begin not include any years completed prior to applying. The commissioner shall determine the new text end 49.32 new text begin number of new scholarship awards made per fiscal year based on availability of state new text end 49.33 new text begin funding. Scholarship awards will be paid by the commissioner directly to the participant's new text end 49.34 new text begin educational institution after full-time enrollment is verified. Appropriations made to the new text end 49.35 new text begin scholarship program do not cancel and are available until expended. new text end 50.1     new text begin Subd. 5. new text end new text begin Obligated service. new text end new text begin A participant shall agree in contract to fulfill a new text end 50.2 new text begin three-year service obligation at an eligible scholar placement site upon completion of new text end 50.3 new text begin training, including residency, and obtaining Minnesota licensure. Participants must new text end 50.4 new text begin provide at least 32 hours of direct patient care per week for at least 45 weeks per year. new text end 50.5 new text begin Obligated service must start by March 31 of the year following completion of required new text end 50.6 new text begin training. new text end 50.7     new text begin Subd. 6. new text end new text begin Affidavit of service required. new text end new text begin Before starting a service obligation and new text end 50.8 new text begin annually thereafter, participants shall submit to the commissioner an affidavit of practice new text end 50.9 new text begin signed by a representative of their eligible scholar placement site verifying employment new text end 50.10 new text begin status and the number of weekly hours of direct patient care provided by the participant. new text end 50.11 new text begin Participants must also provide written notice to the commissioner within 30 days of: new text end 50.12 new text begin (1) a change in name or address; new text end 50.13 new text begin (2) a decision not to fulfill a service obligation; or new text end 50.14 new text begin (3) cessation of obligated practice. new text end 50.15     new text begin Subd. 7. new text end new text begin Penalty for nonfulfillment. new text end new text begin If a participant does not complete the new text end 50.16 new text begin educational program, successfully obtain licensure, or fulfill the required minimum new text end 50.17 new text begin commitment of service according to subdivision 6, the commissioner of health shall collect new text end 50.18 new text begin from the participant the total amount awarded to the participant under the scholarship new text end 50.19 new text begin program plus interest at a rate established according to section 270C.40. Funds collected new text end 50.20 new text begin for nonfulfillment shall be credited to the health professions opportunities scholarship new text end 50.21 new text begin program. The commissioner shall allow waivers of all or part of the money owed the new text end 50.22 new text begin commissioner as a result of a nonfulfillment penalty due to emergency circumstances. new text end 50.23    Sec. 14. new text begin [144.586] PATIENT SAFETY SURVEY. new text end 50.24 new text begin Hospitals licensed under section 144.55 must submit necessary information to the new text end 50.25 new text begin Leapfrog Group patient safety survey on an annual basis in order to publicly report patient new text end 50.26 new text begin safety information and track the progress of each hospital to improve quality, safety, new text end 50.27 new text begin and efficiency of care delivery. new text end 50.28    Sec. 15. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read: 50.29    Subd. 2a. Standards. new text begin Notwithstanding the exemptions in subdivisions 8 and 9, new text end the 50.30commissioner shall accredit laboratories according to the most current environmental 50.31laboratory accreditation standards under subdivision 1 and as accepted by the accreditation 50.32bodies recognized by the National Environmental Laboratory Accreditation Program 50.33(NELAP) of the NELAC Institute. 51.1    Sec. 16. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read: 51.2    Subd. 7. Initial accreditation and annual accreditation renewal. (a) The 51.3commissioner shall issue or renew accreditation after receipt of the completed application 51.4and documentation required in this section, provided the laboratory maintains compliance 51.5with the standards specified in subdivision 2a new text begin , notwithstanding any exemptions under new text end 51.6 new text begin subdivisions 8 and 9 new text end , and attests to the compliance on the application form. 51.7(b) The commissioner shall prorate the fees in subdivision 3 for laboratories 51.8applying for accreditation after December 31. The fees are prorated on a quarterly basis 51.9beginning with the quarter in which the commissioner receives the completed application 51.10from the laboratory. 51.11(c) Applications for renewal of accreditation must be received by November 1 and 51.12no earlier than October 1 of each year. The commissioner shall send annual renewal 51.13notices to laboratories 90 days before expiration. Failure to receive a renewal notice does 51.14not exempt laboratories from meeting the annual November 1 renewal date. 51.15(d) The commissioner shall issue all accreditations for the calendar year for which 51.16the application is made, and the accreditation shall expire on December 31 of that year. 51.17(e) The accreditation of any laboratory that fails to submit a renewal application 51.18and fees to the commissioner expires automatically on December 31 without notice or 51.19further proceeding. Any person who operates a laboratory as accredited after expiration of 51.20accreditation or without having submitted an application and paid the fees is in violation 51.21of the provisions of this section and is subject to enforcement action under sections 51.22144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired 51.23accreditation may reapply under subdivision 6. 51.24    Sec. 17. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 51.25to read: 51.26     new text begin Subd. 8. new text end new text begin Exemption from national standards for quality control and personnel new text end 51.27 new text begin requirements. new text end new text begin Effective January 1, 2012, a laboratory that analyzes samples for new text end 51.28 new text begin compliance with a permit issued under section 115.03, subdivision 5, may request new text end 51.29 new text begin exemption from the personnel requirements and specific quality control provisions for new text end 51.30 new text begin microbiology and chemistry stated in the national standards as incorporated by reference new text end 51.31 new text begin in subdivision 2a. The commissioner shall grant the exemption if the laboratory: new text end 51.32 new text begin (1) complies with the methodology and quality control requirements, where new text end 51.33 new text begin available, in the most recent, approved edition of the Standard Methods for the new text end 51.34 new text begin Examination of Water and Wastewater as published by the Water Environment Federation; new text end 51.35 new text begin and new text end 52.1 new text begin (2) supplies the name of the person meeting the requirements in section 115.73, or new text end 52.2 new text begin the personnel requirements in the national standard pursuant to subdivision 2a. new text end 52.3 new text begin A laboratory applying for this exemption shall not apply for simultaneous new text end 52.4 new text begin accreditation under the national standard. new text end 52.5    Sec. 18. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 52.6to read: 52.7     new text begin Subd. 9. new text end new text begin Exemption from national standards for proficiency testing frequency. new text end 52.8 new text begin (a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under new text end 52.9 new text begin the exemption in subdivision 8 must obtain an acceptable proficiency test result for each new text end 52.10 new text begin of the laboratory's accredited or requested fields of testing. The laboratory must analyze new text end 52.11 new text begin proficiency samples selected from one of two annual proficiency testing studies scheduled new text end 52.12 new text begin by the commissioner. new text end 52.13 new text begin (b) If a laboratory fails to successfully complete the first scheduled proficiency new text end 52.14 new text begin study, the laboratory shall: new text end 52.15 new text begin (1) obtain and analyze a supplemental test sample within 15 days of receiving the new text end 52.16 new text begin test report for the initial failed attempt; and new text end 52.17 new text begin (2) participate in the second annual study as scheduled by the commissioner. new text end 52.18 new text begin (c) If a laboratory does not submit results or fails two consecutive proficiency new text end 52.19 new text begin samples, the commissioner will revoke the laboratory's accreditation for the affected new text end 52.20 new text begin fields of testing. new text end 52.21 new text begin (d) The commissioner may require a laboratory to analyze additional proficiency new text end 52.22 new text begin testing samples beyond what is required in this subdivision if information available to new text end 52.23 new text begin the commissioner indicates that the laboratory's analysis for the field of testing does not new text end 52.24 new text begin meet the requirements for accreditation. new text end 52.25 new text begin (e) The commissioner may collect from laboratories accredited under the exemption new text end 52.26 new text begin in subdivision 8 any additional costs required to administer this subdivision and new text end 52.27 new text begin subdivision 8. new text end 52.28    Sec. 19. Minnesota Statutes 2010, section 144A.102, is amended to read: 52.29144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS; 52.30PENALTIES. 52.31 new text begin (a) new text end By January 2000, the commissioner of health shall work with providers to 52.32examine state and federal rules and regulations governing the provision of care in licensed 52.33nursing facilities and apply for federal waivers and identify necessary changes in state 52.34law to: 53.1(1) allow the use of civil money penalties imposed upon nursing facilities to abate 53.2any deficiencies identified in a nursing facility's plan of correction; and 53.3(2) stop the accrual of any fine imposed by the Health Department when a follow-up 53.4inspection survey is not conducted by the department within the regulatory deadline. 53.5 new text begin (b) By January 2012, the commissioner of health shall work with providers and new text end 53.6 new text begin the ombudsman for long-term care to examine state and federal rules and regulations new text end 53.7 new text begin governing the provision of care in licensed nursing facilities and apply for federal waivers new text end 53.8 new text begin and identify necessary changes in state law to: new text end 53.9 new text begin (1) eliminate the requirement for written plans of correction from nursing homes for new text end 53.10 new text begin federal deficiencies issued at a scope and severity that is not widespread, harmful, or in new text end 53.11 new text begin immediate jeopardy; and new text end 53.12 new text begin (2) issue the federal survey form electronically to nursing homes. new text end 53.13 new text begin The commissioner shall issue a report to the legislative chairs of the committees new text end 53.14 new text begin with jurisdiction over health and human services by January 31, 2012, on the status of new text end 53.15 new text begin implementation of this paragraph. new text end 53.16    Sec. 20. Minnesota Statutes 2010, section 144A.61, is amended by adding a 53.17subdivision to read: 53.18     new text begin Subd. 9. new text end new text begin Electronic transmission. new text end new text begin The commissioner of health must accept new text end 53.19 new text begin electronic transmission of applications and supporting documentation for interstate new text end 53.20 new text begin endorsement for the nursing assistant registry. new text end 53.21    Sec. 21. Minnesota Statutes 2010, section 144E.123, is amended to read: 53.22144E.123 PREHOSPITAL CARE DATA. 53.23    Subdivision 1. Collection and maintenance. new text begin Until July 1, 2014, new text end a licensee shall new text begin new text end 53.24 new text begin may new text end collect and provide prehospital care data to the board in a manner prescribed by the 53.25board. At a minimum, the data must include items identified by the board that are part of 53.26the National Uniform Emergency Medical Services Data Set. A licensee shall maintain 53.27prehospital care data for every response. 53.28    Subd. 2. Copy to receiving hospital. If a patient is transported to a hospital, a copy 53.29of the ambulance report delineating prehospital medical care given shall be provided 53.30to the receiving hospital. 53.31    Subd. 3. Review. Prehospital care data may be reviewed by the board or its 53.32designees. The data shall be classified as private data on individuals under chapter 13, the 53.33Minnesota Government Data Practices Act. 54.1    Subd. 4. Penalty. Failure to report all information required by the board under this 54.2section shall constitute grounds for license revocation. 54.3     new text begin Subd. 5. new text end new text begin Working group. new text end new text begin By October 1, 2011, the board must convene a working new text end 54.4 new text begin group composed of six members, three of which must be appointed by the board and three new text end 54.5 new text begin of which must be appointed by the Minnesota Ambulance Association, to redesign the new text end 54.6 new text begin board's policies related to collection of data from licenses. The issues to be considered new text end 54.7 new text begin include, but are not limited to, the following: user-friendly reporting requirements; data new text end 54.8 new text begin sets; improved accuracy of reported information; appropriate use of information gathered new text end 54.9 new text begin through the reporting system; and methods for minimizing the financial impact of data new text end 54.10 new text begin reporting on licenses, particularly for rural volunteer services. The working group must new text end 54.11 new text begin report its findings and recommendations to the board no later than January 1, 2014. new text end 54.12 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 54.13    Sec. 22. new text begin [145.9271] WHITE EARTH BAND URBAN CLINIC. new text end 54.14     new text begin Subdivision 1. new text end new text begin Condition. new text end new text begin If the White Earth Band of Ojibwe Indians accepts the new text end 54.15 new text begin amount transferred under section 62J.692, subdivision 4, paragraph (b), clause (1), then it new text end 54.16 new text begin must use the funds for purposes of this section. new text end 54.17     new text begin Subd. 2. new text end new text begin Establish urban clinic. new text end new text begin The White Earth Band of Ojibwe Indians shall new text end 54.18 new text begin establish and operate one or more health care clinics in the Minneapolis area or greater new text end 54.19 new text begin Minnesota to serve members of the White Earth Tribe and may use funds received under new text end 54.20 new text begin section 62J.692, subdivision 4, paragraph (b), clause (1), for application to qualify as a new text end 54.21 new text begin federally qualified health center. new text end 54.22     new text begin Subd. 3. new text end new text begin Grant agreements. new text end new text begin Before receiving the funds to be transferred under new text end 54.23 new text begin section 62J.692, subdivision 4, paragraph (b), clause (1), the White Earth Band of Ojibwe new text end 54.24 new text begin Indians is requested to submit to the commissioner of health a work plan and budget that new text end 54.25 new text begin describes its annual plan for the funds. The commissioner will incorporate the work new text end 54.26 new text begin plan and budget into a grant agreement between the commissioner and the White Earth new text end 54.27 new text begin Band of Ojibwe Indians. Before each successive disbursement, the White Earth Band of new text end 54.28 new text begin Ojibwe Indians is requested to submit a narrative progress report and an expenditure new text end 54.29 new text begin report to the commissioner. new text end 54.30    Sec. 23. new text begin [145.9272] COMMUNITY MENTAL HEALTH CENTER GRANTS. new text end 54.31     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin For purposes of this section, "community mental new text end 54.32 new text begin health center" means an entity that is eligible for payment under section 256B.0625, new text end 54.33 new text begin subdivision 5. new text end 55.1     new text begin Subd. 2. new text end new text begin Allocation of subsidies. new text end new text begin The commissioner of health shall distribute, from new text end 55.2 new text begin money appropriated for this purpose, grants to community mental health centers operating new text end 55.3 new text begin in the state on July 1 of the year 2011 and each subsequent year for community mental new text end 55.4 new text begin health center services to low-income consumers and patients with mental illness. The new text end 55.5 new text begin amount of each grant shall be in proportion to each community mental health center's new text end 55.6 new text begin revenues received from state health care programs in the most recent calendar year for new text end 55.7 new text begin which data is available. new text end 55.8    Sec. 24. Minnesota Statutes 2010, section 145.928, subdivision 2, is amended to read: 55.9    Subd. 2. State-community partnerships; plan. The commissioner, in partnership 55.10with culturally based community organizations; the Indian Affairs Council under section 55.113.922 ; the Council on Affairs of Chicano/Latino People under section 3.9223; the Council 55.12on Black Minnesotans under section 3.9225; the Council on Asian-Pacific Minnesotans 55.13under section 3.9226; new text begin the Alliance for Racial and Cultural Health Equity; new text end community 55.14health boards as defined in section 145A.02; and tribal governments, shall develop and 55.15implement a comprehensive, coordinated plan to reduce health disparities in the health 55.16disparity priority areas identified in subdivision 1. 55.17    Sec. 25. new text begin [145.929] PROFESSIONALS FROM POPULATIONS WITH HEALTH new text end 55.18 new text begin DISPARITIES. new text end 55.19 new text begin The commissioner of health shall survey the diversity of the work force for new text end 55.20 new text begin health-related professions and compare proportions in the allied health professions new text end 55.21 new text begin among populations experiencing health disparities, including cultural, racial, ethnic, new text end 55.22 new text begin and geographic factors, compared to the population of the state. Based on this survey, new text end 55.23 new text begin the commissioner shall determine on an annual basis the ratio of training and residency new text end 55.24 new text begin positions needed versus those available based on funding capacity. new text end 55.25    Sec. 26. Minnesota Statutes 2010, section 145.986, is amended by adding a subdivision 55.26to read: 55.27     new text begin Subd. 7. new text end new text begin Consultation and engagement of consumers and communities with new text end 55.28 new text begin poorer health and outcomes. new text end new text begin Communities who receive state and federal health new text end 55.29 new text begin grants must demonstrate to the commissioner that the applicant or grantee consulted new text end 55.30 new text begin with and engaged local consumers, community organizations, and leaders representing new text end 55.31 new text begin the subgroups of the community that experience the greatest health disparities in the new text end 55.32 new text begin development of the local plan and that the plan incorporates components and activities new text end 55.33 new text begin that reflect the needs and preferences of these communities. The plan must also include new text end 56.1 new text begin a process for ongoing consultation and engagement of these consumers, community new text end 56.2 new text begin organizations, and leaders in the implementation of the plan and activities funded by new text end 56.3 new text begin state grants. new text end 56.4    Sec. 27. Minnesota Statutes 2010, section 145.986, is amended by adding a subdivision 56.5to read: 56.6     new text begin Subd. 8. new text end new text begin Coordination with payment reform demonstration projects. new text end new text begin A new text end 56.7 new text begin community who received a health improvement plan grant under this section and new text end 56.8 new text begin a payment reform demonstration project authorized under section 256B.0755 shall new text end 56.9 new text begin coordinate activities to improve the health of the communities and patients served by both new text end 56.10 new text begin the health improvement plan and the demonstration project provider. new text end 56.11    Sec. 28. new text begin [145.987] COMMUNITY HEALTH CENTERS DEVELOPMENT new text end 56.12 new text begin GRANTS FOR UNDERSERVED COMMUNITIES. new text end 56.13 new text begin (a) The commissioner of health shall award grants from money appropriated for this new text end 56.14 new text begin purpose to expand community health centers, as defined in section 145.9269, subdivision new text end 56.15 new text begin 1, in the state through the establishment of new community health centers or sites in new text end 56.16 new text begin areas defined as small rural areas or isolated rural areas according to the four category new text end 56.17 new text begin classification of the Rural Urban Commuting Area system developed for the United States new text end 56.18 new text begin Health Resources and Services Administration or serving underserved patient populations new text end 56.19 new text begin who experience the greatest disparities in health outcomes. new text end 56.20 new text begin (b) Grant funds may be used to pay for: new text end 56.21 new text begin (1) costs for an organization to develop and submit a proposal to the federal new text end 56.22 new text begin government for the designation of a new community health center or site; new text end 56.23 new text begin (2) costs of engaging underserved communities, health care providers, local new text end 56.24 new text begin government agencies, or businesses in a process of developing a plan for a new center or new text end 56.25 new text begin site to serve people in that community; and new text end 56.26 new text begin (3) costs of planning, designing, remodeling, constructing, or purchasing equipment new text end 56.27 new text begin for a new center or site. new text end 56.28 new text begin Funds may not be used for operating costs. new text end 56.29 new text begin (d) A proposal must demonstrate that racial and ethnic communities to be served by new text end 56.30 new text begin the community health center were consulted with and participated in the development of new text end 56.31 new text begin the proposal. new text end 56.32 new text begin (e) The commissioner shall award grants on a competitive basis based on the new text end 56.33 new text begin following criteria: new text end 56.34 new text begin (1) the unmet need in the underserved community; new text end 57.1 new text begin (2) the degree of disparities in health outcomes in the underserved community; and new text end 57.2 new text begin (3) the extent to which people from the underserved community participated in new text end 57.3 new text begin the development of the proposal. new text end 57.4    Sec. 29. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read: 57.5    Subd. 3. Requirements for programs; process. (a) Community health boards 57.6and tribal governments that receive funding under this section must submit a plan to 57.7the commissioner describing a multidisciplinary approach to targeted home visiting for 57.8families. The plan must be submitted on forms provided by the commissioner. At a 57.9minimum, the plan must include the following: 57.10    (1) a description of outreach strategies to families prenatally or at birth; 57.11    (2) provisions for the seamless delivery of health, safety, and early learning services; 57.12    (3) methods to promote continuity of services when families move within the state; 57.13    (4) a description of the community demographics; 57.14    (5) a plan for meeting outcome measures; and 57.15    (6) a proposed work plan that includes: 57.16    (i) coordination to ensure nonduplication of services for children and families; 57.17    (ii) a description of the strategies to ensure that children and families at greatest risk 57.18receive appropriate services; and 57.19    (iii) collaboration with multidisciplinary partners including public health, 57.20ECFE, Head Start, community health workers, social workers, community home 57.21visiting programs, school districts, and other relevant partners. Letters of intent from 57.22multidisciplinary partners must be submitted with the plan. 57.23    (b) Each program that receives funds must accomplish the following program 57.24requirements: 57.25    (1) use a community-based strategy to provide preventive and early intervention 57.26home visiting services; 57.27    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 57.28home visit must occur prenatally or as soon after birth as possible and must include a 57.29public health nursing assessment by a public health nurse; 57.30    (3) offer, at a minimum, information on infant care, child growth and development, 57.31positive parenting, preventing diseases, preventing exposure to environmental hazards, 57.32and support services available in the community; 57.33    (4) provide information on and referrals to health care services, if needed, including 57.34information on and assistance in applying for health care coverage for which the child or 58.1family may be eligible; and provide information on preventive services, developmental 58.2assessments, and the availability of public assistance programs as appropriate; 58.3    (5) provide youth development programs when appropriate; 58.4    (6) recruit home visitors who will represent, to the extent possible, the races, 58.5cultures, and languages spoken by families that may be served; 58.6    (7) train and supervise home visitors in accordance with the requirements established 58.7under subdivision 4; 58.8    (8) maximize resources and minimize duplication by coordinating or contracting 58.9with local social and human services organizations, education organizations, and other 58.10appropriate governmental entities and community-based organizations and agencies; 58.11    (9) utilize appropriate racial and ethnic approaches to providing home visiting 58.12services; and 58.13    (10) connect eligible families, as needed, to additional resources available in the 58.14community, including, but not limited to, early care and education programs, health or 58.15mental health services, family literacy programs, employment agencies, social services, 58.16and child care resources and referral agencies. 58.17    (c) When available, programs that receive funds under this section must offer or 58.18provide the family with a referral to center-based or group meetings that meet at least 58.19once per month for those families identified with additional needs. The meetings must 58.20focus on further enhancing the information, activities, and skill-building addressed during 58.21home visitation; offering opportunities for parents to meet with and support each other; 58.22and offering infants and toddlers a safe, nurturing, and stimulating environment for 58.23socialization and supervised play with qualified teachers. 58.24    (d) Funds available under this section shall not be used for medical services. The 58.25commissioner shall establish an administrative cost limit for recipients of funds. The 58.26outcome measures established under subdivision 6 must be specified to recipients of 58.27funds at the time the funds are distributed. 58.28    (e) Data collected on individuals served by the home visiting programs must remain 58.29confidential and must not be disclosed by providers of home visiting services without a 58.30specific informed written consent that identifies disclosures to be made. Upon request, 58.31agencies providing home visiting services must provide recipients with information on 58.32disclosures, including the names of entities and individuals receiving the information and 58.33the general purpose of the disclosure. Prospective and current recipients of home visiting 58.34services must be told and informed in writing that written consent for disclosure of data is 58.35not required for access to home visiting services. 59.1 new text begin (f) Upon initial contact with a family, programs that receive funding under this new text end 59.2 new text begin section must request permission from the family to share with other family service new text end 59.3 new text begin providers information about services the family is receiving and unmet needs of the family new text end 59.4 new text begin in order to select a lead agency for the family and coordinate available resources. For new text end 59.5 new text begin purposes of this paragraph, the term "family service providers" includes local public new text end 59.6 new text begin health, social services, school districts, Head Start programs, health care providers, and new text end 59.7 new text begin other public agencies. new text end 59.8    Sec. 30. Minnesota Statutes 2010, section 152.027, is amended by adding a subdivision 59.9to read: 59.10     new text begin Subd. 6. new text end new text begin Sale or possession of synthetic cannabinoids. new text end new text begin (a) A person who new text end 59.11 new text begin unlawfully sells any amount of a synthetic cannabinoid is guilty of a gross misdemeanor. new text end 59.12 new text begin (b) A person who unlawfully possesses any amount of a synthetic cannabinoid is new text end 59.13 new text begin guilty of a misdemeanor. new text end 59.14 new text begin (c) For purposes of this subdivision, "synthetic cannabinoid" includes, unless new text end 59.15 new text begin specifically excepted or unless listed in another schedule, any natural or synthetic material, new text end 59.16 new text begin compound, mixture, or preparation that contains any quantity of a substance that is a new text end 59.17 new text begin cannabinoid receptor agonist, including, but not limited to, the following substances and new text end 59.18 new text begin their analogs, including homologues; isomers, whether optical, positional, or geometric; new text end 59.19 new text begin esters; ethers; salts; and salts of isomers, esters, and ethers, whenever the existence of the new text end 59.20 new text begin isomers, esters, ethers, or salts is possible within the specific chemical designation: new text end 59.21 new text begin 1-pentyl-2-methyl-3-(1-naphthoyl)indole (JWH-007), new text end 59.22 new text begin (2-Methyl-1-propyl-1H-indol-3-yl)-1-naphthalenylmethanone (JWH-015), new text end 59.23 new text begin 1-Pentyl-3-(1-naphthoyl)indole (JWH-018), 1-hexyl-3-(naphthalen-1-oyl)indole new text end 59.24 new text begin (JWH-019), 1-Butyl-3-(1-naphthoyl)indole (JWH-073), new text end 59.25 new text begin 4-methoxynaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-081), new text end 59.26 new text begin 4-methoxynaphthalen-1-yl-(1-pentyl-2-methylindol-3-yl)methanone new text end 59.27 new text begin (JWH-098), (1-(2-morpholin-4-ylethyl)indol-3-yl)-naphthalen-1-ylmethanone new text end 59.28 new text begin (JWH-200), 7-methoxynaphthalen-1-yl-(1-pentylindol-3-yl)methanone new text end 59.29 new text begin (JWH-164), 2-(2-chlorophenyl)-1-(1-pentylindol-3-yl)ethanone (JWH-203), new text end 59.30 new text begin 4-ethylnaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-210), new text end 59.31 new text begin 2-(2-methoxyphenyl)-1-(1-pentylindol-3-yl)ethanone (JWH-250), new text end 59.32 new text begin 1-pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398), (6aR,10aR)- new text end 59.33 new text begin 9-(Hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)-6a,7,10,10a- new text end 59.34 new text begin tetrahydrobenzo[c]chromen-1-ol (HU-210), (dexanabinol, (6aS,10aS)-9- new text end 59.35 new text begin (hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)-6a,7,10,10a- new text end 60.1 new text begin tetrahydrobenzo[c]chromen-1-ol) (HU-211), (R)-(+)-[2,3-Dihydro-5-methyl-3- new text end 60.2 new text begin (4-morpholinylmethyl)pyrrolo[1,2,3-de)-1,4-benzoxazin-6-yl]-1-napthalenylmethanone new text end 60.3 new text begin (WIN-55/212-2), 2-[(1R,3S)-3-hydroxycyclohexyl]- 5-(2-methyloctan-2-yl)phenol new text end 60.4 new text begin (CP47,497), dimethylheptylpyran. new text end 60.5 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2011, and applies to crimes new text end 60.6 new text begin committed on or after that date. new text end 60.7    Sec. 31. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision 60.8to read: 60.9     new text begin Subd. 7a. new text end new text begin Limited food establishment. new text end new text begin "Limited food establishment" means a food new text end 60.10 new text begin and beverage service establishment that primarily provides beverages that consist of new text end 60.11 new text begin combining dry mixes and water or ice for immediate service to the consumer. Limited new text end 60.12 new text begin food establishments must use equipment and utensils that are nontoxic, durable, and retain new text end 60.13 new text begin their characteristic qualities under normal use conditions and may request a variance for new text end 60.14 new text begin plumbing requirements from the commissioner. new text end 60.15    Sec. 32. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision 60.16to read: 60.17     new text begin Subd. 5. new text end new text begin Waivers during inspection. new text end new text begin Notwithstanding any provision of this new text end 60.18 new text begin chapter or Minnesota Rules, chapter 4626, any plumbing or other facility requirement, new text end 60.19 new text begin including sewage access charge and related local fees, may be waived by the inspector if new text end 60.20 new text begin the inspector deems a waiver appropriate and reasonable and determines that no significant new text end 60.21 new text begin adverse effects on public health, safety, or the environment would result from such waiver. new text end 60.22    Sec. 33. Minnesota Statutes 2010, section 169A.20, subdivision 1, is amended to read: 60.23    Subdivision 1. Driving while impaired crime; motor vehicle. It is a crime for 60.24any person to drive, operate, or be in physical control of any motor vehicle, as defined 60.25in section 169A.03, subdivision 15, except for motorboats in operation and off-road 60.26recreational vehicles, within this state or on any boundary water of this state when: 60.27(1) the person is under the influence of alcohol; 60.28(2) the person is under the influence of a controlled substance new text begin or a substance listed in new text end 60.29 new text begin section 152.027, subdivision 6 new text end ; 60.30(3) the person is knowingly under the influence of a hazardous substance that 60.31affects the nervous system, brain, or muscles of the person so as to substantially impair 60.32the person's ability to drive or operate the motor vehicle; 61.1(4) the person is under the influence of a combination of any two or more of the 61.2elements named in clauses (1) to (3); 61.3(5) the person's alcohol concentration at the time, or as measured within two hours 61.4of the time, of driving, operating, or being in physical control of the motor vehicle is 61.50.08 or more; 61.6(6) the vehicle is a commercial motor vehicle and the person's alcohol concentration 61.7at the time, or as measured within two hours of the time, of driving, operating, or being in 61.8physical control of the commercial motor vehicle is 0.04 or more; or 61.9(7) the person's body contains any amount of a controlled substance listed in 61.10Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols. 61.11 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2011, and applies to crimes new text end 61.12 new text begin committed on or after that date. new text end 61.13    Sec. 34. Minnesota Statutes 2010, section 169A.20, subdivision 1a, is amended to read: 61.14    Subd. 1a. Driving while impaired crime; motorboat in operation. It is a crime 61.15for any person to operate or be in physical control of a motorboat in operation on any 61.16waters or boundary water of this state when: 61.17(1) the person is under the influence of alcohol; 61.18(2) the person is under the influence of a controlled substance new text begin or a substance listed in new text end 61.19 new text begin section 152.027, subdivision 6 new text end ; 61.20(3) the person is knowingly under the influence of a hazardous substance that affects 61.21the nervous system, brain, or muscles of the person so as to substantially impair the 61.22person's ability to drive or operate the motorboat; 61.23(4) the person is under the influence of a combination of any two or more of the 61.24elements named in clauses (1) to (3); 61.25(5) the person's alcohol concentration at the time, or as measured within two hours 61.26of the time, of driving, operating, or being in physical control of the motorboat is 0.08 or 61.27more; or 61.28(6) the person's body contains any amount of a controlled substance listed in 61.29Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols. 61.30 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2011, and applies to crimes new text end 61.31 new text begin committed on or after that date. new text end 61.32    Sec. 35. Minnesota Statutes 2010, section 169A.20, subdivision 1b, is amended to read: 62.1    Subd. 1b. Driving while impaired crime; snowmobile and all-terrain vehicle. It 62.2is a crime for any person to operate or be in physical control of a snowmobile as defined in 62.3section 84.81, subdivision 3, or all-terrain vehicle as defined in section 84.92, subdivision 62.48, anywhere in this state or on the ice of any boundary water of this state when: 62.5(1) the person is under the influence of alcohol; 62.6(2) the person is under the influence of a controlled substance new text begin or a substance listed in new text end 62.7 new text begin section 152.027, subdivision 6 new text end ; 62.8(3) the person is knowingly under the influence of a hazardous substance that affects 62.9the nervous system, brain, or muscles of the person so as to substantially impair the 62.10person's ability to drive or operate the snowmobile or all-terrain vehicle; 62.11(4) the person is under the influence of a combination of any two or more of the 62.12elements named in clauses (1) to (3); 62.13(5) the person's alcohol concentration at the time, or as measured within two hours 62.14of the time, of driving, operating, or being in physical control of the snowmobile or 62.15all-terrain vehicle is 0.08 or more; or 62.16(6) the person's body contains any amount of a controlled substance listed in 62.17Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols. 62.18 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2011, and applies to crimes new text end 62.19 new text begin committed on or after that date. new text end 62.20    Sec. 36. Minnesota Statutes 2010, section 169A.20, subdivision 1c, is amended to read: 62.21    Subd. 1c. Driving while impaired crime; off-highway motorcycle and off-road 62.22vehicle. It is a crime for any person to operate or be in physical control of any off-highway 62.23motorcycle as defined in section 84.787, subdivision 7, or any off-road vehicle as defined 62.24in section 84.797, subdivision 7, anywhere in this state or on the ice of any boundary 62.25water of this state when: 62.26(1) the person is under the influence of alcohol; 62.27(2) the person is under the influence of a controlled substance new text begin or a substance listed in new text end 62.28 new text begin section 152.027, subdivision 6 new text end ; 62.29(3) the person is knowingly under the influence of a hazardous substance that affects 62.30the nervous system, brain, or muscles of the person so as to substantially impair the 62.31person's ability to drive or operate the off-highway motorcycle or off-road vehicle; 62.32(4) the person is under the influence of a combination of any two or more of the 62.33elements named in clauses (1) to (3); 63.1(5) the person's alcohol concentration at the time, or as measured within two hours of 63.2the time, of driving, operating, or being in physical control of the off-highway motorcycle 63.3or off-road vehicle is 0.08 or more; or 63.4(6) the person's body contains any amount of a controlled substance listed in 63.5Schedule I or II, or its metabolite, other than marijuana or tetrahydrocannabinols. 63.6 new text begin EFFECTIVE DATE. new text end new text begin This section is effective August 1, 2011, and applies to crimes new text end 63.7 new text begin committed on or after that date. new text end 63.8    Sec. 37. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read: 63.9    Subdivision 1. Tax and use tax on cigarettes. Revenue received from cigarette 63.10taxes, as well as related penalties, interest, license fees, and miscellaneous sources of 63.11revenue shall be deposited by the commissioner in the state treasury and credited as 63.12follows: 63.13(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each 63.14year thereafter must be credited to the Academic Health Center special revenue fund 63.15hereby created and is annually appropriated to the Board of Regents at the University of 63.16Minnesota for Academic Health Center funding at the University of Minnesota; and 63.17(2) $8,553,000 for fiscal year 2006 and new text begin , new text end $8,550,000 for fiscal year 2007 and new text begin , new text end 63.18 new text begin $8,337,000 for fiscal year 2012, and $6,781,000 new text end each year thereafter must be credited to 63.19the medical education and research costs account hereby created in the special revenue 63.20fund and is annually appropriated to the commissioner of health for distribution under 63.21section 62J.692, subdivision 4 new text begin or 11, as appropriate new text end ; and 63.22(3) the balance of the revenues derived from taxes, penalties, and interest (under 63.23this chapter) and from license fees and miscellaneous sources of revenue shall be credited 63.24to the general fund. 63.25    Sec. 38. new text begin TRANSFER OF HEALTH QUALITY DATA COLLECTION. new text end 63.26     new text begin Subdivision 1. new text end new text begin Transfer. new text end new text begin The duties and activities of the commissioner of new text end 63.27 new text begin health conducted pursuant to Minnesota Statutes, chapter 62U, are transferred to the new text end 63.28 new text begin commissioner of human services. new text end 63.29     new text begin Subd. 2. new text end new text begin Effect of transfer. new text end new text begin Minnesota Statutes, section 15.039 applies to the new text end 63.30 new text begin transfer required in subdivision 1. new text end 63.31     new text begin Subd. 3. new text end new text begin Effective date. new text end new text begin The transfer required in subdivision 1 is effective July 1, new text end 63.32 new text begin 2011. new text end 63.33     new text begin Subd. 4. new text end new text begin Suspended data collection. new text end new text begin Data collection under Minnesota Statutes, new text end 63.34 new text begin section 62U.04, subdivision 4, is suspended, effective July 1, 2011. new text end 64.1     new text begin Subd. 5. new text end new text begin Commissioner of human services. new text end new text begin (a) During the 2012 legislative session, new text end 64.2 new text begin the commissioner of human services, in consultation with the revisor of statutes, shall new text end 64.3 new text begin submit to the legislature a bill making all statutory changes required by the reorganization new text end 64.4 new text begin required under subdivision 1. new text end 64.5 new text begin (b) By July 1, 2013, the commissioner must make recommendations to the legislature new text end 64.6 new text begin for collection of encounter data for state health care programs, including SEGIP, through a new text end 64.7 new text begin mechanism that allows a third-party contractor to capture data as it is transmitted through new text end 64.8 new text begin existing claims processing mechanisms. new text end 64.9    Sec. 39. new text begin PATIENT AND COMMUNITY ENGAGEMENT IN PAYMENT new text end 64.10 new text begin REFORM AND HEALTH CARE PROGRAM REFORMS. new text end 64.11     new text begin Subdivision 1. new text end new text begin Implementation of data system improvements. new text end new text begin The commissioners new text end 64.12 new text begin of health and human services shall implement the recommendations regarding data on new text end 64.13 new text begin health disparities that were contained in the report prepared under Laws 2010, First new text end 64.14 new text begin Special Session chapter 1, article 19, section 23, in consultation with an advisory work new text end 64.15 new text begin group representing racial and ethnic groups and representatives of government and private new text end 64.16 new text begin sector health care organizations. Among other activities, the commissioners shall: new text end 64.17 new text begin (1) continue engagement with diverse communities on collection of and access to new text end 64.18 new text begin racial and ethnic data from state agencies, health care providers, and health plans; new text end 64.19 new text begin (2) develop a plan to make data more accessible to communities; new text end 64.20 new text begin (3) develop consistent data elements across programs when feasible; and new text end 64.21 new text begin (4) develop consistent policies on data sampling. new text end 64.22     new text begin Subd. 2. new text end new text begin Patient and community engagement. new text end new text begin The commissioner of health, in new text end 64.23 new text begin cooperation with the commissioners of human services and commerce, shall consult with new text end 64.24 new text begin an advisory committee representing racial and ethnic groups regarding the implementation new text end 64.25 new text begin of subdivision 1 and major agency activities related to state and federal health care reform, new text end 64.26 new text begin payment reform demonstration projects, state health care program reforms, improvements new text end 64.27 new text begin in quality and patient satisfaction measures, and major changes in state public health new text end 64.28 new text begin priorities and strategies. At the request of the advisory committee established under Laws new text end 64.29 new text begin 2010, First Special Session chapter 1, article 19, section 23, the commissioner shall new text end 64.30 new text begin designate a private sector organization of multiple racial and ethnic groups to serve as the new text end 64.31 new text begin advisory committee under this subdivision. new text end 64.32    Sec. 40. new text begin EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY new text end 64.33 new text begin RESPONSIBILITIES. new text end 65.1 new text begin (a) The commissioner of health, in consultation with the commissioner of human new text end 65.2 new text begin services, shall evaluate and recommend options for reorganizing health and human new text end 65.3 new text begin services regulatory responsibilities in both agencies to provide better efficiency and new text end 65.4 new text begin operational cost savings while maintaining the protection of the health, safety, and welfare new text end 65.5 new text begin of the public. Regulatory responsibilities that are to be evaluated are those found in new text end 65.6 new text begin Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B, new text end 65.7 new text begin 149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50, new text end 65.8 new text begin 144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557. new text end 65.9 new text begin (b) The evaluation and recommendations shall be submitted in a report to the new text end 65.10 new text begin legislative committees with jurisdiction over health and human services no later than new text end 65.11 new text begin February 15, 2012, and shall include, at a minimum, the following: new text end 65.12 new text begin (1) whether the regulatory responsibilities of each agency should be combined into new text end 65.13 new text begin a separate agency; new text end 65.14 new text begin (2) whether the regulatory responsibilities of each agency should be merged into new text end 65.15 new text begin an existing agency; new text end 65.16 new text begin (3) what cost savings would result by merging the activities regardless of where new text end 65.17 new text begin they are located; new text end 65.18 new text begin (4) what additional costs would result if the activities were merged; new text end 65.19 new text begin (5) whether there are additional regulatory responsibilities in both agencies that new text end 65.20 new text begin should be considered in any reorganization; and new text end 65.21 new text begin (6) for each option recommended, projected cost and a timetable and identification new text end 65.22 new text begin of the necessary steps and requirements for a successful transition period. new text end 65.23    Sec. 41. new text begin TRANSFER OF THE HEALTH ECONOMICS PROGRAM. new text end 65.24     new text begin Subdivision 1. new text end new text begin Transfer. new text end new text begin The duties and activities of the health economics program new text end 65.25 new text begin at the Minnesota Department of Health conducted pursuant to Minnesota Statutes, chapter new text end 65.26 new text begin 62J, are transferred to the commissioner of commerce. new text end 65.27     new text begin Subd. 2. new text end new text begin Effect of transfer. new text end new text begin Minnesota Statutes, section 15.039, applies to the new text end 65.28 new text begin transfer required in subdivision 1. new text end 65.29     new text begin Subd. 3. new text end new text begin Commissioner of commerce. new text end new text begin During the 2012 legislative session, the new text end 65.30 new text begin commissioner of commerce, in consultation with the revisor of statutes, shall submit to new text end 65.31 new text begin the legislature a bill making all statutory changes required by the reorganization required new text end 65.32 new text begin under subdivision 1. new text end 65.33     new text begin Subd. 4. new text end new text begin Effective date. new text end new text begin The transfer required in subdivision 1 is effective July 1, new text end 65.34 new text begin 2011. new text end 66.1    Sec. 42. new text begin STUDY OF FOR-PROFIT HEALTH MAINTENANCE new text end 66.2 new text begin ORGANIZATIONS. new text end 66.3 new text begin The commissioner of health shall contract with an entity with expertise in health new text end 66.4 new text begin economics and health care delivery and quality to study the efficiency, costs, service new text end 66.5 new text begin quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to new text end 66.6 new text begin not-for-profit health maintenance organizations operating in Minnesota and other states. new text end 66.7 new text begin The study findings must address whether the state of Minnesota could: (1) reduce medical new text end 66.8 new text begin assistance and MinnesotaCare costs and costs of providing coverage to state employees; new text end 66.9 new text begin and (2) maintain or improve the quality of care provided to state health care program new text end 66.10 new text begin enrollees and state employees if for-profit health maintenance organizations were allowed new text end 66.11 new text begin to operate in the state. The commissioner shall require the entity under contract to report new text end 66.12 new text begin study findings to the commissioner and the legislature by January 15, 2012. new text end 66.13    Sec. 43. new text begin MINNESOTA TASK FORCE ON PREMATURITY. new text end 66.14     new text begin Subdivision 1. new text end new text begin Establishment. new text end new text begin The Minnesota Task Force on Prematurity is new text end 66.15 new text begin established to evaluate and make recommendations on methods for reducing prematurity new text end 66.16 new text begin and improving premature infant health care in the state. new text end 66.17     new text begin Subd. 2. new text end new text begin Membership; meetings; staff. new text end new text begin (a) The task force shall be composed of at new text end 66.18 new text begin least the following members, who serve at the pleasure of their appointing authority: new text end 66.19 new text begin (1) 15 representatives of the Minnesota Prematurity Coalition including, but not new text end 66.20 new text begin limited to, health care providers who treat pregnant women or neonates, organizations new text end 66.21 new text begin focused on preterm births, early childhood education and development professionals, and new text end 66.22 new text begin families affected by prematurity; new text end 66.23 new text begin (2) one representative appointed by the commissioner of human services; new text end 66.24 new text begin (3) two representatives appointed by the commissioner of health; new text end 66.25 new text begin (4) one representative appointed by the commissioner of education; new text end 66.26 new text begin (5) two members of the house of representatives, one appointed by the speaker of new text end 66.27 new text begin the house and one appointed by the minority leader; and new text end 66.28 new text begin (6) two members of the senate, appointed according to the rules of the senate. new text end 66.29 new text begin (b) Members of the task force serve without compensation or payment of expenses. new text end 66.30 new text begin (c) The commissioner of health must convene the first meeting of the Minnesota new text end 66.31 new text begin Task Force on Prematurity by July 31, 2011. The task force must continue to meet at new text end 66.32 new text begin least quarterly. Staffing and technical assistance shall be provided by the Minnesota new text end 66.33 new text begin Perinatal Coalition. new text end 67.1     new text begin Subd. 3. new text end new text begin Duties. new text end new text begin The task force must report the current state of prematurity in new text end 67.2 new text begin Minnesota and develop recommendations on strategies for reducing prematurity and new text end 67.3 new text begin improving premature infant health care in the state by considering the following: new text end 67.4 new text begin (1) standards of care for premature infants born less than 37 weeks gestational age, new text end 67.5 new text begin including recommendations to improve hospital discharge and follow-up care procedures; new text end 67.6 new text begin (2) coordination of information among appropriate professional and advocacy new text end 67.7 new text begin organizations on measures to improve health care for infants born prematurely; new text end 67.8 new text begin (3) identification and centralization of available resources to improve access and new text end 67.9 new text begin awareness for caregivers of premature infants; new text end 67.10 new text begin (4) development and dissemination of evidence-based practices through networking new text end 67.11 new text begin and educational opportunities; new text end 67.12 new text begin (5) a review of relevant evidence-based research regarding the causes and effects of new text end 67.13 new text begin premature births in Minnesota; new text end 67.14 new text begin (6) a review of relevant evidence-based research regarding premature infant health new text end 67.15 new text begin care, including methods for improving quality of and access to care for premature infants; new text end 67.16 new text begin and new text end 67.17 new text begin (7) identification of gaps in public reporting measures and possible effects of these new text end 67.18 new text begin measures on prematurity rates. new text end 67.19     new text begin Subd. 4. new text end new text begin Report; expiration. new text end new text begin (a) By November 30, 2011, the task force must submit new text end 67.20 new text begin a report on the current state of prematurity in Minnesota to the chairs of the legislative new text end 67.21 new text begin policy committees on health and human services. new text end 67.22 new text begin (b) By January 15, 2013, the task force must report its final recommendations, new text end 67.23 new text begin including any draft legislation necessary for implementation, to the chairs of the legislative new text end 67.24 new text begin policy committees on health and human services. new text end 67.25 new text begin (c) This task force expires on January 31, 2013, or upon submission of the final new text end 67.26 new text begin report required in paragraph (b), whichever is earlier. new text end 67.27    Sec. 44. new text begin NURSING HOME REGULATORY EFFICIENCY. new text end 67.28 new text begin The commissioner of health shall work with stakeholders to review, develop, new text end 67.29 new text begin implement, and recommend legislative changes in the nursing home licensure process that new text end 67.30 new text begin address efficiency, eliminate duplication, and ensure positive resident clinical outcomes. new text end 67.31 new text begin The commissioner shall ensure that the changes are cost-neutral. new text end 67.32    Sec. 45. new text begin REPEALER. new text end 67.33 new text begin (a) new text end new text begin Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; new text end 67.34 new text begin 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; and 144.1464, new text end new text begin are repealed. new text end 68.1 new text begin (b) new text end new text begin Minnesota Statutes 2010, section 145A.14, subdivisions 1 and 2, new text end new text begin are repealed new text end 68.2 new text begin effective January 1, 2012. new text end 68.3 new text begin (c) new text end new text begin Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, new text end 68.4 new text begin 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; new text end 68.5 new text begin 4651.0120; 4651.0130; 4651.0140; and 4651.0150, new text end new text begin are repealed effective July 1, 2011. new text end 68.6ARTICLE 3 68.7MISCELLANEOUS 68.8    Section 1. Minnesota Statutes 2010, section 3.98, is amended by adding a subdivision 68.9to read: 68.10     new text begin Subd. 5. new text end new text begin Health note. new text end new text begin The commissioner of health, in consultation with other state new text end 68.11 new text begin agencies, shall develop a report and recommendations for the legislature for a process new text end 68.12 new text begin through which a health impact review of proposed legislation may be requested by a new text end 68.13 new text begin legislative committee chair and ranking minority members of the house of representatives new text end 68.14 new text begin and senate committees with jurisdiction over health and human services finance and policy new text end 68.15 new text begin issues and added to fiscal notes to estimate the impact of the proposed legislation on new text end 68.16 new text begin costs of health care for public employees, state health care programs, private employers, new text end 68.17 new text begin local governments, or Minnesota individuals and families, including costs related to the new text end 68.18 new text begin impact of the legislation on private insurance premiums and the health status of the state new text end 68.19 new text begin or a community. The commissioner may consult with local and private public health new text end 68.20 new text begin organizations and other persons or organizations in the development of the report and new text end 68.21 new text begin recommendations. The report and recommendations shall be provided to the legislature by new text end 68.22 new text begin January 15, 2012. new text end 68.23    Sec. 2. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to read: 68.24    Subd. 4. Special family day care homes. Nonresidential child care programs 68.25serving 14 or fewer children that are conducted at a location other than the license holder's 68.26own residence shall be licensed under this section and the rules governing family day 68.27care or group family day care if: 68.28(a) the license holder is the primary provider of care and the nonresidential child 68.29care program is conducted in a dwelling that is located on a residential lot; 68.30(b) the license holder is an employer who may or may not be the primary provider 68.31of care, and the purpose for the child care program is to provide child care services to 68.32children of the license holder's employees; 68.33(c) the license holder is a church or religious organization; 69.1(d) the license holder is a community collaborative child care provider. For 69.2purposes of this subdivision, a community collaborative child care provider is a provider 69.3participating in a cooperative agreement with a community action agency as defined in 69.4section 256E.31; or 69.5(e) the license holder is a not-for-profit agency that provides child care in a dwelling 69.6located on a residential lot and the license holder maintains two or more contracts with 69.7community employers or other community organizations to provide child care services. 69.8The county licensing agency may grant a capacity variance to a license holder licensed 69.9under this paragraph to exceed the licensed capacity of 14 children by no more than five 69.10children during transition periods related to the work schedules of parents, if the license 69.11holder meets the following requirements: 69.12(1) the program does not exceed a capacity of 14 children more than a cumulative 69.13total of four hours per day; 69.14(2) the program meets a one to seven staff-to-child ratio during the variance period; 69.15(3) all employees receive at least an extra four hours of training per year than 69.16required in the rules governing family child care each year; 69.17(4) the facility has square footage required per child under Minnesota Rules, part 69.189502.0425; 69.19(5) the program is in compliance with local zoning regulations; 69.20(6) the program is in compliance with the applicable fire code as follows: 69.21(i) if the program serves more than five children older than 2-1/2 years of age, 69.22but no more than five children 2-1/2 years of age or less, the applicable fire code is 69.23educational occupancy, as provided in Group E Occupancy under the Minnesota State 69.24Fire Code 2003, Section 202; or 69.25(ii) if the program serves more than five children 2-1/2 years of age or less, the 69.26applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire 69.27Code 2003, Section 202; and 69.28(7) any age and capacity limitations required by the fire code inspection and square 69.29footage determinations shall be printed on the license. new text begin ; or new text end 69.30 new text begin (f) the license holder is the primary provider of care and has located the licensed new text end 69.31 new text begin child care program in a commercial space, if the license holder meets the following new text end 69.32 new text begin requirements: new text end 69.33 new text begin (1) the program is in compliance with local zoning regulations; new text end 69.34 new text begin (2) the program is in compliance with the applicable fire code as follows: new text end 69.35 new text begin (i) if the program serves more than five children older than 2-1/2 years of age, new text end 69.36 new text begin but no more than five children 2-1/2 years of age or less, the applicable fire code is new text end 70.1 new text begin educational occupancy, as provided in Group E Occupancy under the Minnesota State new text end 70.2 new text begin Fire Code 2003, Section 202; or new text end 70.3 new text begin (ii) if the program serves more than five children 2-1/2 years of age or less, the new text end 70.4 new text begin applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire new text end 70.5 new text begin Code 2003, Section 202; new text end 70.6 new text begin (3) any age and capacity limitations required by the fire code inspection and square new text end 70.7 new text begin footage determinations are printed on the license; and new text end 70.8 new text begin (4) the license holder prominently displays the license issued by the commissioner new text end 70.9 new text begin which contains the statement "This special family child care provider is not licensed as a new text end 70.10 new text begin child care center." new text end 70.11    Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 70.12to read: 70.13     new text begin Subd. 33. new text end new text begin Combined application form; referral of veterans. new text end new text begin The commissioner new text end 70.14 new text begin shall modify the combined application form to add a question asking applicants: "Are new text end 70.15 new text begin you a United States military veteran?" The commissioner shall ensure that all applicants new text end 70.16 new text begin who identify themselves as veterans are referred to a county veterans service officer for new text end 70.17 new text begin assistance in applying to the United States Department of Veterans Affairs for any benefits new text end 70.18 new text begin for which they may be eligible. new text end 70.19    Sec. 4. Minnesota Statutes 2010, section 256B.04, subdivision 14a, is amended to read: 70.20    Subd. 14a. Level of need determination. Nonemergency medical transportation 70.21level of need determinations must be performed by a physician, a registered nurse working 70.22under direct supervision of a physician, a physician's assistant, a nurse practitioner, a 70.23licensed practical nurse, or a discharge planner. 70.24 Nonemergency medical transportation level of need determinations must not be 70.25performed more than annually on any individual, unless the individual's circumstances 70.26have sufficiently changed so as to require a new level of need determination. new text begin No entity new text end 70.27 new text begin shall charge, and the commissioner shall pay, no more than $25 for performing a level of new text end 70.28 new text begin need determination regarding any person receiving nonemergency medical transportation, new text end 70.29 new text begin including special transportation. new text end 70.30 new text begin Special transportation services to eligible persons who need a stretcher-accessible new text end 70.31 new text begin vehicle from a hospital are exempt from a level of need determination if the special new text end 70.32 new text begin transportation services have been ordered by the eligible person's physician, registered new text end 70.33 new text begin nurse working under direct supervision of a physician, physician's assistant, nurse new text end 70.34 new text begin practitioner, licensed practical nurse, or discharge planner pursuant to Medicare guidelines. new text end 71.1 Individuals new text begin transported to or new text end residing in licensed nursing facilities are exempt from a 71.2level of need determination and are eligible for special transportation services until the 71.3individual no longer resides in a licensed nursing facility. If a person authorized by this 71.4subdivision to perform a level of need determination determines that an individual requires 71.5stretcher transportation, the individual is presumed to maintain that level of need until 71.6otherwise determined by a person authorized to perform a level of need determination, or 71.7for six months, whichever is sooner. 71.8    Sec. 5. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 71.9read: 71.10    Subd. 17. Transportation costs. (a) Medical assistance covers medical 71.11transportation costs incurred solely for obtaining emergency medical care or transportation 71.12costs incurred by eligible persons in obtaining emergency or nonemergency medical 71.13care when paid directly to an ambulance company, common carrier, or other recognized 71.14providers of transportation services. Medical transportation must be provided by: 71.15(1) an ambulance, as defined in section 144E.001, subdivision 2; 71.16(2) special transportation; or 71.17(3) common carrier including, but not limited to, bus, taxicab, other commercial 71.18carrier, or private automobile. 71.19(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 71.20part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 71.21would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 71.22transportation, or private automobile. 71.23The commissioner may use an order by the recipient's attending physician to certify that 71.24the recipient requires special transportation services. Special transportation providers 71.25shall perform driver-assisted services for eligible individuals. Driver-assisted service 71.26includes passenger pickup at and return to the individual's residence or place of business, 71.27assistance with admittance of the individual to the medical facility, and assistance in 71.28passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special 71.29transportation providers must obtain written documentation from the health care service 71.30provider who is serving the recipient being transported, identifying the time that the 71.31recipient arrived. Special transportation providers may not bill for separate base rates for 71.32the continuation of a trip beyond the original destination. Special transportation providers 71.33must take recipients to the nearest appropriate health care provider, using the most direct 71.34route new text begin as determined by a commercially available mileage software program approved by new text end 72.1 new text begin the commissioner new text end . The minimum medical assistance reimbursement rates for special 72.2transportation services are: 72.3(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 72.4eligible persons who need a wheelchair-accessible van; 72.5(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 72.6eligible persons who do not need a wheelchair-accessible van; and 72.7(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 72.8special transportation services to eligible persons who need a stretcher-accessible vehicle; 72.9(2) the base rates for special transportation services in areas defined under RUCA 72.10to be super rural shall be equal to the reimbursement rate established in clause (1) plus 72.1111.3 percent; and 72.12(3) for special transportation services in areas defined under RUCA to be rural 72.13or super rural areas: 72.14(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 72.15percent of the respective mileage rate in clause (1); and 72.16(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 72.17112.5 percent of the respective mileage rate in clause (1). 72.18(c) For purposes of reimbursement rates for special transportation services under 72.19paragraph (b), the zip code of the recipient's place of residence shall determine whether 72.20the urban, rural, or super rural reimbursement rate applies. 72.21(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 72.22means a census-tract based classification system under which a geographical area is 72.23determined to be urban, rural, or super rural. 72.24    Sec. 6. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision 72.25to read: 72.26     new text begin Subd. 3a. new text end new text begin Spousal contribution. new text end new text begin (a) For purposes of this subdivision, the following new text end 72.27 new text begin terms have the meanings given: new text end 72.28 new text begin (1) "commissioner" means the commissioner of human services; new text end 72.29 new text begin (2) "community spouse" means the spouse, who lives in the community, of an new text end 72.30 new text begin individual receiving long-term care services in a long-term care facility or home care new text end 72.31 new text begin services pursuant to the Medicaid waiver for elderly services under section 256B.0915 new text end 72.32 new text begin or the alternative care program under section 256B.0913. A community spouse does not new text end 72.33 new text begin include a spouse living in the community who receives a monthly income allowance new text end 72.34 new text begin under section 256B.058, subdivision 2, or who receives home care services or home new text end 73.1 new text begin and community-based services under section 256B.0915, 256B.092, or 256B.49, or the new text end 73.2 new text begin alternative care program under section 256B.0913; new text end 73.3 new text begin (3) "cost of care" means the actual fee-for-service costs or capitated payments for new text end 73.4 new text begin the long-term care spouse; new text end 73.5 new text begin (4) "department" means the Department of Human Services; new text end 73.6 new text begin (5) "disabled child" means a blind or permanently and totally disabled son or new text end 73.7 new text begin daughter of any age as defined in the Supplemental Security Income program or the state new text end 73.8 new text begin medical review team; new text end 73.9 new text begin (6) "income" means earned and unearned income, attributable to the community new text end 73.10 new text begin spouse, used to calculate the adjusted gross income on the prior year's income tax return. new text end 73.11 new text begin Evidence of income includes, but is not limited to, W-2 and 1099 forms; and new text end 73.12 new text begin (7) "long-term care spouse" means the spouse who is receiving long-term care new text end 73.13 new text begin services in a long-term care facility or home care services pursuant to the Medicaid new text end 73.14 new text begin waiver for elderly services under section 256B.0915 or the alternative care program under new text end 73.15 new text begin section 256B.0913. new text end 73.16 new text begin (b) The community spouse of a long-term care spouse who receives medical new text end 73.17 new text begin assistance or alternative care services has an obligation to contribute to the cost of care. new text end 73.18 new text begin The community spouse must pay a monthly fee on a sliding fee scale based on the new text end 73.19 new text begin community spouse's income. If a minor or disabled child resides with and receives care new text end 73.20 new text begin from the community spouse, then no fee shall be assessed. new text end 73.21 new text begin (c) For a community spouse with an income equal to or greater than 250 percent of new text end 73.22 new text begin the federal poverty guidelines for a family of two and less than 545 percent of the federal new text end 73.23 new text begin poverty guidelines for a family of two, the spousal contribution shall be determined using new text end 73.24 new text begin a sliding fee scale established by the commissioner that begins at 7.5 percent of the new text end 73.25 new text begin community spouse's income and increases to 15 percent for those with an income of up to new text end 73.26 new text begin 545 percent of the federal poverty guidelines for a family of two. new text end 73.27 new text begin (d) For a community spouse with an income equal to or greater than 545 percent of new text end 73.28 new text begin the federal poverty guidelines for a family of two and less than 750 percent of the federal new text end 73.29 new text begin poverty guidelines for a family of two, the spousal contribution shall be determined using new text end 73.30 new text begin a sliding fee scale established by the commissioner that begins at 15 percent of the new text end 73.31 new text begin community spouse's income and increases to 25 percent for those with an income of up to new text end 73.32 new text begin 750 percent of the federal poverty guidelines for a family of two. new text end 73.33 new text begin (e) For a community spouse with an income equal to or greater than 750 percent of new text end 73.34 new text begin the federal poverty guidelines for a family of two and less than 975 percent of the federal new text end 73.35 new text begin poverty guidelines for a family of two, the spousal contribution shall be determined using new text end 73.36 new text begin a sliding fee scale established by the commissioner that begins at 25 percent of the new text end 74.1 new text begin community spouse's income and increases to 33 percent for those with an income of up to new text end 74.2 new text begin 975 percent of the federal poverty guidelines for a family of two. new text end 74.3 new text begin (f) For a community spouse with an income equal to or greater than 975 percent of new text end 74.4 new text begin the federal poverty guidelines for a family of two, the spousal contribution shall be 33 new text end 74.5 new text begin percent of the community spouse's income. new text end 74.6 new text begin (g) The spousal contribution shall be explained in writing at the time eligibility new text end 74.7 new text begin for medical assistance or alternative care is being determined. In addition to explaining new text end 74.8 new text begin the formula used to determine the fee, the county or tribal agency shall provide written new text end 74.9 new text begin information describing how to request a variance for undue hardship, how a contribution new text end 74.10 new text begin may be reviewed or redetermined, the right to appeal a contribution determination, and new text end 74.11 new text begin that the consequences for not complying with a request to provide information shall be new text end 74.12 new text begin an assessment against the community spouse for the full cost of care for the long-term new text end 74.13 new text begin care spouse. new text end 74.14 new text begin (h) The contribution shall be assessed for each month the long-term care spouse new text end 74.15 new text begin has a community spouse and is eligible for medical assistance payment of long-term new text end 74.16 new text begin care services or alternative care. new text end 74.17 new text begin (i) The spousal contribution shall be reviewed at least once every 12 months and new text end 74.18 new text begin when there is a loss or gain in income in excess of ten percent. Thirty days prior to a new text end 74.19 new text begin review or redetermination, written notice must be provided to the community spouse new text end 74.20 new text begin and must contain the amount the spouse is required to contribute, notice of the right to new text end 74.21 new text begin redetermination and appeal, and the telephone number of the division at the agency that is new text end 74.22 new text begin responsible for redetermination and review. If, after review, the contribution amount is to new text end 74.23 new text begin be adjusted, the county or tribal agency shall mail a written notice to the community spouse new text end 74.24 new text begin 30 days in advance of the effective date of the change in the amount of the contribution. new text end 74.25 new text begin (1) The spouse shall notify the county or tribal agency within 30 days of a gain or new text end 74.26 new text begin loss in income in excess of ten percent and provide the agency supporting documentation new text end 74.27 new text begin to verify the need for redetermination of the fee. new text end 74.28 new text begin (2) When a spouse requests a review or redetermination of the contribution amount, new text end 74.29 new text begin a request for information shall be sent to the spouse within ten calendar days after the new text end 74.30 new text begin county or tribal agency receives the request for review. new text end 74.31 new text begin (3) No action shall be taken on a review or redetermination until the required new text end 74.32 new text begin information is received by the county or tribal agency. new text end 74.33 new text begin (4) The review of the spousal contribution shall be completed within ten days after new text end 74.34 new text begin the county or tribal agency receives completed information that verifies a loss or gain in new text end 74.35 new text begin income in excess of ten percent. new text end 75.1 new text begin (5) An increase in the contribution amount is effective in the month in which the new text end 75.2 new text begin increase in spousal income occurs. new text end 75.3 new text begin (6) A decrease in the contribution amount is effective in the month the spouse new text end 75.4 new text begin verifies the reduction in income, retroactive to no longer than six months. new text end 75.5 new text begin (j) In no case shall the spousal contribution exceed the amount of medical assistance new text end 75.6 new text begin expended or the cost of alternative care services for the care of the long-term care spouse. new text end 75.7 new text begin Annually, upon redetermination, or at termination of eligibility, the total amount of new text end 75.8 new text begin medical assistance paid or costs of alternative care for the care of the long-term care spouse new text end 75.9 new text begin and the total amount of the spousal contribution shall be compared. If the total amount new text end 75.10 new text begin of the spousal contribution exceeds the total amount of medical assistance expended or new text end 75.11 new text begin cost of alternative care, then the agency shall reimburse the community spouse the excess new text end 75.12 new text begin amount if the long-term care spouse is no longer receiving services, or apply the excess new text end 75.13 new text begin amount to the spousal contribution due until the excess amount is exhausted. new text end 75.14 new text begin (k) A community spouse may request a variance by submitting a written request new text end 75.15 new text begin and supporting documentation that payment of the calculated contribution would cause new text end 75.16 new text begin an undue hardship. An undue hardship is defined as the inability to pay the calculated new text end 75.17 new text begin contribution due to medical expenses incurred by the community spouse. Documentation new text end 75.18 new text begin must include proof of medical expenses incurred by the community spouse since the last new text end 75.19 new text begin annual redetermination of the contribution amount that are not reimbursable by any public new text end 75.20 new text begin or private source, and are a type, regardless of amount, that would be allowable as a new text end 75.21 new text begin federal tax deduction under the Internal Revenue Code. new text end 75.22 new text begin (1) A spouse who requests a variance from a notice of an increase in the amount new text end 75.23 new text begin of spousal contribution shall continue to make monthly payments at the lower amount new text end 75.24 new text begin pending determination of the variance request. A spouse who requests a variance from new text end 75.25 new text begin the initial determination shall not be required to make a payment pending determination new text end 75.26 new text begin of the variance request. Payments made pending outcome of the variance request that new text end 75.27 new text begin result in overpayment must be returned to the spouse, if the community spouse is no new text end 75.28 new text begin longer receiving services, or applied to the spousal contribution in the current year. If the new text end 75.29 new text begin variance is denied, the spouse shall pay the additional amount due from the effective date new text end 75.30 new text begin of the increase or the total amount due from the effective date of the original notice of new text end 75.31 new text begin determination of the spousal contribution. new text end 75.32 new text begin (2) A spouse who is granted a variance shall sign a written agreement in which the new text end 75.33 new text begin spouse agrees to report to the county or tribal agency any changes in circumstances that new text end 75.34 new text begin gave rise to the undue hardship variance. new text end 75.35 new text begin (3) When the county or tribal agency receives a request for a variance, written notice new text end 75.36 new text begin of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days new text end 76.1 new text begin after the county or tribal agency receives the financial information required in this clause. new text end 76.2 new text begin The granting of a variance will necessitate a written agreement between the spouse and the new text end 76.3 new text begin county or tribal agency with regard to the specific terms of the variance. The variance new text end 76.4 new text begin will not become effective until the written agreement is signed by the spouse. If the new text end 76.5 new text begin county or tribal agency denies in whole or in part the request for a variance, the denial new text end 76.6 new text begin notice shall set forth in writing the reasons for the denial that address the specific hardship new text end 76.7 new text begin and right to appeal. new text end 76.8 new text begin (4) If a variance is granted, the term of the variance shall not exceed 12 months new text end 76.9 new text begin unless otherwise determined by the county or tribal agency. new text end 76.10 new text begin (5) Undue hardship does not include action taken by a spouse which divested or new text end 76.11 new text begin diverted income in order to avoid being assessed a spousal contribution. new text end 76.12 new text begin (l) A spouse aggrieved by an action under this subdivision has the right to appeal new text end 76.13 new text begin under subdivision 4. If the spouse appeals on or before the effective date of an increase new text end 76.14 new text begin in the spousal fee, the spouse shall continue to make payments to the county or tribal new text end 76.15 new text begin agency in the lower amount while the appeal is pending. A spouse appealing an initial new text end 76.16 new text begin determination of a spousal contribution shall not be required to make monthly payments new text end 76.17 new text begin pending an appeal decision. Payments made that result in an overpayment shall be new text end 76.18 new text begin reimbursed to the spouse if the long-term care spouse is no longer receiving services, or new text end 76.19 new text begin applied to the spousal contribution remaining in the current year. If the commissioner's new text end 76.20 new text begin determination is affirmed, the community spouse shall pay within 90 calendar days of the new text end 76.21 new text begin order the total amount due from the effective date of the original notice of determination new text end 76.22 new text begin of the spousal contribution. The commissioner's order is binding on the spouse and the new text end 76.23 new text begin agency and shall be implemented subject to section 256.045, subdivision 7. No additional new text end 76.24 new text begin notice is required to enforce the commissioner's order. new text end 76.25 new text begin (m) If the county or tribal agency finds that notice of the payment obligation was new text end 76.26 new text begin given to the community spouse and the spouse was determined to be able to pay, but that new text end 76.27 new text begin the spouse failed or refused to pay, a cause of action exists against the community spouse new text end 76.28 new text begin for that portion of medical assistance payment of long-term care services or alternative new text end 76.29 new text begin care services granted after notice was given to the community spouse. The action may be new text end 76.30 new text begin brought by the county or tribal agency in the county where assistance was granted for the new text end 76.31 new text begin assistance together with the costs of disbursements incurred due to the action. In addition new text end 76.32 new text begin to granting the county or tribal agency a money judgment, the court may, upon a motion or new text end 76.33 new text begin order to show cause, order continuing contributions by a community spouse found able to new text end 76.34 new text begin repay the county or tribal agency. The order shall be effective only for the period of time new text end 76.35 new text begin during which a contribution shall be assessed. new text end 77.1     new text begin (n) Counties and tribes are entitled to one-half of the nonfederal share of new text end 77.2 new text begin contributions made under this section for long-term care spouses on medical assistance new text end 77.3 new text begin that are directly attributed to county or tribal efforts. Counties and tribes are entitled to new text end 77.4 new text begin 25 percent of the contributions made under this section for long-term care spouses on new text end 77.5 new text begin alternative care directly attributed to county or tribal efforts. new text end 77.6    Sec. 7. Minnesota Statutes 2010, section 326B.175, is amended to read: 77.7326B.175 ELEVATORS, ENTRANCES SEALED. 77.8     new text begin Except as provided in section 326B.188, new text end it shall be the duty of the department and 77.9the licensing authority of any municipality which adopts any such ordinance whenever 77.10it finds any such elevator under its jurisdiction in use in violation of any provision of 77.11sections 326B.163 to 326B.178 to seal the entrances of such elevator and attach a notice 77.12forbidding the use of such elevator until the provisions thereof are complied with. 77.13    Sec. 8. new text begin [326B.188] COMPLIANCE WITH ELEVATOR CODE CHANGES. new text end 77.14 new text begin (a) This section applies to code requirements for existing elevators and related new text end 77.15 new text begin devices under Minnesota Rules, chapter 1307, where the deadline set by law for meeting new text end 77.16 new text begin the code requirements is January 29, 2012, or later. new text end 77.17 new text begin (b) If the department or municipality conducting elevator inspections within its new text end 77.18 new text begin jurisdiction notifies the owner of an existing elevator or related device of the code new text end 77.19 new text begin requirements before the effective date of this section, the owner may submit a compliance new text end 77.20 new text begin plan by December 30, 2011. If the department or municipality does not notify the owner new text end 77.21 new text begin of an existing elevator or related device of the code requirements before the effective new text end 77.22 new text begin date of this section, the department or municipality shall notify the owner of the code new text end 77.23 new text begin requirements and permit the owner to submit a compliance plan by December 30, 2011, or new text end 77.24 new text begin within 60 days after the date of notification, whichever is later. new text end 77.25 new text begin (c) Any compliance plan submitted under this section must result in compliance with new text end 77.26 new text begin the code requirements by the later of January 29, 2012, or three years after submission of new text end 77.27 new text begin the compliance plan. Elevators and related devices that are not in compliance with the new text end 77.28 new text begin code requirements by the later of January 29, 2012, or three years after the submission of new text end 77.29 new text begin the compliance plan may be taken out of service as provided in section 326B.175. new text end 77.30    Sec. 9. new text begin DEVELOPMENTAL DISABILITY WAIVERED SERVICES. new text end 77.31     new text begin Subdivision 1. new text end new text begin Purpose. new text end new text begin All individuals in the state of Minnesota who are eligible new text end 77.32 new text begin for developmental disability waivered services are entitled to receive adequate services, new text end 78.1 new text begin within the limits of available funding, to ensure their basic needs for housing, food, health, new text end 78.2 new text begin and safety are met. new text end 78.3     new text begin Subd. 2. new text end new text begin Instructions to commissioner. new text end new text begin (a) No later than November 1, 2011, new text end 78.4 new text begin the commissioner of human services shall convene a workgroup to define the essential new text end 78.5 new text begin services required to adequately meet the needs of individuals who receive developmental new text end 78.6 new text begin disability waivered services. The commissioner shall identify the essential services in new text end 78.7 new text begin each of the following tiers: new text end 78.8 new text begin (1) tier 1, services and costs associated with safety, food, housing, and health care; new text end 78.9 new text begin (2) tier 2, services and costs associated with enhancements toward self-sufficiency; new text end 78.10 new text begin and new text end 78.11 new text begin (3) tier 3, services and costs associated with quality of life improvements. new text end 78.12 new text begin (b) The commissioner, or designee, and a representative designated by the counties new text end 78.13 new text begin shall cochair the workgroup. The workgroup shall consider Tier 1 services to be the most new text end 78.14 new text begin important and of highest priority for available funds, and may choose to implement a policy new text end 78.15 new text begin that all waiver-eligible individuals receive Tier 1 services within the limits of available new text end 78.16 new text begin funding before services from Tier 2 or 3 are offered to waiver-eligible individuals. new text end 78.17    Sec. 10. new text begin ANALYSIS OF PROGRAMS AND THEIR EFFECT ON MARRIAGES; new text end 78.18 new text begin REPORT. new text end 78.19 new text begin (a) The commissioner of human services shall conduct an analysis of how current new text end 78.20 new text begin human services programs affect the motivation and capacity of individuals to form and new text end 78.21 new text begin sustain marriages in which to raise children. Programs to be examined in this marriage new text end 78.22 new text begin impact analysis may include, but are not limited to, medical assistance, MinnesotaCare, new text end 78.23 new text begin Minnesota family investment program, child protection, child support enforcement, and new text end 78.24 new text begin child welfare services. new text end 78.25 new text begin (b) Before January 1, 2012, the commissioner shall submit a report to the legislature new text end 78.26 new text begin describing the results of this analysis and outline proposals to improve the ability of new text end 78.27 new text begin human services programs to help people who are interested in marriage to form and new text end 78.28 new text begin sustain marriages in which to raise children. The commissioner shall ensure that experts new text end 78.29 new text begin on marriage are consulted on the process of conducting the analysis and writing the report. new text end 78.30    Sec. 11. new text begin LEGISLATIVE APPROVAL FOR FEDERAL FUNDS. new text end 78.31 new text begin In addition to the requirements of Minnesota Statutes, section 3.3005, the new text end 78.32 new text begin commissioners of human services and health shall not expend any funding received new text end 78.33 new text begin through federal grants or subsequent renewal of federal grants without the approval of new text end 79.1 new text begin three of the four chairs and ranking minority members of the legislative committees with new text end 79.2 new text begin jurisdiction over health and human services finance. new text end 79.3    Sec. 12. new text begin NONEMERGENCY MEDICAL TRANSPORTATION SINGLE new text end 79.4 new text begin ADMINISTRATIVE STRUCTURE PROPOSAL. new text end 79.5 new text begin (a) The commissioner of human services shall develop a proposal to create a single new text end 79.6 new text begin administrative structure for providing nonemergency medical transportation services to new text end 79.7 new text begin fee-for-service medical assistance recipients. This proposal must consolidate access and new text end 79.8 new text begin special transportation into one administrative structure with the goal of standardizing new text end 79.9 new text begin eligibility determination processes, scheduling arrangements, billing procedures, data new text end 79.10 new text begin collection, and oversight mechanisms in order to enhance coordination, improve new text end 79.11 new text begin accountability, and lessen confusion. new text end 79.12 new text begin (b) In developing the proposal, the commissioner shall: new text end 79.13 new text begin (1) examine the current responsibilities performed by the counties and the new text end 79.14 new text begin Department of Human Services and consider the shift in costs if these responsibilities are new text end 79.15 new text begin changed; new text end 79.16 new text begin (2) identify key performance measures to assess the cost effectiveness of new text end 79.17 new text begin nonemergency medical transportation statewide, including a process to collect, audit, new text end 79.18 new text begin and report data; new text end 79.19 new text begin (3) develop a statewide complaint system for medical assistance recipients using new text end 79.20 new text begin special transportation; new text end 79.21 new text begin (4) establish a standardized billing process; new text end 79.22 new text begin (5) establish a process that provides public input from interested parties before new text end 79.23 new text begin special transportation eligibility policies are implemented or significantly changed; new text end 79.24 new text begin (6) establish specific eligibility criteria that include the frequency of eligibility new text end 79.25 new text begin assessments and the length of time a recipient remains eligible for special transportation; new text end 79.26 new text begin (7) develop a reimbursement method to compensate volunteers for no-load miles new text end 79.27 new text begin when transporting recipients to or from health-related appointments; and new text end 79.28 new text begin (8) establish specific eligibility criteria to maximize the use of public transportation new text end 79.29 new text begin by recipients who are without a physical, mental, or other impairment that would prohibit new text end 79.30 new text begin safely accessing and using public transportation. new text end 79.31 new text begin (c) In developing the proposal, the commissioner shall consult with the new text end 79.32 new text begin nonemergency medical transportation advisory council established under paragraph (d). new text end 79.33 new text begin (d) The commissioner shall establish the nonemergency medical transportation new text end 79.34 new text begin advisory council to assist the commissioner in developing a single administrative structure new text end 80.1 new text begin for providing nonemergency medical transportation services. The council shall be new text end 80.2 new text begin comprised of: new text end 80.3 new text begin (1) one representative each from the departments of human services and new text end 80.4 new text begin transportation; new text end 80.5 new text begin (2) one representative each from the following organizations: the Minnesota State new text end 80.6 new text begin Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC of new text end 80.7 new text begin Minnesota, the Association of Minnesota Counties, the R-80 Medical Transportation new text end 80.8 new text begin Coalition, the Minnesota Para Transit Association, Legal Aid, the Minnesota Ambulance new text end 80.9 new text begin Association, the National Alliance on Mental Illness, the Minnesota Transportation new text end 80.10 new text begin Providers Alliance, and the Minnesota Inter-County Association; and new text end 80.11 new text begin (3) four members from the house of representatives, two from the majority party new text end 80.12 new text begin and two from the minority party, appointed by the speaker, and four members from the new text end 80.13 new text begin senate, two from the majority party and two from the minority party, appointed by the new text end 80.14 new text begin Subcommittee on Committees of the Committee on Rules and Administration. new text end 80.15 new text begin The council is governed by Minnesota Statutes, section 15.509, except that members new text end 80.16 new text begin shall not receive per diems. The commissioner of human services shall fund all costs new text end 80.17 new text begin related to the council from existing resources. new text end 80.18 new text begin (e) The commissioner shall submit the proposal and draft legislation necessary for new text end 80.19 new text begin implementation to the chairs and ranking minority members of the senate and house of new text end 80.20 new text begin representatives committees or divisions with jurisdiction over health care policy and new text end 80.21 new text begin finance by January 15, 2012. new text end 80.22    Sec. 13. new text begin RECOVERY FROM BROKER. new text end 80.23 new text begin (a) If deemed appropriate after a review by the Attorney General's office, the new text end 80.24 new text begin commissioner of human services, in cooperation with the commissioner of management new text end 80.25 new text begin and budget, shall recover from any broker of nonemergency medical transportation new text end 80.26 new text begin services all administrative amounts paid in excess of the original agreed upon amount as new text end 80.27 new text begin stated in any contract or compensation agreement that provided for the total compensation new text end 80.28 new text begin for administrative services in each state fiscal year to not exceed a specific agreed amount new text end 80.29 new text begin for fiscal years 2005, 2006, 2007, 2008, 2009, and 2010. new text end 80.30 new text begin (b) Recoveries under this section shall be based on the findings of the Office of new text end 80.31 new text begin Legislative Auditor's report on medical nonemergency transportation released in February new text end 80.32 new text begin 2011. new text end 81.1ARTICLE 4 81.2HEALTH LICENSING FEES 81.3    Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read: 81.4    Subdivision 1. Renewal fees. All persons practicing chiropractic within this state, 81.5or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the 81.6Board of Chiropractic Examiners a renewal fee set by the board new text begin in accordance with section new text end 81.7 new text begin 16A.1283 new text end , with a penalty set by the board for each month or portion thereof for which a 81.8license fee is in arrears and upon payment of the renewal and upon compliance with all the 81.9rules of the board, shall be entitled to renewal of their license. 81.10    Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision 81.11to read: 81.12     new text begin Subd. 4. new text end new text begin Animal chiropractic. new text end new text begin (a) Animal chiropractic registration fee is $125. new text end 81.13 new text begin (b) Animal chiropractic registration renewal fee is $75. new text end 81.14 new text begin (c) Animal chiropractic inactive renewal fee is $25. new text end 81.15    Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read: 81.16    Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise 81.17rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 81.18provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula 81.19and standards for schools and courses preparing persons for licensure under sections 81.20148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses 81.21at such times as it may deem necessary. It shall approve such schools and courses as 81.22meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine, 81.23license, and renew the license of duly qualified applicants. It shall hold examinations 81.24at least once in each year at such time and place as it may determine. It shall by rule 81.25adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for 81.26registration and renewal of registration as defined in section 148.231. It shall maintain a 81.27record of all persons licensed by the board to practice professional or practical nursing and 81.28all registered nurses who hold Minnesota licensure and registration and are certified as 81.29advanced practice registered nurses. It shall cause the prosecution of all persons violating 81.30sections 148.171 to 148.285 and have power to incur such necessary expense therefor. 81.31It shall register public health nurses who meet educational and other requirements 81.32established by the board by rule, including payment of a fee. Prior to the adoption of rules, 81.33the board shall use the same procedures used by the Department of Health to certify public 82.1health nurses. It shall have power to issue subpoenas, and to compel the attendance of 82.2witnesses and the production of all necessary documents and other evidentiary material. 82.3Any board member may administer oaths to witnesses, or take their affirmation. It shall 82.4keep a record of all its proceedings. 82.5(b) The board shall have access to hospital, nursing home, and other medical records 82.6of a patient cared for by a nurse under review. If the board does not have a written consent 82.7from a patient permitting access to the patient's records, the nurse or facility shall delete 82.8any data in the record that identifies the patient before providing it to the board. The board 82.9shall have access to such other records as reasonably requested by the board to assist the 82.10board in its investigation. Nothing herein may be construed to allow access to any records 82.11protected by section 145.64. The board shall maintain any records obtained pursuant to 82.12this paragraph as investigative data under chapter 13. 82.13 new text begin (c) The board may accept and expend grants or gifts of money or in-kind services new text end 82.14 new text begin from a person, a public or private entity, or any other source for purposes consistent with new text end 82.15 new text begin the board's role and within the scope of its statutory authority. new text end 82.16 new text begin (d) The board may accept registration fees for meetings and conferences conducted new text end 82.17 new text begin for the purposes of board activities that are within the scope of its authority. new text end 82.18    Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read: 82.19    Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration 82.20fee and permit fee, and in accordance with rules of the board, the board may issue 82.21a nonrenewable temporary permit to practice professional or practical nursing to an 82.22applicant for licensure or reregistration who is not the subject of a pending investigation 82.23or disciplinary action, nor disqualified for any other reason, under the following 82.24circumstances: 82.25(a) The applicant for licensure by examination under section 148.211, subdivision 82.261 , has graduated from an approved nursing program within the 60 days preceding board 82.27receipt of an affidavit of graduation or transcript and has been authorized by the board to 82.28write the licensure examination for the first time in the United States. The permit holder 82.29must practice professional or practical nursing under the direct supervision of a registered 82.30nurse. The permit is valid from the date of issue until the date the board takes action on 82.31the application or for 60 days whichever occurs first. 82.32(b) The applicant for licensure by endorsement under section 148.211, subdivision 2, 82.33is currently licensed to practice professional or practical nursing in another state, territory, 82.34or Canadian province. The permit is valid from submission of a proper request until the 82.35date of board action on the application new text begin or for 60 days, whichever comes first new text end . 83.1(c) new text begin (b) new text end The applicant for licensure by endorsement under section 148.211, 83.2subdivision 2 , or for reregistration under section 148.231, subdivision 5, is currently 83.3registered in a formal, structured refresher course or its equivalent for nurses that includes 83.4clinical practice. 83.5(d) The applicant for licensure by examination under section 148.211, subdivision 83.61 , who graduated from a nursing program in a country other than the United States or 83.7Canada has completed all requirements for licensure except registering for and taking the 83.8nurse licensure examination for the first time in the United States. The permit holder must 83.9practice professional nursing under the direct supervision of a registered nurse. The permit 83.10is valid from the date of issue until the date the board takes action on the application or for 83.1160 days, whichever occurs first. 83.12    Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read: 83.13148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 83.14VERIFICATION. 83.15    Subdivision 1. Registration. Every person licensed to practice professional or 83.16practical nursing must maintain with the board a current registration for practice as a 83.17registered nurse or licensed practical nurse which must be renewed at regular intervals 83.18established by the board by rule. No certificate of registration shall be issued by the board 83.19to a nurse until the nurse has submitted satisfactory evidence of compliance with the 83.20procedures and minimum requirements established by the board. 83.21The fee for periodic registration for practice as a nurse shall be determined by the 83.22board by rule new text begin law new text end . A penalty fee shall be added for any application received after the 83.23required date as specified by the board by rule. Upon receipt of the application and the 83.24required fees, the board shall verify the application and the evidence of completion of 83.25continuing education requirements in effect, and thereupon issue to the nurse a certificate 83.26of registration for the next renewal period. 83.27    Subd. 4. Failure to register. Any person licensed under the provisions of sections 83.28148.171 to 148.285 who fails to register within the required period shall not be entitled to 83.29practice nursing in this state as a registered nurse or licensed practical nurse. 83.30    Subd. 5. Reregistration. A person whose registration has lapsed desiring to 83.31resume practice shall make application for reregistration, submit satisfactory evidence of 83.32compliance with the procedures and requirements established by the board, and pay the 83.33registration new text begin reregistration new text end fee for the current period to the board. A penalty fee shall be 83.34required from a person who practiced nursing without current registration. Thereupon, the 84.1registration certificate shall be issued to the person who shall immediately be placed on 84.2the practicing list as a registered nurse or licensed practical nurse. 84.3    Subd. 6. Verification. A person licensed under the provisions of sections 148.171 to 84.4148.285 who requests the board to verify a Minnesota license to another state, territory, 84.5or country or to an agency, facility, school, or institution shall pay a fee to the board 84.6for each verification. 84.7    Sec. 6. new text begin [148.242] FEES. new text end 84.8 new text begin The fees specified in section 148.243 are nonrefundable and must be deposited in new text end 84.9 new text begin the state government special revenue fund. new text end 84.10    Sec. 7. new text begin [148.243] FEE AMOUNTS. new text end 84.11     new text begin Subdivision 1. new text end new text begin Licensure by examination. new text end new text begin The fee for licensure by examination is new text end 84.12 new text begin $105. new text end 84.13     new text begin Subd. 2. new text end new text begin Reexamination fee. new text end new text begin The reexamination fee is $60. new text end 84.14     new text begin Subd. 3. new text end new text begin Licensure by endorsement. new text end new text begin The fee for licensure by endorsement is $105. new text end 84.15     new text begin Subd. 4. new text end new text begin Registration renewal. new text end new text begin The fee for registration renewal is $85. new text end 84.16     new text begin Subd. 5. new text end new text begin Reregistration. new text end new text begin The fee for reregistration is $105. new text end 84.17     new text begin Subd. 6. new text end new text begin Replacement license. new text end new text begin The fee for a replacement license is $20. new text end 84.18     new text begin Subd. 7. new text end new text begin Public health nurse certification. new text end new text begin The fee for public health nurse new text end 84.19 new text begin certification is $30. new text end 84.20     new text begin Subd. 8. new text end new text begin Drug Enforcement Administration verification for Advanced Practice new text end 84.21 new text begin Registered Nurse (APRN). new text end new text begin The Drug Enforcement Administration verification for new text end 84.22 new text begin APRN is $50. new text end 84.23     new text begin Subd. 9. new text end new text begin Licensure verification other than through Nursys. new text end new text begin The fee for new text end 84.24 new text begin verification of licensure status other than through Nursys verification is $20. new text end 84.25     new text begin Subd. 10. new text end new text begin Verification of examination scores. new text end new text begin The fee for verification of new text end 84.26 new text begin examination scores is $20. new text end 84.27     new text begin Subd. 11. new text end new text begin Microfilmed licensure application materials. new text end new text begin The fee for a copy of new text end 84.28 new text begin microfilmed licensure application materials is $20. new text end 84.29     new text begin Subd. 12. new text end new text begin Nursing business registration; initial application. new text end new text begin The fee for the initial new text end 84.30 new text begin application for nursing business registration is $100. new text end 84.31     new text begin Subd. 13. new text end new text begin Nursing business registration; annual application. new text end new text begin The fee for the new text end 84.32 new text begin annual application for nursing business registration is $25. new text end 84.33     new text begin Subd. 14. new text end new text begin Practicing without current registration. new text end new text begin The fee for practicing without new text end 84.34 new text begin current registration is two times the amount of the current registration renewal fee for any new text end 85.1 new text begin part of the first calendar month, plus the current registration renewal fee for any part of new text end 85.2 new text begin any subsequent month up to 24 months. new text end 85.3     new text begin Subd. 15. new text end new text begin Practicing without current APRN certification. new text end new text begin The fee for practicing new text end 85.4 new text begin without current APRN certification is $200 for the first month or any part thereof, plus new text end 85.5 new text begin $100 for each subsequent month or part thereof. new text end 85.6     new text begin Subd. 16. new text end new text begin Dishonored check fee. new text end new text begin The service fee for a dishonored check is as new text end 85.7 new text begin provided in section 604.113. new text end 85.8     new text begin Subd. 17. new text end new text begin Border state registry fee. new text end new text begin The initial application fee for border state new text end 85.9 new text begin registration is $50. Any subsequent notice of employment change to remain or be new text end 85.10 new text begin reinstated on the registry is $50. new text end 85.11    Sec. 8. Minnesota Statutes 2010, section 148B.17, is amended to read: 85.12148B.17 FEES. 85.13     new text begin Subdivision. 1. new text end new text begin Fees; Board of Marriage and Family Therapy. new text end Each board shall 85.14by rule establish new text begin The board's new text end fees, including late fees, for licenses and renewals new text begin are new text end 85.15 new text begin established new text end so that the total fees collected by the board will as closely as possible equal 85.16anticipated expenditures during the fiscal biennium, as provided in section 16A.1285. 85.17Fees must be credited to accounts new text begin the board's account new text end in the new text begin state government new text end special 85.18revenue fund. 85.19     new text begin Subd. 2. new text end new text begin Licensure and application fees. new text end new text begin Nonrefundable licensure and application new text end 85.20 new text begin fees charged by the board are as follows: new text end 85.21 new text begin (1) application fee for national examination is $220; new text end 85.22 new text begin (2) application fee for Licensed Marriage and Family Therapist (LMFT) state new text end 85.23 new text begin examination is $110; new text end 85.24 new text begin (3) initial LMFT license fee is prorated, but cannot exceed $125; new text end 85.25 new text begin (4) annual renewal fee for LMFT license is $125; new text end 85.26 new text begin (5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT new text end 85.27 new text begin license renewal is $50; new text end 85.28 new text begin (6) application fee for LMFT licensure by reciprocity is $340; new text end 85.29 new text begin (7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) new text end 85.30 new text begin license is $75; new text end 85.31 new text begin (8) annual renewal fee for LAMFT license is $75; new text end 85.32 new text begin (9) late fee for LAMFT renewal is $50; new text end 85.33 new text begin (10) fee for reinstatement of license is $150; and new text end 85.34 new text begin (11) fee for emeritus status is $125. new text end 85.35     new text begin Subd. 3. new text end new text begin Other fees. new text end new text begin Other fees charged by the board are as follows: new text end 86.1 new text begin (1) sponsor application fee for approval of a continuing education course is $60; new text end 86.2 new text begin (2) fee for license verification by mail is $10; new text end 86.3 new text begin (3) duplicate license fee is $25; new text end 86.4 new text begin (4) duplicate renewal card fee is $10; new text end 86.5 new text begin (5) fee for licensee mailing list is $60; new text end 86.6 new text begin (6) fee for a rule book is $10; and new text end 86.7 new text begin (7) fees as authorized by section 148B.175, subdivision 6, clause (7). new text end 86.8    Sec. 9. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read: 86.9    Subd. 2. Fee. Each applicant shall pay a nonrefundable application fee set by 86.10the board new text begin under section 148B.17 new text end . 86.11    Sec. 10. Minnesota Statutes 2010, section 148B.52, is amended to read: 86.12148B.52 DUTIES OF THE BOARD. 86.13(a) The Board of Behavioral Health and Therapy shall: 86.14(1) establish by rule appropriate techniques, including examinations and other 86.15methods, for determining whether applicants and licensees are qualified under sections 86.16148B.50 to 148B.593; 86.17(2) establish by rule standards for professional conduct, including adoption of a 86.18Code of Professional Ethics and requirements for continuing education and supervision; 86.19(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593; 86.20(4) establish by rule standards for initial education including coursework for 86.21licensure and content of professional education; 86.22(5) establish, maintain, and publish annually a register of current licensees and 86.23approved supervisors; 86.24(6) establish initial and renewal application and examination fees sufficient to cover 86.25operating expenses of the board and its agents new text begin in accordance with section 16A.1283 new text end ; 86.26(7) educate the public about the existence and content of the laws and rules for 86.27licensed professional counselors to enable consumers to file complaints against licensees 86.28who may have violated the rules; and 86.29(8) periodically evaluate its rules in order to refine the standards for licensing 86.30professional counselors and to improve the methods used to enforce the board's standards. 86.31(b) The board may appoint a professional discipline committee for each occupational 86.32licensure regulated by the board, and may appoint a board member as chair. The 86.33professional discipline committee shall consist of five members representative of the 87.1licensed occupation and shall provide recommendations to the board with regard to rule 87.2techniques, standards, procedures, and related issues specific to the licensed occupation. 87.3    Sec. 11. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read: 87.4    Subd. 2. Application fees. Each applicant shall submit with a license new text begin , advanced new text end 87.5 new text begin dental therapist certificate, new text end or permit application a nonrefundable fee in the following 87.6amounts in order to administratively process an application: 87.7(1) dentist, $140; 87.8 new text begin (2) full faculty dentist, $140; new text end 87.9(2) new text begin (3) new text end limited faculty dentist, $140; 87.10(3) new text begin (4) new text end resident dentist new text begin or dental provider new text end , $55; 87.11 new text begin (5) advanced dental therapist, $100; new text end 87.12(4) new text begin (6) new text end dental therapist, $100; 87.13(5) new text begin (7) new text end dental hygienist, $55; 87.14(6) new text begin (8) new text end licensed dental assistant, $55; and 87.15(7) new text begin (9) new text end dental assistant with a permit as described in Minnesota Rules, part 87.163100.8500, subpart 3, $15. 87.17    Sec. 12. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read: 87.18    Subd. 3. Initial license or permit fees. Along with the application fee, each of the 87.19following applicants shall submit a separate prorated initial license or permit fee. The 87.20prorated initial fee shall be established by the board based on the number of months of the 87.21applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to 87.22exceed the following monthly fee amounts: 87.23(1) dentist new text begin or full faculty dentist new text end , $14 times the number of months of the initial term; 87.24(2) dental therapist, $10 times the number of months of the initial term; 87.25(3) dental hygienist, $5 times the number of months of the initial term; 87.26(4) licensed dental assistant, $3 times the number of months of the initial term; and 87.27(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 87.28subpart 3, $1 times the number of months of the initial term. 87.29    Sec. 13. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read: 87.30    Subd. 4. Annual license fees. Each limited faculty or resident dentist shall submit 87.31with an annual license renewal application a fee established by the board not to exceed 87.32the following amounts: 87.33(1) limited faculty dentist, $168; and 88.1(2) resident dentist new text begin or dental provider new text end , $59. 88.2    Sec. 14. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read: 88.3    Subd. 5. Biennial license or permit fees. Each of the following applicants shall 88.4submit with a biennial license or permit renewal application a fee as established by the 88.5board, not to exceed the following amounts: 88.6(1) dentist new text begin or full faculty dentist new text end , $336; 88.7(2) dental therapist, $180; 88.8(3) dental hygienist, $118; 88.9(4) licensed dental assistant, $80; and 88.10(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 88.11subpart 3, $24. 88.12    Sec. 15. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read: 88.13    Subd. 8. Duplicate license or certificate fee. Each applicant shall submit, with 88.14a request for issuance of a duplicate of the original license, or of an annual or biennial 88.15renewal certificate for a license or permit, a fee in the following amounts: 88.16(1) original dentist, new text begin full faculty dentist, new text end dental therapist, dental hygiene, or dental 88.17assistant license, $35; and 88.18(2) annual or biennial renewal certificates, $10. 88.19    Sec. 16. Minnesota Statutes 2010, section 150A.091, is amended by adding a 88.20subdivision to read: 88.21     new text begin Subd. 16. new text end new text begin Failure of professional development portfolio audit. new text end new text begin A licensee shall new text end 88.22 new text begin submit a fee as established by the board not to exceed the amount of $250 after failing new text end 88.23 new text begin two consecutive professional development portfolio audits and, thereafter, for each failed new text end 88.24 new text begin professional development portfolio audit under Minnesota Rules, part 3100.5300. new text end 88.25    Sec. 17. new text begin [151.065] FEE AMOUNTS. new text end 88.26     new text begin Subdivision 1. new text end new text begin Application fees. new text end new text begin Application fees for licensure and registration new text end 88.27 new text begin are as follows: new text end 88.28 new text begin (1) pharmacist licensed by examination, $130; new text end 88.29 new text begin (2) pharmacist licensed by reciprocity, $225; new text end 88.30 new text begin (3) pharmacy intern, $30; new text end 88.31 new text begin (4) pharmacy technician, $30; new text end 88.32 new text begin (5) pharmacy, $190; new text end 89.1 new text begin (6) drug wholesaler, legend drugs only, $200; new text end 89.2 new text begin (7) drug wholesaler, legend and nonlegend drugs, $200; new text end 89.3 new text begin (8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175; new text end 89.4 new text begin (9) drug wholesaler, medical gases, $150; new text end 89.5 new text begin (10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125; new text end 89.6 new text begin (11) drug manufacturer, legend drugs only, $200; new text end 89.7 new text begin (12) drug manufacturer, legend and nonlegend drugs, $200; new text end 89.8 new text begin (13) drug manufacturer, nonlegend or veterinary legend drugs, $175; new text end 89.9 new text begin (14) drug manufacturer, medical gases, $150; new text end 89.10 new text begin (15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125; new text end 89.11 new text begin (16) medical gas distributor, $75; new text end 89.12 new text begin (17) controlled substance researcher, $50; and new text end 89.13 new text begin (18) pharmacy professional corporation, $100. new text end 89.14     new text begin Subd. 2. new text end new text begin Original license fee. new text end new text begin The pharmacist original licensure fee, $130. new text end 89.15     new text begin Subd. 3. new text end new text begin Annual renewal fees. new text end new text begin Annual licensure and registration renewal fees new text end 89.16 new text begin are as follows: new text end 89.17 new text begin (1) pharmacist, $130; new text end 89.18 new text begin (2) pharmacy technician, $30; new text end 89.19 new text begin (3) pharmacy, $190; new text end 89.20 new text begin (4) drug wholesaler, legend drugs only, $200; new text end 89.21 new text begin (5) drug wholesaler, legend and nonlegend drugs, $200; new text end 89.22 new text begin (6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175; new text end 89.23 new text begin (7) drug wholesaler, medical gases, $150; new text end 89.24 new text begin (8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125; new text end 89.25 new text begin (9) drug manufacturer, legend drugs only, $200; new text end 89.26 new text begin (10) drug manufacturer, legend and nonlegend drugs, $200; new text end 89.27 new text begin (11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175; new text end 89.28 new text begin (12) drug manufacturer, medical gases, $150; new text end 89.29 new text begin (13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125; new text end 89.30 new text begin (14) medical gas distributor, $75; new text end 89.31 new text begin (15) controlled substance researcher, $50; and new text end 89.32 new text begin (16) pharmacy professional corporation, $45. new text end 89.33     new text begin Subd. 4. new text end new text begin Miscellaneous fees. new text end new text begin Fees for issuance of affidavits and duplicate licenses new text end 89.34 new text begin and certificates are as follows: new text end 89.35 new text begin (1) intern affidavit, $15; new text end 89.36 new text begin (2) duplicate small license, $15; and new text end 90.1 new text begin (3) duplicate large certificate, $25. new text end 90.2     new text begin Subd. 5. new text end new text begin Late fees. new text end new text begin All annual renewal fees are subject to a 50 percent late fee if new text end 90.3 new text begin the renewal fee and application are not received by the board prior to the date specified new text end 90.4 new text begin by the board. new text end 90.5     new text begin Subd. 6. new text end new text begin Reinstatement fees. new text end new text begin (a) A pharmacist who has allowed the pharmacist's new text end 90.6 new text begin license to lapse may reinstate the license with board approval and upon payment of any new text end 90.7 new text begin fees and late fees in arrears, up to a maximum of $1,000. new text end 90.8 new text begin (b) A pharmacy technician who has allowed the technician's registration to lapse new text end 90.9 new text begin may reinstate the registration with board approval and upon payment of any fees and late new text end 90.10 new text begin fees in arrears, up to a maximum of $90. new text end 90.11 new text begin (c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical new text end 90.12 new text begin gas distributor who has allowed the license of the establishment to lapse may reinstate the new text end 90.13 new text begin license with board approval and upon payment of any fees and late fees in arrears. new text end 90.14 new text begin (d) A controlled substance researcher who has allowed the researcher's registration new text end 90.15 new text begin to lapse may reinstate the registration with board approval and upon payment of any fees new text end 90.16 new text begin and late fees in arrears. new text end 90.17 new text begin (e) A pharmacist owner of a professional corporation who has allowed the new text end 90.18 new text begin corporation's registration to lapse may reinstate the registration with board approval and new text end 90.19 new text begin upon payment of any fees and late fees in arrears. new text end 90.20    Sec. 18. Minnesota Statutes 2010, section 151.07, is amended to read: 90.21151.07 MEETINGS; EXAMINATION FEE. 90.22The board shall meet at times as may be necessary and as it may determine to 90.23examine applicants for licensure and to transact its other business, giving reasonable 90.24notice of all examinations by mail to known applicants therefor. The secretary shall record 90.25the names of all persons licensed by the board, together with the grounds upon which 90.26the right of each to licensure was claimed. The fee for examination shall be in such new text begin the new text end 90.27 amount as the board may determine new text begin specified in section 151.065 new text end , which fee may in the 90.28discretion of the board be returned to applicants not taking the examination. 90.29    Sec. 19. Minnesota Statutes 2010, section 151.101, is amended to read: 90.30151.101 INTERNSHIP. 90.31 new text begin Upon payment of the fee specified in section 151.065, new text end the board may license new text begin register new text end 90.32as an intern any natural persons who have satisfied the board that they are of good moral 90.33character, not physically or mentally unfit, and who have successfully completed the 90.34educational requirements for intern licensure new text begin registration new text end prescribed by the board. The 91.1board shall prescribe standards and requirements for interns, pharmacist-preceptors, and 91.2internship training but may not require more than one year of such training. 91.3The board in its discretion may accept internship experience obtained in another 91.4state provided the internship requirements in such other state are in the opinion of the 91.5board equivalent to those herein provided. 91.6    Sec. 20. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision 91.7to read: 91.8     new text begin Subd. 3. new text end new text begin Registration fee. new text end new text begin The board shall not register an individual as a pharmacy new text end 91.9 new text begin technician unless all applicable fees specified in section 151.065 have been paid. new text end 91.10    Sec. 21. Minnesota Statutes 2010, section 151.12, is amended to read: 91.11151.12 RECIPROCITY; LICENSURE. 91.12The board may in its discretion grant licensure without examination to any 91.13pharmacist licensed by the Board of Pharmacy or a similar board of another state which 91.14accords similar recognition to licensees of this state; provided, the requirements for 91.15licensure in such other state are in the opinion of the board equivalent to those herein 91.16provided. The fee for licensure shall be in such new text begin the new text end amount as the board may determine by 91.17rule new text begin specified in section 151.065 new text end . 91.18    Sec. 22. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read: 91.19    Subdivision 1. Renewal fee. Every person licensed by the board new text begin as a pharmacist new text end 91.20shall pay to the board a new text begin the annual new text end renewal fee to be fixed by it new text begin specified in section new text end 91.21 new text begin 151.065 new text end . The board may promulgate by rule a charge to be assessed for the delinquent 91.22payment of a fee. new text begin the late fee specified in section 151.065 if the renewal fee and new text end 91.23 new text begin application are not received by the board prior to the date specified by the board. new text end It shall 91.24be unlawful for any person licensed as a pharmacist who refuses or fails to pay such new text begin any new text end 91.25 new text begin applicable new text end renewal new text begin or late new text end fee to practice pharmacy in this state. Every certificate and 91.26license shall expire at the time therein prescribed. 91.27    Sec. 23. Minnesota Statutes 2010, section 151.19, is amended to read: 91.28151.19 REGISTRATION; FEES. 91.29    Subdivision 1. Pharmacy registration. The board shall require and provide for the 91.30annual registration of every pharmacy now or hereafter doing business within this state. 91.31Upon the payment of a new text begin any applicable new text end fee to be set by the board new text begin specified in section new text end 91.32 new text begin 151.065 new text end , the board shall issue a registration certificate in such form as it may prescribe to 92.1such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be 92.2displayed in a conspicuous place in the pharmacy for which it is issued and expire on the 92.330th day of June following the date of issue. It shall be unlawful for any person to conduct 92.4a pharmacy unless such certificate has been issued to the person by the board. 92.5    Subd. 2. Nonresident pharmacies. The board shall require and provide for an 92.6annual nonresident special pharmacy registration for all pharmacies located outside of this 92.7state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 92.8prescription medications into this state. Nonresident special pharmacy registration shall 92.9be granted by the board upon new text begin payment of any applicable fee specified in section 151.065 new text end 92.10 new text begin and new text end the disclosure and certification by a pharmacy: 92.11    (1) that it is licensed in the state in which the dispensing facility is located and from 92.12which the drugs are dispensed; 92.13    (2) the location, names, and titles of all principal corporate officers and all 92.14pharmacists who are dispensing drugs to residents of this state; 92.15    (3) that it complies with all lawful directions and requests for information from 92.16the Board of Pharmacy of all states in which it is licensed or registered, except that it 92.17shall respond directly to all communications from the board concerning emergency 92.18circumstances arising from the dispensing of drugs to residents of this state; 92.19    (4) that it maintains its records of drugs dispensed to residents of this state so that the 92.20records are readily retrievable from the records of other drugs dispensed; 92.21    (5) that it cooperates with the board in providing information to the Board of 92.22Pharmacy of the state in which it is licensed concerning matters related to the dispensing 92.23of drugs to residents of this state; 92.24    (6) that during its regular hours of operation, but not less than six days per week, for 92.25a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 92.26communication between patients in this state and a pharmacist at the pharmacy who has 92.27access to the patients' records; the toll-free number must be disclosed on the label affixed 92.28to each container of drugs dispensed to residents of this state; and 92.29    (7) that, upon request of a resident of a long-term care facility located within the 92.30state of Minnesota, the resident's authorized representative, or a contract pharmacy or 92.31licensed health care facility acting on behalf of the resident, the pharmacy will dispense 92.32medications prescribed for the resident in unit-dose packaging or, alternatively, comply 92.33with the provisions of section 151.415, subdivision 5. 92.34    Subd. 3. Sale of federally restricted medical gases. The board shall require and 92.35provide for the annual registration of every person or establishment not licensed as a 92.36pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 93.1medical gases. Upon the payment of a new text begin any applicable new text end fee to be set by the board new text begin specified new text end 93.2 new text begin in section 151.065 new text end , the board shall issue a registration certificate in such form as it may 93.3prescribe to those persons or places that may be qualified to sell or distribute federally 93.4restricted medical gases. The certificate shall be displayed in a conspicuous place in the 93.5business for which it is issued and expire on the date set by the board. It is unlawful for 93.6a person to sell or distribute federally restricted medical gases unless a certificate has 93.7been issued to that person by the board. 93.8    Sec. 24. Minnesota Statutes 2010, section 151.25, is amended to read: 93.9151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS. 93.10The board shall require and provide for the annual registration of every person 93.11engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, 93.12now or hereafter doing business with accounts in this state. Upon a payment of a new text begin any new text end 93.13 new text begin applicable new text end fee as set by the board new text begin specified in section 151.065 new text end , the board shall issue a 93.14registration certificate in such form as it may prescribe to such manufacturer. Such 93.15registration certificate shall be displayed in a conspicuous place in such manufacturer's 93.16or wholesaler's place of business for which it is issued and expire on the date set by the 93.17board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals, 93.18or poisons for medicinal purposes unless such a certificate has been issued to the person 93.19by the board. It shall be unlawful for any person engaged in the manufacture of drugs, 93.20medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell 93.21legend drugs to other than a pharmacy, except as provided in this chapter. 93.22    Sec. 25. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read: 93.23    Subdivision 1. Requirements. All wholesale drug distributors are subject to the 93.24requirements in paragraphs (a) to (f). 93.25(a) No person or distribution outlet shall act as a wholesale drug distributor without 93.26first obtaining a license from the board and paying the required new text begin any applicable new text end fee new text begin new text end 93.27 new text begin specified in section 151.065 new text end . 93.28(b) No license shall be issued or renewed for a wholesale drug distributor to operate 93.29unless the applicant agrees to operate in a manner prescribed by federal and state law and 93.30according to the rules adopted by the board. 93.31(c) The board may require a separate license for each facility directly or indirectly 93.32owned or operated by the same business entity within the state, or for a parent entity 93.33with divisions, subsidiaries, or affiliate companies within the state, when operations 94.1are conducted at more than one location and joint ownership and control exists among 94.2all the entities. 94.3(d) As a condition for receiving and retaining a wholesale drug distributor license 94.4issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has 94.5and will continuously maintain: 94.6(1) adequate storage conditions and facilities; 94.7(2) minimum liability and other insurance as may be required under any applicable 94.8federal or state law; 94.9(3) a viable security system that includes an after hours central alarm, or comparable 94.10entry detection capability; restricted access to the premises; comprehensive employment 94.11applicant screening; and safeguards against all forms of employee theft; 94.12(4) a system of records describing all wholesale drug distributor activities set forth 94.13in section 151.44 for at least the most recent two-year period, which shall be reasonably 94.14accessible as defined by board regulations in any inspection authorized by the board; 94.15(5) principals and persons, including officers, directors, primary shareholders, 94.16and key management executives, who must at all times demonstrate and maintain their 94.17capability of conducting business in conformity with sound financial practices as well 94.18as state and federal law; 94.19(6) complete, updated information, to be provided to the board as a condition for 94.20obtaining and retaining a license, about each wholesale drug distributor to be licensed, 94.21including all pertinent corporate licensee information, if applicable, or other ownership, 94.22principal, key personnel, and facilities information found to be necessary by the board; 94.23(7) written policies and procedures that assure reasonable wholesale drug distributor 94.24preparation for, protection against, and handling of any facility security or operation 94.25problems, including, but not limited to, those caused by natural disaster or government 94.26emergency, inventory inaccuracies or product shipping and receiving, outdated product 94.27or other unauthorized product control, appropriate disposition of returned goods, and 94.28product recalls; 94.29(8) sufficient inspection procedures for all incoming and outgoing product 94.30shipments; and 94.31(9) operations in compliance with all federal requirements applicable to wholesale 94.32drug distribution. 94.33(e) An agent or employee of any licensed wholesale drug distributor need not seek 94.34licensure under this section. 94.35(f) A wholesale drug distributor shall file with the board an annual report, in a 94.36form and on the date prescribed by the board, identifying all payments, honoraria, 95.1reimbursement or other compensation authorized under section 151.461, clauses (3) to 95.2(5), paid to practitioners in Minnesota during the preceding calendar year. The report 95.3shall identify the nature and value of any payments totaling $100 or more, to a particular 95.4practitioner during the year, and shall identify the practitioner. Reports filed under this 95.5provision are public data. 95.6    Sec. 26. Minnesota Statutes 2010, section 151.48, is amended to read: 95.7151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING. 95.8(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business 95.9in the state without first obtaining a license from the board and paying the required new text begin any new text end 95.10 new text begin applicable new text end fee new text begin specified in section 151.065 new text end . 95.11(b) Application for an out-of-state wholesale drug distributor license under this 95.12section shall be made on a form furnished by the board. 95.13(c) No person acting as principal or agent for any out-of-state wholesale drug 95.14distributor may sell or distribute drugs in the state unless the distributor has obtained 95.15a license. 95.16(d) The board may adopt regulations that permit out-of-state wholesale drug 95.17distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state 95.18wholesale drug distributor: 95.19(1) possesses a valid license granted by another state under legal standards 95.20comparable to those that must be met by a wholesale drug distributor of this state as 95.21prerequisites for obtaining a license under the laws of this state; and 95.22(2) can show that the other state would extend reciprocal treatment under its own 95.23laws to a wholesale drug distributor of this state. 95.24    Sec. 27. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read: 95.25    Subd. 3. Research project use of controlled substances. Any qualified person 95.26may use controlled substances in the course of a bona fide research project but cannot 95.27administer or dispense such drugs to human beings unless such drugs are prescribed, 95.28dispensed and administered by a person lawfully authorized to do so. Every person 95.29who engages in research involving the use of such substances shall apply annually for 95.30registration by the state Board of Pharmacy new text begin and shall pay any applicable fee specified in new text end 95.31 new text begin section 151.065, new text end provided that such registration shall not be required if the person is 95.32covered by and has complied with federal laws covering such research projects. 96.1ARTICLE 5 96.2HEALTH CARE 96.3    Section 1. new text begin [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT. new text end 96.4     new text begin Subdivision 1. new text end new text begin Citation. new text end new text begin This section shall be known as and may be cited as the new text end 96.5 new text begin "Freedom of Choice in Health Care Act." new text end 96.6     new text begin Subd. 2. new text end new text begin Definitions. new text end new text begin (a) For purposes of this section, the following terms have new text end 96.7 new text begin the meanings given them. new text end 96.8 new text begin (b) "Health care service" means any service, treatment, or provision of a product for new text end 96.9 new text begin the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise new text end 96.10 new text begin maintain or improve physical or mental health, subject to all laws and rules regulating new text end 96.11 new text begin health service providers and products within the state of Minnesota. new text end 96.12 new text begin (c) "Mode of securing" means to purchase directly or on credit or by trade, or to new text end 96.13 new text begin contract for third-party payment by insurance or other legal means as authorized by the new text end 96.14 new text begin state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored new text end 96.15 new text begin health care benefits under such conditions as may legally be required as a condition of new text end 96.16 new text begin such benefits, or any combination of the same. new text end 96.17 new text begin (d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding, new text end 96.18 new text begin surcharge, fee, or any other imposed consequence established by law or rule of a new text end 96.19 new text begin government or its subdivision or agency that is used to punish or discourage the exercise new text end 96.20 new text begin of rights protected under this section. new text end 96.21     new text begin Subd. 3. new text end new text begin Statement of public policy. new text end new text begin (a) The power to require or regulate a person's new text end 96.22 new text begin choice in the mode of securing health care services, or to impose a penalty related to that new text end 96.23 new text begin choice, is not found in the Constitution of the United States of America, and is therefore a new text end 96.24 new text begin power reserved to the people pursuant to the Ninth Amendment, and to the several states new text end 96.25 new text begin pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign new text end 96.26 new text begin power to declare the public policy of the state of Minnesota regarding the right of all new text end 96.27 new text begin persons residing in the state in choosing the mode of securing health care services. new text end 96.28 new text begin (b) It is hereby declared that the public policy of the state of Minnesota, consistent new text end 96.29 new text begin with our constitutionally recognized and inalienable rights of liberty, is that every person new text end 96.30 new text begin within the state of Minnesota is and shall be free to choose or decline to choose any mode new text end 96.31 new text begin of securing health care services without penalty or threat of penalty. new text end 96.32 new text begin (c) The policy stated under this section shall not be applied to impair any right of new text end 96.33 new text begin contract related to the provision of health care services to any person or group. new text end 96.34     new text begin Subd. 4. new text end new text begin Enforcement. new text end new text begin Upon penalty of suspension or revocation of any applicable new text end 96.35 new text begin license, no public official, employee, officer of the court, or agent of the state of new text end 97.1 new text begin Minnesota, or any branch or political subdivision thereof, shall act to impose, collect, new text end 97.2 new text begin enforce, or effectuate any penalty in the state of Minnesota that violates the public policy new text end 97.3 new text begin set forth in this section. new text end 97.4    Sec. 2. Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read: 97.5    Subdivision 1. Establishment. The association shall establish the following 97.6maximum premiums to be charged for membership in the comprehensive health insurance 97.7plan: 97.8(a) the premium for the number one qualified plan shall range from a minimum of 97.9101 percent to a maximum of 125 percent of the weighted average of rates charged by 97.10those insurers and health maintenance organizations with individuals enrolled in: 97.11(1) $1,000 annual deductible individual plans of insurance in force in Minnesota; 97.12(2) individual health maintenance organization contracts of coverage with a $1,000 97.13annual deductible which are in force in Minnesota; and 97.14(3) other plans of coverage similar to plans offered by the association based on 97.15generally accepted actuarial principles; 97.16(b) the premium for the number two qualified plan shall range from a minimum of 97.17101 percent to a maximum of 125 percent of the weighted average of rates charged by 97.18those insurers and health maintenance organizations with individuals enrolled in: 97.19(1) $500 annual deductible individual plans of insurance in force in Minnesota; 97.20(2) individual health maintenance organization contracts of coverage with a $500 97.21annual deductible which are in force in Minnesota; and 97.22(3) other plans of coverage similar to plans offered by the association based on 97.23generally accepted actuarial principles; 97.24(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible 97.25shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted 97.26average of rates charged by those insurers and health maintenance organizations with 97.27individuals enrolled in: 97.28(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in 97.29force in Minnesota; and 97.30(2) individual health maintenance organization contracts of coverage with a $2,000, 97.31$5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or 97.32(3) other plans of coverage similar to plans offered by the association based on 97.33generally accepted actuarial principles; 97.34(d) the premium for each type of Medicare supplement plan required to be offered 97.35by the association pursuant to section 62E.12 shall range from a minimum of 101 percent 98.1to a maximum of 125 percent of the weighted average of rates charged by those insurers 98.2and health maintenance organizations with individuals enrolled in: 98.3(1) Medicare supplement plans in force in Minnesota; 98.4(2) health maintenance organization Medicare supplement contracts of coverage 98.5which are in force in Minnesota; and 98.6(3) other plans of coverage similar to plans offered by the association based on 98.7generally accepted actuarial principles; and 98.8(e) the charge for health maintenance organization coverage shall be based on 98.9generally accepted actuarial principles. new text begin ; and new text end 98.10 new text begin (f) the premium for a high-deductible, basic plan offered under section 62E.121 shall new text end 98.11 new text begin range from a minimum of 101 percent to a maximum of 125 percent of the weighted new text end 98.12 new text begin average of rates charged by those insurers and health maintenance organizations offering new text end 98.13 new text begin comparable plans outside of the Minnesota Comprehensive Health Association. new text end 98.14The list of insurers and health maintenance organizations whose rates are used to 98.15establish the premium for coverage offered by the association pursuant to paragraphs (a) 98.16to (d) new text begin and (f) new text end shall be established by the commissioner on the basis of information which 98.17shall be provided to the association by all insurers and health maintenance organizations 98.18annually at the commissioner's request. This information shall include the number of 98.19individuals covered by each type of plan or contract specified in paragraphs (a) to (d) new text begin and new text end 98.20 new text begin (f) new text end that is sold, issued, and renewed by the insurers and health maintenance organizations, 98.21including those plans or contracts available only on a renewal basis. The information shall 98.22also include the rates charged for each type of plan or contract. 98.23In establishing premiums pursuant to this section, the association shall utilize 98.24generally accepted actuarial principles, provided that the association shall not discriminate 98.25in charging premiums based upon sex. In order to compute a weighted average for each 98.26type of plan or contract specified under paragraphs (a) to (d) new text begin and (f) new text end , the association 98.27shall, using the information collected pursuant to this subdivision, list insurers and health 98.28maintenance organizations in rank order of the total number of individuals covered by 98.29each insurer or health maintenance organization. The association shall then compute 98.30a weighted average of the rates charged for coverage by all the insurers and health 98.31maintenance organizations by: 98.32(1) multiplying the numbers of individuals covered by each insurer or health 98.33maintenance organization by the rates charged for coverage; 98.34(2) separately summing both the number of individuals covered by all the insurers 98.35and health maintenance organizations and all the products computed under clause (1); and 99.1(3) dividing the total of the products computed under clause (1) by the total number 99.2of individuals covered. 99.3The association may elect to use a sample of information from the insurers and 99.4health maintenance organizations for purposes of computing a weighted average. In no 99.5case, however, may a sample used by the association to compute a weighted average 99.6include information from fewer than the two insurers or health maintenance organizations 99.7highest in rank order. 99.8    Sec. 3. new text begin [62E.121] HIGH-DEDUCTIBLE, BASIC PLAN. new text end 99.9     new text begin Subdivision 1. new text end new text begin Required offering. new text end new text begin The Minnesota Comprehensive Health new text end 99.10 new text begin Association shall offer a high-deductible, basic plan that meets the requirements specified new text end 99.11 new text begin in this section. The high-deductible, basic plan is a one-person plan. Any dependents new text end 99.12 new text begin must be covered separately. new text end 99.13     new text begin Subd. 2. new text end new text begin Annual deductible; out-of-pocket maximum. new text end new text begin (a) The plan shall provide new text end 99.14 new text begin the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000. new text end 99.15 new text begin The in-network annual out-of-pocket maximum for each annual deductible option shall be new text end 99.16 new text begin $1,000 greater than the amount of the annual deductible. new text end 99.17 new text begin (b) The deductible is subject to an annual increase based on the change in the new text end 99.18 new text begin Consumer Price Index (CPI). new text end 99.19     new text begin Subd. 3. new text end new text begin Office visits for nonpreventive care. new text end new text begin The following co-payments shall new text end 99.20 new text begin apply for each of the first three office visits per calendar year for nonpreventive care: new text end 99.21 new text begin (1) $30 per visit for the $3,000 annual deductible option; new text end 99.22 new text begin (2) $40 per visit for the $6,000 annual deductible option; new text end 99.23 new text begin (3) $50 per visit for the $9,000 annual deductible option; and new text end 99.24 new text begin (4) $60 per visit for the $12,000 annual deductible option. new text end 99.25 new text begin For the fourth and subsequent visits during the calendar year, 80 percent coverage is new text end 99.26 new text begin provided under all deductible options, after the deductible is met. new text end 99.27     new text begin Subd. 4. new text end new text begin Preventive care. new text end new text begin One hundred percent coverage is provided for preventive new text end 99.28 new text begin care, and no co-payment, coinsurance, or deductible requirements apply. new text end 99.29     new text begin Subd. 5. new text end new text begin Prescription drugs. new text end new text begin A $10 co-payment applies to preferred generic drugs. new text end 99.30 new text begin Preferred brand-name drugs require an enrollee payment of 100 percent of the health new text end 99.31 new text begin plan's discounted rate. new text end 99.32     new text begin Subd. 6. new text end new text begin Convenience care center visits. new text end new text begin A $20 co-payment applies for the first new text end 99.33 new text begin three convenience care center visits during a calendar year. For the fourth and subsequent new text end 99.34 new text begin visits during a calendar year, 80 percent coverage is provided after the deductible is met. new text end 100.1     new text begin Subd. 7. new text end new text begin Urgent care center visits. new text end new text begin A $100 co-payment applies for the first urgent new text end 100.2 new text begin care center visit during a calendar year. For the second and subsequent visits during a new text end 100.3 new text begin calendar year, 80 percent coverage is provided after the deductible is met. new text end 100.4     new text begin Subd. 8. new text end new text begin Emergency room visits. new text end new text begin A $200 co-payment applies for the first new text end 100.5 new text begin emergency room visit during a calendar year. For the second and subsequent visits during new text end 100.6 new text begin a calendar year, 80 percent coverage is provided after the deductible is met. new text end 100.7     new text begin Subd. 9. new text end new text begin Lab and x-ray; hospital services; ambulance; surgery. new text end new text begin Lab and x-ray new text end 100.8 new text begin services, hospital services, ambulance services, and surgery are covered at 80 percent new text end 100.9 new text begin after the deductible is met. new text end 100.10     new text begin Subd. 10. new text end new text begin Eyewear. new text end new text begin The health plan pays up to $50 per calendar year for eyewear. new text end 100.11     new text begin Subd. 11. new text end new text begin Maternity. new text end new text begin Maternity, labor and delivery, and postpartum care are not new text end 100.12 new text begin covered. One hundred percent coverage is provided for prenatal care and no deductible new text end 100.13 new text begin applies. new text end 100.14     new text begin Subd. 12. new text end new text begin Other eligible health care services. new text end new text begin Other eligible health care services new text end 100.15 new text begin are covered at 80 percent after the deductible is met. new text end 100.16     new text begin Subd. 13. new text end new text begin Option to remove mental health and substance abuse coverage. new text end 100.17 new text begin Enrollees have the option of removing mental health and substance abuse coverage in new text end 100.18 new text begin exchange for a reduced premium. new text end 100.19     new text begin Subd. 14. new text end new text begin Option to upgrade prescription drug coverage. new text end new text begin Enrollees have new text end 100.20 new text begin the option to upgrade prescription drug coverage to include coverage for preferred new text end 100.21 new text begin brand-name drugs with a $50 co-payment and coverage for nonpreferred drugs with a new text end 100.22 new text begin $100 co-payment in exchange for an increased premium. new text end 100.23     new text begin Subd. 15. new text end new text begin Out-of-network services. new text end new text begin (a) The out-of-network annual deductible is new text end 100.24 new text begin double the in-network annual deductible. new text end 100.25 new text begin (b) There is no out-of-pocket maximum for out-of-network services. new text end 100.26 new text begin (c) Benefits for out-of-network services are covered at 60 percent after the deductible new text end 100.27 new text begin is met. new text end 100.28 new text begin (d) The lifetime maximum benefit for out-of-network services is $1,000,000. new text end 100.29     new text begin Subd. 16. new text end new text begin Services not covered. new text end new text begin Services not covered include: custodial care new text end 100.30 new text begin or rest care; most dental services; cosmetic services; refractive eye surgery; infertility new text end 100.31 new text begin services; and services that are investigational, not medically necessary, or received while new text end 100.32 new text begin on military duty. new text end 100.33    Sec. 4. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision 100.34to read: 101.1     new text begin Subd. 4f. new text end new text begin Waiver of preexisting conditions for persons covered by healthy new text end 101.2 new text begin Minnesota contribution program. new text end new text begin A person may enroll in the comprehensive plan with new text end 101.3 new text begin a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for new text end 101.4 new text begin the healthy Minnesota contribution program, and has been denied coverage as described new text end 101.5 new text begin under section 256L.031, subdivision 6. new text end 101.6    Sec. 5. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read: 101.7    Subd. 9. Growth limits; federal programs. The commissioners of health and 101.8human services shall establish a rate methodology for Medicare and Medicaid risk-based 101.9contracting with health plan companies that is consistent with statewide growth limits. 101.10The methodology shall be presented for review by the Minnesota Health Care Commission 101.11and the Legislative Commission on Health Care Access prior to the submission of a 101.12waiver request to the Centers for Medicare and Medicaid Services and subsequent 101.13implementation of the methodology. 101.14    Sec. 6. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read: 101.15    Subd. 9. Review of eligible providers. The commissioner and the Medical 101.16Education and Research Costs Advisory Committee may review provider groups included 101.17in the definition of a clinical medical education program to assure that the distribution of 101.18the funds continue to be consistent with the purpose of this section. The results of any 101.19such reviews must be reported to the Legislative Commission on Health Care Access new text begin new text end 101.20 new text begin chairs and ranking minority members of the legislative committees with jurisdiction over new text end 101.21 new text begin health care policy and finance new text end . 101.22    Sec. 7. new text begin [62J.824] BILLING FOR PROCEDURES TO CORRECT MEDICAL new text end 101.23 new text begin ERRORS PROHIBITED. new text end 101.24 new text begin A health care provider shall not bill a patient, and shall not be reimbursed, for new text end 101.25 new text begin any operation, treatment, or other care that is provided to reverse, correct, or otherwise new text end 101.26 new text begin minimize the affects of an adverse health care event, as described in section 144.7065, new text end 101.27 new text begin subdivisions 2 to 7, for which that health care provider is responsible. new text end 101.28    Sec. 8. Minnesota Statutes 2010, section 62Q.32, is amended to read: 101.2962Q.32 LOCAL OMBUDSPERSON. 101.30County board or community health service agencies may establish an office of 101.31ombudsperson to provide a system of consumer advocacy for persons receiving health 102.1care services through a health plan company. The ombudsperson's functions may include, 102.2but are not limited to: 102.3(a) mediation or advocacy on behalf of a person accessing the complaint and appeal 102.4procedures to ensure that necessary medical services are provided by the health plan 102.5company; and 102.6(b) investigation of the quality of services provided to a person and determine the 102.7extent to which quality assurance mechanisms are needed or any other system change 102.8may be needed. The commissioner of health shall make recommendations for funding 102.9these functions including the amount of funding needed and a plan for distribution. The 102.10commissioner shall submit these recommendations to the Legislative Commission on 102.11Health Care Access by January 15, 1996. 102.12    Sec. 9. new text begin [62Q.46] PAYMENT TO OUT-OF-NETWORK PROVIDERS. new text end 102.13     new text begin A health plan company may limit payments to out-of-network providers to the usual new text end 102.14 new text begin and customary payment rate that applies to similarly situated providers participating in the new text end 102.15 new text begin health plan company's provider network. new text end 102.16    Sec. 10. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read: 102.17    Subd. 3. Provider peer grouping. (a) The commissioner shall develop a peer 102.18grouping system for providers based on a combined measure that incorporates both 102.19provider risk-adjusted cost of care and quality of care, and for specific conditions as 102.20determined by the commissioner. In developing this system, the commissioner shall 102.21consult and coordinate with health care providers, health plan companies, state agencies, 102.22and organizations that work to improve health care quality in Minnesota. For purposes of 102.23the final establishment of the peer grouping system, the commissioner shall not contract 102.24with any private entity, organization, or consortium of entities that has or will have a direct 102.25financial interest in the outcome of the system. 102.26    (b) By no later than October 15, 2010, the commissioner shall disseminate 102.27information to providers on their total cost of care, total resource use, total quality of care, 102.28and the total care results of the grouping developed under this subdivision in comparison 102.29to an appropriate peer group. Any analyses or reports that identify providers may only be 102.30published after the provider has been provided the opportunity by the commissioner to 102.31review the underlying data and submit comments. Providers may be given any data for 102.32which they are the subject of the data. The provider shall have 30 days to review the data 102.33for accuracy and initiate an appeal as specified in paragraph (d). 103.1    (c) By no later than January 1, 2011, the commissioner shall disseminate information 103.2to providers on their condition-specific cost of care, condition-specific resource use, 103.3condition-specific quality of care, and the condition-specific results of the grouping 103.4developed under this subdivision in comparison to an appropriate peer group. Any 103.5analyses or reports that identify providers may only be published after the provider has 103.6been provided the opportunity by the commissioner to review the underlying data and 103.7submit comments. Providers may be given any data for which they are the subject of the 103.8data. The provider shall have 30 days to review the data for accuracy and initiate an 103.9appeal as specified in paragraph (d). 103.10(d) The commissioner shall establish an appeals process to resolve disputes from 103.11providers regarding the accuracy of the data used to develop analyses or reports. When 103.12a provider appeals the accuracy of the data used to calculate the peer grouping system 103.13results, the provider shall: 103.14(1) clearly indicate the reason they believe the data used to calculate the peer group 103.15system results are not accurate; 103.16(2) provide evidence and documentation to support the reason that data was not 103.17accurate; and 103.18(3) cooperate with the commissioner, including allowing the commissioner access to 103.19data necessary and relevant to resolving the dispute. 103.20If a provider does not meet the requirements of this paragraph, a provider's appeal shall be 103.21considered withdrawn. The commissioner shall not publish results for a specific provider 103.22under paragraph (e) or (f) while that provider has an unresolved appeal. 103.23    (e) Beginning January 1, 2011, the commissioner shall, no less than annually, 103.24publish information on providers' total cost, total resource use, total quality, and the results 103.25of the total care portion of the peer grouping process. The results that are published must 103.26be on a risk-adjusted basis. 103.27(f) Beginning March 30, 2011, the commissioner shall no less than annually publish 103.28information on providers' condition-specific cost, condition-specific resource use, and 103.29condition-specific quality, and the results of the condition-specific portion of the peer 103.30grouping process. The results that are published must be on a risk-adjusted basis. 103.31(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing 103.32information under paragraph (e) or (f), the commissioner shall ensure the scientific 103.33validity and reliability of the results according to the standards described in paragraph (h). 103.34If additional time is needed to establish the scientific validity and reliability of the results, 103.35the commissioner may delay the dissemination of data to providers under paragraph (b) 103.36or (c), or the publication of information under paragraph (e) or (f). If the delay is more 104.1than 60 days, the commissioner shall report in writing to the Legislative Commission on 104.2Health Care Access new text begin chairs and ranking minority members of the legislative committees new text end 104.3 new text begin with jurisdiction over health care policy and finance new text end the following information: 104.4(1) the reason for the delay; 104.5(2) the actions being taken to resolve the delay and establish the scientific validity 104.6and reliability of the results; and 104.7(3) the new dates by which the results shall be disseminated. 104.8If there is a delay under this paragraph, the commissioner must disseminate the 104.9information to providers under paragraph (b) or (c) at least 90 days before publishing 104.10results under paragraph (e) or (f). 104.11(h) The commissioner's assurance of valid and reliable clinic and hospital peer 104.12grouping performance results shall include, at a minimum, the following: 104.13(1) use of the best available evidence, research, and methodologies; and 104.14(2) establishment of an explicit minimum reliability threshold developed in 104.15collaboration with the subjects of the data and the users of the data, at a level not below 104.16nationally accepted standards where such standards exist. 104.17In achieving these thresholds, the commissioner shall not aggregate clinics that are not 104.18part of the same system or practice group. The commissioner shall consult with and solicit 104.19feedback from representatives of physician clinics and hospitals during the peer grouping 104.20data analysis process to obtain input on the methodological options prior to final analysis 104.21and on the design, development, and testing of provider reports. 104.22    Sec. 11. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read: 104.23    Subd. 9. Uses of information. (a) By no later than 12 months after the commissioner 104.24publishes the information in subdivision 3, paragraph (e): new text begin For product renewals or for new text end 104.25 new text begin new products that are offered, after 12 months have elapsed from publication by the new text end 104.26 new text begin commissioner of the information in subdivision 3, paragraph (e): new text end 104.27    (1) the commissioner of management and budget shall use the information and 104.28methods developed under subdivision 3 to strengthen incentives for members of the state 104.29employee group insurance program to use high-quality, low-cost providers; 104.30    (2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer 104.31health benefits to their employees must offer plans that differentiate providers on their 104.32cost and quality performance and create incentives for members to use better-performing 104.33providers; 105.1    (3) all health plan companies shall use the information and methods developed 105.2under subdivision 3 to develop products that encourage consumers to use high-quality, 105.3low-cost providers; and 105.4    (4) health plan companies that issue health plans in the individual market or the 105.5small employer market must offer at least one health plan that uses the information 105.6developed under subdivision 3 to establish financial incentives for consumers to choose 105.7higher-quality, lower-cost providers through enrollee cost-sharing or selective provider 105.8networks. 105.9    (b) By January 1, 2011, the commissioner of health shall report to the governor 105.10and the legislature on recommendations to encourage health plan companies to promote 105.11widespread adoption of products that encourage the use of high-quality, low-cost providers. 105.12The commissioner's recommendations may include tax incentives, public reporting of 105.13health plan performance, regulatory incentives or changes, and other strategies. 105.14    Sec. 12. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read: 105.15    Subd. 2. Legislative oversight. Beginning January 15, 2009, the commissioner 105.16of health shall submit to the Legislative Commission on Health Care Access new text begin chairs and new text end 105.17 new text begin ranking minority members of the legislative committees with jurisdiction over health care new text end 105.18 new text begin policy and finance new text end periodic progress reports on the implementation of this chapter and 105.19sections 256B.0751 to 256B.0754. 105.20    Sec. 13. Minnesota Statutes 2010, section 256.01, subdivision 2b, is amended to read: 105.21    Subd. 2b. Performance payments. The commissioner shall develop and implement 105.22a pay-for-performance system to provide performance payments to eligible medical 105.23groups and clinics that demonstrate optimum care in serving individuals with chronic 105.24diseases who are enrolled in health care programs administered by the commissioner under 105.25chapters 256B, 256D, and 256L. The commissioner may receive any federal matching 105.26money that is made available through the medical assistance program for managed care 105.27oversight contracted through vendors, including consumer surveys, studies, and external 105.28quality reviews as required by the federal Balanced Budget Act of 1997, Code of Federal 105.29Regulations, title 42, part 438-managed care, subpart E-external quality review. Any 105.30federal money received for managed care oversight is appropriated to the commissioner 105.31for this purpose. The commissioner may expend the federal money received in either 105.32year of the biennium. 106.1    Sec. 14. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 106.2to read: 106.3     new text begin Subd. 33. new text end new text begin Contingency contract fees. new text end new text begin When the commissioner enters into new text end 106.4 new text begin a contingency-based contract for the purpose of recovering medical assistance or new text end 106.5 new text begin MinnesotaCare funds, the commissioner may retain that portion of the recovered funds new text end 106.6 new text begin equal to the amount of the contingency fee. new text end 106.7    Sec. 15. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 106.8to read: 106.9     new text begin Subd. 34. new text end new text begin Elimination of certain provider reporting requirements; sunset of new text end 106.10 new text begin new requirements. new text end new text begin (a) Notwithstanding any other law, rule, or provision to the contrary, new text end 106.11 new text begin effective July 1, 2012, the commissioner shall cease collecting from health care providers new text end 106.12 new text begin and purchasers all reports and data related to health care costs, quality, utilization, access, new text end 106.13 new text begin patient encounters, and disease surveillance and public health, and related to provider new text end 106.14 new text begin licensure, monitoring, finances, and regulation, unless the reports or data are necessary for new text end 106.15 new text begin federal compliance. For purposes of this subdivision, the term "health care providers and new text end 106.16 new text begin purchasers" has the meaning provided in section 62J.03, subdivision 8, except that it also new text end 106.17 new text begin includes nursing homes, health plan companies as defined in section 62Q.01, subdivision new text end 106.18 new text begin 4, and managed care and county-based purchasing plans delivering services under sections new text end 106.19 new text begin 256B.69 and 256B.692. new text end 106.20 new text begin (b) The commissioner shall present to the 2012 legislature draft legislation to repeal, new text end 106.21 new text begin effective July 1, 2012, the provider reporting requirements identified under paragraph (a) new text end 106.22 new text begin that are not necessary for federal compliance. new text end 106.23 new text begin (c) The commissioner may establish new provider reporting requirements to take new text end 106.24 new text begin effect on or after July 1, 2012. These new reporting requirements must sunset five years new text end 106.25 new text begin from their effective date, unless they are renewed by the commissioner. All new provider new text end 106.26 new text begin reporting requirements and requests for their renewal shall not take effect unless they new text end 106.27 new text begin are enacted in state law. new text end 106.28    Sec. 16. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read: 106.29    Subd. 2b. Operating payment rates. In determining operating payment rates for 106.30admissions occurring on or after the rate year beginning January 1, 1991, and every two 106.31years after, or more frequently as determined by the commissioner, the commissioner 106.32shall obtain operating data from an updated base year and establish operating payment 106.33rates per admission for each hospital based on the cost-finding methods and allowable 106.34costs of the Medicare program in effect during the base year. Rates under the general 107.1assistance medical care, medical assistance, and MinnesotaCare programs shall not be 107.2rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months 107.3of the rebased period beginning January 1, 2009. For the first 24 months of the rebased 107.4period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota 107.5long-term hospital shall be rebased effective January 1, 2011, based on its most recent 107.6Medicare cost report ending on or before September 1, 2008, with the provisions under 107.7subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent 107.8rate setting periods in which the base years are updated, a Minnesota long-term hospital's 107.9base year shall remain within the same period as other hospitals. Effective January 1, 107.102013, rates shall be rebased at full value new text begin Rates must not be rebased to more current data new text end 107.11 new text begin for the first six months of the rebased period beginning January 1, 2013 new text end . The base year 107.12operating payment rate per admission is standardized by the case mix index and adjusted 107.13by the hospital cost index, relative values, and disproportionate population adjustment. 107.14The cost and charge data used to establish operating rates shall only reflect inpatient 107.15services covered by medical assistance and shall not include property cost information 107.16and costs recognized in outlier payments. 107.17    Sec. 17. Minnesota Statutes 2010, section 256.969, is amended by adding a subdivision 107.18to read: 107.19     new text begin Subd. 31. new text end new text begin Initiatives to reduce incidence of low birth-weight. new text end new text begin The commissioner new text end 107.20 new text begin shall require hospitals located in the seven-county metropolitan area, as a condition of new text end 107.21 new text begin contract, to implement strategies to reduce the incidence of low birth-weight in geographic new text end 107.22 new text begin areas identified by the commissioner as having a higher than average incidence of low new text end 107.23 new text begin birth-weight, with special emphasis on areas within a one-mile radius of the hospital. new text end 107.24 new text begin These strategies may focus on smoking prevention and cessation, ensuring that pregnant new text end 107.25 new text begin women get adequate nutrition, and addressing demographic, social, and environmental new text end 107.26 new text begin risk factors. The strategies must coordinate health care with social services and the new text end 107.27 new text begin local public health system, and offer patient education through appropriate means. new text end 107.28 new text begin The commissioner shall require hospitals to submit proposed initiatives for approval new text end 107.29 new text begin to the commissioner by January 1, 2012, and the commissioner shall require hospitals new text end 107.30 new text begin to implement approved initiatives by July 1, 2012. The commissioner shall evaluate new text end 107.31 new text begin the strategies adopted to reduce low birth-weight, and shall require hospitals to submit new text end 107.32 new text begin outcome and other data necessary for the evaluation. new text end 107.33    Sec. 18. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read: 108.1    Subd. 18. Applications for medical assistance. new text begin (a) new text end The state agency may 108.2take applications for medical assistance and conduct eligibility determinations for 108.3MinnesotaCare enrollees. 108.4     new text begin (b) The commissioner of human services shall modify the Minnesota health care new text end 108.5 new text begin programs application form to add a question asking applicants: "Are you a United States new text end 108.6 new text begin military veteran?" new text end 108.7    Sec. 19. Minnesota Statutes 2010, section 256B.05, is amended by adding a 108.8subdivision to read: 108.9     new text begin Subd. 5. new text end new text begin Technical assistance. new text end new text begin The commissioner shall provide technical assistance new text end 108.10 new text begin to county agencies in processing complex medical assistance applications, including but new text end 108.11 new text begin not limited to applications for long-term care services. The commissioner shall provide new text end 108.12 new text begin this technical assistance using existing financial resources. new text end 108.13    Sec. 20. Minnesota Statutes 2010, section 256B.055, subdivision 15, is amended to 108.14read: 108.15    Subd. 15. Adults without children. new text begin (a) new text end Medical assistance may be paid for a 108.16person who is: 108.17(1) at least age 21 and under age 65; 108.18(2) not pregnant; 108.19(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII 108.20of the Social Security Act; 108.21(4) not an adult in a family with children as defined in section 256L.01, subdivision 108.223a; and 108.23(5) not described in another subdivision of this section. 108.24 new text begin (b) If the federal government eliminates the federal Medicaid match or reduces the new text end 108.25 new text begin federal Medicaid matching rate beyond any adjustment required as part of the annual new text end 108.26 new text begin recalculation of the state's overall Medicaid matching rate for persons eligible under this new text end 108.27 new text begin subdivision, the commissioner shall eliminate coverage for persons enrolled under this new text end 108.28 new text begin subdivision and suspend new enrollment under this subdivision effective on the date new text end 108.29 new text begin of the elimination or reduction. new text end 108.30 new text begin EFFECTIVE DATE. new text end new text begin The amendments to this section are effective the day new text end 108.31 new text begin following final enactment and expire January 1, 2014. new text end 108.32    Sec. 21. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read: 109.1    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for 109.2medical assistance, a person must not individually own more than $3,000 in assets, or if a 109.3member of a household with two family members, husband and wife, or parent and child, 109.4the household must not own more than $6,000 in assets, plus $200 for each additional 109.5legal dependent. In addition to these maximum amounts, an eligible individual or family 109.6may accrue interest on these amounts, but they must be reduced to the maximum at the 109.7time of an eligibility redetermination. The accumulation of the clothing and personal 109.8needs allowance according to section 256B.35 must also be reduced to the maximum at 109.9the time of the eligibility redetermination. The value of assets that are not considered in 109.10determining eligibility for medical assistance is the value of those assets excluded under 109.11the supplemental security income program for aged, blind, and disabled persons, with 109.12the following exceptions: 109.13    (1) household goods and personal effects are not considered; 109.14    (2) capital and operating assets of a trade or business that the local agency determines 109.15are necessary to the person's ability to earn an income are not considered; 109.16    (3) motor vehicles are excluded to the same extent excluded by the supplemental 109.17security income program; 109.18    (4) assets designated as burial expenses are excluded to the same extent excluded by 109.19the supplemental security income program. Burial expenses funded by annuity contracts 109.20or life insurance policies must irrevocably designate the individual's estate as contingent 109.21beneficiary to the extent proceeds are not used for payment of selected burial expenses; and 109.22    (5) effective upon federal approval, for a person who no longer qualifies as an 109.23employed person with a disability due to loss of earnings, assets allowed while eligible 109.24for medical assistance under section 256B.057, subdivision 9, are not considered for 12 109.25months, beginning with the first month of ineligibility as an employed person with a 109.26disability, to the extent that the person's total assets remain within the allowed limits of 109.27section 256B.057, subdivision 9, paragraph (c). 109.28    (b) No asset limit shall apply to persons eligible under section , subdivision 109.2915. 109.30 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 109.31    Sec. 22. Minnesota Statutes 2010, section 256B.056, subdivision 4, is amended to read: 109.32    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under 109.33section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of 109.34the federal poverty guidelines. Effective January 1, 2000, and each successive January, 110.1recipients of supplemental security income may have an income up to the supplemental 110.2security income standard in effect on that date. 110.3    (b) To be eligible for medical assistance, families and children may have an income 110.4up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, 110.5AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 110.61996, shall be increased by three percent. 110.7    (c) Effective July 1, 2002, to be eligible for medical assistance, families and children 110.8may have an income up to 100 percent of the federal poverty guidelines for the family size. 110.9    (d) To be eligible for medical assistance under section 256B.055, subdivision 15, a 110.10person may have an income up to 75 percent of federal poverty guidelines for the family 110.11size. 110.12    (e) new text begin (d) new text end In computing income to determine eligibility of persons under paragraphs 110.13(a) to (d) new text begin (c) new text end who are not residents of long-term care facilities, the commissioner shall 110.14disregard increases in income as required by Public Law Numbers 94-566, section 503; 110.1599-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration 110.16unusual medical expense payments are considered income to the recipient. 110.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 110.18    Sec. 23. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read: 110.19    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited 110.20to citizens of the United States, qualified noncitizens as defined in this subdivision, and 110.21other persons residing lawfully in the United States. Citizens or nationals of the United 110.22States must cooperate in obtaining satisfactory documentary evidence of citizenship or 110.23nationality according to the requirements of the federal Deficit Reduction Act of 2005, 110.24Public Law 109-171. 110.25(b) "Qualified noncitizen" means a person who meets one of the following 110.26immigration criteria: 110.27(1) admitted for lawful permanent residence according to United States Code, title 8; 110.28(2) admitted to the United States as a refugee according to United States Code, 110.29title 8, section 1157; 110.30(3) granted asylum according to United States Code, title 8, section 1158; 110.31(4) granted withholding of deportation according to United States Code, title 8, 110.32section 1253(h); 110.33(5) paroled for a period of at least one year according to United States Code, title 8, 110.34section 1182(d)(5); 111.1(6) granted conditional entrant status according to United States Code, title 8, 111.2section 1153(a)(7); 111.3(7) determined to be a battered noncitizen by the United States Attorney General 111.4according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 111.5title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 111.6(8) is a child of a noncitizen determined to be a battered noncitizen by the United 111.7States Attorney General according to the Illegal Immigration Reform and Immigrant 111.8Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 111.9Public Law 104-200; or 111.10(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 111.11Law 96-422, the Refugee Education Assistance Act of 1980. 111.12(c) All qualified noncitizens who were residing in the United States before August 111.1322, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 111.14medical assistance with federal financial participation. 111.15(d) All qualified noncitizens who entered the United States on or after August 22, 111.161996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 111.17medical assistance with federal financial participation through November 30, 1996. 111.18Beginning December 1, 1996, qualified noncitizens who entered the United States 111.19on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 111.20chapter are eligible for medical assistance with federal participation for five years if they 111.21meet one of the following criteria: 111.22(i) refugees admitted to the United States according to United States Code, title 8, 111.23section 1157; 111.24(ii) persons granted asylum according to United States Code, title 8, section 1158; 111.25(iii) persons granted withholding of deportation according to United States Code, 111.26title 8, section 1253(h); 111.27(iv) veterans of the United States armed forces with an honorable discharge for 111.28a reason other than noncitizen status, their spouses and unmarried minor dependent 111.29children; or 111.30(v) persons on active duty in the United States armed forces, other than for training, 111.31their spouses and unmarried minor dependent children. 111.32Beginning December 1, 1996, qualified noncitizens who do not meet one of the 111.33criteria in items (i) to (v) are eligible for medical assistance without federal financial 111.34participation as described in paragraph (j). 111.35Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant 111.36women who are noncitizens described in paragraph (b) or (e), are eligible for medical 112.1assistance with federal financial participation as provided by the federal Children's Health 112.2Insurance Program Reauthorization Act of 2009, Public Law 111-3. 112.3(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 112.4are lawfully present in the United States, as defined in Code of Federal Regulations, title 112.58, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 112.6eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 112.7with the United States Citizenship and Immigration Services to pursue any applicable 112.8immigration status, including citizenship, that would qualify them for medical assistance 112.9with federal financial participation. 112.10(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 112.11for medical assistance with federal financial participation through December 31, 1996. 112.12(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 112.13medical assistance without federal financial participation as described in paragraph (j). 112.14(3) Beginning December 1, 1996, persons residing in the United States prior to 112.15August 22, 1996, who were not receiving medical assistance and persons who arrived on 112.16or after August 22, 1996, are eligible for medical assistance without federal financial 112.17participation as described in paragraph (j). 112.18(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 112.19are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this 112.20subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 112.21Code, title 8, section 1101(a)(15). 112.22(g) Payment shall also be made for care and services that are furnished to noncitizens, 112.23regardless of immigration status, who otherwise meet the eligibility requirements of 112.24this chapter, if such care and services are necessary for the treatment of an emergency 112.25medical condition, except for organ transplants and related care and services and routine 112.26prenatal care. 112.27(h) For purposes of this subdivision, the term "emergency medical condition" means 112.28a medical condition that meets the requirements of United States Code, title 42, section 112.291396b(v). 112.30 new text begin (i)(1) Notwithstanding paragraph (h), services that are necessary for the treatment of new text end 112.31 new text begin an emergency medical condition are limited to the following: new text end 112.32 new text begin (i) services delivered in an emergency room that are directly related to the treatment new text end 112.33 new text begin of an emergency medical condition; new text end 112.34 new text begin (ii) services delivered in an inpatient hospital setting following admission from an new text end 112.35 new text begin emergency room or clinic for an acute emergency condition; and new text end 113.1 new text begin (iii) follow-up services that are directly related to the original service provided to new text end 113.2 new text begin treat the emergency medical condition and that are covered by the global payment made new text end 113.3 new text begin to the provider. new text end 113.4     new text begin (2) Services for the treatment of emergency medical conditions do not include: new text end 113.5 new text begin (i) services delivered in an emergency room or inpatient setting to treat a new text end 113.6 new text begin nonemergency condition; new text end 113.7 new text begin (ii) organ and stem cell transplants and related care; new text end 113.8 new text begin (iii) services for routine prenatal care; new text end 113.9 new text begin (iv) continuing care, including long-term care, nursing facility services, home health new text end 113.10 new text begin care, adult day care, day training, or supportive living services; new text end 113.11 new text begin (v) elective surgery; new text end 113.12 new text begin (vi) outpatient prescription drugs, unless the drugs are administered or dispensed as new text end 113.13 new text begin part of an emergency room visit; new text end 113.14 new text begin (vii) preventative health care and family planning services; new text end 113.15 new text begin (viii) dialysis; new text end 113.16 new text begin (ix) chemotherapy or therapeutic radiation services; new text end 113.17 new text begin (x) rehabilitation services; new text end 113.18 new text begin (xi) physical, occupational, or speech therapy; new text end 113.19 new text begin (xii) transportation services; new text end 113.20 new text begin (xiii) case management; new text end 113.21 new text begin (xiv) prosthetics, orthotics, durable medical equipment, or medical supplies; new text end 113.22 new text begin (xv) dental services; new text end 113.23 new text begin (xvi) hospice care; new text end 113.24 new text begin (xvii) audiology services and hearing aids; new text end 113.25 new text begin (xviii) podiatry services; new text end 113.26 new text begin (xix) chiropractic services; new text end 113.27 new text begin (xx) immunizations; new text end 113.28 new text begin (xxi) vision services and eyeglasses; new text end 113.29 new text begin (xxii) waiver services; new text end 113.30 new text begin (xxiii) individualized education programs; or new text end 113.31 new text begin (xxiv) chemical dependency treatment. new text end 113.32(i) new text begin (j) new text end Beginning July 1, 2009, pregnant noncitizens who are undocumented, 113.33nonimmigrants, or lawfully present as designated in paragraph (e) and who are not 113.34covered by a group health plan or health insurance coverage according to Code of 113.35Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility 113.36requirements of this chapter, are eligible for medical assistance through the period of 114.1pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal 114.2funds are available under title XXI of the Social Security Act, and the state children's 114.3health insurance program. 114.4(j) new text begin (k) new text end Qualified noncitizens as described in paragraph (d), and all other noncitizens 114.5lawfully residing in the United States as described in paragraph (e), who are ineligible 114.6for medical assistance with federal financial participation and who otherwise meet the 114.7eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 114.8assistance without federal financial participation. Qualified noncitizens as described 114.9in paragraph (d) are only eligible for medical assistance without federal financial 114.10participation for five years from their date of entry into the United States. 114.11(k) new text begin (l) new text end Beginning October 1, 2003, persons who are receiving care and rehabilitation 114.12services from a nonprofit center established to serve victims of torture and are otherwise 114.13ineligible for medical assistance under this chapter are eligible for medical assistance 114.14without federal financial participation. These individuals are eligible only for the period 114.15during which they are receiving services from the center. Individuals eligible under this 114.16paragraph shall not be required to participate in prepaid medical assistance. 114.17    Sec. 24. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 114.18subdivision to read: 114.19     new text begin Subd. 1b. new text end new text begin Care coordination services provided through pediatric hospitals. new text end 114.20 new text begin (a) Medical assistance covers care coordination services provided by certain pediatric new text end 114.21 new text begin hospitals to children with high-cost medical conditions and children at risk of recurrent new text end 114.22 new text begin hospitalization for acute or chronic illnesses. There must be Level I and Level II pediatric new text end 114.23 new text begin care coordination services. new text end 114.24 new text begin (b) Level I pediatric care coordination services are provided by advanced practice new text end 114.25 new text begin nurses employed by or under contract with pediatric hospitals that have a neonatal new text end 114.26 new text begin intensive care unit and are either recipients of payments to support the training of residents new text end 114.27 new text begin from an approved graduate medical residency program under United States Code, title new text end 114.28 new text begin 42, section 256e, or the major pediatric teaching hospital affiliate of the University of new text end 114.29 new text begin Minnesota Medical School, and that meet the criteria in this subdivision. new text end 114.30 new text begin (c) The services in paragraph (b) must be available through in-home video telehealth new text end 114.31 new text begin management and other methods, and must be designed to improve patient outcomes new text end 114.32 new text begin and reduce unnecessary hospital and emergency room utilization. The services must new text end 114.33 new text begin streamline communication, reduce redundancy, and eliminate unnecessary documentation new text end 114.34 new text begin through the use of a Web-accessible, uniform document that contains critical patient care new text end 114.35 new text begin management information, and which is accessible to all providers with patient consent. new text end 115.1 new text begin The commissioner shall develop the uniform document and associated Web site and shall new text end 115.2 new text begin implement procedures to assess patient outcomes and evaluate the effectiveness of the new text end 115.3 new text begin care coordination services provided under this subdivision. new text end 115.4 new text begin (d) Medical assistance also covers, as durable medical equipment, computers, new text end 115.5 new text begin webcams, and other technology necessary to allow in-home video telehealth management. new text end 115.6 new text begin (e) For purposes of paragraph (b), a child has a high-cost medical condition if new text end 115.7 new text begin inpatient hospital expenses for that child related to complex or chronic illnesses or new text end 115.8 new text begin conditions for the most recent calendar year exceeded $100,000, or if the expenses for that new text end 115.9 new text begin child are projected to exceed $100,000 for the current calendar year. For purposes of this new text end 115.10 new text begin subdivision, a child is at risk of recurrent hospitalization if the child was hospitalized three new text end 115.11 new text begin or more times for acute or chronic illness in the most recent calendar year. new text end 115.12 new text begin (f) For purposes of paragraph (b), "care coordination" means collaboration between new text end 115.13 new text begin the advanced practice nurse and primary care physicians and specialists to manage new text end 115.14 new text begin care and reduce hospitalizations, patient case management, development of medical new text end 115.15 new text begin management plans for chronic illnesses and recurrent acute illnesses, oversight and new text end 115.16 new text begin coordination of all aspects of care in partnership with families, organization of medical new text end 115.17 new text begin information into a summary of critical information, coordination and appropriate new text end 115.18 new text begin sequencing of tests and multiple appointments, information and assistance with accessing new text end 115.19 new text begin resources, and telephone triage for acute illnesses or problems. new text end 115.20 new text begin (g) The commissioner shall adjust managed care and county-based purchasing plan new text end 115.21 new text begin capitation rates to reflect savings from the coverage of this service. new text end 115.22 new text begin (h) Level II pediatric care coordination services are provided by registered nurses new text end 115.23 new text begin employed by or under contract with a pediatric hospital that has been designated as new text end 115.24 new text begin an essential community provider under section 62Q.19, subdivision 1, clause (4), and new text end 115.25 new text begin has been a recipient of payments to support the training of residents from an approved new text end 115.26 new text begin graduate medical residency program pursuant to United States Code, title 42, section new text end 115.27 new text begin 256e, and that meets the following criteria: new text end 115.28 new text begin (1) the services must be provided through telehealth management and other methods, new text end 115.29 new text begin be available on a regular schedule seven days per week, and be designed to provide new text end 115.30 new text begin collaboration in patient care as provided by the patient's family, primary care providers, new text end 115.31 new text begin and the hospital and specialized physicians; new text end 115.32 new text begin (2) for purposes of this paragraph, a child has a high-cost medical condition if the new text end 115.33 new text begin child has a serious chronic physical disability caused by a congenital anomaly, birth new text end 115.34 new text begin injury or traumatic injury, complications which can be expected to cause further injury, new text end 115.35 new text begin hospitalization, or death, but that can be effectively addressed through ongoing family new text end 116.1 new text begin and primary care supported by communication of ongoing care information and care new text end 116.2 new text begin coordination; and new text end 116.3 new text begin (3) for purposes of this paragraph, "care coordination" means the ready availability new text end 116.4 new text begin of telehealth management services to support collaboration through a registered nurse new text end 116.5 new text begin between a child's family, the primary care professional that is available to care for the new text end 116.6 new text begin child, and appropriate professionals to address urgent questions about and minimize the new text end 116.7 new text begin consequences of medical complications, develop medical management plans for complex new text end 116.8 new text begin conditions, and avoid serious health consequences and hospitalizations to treat such new text end 116.9 new text begin complications. new text end 116.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 116.11    Sec. 25. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 116.12subdivision to read: 116.13     new text begin Subd. 3q. new text end new text begin Evidence-based childbirth program. new text end new text begin (a) The commissioner shall new text end 116.14 new text begin implement a program to reduce the number of elective inductions of labor prior to 39 new text end 116.15 new text begin weeks' gestation. In this subdivision, the term "elective induction of labor" means the new text end 116.16 new text begin use of artificial means to stimulate labor in a woman without the presence of a medical new text end 116.17 new text begin condition affecting the woman or the child that makes the onset of labor a medical new text end 116.18 new text begin necessity. The program must promote the implementation of policies within hospitals new text end 116.19 new text begin providing services to recipients of medical assistance or MinnesotaCare that prohibit the new text end 116.20 new text begin use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by new text end 116.21 new text begin the attending providers. new text end 116.22 new text begin (b) For all births covered by medical assistance or MinnesotaCare on or after new text end 116.23 new text begin January 1, 2012, a payment for professional services associated with the delivery of a new text end 116.24 new text begin child in a hospital must not be made unless the provider has submitted information about new text end 116.25 new text begin the nature of the labor and delivery including any induction of labor that was performed new text end 116.26 new text begin in conjunction with that specific birth. The information must be on a form prescribed by new text end 116.27 new text begin the commissioner. new text end 116.28 new text begin (c) The requirements in paragraph (b) must not apply to deliveries performed new text end 116.29 new text begin at a hospital that has policies and processes in place that have been approved by the new text end 116.30 new text begin commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process new text end 116.31 new text begin for review of hospital induction policies must be established by the commissioner and new text end 116.32 new text begin review of policies must occur at the discretion of the commissioner. The commissioner's new text end 116.33 new text begin decision to approve or rescind approval must include verification and review of items new text end 116.34 new text begin including, but not limited to: new text end 116.35 new text begin (1) policies that prohibit use of elective inductions for gestation less than 39 weeks; new text end 117.1 new text begin (2) policies that encourage providers to document and communicate with patients a new text end 117.2 new text begin final expected date of delivery by 20 weeks' gestation that includes data from ultrasound new text end 117.3 new text begin measurements as applicable; new text end 117.4 new text begin (3) policies that encourage patient education regarding elective inductions, and new text end 117.5 new text begin requires documentation of the processes used to educate patients; new text end 117.6 new text begin (4) ongoing quality improvement review as determined by the commissioner; and new text end 117.7 new text begin (5) any data that has been collected by the commissioner. new text end 117.8 new text begin (d) All hospitals must report annually to the commissioner induction information new text end 117.9 new text begin for all births that were covered by medical assistance or MinnesotaCare in a format and new text end 117.10 new text begin manner to be established by the commissioner. new text end 117.11 new text begin (e) The commissioner at any time may choose not to implement or may discontinue new text end 117.12 new text begin any or all aspects of the program if the commissioner is able to determine that hospitals new text end 117.13 new text begin representing at least 90 percent of births covered by medical assistance or MinnesotaCare new text end 117.14 new text begin have approved policies in place. new text end 117.15 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 117.16    Sec. 26. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to 117.17read: 117.18    Subd. 8e. Chiropractic services. Payment for chiropractic services is limited to 117.19one annual evaluation and 12 new text begin 24 new text end visits per year unless prior authorization of a greater 117.20number of visits is obtained. 117.21    Sec. 27. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 117.22subdivision to read: 117.23     new text begin Subd. 8f. new text end new text begin Acupuncture services. new text end new text begin Medical assistance covers acupuncture, as defined new text end 117.24 new text begin in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by new text end 117.25 new text begin another Minnesota licensed practitioner for whom acupuncture is within the practitioner's new text end 117.26 new text begin scope of practice and who has specific acupuncture training or credentialing. new text end 117.27    Sec. 28. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to 117.28read: 117.29    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment 117.30shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; 117.31the maximum allowable cost set by the federal government or by the commissioner plus 117.32the fixed dispensing fee; or the usual and customary price charged to the public. The 117.33amount of payment basis must be reduced to reflect all discount amounts applied to the 118.1charge by any provider/insurer agreement or contract for submitted charges to medical 118.2assistance programs. The net submitted charge may not be greater than the patient liability 118.3for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 118.4for intravenous solutions which must be compounded by the pharmacist shall be $8 per 118.5bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 118.6nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 118.7nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 118.8includes quantity and other special discounts except time and cash discounts. Effective 118.9July 1, 2009, The actual acquisition cost of a drug shall be estimated by the commissioner, 118.10at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic 118.11factor drugs shall be estimated at the average wholesale price minus 30 percent. new text begin wholesale new text end 118.12 new text begin acquisition cost plus four percent for independently owned pharmacies located in a new text end 118.13 new text begin designated rural area within Minnesota, and at wholesale acquisition cost plus two percent new text end 118.14 new text begin for all other pharmacies. A pharmacy is "independently owned" if it is one of four or new text end 118.15 new text begin fewer pharmacies under the same ownership nationally. A "designated rural area" means new text end 118.16 new text begin an area defined as a small rural area or isolated rural area according to the four-category new text end 118.17 new text begin classification of the Rural Urban Commuting Area system developed for the United States new text end 118.18 new text begin Health Resources and Services Administration. Wholesale acquisition cost is defined as new text end 118.19 new text begin the manufacturer's list price for a drug or biological to wholesalers or direct purchasers new text end 118.20 new text begin in the United States, not including prompt pay or other discounts, rebates, or reductions new text end 118.21 new text begin in price, for the most recent month for which information is available, as reported in new text end 118.22 new text begin wholesale price guides or other publications of drug or biological pricing data. new text end The 118.23maximum allowable cost of a multisource drug may be set by the commissioner and it 118.24shall be comparable to, but no higher than, the maximum amount paid by other third-party 118.25payors in this state who have maximum allowable cost programs. Establishment of the 118.26amount of payment for drugs shall not be subject to the requirements of the Administrative 118.27Procedure Act. 118.28    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 118.29to pharmacists for legend drug prescriptions dispensed to residents of long-term care 118.30facilities when a unit dose blister card system, approved by the department, is used. Under 118.31this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 118.32The National Drug Code (NDC) from the drug container used to fill the blister card must 118.33be identified on the claim to the department. The unit dose blister card containing the 118.34drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 118.35that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 118.36will be required to credit the department for the actual acquisition cost of all unused 119.1drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 119.2manufacturer's unopened package. The commissioner may permit the drug clozapine to be 119.3dispensed in a quantity that is less than a 30-day supply. 119.4    (c) Whenever a maximum allowable cost has been set for a multisource drug, 119.5payment shall be on the basis of the maximum allowable cost established by the 119.6commissioner unless prior authorization for the brand name product has been granted 119.7according to the criteria established by the Drug Formulary Committee as required by 119.8subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on 119.9the prescription in a manner consistent with section 151.21, subdivision 2. 119.10    (d) The basis for determining the amount of payment for drugs administered in an 119.11outpatient setting shall be the lower of the usual and customary cost submitted by the 119.12provider or the amount established for Medicare by the new text begin 106 percent of the average sales new text end 119.13 new text begin price as determined by the new text end United States Department of Health and Human Services 119.14pursuant to title XVIII, section 1847a of the federal Social Security Act. new text begin If average sales new text end 119.15 new text begin price is unavailable, the amount of payment must be lower of the usual and customary cost new text end 119.16 new text begin submitted by the provider or the wholesale acquisition cost. new text end 119.17    (e) The commissioner may negotiate lower reimbursement rates for specialty 119.18pharmacy products than the rates specified in paragraph (a). The commissioner may 119.19require individuals enrolled in the health care programs administered by the department 119.20to obtain specialty pharmacy products from providers with whom the commissioner has 119.21negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 119.22used by a small number of recipients or recipients with complex and chronic diseases 119.23that require expensive and challenging drug regimens. Examples of these conditions 119.24include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 119.25C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 119.26of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 119.27biotechnology drugs, new text begin antihemophilic factor products, new text end high-cost therapies, and therapies 119.28that require complex care. The commissioner shall consult with the formulary committee 119.29to develop a list of specialty pharmacy products subject to this paragraph. In consulting 119.30with the formulary committee in developing this list, the commissioner shall take into 119.31consideration the population served by specialty pharmacy products, the current delivery 119.32system and standard of care in the state, and access to care issues. The commissioner shall 119.33have the discretion to adjust the reimbursement rate to prevent access to care issues. 119.34(f) Home infusion therapy services provided by home infusion therapy pharmacies 119.35must be paid at rates according to subdivision 8d. 120.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011, or upon federal new text end 120.2 new text begin approval, whichever is later. new text end 120.3    Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to 120.4read: 120.5    Subd. 13h. Medication therapy management services. (a) Medical assistance 120.6and general assistance medical care cover medication therapy management services for 120.7a recipient taking four new text begin three new text end or more prescriptions to treat or prevent two new text begin one new text end or more 120.8chronic medical conditions, or new text begin ; new text end a recipient with a drug therapy problem that is identified new text begin new text end 120.9 new text begin by the commissioner or identified by a pharmacist and approved by the commissioner; new text end or 120.10prior authorized by the commissioner that has resulted or is likely to result in significant 120.11nondrug program costs. The commissioner may cover medical therapy management 120.12services under MinnesotaCare if the commissioner determines this is cost-effective. For 120.13purposes of this subdivision, "medication therapy management" means the provision 120.14of the following pharmaceutical care services by a licensed pharmacist to optimize the 120.15therapeutic outcomes of the patient's medications: 120.16    (1) performing or obtaining necessary assessments of the patient's health status; 120.17    (2) formulating a medication treatment plan; 120.18    (3) monitoring and evaluating the patient's response to therapy, including safety 120.19and effectiveness; 120.20    (4) performing a comprehensive medication review to identify, resolve, and prevent 120.21medication-related problems, including adverse drug events; 120.22    (5) documenting the care delivered and communicating essential information to 120.23the patient's other primary care providers; 120.24    (6) providing verbal education and training designed to enhance patient 120.25understanding and appropriate use of the patient's medications; 120.26    (7) providing information, support services, and resources designed to enhance 120.27patient adherence with the patient's therapeutic regimens; and 120.28    (8) coordinating and integrating medication therapy management services within the 120.29broader health care management services being provided to the patient. 120.30Nothing in this subdivision shall be construed to expand or modify the scope of practice of 120.31the pharmacist as defined in section 151.01, subdivision 27. 120.32    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist 120.33must meet the following requirements: 120.34    (1) have a valid license issued under chapter 151; 121.1    (2) have graduated from an accredited college of pharmacy on or after May 1996, or 121.2completed a structured and comprehensive education program approved by the Board of 121.3Pharmacy and the American Council of Pharmaceutical Education for the provision and 121.4documentation of pharmaceutical care management services that has both clinical and 121.5didactic elements; 121.6    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 121.7have developed a structured patient care process that is offered in a private or semiprivate 121.8patient care area that is separate from the commercial business that also occurs in the 121.9setting, or in home settings, excluding new text begin including new text end long-term care and new text begin settings, new text end group homes, 121.10if the service is ordered by the provider-directed care coordination team new text begin and facilities new text end 121.11 new text begin providing assisted living services new text end ; and 121.12    (4) make use of an electronic patient record system that meets state standards. 121.13    (c) For purposes of reimbursement for medication therapy management services, 121.14the commissioner may enroll individual pharmacists as medical assistance and general 121.15assistance medical care providers. The commissioner may also establish contact 121.16requirements between the pharmacist and recipient, including limiting the number of 121.17reimbursable consultations per recipient. 121.18(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 121.19within a reasonable geographic distance of the patient, a pharmacist who meets the 121.20requirements may provide the services via two-way interactive video. Reimbursement 121.21shall be at the same rates and under the same conditions that would otherwise apply to 121.22the services provided. To qualify for reimbursement under this paragraph, the pharmacist 121.23providing the services must meet the requirements of paragraph (b), and must be located 121.24within an ambulatory care setting approved by the commissioner. The patient must also 121.25be located within an ambulatory care setting approved by the commissioner. Services 121.26provided under this paragraph may not be transmitted into the patient's residence. 121.27(e) The commissioner shall establish a pilot project for an intensive medication 121.28therapy management program for patients identified by the commissioner with multiple 121.29chronic conditions and a high number of medications who are at high risk of preventable 121.30hospitalizations, emergency room use, medication complications, and suboptimal 121.31treatment outcomes due to medication-related problems. For purposes of the pilot 121.32project, medication therapy management services may be provided in a patient's home 121.33or community setting, in addition to other authorized settings. The commissioner may 121.34waive existing payment policies and establish special payment rates for the pilot project. 121.35The pilot project must be designed to produce a net savings to the state compared to the 122.1estimated costs that would otherwise be incurred for similar patients without the program. 122.2The pilot project must begin by January 1, 2010, and end June 30, 2012. 122.3 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 122.4    Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 122.5read: 122.6    Subd. 17. Transportation costs. (a) Medical assistance covers medical 122.7transportation costs incurred solely for obtaining emergency medical care or transportation 122.8costs incurred by eligible persons in obtaining emergency or nonemergency medical 122.9care when paid directly to an ambulance company, common carrier, or other recognized 122.10providers of transportation services. Medical transportation must be provided by: 122.11(1) an ambulance, as defined in section 144E.001, subdivision 2; 122.12(2) special transportation; or 122.13(3) common carrier including, but not limited to, bus, taxicab, other commercial 122.14carrier, or private automobile. 122.15(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 122.16part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 122.17would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 122.18transportation, or private automobile. 122.19The commissioner may use an order by the recipient's attending physician to certify that 122.20the recipient requires special transportation services. Special transportation providers shall 122.21perform driver-assisted services for eligible individuals. Driver-assisted service includes 122.22passenger pickup at and return to the individual's residence or place of business, assistance 122.23with admittance of the individual to the medical facility, and assistance in passenger 122.24securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 122.25providers must obtain written documentation from the health care service provider who 122.26is serving the recipient being transported, identifying the time that the recipient arrived. 122.27Special transportation providers may not bill for separate base rates for the continuation of 122.28a trip beyond the original destination. Special transportation providers must take recipients 122.29to the nearest appropriate health care provider, using the most direct route. The minimum 122.30medical assistance reimbursement rates for special transportation services are: 122.31(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 122.32eligible persons who need a wheelchair-accessible van; 122.33(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 122.34eligible persons who do not need a wheelchair-accessible van; and 123.1(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 123.2special transportation services to eligible persons who need a stretcher-accessible vehicle; 123.3(2) the base rates for special transportation services in areas defined under RUCA 123.4to be super rural shall be equal to the reimbursement rate established in clause (1) plus 123.511.3 percent; and 123.6(3) for special transportation services in areas defined under RUCA to be rural 123.7or super rural areas: 123.8(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 123.9percent of the respective mileage rate in clause (1); and 123.10(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 123.11112.5 percent of the respective mileage rate in clause (1). 123.12(c) For purposes of reimbursement rates for special transportation services under 123.13paragraph (b), the zip code of the recipient's place of residence shall determine whether 123.14the urban, rural, or super rural reimbursement rate applies. 123.15(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 123.16means a census-tract based classification system under which a geographical area is 123.17determined to be urban, rural, or super rural. 123.18 new text begin (e) Effective for services provided on or after July 1, 2011, nonemergency new text end 123.19 new text begin transportation rates, including special transportation, taxi, and other commercial carriers, new text end 123.20 new text begin are reduced 4.5 percent. Payments made to managed care plans and county-based new text end 123.21 new text begin purchasing plans must be reduced for services provided on or after January 1, 2012, new text end 123.22 new text begin to reflect this reduction. new text end 123.23    Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to 123.24read: 123.25    Subd. 17a. Payment for ambulance services. new text begin (a) new text end Medical assistance covers 123.26ambulance services. Providers shall bill ambulance services according to Medicare 123.27criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 123.28for services rendered on or after July 1, 2001, medical assistance payments for ambulance 123.29services shall be paid at the Medicare reimbursement rate or at the medical assistance 123.30payment rate in effect on July 1, 2000, whichever is greater. 123.31 new text begin (b) Effective for services provided on or after July 1, 2011, ambulance services new text end 123.32 new text begin payment rates are reduced 4.5 percent. Payments made to managed care plans and new text end 123.33 new text begin county-based purchasing plans must be reduced for services provided on or after January new text end 123.34 new text begin 1, 2012, to reflect this reduction. new text end 124.1    Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to 124.2read: 124.3    Subd. 18. Bus or taxicab transportation. To the extent authorized by rule of the 124.4state agency, medical assistance covers costs of the most appropriate and cost-effective 124.5form of transportation incurred by any ambulatory eligible person for obtaining 124.6nonemergency medical care. 124.7    Sec. 33. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 124.8subdivision to read: 124.9     new text begin Subd. 25b. new text end new text begin Authorization with third-party liability. new text end new text begin (a) Except as otherwise new text end 124.10 new text begin allowed under this subdivision or required under federal or state regulations, the new text end 124.11 new text begin commissioner must not consider a request for authorization of a service when the recipient new text end 124.12 new text begin has coverage from a third-party payer unless the provider requesting authorization has new text end 124.13 new text begin made a good faith effort to receive payment or authorization from the third-party payer. new text end 124.14 new text begin A good faith effort is established by supplying with the authorization request to the new text end 124.15 new text begin commissioner the following: new text end 124.16 new text begin (1) a determination of payment for the service from the third-party payer, a new text end 124.17 new text begin determination of authorization for the service from the third-party payer, or a verification new text end 124.18 new text begin of noncoverage of the service by the third-party payer; and new text end 124.19 new text begin (2) the information or records required by the department to document the reason for new text end 124.20 new text begin the determination or to validate noncoverage from the third-party payer. new text end 124.21 new text begin (b) A provider requesting authorization for services covered by Medicare is not new text end 124.22 new text begin required to bill Medicare before requesting authorization from the commissioner if the new text end 124.23 new text begin provider has reason to believe that a service covered by Medicare is not eligible for new text end 124.24 new text begin payment. The provider must document that, because of recent claim experiences with new text end 124.25 new text begin Medicare or because of written communication from Medicare, coverage is not available new text end 124.26 new text begin for the service. new text end 124.27 new text begin (c) Authorization is not required if a third-party payer has made payment that is new text end 124.28 new text begin equal to or greater than 60 percent of the maximum payment amount for the service new text end 124.29 new text begin allowed under medical assistance. new text end 124.30    Sec. 34. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to 124.31read: 124.32    Subd. 31a. Augmentative and alternative communication systems. (a) Medical 124.33assistance covers augmentative and alternative communication systems consisting of 124.34electronic or nonelectronic devices and the related components necessary to enable a 125.1person with severe expressive communication limitations to produce or transmit messages 125.2or symbols in a manner that compensates for that disability. 125.3(b) Until the volume of systems purchased increases to allow a discount price, the 125.4commissioner shall reimburse augmentative and alternative communication manufacturers 125.5and vendors at the manufacturer's suggested retail price for augmentative and alternative 125.6communication systems and related components. The commissioner shall separately 125.7reimburse providers for purchasing and integrating individual communication systems 125.8which are unavailable as a package from an augmentative and alternative communication 125.9vendor. new text begin Augmentative and alternative communication systems must be paid the lower new text end 125.10 new text begin of the: new text end 125.11 new text begin (1) submitted charge; or new text end 125.12 new text begin (2)(i) manufacturer's suggested retail price minus 20 percent for providers that are new text end 125.13 new text begin manufacturers of augmentative and alternative communication systems; or new text end 125.14 new text begin (ii) manufacturer's invoice charge plus 20 percent for providers that are not new text end 125.15 new text begin manufacturers of augmentative and alternative communication systems. new text end 125.16(c) Reimbursement rates established by this purchasing program are not subject to 125.17Minnesota Rules, part 9505.0445, item S or T. 125.18    Sec. 35. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 125.19subdivision to read: 125.20     new text begin Subd. 55. new text end new text begin Payment for multiple services provided on same day. new text end new text begin The new text end 125.21 new text begin commissioner shall not prohibit payment, including any supplemental payments, for new text end 125.22 new text begin mental health services or dental services provided to a patient by a clinic or health care new text end 125.23 new text begin professional solely because the mental health services or dental services were provided on new text end 125.24 new text begin the same day as other covered health care services furnished by the same provider. new text end 125.25    Sec. 36. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 125.26subdivision to read: 125.27     new text begin Subd. 56. new text end new text begin Medical care coordination. new text end new text begin (a) Medical assistance covers in-reach new text end 125.28 new text begin community-based care coordination that is performed in a hospital emergency department new text end 125.29 new text begin as an eligible procedure under a state health care program or private insurance for a new text end 125.30 new text begin frequent user. new text end 125.31 new text begin (b) Reimbursement must be made in 15-minute increments under current Medicaid new text end 125.32 new text begin mental health social work reimbursement methodology and allowed for up to 60 days new text end 125.33 new text begin posthospital discharge based upon the specific identified emergency department visit or new text end 125.34 new text begin inpatient admitting event. A frequent user who is participating in care coordination within new text end 126.1 new text begin a health care home framework is ineligible for reimbursement under this subdivision. new text end 126.2 new text begin Eligible in-reach care coordinators must hold a minimum of a bachelor's degree in social new text end 126.3 new text begin work, public health, corrections, or related field. The commissioner shall submit any new text end 126.4 new text begin necessary application for waivers to the Centers for Medicare and Medicaid Services to new text end 126.5 new text begin implement this subdivision. new text end 126.6 new text begin (c) A frequent user is defined as an individual who: new text end 126.7 new text begin (1) has frequented the hospital emergency department for services three or more new text end 126.8 new text begin times in the previous six consecutive months; new text end 126.9 new text begin (2) would benefit from the provision of in-reach community-based services; and new text end 126.10 new text begin (3) has two or more of the following risk factors: new text end 126.11 new text begin (i) on one or more occasions within the last 24 months, the individual was diagnosed new text end 126.12 new text begin with a chronic or life-threatening condition that requires management of symptoms, new text end 126.13 new text begin medications, health care, or changes in lifestyle or risk-related behaviors that may new text end 126.14 new text begin include, but are not limited to, HIV/AIDS, hepatitis, diabetes, heart disease, hypertension, new text end 126.15 new text begin emphysema, asthma, or cancer; new text end 126.16 new text begin (ii) on one or more occasions within the last 24 months, the individual was diagnosed new text end 126.17 new text begin or, in the judgment of an emergency department physician, would likely be diagnosed, new text end 126.18 new text begin if provided a mental assessment, with an Axis I or II mental disorder identified in the new text end 126.19 new text begin Diagnostic and Statistical Manual of Mental Disorders; new text end 126.20 new text begin (iii) on one or more occasions within the last 24 months, the individual was new text end 126.21 new text begin diagnosed or, in the judgment of an emergency department physician, would likely be new text end 126.22 new text begin diagnosed, if provided an assessment, with a substance use problem that interferes with new text end 126.23 new text begin the individual's health or appropriate utilization of health services; or new text end 126.24 new text begin (iv) the individual is currently experiencing homelessness. "Homelessness" means new text end 126.25 new text begin lacking a fixed, regular, or adequate nighttime residence or a primary nighttime residence new text end 126.26 new text begin that is a supervised publicly or privately operated shelter designed to provide temporary new text end 126.27 new text begin living accommodations or a public or private place not designed for, or ordinarily used new text end 126.28 new text begin as, regular sleeping accommodations for human beings. new text end 126.29 new text begin (d) Any hospital choosing to participate in medical care coordination under this new text end 126.30 new text begin subdivision must, upon request by the commissioner of human services, make available new text end 126.31 new text begin program utilization data. Frequent users who are enrolled in a program must track: new text end 126.32 new text begin (1) the total number of program participants in the frequent user program for a new text end 126.33 new text begin defined period of time established by the commissioner; new text end 126.34 new text begin (2) the total number of program participants and what form of health care coverage new text end 126.35 new text begin they had at the time of enrollment and the number of beneficiaries who did not remain new text end 126.36 new text begin enrolled in the program for at least two months; new text end 127.1 new text begin (3) the frequency of emergency department visits during the 12 months prior to new text end 127.2 new text begin enrollment in the program and associated costs to the hospital; new text end 127.3 new text begin (4) the frequency of emergency department visits during the 12 months after new text end 127.4 new text begin program enrollment and the associated costs to the hospital; new text end 127.5 new text begin (5) the total number of inpatient admissions during the 12 months immediately new text end 127.6 new text begin preceding enrollment and the associated costs to the hospital; new text end 127.7 new text begin (6) the total number of inpatient admissions during the 12 months after enrollment in new text end 127.8 new text begin the program and the associated costs to the hospital; new text end 127.9 new text begin (7) the total number of inpatient days during the 12 months immediately preceding new text end 127.10 new text begin enrollment and the associated costs to the hospital; and new text end 127.11 new text begin (8) the total number of inpatient days during the 12 months after program enrollment new text end 127.12 new text begin and the associated costs to the hospital. new text end 127.13 new text begin (e) For the purposes of this subdivision, "in-reach community-based care new text end 127.14 new text begin coordination" means the practice of a community-based worker with training, knowledge, new text end 127.15 new text begin skills, and ability to access a continuum of services, including housing, transportation, new text end 127.16 new text begin chemical and mental health treatment, employment, and peer support services, by working new text end 127.17 new text begin with an organization's staff to transition an individual back into the individual's living new text end 127.18 new text begin environment. In-reach community-based care coordination includes working with the new text end 127.19 new text begin individual during their discharge and for up to a defined amount of time in the individual's new text end 127.20 new text begin living environment, reducing the individual's need for readmittance. new text end 127.21    Sec. 37. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 127.22subdivision to read: 127.23     new text begin Subd. 57. new text end new text begin Payment for Part B Medicare crossover claims. new text end new text begin Effective for services new text end 127.24 new text begin provided on or after January 1, 2012, medical assistance payment for an enrollee's cost new text end 127.25 new text begin sharing associated with Medicare Part B is limited to an amount up to the medical new text end 127.26 new text begin assistance total allowed, when the medical assistance rate exceeds the amount paid by new text end 127.27 new text begin Medicare. new text end 127.28 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 127.29    Sec. 38. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 127.30subdivision to read: 127.31     new text begin Subd. 58. new text end new text begin Early and periodic screening, diagnosis, and treatment services. new text end 127.32 new text begin Medical assistance covers early and periodic screening, diagnosis, and treatment services new text end 127.33 new text begin (EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate new text end 127.34 new text begin established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010. new text end 128.1    Sec. 39. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 128.2subdivision to read: 128.3     new text begin Subd. 59. new text end new text begin Services provided by advanced dental therapists and dental new text end 128.4 new text begin therapists. new text end new text begin Medical assistance covers services provided by advanced dental therapists new text end 128.5 new text begin and dental therapists when provided within the scope of practice identified in sections new text end 128.6 new text begin 150A.105 and 150A.106. new text end 128.7    Sec. 40. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 128.8subdivision to read: 128.9     new text begin Subd. 60. new text end new text begin Payment for noncovered services. new text end new text begin (a) Except when specifically new text end 128.10 new text begin prohibited by the commissioner or federal law, a provider may seek payment from the new text end 128.11 new text begin recipient for services not eligible for payment under the medical assistance program when new text end 128.12 new text begin the provider, prior to delivering the service, reviews and considers all other available new text end 128.13 new text begin covered alternatives with the recipient and obtains a signed acknowledgment from the new text end 128.14 new text begin recipient of the potential of the recipient's liability. The signed acknowledgment must be new text end 128.15 new text begin in a form approved by the commissioner. new text end 128.16     new text begin (b) Conditions under which a provider must not request payment from the recipient new text end 128.17 new text begin include, but are not limited to: new text end 128.18     new text begin (1) a service that requires prior authorization, unless authorization has been denied new text end 128.19 new text begin as not medically necessary and all other therapeutic alternatives have been reviewed; new text end 128.20     new text begin (2) a service for which payment has been denied for reasons relating to billing new text end 128.21 new text begin requirements; new text end 128.22     new text begin (3) standard shipping or delivery and setup of medical equipment or medical new text end 128.23 new text begin supplies; new text end 128.24     new text begin (4) services that are included in the recipient's long-term care per diem; new text end 128.25     new text begin (5) the recipient is enrolled in the restricted recipient program and the provider is new text end 128.26 new text begin one of a provider type designated for the recipient's health care services; and new text end 128.27     new text begin (6) the noncovered service is a prescriptive drug identified by the commissioner as new text end 128.28 new text begin having the potential for abuse and overuse, except where payment by the recipient is new text end 128.29 new text begin specifically approved by the commissioner on the date of service based upon compelling new text end 128.30 new text begin evidence supplied by the prescribing provider that establishes medical necessity for that new text end 128.31 new text begin particular drug. new text end 128.32     new text begin (c) The payment requested from recipients for noncovered services under this new text end 128.33 new text begin subdivision must not exceed the provider's usual and customary charge for the actual new text end 128.34 new text begin service received by the recipient. A recipient must not be billed for the difference between new text end 129.1 new text begin what medical assistance paid for the service or would pay for a less costly alternative new text end 129.2 new text begin service. new text end 129.3    Sec. 41. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to 129.4read: 129.5    Subdivision 1. Co-payments new text begin Cost-sharing new text end . (a) Except as provided in subdivision 129.62, the medical assistance benefit plan shall include the following co-payments new text begin cost-sharing new text end 129.7for all recipients, effective for services provided on or after October 1, 2003, and before 129.8January 1, 2009 new text begin July 1, 2011 new text end : 129.9    (1) $3 per nonpreventive visit new text begin , except as provided in paragraph (c) new text end . For purposes 129.10of this subdivision, a visit means an episode of service which is required because of 129.11a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 129.12ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 129.13midwife, advanced practice nurse, audiologist, optician, or optometrist; 129.14    (2) $3 for eyeglasses; 129.15    (3) $6 new text begin $3.50 new text end for nonemergency visits to a hospital-based emergency room new text begin , except new text end 129.16 new text begin that this co-payment shall be increased to $20 upon federal approval new text end ; and 129.17    (4) $3 per brand-name drug prescription and $1 per generic drug prescription, 129.18subject to a $12 per month maximum for prescription drug co-payments. No co-payments 129.19shall apply to antipsychotic drugs when used for the treatment of mental illness. new text begin ; new text end 129.20 new text begin (5) a family deductible equal to the maximum amount allowed under Code of new text end 129.21 new text begin Federal Regulations, title 42, part 447.54; and new text end 129.22    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall 129.23include the following co-payments for all recipients, effective for services provided on 129.24or after January 1, 2009: 129.25    (1) $3.50 for nonemergency visits to a hospital-based emergency room; 129.26    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, 129.27subject to a $7 per month maximum for prescription drug co-payments. No co-payments 129.28shall apply to antipsychotic drugs when used for the treatment of mental illness; and 129.29    (3) new text begin (6) new text end for individuals identified by the commissioner with income at or below 100 129.30percent of the federal poverty guidelines, total monthly co-payments new text begin cost-sharing new text end must 129.31not exceed five percent of family income. For purposes of this paragraph, family income 129.32is the total earned and unearned income of the individual and the individual's spouse, if 129.33the spouse is enrolled in medical assistance and also subject to the five percent limit on 129.34co-payments new text begin cost-sharing new text end . 130.1    (c) new text begin (b) new text end Recipients of medical assistance are responsible for all co-payments new text begin and new text end 130.2 new text begin deductibles new text end in this subdivision. 130.3 new text begin (c) Effective January 1, 2012, or upon federal approval, whichever is later, the new text end 130.4 new text begin following co-payments for nonpreventive visits shall apply to providers included in new text end 130.5 new text begin provider peer grouping: new text end 130.6 new text begin (1) $3 for visits to providers whose average, risk-adjusted, total annual cost of new text end 130.7 new text begin care per medical assistance enrollee is at the 60th percentile or lower for providers of new text end 130.8 new text begin the same type; new text end 130.9 new text begin (2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care new text end 130.10 new text begin per medical assistance enrollee is greater than the 60th percentile but does not exceed the new text end 130.11 new text begin 80th percentile for providers of the same type; and new text end 130.12 new text begin (3) $10 for visits to providers whose average, risk-adjusted, total annual cost of new text end 130.13 new text begin care per medical assistance enrollee is greater than the 80th percentile for providers of new text end 130.14 new text begin the same type. new text end 130.15 new text begin Each managed care and county-based purchasing plan shall calculate the average, new text end 130.16 new text begin risk-adjusted, total annual cost of care for providers under this paragraph using a new text end 130.17 new text begin methodology approved by the commissioner. The commissioner shall develop a new text end 130.18 new text begin methodology for calculating the average, risk-adjusted, total annual cost of care for new text end 130.19 new text begin fee-for-service providers. new text end 130.20 new text begin (d) The commissioner shall seek any federal waivers and approvals necessary to new text end 130.21 new text begin increase the co-payment for nonemergency visits to a hospital-based emergency room new text end 130.22 new text begin under paragraph (a), clause (3), and to implement paragraph (c). new text end 130.23    Sec. 42. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to 130.24read: 130.25    Subd. 2. Exceptions. Co-payments new text begin and deductibles new text end shall be subject to the following 130.26exceptions: 130.27(1) children under the age of 21; 130.28(2) pregnant women for services that relate to the pregnancy or any other medical 130.29condition that may complicate the pregnancy; 130.30(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or 130.31intermediate care facility for the developmentally disabled; 130.32(4) recipients receiving hospice care; 130.33(5) 100 percent federally funded services provided by an Indian health service; 130.34(6) emergency services; 130.35(7) family planning services; 131.1(8) services that are paid by Medicare, resulting in the medical assistance program 131.2paying for the coinsurance and deductible; and 131.3(9) co-payments that exceed one per day per provider for nonpreventive visits, 131.4eyeglasses, and nonemergency visits to a hospital-based emergency room. 131.5    Sec. 43. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to 131.6read: 131.7    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider shall 131.8be reduced by the amount of the co-payment new text begin or deductible new text end , except that reimbursements 131.9shall not be reduced: 131.10    (1) once a recipient has reached the $12 per month maximum or the $7 per month 131.11maximum effective January 1, 2009, for prescription drug co-payments; or 131.12    (2) for a recipient identified by the commissioner under 100 percent of the federal 131.13poverty guidelines who has met their monthly five percent co-payment new text begin cost-sharing new text end limit. 131.14    (b) The provider collects the co-payment new text begin or deductible new text end from the recipient. Providers 131.15may not deny services to recipients who are unable to pay the co-payment new text begin or deductible new text end . 131.16    (c) Medical assistance reimbursement to fee-for-service providers and payments to 131.17managed care plans shall not be increased as a result of the removal of co-payments new text begin or new text end 131.18 new text begin deductibles new text end effective on or after January 1, 2009. 131.19    Sec. 44. Minnesota Statutes 2010, section 256B.0644, is amended to read: 131.20256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 131.21PROGRAMS. 131.22    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a 131.23health maintenance organization, as defined in chapter 62D, must participate as a provider 131.24or contractor in the medical assistance program, general assistance medical care program, 131.25and MinnesotaCare as a condition of participating as a provider in health insurance plans 131.26and programs or contractor for state employees established under section 43A.18, the 131.27public employees insurance program under section 43A.316, for health insurance plans 131.28offered to local statutory or home rule charter city, county, and school district employees, 131.29the workers' compensation system under section 176.135, and insurance plans provided 131.30through the Minnesota Comprehensive Health Association under sections 62E.01 to 131.3162E.19 . The limitations on insurance plans offered to local government employees shall 131.32not be applicable in geographic areas where provider participation is limited by managed 131.33care contracts with the Department of Human Services. 132.1    (b) For providers other than health maintenance organizations, participation in the 132.2medical assistance program means that: 132.3     (1) the provider accepts new medical assistance, general assistance medical care, 132.4and MinnesotaCare patients; 132.5    (2) for providers other than dental service providers, at least 20 percent of the 132.6provider's patients are covered by medical assistance, general assistance medical care, 132.7and MinnesotaCare as their primary source of coverage; or 132.8    (3) for dental service providers, at least ten percent of the provider's patients are 132.9covered by medical assistance, general assistance medical care, and MinnesotaCare as 132.10their primary source of coverage, or the provider accepts new medical assistance and 132.11MinnesotaCare patients who are children with special health care needs. For purposes 132.12of this section, "children with special health care needs" means children up to age 18 132.13who: (i) require health and related services beyond that required by children generally; 132.14and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 132.15condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 132.16cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 132.17neurological diseases; visual impairment or deafness; Down syndrome and other genetic 132.18disorders; autism; fetal alcohol syndrome; and other conditions designated by the 132.19commissioner after consultation with representatives of pediatric dental providers and 132.20consumers. 132.21    (c) Patients seen on a volunteer basis by the provider at a location other than 132.22the provider's usual place of practice may be considered in meeting the participation 132.23requirement in this section. The commissioner shall establish participation requirements 132.24for health maintenance organizations. The commissioner shall provide lists of participating 132.25medical assistance providers on a quarterly basis to the commissioner of management and 132.26budget, the commissioner of labor and industry, and the commissioner of commerce. Each 132.27of the commissioners shall develop and implement procedures to exclude as participating 132.28providers in the program or programs under their jurisdiction those providers who do 132.29not participate in the medical assistance program. The commissioner of management 132.30and budget shall implement this section through contracts with participating health and 132.31dental carriers. 132.32    (d) For purposes of paragraphs (a) and (b), participation in the general assistance 132.33medical care program applies only to pharmacy providers. 132.34     new text begin (e) A provider described in section 256B.76, subdivision 5, may limit the eligibility new text end 132.35 new text begin of new medical assistance, general assistance medical care, and MinnesotaCare patients new text end 132.36 new text begin for specific categories of rehabilitative services, if medical assistance, general assistance new text end 133.1 new text begin medical care, and MinnesotaCare patients served by the provider in the aggregate exceed new text end 133.2 new text begin 30 percent of the provider's overall patient population. new text end 133.3    Sec. 45. Minnesota Statutes 2010, section 256B.0751, subdivision 1, is amended to 133.4read: 133.5    Subdivision 1. Definitions. (a) For purposes of sections 256B.0751 to 256B.0753, 133.6the following definitions apply. 133.7    (b) "Commissioner" means the commissioner of human services. 133.8    (c) "Commissioners" means the commissioner of humans services and the 133.9commissioner of health, acting jointly. 133.10    (d) "Health plan company" has the meaning provided in section 62Q.01, subdivision 133.114. 133.12    (e) "Personal clinician" means a physician licensed under chapter 147, a physician 133.13assistant licensed and practicing under chapter 147A, or new text begin a mental health professional new text end 133.14 new text begin licensed under section 245.462, subdivision 18, clauses (1) to (6); or 245.4871, subdivision new text end 133.15 new text begin 27, clauses (1) to (6), or new text end an advanced practice nurse licensed and registered to practice 133.16under chapter 148. 133.17    (f) "State health care program" means the medical assistance, MinnesotaCare, and 133.18general assistance medical care programs. 133.19    Sec. 46. Minnesota Statutes 2010, section 256B.0751, subdivision 2, is amended to 133.20read: 133.21    Subd. 2. Development and implementation of standards. (a) By July 1, 2009, 133.22the commissioners of health and human services shall develop and implement standards 133.23of certification for health care homes for state health care programs. In developing these 133.24standards, the commissioners shall consider existing standards developed by national 133.25independent accrediting and medical home organizations. The standards developed by the 133.26commissioners must meet the following criteria: 133.27    (1) emphasize, enhance, and encourage the use of primary care, and include the use 133.28of primary care physicians, advanced practice nurses, and new text begin mental health professionals, new text end 133.29 new text begin and new text end physician assistants as personal clinicians new text begin but permitting multidisciplinary teams of new text end 133.30 new text begin other health professionals new text end ; 133.31    (2) focus on delivering high-quality, efficient, and effective health care services new text begin new text end 133.32 new text begin and providing, arranging, or coordinating related social and public health services and new text end 133.33 new text begin other services that directly affect an individual's health, access to services, quality and new text end 133.34 new text begin outcomes, and patient satisfaction new text end ; 134.1    (3) encourage patient-centered care new text begin and services new text end , including active participation by 134.2the patient and family or a legal guardian, or a health care agent as defined in chapter 134.3145C, as appropriate in decision making and care plan development, and providing care 134.4that is appropriate to the patient's race, ethnicity, and language; 134.5    (4) provide patients with a consistent, ongoing contact with a personal clinician or 134.6team of clinical professionals to ensure continuous and appropriate care for the patient's 134.7condition; 134.8    (5) ensure that health care homes develop and maintain appropriate comprehensive 134.9care new text begin and wellness new text end plans for their patients with complex or chronic conditions, including an 134.10assessment of health risks and new text begin , new text end chronic conditions new text begin , and socioeconomic factors affecting new text end 134.11 new text begin health and treatment new text end ; 134.12    (6) enable and encourage utilization of a range of qualified health care professionals new text begin new text end 134.13 new text begin and other professionals or services related to the health and treatment of the patient new text end , 134.14including dedicated care coordinators, in a manner that enables providers to practice to 134.15the fullest extent of their license; 134.16    (7) focus initially on patients who have or are at risk of developing chronic health 134.17conditions; 134.18    (8) incorporate measures of quality, resource use, cost of care, and patient 134.19experience new text begin , with appropriate adjustments for socioeconomic factors new text end ; 134.20    (9) ensure the use of health information technology and systematic follow-up, 134.21including the use of patient registries; and 134.22    (10) encourage the use of scientifically based health care, patient decision-making 134.23aids that provide patients with information about treatment new text begin and service new text end options and their 134.24associated benefits, risks, costs, and comparative outcomes, and other clinical decision 134.25support tools. 134.26    (b) In developing these standards, the commissioners shall consult with national 134.27and local organizations working on health care home models, physicians, relevant 134.28state agencies, health plan companies, hospitals, other providers, patients, and patient 134.29advocates. The commissioners may satisfy this requirement by continuing the provider 134.30directed care coordination advisory committee. 134.31    (c) For the purposes of developing and implementing these standards, the 134.32commissioners may use the expedited rulemaking process under section 14.389. 134.33    Sec. 47. Minnesota Statutes 2010, section 256B.0751, subdivision 3, is amended to 134.34read: 135.1    Subd. 3. Requirements for clinicians certified as health care homes. (a) A 135.2personal clinician or new text begin , new text end a primary care clinic new text begin , or community mental health center eligible for new text end 135.3 new text begin payment under section 256B.0625, subdivision 5, new text end may be certified as a health care home. 135.4If a primary care clinic new text begin or mental health center new text end is certified, all of the primary care clinic's 135.5 new text begin or mental health center's new text end clinicians new text begin who may provide care to persons enrolled with the new text end 135.6 new text begin health care home new text end must meet the criteria of a health care home. In order to be certified as 135.7a health care home, a clinician or new text begin , new text end clinic new text begin , or community mental health center new text end must meet 135.8the standards set by the commissioners in accordance with this section. Certification as 135.9a health care home is voluntary. In order to maintain their status as health care homes, 135.10clinicians or clinics must renew their certification annually. 135.11    (b) Clinicians or new text begin , new text end clinics new text begin , or mental health centers new text end certified as health care homes must 135.12offer their health care home services to all their patients with complex or chronic health 135.13conditions who are interested in participation. 135.14    (c) Health care homes must participate in the health care home collaborative 135.15established under subdivision 5. 135.16    Sec. 48. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to 135.17read: 135.18    Subd. 4. Alternative models new text begin and waivers of requirements new text end . new text begin (a) new text end Nothing in this 135.19section shall preclude the continued development of existing medical or health care 135.20home projects currently operating or under development by the commissioner of human 135.21services or preclude the commissioner from establishing alternative models and payment 135.22mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs 135.23under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term 135.24care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and 135.25medical assistance, are in the waiting period for Medicare, or who have other primary 135.26coverage. 135.27 new text begin (b) The commissioner of health shall modify the health care homes application new text end 135.28 new text begin for certification to add an item allowing an applicant to indicate status as a federally new text end 135.29 new text begin qualified health center or a federally qualified health center look-alike, as defined in new text end 135.30 new text begin section 145.9269, subdivision 1. Effective July 1, 2012, the commissioner shall certify as new text end 135.31 new text begin a health care home each applicant that indicates this status on a completed application for new text end 135.32 new text begin certification, without requiring the applicant to meet the standards in Minnesota Rules, new text end 135.33 new text begin part 4764.0040. In order to retain certification, a federally qualified health center or new text end 135.34 new text begin federally qualified health center look-alike certified under this paragraph must seek annual new text end 136.1 new text begin recertification by submitting a letter of intent stating its desire to be recertified but is not new text end 136.2 new text begin required to meet the standards for recertification in Minnesota Rules, part 4764.0040. new text end 136.3 new text begin (c) The commissioner of health shall waive health care home certification new text end 136.4 new text begin requirements if an applicant demonstrates that compliance with a certification requirement new text end 136.5 new text begin will create a major financial hardship or is not feasible, and the applicant establishes an new text end 136.6 new text begin alternative way to accomplish the objectives of the certification requirement. new text end 136.7    Sec. 49. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 136.8subdivision to read: 136.9     new text begin Subd. 8. new text end new text begin Coordination with local services. new text end new text begin The health care home and the county new text end 136.10 new text begin shall coordinate care and services provided to patients enrolled with a health care home new text end 136.11 new text begin who have complex medical or socioeconomic needs or a disability, and who need and are new text end 136.12 new text begin eligible for additional local services administered by counties, including but not limited new text end 136.13 new text begin to waivered services, mental health services, social services, public health services, new text end 136.14 new text begin transportation, and housing. The coordination of care and services must be as provided in new text end 136.15 new text begin the plan established by the patient and health care home. new text end 136.16    Sec. 50. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 136.17subdivision to read: 136.18     new text begin Subd. 9. new text end new text begin Patient choice of health care home. new text end new text begin Notwithstanding section 256B.69, new text end 136.19 new text begin subdivisions 4 and 23, and subject to any necessary federal approval, the commissioner new text end 136.20 new text begin may require a patient enrolled in a state health care program through a managed care new text end 136.21 new text begin plan, county-based purchasing plan, fee-for-service, or demonstration project under new text end 136.22 new text begin section 256B.0755 to select a health care home and agree to receive primary care and new text end 136.23 new text begin care coordination services through the health care home as a condition of enrollment in new text end 136.24 new text begin the state health care program. The patient must be allowed to choose from among all new text end 136.25 new text begin available qualified health care providers, including an essential community provider as new text end 136.26 new text begin defined in section 62Q.19, if the provider is certified as a health care home and agrees to new text end 136.27 new text begin accept the terms, conditions, and payment rates for participation in the managed care plan, new text end 136.28 new text begin county-based purchasing plan, fee-for-service program, or demonstration project, except new text end 136.29 new text begin that reimbursement to federally qualified health centers and federally qualified health new text end 136.30 new text begin center look-alikes as defined in section 145.9269 must comply with federal law. new text end 136.31    Sec. 51. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 136.32subdivision to read: 137.1     new text begin Subd. 10. new text end new text begin Engagement of patients and communities in health care home. new text end new text begin The new text end 137.2 new text begin commissioner of health shall require health care homes to demonstrate that their health new text end 137.3 new text begin care home patients, and the racial and ethnic communities of current or potential patients, new text end 137.4 new text begin participate in evaluating the health care home and recommending improvements and new text end 137.5 new text begin changes to the health care home's methods and procedures in order to improve health, new text end 137.6 new text begin quality, and patient satisfaction for patients from those communities. The commissioner new text end 137.7 new text begin shall consult with racial and ethnic communities to determine whether the requirements of new text end 137.8 new text begin this section and rules adopted under it are barriers to effective health care home methods new text end 137.9 new text begin and procedures for serving patients of racial and ethnic communities. new text end 137.10    Sec. 52. Minnesota Statutes 2010, section 256B.0753, is amended by adding a 137.11subdivision to read: 137.12     new text begin Subd. 4. new text end new text begin Waiver recipients. new text end new text begin A health care home shall receive the highest care new text end 137.13 new text begin coordination payment established under section 256B.0753 for providing services to an new text end 137.14 new text begin enrollee receiving home and community-based waiver services. new text end 137.15    Sec. 53. Minnesota Statutes 2010, section 256B.0754, is amended by adding a 137.16subdivision to read: 137.17     new text begin Subd. 3. new text end new text begin Primary care provider tiering. new text end new text begin (a) The commissioner shall establish new text end 137.18 new text begin a tiering system for all providers participating in Minnesota health care programs. new text end 137.19 new text begin The tiering system must differentiate providers on the basis of their ability to provide new text end 137.20 new text begin cost-effective, quality care and must incorporate the provider peer grouping measures new text end 137.21 new text begin established under section 62U.04. The tier assignments must be established annually based new text end 137.22 new text begin on the most recent peer grouping measures available. Differentiation of tier assignments new text end 137.23 new text begin must be statistically valid. The commissioner may set specific quality standards for new text end 137.24 new text begin providers designated as high-performing providers under this subdivision. new text end 137.25 new text begin (b) The commissioner may adjust the rates paid to providers within each tier group new text end 137.26 new text begin established under paragraph (a) on an annual basis. Adjustments to rates shall not include new text end 137.27 new text begin the rate paid for care coordination services to certified health care homes under section new text end 137.28 new text begin 256B.0753. Providers designated high-performing providers under paragraph (c) are not new text end 137.29 new text begin eligible for rate increases unless the provider also meets the cost and quality criteria new text end 137.30 new text begin associated with that tier level. new text end 137.31 new text begin (c) Health care homes certified under section 256B.0751, rural health clinics, and new text end 137.32 new text begin federally qualified health care clinics are designated as high-performing providers under new text end 137.33 new text begin this subdivision. new text end 138.1 new text begin (d) Providers reimbursed on a cost basis are subject to rate adjustments under this new text end 138.2 new text begin section. new text end 138.3 new text begin (e) The commissioner may phase in the tiering system by service type. new text end 138.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective one year from the public release of new text end 138.5 new text begin provider peer grouping measures under Minnesota Statutes, section 62U.04, or upon new text end 138.6 new text begin federal approval, whichever is later. new text end 138.7    Sec. 54. Minnesota Statutes 2010, section 256B.0755, subdivision 4, is amended to 138.8read: 138.9    Subd. 4. Payment system. (a) In developing a payment system for health care 138.10delivery systems, the commissioner shall establish a total cost of care benchmark or a 138.11risk/gain sharing payment model to be paid for services provided to the recipients enrolled 138.12in a health care delivery system. 138.13(b) The payment system may include incentive payments to health care delivery 138.14systems that meet or exceed annual quality and performance targets realized through 138.15the coordination of care. 138.16(c) An amount equal to the savings realized to the general fund as a result of the 138.17demonstration project shall be transferred each fiscal year to the health care access fund. 138.18 new text begin (d) The total cost of care benchmark for demonstration projects must be no new text end 138.19 new text begin greater than the capitation rate that would have been paid to a managed care plan for a new text end 138.20 new text begin substantially similar enrollee population based on the per-member per-month rate in new text end 138.21 new text begin effect on December 31, 2010. The commissioner shall adjust benchmark payment rates new text end 138.22 new text begin for demonstration projects as necessary to reflect the higher level of service and cost new text end 138.23 new text begin necessary to serve a patient population with a higher incidence of socioeconomic barriers new text end 138.24 new text begin and complexity, and shall make corresponding reductions in payment rates for projects new text end 138.25 new text begin with a lower concentration of patients with socioeconomic barriers and complexity. new text end 138.26    Sec. 55. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 138.27subdivision to read: 138.28     new text begin Subd. 8. new text end new text begin Coordination with local services. new text end new text begin The health care home and the county new text end 138.29 new text begin shall coordinate care and services provided to patients enrolled in a demonstration project new text end 138.30 new text begin who have complex medical or socioeconomic needs or a disability, and who need and are new text end 138.31 new text begin eligible for additional local services administered by counties, including but not limited new text end 138.32 new text begin to waivered services, mental health services, social services, public health services, new text end 138.33 new text begin transportation, or housing. The coordination of care and services must be as provided in new text end 138.34 new text begin the plan established by the patient and primary care provider or health care home. new text end 139.1    Sec. 56. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 139.2subdivision to read: 139.3     new text begin Subd. 9. new text end new text begin Rural demonstration projects. new text end new text begin For demonstration projects serving new text end 139.4 new text begin rural areas, the commissioner shall consult with rural hospitals, primary care providers, new text end 139.5 new text begin county boards, health plans, and other key stakeholders primarily domiciled in the new text end 139.6 new text begin service area regarding the development and approval of alternative rural health care new text end 139.7 new text begin delivery demonstration projects under this section. In addition to organizations eligible new text end 139.8 new text begin to establish a demonstration project under subdivision 1, a rural demonstration project new text end 139.9 new text begin may be established by a county public health or social services agency or a county-based new text end 139.10 new text begin purchasing plan. In a rural area where multiple, competing provider-based demonstration new text end 139.11 new text begin projects are not possible, the commissioner shall not approve more than one demonstration new text end 139.12 new text begin project to serve the primary geographic area and shall follow the applicable procedures new text end 139.13 new text begin and requirements in section 256B.692 regarding participation of county boards in new text end 139.14 new text begin reviewing and approving demonstration project proposals. new text end 139.15    Sec. 57. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 139.16subdivision to read: 139.17     new text begin Subd. 10. new text end new text begin Patient choice of qualified provider. new text end new text begin The commissioner shall implement new text end 139.18 new text begin and approve demonstration projects in a manner that allows a patient to choose a primary new text end 139.19 new text begin care provider and health care home from among all available qualified options. The new text end 139.20 new text begin commissioner may require the patient to remain with the chosen provider, health care new text end 139.21 new text begin home, or demonstration project organization for a period of time determined by the new text end 139.22 new text begin commissioner. The commissioner shall implement the demonstration projects in a manner new text end 139.23 new text begin that ensures that a patient has the option of receiving services, including health care home new text end 139.24 new text begin services, through a provider designated as an essential community provider under section new text end 139.25 new text begin 62Q.19. Demonstration projects and essential community providers must comply with new text end 139.26 new text begin section 62Q.19, subdivisions 3 to 7, for purposes of participation of providers in the new text end 139.27 new text begin demonstration project, except that reimbursement to federally qualified health centers new text end 139.28 new text begin and federally qualified health center look-alikes as defined in section 145.9269 must be new text end 139.29 new text begin in compliance with federal law. new text end 139.30    Sec. 58. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 139.31subdivision to read: 139.32     new text begin Subd. 11. new text end new text begin Patient and community engagement. new text end new text begin As a condition of approval of new text end 139.33 new text begin a demonstration project, the commissioner shall require the applicant to demonstrate new text end 139.34 new text begin that consumers and communities to be served under the project were consulted with and new text end 140.1 new text begin engaged in the process of developing the project proposal. The proposal must identify the new text end 140.2 new text begin needs and preferences of consumers and communities that were identified through this new text end 140.3 new text begin process of consultation and engagement. The consumers and communities consulted with new text end 140.4 new text begin and engaged in the development of the proposal must generally reflect the demographics, new text end 140.5 new text begin race, and ethnicity of those likely to be served under the demonstration project, with a new text end 140.6 new text begin special focus on those who experience the greatest health disparities. The commissioner new text end 140.7 new text begin shall require that demonstration project providers continue to consult with and engage new text end 140.8 new text begin consumers and communities during implementation and operation of the demonstration new text end 140.9 new text begin project. new text end 140.10    Sec. 59. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 140.11subdivision to read: 140.12     new text begin Subd. 12. new text end new text begin Care coordination system. new text end new text begin The commissioner of human services, in new text end 140.13 new text begin consultation with the commissioner of health, shall convene an advisory committee of new text end 140.14 new text begin small, independent, rural, and safety net primary care clinics, community hospitals, new text end 140.15 new text begin mental health centers, dental clinics, and other providers to advise the commissioner new text end 140.16 new text begin on the establishment of a system that will allow providers participating in payment new text end 140.17 new text begin reform demonstration projects established under this section and section 256B.0756 to new text end 140.18 new text begin effectively coordinate and deliver care to patients. In consultation with the advisory new text end 140.19 new text begin committee, the commissioner shall develop a plan for the care coordination system, issue a new text end 140.20 new text begin request for proposals, and contract with a vendor or vendors to establish and maintain the new text end 140.21 new text begin technology for the care coordination system. Using appropriations made for this purpose, new text end 140.22 new text begin the commissioner shall fund the planning, development, and establishment of the system. new text end 140.23 new text begin Ongoing costs must be covered by payments made by the providers who use the system. new text end 140.24    Sec. 60. Minnesota Statutes 2010, section 256B.0755, is amended by adding a 140.25subdivision to read: 140.26     new text begin Subd. 13. new text end new text begin Approval and implementation. new text end new text begin Beginning January 1, 2012, the new text end 140.27 new text begin commissioner of human services shall approve payment reform projects authorized under new text end 140.28 new text begin this section for medical assistance and MinnesotaCare. The commissioner may approve new text end 140.29 new text begin projects for persons enrolled in fee-for-service programs and may require managed care new text end 140.30 new text begin plans and county-based purchasing plans to contract with a demonstration project provider new text end 140.31 new text begin on the same terms, conditions, and payment arrangements as are established by the new text end 140.32 new text begin commissioner for fee-for-service programs. new text end 141.1    Sec. 61. Minnesota Statutes 2010, section 256B.0756, is amended to read: 141.2256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM. 141.3(a) The commissioner, upon federal approval of a new waiver request or amendment 141.4of an existing demonstration, may establish a pilot program in Hennepin County or 141.5Ramsey County, or both, to test alternative and innovative integrated health care delivery 141.6networks. 141.7(b) Individuals eligible for the pilot program shall be individuals who are eligible for 141.8medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin 141.9County or Ramsey County. 141.10(c) Individuals enrolled in the pilot program shall be enrolled in an integrated 141.11health care delivery network in their county of residence. The integrated health care 141.12delivery network in Hennepin County shall be a network, such as an accountable care 141.13organization or a community-based collaborative care network, created by or including 141.14Hennepin County Medical Center. The integrated health care delivery network in Ramsey 141.15County shall be a network, such as an accountable care organization or community-based 141.16collaborative care network, created by or including Regions Hospital. 141.17(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for 141.18Hennepin County and 3,500 enrollees for Ramsey County. 141.19(e) In developing a payment system for the pilot programs, the commissioner shall 141.20establish a total cost of care for the recipients enrolled in the pilot programs that equals 141.21the cost of care that would otherwise be spent for these enrollees in the prepaid medical 141.22assistance program. 141.23(f) Counties may transfer funds necessary to support the nonfederal share of 141.24payments for integrated health care delivery networks in their county. Such transfers per 141.25county shall not exceed 15 percent of the expected expenses for county enrollees. 141.26(g) The commissioner shall apply to the federal government for, or as appropriate, 141.27cooperate with counties, providers, or other entities that are applying for any applicable 141.28grant or demonstration under the Patient Protection and Affordable Health Care Act, Public 141.29Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 141.30111-152, that would further the purposes of or assist in the creation of an integrated health 141.31care delivery network for the purposes of this subdivision, including, but not limited to, a 141.32global payment demonstration or the community-based collaborative care network grants. 141.33 new text begin (h) A demonstration project established under this section must meet the new text end 141.34 new text begin requirements of section 256B.0755, subdivisions 8, 9, 10, and 11. new text end 141.35    Sec. 62. new text begin [256B.0758] PREGNANCY CARE HOMES. new text end 142.1     new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin (a) For purposes of this section, the following definitions new text end 142.2 new text begin apply. new text end 142.3 new text begin (b) "Pregnancy care home" means a health care home certified by the commissioner new text end 142.4 new text begin of health under section 256B.0751 that provides pregnancy care services in a way that new text end 142.5 new text begin is patient-centered, outcome-driven, comprehensive, and coordinated, and meets the new text end 142.6 new text begin standards specified and developed under subdivision 3. new text end 142.7 new text begin (c) "Pregnancy care services" means prenatal care, consultative perinatal services, new text end 142.8 new text begin intrapartum and postpartum care, and well-baby care for the first week. new text end 142.9 new text begin (d) "State health care program" means the medical assistance and MinnesotaCare new text end 142.10 new text begin programs. new text end 142.11     new text begin Subd. 2. new text end new text begin Development and implementation of standards. new text end new text begin (a) The commissioners new text end 142.12 new text begin of human services and health shall develop and implement standards of certification new text end 142.13 new text begin of pregnancy care homes for state health care programs. In developing standards, the new text end 142.14 new text begin commissioners shall consult with representatives of the American College of Nurse new text end 142.15 new text begin Midwives, the American Congress of OB/GYN, the American Academy of Family new text end 142.16 new text begin Practice, the American Academy of Pediatrics, and relevant local consumer groups. new text end 142.17     new text begin Subd. 3. new text end new text begin Criteria for development of standards. new text end new text begin (a) A pregnancy care home must new text end 142.18 new text begin meet the general health care home standards developed by the commissioners under new text end 142.19 new text begin section 256B.0751, subdivision 2, paragraph (a), clauses (1) to (4), (6), and (8) to (10), and new text end 142.20 new text begin must also meet specific standards for pregnancy care homes. The specific standards for new text end 142.21 new text begin pregnancy care homes developed by the commissioners must meet the criteria specified new text end 142.22 new text begin in this subdivision. new text end 142.23 new text begin (b) A pregnancy care home must provide pregnancy care services. Nonpregnancy new text end 142.24 new text begin complications, such as preexisting illness, shall be covered by medical assistance outside new text end 142.25 new text begin of the pregnancy care home. During a pregnancy episode, the pregnancy care home must new text end 142.26 new text begin coordinate necessary nonpregnancy health care services with the mother's primary care new text end 142.27 new text begin provider or another appropriate provider. new text end 142.28 new text begin (c) Each pregnancy care home must have adequate malpractice insurance that meets new text end 142.29 new text begin the standards specified by the commissioners. new text end 142.30 new text begin (d) A pregnancy care home may provide pregnancy services through any health care new text end 142.31 new text begin professional licensed to provide the service in Minnesota, including but not limited to new text end 142.32 new text begin licensed traditional midwives, certified nurse midwives, family practitioners, obstetricians, new text end 142.33 new text begin perinatologists, neonatologists, and other advanced practice registered nurses. new text end 142.34 new text begin (e) Pregnancy care within a pregnancy care home may be provided at any Minnesota new text end 142.35 new text begin facility licensed to provide pregnancy care and birth, including but not limited to new text end 142.36 new text begin freestanding birth centers, integrated birth centers, and hospitals. Each pregnancy care new text end 143.1 new text begin home must offer the option of midwife-directed pregnancy care services in a licensed new text end 143.2 new text begin integrated or freestanding birth center. new text end 143.3 new text begin (f) A pregnancy care home must have a governing board comprised of at least new text end 143.4 new text begin eight members. One-half of the governing board members must be providers licensed to new text end 143.5 new text begin attend births. new text end 143.6 new text begin (g) Each pregnancy care home must have a formal consultative relationship with at new text end 143.7 new text begin least one level III perinatal center to provide care for mothers and babies who develop new text end 143.8 new text begin pregnancy complications. new text end 143.9 new text begin (h) Each pregnancy care home must comply with state and federal requirements for new text end 143.10 new text begin the use of interoperable electronic medical records. new text end 143.11 new text begin (i) Each pregnancy care home must submit annual reports to the commissioners of new text end 143.12 new text begin human services and health that document: new text end 143.13 new text begin (1) all relevant pregnancy care outcomes and patient satisfaction measures; and new text end 143.14 new text begin (2) the financial status of the pregnancy care home. new text end 143.15 new text begin All reports are public data under section 13.02. new text end 143.16 new text begin (j) Each pregnancy care home must offer culturally competent care coordination new text end 143.17 new text begin services in a manner that is consistent with health care home requirements. new text end 143.18 new text begin (k) For the purposes of developing and implementing the standards in this new text end 143.19 new text begin subdivision, the commissioners may use the expedited rulemaking process under section new text end 143.20 new text begin 14.389. new text end 143.21     new text begin Subd. 4. new text end new text begin Certification process. new text end new text begin Providers seeking certification as a pregnancy care new text end 143.22 new text begin home must apply to the commissioner of health. Providers certified by the commissioner new text end 143.23 new text begin of health may provide pregnancy care services through pregnancy care homes beginning new text end 143.24 new text begin July 1, 2012. Certification as a pregnancy care home is voluntary, except that beginning new text end 143.25 new text begin July 1, 2014, all nonemergency pregnancy care services covered under state health care new text end 143.26 new text begin programs must be provided through providers certified as pregnancy care homes. new text end 143.27     new text begin Subd. 5. new text end new text begin Payments to pregnancy care homes. new text end new text begin (a) The commissioner of human new text end 143.28 new text begin services, in coordination with the commissioner of health, shall develop a payment system new text end 143.29 new text begin that provides a single per-person payment to pregnancy care homes to cover all pregnancy new text end 143.30 new text begin care services provided to each mother and infant enrolled in a state health care program. new text end 143.31 new text begin Pregnancy care homes receiving payments under this subdivision remain eligible for care new text end 143.32 new text begin coordination payments under section 256B.0753. new text end 143.33 new text begin (b) Payment amounts for pregnancy care homes shall be uniform statewide and new text end 143.34 new text begin determined annually by the commissioner, based initially upon a specified percentage new text end 143.35 new text begin of the calculated average cost of care for mothers and infants under state health care new text end 143.36 new text begin programs for the three most recent fiscal years for which cost information is available. new text end 144.1 new text begin Beginning July 1, 2014, statewide payment amounts for pregnancy care homes shall be new text end 144.2 new text begin determined annually by the commissioner by adjusting the current payment amount by new text end 144.3 new text begin a measure of medical inflation selected by the commissioner that best represents the new text end 144.4 new text begin change in the cost of pregnancy-related services provided to patients covered by private new text end 144.5 new text begin sector health coverage. new text end 144.6 new text begin (c) Pregnancy care home payments must initially be made for pregnancy care new text end 144.7 new text begin services provided to pregnant women who are not high risk, beginning July 1, 2012. new text end 144.8 new text begin Beginning January 1, 2013, the commissioner shall phase in higher payments for high-risk new text end 144.9 new text begin pregnancy categories so that beginning July 1, 2014, pregnancy care services for all new text end 144.10 new text begin low-risk and high-risk pregnancies are reimbursed under this subdivision. new text end 144.11    Sec. 63. new text begin [256B.0759] CARE COORDINATION FOR ENROLLEES. new text end 144.12     new text begin Subdivision 1. new text end new text begin Qualified enrollee. new text end new text begin For purposes of this section, a "qualified new text end 144.13 new text begin enrollee" means: (1) a medical assistance enrollee eligible under this chapter; or (2) a new text end 144.14 new text begin MinnesotaCare enrollee eligible under chapter 256L. new text end 144.15     new text begin Subd. 2. new text end new text begin Selection of primary care provider. new text end new text begin The commissioner shall require new text end 144.16 new text begin qualified enrollees who do not have a designated medical condition to select a primary new text end 144.17 new text begin care provider and agree to receive primary care services from that provider as a condition new text end 144.18 new text begin of medical assistance or MinnesotaCare enrollment. new text end 144.19     new text begin Subd. 3. new text end new text begin Selection of health care home; care coordination. new text end new text begin (a) The commissioner new text end 144.20 new text begin shall require qualified enrollees who have a medical condition designated by the new text end 144.21 new text begin commissioner to select a health care home certified under section 256B.0751 and agree new text end 144.22 new text begin to receive primary care and care coordination services through that health care home as new text end 144.23 new text begin a condition of medical assistance or MinnesotaCare enrollment. For purposes of this new text end 144.24 new text begin subdivision, the commissioner shall designate medical conditions with a high likelihood new text end 144.25 new text begin of inappropriate inpatient hospital admissions for which care coordination and prior new text end 144.26 new text begin authorization of admissions are expected to improve the quality of care and lead to costs new text end 144.27 new text begin savings for state health care programs. new text end 144.28 new text begin (b) The commissioner shall include on Minnesota health care program enrollment new text end 144.29 new text begin cards a designation as to whether an enrollee meets the criteria in paragraph (a). In order new text end 144.30 new text begin to receive medical assistance or MinnesotaCare payment for nonemergency inpatient new text end 144.31 new text begin hospital admissions for enrollees meeting the criteria in paragraph (a), a hospital must new text end 144.32 new text begin receive prior authorization from the enrollee's health care home. new text end 144.33 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, for MinnesotaCare new text end 144.34 new text begin enrollees not eligible for a federal match, and is effective January 1, 2012, or upon federal new text end 145.1 new text begin approval, whichever is later, for medical assistance enrollees and for MinnesotaCare new text end 145.2 new text begin enrollees eligible for a federal match. new text end 145.3    Sec. 64. new text begin [256B.0760] ELECTIVE SURGERY. new text end 145.4     new text begin Subdivision 1. new text end new text begin Payment prohibition. new text end new text begin The commissioner, in consultation with new text end 145.5 new text begin health care providers, health care homes certified under section 256B.0751, managed new text end 145.6 new text begin care plans providing services under section 256B.69, and county-based purchasing plans new text end 145.7 new text begin providing services under section 256B.692, shall identify elective or nonemergency new text end 145.8 new text begin surgical procedures for which less invasive and less costly alternative treatment methods new text end 145.9 new text begin are available, and shall prohibit payment for these elective or nonemergency surgical new text end 145.10 new text begin procedures if the alternative treatment methods have not first been evaluated for use new text end 145.11 new text begin and, if appropriate, provided to the enrollee. new text end 145.12     new text begin Subd. 2. new text end new text begin Implementation. new text end new text begin The commissioner shall implement the payment new text end 145.13 new text begin prohibitions in paragraph (a) for fee-for-service medical assistance providers by January new text end 145.14 new text begin 1, 2012, and shall require managed care and county-based purchasing plans to implement new text end 145.15 new text begin the payment prohibitions in paragraph (a) for providers employed or under contract for new text end 145.16 new text begin services provided to medical assistance and MinnesotaCare enrollees beginning January new text end 145.17 new text begin 1, 2012. new text end 145.18     new text begin Subd. 3. new text end new text begin Reduction in capitation rates. new text end new text begin The commissioner shall reduce medical new text end 145.19 new text begin assistance and MinnesotaCare capitation rates to managed care and county-based new text end 145.20 new text begin purchasing plans beginning January 1, 2012, to reflect cost-savings to plans resulting from new text end 145.21 new text begin implementation of the payment prohibitions required by this subdivision. new text end 145.22    Sec. 65. Minnesota Statutes 2010, section 256B.37, subdivision 5, is amended to read: 145.23    Subd. 5. Private benefits to be used first. Private accident and health care 145.24coverage new text begin , new text end including Medicare for medical services new text begin and coverage provided through the new text end 145.25 new text begin United States Department of Veterans Affairs, new text end is primary coverage and must be exhausted 145.26before medical assistance or alternative care services are paid for medical services 145.27including home health care, personal care assistance services, hospice, supplies and 145.28equipment, or services covered under a Centers for Medicare and Medicaid Services 145.29waiver. When a person who is otherwise eligible for medical assistance has private 145.30accident or health care coverage, including Medicare or a prepaid health plan new text begin or coverage new text end 145.31 new text begin provided through the United States Department of Veterans Affairs new text end , the private health care 145.32benefits available to the person must be used first and to the fullest extent. 145.33    Sec. 66. Minnesota Statutes 2010, section 256B.69, subdivision 3a, is amended to read: 146.1    Subd. 3a. County authority. (a) The commissioner, when implementing new text begin or new text end 146.2 new text begin administering new text end the medical assistance prepayment program within a county, must include 146.3the county board in the process of development, approval, and issuance of the request for 146.4proposals to provide services to eligible individuals within the proposed county new text begin , including new text end 146.5 new text begin proposals for demonstration projects established under section 256B.0755 new text end . County boards 146.6must be given reasonable opportunity to make recommendations regarding new text begin assist in new text end 146.7the development, issuance, review of responses, and changes needed in the request for 146.8proposals. The commissioner must provide county boards the opportunity to review 146.9each proposal based on the identification of community needs under chapters 145A and 146.10256E and county advocacy activities. If a county board finds that a proposal does not 146.11address certain community needs, the county board and commissioner shall continue 146.12efforts for improving the proposal and network prior to the approval of the contract. 146.13The county board shall make recommendations new text begin determinations new text end regarding the approval 146.14of local networks and their operations to ensure adequate new text begin local new text end availability and access to 146.15covered services. The provider or health plan must respond directly to county advocates 146.16and the state prepaid medical assistance ombudsperson regarding service delivery and 146.17must be accountable to the state regarding contracts with medical assistance funds. The 146.18county board may recommend new text begin shall decide new text end a maximum number of participating health 146.19plans new text begin including county-based purchasing plans new text end after considering the size of the enrolling 146.20population; ensuring adequate access and capacity; considering the client and county 146.21administrative complexity; and considering the need to promote the viability of locally 146.22developed health plans new text begin , managed care plans, or demonstration projects established under new text end 146.23 new text begin section 256B.0755 new text end . The county board or a single entity representing a group of county 146.24boards and the commissioner shall mutually select new text begin one or more qualified new text end health plans new text begin or new text end 146.25 new text begin county-based purchasing plans new text end for participation at the time of initial implementation of the 146.26prepaid medical assistance program new text begin or a demonstration project established under section new text end 146.27 new text begin 256B.0755 new text end in that county or group of counties and at the time of contract renewal. The 146.28commissioner shall also seek input for contract requirements from the county or single 146.29entity representing a group of county boards at each contract renewal and incorporate 146.30those recommendations into the contract negotiation process. 146.31    (b) At the option of the county board, the board may develop contract requirements 146.32related to the achievement of local public health goals new text begin and health care delivery and access new text end 146.33 new text begin goals new text end to meet the health needs of medical assistance enrollees. These requirements must 146.34be reasonably related to the performance of health plan new text begin managed care or delivery system new text end 146.35 new text begin demonstration project new text end functions and within the scope of the medical assistance benefit 146.36set. If the county board and the commissioner mutually agree to such requirements, the 147.1department new text begin The commissioner new text end shall include such requirements in all health plan contracts 147.2governing the prepaid medical assistance program in that county at initial implementation 147.3of the program new text begin or demonstration project new text end in that county and at the time of contract renewal. 147.4The county board may participate in the enforcement of the contract provisions related to 147.5local public health goals. 147.6    (c) For counties in which a prepaid medical assistance program has not been 147.7established, the commissioner shall not implement that program if a county board submits 147.8an acceptable and timely preliminary and final proposal under section 256B.692, until 147.9county-based purchasing is no longer operational in that county. For counties in which 147.10a prepaid medical assistance program is in existence on or after September 1, 1997, the 147.11commissioner must terminate contracts with health plans according to section 256B.692, 147.12subdivision 5 , if the county board submits and the commissioner accepts a preliminary and 147.13final proposal according to that subdivision. The commissioner is not required to terminate 147.14contracts that begin on or after September 1, 1997, according to section 256B.692 until 147.15two years have elapsed from the date of initial enrollment. 147.16    (d) In the event that a county board or a single entity representing a group of county 147.17boards and the commissioner cannot reach agreement regarding: (i) the selection of 147.18participating health plans new text begin or demonstration projects under section 256B.0755 new text end in that 147.19county; (ii) contract requirements; or (iii) implementation and enforcement of county 147.20requirements including provisions regarding local public health goals, the commissioner 147.21shall resolve all disputes after taking into account new text begin by approving new text end the recommendations of 147.22a three-person mediation panel. The panel shall be composed of one designee of the 147.23president of the association of Minnesota counties, one designee of the commissioner of 147.24human services, and one person selected jointly by the designee of the commissioner of 147.25human services and the designee of the Association of Minnesota Counties. Within a 147.26reasonable period of time before the hearing, the panelists must be provided all documents 147.27and information relevant to the mediation. The parties to the mediation must be given 147.2830 days' notice of a hearing before the mediation panel. 147.29    (e) If a county which elects to implement county-based purchasing ceases to 147.30implement county-based purchasing, it is prohibited from assuming the responsibility of 147.31county-based purchasing for a period of five years from the date it discontinues purchasing. 147.32    (f) The commissioner shall not require that contractual disputes between 147.33county-based purchasing entities and the commissioner be mediated by a panel that 147.34includes a representative of the Minnesota Council of Health Plans. 148.1    (g) At the request of a county-purchasing entity, the commissioner shall adopt a 148.2contract reprocurement or renewal schedule under which all counties included in the 148.3entity's service area are reprocured or renewed at the same time. 148.4    (h) The commissioner shall provide a written report under section 3.195 to the chairs 148.5of the legislative committees having jurisdiction over human services in the senate and the 148.6house of representatives describing in detail the activities undertaken by the commissioner 148.7to ensure full compliance with this section. The report must also provide an explanation 148.8for any decisions of the commissioner not to accept the recommendations of a county or 148.9group of counties required to be consulted under this section. The report must be provided 148.10at least 30 days prior to the effective date of a new or renewed prepaid or managed care 148.11contract in a county. 148.12 new text begin (i) This section also applies to other Minnesota health care programs administered new text end 148.13 new text begin by the commissioner, including but not limited to the MinnesotaCare program. new text end 148.14    Sec. 67. Minnesota Statutes 2010, section 256B.69, subdivision 4, is amended to read: 148.15    Subd. 4. Limitation of choice. (a) The commissioner shall develop criteria to 148.16determine when limitation of choice may be implemented in the experimental counties. 148.17The criteria shall ensure that all eligible individuals in the county have continuing access 148.18to the full range of medical assistance services as specified in subdivision 6. 148.19    (b) The commissioner shall exempt the following persons from participation in the 148.20project, in addition to those who do not meet the criteria for limitation of choice: 148.21    (1) persons eligible for medical assistance according to section 256B.055, 148.22subdivision 1 ; 148.23    (2) persons eligible for medical assistance due to blindness or disability as 148.24determined by the Social Security Administration or the state medical review team, unless: 148.25    (i) they are 65 years of age or older; or 148.26    (ii) they reside in Itasca County or they reside in a county in which the commissioner 148.27conducts a pilot project under a waiver granted pursuant to section 1115 of the Social 148.28Security Act; 148.29    (3) recipients who currently have private coverage through a health maintenance 148.30organization; 148.31    (4) recipients who are eligible for medical assistance by spending down excess 148.32income for medical expenses other than the nursing facility per diem expense; 148.33    (5) recipients who receive benefits under the Refugee Assistance Program, 148.34established under United States Code, title 8, section 1522(e); 149.1    (6) children who are both determined to be severely emotionally disturbed and 149.2receiving case management services according to section 256B.0625, subdivision 20, 149.3except children who are eligible for and who decline enrollment in an approved preferred 149.4integrated network under section 245.4682; 149.5    (7) adults who are both determined to be seriously and persistently mentally ill and 149.6received case management services according to section 256B.0625, subdivision 20; 149.7    (8) persons eligible for medical assistance according to section 256B.057, 149.8subdivision 10 ; and 149.9    (9) persons with access to cost-effective employer-sponsored private health 149.10insurance or persons enrolled in a non-Medicare individual health plan determined to be 149.11cost-effective according to section 256B.0625, subdivision 15. 149.12Children under age 21 who are in foster placement may enroll in the project on an elective 149.13basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an 149.14elective basis. The commissioner may enroll recipients in the prepaid medical assistance 149.15program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by 149.16spending down excess income. 149.17    (c) The commissioner may allow persons with a one-month spenddown who are 149.18otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay 149.19their monthly spenddown to the state. 149.20    (d) The commissioner may require those individuals to enroll in the prepaid medical 149.21assistance program who otherwise would have been excluded under paragraph (b), clauses 149.22(1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L. 149.23    (e) Before limitation of choice is implemented, eligible individuals shall be notified 149.24and after notification, shall be allowed to choose only among demonstration providers. 149.25The commissioner may assign an individual with private coverage through a health 149.26maintenance organization, to the same health maintenance organization for medical 149.27assistance coverage, if the health maintenance organization is under contract for medical 149.28assistance in the individual's county of residence. After initially choosing a provider, 149.29the recipient is allowed to change that choice only at specified times as allowed by the 149.30commissioner. If a demonstration provider ends participation in the project for any reason, 149.31a recipient enrolled with that provider must select a new provider but may change providers 149.32without cause once more within the first 60 days after enrollment with the second provider. 149.33    (f) An infant born to a woman who is eligible for and receiving medical assistance 149.34and who is enrolled in the prepaid medical assistance program shall be retroactively 149.35enrolled to the month of birth in the same managed care plan as the mother once the 150.1child is enrolled in medical assistance unless the child is determined to be excluded from 150.2enrollment in a prepaid plan under this section. 150.3 new text begin (g) For an eligible individual under the age of 65, in the absence of a specific new text end 150.4 new text begin managed care plan choice by the individual, the commissioner shall assign the individual to new text end 150.5 new text begin the county-based purchasing plan, if any, in the county of the individual's residence. For an new text end 150.6 new text begin eligible individual over the age of 65, the commissioner shall make the default assignment new text end 150.7 new text begin on the county-based purchasing plan entering into a contract with the commissioner to new text end 150.8 new text begin serve this population and receiving federal approval as a special needs plan. new text end 150.9    Sec. 68. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read: 150.10    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section 150.11and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 150.12January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 150.13renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 150.1431, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 150.15issue separate contracts with requirements specific to services to medical assistance 150.16recipients age 65 and older. 150.17    (b) A prepaid health plan providing covered health services for eligible persons 150.18pursuant to chapters 256B and 256L is responsible for complying with the terms of its 150.19contract with the commissioner. Requirements applicable to managed care programs 150.20under chapters 256B and 256L established after the effective date of a contract with the 150.21commissioner take effect when the contract is next issued or renewed. 150.22    (c) Effective for services rendered on or after January 1, 2003, the commissioner 150.23shall withhold five percent of managed care plan payments under this section and 150.24county-based purchasing plan payments under section 256B.692 for the prepaid medical 150.25assistance program pending completion of performance targets. Each performance target 150.26must be quantifiable, objective, measurable, and reasonably attainable, except in the case 150.27of a performance target based on a federal or state law or rule. Criteria for assessment 150.28of each performance target must be outlined in writing prior to the contract effective 150.29date. The managed care plan must demonstrate, to the commissioner's satisfaction, 150.30that the data submitted regarding attainment of the performance target is accurate. The 150.31commissioner shall periodically change the administrative measures used as performance 150.32targets in order to improve plan performance across a broader range of administrative 150.33services. The performance targets must include measurement of plan efforts to contain 150.34spending on health care services and administrative activities. The commissioner may 150.35adopt plan-specific performance targets that take into account factors affecting only one 151.1plan, including characteristics of the plan's enrollee population. The withheld funds 151.2must be returned no sooner than July of the following year if performance targets in the 151.3contract are achieved. The commissioner may exclude special demonstration projects 151.4under subdivision 23. 151.5    (d) Effective for services rendered on or after January 1, 2009, through December 151.631, 2009, the commissioner shall withhold three percent of managed care plan payments 151.7under this section and county-based purchasing plan payments under section 256B.692 151.8for the prepaid medical assistance program. The withheld funds must be returned no 151.9sooner than July 1 and no later than July 31 of the following year. The commissioner may 151.10exclude special demonstration projects under subdivision 23. 151.11(e) Effective for services provided on or after January 1, 2010, the commissioner 151.12shall require that managed care plans use the assessment and authorization processes, 151.13forms, timelines, standards, documentation, and data reporting requirements, protocols, 151.14billing processes, and policies consistent with medical assistance fee-for-service or the 151.15Department of Human Services contract requirements consistent with medical assistance 151.16fee-for-service or the Department of Human Services contract requirements for all 151.17personal care assistance services under section 256B.0659. 151.18(f) Effective for services rendered on or after January 1, 2010, through December 151.1931, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 151.20under this section and county-based purchasing plan payments under section 256B.692 151.21for the prepaid medical assistance program. The withheld funds must be returned no 151.22sooner than July 1 and no later than July 31 of the following year. The commissioner may 151.23exclude special demonstration projects under subdivision 23. 151.24(g) Effective for services rendered on or after January 1, 2011, the commissioner 151.25shall include as part of the performance targets described in paragraph (c) a reduction in 151.26the health plan's emergency room utilization rate for state health care program enrollees 151.27by a measurable rate of five percent from the plan's utilization rate for state health care 151.28program enrollees for the previous calendar year. 151.29The withheld funds must be returned no sooner than July 1 and no later than July 31 151.30of the following calendar year if the managed care plan demonstrates to the satisfaction of 151.31the commissioner that a reduction in the utilization rate was achieved. 151.32The withhold described in this paragraph shall continue for each consecutive 151.33contract period until the plan's emergency room utilization rate for state health care 151.34program enrollees is reduced by 25 percent of the plan's emergency room utilization 151.35rate for state health care program enrollees for calendar year 2009. Hospitals shall 151.36cooperate with the health plans in meeting this performance target and shall accept 152.1payment withholds that may be returned to the hospitals if the performance target is 152.2achieved. The commissioner shall structure the withhold so that the commissioner returns 152.3a portion of the withheld funds in amounts commensurate with achieved reductions in 152.4utilization less than the targeted amount. The withhold in this paragraph does not apply to 152.5county-based purchasing plans. 152.6 new text begin (h) Effective for services rendered on or after January 1, 2012, the commissioner new text end 152.7 new text begin shall include as part of the performance targets described in paragraph (c) a reduction in new text end 152.8 new text begin the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous new text end 152.9 new text begin hospitalization of a patient regardless of the reason for the hospitalization for state health new text end 152.10 new text begin care program enrollees by a measurable rate of five percent from the plan's utilization rate new text end 152.11 new text begin for state health care program enrollees for the previous calendar year. new text end 152.12 new text begin The withheld funds must be returned no sooner than July 1 and no later than July 31 new text end 152.13 new text begin of the following calendar year if the managed care plan or county-based purchasing plan new text end 152.14 new text begin demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization new text end 152.15 new text begin rate was achieved. new text end 152.16 new text begin The withhold described in this paragraph must continue for each consecutive new text end 152.17 new text begin contract period until the plan's subsequent hospitalization rate for state health care new text end 152.18 new text begin program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate new text end 152.19 new text begin for state health care program enrollees for calendar year 2010. Hospitals shall cooperate new text end 152.20 new text begin with the plans in meeting this performance target and shall accept payment withholds that new text end 152.21 new text begin must be returned to the hospitals if the performance target is achieved. The commissioner new text end 152.22 new text begin shall structure the withhold so that the commissioner returns a portion of the withheld new text end 152.23 new text begin funds in amounts commensurate with achieved reductions in utilization less than the new text end 152.24 new text begin targeted amount. new text end 152.25(h) new text begin (i) new text end Effective for services rendered on or after January 1, 2011, through December 152.2631, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments 152.27under this section and county-based purchasing plan payments under section 256B.692 152.28for the prepaid medical assistance program. The withheld funds must be returned no 152.29sooner than July 1 and no later than July 31 of the following year. The commissioner may 152.30exclude special demonstration projects under subdivision 23. 152.31(i) new text begin (j) new text end Effective for services rendered on or after January 1, 2012, through December 152.3231, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 152.33under this section and county-based purchasing plan payments under section 256B.692 152.34for the prepaid medical assistance program. The withheld funds must be returned no 152.35sooner than July 1 and no later than July 31 of the following year. The commissioner may 152.36exclude special demonstration projects under subdivision 23. 153.1(j) new text begin (k) new text end Effective for services rendered on or after January 1, 2013, through December 153.231, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 153.3under this section and county-based purchasing plan payments under section 256B.692 153.4for the prepaid medical assistance program. The withheld funds must be returned no 153.5sooner than July 1 and no later than July 31 of the following year. The commissioner may 153.6exclude special demonstration projects under subdivision 23. 153.7(k) new text begin (l) new text end Effective for services rendered on or after January 1, 2014, the commissioner 153.8shall withhold three percent of managed care plan payments under this section and 153.9county-based purchasing plan payments under section 256B.692 for the prepaid medical 153.10assistance program. The withheld funds must be returned no sooner than July 1 and 153.11no later than July 31 of the following year. The commissioner may exclude special 153.12demonstration projects under subdivision 23. 153.13(l) new text begin (m) new text end A managed care plan or a county-based purchasing plan under section 153.14256B.692 may include as admitted assets under section 62D.044 any amount withheld 153.15under this section that is reasonably expected to be returned. 153.16(m) new text begin (n) new text end Contracts between the commissioner and a prepaid health plan are exempt 153.17from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 153.18(a), and 7. 153.19(n) new text begin (o) new text end The return of the withhold under paragraphs (d), (f), and (h) to (k) is not 153.20subject to the requirements of paragraph (c). 153.21    Sec. 69. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read: 153.22    Subd. 5c. Medical education and research fund. (a) The commissioner of human 153.23services shall transfer each year to the medical education and research fund established 153.24under section 62J.692, the following: 153.25(1) an amount equal to the reduction in the prepaid medical assistance payments as 153.26specified in this clause. Until January 1, 2002, the county medical assistance capitation 153.27base rate prior to plan specific adjustments and after the regional rate adjustments under 153.28subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining 153.29metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after 153.30January 1, 2002, the county medical assistance capitation base rate prior to plan specific 153.31adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining 153.32metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing 153.33facility and elderly waiver payments and demonstration project payments operating 153.34under subdivision 23 are excluded from this reduction. The amount calculated under 154.1this clause shall not be adjusted for periods already paid due to subsequent changes to 154.2the capitation payments; 154.3(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this 154.4section; 154.5(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 154.6paid under this section; and 154.7(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 154.8under this section. 154.9(b) This subdivision shall be effective upon approval of a federal waiver which 154.10allows federal financial participation in the medical education and research fund. Effective 154.11July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4), 154.12shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first 154.13reduce the amounts otherwise required to be transferred under paragraph (a), clauses 154.14(2) to (4). Any excess following this reduction shall proportionally reduce the transfers 154.15under paragraph (a), clause (1). 154.16(c) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall 154.17transfer $21,714,000 each fiscal year to the medical education and research fund. The 154.18balance of the transfers under paragraph (a) shall be transferred to the medical education 154.19and research fund no earlier than July 1 of the following fiscal year. 154.20 new text begin (d) Beginning in fiscal year 2012, the commissioner shall reduce the amount new text end 154.21 new text begin transferred to the medical education research fund under paragraph (a), by $4,500,000 new text end 154.22 new text begin each fiscal year. This reduction must be applied to the amount available for general new text end 154.23 new text begin distribution under section 62J.692, subdivision 7, clause (5). new text end 154.24    Sec. 70. Minnesota Statutes 2010, section 256B.69, subdivision 6, is amended to read: 154.25    Subd. 6. Service delivery. (a) Each demonstration provider shall be responsible for 154.26the health care coordination for eligible individuals. Demonstration providers: 154.27    (1) shall authorize and arrange for the provision of all needed health services 154.28including but not limited to the full range of services listed in sections 256B.02, 154.29subdivision 8 , and 256B.0625 in order to ensure appropriate health care is delivered to 154.30enrollees. Notwithstanding section 256B.0621, demonstration providers that provide 154.31nursing home and community-based services under this section shall provide relocation 154.32service coordination to enrolled persons age 65 and over; 154.33    (2) shall accept the prospective, per capita payment from the commissioner in return 154.34for the provision of comprehensive and coordinated health care services for eligible 154.35individuals enrolled in the program; 155.1    (3) may contract with other health care and social service practitioners to provide 155.2services to enrollees; and 155.3    (4) shall institute recipient grievance procedures according to the method established 155.4by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved 155.5through this process shall be appealable to the commissioner as provided in subdivision 11. 155.6    (b) Demonstration providers must comply with the standards for claims settlement 155.7under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health 155.8care and social service practitioners to provide services to enrollees. A demonstration 155.9provider must pay a clean claim, as defined in Code of Federal Regulations, title 42, 155.10section 447.45(b), within 30 business days of the date of acceptance of the claim. 155.11 new text begin (c) A demonstration provider must accept into its medical assistance and new text end 155.12 new text begin MinnesotaCare provider networks any health care or social service provider that agrees new text end 155.13 new text begin to accept payment, quality assurance, and other contract terms that the demonstration new text end 155.14 new text begin provider applies to other similarly situated providers in its provider network. new text end 155.15 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, and applies to new text end 155.16 new text begin provider contracts that take effect on or after that date. new text end 155.17    Sec. 71. Minnesota Statutes 2010, section 256B.69, is amended by adding a 155.18subdivision to read: 155.19     new text begin Subd. 30. new text end new text begin Provider payment rates. new text end new text begin (a) Each managed care and county-based plan new text end 155.20 new text begin shall, by October 1, 2011, array all providers within each provider type, employed by or new text end 155.21 new text begin under contract with the plan, by their average total annual cost of care for serving medical new text end 155.22 new text begin assistance and MinnesotaCare enrollees for the most recent reporting year for which data new text end 155.23 new text begin is available, risk-adjusted for enrollee demographics and health status. new text end 155.24 new text begin (b) Beginning January 1, 2012, and each contract year thereafter, each managed new text end 155.25 new text begin care and county-based purchasing plan shall implement a progressive payment withhold new text end 155.26 new text begin methodology for each provider type, under which the withhold for a provider increases new text end 155.27 new text begin proportionally as the provider's risk-adjusted total annual cost increases, relative to other new text end 155.28 new text begin providers of the same type. For purposes of this paragraph, the risk-adjusted total annual new text end 155.29 new text begin cost of care is the dollar amount calculated under paragraph (a). new text end 155.30 new text begin (c) At the end of each contract year, each plan shall array all providers within each new text end 155.31 new text begin provider type by their average total annual cost of care for serving medical assistance and new text end 155.32 new text begin MinnesotaCare enrollees for that contract year, risk-adjusted for enrollee demographics new text end 155.33 new text begin and health status. For each provider whose risk-adjusted total annual cost of care is at or new text end 155.34 new text begin below a benchmark percentile established by the plan, the plan shall return the full amount new text end 155.35 new text begin of any withhold. For each provider whose risk-adjusted total annual cost of care is above new text end 156.1 new text begin the benchmark percentile, the plan shall return only the portion of the withhold sufficient new text end 156.2 new text begin to bring the provider's payment rate to the average for providers within the provider type new text end 156.3 new text begin whose risk-adjusted total annual cost of care is at the benchmark percentile. Each plan shall new text end 156.4 new text begin establish the benchmark percentile at a level that allows the plan to adjust expenditures for new text end 156.5 new text begin provider payments to reflect the reduction in capitation rates under paragraph (f). new text end 156.6 new text begin (d) Each managed care and county-based purchasing plan must establish an appeals new text end 156.7 new text begin process to allow providers to appeal determinations of risk-adjusted total annual cost of new text end 156.8 new text begin care. Each plan's appeals process must be approved by the commissioner. new text end 156.9 new text begin (e) The commissioner shall require each plan to submit to the commissioner, in new text end 156.10 new text begin the form and manner specified by the commissioner, all provider payment data and new text end 156.11 new text begin information on the withhold methodology that the commissioner determines is necessary new text end 156.12 new text begin to verify compliance with this subdivision. new text end 156.13 new text begin (f) The commissioner, for the contract year beginning January 1, 2012, shall reduce new text end 156.14 new text begin plan capitation rates by 12 percent from the rates that would otherwise apply, absent new text end 156.15 new text begin application of this subdivision. The reduced rate shall be the historical base rate for new text end 156.16 new text begin negotiating capitation rates for future contract years. The commissioner may recommend new text end 156.17 new text begin additional reductions in capitation rates for future contract years to the legislature, if the new text end 156.18 new text begin commissioner determines this is necessary to ensure that health care providers under new text end 156.19 new text begin contract with managed care and county-based purchasing plans practice in an efficient new text end 156.20 new text begin manner. Effective for services rendered on or after January 1, 2012, managed care plans new text end 156.21 new text begin and county-based purchasing plans contracted with the state to administer the health new text end 156.22 new text begin care programs provided under sections 256B.69, 256B.692, and 256L.12, may reduce new text end 156.23 new text begin payments made to providers employed or under contract with the plan. new text end 156.24 new text begin (g) The commissioner of human services, in consultation with the commissioner of new text end 156.25 new text begin health, shall develop and provide to managed care and county-based purchasing plans, by new text end 156.26 new text begin September 1, 2011, standard criteria and definitions necessary for consistent calculation new text end 156.27 new text begin of the total annual risk-adjusted cost of care across plans. The commissioner may use new text end 156.28 new text begin encounter data to implement this subdivision, and may provide encounter data or analyses new text end 156.29 new text begin to plans. new text end 156.30 new text begin (h) For purposes of this subdivision, "provider" means a vendor of medical care new text end 156.31 new text begin as defined in section 256B.02, subdivision 7, for which sufficient encounter data on new text end 156.32 new text begin utilization and costs is available to implement this subdivision. new text end 156.33 new text begin (i) A managed care or county-based purchasing plan must use the methodology new text end 156.34 new text begin described in paragraphs (a) to (e), unless the plan develops an alternative model consistent new text end 156.35 new text begin with the purpose of this subdivision. new text end 156.36 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 157.1    Sec. 72. Minnesota Statutes 2010, section 256B.69, is amended by adding a 157.2subdivision to read: 157.3     new text begin Subd. 31. new text end new text begin Initiatives to reduce incidence of low birth weight. new text end new text begin The commissioner new text end 157.4 new text begin shall require managed care and county-based purchasing plans as a condition of contract new text end 157.5 new text begin to implement strategies to reduce the incidence of low birth weight in geographic areas new text end 157.6 new text begin identified by the commissioner as having a higher than average incidence of low birth new text end 157.7 new text begin weight, with special emphasis on areas within a one-mile radius of hospitals within their new text end 157.8 new text begin provider networks. These strategies may focus on smoking prevention and cessation, new text end 157.9 new text begin ensuring that pregnant women get adequate nutrition, and addressing demographic, new text end 157.10 new text begin social, and environmental risk factors. The strategies must coordinate health care with new text end 157.11 new text begin social services and the local public health system, and offer patient education through new text end 157.12 new text begin appropriate means. The commissioner shall require plans to submit proposed initiatives new text end 157.13 new text begin for approval to the commissioner by January 1, 2012, and the commissioner shall require new text end 157.14 new text begin plans to implement approved initiatives by July 1, 2012. The commissioner shall evaluate new text end 157.15 new text begin the strategies adopted to reduce low birth weight and shall require plans to submit outcome new text end 157.16 new text begin and other data necessary for the evaluation. new text end 157.17    Sec. 73. Minnesota Statutes 2010, section 256B.69, is amended by adding a 157.18subdivision to read: 157.19     new text begin Subd. 32. new text end new text begin Health education. new text end new text begin The commissioner shall require managed care and new text end 157.20 new text begin county-based purchasing plans, as a condition of contract, to provide health education, new text end 157.21 new text begin wellness training, and information about the availability and benefits of preventive new text end 157.22 new text begin services to all medical assistance and MinnesotaCare enrollees, beginning January 1, new text end 157.23 new text begin 2012. Plan initiatives developed or implemented to comply with this requirement must be new text end 157.24 new text begin approved by the commissioner. new text end 157.25    Sec. 74. Minnesota Statutes 2010, section 256B.692, subdivision 2, is amended to read: 157.26    Subd. 2. Duties of commissioner of health. (a) Notwithstanding chapters 62D and 157.2762N, a county that elects to purchase medical assistance in return for a fixed sum without 157.28regard to the frequency or extent of services furnished to any particular enrollee is not 157.29required to obtain a certificate of authority under chapter 62D or 62N. The county board 157.30of commissioners is the governing body of a county-based purchasing program. In a 157.31multicounty arrangement, the governing body is a joint powers board established under 157.32section 471.59. 157.33    (b) A county that elects to purchase medical assistance services under this section 157.34must satisfy the commissioner of health that the requirements for assurance of consumer 158.1protection, provider protection, and, effective January 1, 2010, fiscal solvency of chapter 158.262D, applicable to health maintenance organizations will be met according to the 158.3following schedule: 158.4    (1) for a county-based purchasing plan approved on or before June 30, 2008, the 158.5plan must have in reserve: 158.6    (i) at least 50 percent of the minimum amount required under chapter 62D as 158.7of January 1, 2010; 158.8    (ii) at least 75 percent of the minimum amount required under chapter 62D as of 158.9January 1, 2011; 158.10    (iii) at least 87.5 percent of the minimum amount required under chapter 62D as 158.11of January 1, 2012; and 158.12    (iv) at least 100 percent of the minimum amount required under chapter 62D as 158.13of January 1, 2013; and 158.14    (2) for a county-based purchasing plan first approved after June 30, 2008, the plan 158.15must have in reserve: 158.16    (i) at least 50 percent of the minimum amount required under chapter 62D at the 158.17time the plan begins enrolling enrollees; 158.18    (ii) at least 75 percent of the minimum amount required under chapter 62D after 158.19the first full calendar year; 158.20    (iii) at least 87.5 percent of the minimum amount required under chapter 62D after 158.21the second full calendar year; and 158.22    (iv) at least 100 percent of the minimum amount required under chapter 62D after 158.23the third full calendar year. 158.24    (c) Until a plan is required to have reserves equaling at least 100 percent of the 158.25minimum amount required under chapter 62D, the plan may demonstrate its ability 158.26to cover any losses by satisfying the requirements of chapter 62N. new text begin Notwithstanding new text end 158.27 new text begin this paragraph and paragraph (b), a county-based purchasing plan may satisfy its fiscal new text end 158.28 new text begin solvency requirements by obtaining written financial guarantees from participating new text end 158.29 new text begin counties in amounts equivalent to the minimum amounts that would otherwise apply. new text end 158.30A county-based purchasing plan must also assure the commissioner of health that the 158.31requirements of sections 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 158.32applicable provisions of chapter 62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 158.3362Q.12 ; 62Q.135; 62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47; 158.3462Q.50 ; 62Q.52 to 62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met. 159.1    (d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62M, 159.262N, and 62Q are hereby granted to the commissioner of health with respect to counties 159.3that purchase medical assistance services under this section. 159.4    (e) The commissioner, in consultation with county government, shall develop 159.5administrative and financial reporting requirements for county-based purchasing programs 159.6relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31, 159.7and other sections as necessary, that are specific to county administrative, accounting, and 159.8reporting systems and consistent with other statutory requirements of counties. 159.9    (f) The commissioner shall collect from a county-based purchasing plan under 159.10this section the following fees: 159.11    (1) fees attributable to the costs of audits and other examinations of plan financial 159.12operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800, 159.13subpart 1, item F; 159.14    (2) an annual fee of $21,500, to be paid by June 15 of each calendar year, beginning 159.15in calendar year 2009; and 159.16    (3) for fiscal year 2009 only, a per-enrollee fee of 14.6 cents, based on the number of 159.17enrollees as of December 31, 2008. 159.18All fees collected under this paragraph shall be deposited in the state government special 159.19revenue fund. 159.20    Sec. 75. Minnesota Statutes 2010, section 256B.692, subdivision 5, is amended to read: 159.21    Subd. 5. County proposals. (a) On or before September 1, 1997, a county board 159.22that wishes to purchase or provide health care under this section must submit a preliminary 159.23proposal that substantially demonstrates the county's ability to meet all the requirements 159.24of this section in response to criteria for proposals issued by the department on or before 159.25July 1, 1997. Counties submitting preliminary proposals must establish a local planning 159.26process that involves input from medical assistance recipients, recipient advocates, 159.27providers and representatives of local school districts, labor, and tribal government to 159.28advise on the development of a final proposal and its implementation. 159.29(b) The county board must submit a final proposal on or before July 1, 1998, that 159.30demonstrates the ability to meet all the requirements of this section, including beginning 159.31enrollment on January 1, 1999, unless a delay has been granted under section 256B.69, 159.32subdivision 3a , paragraph (g). 159.33(c) After January 1, 1999, for a county in which the prepaid medical assistance 159.34program is in existence, the county board must submit a preliminary proposal at least 15 159.35months prior to termination of health plan contracts in that county and a final proposal new text begin new text end 160.1 new text begin that meets the requirements of this section new text end six months prior to the health plan contract 160.2termination date in order to begin enrollment after the termination. Nothing in this section 160.3shall impede or delay implementation or continuation of the prepaid medical assistance 160.4program in counties for which the board does not submit a proposal, or submits a proposal 160.5that is not in compliance with this section. 160.6(d) The commissioner is not required to terminate contracts for the prepaid medical 160.7assistance program that begin on or after September 1, 1997, in a county for which a 160.8county board has submitted a proposal under this paragraph, until two years have elapsed 160.9from the date of initial enrollment in the prepaid medical assistance program. 160.10    Sec. 76. Minnesota Statutes 2010, section 256B.692, subdivision 7, is amended to read: 160.11    Subd. 7. Dispute resolution. In the event the commissioner rejects a proposal 160.12under subdivision 6, the county board may request the recommendation new text begin decision new text end of a 160.13three-person mediation panel. The commissioner shall resolve all disputes after taking 160.14into account new text begin by following new text end the recommendations new text begin decision new text end of the mediation panel. The 160.15panel shall be composed of one designee of the president of the Association of Minnesota 160.16Counties, one designee of the commissioner of human services, and one person selected 160.17jointly by the designee of the commissioner of human services and the designee of 160.18the Association of Minnesota Counties. Within a reasonable period of time before the 160.19hearing, the panelists must be provided all documents and information relevant to the 160.20mediation. The parties to the mediation must be given 30 days' notice of a hearing before 160.21the mediation panel. 160.22    Sec. 77. Minnesota Statutes 2010, section 256B.692, is amended by adding a 160.23subdivision to read: 160.24     new text begin Subd. 11. new text end new text begin Patient choice of qualified provider. new text end new text begin Effective January 1, 2012, a county new text end 160.25 new text begin board operating a county-based purchasing plan must ensure that each enrollee has the new text end 160.26 new text begin option of choosing a primary care provider or a health care home from all qualified new text end 160.27 new text begin providers who agree to accept the terms, conditions, and payment rates offered by the new text end 160.28 new text begin plan to similarly situated providers. Notwithstanding this requirement, reimbursement new text end 160.29 new text begin to federally qualified health centers and federally qualified health center look-alikes as new text end 160.30 new text begin defined in section 145.9269 must be in compliance with federal law. new text end 160.31    Sec. 78. Minnesota Statutes 2010, section 256B.694, is amended to read: 160.32256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE 160.33CONTRACT. 161.1    (a) Notwithstanding section 256B.692, subdivision 6, clause (1), paragraph (c), 161.2the commissioner of human services shall approve a county-based purchasing health 161.3plan proposal, submitted on behalf of Cass, Crow Wing, Morrison, Todd, and Wadena 161.4Counties, that requires county-based purchasing on a single-plan basis contract if the 161.5implementation of the single-plan purchasing proposal does not limit an enrollee's 161.6provider choice or access to services and all other requirements applicable to health plan 161.7purchasing are satisfied. The commissioner shall continue to use single-health plan, 161.8county-based purchasing arrangements for medical assistance and general assistance 161.9medical care programs and products for the counties that were in single-health plan, 161.10county-based purchasing arrangements on March 1, 2008. This paragraph does not require 161.11the commissioner to terminate an existing contract with a noncounty-based purchasing 161.12plan that had enrollment in a medical assistance program or product in these counties on 161.13March 1, 2008. This paragraph expires on December 31, 2010, or the effective date 161.14of a new contract for medical assistance and general assistance medical care managed 161.15care programs entered into at the conclusion of the commissioner's next scheduled 161.16reprocurement process for the county-based purchasing entities covered by this paragraph, 161.17whichever is later. 161.18    (b) new text begin At the request of a county or group of counties, new text end the commissioner shall consider, 161.19and may approve, contracting on a single-health plan basis with other county-based 161.20purchasing plans, or with other qualified health plans that have coordination arrangements 161.21with counties, to serve persons with a disability who voluntarily enroll, new text begin enrolled in new text end 161.22 new text begin Minnesota health care programs new text end in order to promote better coordination or integration 161.23of health care services, social services and other community-based services, provided 161.24that all requirements applicable to health plan purchasing, including those in section 161.25256B.69, subdivision 23 , are satisfied. Nothing in this paragraph supersedes or modifies 161.26the requirements in paragraph (a). 161.27    Sec. 79. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read: 161.28    Subd. 4. Critical access dental providers. (a) Effective for dental services 161.29rendered on or after January 1, 2002, the commissioner shall increase reimbursements 161.30to dentists and dental clinics deemed by the commissioner to be critical access dental 161.31providers. For dental services rendered on or after July 1, 2007, the commissioner shall 161.32increase reimbursement by 30 percent above the reimbursement rate that would otherwise 161.33be paid to the critical access dental provider. The commissioner shall pay the managed 161.34care plans and county-based purchasing plans in amounts sufficient to reflect increased 161.35reimbursements to critical access dental providers as approved by the commissioner. 162.1(b) The commissioner shall designate the following dentists and dental clinics as 162.2critical access dental providers: 162.3    (1) nonprofit community clinics that: 162.4(i) have nonprofit status in accordance with chapter 317A; 162.5(ii) have tax exempt status in accordance with the Internal Revenue Code, section 162.6501(c)(3); 162.7(iii) are established to provide oral health services to patients who are low income, 162.8uninsured, have special needs, and are underserved; 162.9(iv) have professional staff familiar with the cultural background of the clinic's 162.10patients; 162.11(v) charge for services on a sliding fee scale designed to provide assistance to 162.12low-income patients based on current poverty income guidelines and family size; 162.13(vi) do not restrict access or services because of a patient's financial limitations 162.14or public assistance status; and 162.15(vii) have free care available as needed; 162.16    (2) federally qualified health centers, rural health clinics, and public health clinics; 162.17    (3) county owned and operated hospital-based dental clinics; 162.18(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 162.19accordance with chapter 317A with more than 10,000 patient encounters per year with 162.20patients who are uninsured or covered by medical assistance, general assistance medical 162.21care, or MinnesotaCare; and 162.22(5) a dental clinic associated with an oral health or dental education program new text begin owned new text end 162.23 new text begin and new text end operated by the University of Minnesota or an institution within the Minnesota State 162.24Colleges and Universities system. 162.25     (c) The commissioner may designate a dentist or dental clinic as a critical access 162.26dental provider if the dentist or dental clinic is willing to provide care to patients covered 162.27by medical assistance, general assistance medical care, or MinnesotaCare at a level which 162.28significantly increases access to dental care in the service area. 162.29(d) Notwithstanding paragraph (a), critical access payments must not be made for 162.30dental services provided from April 1, 2010, through June 30, 2010. 162.31 new text begin (e) Notwithstanding section 256B.04, subdivision 2, the commissioner of human new text end 162.32 new text begin services shall not adopt rules governing this section or section 256L.11, subdivision 7. new text end 162.33 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 162.34    Sec. 80. new text begin [256B.7671] PATIENT-CENTERED DECISION-MAKING. new text end 163.1 new text begin (a) For purposes of this section, "patient-centered decision-making process" means a new text end 163.2 new text begin process that involves directed interaction with the patient to assist the patient in arriving at new text end 163.3 new text begin an informed objective health care decision regarding the surgical procedure that is both new text end 163.4 new text begin informed and consistent with the patient's preference and values. The interaction may be new text end 163.5 new text begin conducted by a health care provider or through the electronic use of decision aids. If new text end 163.6 new text begin decision aids are used in the process, the aids must meet the criteria established by the new text end 163.7 new text begin International Patients Decision Aids Standards Collaboration or the Cochrane Decision new text end 163.8 new text begin Aid Registry. new text end 163.9 new text begin (b) Effective January 1, 2012, the commissioner of human services shall require new text end 163.10 new text begin active participation in a patient-centered decision-making process before authorization is new text end 163.11 new text begin approved or payment reimbursement is provided for any of the following: new text end 163.12 new text begin (1) a surgical procedure for abnormal uterine bleeding, benign prostate enlargement, new text end 163.13 new text begin chronic back pain, early stage of breast and prostate cancers, gastroesophageal reflux new text end 163.14 new text begin disease, hemorrhoids, spinal stenosis, temporomandibular joint dysfunction, ulcerative new text end 163.15 new text begin colitis, urinary incontinence, uterine fibroids, or varicose veins; and new text end 163.16 new text begin (2) bypass surgery for coronary disease, angioplasty for stable coronary artery new text end 163.17 new text begin disease, or total hip replacement. new text end 163.18 new text begin (c) A list of the procedures in paragraph (b) shall be published in the State Register new text end 163.19 new text begin by October 1, 2011. The list shall be reviewed no less than every two years by the new text end 163.20 new text begin commissioner, in consultation with the commissioner of health. The commissioner new text end 163.21 new text begin shall hold a public forum and receive public comment prior to any changes to the list in new text end 163.22 new text begin paragraph (b). Any changes made shall be published in the State Register. new text end 163.23 new text begin (d) Prior to receiving authorization or reimbursement for the procedures identified new text end 163.24 new text begin under this section, a health care provider must certify that the patient has participated in a new text end 163.25 new text begin patient-centered decision-making process. The format for this certification and the process new text end 163.26 new text begin for coordination between providers shall be developed by the Health Services Policy new text end 163.27 new text begin Committee under section 256B.0625, subdivision 3c. new text end 163.28 new text begin (e) This section does not apply if any of the procedures identified in this section are new text end 163.29 new text begin performed under an emergency situation. new text end 163.30    Sec. 81. new text begin [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE new text end 163.31 new text begin DEMONSTRATION PROJECT. new text end 163.32     new text begin Subdivision 1. new text end new text begin Establishment and implementation. new text end new text begin The commissioner of new text end 163.33 new text begin human services, in consultation with the commissioner of health, shall contract new text end 163.34 new text begin with a Minnesota-based academic and research institution specializing in providing new text end 163.35 new text begin complementary and alternative medicine education and clinical services to establish and new text end 164.1 new text begin implement a five-year demonstration project in conjunction with federally qualified health new text end 164.2 new text begin centers and federally qualified health center look-alikes as defined in section 145.9269, to new text end 164.3 new text begin improve the quality and cost-effectiveness of care provided under medical assistance to new text end 164.4 new text begin enrollees with neck and back problems. The demonstration project must maximize the use new text end 164.5 new text begin of complementary and alternative medicine-oriented primary care providers, including but new text end 164.6 new text begin not limited to physicians and chiropractors. The demonstration project must be designed new text end 164.7 new text begin to significantly improve physical and mental health for enrollees who present with new text end 164.8 new text begin neck and back problems while decreasing medical treatment costs. The commissioner, new text end 164.9 new text begin in consultation with the commissioner of health, shall deliver services through the new text end 164.10 new text begin demonstration project beginning July 1, 2011, or upon federal approval, whichever is later. new text end 164.11     new text begin Subd. 2. new text end new text begin RFP and project criteria. new text end new text begin The commissioner, in consultation with the new text end 164.12 new text begin commissioner of health, shall develop and issue a request for proposal (RFP) for the new text end 164.13 new text begin demonstration project. The RFP must require the academic and research institution new text end 164.14 new text begin selected to demonstrate a proven track record over at least five years of conducting new text end 164.15 new text begin high-quality, federally funded clinical research. The institution and the federally qualified new text end 164.16 new text begin health centers and federally qualified health center look-alikes shall also: new text end 164.17 new text begin (1) provide patient education, provider education, and enrollment training new text end 164.18 new text begin components on health and lifestyle issues in order to promote enrollee responsibility for new text end 164.19 new text begin health care decisions, enhance productivity, prepare enrollees to reenter the workforce, new text end 164.20 new text begin and reduce future health care expenditures; new text end 164.21 new text begin (2) use high-quality and cost-effective integrated disease management that includes new text end 164.22 new text begin the best practices of traditional and complementary and alternative medicine; new text end 164.23 new text begin (3) incorporate holistic medical care, appropriate nutrition, exercise, medications, new text end 164.24 new text begin and conflict resolution techniques; new text end 164.25 new text begin (4) include a provider education component that makes use of professional new text end 164.26 new text begin organizations representing chiropractors, nurses, and other primary care providers new text end 164.27 new text begin and provides appropriate educational materials and activities in order to improve the new text end 164.28 new text begin integration of traditional medical care with licensed chiropractic services and other new text end 164.29 new text begin alternative health care services and achieve program enrollment objectives; and new text end 164.30 new text begin (5) provide to the commissioner the information and data necessary for the new text end 164.31 new text begin commissioner to prepare the annual reports required under subdivision 6. new text end 164.32     new text begin Subd. 3. new text end new text begin Enrollment. new text end new text begin Enrollees from the program shall be selected by the new text end 164.33 new text begin commissioner from current enrollees in the prepaid medical assistance program who new text end 164.34 new text begin have, or are determined to be at significant risk of developing, neck and back problems. new text end 164.35 new text begin Participation in the demonstration project shall be voluntary. The commissioner shall new text end 164.36 new text begin seek to enroll, over the term of the demonstration project, ten percent of current and new text end 165.1 new text begin future medical assistance enrollees who have, or are determined to be at significant risk new text end 165.2 new text begin of developing, neck and back problems. new text end 165.3     new text begin Subd. 4. new text end new text begin Federal approval. new text end new text begin The commissioner shall seek any federal waivers and new text end 165.4 new text begin approvals necessary to implement the demonstration project. new text end 165.5     new text begin Subd. 5. new text end new text begin Project costs. new text end new text begin The commissioner shall require the academic and research new text end 165.6 new text begin institution selected, federally qualified health centers, and federally qualified health center new text end 165.7 new text begin look-alikes to fund all net costs of the demonstration project. new text end 165.8     new text begin Subd. 6. new text end new text begin Annual reports. new text end new text begin The commissioner, in consultation with the commissioner new text end 165.9 new text begin of health, beginning December 15, 2011, and each December 15 thereafter through new text end 165.10 new text begin December 15, 2015, shall report annually to the legislature on the functional and mental new text end 165.11 new text begin improvements of the populations served by the demonstration project, patient satisfaction, new text end 165.12 new text begin and the cost-effectiveness of the program. The reports must also include data on hospital new text end 165.13 new text begin admissions, days in hospital, rates of outpatient surgery and other services, and drug new text end 165.14 new text begin utilization. The report, due December 15, 2015, must include recommendations on new text end 165.15 new text begin whether the demonstration project should be continued and expanded. new text end 165.16    Sec. 82. new text begin [256B.841] WAIVER APPLICATION AND PROCESS. new text end 165.17     new text begin Subdivision 1. new text end new text begin Intent. new text end new text begin It is the intent of the legislature that medical assistance be: new text end 165.18 new text begin (1) a sustainable, cost-effective, person-centered, and opportunity-driven program new text end 165.19 new text begin utilizing competitive and value-based purchasing to maximize available service options; new text end 165.20 new text begin and new text end 165.21 new text begin (2) a results-oriented system of coordinated care that focuses on independence new text end 165.22 new text begin and choice, promotes accountability and transparency, encourages and rewards healthy new text end 165.23 new text begin outcomes and responsible choices, and promotes efficiency. new text end 165.24     new text begin Subd. 2. new text end new text begin Waiver application. new text end new text begin (a) By September 1, 2011, the commissioner of new text end 165.25 new text begin human services shall apply for a waiver and any necessary state plan amendments from new text end 165.26 new text begin the secretary of the United States Department of Health and Human Services, including, new text end 165.27 new text begin but not limited to, a waiver of the appropriate sections of title XIX of the federal Social new text end 165.28 new text begin Security Act, United States Code, title 42, section 1396 et seq., or other provisions of new text end 165.29 new text begin federal law that provide program flexibility and under which Minnesota will operate all new text end 165.30 new text begin facets of the state's medical assistance program. new text end 165.31 new text begin (b) The commissioner of human services shall provide the legislative committees new text end 165.32 new text begin with jurisdiction over health and human services finance and policy with the waiver new text end 165.33 new text begin application and financial and other related materials, at least ten days prior to submitting new text end 165.34 new text begin the application and materials to the federal Centers for Medicare and Medicaid Services. new text end 166.1 new text begin (c) If the state's waiver application is approved, the commissioner of human services new text end 166.2 new text begin shall: new text end 166.3 new text begin (1) notify the chairs of the legislative committees with jurisdiction over health and new text end 166.4 new text begin human services finance and policy and allow the legislative committees with jurisdiction new text end 166.5 new text begin over health and human services finance and policy to review the terms of the waiver; and new text end 166.6 new text begin (2) not implement the waiver until ten legislative days have passed following new text end 166.7 new text begin notification of the chairs. new text end 166.8     new text begin Subd. 3. new text end new text begin Rulemaking; legislative proposals. new text end new text begin Upon acceptance of the terms of the new text end 166.9 new text begin waiver, the commissioner of human services shall: new text end 166.10 new text begin (1) adopt rules to implement the waiver; and new text end 166.11 new text begin (2) propose any legislative changes necessary to implement the terms of the waiver. new text end 166.12     new text begin Subd. 4. new text end new text begin Joint commission on waiver implementation. new text end new text begin (a) After acceptance new text end 166.13 new text begin of the terms of the waiver, the governor shall establish a joint commission on waiver new text end 166.14 new text begin implementation. The commission shall consist of eight members; four of whom shall new text end 166.15 new text begin be members of the senate, not more than three from the same political party, to be new text end 166.16 new text begin appointed by the Subcommittee on Committees of the senate Committee on Rules and new text end 166.17 new text begin Administration, and four of whom shall be members of the house of representatives, not new text end 166.18 new text begin more than three from the same political party, to be appointed by the speaker of the house. new text end 166.19 new text begin (b) The commission shall: new text end 166.20 new text begin (1) oversee implementation of the waiver; new text end 166.21 new text begin (2) confer as necessary with state agency commissioners; new text end 166.22 new text begin (3) make recommendations on services covered under the medical assistance new text end 166.23 new text begin program; new text end 166.24 new text begin (4) monitor and make recommendations on quality and access to care under the new text end 166.25 new text begin global waiver; and new text end 166.26 new text begin (5) make recommendations for the efficient and cost-effective administration of the new text end 166.27 new text begin medical assistance program under the terms of the waiver. new text end 166.28    Sec. 83. new text begin [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE new text end 166.29 new text begin REFORM. new text end 166.30     new text begin Subdivision 1. new text end new text begin Goals for reform. new text end new text begin In developing the waiver application and new text end 166.31 new text begin implementing the waiver, the commissioner of human services shall ensure that the new text end 166.32 new text begin reformed medical assistance program is a person-centered, financially sustainable, and new text end 166.33 new text begin cost-effective program. new text end 166.34     new text begin Subd. 2. new text end new text begin Reformed medical assistance criteria. new text end new text begin The reformed medical assistance new text end 166.35 new text begin program established through the waiver must: new text end 167.1 new text begin (1) empower consumers to make informed and cost-effective choices about their new text end 167.2 new text begin health and offer consumers rewards for healthy decisions; new text end 167.3 new text begin (2) ensure adequate access to needed services; new text end 167.4 new text begin (3) enable consumers to receive individualized health care that is outcome-oriented new text end 167.5 new text begin and focused on prevention, disease management, recovery, and maintaining independence; new text end 167.6 new text begin (4) promote competition between health care providers to ensure best value new text end 167.7 new text begin purchasing, leverage resources, and to create opportunities for improving service quality new text end 167.8 new text begin and performance; new text end 167.9 new text begin (5) redesign purchasing and payment methods and encourage and reward new text end 167.10 new text begin high-quality and cost-effective care by incorporating and expanding upon current payment new text end 167.11 new text begin reform and quality of care initiatives, including but not limited to those initiatives new text end 167.12 new text begin authorized under chapter 62U; and new text end 167.13 new text begin (6) continually improve technology to take advantage of recent innovations and new text end 167.14 new text begin advances that help decision makers, consumers, and providers make informed and new text end 167.15 new text begin cost-effective decisions regarding health care. new text end 167.16     new text begin Subd. 3. new text end new text begin Annual report. new text end new text begin The commissioner of human services shall annually new text end 167.17 new text begin submit a report to the governor and the legislature, beginning December 1, 2012, and each new text end 167.18 new text begin December 1 thereafter, describing the status of the administration and implementation new text end 167.19 new text begin of the waiver. new text end 167.20    Sec. 84. new text begin [256B.843] WAIVER APPLICATION REQUIREMENTS. new text end 167.21     new text begin Subdivision 1. new text end new text begin Requirements for waiver request. new text end new text begin The commissioner shall seek new text end 167.22 new text begin federal approval to: new text end 167.23 new text begin (1) enter into a five-year agreement with the United States Department of Health and new text end 167.24 new text begin Human Services and Centers for Medicaid and Medicare Services (CMS) under section new text end 167.25 new text begin 1115a to waive provisions of title XIX of the federal Social Security Act, United States new text end 167.26 new text begin Code, title 42, section 1396 et seq., requiring: new text end 167.27 new text begin (i) statewideness to allow for the provision of different services in different areas or new text end 167.28 new text begin regions of the state; new text end 167.29 new text begin (ii) comparability of services to allow for the provision of different services to new text end 167.30 new text begin members of the same or different coverage groups; new text end 167.31 new text begin (iii) no prohibitions restricting the amount, duration, and scope of services included new text end 167.32 new text begin in the medical assistance state plan; new text end 167.33 new text begin (iv) no prohibitions limiting freedom of choice of providers; and new text end 167.34 new text begin (v) retroactive payment for medical assistance, at the state's discretion; new text end 168.1 new text begin (2) waive the applicable provisions of title XIX of the federal Social Security Act, new text end 168.2 new text begin United States Code, title 42, section 1396 et seq., in order to: new text end 168.3 new text begin (i) expand cost sharing requirements above the five percent of income threshold for new text end 168.4 new text begin beneficiaries in certain populations; new text end 168.5 new text begin (ii) establish health savings or power accounts that encourage and reward new text end 168.6 new text begin beneficiaries who reach certain prevention and wellness targets; and new text end 168.7 new text begin (iii) implement a tiered set of parameters to use as the basis for determining new text end 168.8 new text begin long-term service care and setting needs; new text end 168.9 new text begin (3) modify income and resource rules in a manner consistent with the goals of the new text end 168.10 new text begin reformed program; new text end 168.11 new text begin (4) provide enrollees with a choice of appropriate private sector health coverage new text end 168.12 new text begin options, with full federal financial participation; new text end 168.13 new text begin (5) treat payments made toward the cost of care as a monthly premium for new text end 168.14 new text begin beneficiaries receiving home and community-based services when applicable; new text end 168.15 new text begin (6) provide health coverage and services to individuals over the age of 65 that are new text end 168.16 new text begin limited in scope and are available only in the home and community-based setting; new text end 168.17 new text begin (7) consolidate all home and community-based services currently provided under new text end 168.18 new text begin title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c), new text end 168.19 new text begin into a single program of home and community-based services that include options for new text end 168.20 new text begin consumer direction and shared living; new text end 168.21 new text begin (8) expand disease management, care coordination, and wellness programs for all new text end 168.22 new text begin medical assistance recipients; and new text end 168.23 new text begin (9) empower and encourage able-bodied medical assistance recipients to work, new text end 168.24 new text begin whenever possible. new text end 168.25     new text begin Subd. 2. new text end new text begin Agency coordination. new text end new text begin The commissioner shall establish an intraagency new text end 168.26 new text begin assessment and coordination unit to ensure that decision making and program planning for new text end 168.27 new text begin recipients who may need long-term care, residential placement, and community support new text end 168.28 new text begin services are coordinated. The assessment and coordination unit shall determine level of new text end 168.29 new text begin care, develop service plans and a service budget, make referrals to appropriate settings, new text end 168.30 new text begin provide education and choice counseling to consumers and providers, track utilization, new text end 168.31 new text begin and monitor outcomes. new text end 168.32    Sec. 85. Minnesota Statutes 2010, section 256D.03, subdivision 3, is amended to read: 168.33    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1, 168.342010 new text begin January 1, 2012 new text end , the general assistance medical care program shall be administered 168.35according to section 256D.031, unless otherwise stated, except for outpatient prescription 169.1drug coverage, which shall continue to be administered under this section and funded 169.2under section 256D.031, subdivision 9, beginning June 1, 2010. 169.3    (b) Outpatient prescription drug coverage under general assistance medical care is 169.4limited to prescription drugs that: 169.5    (1) are covered under the medical assistance program as described in section 169.6256B.0625, subdivisions 13 and 13d; and 169.7    (2) are provided by manufacturers that have fully executed general assistance 169.8medical care rebate agreements with the commissioner and comply with the agreements. 169.9Outpatient prescription drug coverage under general assistance medical care must conform 169.10to coverage under the medical assistance program according to section 256B.0625, 169.11subdivisions 13 to 13h. 169.12    (c) Outpatient prescription drug coverage does not include drugs administered in a 169.13clinic or other outpatient setting. 169.14    (d) For the period beginning April 1, 2010, to May 31, 2010, general assistance 169.15medical care covers the services listed in subdivision 4. 169.16 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 169.17    Sec. 86. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read: 169.18    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010 new text begin January new text end 169.19 new text begin 1, 2012 new text end , the commissioner shall contract with hospitals or groups of hospitals new text begin , or new text end 169.20 new text begin county-based purchasing plans, new text end that qualify under paragraph (b) and agree to deliver 169.21services according to this subdivision. Contracting hospitals new text begin or plans new text end shall develop 169.22and implement a coordinated care delivery system to provide health care services to 169.23individuals who are eligible for general assistance medical care under this section and who 169.24either choose to receive services through the coordinated care delivery system or who are 169.25enrolled by the commissioner under paragraph (c). The health care services provided by 169.26the system must include: (1) the services described in subdivision 4 with the exception 169.27of outpatient prescription drug coverage but shall include drugs administered in a clinic 169.28or other outpatient setting; or (2) a set of comprehensive and medically necessary health 169.29services that the recipients might reasonably require to be maintained in good health and 169.30that has been approved by the commissioner, including at a minimum, but not limited 169.31to, emergency care, medical transportation services, inpatient hospital and physician 169.32care, outpatient health services, preventive health services, mental health services, 169.33and prescription drugs administered in a clinic or other outpatient setting. Outpatient 169.34prescription drug coverage is covered on a fee-for-service basis in accordance with section 169.35256D.03, subdivision 3, and funded under subdivision 9. A hospital new text begin or plan new text end establishing a 170.1coordinated care delivery system under this subdivision must ensure that the requirements 170.2of this subdivision are met. 170.3    (b) A hospital or group of hospitals new text begin , or a county-based purchasing plan established new text end 170.4 new text begin under section 256B.692, new text end may contract with the commissioner to develop and implement a 170.5coordinated care delivery system as follows: new text begin if the hospital or group of hospitals or plan new text end 170.6 new text begin agrees to satisfy the requirements of this subdivision. new text end 170.7    (1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during 170.8calendar year 2008, it received fee-for-service payments for services to general assistance 170.9medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater 170.10than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to 170.11provide geographic access or to ensure that at least 80 percent of enrollees have access to 170.12a coordinated care delivery system; and 170.13    (2) effective December 1, 2010, a Minnesota hospital not qualified under clause 170.14(1) may contract with the commissioner under this subdivision if it agrees to satisfy the 170.15requirements of this subdivision. 170.16Participation by hospitals new text begin or plans new text end shall become effective quarterly on June 1, September 170.171, December 1, or March 1 new text begin January 1, April 1, July 1, or October 1 new text end . Hospital new text begin or plan new text end 170.18participation is effective for a period of 12 months and may be renewed for successive 170.1912-month periods. 170.20    (c) Applicants and recipients may enroll in any available coordinated care delivery 170.21system statewide. If more than one coordinated care delivery system is available, the 170.22applicant or recipient shall be allowed to choose among the systems. The commissioner 170.23may assign an applicant or recipient to a coordinated care delivery system if no choice 170.24is made by the applicant or recipient. The commissioner shall consider a recipient's zip 170.25code, city of residence, county of residence, or distance from a participating coordinated 170.26care delivery system when determining default assignment. An applicant or recipient may 170.27decline enrollment in a coordinated care delivery system new text begin but services are only available new text end 170.28 new text begin through a coordinated care delivery system new text end . Upon enrollment into a coordinated care 170.29delivery system, the recipient must agree to receive all nonemergency services through the 170.30coordinated care delivery system. Enrollment in a coordinated care delivery system is 170.31for six months and may be renewed for additional six-month periods, except that initial 170.32enrollment is for six months or until the end of a recipient's period of general assistance 170.33medical care eligibility, whichever occurs first. A recipient who continues to meet the 170.34eligibility requirements of this section is not eligible to enroll in MinnesotaCare during 170.35a period of enrollment in a coordinated care delivery system. From June 1, 2010, to 170.36February 28, 2011, applicants and recipients not enrolled in a coordinated care delivery 171.1system may seek services from a hospital eligible for reimbursement under the temporary 171.2uncompensated care pool established under subdivision 8. After February 28, 2011, 171.3services are available only through a coordinated care delivery system. 171.4    (d) The hospital new text begin or plan new text end may contract and coordinate with providers and clinics 171.5for the delivery of services and shall contract with essential community providers as 171.6defined under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the 171.7extent practicable. new text begin When contracting with providers and clinics, the hospital or plan new text end 171.8 new text begin shall give preference to providers and clinics certified as health care homes under section new text end 171.9 new text begin 256B.0751. The hospital or plan must contract with federally qualified health centers or new text end 171.10 new text begin federally qualified health center look-alikes, as defined in section 145.9269, subdivision 1, new text end 171.11 new text begin and essential community providers as defined in section 62Q.19, that agree to accept the new text end 171.12 new text begin terms, conditions, and payment rates offered by the hospital or plan to similarly situated new text end 171.13 new text begin providers, except that reimbursement to federally qualified health centers and federally new text end 171.14 new text begin qualified health center look-alikes must comply with federal law. new text end If a provider or clinic new text begin or new text end 171.15 new text begin health center new text end contracts with a hospital new text begin or plan new text end to provide services through the coordinated 171.16care delivery system, the provider may not refuse to provide services to any recipient 171.17enrolled in the system, and payment for services shall be negotiated with the hospital new text begin or new text end 171.18 new text begin plan new text end and paid by the hospital new text begin or plan new text end from the system's allocation under subdivision 7. 171.19    (e) A coordinated care delivery system must: 171.20    (1) provide the covered services required under paragraph (a) to recipients enrolled 171.21in the coordinated care delivery system, and comply with the requirements of subdivision 171.224, paragraphs (b) to (g); 171.23    (2) establish a process to monitor enrollment and ensure the quality of care provided; 171.24    (3) in cooperation with counties, coordinate the delivery of health care services with 171.25existing homeless prevention, supportive housing, and rent subsidy programs and funding 171.26administered by the Minnesota Housing Finance Agency under chapter 462A; and 171.27    (4) adopt innovative and cost-effective methods of care delivery and coordination, 171.28which may include the use of allied health professionals, telemedicine, patient educators, 171.29care coordinators, and community health workers. 171.30    (f) The hospital new text begin or plan new text end may require a recipient to designate a primary care provider 171.31or a primary care clinic. The hospital new text begin or plan new text end may limit the delivery of services to a 171.32network of providers who have contracted with the hospital new text begin or plan new text end to deliver services in 171.33accordance with this subdivision, and require a recipient to seek services only within this 171.34network. The hospital new text begin or plan new text end may also require a referral to a provider before the service 171.35is eligible for payment. A coordinated care delivery system is not required to provide 171.36payment to a provider who is not employed by or under contract with the system for 172.1services provided to a recipient enrolled in the system, except in cases of an emergency. 172.2For purposes of this section, emergency services are defined in accordance with Code of 172.3Federal Regulations, title 42, section 438.114 (a). 172.4    (g) A recipient enrolled in a coordinated care delivery system has the right to appeal 172.5to the commissioner according to section 256.045. 172.6    (h) The state shall not be liable for the payment of any cost or obligation incurred 172.7by the coordinated care delivery system. 172.8    (i) The hospital new text begin or plan new text end must provide the commissioner with data necessary for 172.9assessing enrollment, quality of care, cost, and utilization of services. Each hospital new text begin or new text end 172.10 new text begin plan new text end must provide, on a quarterly basis on a form prescribed by the commissioner for each 172.11recipient served by the coordinated care delivery system, the services provided, the cost of 172.12services provided, and the actual payment amount for the services provided and any other 172.13information the commissioner deems necessary to claim federal Medicaid match. The 172.14commissioner must provide this data to the legislature on a quarterly basis. 172.15    (j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2, 172.16paragraph (b), do not apply to general assistance medical care provided under this section. 172.17    (k) Notwithstanding any other provision in this section to the contrary, for 172.18participation beginning September 1, 2010, the commissioner shall offer the same contract 172.19terms related to new text begin shall negotiate new text end an enrollment threshold formula and financial liability 172.20protections to new text begin with new text end a hospital or group of hospitals new text begin or plan new text end qualified under this subdivision 172.21to develop and implement a coordinated care delivery system as those contained in the 172.22coordinated care delivery system contracts effective June 1, 2010. 172.23    (l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are 172.24implemented effective July 1, 2010, this subdivision must not be implemented. 172.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 172.26    Sec. 87. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read: 172.27    Subd. 7. Payments; rate setting for the hospital coordinated care delivery 172.28system. (a) Effective for general assistance medical care services, with the exception 172.29of outpatient prescription drug coverage, provided on or after June 1, 2010, through a 172.30coordinated care delivery system, the commissioner shall allocate the annual appropriation 172.31for the coordinated care delivery system to hospitals new text begin or plans new text end participating under 172.32subdivision 6 in quarterly payments, beginning on the first scheduled warrant on or after 172.33June 1, 2010 new text begin March 1, 2012 new text end . The payment shall be allocated among all hospitals new text begin or plans new text end 172.34qualified to participate on the allocation date as follows: new text begin based upon the enrollment new text end 172.35 new text begin thresholds negotiated with the commissioner. new text end 173.1    (1) each hospital or group of hospitals shall be allocated an initial amount based on 173.2the hospital's or group of hospitals' pro rata share of calendar year 2008 payments for 173.3general assistance medical care services to all participating hospitals; 173.4    (2) the initial allocations to Hennepin County Medical Center; Regions Hospital; 173.5Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview, 173.6shall be increased to 110 percent of the value determined in clause (1); 173.7    (3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata 173.8amount in order to keep the allocations within the limit of available appropriations; and 173.9    (4) the amounts determined under clauses (1) to (3) shall be allocated to participating 173.10hospitals. 173.11The commissioner may prospectively reallocate payments to participating hospitals new text begin or new text end 173.12 new text begin plans new text end on a biannual basis to ensure that final allocations reflect actual coordinated care 173.13delivery system enrollment. The 2008 base year shall be updated by one calendar year 173.14each June 1, beginning June 1, 2011. 173.15    (b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the 173.16commissioner shall make one-third of the quarterly payment in June and the remaining 173.17two-thirds of the quarterly payment in July to each participating hospital or group of 173.18hospitals. 173.19    (c) new text begin (b) new text end In order to be reimbursed under this section, nonhospital providers of health 173.20care services shall contract with one or more hospitals new text begin or plans new text end described in paragraph (a) 173.21to provide services to general assistance medical care recipients through the coordinated 173.22care delivery system established by the hospital new text begin or plan new text end . The hospital new text begin or plan new text end shall 173.23reimburse bills submitted by nonhospital providers participating under this paragraph at a 173.24rate negotiated between the hospital new text begin or plan new text end and the nonhospital provider. 173.25    (d) new text begin (c) new text end The commissioner shall apply for federal matching funds under section 173.26256B.199 , paragraphs (a) to (d), for expenditures under this subdivision. 173.27    (e) new text begin (d) new text end Outpatient prescription drug coverage is provided in accordance with section 173.28256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9. 173.29 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 173.30    Sec. 88. Minnesota Statutes 2010, section 256D.031, subdivision 10, is amended to 173.31read: 173.32    Subd. 10. Assistance for veterans. Hospitals new text begin and plans new text end participating in the 173.33coordinated care delivery system under subdivision 6 shall consult with counties, county 174.1veterans service officers, and the Veterans Administration to identify other programs for 174.2which general assistance medical care recipients enrolled in their system are qualified. 174.3    Sec. 89. Minnesota Statutes 2010, section 256L.01, subdivision 4a, is amended to read: 174.4    Subd. 4a. Gross individual or gross family income. (a) "Gross individual or gross 174.5family income" for nonfarm self-employed means income calculated for the 12-month new text begin new text end 174.6 new text begin six-month new text end period of eligibility using as a baseline the adjusted gross income reported 174.7on the applicant's federal income tax form for the previous year and adding back in 174.8depreciation, and carryover net operating loss amounts that apply to the business in which 174.9the family is currently engaged. 174.10(b) "Gross individual or gross family income" for farm self-employed means 174.11income calculated for the 12-month new text begin six-month new text end period of eligibility using as the baseline 174.12the adjusted gross income reported on the applicant's federal income tax form for the 174.13previous year. 174.14(c) "Gross individual or gross family income" means the total income for all family 174.15members, calculated for the 12-month new text begin six-month new text end period of eligibility. 174.16    Sec. 90. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read: 174.17    Subd. 3. Financial management. (a) The commissioner shall manage spending for 174.18the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 174.19each state revenue and expenditure forecast, the commissioner must make an assessment 174.20of the expected expenditures for the covered services for the remainder of the current 174.21biennium and for the following biennium. The estimated expenditure, including the 174.22reserve, shall be compared to an estimate of the revenues that will be available in the health 174.23care access fund. Based on this comparison, and after consulting with the chairs of the 174.24house of representatives Ways and Means Committee and the senate Finance Committee, 174.25and the Legislative Commission on Health Care Access, the commissioner shall, as 174.26necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 174.27remain within the limits of available revenues for the remainder of the current biennium 174.28and for the following biennium. The commissioner shall not hire additional staff using 174.29appropriations from the health care access fund until the commissioner of management 174.30and budget makes a determination that the adjustments implemented under paragraph (b) 174.31are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 174.32revenues for the remainder of the current biennium and for the following biennium. 174.33(b) The adjustments the commissioner shall use must be implemented in this order: 174.34first, stop enrollment of single adults and households without children; second, upon 45 175.1days' notice, stop coverage of single adults and households without children already 175.2enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium 175.3subsidy amounts by ten percent for new text begin children in new text end families with gross annual income above 175.4200 percent of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the 175.5premium subsidy amounts by ten percent for new text begin children in new text end families with gross annual income 175.6at or below 200 percent; and fifth, require applicants to be uninsured for at least six months 175.7prior to eligibility in the MinnesotaCare program. If these measures are insufficient to 175.8limit the expenditures to the estimated amount of revenue, the commissioner shall further 175.9limit enrollment or decrease premium subsidies. 175.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, or upon federal new text end 175.11 new text begin approval, whichever is later, and expires June 30, 2013. The commissioner shall notify new text end 175.12 new text begin the revisor of statutes when federal approval is obtained and publish a notice in the State new text end 175.13 new text begin Register. new text end 175.14    Sec. 91. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read: 175.15    Subd. 3. Financial management. (a) The commissioner shall manage spending for 175.16the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 175.17each state revenue and expenditure forecast, the commissioner must make an assessment 175.18of the expected expenditures for the covered services for the remainder of the current 175.19biennium and for the following biennium. The estimated expenditure, including the 175.20reserve, shall be compared to an estimate of the revenues that will be available in the health 175.21care access fund. Based on this comparison, and after consulting with the chairs of the 175.22house of representatives Ways and Means Committee and the senate Finance Committee, 175.23and the Legislative Commission on Health Care Access, the commissioner shall, as 175.24necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 175.25remain within the limits of available revenues for the remainder of the current biennium 175.26and for the following biennium. The commissioner shall not hire additional staff using 175.27appropriations from the health care access fund until the commissioner of management 175.28and budget makes a determination that the adjustments implemented under paragraph (b) 175.29are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 175.30revenues for the remainder of the current biennium and for the following biennium. 175.31(b) The adjustments the commissioner shall use must be implemented in this order: 175.32first, stop enrollment of single adults and households without children; second, upon 45 175.33days' notice, stop coverage of single adults and households without children already 175.34enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium 175.35subsidy amounts by ten percent for families with gross annual income above 200 percent 176.1of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium 176.2subsidy amounts by ten percent for families with gross annual income at or below 200 176.3percent; and fifth, require applicants to be uninsured for at least six months prior to 176.4eligibility in the MinnesotaCare program. If these measures are insufficient to limit the 176.5expenditures to the estimated amount of revenue, the commissioner shall further limit 176.6enrollment or decrease premium subsidies. 176.7    Sec. 92. Minnesota Statutes 2010, section 256L.03, subdivision 3, is amended to read: 176.8    Subd. 3. Inpatient hospital services. (a) Covered health services shall include 176.9inpatient hospital services, including inpatient hospital mental health services and inpatient 176.10hospital and residential chemical dependency treatment, subject to those limitations 176.11necessary to coordinate the provision of these services with eligibility under the medical 176.12assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under 176.13section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 176.142 , with family gross income that exceeds 200 percent of the federal poverty guidelines or 176.15215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not 176.16pregnant, is subject to an annual limit of $10,000. 176.17    (b) Admissions for inpatient hospital services paid for under section 256L.11, 176.18subdivision 3 , must be certified as medically necessary in accordance with Minnesota 176.19Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2): 176.20    (1) all admissions must be certified, except those authorized under rules established 176.21under section 254A.03, subdivision 3, or approved under Medicare; and 176.22    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent 176.23for admissions for which certification is requested more than 30 days after the day of 176.24admission. The hospital may not seek payment from the enrollee for the amount of the 176.25payment reduction under this clause. 176.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, or upon federal new text end 176.27 new text begin approval, whichever is later, and expires June 30, 2013. The commissioner shall notify new text end 176.28 new text begin the revisor of statutes when federal approval is obtained and publish a notice in the State new text end 176.29 new text begin Register. new text end 176.30    Sec. 93. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read: 176.31    Subd. 5. Co-payments and coinsurance new text begin Cost-sharing new text end . (a) Except as provided in 176.32paragraphs (b) and new text begin , new text end (c), new text begin and (h), new text end the MinnesotaCare benefit plan shall include the following 176.33co-payments and coinsurance new text begin cost-sharing new text end requirements for all enrollees: 177.1    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 177.2subject to an annual inpatient out-of-pocket maximum of $1,000 per individual; 177.3    (2) $3 per prescription for adult enrollees; 177.4    (3) $25 for eyeglasses for adult enrollees; 177.5    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 177.6episode of service which is required because of a recipient's symptoms, diagnosis, or 177.7established illness, and which is delivered in an ambulatory setting by a physician or 177.8physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 177.9audiologist, optician, or optometrist; and 177.10    (5) $6 for nonemergency visits to a hospital-based emergency room for services 177.11provided through December 31, 2010, and $3.50 effective January 1, 2011 new text begin ; and new text end 177.12 new text begin (6) a family deductible equal to the maximum amount allowed under Code of new text end 177.13 new text begin Federal Regulations, title 42, part 447.54 new text end . 177.14    (b) Paragraph (a), clause (1), does new text begin and paragraph (e) do new text end not apply to parents and 177.15relative caretakers of children under the age of 21. 177.16    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21. 177.17    (d) Paragraph (a), clause (4), does not apply to mental health services. 177.18    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal 177.19poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 177.20and who are not pregnant shall be financially responsible for the coinsurance amount, if 177.21applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit. 177.22    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 177.23or changes from one prepaid health plan to another during a calendar year, any charges 177.24submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 177.25expenses incurred by the enrollee for inpatient services, that were submitted or incurred 177.26prior to enrollment, or prior to the change in health plans, shall be disregarded. 177.27(g) MinnesotaCare reimbursements to fee-for-service providers and payments to 177.28managed care plans or county-based purchasing plans shall not be increased as a result of 177.29the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011. 177.30 new text begin (h) Effective January 1, 2012, the following co-payments for nonpreventive visits new text end 177.31 new text begin shall apply to enrollees who are adults without children eligible under section 256L.04, new text end 177.32 new text begin subdivision 7: new text end 177.33 new text begin (1) $3 for visits to providers whose average, risk-adjusted, total annual cost of care new text end 177.34 new text begin per MinnesotaCare enrollee is at the 60th percentile or lower for providers of the same new text end 177.35 new text begin type; new text end 178.1 new text begin (2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care new text end 178.2 new text begin per MinnesotaCare enrollee is greater than the 60th percentile but does not exceed the new text end 178.3 new text begin 80th percentile for providers of the same type; and new text end 178.4 new text begin (3) $10 for visits to providers whose average, risk-adjusted, total annual cost of new text end 178.5 new text begin care per MinnesotaCare enrollee is greater than the 80th percentile for providers of the new text end 178.6 new text begin same type. new text end 178.7 new text begin Each managed care and county-based purchasing plan shall calculate the average, new text end 178.8 new text begin risk-adjusted, total annual cost of care for providers under this paragraph using a new text end 178.9 new text begin methodology that has been approved by the commissioner. new text end 178.10 new text begin EFFECTIVE DATE. new text end new text begin The amendments to paragraph (e) are effective January 1, new text end 178.11 new text begin 2012, or upon federal approval, whichever is later, and expires June 30, 2013. The new text end 178.12 new text begin commissioner shall notify the revisor of statutes when federal approval is obtained and new text end 178.13 new text begin publish a notice in the State Register. new text end 178.14    Sec. 94. new text begin [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM. new text end 178.15     new text begin Subdivision 1. new text end new text begin Defined contributions to enrollees. new text end new text begin (a) Beginning January 1, 2012, new text end 178.16 new text begin the commissioner shall provide each MinnesotaCare enrollee eligible under section new text end 178.17 new text begin 256L.04, subdivision 7, with gross family income equal to or greater than 133 percent new text end 178.18 new text begin of the federal poverty guidelines, with a monthly defined contribution to purchase health new text end 178.19 new text begin coverage under a health plan as defined in section 62A.011, subdivision 3. Beginning new text end 178.20 new text begin January 1, 2012, or upon federal approval, whichever is later, the commissioner shall new text end 178.21 new text begin provide each MinnesotaCare enrollee eligible under section 256L.04, subdivision 1, with new text end 178.22 new text begin gross family income equal to or greater than 133 percent of the federal poverty guidelines, new text end 178.23 new text begin with a monthly defined contribution to purchase health coverage under a health plan as new text end 178.24 new text begin defined in section 62A.011, subdivision 3, offered by a health plan company as defined new text end 178.25 new text begin in section 62Q.01, subdivision 4. new text end 178.26 new text begin (b) Enrollees eligible under paragraph (a) shall not be charged premiums under new text end 178.27 new text begin section 256L.15 and are exempt from the managed care enrollment requirement of section new text end 178.28 new text begin 256L.12. new text end 178.29 new text begin (c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to new text end 178.30 new text begin enrollees eligible under paragraph (a). Covered services, cost-sharing, disenrollment new text end 178.31 new text begin for nonpayment of premium, enrollee appeal rights and complaint procedures, and the new text end 178.32 new text begin effective date of coverage for enrollees eligible under paragraph (a) shall be as provided new text end 178.33 new text begin under the terms of the health plan purchased by the enrollee. new text end 179.1 new text begin (d) Unless otherwise provided in this section, all MinnesotaCare requirements new text end 179.2 new text begin related to eligibility, income and asset methodology, income reporting, and program new text end 179.3 new text begin administration continue to apply to enrollees obtaining coverage under this section. new text end 179.4     new text begin Subd. 2. new text end new text begin Use of defined contribution. new text end new text begin An enrollee may use up to the monthly new text end 179.5 new text begin defined contribution to pay premiums for coverage under a health plan as defined in new text end 179.6 new text begin section 62A.011, subdivision 3. new text end 179.7     new text begin Subd. 3. new text end new text begin Determination of defined contribution amount. new text end new text begin (a) The commissioner new text end 179.8 new text begin shall determine the defined contribution sliding scale using the base contribution specified new text end 179.9 new text begin in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale new text end 179.10 new text begin for defined contributions that provides: new text end 179.11 new text begin (1) persons with household incomes equal to 133 percent of the federal poverty new text end 179.12 new text begin guidelines with a defined contribution of 150 percent of the base contribution; new text end 179.13 new text begin (2) persons with household incomes equal to 175 percent of the federal poverty new text end 179.14 new text begin guidelines with a defined contribution of 100 percent of the base contribution; new text end 179.15 new text begin (3) persons with household incomes equal to or greater than 250 percent of new text end 179.16 new text begin the federal poverty guidelines with a defined contribution of 80 percent of the base new text end 179.17 new text begin contribution; and new text end 179.18 new text begin (4) persons with household incomes in evenly spaced increments between the new text end 179.19 new text begin percentages of the federal poverty guideline specified in clauses (1) to (3) with a base new text end 179.20 new text begin contribution that is a percentage interpolated from the defined contribution percentages new text end 179.21 new text begin specified in clauses (1) to (3). new text end 179.22 new text begin Age new text end new text begin Monthly Per-Person Base Contribution new text end 179.23 new text begin Under 21 new text end new text begin $122.79 new text end 179.24 new text begin 21-29 new text end new text begin 122.79 new text end 179.25 new text begin 30-31 new text end new text begin 129.19 new text end 179.26 new text begin 32-33 new text end new text begin 132.38 new text end 179.27 new text begin 34-35 new text end new text begin 134.31 new text end 179.28 new text begin 36-37 new text end new text begin 136.06 new text end 179.29 new text begin 38-39 new text end new text begin 141.02 new text end 179.30 new text begin 40-41 new text end new text begin 151.25 new text end 179.31 new text begin 42-43 new text end new text begin 159.89 new text end 179.32 new text begin 44-45 new text end new text begin 175.08 new text end 179.33 new text begin 46-47 new text end new text begin 191.71 new text end 179.34 new text begin 48-49 new text end new text begin 213.13 new text end 179.35 new text begin 50-51 new text end new text begin 239.51 new text end 179.36 new text begin 52-53 new text end new text begin 266.69 new text end 179.37 new text begin 54-55 new text end new text begin 293.88 new text end 179.38 new text begin 56-57 new text end new text begin 323.77 new text end 180.1 new text begin 58-59 new text end new text begin 341.20 new text end 180.2 new text begin 60+ new text end new text begin 357.19 new text end 180.3 new text begin (b) The commissioner shall multiply the defined contribution amounts developed new text end 180.4 new text begin under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual new text end 180.5 new text begin health plan by a health plan company and who purchase coverage through the Minnesota new text end 180.6 new text begin Comprehensive Health Association. new text end 180.7 new text begin (c) Notwithstanding paragraphs (a) and (b), the monthly defined contribution shall new text end 180.8 new text begin not exceed 90 percent of the monthly premium for the health plan purchased by the new text end 180.9 new text begin enrollee. If the enrollee purchases coverage under a health plan that does not include new text end 180.10 new text begin mental health services and chemical dependency treatment services, the monthly defined new text end 180.11 new text begin contribution amount determined under this subdivision shall be reduced by five percent. new text end 180.12     new text begin Subd. 4. new text end new text begin Administration by commissioner. new text end new text begin The commissioner shall administer the new text end 180.13 new text begin defined contributions. The commissioner shall: new text end 180.14     new text begin (1) calculate and process defined contributions for enrollees; and new text end 180.15     new text begin (2) pay the defined contribution amount to health plan companies or the Minnesota new text end 180.16 new text begin Comprehensive Health Association, as applicable, for enrollee health plan coverage. new text end 180.17     new text begin Subd. 5. new text end new text begin Assistance to enrollees. new text end new text begin The commissioner of human services, in new text end 180.18 new text begin consultation with the commissioner of commerce, shall develop an efficient and new text end 180.19 new text begin cost-effective method of referring eligible applicants to professional insurance agent new text end 180.20 new text begin associations. new text end 180.21     new text begin Subd. 6. new text end new text begin Minnesota Comprehensive Health Association (MCHA). new text end new text begin Beginning new text end 180.22 new text begin January 1, 2012, MinnesotaCare enrollees who are denied coverage under an individual new text end 180.23 new text begin health plan by a health plan company are eligible for coverage through a health plan new text end 180.24 new text begin offered by the MCHA and may enroll in MCHA according to section 62E.14. Any new text end 180.25 new text begin difference between the revenue and covered losses to the MCHA related to implementation new text end 180.26 new text begin of this section shall be paid to the MCHA from the health care access fund. new text end 180.27     new text begin Subd. 7. new text end new text begin Federal approval. new text end new text begin The commissioner shall seek all federal waivers new text end 180.28 new text begin and approvals necessary to implement coverage under this section for MinnesotaCare new text end 180.29 new text begin enrollees eligible under section 256L.04, subdivision 1, with gross family incomes equal new text end 180.30 new text begin to or greater than 133 percent of the federal poverty guidelines, while continuing to new text end 180.31 new text begin receive federal matching funds. new text end 180.32    Sec. 95. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read: 180.33    Subdivision 1. Families with children. (a) Families with Children with family 180.34income equal to or less than 275 percent of the federal poverty guidelines for the 180.35applicable family size new text begin and adults in families with children with family income equal to or new text end 181.1 new text begin less than 200 percent of the federal poverty guidelines for the applicable family size, new text end shall 181.2be eligible for MinnesotaCare according to this section. All other provisions of sections 181.3256L.01 to 256L.18, including the insurance-related barriers to enrollment under section 181.4256L.07 , shall apply unless otherwise specified. 181.5    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, 181.6if the children are eligible. Children may be enrolled separately without enrollment by 181.7parents. However, if one parent in the household enrolls, both parents must enroll, unless 181.8other insurance is available. If one child from a family is enrolled, all children must 181.9be enrolled, unless other insurance is available. If one spouse in a household enrolls, 181.10the other spouse in the household must also enroll, unless other insurance is available. 181.11Families cannot choose to enroll only certain uninsured members. 181.12    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies 181.13to the MinnesotaCare program. These persons are no longer counted in the parental 181.14household and may apply as a separate household. 181.15    (d) Beginning July 1, 2010, or upon federal approval, whichever is later, parents are 181.16not eligible for MinnesotaCare if their gross income exceeds $57,500. 181.17    (e) Children formerly enrolled in medical assistance and automatically deemed 181.18eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 181.19from the requirements of this section until renewal. 181.20(f) [Reserved.] 181.21 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, or upon federal new text end 181.22 new text begin approval, whichever is later, and expires June 30, 2013, except that the amendment new text end 181.23 new text begin striking paragraph (e) is effective retroactively from October 1, 2008, does not expire, new text end 181.24 new text begin and federal approval is no longer necessary. The commissioner shall notify the revisor of new text end 181.25 new text begin statutes when federal approval is obtained and publish a notice in the State Register. new text end 181.26    Sec. 96. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read: 181.27    Subd. 7. Single adults and households with no children. (a) The definition of 181.28eligible persons new text begin , through December 31, 2011, new text end includes all individuals and households with 181.29no children who have gross family incomes that are equal to or less than 200 percent 181.30of the federal poverty guidelines. 181.31    (b) Effective July 1, 2009 new text begin January 1, 2012 new text end , the definition of eligible persons includes 181.32all individuals and households with no children who have gross family incomes that are 181.33 new text begin greater than 75 percent of the federal poverty guidelines and new text end equal to or less than 250 new text begin 200 new text end 181.34percent of the federal poverty guidelines. new text begin Effective July 1, 2013, the maximum income new text end 181.35 new text begin limit under this paragraph is increased to 250 percent of the federal poverty guidelines. new text end 182.1 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 182.2    Sec. 97. Minnesota Statutes 2010, section 256L.05, subdivision 2, is amended to read: 182.3    Subd. 2. Commissioner's duties. new text begin (a) new text end The commissioner or county agency shall 182.4use electronic verification as the primary method of income verification. If there is a 182.5discrepancy between reported income and electronically verified income, an individual 182.6may be required to submit additional verification. In addition, the commissioner shall 182.7perform random audits to verify reported income and eligibility. The commissioner 182.8may execute data sharing arrangements with the Department of Revenue and any other 182.9governmental agency in order to perform income verification related to eligibility and 182.10premium payment under the MinnesotaCare program. 182.11 new text begin (b) In determining eligibility for MinnesotaCare, the commissioner shall require new text end 182.12 new text begin applicants and enrollees seeking renewal of eligibility to verify both earned and unearned new text end 182.13 new text begin income. The commissioner shall also require applicants and enrollees to submit the new text end 182.14 new text begin names of their employers and a contact name with a phone number for each employer new text end 182.15 new text begin for purposes of verifying whether the applicant or enrollee, and any dependents, are new text end 182.16 new text begin eligible for employer-subsidized coverage. Data collected is nonpublic data as defined new text end 182.17 new text begin in section 13.02, subdivision 9. new text end 182.18    Sec. 98. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read: 182.19    Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007 new text begin 2011 new text end , an enrollee's 182.20eligibility must be renewed every 12 new text begin six new text end months. The 12-month period begins in the 182.21month after the month the application is approved. 182.22    (b) new text begin The first six-month period of eligibility begins the month the application is new text end 182.23 new text begin received by the commissioner. The effective date of coverage within the first six-month new text end 182.24 new text begin period of eligibility is as provided in subdivision 3. new text end Each new period of eligibility must 182.25take into account any changes in circumstances that impact eligibility and premium 182.26amount. An enrollee must provide all the information needed to redetermine eligibility 182.27by the first day of the month that ends the eligibility period. If there is no change in 182.28circumstances, the enrollee may renew eligibility at designated locations that include 182.29community clinics and health care providers' offices. The designated sites shall forward 182.30the renewal forms to the commissioner. The commissioner may establish criteria and 182.31timelines for sites to forward applications to the commissioner or county agencies. The 182.32premium for the new period of eligibility must be received as provided in section 256L.06 182.33in order for eligibility to continue. 183.1    (c) An enrollee who fails to submit renewal forms and related documentation 183.2necessary for verification of continued eligibility in a timely manner shall remain eligible 183.3for one additional month beyond the end of the current eligibility period before being 183.4disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the 183.5additional month. 183.6    Sec. 99. Minnesota Statutes 2010, section 256L.05, subdivision 5, is amended to read: 183.7    Subd. 5. Availability of private insurance. The commissioner, in consultation with 183.8the commissioners of health and commerce, shall provide information regarding the 183.9availability of private health insurance coverage and the possibility of disenrollment 183.10under section 256L.07, subdivision 1, paragraphs (b) and (c), to all: (1) families enrolled 183.11in the MinnesotaCare program whose gross family income is equal to or more than 225 183.12percent of the federal poverty guidelines; and (2) single adults and households without 183.13children enrolled in the MinnesotaCare program whose gross family income is equal to 183.14or more than 165 percent of the federal poverty guidelines. This information must be 183.15provided upon initial enrollment and annually thereafter. The commissioner shall also 183.16include information regarding the availability of private health insurance coverage in the 183.17notice of ineligibility provided to persons subject to disenrollment under section 256L.07, 183.18subdivision 1 , paragraphs (b) and (c). 183.19 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, and expires June new text end 183.20 new text begin 30, 2013. new text end 183.21    Sec. 100. Minnesota Statutes 2010, section 256L.05, is amended by adding a 183.22subdivision to read: 183.23     new text begin Subd. 6. new text end new text begin Referral of veterans. new text end new text begin The commissioner shall ensure that all applicants new text end 183.24 new text begin for MinnesotaCare with incomes less than 133 percent of the federal poverty guidelines new text end 183.25 new text begin who identify themselves as veterans are referred to a county veterans service officer for new text end 183.26 new text begin assistance in applying to the United States Department of Veterans Affairs for any veterans new text end 183.27 new text begin benefits for which they may be eligible. new text end 183.28    Sec. 101. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read: 183.29    Subdivision 1. General requirements. (a) Children enrolled in the original 183.30children's health plan as of September 30, 1992, children who enrolled in the 183.31MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 183.32article 4, section 17, and children who have family gross incomes that are equal to or 183.33less than 150 percent of the federal poverty guidelines are eligible without meeting 184.1the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 184.2long as they maintain continuous coverage in the MinnesotaCare program or medical 184.3assistance. Children who apply for MinnesotaCare on or after the implementation date 184.4of the employer-subsidized health coverage program as described in Laws 1998, chapter 184.5407, article 5, section 45, who have family gross incomes that are equal to or less than 150 184.6percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 184.7be eligible for MinnesotaCare. 184.8     new text begin (b) new text end Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose 184.9income increases above 275 percent of the federal poverty guidelines, are no longer 184.10eligible for the program and shall be disenrolled by the commissioner. Beginning January 184.111, 2008, 184.12 new text begin (c) new text end Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, 184.13whose income increases above 200 percent of the federal poverty guidelines or 250 184.14percent of the federal poverty guidelines on or after July 1, 2009, new text begin the limits described new text end 184.15 new text begin in section 256L.04, subdivision 7, new text end are no longer eligible for the program and shall be 184.16disenrolled by the commissioner. 184.17 new text begin (d) new text end For persons disenrolled under this subdivision, MinnesotaCare coverage 184.18terminates the last day of the calendar month following the month in which the 184.19commissioner determines that the income of a family or individual exceeds program 184.20income limits. 184.21    (b) new text begin (e) new text end Notwithstanding paragraph (a), children may remain enrolled in 184.22MinnesotaCare if ten percent of their gross individual or gross family income as defined 184.23in section 256L.01, subdivision 4, is less than the annual premium for a new text begin six-month new text end 184.24policy with a $500 deductible available through the Minnesota Comprehensive Health 184.25Association. Children who are no longer eligible for MinnesotaCare under this clause shall 184.26be given a 12-month notice period from the date that ineligibility is determined before 184.27disenrollment. The premium for children remaining eligible under this clause shall be the 184.28maximum premium determined under section 256L.15, subdivision 2, paragraph (b). 184.29    (c) new text begin (f) new text end Notwithstanding paragraphs (a) and (b) new text begin (e) new text end , parents are not eligible for 184.30MinnesotaCare if gross household income exceeds $57,500 for the 12-month new text begin $25,000 for new text end 184.31 new text begin the six-month new text end period of eligibility. 184.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, and expires June new text end 184.33 new text begin 30, 2013, except the amendments to the new paragraphs (e) and (f) are effective July 1, new text end 184.34 new text begin 2011, and do not expire. new text end 184.35    Sec. 102. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read: 185.1    Subdivision 1. General requirements. (a) Children enrolled in the original 185.2children's health plan as of September 30, 1992, children who enrolled in the 185.3MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, 185.4article 4, section 17, and children who have family gross incomes that are equal to or 185.5less than 150 percent of the federal poverty guidelines are eligible without meeting 185.6the requirements of subdivision 2 and the four-month requirement in subdivision 3, as 185.7long as they maintain continuous coverage in the MinnesotaCare program or medical 185.8assistance. Children who apply for MinnesotaCare on or after the implementation date 185.9of the employer-subsidized health coverage program as described in Laws 1998, chapter 185.10407, article 5, section 45, who have family gross incomes that are equal to or less than 150 185.11percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to 185.12be eligible for MinnesotaCare. 185.13     new text begin (b) new text end Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose 185.14income increases above 275 percent of the federal poverty guidelines new text begin the limits described new text end 185.15 new text begin in section 256L.04, subdivision 1 new text end , are no longer eligible for the program and shall be 185.16disenrolled by the commissioner. 185.17 new text begin (c) new text end Beginning January 1, 2008, individuals enrolled in MinnesotaCare under section 185.18256L.04, subdivision 7 , whose income increases above 200 percent of the federal poverty 185.19guidelines or 250 percent of the federal poverty guidelines on or after July 1, 2009, are no 185.20longer eligible for the program and shall be disenrolled by the commissioner. 185.21 new text begin (d) new text end For persons disenrolled under this subdivision, MinnesotaCare coverage 185.22terminates the last day of the calendar month following the month in which the 185.23commissioner determines that the income of a family or individual exceeds program 185.24income limits. 185.25    (b) new text begin (e) new text end Notwithstanding paragraph (a), children may remain enrolled in 185.26MinnesotaCare if ten percent of their gross individual or gross family income as defined in 185.27section 256L.01, subdivision 4, is less than the annual premium for a policy with a $500 185.28deductible available through the Minnesota Comprehensive Health Association. Children 185.29who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month 185.30notice period from the date that ineligibility is determined before disenrollment. The 185.31premium for children remaining eligible under this clause shall be the maximum premium 185.32determined under section 256L.15, subdivision 2, paragraph (b). 185.33    (c) new text begin (f) new text end Notwithstanding paragraphs (a) and (b) new text begin (e) new text end , parents are not eligible for 185.34MinnesotaCare if gross household income exceeds $57,500 for the 12-month period 185.35of eligibility. 186.1 new text begin EFFECTIVE DATE. new text end new text begin The amendment in paragraph (b) is effective January 1, 2012, new text end 186.2 new text begin or upon federal approval whichever is later, and expires June 30, 2013. The commissioner new text end 186.3 new text begin shall notify the revisor of statutes when federal approval is obtained and publish a notice new text end 186.4 new text begin in the State Register. new text end 186.5    Sec. 103. Minnesota Statutes 2010, section 256L.09, subdivision 4, is amended to read: 186.6    Subd. 4. Eligibility as Minnesota resident. (a) For purposes of this section, a 186.7permanent Minnesota resident is a person who has demonstrated, through persuasive and 186.8objective evidence, that the person is domiciled in the state and intends to live in the 186.9state permanently. 186.10    (b) To be eligible as a permanent resident, an applicant must demonstrate the 186.11requisite intent to live in the state permanently by: 186.12    (1) showing that the applicant maintains a residence at a verified address new text begin other than a new text end 186.13 new text begin place of public accommodation, unless the place of public accommodation is the person's new text end 186.14 new text begin primary or only residence new text end , through the use of evidence of residence described in section 186.15256D.02, subdivision 12a , paragraph (b), clause (2) new text begin (1) new text end ; 186.16    (2) demonstrating that the applicant has been continuously domiciled in the state for 186.17no less than 180 days immediately before the application; and 186.18    (3) signing an affidavit declaring that (A) the applicant currently resides in the state 186.19and intends to reside in the state permanently; and (B) the applicant did not come to the 186.20state for the primary purpose of obtaining medical coverage or treatment. 186.21    (c) A person who is temporarily absent from the state does not lose eligibility for 186.22MinnesotaCare. "Temporarily absent from the state" means the person is out of the state 186.23for a temporary purpose and intends to return when the purpose of the absence has been 186.24accomplished. A person is not temporarily absent from the state if another state has 186.25determined that the person is a resident for any purpose. If temporarily absent from the 186.26state, the person must follow the requirements of the health plan in which the person is 186.27enrolled to receive services. 186.28    Sec. 104. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read: 186.29    Subd. 7. Critical access dental providers. Effective for dental services provided to 186.30MinnesotaCare enrollees on or after January 1, 2007, new text begin July 1, 2011, new text end the commissioner shall 186.31increase payment rates to dentists and dental clinics deemed by the commissioner to be 186.32critical access providers under section 256B.76, subdivision 4, by 50 new text begin 30 new text end percent above 186.33the payment rate that would otherwise be paid to the provider. The commissioner shall 186.34pay the prepaid health plans under contract with the commissioner amounts sufficient to 187.1reflect this rate increase. The prepaid health plan must pass this rate increase to providers 187.2who have been identified by the commissioner as critical access dental providers under 187.3section 256B.76, subdivision 4. 187.4    Sec. 105. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read: 187.5    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective, 187.6per capita, where possible. The commissioner may allow health plans to arrange for 187.7inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 187.8an independent actuary to determine appropriate rates. 187.9    (b) For services rendered on or after January 1, 2004, the commissioner shall 187.10withhold five percent of managed care plan payments and county-based purchasing 187.11plan payments under this section pending completion of performance targets. Each 187.12performance target must be quantifiable, objective, measurable, and reasonably attainable, 187.13except in the case of a performance target based on a federal or state law or rule. Criteria 187.14for assessment of each performance target must be outlined in writing prior to the 187.15contract effective date. The managed care plan must demonstrate, to the commissioner's 187.16satisfaction, that the data submitted regarding attainment of the performance target is 187.17accurate. The commissioner shall periodically change the administrative measures used 187.18as performance targets in order to improve plan performance across a broader range of 187.19administrative services. The performance targets must include measurement of plan 187.20efforts to contain spending on health care services and administrative activities. The 187.21commissioner may adopt plan-specific performance targets that take into account factors 187.22affecting only one plan, such as characteristics of the plan's enrollee population. The 187.23withheld funds must be returned no sooner than July 1 and no later than July 31 of the 187.24following calendar year if performance targets in the contract are achieved. 187.25(c) For services rendered on or after January 1, 2011, the commissioner shall 187.26withhold an additional three percent of managed care plan or county-based purchasing 187.27plan payments under this section. The withheld funds must be returned no sooner than 187.28July 1 and no later than July 31 of the following calendar year. The return of the withhold 187.29under this paragraph is not subject to the requirements of paragraph (b). 187.30(d) Effective for services rendered on or after January 1, 2011, the commissioner 187.31shall include as part of the performance targets described in paragraph (b) a reduction in 187.32the plan's emergency room utilization rate for state health care program enrollees by a 187.33measurable rate of five percent from the plan's utilization rate for the previous calendar 187.34year. 188.1The withheld funds must be returned no sooner than July 1 and no later than July 31 188.2of the following calendar year if the managed care plan demonstrates to the satisfaction of 188.3the commissioner that a reduction in the utilization rate was achieved. 188.4The withhold described in this paragraph shall continue for each consecutive 188.5contract period until the plan's emergency room utilization rate for state health care 188.6program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 188.7for state health care program enrollees for calendar year 2009. Hospitals shall cooperate 188.8with the health plans in meeting this performance target and shall accept payment 188.9withholds that may be returned to the hospitals if the performance target is achieved. The 188.10commissioner shall structure the withhold so that the commissioner returns a portion of 188.11the withheld funds in amounts commensurate with achieved reductions in utilization less 188.12than the targeted amount. The withhold described in this paragraph does not apply to 188.13county-based purchasing plans. 188.14 new text begin (e) Effective for services provided on or after January 1, 2012, the commissioner new text end 188.15 new text begin shall include as part of the performance targets described in paragraph (b) a reduction in new text end 188.16 new text begin the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous new text end 188.17 new text begin hospitalization of a patient regardless of the reason for the hospitalization for state health new text end 188.18 new text begin care program enrollees by a measurable rate of five percent from the plan's hospitalization new text end 188.19 new text begin rate for the previous calendar year. new text end 188.20 new text begin The withheld funds must be returned no sooner than July 1 and no later than July 31 new text end 188.21 new text begin of the following calendar year if the managed care plan or county-based purchasing plan new text end 188.22 new text begin demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization new text end 188.23 new text begin rate was achieved. new text end 188.24 new text begin The withhold described in this paragraph must continue for each consecutive new text end 188.25 new text begin contract period until the plan's subsequent hospitalization rate for state health care new text end 188.26 new text begin program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate new text end 188.27 new text begin for state health care program enrollees for calendar year 2010. Hospitals shall cooperate new text end 188.28 new text begin with the plans in meeting this performance target and shall accept payment withholds that new text end 188.29 new text begin must be returned to the hospitals if the performance target is achieved. The commissioner new text end 188.30 new text begin shall structure the withhold so that the commissioner returns a portion of the withheld new text end 188.31 new text begin funds in amounts commensurate with achieved reductions in utilizations less than the new text end 188.32 new text begin targeted amount. The withhold described in this paragraph does not apply to county-based new text end 188.33 new text begin purchasing plans. new text end 188.34(e) new text begin (f) new text end A managed care plan or a county-based purchasing plan under section 188.35256B.692 may include as admitted assets under section 62D.044 any amount withheld 188.36under this section that is reasonably expected to be returned. 189.1    Sec. 106. Minnesota Statutes 2010, section 256L.15, subdivision 1a, is amended to 189.2read: 189.3    Subd. 1a. Payment options. The commissioner may offer the following payment 189.4options to an enrollee: 189.5(1) payment by check; 189.6(2) payment by credit card; 189.7(3) payment by recurring automatic checking withdrawal; 189.8(4) payment by onetime electronic transfer of funds; 189.9(5) payment by wage withholding with the consent of the employer and the 189.10employee; or 189.11(6) payment by using state tax refund payments. 189.12 new text begin The commissioner shall include information about the payment options on each new text end 189.13 new text begin premium notice. new text end At application or reapplication, a MinnesotaCare applicant or enrollee 189.14may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to 189.15collect funds from the applicant's or enrollee's refund for the purposes of meeting all or 189.16part of the applicant's or enrollee's MinnesotaCare premium obligation. The applicant or 189.17enrollee may authorize the commissioner to apply for the state working family tax credit 189.18on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be 189.19subject to the $10 fee under section 270A.07, subdivision 1. 189.20    Sec. 107. Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to 189.21read: 189.22 Subd. 5.Basic Health Care Grants 189.23 (a) MinnesotaCare Grants 189.24 Health Care Access -0- (770,000) 189.25Incentive Program and Outreach Grants. 189.26Of the appropriation for the Minnesota health 189.27care outreach program in Laws 2007, chapter 189.28147, article 19, section 3, subdivision 7, 189.29paragraph (b): 189.30(1) $400,000 in fiscal year 2009 from the 189.31general fund and $200,000 in fiscal year 2009 189.32from the health care access fund are for the 189.33incentive program under Minnesota Statutes, 189.34section 256.962, subdivision 5. For the 190.1biennium beginning July 1, 2009, base level 190.2funding for this activity shall be $360,000 190.3from the general fund and $160,000 from the 190.4health care access fund; and 190.5(2) $100,000 in fiscal year 2009 from the 190.6general fund and $50,000 in fiscal year 2009 190.7from the health care access fund are for the 190.8outreach grants under Minnesota Statutes, 190.9section 256.962, subdivision 2. For the 190.10biennium beginning July 1, 2009, base level 190.11funding for this activity shall be $90,000 190.12from the general fund and $40,000 from the 190.13health care access fund. 190.14 190.15 (b) MA Basic Health Care Grants - Families and Children -0- (17,280,000) 190.16Third-Party Liability. (a) During 190.17fiscal year 2009, the commissioner shall 190.18employ a contractor paid on a percentage 190.19basis to improve third-party collections. 190.20Improvement initiatives may include, but not 190.21be limited to, efforts to improve postpayment 190.22collection from nonresponsive claims and 190.23efforts to uncover third-party payers the 190.24commissioner has been unable to identify. 190.25(b) In fiscal year 2009, the first $1,098,000 190.26of recoveries, after contract payments and 190.27federal repayments, is appropriated to 190.28the commissioner for technology-related 190.29expenses. 190.30Administrative Costs. (a) For contracts 190.31effective on or after January 1, 2009, 190.32the commissioner shall limit aggregate 190.33administrative costs paid to managed care 190.34plans under Minnesota Statutes, section 190.35256B.69 , and to county-based purchasing 191.1plans under Minnesota Statutes, section 191.2256B.692 , to an overall average of 6.6 new text begin 6.1 new text end 191.3percent of total contract payments under 191.4Minnesota Statutes, sections 256B.69 and 191.5256B.692 , for each calendar year. For 191.6purposes of this paragraph, administrative 191.7costs do not include premium taxes paid 191.8under Minnesota Statutes, section 297I.05, 191.9subdivision 5 , and provider surcharges paid 191.10under Minnesota Statutes, section 256.9657, 191.11subdivision 3 . 191.12(b) Notwithstanding any law to the contrary, 191.13the commissioner may reduce or eliminate 191.14administrative requirements to meet the 191.15administrative target under paragraph (a). 191.16(c) Notwithstanding any contrary provision 191.17of this article, this rider shall not expire. 191.18Hospital Payment Delay. Notwithstanding 191.19Laws 2005, First Special Session chapter 4, 191.20article 9, section 2, subdivision 6, payments 191.21from the Medicaid Management Information 191.22System that would otherwise have been made 191.23for inpatient hospital services for medical 191.24assistance enrollees are delayed as follows: 191.25(1) for fiscal year 2008, June payments must 191.26be included in the first payments in fiscal 191.27year 2009; and (2) for fiscal year 2009, 191.28June payments must be included in the first 191.29payment of fiscal year 2010. The provisions 191.30of Minnesota Statutes, section 16A.124, 191.31do not apply to these delayed payments. 191.32Notwithstanding any contrary provision in 191.33this article, this paragraph expires on June 191.3430, 2010. 191.35 191.36 (c) MA Basic Health Care Grants - Elderly and Disabled (14,028,000) (9,368,000) 192.1Minnesota Disability Health Options Rate 192.2Setting Methodology. The commissioner 192.3shall develop and implement a methodology 192.4for risk adjusting payments for community 192.5alternatives for disabled individuals (CADI) 192.6and traumatic brain injury (TBI) home 192.7and community-based waiver services 192.8delivered under the Minnesota disability 192.9health options program (MnDHO) effective 192.10January 1, 2009. The commissioner shall 192.11take into account the weighting system used 192.12to determine county waiver allocations in 192.13developing the new payment methodology. 192.14Growth in the number of enrollees receiving 192.15CADI or TBI waiver payments through 192.16MnDHO is limited to an increase of 200 192.17enrollees in each calendar year from January 192.182009 through December 2011. If those limits 192.19are reached, additional members may be 192.20enrolled in MnDHO for basic care services 192.21only as defined under Minnesota Statutes, 192.22section 256B.69, subdivision 28, and the 192.23commissioner may establish a waiting list for 192.24future access of MnDHO members to those 192.25waiver services. 192.26MA Basic Elderly and Disabled 192.27Adjustments. For the fiscal year ending June 192.2830, 2009, the commissioner may adjust the 192.29rates for each service affected by rate changes 192.30under this section in such a manner across 192.31the fiscal year to achieve the necessary cost 192.32savings and minimize disruption to service 192.33providers, notwithstanding the requirements 192.34of Laws 2007, chapter 147, article 7, section 192.3571. 192.36 (d) General Assistance Medical Care Grants -0- (6,971,000) 193.1 (e) Other Health Care Grants -0- (17,000) 193.2MinnesotaCare Outreach Grants Special 193.3Revenue Account. The balance in the 193.4MinnesotaCare outreach grants special 193.5revenue account on July 1, 2009, estimated 193.6to be $900,000, must be transferred to the 193.7general fund. 193.8Grants Reduction. Effective July 1, 2008, 193.9base level funding for nonforecast, general 193.10fund health care grants issued under this 193.11paragraph shall be reduced by 1.8 percent at 193.12the allotment level. 193.13    Sec. 108. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 193.146, is amended to read: 193.15 Subd. 6.Health Care Grants 193.16 (a) MinnesotaCare Grants 998,000 (13,376,000) 193.17This appropriation is from the health care 193.18access fund. 193.19Health Care Access Fund Transfer to 193.20General Fund. The commissioner of 193.21management and budget shall transfer the 193.22following amounts in the following years 193.23from the health care access fund to the 193.24general fund: $998,000 new text begin $0 new text end in fiscal year 193.252010; $176,704,000 new text begin $59,901,000 new text end in fiscal 193.26year 2011; $141,041,000 in fiscal year 2012; 193.27and $286,150,000 in fiscal year 2013. If at 193.28any time the governor issues an executive 193.29order not to participate in early medical 193.30assistance expansion, no funds shall be 193.31transferred from the health care access 193.32fund to the general fund until early medical 193.33assistance expansion takes effect. This 194.1paragraph is effective the day following final 194.2enactment. 194.3MinnesotaCare Ratable Reduction. 194.4Effective for services rendered on or after 194.5July 1, 2010, to December 31, 2013, 194.6MinnesotaCare payments to managed care 194.7plans under Minnesota Statutes, section 194.8256L.12 , for single adults and households 194.9without children whose income is greater 194.10than 75 percent of federal poverty guidelines 194.11shall be reduced by 15 percent. Effective 194.12for services provided from July 1, 2010, to 194.13June 30, 2011, this reduction shall apply to 194.14all services. Effective for services provided 194.15from July 1, 2011, to December 31, 2013, this 194.16reduction shall apply to all services except 194.17inpatient hospital services. Notwithstanding 194.18any contrary provision of this article, this 194.19paragraph shall expire on December 31, 194.202013. 194.21 194.22 (b) Medical Assistance Basic Health Care Grants - Families and Children -0- 295,512,000 194.23Critical Access Dental. Of the general 194.24fund appropriation, $731,000 in fiscal year 194.252011 is to the commissioner for critical 194.26access dental provider reimbursement 194.27payments under Minnesota Statutes, section 194.28256B.76 subdivision 4. This is a onetime 194.29appropriation. 194.30Nonadministrative Rate Reduction. For 194.31services rendered on or after July 1, 2010, 194.32to December 31, 2013, the commissioner 194.33shall reduce contract rates paid to managed 194.34care plans under Minnesota Statutes, 194.35sections 256B.69 and 256L.12, and to 194.36county-based purchasing plans under 195.1Minnesota Statutes, section 256B.692, by 195.2three percent of the contract rate attributable 195.3to nonadministrative services in effect on 195.4June 30, 2010. Notwithstanding any contrary 195.5provision in this article, this rider expires on 195.6December 31, 2013. 195.7 195.8 (c) Medical Assistance Basic Health Care Grants - Elderly and Disabled -0- (30,265,000) 195.9 195.10 (d) General Assistance Medical Care Grants -0- (75,389,000) new text begin (59,583,000) new text end 195.11 new text begin The reduction to general assistance medical new text end 195.12 new text begin care grants is contingent upon the effective new text end 195.13 new text begin date in Laws 2010, First Special Session new text end 195.14 new text begin chapter 1, article 16, section 48. The new text end 195.15 new text begin reduction shall be reestimated based upon new text end 195.16 new text begin the actual effective date of the law. The new text end 195.17 new text begin commissioner of management and budget new text end 195.18 new text begin shall make adjustments in fiscal year new text end 195.19 new text begin 2011 to general assistance medical care new text end 195.20 new text begin appropriations to conform to the total new text end 195.21 new text begin expected expenditure reductions specified in new text end 195.22 new text begin this section. new text end 195.23 (e) Other Health Care Grants -0- (7,000,000) 195.24Cobra Carryforward. Unexpended funds 195.25appropriated in fiscal year 2010 for COBRA 195.26grants under Laws 2009, chapter 79, article 195.275, section 78, do not cancel and are available 195.28to the commissioner for fiscal year 2011 195.29COBRA grant expenditures. Up to $111,000 195.30of the fiscal year 2011 appropriation for 195.31COBRA grants provided in Laws 2009, 195.32chapter 79, article 13, section 3, subdivision 195.336, may be used by the commissioner for costs 195.34related to administration of the COBRA 195.35grants. 196.1    Sec. 109. new text begin COMMISSIONER'S ACTIONS; REPEAL OF EARLY MEDICAL new text end 196.2 new text begin ASSISTANCE EXPANSION. new text end 196.3     new text begin Effective January 1, 2012, the commissioner of human services shall suspend new text end 196.4 new text begin implementation and administration of Minnesota Statutes 2010, sections 256B.055, new text end 196.5 new text begin subdivision 15; 256B.056, subdivision 3, paragraph (b); and 256B.056, subdivision 4, new text end 196.6 new text begin paragraph (d). The commissioner shall refer persons enrolled under these provisions, and new text end 196.7 new text begin applicants for coverage under these provisions, to the general assistance medical care new text end 196.8 new text begin program established under Minnesota Statutes, section 256D.031. new text end 196.9    Sec. 110. new text begin GENERAL ASSISTANCE MEDICAL CARE PROGRAM; new text end 196.10 new text begin PROVISIONS REVIVED. new text end 196.11     new text begin Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter new text end 196.12 new text begin 1, article 16, section 47, the following statutes are revived and have the force of law new text end 196.13 new text begin effective January 1, 2012: new text end 196.14     new text begin (1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 6, 7, and 8; new text end 196.15     new text begin (2) Minnesota Statutes 2010, section 256D.031, subdivisions 1, 2, 3, 4, 6, 7, and new text end 196.16 new text begin 10; and new text end 196.17     new text begin (3) Laws 2010, chapter 200, article 1, section 18. new text end 196.18    Sec. 111. new text begin PLAN TO COORDINATE CARE FOR CHILDREN WITH new text end 196.19 new text begin HIGH-COST MENTAL HEALTH CONDITIONS. new text end 196.20 new text begin The commissioner of human services shall develop and submit to the legislature new text end 196.21 new text begin by December 15, 2011, a plan to provide care coordination to medical assistance and new text end 196.22 new text begin MinnesotaCare enrollees who are children with high-cost mental health conditions. For new text end 196.23 new text begin purposes of this section, a child has a "high-cost mental health condition" if mental health new text end 196.24 new text begin and medical expenses over the past year totalled $100,000 or more. For purposes of this new text end 196.25 new text begin section, "care coordination" means collaboration between an advanced practice nurse and new text end 196.26 new text begin primary care physicians and specialists to manage care; development of mental health new text end 196.27 new text begin management plans for recurrent mental health issues; oversight and coordination of all new text end 196.28 new text begin aspects of care in partnership with families; organization of medical, treatment, and new text end 196.29 new text begin therapy information into a summary of critical information; coordination and appropriate new text end 196.30 new text begin sequencing of evaluations and multiple appointments; information and assistance with new text end 196.31 new text begin accessing resources; and telephone triage for behavior or other problems. new text end 196.32    Sec. 112. new text begin DATA ON CLAIMS AND UTILIZATION. new text end 197.1 new text begin The commissioner of human services, in consultation with the Health and Human new text end 197.2 new text begin Services Reform Committee, shall develop and provide to the legislature by December 15, new text end 197.3 new text begin 2011, a methodology and any draft legislation necessary to allow for the release, upon new text end 197.4 new text begin request, of summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, new text end 197.5 new text begin on claims and utilization for medical assistance, general assistance medical care, and new text end 197.6 new text begin MinnesotaCare enrollees at no charge to the University of Minnesota Medical School, the new text end 197.7 new text begin Mayo Medical School, Northwestern Health Sciences University, the Institute for Clinical new text end 197.8 new text begin Systems Improvement, and other research institutions to conduct analyses of health care new text end 197.9 new text begin outcomes and treatment effectiveness, provided the research institutions do not release new text end 197.10 new text begin private or nonpublic data or data for which dissemination is prohibited by law. new text end 197.11    Sec. 113. new text begin REDUCTION OF STATE-MANDATED ADMINISTRATIVE new text end 197.12 new text begin REPORTS. new text end 197.13 new text begin (a) The commissioner of management and budget shall convene a report reduction new text end 197.14 new text begin working group of persons designated by the commissioners of health, human services, and new text end 197.15 new text begin commerce to eliminate redundant, unnecessary, obsolete, and low-priority state-mandated new text end 197.16 new text begin administrative reports required of health plans and county-based purchasing plans new text end 197.17 new text begin that serve persons enrolled in Minnesota health care programs. The commissioner of new text end 197.18 new text begin management and budget and the report reduction working group shall develop a plan to new text end 197.19 new text begin oversee the report reduction activities of the individual state agencies and coordinate the new text end 197.20 new text begin activities of multiple state agencies to consolidate reports or eliminate redundant reports new text end 197.21 new text begin required by more than one state agency on the same or a similar topic. new text end 197.22 new text begin (b) The commissioners of health, human services, and commerce shall reduce, new text end 197.23 new text begin eliminate, or consolidate state-mandated reports according to the plan developed by the new text end 197.24 new text begin commissioner of management and budget through the report reduction working group. new text end 197.25 new text begin In addition to other report reduction actions the commissioners or the working group new text end 197.26 new text begin may undertake, the commissioners shall: new text end 197.27 new text begin (1) collect encounter data, including provider payment data if collected, in a new text end 197.28 new text begin consolidated report provided to a single state agency, with the data collected by that state new text end 197.29 new text begin agency to be shared with other state agencies who need the data; new text end 197.30 new text begin (2) collect only one provider network report annually through a single state agency, new text end 197.31 new text begin with the data collected by that state agency to be shared with other state agencies who new text end 197.32 new text begin need the data; new text end 197.33 new text begin (3) collect only one standard financial report through a single state agency, with new text end 197.34 new text begin the data collected by that state agency to be shared with other state agencies who need new text end 197.35 new text begin the data. Data collected must be of a nature and in a format to allow comparison of the new text end 198.1 new text begin cost-effectiveness of fee-for-service payment systems and prepaid programs administered new text end 198.2 new text begin by health plans and county-based purchasing plans; new text end 198.3 new text begin (4) consolidate and simplify reports and documentation requirements relating to new text end 198.4 new text begin member communications and marketing materials, and establish a single review process new text end 198.5 new text begin for all programs, products, and agencies in order to ensure uniform and consistent new text end 198.6 new text begin regulation of health plan contracts; new text end 198.7 new text begin (5) consolidate state regulation and oversight of health plans and county-based new text end 198.8 new text begin purchasing plans so that activities of multiple agencies are administered through an new text end 198.9 new text begin efficient and uniform multiagency process of oversight and audits, with consistent new text end 198.10 new text begin standards, measures, and definitions for state oversight of quality, utilization management, new text end 198.11 new text begin care management, delegation accountability, access to care, appeals and grievances, and new text end 198.12 new text begin financial management; new text end 198.13 new text begin (6) establish uniform requirements and procedures for denial, termination, or new text end 198.14 new text begin reduction of services and member appeals and grievances, and align state requirements new text end 198.15 new text begin and procedures with federal requirements and procedures; and new text end 198.16 new text begin (7) reform the state's performance improvement projects, requirements, and new text end 198.17 new text begin procedures to be more flexible and efficient, and to place greater focus on measuring new text end 198.18 new text begin improvement of outcomes and less on mandating detailed or prescriptive requirements for new text end 198.19 new text begin specific performance improvement projects or activities. new text end 198.20 new text begin (d) New reporting requirements or ad hoc report requests shall be established by a new text end 198.21 new text begin state agency only: new text end 198.22 new text begin (1) if required by a federal agency; new text end 198.23 new text begin (2) if needed for a state regulatory audit or corrective action plan; or new text end 198.24 new text begin (3) after the completion of a review and analysis, and the development of new text end 198.25 new text begin recommendations by the commissioner of management and budget, in consultation new text end 198.26 new text begin with the report reduction working group, regarding the necessity, importance, and new text end 198.27 new text begin administrative cost of the new report, and after completing a review to determine new text end 198.28 new text begin whether the information sought can be obtained through another available state or federal new text end 198.29 new text begin report. The results of the review, analysis, and recommendations of the commissioner of new text end 198.30 new text begin management and budget must be provided to health plans and county-based purchasing new text end 198.31 new text begin plans for review and comment at least 60 days before a new report or requirement is new text end 198.32 new text begin established. new text end 198.33 new text begin (e) To the extent possible, all state agencies shall use the procedures, reports, new text end 198.34 new text begin and audits of the Centers for Medicare and Medicaid Services instead of requiring an new text end 198.35 new text begin additional state-mandated report on the same or a similar topic. new text end 199.1 new text begin (f) By January 15, 2012, the commissioner of management and budget shall provide new text end 199.2 new text begin a report on the activities and results of the report reduction project to the legislature. new text end 199.3 new text begin The report must include: new text end 199.4 new text begin (1) a timetable for report reduction actions already taken or planned by the new text end 199.5 new text begin commissioners or the report reduction working group; new text end 199.6 new text begin (2) the specific reports that have been or will be eliminated or consolidated; new text end 199.7 new text begin (3) the amount of money that will be saved through reductions in administrative new text end 199.8 new text begin costs of health plans and county-based purchasing plans as a result of the report reduction new text end 199.9 new text begin project; and new text end 199.10 new text begin (4) proposed legislation for changes to laws or rules that are needed to allow state new text end 199.11 new text begin agencies to further reduce, consolidate, or eliminate reports when the changes cannot new text end 199.12 new text begin be made administratively. new text end 199.13    Sec. 114. new text begin COMPETITIVE BIDDING PILOT. new text end 199.14 new text begin For managed care contracts effective January 1, 2012, the commissioner of new text end 199.15 new text begin human services is required to establish a competitive price bidding pilot for nonelderly, new text end 199.16 new text begin nondisabled adults and children in medical assistance and MinnesotaCare in the new text end 199.17 new text begin seven-county metropolitan area. The pilot must allow a minimum of two managed care new text end 199.18 new text begin organizations to serve the metropolitan area. The pilot shall expire after two full calendar new text end 199.19 new text begin years on December 31, 2013. The commissioner of human service shall conduct an new text end 199.20 new text begin evaluation of the pilot to determine the cost-effectiveness and impacts to provider access at new text end 199.21 new text begin the end of the two-year period. The commissioner must consult with other states that have new text end 199.22 new text begin experience implementing competitive bidding in their medical assistance population and new text end 199.23 new text begin incorporate best practices from those states in designing this pilot. The commissioner, prior new text end 199.24 new text begin to implementation, must also consult with stakeholders on the design and implementation new text end 199.25 new text begin of the pilot, including providers, plans, advocacy groups, and other interested parties. new text end 199.26    Sec. 115. new text begin REQUEST FOR PROPOSAL; PROVIDER BILLING PATTERNS. new text end 199.27 new text begin (a) The commissioner of human services shall issue a request for proposal, using new text end 199.28 new text begin existing resources, to identify abnormal provider billing patterns in order to prevent and new text end 199.29 new text begin identify improper medical assistance payments. new text end 199.30 new text begin (b) The request for proposal must include the following requirements for the new text end 199.31 new text begin contractor: new text end 199.32 new text begin (1) identification and reporting of improper claims, outlier claims, and improper new text end 199.33 new text begin payments, both prior to and subsequent to reimbursement; new text end 200.1 new text begin (2) utilization of fraud detection methods that maximize contemporary predictive new text end 200.2 new text begin analytic tools, including but not limited to identity analytics, link analysis, and matching new text end 200.3 new text begin capabilities; new text end 200.4 new text begin (3) utilization of data analytics that improve fraud detection through the identification new text end 200.5 new text begin of outlier reimbursement; new text end 200.6 new text begin (4) reduction in state expenditures by reducing or eliminating payouts of improper new text end 200.7 new text begin medical assistance claims; and new text end 200.8 new text begin (5) demonstrated success with other states and state agencies using the specified new text end 200.9 new text begin proposed solution, deployment, and implementation. new text end 200.10 new text begin (c) The commissioner shall enter into a contract for the services in this section by new text end 200.11 new text begin October 1, 2011. The contract must incorporate a performance-based vendor financing new text end 200.12 new text begin mechanism under which the vendor shares in the risk of the project's success. new text end 200.13    Sec. 116. new text begin HEALTH SERVICES POLICY COMMITTEE STUDIES. new text end 200.14 new text begin (a) The commissioner of human services, through the health services policy new text end 200.15 new text begin committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall new text end 200.16 new text begin identify and review medical assistance services provided by health care professionals who new text end 200.17 new text begin are not trained to provide the services in a high-quality manner. The commissioner shall new text end 200.18 new text begin develop a process to limit payment for medical assistance services to providers who are new text end 200.19 new text begin not appropriately trained to provide the service, and shall present recommendations and new text end 200.20 new text begin draft legislation by January 15, 2012, to the legislature. new text end 200.21 new text begin (b) The commissioner of human services, through the health services policy new text end 200.22 new text begin committee established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall new text end 200.23 new text begin study the effectiveness of new strategies for wound care treatment for medical assistance new text end 200.24 new text begin and MinnesotaCare enrollees with diabetes, including but not limited to the use of new new text end 200.25 new text begin wound care technologies, assessment tools, and reporting programs. The commissioner new text end 200.26 new text begin shall present recommendations by December 15, 2011, to the legislature on whether these new text end 200.27 new text begin new strategies for wound care treatment should be covered under medical assistance new text end 200.28 new text begin and MinnesotaCare. new text end 200.29    Sec. 117. new text begin SPECIALIZED MAINTENANCE THERAPY. new text end 200.30 new text begin The commissioner of human services shall evaluate whether providing medical new text end 200.31 new text begin assistance coverage for specialized maintenance therapy for enrollees with serious and new text end 200.32 new text begin persistent mental illness who are at risk of hospitalization will improve the quality of new text end 200.33 new text begin care and lower medical assistance spending by reducing rates of hospitalization. The new text end 200.34 new text begin commissioner shall present findings and recommendations to the chairs and ranking new text end 201.1 new text begin minority members of the legislative committees with jurisdiction over health and human new text end 201.2 new text begin services finance and policy by December 15, 2011. new text end 201.3    Sec. 118. new text begin COVERAGE FOR LOWER-INCOME MINNESOTACARE new text end 201.4 new text begin ENROLLEES. new text end 201.5 new text begin The commissioner of human services shall develop and present to the legislature, new text end 201.6 new text begin by December 15, 2011, a plan to redesign service delivery for MinnesotaCare enrollees new text end 201.7 new text begin eligible under Minnesota Statutes, section 256L.04, subdivisions 1 and 7, with incomes new text end 201.8 new text begin less than 133 percent of the federal poverty guidelines. The plan must be designed to new text end 201.9 new text begin improve continuity and quality of care, reduce unnecessary emergency room visits, and new text end 201.10 new text begin reduce average per-enrollee costs. In developing the plan, the commissioner shall consider new text end 201.11 new text begin innovative methods of service delivery, including but not limited to increasing the use new text end 201.12 new text begin and choice of private sector health plan coverage and encouraging the use of community new text end 201.13 new text begin health clinics, as defined in the federal Community Health Care Act of 1964, as health new text end 201.14 new text begin care homes. new text end 201.15    Sec. 119. new text begin DIRECTION TO COMMISSIONER; FEDERAL WAIVERS. new text end 201.16 new text begin (a) The commissioner of human services shall apply to the Centers for Medicare new text end 201.17 new text begin and Medicaid Services (CMS) for federal waivers to cover: new text end 201.18 new text begin (1) families with children eligible under Minnesota Statutes, section 256L.04, new text end 201.19 new text begin subdivision 1; and new text end 201.20 new text begin (2) adults eligible under Minnesota Statutes, section 256L.04, subdivision 1, new text end 201.21 new text begin under the MinnesotaCare healthy Minnesota contribution program established under new text end 201.22 new text begin Minnesota Statutes, section 256L.031, by July 1, 2011. The commissioner shall report to new text end 201.23 new text begin the legislative committees with jurisdiction over health and human services policy and new text end 201.24 new text begin finance whether or not the federal waiver application was accepted within ten working new text end 201.25 new text begin days of receipt of the decision. new text end 201.26 new text begin (b) The commissioner of human services shall apply to the CMS for a section new text end 201.27 new text begin 1115(a) demonstration waiver, and any other necessary federal waivers and amendments, new text end 201.28 new text begin including, but not limited to, a waiver of the appropriate sections of title XIX, United new text end 201.29 new text begin States Code, title 42, section 1396a, and a waiver of any applicable federal maintenance of new text end 201.30 new text begin effort provisions that would provide Minnesota with medical assistance program flexibility new text end 201.31 new text begin in exchange for federal budget certainty. The commissioner shall seek federal approval to new text end 201.32 new text begin enter into an agreement with CMS under which Minnesota would: new text end 202.1 new text begin (1) accept an aggregate annual allotment for the medical assistance program, trended new text end 202.2 new text begin forward at an agreed upon rate, with protections to cover medical inflation and projected new text end 202.3 new text begin caseload growth; and new text end 202.4 new text begin (2) receive federal waivers of Medicaid requirements related to: statewideness and new text end 202.5 new text begin comparability of services; the amount, duration, and scope of services; freedom of choice; new text end 202.6 new text begin cost-sharing; and other areas of program administration specified by the commissioner. new text end 202.7 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 202.8    Sec. 120. new text begin TRANSPARENCY AND QUALITY REPORTING FOR PUBLIC new text end 202.9 new text begin HEALTH CARE PROGRAMS. new text end 202.10 new text begin When negotiating with external vendors to provide managed care services, the new text end 202.11 new text begin commissioner of human services shall require use of an advanced request for information new text end 202.12 new text begin tool. This tool must provide the department with an evidence-based assessment that new text end 202.13 new text begin focuses on the cost control, quality, and information transparency of the health care new text end 202.14 new text begin vendor. The assessment may include evidence-based performance measures that have new text end 202.15 new text begin been shown to influence better health, better health care, and more cost-effective use of new text end 202.16 new text begin resources including, but not limited to, areas that determine each plan's capabilities and new text end 202.17 new text begin performance with respect to: new text end 202.18 new text begin (1) consumer engagement, support, and incentives; new text end 202.19 new text begin (2) processes and outcomes for closing gaps in care according to clinical guideline new text end 202.20 new text begin expectations; new text end 202.21 new text begin (3) provider management, including outcome and population-based reimbursement, new text end 202.22 new text begin transparent measurement of provider performance, and support of physician practice new text end 202.23 new text begin structures that lead to better care; and new text end 202.24 new text begin (4) measures of clinical outcomes and waste approved by the National Quality new text end 202.25 new text begin Forum. new text end 202.26    Sec. 121. new text begin RISK CORRIDORS. new text end 202.27 new text begin (a) Effective for services rendered on or after January 1, 2012, the commissioner new text end 202.28 new text begin shall establish risk corridors for state public programs that are actuarially sound for each new text end 202.29 new text begin managed care plan and each county-based purchasing plan. The risk corridors will be new text end 202.30 new text begin calculated annually based on the calendar year's net underwriting gain or loss. If the new text end 202.31 new text begin managed care plan or county-based purchasing plan has achieved a net underwriting gain new text end 202.32 new text begin of greater than three percent of revenue, 80 percent of any excess must be repaid to the new text end 202.33 new text begin commissioner by July 31 of the year following calculation of the risk corridor year, and new text end 202.34 new text begin 20 percent must be invested by the plan directly into programs for improving quality of new text end 203.1 new text begin care or access to care for state public health care program enrollees. If the managed new text end 203.2 new text begin care plan or county-based purchasing plan has incurred a net underwriting loss greater new text end 203.3 new text begin than three percent of total revenue, 50 percent of any excess must be repaid to the plan new text end 203.4 new text begin by the commissioner by July 31 of the year following calculation of the risk corridor new text end 203.5 new text begin year. Determination of total revenues and net underwriting gain or loss must be based new text end 203.6 new text begin on the Minnesota Supplement Report #1 which is filed on April 1 of the year following new text end 203.7 new text begin calculation of the risk corridor and adjusted for the actual withhold calculation under new text end 203.8 new text begin sections 256B.69, subdivision 5a, and 256L.12, subdivision 9. The report must be filed new text end 203.9 new text begin with and publicly disclosed by the Department of Health. new text end 203.10 new text begin (b) For purposes of this section, "state public programs" means those prepaid new text end 203.11 new text begin medical assistance and MinnesotaCare programs for which a managed care plan or new text end 203.12 new text begin county-based purchasing plan contracts with the commissioner to provide coverage under new text end 203.13 new text begin sections 256B.69, 256B.692, and 256L.12. The risk corridors shall not apply to plans for new text end 203.14 new text begin persons who are enrolled in integrated Medicare and medical assistance programs under new text end 203.15 new text begin section 256B.69, subdivisions 23 and 28. new text end 203.16 new text begin (c) This section expires January 1, 2014. new text end 203.17    Sec. 122. new text begin REPEALER. new text end 203.18 new text begin (a) new text end new text begin Minnesota Statutes 2010, section 62J.07, subdivisions 1, 2, and 3, new text end new text begin ( new text end new text begin Legislative new text end 203.19 new text begin Commission on Health Care Access new text end new text begin ) are repealed. new text end 203.20 new text begin (b) new text end new text begin Laws 2009, chapter 79, article 5, section 64, new text end new text begin ( new text end new text begin 256L.07, subdivision 2 new text end new text begin ) is repealed new text end 203.21 new text begin retroactively from July 1, 2009, and federal approval is no longer necessary. new text end 203.22 new text begin (c) new text end new text begin Laws 2009, chapter 79, article 5, section 65, new text end new text begin ( new text end new text begin 256L.07, subdivision 3 new text end new text begin ) is repealed new text end 203.23 new text begin retroactively from July 1, 2009, and federal approval is no longer necessary. new text end 203.24 new text begin (d) new text end new text begin Laws 2009, chapter 79, article 5, section 68, new text end new text begin ( new text end new text begin 256L.15, subdivision 2, exemption new text end 203.25 new text begin of low-income children from MinnesotaCare premiums and insurance barriers new text end new text begin ) is new text end 203.26 new text begin repealed retroactively from July 1, 2009, and federal approval is no longer necessary. new text end 203.27 new text begin (e) new text end new text begin Minnesota Statutes 2010, section 256L.07, subdivision 7, new text end new text begin exempting eligibility new text end 203.28 new text begin for children formally under medical assistance new text end new text begin , is repealed retroactively from October new text end 203.29 new text begin 1, 2008, and federal approval is no longer necessary. new text end 203.30 new text begin (f) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 55, as amended by new text end 203.31 new text begin Laws 2009, chapter 173, article 1, section 36, new text end new text begin ( new text end new text begin 256L.04, subdivision 1, children deemed new text end 203.32 new text begin eligible are exempt from eligibility requirements new text end new text begin ) is repealed retroactively from January new text end 203.33 new text begin 1, 2009, and federal approval is no longer necessary. new text end 204.1 new text begin (g) new text end new text begin Laws 2009, chapter 79, article 5, section 56, new text end new text begin ( new text end new text begin 256L.04, subdivision 1b, new text end 204.2 new text begin exemption from income limit for children new text end new text begin ) is repealed retroactively from July 1, 2009, new text end 204.3 new text begin and federal approval is no longer necessary. new text end 204.4 new text begin (h) new text end new text begin Laws 2009, chapter 79, article 5, section 60, new text end new text begin ( new text end new text begin 256L.05, subdivision 1c, open new text end 204.5 new text begin enrollment and streamlined application new text end new text begin ) is repealed retroactively from July 1, 2009, new text end 204.6 new text begin and federal approval is no longer necessary. new text end 204.7 new text begin (i) new text end new text begin Laws 2009, chapter 79, article 5, section 66, new text end new text begin ( new text end new text begin 256L.07, subdivision 8, automatic new text end 204.8 new text begin eligibility certain children new text end new text begin ) is repealed retroactively from July 1, 2009, and federal new text end 204.9 new text begin approval is no longer necessary. new text end 204.10 new text begin (j) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 57, new text end new text begin ( new text end new text begin 256L.04, new text end 204.11 new text begin subdivision 7a, ineligibility for adults with certain income new text end new text begin ) is repealed retroactively new text end 204.12 new text begin from July 1, 2009, and federal approval is no longer necessary. new text end 204.13 new text begin (k) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 61, new text end new text begin ( new text end new text begin 256L.05, new text end 204.14 new text begin subdivision 3, children eligibility following termination from foster care new text end new text begin ) is repealed new text end 204.15 new text begin retroactively from July 1, 2009, and federal approval is no longer necessary. new text end 204.16 new text begin (l) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 62, new text end new text begin ( new text end new text begin 256L.05, new text end 204.17 new text begin subdivision 3a, exemption from cancellation for nonrenewal for children new text end new text begin ) is repealed new text end 204.18 new text begin retroactively from July 1, 2009, and federal approval is no longer necessary. new text end 204.19 new text begin (m) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 63, new text end new text begin ( new text end new text begin 256L.07, new text end 204.20 new text begin subdivision 1, children whose gross family income is greater than 275 percent FPG new text end 204.21 new text begin may remain enrolled new text end new text begin ) is repealed retroactively from July 1, 2009, and federal approval is new text end 204.22 new text begin no longer necessary. new text end 204.23 new text begin (n) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 64, new text end new text begin ( new text end new text begin 256L.07, new text end 204.24 new text begin subdivision 2, exempts children from requirement not to have employer-subsidized new text end 204.25 new text begin coverage new text end new text begin ) is repealed retroactively from July 1, 2009, and federal approval is no longer new text end 204.26 new text begin necessary. new text end 204.27 new text begin (o) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 65, new text end new text begin ( new text end new text begin 256L.07, new text end 204.28 new text begin subdivision 3, requires children with family gross income over 200 percent of FPG new text end 204.29 new text begin to have had no health coverage for four months prior to application new text end new text begin ) is repealed new text end 204.30 new text begin retroactively from July 1, 2009, and federal approval is no longer necessary. new text end 204.31 new text begin (p) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 68, new text end new text begin ( new text end new text begin 256L.15, new text end 204.32 new text begin subdivision 2, children in families with income less than 200 percent FPG pay no new text end 204.33 new text begin premium new text end new text begin ) is repealed retroactively from July 1, 2009, and federal approval is no longer new text end 204.34 new text begin necessary. new text end 204.35 new text begin (q) The amendment in new text end new text begin Laws 2009, chapter 79, article 5, section 69, new text end new text begin ( new text end new text begin 256L.15, new text end 204.36 new text begin subdivision 3, exempts children with family income below 200 percent FPG from new text end 205.1 new text begin sliding fee scale new text end new text begin ) is repealed retroactively from July 1, 2009, and federal approval is new text end 205.2 new text begin no longer necessary. new text end 205.3 new text begin (r) new text end new text begin Laws 2009, chapter 79, article 5, section 79, new text end new text begin ( new text end new text begin uncoded federal approval new text end new text begin ) is new text end 205.4 new text begin repealed the day following final enactment. new text end 205.5 new text begin (s) new text end new text begin Minnesota Statutes 2010, section 256B.057, subdivision 2c, new text end new text begin ( new text end new text begin extended medical new text end 205.6 new text begin assistance for certain children new text end new text begin ) is repealed. new text end 205.7 new text begin (t) The amendments in new text end new text begin Laws 2008, chapter 358, article 3, sections 8; and 9, new text end new text begin ( new text end new text begin renewal new text end 205.8 new text begin rolling month and premium grace month new text end new text begin ) are repealed. new text end 205.9    Sec. 123. new text begin REPEALER; EARLY MEDICAL ASSISTANCE EXPANSION. new text end 205.10 new text begin Minnesota Statutes 2010, section 256B.055, subdivision 15, new text end new text begin is repealed January new text end 205.11 new text begin 1, 2012. new text end 205.12ARTICLE 6 205.13CONTINUING CARE 205.14    Section 1. Minnesota Statutes 2010, section 144A.071, is amended by adding a 205.15subdivision to read: 205.16     new text begin Subd. 4d. new text end new text begin Consolidation of nursing facilities. new text end new text begin (a) The commissioner of health, new text end 205.17 new text begin in consultation with the commissioner of human services, may approve a request for new text end 205.18 new text begin consolidation of nursing facilities which includes the closure of one or more facilities new text end 205.19 new text begin and the upgrading of the physical plant of the remaining nursing facility or facilities, new text end 205.20 new text begin the costs of which exceed the threshold project limit under subdivision 2, clause (a). new text end 205.21 new text begin The commissioners shall consider the criteria in this section, section 144A.073, and new text end 205.22 new text begin section 256B.437, in approving or rejecting a consolidation proposal. In the event the new text end 205.23 new text begin commissioners approve the request, the commissioner of human services shall calculate a new text end 205.24 new text begin property rate adjustment according to clauses (1) to (3): new text end 205.25 new text begin (1) the closure of beds shall not be eligible for a planned closure rate adjustment new text end 205.26 new text begin under section 256B.437, subdivision 6; new text end 205.27 new text begin (2) the construction project permitted in this clause shall not be eligible for a new text end 205.28 new text begin threshold project rate adjustment under section 256B.434, subdivision 4f, or a moratorium new text end 205.29 new text begin exception adjustment under section 144A.073; and new text end 205.30 new text begin (3) the property payment rate for a remaining facility or facilities shall be increased new text end 205.31 new text begin by an amount equal to 65 percent of the projected net cost savings to the state calculated in new text end 205.32 new text begin paragraph (b), divided by the state's medical assistance percentage of medical assistance new text end 205.33 new text begin dollars, and then divided by estimated medical assistance resident days, as determined in new text end 205.34 new text begin paragraph (c), of the remaining nursing facility or facilities in the request in this paragraph. new text end 206.1 new text begin (b) For purposes of calculating the net cost savings to the state, the commissioner new text end 206.2 new text begin shall consider clauses (1) to (7): new text end 206.3 new text begin (1) the annual savings from estimated medical assistance payments from the net new text end 206.4 new text begin number of beds closed taking into consideration only beds that are in active service on the new text end 206.5 new text begin date of the request and that have been in active service for at least three years; new text end 206.6 new text begin (2) the estimated annual cost of increased case load of individuals receiving services new text end 206.7 new text begin under the elderly waiver; new text end 206.8 new text begin (3) the estimated annual cost of elderly waiver recipients receiving support under new text end 206.9 new text begin group residential housing; new text end 206.10 new text begin (4) the estimated annual cost of increased case load of individuals receiving services new text end 206.11 new text begin under the alternative care program; new text end 206.12 new text begin (5) the annual loss of license surcharge payments on closed beds; new text end 206.13 new text begin (6) the savings from not paying planned closure rate adjustments that the facilities new text end 206.14 new text begin would otherwise be eligible for under section 256B.437; and new text end 206.15 new text begin (7) the savings from not paying property payment rate adjustments from submission new text end 206.16 new text begin of renovation costs that would otherwise be eligible as threshold projects under section new text end 206.17 new text begin 256B.434, subdivision 4f. new text end 206.18 new text begin (c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical new text end 206.19 new text begin assistance resident days of the remaining facility or facilities shall be computed assuming new text end 206.20 new text begin 95 percent occupancy multiplied by the historical percentage of medical assistance new text end 206.21 new text begin resident days of the remaining facility or facilities, as reported on the facility's or facilities' new text end 206.22 new text begin most recent nursing facility statistical and cost report filed before the plan of closure new text end 206.23 new text begin is submitted, multiplied by 365. new text end 206.24 new text begin (d) For purposes of net cost of savings to the state in paragraph (b), the average new text end 206.25 new text begin occupancy percentages will be those reported on the facility's or facilities' most recent new text end 206.26 new text begin nursing facility statistical and cost report filed before the plan of closure is submitted, and new text end 206.27 new text begin the average payment rates shall be calculated based on the approved payment rates in new text end 206.28 new text begin effect at the time the consolidation request is submitted. new text end 206.29 new text begin (e) To qualify for the property payment rate adjustment under this provision, the new text end 206.30 new text begin closing facilities shall: new text end 206.31 new text begin (1) submit an application for closure according to section 256B.437, subdivision new text end 206.32 new text begin 3; and new text end 206.33 new text begin (2) follow the resident relocation provisions of section 144A.161. new text end 206.34 new text begin (f) The county or counties in which a facility or facilities are closed under this new text end 206.35 new text begin subdivision shall not be eligible for designation as a hardship area under section 144A.071, new text end 206.36 new text begin subdivision 3, for five years from the date of the approval of the proposed consolidation. new text end 207.1 new text begin The applicant shall notify the county of this limitation and the county shall acknowledge new text end 207.2 new text begin this in a letter of support. new text end 207.3    Sec. 2. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read: 207.4    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 207.5child, including a child determined eligible for medical assistance without consideration of 207.6parental income, must contribute to the cost of services used by making monthly payments 207.7on a sliding scale based on income, unless the child is married or has been married, 207.8parental rights have been terminated, or the child's adoption is subsidized according to 207.9section 259.67 or through title IV-E of the Social Security Act. The parental contribution 207.10is a partial or full payment for medical services provided for diagnostic, therapeutic, 207.11curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 207.12defined in United States Code, title 26, section 213, needed by the child with a chronic 207.13illness or disability. 207.14    (b) For households with adjusted gross income equal to or greater than 100 percent 207.15of federal poverty guidelines, the parental contribution shall be computed by applying the 207.16following schedule of rates to the adjusted gross income of the natural or adoptive parents: 207.17    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 207.18poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 207.19contribution is $4 per month; 207.20    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 207.21poverty guidelines and less than or equal to 545 new text begin 525 new text end percent of federal poverty guidelines, 207.22the parental contribution shall be determined using a sliding fee scale established by the 207.23commissioner of human services which begins at one percent of adjusted gross income at 207.24175 percent of federal poverty guidelines and increases to 7.5 new text begin eight new text end percent of adjusted 207.25gross income for those with adjusted gross income up to 545 new text begin 525 new text end percent of federal 207.26poverty guidelines; 207.27    (3) if the adjusted gross income is greater than 545 new text begin 525 new text end percent of federal 207.28poverty guidelines and less than 675 percent of federal poverty guidelines, the parental 207.29contribution shall be 7.5 new text begin 9.5 new text end percent of adjusted gross income; 207.30    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 207.31poverty guidelines and less than 975 new text begin 900 new text end percent of federal poverty guidelines, the parental 207.32contribution shall be determined using a sliding fee scale established by the commissioner 207.33of human services which begins at 7.5 new text begin 9.5 new text end percent of adjusted gross income at 675 percent 207.34of federal poverty guidelines and increases to ten new text begin 12 new text end percent of adjusted gross income for 207.35those with adjusted gross income up to 975 new text begin 900 new text end percent of federal poverty guidelines; and 208.1    (5) if the adjusted gross income is equal to or greater than 975 new text begin 900 new text end percent of 208.2federal poverty guidelines, the parental contribution shall be 12.5 new text begin 13.5 new text end percent of adjusted 208.3gross income. 208.4    If the child lives with the parent, the annual adjusted gross income is reduced by 208.5$2,400 prior to calculating the parental contribution. If the child resides in an institution 208.6specified in section 256B.35, the parent is responsible for the personal needs allowance 208.7specified under that section in addition to the parental contribution determined under this 208.8section. The parental contribution is reduced by any amount required to be paid directly to 208.9the child pursuant to a court order, but only if actually paid. 208.10    (c) The household size to be used in determining the amount of contribution under 208.11paragraph (b) includes natural and adoptive parents and their dependents, including the 208.12child receiving services. Adjustments in the contribution amount due to annual changes 208.13in the federal poverty guidelines shall be implemented on the first day of July following 208.14publication of the changes. 208.15    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 208.16natural or adoptive parents determined according to the previous year's federal tax form, 208.17except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 208.18have been used to purchase a home shall not be counted as income. 208.19    (e) The contribution shall be explained in writing to the parents at the time eligibility 208.20for services is being determined. The contribution shall be made on a monthly basis 208.21effective with the first month in which the child receives services. Annually upon 208.22redetermination or at termination of eligibility, if the contribution exceeded the cost of 208.23services provided, the local agency or the state shall reimburse that excess amount to 208.24the parents, either by direct reimbursement if the parent is no longer required to pay a 208.25contribution, or by a reduction in or waiver of parental fees until the excess amount is 208.26exhausted. All reimbursements must include a notice that the amount reimbursed may be 208.27taxable income if the parent paid for the parent's fees through an employer's health care 208.28flexible spending account under the Internal Revenue Code, section 125, and that the 208.29parent is responsible for paying the taxes owed on the amount reimbursed. 208.30    (f) The monthly contribution amount must be reviewed at least every 12 months; 208.31when there is a change in household size; and when there is a loss of or gain in income 208.32from one month to another in excess of ten percent. The local agency shall mail a written 208.33notice 30 days in advance of the effective date of a change in the contribution amount. 208.34A decrease in the contribution amount is effective in the month that the parent verifies a 208.35reduction in income or change in household size. 209.1    (g) Parents of a minor child who do not live with each other shall each pay the 209.2contribution required under paragraph (a). An amount equal to the annual court-ordered 209.3child support payment actually paid on behalf of the child receiving services shall be 209.4deducted from the adjusted gross income of the parent making the payment prior to 209.5calculating the parental contribution under paragraph (b). 209.6    (h) The contribution under paragraph (b) shall be increased by an additional five 209.7percent if the local agency determines that insurance coverage is available but not 209.8obtained for the child. For purposes of this section, "available" means the insurance is a 209.9benefit of employment for a family member at an annual cost of no more than five percent 209.10of the family's annual income. For purposes of this section, "insurance" means health 209.11and accident insurance coverage, enrollment in a nonprofit health service plan, health 209.12maintenance organization, self-insured plan, or preferred provider organization. 209.13    Parents who have more than one child receiving services shall not be required 209.14to pay more than the amount for the child with the highest expenditures. There shall 209.15be no resource contribution from the parents. The parent shall not be required to pay 209.16a contribution in excess of the cost of the services provided to the child, not counting 209.17payments made to school districts for education-related services. Notice of an increase in 209.18fee payment must be given at least 30 days before the increased fee is due. 209.19    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 209.20in the 12 months prior to July 1: 209.21    (1) the parent applied for insurance for the child; 209.22    (2) the insurer denied insurance; 209.23    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 209.24a complaint or appeal, in writing, to the commissioner of health or the commissioner of 209.25commerce, or litigated the complaint or appeal; and 209.26    (4) as a result of the dispute, the insurer reversed its decision and granted insurance. 209.27    For purposes of this section, "insurance" has the meaning given in paragraph (h). 209.28    A parent who has requested a reduction in the contribution amount under this 209.29paragraph shall submit proof in the form and manner prescribed by the commissioner or 209.30county agency, including, but not limited to, the insurer's denial of insurance, the written 209.31letter or complaint of the parents, court documents, and the written response of the insurer 209.32approving insurance. The determinations of the commissioner or county agency under this 209.33paragraph are not rules subject to chapter 14. 209.34(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 209.352013, the parental contribution shall be computed by applying the following contribution 209.36schedule to the adjusted gross income of the natural or adoptive parents: 210.1(1) if the adjusted gross income is equal to or greater than 100 percent of federal 210.2poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 210.3contribution is $4 per month; 210.4(2) if the adjusted gross income is equal to or greater than 175 percent of federal 210.5poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, 210.6the parental contribution shall be determined using a sliding fee scale established by the 210.7commissioner of human services which begins at one percent of adjusted gross income 210.8at 175 percent of federal poverty guidelines and increases to eight percent of adjusted 210.9gross income for those with adjusted gross income up to 525 percent of federal poverty 210.10guidelines; 210.11(3) if the adjusted gross income is greater than 525 percent of federal poverty 210.12guidelines and less than 675 percent of federal poverty guidelines, the parental contribution 210.13shall be 9.5 percent of adjusted gross income; 210.14(4) if the adjusted gross income is equal to or greater than 675 percent of federal 210.15poverty guidelines and less than 900 percent of federal poverty guidelines, the parental 210.16contribution shall be determined using a sliding fee scale established by the commissioner 210.17of human services which begins at 9.5 percent of adjusted gross income at 675 percent of 210.18federal poverty guidelines and increases to 12 percent of adjusted gross income for those 210.19with adjusted gross income up to 900 percent of federal poverty guidelines; and 210.20(5) if the adjusted gross income is equal to or greater than 900 percent of federal 210.21poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross 210.22income. If the child lives with the parent, the annual adjusted gross income is reduced by 210.23$2,400 prior to calculating the parental contribution. If the child resides in an institution 210.24specified in section , the parent is responsible for the personal needs allowance 210.25specified under that section in addition to the parental contribution determined under this 210.26section. The parental contribution is reduced by any amount required to be paid directly to 210.27the child pursuant to a court order, but only if actually paid. 210.28    Sec. 3. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read: 210.29    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability 210.30Linkage Line, a new text begin to serve as Minnesota's neutral access point for new text end statewide consumer new text begin new text end 210.31 new text begin disability new text end information, referral, and assistance system for people with disabilities and 210.32chronic illnesses that new text begin . The Disability Linkage Line shall new text end : 210.33 new text begin (1) deliver information and assistance based on national and state standards; new text end 210.34    (1) provides new text begin (2) provide new text end information about state and federal eligibility requirements, 210.35benefits, and service options; 211.1 new text begin (3) provide benefits and options counseling; new text end 211.2    (2) makes new text begin (4) make new text end referrals to appropriate support entities; 211.3    (3) delivers information and assistance based on national and state standards; 211.4    (4) assists new text begin (5) educate new text end people to new text begin on their options so they can new text end make well-informed 211.5decisions new text begin choices new text end ; and 211.6    (5) supports new text begin (6) help support new text end the timely resolution of service access and benefit 211.7issues. new text begin ; new text end 211.8 new text begin (7) inform people of their long-term community services and supports; new text end 211.9 new text begin (8) provide necessary resources and supports that can lead to employment and new text end 211.10 new text begin increased economic stability of people with disabilities; and new text end 211.11 new text begin (9) serve as the technical assistance and help center for the Web-based tool, new text end 211.12 new text begin Minnesota's Disability Benefits 101.org. new text end 211.13 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 211.14    Sec. 4. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read: 211.15    Subd. 29. State medical review team. (a) To ensure the timely processing of 211.16determinations of disability by the commissioner's state medical review team under 211.17sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph 211.18(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence 211.19submitted by county agencies with a referral and seek additional information from 211.20providers, applicants, and enrollees to support the determination of disability where 211.21necessary. Disability shall be determined according to the rules of title XVI and title 211.22XIX of the Social Security Act and pertinent rules and policies of the Social Security 211.23Administration. 211.24    (b) Prior to a denial or withdrawal of a requested determination of disability due 211.25to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 211.26necessary and appropriate to a determination of disability, and (2) assist applicants and 211.27enrollees to obtain the evidence, including, but not limited to, medical examinations 211.28and electronic medical records. 211.29(c) The commissioner shall provide the chairs of the legislative committees with 211.30jurisdiction over health and human services finance and budget the following information 211.31on the activities of the state medical review team by February 1 of each year: 211.32(1) the number of applications to the state medical review team that were denied, 211.33approved, or withdrawn; 211.34(2) the average length of time from receipt of the application to a decision; 212.1(3) the number of appeals, appeal results, and the length of time taken from the date 212.2the person involved requested an appeal for a written decision to be made on each appeal; 212.3(4) for applicants, their age, health coverage at the time of application, hospitalization 212.4history within three months of application, and whether an application for Social Security 212.5or Supplemental Security Income benefits is pending; and 212.6(5) specific information on the medical certification, licensure, or other credentials 212.7of the person or persons performing the medical review determinations and length of 212.8time in that position. 212.9(d) Any appeal made under section 256.045, subdivision 3, of a disability 212.10determination made by the state medical review team must be decided according to the 212.11timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is 212.12not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the 212.13appeal must be immediately reviewed by the chief appeals referee. 212.14 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 212.15    Sec. 5. Minnesota Statutes 2010, section 256.045, subdivision 4a, is amended to read: 212.16    Subd. 4a. Case management appeals. new text begin (a) new text end Any recipient of case management 212.17services pursuant to section new text begin 256B.0625 or new text end 256B.092, new text begin personal care assistance services new text end 212.18 new text begin under section 256B.0625, or other services new text end who contests the county agency's action new text begin , new text end 212.19 new text begin reduction, suspension, denial, or termination of services, new text end or failure to act in the provision 212.20of those services, other than a failure to act with reasonable promptness or a suspension, 212.21reduction, denial, or termination of services, must submit a written request for a 212.22conciliation conference new text begin with the recipient's case worker and the county social service new text end 212.23 new text begin director or designee new text end to the county agency new text begin prior to filing an appeal under this section new text end . 212.24     new text begin (b) For purposes of this subdivision, a county agency's actions include actions by new text end 212.25 new text begin the department with respect to these services. The request must be filed no later than 30 new text end 212.26 new text begin days from the date of a notice of action on personal care assistance services or ten days new text end 212.27 new text begin from the date of a notice of agency action on case management or other services. The new text end 212.28 new text begin county agency or the state may implement the action, reduction, suspension, denial, or new text end 212.29 new text begin termination of services described in the notice of action unless the recipient includes a new text end 212.30 new text begin request for continuation of services. The recipient may request a 30-day continuation of new text end 212.31 new text begin personal care assistance services or ten-day continuation for case management or other new text end 212.32 new text begin services. The county agency may hold the conference by telephone or by electronic media new text end 212.33 new text begin unless the recipient requests the conference take place in person in their written request for new text end 212.34 new text begin conference. The county agency shall have discretion to continue the conference. new text end 213.1     new text begin (c) new text end The county agency shall inform the commissioner of the receipt of a request 213.2when it is submitted and shall schedule a conciliation conference new text begin to be held in person, by new text end 213.3 new text begin telephone, or by electronic media within ten days of the receipt of the recipient's written new text end 213.4 new text begin request new text end . The county agency shall notify the recipient, the commissioner, and all interested 213.5persons of the time, date, and location of the conciliation conference. The commissioner 213.6may assist the county by providing mediation services or by identifying other resources 213.7that may assist in the mediation between the parties. Within 30 new text begin 15 new text end days new text begin after the conference new text end 213.8 new text begin has been held new text end , the county agency shall conduct the conciliation conference and inform the 213.9recipient in writing of the action the county agency is going to take and when that action 213.10will be taken and notify the recipient of the right to a hearing under this subdivision. 213.11    The conciliation conference shall be conducted in a manner consistent with the 213.12commissioner's instructions. new text begin (d) new text end If the county fails to conduct the conciliation conference 213.13and issue its report within 30 days, or, at any time up to 90 days after the conciliation 213.14conference is held new text begin as provided in paragraph (b) and the recipient disputes the county new text end 213.15 new text begin agency's notice of its intended action, or if a recipient is otherwise entitled to a fair hearing new text end 213.16 new text begin under subdivision 3a new text end , a recipient may submit to the commissioner a written request for a 213.17 new text begin fair new text end hearing before a state human services referee to determine whether case management 213.18services have been provided in accordance with applicable laws and rules or whether the 213.19county agency has assured that the services identified in the recipient's individual service 213.20plan have been delivered in accordance with the laws and rules governing the provision of 213.21those services new text begin under this section new text end . 213.22     new text begin (e) Hearings involving claims the county agency failed to comply with the new text end 213.23 new text begin requirement to schedule and hold a conference or to notify the recipient of its intended new text end 213.24 new text begin action according to this subdivision shall be limited in scope to those issues only, and the new text end 213.25 new text begin human services judge may recommend an order to the commissioner remanding the case new text end 213.26 new text begin to the county agency with directions to schedule and hold the conference and to notify new text end 213.27 new text begin the recipient of its intended action. new text end The state human services referee shall recommend an 213.28order to the commissioner, who shall, in accordance with the procedure in subdivision 5, 213.29issue a final order within 60 days of the receipt of the request for a hearing new text begin involving case new text end 213.30 new text begin management services only new text end , unless the commissioner refuses to accept the recommended 213.31order, in which event a final order shall issue within 90 days of the receipt of that request. 213.32The order may direct the county agency to take those actions necessary to comply with 213.33applicable laws or rules. The commissioner may issue a temporary order prohibiting the 213.34demission of a recipient of case management services new text begin under section 256B.092, new text end from 213.35a residential or day habilitation program licensed under chapter 245A, while a county 213.36agency review process or an appeal brought by a recipient under this subdivision is 214.1pending, or for the period of time necessary for the county agency to implement the 214.2commissioner's order. The commissioner shall not issue a final order staying the demission 214.3of a recipient of case management services from a residential or day habilitation program 214.4licensed under chapter 245A. 214.5     new text begin (f) Any recipient of case management services under section 256B.0625 or new text end 214.6 new text begin 256B.092, or personal care assistance services under section 256B.0625, must be informed new text end 214.7 new text begin in writing at the time of application and at the time of any change in services that they new text end 214.8 new text begin must submit a written request to the county agency for a conference with the case manager new text end 214.9 new text begin and the county social service director before they can file an appeal under this section, new text end 214.10 new text begin of their right to continue receiving services pending the outcome of the conference new text end 214.11 new text begin and notice from the county agency, and that their time for requesting a hearing under new text end 214.12 new text begin subdivision 3a and requesting continuation of services begins to run when they receive the new text end 214.13 new text begin postconference notice of the county's intended actions. For purposes of this paragraph, new text end 214.14 new text begin recipients are presumed to have received notice of the agency's intended actions three new text end 214.15 new text begin business days after the date of the notice. Recipients have the burden of overcoming this new text end 214.16 new text begin presumption by a preponderance of the evidence. new text end 214.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for all notices of action dated on new text end 214.18 new text begin or after January 1, 2012. new text end 214.19    Sec. 6. Minnesota Statutes 2010, section 256.9657, subdivision 1, is amended to read: 214.20    Subdivision 1. Nursing home license surcharge. (a) Effective July 1, 1993, 214.21each non-state-operated nursing home licensed under chapter 144A shall pay to the 214.22commissioner an annual surcharge according to the schedule in subdivision 4. The 214.23surcharge shall be calculated as $620 per licensed bed. If the number of licensed beds 214.24is reduced, the surcharge shall be based on the number of remaining licensed beds the 214.25second month following the receipt of timely notice by the commissioner of human 214.26services that beds have been delicensed. The nursing home must notify the commissioner 214.27of health in writing when beds are delicensed. The commissioner of health must notify 214.28the commissioner of human services within ten working days after receiving written 214.29notification. If the notification is received by the commissioner of human services by 214.30the 15th of the month, the invoice for the second following month must be reduced 214.31to recognize the delicensing of beds. Beds on layaway status continue to be subject to 214.32the surcharge. The commissioner of human services must acknowledge a medical care 214.33surcharge appeal within 30 days of receipt of the written appeal from the provider. 214.34(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625. 215.1(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased 215.2to $990. 215.3(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased 215.4to $2,815. 215.5(e) new text begin Effective July 15, 2013, the surcharge under paragraph (d) shall apply only to new text end 215.6 new text begin occupied, licensed nursing home beds that are not in layaway under section 144A.071, new text end 215.7 new text begin subdivision 4b. Beginning January 1, 2013, nursing facilities may, on a quarterly basis, new text end 215.8 new text begin report data on occupancy as a percent of capacity days, on a form and in a manner new text end 215.9 new text begin prescribed by the commissioner. This data must be provided by the end of the month new text end 215.10 new text begin following the calendar quarter. The commissioner shall use this data to adjust the new text end 215.11 new text begin surcharge amount due for the calendar quarter following submission of the data. This new text end 215.12 new text begin adjustment shall be allowed only for a nursing facility that provides complete and timely new text end 215.13 new text begin data allowed in this paragraph. The commissioner shall apply a monthly surcharge new text end 215.14 new text begin computed as the occupancy percentage as reported in this paragraph times the number of new text end 215.15 new text begin licensed nursing home beds times $2,815 divided by 12. new text end 215.16 new text begin (f) new text end The commissioner may reduce, and may subsequently restore, the surcharge 215.17under paragraph (d) based on the commissioner's determination of a permissible surcharge. 215.18(f) new text begin (g) new text end Between April 1, 2002, and August 15, 2004, a facility governed by this 215.19subdivision may elect to assume full participation in the medical assistance program 215.20by agreeing to comply with all of the requirements of the medical assistance program, 215.21including the rate equalization law in section 256B.48, subdivision 1, paragraph (a), and 215.22all other requirements established in law or rule, and to begin intake of new medical 215.23assistance recipients. Rates will be determined under Minnesota Rules, parts 9549.0010 215.24to 9549.0080. Notwithstanding section 256B.431, subdivision 27, paragraph (i), rate 215.25calculations will be subject to limits as prescribed in rule and law. Other than the 215.26adjustments in sections 256B.431, subdivisions 30 and 32; 256B.437, subdivision 3, 215.27paragraph (b), Minnesota Rules, part 9549.0057, and any other applicable legislation 215.28enacted prior to the finalization of rates, facilities assuming full participation in medical 215.29assistance under this paragraph are not eligible for any rate adjustments until the July 1 215.30following their settle-up period. 215.31    Sec. 7. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read: 215.32    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for 215.33medical assistance, a person must not individually own more than $3,000 in assets, or if a 215.34member of a household with two family members, husband and wife, or parent and child, 215.35the household must not own more than $6,000 in assets, plus $200 for each additional 216.1legal dependent. In addition to these maximum amounts, an eligible individual or family 216.2may accrue interest on these amounts, but they must be reduced to the maximum at the 216.3time of an eligibility redetermination. The accumulation of the clothing and personal 216.4needs allowance according to section 256B.35 must also be reduced to the maximum at 216.5the time of the eligibility redetermination. The value of assets that are not considered in 216.6determining eligibility for medical assistance is the value of those assets excluded under 216.7the supplemental security income program for aged, blind, and disabled persons, with 216.8the following exceptions: 216.9(1) household goods and personal effects are not considered; 216.10(2) capital and operating assets of a trade or business that the local agency determines 216.11are necessary to the person's ability to earn an income are not considered; 216.12(3) motor vehicles are excluded to the same extent excluded by the supplemental 216.13security income program; 216.14(4) assets designated as burial expenses are excluded to the same extent excluded by 216.15the supplemental security income program. Burial expenses funded by annuity contracts 216.16or life insurance policies must irrevocably designate the individual's estate as contingent 216.17beneficiary to the extent proceeds are not used for payment of selected burial expenses; and 216.18(5) effective upon federal approval, for a person who no longer qualifies as an 216.19employed person with a disability due to loss of earnings, assets allowed while eligible 216.20for medical assistance under section 256B.057, subdivision 9, are not considered for 12 216.21months, beginning with the first month of ineligibility as an employed person with a 216.22disability, to the extent that the person's total assets remain within the allowed limits of 216.23section 256B.057, subdivision 9, paragraph (c) new text begin (d) new text end . 216.24(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 216.2515. 216.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2014. new text end 216.27    Sec. 8. Minnesota Statutes 2010, section 256B.056, is amended by adding a 216.28subdivision to read: 216.29     new text begin Subd. 5d. new text end new text begin Spenddown adjustments. new text end new text begin When income is projected for a six-month new text end 216.30 new text begin budget period, retroactive adjustments to income determined to be available to a person new text end 216.31 new text begin under section 256B.0575 must be made at the end of each six-month budget period new text end 216.32 new text begin based on changes occurring during the budget period. For changes occurring outside the new text end 216.33 new text begin six-month budget period, such retroactive adjustments are limited to the six full calendar new text end 216.34 new text begin months before the month the change is reported or discovered. new text end 217.1    Sec. 9. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read: 217.2    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid 217.3for a person who is employed and who: 217.4(1) but for excess earnings or assets, meets the definition of disabled under the 217.5Supplemental Security Income program; 217.6(2) is at least 16 but less than 65 years of age; 217.7(3) meets the asset limits in paragraph (c) new text begin (d) new text end ; and 217.8(4) pays a premium and other obligations under paragraph (e). 217.9     new text begin (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible new text end 217.10 new text begin for medical assistance under this subdivision, a person must have more than $65 of earned new text end 217.11 new text begin income. Earned income must have Medicare, Social Security, and applicable state and new text end 217.12 new text begin federal taxes withheld. The person must document earned income tax withholding. new text end Any 217.13spousal income or assets shall be disregarded for purposes of eligibility and premium 217.14determinations. 217.15(b) new text begin (c) new text end After the month of enrollment, a person enrolled in medical assistance under 217.16this subdivision who: 217.17(1) is temporarily unable to work and without receipt of earned income due to a 217.18medical condition, as verified by a physician, may retain eligibility for up to four calendar 217.19months; or 217.20(2) effective January 1, 2004, loses employment for reasons not attributable to the 217.21enrollee, new text begin and is without receipt of earned income new text end may retain eligibility for up to four 217.22consecutive months after the month of job loss. To receive a four-month extension, 217.23enrollees must verify the medical condition or provide notification of job loss. All other 217.24eligibility requirements must be met and the enrollee must pay all calculated premium 217.25costs for continued eligibility. 217.26(c) new text begin (d) new text end For purposes of determining eligibility under this subdivision, a person's 217.27assets must not exceed $20,000, excluding: 217.28(1) all assets excluded under section 256B.056; 217.29(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 217.30Keogh plans, and pension plans; and 217.31(3) medical expense accounts set up through the person's employer. new text begin ; and new text end 217.32 new text begin (4) spousal assets, including spouse's share of jointly held assets. new text end 217.33(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 217.34earned income disregard. To be eligible, a person applying for medical assistance under 217.35this subdivision must have earned income above the disregard level. 218.1(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 218.2Security, and applicable state and federal income taxes must be withheld. To be eligible, 218.3a person must document earned income tax withholding. 218.4(e)(1) A person whose earned and unearned income is equal to or greater than 100 218.5percent of federal poverty guidelines for the applicable family size must pay a premium 218.6to be eligible for medical assistance under this subdivision. new text begin (e) All enrollees must pay a new text end 218.7 new text begin premium to be eligible for medical assistance under this subdivision, except as provided new text end 218.8 new text begin under section 256.01, subdivision 18b. new text end 218.9 new text begin (1) An enrollee must pay the greater of a $65 premium or new text end the premium shall be new text begin new text end 218.10 new text begin calculated new text end based on the person's gross earned and unearned income and the applicable 218.11family size using a sliding fee scale established by the commissioner, which begins at 218.12one percent of income at 100 percent of the federal poverty guidelines and increases 218.13to 7.5 percent of income for those with incomes at or above 300 percent of the federal 218.14poverty guidelines. 218.15 new text begin (2) new text end Annual adjustments in the premium schedule based upon changes in the federal 218.16poverty guidelines shall be effective for premiums due in July of each year. 218.17(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 218.18medical assistance under this subdivision. An enrollee shall pay the greater of a $35 218.19premium or the premium calculated in clause (1). 218.20(3) Effective November 1, 2003, All enrollees who receive unearned income must 218.21pay one-half of one new text begin five new text end percent of unearned income in addition to the premium amount new text begin , new text end 218.22 new text begin except as provided under section 256.01, subdivision 18b new text end . 218.23(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 218.24percent of the federal poverty guidelines and who are also enrolled in Medicare, the 218.25commissioner must reimburse the enrollee for Medicare Part B premiums under section 218.26256B.0625, subdivision 15, paragraph (a). 218.27(5) new text begin (4) new text end Increases in benefits under title II of the Social Security Act shall not be 218.28counted as income for purposes of this subdivision until July 1 of each year. 218.29(f) A person's eligibility and premium shall be determined by the local county 218.30agency. Premiums must be paid to the commissioner. All premiums are dedicated to 218.31the commissioner. 218.32(g) Any required premium shall be determined at application and redetermined at 218.33the enrollee's six-month income review or when a change in income or household size is 218.34reported. Enrollees must report any change in income or household size within ten days 218.35of when the change occurs. A decreased premium resulting from a reported change in 218.36income or household size shall be effective the first day of the next available billing month 219.1after the change is reported. Except for changes occurring from annual cost-of-living 219.2increases, a change resulting in an increased premium shall not affect the premium amount 219.3until the next six-month review. 219.4(h) Premium payment is due upon notification from the commissioner of the 219.5premium amount required. Premiums may be paid in installments at the discretion of 219.6the commissioner. 219.7(i) Nonpayment of the premium shall result in denial or termination of medical 219.8assistance unless the person demonstrates good cause for nonpayment. Good cause exists 219.9if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 219.10D, are met. Except when an installment agreement is accepted by the commissioner, 219.11all persons disenrolled for nonpayment of a premium must pay any past due premiums 219.12as well as current premiums due prior to being reenrolled. Nonpayment shall include 219.13payment with a returned, refused, or dishonored instrument. The commissioner may 219.14require a guaranteed form of payment as the only means to replace a returned, refused, 219.15or dishonored instrument. 219.16(j) The commissioner shall notify enrollees annually beginning at least 24 months 219.17before the person's 65th birthday of the medical assistance eligibility rules affecting 219.18income, assets, and treatment of a spouse's income and assets that will be applied upon 219.19reaching age 65. 219.20 new text begin (k) For enrollees whose income does not exceed 200 percent of the federal poverty new text end 219.21 new text begin guidelines and who are also enrolled in Medicare, the commissioner shall reimburse new text end 219.22 new text begin the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, new text end 219.23 new text begin paragraph (a). new text end 219.24 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2014, for adults age 21 or new text end 219.25 new text begin older, and October 1, 2019, for children age 16 to before the child's 21st birthday. new text end 219.26    Sec. 10. Minnesota Statutes 2010, section 256B.0657, is amended to read: 219.27256B.0657 SELF-DIRECTED SUPPORTS OPTION new text begin OPTIONS new text end . 219.28    Subdivision 1. Definition. new text begin (a) "Lead agency" has the meaning given in section new text end 219.29 new text begin 256B.0911, subdivision 1a, paragraph (d). new text end 219.30 new text begin (b) "Legal representative" means a legal guardian of a child or an adult, or parent of new text end 219.31 new text begin a minor child. new text end 219.32 new text begin (c) "Individual representative" means an individual who has been authorized, in new text end 219.33 new text begin a written statement by the person or the person's legal representative, to speak on the new text end 219.34 new text begin person's behalf and help the person understand and make informed choices in matters new text end 220.1 new text begin related to identification of needs and choice of services and supports and assist the person new text end 220.2 new text begin to implement an approved support plan and has no financial interest in the provision of any new text end 220.3 new text begin services included in the individual's plan unless related by blood, adoption, or marriage. new text end 220.4 new text begin (d) new text end "Self-directed supports option new text begin options new text end " means personal assistance, supports, 220.5items, and related services purchased under an approved budget plan and budget by a 220.6recipient. 220.7    Subd. 2. Eligibility. (a) The self-directed supports option is available to a person 220.8who: 220.9    (1) is a recipient of medical assistance as determined under sections 256B.055, 220.10256B.056 , and 256B.057, subdivision 9; 220.11    (2) is eligible for personal care assistance services under section 256B.0659 new text begin , or new text end 220.12 new text begin for a home and community-based services waiver program under section 256B.0915, new text end 220.13 new text begin 256B.092, or 256B.49, or alternative care under section 256B.0913 new text end ; 220.14    (3) lives in the person's own apartment or home, which is not owned, operated, or 220.15controlled by a provider of services not new text begin except for services provided by those new text end related by 220.16blood or new text begin , adoption, new text end marriage new text begin , or family foster care consistent with the requirements of new text end 220.17 new text begin section 256B.0651, subdivision 1, paragraph (e) new text end ; 220.18    (4) has the ability to hire, fire, supervise, establish staff compensation for, and 220.19manage the individuals providing services, and to choose and obtain items, related 220.20services, and supports as described in the participant's plan. If the recipient is not able 220.21to carry out these functions but has a legal guardian new text begin , individual representative, new text end or parent 220.22to carry them out, the guardian new text begin , individual representative, new text end or parent may fulfill these 220.23functions on behalf of the recipient; and 220.24    (5) has not been excluded or disenrolled by the commissioner. 220.25    (b) The commissioner may disenroll or new text begin , new text end exclude new text begin , or require other measures such as new text end 220.26 new text begin training, increased assistance, reporting, or oversight for new text end recipients, including guardians 220.27and new text begin , new text end parents, new text begin and individual representatives new text end under the following circumstances: 220.28    (1) recipients who have been restricted by the Primary Care Utilization Review 220.29Committee new text begin Minnesota restricted recipient program new text end may be excluded for a specified time 220.30period; 220.31    (2) recipients who exit the self-directed supports option during the recipient's 220.32service plan year shall not access the self-directed supports option for the remainder of 220.33that service plan year; and 220.34    (3) when the department determines that the recipient cannot manage recipient 220.35responsibilities under the program. 221.1 new text begin (c) For vendors or other self-directed service providers, the commissioner may new text end 221.2 new text begin take any action authorized under surveillance and integrity review in Minnesota Rules, new text end 221.3 new text begin parts 9505.2160 to 9505.2245. new text end 221.4    Subd. 3. Eligibility for other services. Selection of the self-directed supports 221.5option by a recipient shall not restrict access to other medically necessary care and 221.6services furnished under the state plan medical assistance benefit, including home care 221.7targeted case management, except that a person receiving new text begin choosing lead agency managed new text end 221.8home and community-based waiver services, new text begin agency-provided personal care assistance new text end 221.9 new text begin services, new text end a family support grant, or a consumer support grant is not eligible for funding 221.10under the self-directed supports option. 221.11    Subd. 4. Assessment requirements. (a) The self-directed supports option 221.12assessment must meet the following requirements: 221.13    (1) it shall be conducted by the county public health nurse or a certified public health 221.14nurse under contract with the county new text begin consistent with the requirements of personal care new text end 221.15 new text begin assistance services under section 256B.0659, subdivision 3a; home and community-based new text end 221.16 new text begin waiver services programs under section 256B.0915, 256B.092, or 256B.49; and the new text end 221.17 new text begin alternative care program under section 256B.0913, until section 256B.0911, subdivision new text end 221.18 new text begin 3a, has been implemented new text end ; 221.19    (2) it shall be conducted face-to-face in the recipient's home initially, and at least 221.20annually thereafter; when there is a significant change in the recipient's condition; and 221.21when there is a change in the new text begin person's new text end need for personal care assistance services new text begin under the new text end 221.22 new text begin programs listed in subdivision 2, paragraph (a), clause (2) new text end . A recipient who is residing in a 221.23facility may be assessed for the self-directed support option for the purpose of returning 221.24to the community using this option; and 221.25    (3) it shall be completed using the format established by the commissioner. 221.26    (b) The results of the new text begin personal care assistance new text end assessment and recommendations shall 221.27be communicated to the commissioner and the recipient by the county public health nurse 221.28or certified public health nurse under contract with the county new text begin as required under section new text end 221.29 new text begin 256B.0659, subdivision 3a. The person's annual and monthly average authorization for new text end 221.30 new text begin the self-directed budget amount shall be provided within 40 days after the personal care new text end 221.31 new text begin assessment or reassessment, or within ten days after a request not related to an assessment new text end . 221.32 new text begin (c) The lead agency responsible for administration of home and community-based new text end 221.33 new text begin waiver services under section 256B.0915, 256B.092, or 256B.49, and alternative care new text end 221.34 new text begin under section 256B.0913, shall provide annual and monthly average authorization for the new text end 221.35 new text begin self-directed services budget amounts for all eligible persons within 40 days after an new text end 222.1 new text begin initial assessment or annual review and within ten days if requested at a time unrelated to new text end 222.2 new text begin the assessment or annual review. new text end 222.3    Subd. 5. Self-directed supports option plan requirements. (a) The plan new text begin and new text end 222.4 new text begin provider new text end for the self-directed supports option must meet the following requirements: 222.5    (1) the plan must be completed using a person-centered process that: 222.6    (i) builds upon the recipient's capacity to engage in activities that promote 222.7community life; 222.8    (ii) respects the recipient's preferences, choices, and abilities; 222.9    (iii) involves families, friends, and professionals in the planning or delivery of 222.10services or supports as desired or required by the recipient; and 222.11    (iv) addresses the need for personal care assistance new text begin and other new text end services new text begin and supports new text end 222.12identified in the recipient's self-directed supports option assessment; 222.13    (2) the plan shall be developed by the recipient new text begin , legal representative, new text end or by the 222.14guardian of an adult recipient or by a parent or guardian of a minor child, new text begin individual new text end 222.15 new text begin representative, new text end and may be assisted by a provider who meets the requirements established 222.16for using a person-centered planning process and shall be reviewed at least annually upon 222.17reassessment or when there is a significant change in the recipient's condition; and 222.18    (3) the plan must include the total budget amount available divided into monthly 222.19amounts that cover the number of months of personal care assistance services new text begin or home new text end 222.20 new text begin and community-based waiver or alternative care new text end authorization included in the budget. 222.21 new text begin A recipient may reserve funds monthly for the purchase of items that meet the standards new text end 222.22 new text begin in subdivision 6, paragraph (a), clause (2), and are reflected in the support plan. new text end The 222.23amount used each month may vary, but additional funds shall not be provided above the 222.24annual personal care assistance services authorized amount unless a change in condition 222.25is documented. 222.26    (b) The commissioner new text begin or the commissioner's designee new text end shall: 222.27     new text begin (1) ensure that outreach activities and information materials on self-directed options new text end 222.28 new text begin are developed and provided across the state to persons who use or are seeking community new text end 222.29 new text begin support services; new text end 222.30    (1) new text begin (2) new text end establish the format and criteria for the plan as well as the requirements for 222.31providers who assist with plan development; 222.32    (2) new text begin (3) new text end review the assessment and plan and, within 30 days after receiving the 222.33assessment and plan, make a decision on approval of the plan; 222.34    (3) new text begin (4) new text end notify the recipient, parent, or guardian new text begin legal representative, or individual new text end 222.35 new text begin representative new text end of approval or denial of the plan and provide notice of the right to appeal 222.36under section 256.045; and 223.1    (4) new text begin (5) new text end provide a copy of the plan to the fiscal support entity selected by the recipient new text begin new text end 223.2 new text begin from among at least three certified entities new text end . 223.3     new text begin (c) The commissioner shall: new text end 223.4     new text begin (1) establish provider enrollment requirements for provision of fiscal support entity new text end 223.5 new text begin services and person-centered support plan services, including benefits counseling to new text end 223.6 new text begin support employment; and new text end 223.7     new text begin (2) collect a fee to cover the costs of certifying providers for the services described new text end 223.8 new text begin in this subdivision. new text end 223.9    Subd. 6. Services covered. (a) Services covered under the self-directed supports 223.10option include: 223.11    (1) personal care assistance services under section 256B.0659 new text begin , and services under new text end 223.12 new text begin the home and community-based waivers, except those provided in licensed or registered new text end 223.13 new text begin residential settings unless the services are provided in a family foster care setting which new text end 223.14 new text begin meets the requirements of section 256B.0651, subdivision 1, paragraph (e) new text end ; and 223.15    (2) items, related services, and supports, including assistive technology, that increase 223.16independence or substitute for human assistance to the extent expenditures would 223.17otherwise be used for human assistance. 223.18    (b) Items, supports, and related services purchased under this option shall not be 223.19considered home care services for the purposes of section 144A.43. 223.20    Subd. 7. Noncovered services. Services or supports that are not eligible for 223.21payment under the self-directed supports option include: 223.22    (1) services, goods, or supports that do not benefit the recipient; 223.23    (2) any fees incurred by the recipient, such as Minnesota health care program fees 223.24and co-pays, legal fees, or costs related to advocate agencies; 223.25    (3) insurance, except for insurance costs related to employee coverage or fiscal 223.26support entity payments; 223.27    (4) room and board and personal items that are not related to the disability, except 223.28that medically prescribed specialized diet items may be covered if they reduce the need for 223.29human assistance; 223.30    (5) home modifications that add square footage new text begin , except those modifications that new text end 223.31 new text begin configure a bathroom to accommodate a wheelchair new text end ; 223.32    (6) home modifications for a residence other than the primary residence of the 223.33recipient, or in the event of a minor with parents not living together, the primary residences 223.34of the parents; 224.1    (7) expenses for travel, lodging, or meals related to training the recipient, the 224.2parent or guardian of an adult recipient, or the parent or guardian of a minor child new text begin legal new text end 224.3 new text begin representative new text end , or paid or unpaid caregivers that exceed $500 in a 12-month period; 224.4    (8) experimental treatment; 224.5    (9) any service or item new text begin to the extent the service or item is new text end covered by other medical 224.6assistance state plan services, including prescription and over-the-counter medications, 224.7compounds, and solutions and related fees, including premiums and co-payments; 224.8    (10) membership dues or costs, except when the service is necessary and appropriate 224.9to treat a physical condition or to improve or maintain the recipient's physical condition. 224.10The condition must be identified in the recipient's plan of care and monitored by a 224.11Minnesota health care program enrolled physician; 224.12    (11) vacation expenses other than the cost of direct services; 224.13    (12) vehicle maintenance or modifications not related to the disability; 224.14    (13) tickets and related costs to attend sporting or other recreational events; and 224.15    (14) costs related to Internet access, except when necessary for operation of assistive 224.16technology, to increase independence, or to substitute for human assistance. 224.17    Subd. 8. Self-directed budget requirements. new text begin (a) new text end The budget for the provision of 224.18the self-directed service option shall be established new text begin for persons eligible for personal care new text end 224.19 new text begin assistance services under section 256B.0659 new text end based on: 224.20    (1) assessed personal care assistance units, not to exceed the maximum number of 224.21personal care assistance units available, as determined by section 256B.0659; and 224.22    (2) the personal care assistance unit rate: 224.23    (i) with a reduction to the unit rate to pay for a program administrator as defined in 224.24subdivision 10; and 224.25    (ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for 224.26the state. 224.27 new text begin (b) The budget for persons eligible for programs listed in subdivision 2, paragraph new text end 224.28 new text begin (a), clause (2), is based on the approved budget methodologies for each program. new text end 224.29    Subd. 9. Quality assurance and risk management. (a) The commissioner 224.30shall establish quality assurance and risk management measures for use in developing 224.31and implementing self-directed plans and budgets that (1) recognize the roles and 224.32responsibilities involved in obtaining services in a self-directed manner, and (2) assure 224.33the appropriateness of such plans and budgets based upon a recipient's resources and 224.34capabilities. These measures must include (i) background studies, and (ii) backup and 224.35emergency plans, including disaster planning new text begin , and (iii) for persons using home and new text end 225.1 new text begin community-based waiver services, monitoring by the lead agency on quality assurance new text end 225.2 new text begin measures and recipient health, safety, and welfare new text end . 225.3    (b) The commissioner shall provide ongoing technical assistance and resource 225.4and educational materials for families and recipients selecting the self-directed option new text begin , new text end 225.5 new text begin including information on the quality assurance efforts new text end . 225.6    (c) Performance assessments measures, such as of a recipient's new text begin functioning, new text end 225.7satisfaction with the services and supports, and ongoing monitoring of health and 225.8well-being shall be identified in consultation with the stakeholder group. 225.9    Subd. 10. Fiscal support entity. (a) Each recipient new text begin or legal representative new text end shall 225.10choose a fiscal support entity provider certified by the commissioner to make payments 225.11for services, items, supports, and administrative costs related to managing a self-directed 225.12service plan authorized for payment in the approved plan and budget. Recipients new text begin The new text end 225.13 new text begin recipient or legal representative new text end shall also choose the payroll, agency with choice, or the 225.14fiscal conduit model of financial and service management. 225.15    (b) The fiscal support entity: 225.16    (1) may not limit or restrict the recipient's choice of service or support providers, 225.17including use of the payroll, agency with choice, or fiscal conduit model of financial 225.18and service management; 225.19    (2) must have a written agreement with the recipient new text begin , individual representative, new text end or 225.20the recipient's new text begin legal new text end representative that identifies the duties and responsibilities to be 225.21performed and the specific related charges; 225.22    (3) must provide the recipient and the home care targeted case manager new text begin , legal new text end 225.23 new text begin representative, and individual representative new text end with a monthly written summary of the 225.24self-directed supports option services that were billed, including charges from the fiscal 225.25support entity; 225.26    (4) must be knowledgeable of and comply with Internal Revenue Service 225.27requirements necessary to process employer and employee deductions, provide appropriate 225.28and timely submission of employer tax liabilities, and maintain documentation to support 225.29medical assistance claims; 225.30    (5) must have current and adequate liability insurance and bonding and sufficient 225.31cash flow and have on staff or under contract a certified public accountant or an individual 225.32with a baccalaureate degree in accounting; and 225.33    (6) must maintain records to track all self-directed supports option services 225.34expenditures, including time records of persons paid to provide supports and receipts for 225.35any goods purchased. The records must be maintained for a minimum of five years from 225.36the claim date and be available for audit or review upon request. Claims submitted by 226.1the fiscal support entity must correspond with services, amounts, and time periods as 226.2authorized in the recipient's self-directed supports option plan. 226.3    (c) The commissioner shall have authority to: 226.4    (1) set or negotiate rates with fiscal support entities; 226.5    (2) limit the number of fiscal support entities; 226.6    (3) identify a process to certify and recertify fiscal support entities and assure fiscal 226.7support entities are available to recipients throughout the state; and 226.8    (4) establish a uniform format and protocol to be used by eligible fiscal support 226.9entities. 226.10    Subd. 11. Stakeholder consultation. The commissioner shall consult with 226.11a statewide consumer-directed new text begin self-directed new text end services stakeholder group, including 226.12representatives of all types of consumer-directed new text begin self-directed new text end service users, advocacy 226.13organizations, counties, and consumer-directed new text begin self-directed new text end service providers. The 226.14commissioner shall seek recommendations from this stakeholder group in developing new text begin , new text end 226.15 new text begin monitoring, evaluating, and modifying new text end : 226.16    (1) the self-directed plan format; 226.17    (2) requirements and guidelines for the person-centered plan assessment and 226.18planning process; 226.19    (3) implementation of the option and the quality assurance and risk management 226.20techniques; and 226.21    (4) standards and requirements, including rates for the personal support plan 226.22development provider and the fiscal support entity; policies; training; and implementation new text begin ; new text end 226.23 new text begin and new text end 226.24 new text begin (5) the self-directed supports options available through the home and new text end 226.25 new text begin community-based waivers under section 256B.0916 and the personal care assistance new text end 226.26 new text begin program under section 256B.0659, including recommendations on possible ways to new text end 226.27 new text begin increase participation, improve flexibility, and provide incentives for recipients to new text end 226.28 new text begin participate in a life transition and crisis funding pool with others to save and contribute new text end 226.29 new text begin part of their authorized budgets, which can be carried over year to year and used according new text end 226.30 new text begin to priority standards under section 256B.092, subdivision 12, paragraph (a), clauses (1), new text end 226.31 new text begin (3), (4), (5), and (6) new text end . 226.32The stakeholder group shall provide recommendations on the repeal of the personal 226.33care assistance choice option, transition issues, and whether the consumer support grant 226.34program under section 256.476 should be modified. The stakeholder group shall meet 226.35at least three times each year to provide advice on policy, implementation, and other 226.36aspects of consumer and self-directed services. 227.1    Subd. 12. Enrollment and evaluation. Enrollment in the self-directed supports 227.2option is available to current personal care assistance recipients upon annual personal 227.3care assistance reassessment, with a maximum enrollment of 1,000 new text begin 2,000 new text end people in the 227.4first fiscal year of implementation and an additional 1,000 new text begin 3,000 new text end people in the second 227.5fiscal year. The commissioner shall evaluate the self-directed supports option during the 227.6first two years of implementation and make any necessary changes prior to the option 227.7becoming available statewide. 227.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2012. new text end 227.9    Sec. 11. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to 227.10read: 227.11    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant 227.12must meet the following requirements: 227.13    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years 227.14of age with these additional requirements: 227.15    (i) supervision by a qualified professional every 60 days; and 227.16    (ii) employment by only one personal care assistance provider agency responsible 227.17for compliance with current labor laws; 227.18    (2) be employed by a personal care assistance provider agency; 227.19    (3) enroll with the department as a personal care assistant after clearing a background 227.20study. Except as provided in subdivision 11a, before a personal care assistant provides 227.21services, the personal care assistance provider agency must initiate a background study on 227.22the personal care assistant under chapter 245C, and the personal care assistance provider 227.23agency must have received a notice from the commissioner that the personal care assistant 227.24is: 227.25    (i) not disqualified under section 245C.14; or 227.26    (ii) is disqualified, but the personal care assistant has received a set aside of the 227.27disqualification under section 245C.22; 227.28    (4) be able to effectively communicate with the recipient and personal care 227.29assistance provider agency; 227.30    (5) be able to provide covered personal care assistance services according to the 227.31recipient's personal care assistance care plan, respond appropriately to recipient needs, 227.32and report changes in the recipient's condition to the supervising qualified professional 227.33or physician; 227.34    (6) not be a consumer of personal care assistance services; 228.1    (7) maintain daily written records including, but not limited to, time sheets under 228.2subdivision 12; 228.3    (8) effective January 1, 2010, complete standardized training as determined 228.4by the commissioner before completing enrollment. The training must be available 228.5in languages other than English and to those who need accommodations due to 228.6disabilities. Personal care assistant training must include successful completion of the 228.7following training components: basic first aid, vulnerable adult, child maltreatment, 228.8OSHA universal precautions, basic roles and responsibilities of personal care assistants 228.9including information about assistance with lifting and transfers for recipients, emergency 228.10preparedness, orientation to positive behavioral practices, fraud issues, and completion of 228.11time sheets. Upon completion of the training components, the personal care assistant must 228.12demonstrate the competency to provide assistance to recipients; 228.13    (9) complete training and orientation on the needs of the recipient within the first 228.14seven days after the services begin; and 228.15    (10) be limited to providing and being paid for up to 275 hours per month, except 228.16that this limit shall be 275 hours per month for the period July 1, 2009, through June 30, 228.172011, of personal care assistance services regardless of the number of recipients being 228.18served or the number of personal care assistance provider agencies enrolled with. The 228.19number of hours worked per day shall not be disallowed by the department unless in 228.20violation of the law. 228.21    (b) A legal guardian may be a personal care assistant if the guardian is not being paid 228.22for the guardian services and meets the criteria for personal care assistants in paragraph (a). 228.23    (c) Effective January 1, 2010, persons who do not qualify as a personal care assistant 228.24include parents and stepparents of minors, spouses, paid legal guardians, family foster 228.25care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 228.26staff of a residential setting. new text begin When the personal care assistant is a relative of the recipient, new text end 228.27 new text begin the commissioner shall pay 80 percent of the provider rate. For purposes of this section, new text end 228.28 new text begin relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or new text end 228.29 new text begin older, an adult child, a grandparent, or a grandchild. new text end 228.30    Sec. 12. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to 228.31read: 228.32    Subd. 28. Personal care assistance provider agency; required documentation. 228.33 new text begin (a) new text end Required documentation must be completed and kept in the personal care assistance 228.34provider agency file or the recipient's home residence. The required documentation 228.35consists of: 229.1(1) employee files, including: 229.2(i) applications for employment; 229.3(ii) background study requests and results; 229.4(iii) orientation records about the agency policies; 229.5(iv) trainings completed with demonstration of competence; 229.6(v) supervisory visits; 229.7(vi) evaluations of employment; and 229.8(vii) signature on fraud statement; 229.9(2) recipient files, including: 229.10(i) demographics; 229.11(ii) emergency contact information and emergency backup plan; 229.12(iii) personal care assistance service plan; 229.13(iv) personal care assistance care plan; 229.14(v) month-to-month service use plan; 229.15(vi) all communication records; 229.16(vii) start of service information, including the written agreement with recipient; and 229.17(viii) date the home care bill of rights was given to the recipient; 229.18(3) agency policy manual, including: 229.19(i) policies for employment and termination; 229.20(ii) grievance policies with resolution of consumer grievances; 229.21(iii) staff and consumer safety; 229.22(iv) staff misconduct; and 229.23(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 229.24resolution of consumer grievances; 229.25(4) time sheets for each personal care assistant along with completed activity sheets 229.26for each recipient served; and 229.27(5) agency marketing and advertising materials and documentation of marketing 229.28activities and costs new text begin ; and new text end 229.29 new text begin (6) for each personal care assistant, whether or not the personal care assistant is new text end 229.30 new text begin providing care to a relative as defined in subdivision 11 new text end . 229.31 new text begin (b) The commissioner may assess a fine of up to $500 on provider agencies that do new text end 229.32 new text begin not consistently comply with the requirements of this subdivision. new text end 229.33    Sec. 13. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to 229.34read: 229.35    Subd. 1a. Definitions. For purposes of this section, the following definitions apply: 230.1    (a) "Long-term care consultation services" means: 230.2    (1) assistance in identifying services needed to maintain an individual in the most 230.3inclusive environment; 230.4    (2) providing recommendations on cost-effective community services that are 230.5available to the individual; 230.6    (3) development of an individual's person-centered community support plan; 230.7    (4) providing information regarding eligibility for Minnesota health care programs; 230.8    (5) face-to-face long-term care consultation assessments, which may be completed 230.9in a hospital, nursing facility, intermediate care facility for persons with developmental 230.10disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 230.11residence; 230.12    (6) federally mandated screening to determine the need for an institutional level of 230.13care under subdivision 4a; 230.14    (7) determination of home and community-based waiver service eligibility 230.15including level of care determination for individuals who need an institutional level of 230.16care as defined under section 144.0724, subdivision 11, or 256B.092, service eligibility 230.17including state plan home care services identified in sections 256B.0625, subdivisions 230.186 , 7, and 19, paragraphs (a) and (c), and 256B.0657, based on assessment and support 230.19plan development with appropriate referrals, including the option for consumer-directed 230.20community new text begin self-directed new text end supports; 230.21    (8) providing recommendations for nursing facility placement when there are no 230.22cost-effective community services available; and 230.23    (9) assistance to transition people back to community settings after facility 230.24admission new text begin ; and new text end 230.25 new text begin (10) providing notice to the individual or legal representative of the annual and new text end 230.26 new text begin monthly average authorized amount for traditional agency services and self-directed new text end 230.27 new text begin services under section 256B.0657 for which the recipient is found eligible new text end . 230.28    (b) "Long-term care options counseling" means the services provided by the linkage 230.29lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 230.30telephone assistance and follow up once a long-term care consultation assessment has 230.31been completed. 230.32    (c) "Minnesota health care programs" means the medical assistance program under 230.33chapter 256B and the alternative care program under section 256B.0913. 230.34    (d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 230.35plans administering long-term care consultation assessment and support planning services. 230.36 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 231.1    Sec. 14. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to 231.2read: 231.3    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 231.4services planning, or other assistance intended to support community-based living, 231.5including persons who need assessment in order to determine waiver or alternative 231.6care program eligibility, must be visited by a long-term care consultation team within 231.715 calendar new text begin 20 calendar new text end days after the date on which an assessment was requested or 231.8recommended. After January 1, 2011, these requirements also apply to personal care 231.9assistance services, private duty nursing, and home health agency services, on timelines 231.10established in subdivision 5. Face-to-face assessments must be conducted according 231.11to paragraphs (b) to (i). 231.12    (b) The county may utilize a team of either the social worker or public health nurse, 231.13or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 231.14assessment in a face-to-face interview. The consultation team members must confer 231.15regarding the most appropriate care for each individual screened or assessed. 231.16    (c) The assessment must be comprehensive and include a person-centered 231.17assessment of the health, psychological, functional, environmental, and social needs of 231.18referred individuals and provide information necessary to develop a support plan that 231.19meets the consumers needs, using an assessment form provided by the commissioner. 231.20    (d) The assessment must be conducted in a face-to-face interview with the person 231.21being assessed and the person's legal representative, as required by legally executed 231.22documents, and other individuals as requested by the person, who can provide information 231.23on the needs, strengths, and preferences of the person necessary to develop a support plan 231.24that ensures the person's health and safety, but who is not a provider of service or has any 231.25financial interest in the provision of services. 231.26    (e) The person, or the person's legal representative, must be provided with 231.27written recommendations for community-based services, including consumer-directed new text begin new text end 231.28 new text begin self-directed new text end options, or institutional care that include documentation that the most 231.29cost-effective alternatives available were offered to the individual. For purposes of 231.30this requirement, "cost-effective alternatives" means community services and living 231.31arrangements that cost the same as or less than institutional care. new text begin For persons determined new text end 231.32 new text begin eligible for services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the new text end 231.33 new text begin community support plan must also include the estimated annual and monthly average new text end 231.34 new text begin authorized budget amount for those services. new text end 231.35    (f) If the person chooses to use community-based services, the person or the person's 231.36legal representative must be provided with a written community support plan, regardless 232.1of whether the individual is eligible for Minnesota health care programs. new text begin The written new text end 232.2 new text begin community support plan must include: new text end 232.3     new text begin (1) a summary of assessed needs as defined in paragraphs (c) and (d); new text end 232.4     new text begin (2) the individual's options and choices to meet identified needs, including all new text end 232.5 new text begin available options for case management services and providers; new text end 232.6     new text begin (3) identification of health and safety risks and how those risks will be addressed, new text end 232.7 new text begin including personal risk management strategies; new text end 232.8     new text begin (4) referral information; and new text end 232.9     new text begin (5) informal caregiver supports, if applicable. new text end 232.10     new text begin For persons determined eligible for services defined under subdivision 1a, paragraph new text end 232.11 new text begin (a), clauses (7) to (10), the community support plan must also include: new text end 232.12     new text begin (6) identification of individual goals; new text end 232.13     new text begin (7) identification of short-term and long-term service outcomes. Short-term service new text end 232.14 new text begin outcomes are defined as achievable within six months; new text end 232.15     new text begin (8) a recommended schedule for case management visits. When achievement of new text end 232.16 new text begin short-term service outcomes may affect the amount of service required, the schedule must new text end 232.17 new text begin be at least every six months and must reflect evaluation and progress toward identified new text end 232.18 new text begin short-term service outcomes; and new text end 232.19     new text begin (9) the estimated annual and monthly budget amount for services. new text end 232.20     new text begin In addition, for persons determined eligible for state plan home care under new text end 232.21 new text begin subdivision 1a, paragraph (a), clause (8), the person or person's representative must also new text end 232.22 new text begin receive a copy of the home care service plan developed by a certified assessor. new text end 232.23A person may request assistance in identifying community supports without 232.24participating in a complete assessment. Upon a request for assistance identifying 232.25community support, the person must be transferred or referred to the services available 232.26under sections 256.975, subdivision 7, and 256.01, subdivision 24, for telephone 232.27assistance and follow up. 232.28    (g) The person has the right to make the final decision between institutional 232.29placement and community placement after the recommendations have been provided, 232.30except as provided in subdivision 4a, paragraph (c). 232.31    (h) The team must give the person receiving assessment or support planning, or 232.32the person's legal representative, materials, and forms supplied by the commissioner 232.33containing the following information: 232.34    (1) the need for and purpose of preadmission screening if the person selects nursing 232.35facility placement; 233.1    (2) the role of the long-term care consultation assessment and support planning in 233.2waiver and alternative care program eligibility determination; 233.3    (3) information about Minnesota health care programs; 233.4    (4) the person's freedom to accept or reject the recommendations of the team; 233.5    (5) the person's right to confidentiality under the Minnesota Government Data 233.6Practices Act, chapter 13; 233.7    (6) the long-term care consultant's decision regarding the person's need for 233.8institutional level of care as determined under criteria established in section 144.0724, 233.9subdivision 11 , or 256B.092; and 233.10(7) the person's right to appeal the decision regarding the need for nursing facility 233.11level of care or the county's final decisions regarding public programs eligibility according 233.12to section 256.045, subdivision 3. 233.13    (i) Face-to-face assessment completed as part of eligibility determination for 233.14the alternative care, elderly waiver, community alternatives for disabled individuals, 233.15community alternative care, and traumatic brain injury waiver programs under sections 233.16256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more 233.17than 60 calendar days after the date of assessment. The effective eligibility start date 233.18for these programs can never be prior to the date of assessment. If an assessment was 233.19completed more than 60 days before the effective waiver or alternative care program 233.20eligibility start date, assessment and support plan information must be updated in a 233.21face-to-face visit and documented in the department's Medicaid Management Information 233.22System (MMIS). new text begin The updated assessment may be completed by face-to-face visit, written new text end 233.23 new text begin communication, or telephone as determined by the commissioner to establish statewide new text end 233.24 new text begin consistency. new text end The effective date of program eligibility in this case cannot be prior to the 233.25date the updated assessment is completed. 233.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 233.27    Sec. 15. Minnesota Statutes 2010, section 256B.0911, subdivision 4a, is amended to 233.28read: 233.29    Subd. 4a. Preadmission screening activities related to nursing facility 233.30admissions. (a) All applicants to Medicaid certified nursing facilities, including certified 233.31boarding care facilities, must be screened prior to admission regardless of income, assets, 233.32or funding sources for nursing facility care, except as described in subdivision 4b. The 233.33purpose of the screening is to determine the need for nursing facility level of care as 233.34described in paragraph (d) and to complete activities required under federal law related to 233.35mental illness and developmental disability as outlined in paragraph (b). 234.1(b) A person who has a diagnosis or possible diagnosis of mental illness or 234.2developmental disability must receive a preadmission screening before admission 234.3regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need 234.4for further evaluation and specialized services, unless the admission prior to screening is 234.5authorized by the local mental health authority or the local developmental disabilities case 234.6manager, or unless authorized by the county agency according to Public Law 101-508. 234.7The following criteria apply to the preadmission screening: 234.8(1) the county must use forms and criteria developed by the commissioner to identify 234.9persons who require referral for further evaluation and determination of the need for 234.10specialized services; and 234.11(2) the evaluation and determination of the need for specialized services must be 234.12done by: 234.13(i) a qualified independent mental health professional, for persons with a primary or 234.14secondary diagnosis of a serious mental illness; or 234.15(ii) a qualified developmental disability professional, for persons with a primary or 234.16secondary diagnosis of developmental disability. For purposes of this requirement, a 234.17qualified developmental disability professional must meet the standards for a qualified 234.18developmental disability professional under Code of Federal Regulations, title 42, section 234.19483.430. 234.20(c) The local county mental health authority or the state developmental disability 234.21authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 234.22nursing facility if the individual does not meet the nursing facility level of care criteria or 234.23needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 234.24purposes of this section, "specialized services" for a person with developmental disability 234.25means active treatment as that term is defined under Code of Federal Regulations, title 234.2642, section 483.440 (a)(1). 234.27(d) The determination of the need for nursing facility level of care must be made 234.28according to criteria established new text begin developed by the commissioner, and new text end in section 144.0724, 234.29subdivision 11 , and 256B.092, using forms developed by the commissioner. new text begin Effective no new text end 234.30 new text begin sooner than on or after January 1, 2014, for individuals age 21 and older, and on or after new text end 234.31 new text begin October 1, 2019, for individuals under age 21, the determination of need for nursing new text end 234.32 new text begin facility level of care shall be based on criteria in section 144.0724, subdivision 11. new text end In 234.33assessing a person's needs, consultation team members shall have a physician available for 234.34consultation and shall consider the assessment of the individual's attending physician, if 234.35any. The individual's physician must be included if the physician chooses to participate. 234.36Other personnel may be included on the team as deemed appropriate by the county. 235.1    Sec. 16. Minnesota Statutes 2010, section 256B.0911, subdivision 6, is amended to 235.2read: 235.3    Subd. 6. Payment for long-term care consultation services. (a) new text begin Seventy-five new text end 235.4 new text begin percent of new text end the total payment for each county must be paid monthly by certified nursing 235.5facilities in the county. The monthly amount to be paid by each nursing facility for each 235.6fiscal year must be determined by dividing the county's annual allocation for long-term 235.7care consultation services by 12 to determine the monthly payment and allocating the 235.8monthly payment to each nursing facility based on the number of licensed beds in the 235.9nursing facility. Payments to counties in which there is no certified nursing facility must be 235.10made by increasing the payment rate of the two facilities located nearest to the county seat. 235.11    (b) The commissioner shall include the total annual payment determined under 235.12paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434 235.13according to section 256B.431, subdivision 2b, paragraph (g). 235.14    (c) In the event of the layaway, delicensure and decertification, or removal from 235.15layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 235.16the per diem payment amount in paragraph (b) and may adjust the monthly payment 235.17amount in paragraph (a). The effective date of an adjustment made under this paragraph 235.18shall be on or after the first day of the month following the effective date of the layaway, 235.19delicensure and decertification, or removal from layaway. 235.20    (d) Payments for long-term care consultation services are available to the county 235.21or counties to cover staff salaries and expenses to provide the services described in 235.22subdivision 1a. The county shall employ, or contract with other agencies to employ, within 235.23the limits of available funding, sufficient personnel to provide long-term care consultation 235.24services while meeting the state's long-term care outcomes and objectives as defined in 235.25section 256B.0917, subdivision 1. The county shall be accountable for meeting local 235.26objectives as approved by the commissioner in the biennial home and community-based 235.27services quality assurance plan on a form provided by the commissioner. 235.28    (e) Notwithstanding section 256B.0641, overpayments attributable to payment of the 235.29screening costs under the medical assistance program may not be recovered from a facility. 235.30    (f) The commissioner of human services shall amend the Minnesota medical 235.31assistance plan to include reimbursement for the local consultation teams. 235.32    (g) The county may bill, as case management services, assessments, support 235.33planning, and follow-along provided to persons determined to be eligible for case 235.34management under Minnesota health care programs. No individual or family member 235.35shall be charged for an initial assessment or initial support plan development provided 235.36under subdivision 3a or 3b. new text begin Counties may set a fee schedule for initial assessments and new text end 236.1 new text begin support plan development for individuals who are not financially eligible for medical new text end 236.2 new text begin assistance or MinnesotaCare. The maximum fee must not be greater than the actual cost new text end 236.3 new text begin of the initial assessment and support plan development. new text end 236.4(h) The commissioner shall develop an alternative payment methodology for 236.5long-term care consultation services that includes the funding available under this 236.6subdivision, and sections 256B.092 and 256B.0659. In developing the new payment 236.7methodology, the commissioner shall consider the maximization of federal funding for 236.8this activity. 236.9    Sec. 17. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to 236.10read: 236.11    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients. 236.12    (a) Funding for services under the alternative care program is available to persons who 236.13meet the following criteria: 236.14    (1) the person has been determined by a community assessment under section 236.15256B.0911 to be a person who would require the level of care provided in a nursing 236.16facility, new text begin as determined under section 256B.0911, subdivision 4a, paragraph (d), new text end but for 236.17the provision of services under the alternative care program. Effective January 1, 2011, 236.18this determination must be made according to the criteria established in section 144.0724, 236.19subdivision 11 ; 236.20    (2) the person is age 65 or older; 236.21    (3) the person would be eligible for medical assistance within 135 days of admission 236.22to a nursing facility; 236.23    (4) the person is not ineligible for the payment of long-term care services by the 236.24medical assistance program due to an asset transfer penalty under section 256B.0595 or 236.25equity interest in the home exceeding $500,000 as stated in section 256B.056; 236.26    (5) the person needs long-term care services that are not funded through other 236.27state or federal funding, or other health insurance or other third-party insurance such as 236.28long-term care insurance; 236.29    (6) except for individuals described in clause (7), the monthly cost of the alternative 236.30care services funded by the program for this person does not exceed 75 percent of the 236.31monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 236.32does not prohibit the alternative care client from payment for additional services, but in no 236.33case may the cost of additional services purchased under this section exceed the difference 236.34between the client's monthly service limit defined under section 256B.0915, subdivision 236.353 , and the alternative care program monthly service limit defined in this paragraph. If 237.1care-related supplies and equipment or environmental modifications and adaptations are or 237.2will be purchased for an alternative care services recipient, the costs may be prorated on a 237.3monthly basis for up to 12 consecutive months beginning with the month of purchase. 237.4If the monthly cost of a recipient's other alternative care services exceeds the monthly 237.5limit established in this paragraph, the annual cost of the alternative care services shall be 237.6determined. In this event, the annual cost of alternative care services shall not exceed 12 237.7times the monthly limit described in this paragraph; 237.8    (7) for individuals assigned a case mix classification A as described under section 237.9256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily 237.10living, new text begin or new text end (ii) only one dependency new text begin up to two dependencies new text end in bathing, dressing, grooming, 237.11or walking, or (iii) a dependency score of less than three if eating is the only dependency new text begin new text end 237.12 new text begin and eating when the dependency score in eating is three or greater new text end as determined by 237.13an assessment performed under section 256B.0911, the monthly cost of alternative 237.14care services funded by the program cannot exceed $600 new text begin $593 new text end per month for all new 237.15participants enrolled in the program on or after July 1, 2009 new text begin 2011 new text end . This monthly limit 237.16shall be applied to all other participants who meet this criteria at reassessment. This 237.17monthly limit shall be increased annually as described in section 256B.0915, subdivision 237.183a , paragraph (a). This monthly limit does not prohibit the alternative care client from 237.19payment for additional services, but in no case may the cost of additional services 237.20purchased exceed the difference between the client's monthly service limit defined in this 237.21clause and the limit described in clause (6) for case mix classification A; and 237.22(8) the person is making timely payments of the assessed monthly fee. 237.23A person is ineligible if payment of the fee is over 60 days past due, unless the person 237.24agrees to: 237.25    (i) the appointment of a representative payee; 237.26    (ii) automatic payment from a financial account; 237.27    (iii) the establishment of greater family involvement in the financial management of 237.28payments; or 237.29    (iv) another method acceptable to the lead agency to ensure prompt fee payments. 237.30    The lead agency may extend the client's eligibility as necessary while making 237.31arrangements to facilitate payment of past-due amounts and future premium payments. 237.32Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 237.33reinstated for a period of 30 days. 237.34    (b) Alternative care funding under this subdivision is not available for a person 237.35who is a medical assistance recipient or who would be eligible for medical assistance 237.36without a spenddown or waiver obligation. A person whose initial application for medical 238.1assistance and the elderly waiver program is being processed may be served under the 238.2alternative care program for a period up to 60 days. If the individual is found to be eligible 238.3for medical assistance, medical assistance must be billed for services payable under the 238.4federally approved elderly waiver plan and delivered from the date the individual was 238.5found eligible for the federally approved elderly waiver plan. Notwithstanding this 238.6provision, alternative care funds may not be used to pay for any service the cost of which: 238.7(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 238.8or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 238.9to participate in the federally approved elderly waiver program under the special income 238.10standard provision. 238.11    (c) Alternative care funding is not available for a person who resides in a licensed 238.12nursing home, certified boarding care home, hospital, or intermediate care facility, except 238.13for case management services which are provided in support of the discharge planning 238.14process for a nursing home resident or certified boarding care home resident to assist with 238.15a relocation process to a community-based setting. 238.16    (d) Alternative care funding is not available for a person whose income is greater 238.17than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 238.18to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 238.19year for which alternative care eligibility is determined, who would be eligible for the 238.20elderly waiver with a waiver obligation. 238.21    Sec. 18. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to 238.22read: 238.23    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of 238.24waivered services to an individual elderly waiver client except for individuals described 238.25in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 238.26mix resident class to which the elderly waiver client would be assigned under Minnesota 238.27Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 238.28as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 238.29which the resident assessment system as described in section 256B.438 for nursing home 238.30rate determination is implemented. Effective on the first day of the state fiscal year in 238.31which the resident assessment system as described in section 256B.438 for nursing home 238.32rate determination is implemented and the first day of each subsequent state fiscal year, the 238.33monthly limit for the cost of waivered services to an individual elderly waiver client shall 238.34be the rate of the case mix resident class to which the waiver client would be assigned 238.35under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 239.1previous state fiscal year, adjusted by the greater of any legislatively adopted home and 239.2community-based services percentage rate increase or the average statewide percentage 239.3increase in nursing facility payment rates new text begin adjustment new text end . 239.4    (b) The monthly limit for the cost of waivered services to an individual elderly 239.5waiver client assigned to a case mix classification A under paragraph (a) with new text begin : new text end 239.6(1) no dependencies in activities of daily living, new text begin ; or new text end 239.7(2) only one dependency new text begin up to two dependencies new text end in bathing, dressing, grooming, or 239.8walking, or (3) a dependency score of less than three if eating is the only dependency, new text begin new text end 239.9 new text begin and eating when the dependency score in eating is three or greater as determined by an new text end 239.10 new text begin assessment performed under section 256B.0911 new text end 239.11 shall be the lower of the case mix classification amount for case mix A as determined 239.12under paragraph (a) or the case mix classification amount for case mix A new text begin $1,750 per new text end 239.13 new text begin month new text end effective on October new text begin July new text end 1, 2008 new text begin 2011 new text end , per month for all new participants enrolled 239.14in the program on or after July 1, 2009 new text begin 2011 new text end . This monthly limit shall be applied to all 239.15other participants who meet this criteria at reassessment. new text begin This monthly limit shall be new text end 239.16 new text begin increased annually as described in paragraph (a). new text end 239.17(c) If extended medical supplies and equipment or environmental modifications are 239.18or will be purchased for an elderly waiver client, the costs may be prorated for up to 239.1912 consecutive months beginning with the month of purchase. If the monthly cost of a 239.20recipient's waivered services exceeds the monthly limit established in paragraph (a) or 239.21(b), the annual cost of all waivered services shall be determined. In this event, the annual 239.22cost of all waivered services shall not exceed 12 times the monthly limit of waivered 239.23services as described in paragraph (a) or (b). 239.24    Sec. 19. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to 239.25read: 239.26    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing 239.27facility. (a) For a person who is a nursing facility resident at the time of requesting a 239.28determination of eligibility for elderly waivered services, a monthly conversion new text begin budget new text end 239.29limit for the cost of elderly waivered services may be requested. The monthly conversion 239.30 new text begin budget new text end limit for the cost of elderly waiver services shall be the resident class assigned 239.31under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing 239.32facility where the resident currently resides until July 1 of the state fiscal year in which 239.33the resident assessment system as described in section 256B.438 for nursing home rate 239.34determination is implemented. Effective on July 1 of the state fiscal year in which the 239.35resident assessment system as described in section 256B.438 for nursing home rate 240.1determination is implemented, the monthly conversion new text begin budget new text end limit for the cost of elderly 240.2waiver services shall be new text begin based on new text end the per diem nursing facility rate as determined by the 240.3resident assessment system as described in section 256B.438 for that resident new text begin residents new text end 240.4in the nursing facility where the resident new text begin elderly waiver applicant new text end currently resides 240.5multiplied new text begin . The monthly conversion budget limit shall be calculated by multiplying the new text end 240.6 new text begin per diem new text end by 365 and new text begin , new text end divided by 12, less new text begin and reduced by new text end the recipient's maintenance needs 240.7allowance as described in subdivision 1d. The initially approved new text begin monthly new text end conversion rate 240.8may new text begin budget limit shall new text end be adjusted by the greater of any subsequent legislatively adopted 240.9home and community-based services percentage rate increase or the average statewide 240.10percentage increase in nursing facility payment rates new text begin annually as described in subdivision new text end 240.11 new text begin 3a, paragraph (a) new text end . The limit under this subdivision only applies to persons discharged from 240.12a nursing facility after a minimum 30-day stay and found eligible for waivered services 240.13on or after July 1, 1997. For conversions from the nursing home to the elderly waiver 240.14with consumer directed community support services, the conversion rate limit is equal to 240.15the nursing facility rate new text begin per diem used to calculate the monthly conversion budget limit new text end 240.16 new text begin must be new text end reduced by a percentage equal to the percentage difference between the consumer 240.17directed services budget limit that would be assigned according to the federally approved 240.18waiver plan and the corresponding community case mix cap, but not to exceed 50 percent. 240.19    (b) The following costs must be included in determining the total monthly costs 240.20for the waiver client: 240.21    (1) cost of all waivered services, including extended medical new text begin specialized new text end supplies 240.22and equipment and environmental modifications and new text begin accessibility new text end adaptations; and 240.23    (2) cost of skilled nursing, home health aide, and personal care services reimbursable 240.24by medical assistance. 240.25    Sec. 20. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to 240.26read: 240.27    Subd. 3e. Customized living service rate. (a) Payment for customized living 240.28services shall be a monthly rate authorized by the lead agency within the parameters 240.29established by the commissioner. The payment agreement must delineate the amount of 240.30each component service included in the recipient's customized living service plan. The 240.31lead agency shall ensure that there is a documented need within the parameters established 240.32by the commissioner for all component customized living services authorized. 240.33(b) The payment rate must be based on the amount of component services to be 240.34provided utilizing component rates established by the commissioner. Counties and tribes 241.1shall use tools issued by the commissioner to develop and document customized living 241.2service plans and rates. 241.3(c) Component service rates must not exceed payment rates for comparable elderly 241.4waiver or medical assistance services and must reflect economies of scale. Customized 241.5living services must not include rent or raw food costs. 241.6    (d) new text begin With the exception of individuals described in subdivision 3a, paragraph (b), new text end the 241.7individualized monthly authorized payment for the customized living service plan shall 241.8not exceed 50 percent of the greater of either the statewide or any of the geographic 241.9groups' weighted average monthly nursing facility rate of the case mix resident class 241.10to which the elderly waiver eligible client would be assigned under Minnesota Rules, 241.11parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 241.12in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 241.13resident assessment system as described in section 256B.438 for nursing home rate 241.14determination is implemented. Effective on July 1 of the state fiscal year in which 241.15the resident assessment system as described in section 256B.438 for nursing home 241.16rate determination is implemented and July 1 of each subsequent state fiscal year, the 241.17individualized monthly authorized payment for the services described in this clause shall 241.18not exceed the limit which was in effect on June 30 of the previous state fiscal year 241.19updated annually based on legislatively adopted changes to all service rate maximums for 241.20home and community-based service providers. 241.21 new text begin (e) Effective July 1, 2011, the individualized monthly payment for the customized new text end 241.22 new text begin living service plan for individuals described in subdivision 3a, paragraph (b), must be the new text end 241.23 new text begin monthly authorized payment limit for customized living for individuals classified as case new text end 241.24 new text begin mix A, reduced by 25 percent. This rate limit must be applied to all new participants new text end 241.25 new text begin enrolled in the program on or after July 1, 2011, who meet the criteria described in new text end 241.26 new text begin subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who new text end 241.27 new text begin meet the criteria described in subdivision 3a, paragraph (b), at reassessment. new text end 241.28    (e) new text begin (f) new text end Customized living services are delivered by a provider licensed by the 241.29Department of Health as a class A or class F home care provider and provided in a 241.30building that is registered as a housing with services establishment under chapter 144D. new text begin new text end 241.31 new text begin Licensed home care providers are subject to section 256B.0651, subdivision 14. new text end 241.32 new text begin (g) A provider may not bill or otherwise charge an elderly waiver participant or their new text end 241.33 new text begin family for additional units of any allowable component service beyond those available new text end 241.34 new text begin under the service rate limits described in paragraph (d), nor for additional units of any new text end 241.35 new text begin allowable component service beyond those approved in the service plan by the lead agency. new text end 242.1    Sec. 21. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to 242.2read: 242.3    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The 242.4payment rate for 24-hour customized living services is a monthly rate authorized by the 242.5lead agency within the parameters established by the commissioner of human services. 242.6The payment agreement must delineate the amount of each component service included in 242.7each recipient's customized living service plan. The lead agency shall ensure that there is a 242.8documented need within the parameters established by the commissioner for all component 242.9customized living services authorized. The lead agency shall not authorize 24-hour 242.10customized living services unless there is a documented need for 24-hour supervision. 242.11(b) For purposes of this section, "24-hour supervision" means that the recipient 242.12requires assistance due to needs related to one or more of the following: 242.13    (1) intermittent assistance with toileting, positioning, or transferring; 242.14    (2) cognitive or behavioral issues; 242.15    (3) a medical condition that requires clinical monitoring; or 242.16    (4) for all new participants enrolled in the program on or after January new text begin July new text end 1, 2011, 242.17and all other participants at their first reassessment after January new text begin July new text end 1, 2011, dependency 242.18in at least two new text begin three new text end of the following activities of daily living as determined by assessment 242.19under section 256B.0911: bathing; dressing; grooming; walking; or eating new text begin when the new text end 242.20 new text begin dependency score in eating is three or greater new text end ; and needs medication management and at 242.21least 50 hours of service per month. The lead agency shall ensure that the frequency and 242.22mode of supervision of the recipient and the qualifications of staff providing supervision 242.23are described and meet the needs of the recipient. 242.24(c) The payment rate for 24-hour customized living services must be based on the 242.25amount of component services to be provided utilizing component rates established by the 242.26commissioner. Counties and tribes will use tools issued by the commissioner to develop 242.27and document customized living plans and authorize rates. 242.28(d) Component service rates must not exceed payment rates for comparable elderly 242.29waiver or medical assistance services and must reflect economies of scale. 242.30(e) The individually authorized 24-hour customized living payments, in combination 242.31with the payment for other elderly waiver services, including case management, must not 242.32exceed the recipient's community budget cap specified in subdivision 3a. Customized 242.33living services must not include rent or raw food costs. 242.34(f) The individually authorized 24-hour customized living payment rates shall not 242.35exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 242.36living services in effect and in the Medicaid management information systems on March 243.131, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 243.2to 9549.0059, to which elderly waiver service clients are assigned. When there are 243.3fewer than 50 authorizations in effect in the case mix resident class, the commissioner 243.4shall multiply the calculated service payment rate maximum for the A classification by 243.5the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 243.69549.0059, to determine the applicable payment rate maximum. Service payment rate 243.7maximums shall be updated annually based on legislatively adopted changes to all service 243.8rates for home and community-based service providers. 243.9    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 243.10may establish alternative payment rate systems for 24-hour customized living services in 243.11housing with services establishments which are freestanding buildings with a capacity of 243.1216 or fewer, by applying a single hourly rate for covered component services provided 243.13in either: 243.14    (1) licensed corporate adult foster homes; or 243.15    (2) specialized dementia care units which meet the requirements of section 144D.065 243.16and in which: 243.17    (i) each resident is offered the option of having their own apartment; or 243.18    (ii) the units are licensed as board and lodge establishments with maximum capacity 243.19of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 243.20subparts 1, 2, 3, and 4, item A. 243.21 new text begin (h) A provider may not bill or otherwise charge an elderly waiver participant or their new text end 243.22 new text begin family for additional units of any allowable component service beyond those available new text end 243.23 new text begin under the service rate limits described in paragraph (e), nor for additional units of any new text end 243.24 new text begin allowable component service beyond those approved in the service plan by the lead agency. new text end 243.25    Sec. 22. Minnesota Statutes 2010, section 256B.0915, subdivision 5, is amended to 243.26read: 243.27    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client 243.28shall receive an initial assessment of strengths, informal supports, and need for services 243.29in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 243.30client served under the elderly waiver must be conducted at least every 12 months and 243.31at other times when the case manager determines that there has been significant change 243.32in the client's functioning. This may include instances where the client is discharged 243.33from the hospital. There must be a determination that the client requires nursing facility 243.34level of care as defined in section 144.0724, subdivision 11 new text begin 256B.0911, subdivision 4a, new text end 244.1 new text begin paragraph (d) new text end , at initial and subsequent assessments to initiate and maintain participation 244.2in the waiver program. 244.3(b) Regardless of other assessments identified in section 144.0724, subdivision 244.44, as appropriate to determine nursing facility level of care for purposes of medical 244.5assistance payment for nursing facility services, only face-to-face assessments conducted 244.6according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 244.7level of care determination will be accepted for purposes of initial and ongoing access to 244.8waiver service payment. 244.9    Sec. 23. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to 244.10read: 244.11    Subd. 10. Waiver payment rates; managed care organizations. The 244.12commissioner shall adjust the elderly waiver capitation payment rates for managed care 244.13organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 244.14service rate limits for customized living services and 24-hour customized living services 244.15under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 244.16assistance rates paid to customized living providers by managed care organizations under 244.17this section shall not exceed the maximum service rate limits new text begin and component rates as new text end 244.18determined by the commissioner under subdivisions 3e and 3h. 244.19    Sec. 24. Minnesota Statutes 2010, section 256B.0916, subdivision 6a, is amended to 244.20read: 244.21    Subd. 6a. Statewide availability of consumer-directed community new text begin self-directed new text end 244.22 support services. (a) The commissioner shall submit to the federal Health Care Financing 244.23Administration by August 1, 2001, an amendment to the home and community-based 244.24waiver for persons with developmental disabilities new text begin under section 256B.092 and by April 1, new text end 244.25 new text begin 2005, for waivers under sections 256B.0915 and 256B.49, new text end to make consumer-directed 244.26community new text begin self-directed new text end support services available in every county of the state by January 244.271, 2002. 244.28(b) new text begin Until the waiver amendment for self-directed community supports under new text end 244.29 new text begin section 51 is effective, new text end if a county declines to meet the requirements for provision of 244.30consumer-directed community new text begin self-directed new text end supports, the commissioner shall contract 244.31with another county, a group of counties, or a private agency to plan for and administer 244.32consumer-directed community new text begin self-directed new text end supports in that county. 244.33(c) The state of Minnesota, county agencies, tribal governments, or administrative 244.34entities under contract to participate in the implementation and administration of the home 245.1and community-based waiver for persons with developmental disabilities, shall not be 245.2liable for damages, injuries, or liabilities sustained through the purchase of support by the 245.3individual, the individual's family, legal representative, or the authorized representative 245.4with funds received through the consumer-directed community new text begin self-directed new text end support 245.5service under this section. Liabilities include but are not limited to: workers' compensation 245.6liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment 245.7Tax Act (FUTA). 245.8 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 245.9    Sec. 25. Minnesota Statutes 2010, section 256B.092, subdivision 1a, is amended to 245.10read: 245.11    Subd. 1a. Case management administration and services. (a) The administrative 245.12functions of case management provided to or arranged for a person include: 245.13(1) review of eligibility for services; 245.14(2) screening; 245.15(3) intake; 245.16(4) diagnosis; 245.17(5) the review and authorization of services based upon an individualized service 245.18plan; and 245.19(6) responding to requests for conciliation conferences and appeals according 245.20to section made by the person, the person's legal guardian or conservator, or 245.21the parent if the person is a minor. new text begin Case management services must be provided by a new text end 245.22 new text begin public or private agency that is enrolled as a medical assistance provider determined by new text end 245.23 new text begin the commissioner to meet all of the requirements in the approved federal waiver plans. new text end 245.24 new text begin Case management services cannot be provided to a recipient by a private agency that has new text end 245.25 new text begin any financial interest in the provisions of any other services included in the recipient's new text end 245.26 new text begin coordinated service and support plan. new text end 245.27(b) Case management service activities provided to or arranged for a person include new text begin new text end 245.28 new text begin services must be provided to each recipient of home and community-based waiver new text end 245.29 new text begin services and available to those eligible for case management under sections 256B.0621 new text end 245.30 new text begin and 256B.0924, subdivision 4, who choose this service. Case management services for an new text end 245.31 new text begin eligible person include new text end : 245.32(1) development of the individual new text begin coordinated new text end service new text begin and support new text end plan; 245.33(2) informing the individual or the individual's legal guardian or conservator, or 245.34parent if the person is a minor, of service options; 245.35(3) consulting with relevant medical experts or service providers; 246.1(4) assisting the person in the identification of potential providers; 246.2(5) assisting the person to access services; 246.3(6) coordination of services, new text begin including coordinating with the person's health care new text end 246.4 new text begin home or health coordinator, new text end if coordination new text begin of long-term care or community supports and new text end 246.5 new text begin health care new text end is not provided by another service provider; 246.6(7) evaluation and monitoring of the services identified in the plan new text begin including at least new text end 246.7 new text begin one face-to-face visit with each person annually by the case manager new text end ; and 246.8(8) annual reviews of service plans and services provided new text begin providing the lead agency new text end 246.9 new text begin with recommendations for service authorization based upon the individual's needs new text end 246.10 new text begin identified in the support plan within ten working days after receiving the community new text end 246.11 new text begin support plan from the certified assessor under section 256B.0911 new text end . 246.12(c) Case management administration and service activities that are provided to the 246.13person with a developmental disability shall be provided directly by county agencies or 246.14under contract new text begin a public or private agency that is enrolled as a medical assistance provider new text end 246.15 new text begin determined by the commissioner to meet all of the requirements in section 256B.0621, new text end 246.16 new text begin subdivision 5, paragraphs (a) and (b), clauses (1) to (5), and has no financial interest in the new text end 246.17 new text begin provision of any other services to the person choosing case management service new text end . 246.18(d) Case managers are responsible for the administrative duties and service 246.19provisions listed in paragraphs (a) and (b). Case managers shall collaborate with 246.20consumers, families, legal representatives, and relevant medical experts and service 246.21providers in the development and annual review of the individualized service and 246.22habilitation plans. 246.23(e) The Department of Human Services shall offer ongoing education in case 246.24management to case managers. Case managers shall receive no less than ten hours of case 246.25management education and disability-related training each year. 246.26 new text begin (f) Persons eligible for home and community-based waiver services may choose a new text end 246.27 new text begin case management service provider from among the public or private vendors enrolled new text end 246.28 new text begin according to paragraph (d). new text end 246.29 new text begin (g) For persons eligible for case management under section 256B.0924, and new text end 246.30 new text begin Minnesota Rules, parts 9525.0004 to 9525.0036, the county or lead agency shall designate new text end 246.31 new text begin the case management service provider. new text end 246.32 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2013, except subdivision new text end 246.33 new text begin 1a, paragraph (b), clause (6), is effective July 1, 2011. new text end 246.34    Sec. 26. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to 246.35read: 247.1    Subd. 1b. Individual new text begin Coordinated new text end service new text begin and support new text end plan. The individual new text begin Each new text end 247.2 new text begin recipient of case management services and any legal representative shall be provided a new text end 247.3 new text begin written copy of the coordinated new text end service new text begin and support new text end plan must new text begin , which new text end : 247.4(1) include new text begin is developed within ten working days after the case management service new text end 247.5 new text begin receives the community support plan from the certified assessor under section 256B.0911; new text end 247.6 new text begin (2) includes new text end the results of the assessment information on the person's need for 247.7service, including identification of service needs that will be or that are met by the person's 247.8relatives, friends, and others, as well as community services used by the general public; 247.9 new text begin (3) reasonably assures the health, safety, and welfare of the recipient; new text end 247.10(2) identify new text begin (4) identifies new text end the person's preferences for services as stated by the person, 247.11the person's legal guardian or conservator, or the parent if the person is a minor; 247.12 new text begin (5) provides for an informed choice, as defined in section 256B.77, subdivision 2, new text end 247.13 new text begin paragraph (o), of service and support providers; new text end 247.14(3) identify new text begin (6) identifies new text end long- and short-range goals for the person; 247.15(4) identify new text begin (7) identifies new text end specific services and the amount and frequency of the 247.16services to be provided to the person based on assessed needs, preferences, and available 247.17resources. The individual service plan shall also specify other services the person needs 247.18that are not available new text begin , and other services the person needs that are not available. The new text end 247.19 new text begin individual coordinated service and support plan shall also specify service outcomes and new text end 247.20 new text begin the provider's responsibility to monitor the achievement of the service outcomes new text end ; 247.21(5) identify new text begin (8) identifies new text end the need for an individual program new text begin individual's provider new text end 247.22plan to be developed by the provider according to the respective state and federal licensing 247.23and certification standards, and additional assessments to be completed or arranged by the 247.24provider after service initiation; 247.25(6) identify new text begin (9) identifies new text end provider responsibilities to implement and make 247.26recommendations for modification to the individual new text begin coordinated new text end service new text begin and support new text end plan; 247.27(7) include new text begin (10) includes new text end notice of the right to new text begin have assessments completed and new text end 247.28 new text begin service plans developed within specified time periods, the right to appeal action or new text end 247.29 new text begin inaction, and the right to new text end request a conciliation conference or a hearing new text begin an appeal new text end under 247.30section 256.045; 247.31(8) be new text begin (11) is new text end agreed upon and signed by the person, the person's legal guardian 247.32or conservator, or the parent if the person is a minor, and the authorized county 247.33representative; and 247.34(9) be new text begin (12) is new text end reviewed by a health professional if the person has overriding medical 247.35needs that impact the delivery of services. 248.1Service planning formats developed for interagency planning such as transition, 248.2vocational, and individual family service plans may be substituted for service planning 248.3formats developed by county agencies. 248.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2013. new text end 248.5    Sec. 27. Minnesota Statutes 2010, section 256B.092, subdivision 1e, is amended to 248.6read: 248.7    Subd. 1e. new text begin Case management service monitoring, new text end coordination, new text begin and new text end evaluation, 248.8and monitoring of services new text begin duties new text end . (a) If the individual new text begin coordinated new text end service new text begin and support new text end 248.9plan identifies the need for individual program new text begin provider new text end plans for authorized services, 248.10the case manager new text begin management service provider new text end shall assure that individual program new text begin the new text end 248.11 new text begin individual provider new text end plans are developed by the providers according to clauses (2) to (5). 248.12The providers shall assure that the individual program new text begin provider new text end plans: 248.13(1) are developed according to the respective state and federal licensing and 248.14certification requirements; 248.15(2) are designed to achieve the goals of the individual service plan; 248.16(3) are consistent with other aspects of the individual new text begin coordinated new text end service new text begin and new text end 248.17 new text begin support new text end plan; 248.18(4) assure the health and safety of the person; and 248.19(5) are developed with consistent and coordinated approaches to services new text begin and service new text end 248.20 new text begin outcomes new text end among the various service providers. 248.21(b) The case manager new text begin management service provider new text end shall monitor the provision of 248.22services: 248.23(1) to assure that the individual service plan is being followed according to 248.24paragraph (a); 248.25(2) to identify any changes or modifications that might be needed in the individual 248.26service plan, including changes resulting from recommendations of current service 248.27providers; 248.28(3) to determine if the person's legal rights are protected, and if not, notify the 248.29person's legal guardian or conservator, or the parent if the person is a minor, protection 248.30services, or licensing agencies as appropriate; and 248.31(4) to determine if the person, the person's legal guardian or conservator, or the 248.32parent if the person is a minor, is satisfied with the services provided. 248.33(c) If the provider fails to develop or carry out the individual program new text begin provider new text end plan 248.34according to paragraph (a), the case manager shall notify the person's legal guardian or 248.35conservator, or the parent if the person is a minor, the provider, the respective licensing 249.1and certification agencies, and the county board where the services are being provided. In 249.2addition, the case manager shall identify other steps needed to assure the person receives 249.3the services identified in the individual new text begin coordinated new text end service new text begin and support new text end plan. 249.4 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 249.5    Sec. 28. Minnesota Statutes 2010, section 256B.092, subdivision 1g, is amended to 249.6read: 249.7    Subd. 1g. Conditions not requiring development of individual new text begin a coordinated new text end 249.8service new text begin and support new text end plan. Unless otherwise required by federal law, the county agency is 249.9not required to complete an individual new text begin a coordinated new text end service new text begin and support new text end plan as defined in 249.10subdivision 1b for: 249.11(1) persons whose families are requesting respite care for their family member who 249.12resides with them, or whose families are requesting a family support grant and are not 249.13requesting purchase or arrangement of habilitative services; and 249.14(2) persons with developmental disabilities, living independently without authorized 249.15services or receiving funding for services at a rehabilitation facility as defined in section 249.16268A.01, subdivision 6 , and not in need of or requesting additional services. 249.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 249.18    Sec. 29. Minnesota Statutes 2010, section 256B.092, subdivision 3, is amended to read: 249.19    Subd. 3. Authorization and termination of services. County agency case 249.20managers new text begin Lead agencies new text end , under rules of the commissioner, shall authorize and terminate 249.21services of community and regional treatment center providers according to individual new text begin new text end 249.22 new text begin coordinated new text end service new text begin and support new text end plans. Services provided to persons with developmental 249.23disabilities may only be authorized and terminated by case managers according to (1) 249.24rules of the commissioner and (2) the individual new text begin coordinated new text end service new text begin and support new text end plan as 249.25defined in subdivision 1b. Medical assistance services not needed shall not be authorized 249.26by county agencies or funded by the commissioner. When purchasing or arranging for 249.27unlicensed respite care services for persons with overriding health needs, the county 249.28agency shall seek the advice of a health care professional in assessing provider staff 249.29training needs and skills necessary to meet the medical needs of the person. 249.30 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 249.31    Sec. 30. Minnesota Statutes 2010, section 256B.092, subdivision 8, is amended to read: 250.1    Subd. 8. Screening team new text begin Additional certified assessor new text end duties. The screening team 250.2 new text begin certified assessor new text end shall: 250.3(1) review diagnostic data; 250.4(2) review health, social, and developmental assessment data using a uniform 250.5screening new text begin comprehensive assessment new text end tool specified by the commissioner; 250.6(3) identify the level of services appropriate to maintain the person in the most 250.7normal and least restrictive setting that is consistent with the person's treatment needs; 250.8(4) identify other noninstitutional public assistance or social service that may prevent 250.9or delay long-term residential placement; 250.10(5) assess whether a person is in need of long-term residential care; 250.11(6) make recommendations regarding placement new text begin services new text end and payment for: (i) social 250.12service or public assistance support, or both, to maintain a person in the person's own home 250.13or other place of residence; (ii) training and habilitation service, vocational rehabilitation, 250.14and employment training activities; (iii) community residential placement new text begin services new text end ; (iv) 250.15regional treatment center placement; or (v) new text begin (iv) new text end a home and community-based service 250.16alternative to community residential placement or regional treatment center placement; 250.17(7) evaluate the availability, location, and quality of the services listed in clause 250.18(6), including the impact of placement alternatives new text begin services and supports options new text end on the 250.19person's ability to maintain or improve existing patterns of contact and involvement with 250.20parents and other family members; 250.21(8) identify the cost implications of recommendations in clause (6) new text begin and provide new text end 250.22 new text begin written notice of the annual and monthly average authorized amount to be spent for new text end 250.23 new text begin services for the recipient new text end ; 250.24(9) make recommendations to a court as may be needed to assist the court in making 250.25decisions regarding commitment of persons with developmental disabilities; and 250.26(10) inform the person and the person's legal guardian or conservator, or the parent if 250.27the person is a minor, that appeal may be made to the commissioner pursuant to section 250.28256.045 . 250.29 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 250.30    Sec. 31. new text begin [256B.0961] STATE QUALITY ASSURANCE, QUALITY new text end 250.31 new text begin IMPROVEMENT, AND LICENSING SYSTEM. new text end 250.32     new text begin Subdivision 1. new text end new text begin Scope. new text end new text begin (a) In order to improve the quality of services provided to new text end 250.33 new text begin Minnesotans with disabilities and to meet the requirements of the federally approved new text end 250.34 new text begin home and community-based waivers under section 1915c of the Social Security Act, a new text end 250.35 new text begin State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans new text end 251.1 new text begin receiving disability services is enacted. This system is a partnership between the new text end 251.2 new text begin Department of Human Services and the State Quality Council established under new text end 251.3 new text begin subdivision 3. new text end 251.4     new text begin (b) This system is a result of the recommendations from the Department of Human new text end 251.5 new text begin Services' licensing and alternative quality assurance study mandated under Laws 2005, new text end 251.6 new text begin First Special Session chapter 4, article 7, section 57, and presented to the legislature new text end 251.7 new text begin in February 2007. new text end 251.8     new text begin (c) The disability services eligible under this section include: new text end 251.9     new text begin (1) the home and community-based services waiver programs for persons with new text end 251.10 new text begin developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, new text end 251.11 new text begin including traumatic brain injuries and services for those who qualify for nursing facility new text end 251.12 new text begin level of care or hospital facility level of care; new text end 251.13     new text begin (2) home care services under section 256B.0651; new text end 251.14     new text begin (3) family support grants under section 252.32; new text end 251.15     new text begin (4) consumer support grants under section 256.476; new text end 251.16     new text begin (5) semi-independent living services under section 252.275; and new text end 251.17     new text begin (6) services provided through an intermediate care facility for the developmentally new text end 251.18 new text begin disabled. new text end 251.19     new text begin (d) For purposes of this section, the following definitions apply: new text end 251.20     new text begin (1) "commissioner" means the commissioner of human services; new text end 251.21     new text begin (2) "council" means the State Quality Council under subdivision 3; new text end 251.22     new text begin (3) "Quality Assurance Commission" means the commission under section new text end 251.23 new text begin 256B.0951; and new text end 251.24     new text begin (4) "system" means the State Quality Assurance, Quality Improvement and new text end 251.25 new text begin Licensing System under this section. new text end 251.26     new text begin Subd. 2. new text end new text begin Duties of the commissioner of human services. new text end new text begin (a) The commissioner of new text end 251.27 new text begin human services shall establish the State Quality Council under subdivision 3. new text end 251.28     new text begin (b) The commissioner shall initially delegate authority to perform licensing new text end 251.29 new text begin functions and activities according to section 245A.16 to a host county in Region 10. The new text end 251.30 new text begin commissioner must not license or reimburse a participating facility, program, or service new text end 251.31 new text begin located in Region 10 if the commissioner has received notification from the host county new text end 251.32 new text begin that the facility, program, or service has failed to qualify for licensure. new text end 251.33     new text begin (c) The commissioner may conduct random licensing inspections based on outcomes new text end 251.34 new text begin adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services new text end 251.35 new text begin eligible under this section. The role of the random inspections is to verify that the system new text end 252.1 new text begin protects the safety and well-being of persons served and maintains the availability of new text end 252.2 new text begin high-quality services for persons with disabilities. new text end 252.3     new text begin (d) The commissioner shall ensure that the federal home and community-based new text end 252.4 new text begin waiver requirements are met and that incidents that may have jeopardized safety and health new text end 252.5 new text begin or violated services-related assurances, civil and human rights, and other protections new text end 252.6 new text begin designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and new text end 252.7 new text begin acted upon in a timely manner. new text end 252.8     new text begin (e) The commissioner shall seek a federal waiver by July 1, 2012 to allow new text end 252.9 new text begin intermediate care facilities for persons with developmental disabilities to participate in new text end 252.10 new text begin this system. new text end 252.11     new text begin Subd. 3. new text end new text begin State Quality Council. new text end new text begin (a) There is hereby created a State Quality new text end 252.12 new text begin Council which must define regional quality councils, and carry out a community-based, new text end 252.13 new text begin person-directed quality review component, and a comprehensive system for effective new text end 252.14 new text begin incident reporting, investigation, analysis, and follow-up. new text end 252.15     new text begin (b) By August 1, 2011, the commissioner of human services shall appoint the new text end 252.16 new text begin members of the initial State Quality Council. Members shall include representatives new text end 252.17 new text begin from the following groups: new text end 252.18     new text begin (1) disability service recipients and their family members; new text end 252.19     new text begin (2) during the first two years of the State Quality Council, there must be at least three new text end 252.20 new text begin members from the Region 10 stakeholders. As regional quality councils are formed under new text end 252.21 new text begin subdivision 4, each regional quality council shall appoint one member; new text end 252.22     new text begin (3) disability service providers; new text end 252.23     new text begin (4) disability advocacy groups; and new text end 252.24     new text begin (5) county human services agencies and staff from the Departments of Human new text end 252.25 new text begin Services and Health, and Ombudsman for Mental Health and Developmental Disabilities. new text end 252.26     new text begin (c) Members of the council who do not receive a salary or wages from an employer new text end 252.27 new text begin for time spent on council duties may receive a per diem payment when performing council new text end 252.28 new text begin duties and functions. new text end 252.29     new text begin (d) The State Quality Council shall: new text end 252.30     new text begin (1) assist the Departments of Human Services and Health in fulfilling federally new text end 252.31 new text begin mandated obligations by monitoring disability service quality and quality assurance and new text end 252.32 new text begin improvement practices in Minnesota; and new text end 252.33     new text begin (2) establish state quality improvement priorities with methods for achieving results new text end 252.34 new text begin and provide an annual report to the legislative committees with jurisdiction over policy new text end 252.35 new text begin and funding of disability services on the outcomes, improvement priorities, and activities new text end 252.36 new text begin undertaken by the commission during the previous state fiscal year. new text end 253.1     new text begin (e) The State Quality Council, in partnership with the commissioner, shall: new text end 253.2     new text begin (1) approve and direct implementation of the community-based, person-directed new text end 253.3 new text begin system established in this section; new text end 253.4     new text begin (2) recommend an appropriate method of funding this system, and determine the new text end 253.5 new text begin feasibility of the use of Medicaid, licensing fees, as well as other possible funding options; new text end 253.6     new text begin (3) approve measurable outcomes in the areas of health and safety, consumer new text end 253.7 new text begin evaluation, education and training, providers, and systems; new text end 253.8     new text begin (4) establish variable licensure periods not to exceed three years based on outcomes new text end 253.9 new text begin achieved; and new text end 253.10     new text begin (5) in cooperation with the Quality Assurance Commission, design a transition plan new text end 253.11 new text begin for licensed providers from Region 10 into the alternative licensing system by July 1, 2013. new text end 253.12     new text begin (f) The State Quality Council shall notify the commissioner of human services that a new text end 253.13 new text begin facility, program, or service has been reviewed by quality assurance team members under new text end 253.14 new text begin subdivision 4, paragraph (b), clause (13), and qualifies for a license. new text end 253.15     new text begin (g) The State Quality Council, in partnership with the commissioner, shall establish new text end 253.16 new text begin an ongoing review process for the system. The review shall take into account the new text end 253.17 new text begin comprehensive nature of the system which is designed to evaluate the broad spectrum of new text end 253.18 new text begin licensed and unlicensed entities that provide services to persons with disabilities. The new text end 253.19 new text begin review shall address efficiencies and effectiveness of the system. new text end 253.20     new text begin (h) The State Quality Council may recommend to the commissioner certain new text end 253.21 new text begin variances from the standards governing licensure of programs for persons with disabilities new text end 253.22 new text begin in order to improve the quality of services so long as the recommended variances do new text end 253.23 new text begin not adversely affect the health or safety of persons being served or compromise the new text end 253.24 new text begin qualifications of staff to provide services. new text end 253.25     new text begin (i) The safety standards, rights, or procedural protections referenced under new text end 253.26 new text begin subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make new text end 253.27 new text begin recommendations to the commissioner or to the legislature in the report required under new text end 253.28 new text begin paragraph (c) regarding alternatives or modifications to the safety standards, rights, or new text end 253.29 new text begin procedural protections referenced under subdivision 2, paragraph (c). new text end 253.30     new text begin (j) The State Quality Council may hire staff to perform the duties assigned in this new text end 253.31 new text begin subdivision. new text end 253.32     new text begin Subd. 4. new text end new text begin Regional quality councils. new text end new text begin (a) The commissioner shall establish, as new text end 253.33 new text begin selected by the State Quality Council, regional quality councils of key stakeholders, new text end 253.34 new text begin including regional representatives of: new text end 253.35     new text begin (1) disability service recipients and their family members; new text end 253.36     new text begin (2) disability service providers; new text end 254.1     new text begin (3) disability advocacy groups; and new text end 254.2     new text begin (4) county human services agencies and staff from the Departments of Human new text end 254.3 new text begin Services, and Health, and Ombudsman for Mental Health and Developmental Disabilities. new text end 254.4     new text begin (b) Each regional quality council shall: new text end 254.5     new text begin (1) direct and monitor the community-based, person-directed quality assurance new text end 254.6 new text begin system in this section; new text end 254.7     new text begin (2) approve a training program for quality assurance team members under clause new text end 254.8 new text begin (13); new text end 254.9     new text begin (3) review summary reports from quality assurance team reviews and make new text end 254.10 new text begin recommendations to the State Quality Council regarding program licensure; new text end 254.11     new text begin (4) make recommendations to the State Quality Council regarding the system; new text end 254.12     new text begin (5) resolve complaints between the quality assurance teams, counties, providers, new text end 254.13 new text begin persons receiving services, their families, and legal representatives; new text end 254.14     new text begin (6) analyze and review quality outcomes and critical incident data reporting new text end 254.15 new text begin incidents of life safety concerns immediately to the Department of Human Services new text end 254.16 new text begin licensing division; new text end 254.17     new text begin (7) provide information and training programs for persons with disabilities and their new text end 254.18 new text begin families and legal representatives on service options and quality expectations; new text end 254.19     new text begin (8) disseminate information and resources developed to other regional quality new text end 254.20 new text begin councils; new text end 254.21     new text begin (9) respond to state-level priorities; new text end 254.22     new text begin (10) establish regional priorities for quality improvement; new text end 254.23     new text begin (11) submit an annual report to the State Quality Council on the status, outcomes, new text end 254.24 new text begin improvement priorities, and activities in the region; new text end 254.25     new text begin (12) choose a representative to participate on the State Quality Council and assume new text end 254.26 new text begin other responsibilities consistent with the priorities of the State Quality Council; and new text end 254.27     new text begin (13) recruit, train, and assign duties to members of quality assurance teams, taking new text end 254.28 new text begin into account the size of the service provider, the number of services to be reviewed, new text end 254.29 new text begin the skills necessary for the team members to complete the process, and ensure that no new text end 254.30 new text begin team member has a financial, personal, or family relationship with the facility, program, new text end 254.31 new text begin or service being reviewed or with anyone served at the facility, program, or service. new text end 254.32 new text begin Quality assurance teams must be comprised of county staff, persons receiving services new text end 254.33 new text begin or the person's families, legal representatives, members of advocacy organizations, new text end 254.34 new text begin providers, and other involved community members. Team members must complete new text end 254.35 new text begin the training program approved by the regional quality council and must demonstrate new text end 255.1 new text begin performance-based competency. Team members may be paid a per diem and reimbursed new text end 255.2 new text begin for expenses related to their participation in the quality assurance process. new text end 255.3     new text begin (c) The commissioner shall monitor the safety standards, rights, and procedural new text end 255.4 new text begin protections for the monitoring of psychotropic medications and those identified under new text end 255.5 new text begin sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) new text end 255.6 new text begin and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause new text end 255.7 new text begin (7); 626.556; and 626.557. new text end 255.8     new text begin (d) The regional quality councils may hire staff to perform the duties assigned in new text end 255.9 new text begin this subdivision. new text end 255.10     new text begin (e) The regional quality councils may charge fees for their services. new text end 255.11     new text begin (f) The quality assurance process undertaken by a regional quality council consists of new text end 255.12 new text begin an evaluation by a quality assurance team of the facility, program, or service. The process new text end 255.13 new text begin must include an evaluation of a random sample of persons served. The sample must be new text end 255.14 new text begin representative of each service provided. The sample size must be at least five percent but new text end 255.15 new text begin not less than two persons served. All persons must be given the opportunity to be included new text end 255.16 new text begin in the quality assurance process in addition to those chosen for the random sample. new text end 255.17     new text begin (g) A facility, program, or service may contest a licensing decision of the regional new text end 255.18 new text begin quality council as permitted under chapter 245A. new text end 255.19     new text begin Subd. 5. new text end new text begin Annual survey of service recipients. new text end new text begin The commissioner, in consultation new text end 255.20 new text begin with the State Quality Council, shall conduct an annual independent statewide survey new text end 255.21 new text begin of service recipients, randomly selected, to determine the effectiveness and quality new text end 255.22 new text begin of disability services. The survey must be consistent with the system performance new text end 255.23 new text begin expectations of the Centers for Medicare and Medicaid Services (CMS) Quality new text end 255.24 new text begin Framework. The survey must analyze whether desired outcomes for persons with different new text end 255.25 new text begin demographic, diagnostic, health, and functional needs, who are receiving different types new text end 255.26 new text begin of services in different settings and with different costs, have been achieved. Annual new text end 255.27 new text begin statewide and regional reports of the results must be published and used to assist regions, new text end 255.28 new text begin counties, and providers to plan and measure the impact of quality improvement activities. new text end 255.29     new text begin Subd. 6. new text end new text begin Mandated reporters. new text end new text begin Members of the State Quality Council under new text end 255.30 new text begin subdivision 3, the regional quality councils under subdivision 4, and quality assurance new text end 255.31 new text begin team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as new text end 255.32 new text begin defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16. new text end 255.33 new text begin EFFECTIVE DATE. new text end new text begin (a) Subdivisions 1 to 6 are effective July 1, 2011. new text end 255.34     new text begin (b) The jurisdictions of the regional quality councils in subdivision 4 must be new text end 255.35 new text begin defined, with implementation dates, by July 1, 2012. During the biennium beginning July new text end 256.1 new text begin 1, 2011, the Quality Assurance Commission shall continue to implement the alternative new text end 256.2 new text begin licensing system under this section. new text end 256.3    Sec. 32. Minnesota Statutes 2010, section 256B.19, is amended by adding a 256.4subdivision to read: 256.5     new text begin Subd. 2d. new text end new text begin Obligation of local agency to process medical assistance applications new text end 256.6 new text begin within established timelines. new text end new text begin (a) Except as provided in paragraph (b), when an individual new text end 256.7 new text begin submits an application for medical assistance and the applicant's eligibility is based on new text end 256.8 new text begin disability or on being age 65 or older, the county must determine the applicant's eligibility new text end 256.9 new text begin and mail a notice of its decision to the applicant within: new text end 256.10 new text begin (1) 60 days from the date of the application for an individual whose eligibility new text end 256.11 new text begin is based on disability; or new text end 256.12 new text begin (2) 45 days from the date of the application for an individual whose eligibility is new text end 256.13 new text begin based on being age 65 or older. new text end 256.14 new text begin (b) The county must determine eligibility and mail a notice of its decision within the new text end 256.15 new text begin time frames stated in paragraph (a), except in the following circumstances: new text end 256.16 new text begin (1) the county cannot make a determination because, despite reasonable efforts by new text end 256.17 new text begin the county to communicate what is required, the applicant or an examining physician new text end 256.18 new text begin delays or fails to take a required action; or new text end 256.19 new text begin (2) there is an administrative or other emergency beyond the county's control. For new text end 256.20 new text begin purposes of this clause, a staffing shortage does not constitute an emergency beyond new text end 256.21 new text begin the county's control. new text end 256.22 new text begin For the events in either clause (1) or (2), the county must document in the applicant's new text end 256.23 new text begin case record the reason for delaying beyond the established time frames. new text end 256.24 new text begin (c) The county must not use the time frames established in paragraph (a) as a waiting new text end 256.25 new text begin period before determining eligibility or as a reason for denying eligibility because it has new text end 256.26 new text begin not determined eligibility within the established time frames. new text end 256.27 new text begin (d) Effective July 1, 2011, unless one of the exceptions listed under paragraph (b) new text end 256.28 new text begin applies, if a county fails to comply with paragraph (a) and the applicant ultimately is new text end 256.29 new text begin determined to be eligible for medical assistance, the county is responsible for the entire new text end 256.30 new text begin cost of medical assistance services provided to the applicant by a nursing facility and not new text end 256.31 new text begin paid for by federal funds, from and including the first date of eligibility through the date new text end 256.32 new text begin on which the county mails written notice of its decision on the application. The applicable new text end 256.33 new text begin facility will bill and receive payment directly from the commissioner in customary new text end 256.34 new text begin fashion, and the commissioner shall deduct any obligation incurred under this paragraph new text end 256.35 new text begin from the amount due to the local agency under subdivision 1. new text end 257.1 new text begin (e) This subdivision supersedes subdivision 1, clause (2), if both apply to an new text end 257.2 new text begin applicant. new text end 257.3    Sec. 33. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to 257.4read: 257.5    Subd. 2r. Payment restrictions on leave days. new text begin (a) new text end Effective July 1, 1993, the 257.6commissioner shall limit payment for leave days in a nursing facility to 79 percent of that 257.7nursing facility's total payment rate for the involved resident. 257.8 new text begin (b) new text end For services rendered on or after July 1, 2003, for facilities reimbursed under this 257.9section or section 256B.434, the commissioner shall limit payment for leave days in a 257.10nursing facility to 60 percent of that nursing facility's total payment rate for the involved 257.11resident. 257.12 new text begin (c) For services rendered on or after July 1, 2011, for facilities reimbursed under new text end 257.13 new text begin this chapter, the commissioner shall limit payment for leave days in a nursing facility new text end 257.14 new text begin to 30 percent of that nursing facility's total payment rate for the involved resident, and new text end 257.15 new text begin shall allow this payment only when the occupancy of the nursing facility, inclusive of new text end 257.16 new text begin bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules, new text end 257.17 new text begin part 9505.0415. new text end 257.18    Sec. 34. Minnesota Statutes 2010, section 256B.431, is amended by adding a 257.19subdivision to read: 257.20     new text begin Subd. 44. new text end new text begin Property rate increase for a facility in Bloomington effective new text end 257.21 new text begin November 1, 2010. new text end new text begin Notwithstanding any other law to the contrary, money available for new text end 257.22 new text begin moratorium projects under section 144A.073, subdivision 11, shall be used, effective new text end 257.23 new text begin November 1, 2010, to fund an approved moratorium exception project for a nursing new text end 257.24 new text begin facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total new text end 257.25 new text begin property rate adjustment of $19.33. new text end 257.26    Sec. 35. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read: 257.27    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which 257.28have their payment rates determined under this section rather than section 256B.431, the 257.29commissioner shall establish a rate under this subdivision. The nursing facility must enter 257.30into a written contract with the commissioner. 257.31    (b) A nursing facility's case mix payment rate for the first rate year of a facility's 257.32contract under this section is the payment rate the facility would have received under 257.33section 256B.431. 258.1    (c) A nursing facility's case mix payment rates for the second and subsequent years 258.2of a facility's contract under this section are the previous rate year's contract payment 258.3rates plus an inflation adjustment and, for facilities reimbursed under this section or 258.4section 256B.431, an adjustment to include the cost of any increase in Health Department 258.5licensing fees for the facility taking effect on or after July 1, 2001. The index for the 258.6inflation adjustment must be based on the change in the Consumer Price Index-All Items 258.7(United States City average) (CPI-U) forecasted by the commissioner of management and 258.8budget's national economic consultant, as forecasted in the fourth quarter of the calendar 258.9year preceding the rate year. The inflation adjustment must be based on the 12-month 258.10period from the midpoint of the previous rate year to the midpoint of the rate year for 258.11which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 258.122000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, 258.13July 1, 2007, July 1, 2008, October 1, 2009, new text begin and new text end October 1, 2010, October 1, 2011, and 258.14October 1, 2012. this paragraph shall apply only to the property-related payment rate, 258.15except that adjustments to include the cost of any increase in Health Department licensing 258.16fees taking effect on or after July 1, 2001, shall be provided. new text begin For the rate years beginning new text end 258.17 new text begin on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall new text end 258.18 new text begin be suspended. new text end Beginning in 2005, adjustment to the property payment rate under this 258.19section and section 256B.431 shall be effective on October 1. In determining the amount 258.20of the property-related payment rate adjustment under this paragraph, the commissioner 258.21shall determine the proportion of the facility's rates that are property-related based on the 258.22facility's most recent cost report. 258.23    (d) The commissioner shall develop additional incentive-based payments of up to 258.24five percent above a facility's operating payment rate for achieving outcomes specified 258.25in a contract. The commissioner may solicit contract amendments and implement those 258.26which, on a competitive basis, best meet the state's policy objectives. The commissioner 258.27shall limit the amount of any incentive payment and the number of contract amendments 258.28under this paragraph to operate the incentive payments within funds appropriated for this 258.29purpose. The contract amendments may specify various levels of payment for various 258.30levels of performance. Incentive payments to facilities under this paragraph may be in the 258.31form of time-limited rate adjustments or onetime supplemental payments. In establishing 258.32the specified outcomes and related criteria, the commissioner shall consider the following 258.33state policy objectives: 258.34    (1) successful diversion or discharge of residents to the residents' prior home or other 258.35community-based alternatives; 258.36    (2) adoption of new technology to improve quality or efficiency; 259.1    (3) improved quality as measured in the Nursing Home Report Card; 259.2    (4) reduced acute care costs; and 259.3    (5) any additional outcomes proposed by a nursing facility that the commissioner 259.4finds desirable. 259.5    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 259.6take action to come into compliance with existing or pending requirements of the life 259.7safety code provisions or federal regulations governing sprinkler systems must receive 259.8reimbursement for the costs associated with compliance if all of the following conditions 259.9are met: 259.10    (1) the expenses associated with compliance occurred on or after January 1, 2005, 259.11and before December 31, 2008; 259.12    (2) the costs were not otherwise reimbursed under subdivision 4f or section 259.13144A.071 or 144A.073; and 259.14    (3) the total allowable costs reported under this paragraph are less than the minimum 259.15threshold established under section 256B.431, subdivision 15, paragraph (e), and 259.16subdivision 16. 259.17The commissioner shall use money appropriated for this purpose to provide to qualifying 259.18nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 259.192008. Nursing facilities that have spent money or anticipate the need to spend money 259.20to satisfy the most recent life safety code requirements by (1) installing a sprinkler 259.21system or (2) replacing all or portions of an existing sprinkler system may submit to the 259.22commissioner by June 30, 2007, on a form provided by the commissioner the actual 259.23costs of a completed project or the estimated costs, based on a project bid, of a planned 259.24project. The commissioner shall calculate a rate adjustment equal to the allowable 259.25costs of the project divided by the resident days reported for the report year ending 259.26September 30, 2006. If the costs from all projects exceed the appropriation for this 259.27purpose, the commissioner shall allocate the money appropriated on a pro rata basis 259.28to the qualifying facilities by reducing the rate adjustment determined for each facility 259.29by an equal percentage. Facilities that used estimated costs when requesting the rate 259.30adjustment shall report to the commissioner by January 31, 2009, on the use of this 259.31money on a form provided by the commissioner. If the nursing facility fails to provide 259.32the report, the commissioner shall recoup the money paid to the facility for this purpose. 259.33If the facility reports expenditures allowable under this subdivision that are less than 259.34the amount received in the facility's annualized rate adjustment, the commissioner shall 259.35recoup the difference. 260.1    Sec. 36. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read: 260.2    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human 260.3services shall calculate the amount of the planned closure rate adjustment available under 260.4subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4): 260.5(1) the amount available is the net reduction of nursing facility beds multiplied 260.6by $2,080; 260.7(2) the total number of beds in the nursing facility or facilities receiving the planned 260.8closure rate adjustment must be identified; 260.9(3) capacity days are determined by multiplying the number determined under 260.10clause (2) by 365; and 260.11(4) the planned closure rate adjustment is the amount available in clause (1), divided 260.12by capacity days determined under clause (3). 260.13(b) A planned closure rate adjustment under this section is effective on the first day 260.14of the month following completion of closure of the facility designated for closure in the 260.15application and becomes part of the nursing facility's total operating payment rate. 260.16(c) Applicants may use the planned closure rate adjustment to allow for a property 260.17payment for a new nursing facility or an addition to an existing nursing facility or as an 260.18operating payment rate adjustment. Applications approved under this subdivision are 260.19exempt from other requirements for moratorium exceptions under section 144A.073, 260.20subdivisions 2 and 3. 260.21(d) Upon the request of a closing facility, the commissioner must allow the facility a 260.22closure rate adjustment as provided under section 144A.161, subdivision 10. 260.23(e) A facility that has received a planned closure rate adjustment may reassign it 260.24to another facility that is under the same ownership at any time within three years of its 260.25effective date. The amount of the adjustment shall be computed according to paragraph (a). 260.26(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 260.27the commissioner shall recalculate planned closure rate adjustments for facilities that 260.28delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 260.29bed dollar amount. The recalculated planned closure rate adjustment shall be effective 260.30from the date the per bed dollar amount is increased. 260.31(g) For planned closures approved after June 30, 2009, the commissioner of human 260.32services shall calculate the amount of the planned closure rate adjustment available under 260.33subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4). 260.34 new text begin (h) Beginning July 16, 2011, the commissioner shall no longer approve planned new text end 260.35 new text begin closure rate adjustments under this subdivision. new text end 261.1    Sec. 37. Minnesota Statutes 2010, section 256B.441, is amended by adding a 261.2subdivision to read: 261.3     new text begin Subd. 60. new text end new text begin Rate increase for low-rate facilities. new text end new text begin (a) Effective October 1, 2011, new text end 261.4 new text begin the commissioner shall adjust the operating payment rates of a nursing facility whose new text end 261.5 new text begin operating payment rate on September 30, 2011, is greater than the 95th percentile of all new text end 261.6 new text begin nursing facilities operating payment rates. The commissioner shall: new text end 261.7 new text begin (1) array all operating payment rates in effect on September 30, 2011, at a case-mix new text end 261.8 new text begin weight equal to 1.00 (DDF) from lowest to highest; new text end 261.9 new text begin (2) remove from the array any nursing facility determined by the commissioner to new text end 261.10 new text begin be providing specialized care, determined in accordance with criteria in subdivision 51a, new text end 261.11 new text begin paragraph (b), and any facilities receiving a rate increase under paragraph (c), clause (1); new text end 261.12 new text begin (3) determine the 95th percentile of the array in clause (1); new text end 261.13 new text begin (4) compute a reduction amount not to exceed three percent, if a facility's amount new text end 261.14 new text begin in clause (1) is greater than the amount computed in clause (3) by subtracting a facility's new text end 261.15 new text begin DDF rate in clause (1) from the amount computed in clause (3); new text end 261.16 new text begin (5) compute the portion of each facility's DDF operating payment rate that is the new text end 261.17 new text begin direct care per diem based on the rates in effect on September 30, 2011; and new text end 261.18 new text begin (6) determine the change for all other case-mix levels, by multiplying the amount in new text end 261.19 new text begin clause (4) by the percentage in clause (5) and by the corresponding case-mix weight for new text end 261.20 new text begin each care level. Add to this product the non-direct care per diem portion of the amount new text end 261.21 new text begin in clause (4). new text end 261.22 new text begin (b) The total amount to be saved by the rate reductions will be computed. The new text end 261.23 new text begin commissioner shall: new text end 261.24 new text begin (1) for each facility receiving a rate change in paragraph (a), multiply each case-mix new text end 261.25 new text begin level's rate change in paragraph (a), clause (6), by the corresponding case-mix resident new text end 261.26 new text begin days from the most recent cost report that has been desk audited; and new text end 261.27 new text begin (2) sum all the products computed in clause (1). new text end 261.28 new text begin (c) The amount of total payment reductions computed in paragraph (b) shall be new text end 261.29 new text begin distributed to the facilities with the lowest DDF operating payment rates determined in new text end 261.30 new text begin paragraph (a), clause (1). The commissioner shall: new text end 261.31 new text begin (1) for nursing facilities located no more than one-quarter mile from a peer group new text end 261.32 new text begin with higher limits under either subdivision 50 or 51, give an operating rate adjustment. new text end 261.33 new text begin The operating payment rates of a lower-limit peer group facility must be adjusted to be new text end 261.34 new text begin equal to those of the nearest facility in a higher-limit peer group if that facility's RUG rate new text end 261.35 new text begin with a weight of 1.00 is higher than the lower-limit peer group facility. Peer groups are new text end 262.1 new text begin those defined in subdivision 30. The nearest facility must be determined by the most new text end 262.2 new text begin direct driving route; new text end 262.3 new text begin (2) start with the facility or facilities with the lowest DDF operating payment rate new text end 262.4 new text begin and compute the amount of a rate adjustment needed to make the DDF rate equal to the new text end 262.5 new text begin DDF of the facility directly below it in the array; new text end 262.6 new text begin (3) compute the rate increases for the other case-mix levels using the amount new text end 262.7 new text begin computed in clause (2), and the process stated in paragraph (a), clauses (5) and (6); new text end 262.8 new text begin (4) compute the total amount the lowest facilities will receive using the process new text end 262.9 new text begin described in paragraph (b); new text end 262.10 new text begin (5) compute the running total to be spent at all facilities receiving an increase under new text end 262.11 new text begin this paragraph by summing each facility's amount computed in clause (4); and new text end 262.12 new text begin (6) repeat the process in clauses (2) to (5) as long as the amount in clause (5) does new text end 262.13 new text begin not exceed the amount in paragraph (b), clause (2). In no case shall the DDF operating new text end 262.14 new text begin payment rate increase determined in clauses (2) to (6) exceed two percent. new text end 262.15    Sec. 38. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read: 262.16    Subdivision 1. Prohibited practices. A nursing facility is not eligible to receive 262.17medical assistance payments unless it refrains from all of the following: 262.18(a) Charging private paying residents rates for similar services which exceed those 262.19which are approved by the state agency for medical assistance recipients as determined by 262.20the prospective desk audit rate, except under the following circumstances: 262.21 new text begin (1) new text end the nursing facility may new text begin : new text end 262.22(1) new text begin (i) new text end charge private paying residents a higher rate for a private room, new text begin ; new text end and 262.23(2) new text begin (ii) new text end charge for special services which are not included in the daily rate if medical 262.24assistance residents are charged separately at the same rate for the same services in 262.25addition to the daily rate paid by the commissioner. new text begin ; new text end 262.26 new text begin (2) effective July 1, 2011, through September 30, 2012, nursing facilities may charge new text end 262.27 new text begin private paying residents rates up to two percent higher than the allowable payment rate new text end 262.28 new text begin determined by the commissioner for the RUGS group currently assigned to the resident; new text end 262.29 new text begin (3) effective October 1, 2012, through September 30, 2013, nursing facilities new text end 262.30 new text begin may charge private paying residents rates up to four percent higher than the allowable new text end 262.31 new text begin payment rate determined by the commissioner for the RUGS group currently assigned new text end 262.32 new text begin to the resident; new text end 262.33 new text begin (4) effective October 1, 2013, through September 30, 2014, nursing facilities may new text end 262.34 new text begin charge private paying residents rates up to six percent higher than the allowable payment new text end 263.1 new text begin rate determined by the commissioner for the RUGS group currently assigned to the new text end 263.2 new text begin resident; new text end 263.3 new text begin (5) effective October 1, 2014, nursing facilities may charge private paying new text end 263.4 new text begin residents up to eight percent higher than the allowable payment rate determined by the new text end 263.5 new text begin commissioner for the RUGS group currently assigned to the resident; and new text end 263.6 new text begin (6) the higher private pay charges allowed in this paragraph shall be limited to actual new text end 263.7 new text begin costs per resident day, as determined by the commissioner, based on data provided in the new text end 263.8 new text begin statistical and cost report in section 256B.441. new text end 263.9 new text begin Nothing in this section precludes a nursing facility from charging a rate allowable new text end 263.10 new text begin under the facility's single room election option under Minnesota Rules, part 9549.0060, new text end 263.11 new text begin subpart 11. new text end Services covered by the payment rate must be the same regardless of payment 263.12source. Special services, if offered, must be available to all residents in all areas of the 263.13nursing facility and charged separately at the same rate. Residents are free to select 263.14or decline special services. Special services must not include services which must be 263.15provided by the nursing facility in order to comply with licensure or certification standards 263.16and that if not provided would result in a deficiency or violation by the nursing facility. 263.17Services beyond those required to comply with licensure or certification standards must 263.18not be charged separately as a special service if they were included in the payment rate for 263.19the previous reporting year. A nursing facility that charges a private paying resident a rate 263.20in violation of this clause is subject to an action by the state of Minnesota or any of its 263.21subdivisions or agencies for civil damages. A private paying resident or the resident's legal 263.22representative has a cause of action for civil damages against a nursing facility that charges 263.23the resident rates in violation of this clause. The damages awarded shall include three 263.24times the payments that result from the violation, together with costs and disbursements, 263.25including reasonable attorneys' fees or their equivalent. A private paying resident or the 263.26resident's legal representative, the state, subdivision or agency, or a nursing facility may 263.27request a hearing to determine the allowed rate or rates at issue in the cause of action. 263.28Within 15 calendar days after receiving a request for such a hearing, the commissioner 263.29shall request assignment of an administrative law judge under sections 14.48 to 14.56 to 263.30conduct the hearing as soon as possible or according to agreement by the parties. The 263.31administrative law judge shall issue a report within 15 calendar days following the close 263.32of the hearing. The prohibition set forth in this clause shall not apply to facilities licensed 263.33as boarding care facilities which are not certified as skilled or intermediate care facilities 263.34level I or II for reimbursement through medical assistance. 263.35(b)(1) Charging, soliciting, accepting, or receiving from an applicant for admission 263.36to the facility, or from anyone acting in behalf of the applicant, as a condition of 264.1admission, expediting the admission, or as a requirement for the individual's continued 264.2stay, any fee, deposit, gift, money, donation, or other consideration not otherwise required 264.3as payment under the state plan new text begin . For residents on medical assistance, medical assistance new text end 264.4 new text begin payment according to the state plan must be accepted as payment in full for continued new text end 264.5 new text begin stay, except where otherwise provided for under statute new text end ; 264.6(2) requiring an individual, or anyone acting in behalf of the individual, to loan 264.7any money to the nursing facility; 264.8(3) requiring an individual, or anyone acting in behalf of the individual, to promise 264.9to leave all or part of the individual's estate to the facility; or 264.10(4) requiring a third-party guarantee of payment to the facility as a condition of 264.11admission, expedited admission, or continued stay in the facility. 264.12Nothing in this paragraph would prohibit discharge for nonpayment of services in 264.13accordance with state and federal regulations. 264.14(c) Requiring any resident of the nursing facility to utilize a vendor of health care 264.15services chosen by the nursing facility. A nursing facility may require a resident to use 264.16pharmacies that utilize unit dose packing systems approved by the Minnesota Board of 264.17Pharmacy, and may require a resident to use pharmacies that are able to meet the federal 264.18regulations for safe and timely administration of medications such as systems with specific 264.19number of doses, prompt delivery of medications, or access to medications on a 24-hour 264.20basis. Notwithstanding the provisions of this paragraph, nursing facilities shall not restrict 264.21a resident's choice of pharmacy because the pharmacy utilizes a specific system of unit 264.22dose drug packing. 264.23(d) Providing differential treatment on the basis of status with regard to public 264.24assistance. 264.25(e) Discriminating in admissions, services offered, or room assignment on the 264.26basis of status with regard to public assistance or refusal to purchase special services. 264.27 new text begin Discrimination in new text end admissions discrimination new text begin , services offered, or room assignment new text end shall 264.28include, but is not limited to: 264.29(1) basing admissions decisions upon assurance by the applicant to the nursing 264.30facility, or the applicant's guardian or conservator, that the applicant is neither eligible for 264.31nor will seek new text begin information or assurances regarding current or future eligibility for new text end public 264.32assistance for payment of nursing facility care costs; and 264.33(2) engaging in preferential selection from waiting lists based on an applicant's 264.34ability to pay privately or an applicant's refusal to pay for a special service. 264.35The collection and use by a nursing facility of financial information of any applicant 264.36pursuant to a preadmission screening program established by law shall not raise an 265.1inference that the nursing facility is utilizing that information for any purpose prohibited 265.2by this paragraph. 265.3(f) Requiring any vendor of medical care as defined by section 256B.02, subdivision 265.47 , who is reimbursed by medical assistance under a separate fee schedule, to pay any 265.5amount based on utilization or service levels or any portion of the vendor's fee to the 265.6nursing facility except as payment for renting or leasing space or equipment or purchasing 265.7support services from the nursing facility as limited by section 256B.433. All agreements 265.8must be disclosed to the commissioner upon request of the commissioner. Nursing 265.9facilities and vendors of ancillary services that are found to be in violation of this provision 265.10shall each be subject to an action by the state of Minnesota or any of its subdivisions or 265.11agencies for treble civil damages on the portion of the fee in excess of that allowed by 265.12this provision and section 256B.433. Damages awarded must include three times the 265.13excess payments together with costs and disbursements including reasonable attorney's 265.14fees or their equivalent. 265.15(g) Refusing, for more than 24 hours, to accept a resident returning to the same 265.16bed or a bed certified for the same level of care, in accordance with a physician's order 265.17authorizing transfer, after receiving inpatient hospital services. 265.18 new text begin (h) new text end For a period not to exceed 180 days, the commissioner may continue to make 265.19medical assistance payments to a nursing facility or boarding care home which is in 265.20violation of this section if extreme hardship to the residents would result. In these cases 265.21the commissioner shall issue an order requiring the nursing facility to correct the violation. 265.22The nursing facility shall have 20 days from its receipt of the order to correct the violation. 265.23If the violation is not corrected within the 20-day period the commissioner may reduce 265.24the payment rate to the nursing facility by up to 20 percent. The amount of the payment 265.25rate reduction shall be related to the severity of the violation and shall remain in effect 265.26until the violation is corrected. The nursing facility or boarding care home may appeal the 265.27commissioner's action pursuant to the provisions of chapter 14 pertaining to contested 265.28cases. An appeal shall be considered timely if written notice of appeal is received by the 265.29commissioner within 20 days of notice of the commissioner's proposed action. 265.30In the event that the commissioner determines that a nursing facility is not eligible 265.31for reimbursement for a resident who is eligible for medical assistance, the commissioner 265.32may authorize the nursing facility to receive reimbursement on a temporary basis until the 265.33resident can be relocated to a participating nursing facility. 265.34Certified beds in facilities which do not allow medical assistance intake on July 1, 265.351984, or after shall be deemed to be decertified for purposes of section 144A.071 only. 266.1    Sec. 39. Minnesota Statutes 2010, section 256B.49, subdivision 12, is amended to read: 266.2    Subd. 12. Informed choice. Persons who are determined likely to require the 266.3level of care provided in a nursing facility as determined under sections , 266.4subdivision 11, and new text begin section new text end 256B.0911, or new text begin a new text end hospital shall be informed of the home and 266.5community-based support alternatives to the provision of inpatient hospital services or 266.6nursing facility services. Each person must be given the choice of either institutional or 266.7home and community-based services using the provisions described in section 256B.77, 266.8subdivision 2 , paragraph (p). 266.9    Sec. 40. Minnesota Statutes 2010, section 256B.49, subdivision 13, is amended to read: 266.10    Subd. 13. Case management. (a) Each recipient of a home and community-based 266.11waiver new text begin under this section new text end shall be provided case management services new text begin according to new text end 266.12 new text begin section 256B.092, subdivisions 1a, 1b, and 1e, new text end by qualified vendors as described in the 266.13federally approved waiver application. The case management service activities provided 266.14will include: 266.15    (1) assessing the needs of the individual within 20 working days of a recipient's 266.16request; 266.17    (2) developing the written individual service plan within ten working days after the 266.18assessment is completed; 266.19    (3) informing the recipient or the recipient's legal guardian or conservator of service 266.20options; 266.21    (4) assisting the recipient in the identification of potential service providers; 266.22    (5) assisting the recipient to access services; 266.23    (6) coordinating, evaluating, and monitoring of the services identified in the service 266.24plan; 266.25    (7) completing the annual reviews of the service plan; and 266.26    (8) informing the recipient or legal representative of the right to have assessments 266.27completed and service plans developed within specified time periods, and to appeal county 266.28action or inaction under section 256.045, subdivision 3, including the determination of 266.29nursing facility level of care. 266.30    (b) The case manager may delegate certain aspects of the case management service 266.31activities to another individual provided there is oversight by the case manager. The case 266.32manager may not delegate those aspects which require professional judgment including 266.33assessments, reassessments, and care plan development. 266.34 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012. new text end 267.1    Sec. 41. Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read: 267.2    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's 267.3strengths, informal support systems, and need for services shall be completed within 20 267.4working days of the recipient's request new text begin as provided in section 256B.0911 new text end . Reassessment 267.5of each recipient's strengths, support systems, and need for services shall be conducted 267.6at least every 12 months and at other times when there has been a significant change in 267.7the recipient's functioning. 267.8(b) There must be a determination that the client requires a hospital level of care or a 267.9nursing facility level of care as defined in section 144.0724, subdivision 11 new text begin 256B.0911, new text end 267.10 new text begin subdivision 4a, paragraph (d) new text end , at initial and subsequent assessments to initiate and 267.11maintain participation in the waiver program. 267.12(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 267.13appropriate to determine nursing facility level of care for purposes of medical assistance 267.14payment for nursing facility services, only face-to-face assessments conducted according 267.15to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 267.16determination or a nursing facility level of care determination must be accepted for 267.17purposes of initial and ongoing access to waiver services payment. 267.18(d) Persons with developmental disabilities who apply for services under the nursing 267.19facility level waiver programs shall be screened for the appropriate level of care according 267.20to section 256B.092. 267.21(e) Recipients who are found eligible for home and community-based services under 267.22this section before their 65th birthday may remain eligible for these services after their 267.2365th birthday if they continue to meet all other eligibility factors. 267.24 new text begin (f) The commissioner shall develop criteria to identify individuals whose level of new text end 267.25 new text begin functioning is reasonably expected to improve and reassess these individuals every six new text end 267.26 new text begin months. Individuals who meet these criteria must have a comprehensive transitional new text end 267.27 new text begin service plan developed under subdivision 15, paragraphs (b) and (c). Counties, case new text end 267.28 new text begin managers, and service providers are responsible for conducting these reassessments and new text end 267.29 new text begin shall complete the reassessments out of existing funds. new text end 267.30 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, except for paragraph new text end 267.31 new text begin (f), which is effective July 1, 2013. new text end 267.32    Sec. 42. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read: 267.33    Subd. 15. Individualized new text begin Coordinated new text end service new text begin and support new text end plan new text begin ; comprehensive new text end 267.34 new text begin transitional service plan; maintenance service plan new text end . (a) Each recipient of home and 267.35community-based waivered services shall be provided a copy of the written new text begin coordinated new text end 268.1service new text begin and support new text end plan which: new text begin that complies with the requirements of section 256B.092, new text end 268.2 new text begin subdivisions 1b and 1e. new text end 268.3(1) is developed and signed by the recipient within ten working days of the 268.4completion of the assessment; 268.5(2) meets the assessed needs of the recipient; 268.6(3) reasonably ensures the health and safety of the recipient; 268.7(4) promotes independence; 268.8(5) allows for services to be provided in the most integrated settings; and 268.9(6) provides for an informed choice, as defined in section 256B.77, subdivision 2, 268.10paragraph (p), of service and support providers. 268.11 new text begin (b) In developing the comprehensive transitional service plan, the individual new text end 268.12 new text begin receiving services, the case manager, and the guardian, if applicable, will identify new text end 268.13 new text begin the transitional service plan fundamental service outcome and anticipated timeline to new text end 268.14 new text begin achieve this outcome. Within the first 20 days following a recipient's request for an new text end 268.15 new text begin assessment or reassessment, the transitional service planning team must be identified. A new text end 268.16 new text begin team leader must be identified who will be responsible for assigning responsibility and new text end 268.17 new text begin communicating with team members to ensure implementation of the transition plan and new text end 268.18 new text begin ongoing assessment and communication process. The team leader should be an individual, new text end 268.19 new text begin such as the case manager or guardian, who has the opportunity to follow the individual to new text end 268.20 new text begin the next level of service. new text end 268.21 new text begin Within ten days following an assessment, a comprehensive transitional service plan new text end 268.22 new text begin must be developed incorporating elements of a comprehensive functional assessment and new text end 268.23 new text begin including short-term measurable outcomes and timelines for achievement of and reporting new text end 268.24 new text begin on these outcomes. Functional milestones must also be identified and reported according new text end 268.25 new text begin to the timelines agreed upon by the transitional service planning team. In addition, the new text end 268.26 new text begin comprehensive transitional service plan must identify additional supports that may assist new text end 268.27 new text begin in the achievement of the fundamental service outcome such as the development of greater new text end 268.28 new text begin natural community support, increased collaboration among agencies, and technological new text end 268.29 new text begin supports. new text end 268.30 new text begin The timelines for reporting on functional milestones will prompt a reassessment of new text end 268.31 new text begin services provided, the units of services, rates, and appropriate service providers. It is new text end 268.32 new text begin the responsibility of the transitional service planning team leader to review functional new text end 268.33 new text begin milestone reporting to determine if the milestones are consistent with observable skills new text end 268.34 new text begin and that milestone achievement prompts any needed changes to the comprehensive new text end 268.35 new text begin transitional service plan. new text end 269.1 new text begin For those whose fundamental transitional service outcome involves the need to new text end 269.2 new text begin procure housing, a plan for the individual to seek the resources necessary to secure new text end 269.3 new text begin the least restrictive housing possible should be incorporated into the plan, including new text end 269.4 new text begin employment and public supports such as housing access and shelter needy funding. new text end 269.5 new text begin (c) Counties and other agencies responsible for funding community placement and new text end 269.6 new text begin ongoing community supportive services are responsible for the implementation of the new text end 269.7 new text begin comprehensive transitional service plans. Oversight responsibilities include both ensuring new text end 269.8 new text begin effective transitional service delivery and efficient utilization of funding resources. new text end 269.9 new text begin (d) Following one year of transitional services, the transitional services planning new text end 269.10 new text begin team will make a determination as to whether or not the individual receiving services new text end 269.11 new text begin requires the current level of continuous and consistent support in order to maintain the new text end 269.12 new text begin individual's current level of functioning. Individuals who move from a transitional to a new text end 269.13 new text begin maintenance service plan must be reassessed to determine if the individual would benefit new text end 269.14 new text begin from a transitional service plan on at least an annual basis. This assessment should new text end 269.15 new text begin consider any changes to technological or natural community supports. new text end 269.16(b) new text begin (e) new text end When a county is evaluating denials, reductions, or terminations of home 269.17and community-based services under section 256B.49 for an individual, the case manager 269.18shall offer to meet with the individual or the individual's guardian in order to discuss the 269.19prioritization of service needs within the individualized service plan new text begin , comprehensive new text end 269.20 new text begin transitional service plan, or maintenance service plan new text end . The reduction in the authorized 269.21services for an individual due to changes in funding for waivered services may not exceed 269.22the amount needed to ensure medically necessary services to meet the individual's health, 269.23safety, and welfare. 269.24 new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2012, except for new text end 269.25 new text begin paragraphs (b), (c), and (d), which are effective July 1, 2013. new text end 269.26    Sec. 43. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 269.27subdivision to read: 269.28     new text begin Subd. 9. new text end new text begin ICF/MR rate increase. new text end new text begin Effective July 1, 2011, the commissioner shall new text end 269.29 new text begin increase the daily rate to $138.23 at an intermediate care facility for the developmentally new text end 269.30 new text begin disabled located in Clearwater County and classified as a class A facility with 15 beds. new text end 269.31 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 269.32    Sec. 44. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 269.33subdivision to read: 270.1     new text begin Subd. 10. new text end new text begin ICF/MR rate adjustment. new text end new text begin For each facility reimbursed under this new text end 270.2 new text begin section, except for a facility located in Clearwater County and classified as a class A new text end 270.3 new text begin facility with 15 beds, the commissioner shall decrease operating payment rates equal to ... new text end 270.4 new text begin percent of the operating payment rates in effect on June 30, 2011. For each facility, the new text end 270.5 new text begin commissioner shall apply the rate reduction, based on occupied beds, using the percentage new text end 270.6 new text begin specified in this subdivision multiplied by the total payment rate, including the variable rate new text end 270.7 new text begin but excluding the property-related payment rate, in effect on the preceding date. The total new text end 270.8 new text begin rate reduction shall include the adjustment provided in section 256B.501, subdivision 12. new text end 270.9    Sec. 45. Minnesota Statutes 2010, section 256G.02, subdivision 6, is amended to read: 270.10    Subd. 6. Excluded time. "Excluded time" means: 270.11(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter 270.12other than an emergency shelter, halfway house, foster home, semi-independent living 270.13domicile or services program, residential facility offering care, board and lodging facility 270.14or other institution for the hospitalization or care of human beings, as defined in section 270.15144.50 , 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter, 270.16or correctional facility; or any facility based on an emergency hold under sections 270.17253B.05, subdivisions 1 and 2 , and 253B.07, subdivision 6; 270.18(b) any period an applicant spends on a placement basis in a training and habilitation 270.19program, including a rehabilitation facility or work or employment program as defined 270.20in section 268A.01; or receiving personal care assistance services pursuant to section 270.21; semi-independent living services provided under section 252.275, and 270.22Minnesota Rules, parts 9525.0500 to 9525.0660; day training and habilitation programs 270.23and assisted living services; and 270.24(c) any placement for a person with an indeterminate commitment, including 270.25independent living. 270.26 new text begin EFFECTIVE DATE. new text end new text begin This section is effective July 1, 2011. new text end 270.27    Sec. 46. Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by 270.28Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read: 270.29EFFECTIVE DATE.The new text begin This new text end section is effective July 1, 2011 new text begin on or after January new text end 270.30 new text begin 1, 2014, for individuals age 21 and older, and on or after October 1, 2019, for individuals new text end 270.31 new text begin under age 21 new text end . 271.1    Sec. 47. Laws 2009, chapter 79, article 8, section 51, the effective date, as amended by 271.2Laws 2010, First Special Session chapter 1, article 17, section 14, is amended to read: 271.3EFFECTIVE DATE.This section is effective July 1, 2011 new text begin January 1, 2014 new text end . 271.4    Sec. 48. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 271.5Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special 271.6Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read: 271.7 Subd. 8.Continuing Care Grants271.8The amounts that may be spent from the 271.9appropriation for each purpose are as follows: 271.10 (a) Aging and Adult Services Grants 13,499,000 15,805,000 271.11Base Adjustment. The general fund base is 271.12increased by $5,751,000 in fiscal year 2012 271.13and $6,705,000 in fiscal year 2013. 271.14Information and Assistance 271.15Reimbursement. Federal administrative 271.16reimbursement obtained from information 271.17and assistance services provided by the 271.18Senior LinkAge or Disability Linkage lines 271.19to people who are identified as eligible for 271.20medical assistance shall be appropriated to 271.21the commissioner for this activity. 271.22Community Service Development Grant 271.23Reduction. Funding for community service 271.24development grants must be reduced by 271.25$260,000 for fiscal year 2010; $284,000 in 271.26fiscal year 2011; $43,000 in fiscal year 2012; 271.27and $43,000 in fiscal year 2013. Base level 271.28funding shall be restored in fiscal year 2014. 271.29Community Service Development Grant 271.30Community Initiative. Funding for 271.31community service development grants shall 271.32be used to offset the cost of aging support 272.1grants. Base level funding shall be restored 272.2in fiscal year 2014. 272.3Senior Nutrition Use of Federal Funds. 272.4For fiscal year 2010, general fund grants 272.5for home-delivered meals and congregate 272.6dining shall be reduced by $500,000. The 272.7commissioner must replace these general 272.8fund reductions with equal amounts from 272.9federal funding for senior nutrition from the 272.10American Recovery and Reinvestment Act 272.11of 2009. 272.12 (b) Alternative Care Grants 50,234,000 48,576,000 272.13Base Adjustment. The general fund base is 272.14decreased by $3,598,000 in fiscal year 2012 272.15and $3,470,000 in fiscal year 2013. 272.16Alternative Care Transfer. Any money 272.17allocated to the alternative care program that 272.18is not spent for the purposes indicated does 272.19not cancel but must be transferred to the 272.20medical assistance account. 272.21 272.22 (c) Medical Assistance Grants; Long-Term Care Facilities. 367,444,000 419,749,000 272.23 272.24 (d) Medical Assistance Long-Term Care Waivers and Home Care Grants 853,567,000 1,039,517,000 272.25Manage Growth in TBI and CADI 272.26Waivers. During the fiscal years beginning 272.27on July 1, 2009, and July 1, 2010, the 272.28commissioner shall allocate money for home 272.29and community-based waiver programs 272.30under Minnesota Statutes, section 256B.49, 272.31to ensure a reduction in state spending that is 272.32equivalent to limiting the caseload growth of 272.33the TBI waiver to 12.5 allocations per month 272.34each year of the biennium and the CADI 272.35waiver to 95 allocations per month each year 273.1of the biennium. Limits do not apply: (1) 273.2when there is an approved plan for nursing 273.3facility bed closures for individuals under 273.4age 65 who require relocation due to the 273.5bed closure; (2) to fiscal year 2009 waiver 273.6allocations delayed due to unallotment; or (3) 273.7to transfers authorized by the commissioner 273.8from the personal care assistance program 273.9of individuals having a home care rating 273.10of "CS," "MT," or "HL." Priorities for the 273.11allocation of funds must be for individuals 273.12anticipated to be discharged from institutional 273.13settings or who are at imminent risk of a 273.14placement in an institutional setting. 273.15Manage Growth in DD Waiver. The 273.16commissioner shall manage the growth in 273.17the DD waiver by limiting the allocations 273.18included in the February 2009 forecast to 15 273.19additional diversion allocations each month 273.20for the calendar years that begin on January 273.211, 2010, and January 1, 2011. Additional 273.22allocations must be made available for 273.23transfers authorized by the commissioner 273.24from the personal care program of individuals 273.25having a home care rating of "CS," "MT," 273.26or "HL." 273.27Adjustment to Lead Agency Waiver 273.28Allocations. Prior to the availability of the 273.29alternative license defined in Minnesota 273.30Statutes, section 245A.11, subdivision 8, 273.31the commissioner shall reduce lead agency 273.32waiver allocations for the purposes of 273.33implementing a moratorium on corporate 273.34foster care. 274.1Alternatives to Personal Care Assistance 274.2Services. Base level funding of $3,237,000 274.3in fiscal year 2012 and $4,856,000 in 274.4fiscal year 2013 is to implement alternative 274.5services to personal care assistance services 274.6for persons with mental health and other 274.7behavioral challenges who can benefit 274.8from other services that more appropriately 274.9meet their needs and assist them in living 274.10independently in the community. These 274.11services may include, but not be limited to, a 274.121915(i) state plan option. 274.13 (e) Mental Health Grants 274.14 Appropriations by Fund 274.15 General 77,739,000 77,739,000 274.16 Health Care Access 750,000 750,000 274.17 Lottery Prize 1,508,000 1,508,000 274.18Funding Usage. Up to 75 percent of a fiscal 274.19year's appropriation for adult mental health 274.20grants may be used to fund allocations in that 274.21portion of the fiscal year ending December 274.2231. 274.23 (f) Deaf and Hard-of-Hearing Grants 1,930,000 1,917,000 274.24 (g) Chemical Dependency Entitlement Grants 111,303,000 122,822,000 274.25Payments for Substance Abuse Treatment. 274.26For placements beginning during fiscal years 274.272010 and 2011, county-negotiated rates and 274.28provider claims to the consolidated chemical 274.29dependency fund must not exceed the lesser 274.30of: 274.31(1) rates charged for these services on 274.32January 1, 2009; or 275.1(2) 160 percent of the average rate on January 275.21, 2009, for each group of vendors with 275.3similar attributes. 275.4Rates for fiscal years 2010 and 2011 must 275.5not exceed 160 percent of the average rate on 275.6January 1, 2009, for each group of vendors 275.7with similar attributes. 275.8Effective July 1, 2010, rates that were above 275.9the average rate on January 1, 2009, are 275.10reduced by five percent from the rates in 275.11effect on June 1, 2010. Rates below the 275.12average rate on January 1, 2009, are reduced 275.13by 1.8 percent from the rates in effect on 275.14June 1, 2010. Services provided under 275.15this section by state-operated services are 275.16exempt from the rate reduction. For services 275.17provided in fiscal years 2012 and 2013, the 275.18statewide aggregate payment under the new 275.19rate methodology to be developed under 275.20Minnesota Statutes, section 254B.12, must 275.21not exceed the projected aggregate payment 275.22under the rates in effect for fiscal year 2011 275.23excluding the rate reduction for rates that 275.24were below the average on January 1, 2009, 275.25plus a state share increase of $3,787,000 for 275.26fiscal year 2012 and $5,023,000 for fiscal 275.27year 2013. Notwithstanding any provision 275.28to the contrary in this article, this provision 275.29expires on June 30, 2013. 275.30Chemical Dependency Special Revenue 275.31Account. For fiscal year 2010, $750,000 275.32must be transferred from the consolidated 275.33chemical dependency treatment fund 275.34administrative account and deposited into the 275.35general fund. 276.1County CD Share of MA Costs for 276.2ARRA Compliance. Notwithstanding the 276.3provisions of Minnesota Statutes, chapter 276.4254B, for chemical dependency services 276.5provided during the period October 1, 2008, 276.6to December 31, 2010, and reimbursed by 276.7medical assistance at the enhanced federal 276.8matching rate provided under the American 276.9Recovery and Reinvestment Act of 2009, the 276.10county share is 30 percent of the nonfederal 276.11share. This provision is effective the day 276.12following final enactment. 276.13 276.14 (h) Chemical Dependency Nonentitlement Grants 1,729,000 1,729,000 276.15 (i) Other Continuing Care Grants 19,201,000 17,528,000 276.16Base Adjustment. The general fund base is 276.17increased by $2,639,000 in fiscal year 2012 276.18and increased by $3,854,000 in fiscal year 276.192013. 276.20Technology Grants. $650,000 in fiscal 276.21year 2010 and $1,000,000 in fiscal year 276.222011 are for technology grants, case 276.23consultation, evaluation, and consumer 276.24information grants related to developing and 276.25supporting alternatives to shift-staff foster 276.26care residential service models. 276.27Other Continuing Care Grants; HIV 276.28Grants. Money appropriated for the HIV 276.29drug and insurance grant program in fiscal 276.30year 2010 may be used in either year of the 276.31biennium. 276.32Quality Assurance Commission. Effective 276.33July 1, 2009, state funding for the quality 276.34assurance commission under Minnesota 276.35Statutes, section 256B.0951, is canceled. 277.1    Sec. 49. new text begin DIRECTIONS TO COMMISSIONER. new text end 277.2     new text begin Subdivision 1. new text end new text begin Co-payments for home and community-based services. new text end new text begin Upon new text end 277.3 new text begin federal approval, the commissioner of human services shall develop and implement a new text end 277.4 new text begin co-payment schedule for individuals receiving home and community-based services under new text end 277.5 new text begin Minnesota Statutes, chapter 256B. new text end 277.6     new text begin Subd. 2. new text end new text begin Federal waiver amendment. new text end new text begin The commissioner shall seek an amendment new text end 277.7 new text begin to the 1915c home and community-based waivers under Minnesota Statutes, sections new text end 277.8 new text begin 256B.092 and 256B.49, to allow properly licensed residential programs under Minnesota new text end 277.9 new text begin Statutes, section 245A.02, subdivision 14, to provide residential services to up to eight new text end 277.10 new text begin individuals with physical or developmental disabilities, chronic illnesses, or traumatic new text end 277.11 new text begin brain injuries. A facility licensed for five to eight people must be an existing residential new text end 277.12 new text begin building, such as a duplex, that is owned by the same company and meets all other new text end 277.13 new text begin licensing requirements. new text end 277.14     new text begin Subd. 3. new text end new text begin Recommendations for personal care assistance service changes. new text end new text begin The new text end 277.15 new text begin commissioner shall consult with stakeholder groups, including counties, advocates, new text end 277.16 new text begin persons receiving personal care assistance services, and personal care assistance providers, new text end 277.17 new text begin and make recommendations to the legislature by February 1, 2014, on changes that could new text end 277.18 new text begin be made to the program to improve oversight, program efficiency, and cost-effectiveness. new text end 277.19     new text begin Subd. 4. new text end new text begin Nursing facility pay-for-performance reimbursement system. new text end 277.20 new text begin The commissioner of human services shall report to the legislative committees with new text end 277.21 new text begin jurisdiction over nursing facility policy and finance with recommendations for developing new text end 277.22 new text begin and implementing a pay-for-performance reimbursement system with a quality add-on by new text end 277.23 new text begin January 15, 2012. new text end 277.24     new text begin Subd. 5. new text end new text begin ICF/MR transition plan. new text end new text begin The commissioner of human services shall new text end 277.25 new text begin work with stakeholders to develop and implement a plan by June 30, 2013, to transition new text end 277.26 new text begin individuals currently residing in intermediate care facilities for persons with developmental new text end 277.27 new text begin disabilities into the least restrictive community settings possible. The plan must include a new text end 277.28 new text begin requirement for a cooperative planning process between the counties and providers for new text end 277.29 new text begin the downsizing or closure of intermediate care facilities for persons with developmental new text end 277.30 new text begin disabilities, with funding from the bed closures converting to home and community-based new text end 277.31 new text begin waiver funding to fund services for those leaving the intermediate care facilities for new text end 277.32 new text begin persons with developmental disabilities based on a plan approved by the commissioner. In new text end 277.33 new text begin order to facilitate this process, the commissioner shall provide information to facilities and new text end 277.34 new text begin counties about the number of people in facilities who have requested to move to home and new text end 277.35 new text begin community-based services. Individuals residing in intermediate care facilities for persons new text end 277.36 new text begin with developmental disabilities who choose to remain there or whose health or safety new text end 278.1 new text begin would be put at risk in a less restrictive setting may continue to reside in intermediate care new text end 278.2 new text begin facilities for persons with developmental disabilities. new text end 278.3     new text begin Subd. 6. new text end new text begin Representative payee. new text end new text begin The commissioner of human services shall make new text end 278.4 new text begin recommendations to the legislative committees with jurisdiction over health and human new text end 278.5 new text begin services policy and finance by January 15, 2012, on ways to better manage funds for new text end 278.6 new text begin persons who rely on a representative payee. new text end 278.7     new text begin Subd. 7. new text end new text begin Autism treatment. new text end new text begin The commissioner of human services shall review new text end 278.8 new text begin autism treatment benefits under the TEFRA option and make recommendations to the new text end 278.9 new text begin legislative committees with jurisdiction over health and human services policy and finance new text end 278.10 new text begin by January 1, 2012, to extend the same autism treatment benefits to MA managed care and new text end 278.11 new text begin county-based purchasing. new text end 278.12    Sec. 50. new text begin STATE PLAN AMENDMENT TO IMPLEMENT SELF-DIRECTED new text end 278.13 new text begin PERSONAL SUPPORTS. new text end 278.14 new text begin By July 15, 2011, the commissioner shall submit a state plan amendment to new text end 278.15 new text begin implement Minnesota Statutes, section 256B.0657, as soon as possible upon federal new text end 278.16 new text begin approval. new text end 278.17    Sec. 51. new text begin AMENDMENT FOR SELF-DIRECTED COMMUNITY SUPPORTS. new text end 278.18 new text begin By September 1, 2011, the commissioner shall submit an amendment to the home new text end 278.19 new text begin and community-based waiver programs consistent with implementing the self-directed new text end 278.20 new text begin option under Minnesota Statutes, section 256B.0657, through statewide enrolled providers new text end 278.21 new text begin contracted to provide outreach information, training, and fiscal support entity services to new text end 278.22 new text begin all eligible recipients choosing this option and with shared care in some types of services. new text end 278.23 new text begin The waiver amendment shall be consistent with changes in case management services new text end 278.24 new text begin under Minnesota Statutes, section 256B.092. new text end 278.25    Sec. 52. new text begin ESTABLISHMENT OF RATES FOR SHARED HOME AND new text end 278.26 new text begin COMMUNITY-BASED WAIVER SERVICES. new text end 278.27 new text begin By January 1, 2012, the commissioner shall establish rates to begin paying for new text end 278.28 new text begin in-home services and personal supports under all of the home and community-based new text end 278.29 new text begin waiver services programs consistent with the standards in Minnesota Statutes, section new text end 278.30 new text begin 256B.4912, subdivision 2. new text end 278.31    Sec. 53. new text begin ESTABLISHMENT OF RATE FOR CASE MANAGEMENT new text end 278.32 new text begin SERVICES. new text end 279.1 new text begin By July 1, 2012, the commissioner shall establish the rate to be paid for case new text end 279.2 new text begin management services under Minnesota Statutes, sections 256B.0621, subdivision 2, clause new text end 279.3 new text begin (4), 256B.092, and 256B.49, consistent with the standards in Minnesota Statutes, section new text end 279.4 new text begin 256B.4912, subdivision 2. new text end 279.5    Sec. 54. new text begin RECOMMENDATIONS FOR FURTHER CASE MANAGEMENT new text end 279.6 new text begin REDESIGN. new text end 279.7 new text begin By February 1, 2012, the commissioner of human services shall develop a legislative new text end 279.8 new text begin report with specific recommendations and language for proposed legislation to be effective new text end 279.9 new text begin July 1, 2012, for the following: new text end 279.10 new text begin (1) definitions of service and consolidation of standards and rates to the extent new text end 279.11 new text begin appropriate for all types of medical assistance case management services, including new text end 279.12 new text begin targeted case management under Minnesota Statutes, sections 256B.0621; 256B.0625, new text end 279.13 new text begin subdivision 20; and 256B.0924; mental health case management services for children new text end 279.14 new text begin and adults, all types of home and community-based waiver case management, and case new text end 279.15 new text begin management under Minnesota Rules, parts 9525.0004 to 9525.0036. This work shall be new text end 279.16 new text begin completed in collaboration with efforts under Minnesota Statutes, section 256B.4912; new text end 279.17 new text begin (2) recommendations on county of financial responsibility requirements and quality new text end 279.18 new text begin assurance measures for case management; new text end 279.19 new text begin (3) identification of county administrative functions that may remain entwined in new text end 279.20 new text begin case management service delivery models; and new text end 279.21 new text begin (4) implementation of a methodology to fully fund county case management new text end 279.22 new text begin administrative functions. new text end 279.23    Sec. 55. new text begin MY LIFE, MY CHOICES TASK FORCE. new text end 279.24     new text begin Subdivision 1. new text end new text begin Establishment. new text end new text begin The My Life, My Choices Task Force is established new text end 279.25 new text begin to create a system of supports and services for people with disabilities governed by the new text end 279.26 new text begin following principles: new text end 279.27 new text begin (1) freedom to act as a consumer of services in the marketplace; new text end 279.28 new text begin (2) freedom to choose to take as much risk as any other citizen; new text end 279.29 new text begin (3) more choices in levels of service that may vary throughout life; new text end 279.30 new text begin (4) opportunity to work with a trusted partner and fiscal support entity to manage a new text end 279.31 new text begin personal budget and to be accountable for reporting spending and personal outcomes; new text end 279.32 new text begin (5) opportunity to live with minimal constraints instead of minimal freedoms; and new text end 279.33 new text begin (6) ability to consolidate funding streams into an individualized budget. new text end 280.1     new text begin Subd. 2. new text end new text begin Membership. new text end new text begin The My Life, My Choices Task Force shall consist of the new text end 280.2 new text begin lieutenant governor; the commissioner of human services, or designee; a representative of new text end 280.3 new text begin the Minnesota Chamber of Commerce; and the following to be appointed by the governor: new text end 280.4 new text begin one administrative law judge, one labor representative, two family members of people new text end 280.5 new text begin with disabilities, and one individual with disabilities. In addition, the following shall be new text end 280.6 new text begin appointed jointly by the speaker of the house and the senate Subcommittee on Committees new text end 280.7 new text begin of the Committee on Rules and Administration, a representative of a disability advocacy new text end 280.8 new text begin organization; a representative of a disability legal services advocacy organization; new text end 280.9 new text begin representatives of two nonprofit organizations, one of which serves all 87 counties; and new text end 280.10 new text begin a representative of a philanthropic organization. Appointed nongovernmental members new text end 280.11 new text begin of the task force shall serve as staff for the task force and take on the responsibilities of new text end 280.12 new text begin coordinating meetings, reporting on committee recommendations, and providing other new text end 280.13 new text begin staff support as needed to meet the responsibilities of the task force as described in new text end 280.14 new text begin subdivision 3. Legislative appointment of nongovernmental members of the task force new text end 280.15 new text begin shall be conditioned upon agreement from the appointees to provide staff assistance to new text end 280.16 new text begin execute the work of the task force. The chairs and ranking minority members of the new text end 280.17 new text begin legislative committees with jurisdiction over health and human services policy and finance new text end 280.18 new text begin shall serve as ex officio members. new text end 280.19     new text begin Subd. 3. new text end new text begin Duties. new text end new text begin The task force shall make recommendations, including proposed new text end 280.20 new text begin legislation, and report to the legislative committees with jurisdiction over health and new text end 280.21 new text begin human services policy and finance by November 15, 2011, on creating a system of new text end 280.22 new text begin supports and services for people with disabilities by July 1, 2012, as governed by the new text end 280.23 new text begin principles under subdivision 1. In making recommendations and proposed legislation, the new text end 280.24 new text begin council shall work in conjunction with the Consumer-Directed Community Supports Task new text end 280.25 new text begin Force and shall include self-directed planning, individual budgeting, choice of trusted new text end 280.26 new text begin partner, self-directed purchasing of services and supports, reporting of outcomes, ability new text end 280.27 new text begin to share in any savings, and any additional rules or laws that may need to be waived. new text end 280.28 new text begin Recommendations from the task force shall be fully implemented by July 1, 2013. new text end 280.29     new text begin Subd. 4. new text end new text begin Expense reimbursement. new text end new text begin The members of the task force shall not be new text end 280.30 new text begin reimbursed for expenses related to the duties of the task force. The task force shall be new text end 280.31 new text begin independently staffed and coordinated by nongovernmental appointees who serve on the new text end 280.32 new text begin task force, and no state funding shall be appropriated for expenses related to the task new text end 280.33 new text begin force under this section. new text end 280.34     new text begin Subd. 5. new text end new text begin Expiration. new text end new text begin The task force expires on July 1, 2013. new text end 280.35 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 281.1ARTICLE 7 281.2REDESIGNING SERVICE DELIVERY 281.3    Section 1. Minnesota Statutes 2010, section 119B.09, is amended by adding a 281.4subdivision to read: 281.5     new text begin Subd. 4b. new text end new text begin Electronic verification. new text end new text begin County agencies are authorized to use all new text end 281.6 new text begin automated databases containing information regarding recipients' or applicants' income new text end 281.7 new text begin in order to determine eligibility for the child care assistance under this chapter. The new text end 281.8 new text begin information is sufficient to determine eligibility. new text end 281.9    Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 14b, is amended to read: 281.10    Subd. 14b. American Indian child welfare projects. (a) The commissioner of 281.11human services may authorize projects to test tribal delivery of child welfare services to 281.12American Indian children and their parents and custodians living on the reservation. 281.13The commissioner has authority to solicit and determine which tribes may participate 281.14in a project. Grants may be issued to Minnesota Indian tribes to support the projects. 281.15The commissioner may waive existing state rules as needed to accomplish the projects. 281.16Notwithstanding section 626.556, the commissioner may authorize projects to use 281.17alternative methods of investigating and assessing reports of child maltreatment, provided 281.18that the projects comply with the provisions of section 626.556 dealing with the rights 281.19of individuals who are subjects of reports or investigations, including notice and appeal 281.20rights and data practices requirements. The commissioner may seek any federal approvals 281.21necessary to carry out the projects as well as seek and use any funds available to the 281.22commissioner, including use of federal funds, foundation funds, existing grant funds, 281.23and other funds. The commissioner is authorized to advance state funds as necessary to 281.24operate the projects. Federal reimbursement applicable to the projects is appropriated 281.25to the commissioner for the purposes of the projects. The projects must be required to 281.26address responsibility for safety, permanency, and well-being of children. 281.27(b) For the purposes of this section, "American Indian child" means a person under 281.2818 years of age who is a tribal member or eligible for membership in one of the tribes 281.29chosen for a project under this subdivision and who is residing on the reservation of 281.30that tribe. 281.31(c) In order to qualify for an American Indian child welfare project, a tribe must: 281.32(1) be one of the existing tribes with reservation land in Minnesota; 281.33(2) have a tribal court with jurisdiction over child custody proceedings; 282.1(3) have a substantial number of children for whom determinations of maltreatment 282.2have occurred; 282.3(4) have capacity to respond to reports of abuse and neglect under section 626.556; 282.4(5) provide a wide range of services to families in need of child welfare services; and 282.5(6) have a tribal-state title IV-E agreement in effect. 282.6(d) Grants awarded under this section may be used for the nonfederal costs of 282.7providing child welfare services to American Indian children on the tribe's reservation, 282.8including costs associated with: 282.9(1) assessment and prevention of child abuse and neglect; 282.10(2) family preservation; 282.11(3) facilitative, supportive, and reunification services; 282.12(4) out-of-home placement for children removed from the home for child protective 282.13purposes; and 282.14(5) other activities and services approved by the commissioner that further the goals 282.15of providing safety, permanency, and well-being of American Indian children. 282.16(e) When a tribe has initiated a project and has been approved by the commissioner 282.17to assume child welfare responsibilities for American Indian children of that tribe under 282.18this section, the affected county social service agency is relieved of responsibility for 282.19responding to reports of abuse and neglect under section 626.556 for those children 282.20during the time within which the tribal project is in effect and funded. The commissioner 282.21shall work with tribes and affected counties to develop procedures for data collection, 282.22evaluation, and clarification of ongoing role and financial responsibilities of the county 282.23and tribe for child welfare services prior to initiation of the project. Children who have not 282.24been identified by the tribe as participating in the project shall remain the responsibility 282.25of the county. Nothing in this section shall alter responsibilities of the county for law 282.26enforcement or court services. 282.27(f) Participating tribes may conduct children's mental health screenings under section 282.28245.4874, subdivision 1 , paragraph (a), clause (14), for children who are eligible for the 282.29initiative and living on the reservation and who meet one of the following criteria: 282.30(1) the child must be receiving child protective services; 282.31(2) the child must be in foster care; or 282.32(3) the child's parents must have had parental rights suspended or terminated. 282.33Tribes may access reimbursement from available state funds for conducting the screenings. 282.34Nothing in this section shall alter responsibilities of the county for providing services 282.35under section 245.487. 283.1(g) Participating tribes may establish a local child mortality review panel. In 283.2establishing a local child mortality review panel, the tribe agrees to conduct local child 283.3mortality reviews for child deaths or near-fatalities occurring on the reservation under 283.4subdivision 12 . Tribes with established child mortality review panels shall have access 283.5to nonpublic data and shall protect nonpublic data under subdivision 12, paragraphs (c) 283.6to (e). The tribe shall provide written notice to the commissioner and affected counties 283.7when a local child mortality review panel has been established and shall provide data upon 283.8request of the commissioner for purposes of sharing nonpublic data with members of the 283.9state child mortality review panel in connection to an individual case. 283.10(h) The commissioner shall collect information on outcomes relating to child safety, 283.11permanency, and well-being of American Indian children who are served in the projects. 283.12Participating tribes must provide information to the state in a format and completeness 283.13deemed acceptable by the state to meet state and federal reporting requirements. 283.14     new text begin (i) In consultation with the White Earth Band, the commissioner shall develop new text end 283.15 new text begin and submit to the chairs and ranking minority members of the legislative committees new text end 283.16 new text begin with jurisdiction over health and human services a plan to transfer legal responsibility new text end 283.17 new text begin for providing child protective services to White Earth Band member children residing in new text end 283.18 new text begin Hennepin County to the White Earth Band. The plan shall include a financing proposal, new text end 283.19 new text begin definitions of key terms, statutory amendments required, and other provisions required to new text end 283.20 new text begin implement the plan. The commissioner shall submit the plan by January 15, 2012. new text end 283.21    Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 283.22to read: 283.23     new text begin Subd. 14c. new text end new text begin American Indian child welfare, social, and human services project; new text end 283.24 new text begin White Earth Band of Ojibwe. new text end new text begin (a) The commissioner of human services shall enter into a new text end 283.25 new text begin contractual agreement as authorized under subdivision 2, paragraph (a), clause (7), with new text end 283.26 new text begin the White Earth Band of Ojibwe Indians for the tribe to provide all human services and new text end 283.27 new text begin public assistance programs that are under the supervision of the commissioner to tribal new text end 283.28 new text begin members who reside on the reservation. Grants may be issued to the White Earth Band new text end 283.29 new text begin of Ojibwe Indians to support the project. The commissioner may waive existing rules to new text end 283.30 new text begin support this project. The commissioner shall seek any federal approvals necessary to carry new text end 283.31 new text begin out the project as well as seek and use any funds available to the commissioner, including new text end 283.32 new text begin use of federal funds, foundation funds, existing grant funds, and other funds. The new text end 283.33 new text begin commissioner is authorized to advance state funds as necessary to operate the projects. new text end 283.34 new text begin Federal reimbursement applicable to the projects is appropriated to the commissioner for new text end 283.35 new text begin purposes of the project. new text end 284.1 new text begin (b) The commissioner shall redirect all funds provided to Mahnomen County for new text end 284.2 new text begin these services, including administrative expenses, to the White Earth Band of Ojibwe new text end 284.3 new text begin Indians. new text end 284.4 new text begin (c) The commissioner, in consultation with the tribe, is authorized to determine: (1) new text end 284.5 new text begin which programs not currently provided by the White Earth Band of Ojibwe Indians will be new text end 284.6 new text begin transferred to the tribe; and (2) the process by which the new programs will be transferred. new text end 284.7 new text begin In the case of a dispute, a two-thirds vote of the tribal council to transfer a program to new text end 284.8 new text begin the tribe must overrule the decision of the commissioner. new text end 284.9 new text begin (d) When the commissioner approves transfer of programs and the tribe assumes new text end 284.10 new text begin responsibility under this section, Mahnomen County is relieved of responsibility for new text end 284.11 new text begin providing program services to tribal members who live on the reservation while the tribal new text end 284.12 new text begin project is in effect and funded. The commissioner shall seek and use any funds available, new text end 284.13 new text begin including federal funds, foundation funds, existing grant funds, and other state funds as new text end 284.14 new text begin available. new text end 284.15 new text begin (e) The tribe shall comply with all reporting and record keeping requirements under new text end 284.16 new text begin state and federal laws and rules. new text end 284.17    Sec. 4. new text begin [256.0145] COMPUTER SYSTEM SIMPLIFICATION. new text end 284.18     new text begin Subdivision 1. new text end new text begin Reprogram MAXIS. new text end new text begin The commissioner of human services, as part new text end 284.19 new text begin of the enterprise architecture project, shall reprogram the MAXIS computer system to new text end 284.20 new text begin automatically apply child support payments entered into the PRISM computer system to new text end 284.21 new text begin a MAXIS case file. new text end 284.22     new text begin Subd. 2. new text end new text begin Program the social service information system. new text end new text begin The commissioner of new text end 284.23 new text begin human services shall require all prepaid health plans to accept a billing format identical to new text end 284.24 new text begin the MMIS billing format for payment to county agencies for mental health targeted case new text end 284.25 new text begin management claims, elderly waiver claims, and other claim categories as added to the new text end 284.26 new text begin benefit set. The commissioner shall make any necessary changes to the SSIS system to new text end 284.27 new text begin bill prepaid health plans for those claims. new text end 284.28    Sec. 5. new text begin [256.0147] COUNTY ELECTRONIC VERIFICATION TO DETERMINE new text end 284.29 new text begin ELIGIBILITY. new text end 284.30 new text begin County agencies are authorized to use all automated databases containing new text end 284.31 new text begin information regarding recipients' or applicants' income in order to determine eligibility new text end 284.32 new text begin for child support enforcement, general assistance, Minnesota supplemental aid, and new text end 284.33 new text begin programs, services, and supports under chapter 256J. The information is sufficient to new text end 284.34 new text begin determine eligibility. State and county caseworkers shall not be cited in error, as part of new text end 285.1 new text begin any audit and quality review, for an incorrect eligibility determination based on current but new text end 285.2 new text begin inaccurate information received through a state-approved electronic data source. If there new text end 285.3 new text begin is a potential error, the reviewer must forward a corrective action notice to the caseworker new text end 285.4 new text begin for proper and immediate correction. If the state or county caseworker has data available new text end 285.5 new text begin through client reporting, or other means, that are more accurate than state-approved new text end 285.6 new text begin electronic data, the caseworker should use the more accurate information in making the new text end 285.7 new text begin eligibility determination. new text end 285.8    Sec. 6. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 285.9to read: 285.10     new text begin Subd. 30. new text end new text begin Provision of required materials in alternative formats. new text end new text begin (a) For the new text end 285.11 new text begin purposes of this subdivision, "alternative format" means a medium other than paper and new text end 285.12 new text begin "prepaid health plan" means managed care plans and county-based purchasing plans. new text end 285.13 new text begin (b) A prepaid health plan may provide in an alternative format a provider directory new text end 285.14 new text begin and certificate of coverage, or materials otherwise required to be available in writing new text end 285.15 new text begin under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's new text end 285.16 new text begin contract with the prepaid health plan, if the following conditions are met: new text end 285.17 new text begin (1) the prepaid health plan, local agency, or commissioner, as applicable, informs the new text end 285.18 new text begin enrollee that: new text end 285.19 new text begin (i) provision in an alternative format is available and the enrollee affirmatively new text end 285.20 new text begin requests of the prepaid health plan that the provider directory, certificate of coverage, new text end 285.21 new text begin or materials otherwise required under Code of Federal Regulations, title 42, section new text end 285.22 new text begin 438.10, or under the commissioner's contract with the prepaid health plan be provided in new text end 285.23 new text begin an alternative format; and new text end 285.24 new text begin (ii) a record of the enrollee request is retained by the prepaid health plan in the new text end 285.25 new text begin form of written direction from the enrollee or a documented telephone call followed by a new text end 285.26 new text begin confirmation letter to the enrollee from the prepaid health plan that explains that the new text end 285.27 new text begin enrollee may change the request at any time; new text end 285.28 new text begin (2) the materials are sent to a secured mailbox and are made available at a new text end 285.29 new text begin password-protected secured Web site or on a data storage device if the materials contain new text end 285.30 new text begin enrollee data that is individually identifiable; new text end 285.31 new text begin (3) the enrollee is provided a customer service number on the enrollee's membership new text end 285.32 new text begin card that may be called to request a paper version of the materials provided in an new text end 285.33 new text begin alternative format; and new text end 285.34 new text begin (4) the materials provided in an alternative format meet all other requirements of new text end 285.35 new text begin the commissioner regarding content, size of typeface, and any required time frames for new text end 286.1 new text begin distribution. "Required time frames for distribution" must permit sufficient time for new text end 286.2 new text begin prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' new text end 286.3 new text begin requests for the materials. new text end 286.4 new text begin (c) A prepaid health plan may provide in an alternative format its primary care new text end 286.5 new text begin network list to the commissioner and to local agencies within its service area. The new text end 286.6 new text begin commissioner or local agency, as applicable, shall inform a potential enrollee of the new text end 286.7 new text begin availability of a prepaid health plan's primary care network list in an alternative format. If new text end 286.8 new text begin the potential enrollee requests an alternative format of the prepaid health plan's primary new text end 286.9 new text begin care network list, a record of that request shall be retained by the commissioner or local new text end 286.10 new text begin agency. The potential enrollee is permitted to withdraw the request at any time. new text end 286.11 new text begin The prepaid health plan shall submit sufficient paper versions of the primary new text end 286.12 new text begin care network list to the commissioner and to local agencies within its service area to new text end 286.13 new text begin accommodate potential enrollee requests for paper versions of the primary care network new text end 286.14 new text begin list. new text end 286.15 new text begin (d) A prepaid health plan may provide in an alternative format materials otherwise new text end 286.16 new text begin required to be available in writing under Code of Federal Regulations, title 42, section new text end 286.17 new text begin 438.10, or under the commissioner's contract with the prepaid health plan, if the conditions new text end 286.18 new text begin of paragraphs (b), (c), and (e), are met for persons who are: new text end 286.19 new text begin (1) enrolled in integrated Medicare and Medicaid programs under subdivisions new text end 286.20 new text begin 23 and 28; new text end 286.21 new text begin (2) enrolled in managed care long-term care programs under subdivision 6b; new text end 286.22 new text begin (3) dually eligible for Medicare and medical assistance; or new text end 286.23 new text begin (4) in the waiting period for Medicare. new text end 286.24 new text begin (e) The commissioner shall seek any federal Medicaid waivers within 90 days after new text end 286.25 new text begin the effective date of this subdivision that are necessary to provide alternative formats of new text end 286.26 new text begin required material to enrollees of prepaid health plans as authorized under this subdivision. new text end 286.27 new text begin (f) The commissioner shall consult with managed care plans, county-based new text end 286.28 new text begin purchasing plans, counties, and other interested parties to determine how materials new text end 286.29 new text begin required to be made available to enrollees under Code of Federal Regulations, title 42, new text end 286.30 new text begin section 438.10, or under the commissioner's contract with a prepaid health plan may new text end 286.31 new text begin be provided in an alternative format on the basis that the enrollee has not opted in to new text end 286.32 new text begin receive the alternative format. The commissioner shall consult with managed care new text end 286.33 new text begin plans, county-based purchasing plans, counties, and other interested parties to develop new text end 286.34 new text begin recommendations relating to the conditions that must be met for an opt-out process new text end 286.35 new text begin to be granted. new text end 287.1    Sec. 7. Minnesota Statutes 2010, section 256D.09, subdivision 6, is amended to read: 287.2    Subd. 6. Recovery of overpayments. (a) If an amount of general assistance or 287.3family general assistance is paid to a recipient in excess of the payment due, it shall be 287.4recoverable by the county agency. The agency shall give written notice to the recipient of 287.5its intention to recover the overpayment. 287.6(b) new text begin Except as provided for interim assistance in section 256D.06, subdivision new text end 287.7 new text begin 5, new text end when an overpayment occurs, the county agency shall recover the overpayment 287.8from a current recipient by reducing the amount of aid payable to the assistance unit of 287.9which the recipient is a member, for one or more monthly assistance payments, until 287.10the overpayment is repaid. All county agencies in the state shall reduce the assistance 287.11payment by three percent of the assistance unit's standard of need in nonfraud cases and 287.12ten percent where fraud has occurred, or the amount of the monthly payment, whichever is 287.13less, for all overpayments. 287.14(c) In cases when there is both an overpayment and underpayment, the county 287.15agency shall offset one against the other in correcting the payment. 287.16(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual, 287.17in addition to the aid reductions provided in this subdivision, to include further voluntary 287.18reductions in the grant level agreed to in writing by the individual, until the total amount 287.19of the overpayment is repaid. 287.20(e) The county agency shall make reasonable efforts to recover overpayments to 287.21persons no longer on assistance under standards adopted in rule by the commissioner 287.22of human services. The county agency need not attempt to recover overpayments of 287.23less than $35 paid to an individual no longer on assistance if the individual does not 287.24receive assistance again within three years, unless the individual has been convicted of 287.25violating section 256.98. 287.26 new text begin (f) Establishment of an overpayment is limited to 12 months prior to the month of new text end 287.27 new text begin discovery due to agency error and six years prior to the month of discovery due to client new text end 287.28 new text begin error or an intentional program violation determined under section 256.046. new text end 287.29    Sec. 8. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read: 287.30    Subd. 3. Overpayment of monthly grants and recovery of ATM errors. new text begin (a) new text end When 287.31the county agency determines that an overpayment of the recipient's monthly payment 287.32of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 287.33to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 287.34county agency may request voluntary repayment or pursue civil recovery. If the person is 287.35receiving Minnesota supplemental aid, the county agency shall recover the overpayment 288.1by withholding an amount equal to three percent of the standard of assistance for the 288.2recipient or the total amount of the monthly grant, whichever is less. 288.3 new text begin (b) Establishment of an overpayment is limited to 12 months from the date of new text end 288.4 new text begin discovery due to agency error and six years prior to the month of discovery due to client new text end 288.5 new text begin error or an intentional program violation determined under section 256.046. new text end 288.6 new text begin (c) new text end For recipients receiving benefits via electronic benefit transfer, if the overpayment 288.7is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 288.8the agency may recover the ATM error by immediately withdrawing funds from the 288.9recipient's electronic benefit transfer account, up to the amount of the error. 288.10 new text begin (d) new text end Residents of nursing homes, regional treatment centers, and new text begin licensed residential new text end 288.11facilities with negotiated rates shall not have overpayments recovered from their personal 288.12needs allowance. 288.13    Sec. 9. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read: 288.14    Subdivision 1. Scope of overpayment. new text begin (a) new text end When a participant or former participant 288.15receives an overpayment due to agency, client, or ATM error, or due to assistance received 288.16while an appeal is pending and the participant or former participant is determined 288.17ineligible for assistance or for less assistance than was received, the county agency must 288.18recoup or recover the overpayment using the following methods: 288.19(1) reconstruct each affected budget month and corresponding payment month; 288.20(2) use the policies and procedures that were in effect for the payment month; and 288.21(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 288.22calculation of the overpayment when the unit has not reported within two calendar months 288.23following the end of the month in which the income was received. 288.24 new text begin (b) Establishment of an overpayment is limited to 12 months prior to the month of new text end 288.25 new text begin discovery due to agency error and six years prior to the month of discovery due to client new text end 288.26 new text begin error or an intentional program violation determined under section 256.046. new text end 288.27    Sec. 10. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read: 288.28    Subd. 10. Food stamp program; Maternal and Child Nutrition Act. (a) The local 288.29social services agency shall establish and administer the food stamp program according 288.30to rules of the commissioner of human services, the supervision of the commissioner as 288.31specified in section 256.01, and all federal laws and regulations. The commissioner of 288.32human services shall monitor food stamp program delivery on an ongoing basis to ensure 288.33that each county complies with federal laws and regulations. Program requirements to be 288.34monitored include, but are not limited to, number of applications, number of approvals, 289.1number of cases pending, length of time required to process each application and deliver 289.2benefits, number of applicants eligible for expedited issuance, length of time required 289.3to process and deliver expedited issuance, number of terminations and reasons for 289.4terminations, client profiles by age, household composition and income level and sources, 289.5and the use of phone certification and home visits. The commissioner shall determine the 289.6county-by-county and statewide participation rate. 289.7(b) On July 1 of each year, the commissioner of human services shall determine a 289.8statewide and county-by-county food stamp program participation rate. The commissioner 289.9may designate a different agency to administer the food stamp program in a county if the 289.10agency administering the program fails to increase the food stamp program participation 289.11rate among families or eligible individuals, or comply with all federal laws and regulations 289.12governing the food stamp program. The commissioner shall review agency performance 289.13annually to determine compliance with this paragraph. 289.14(c) A person who commits any of the following acts has violated section 256.98 or 289.15609.821 , or both, and is subject to both the criminal and civil penalties provided under 289.16those sections: 289.17(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 289.18willful statement or misrepresentation, or intentional concealment of a material fact, food 289.19stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 289.20is not entitled or in an amount greater than that to which that person is entitled or which 289.21specify nutritional supplements to which that person is not entitled; or 289.22(2) presents or causes to be presented, coupons or vouchers issued according to 289.23sections 145.891 to 145.897 for payment or redemption knowing them to have been 289.24received, transferred or used in a manner contrary to existing state or federal law; or 289.25(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 289.26purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 289.27contrary to existing state or federal law, rules, or regulations; or 289.28(4) buys or sells food stamp coupons, authorization to purchase cards, other 289.29assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 289.30or any food obtained through the redemption of vouchers issued according to sections 289.31145.891 to 145.897 for cash or consideration other than eligible food. 289.32(d) A peace officer or welfare fraud investigator may confiscate food stamps, 289.33authorization to purchase cards, or other assistance transaction devices found in the 289.34possession of any person who is neither a recipient of the food stamp program nor 289.35otherwise authorized to possess and use such materials. Confiscated property shall be 289.36disposed of as the commissioner may direct and consistent with state and federal food 290.1stamp law. The confiscated property must be retained for a period of not less than 30 days 290.2to allow any affected person to appeal the confiscation under section 256.045. 290.3(e) Food stamp overpayment claims which are due in whole or in part to client error 290.4shall be established by the county agency for a period of six years from the date of any 290.5resultant overpayment new text begin Establishment of an overpayment is limited to 12 months prior to new text end 290.6 new text begin the month of discovery due to agency error and six years prior to the month of discovery new text end 290.7 new text begin due to client error or an intentional program violation determined under section 256.046 new text end . 290.8(f) With regard to the federal tax revenue offset program only, recovery incentives 290.9authorized by the federal food and consumer service shall be retained at the rate of 50 290.10percent by the state agency and 50 percent by the certifying county agency. 290.11(g) A peace officer, welfare fraud investigator, federal law enforcement official, 290.12or the commissioner of health may confiscate vouchers found in the possession of any 290.13person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 290.14authorized to possess and use such vouchers. Confiscated property shall be disposed of 290.15as the commissioner of health may direct and consistent with state and federal law. The 290.16confiscated property must be retained for a period of not less than 30 days. 290.17(h) The commissioner of human services may seek a waiver from the United States 290.18Department of Agriculture to allow the state to specify foods that may and may not be 290.19purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 290.20commissioner shall consult with the members of the house of representatives and senate 290.21policy committees having jurisdiction over food support issues in developing the waiver. 290.22The commissioner, in consultation with the commissioners of health and education, shall 290.23develop a broad public health policy related to improved nutrition and health status. The 290.24commissioner must seek legislative approval prior to implementing the waiver. 290.25    Sec. 11. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read: 290.26    Subd. 4. Essential human services or essential services. "Essential human 290.27services" or "essential services" means assistance and services to recipients or potential 290.28recipients of public welfare and other services delivered by counties new text begin or tribes new text end that are 290.29mandated in federal and state law that are to be available in all counties of the state. 290.30    Sec. 12. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read: 290.31    Subd. 5. Service delivery authority. "Service delivery authority" means a single 290.32county, or group new text begin consortium new text end of counties operating by execution of a joint powers 290.33agreement under section 471.59 or other contractual agreement, that has voluntarily 290.34chosen by resolution of the county board of commissioners to participate in the redesign 291.1under this chapter new text begin or has been assigned by the commissioner pursuant to section 402A.18. new text end 291.2 new text begin A service delivery authority includes an Indian tribe or group of tribes that have voluntarily new text end 291.3 new text begin chosen by resolution of tribal government to participate in redesign under this chapter new text end . 291.4    Sec. 13. Minnesota Statutes 2010, section 402A.15, is amended to read: 291.5402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME 291.6REFORMS. 291.7    Subdivision 1. Duties. (a) The Steering Committee on Performance and Outcome 291.8Reforms shall develop a uniform process to establish and review performance and outcome 291.9standards for all essential human services based on the current level of resources available, 291.10and to new text begin shall new text end develop appropriate reporting measures and a uniform accountability process 291.11for responding to a county's or human service new text begin delivery new text end authority's failure to make adequate 291.12progress on achieving performance measures. The accountability process shall focus on 291.13the performance measures rather than inflexible implementation requirements. 291.14(b) The steering committee shall: 291.15(1) by November 1, 2009, establish an agreed-upon list of essential services; 291.16(2) by February 15, 2010, develop and recommend to the legislature a uniform, 291.17graduated process, in addition to the remedies identified in section 402A.18, for responding 291.18to a county's failure to make adequate progress on achieving performance measures; and 291.19(3) by December 15, 2012, for each essential service new text begin , new text end make recommendations 291.20to the legislature regarding (1) new text begin (i) new text end performance measures and goals based on those 291.21measures for each essential service, (2) new text begin and (ii) new text end a system for reporting on the performance 291.22measures and goals, and (3) appropriate resources, including funding, needed to achieve 291.23those performance measures and goals. The resource recommendations shall take into 291.24consideration program demand and the unique differences of local areas in geography and 291.25the populations served. Priority shall be given to services with the greatest variation in 291.26availability and greatest administrative demands. By January 15 of each year starting 291.27January 15, 2011, the steering committee shall report its recommendations to the governor 291.28and legislative committees with jurisdiction over health and human services. As part of its 291.29report, the steering committee shall, as appropriate, recommend statutory provisions, rules 291.30and requirements, and reports that should be repealed or eliminated. 291.31(c) As far as possible, the performance measures, reporting system, and funding 291.32shall be consistent across program areas. The development of performance measures shall 291.33consider the manner in which data will be collected and performance will be reported. 291.34The steering committee shall consider state and local administrative costs related to 291.35collecting data and reporting outcomes when developing performance measures. The 292.1steering committee shall correlate the performance measures and goals to available levels 292.2of resources, including state and local funding. new text begin The steering committee shall also identify new text end 292.3 new text begin and incorporate federal performance measures in its recommendations for those program new text end 292.4 new text begin areas where federal funding is contingent on meeting federal performance standards. new text end The 292.5steering committee shall take into consideration that the goal of implementing changes 292.6to program monitoring and reporting the progress toward achieving outcomes is to 292.7significantly minimize the cost of administrative requirements and to allow funds freed 292.8by reduced administrative expenditures to be used to provide additional services, allow 292.9flexibility in service design and management, and focus energies on achieving program 292.10and client outcomes. 292.11(d) In making its recommendations, the steering committee shall consider input from 292.12the council established in section 402A.20. The steering committee shall review the 292.13measurable goals established in a memorandum of understanding entered into under 292.14section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied 292.15as statewide performance outcomes. 292.16(e) The steering committee shall form work groups that include persons who provide 292.17or receive essential services and representatives of organizations who advocate on behalf 292.18of those persons. 292.19(f) By December 15, 2009, the steering committee shall establish a three-year 292.20schedule for completion of its work. The schedule shall be published on the Department of 292.21Human Services Web site and reported to the legislative committees with jurisdiction over 292.22health and human services. In addition, the commissioner shall post quarterly updates on 292.23the progress of the steering committee on the Department of Human Services Web site. 292.24    Subd. 2. Composition. (a) The steering committee shall include: 292.25(1) the commissioner of human services, or designee, and two additional 292.26representatives of the department; 292.27(2) two county commissioners, representative of rural and urban counties, selected 292.28by the Association of Minnesota Counties; 292.29(3) two county directors of human services, representative of rural and urban 292.30counties, selected by the Minnesota Association of County Social Service Administrators; 292.31and 292.32(4) three clients or client advocates representing different populations receiving 292.33services from the Department of Human Services, who are appointed by the commissioner. 292.34(b) The commissioner, or designee, and a county commissioner shall serve as 292.35cochairs of the committee. The committee shall be convened within 60 days of May 292.3615, 2009. 293.1(c) State agency staff shall serve as informational resources and staff to the steering 293.2committee. Statewide county associations may assemble county program data as required. 293.3(d) To promote information sharing and coordination between the steering committee 293.4and council, one of the county representatives from paragraph (a), clause (2), and one of the 293.5county representatives from paragraph (a), clause (3), must also serve as a representative 293.6on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6). 293.7    Sec. 14. Minnesota Statutes 2010, section 402A.18, is amended to read: 293.8402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET 293.9PERFORMANCE OUTCOMES. 293.10    Subdivision 1. Underperforming county; specific service. If the commissioner 293.11determines that a county or service delivery authority is deficient in achieving minimum 293.12performance outcomes for a specific essential service, the commissioner may impose the 293.13following remedies new text begin and adjust state and federal program allocations accordingly new text end : 293.14(1) voluntary incorporation of the administration and operation of the specific 293.15essential service with an existing service delivery authority or another county. A 293.16service delivery authority or county incorporating an underperforming county shall 293.17not be financially liable for the costs associated with remedying performance outcome 293.18deficiencies; 293.19(2) mandatory incorporation of the administration and operation of the specific 293.20essential service with an existing service delivery authority or another county. A 293.21service delivery authority or county incorporating an underperforming county shall 293.22not be financially liable for the costs associated with remedying performance outcome 293.23deficiencies; or 293.24(3) transfer of authority for program administration and operation of the specific 293.25essential service to the commissioner. 293.26    Subd. 2. Underperforming county; more than one-half of service new text begin services new text end . If 293.27the commissioner determines that a county or service delivery authority is deficient in 293.28achieving minimum performance outcomes for more than one-half of the defined essential 293.29service new text begin services new text end , the commissioner may impose the following remedies: 293.30(1) voluntary incorporation of the administration and operation of the specific 293.31essential service new text begin services new text end with an existing service delivery authority or another county. 293.32A service delivery authority or county incorporating an underperforming county shall 293.33not be financially liable for the costs associated with remedying performance outcome 293.34deficiencies; 294.1(2) mandatory incorporation of the administration and operation of the specific 294.2essential service new text begin services new text end with an existing service delivery authority or another county. 294.3A service delivery authority or county incorporating an underperforming county shall 294.4not be financially liable for the costs associated with remedying performance outcome 294.5deficiencies; or 294.6(3) transfer of authority for program administration and operation of the specific 294.7essential service new text begin services new text end to the commissioner. 294.8     new text begin Subd. 2a. new text end new text begin Financial responsibility of underperforming county. new text end new text begin A county subject new text end 294.9 new text begin to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of new text end 294.10 new text begin the essential service or essential services the amount of nonfederal and nonstate funding new text end 294.11 new text begin needed to remedy performance outcome deficiencies. new text end 294.12    Subd. 3. Conditions prior to imposing remedies. Before the commissioner may 294.13impose the remedies authorized under this section, the following conditions must be met: 294.14(1) the county or service delivery authority determined by the commissioner 294.15to be deficient in achieving minimum performance outcomes has the opportunity, in 294.16coordination with the council, to develop a program outcome improvement plan. The 294.17program outcome improvement plan must be developed no later than six months from the 294.18date of the deficiency determination; and 294.19(2) the council has conducted an assessment of the program outcome improvement 294.20plan to determine if the county or service delivery authority has made satisfactory 294.21progress toward performance outcomes and has made a recommendation about remedies 294.22to the commissioner. The review new text begin assessment new text end and recommendation must be made to the 294.23commissioner within 12 months from the date of the deficiency determination. 294.24    Sec. 15. Minnesota Statutes 2010, section 402A.20, is amended to read: 294.25402A.20 COUNCIL. 294.26    Subdivision 1. Council. (a) The State-County Results, Accountability, and Service 294.27Delivery Redesign Council is established. Appointed council members must be appointed 294.28by their respective agencies, associations, or governmental units by November 1, 2009. 294.29The council shall be cochaired by the commissioner of human services, or designee, and a 294.30county representative from paragraph (b), clause (4) or (5), appointed by the Association 294.31of Minnesota Counties. Recommendations of the council must be approved by a majority 294.32of the new text begin voting new text end council members. The provisions of section 15.059 do not apply to this 294.33council, and this council does not expire. 294.34(b) The council must consist of the following members: 295.1(1) two legislators appointed by the speaker of the house, one from the minority 295.2and one from the majority; 295.3(2) two legislators appointed by the Senate Rules Committee, one from the majority 295.4and one from the minority; 295.5(3) the commissioner of human services, or designee, and three employees from 295.6the department; 295.7(4) two county commissioners appointed by the Association of Minnesota Counties; 295.8(5) two county representatives appointed by the Minnesota Association of County 295.9Social Service Administrators; 295.10(6) one representative appointed by AFSCME as a nonvoting member; and 295.11(7) one representative appointed by the Teamsters as a nonvoting member. 295.12(c) Administrative support to the council may be provided by the Association of 295.13Minnesota Counties and affiliates. 295.14(d) Member agencies and associations are responsible for initial and subsequent 295.15appointments to the council. 295.16    Subd. 2. Council duties. The council shall: 295.17(1) provide review of the new text begin service delivery new text end redesign process new text begin , including proposed new text end 295.18 new text begin memoranda of understanding to establish a service delivery authority to conduct and new text end 295.19 new text begin administer experimental projects to test new methods and procedures of delivering new text end 295.20 new text begin services new text end ; 295.21(2) certify, in accordance with section 402A.30, subdivision 4, the formation of 295.22a service delivery authority, including the memorandum of understanding in section 295.23402A.30, subdivision 2, paragraph (b); 295.24(3) ensure the consistency of the memorandum of understanding entered into 295.25under section 402A.30, subdivision 2, paragraph (b), with the performance standards 295.26recommended by the steering committee and enacted by the legislature; 295.27(4) new text begin (2) new text end ensure the consistency of the memorandum of understanding, to the extent 295.28appropriate, or new text begin with new text end other memorandum of understanding entered into by other service 295.29delivery authorities; 295.30 new text begin (3) review and make recommendations on applications from a service delivery new text end 295.31 new text begin authority for waivers of statutory or rule program requirements that are needed for new text end 295.32 new text begin flexibility to determine the most cost-effective means of achieving specified measurable new text end 295.33 new text begin goals in a redesign of human services delivery; new text end 295.34(5) new text begin (4) new text end establish a process to take public input on the service delivery framework 295.35specified in the memorandum of understanding in section 402A.30, subdivision 2, 296.1paragraph (b) new text begin scope of essential services over which a service delivery authority has new text end 296.2 new text begin jurisdiction new text end ; 296.3(6) new text begin (5) new text end form work groups as necessary to carry out the duties of the council under the 296.4redesign; 296.5(7) new text begin (6) new text end serve as a forum for resolving conflicts among participating counties new text begin and new text end 296.6 new text begin tribes new text end or between participating counties new text begin or tribes new text end and the commissioner of human services, 296.7provided nothing in this section is intended to create a formal binding legal process; 296.8(8) new text begin (7) new text end engage in the program improvement process established in section 402A.18, 296.9subdivision 3; and 296.10(9) new text begin (8) new text end identify and recommend incentives for counties new text begin and tribes new text end to participate in 296.11human services new text begin service delivery new text end authorities. 296.12     new text begin Subd. 3. new text end new text begin Program evaluation. new text end new text begin By December 15, 2014, the council shall request new text end 296.13 new text begin consideration by the legislative auditor for a reevaluation under section 3.971, subdivision new text end 296.14 new text begin 7, of those aspects of the program evaluation of human services administration reported new text end 296.15 new text begin in January 2007 affected by this chapter. new text end 296.16    Sec. 16. new text begin [402A.35] DESIGNATION OF SERVICE DELIVERY AUTHORITY. new text end 296.17     new text begin Subdivision 1. new text end new text begin Requirements for establishing a service delivery authority. new text end 296.18 new text begin (a) A county, tribe, or consortium of counties is eligible to establish a service delivery new text end 296.19 new text begin authority if: new text end 296.20 new text begin (1) the county, tribe, or consortium of counties is: new text end 296.21 new text begin (i) a single county with a population of 55,000 or more; new text end 296.22 new text begin (ii) a consortium of counties with a total combined population of 55,000 or more; new text end 296.23 new text begin (iii) a consortium of four or more counties in reasonable geographic proximity new text end 296.24 new text begin without regard to population; or new text end 296.25 new text begin (iv) one or more tribes with a total combined population of 25,000 or more. new text end 296.26 new text begin The council may recommend that the commissioner of human services exempt a new text end 296.27 new text begin single county, tribe, or consortium of counties from the minimum population standard if new text end 296.28 new text begin the county, tribe, or consortium of counties can demonstrate that it can otherwise meet new text end 296.29 new text begin the requirements of this chapter. new text end 296.30 new text begin (b) A service delivery authority shall: new text end 296.31 new text begin (1) comply with current state and federal law, including any existing federal or state new text end 296.32 new text begin performance measures and performance measures under section 402A.15 when they are new text end 296.33 new text begin enacted into law, except where waivers are approved by the commissioner. Nothing new text end 296.34 new text begin in this subdivision requires the establishment of performance measures under section new text end 297.1 new text begin 402A.15 prior to a service delivery authority participating in the service delivery redesign new text end 297.2 new text begin under this chapter; new text end 297.3 new text begin (2) define the scope of essential services over which the service delivery authority new text end 297.4 new text begin has jurisdiction; new text end 297.5 new text begin (3) designate a single administrative structure to oversee the delivery of those new text end 297.6 new text begin services included in a proposal for a redesigned service or services and identify a single new text end 297.7 new text begin administrative agent for purposes of contact and communication with the department; new text end 297.8 new text begin (4) identify the waivers from statutory or rule program requirements that are needed new text end 297.9 new text begin to ensure greater local control and flexibility to determine the most cost-effective means of new text end 297.10 new text begin achieving specified measurable goals that the participating service delivery authority is new text end 297.11 new text begin expected to achieve; new text end 297.12 new text begin (5) set forth a reasonable level of targeted reductions in overhead and administrative new text end 297.13 new text begin costs for each service delivery authority participating in the service delivery redesign; and new text end 297.14 new text begin (6) set forth the terms under which a county, tribe, or consortium of counties may new text end 297.15 new text begin withdraw from participation. new text end 297.16 new text begin (c) Once a county, tribe, or consortium of counties establishes a service delivery new text end 297.17 new text begin authority, no county, tribe, or consortium of counties that is a member of the service new text end 297.18 new text begin delivery authority may participate as a member of any other service delivery authority. new text end 297.19 new text begin The service delivery authority may allow an additional county, a tribe, or a consortium of new text end 297.20 new text begin counties to join the service delivery authority subject to the approval of the council and new text end 297.21 new text begin the commissioner. new text end 297.22 new text begin (d) Nothing in this chapter precludes local governments from using sections 465.81 new text end 297.23 new text begin and 465.82 to establish procedures for local governments to merge, with the consent new text end 297.24 new text begin of the voters. Nothing in this chapter limits the authority of a county board or tribal new text end 297.25 new text begin council to enter into contractual agreements for services not covered by the provisions new text end 297.26 new text begin of a memorandum of understanding establishing a service delivery authority with other new text end 297.27 new text begin agencies or with other units of government. new text end 297.28     new text begin Subd. 2. new text end new text begin Relief from statutory requirements. new text end new text begin (a) Unless otherwise identified in new text end 297.29 new text begin the memorandum of understanding, any county, tribe, or consortium of counties forming a new text end 297.30 new text begin service delivery authority is exempt from the provisions of sections 245.465; 245.4835; new text end 297.31 new text begin 245.4874; 245.492, subdivision 2; 245.4932; 256F.13; 256J.626, subdivision 2, paragraph new text end 297.32 new text begin (b); and 256M.30. new text end 297.33 new text begin (b) This subdivision does not preclude any county, tribe, or consortium of counties new text end 297.34 new text begin forming a service delivery authority from requesting additional waivers from statutory and new text end 297.35 new text begin rule requirements to ensure greater local control and flexibility. new text end 297.36     new text begin Subd. 3. new text end new text begin Duties. new text end new text begin The service delivery authority shall: new text end 298.1 new text begin (1) within the scope of essential services set forth in the memorandum of new text end 298.2 new text begin understanding establishing the authority, carry out the responsibilities required of local new text end 298.3 new text begin agencies under chapter 393 and human services boards under chapter 402; new text end 298.4 new text begin (2) manage the public resources devoted to human services and other public services new text end 298.5 new text begin delivered or purchased by the counties or tribes that are subsidized or regulated by the new text end 298.6 new text begin Department of Human Services under chapters 245 to 261; new text end 298.7 new text begin (3) employ staff to assist in carrying out its duties; new text end 298.8 new text begin (4) develop and maintain a continuity of operations plan to ensure the continued new text end 298.9 new text begin operation or resumption of essential human services functions in the event of any business new text end 298.10 new text begin interruption according to local, state, and federal emergency planning requirements; new text end 298.11 new text begin (5) receive and expend funds received for the redesign process under the new text end 298.12 new text begin memorandum of understanding; new text end 298.13 new text begin (6) plan and deliver services directly or through contract with other governmental, new text end 298.14 new text begin tribal, or nongovernmental providers; new text end 298.15 new text begin (7) rent, purchase, sell, and otherwise dispose of real and personal property as new text end 298.16 new text begin necessary to carry out the redesign; and new text end 298.17 new text begin (8) carry out any other service designated as a responsibility of a county. new text end 298.18     new text begin Subd. 4. new text end new text begin Process for establishing a service delivery authority. new text end new text begin (a) The county, new text end 298.19 new text begin tribe, or consortium of counties meeting the requirements of section 402A.30 and new text end 298.20 new text begin proposing to establish a service delivery authority shall present to the council: new text end 298.21 new text begin (1) in conjunction with the commissioner, a proposed memorandum of understanding new text end 298.22 new text begin meeting the requirements of subdivision 1, paragraph (b), and outlining: new text end 298.23 new text begin (i) the details of the proposal; new text end 298.24 new text begin (ii) the state, tribal, and local resources, which may include, but are not limited to, new text end 298.25 new text begin funding, administrative and technology support, and other requirements necessary for new text end 298.26 new text begin the service delivery authority; and new text end 298.27 new text begin (iii) the relief available to the service delivery authority if the resource commitments new text end 298.28 new text begin identified in item (ii) are not met; and new text end 298.29 new text begin (2) a board resolution from the board of commissioners of each participating county new text end 298.30 new text begin stating the county's intent to participate, or in the case of a tribe, a resolution from tribal new text end 298.31 new text begin government, stating the tribe's intent to participate. new text end 298.32 new text begin (b) After the council has considered and recommended approval of a proposed new text end 298.33 new text begin memorandum of understanding, the commissioner may finalize and execute the new text end 298.34 new text begin memorandum of understanding. new text end 298.35     new text begin Subd. 5. new text end new text begin Commissioner authority to seek waivers. new text end new text begin The commissioner may use the new text end 298.36 new text begin authority under section 256.01, subdivision 2, paragraph (l), to grant waivers identified as new text end 299.1 new text begin part of a proposed service delivery authority under subdivision 1, paragraph (b), clause new text end 299.2 new text begin (4), except that waivers granted under this section must be approved by the council under new text end 299.3 new text begin section 402A.20 rather than the Legislative Advisory Committee. new text end 299.4    Sec. 17. new text begin ALIGNMENT OF VERIFICATION AND REDETERMINATION new text end 299.5 new text begin POLICIES. new text end 299.6 new text begin The commissioner of human services shall develop recommendations to align new text end 299.7 new text begin eligibility verification procedures for all health care, economic assistance, food support, new text end 299.8 new text begin child support enforcement, and child care programs. The commissioner shall report back new text end 299.9 new text begin to the chairs of the legislative committees with jurisdiction over these issues by January new text end 299.10 new text begin 15, 2012, with recommendations and draft legislation to implement the alignment of new text end 299.11 new text begin eligibility verifications. new text end 299.12    Sec. 18. new text begin ALTERNATIVE STRATEGIES FOR CERTAIN new text end 299.13 new text begin REDETERMINATIONS. new text end 299.14 new text begin The commissioner of human services shall develop and implement by January 15, new text end 299.15 new text begin 2012, a simplified process to redetermine eligibility for recipient populations in the medical new text end 299.16 new text begin assistance, Minnesota supplemental aid, food support, and group residential housing new text end 299.17 new text begin programs who are eligible based upon disability, age, or chronic medical conditions, and new text end 299.18 new text begin who are expected to experience minimal change in income or assets from month to month. new text end 299.19 new text begin The commissioner shall apply for any federal waivers needed to implement this section. new text end 299.20    Sec. 19. new text begin SIMPLIFICATION OF ELIGIBILITY AND ENROLLMENT new text end 299.21 new text begin PROCESS. new text end 299.22     new text begin Subdivision 1. new text end new text begin Request for proposal. new text end new text begin (a) The commissioner of human services new text end 299.23 new text begin shall issue a request for proposals for a contract to create an implementation plan for new text end 299.24 new text begin an integrated service delivery framework including, at a minimum, all service delivery new text end 299.25 new text begin components specified in paragraph (f). The implementation plan shall include proposed new text end 299.26 new text begin implementation phasing with implementation timelines, estimated costs and savings new text end 299.27 new text begin associated with each implementation phase, tasks related to obtaining federal financial new text end 299.28 new text begin participation, and a draft of the first implementation request for proposals that will be new text end 299.29 new text begin issued. The first implementation request for proposals shall be for implementation of a new text end 299.30 new text begin phased-in integrated online eligibility and application portal for health care programs, new text end 299.31 new text begin food support, cash assistance, and child care. The implementation request for proposals new text end 299.32 new text begin may incorporate a performance-based vendor financing option in which the vendor shares new text end 299.33 new text begin the risk of the project's success. The health care portal must be developed in phases with new text end 300.1 new text begin the capacity to integrate food support, cash assistance, and child care programs as funds new text end 300.2 new text begin are available. The request for proposals must require that the system recommended and new text end 300.3 new text begin implemented by the contractor: new text end 300.4     new text begin (1) streamline eligibility determinations and case processing to support statewide new text end 300.5 new text begin eligibility processing. Responses to the request for proposals must specify components of new text end 300.6 new text begin the service delivery framework the proposal addresses and the expected administrative new text end 300.7 new text begin savings; new text end 300.8     new text begin (2) enable interested persons to determine eligibility for each program, and to apply new text end 300.9 new text begin for programs online in a manner that the applicant will be asked only those questions new text end 300.10 new text begin relevant to the programs for which the person is applying; new text end 300.11     new text begin (3) leverage technology that has been operational in other state environments with new text end 300.12 new text begin similar requirements; and new text end 300.13     new text begin (4) include Web-based application, worker application processing support, and the new text end 300.14 new text begin opportunity for expansion. Responses to the request for proposals must indicate how new text end 300.15 new text begin future expansion can include remaining service delivery components as specified in new text end 300.16 new text begin paragraph (f). new text end 300.17     new text begin (b) The commissioner shall issue a final report, including the implementation new text end 300.18 new text begin plan and first implementation request for proposals, to the chairs and ranking minority new text end 300.19 new text begin members of the legislative committees with jurisdiction over health and human services new text end 300.20 new text begin no later than April 30, 2012. new text end 300.21     new text begin (c) The commissioner shall partner with counties, a service delivery authority new text end 300.22 new text begin established under Minnesota Statutes, chapter 402A, the Office of Enterprise Technology, new text end 300.23 new text begin other state agencies, and service partners to develop an integrated service delivery new text end 300.24 new text begin framework which will simplify and streamline human services eligibility and enrollment new text end 300.25 new text begin processes. The primary objectives for the simplification effort include significantly new text end 300.26 new text begin improved eligibility processing productivity resulting in reduced time for eligibility new text end 300.27 new text begin determination and enrollment, increased customer service for applicants and recipients of new text end 300.28 new text begin services, increased program integrity, and greater administrative flexibility. new text end 300.29     new text begin (d) The commissioner shall develop a service-oriented business architecture new text end 300.30 new text begin for a fully automated medical, cash support, food support, and child care eligibility new text end 300.31 new text begin and enrollment process that aligns with, and supports, the business processes. The new text end 300.32 new text begin commissioner shall use the eligibility and enrollment business architecture to create an new text end 300.33 new text begin integrated and collaborative service delivery framework for evolving or maintaining new text end 300.34 new text begin existing information technology and acquiring new information technology. The agency's new text end 300.35 new text begin plan and program for creating the business architecture and integrated service delivery new text end 300.36 new text begin framework shall include counties, service delivery authorities, collaborative partners, new text end 301.1 new text begin the Office of Enterprise Technology, and end-users in the delivery of human services. new text end 301.2 new text begin An Enterprise Architecture Board shall govern these efforts and shall be chaired by the new text end 301.3 new text begin commissioner. new text end 301.4     new text begin (e) The commissioner will ensure agency compliance with the prompt, efficient, and new text end 301.5 new text begin effective implementation of these governance provisions and specific service delivery new text end 301.6 new text begin components. The commissioner, along with a county representative appointed by the new text end 301.7 new text begin Association of Minnesota Counties, shall report specific implementation progress to the new text end 301.8 new text begin legislature every six months beginning January 15, 2012. new text end 301.9     new text begin (f) The commissioner shall work with the Minnesota Association of County Social new text end 301.10 new text begin Service Administrators and the Office of Enterprise Technology to develop collaborative new text end 301.11 new text begin task forces, as necessary, to support implementation of these service delivery components. new text end 301.12 new text begin The commissioner must develop and include, as part of the integrated eligibility and new text end 301.13 new text begin enrollment service delivery framework, the following: new text end 301.14     new text begin (1) screening tools for applicants to determine potential eligibility as part of an new text end 301.15 new text begin online application process; new text end 301.16     new text begin (2) the capacity to use databases to electronically verify application and renewal new text end 301.17 new text begin data as required by law; new text end 301.18     new text begin (3) online accounts accessible by applicants, enrollees, and third parties acting on new text end 301.19 new text begin behalf of applicants and enrollees. At a minimum, online accounts must contain date of new text end 301.20 new text begin application, application data, status of eligibility determination, premium and spenddown new text end 301.21 new text begin amounts and due dates, recertification dates, required verifications, and supplemental new text end 301.22 new text begin information. These accounts must be a component of a self-service Web site that includes new text end 301.23 new text begin the capacity for online application and renewal; new text end 301.24     new text begin (4) recertification forms prepopulated with name, case number, eligibility data, new text end 301.25 new text begin and a bar code for use statewide; new text end 301.26     new text begin (5) an Interactive Voice Response system, available statewide, that provides case new text end 301.27 new text begin information for applicants, enrollees, and authorized third parties; new text end 301.28     new text begin (6) a statewide electronic document management system that provides seamless new text end 301.29 new text begin electronic transfer of all documents required for eligibility and enrollment processes. All new text end 301.30 new text begin entities processing eligibility and enrollment within the state shall use the electronic new text end 301.31 new text begin document management system to accept and transfer any eligibility and enrollment new text end 301.32 new text begin documents. Processing entities include the state, counties, service delivery authorities new text end 301.33 new text begin established under Minnesota Statutes, chapter 402A, and authorized third parties. new text end 301.34 new text begin The electronic document management system must interface with existing document new text end 301.35 new text begin management systems and automated eligibility systems. Agency produced documents will new text end 301.36 new text begin contain bar codes that must be used by all eligibility processing entities; and new text end 302.1     new text begin (7) a centralized customer contact center that applicants, enrollees, and authorized new text end 302.2 new text begin third parties can use statewide to receive program information, application assistance, and new text end 302.3 new text begin case information; to report changes; to make cost-sharing payments; and conduct other new text end 302.4 new text begin eligibility and enrollment transactions. new text end 302.5     new text begin (g) All provisions in paragraph (f) must be fully integrated as part of any automated new text end 302.6 new text begin eligibility systems. The commissioner must seek federal financial participation to fund new text end 302.7 new text begin system development. new text end 302.8     new text begin Subd. 2. new text end new text begin Appropriation. new text end new text begin $200,000 is appropriated to the commissioner from the new text end 302.9 new text begin general fund for implementation of this section. new text end 302.10 new text begin EFFECTIVE DATE. new text end new text begin This section is effective the day following final enactment. new text end 302.11    Sec. 20. new text begin REPEALER. new text end 302.12 new text begin (a) new text end new text begin Minnesota Statutes 2010, sections 402A.30; and 402A.45, new text end new text begin are repealed. new text end 302.13 new text begin (b) new text end new text begin Minnesota Rules, part 9500.1243, subpart 3, new text end new text begin is repealed. new text end 302.14ARTICLE 8 302.15CHEMICAL AND MENTAL HEALTH 302.16    Section 1. Minnesota Statutes 2010, section 245.50, is amended to read: 302.17245.50 INTERSTATE CONTRACTS, MENTAL HEALTH, CHEMICAL 302.18HEALTH new text begin , DETOXIFICATION new text end SERVICES. 302.19    Subdivision 1. Definitions. For purposes of this section, the following terms have 302.20the meanings given them. 302.21    (a) "Bordering state" means Iowa, North Dakota, South Dakota, or Wisconsin. 302.22    (b) "Receiving agency" means a public or private hospital, mental health center, 302.23chemical health treatment facility, new text begin detoxification facility, new text end or other person or organization 302.24which provides mental health or new text begin , new text end chemical health new text begin , or detoxification new text end services under this 302.25section to individuals from a state other than the state in which the agency is located. 302.26    (c) "Receiving state" means the state in which a receiving agency is located. 302.27    (d) "Sending agency" means a state or county agency which sends an individual to a 302.28bordering state for treatment new text begin or detoxification new text end under this section. 302.29    (e) "Sending state" means the state in which the sending agency is located. 302.30    Subd. 2. Purpose and authority. (a) The purpose of this section is to enable 302.31appropriate treatment new text begin or detoxification services new text end to be provided to individuals, across state 302.32lines from the individual's state of residence, in qualified facilities that are closer to the 302.33homes of individuals than are facilities available in the individual's home state. 303.1    (b) Unless prohibited by another law and subject to the exceptions listed in 303.2subdivision 3, a county board or the commissioner of human services may contract 303.3with an agency or facility in a bordering state for mental health or new text begin , new text end chemical health new text begin , or new text end 303.4 new text begin detoxification new text end services for residents of Minnesota, and a Minnesota mental health or new text begin , new text end 303.5chemical health new text begin , or detoxification new text end agency or facility may contract to provide services to 303.6residents of bordering states. Except as provided in subdivision 5, a person who receives 303.7services in another state under this section is subject to the laws of the state in which 303.8services are provided. A person who will receive services in another state under this 303.9section must be informed of the consequences of receiving services in another state, 303.10including the implications of the differences in state laws, to the extent the individual will 303.11be subject to the laws of the receiving state. 303.12    Subd. 3. Exceptions. A contract may not be entered into under this section for 303.13services to persons who: 303.14    (1) are serving a sentence after conviction of a criminal offense; 303.15    (2) are on probation or parole; 303.16    (3) are the subject of a presentence investigation; or 303.17    (4) have been committed involuntarily in Minnesota under chapter 253B for 303.18treatment of mental illness or chemical dependency, except as provided under subdivision 303.195. 303.20    Subd. 4. Contracts. Contracts entered into under this section must, at a minimum: 303.21    (1) describe the services to be provided; 303.22    (2) establish responsibility for the costs of services; 303.23    (3) establish responsibility for the costs of transporting individuals receiving 303.24services under this section; 303.25    (4) specify the duration of the contract; 303.26    (5) specify the means of terminating the contract; 303.27    (6) specify the terms and conditions for refusal to admit or retain an individual; and 303.28    (7) identify the goals to be accomplished by the placement of an individual under 303.29this section. 303.30    Subd. 5. Special contracts; bordering states. (a) An individual who is detained, 303.31committed, or placed on an involuntary basis under chapter 253B may be confined or 303.32treated in a bordering state pursuant to a contract under this section. An individual 303.33who is detained, committed, or placed on an involuntary basis under the civil law of a 303.34bordering state may be confined or treated in Minnesota pursuant to a contract under 303.35this section. A peace or health officer who is acting under the authority of the sending 303.36state may transport an individual to a receiving agency that provides services pursuant to 304.1a contract under this section and may transport the individual back to the sending state 304.2under the laws of the sending state. Court orders valid under the law of the sending state 304.3are granted recognition and reciprocity in the receiving state for individuals covered by 304.4a contract under this section to the extent that the court orders relate to confinement for 304.5treatment or care of mental illness or new text begin , new text end chemical dependency new text begin , or detoxification new text end . Such 304.6treatment or care may address other conditions that may be co-occurring with the mental 304.7illness or chemical dependency. These court orders are not subject to legal challenge in 304.8the courts of the receiving state. Individuals who are detained, committed, or placed under 304.9the law of a sending state and who are transferred to a receiving state under this section 304.10continue to be in the legal custody of the authority responsible for them under the law 304.11of the sending state. Except in emergencies, those individuals may not be transferred, 304.12removed, or furloughed from a receiving agency without the specific approval of the 304.13authority responsible for them under the law of the sending state. 304.14    (b) While in the receiving state pursuant to a contract under this section, an 304.15individual shall be subject to the sending state's laws and rules relating to length of 304.16confinement, reexaminations, and extensions of confinement. No individual may be sent 304.17to another state pursuant to a contract under this section until the receiving state has 304.18enacted a law recognizing the validity and applicability of this section. 304.19    (c) If an individual receiving services pursuant to a contract under this section leaves 304.20the receiving agency without permission and the individual is subject to involuntary 304.21confinement under the law of the sending state, the receiving agency shall use all 304.22reasonable means to return the individual to the receiving agency. The receiving agency 304.23shall immediately report the absence to the sending agency. The receiving state has the 304.24primary responsibility for, and the authority to direct, the return of these individuals 304.25within its borders and is liable for the cost of the action to the extent that it would be 304.26liable for costs of its own resident. 304.27    (d) Responsibility for payment for the cost of care remains with the sending agency. 304.28    (e) This subdivision also applies to county contracts under subdivision 2 which 304.29include emergency care and treatment provided to a county resident in a bordering state. 304.30    (f) If a Minnesota resident is admitted to a facility in a bordering state under this 304.31chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or 304.32an advance practice registered nurse certified in mental health, who is licensed in the 304.33bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092, 304.34253B.12 , and 253B.17 subject to the same requirements and limitations in section 304.35253B.02, subdivision 7 . Such examiner may initiate an emergency hold under section 304.36253B.05 on a Minnesota resident who is in a hospital that is under contract with a 305.1Minnesota governmental entity under this section provided the resident, in the opinion of 305.2the examiner, meets the criteria in section 253B.05. 305.3     new text begin (g) This section shall apply to detoxification services that are unrelated to treatment new text end 305.4 new text begin whether the services are provided on a voluntary or involuntary basis. new text end 305.5    Sec. 2. Minnesota Statutes 2010, section 246B.10, is amended to read: 305.6246B.10 LIABILITY OF COUNTY; REIMBURSEMENT. 305.7    The civilly committed sex offender's county shall pay to the state a portion of the 305.8cost of care provided in the Minnesota sex offender program to a civilly committed sex 305.9offender who has legally settled in that county. A county's payment must be made from 305.10the county's own sources of revenue and payments must equal ten new text begin 25 new text end percent of the cost of 305.11care, as determined by the commissioner, for each day or portion of a day, that the civilly 305.12committed sex offender spends at the facility. If payments received by the state under this 305.13chapter exceed 90 new text begin 75 new text end percent of the cost of care, the county is responsible for paying the 305.14state the remaining amount. The county is not entitled to reimbursement from the civilly 305.15committed sex offender, the civilly committed sex offender's estate, or from the civilly 305.16committed sex offender's relatives, except as provided in section 246B.07. 305.17 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for all individuals who are civilly new text end 305.18 new text begin committed to the Minnesota sex offender program on or after August 1, 2011. new text end 305.19    Sec. 3. Minnesota Statutes 2010, section 252.025, subdivision 7, is amended to read: 305.20    Subd. 7. Minnesota extended treatment options. The commissioner shall develop 305.21by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who 305.22have developmental disabilities and exhibit severe behaviors which present a risk to 305.23public safety. This program is statewide and must provide specialized residential services 305.24in Cambridge and an array of community-based services with sufficient levels of care 305.25and a sufficient number of specialists to ensure that individuals referred to the program 305.26receive the appropriate care. The individuals working in the community-based services 305.27under this section are state employees supervised by the commissioner of human services. 305.28No new text begin midcontract new text end layoffs shall occur as a result of restructuring under this section new text begin , but new text end 305.29 new text begin layoffs may occur as a normal consequence of a low census or closure of the facility new text end 305.30 new text begin due to decreased census new text end . 306.1    Sec. 4. Minnesota Statutes 2010, section 253B.212, is amended to read: 306.2253B.212 COMMITMENT; RED LAKE BAND OF CHIPPEWA INDIANS new text begin ; new text end 306.3 new text begin WHITE EARTH BAND OF OJIBWE new text end . 306.4    Subdivision 1. Cost of care; commitment by tribal court order new text begin ; Red Lake new text end 306.5 new text begin Band of Chippewa Indians new text end . The commissioner of human services may contract with 306.6and receive payment from the Indian Health Service of the United States Department of 306.7Health and Human Services for the care and treatment of those members of the Red 306.8Lake Band of Chippewa Indians who have been committed by tribal court order to the 306.9Indian Health Service for care and treatment of mental illness, developmental disability, or 306.10chemical dependency. The contract shall provide that the Indian Health Service may not 306.11transfer any person for admission to a regional center unless the commitment procedure 306.12utilized by the tribal court provided due process protections similar to those afforded 306.13by sections 253B.05 to 253B.10. 306.14     new text begin Subd. 1a. new text end new text begin Cost of care; commitment by tribal court order; White Earth Band of new text end 306.15 new text begin Ojibwe Indians. new text end new text begin The commissioner of human services may contract with and receive new text end 306.16 new text begin payment from the Indian Health Service of the United States Department of Health and new text end 306.17 new text begin Human Services for the care and treatment of those members of the White Earth Band new text end 306.18 new text begin of Ojibwe Indians who have been committed by tribal court order to the Indian Health new text end 306.19 new text begin Service for care and treatment of mental illness, developmental disability, or chemical new text end 306.20 new text begin dependency. The tribe may also contract directly with the commissioner for treatment new text end 306.21 new text begin of those members of the White Earth Band who have been committed by tribal court new text end 306.22 new text begin order to the White Earth Department of Health for care and treatment of mental illness, new text end 306.23 new text begin developmental disability, or chemical dependency. The contract shall provide that the new text end 306.24 new text begin Indian Health Service and the White Earth Band shall not transfer any person for admission new text end 306.25 new text begin to a regional center unless the commitment procedure utilized by the tribal court provided new text end 306.26 new text begin due process protections similar to those afforded by sections new text end new text begin to new text end new text begin . new text end 306.27    Subd. 2. Effect given to tribal commitment order. When, under an agreement 306.28entered into pursuant to subdivision 1 new text begin subdivisions 1 or 1a new text end , the Indian Health Service 306.29applies to a regional center for admission of a person committed to the jurisdiction of the 306.30health service by the tribal court as a person who is mentally ill, developmentally disabled, 306.31or chemically dependent, the commissioner may treat the patient with the consent of 306.32the Indian Health Service. 306.33A person admitted to a regional center pursuant to this section has all the rights 306.34accorded by section 253B.03. In addition, treatment reports, prepared in accordance with 306.35the requirements of section 253B.12, subdivision 1, shall be filed with the Indian Health 306.36Service within 60 days of commencement of the patient's stay at the facility. A subsequent 307.1treatment report shall be filed with the Indian Health Service within six months of the 307.2patient's admission to the facility or prior to discharge, whichever comes first. Provisional 307.3discharge or transfer of the patient may be authorized by the head of the treatment facility 307.4only with the consent of the Indian Health Service. Discharge from the facility to the 307.5Indian Health Service may be authorized by the head of the treatment facility after notice 307.6to and consultation with the Indian Health Service. 307.7    Sec. 5. Minnesota Statutes 2010, section 254B.03, subdivision 1, is amended to read: 307.8    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical 307.9dependency services to persons residing within its jurisdiction who meet criteria 307.10established by the commissioner for placement in a chemical dependency residential 307.11or nonresidential treatment service new text begin subject to the limitations on residential chemical new text end 307.12 new text begin dependency treatment in section 254B.04, subdivision 1 new text end . Chemical dependency money 307.13must be administered by the local agencies according to law and rules adopted by the 307.14commissioner under sections 14.001 to 14.69. 307.15    (b) In order to contain costs, the commissioner of human services shall select eligible 307.16vendors of chemical dependency services who can provide economical and appropriate 307.17treatment. Unless the local agency is a social services department directly administered by 307.18a county or human services board, the local agency shall not be an eligible vendor under 307.19section 254B.05. The commissioner may approve proposals from county boards to provide 307.20services in an economical manner or to control utilization, with safeguards to ensure that 307.21necessary services are provided. If a county implements a demonstration or experimental 307.22medical services funding plan, the commissioner shall transfer the money as appropriate. 307.23    (c) A culturally specific vendor that provides assessments under a variance under 307.24Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 307.25persons not covered by the variance. 307.26    Sec. 6. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read: 307.27    Subd. 4. Division of costs. Except for services provided by a county under 307.28section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 307.29subdivision 4 , paragraph (b), the county shall, out of local money, pay the state for 307.3016.14 new text begin 22.95 new text end percent of the cost of chemical dependency services, including those services 307.31provided to persons eligible for medical assistance under chapter 256B and general 307.32assistance medical care under chapter 256D. Counties may use the indigent hospitalization 307.33levy for treatment and hospital payments made under this section. 16.14 new text begin 22.95 new text end percent 307.34of any state collections from private or third-party pay, less 15 percent for the cost of 308.1payment and collections, must be distributed to the county that paid for a portion of the 308.2treatment under this section. 308.3 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for claims processed beginning new text end 308.4 new text begin July 1, 2011. new text end 308.5    Sec. 7. Minnesota Statutes 2010, section 254B.04, subdivision 1, is amended to read: 308.6    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal 308.7Regulations, title 25, part 20, persons eligible for medical assistance benefits under 308.8sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet 308.9the income standards of section 256B.056, subdivision 4, and persons eligible for general 308.10assistance medical care under section 256D.03, subdivision 3, are entitled to chemical 308.11dependency fund services new text begin subject to the following limitations: (1) no more than three new text end 308.12 new text begin residential chemical dependency treatment episodes for the same person in a four-year new text end 308.13 new text begin period of time unless the person meets the criteria established by the commissioner of new text end 308.14 new text begin human services; and (2) no more than four residential chemical dependency treatment new text end 308.15 new text begin episodes in a lifetime unless the person meets the criteria established by the commissioner new text end 308.16 new text begin of human services new text end . State money appropriated for this paragraph must be placed in a 308.17separate account established for this purpose. 308.18Persons with dependent children who are determined to be in need of chemical 308.19dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 308.20a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 308.21local agency to access needed treatment services. Treatment services must be appropriate 308.22for the individual or family, which may include long-term care treatment or treatment in a 308.23facility that allows the dependent children to stay in the treatment facility. The county 308.24shall pay for out-of-home placement costs, if applicable. 308.25(b) A person not entitled to services under paragraph (a), but with family income 308.26that is less than 215 percent of the federal poverty guidelines for the applicable family 308.27size, shall be eligible to receive chemical dependency fund services within the limit 308.28of funds appropriated for this group for the fiscal year. If notified by the state agency 308.29of limited funds, a county must give preferential treatment to persons with dependent 308.30children who are in need of chemical dependency treatment pursuant to an assessment 308.31under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision 308.326 , or 260C.212. A county may spend money from its own sources to serve persons under 308.33this paragraph. State money appropriated for this paragraph must be placed in a separate 308.34account established for this purpose. 309.1(c) Persons whose income is between 215 percent and 412 percent of the federal 309.2poverty guidelines for the applicable family size shall be eligible for chemical dependency 309.3services on a sliding fee basis, within the limit of funds appropriated for this group for the 309.4fiscal year. Persons eligible under this paragraph must contribute to the cost of services 309.5according to the sliding fee scale established under subdivision 3. A county may spend 309.6money from its own sources to provide services to persons under this paragraph. State 309.7money appropriated for this paragraph must be placed in a separate account established 309.8for this purpose. 309.9 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for all chemical dependency new text end 309.10 new text begin residential treatment beginning on or after July 1, 2011. new text end 309.11    Sec. 8. Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision 309.12to read: 309.13     new text begin Subd. 2a. new text end new text begin Eligibility for treatment in residential settings. new text end new text begin Notwithstanding new text end 309.14 new text begin provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's new text end 309.15 new text begin discretion in making placements to residential treatment settings, a person eligible for new text end 309.16 new text begin services under this section must score at level 4 on assessment dimensions related to new text end 309.17 new text begin relapse, continued use, and recovery environment in order to be assigned to services with new text end 309.18 new text begin a room and board component reimbursed under this section. new text end 309.19    Sec. 9. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read: 309.20    Subd. 2. Allocation of collections. The commissioner shall allocate all federal 309.21financial participation collections to a special revenue account. The commissioner shall 309.22allocate 83.86 new text begin 77.05 new text end percent of patient payments and third-party payments to the special 309.23revenue account and 16.14 new text begin 22.95 new text end percent to the county financially responsible for the 309.24patient. 309.25 new text begin EFFECTIVE DATE. new text end new text begin This section is effective for claims processed beginning new text end 309.26 new text begin July 1, 2011. new text end 309.27    Sec. 10. Minnesota Statutes 2010, section 256B.0625, subdivision 41, is amended to 309.28read: 309.29    Subd. 41. Residential services for children with severe emotional disturbance. 309.30Medical assistance covers rehabilitative services in accordance with section 256B.0945 309.31that are provided by a county new text begin or an American Indian tribe new text end through a residential facility, 310.1for children who have been diagnosed with severe emotional disturbance and have been 310.2determined to require the level of care provided in a residential facility. 310.3 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2011. new text end 310.4    Sec. 11. Minnesota Statutes 2010, section 256B.0945, subdivision 4, is amended to 310.5read: 310.6    Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, 310.7payments to counties for residential services provided by a residential facility shall only 310.8be made of federal earnings for services provided under this section, and the nonfederal 310.9share of costs for services provided under this section shall be paid by the county from 310.10sources other than federal funds or funds used to match other federal funds. Payment to 310.11counties for services provided according to this section shall be a proportion of the per 310.12day contract rate that relates to rehabilitative mental health services and shall not include 310.13payment for costs or services that are billed to the IV-E program as room and board. 310.14    (b) Per diem rates paid to providers under this section by prepaid plans shall be 310.15the proportion of the per-day contract rate that relates to rehabilitative mental health 310.16services and shall not include payment for group foster care costs or services that are 310.17billed to the county of financial responsibility. Services provided in facilities located in 310.18bordering states are eligible for reimbursement on a fee-for-service basis only as described 310.19in paragraph (a) and are not covered under prepaid health plans. 310.20    (c) new text begin Payment for mental health rehabilitative services provided under this section by new text end 310.21 new text begin or under contract with an American Indian tribe or tribal organization or by agencies new text end 310.22 new text begin operated by or under contract with an American Indian tribe or tribal organization must new text end 310.23 new text begin be made according to section 256B.0625, subdivision 34, or other relevant federally new text end 310.24 new text begin approved rate-setting methodology. new text end 310.25 new text begin (d) new text end The commissioner shall set aside a portion not to exceed five percent of the 310.26federal funds earned for county expenditures under this section to cover the state costs of 310.27administering this section. Any unexpended funds from the set-aside shall be distributed 310.28to the counties in proportion to their earnings under this section. 310.29 new text begin EFFECTIVE DATE. new text end new text begin This section is effective October 1, 2011. new text end 310.30    Sec. 12. new text begin COMMUNITY MENTAL HEALTH SERVICES; USE OF new text end 310.31 new text begin BEHAVIORAL HEALTH HOSPITALS. new text end 310.32 new text begin The commissioner shall issue a written report to the chairs and ranking minority new text end 310.33 new text begin members of the house and senate committees with jurisdiction of health and human new text end 311.1 new text begin services by December 31, 2011, on how the community behavioral health hospital new text end 311.2 new text begin facilities will be fully utilized to meet the mental health needs of regions in which the new text end 311.3 new text begin hospitals are located. The commissioner must consult with the regional planning work new text end 311.4 new text begin groups for adult mental health and must include the recommendations of the work groups new text end 311.5 new text begin in the legislative report. The report must address future use of community behavioral new text end 311.6 new text begin health hospitals that are not certified as Medicaid eligible by CMS or have a less than 65 new text end 311.7 new text begin percent licensed bed occupancy rate, and using the facilities for another purpose that will new text end 311.8 new text begin meet the mental health needs of residents of the region. The regional planning work new text end 311.9 new text begin groups shall work with the commissioner to prioritize the needs of their regions. These new text end 311.10 new text begin priorities, by region, must be included in the commissioner's report to the legislature. new text end 311.11    Sec. 13. new text begin INTEGRATED DUAL DIAGNOSIS TREATMENT. new text end 311.12 new text begin (a) The commissioner shall require individuals who perform chemical dependency new text end 311.13 new text begin assessments or mental health assessments to use approved screening tools in order to new text end 311.14 new text begin identify whether an individual who is the subject of the assessment has a co-occurring new text end 311.15 new text begin mental health or chemical dependency disorder. Screening for co-occurring disorders must new text end 311.16 new text begin begin no later than December 31, 2011. new text end 311.17 new text begin (b) No later than October 1, 2011, the commissioner shall develop and implement a new text end 311.18 new text begin certification process for integrated dual diagnosis treatment providers. new text end 311.19 new text begin (c) No later than December 31, 2011, the commissioner shall develop and implement new text end 311.20 new text begin a referral system so that individuals who, at screening, are identified with co-occurring new text end 311.21 new text begin disorders are referred to certified integrated dual diagnosis treatment providers. new text end 311.22 new text begin (d) The commissioner shall apply for any federal waivers necessary to secure, to the new text end 311.23 new text begin extent allowed by law, federal financial participation for the provision of integrated dual new text end 311.24 new text begin diagnosis treatment to persons with co-occurring disorders. new text end 311.25    Sec. 14. new text begin STATE-OPERATED SERVICES FACILITIES. new text end 311.26     new text begin (a) The commissioner shall close the Willmar Community Behavioral Health new text end 311.27 new text begin Hospital no later than October 1, 2011. new text end 311.28     new text begin (b) The commissioner shall present a plan to the legislative committees with new text end 311.29 new text begin jurisdiction over health and human services finance no later than January 1, 2012, on new text end 311.30 new text begin how the department will: new text end 311.31     new text begin (1) accommodate the mental health needs of clients impacted by the closure or new text end 311.32 new text begin redesign of any state-operated services facilities; and new text end 311.33     new text begin (2) accommodate the state employees adversely affected by the closure or redesign new text end 311.34 new text begin of any state-operated services facilities. new text end 312.1    Sec. 15. new text begin REGIONAL TREATMENT CENTERS; EMPLOYEES; REPORT. new text end 312.2 new text begin (a) No layoffs shall occur as a result of restructuring services at the Anoka-Metro new text end 312.3 new text begin Regional Treatment Center. new text end 312.4 new text begin (b) The commissioner shall issue a report to the legislative committees with new text end 312.5 new text begin jurisdiction over health and human services finance no later than December 31, 2011, new text end 312.6 new text begin which provides the number of employees in management positions at the Anoka-Metro new text end 312.7 new text begin Regional Treatment Center and the Minnesota Security Hospital at St. Peter and the ratio new text end 312.8 new text begin of management to direct-care staff for each facility. new text end 312.9    Sec. 16. new text begin COMMISSIONER'S CRITERIA FOR RESIDENTIAL TREATMENT. new text end 312.10 new text begin The commissioner shall develop specific criteria to approve treatment for individuals new text end 312.11 new text begin who require residential chemical dependency treatment in excess of the maximum allowed new text end 312.12 new text begin in section 254B.04, subdivision 1, due to co-occurring disorders, including disorders new text end 312.13 new text begin related to cognition, traumatic brain injury, or documented disability. Criteria shall be new text end 312.14 new text begin developed for use no later than October 1, 2011. new text end 312.15    Sec. 17. new text begin MINNESOTA STATE-OPERATED COMMUNITY SERVICES. new text end 312.16     new text begin The commissioner shall evaluate the effectiveness of overnight supervision new text end 312.17 new text begin provided at the Minnesota state-operated community services residential programs. The new text end 312.18 new text begin commissioner shall determine whether safety is compromised when only one overnight new text end 312.19 new text begin staff person is scheduled to work, and shall document the incidents in which the staff new text end 312.20 new text begin person called for assistance or reported behavior that threatened the safety of clients or the new text end 312.21 new text begin staff person. The commissioner shall report findings to the legislative committees with new text end 312.22 new text begin jurisdiction over health and human services no later than January 15, 2012. new text end 312.23    Sec. 18. new text begin REPEALER. new text end 312.24 new text begin Laws 2009, chapter 79, article 3, section 18, as amended by Laws 2010, First Special new text end 312.25 new text begin Session chapter 1, article 19, section 19, new text end new text begin is repealed. new text end 312.26ARTICLE 9 312.27HEALTH AND HUMAN SERVICES APPROPRIATIONS 312.28 Section 1. new text begin SUMMARY OF APPROPRIATIONS. new text end 312.29 new text begin The amounts shown in this section summarize direct appropriations, by fund, made new text end 312.30 new text begin in this article. new text end 312.31 new text begin 2012 new text end new text begin 2013 new text end new text begin Total new text end 312.32 new text begin General new text end new text begin $ new text end new text begin 5,646,994,000 new text end new text begin $ new text end new text begin 5,159,920,000 new text end new text begin $ new text end new text begin 10,806,914,000 new text end 313.1 313.2 new text begin State Government Special new text end new text begin Revenue new text end new text begin 63,198,000 new text end new text begin 63,154,000 new text end new text begin 126,352,000 new text end 313.3 new text begin Health Care Access new text end new text begin 400,917,000 new text end new text begin 409,880,000 new text end new text begin 810,797,000 new text end 313.4 new text begin Federal TANF new text end new text begin 274,091,000 new text end new text begin 282,814,000 new text end new text begin 556,905,000 new text end 313.5 new text begin Lottery Prize Fund new text end new text begin 1,665,000 new text end new text begin 1,665,000 new text end new text begin 3,330,000 new text end 313.6 new text begin Total new text end new text begin $ new text end new text begin 6,386,865,000 new text end new text begin $ new text end new text begin 5,917,433,000 new text end new text begin $ new text end new text begin 12,304,298,000 new text end 313.7 Sec. 2. new text begin HUMAN SERVICES APPROPRIATIONS. new text end 313.8 new text begin The sums shown in the columns marked "Appropriations" are appropriated to the new text end 313.9 new text begin agencies and for the purposes specified in this article. The appropriations are from the new text end 313.10 new text begin general fund, or another named fund, and are available for the fiscal years indicated new text end 313.11 new text begin for each purpose. The figures "2012" and "2013" used in this article mean that the new text end 313.12 new text begin appropriations listed under them are available for the fiscal year ending June 30, 2012, or new text end 313.13 new text begin June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal new text end 313.14 new text begin year 2013. "The biennium" is fiscal years 2012 and 2013. new text end 313.15 new text begin APPROPRIATIONS new text end 313.16 new text begin Available for the Year new text end 313.17 new text begin Ending June 30 new text end 313.18 new text begin 2012 new text end new text begin 2013 new text end 313.19 313.20 Sec. 3. new text begin COMMISSIONER OF HUMAN new text end new text begin SERVICES new text end 313.21 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin 6,215,925,000 new text end new text begin $ new text end new text begin 5,756,045,000 new text end 313.22 new text begin Appropriations by Fund new text end 313.23 new text begin 2012 new text end new text begin 2013 new text end 313.24 new text begin General new text end new text begin 5,564,174,000 new text end new text begin 5,081,996,000 new text end 313.25 313.26 new text begin State Government new text end new text begin Special Revenue new text end new text begin 565,000 new text end new text begin 565,000 new text end 313.27 new text begin Health Care Access new text end new text begin 387,143,000 new text end new text begin 400,718,000 new text end 313.28 new text begin Federal TANF new text end new text begin 262,378,000 new text end new text begin 271,101,000 new text end 313.29 new text begin Lottery Prize Fund new text end new text begin 1,665,000 new text end new text begin 1,665,000 new text end 313.30 new text begin Receipts for Systems Projects. new text end 313.31 new text begin Appropriations and federal receipts for new text end 313.32 new text begin information systems projects for MAXIS, new text end 313.33 new text begin PRISM, MMIS, and SSIS must be deposited new text end 313.34 new text begin in the state systems account authorized in new text end 313.35 new text begin Minnesota Statutes, section 256.014. Money new text end 313.36 new text begin appropriated for computer projects approved new text end 313.37 new text begin by the Minnesota Office of Enterprise new text end 314.1 new text begin Technology, funded by the legislature, new text end 314.2 new text begin and approved by the commissioner of new text end 314.3 new text begin Minnesota Management and Budget, may new text end 314.4 new text begin be transferred from one project to another new text end 314.5 new text begin and from development to operations as the new text end 314.6 new text begin commissioner of human services considers new text end 314.7 new text begin necessary. Any unexpended balance in new text end 314.8 new text begin the appropriation for these projects does new text end 314.9 new text begin not cancel but is available for ongoing new text end 314.10 new text begin development and operations. new text end 314.11 new text begin Nonfederal Share Transfers. new text end new text begin The new text end 314.12 new text begin nonfederal share of activities for which new text end 314.13 new text begin federal administrative reimbursement is new text end 314.14 new text begin appropriated to the commissioner may be new text end 314.15 new text begin transferred to the special revenue fund. new text end 314.16 new text begin TANF Maintenance of Effort. new text end 314.17 new text begin (a) In order to meet the basic maintenance new text end 314.18 new text begin of effort (MOE) requirements of the TANF new text end 314.19 new text begin block grant specified under Code of Federal new text end 314.20 new text begin Regulations, title 45, section 263.1, the new text end 314.21 new text begin commissioner may only report nonfederal new text end 314.22 new text begin money expended for allowable activities new text end 314.23 new text begin listed in the following clauses as TANF/MOE new text end 314.24 new text begin expenditures: new text end 314.25 new text begin (1) MFIP cash, diversionary work program, new text end 314.26 new text begin and food assistance benefits under Minnesota new text end 314.27 new text begin Statutes, chapter 256J; new text end 314.28 new text begin (2) the child care assistance programs new text end 314.29 new text begin under Minnesota Statutes, sections 119B.03 new text end 314.30 new text begin and 119B.05, and county child care new text end 314.31 new text begin administrative costs under Minnesota new text end 314.32 new text begin Statutes, section 119B.15; new text end 314.33 new text begin (3) state and county MFIP administrative new text end 314.34 new text begin costs under Minnesota Statutes, chapters new text end 314.35 new text begin 256J and 256K; new text end 315.1 new text begin (4) state, county, and tribal MFIP new text end 315.2 new text begin employment services under Minnesota new text end 315.3 new text begin Statutes, chapters 256J and 256K; new text end 315.4 new text begin (5) expenditures made on behalf of new text end 315.5 new text begin noncitizen MFIP recipients who qualify new text end 315.6 new text begin for the medical assistance without federal new text end 315.7 new text begin financial participation program under new text end 315.8 new text begin Minnesota Statutes, section 256B.06, new text end 315.9 new text begin subdivision 4, paragraphs (d), (e), and (j); new text end 315.10 new text begin (6) qualifying working family credit new text end 315.11 new text begin expenditures under Minnesota Statutes, new text end 315.12 new text begin section 290.0671; and new text end 315.13 new text begin (7) qualifying Minnesota education credit new text end 315.14 new text begin expenditures under Minnesota Statutes, new text end 315.15 new text begin section 290.0674. new text end 315.16 new text begin (b) The commissioner shall ensure that new text end 315.17 new text begin sufficient qualified nonfederal expenditures new text end 315.18 new text begin are made each year to meet the state's new text end 315.19 new text begin TANF/MOE requirements. For the activities new text end 315.20 new text begin listed in paragraph (a), clauses (2) to new text end 315.21 new text begin (7), the commissioner may only report new text end 315.22 new text begin expenditures that are excluded from the new text end 315.23 new text begin definition of assistance under Code of new text end 315.24 new text begin Federal Regulations, title 45, section 260.31. new text end 315.25 new text begin (c) For fiscal years beginning with state fiscal new text end 315.26 new text begin year 2003, the commissioner shall assure new text end 315.27 new text begin that the maintenance of effort used by the new text end 315.28 new text begin commissioner of management and budget new text end 315.29 new text begin for the February and November forecasts new text end 315.30 new text begin required under Minnesota Statutes, section new text end 315.31 new text begin 16A.103, contains expenditures under new text end 315.32 new text begin paragraph (a), clause (1), equal to at least 16 new text end 315.33 new text begin percent of the total required under Code of new text end 315.34 new text begin Federal Regulations, title 45, section 263.1. new text end 316.1 new text begin (d) Minnesota Statutes, section 256.011, new text end 316.2 new text begin subdivision 3, which requires that federal new text end 316.3 new text begin grants or aids secured or obtained under that new text end 316.4 new text begin subdivision be used to reduce any direct new text end 316.5 new text begin appropriations provided by law, do not apply new text end 316.6 new text begin if the grants or aids are federal TANF funds. new text end 316.7 new text begin (e) Notwithstanding any contrary provision new text end 316.8 new text begin in this article, paragraph (a), clauses (1) to new text end 316.9 new text begin (7), and paragraphs (b) to (d), expire June new text end 316.10 new text begin 30, 2015. new text end 316.11 new text begin Working Family Credit Expenditures new text end 316.12 new text begin as TANF/MOE. new text end new text begin The commissioner may new text end 316.13 new text begin claim as TANF maintenance of effort up to new text end 316.14 new text begin $6,707,000 per year of working family credit new text end 316.15 new text begin expenditures for fiscal years 2012 and 2013. new text end 316.16 new text begin Working Family Credit Expenditures new text end 316.17 new text begin to be Claimed for TANF/MOE. new text end new text begin The new text end 316.18 new text begin commissioner may count the following new text end 316.19 new text begin amounts of working family credit new text end 316.20 new text begin expenditures as TANF/MOE: new text end 316.21 new text begin (1) fiscal year 2012, $12,037,000; new text end 316.22 new text begin (2) fiscal year 2013, $29,942,000; new text end 316.23 new text begin (3) fiscal year 2014, $23,235,000; and new text end 316.24 new text begin (4) fiscal year 2015, $23,198,000. new text end 316.25 new text begin Notwithstanding any contrary provision in new text end 316.26 new text begin this article, this rider expires June 30, 2015. new text end 316.27 new text begin TANF Transfer to Federal Child Care new text end 316.28 new text begin and Development Fund. new text end new text begin (a) The following new text end 316.29 new text begin TANF fund amounts are appropriated new text end 316.30 new text begin to the commissioner for purposes of new text end 316.31 new text begin MFIP/Transition Year Child Care Assistance new text end 316.32 new text begin under Minnesota Statutes, section 119B.05: new text end 316.33 new text begin (1) fiscal year 2012, $11,020,000; new text end 317.1 new text begin (2) fiscal year 2013, $35,020,000; new text end 317.2 new text begin (3) fiscal year 2014, $14,020,000; and new text end 317.3 new text begin (4) fiscal year 2015, $14,020,000. new text end 317.4 new text begin (b) The commissioner shall authorize the new text end 317.5 new text begin transfer of sufficient TANF funds to the new text end 317.6 new text begin federal child care and development fund to new text end 317.7 new text begin meet this appropriation and shall ensure that new text end 317.8 new text begin all transferred funds are expended according new text end 317.9 new text begin to federal child care and development fund new text end 317.10 new text begin regulations. new text end 317.11 new text begin Food Stamps Employment and Training new text end 317.12 new text begin Funds. new text end new text begin (a) Notwithstanding Minnesota new text end 317.13 new text begin Statutes, sections 256D.051, subdivisions 1a, new text end 317.14 new text begin 6b, and 6c, and 256J.626, federal food stamps new text end 317.15 new text begin employment and training funds received new text end 317.16 new text begin as reimbursement for child care assistance new text end 317.17 new text begin program expenditures must be deposited in new text end 317.18 new text begin the general fund. The amount of funds must new text end 317.19 new text begin be limited to $500,000 per year in fiscal new text end 317.20 new text begin years 2012 through 2015, contingent upon new text end 317.21 new text begin approval by the federal Food and Nutrition new text end 317.22 new text begin Service. new text end 317.23 new text begin (b) Consistent with the receipt of these new text end 317.24 new text begin federal funds, the commissioner may new text end 317.25 new text begin adjust the level of working family credit new text end 317.26 new text begin expenditures claimed as TANF maintenance new text end 317.27 new text begin of effort. Notwithstanding any contrary new text end 317.28 new text begin provision in this article, this rider expires new text end 317.29 new text begin June 30, 2015. new text end 317.30 new text begin ARRA Food Support Benefit Increases. new text end 317.31 new text begin The funds provided for food support benefit new text end 317.32 new text begin increases under the Supplemental Nutrition new text end 317.33 new text begin Assistance Program provisions of the new text end 317.34 new text begin American Recovery and Reinvestment Act new text end 318.1 new text begin (ARRA) of 2009 must be used for benefit new text end 318.2 new text begin increases beginning July 1, 2009. new text end 318.3 new text begin Supplemental Security Interim Assistance new text end 318.4 new text begin Reimbursement Funds. new text end new text begin $2,800,000 of new text end 318.5 new text begin uncommitted revenue available to the new text end 318.6 new text begin commissioner of human services for SSI new text end 318.7 new text begin advocacy and outreach services must be new text end 318.8 new text begin transferred to and deposited into the general new text end 318.9 new text begin fund by June 30, 2012. new text end 318.10 new text begin Subd. 2. new text end new text begin Central Office Operations new text end 318.11 new text begin The amounts that may be spent from this new text end 318.12 new text begin appropriation for each purpose are as follows: new text end 318.13 new text begin (a) new text end new text begin Operations new text end 318.14 new text begin Appropriations by Fund new text end 318.15 new text begin General new text end new text begin 81,458,000 new text end new text begin 80,335,000 new text end 318.16 new text begin Health Care Access new text end new text begin 11,742,000 new text end new text begin 11,508,000 new text end 318.17 318.18 new text begin State Government new text end new text begin Special Revenue new text end new text begin 440,000 new text end new text begin 440,000 new text end 318.19 new text begin Federal TANF new text end new text begin 222,000 new text end new text begin 222,000 new text end 318.20 new text begin DHS Receipt Center Accounting. new text end new text begin The new text end 318.21 new text begin commissioner is authorized to transfer new text end 318.22 new text begin appropriations to, and account for DHS new text end 318.23 new text begin receipt center operations in, the special new text end 318.24 new text begin revenue fund. new text end 318.25 new text begin Base Adjustment. new text end new text begin The general fund base new text end 318.26 new text begin for fiscal year 2014 shall be increased by new text end 318.27 new text begin $79,000. This adjustment is onetime. new text end 318.28 new text begin (b) new text end new text begin Children and Families new text end 318.29 new text begin Appropriations by Fund new text end 318.30 new text begin General new text end new text begin 9,615,000 new text end new text begin 9,417,000 new text end 318.31 new text begin Federal TANF new text end new text begin 2,160,000 new text end new text begin 2,160,000 new text end 318.32 new text begin Financial Institution Data Match and new text end 318.33 new text begin Payment of Fees. new text end new text begin The commissioner is new text end 318.34 new text begin authorized to allocate up to $310,000 each new text end 318.35 new text begin year in fiscal years 2012 and 2013 from the new text end 319.1 new text begin PRISM special revenue account to make new text end 319.2 new text begin payments to financial institutions in exchange new text end 319.3 new text begin for performing data matches between account new text end 319.4 new text begin information held by financial institutions new text end 319.5 new text begin and the public authority's database of child new text end 319.6 new text begin support obligors as authorized by Minnesota new text end 319.7 new text begin Statutes, section 13B.06, subdivision 7. new text end 319.8 new text begin (c) new text end new text begin Health Care new text end 319.9 new text begin Appropriations by Fund new text end 319.10 new text begin General new text end new text begin 16,284,000 new text end new text begin 16,030,000 new text end 319.11 new text begin Health Care Access new text end new text begin 22,574,000 new text end new text begin 26,555,000 new text end 319.12 new text begin Minnesota Senior Health Options new text end 319.13 new text begin Reimbursement. new text end new text begin Federal administrative new text end 319.14 new text begin reimbursement resulting from the Minnesota new text end 319.15 new text begin senior health options project is appropriated new text end 319.16 new text begin to the commissioner for this activity. new text end 319.17 new text begin Utilization Review. new text end new text begin Federal administrative new text end 319.18 new text begin reimbursement resulting from prior new text end 319.19 new text begin authorization and inpatient admission new text end 319.20 new text begin certification by a professional review new text end 319.21 new text begin organization shall be dedicated to the new text end 319.22 new text begin commissioner for these purposes. A portion new text end 319.23 new text begin of these funds must be used for activities to new text end 319.24 new text begin decrease unnecessary pharmaceutical costs new text end 319.25 new text begin in medical assistance. new text end 319.26 new text begin Base Adjustment. new text end new text begin The general fund base new text end 319.27 new text begin shall be decreased by $2,000 in fiscal year new text end 319.28 new text begin 2014 and $114,000 in 2015. new text end 319.29 new text begin The health care access fund base is decreased new text end 319.30 new text begin by $16,000 in fiscal year 2014 and $142,000 new text end 319.31 new text begin in 2015. new text end 319.32 new text begin (d) new text end new text begin Continuing Care new text end 320.1 new text begin Appropriations by Fund new text end 320.2 new text begin General new text end new text begin 18,110,000 new text end new text begin 18,011,000 new text end 320.3 320.4 new text begin State Government new text end new text begin Special Revenue new text end new text begin 125,000 new text end new text begin 125,000 new text end 320.5 new text begin Region 10 Administrative Expenses. new text end new text begin new text end 320.6 new text begin $100,000 is appropriated each fiscal new text end 320.7 new text begin year, beginning in fiscal year 2012, for new text end 320.8 new text begin the administration of the State Quality new text end 320.9 new text begin Improvement and Licensing System under new text end 320.10 new text begin Minnesota Statutes, section 256B.0961. new text end 320.11 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 320.12 new text begin decreased by $259,000 in each of fiscal years new text end 320.13 new text begin 2014 and 2015. new text end 320.14 new text begin (e) new text end new text begin Chemical and Mental Health new text end 320.15 new text begin Appropriations by Fund new text end 320.16 new text begin General new text end new text begin 4,194,000 new text end new text begin 4,194,000 new text end 320.17 new text begin Lottery Prize new text end new text begin 157,000 new text end new text begin 157,000 new text end 320.18 new text begin Subd. 3. new text end new text begin Forecasted Programs new text end 320.19 new text begin The amounts that may be spent from this new text end 320.20 new text begin appropriation for each purpose are as follows: new text end 320.21 new text begin (a) new text end new text begin MFIP/DWP Grants new text end 320.22 new text begin Appropriations by Fund new text end 320.23 new text begin General new text end new text begin 84,256,000 new text end new text begin 91,212,000 new text end 320.24 new text begin Federal TANF new text end new text begin 84,425,000 new text end new text begin 75,417,000 new text end 320.25 new text begin (b) new text end new text begin MFIP Child Care Assistance Grants new text end new text begin 55,726,000 new text end new text begin 26,652,000 new text end 320.26 new text begin (c) new text end new text begin General Assistance Grants new text end new text begin 43,629,000 new text end new text begin 42,440,000 new text end 320.27 new text begin General Assistance Standard. new text end new text begin The new text end 320.28 new text begin commissioner shall set the monthly standard new text end 320.29 new text begin of assistance for general assistance units new text end 320.30 new text begin consisting of an adult recipient who is new text end 320.31 new text begin childless and unmarried or living apart new text end 320.32 new text begin from parents or a legal guardian at $203. new text end 320.33 new text begin The commissioner may reduce this amount new text end 321.1 new text begin according to Laws 1997, chapter 85, article new text end 321.2 new text begin 3, section 54. new text end 321.3 new text begin Emergency General Assistance. new text end new text begin The new text end 321.4 new text begin amount appropriated for emergency general new text end 321.5 new text begin assistance funds is limited to no more new text end 321.6 new text begin than $7,889,812 in fiscal year 2012 and new text end 321.7 new text begin $7,889,812 in fiscal year 2013. Funds new text end 321.8 new text begin to counties shall be allocated by the new text end 321.9 new text begin commissioner using the allocation method new text end 321.10 new text begin specified in Minnesota Statutes, section new text end 321.11 new text begin 256D.06. new text end 321.12 new text begin (d) new text end new text begin Minnesota Supplemental Aid Grants new text end new text begin 38,091,000 new text end new text begin 39,092,000 new text end 321.13 new text begin Emergency Minnesota Supplemental new text end 321.14 new text begin Aid Funds. new text end new text begin The amount appropriated for new text end 321.15 new text begin emergency Minnesota supplemental aid new text end 321.16 new text begin funds is limited to no more than $1,100,000 new text end 321.17 new text begin in fiscal year 2012 and $1,100,000 in fiscal new text end 321.18 new text begin year 2013. Funds to counties shall be new text end 321.19 new text begin allocated by the commissioner using the new text end 321.20 new text begin allocation method specified in Minnesota new text end 321.21 new text begin Statutes, section 256D.46. new text end 321.22 new text begin (e) new text end new text begin Group Residential Housing Grants new text end new text begin 121,092,000 new text end new text begin 129,250,000 new text end 321.23 new text begin (f) new text end new text begin MinnesotaCare Grants new text end new text begin 351,927,000 new text end new text begin 361,755,000 new text end 321.24 new text begin This appropriation is from the health care new text end 321.25 new text begin access fund. new text end 321.26 new text begin (g) new text end new text begin GAMC Grants new text end new text begin 120,000,000 new text end new text begin 280,000,000 new text end 321.27 new text begin Coordinated Care Delivery System. new text end new text begin This new text end 321.28 new text begin appropriation is to fund coordinated care new text end 321.29 new text begin delivery systems under Minnesota Statutes, new text end 321.30 new text begin section 256D.031, subdivision 6. new text end 321.31 new text begin Payments for Cost Settlements. new text end new text begin The new text end 321.32 new text begin commissioner is authorized to use amounts new text end 321.33 new text begin repaid to the general assistance medical care new text end 321.34 new text begin program under Minnesota Statutes 2009 new text end 322.1 new text begin Supplement, section 256D.03, subdivision new text end 322.2 new text begin 3, to pay cost settlements for claims for new text end 322.3 new text begin services provided prior to June 1, 2010. new text end 322.4 new text begin Notwithstanding any contrary provision in new text end 322.5 new text begin this article, this provision does not expire. new text end 322.6 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 322.7 new text begin reduced by $120,000,000 in fiscal year 2014 new text end 322.8 new text begin and by $280,000,000 in fiscal year 2015. new text end 322.9 new text begin (h) new text end new text begin Medical Assistance Grants new text end new text begin 4,253,018,000 new text end new text begin 3,602,473,000 new text end 322.10 new text begin Managed Care Incentive Payments. new text end new text begin The new text end 322.11 new text begin commissioner shall not make managed care new text end 322.12 new text begin incentive payments for expanding preventive new text end 322.13 new text begin services during fiscal years beginning July 1, new text end 322.14 new text begin 2011 and July 1, 2012. new text end 322.15 new text begin Reduction of Rates for Congregate new text end 322.16 new text begin Living for Individuals with Lower Needs. new text end 322.17 new text begin Beginning October 1, 2011, lead agencies new text end 322.18 new text begin must reduce rates in effect on January 1, new text end 322.19 new text begin 2011, by ten percent for individuals with new text end 322.20 new text begin lower needs living in foster care settings new text end 322.21 new text begin where the license holder does not share the new text end 322.22 new text begin residence with recipients on the CADI, DD, new text end 322.23 new text begin and TBI waivers and customized living new text end 322.24 new text begin settings for CADI and TBI. Lead agencies new text end 322.25 new text begin must adjust contracts within 60 days of the new text end 322.26 new text begin effective date. new text end 322.27 new text begin Reduction of Lead Agency Waiver new text end 322.28 new text begin Allocations to Implement Rate Reductions new text end 322.29 new text begin for Congregate Living for Individuals new text end 322.30 new text begin with Lower Needs. new text end new text begin Beginning October 1, new text end 322.31 new text begin 2011, the commissioner shall reduce lead new text end 322.32 new text begin agency waiver allocations to implement the new text end 322.33 new text begin reduction of rates for individuals with lower new text end 322.34 new text begin needs living in foster care settings where the new text end 322.35 new text begin license holder does not share the residence new text end 323.1 new text begin with recipients on the CADI, DD, and TBI new text end 323.2 new text begin waivers and customized living settings for new text end 323.3 new text begin CADI and TBI. new text end 323.4 new text begin Reduce customized living and 24-hour new text end 323.5 new text begin customized living component rates. new text end new text begin new text end 323.6 new text begin Effective July 1, 2011, the commissioner new text end 323.7 new text begin shall reduce elderly waiver customized living new text end 323.8 new text begin and 24-hour customized living component new text end 323.9 new text begin service spending by ten percent through new text end 323.10 new text begin reductions in component rates and service new text end 323.11 new text begin rate limits. The commissioner shall adjust new text end 323.12 new text begin the elderly waiver capitation payment new text end 323.13 new text begin rates for managed care organizations paid new text end 323.14 new text begin under Minnesota Statutes, section 256B.69, new text end 323.15 new text begin subdivisions 6a and 23, to reflect reductions new text end 323.16 new text begin in component spending for customized living new text end 323.17 new text begin services and 24-hour customized living new text end 323.18 new text begin services under Minnesota Statutes, section new text end 323.19 new text begin 256B.0915, subdivisions 3e and 3h, for the new text end 323.20 new text begin contract period beginning January 1, 2012. new text end 323.21 new text begin To implement the reduction specified in new text end 323.22 new text begin this provision, capitation rates paid by the new text end 323.23 new text begin commissioner to managed care organizations new text end 323.24 new text begin under Minnesota Statutes, section 256B.69, new text end 323.25 new text begin shall reflect a 20 percent reduction for the new text end 323.26 new text begin specified services for the period January 1, new text end 323.27 new text begin 2012, to June 30, 2012, and a ten percent new text end 323.28 new text begin reduction for those services on or after July new text end 323.29 new text begin 1, 2012. new text end 323.30 new text begin Limit Growth in the Developmental new text end 323.31 new text begin Disability Waiver. new text end new text begin For the biennium new text end 323.32 new text begin beginning July 1, 2011, the commissioner new text end 323.33 new text begin shall limit the developmental disability new text end 323.34 new text begin waiver to the number of recipients served new text end 323.35 new text begin in March 2010. To achieve this level, the new text end 323.36 new text begin commissioner shall not refill waiver openings new text end 324.1 new text begin until the number of waiver recipients new text end 324.2 new text begin reaches the March 2010 level. Once the new text end 324.3 new text begin March 2010 enrollment level is reached, the new text end 324.4 new text begin commissioner shall refill vacated openings to new text end 324.5 new text begin maintain the March 2010 enrollment level. new text end 324.6 new text begin To the extent possible, waiver allocations new text end 324.7 new text begin shall be available to individuals who meet new text end 324.8 new text begin the priorities for accessing waiver services new text end 324.9 new text begin described in Minnesota Statutes, section new text end 324.10 new text begin 256B.092, subdivision 12. The limits do not new text end 324.11 new text begin include conversions from intermediate care new text end 324.12 new text begin facilities for persons with developmental new text end 324.13 new text begin disabilities. When implementing the waiver new text end 324.14 new text begin enrollment limits under this provision, it new text end 324.15 new text begin is an absolute defense to an appeal under new text end 324.16 new text begin Minnesota Statutes, section 256.045, if new text end 324.17 new text begin the commissioner or lead agency proves new text end 324.18 new text begin that it followed the established written new text end 324.19 new text begin procedures and criteria and determined that new text end 324.20 new text begin home and community-based services could new text end 324.21 new text begin not be provided to the person within the new text end 324.22 new text begin appropriations or lead agency's allocation of new text end 324.23 new text begin home and community-based services money. new text end 324.24 new text begin Limit Growth in the Community new text end 324.25 new text begin Alternatives for Disabled Individuals new text end 324.26 new text begin Waiver. new text end new text begin For the biennium beginning new text end 324.27 new text begin July 1, 2011, the commissioner shall limit new text end 324.28 new text begin the community alternatives for disabled new text end 324.29 new text begin individuals waiver to the number of new text end 324.30 new text begin recipients served in March 2010. To achieve new text end 324.31 new text begin this level, the commissioner shall not new text end 324.32 new text begin refill waiver openings until the number of new text end 324.33 new text begin waiver recipients reaches the March 2010 new text end 324.34 new text begin level. Once the March 2010 enrollment new text end 324.35 new text begin level is reached, the commissioner shall new text end 324.36 new text begin refill vacated openings to maintain the new text end 325.1 new text begin March 2010 enrollment level. To the new text end 325.2 new text begin extent possible, waiver allocations shall new text end 325.3 new text begin be available to individuals who meet the new text end 325.4 new text begin priorities for accessing waiver services new text end 325.5 new text begin described in Minnesota Statutes, section new text end 325.6 new text begin 256B.49, subdivision 11a. The limits include new text end 325.7 new text begin conversions and diversions, unless the new text end 325.8 new text begin commissioner has approved a plan to convert new text end 325.9 new text begin funding due to the closure or downsizing new text end 325.10 new text begin of a residential facility or nursing facility new text end 325.11 new text begin to serve directly affected individuals on new text end 325.12 new text begin the community alternatives for disabled new text end 325.13 new text begin individuals waiver. When implementing new text end 325.14 new text begin the waiver enrollment limits under this new text end 325.15 new text begin provision, it is an absolute defense to an new text end 325.16 new text begin appeal under Minnesota Statutes, section new text end 325.17 new text begin 256.045, if the commissioner or lead agency new text end 325.18 new text begin proves that it followed the established written new text end 325.19 new text begin procedures and criteria and determined that new text end 325.20 new text begin home and community-based services could new text end 325.21 new text begin not be provided to the person within the new text end 325.22 new text begin appropriations or lead agency's allocation of new text end 325.23 new text begin home and community-based services money. new text end 325.24 new text begin Limit Growth in the Waiver for new text end 325.25 new text begin Individuals with Traumatic Brain Injury. new text end new text begin new text end 325.26 new text begin For the biennium beginning July 1, 2011, new text end 325.27 new text begin the commissioner shall limit the traumatic new text end 325.28 new text begin brain injury waiver to the number of new text end 325.29 new text begin recipients served in March 2010. To achieve new text end 325.30 new text begin this level, the commissioner shall not new text end 325.31 new text begin refill waiver openings until the number of new text end 325.32 new text begin waiver recipients reaches the March 2010 new text end 325.33 new text begin level. Once the March 2010 enrollment new text end 325.34 new text begin level is reached, the commissioner shall new text end 325.35 new text begin refill vacated openings to maintain the new text end 325.36 new text begin March 2010 enrollment level. To the new text end 326.1 new text begin extent possible, waiver allocations shall new text end 326.2 new text begin be available to individuals who meet the new text end 326.3 new text begin priorities for accessing waiver services new text end 326.4 new text begin described in Minnesota Statutes, section new text end 326.5 new text begin 256B.49, subdivision 11a. The limits include new text end 326.6 new text begin conversions and diversions, unless the new text end 326.7 new text begin commissioner has approved a plan to convert new text end 326.8 new text begin funding due to the closure or downsizing of a new text end 326.9 new text begin residential facility or nursing facility to serve new text end 326.10 new text begin directly affected individuals on the traumatic new text end 326.11 new text begin brain injury waiver. When implementing new text end 326.12 new text begin the waiver enrollment limits under this new text end 326.13 new text begin provision, it is an absolute defense to an new text end 326.14 new text begin appeal under Minnesota Statutes, section new text end 326.15 new text begin 256.045, if the commissioner or lead agency new text end 326.16 new text begin proves that it followed the established written new text end 326.17 new text begin procedures and criteria and determined that new text end 326.18 new text begin home and community-based services could new text end 326.19 new text begin not be provided to the person within the new text end 326.20 new text begin appropriations or lead agency's allocation of new text end 326.21 new text begin home and community-based services money. new text end 326.22 new text begin Management of Fee-for-Service Spending. new text end 326.23 new text begin Total state and federal funding for the new text end 326.24 new text begin biennium beginning on July 1, 2011, for new text end 326.25 new text begin fee-for-service medical assistance basic care new text end 326.26 new text begin for the elderly and persons with disabilities new text end 326.27 new text begin is limited to $2,536,949,000. Total state and new text end 326.28 new text begin federal funding for the biennium beginning new text end 326.29 new text begin July 1, 2011, for fee-for-service medical new text end 326.30 new text begin assistance basic care for adults without new text end 326.31 new text begin children is limited to $526,251,000. new text end 326.32 new text begin (1) Total state and federal funding for new text end 326.33 new text begin fee-for-service medical assistance basic care new text end 326.34 new text begin for the elderly and persons with disabilities is new text end 326.35 new text begin limited to $950,183,000 for fiscal year 2012 new text end 326.36 new text begin and $1,115,961,000 for fiscal year 2013. new text end 327.1 new text begin (2) The commissioner shall contract with new text end 327.2 new text begin a vendor to manage spending within these new text end 327.3 new text begin limits, beginning January 1, 2012. The new text end 327.4 new text begin vendor selected may: new text end 327.5 new text begin (i) manage and coordinate the care provided new text end 327.6 new text begin by high-cost providers; new text end 327.7 new text begin (ii) implement payment reform initiatives to new text end 327.8 new text begin encourage efficient and cost-effective service new text end 327.9 new text begin provision; new text end 327.10 new text begin (iii) identify and deny payment for new text end 327.11 new text begin unnecessary services; and new text end 327.12 new text begin (iv) implement other initiatives proven to new text end 327.13 new text begin improve the efficiency of fee-for-service care new text end 327.14 new text begin delivery. new text end 327.15 new text begin The contract with the vendor must be new text end 327.16 new text begin on a contingency basis, under which the new text end 327.17 new text begin vendor retains six percent of any savings new text end 327.18 new text begin obtained from management of fee-for-service new text end 327.19 new text begin spending. new text end 327.20 new text begin (3) The commissioner, by October 1, new text end 327.21 new text begin 2012, shall evaluate the extent to which new text end 327.22 new text begin initiatives implemented by the vendor will new text end 327.23 new text begin be successful in managing spending within new text end 327.24 new text begin the specified limits. If the commissioner new text end 327.25 new text begin determines that the vendor will not be new text end 327.26 new text begin successful in managing spending within new text end 327.27 new text begin the specified limits, the commissioner shall new text end 327.28 new text begin reduce medical assistance provider payments new text end 327.29 new text begin by an amount sufficient to comply with new text end 327.30 new text begin the spending limits. In implementing rate new text end 327.31 new text begin reductions, the commissioner shall exempt new text end 327.32 new text begin payments to nursing facilities and providers new text end 327.33 new text begin of home and community-based waiver new text end 327.34 new text begin services. No provider payment reduction new text end 328.1 new text begin shall affect services provided to the elderly new text end 328.2 new text begin or persons with disabilities. new text end 328.3 new text begin Contingent Rate Reductions. new text end new text begin If new text end 328.4 new text begin the commissioner determines that new text end 328.5 new text begin implementation of the global waiver under new text end 328.6 new text begin Minnesota Statutes, sections 256B.841, new text end 328.7 new text begin 256B.842, and 256B.843, will not achieve a new text end 328.8 new text begin state general fund savings of $300,000,000 new text end 328.9 new text begin for the biennium beginning July 1, 2011, the new text end 328.10 new text begin commissioner shall calculate an estimate new text end 328.11 new text begin of the shortfall in savings, and, for the new text end 328.12 new text begin fiscal year beginning July 1, 2012, shall new text end 328.13 new text begin reduce medical assistance provider payment new text end 328.14 new text begin rates, including but not limited to rates to new text end 328.15 new text begin individual health care providers and provider new text end 328.16 new text begin agencies, hospitals, other residential settings, new text end 328.17 new text begin and capitation rates provided to managed new text end 328.18 new text begin care and county-based purchasing plans, by new text end 328.19 new text begin the amount necessary to recoup the shortfall new text end 328.20 new text begin in savings over that fiscal year. No provider new text end 328.21 new text begin payment reduction shall affect services new text end 328.22 new text begin provided to the elderly or persons with new text end 328.23 new text begin disabilities. new text end 328.24 new text begin (i) new text end new text begin Alternative Care Grants new text end new text begin 44,630,000 new text end new text begin 44,689,000 new text end 328.25 new text begin Alternative Care Transfer. new text end new text begin Any money new text end 328.26 new text begin allocated to the alternative care program that new text end 328.27 new text begin is not spent for the purposes indicated does new text end 328.28 new text begin not cancel but shall be transferred to the new text end 328.29 new text begin medical assistance account. new text end 328.30 new text begin (j) new text end new text begin Chemical Dependency Entitlement Grants new text end new text begin 104,113,000 new text end new text begin 127,281,000 new text end 328.31 new text begin Subd. 4. new text end new text begin Grant Programs new text end 328.32 new text begin The amounts that may be spent from this new text end 328.33 new text begin appropriation for each purpose are as follows: new text end 328.34 new text begin (a) new text end new text begin Support Services Grants new text end 329.1 new text begin Appropriations by Fund new text end 329.2 new text begin General new text end new text begin 8,715,000 new text end new text begin 8,715,000 new text end 329.3 new text begin Federal TANF new text end new text begin 96,525,000 new text end new text begin 90,611,000 new text end 329.4 new text begin MFIP Consolidated Fund Grants. new text end new text begin The new text end 329.5 new text begin TANF fund base is reduced by $14,000,000 new text end 329.6 new text begin each year beginning in fiscal year 2012. new text end 329.7 new text begin Subsidized Employment Funding Through new text end 329.8 new text begin ARRA. new text end new text begin The commissioner is authorized to new text end 329.9 new text begin apply for TANF emergency fund grants for new text end 329.10 new text begin subsidized employment activities. Growth new text end 329.11 new text begin in expenditures for subsidized employment new text end 329.12 new text begin within the supported work program and the new text end 329.13 new text begin MFIP consolidated fund over the amount new text end 329.14 new text begin expended in the calendar year quarters in new text end 329.15 new text begin the TANF emergency fund base year shall new text end 329.16 new text begin be used to leverage the TANF emergency new text end 329.17 new text begin fund grants for subsidized employment and new text end 329.18 new text begin to fund supported work. The commissioner new text end 329.19 new text begin shall develop procedures to maximize new text end 329.20 new text begin reimbursement of these expenditures over the new text end 329.21 new text begin TANF emergency fund base year quarters, new text end 329.22 new text begin and may contract directly with employers new text end 329.23 new text begin and providers to maximize these TANF new text end 329.24 new text begin emergency fund grants. new text end 329.25 new text begin Healthy Communities. new text end new text begin $150,000 in fiscal new text end 329.26 new text begin year 2012 and $150,000 in fiscal year 2013 new text end 329.27 new text begin are appropriated from the general fund to new text end 329.28 new text begin the commissioner of human services for new text end 329.29 new text begin contracting with the Search Institute to new text end 329.30 new text begin promote healthy community initiatives. new text end 329.31 new text begin The commissioner may expend up to five new text end 329.32 new text begin percent of the appropriation to provide for new text end 329.33 new text begin the program evaluation. new text end 329.34 new text begin Circles of Support. new text end new text begin $200,000 in fiscal year new text end 329.35 new text begin 2012 and $200,000 in fiscal year 2013 are new text end 330.1 new text begin appropriated from the general fund to the new text end 330.2 new text begin commissioner of human services for the new text end 330.3 new text begin purpose of providing grants to community new text end 330.4 new text begin action agencies for circles of support new text end 330.5 new text begin initiatives. new text end 330.6 new text begin Northern Connections. new text end new text begin $100,000 is new text end 330.7 new text begin appropriated in fiscal year 2012 and new text end 330.8 new text begin $100,000 is appropriated in fiscal year 2013 new text end 330.9 new text begin from the general fund to the commissioner new text end 330.10 new text begin of human services for a grant to expand new text end 330.11 new text begin Northern Connections workforce program new text end 330.12 new text begin that provides one-stop supportive services new text end 330.13 new text begin to individuals as they transition into the new text end 330.14 new text begin workforce to up to two interested counties in new text end 330.15 new text begin rural Minnesota. new text end 330.16 330.17 new text begin (b) new text end new text begin Basic Sliding Fee Child Care Assistance new text end new text begin Grants new text end new text begin 38,131,000 new text end new text begin 41,035,000 new text end 330.18 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 330.19 new text begin decreased by $1,131,000 in fiscal year 2014 new text end 330.20 new text begin and $1,126,000 in fiscal year 2015. new text end 330.21 new text begin Child Care and Development Fund new text end 330.22 new text begin Unexpended Balance. new text end new text begin In addition to new text end 330.23 new text begin the amount provided in this section, the new text end 330.24 new text begin commissioner shall expend $5,000,000 new text end 330.25 new text begin in fiscal year 2012 from the federal child new text end 330.26 new text begin care and development fund unexpended new text end 330.27 new text begin balance for basic sliding fee child care under new text end 330.28 new text begin Minnesota Statutes, section new text end new text begin . The new text end 330.29 new text begin commissioner shall ensure that all child new text end 330.30 new text begin care and development funds are expended new text end 330.31 new text begin according to the federal child care and new text end 330.32 new text begin development fund regulations. new text end 330.33 new text begin (c) new text end new text begin Child Care Development Grants new text end new text begin 1,487,000 new text end new text begin 1,487,000 new text end 330.34 new text begin (d) new text end new text begin Child Support Enforcement Grants new text end new text begin 50,000 new text end new text begin 50,000 new text end 331.1 new text begin Federal Child Support Demonstration new text end 331.2 new text begin Grants. new text end new text begin Federal administrative new text end 331.3 new text begin reimbursement resulting from the federal new text end 331.4 new text begin child support grant expenditures authorized new text end 331.5 new text begin under section 1115a of the Social Security new text end 331.6 new text begin Act is appropriated to the commissioner for new text end 331.7 new text begin this activity. new text end 331.8 new text begin (e) new text end new text begin Children's Services Grants new text end 331.9 new text begin Appropriations by Fund new text end 331.10 new text begin General new text end new text begin 46,788,000 new text end new text begin 46,788,000 new text end 331.11 new text begin Federal TANF new text end new text begin 140,000 new text end new text begin 140,000 new text end 331.12 new text begin Adoption Assistance and Relative Custody new text end 331.13 new text begin Assistance Payments. new text end new text begin $1,661,000 each new text end 331.14 new text begin year is for continuation of current payments new text end 331.15 new text begin for adoption assistance and relative custody new text end 331.16 new text begin assistance. new text end 331.17 new text begin Adoption Assistance and Relative Custody new text end 331.18 new text begin Assistance Transfer. new text end new text begin The commissioner new text end 331.19 new text begin may transfer unencumbered appropriation new text end 331.20 new text begin balances for adoption assistance and relative new text end 331.21 new text begin custody assistance between fiscal years and new text end 331.22 new text begin between programs. new text end 331.23 new text begin Privatized Adoption Grants. new text end new text begin Federal new text end 331.24 new text begin reimbursement for privatized adoption grant new text end 331.25 new text begin and foster care recruitment grant expenditures new text end 331.26 new text begin is appropriated to the commissioner for new text end 331.27 new text begin adoption grants and foster care and adoption new text end 331.28 new text begin administrative purposes. new text end 331.29 new text begin Adoption Assistance Incentive Grants. new text end new text begin new text end 331.30 new text begin Federal funds available during fiscal year new text end 331.31 new text begin 2012 and fiscal year 2013 for adoption new text end 331.32 new text begin incentive grants are appropriated to the new text end 331.33 new text begin commissioner for these purposes. new text end 331.34 new text begin (f) new text end new text begin Children and Community Services Grants new text end new text begin 64,301,000 new text end new text begin 64,301,000 new text end 332.1 new text begin (g) new text end new text begin Children and Economic Support Grants new text end new text begin 16,755,000 new text end new text begin 16,265,000 new text end 332.2 new text begin Long-term homeless services. new text end new text begin $700,000 new text end 332.3 new text begin is appropriated from the federal TANF new text end 332.4 new text begin fund for the biennium beginning July new text end 332.5 new text begin 1, 2011, to the commissioner of human new text end 332.6 new text begin services for long-term homeless services new text end 332.7 new text begin for low-income homeless families under new text end 332.8 new text begin Minnesota Statutes, section 256K.26. This new text end 332.9 new text begin is a onetime appropriation and is not added new text end 332.10 new text begin to the base. new text end 332.11 new text begin Base Adjustment. new text end new text begin The general fund base new text end 332.12 new text begin is increased by $491,000 in fiscal year 2014 new text end 332.13 new text begin only. new text end 332.14 new text begin (h) new text end new text begin Health Care Grants new text end 332.15 new text begin Appropriations by Fund new text end 332.16 new text begin General new text end new text begin 195,000 new text end new text begin -0- new text end 332.17 new text begin Health Care Access new text end new text begin 900,000 new text end new text begin 900,000 new text end 332.18 new text begin Surplus Appropriation Canceled. new text end new text begin Of the new text end 332.19 new text begin appropriation in Laws 2009, chapter 79, new text end 332.20 new text begin article 13, section 3, subdivision 6, paragraph new text end 332.21 new text begin (e), for the COBRA premium state subsidy new text end 332.22 new text begin program, $11,750,000 must be canceled in new text end 332.23 new text begin fiscal year 2011. This provision is effective new text end 332.24 new text begin the day following final enactment. new text end 332.25 new text begin Grant Cancellation. new text end new text begin Effective for the new text end 332.26 new text begin biennium beginning July 1, 2011, the new text end 332.27 new text begin following appropriations are canceled: (1) a new text end 332.28 new text begin general fund appropriation of $205,000 for new text end 332.29 new text begin the U Special Kids program; (2) a general new text end 332.30 new text begin fund appropriation of $90,000 for medical new text end 332.31 new text begin assistance outreach grants; and (3) a health new text end 332.32 new text begin care access fund appropriation of $40,000 for new text end 332.33 new text begin MinnesotaCare outreach grants. new text end 333.1 new text begin State Subsidy Program for Community new text end 333.2 new text begin Mental Health Centers. new text end new text begin $100,000 is new text end 333.3 new text begin appropriated from the general fund to new text end 333.4 new text begin the commissioner of human services for new text end 333.5 new text begin the biennium beginning July 1, 2011, to new text end 333.6 new text begin provide onetime grants to establish new new text end 333.7 new text begin community mental health centers that are new text end 333.8 new text begin eligible for payment under Minnesota new text end 333.9 new text begin Statutes, section 256B.0625, subdivision 5. new text end 333.10 new text begin In awarding grants, the commissioner shall new text end 333.11 new text begin give preference to areas of the state that new text end 333.12 new text begin lack access to mental health services or are new text end 333.13 new text begin underserved. new text end 333.14 new text begin (i) new text end new text begin Aging and Adult Services Grants new text end new text begin 18,734,000 new text end new text begin 18,910,000 new text end 333.15 new text begin Aging Grants Reduction. new text end new text begin Effective July new text end 333.16 new text begin 1, 2011, funding for grants made under new text end 333.17 new text begin Minnesota Statutes, sections 256.9754 and new text end 333.18 new text begin 256B.0917, subdivision 13, is reduced by new text end 333.19 new text begin $3,600,000 for each year of the biennium. new text end 333.20 new text begin These reductions are onetime and do new text end 333.21 new text begin not affect base funding for the 2014-2015 new text end 333.22 new text begin biennium. Grants made during the 2012-2013 new text end 333.23 new text begin biennium under Minnesota Statutes, section new text end 333.24 new text begin 256B.9754, must not be used for new new text end 333.25 new text begin construction or building renovation. new text end 333.26 new text begin Essential Community Support Grant new text end 333.27 new text begin Delay. new text end new text begin Essential community supports new text end 333.28 new text begin grants under Minnesota Statutes, section new text end 333.29 new text begin 256B.0917, subdivision 14, is reduced new text end 333.30 new text begin by $6,410,000 in fiscal year 2012 and new text end 333.31 new text begin $7,279,000 in fiscal year 2013. Base level new text end 333.32 new text begin funding for fiscal year 2014 is reduced by new text end 333.33 new text begin $5,919,000. These reductions are onetime new text end 333.34 new text begin and do not affect base level funding for fiscal new text end 333.35 new text begin year 2015. new text end 334.1 new text begin (j) new text end new text begin Deaf and Hard-of-Hearing Grants new text end new text begin 1,936,000 new text end new text begin 1,767,000 new text end 334.2 new text begin (k) new text end new text begin Disabilities Grants new text end new text begin 22,025,000 new text end new text begin 23,863,000 new text end 334.3 new text begin Money Follows the Person Rebalancing new text end 334.4 new text begin Demonstration Project. new text end new text begin Notwithstanding new text end 334.5 new text begin the provisions of Minnesota Statutes, section new text end 334.6 new text begin 256.011, subdivision 3, estimated general new text end 334.7 new text begin fund savings resulting from the operation of new text end 334.8 new text begin the Money Follows the Person federal grant new text end 334.9 new text begin fund must be retained within the medical new text end 334.10 new text begin assistance general fund appropriation for the new text end 334.11 new text begin payment of federally required rebalancing new text end 334.12 new text begin expenditures. If a rebalancing expenditure new text end 334.13 new text begin is not eligible for medical assistance, the new text end 334.14 new text begin corresponding portion of estimated savings new text end 334.15 new text begin must be transferred to and paid from a special new text end 334.16 new text begin revenue account established for this purpose. new text end 334.17 new text begin Money in the account does not cancel and new text end 334.18 new text begin is appropriated to the commissioner for the new text end 334.19 new text begin purposes of the demonstration project. new text end 334.20 new text begin Region 10. new text end new text begin Any unspent allocation for new text end 334.21 new text begin Region 10 Quality Assurance from the new text end 334.22 new text begin biennium beginning on July 1, 2009, may be new text end 334.23 new text begin carried over into the biennium beginning on new text end 334.24 new text begin July 1, 2011. new text end 334.25 new text begin Local Planning Grants for Creating new text end 334.26 new text begin Alternatives to Congregate Living for new text end 334.27 new text begin Individuals with Lower Needs. new text end new text begin The new text end 334.28 new text begin commissioner shall make available a total new text end 334.29 new text begin of $250,000 per year in local planning new text end 334.30 new text begin grants, beginning July 1, 2011, to assist new text end 334.31 new text begin lead agencies and provider organizations in new text end 334.32 new text begin developing alternatives to congregate living new text end 334.33 new text begin within the available level of resources for the new text end 334.34 new text begin home and community-based services waivers new text end 334.35 new text begin for persons with disabilities. new text end 335.1 new text begin (l) new text end new text begin Adult Mental Health Grants new text end 335.2 new text begin Appropriations by Fund new text end 335.3 new text begin General new text end new text begin 77,539,000 new text end new text begin 77,539,000 new text end 335.4 new text begin Lottery Prize Fund new text end new text begin 1,508,000 new text end new text begin 1,508,000 new text end 335.5 new text begin Funding Usage. new text end new text begin Up to 75 percent of a fiscal new text end 335.6 new text begin year's appropriation for adult mental health new text end 335.7 new text begin grants may be used to fund allocations in that new text end 335.8 new text begin portion of the fiscal year ending December new text end 335.9 new text begin 31. new text end 335.10 new text begin Base Adjustment. new text end new text begin The lottery prize fund new text end 335.11 new text begin base for this program shall be increased by new text end 335.12 new text begin $78,000 in each of fiscal years 2014 and new text end 335.13 new text begin 2015. new text end 335.14 new text begin (m) new text end new text begin Children's Mental Health Grants new text end new text begin 16,682,000 new text end new text begin 16,682,000 new text end 335.15 new text begin Funding Usage. new text end new text begin Up to 75 percent of a fiscal new text end 335.16 new text begin year's appropriation for children's mental new text end 335.17 new text begin health grants may be used to fund allocations new text end 335.18 new text begin in that portion of the fiscal year ending new text end 335.19 new text begin December 31. new text end 335.20 335.21 new text begin (n) new text end new text begin Chemical Dependency Nonentitlement new text end new text begin Grants new text end new text begin 1,336,000 new text end new text begin 1,336,000 new text end 335.22 new text begin Subd. 5. new text end new text begin State-Operated Services new text end 335.23 new text begin Transfer Authority Related to new text end 335.24 new text begin State-Operated Services. new text end new text begin Money new text end 335.25 new text begin appropriated for state-operated services new text end 335.26 new text begin may be transferred between fiscal years new text end 335.27 new text begin of the biennium with the approval of the new text end 335.28 new text begin commissioner of management and budget. new text end 335.29 new text begin (a) new text end new text begin State-Operated Services Mental Health new text end new text begin 115,286,000 new text end new text begin 115,135,000 new text end 335.30 new text begin State-Operated Services. new text end new text begin To achieve these new text end 335.31 new text begin savings, the commissioner shall close the new text end 335.32 new text begin Willmar Community Behavioral Health new text end 335.33 new text begin Hospital no later than October 1, 2011, and new text end 335.34 new text begin shall close the inpatient child and adolescent new text end 336.1 new text begin behavioral health service program in new text end 336.2 new text begin Willmar, the subacute mental health facility new text end 336.3 new text begin in Wadena, and the community behavioral new text end 336.4 new text begin health hospitals in Alexandria, Annandale, new text end 336.5 new text begin Baxter, Bemidji, Fergus Falls, and Rochester new text end 336.6 new text begin no later than October 1, 2012. new text end 336.7 new text begin Base Adjustment. new text end new text begin The general fund base is new text end 336.8 new text begin reduced by $8,443,000 in fiscal year 2014 new text end 336.9 new text begin and $11,543,000 in fiscal year 2015. new text end 336.10 new text begin (b) new text end new text begin Minnesota Security Hospital new text end new text begin 69,582,000 new text end new text begin 69,582,000 new text end 336.11 new text begin Subd. 6. new text end new text begin Sex Offender Program new text end new text begin 70,416,000 new text end new text begin 67,570,000 new text end 336.12 new text begin Transfer Authority Related to Minnesota new text end 336.13 new text begin Sex Offender Program. new text end new text begin Money new text end 336.14 new text begin appropriated for the Minnesota sex offender new text end 336.15 new text begin program may be transferred between fiscal new text end 336.16 new text begin years of the biennium with the approval new text end 336.17 new text begin of the commissioner of management and new text end 336.18 new text begin budget. new text end 336.19 new text begin Minnesota Sex Offender Program new text end 336.20 new text begin Reduction. new text end new text begin The fiscal year 2011 general new text end 336.21 new text begin fund appropriation for Minnesota sex new text end 336.22 new text begin offender services under Laws 2009, chapter new text end 336.23 new text begin 79, article 13, section 3, subdivision 10, new text end 336.24 new text begin paragraph (b), is reduced by $3,000,000. new text end 336.25 new text begin Subd. 7. new text end new text begin Technical Activities new text end new text begin 78,206,000 new text end new text begin 102,551,000 new text end 336.26 new text begin This appropriation is from the federal TANF new text end 336.27 new text begin fund. new text end 336.28 Sec. 4. new text begin COMMISSIONER OF HEALTH new text end 336.29 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin 147,939,000 new text end new text begin $ new text end new text begin 136,632,000 new text end 336.30 new text begin Appropriations by Fund new text end 336.31 new text begin 2012 new text end new text begin 2013 new text end 336.32 new text begin General new text end new text begin 77,634,000 new text end new text begin 72,738,000 new text end 336.33 336.34 new text begin State Government new text end new text begin Special Revenue new text end new text begin 45,268,000 new text end new text begin 45,325,000 new text end 337.1 new text begin Health Care Access new text end new text begin 13,774,000 new text end new text begin 9,162,000 new text end 337.2 new text begin Federal TANF new text end new text begin 11,713,000 new text end new text begin 11,713,000 new text end 337.3 new text begin The amounts that may be spent for each new text end 337.4 new text begin purpose are specified in the following new text end 337.5 new text begin subdivisions. new text end 337.6 337.7 new text begin Subd. 2. new text end new text begin Community and Family Health new text end new text begin Promotion new text end 337.8 new text begin Appropriations by Fund new text end 337.9 new text begin General new text end new text begin 50,430,000 new text end new text begin 45,690,000 new text end 337.10 337.11 new text begin State Government new text end new text begin Special Revenue new text end new text begin 1,033,000 new text end new text begin 1,033,000 new text end 337.12 new text begin Health Care Access new text end new text begin 2,918,000 new text end new text begin 2,459,000 new text end 337.13 new text begin Federal TANF new text end new text begin 11,713,000 new text end new text begin 11,713,000 new text end 337.14 new text begin TANF Appropriations. new text end new text begin (1) $1,156,000 of new text end 337.15 new text begin the TANF funds is appropriated each year to new text end 337.16 new text begin the commissioner for family planning grants new text end 337.17 new text begin under Minnesota Statutes, section 145.925. new text end 337.18 new text begin (2) $3,579,000 of the TANF funds is new text end 337.19 new text begin appropriated each year to the commissioner new text end 337.20 new text begin for home visiting and nutritional services new text end 337.21 new text begin listed under Minnesota Statutes, section new text end 337.22 new text begin 145.882, subdivision 7, clauses (6) and (7). new text end 337.23 new text begin Funds must be distributed to community new text end 337.24 new text begin health boards according to Minnesota new text end 337.25 new text begin Statutes, section 145A.131, subdivision 1. new text end 337.26 new text begin (3) $2,000,000 of the TANF funds is new text end 337.27 new text begin appropriated each year to the commissioner new text end 337.28 new text begin for decreasing racial and ethnic disparities new text end 337.29 new text begin in infant mortality rates under Minnesota new text end 337.30 new text begin Statutes, section 145.928, subdivision 7. new text end 337.31 new text begin (4) $4,978,000 of the TANF funds is new text end 337.32 new text begin appropriated each year to the commissioner new text end 337.33 new text begin for the family home visiting grant program new text end 337.34 new text begin according to Minnesota Statutes, section new text end 337.35 new text begin 145A.17. $4,000,000 of the funding must new text end 337.36 new text begin be distributed to community health boards new text end 338.1 new text begin according to Minnesota Statutes, section new text end 338.2 new text begin 145A.131, subdivision 1. $978,000 of new text end 338.3 new text begin the funding must be distributed to tribal new text end 338.4 new text begin governments based on Minnesota Statutes, new text end 338.5 new text begin section 145A.14, subdivision 2a. new text end 338.6 new text begin (5) The commissioner may use up to 6.23 new text end 338.7 new text begin percent of the funds appropriated each fiscal new text end 338.8 new text begin year to conduct the ongoing evaluations new text end 338.9 new text begin required under Minnesota Statutes, section new text end 338.10 new text begin 145A.17, subdivision 7, and training and new text end 338.11 new text begin technical assistance as required under new text end 338.12 new text begin Minnesota Statutes, section 145A.17, new text end 338.13 new text begin subdivisions 4 and 5. new text end 338.14 new text begin TANF Carryforward. new text end new text begin Any unexpended new text end 338.15 new text begin balance of the TANF appropriation in the new text end 338.16 new text begin first year of the biennium does not cancel but new text end 338.17 new text begin is available for the second year. new text end 338.18 new text begin Subd. 3. new text end new text begin Policy Quality and Compliance new text end 338.19 new text begin Appropriations by Fund new text end 338.20 new text begin General new text end new text begin 10,434,000 new text end new text begin 10,230,000 new text end 338.21 338.22 new text begin State Government new text end new text begin Special Revenue new text end new text begin 14,026,000 new text end new text begin 14,083,000 new text end 338.23 new text begin Health Care Access new text end new text begin 10,856,000 new text end new text begin 6,703,000 new text end 338.24 new text begin MERC Fund Transfers. new text end new text begin The commissioner new text end 338.25 new text begin of management and budget shall transfer new text end 338.26 new text begin $9,800,000 from the MERC fund to the new text end 338.27 new text begin general fund by October 1, 2011. new text end 338.28 new text begin Comprehensive Advanced Life Support. new text end new text begin new text end 338.29 new text begin Of the general fund appropriation, $31,000 new text end 338.30 new text begin each year is added to the base of the new text end 338.31 new text begin comprehensive advanced life support new text end 338.32 new text begin (CALS) program under Minnesota Statutes, new text end 338.33 new text begin section 144.6062. new text end 338.34 new text begin Unused Federal Match Funds. new text end new text begin Of the new text end 338.35 new text begin funds appropriated in Laws 2009, chapter new text end 339.1 new text begin 79, article 13, section 4, subdivision 3, for new text end 339.2 new text begin state matching funds for the federal Health new text end 339.3 new text begin Information Technology for Economic and new text end 339.4 new text begin Clinical Health Act, $2,800,000 is transferred new text end 339.5 new text begin to the health care access fund by October 1, new text end 339.6 new text begin 2011. new text end 339.7 new text begin Health Careers Opportunities Grants. new text end 339.8 new text begin $447,000 each year is appropriated to the new text end 339.9 new text begin commissioner of health from the health new text end 339.10 new text begin care access fund for the health careers new text end 339.11 new text begin opportunities grant program under Minnesota new text end 339.12 new text begin Statutes, section 144.1499. new text end 339.13 new text begin Health Professions Opportunities new text end 339.14 new text begin Scholarship Program. new text end new text begin $63,000 each year is new text end 339.15 new text begin appropriated to the commissioner of health new text end 339.16 new text begin from the health care access fund for the new text end 339.17 new text begin health professions opportunities scholarship new text end 339.18 new text begin program under Minnesota Statutes, section new text end 339.19 new text begin 144.1503. $138,000 in fiscal year 2012 and new text end 339.20 new text begin $276,000 each year thereafter is appropriated new text end 339.21 new text begin to the commissioner of health from the new text end 339.22 new text begin general fund for the health professions new text end 339.23 new text begin opportunities scholarship program under new text end 339.24 new text begin Minnesota Statutes, section 144.1503. new text end 339.25 new text begin Base Level Adjustment. new text end new text begin The state new text end 339.26 new text begin government special revenue fund base shall new text end 339.27 new text begin be reduced by $141,000 in fiscal years 2014 new text end 339.28 new text begin and 2015. The health care access base shall new text end 339.29 new text begin be increased by $600,000 in fiscal year 2014. new text end 339.30 new text begin Subd. 4. new text end new text begin Health Protection new text end 339.31 new text begin Appropriations by Fund new text end 339.32 new text begin General new text end new text begin 9,370,000 new text end new text begin 9,370,000 new text end 339.33 339.34 new text begin State Government new text end new text begin Special Revenue new text end new text begin 30,209,000 new text end new text begin 30,209,000 new text end 339.35 new text begin Subd. 5. new text end new text begin Administrative Support Services new text end new text begin 7,400,000 new text end new text begin 7,448,000 new text end 340.1 Sec. 5. new text begin COUNCIL ON DISABILITY new text end new text begin $ new text end new text begin 524,000 new text end new text begin $ new text end new text begin 524,000 new text end 340.2 340.3 340.4 Sec. 6. new text begin OMBUDSMAN FOR MENTAL new text end new text begin HEALTH AND DEVELOPMENTAL new text end new text begin DISABILITIES new text end new text begin $ new text end new text begin 1,655,000 new text end new text begin $ new text end new text begin 1,655,000 new text end 340.5 new text begin Funds appropriated for fiscal year 2011 are new text end 340.6 new text begin available until expended. new text end 340.7 Sec. 7. new text begin OMBUDSPERSON FOR FAMILIES new text end new text begin $ new text end new text begin 265,000 new text end new text begin $ new text end new text begin 265,000 new text end 340.8 Sec. 8. new text begin HEALTH-RELATED BOARDS new text end 340.9 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin 17,365,000 new text end new text begin $ new text end new text begin 17,264,000 new text end 340.10 new text begin This appropriation is from the state new text end 340.11 new text begin government special revenue fund. The new text end 340.12 new text begin amounts that may be spent for each purpose new text end 340.13 new text begin are specified in the following subdivisions. new text end 340.14 new text begin Subd. 2. new text end new text begin Board of Chiropractic Examiners new text end new text begin 469,000 new text end new text begin 469,000 new text end 340.15 new text begin Subd. 3. new text end new text begin Board of Dentistry new text end new text begin 1,959,000 new text end new text begin 1,914,000 new text end 340.16 new text begin Health Professional Services Program. new text end new text begin new text end 340.17 new text begin $834,000 in fiscal year 2012 and $804,000 in new text end 340.18 new text begin fiscal year 2013 from the state government new text end 340.19 new text begin special revenue fund are for the health new text end 340.20 new text begin professional services program. new text end 340.21 340.22 new text begin Subd. 4. new text end new text begin Board of Dietetic and Nutrition new text end new text begin Practice new text end new text begin 110,000 new text end new text begin 110,000 new text end 340.23 340.24 new text begin Subd. 5. new text end new text begin Board of Marriage and Family new text end new text begin Therapy new text end new text begin 192,000 new text end new text begin 167,000 new text end 340.25 new text begin Rulemaking. new text end new text begin Of this appropriation, $25,000 new text end 340.26 new text begin in fiscal year 2012 is for rulemaking. This is new text end 340.27 new text begin a onetime appropriation. new text end 340.28 new text begin Subd. 6. new text end new text begin Board of Medical Practice new text end new text begin 3,866,000 new text end new text begin 3,866,000 new text end 340.29 new text begin Subd. 7. new text end new text begin Board of Nursing new text end new text begin 3,545,000 new text end new text begin 3,545,000 new text end 340.30 340.31 new text begin Subd. 8. new text end new text begin Board of Nursing Home new text end new text begin Administrators new text end new text begin 2,153,000 new text end new text begin 2,145,000 new text end 341.1 new text begin Rulemaking. new text end new text begin Of this appropriation, $44,000 new text end 341.2 new text begin in fiscal year 2012 is for rulemaking. This is new text end 341.3 new text begin a onetime appropriation. new text end 341.4 new text begin Electronic Licensing System Adaptors. new text end new text begin new text end 341.5 new text begin Of this appropriation, $761,000 in fiscal new text end 341.6 new text begin year 2013 from the state government special new text end 341.7 new text begin revenue fund is to the administrative services new text end 341.8 new text begin unit to cover the costs to connect to the new text end 341.9 new text begin e-licensing system. Minnesota Statutes, new text end 341.10 new text begin section 16E.22. Base level funding for this new text end 341.11 new text begin activity in fiscal year 2014 shall be $100,000. new text end 341.12 new text begin Base level funding for this activity in fiscal new text end 341.13 new text begin year 2015 shall be $50,000. new text end 341.14 new text begin Development and Implementation of a new text end 341.15 new text begin Disciplinary, Regulatory, Licensing and new text end 341.16 new text begin Information Management System. new text end new text begin Of this new text end 341.17 new text begin appropriation, $800,000 in fiscal year 2012 new text end 341.18 new text begin and $300,000 in fiscal year 2013 are for the new text end 341.19 new text begin development of a shared system. Base level new text end 341.20 new text begin funding for this activity in fiscal year 2014 new text end 341.21 new text begin shall be $50,000. new text end 341.22 new text begin Administrative Services Unit - Operating new text end 341.23 new text begin Costs. new text end new text begin Of this appropriation, $526,000 new text end 341.24 new text begin in fiscal year 2012 and $526,000 in new text end 341.25 new text begin fiscal year 2013 are for operating costs new text end 341.26 new text begin of the administrative services unit. The new text end 341.27 new text begin administrative services unit may receive new text end 341.28 new text begin and expend reimbursements for services new text end 341.29 new text begin performed by other agencies. new text end 341.30 new text begin Administrative Services Unit - Retirement new text end 341.31 new text begin Costs. new text end new text begin Of this appropriation in fiscal year new text end 341.32 new text begin 2012, $225,000 is for onetime retirement new text end 341.33 new text begin costs in the health-related boards. This new text end 341.34 new text begin funding may be transferred to the health new text end 341.35 new text begin boards incurring those costs for their new text end 342.1 new text begin payment. These funds are available either new text end 342.2 new text begin year of the biennium. new text end 342.3 new text begin Administrative Services Unit - Volunteer new text end 342.4 new text begin Health Care Provider Program. new text end new text begin Of this new text end 342.5 new text begin appropriation, $150,000 in fiscal year 2012 new text end 342.6 new text begin and $150,000 in fiscal year 2013 are to pay new text end 342.7 new text begin for medical professional liability coverage new text end 342.8 new text begin required under Minnesota Statutes, section new text end 342.9 new text begin 214.40. new text end 342.10 new text begin Administrative Services Unit - Contested new text end 342.11 new text begin Cases and Other Legal Proceedings. new text end new text begin new text end 342.12 new text begin Of this appropriation, $200,000 in fiscal new text end 342.13 new text begin year 2012 and $200,000 in fiscal year new text end 342.14 new text begin 2013 are for costs of contested case new text end 342.15 new text begin hearings and other unanticipated costs of new text end 342.16 new text begin legal proceedings involving health-related new text end 342.17 new text begin boards funded under this section. Upon new text end 342.18 new text begin certification of a health-related board to the new text end 342.19 new text begin administrative services unit that the costs new text end 342.20 new text begin will be incurred and that there is insufficient new text end 342.21 new text begin money available to pay for the costs out of new text end 342.22 new text begin money currently available to that board, the new text end 342.23 new text begin administrative services unit is authorized new text end 342.24 new text begin to transfer money from this appropriation new text end 342.25 new text begin to the board for payment of those costs new text end 342.26 new text begin with the approval of the commissioner of new text end 342.27 new text begin finance. This appropriation does not cancel. new text end 342.28 new text begin Any unencumbered and unspent balances new text end 342.29 new text begin remain available for these expenditures in new text end 342.30 new text begin subsequent fiscal years. new text end 342.31 new text begin Subd. 9. new text end new text begin Board of Optometry new text end new text begin 106,000 new text end new text begin 106,000 new text end 342.32 new text begin Subd. 10. new text end new text begin Board of Pharmacy new text end new text begin 1,977,000 new text end new text begin 1,980,000 new text end 342.33 new text begin Prescription Electronic Reporting. new text end new text begin Of new text end 342.34 new text begin this appropriation, $356,000 in fiscal year new text end 342.35 new text begin 2012 and $356,000 in fiscal year 2013 from new text end 343.1 new text begin the state government special revenue fund new text end 343.2 new text begin are to the board to operate the prescription new text end 343.3 new text begin electronic reporting system in Minnesota new text end 343.4 new text begin Statutes, section 152.126. Base level funding new text end 343.5 new text begin for this activity in fiscal year 2014 shall be new text end 343.6 new text begin $356,000. new text end 343.7 new text begin Subd. 11. new text end new text begin Board of Physical Therapy new text end new text begin 389,000 new text end new text begin 345,000 new text end 343.8 new text begin Rulemaking. new text end new text begin Of this appropriation, $44,000 new text end 343.9 new text begin in fiscal year 2012 is for rulemaking. This is new text end 343.10 new text begin a onetime appropriation. new text end 343.11 new text begin Subd. 12. new text end new text begin Board of Podiatry new text end new text begin 75,000 new text end new text begin 75,000 new text end 343.12 new text begin Subd. 13. new text end new text begin Board of Psychology new text end new text begin 846,000 new text end new text begin 846,000 new text end 343.13 new text begin Subd. 14. new text end new text begin Board of Social Work new text end new text begin 1,036,000 new text end new text begin 1,053,000 new text end 343.14 new text begin Subd. 15. new text end new text begin Board of Veterinary Medicine new text end new text begin 228,000 new text end new text begin 229,000 new text end 343.15 343.16 new text begin Subd. 16. new text end new text begin Board of Behavioral Health and new text end new text begin Therapy new text end new text begin 414,000 new text end new text begin 414,000 new text end 343.17 343.18 Sec. 9. new text begin EMERGENCY MEDICAL SERVICES new text end new text begin BOARD new text end new text begin $ new text end new text begin 2,742,000 new text end new text begin $ new text end new text begin 2,742,000 new text end 343.19 new text begin Of the appropriation, $700,000 in fiscal year new text end 343.20 new text begin 2012 and $700,000 in fiscal year 2013 are new text end 343.21 new text begin for the Cooper/Sams volunteer ambulance new text end 343.22 new text begin program under Minnesota Statutes, section new text end 343.23 new text begin 144E.40. new text end 343.24    Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 343.25to read: 343.26     new text begin Subd. 33. new text end new text begin Federal administrative reimbursement dedicated. new text end new text begin Federal new text end 343.27 new text begin administrative reimbursement resulting from the following activities is appropriated to the new text end 343.28 new text begin commissioner for the designated purposes: new text end 343.29 new text begin (1) reimbursement for the Minnesota senior health options project; and new text end 343.30 new text begin (2) reimbursement related to prior authorization and inpatient admission certification new text end 343.31 new text begin by a professional review organization. A portion of these funds must be used for activities new text end 343.32 new text begin to decrease unnecessary pharmaceutical costs in medical assistance. new text end 344.1    Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 344.26, is amended to read: 344.3 Subd. 6.Continuing Care Grants 344.4 (a) Aging and Adult Services Grants (3,600,000) (3,600,000) 344.5Community Service/Service Development 344.6Grants Reduction. Effective retroactively 344.7from July 1, 2009, funding for grants made 344.8under Minnesota Statutes, sections 256.9754 344.9and 256B.0917, subdivision 13, is reduced 344.10by $5,807,000 for each year of the biennium. 344.11Grants made during the biennium under 344.12Minnesota Statutes, section 256.9754, shall 344.13not be used for new construction or building 344.14renovation. 344.15Aging Grants Delay. Aging grants must be 344.16reduced by $917,000 in fiscal year 2011 and 344.17increased by $917,000 in fiscal year 2012. 344.18These adjustments are onetime and must not 344.19be applied to the base. This provision expires 344.20June 30, 2012. 344.21 344.22 (b) Medical Assistance Long-Term Care Facilities Grants (3,827,000) (2,745,000) 344.23ICF/MR Variable Rates Suspension. 344.24Effective retroactively from July 1, 2009, 344.25to June 30, 2010, no new variable rates 344.26shall be authorized for intermediate care 344.27facilities for persons with developmental 344.28disabilities under Minnesota Statutes, section 344.29256B.5013, subdivision 1 . 344.30ICF/MR Occupancy Rate Adjustment 344.31Suspension. Effective retroactively from 344.32July 1, 2009, to June 30, 2011, approval 344.33of new applications for occupancy rate 344.34adjustments for unoccupied short-term 345.1beds under Minnesota Statutes, section 345.2256B.5013, subdivision 7 , is suspended. 345.3 345.4 (c) Medical Assistance Long-Term Care Waivers and Home Care Grants (2,318,000) (5,807,000) 345.5Developmental Disability Waiver Acuity 345.6Factor. Effective retroactively from January 345.71, 2010, the January 1, 2010, one percent 345.8growth factor in the developmental disability 345.9waiver allocations under Minnesota Statutes, 345.10section 256B.092, subdivisions 4 and 5, 345.11that is attributable to changes in acuity, 345.12is suspended to June 30, 2011 new text begin eliminated. new text end 345.13 new text begin Effective January 1, 2012, the one percent new text end 345.14 new text begin growth factor in the developmental new text end 345.15 new text begin disability waiver allocations is eliminated. new text end 345.16 new text begin Notwithstanding any law to the contrary, this new text end 345.17 new text begin provision does not expire new text end . 345.18 (d) Adult Mental Health Grants (5,000,000) -0- 345.19 (e) Chemical Dependency Entitlement Grants (3,622,000) (3,622,000) 345.20 345.21 (f) Chemical Dependency Nonentitlement Grants (393,000) (393,000) 345.22 345.23 (g) Other Continuing Care Grants -0- (2,500,000) new text begin (1,414,000) new text end 345.24Other Continuing Care Grants Delay. 345.25Other continuing care grants must be reduced 345.26by $1,414,000 in fiscal year 2011 and 345.27increased by $1,414,000 in fiscal year 2012. 345.28These adjustments are onetime and must not 345.29be applied to the base. This provision expires 345.30June 30, 2012. 345.31 new text begin (h) new text end new text begin Deaf and Hard-of-Hearing Grants new text end new text begin -0- new text end new text begin (169,000) new text end 345.32 new text begin Deaf and Hard-of-Hearing Grants Delay. new text end new text begin new text end 345.33 new text begin Effective retroactively from July 1, 2010, new text end 345.34 new text begin deaf and hard-of-hearing grants must be new text end 345.35 new text begin reduced by $169,000 in fiscal year 2011 and new text end 346.1 new text begin increased by $169,000 in fiscal year 2012. new text end 346.2 new text begin These adjustments are onetime and must not new text end 346.3 new text begin be applied to the base. This provision expires new text end 346.4 new text begin June 30, 2012. new text end 346.5    Sec. 12. new text begin TRANSFERS. new text end 346.6     new text begin Subdivision 1. new text end new text begin Grants. new text end new text begin The commissioner of human services, with the approval new text end 346.7 new text begin of the commissioner of management and budget, and after notification of the chairs of new text end 346.8 new text begin the senate health and human services budget and policy committee and the house of new text end 346.9 new text begin representatives health and human services finance committee, may transfer unencumbered new text end 346.10 new text begin appropriation balances for the biennium ending June 30, 2013, within fiscal years among new text end 346.11 new text begin the MFIP; general assistance; general assistance medical care under Minnesota Statutes new text end 346.12 new text begin 2009 Supplement, section 256D.03, subdivision 3; medical assistance; MFIP child care new text end 346.13 new text begin assistance under Minnesota Statutes, section 119B.05; Minnesota supplemental aid; new text end 346.14 new text begin and group residential housing programs, and the entitlement portion of the chemical new text end 346.15 new text begin dependency consolidated treatment fund, and between fiscal years of the biennium. new text end 346.16     new text begin Subd. 2. new text end new text begin Administration. new text end new text begin Positions, salary money, and nonsalary administrative new text end 346.17 new text begin money may be transferred within the Departments of Health and Human Services as the new text end 346.18 new text begin commissioners consider necessary, with the advance approval of the commissioner of new text end 346.19 new text begin management and budget. The commissioner shall inform the chairs of the senate health new text end 346.20 new text begin and human services budget and policy committee and the house of representatives health new text end 346.21 new text begin and human services finance committee quarterly about transfers made under this provision. new text end 346.22    Sec. 13. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS. new text end 346.23 new text begin The commissioners of health and human services shall not use indirect cost new text end 346.24 new text begin allocations to pay for the operational costs of any program for which they are responsible. new text end 346.25    Sec. 14. new text begin EXPIRATION OF UNCODIFIED LANGUAGE. new text end 346.26 new text begin All uncodified language contained in this article expires on June 30, 2013, unless a new text end 346.27 new text begin different expiration date is explicit. new text end 346.28    Sec. 15. new text begin EFFECTIVE DATE. new text end 346.29 new text begin The provisions in this article are effective July 1, 2011, unless a different effective new text end 346.30 new text begin date is specified. new text end 347.1ARTICLE 10 347.2HUMAN SERVICES FORECAST ADJUSTMENTS 347.3 347.4 Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT new text end new text begin APPROPRIATIONS. new text end 347.5 new text begin The sums shown are added to, or if shown in parentheses, are subtracted from the new text end 347.6 new text begin appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter new text end 347.7 new text begin 173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and new text end 347.8 new text begin Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human new text end 347.9 new text begin services and for the purposes specified in this article. The appropriations are from the new text end 347.10 new text begin general fund or another named fund and are available for the fiscal year indicated for new text end 347.11 new text begin each purpose. The figure "2011" used in this article means that the appropriation or new text end 347.12 new text begin appropriations listed are available for the fiscal year ending June 30, 2011. new text end 347.13 347.14 Sec. 2. new text begin COMMISSIONER OF HUMAN new text end new text begin SERVICES new text end 347.15 new text begin Subdivision 1. new text end new text begin Total Appropriation new text end new text begin $ new text end new text begin (235,463,000) new text end 347.16 new text begin Appropriations by Fund new text end 347.17 new text begin 2011 new text end 347.18 new text begin General new text end new text begin (381,869,000) new text end 347.19 new text begin Health Care Access new text end new text begin 169,514,000 new text end 347.20 new text begin Federal TANF new text end new text begin (23,108,000) new text end 347.21 new text begin The amounts that may be spent for each new text end 347.22 new text begin purpose are specified in the following new text end 347.23 new text begin subdivisions. new text end 347.24 new text begin Subd. 2. new text end new text begin Revenue and Pass-through new text end new text begin 732,000 new text end 347.25 new text begin This appropriation is from the federal TANF new text end 347.26 new text begin fund. new text end 347.27 347.28 new text begin Subd. 3. new text end new text begin Children and Economic Assistance new text end new text begin Grants new text end 347.29 new text begin Appropriations by Fund new text end 347.30 new text begin General new text end new text begin (7,098,000) new text end 347.31 new text begin Federal TANF new text end new text begin (23,840,000) new text end 347.32 new text begin (a) new text end new text begin MFIP/DWP Grants new text end 347.33 new text begin Appropriations by Fund new text end 347.34 new text begin General new text end new text begin 18,715,000 new text end 347.35 new text begin Federal TANF new text end new text begin (23,840,000) new text end 348.1 new text begin (b) new text end new text begin MFIP Child Care Assistance Grants new text end new text begin (24,394,000) new text end 348.2 new text begin (c) new text end new text begin General Assistance Grants new text end new text begin (664,000) new text end 348.3 new text begin (d) new text end new text begin Minnesota Supplemental Aid Grants new text end new text begin 793,000 new text end 348.4 new text begin (e) new text end new text begin Group Residential Housing Grants new text end new text begin (1,548,000) new text end 348.5 new text begin Subd. 4. new text end new text begin Basic Health Care Grants new text end 348.6 new text begin Appropriations by Fund new text end 348.7 new text begin General new text end new text begin (335,050,000) new text end 348.8 new text begin Health Care Access new text end new text begin 169,514,000 new text end 348.9 new text begin (a) new text end new text begin MinnesotaCare Grants new text end new text begin 169,514,000 new text end 348.10 new text begin This appropriation is from the health care new text end 348.11 new text begin access fund. new text end 348.12 348.13 new text begin (b) new text end new text begin Medical Assistance Basic Health Care - new text end new text begin Families and Children new text end new text begin (49,368,000) new text end 348.14 348.15 new text begin (c) new text end new text begin Medical Assistance Basic Health Care - new text end new text begin Elderly and Disabled new text end new text begin (43,258,000) new text end 348.16 348.17 new text begin (d) new text end new text begin Medical Assistance Basic Health Care - new text end new text begin Adults without Children new text end new text begin (242,424,000) new text end 348.18 new text begin Subd. 5. new text end new text begin Continuing Care Grants new text end new text begin (39,721,000) new text end 348.19 348.20 new text begin (a) new text end new text begin Medical Assistance Long-Term Care new text end new text begin Facilities new text end new text begin (14,627,000) new text end 348.21 348.22 new text begin (b) new text end new text begin Medical Assistance Long-Term Care new text end new text begin Waivers new text end new text begin (44,718,000) new text end 348.23 new text begin (c) new text end new text begin Chemical Dependency Entitlement Grants new text end new text begin 19,624,000 new text end 348.24    Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6, 348.25is amended to read: 348.26 Subd. 6.Health Care Grants 348.27 (a) MinnesotaCare Grants 998,000 (13,376,000) 348.28This appropriation is from the health care 348.29access fund. 348.30Health Care Access Fund Transfer to 348.31General Fund. The commissioner of 349.1management and budget shall transfer the 349.2following amounts in the following years 349.3from the health care access fund to the 349.4general fund: $998,000 new text begin $0 new text end in fiscal year 349.52010; $176,704,000 new text begin $59,901,000 new text end in fiscal 349.6year 2011; $141,041,000 in fiscal year 2012; 349.7and $286,150,000 in fiscal year 2013. If at 349.8any time the governor issues an executive 349.9order not to participate in early medical 349.10assistance expansion, no funds shall be 349.11transferred from the health care access 349.12fund to the general fund until early medical 349.13assistance expansion takes effect. This 349.14paragraph is effective the day following final 349.15enactment. 349.16MinnesotaCare Ratable Reduction. 349.17Effective for services rendered on or after 349.18July 1, 2010, to December 31, 2013, 349.19MinnesotaCare payments to managed care 349.20plans under Minnesota Statutes, section 349.21256L.12 , for single adults and households 349.22without children whose income is greater 349.23than 75 percent of federal poverty guidelines 349.24shall be reduced by 15 percent. Effective 349.25for services provided from July 1, 2010, to 349.26June 30, 2011, this reduction shall apply to 349.27all services. Effective for services provided 349.28from July 1, 2011, to December 31, 2013, this 349.29reduction shall apply to all services except 349.30inpatient hospital services. Notwithstanding 349.31any contrary provision of this article, this 349.32paragraph shall expire on December 31, 349.332013. 349.34 349.35 (b) Medical Assistance Basic Health Care Grants - Families and Children -0- 295,512,000 350.1Critical Access Dental. Of the general 350.2fund appropriation, $731,000 in fiscal year 350.32011 is to the commissioner for critical 350.4access dental provider reimbursement 350.5payments under Minnesota Statutes, section 350.6256B.76 subdivision 4. This is a onetime 350.7appropriation. 350.8Nonadministrative Rate Reduction. For 350.9services rendered on or after July 1, 2010, 350.10to December 31, 2013, the commissioner 350.11shall reduce contract rates paid to managed 350.12care plans under Minnesota Statutes, 350.13sections 256B.69 and 256L.12, and to 350.14county-based purchasing plans under 350.15Minnesota Statutes, section 256B.692, by 350.16three percent of the contract rate attributable 350.17to nonadministrative services in effect on 350.18June 30, 2010. Notwithstanding any contrary 350.19provision in this article, this rider expires on 350.20December 31, 2013. 350.21 350.22 (c) Medical Assistance Basic Health Care Grants - Elderly and Disabled -0- (30,265,000) 350.23 350.24 (d) General Assistance Medical Care Grants -0- (75,389,000) new text begin (59,583,000) new text end 350.25 new text begin The reduction to general assistance medical new text end 350.26 new text begin care grants is contingent upon the effective new text end 350.27 new text begin date in Laws 2010, First Special Session new text end 350.28 new text begin chapter 1, article 16, section 48. The new text end 350.29 new text begin reduction shall be reestimated based upon new text end 350.30 new text begin the actual effective date of the law. The new text end 350.31 new text begin commissioner of management and budget new text end 350.32 new text begin shall make adjustments in fiscal year new text end 350.33 new text begin 2011 to general assistance medical care new text end 350.34 new text begin appropriations to conform to the total new text end 350.35 new text begin expected expenditure reductions specified in new text end 350.36 new text begin this section. new text end 351.1 (e) Other Health Care Grants -0- (7,000,000) 351.2Cobra Carryforward. Unexpended funds 351.3appropriated in fiscal year 2010 for COBRA 351.4grants under Laws 2009, chapter 79, article 351.55, section 78, do not cancel and are available 351.6to the commissioner for fiscal year 2011 351.7COBRA grant expenditures. Up to $111,000 351.8of the fiscal year 2011 appropriation for 351.9COBRA grants provided in Laws 2009, 351.10chapter 79, article 13, section 3, subdivision 351.116, may be used by the commissioner for costs 351.12related to administration of the COBRA 351.13grants. 351.14    Sec. 4. new text begin EFFECTIVE DATE. new text end 351.15 new text begin This article is effective the day following final enactment. new text end