1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services 
1.3 	budget; making changes to children and family services, Department of Health, 
1.4 	miscellaneous provisions, health licensing and fees, human services licensing, 
1.5 	health care, and continuing care; redesigning service delivery; making changes 
1.6 	to chemical and mental health; modifying fee schedules; modifying program 
1.7 	eligibility requirements; authorizing rulemaking; imposing criminal penalties; 
1.8 	requiring reports; appropriating money for the Departments of Health and 
1.9 	Human Services and other health-related boards and councils; amending 
1.10 	Minnesota Statutes 2010, sections 13.461, subdivision 24a; 62E.14, by adding a 
1.11 	subdivision; 62J.04, subdivisions 3, 9; 62J.17, subdivision 4a; 62J.495, by adding 
1.12 	subdivisions; 62J.692; 62Q.32; 62U.04, subdivisions 3, 9; 62U.06, subdivision 
1.13 	2; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision 
1.14 	1; 103I.525, subdivision 2; 103I.531, subdivision 2; 103I.535, subdivision 2; 
1.15 	103I.541, subdivision 2c; 119B.011, subdivision 13; 119B.035, subdivision 
1.16 	4; 119B.09, subdivision 10, by adding subdivisions; 119B.125, by adding a 
1.17 	subdivision; 119B.13, subdivisions 1, 1a, 7; 144.1464, subdivision 1; 144.1501, 
1.18 	subdivision 1; 144.98, subdivisions 2a, 7, by adding subdivisions; 144A.102; 
1.19 	144A.61, by adding a subdivision; 144E.123; 145A.17, subdivision 3; 148.07, 
1.20 	subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2; 148.212, 
1.21 	subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52; 150A.091, 
1.22 	subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101; 151.102, 
1.23 	by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; 151.47, 
1.24 	subdivision 1; 151.48; 152.12, subdivision 3; 157.15, by adding a subdivision; 
1.25 	157.20, by adding a subdivision; 245A.03, subdivision 7, as amended; 245A.10, 
1.26 	subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision 2b; 245A.14, 
1.27 	subdivision 4; 245A.143, subdivision 1; 245C.03, by adding a subdivision; 
1.28 	245C.10, by adding subdivisions; 246B.10; 253B.212; 254B.03, subdivision 4; 
1.29 	254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01, subdivisions 
1.30 	14b, 24, 29, by adding subdivisions; 256.969, subdivisions 2, 2b, by adding a 
1.31 	subdivision; 256B.02, by adding a subdivision; 256B.03, by adding subdivisions; 
1.32 	256B.04, subdivision 18, by adding subdivisions; 256B.05, by adding a 
1.33 	subdivision; 256B.056, subdivision 3; 256B.057, subdivision 9; 256B.06, 
1.34 	subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 8e, 13e, 13h, 17, 17a, 18, 
1.35 	19a, 25, 31, 31a, 41, by adding subdivisions; 256B.0631, subdivisions 1, 2, 3; 
1.36 	256B.064, subdivision 2; 256B.0641, subdivision 1; 256B.0652, subdivision 
1.37 	6; 256B.0659, subdivisions 11, 28; 256B.0751, subdivision 4, by adding a 
1.38 	subdivision; 256B.0911, subdivisions 1a, 3a, 3c, 4a; 256B.0913, subdivision 
1.39 	4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 5, 10; 256B.0943, by adding a 
2.1 	subdivision; 256B.0945, subdivision 4; 256B.14, by adding a subdivision; 
2.2 	256B.19, subdivision 1e; 256B.196, subdivisions 2, 3, 5; 256B.199; 256B.431, 
2.3 	subdivisions 2r, 2t, 32; 256B.434, subdivision 4; 256B.437, subdivision 6; 
2.4 	256B.438, subdivisions 1, 3, 4, by adding a subdivision; 256B.441, subdivisions 
2.5 	50a, 55a, by adding subdivisions; 256B.49, subdivisions 12, 14, 15, 16a, by 
2.6 	adding a subdivision; 256B.5012, by adding subdivisions; 256B.69, subdivisions 
2.7 	5a, 5c, 28, by adding subdivisions; 256B.76, subdivisions 1, 2, 4; 256B.766; 
2.8 	256D.05, subdivision 1; 256D.06, subdivision 2; 256D.09, subdivision 6; 
2.9 	256D.46, subdivision 1; 256D.49, subdivision 3; 256E.35, subdivisions 5, 6; 
2.10 	256I.03, by adding a subdivision; 256I.05, subdivision 1a; 256J.20, subdivision 
2.11 	3; 256J.38, subdivision 1; 256J.49, subdivision 13; 256L.02, subdivision 3; 
2.12 	256L.03, subdivision 5; 256L.04, subdivisions 1, 10; 256L.05, subdivision 
2.13 	3a, by adding a subdivision; 256L.09, subdivision 2; 256L.11, subdivisions 
2.14 	6, 7; 256L.12, subdivision 9; 256L.15, subdivision 1; 256M.01; 256M.10, 
2.15 	subdivision 2; 256M.20, subdivisions 1, 2, 3; 256M.30; 256M.40; 256M.50; 
2.16 	256M.60, subdivision 1; 256M.70, subdivision 2; 256M.80; 295.52, by adding 
2.17 	a subdivision; 297F.10, subdivision 1; 393.07, subdivisions 10, 10a; 402A.10, 
2.18 	subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 518A.51; Laws 2009, chapter 
2.19 	79, article 5, sections 17, as amended; 18, as amended; 22, as amended; article 
2.20 	8, sections 4, as amended; 51, as amended; article 13, section 3, subdivision 
2.21 	8, as amended; Laws 2009, chapter 173, article 1, section 17, as amended; 
2.22 	Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 6; 
2.23 	proposing coding for new law in Minnesota Statutes, chapters 62U; 148; 151; 
2.24 	214; 256; 256B; 256L; 402A; repealing Minnesota Statutes 2010, sections 
2.25 	13.4967, subdivision 3; 62J.07, subdivisions 1, 2, 3; 62J.321, subdivision 
2.26 	5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1499; 245A.10, subdivision 5; 
2.27 	256.979, subdivisions 5, 6, 7, 10; 256.9791; 256B.057, subdivision 2c; 256B.69, 
2.28 	subdivision 9b; 256L.07, subdivision 7; 256M.10, subdivision 5; 256M.60, 
2.29 	subdivision 2; 256M.70, subdivision 1; 295.50, subdivisions 1, 1a, 2, 2a, 3, 4, 
2.30 	6, 6a, 7, 9b, 9c, 10a, 10b, 12b, 13, 14, 15; 295.51, subdivisions 1, 1a; 295.52, 
2.31 	subdivisions 1, 1a, 2, 3, 4, 4a, 5, 6, 7; 295.53, subdivisions 1, 2, 3, 4a; 295.54; 
2.32 	295.55; 295.56; 295.57; 295.58; 295.581; 295.582; 295.59; 402A.30; 402A.45; 
2.33 	Laws 2008, chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 5, 
2.34 	section 62; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100, subparts 
2.35 	1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23; 
2.36 	4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140; 4651.0150; 
2.37 	9500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5.
2.38 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.39 	ARTICLE 1
2.40 	CHILDREN AND FAMILY SERVICES

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

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

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

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

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

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

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

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

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

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

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

5.18 	Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
5.19 		Subdivision 1.Subsidy restrictions. (a) Beginning July 1, 2006 October 31, 2011, 
5.20 	the maximum rate paid for child care assistance in any county or multicounty region under 
5.21 	the child care fund shall be the rate for like-care arrangements in the county effective 
5.22 	JanuaryJuly 1, 2006, increaseddecreased by six2.5 percent.
5.23 	(b) Rate changes shall be implemented for services provided in September 2006 
5.24 	unless a participant eligibility redetermination or a new provider agreement is completed 
5.25 	between July 1, 2006, and August 31, 2006.
5.26 	As necessary, appropriate notice of adverse action must be made according to 
5.27 	Minnesota Rules, part 3400.0185, subparts 3 and 4.
5.28 	New cases approved on or after July 1, 2006, shall have the maximum rates under 
5.29 	paragraph (a), implemented immediately.
5.30 	(c)(b) Every year, the commissioner shall survey rates charged by child care 
5.31 	providers in Minnesota to determine the 75th percentile for like-care arrangements in 
5.32 	counties. When the commissioner determines that, using the commissioner's established 
5.33 	protocol, the number of providers responding to the survey is too small to determine 
5.34 	the 75th percentile rate for like-care arrangements in a county or multicounty region, 
6.1 	the commissioner may establish the 75th percentile maximum rate based on like-care 
6.2 	arrangements in a county, region, or category that the commissioner deems to be similar.
6.3 	(d)(c) A rate which includes a special needs rate paid under subdivision 3 or under a 
6.4 	school readiness service agreement paid under section 119B.231, may be in excess of the 
6.5 	maximum rate allowed under this subdivision.
6.6 	(e)(d) The department shall monitor the effect of this paragraph on provider rates. 
6.7 	The county shall pay the provider's full charges for every child in care up to the maximum 
6.8 	established. The commissioner shall determine the maximum rate for each type of care 
6.9 	on an hourly, full-day, and weekly basis, including special needs and disability care. The 
6.10 	maximum payment to a provider for one day of care must not exceed the daily rate. The 
6.11 	maximum payment to a provider for one week of care must not exceed the weekly rate.
6.12 	(e) Child care providers receiving reimbursement under this chapter must not be 
6.13 	paid activity fees or an additional amount above the maximum rates for care provided 
6.14 	during nonstandard hours for families receiving assistance.
6.15 	(f) When the provider charge is greater than the maximum provider rate allowed, 
6.16 	the parent is responsible for payment of the difference in the rates in addition to any 
6.17 	family co-payment fee.
6.18 	(g) All maximum provider rates changes shall be implemented on the Monday 
6.19 	following the effective date of the maximum provider rate.

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

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

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

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

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

8.20 	Sec. 10. [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
8.21 		Subdivision 1.Electronic benefit transfer (EBT) card. Cash benefits for the 
8.22 	general assistance and Minnesota supplemental aid programs under chapter 256D and 
8.23 	programs under chapter 256J must be issued on a separate EBT card with the name of the 
8.24 	head of household printed on the card. The card must include the following statement: "It 
8.25 	is unlawful to use this card to purchase tobacco products or alcoholic beverages." This 
8.26 	card must be issued within 30 calendar days of an eligibility determination. During the 
8.27 	initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT 
8.28 	card without a name printed on the card. This card may be the same card on which food 
8.29 	support benefits are issued and does not need to meet the requirements of this section.
8.30 		Subd. 2.Prohibited purchases. EBT debit cardholders in programs listed under 
8.31 	subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products 
8.32 	and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for 
8.33 	an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic 
8.34 	beverages with the cardholder's EBT card. Any unlawful use under this subdivision shall 
9.1 	constitute fraud and result in disqualification from the program under section 256.98, 
9.2 	subdivision 8.

9.3 	EFFECTIVE DATE. Subdivision 1 is effective June 1, 2012.

9.4 	Sec. 11. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:
9.5 		Subdivision 1.Eligibility. (a) Each assistance unit with income and resources 
9.6 	less than the standard of assistance established by the commissioner and with a member 
9.7 	who is a resident of the state shall be eligible for and entitled to general assistance if 
9.8 	the assistance unit is:
9.9 	(1) a person who is suffering from a professionally certified permanent or temporary 
9.10 	illness, injury, or incapacity which is expected to continue for more than 30 45 days and 
9.11 	which prevents the person from obtaining or retaining employment;
9.12 	(2) a person whose presence in the home on a substantially continuous basis is 
9.13 	required because of the professionally certified illness, injury, incapacity, or the age of 
9.14 	another member of the household;
9.15 	(3) a person who has been placed in, and is residing in, a licensed or certified facility 
9.16 	for purposes of physical or mental health or rehabilitation, or in an approved chemical 
9.17 	dependency domiciliary facility, if the placement is based on illness or incapacity and is 
9.18 	according to a plan developed or approved by the county agency through its director or 
9.19 	designated representative;
9.20 	(4) a person who resides in a shelter facility described in subdivision 3;
9.21 	(5) a person not described in clause (1) or (3) who is diagnosed by a licensed 
9.22 	physician, psychological practitioner, or other qualified professional, as developmentally 
9.23 	disabled or mentally ill, and that condition prevents the person from obtaining or retaining 
9.24 	employment;
9.25 	(6) a person who has an application pending for, or is appealing termination of 
9.26 	benefits from, the Social Security disability program or the program of supplemental 
9.27 	security income for the aged, blind, and disabled, provided the person has a professionally 
9.28 	certified permanent or temporary illness, injury, or incapacity which is expected to 
9.29 	continue for more than 30 days and which prevents the person from obtaining or retaining 
9.30 	employment;
9.31 	(7) a person who is unable to obtain or retain employment because advanced age 
9.32 	significantly affects the person's ability to seek or engage in substantial work;
9.33 	(8) a person who has been assessed by a vocational specialist and, in consultation 
9.34 	with the county agency, has been determined to be unemployable for purposes of this 
9.35 	clause; a person is considered employable if there exist positions of employment in the 
10.1 	local labor market, regardless of the current availability of openings for those positions, 
10.2 	that the person is capable of performing. The person's eligibility under this category must 
10.3 	be reassessed at least annually. The county agency must provide notice to the person not 
10.4 	later than 30 days before annual eligibility under this item ends, informing the person of the 
10.5 	date annual eligibility will end and the need for vocational assessment if the person wishes 
10.6 	to continue eligibility under this clause. For purposes of establishing eligibility under this 
10.7 	clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
10.8 	(9) a person who is determined by the county agency, according to permanent rules 
10.9 	adopted by the commissioner, to be learning disabled have a condition that qualifies 
10.10 	under Minnesota's special education rules as a specific learning disability, provided that if
10.11 	a rehabilitation plan for the person is developed or approved by the county agency, and
10.12 	the person is following the plan;
10.13 	(10) a child under the age of 18 who is not living with a parent, stepparent, or legal 
10.14 	custodian, and only if: the child is legally emancipated or living with an adult with the 
10.15 	consent of an agency acting as a legal custodian; the child is at least 16 years of age 
10.16 	and the general assistance grant is approved by the director of the county agency or a 
10.17 	designated representative as a component of a social services case plan for the child; or the 
10.18 	child is living with an adult with the consent of the child's legal custodian and the county 
10.19 	agency. For purposes of this clause, "legally emancipated" means a person under the age 
10.20 	of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of 
10.21 	the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv) 
10.22 	is otherwise considered emancipated under Minnesota law, and for whom county social 
10.23 	services has not determined that a social services case plan is necessary, for reasons other 
10.24 	than the child has failed or refuses to cooperate with the county agency in developing 
10.25 	the plan;
10.26 	(11) a person who is eligible for displaced homemaker services, programs, or 
10.27 	assistance under section 116L.96, but only if that person is enrolled as a full-time student;
10.28 	(12) a person who lives more than four hours round-trip traveling time from any 
10.29 	potential suitable employment;
10.30 	(13)(12) a person who is involved with protective or court-ordered services that 
10.31 	prevent the applicant or recipient from working at least four hours per day;
10.32 	(14)(13) a person over age 18 whose primary language is not English and who is 
10.33 	attending high school at least half time; or
10.34 	(15)(14) a person whose alcohol and drug addiction is a material factor that 
10.35 	contributes to the person's disability; applicants who assert this clause as a basis for 
10.36 	eligibility must be assessed by the county agency to determine if they are amenable 
11.1 	to treatment; if the applicant is determined to be not amenable to treatment, but is 
11.2 	otherwise eligible for benefits, then general assistance must be paid in vendor form, for 
11.3 	the individual's shelter costs up to the limit of the grant amount, with the residual, if 
11.4 	any, paid according to section 256D.09, subdivision 2a; if the applicant is determined 
11.5 	to be amenable to treatment, then in order to receive benefits, the applicant must be in 
11.6 	a treatment program or on a waiting list and the benefits must be paid in vendor form, 
11.7 	for the individual's shelter costs, up to the limit of the grant amount, with the residual, if 
11.8 	any, paid according to section 256D.09, subdivision 2a.
11.9 	(b) As a condition of eligibility under paragraph (a), clauses (1), (3), (5), (8), and 
11.10 	(9), the recipient must complete an interim assistance agreement and must apply for other 
11.11 	maintenance benefits as specified in section 256D.06, subdivision 5, and must comply 
11.12 	with efforts to determine the recipient's eligibility for those other maintenance benefits.
11.13 	(c) The burden of providing documentation for a county agency to use to verify 
11.14 	eligibility for general assistance or for exemption from the food stamp employment 
11.15 	and training program is upon the applicant or recipient. The county agency shall use 
11.16 	documents already in its possession to verify eligibility, and shall help the applicant or 
11.17 	recipient obtain other existing verification necessary to determine eligibility which the 
11.18 	applicant or recipient does not have and is unable to obtain.

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

11.20 	Sec. 12. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:
11.21 		Subd. 2.Emergency need. (a) Notwithstanding the provisions of subdivision 1, a 
11.22 	grant of emergency general assistance shall, to the extent funds are available, be made to 
11.23 	an eligible single adult, married couple, or family for an emergency need, as defined in 
11.24 	rules promulgated by the commissioner, where the recipient requests temporary assistance 
11.25 	not exceeding 30 days if an emergency situation appears to exist and the individual or 
11.26 	family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP under 
11.27 	written criteria adopted by the county agency. If an applicant or recipient relates facts 
11.28 	to the county agency which may be sufficient to constitute an emergency situation, the 
11.29 	county agency shall, to the extent funds are available, advise the person of the procedure 
11.30 	for applying for assistance according to this subdivision. 
11.31 	(b) The applicant must be ineligible for assistance under chapter 256J, must have 
11.32 	annual net income no greater than 200 percent of the federal poverty guidelines for the 
11.33 	previous calendar year, and may receive an emergency general assistance grant is available 
11.34 	to a recipient not more than once in any 12-month period. 
12.1 	(c) Funding for an emergency general assistance program is limited to the 
12.2 	appropriation. Each fiscal year, the commissioner shall allocate to counties the money 
12.3 	appropriated for emergency general assistance grants based on each county agency's 
12.4 	average share of state's emergency general expenditures for the immediate past three fiscal 
12.5 	years as determined by the commissioner, and may reallocate any unspent amounts to 
12.6 	other counties. No county shall be allocated less than $1,000 for a fiscal year.
12.7 	(d) Any emergency general assistance expenditures by a county above the amount of 
12.8 	the commissioner's allocation to the county must be made from county funds.

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

12.10 	Sec. 13. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:
12.11 		Subdivision 1.Eligibility. A county agency must grant emergency Minnesota 
12.12 	supplemental aid, to the extent funds are available, if the recipient is without adequate 
12.13 	resources to resolve an emergency that, if unresolved, will threaten the health or safety of 
12.14 	the recipient. For the purposes of this section, the term "recipient" includes persons for 
12.15 	whom a group residential housing benefit is being paid under sections 256I.01 to 256I.06.
12.16 	Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency 
12.17 	need may apply for emergency general assistance under section 256D.06, subdivision 2.

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

12.19 	Sec. 14. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
12.20 		Subd. 5.Household eligibility; participation. (a) To be eligible for state or TANF
12.21 	matching funds in the family assets for independence initiative, a household must meet the 
12.22 	eligibility requirements of the federal Assets for Independence Act, Public Law 105-285, 
12.23 	in Title IV, section 408 of that act.
12.24 	(b) Each participating household must sign a family asset agreement that includes 
12.25 	the amount of scheduled deposits into its savings account, the proposed use, and the 
12.26 	proposed savings goal. A participating household must agree to complete an economic 
12.27 	literacy training program.
12.28 	Participating households may only deposit money that is derived from household 
12.29 	earned income or from state and federal income tax credits.

12.30 	Sec. 15. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
12.31 		Subd. 6.Withdrawal; matching; permissible uses. (a) To receive a match, a 
12.32 	participating household must transfer funds withdrawn from a family asset account to its 
13.1 	matching fund custodial account held by the fiscal agent, according to the family asset 
13.2 	agreement. The fiscal agent must determine if the match request is for a permissible use 
13.3 	consistent with the household's family asset agreement.
13.4 	The fiscal agent must ensure the household's custodial account contains the 
13.5 	applicable matching funds to match the balance in the household's account, including 
13.6 	interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches 
13.7 	must be provided as follows:
13.8 	(1) from state grant and TANF funds a matching contribution of $1.50 for every $1 
13.9 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or a 
13.10 	$3,000 lifetime limit; and
13.11 	(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1 
13.12 	of funds withdrawn from the family asset account equal to the lesser of $720 per year or 
13.13 	a $3,000 lifetime limit.
13.14 	(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a 
13.15 	direct payment to the vendor of the goods or services for the permissible use.

13.16 	Sec. 16. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision 
13.17 	to read:
13.18 		Subd. 8.Supplementary services. "Supplementary services" means services 
13.19 	provided to residents of group residential housing providers in addition to room and 
13.20 	board including, but not limited to, oversight and up to 24-hour supervision, medication 
13.21 	reminders, assistance with transportation, arranging for meetings and appointments, and 
13.22 	arranging for medical and social services.

13.23 	Sec. 17. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:
13.24 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 
13.25 	256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37 
13.26 	for other services necessary to provide room and board provided by the group residence 
13.27 	if the residence is licensed by or registered by the Department of Health, or licensed by 
13.28 	the Department of Human Services to provide services in addition to room and board, 
13.29 	and if the provider of services is not also concurrently receiving funding for services for 
13.30 	a recipient under a home and community-based waiver under title XIX of the Social 
13.31 	Security Act; or funding from the medical assistance program under section 256B.0659, 
13.32 	for personal care services for residents in the setting; or residing in a setting which 
13.33 	receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is 
13.34 	available for other necessary services through a home and community-based waiver, or 
14.1 	personal care services under section 256B.0659, then the GRH rate is limited to the rate 
14.2 	set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary 
14.3 	service rate exceed $426.37. The registration and licensure requirement does not apply to 
14.4 	establishments which are exempt from state licensure because they are located on Indian 
14.5 	reservations and for which the tribe has prescribed health and safety requirements. Service 
14.6 	payments under this section may be prohibited under rules to prevent the supplanting of 
14.7 	federal funds with state funds. The commissioner shall pursue the feasibility of obtaining 
14.8 	the approval of the Secretary of Health and Human Services to provide home and 
14.9 	community-based waiver services under title XIX of the Social Security Act for residents 
14.10 	who are not eligible for an existing home and community-based waiver due to a primary 
14.11 	diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is 
14.12 	determined to be cost-effective.
14.13 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH 
14.14 	fund for beds under this section to other funding programs administered by the department 
14.15 	after consultation with the county or counties in which the affected beds are located. 
14.16 	The commissioner may also make cost-neutral transfers from the GRH fund to county 
14.17 	human service agencies for beds permanently removed from the GRH census under a plan 
14.18 	submitted by the county agency and approved by the commissioner. The commissioner 
14.19 	shall report the amount of any transfers under this provision annually to the legislature.
14.20 	(c) The provisions of paragraph (b) do not apply to a facility that has its 
14.21 	reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).
14.22 	(d) Counties must not negotiate supplementary service rates with providers of group 
14.23 	residential housing that are licensed as board and lodging with special services and that 
14.24 	do not encourage a policy of sobriety on their premises.

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

14.26 	Sec. 18. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:
14.27 		Subd. 3.Other property limitations. To be eligible for MFIP, the equity value of 
14.28 	all nonexcluded real and personal property of the assistance unit must not exceed $2,000 
14.29 	for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to 
14.30 	(19) must be excluded when determining the equity value of real and personal property:
14.31 	(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $10,000. If 
14.32 	the assistance unit owns more than one licensed vehicle, the county agency shall determine 
14.33 	the loan value of all additional vehicles and exclude the combined loan value of less than 
14.34 	or equal to $7,500. The county agency shall apply any excess loan value as if it were 
14.35 	equity value to the asset limit described in this section, excluding: (i) the value of one 
15.1 	vehicle per physically disabled person when the vehicle is needed to transport the disabled 
15.2 	unit member; this exclusion does not apply to mentally disabled people; (ii) the value of 
15.3 	special equipment for a disabled member of the assistance unit; and (iii) any vehicle used 
15.4 	for long-distance travel, other than daily commuting, for the employment of a unit member.
15.5 	To establish the loan value of vehicles, a county agency must use the N.A.D.A. 
15.6 	Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not 
15.7 	listed in the guidebook, or when the applicant or participant disputes the loan value listed 
15.8 	in the guidebook as unreasonable given the condition of the particular vehicle, the county 
15.9 	agency may require the applicant or participant document the loan value by securing a 
15.10 	written statement from a motor vehicle dealer licensed under section 168.27, stating 
15.11 	the amount that the dealer would pay to purchase the vehicle. The county agency shall 
15.12 	reimburse the applicant or participant for the cost of a written statement that documents 
15.13 	a lower loan value;
15.14 	(2) the value of life insurance policies for members of the assistance unit;
15.15 	(3) one burial plot per member of an assistance unit;
15.16 	(4) the value of personal property needed to produce earned income, including 
15.17 	tools, implements, farm animals, inventory, business loans, business checking and 
15.18 	savings accounts used at least annually and used exclusively for the operation of a 
15.19 	self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use 
15.20 	is to produce income and if the vehicles are essential for the self-employment business;
15.21 	(5) the value of personal property not otherwise specified which is commonly 
15.22 	used by household members in day-to-day living such as clothing, necessary household 
15.23 	furniture, equipment, and other basic maintenance items essential for daily living;
15.24 	(6) the value of real and personal property owned by a recipient of Supplemental 
15.25 	Security Income or Minnesota supplemental aid;
15.26 	(7) the value of corrective payments, but only for the month in which the payment 
15.27 	is received and for the following month;
15.28 	(8) a mobile home or other vehicle used by an applicant or participant as the 
15.29 	applicant's or participant's home;
15.30 	(9) money in a separate escrow account that is needed to pay real estate taxes or 
15.31 	insurance and that is used for this purpose;
15.32 	(10) money held in escrow to cover employee FICA, employee tax withholding, 
15.33 	sales tax withholding, employee worker compensation, business insurance, property rental, 
15.34 	property taxes, and other costs that are paid at least annually, but less often than monthly;
15.35 	(11) monthly assistance payments for the current month's or short-term emergency 
15.36 	needs under section 256J.626, subdivision 2;
16.1 	(12) the value of school loans, grants, or scholarships for the period they are 
16.2 	intended to cover;
16.3 	(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held 
16.4 	in escrow for a period not to exceed three months to replace or repair personal or real 
16.5 	property;
16.6 	(14) income received in a budget month through the end of the payment month;
16.7 	(15) savings from earned income of a minor child or a minor parent that are set aside 
16.8 	in a separate account designated specifically for future education or employment costs;
16.9 	(16) the federal earned income credit, Minnesota working family credit, state and 
16.10 	federal income tax refunds, state homeowners and renters credits under chapter 290A, 
16.11 	property tax rebates and other federal or state tax rebates in the month received and the 
16.12 	following month;
16.13 	(17) payments excluded under federal law as long as those payments are held in a 
16.14 	separate account from any nonexcluded funds;
16.15 	(18) the assets of children ineligible to receive MFIP benefits because foster care or 
16.16 	adoption assistance payments are made on their behalf; and
16.17 	(19) the assets of persons whose income is excluded under section 256J.21, 
16.18 	subdivision 2, clause (43).

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

16.20 	Sec. 19. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:
16.21 		Subd. 13. Work activity. (a) "Work activity" means any activity in a participant's 
16.22 	approved employment plan that leads to employment. For purposes of the MFIP program, 
16.23 	this includes activities that meet the definition of work activity under the participation 
16.24 	requirements of TANF. Work activity includes: 
16.25 	(1) unsubsidized employment, including work study and paid apprenticeships or 
16.26 	internships; 
16.27 	(2) subsidized private sector or public sector employment, including grant diversion 
16.28 	as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid 
16.29 	work experience, and supported work when a wage subsidy is provided; 
16.30 	(3) unpaid work experience, including community service, volunteer work, 
16.31 	the community work experience program as specified in section 256J.67, unpaid 
16.32 	apprenticeships or internships, and supported work when a wage subsidy is not provided. 
16.33 	Unpaid work experience is only an option if the participant has been unable to obtain or 
16.34 	maintain paid employment in the competitive labor market, and no paid work experience 
16.35 	programs are available to the participant. Prior to placing a participant in unpaid work, 
17.1 	the county must inform the participant that the participant will be notified if a paid work 
17.2 	experience or supported work position becomes available. Unless a participant consents in 
17.3 	writing to participate in unpaid work experience, the participant's employment plan may 
17.4 	only include unpaid work experience if including the unpaid work experience in the plan 
17.5 	will meet the following criteria: 
17.6 	(i) the unpaid work experience will provide the participant specific skills or 
17.7 	experience that cannot be obtained through other work activity options where the 
17.8 	participant resides or is willing to reside; and 
17.9 	(ii) the skills or experience gained through the unpaid work experience will result 
17.10 	in higher wages for the participant than the participant could earn without the unpaid 
17.11 	work experience; 
17.12 	(4) job search including job readiness assistance, job clubs, job placement, 
17.13 	job-related counseling, and job retention services; 
17.14 	(5) job readiness education, including English as a second language (ESL) or 
17.15 	functional work literacy classes as limited by the provisions of section 256J.531, 
17.16 	subdivision 2, general educational development (GED) course work, high school 
17.17 	completion, and adult basic education as limited by the provisions of section 256J.531, 
17.18 	subdivision 1; 
17.19 	(6) job skills training directly related to employment, including education and 
17.20 	training that can reasonably be expected to lead to employment, as limited by the 
17.21 	provisions of section 256J.53; 
17.22 	(7) providing child care services to a participant who is working in a community 
17.23 	service program; 
17.24 	(8) activities included in the employment plan that is developed under section 
17.25 	256J.521, subdivision 3; and 
17.26 	(9) preemployment activities including chemical and mental health assessments, 
17.27 	treatment, and services; learning disabilities services; child protective services; family 
17.28 	stabilization services; or other programs designed to enhance employability. 
17.29 	(b) "Work activity" does not include activities done for political purposes as defined 
17.30 	in section 211B.01, subdivision 6.

17.31 	Sec. 20. Minnesota Statutes 2010, section 256M.01, is amended to read:
17.32 	256M.01 CITATION.
17.33 	Sections 256M.01 to 256M.80 may be cited as the "Children and Community 
17.34 	Services Vulnerable Children and Adults Act." This act establishes a fund to address the 
17.35 	needs of vulnerable children, adolescents, and adults within each county in accordance 
18.1 	with a service plan entered into by the board of county commissioners of each county 
18.2 	and the commissioner. The service plan shall specify the outcomes to be achieved, the 
18.3 	general strategies to be employed, and the respective state and county roles. The service 
18.4 	plan shall be reviewed and updated every two years, or sooner if both the state and the 
18.5 	county deem it necessary. 

18.6 	Sec. 21. Minnesota Statutes 2010, section 256M.10, subdivision 2, is amended to read:
18.7 		Subd. 2.Children and community  Vulnerable children and adults services.
 18.8 	(a) "Children and communityVulnerable children and adults services" means services 
18.9 	provided or arranged for by county boards for vulnerable children, adolescents and other 
18.10 	individuals in transition from childhood to adulthood, under chapter 260C, and sections 
18.11 	626.556 and 626.5561, and adults under section 626.557 who experience dependency, 
18.12 	abuse, or neglect, poverty, disability, chronic health conditions, or other factors, including 
18.13 	ethnicity and race, that may result in poor outcomes or disparities, as well as services 
18.14 	for family members to support those individuals. These services may be provided 
18.15 	by professionals or nonprofessionals, including the person's natural supports in the 
18.16 	community. For the purpose of this chapter, "vulnerable children" means children and 
18.17 	adolescents.
18.18 	(b) Children and communityVulnerable children and adults services do not include 
18.19 	services under the public assistance programs known as the Minnesota family investment 
18.20 	program, Minnesota supplemental aid, medical assistance, general assistance, general 
18.21 	assistance medical care, MinnesotaCare, or community health services.

18.22 	Sec. 22. Minnesota Statutes 2010, section 256M.20, subdivision 1, is amended to read:
18.23 		Subdivision 1.General supervision. Each year the commissioner shall allocate 
18.24 	funds to each county with an approved service plan according to section 256M.40 and 
18.25 	service plans under section 256M.30. The funds shall be used to address the needs of 
18.26 	vulnerable children, adolescents, and adults. The commissioner, in consultation with 
18.27 	counties, shall provide technical assistance and evaluate county performance in achieving 
18.28 	outcomes. 

18.29 	Sec. 23. Minnesota Statutes 2010, section 256M.20, subdivision 2, is amended to read:
18.30 		Subd. 2.Additional duties. The commissioner shall:
18.31 	(1) provide necessary information and assistance to each county for establishing 
18.32 	baselines and desired improvements on mental health, safety, permanency, and well-being 
18.33 	for vulnerable children and adolescents adults;
19.1 	(2) provide training, technical assistance, and other supports to each county board 
19.2 	to assist in needs assessment, planning, implementation, and monitoring of outcomes 
19.3 	and service quality;
19.4 	(3) use data collection, evaluation of service outcomes, and the review and approval 
19.5 	of county service plans to supervise county performance in the delivery of children and 
19.6 	community services;
19.7 	(4) specify requirements for reports, including fiscal reports to account for funds 
19.8 	distributed;
19.9 	(5) request waivers from federal programs as necessary to implement this section; 
19.10 	and
19.11 	(6) have authority under sections 14.055 and 14.056 to grant a variance to existing 
19.12 	state rules as needed to eliminate barriers to achieving desired outcomes. 

19.13 	Sec. 24. Minnesota Statutes 2010, section 256M.20, subdivision 3, is amended to read:
19.14 		Subd. 3.Sanctions. The commissioner shall establish and maintain a monitoring 
19.15 	program designed to reduce the possibility of noncompliance with federal laws and 
19.16 	federal, regulations, and performance standards that may result in federal fiscal sanctions. 
19.17 	If a county is not complying with federal law or federal regulation and the noncompliance 
19.18 	may result in federal fiscal sanctions, the commissioner may withhold a portion of the 
19.19 	county's share of state and federal funds for that program. The amount withheld must be 
19.20 	equal to the percentage difference between the level of compliance maintained by the 
19.21 	county and the level of compliance required by the federal regulations, multiplied by the 
19.22 	county's share of state and federal funds for the program. The state and federal funds may 
19.23 	be withheld until the county is found to be in compliance with all federal laws or federal 
19.24 	regulations applicable to the program. If a county remains out of compliance for more 
19.25 	than six consecutive months, the commissioner may reallocate the withheld funds to 
19.26 	counties that are in compliance with the federal regulations.

19.27 	Sec. 25. Minnesota Statutes 2010, section 256M.30, is amended to read:
19.28 	256M.30 SERVICE PLAN.
19.29 		Subdivision 1.Service plan submitted to commissioner. Effective January 1, 
19.30 	2004, and each two-year period thereafter 2012, each county must have a biennial service 
19.31 	plan approved by the commissioner in order to receive funds. Counties may submit 
19.32 	multicounty or regional service plans. Plans must be updated as needed to reflect current 
19.33 	county policy and procedures regarding requirements and use of funds under this chapter.
20.1 		Subd. 2.Contents. The service plan shall be completed in a form prescribed by 
20.2 	the commissioner. The plan must include:
20.3 	(1) a statement of the needs of the vulnerable children, adolescents, and adults who 
20.4 	experience the conditions defined in section 256M.10, subdivision 2, paragraph (a), and 
20.5 	strengths and resources available in the community to address those needs;
20.6 	(2) strategies the county will pursue to achieve the performance targets. Strategies 
20.7 	must include specification of how funds under this section and other community resources 
20.8 	will be used to achieve desired performance targets;
20.9 	(3) a description of the county's process to solicit public input and a summary of 
20.10 	that input;
20.11 	(4) beginning with the service plans submitted for the period from January 1, 2006, 
20.12 	through December 31, 2007, performance targets on statewide indicators for each county 
20.13 	to measure outcomes of children's mental health, and childvulnerable children and adult's 
20.14 	safety, permanency, and well-being. The commissioner shall consult with counties and 
20.15 	other stakeholders to develop these indicators and collect baseline data to inform the 
20.16 	establishment of individual county performance targets for the 2006-2007 2012-2013
20.17 	biennium and subsequent plans years; and
20.18 	(5) a budget for services to be provided with funds under this section. The county 
20.19 	must budget at least 40 percent of funds appropriated under sections 256M.01 to 256M.80
20.20 	for services to ensure the mental health, safety, permanency, and well-being of children 
20.21 	from low-income families. The commissioner may reduce the portion of child and 
20.22 	community services funds that must be budgeted by a county for services to children in 
20.23 	low-income families if:
20.24 	(i) the incidence of children in low-income families within the county's population is 
20.25 	significantly below the statewide median; or
20.26 	(ii) the county has successfully achieved past performance targets for children's 
20.27 	mental health, and child safety, permanency, and well-being and its proposed service plan 
20.28 	is judged by the commissioner to provide an adequate level of service to the population 
20.29 	with less funding.
20.30 		Subd. 3.Continuity of services. In developing the plan required under this section, 
20.31 	a county shall endeavor, within the limits of funds available, to consider the continuing 
20.32 	need for services and programs for children and persons with disabilities that were funded 
20.33 	by the former children's services and community service grants.
20.34 		Subd. 4.Information. The commissioner shall provide each county with 
20.35 	information and technical assistance needed to complete the service plan, including: 
20.36 	information on children's mental health, and child and adult safety, permanency, and 
21.1 	well-being in the county; comparisons with other counties; baseline performance on 
21.2 	outcome measures; and promising program practices.
21.3 		Subd. 5.Timelines. The preliminary service plan must be submitted to the 
21.4 	commissioner by October 15, 2003, and October 15 of every two years thereafter 2011.
21.5 		Subd. 6.Public comment. The county board must determine how citizens in the 
21.6 	county will participate in the development of the service plan and provide opportunities 
21.7 	for such participation. The county must allow a period of no less than 30 days prior to 
21.8 	the submission of the plan to the commissioner to solicit comments from the public on 
21.9 	the contents of the plan.
21.10 		Subd. 7.Commissioner's responsibilities. The commissioner must, within 60 
21.11 	days of receiving each county service plan, inform the county if the service plan has 
21.12 	been approved. If the service plan is not approved, the commissioner must inform the 
21.13 	county of any revisions needed for approval.

21.14 	Sec. 26. Minnesota Statutes 2010, section 256M.40, is amended to read:
21.15 	256M.40 CHILDREN AND COMMUNITY SERVICES GRANT 
21.16 	ALLOCATION.
21.17 		Subdivision 1.Formula. The commissioner shall allocate state funds appropriated 
21.18 	for children and community services grantsunder this chapter to each county board on a 
21.19 	calendar year basis in an amount determined according to the formula in paragraphs 
21.20 	(a) to (c)(e).
21.21 	(a) For July 1, 2003, through December 31, 2003, the commissioner shall allocate 
21.22 	funds to each county equal to that county's allocation for the grants under section 256M.10, 
21.23 	subdivision 5, for calendar year 2003 less payments made on or before June 30, 2003.
21.24 	(b) For calendar year 2004 and 2005, the commissioner shall allocate available funds 
21.25 	to each county in proportion to that county's share of the calendar year 2003 allocations 
21.26 	for the grants under section 256M.10, subdivision 5.
21.27 	(c) For calendar year 2006 and each calendar year thereafter, the commissioner 
21.28 	shall allocate available funds to each county in proportion to that county's share in the 
21.29 	preceding calendar year.
21.30 	(a) For calendar years 2011 and 2012, the commissioner shall allocate available 
21.31 	funds to each county in proportion to that county's share in calendar year 2010.
21.32 	(b) For calendar year 2013, the commissioner shall allocate available funds to each 
21.33 	county as follows:
21.34 	(1) 75 percent must be distributed on the basis of the county share in calendar year 
21.35 	2012;
22.1 	(2) five percent must be distributed on the basis of the number of persons residing in 
22.2 	the county as determined by the most recent data of the state demographer;
22.3 	(3) ten percent must be distributed on the basis of the number of vulnerable children 
22.4 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in 
22.5 	the county as determined by the most recent data of the commissioner; and
22.6 	(4) ten percent must be distributed on the basis of the number of vulnerable adults 
22.7 	that are subjects of reports under section 626.557 in the county as determined by the most 
22.8 	recent data of the commissioner.
22.9 	(c) For calendar year 2014, the commissioner shall allocate available funds to each 
22.10 	county as follows:
22.11 	(1) 50 percent must be distributed on the basis of the county share in calendar year 
22.12 	2012;
22.13 	(2) Ten percent must be distributed on the basis of the number of persons residing in 
22.14 	the county as determined by the most recent data of the state demographer;
22.15 	(3) 20 percent must be distributed on the basis of the number of vulnerable children 
22.16 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the 
22.17 	county as determined by the most recent data of the commissioner; and
22.18 	(4) 20 percent must be distributed on the basis of the number of vulnerable adults 
22.19 	that are subjects of reports under section 626.557 in the county as determined by the most 
22.20 	recent data of the commissioner.
22.21 	(d) For calendar year 2015, the commissioner shall allocate available funds to each 
22.22 	county as follows:
22.23 	(1) 25 percent must be distributed on the basis of the county share in calendar year 
22.24 	2012;
22.25 	(2) 15 percent must be distributed on the basis of the number of persons residing in 
22.26 	the county as determined by the most recent data of the state demographer;
22.27 	(3) 30 percent must be distributed on the basis of the number of vulnerable children 
22.28 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the 
22.29 	county as determined by the most recent data of the commissioner; and
22.30 	(4) 30 percent must be distributed on the basis of the number of vulnerable adults 
22.31 	that are subjects of reports under section 626.557 in the county as determined by the most 
22.32 	recent data of the commissioner.
22.33 	(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall 
22.34 	allocate available funds to each county as follows:
22.35 	(1) 20 percent must be distributed on the basis of the number of persons residing in 
22.36 	the county as determined by the most recent data of the state demographer;
23.1 	(2) 40 percent must be distributed on the basis of the number of vulnerable children 
23.2 	that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the 
23.3 	county as determined by the most recent data of the commissioner; and
23.4 	(3) 40 percent must be distributed on the basis of the number of vulnerable adults 
23.5 	that are subjects of reports under section 626.557 in the county as determined by the most 
23.6 	recent data of the commissioner.
23.7 		Subd. 3.Payments. Calendar year allocations under subdivision 1 shall be paid to 
23.8 	counties on or before July 10 of each year.

23.9 	Sec. 27. Minnesota Statutes 2010, section 256M.50, is amended to read:
23.10 	256M.50 FEDERAL CHILDREN AND COMMUNITY SERVICES GRANT 
23.11 	ALLOCATION.
23.12 	In federal fiscal year 2004 2012 and subsequent years, money for social services 
23.13 	received from the federal government to reimburse counties for social service expenditures 
23.14 	according to Title XX of the Social Security Act shall be allocated to each county 
23.15 	according to section 256M.40, except for funds allocated for administrative purposes and 
23.16 	migrant day care. Title XX funds must not be used for any expenditures prohibited by 
23.17 	section 2005 of the Social Security Act and all federal certification requirements under 
23.18 	title XX must be met by counties receiving title XX funds under this chapter.

23.19 	Sec. 28. Minnesota Statutes 2010, section 256M.60, subdivision 1, is amended to read:
23.20 		Subdivision 1.Responsibilities. The county board of each county shall be 
23.21 	responsible for administration and funding of children and community services as defined 
23.22 	in section 256M.10, subdivision 1. Each county board shall singly or in combination with 
23.23 	other county boards use funds available to the county under Laws 2003, First Special 
23.24 	Session chapter 14, to carry out these responsibilities. The county board shall coordinate 
23.25 	and facilitate the effective use of formal and informal helping systems to best support and 
23.26 	nurture children, adolescents, and adults within the county who experience dependency, 
23.27 	abuse, neglect, poverty, disability, chronic health conditions, or other factors, including 
23.28 	ethnicity and race, that may result in poor outcomes or disparities, as well as services 
23.29 	for family members to support such individuals. This includes assisting individuals 
23.30 	to function at the highest level of ability while maintaining family and community 
23.31 	relationships to the greatest extent possible. 

23.32 	Sec. 29. Minnesota Statutes 2010, section 256M.70, subdivision 2, is amended to read:
24.1 		Subd. 2.Identification of services to be provided. If a county has made reasonable 
24.2 	efforts to provide services according to the service plan under section 256M.30, but funds 
24.3 	appropriated for purposes of sections 256M.01 to 256M.80 are insufficient, then the 
24.4 	county may limit services that do not meet the following criteria while giving the highest 
24.5 	funding priority to clauses (1),and (2), and (3): 
24.6 	(1) services needed to protect individuals from maltreatment, abuse, and neglect;
24.7 	(2) emergency and crisis services needed to protect clients from physical, emotional, 
24.8 	or psychological harm;
24.9 	(3) services that maintain a person in the person's home or least restrictive setting;
24.10 	(4) assessment of persons applying for services and referral to appropriate services 
24.11 	when necessary; and
24.12 	(5) public guardianship services;.
24.13 	(6) case management for persons with developmental disabilities, children with 
24.14 	serious emotional disturbances, and adults with serious and persistent mental illness; and
24.15 	(7) fulfilling licensing responsibilities delegated to the county by the commissioner 
24.16 	under section 245A.16. 

24.17 	Sec. 30. Minnesota Statutes 2010, section 256M.80, is amended to read:
24.18 	256M.80 PROGRAM EVALUATION.
24.19 		Subdivision 1.County evaluation. Each county shall submit to the commissioner 
24.20 	data from the past calendar year on the outcomes and performance indicators in the service 
24.21 	plan. The commissioner shall prescribe standard methods to be used by the counties 
24.22 	in providing the data. The data shall be submitted no later than March 1 of each year, 
24.23 	beginning with March 1, 2005.
24.24 		Subd. 2.Statewide evaluation. Six months after the end of the first full calendar 
24.25 	year and annually thereafter, the commissioner shall prepare a report on make public the 
24.26 	counties' progress in improving the outcomes of  vulnerable children, adolescents, and 
24.27 	adults related to mental health, safety, permanency, and well-being. This report shall be 
24.28 	disseminated throughout the state.

24.29 	Sec. 31. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:
24.30 		Subd. 10a.Expedited issuance of food stamps. The commissioner of human 
24.31 	services shall continually monitor the expedited issuance of food stamp benefits to ensure 
24.32 	that each county complies with federal regulations and that households eligible for 
24.33 	expedited issuance of food stamps are identified, processed, and certified within the time 
24.34 	frames prescribed in federal regulations.
25.1 	County food stamp offices shall screen and issue food stamps to applicants on the 
25.2 	day of application. Applicants who meet the federal criteria for expedited issuance and 
25.3 	have an immediate need for food assistance shall receive either: within five working days
25.4 	(1) a manual Authorization to Participate (ATP) card; or
25.5 	(2) the immediate issuance of food stamp coupons benefits.
25.6 	The local food stamp agency shall conspicuously post in each food stamp office a 
25.7 	notice of the availability of and the procedure for applying for expedited issuance and 
25.8 	verbally advise each applicant of the availability of the expedited process.

25.9 	Sec. 32. Minnesota Statutes 2010, section 518A.51, is amended to read:
25.10 	518A.51 FEES FOR IV-D SERVICES.
25.11 	(a) When a recipient of IV-D services is no longer receiving assistance under the 
25.12 	state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the 
25.13 	public authority responsible for child support enforcement must notify the recipient, 
25.14 	within five working days of the notification of ineligibility, that IV-D services will be 
25.15 	continued unless the public authority is notified to the contrary by the recipient. The 
25.16 	notice must include the implications of continuing to receive IV-D services, including the 
25.17 	available services and fees, cost recovery fees, and distribution policies relating to fees.
25.18 	(b) An application fee of $25 shall be paid by the person who applies for child 
25.19 	support and maintenance collection services, except persons who are receiving public 
25.20 	assistance as defined in section 256.741 and the diversionary work program under section 
25.21 	256J.95, persons who transfer from public assistance to nonpublic assistance status, and 
25.22 	minor parents and parents enrolled in a public secondary school, area learning center, or 
25.23 	alternative learning program approved by the commissioner of education.
25.24 	(c) In the case of an individual who has never received assistance under a state 
25.25 	program funded under title IV-A of the Social Security Act and for whom the public 
25.26 	authority has collected at least $500 of support, the public authority must impose an 
25.27 	annual federal collections fee of $25 for each case in which services are furnished. This 
25.28 	fee must be retained by the public authority from support collected on behalf of the 
25.29 	individual, but not from the first $500 collected.
25.30 	(d) When the public authority provides full IV-D services to an obligee who has 
25.31 	applied for those services, upon written notice to the obligee, the public authority must 
25.32 	charge a cost recovery fee of one two percent of the amount collected. This fee must 
25.33 	be deducted from the amount of the child support and maintenance collected and not 
25.34 	assigned under section 256.741 before disbursement to the obligee. This fee does not 
25.35 	apply to an obligee who:
26.1 	(1) is currently receiving assistance under the state's title IV-A, IV-E foster care, 
26.2 	medical assistance, or MinnesotaCare programs; or
26.3 	(2) has received assistance under the state's title IV-A or IV-E foster care programs, 
26.4 	until the person has not received this assistance for 24 consecutive months.
26.5 	 (e) When the public authority provides full IV-D services to an obligor who has 
26.6 	applied for such services, upon written notice to the obligor, the public authority must 
26.7 	charge a cost recovery fee of one two percent of the monthly court-ordered child support 
26.8 	and maintenance obligation. The fee may be collected through income withholding, as 
26.9 	well as by any other enforcement remedy available to the public authority responsible for 
26.10 	child support enforcement.
26.11 	 (f) Fees assessed by state and federal tax agencies for collection of overdue support 
26.12 	owed to or on behalf of a person not receiving public assistance must be imposed on the 
26.13 	person for whom these services are provided. The public authority upon written notice to 
26.14 	the obligee shall assess a fee of $25 to the person not receiving public assistance for each 
26.15 	successful federal tax interception. The fee must be withheld prior to the release of the 
26.16 	funds received from each interception and deposited in the general fund.
26.17 	 (g) Federal collections fees collected under paragraph (c) and cost recovery 
26.18 	fees collected under paragraphs (d) and (e) retained by the commissioner of human 
26.19 	services shall be considered child support program income according to Code of Federal 
26.20 	Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund 
26.21 	account established under paragraph (i). The commissioner of human services must elect 
26.22 	to recover costs based on either actual or standardized costs.
26.23 	 (h) The limitations of this section on the assessment of fees shall not apply to 
26.24 	the extent inconsistent with the requirements of federal law for receiving funds for the 
26.25 	programs under title IV-A and title IV-D of the Social Security Act, United States Code, 
26.26 	title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
26.27 	 (i) The commissioner of human services is authorized to establish a special revenue 
26.28 	fund account to receive the federal collections fees collected under paragraph (c) and cost 
26.29 	recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of 
26.30 	these fees may be retained for expenditures necessary to administer the fees and must be 
26.31 	transferred to the child support system special revenue account. The remaining nonfederal 
26.32 	share of the federal collections fees and cost recovery fees must be retained by the 
26.33 	commissioner and dedicated to the child support general fund county performance-based 
26.34 	grant account authorized under sections 256.979 and 256.9791.
26.35 	(j) The nonfederal share of the cost recovery fee revenue must be retained by the 
26.36 	commissioner and distributed as follows:
27.1 	(1) one-half of the revenue must be transferred to the child support system special 
27.2 	revenue account to support the state's administration of the child support enforcement 
27.3 	program and its federally mandated automated system;
27.4 	(2) an additional portion of the revenue must be transferred to the child support 
27.5 	system special revenue account for expenditures necessary to administer the fees; and
27.6 	(3) the remaining portion of the revenue must be distributed to the counties to aid the 
27.7 	counties in funding their child support enforcement programs.
27.8 	(k) The nonfederal share of the federal collections fees must be distributed to the 
27.9 	counties to aid them in funding their child support enforcement programs.
27.10 	(l) The commissioner of human services shall distribute quarterly any of the funds 
27.11 	dedicated to the counties under paragraphs (j) and (k) using the methodology specified in 
27.12 	section 256.979, subdivision 11. The funds received by the counties must be reinvested in 
27.13 	the child support enforcement program and the counties must not reduce the funding of 
27.14 	their child support programs by the amount of the funding distributed.

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

27.16 	Sec. 33. REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES, 
27.17 	GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.
 27.18 	Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must 
27.19 	negotiate with their third-party processors to block EBT card cash transactions at their 
27.20 	places of business and withdrawals of cash at automatic teller machines located in their 
27.21 	places of business.

27.22 	Sec. 34. MINNESOTA EBT BUSINESS TASK FORCE.
 27.23 		Subdivision 1.Members. The Minnesota EBT Business Task Force includes seven 
27.24 	members, appointed as follows:
27.25 	(1) two members of the Minnesota house of representatives appointed by the speaker 
27.26 	of the house;
27.27 	(2) two members of the Minnesota senate appointed by the senate majority leader;
27.28 	(3) the commissioner of human services, or designee;
27.29 	(4) an appointee of the Minnesota Grocers Association; and
27.30 	(5) a credit card processor, appointed by the commissioner of human services.
27.31 		Subd. 2.Duties. The Minnesota EBT Business Task Force shall create a workable 
27.32 	strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the 
27.33 	general assistance program and Minnesota supplemental aid program under Minnesota 
27.34 	Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT 
28.1 	cards. The task force will consider cost to the state, feasibility of execution at retail, and 
28.2 	ease of use and privacy for EBT cardholders.
28.3 		Subd. 3.Report. The task force will report back to the legislative committees with 
28.4 	jurisdiction over health and human services policy and finance by April 1, 2012, with 
28.5 	recommendations related to the task force duties under subdivision 2.
28.6 		Subd. 4.Expiration. The task force expires on June 30, 2012.

28.7 	Sec. 35.  REPEALER.
 28.8 	(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; and 
28.9 	256.9791, are repealed effective retroactively from July 1, 2011.
28.10 	(b) Minnesota Statutes 2010, sections 256M.10, subdivision 5; 256M.60, subdivision 
28.11 	2; and 256M.70, subdivision 1, are repealed.
28.12 	(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September 
28.13 	3, 2012.
28.14 	(d) Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, are 
28.15 	repealed effective November 1, 2011.

28.16 	ARTICLE 2
28.17 	DEPARTMENT OF HEALTH

28.18 	Section 1. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
28.19 		Subd. 3.Cost containment duties. The commissioner shall:
28.20 	(1) establish statewide and regional cost containment goals for total health care 
28.21 	spending under this section and collect data as described in sections 62J.38to 62J.41 and 
28.22 	62J.40 to monitor statewide achievement of the cost containment goals; 
28.23 	(2) divide the state into no fewer than four regions, with one of those regions being 
28.24 	the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 
28.25 	Wright, and Sherburne Counties, for purposes of fostering the development of regional 
28.26 	health planning and coordination of health care delivery among regional health care 
28.27 	systems and working to achieve the cost containment goals;
28.28 	(3) monitor the quality of health care throughout the state and take action as 
28.29 	necessary to ensure an appropriate level of quality;
28.30 	(4) issue recommendations regarding uniform billing forms, uniform electronic 
28.31 	billing procedures and data interchanges, patient identification cards, and other uniform 
28.32 	claims and administrative procedures for health care providers and private and public 
28.33 	sector payers. In developing the recommendations, the commissioner shall review the 
28.34 	work of the work group on electronic data interchange (WEDI) and the American National 
29.1 	Standards Institute (ANSI) at the national level, and the work being done at the state and 
29.2 	local level. The commissioner may adopt rules requiring the use of the Uniform Bill 
29.3 	82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 
29.4 	version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 
29.5 	forms or procedures;
29.6 	(5) undertake health planning responsibilities;
29.7 	(6) authorize, fund, or promote research and experimentation on new technologies 
29.8 	and health care procedures;
29.9 	(7) within the limits of appropriations for these purposes, administer or contract for 
29.10 	statewide consumer education and wellness programs that will improve the health of 
29.11 	Minnesotans and increase individual responsibility relating to personal health and the 
29.12 	delivery of health care services, undertake prevention programs including initiatives to 
29.13 	improve birth outcomes, expand childhood immunization efforts, and provide start-up 
29.14 	grants for worksite wellness programs;
29.15 	(8) undertake other activities to monitor and oversee the delivery of health care 
29.16 	services in Minnesota with the goal of improving affordability, quality, and accessibility of 
29.17 	health care for all Minnesotans; and
29.18 	(9) make the cost containment goal data available to the public in a 
29.19 	consumer-oriented manner.

29.20 	Sec. 2. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
29.21 		Subd. 4a.Expenditure reporting. Each hospital, outpatient surgical center, 
29.22 	diagnostic imaging center, and physician clinic shall report annually to the commissioner 
29.23 	on all major spending commitments, in the form and manner specified by the 
29.24 	commissioner. The report shall include the following information:
29.25 	(a) a description of major spending commitments made during the previous year, 
29.26 	including the total dollar amount of major spending commitments and purpose of the 
29.27 	expenditures;
29.28 	(b) the cost of land acquisition, construction of new facilities, and renovation of 
29.29 	existing facilities;
29.30 	(c) the cost of purchased or leased medical equipment, by type of equipment;
29.31 	(d) expenditures by type for specialty care and new specialized services;
29.32 	(e) information on the amount and types of added capacity for diagnostic imaging 
29.33 	services, outpatient surgical services, and new specialized services; and
29.34 	(f) information on investments in electronic medical records systems.
30.1 	For hospitals and outpatient surgical centers, this information shall be included in reports 
30.2 	to the commissioner that are required under section 144.698. For diagnostic imaging 
30.3 	centers, this information shall be included in reports to the commissioner that are required 
30.4 	under section 144.565. For physician clinics, this information shall be included in reports 
30.5 	to the commissioner that are required under section 62J.41. For all other health care 
30.6 	providers that are subject to this reporting requirement, reports must be submitted to the 
30.7 	commissioner by March 1 each year for the preceding calendar year.

30.8 	Sec. 3. Minnesota Statutes 2010, section 62J.692, is amended to read:
30.9 	62J.692 MEDICAL EDUCATION.
30.10 		Subdivision 1.Definitions. For purposes of this section, the following definitions 
30.11 	apply:
30.12 	(a) "Accredited clinical training" means the clinical training provided by a 
30.13 	medical education program that is accredited through an organization recognized by the 
30.14 	Department of Education, the Centers for Medicare and Medicaid Services, or another 
30.15 	national body who reviews the accrediting organizations for multiple disciplines and 
30.16 	whose standards for recognizing accrediting organizations are reviewed and approved by 
30.17 	the commissioner of health in consultation with the Medical Education and Research 
30.18 	Advisory Committee.
30.19 	(b) "Commissioner" means the commissioner of health.
30.20 	(c) "Clinical medical education program" means the accredited clinical training of 
30.21 	physicians (medical students and residents), doctor of pharmacy practitioners, doctors 
30.22 	of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 
30.23 	registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 
30.24 	physician assistants.
30.25 	(d) "Sponsoring institution" means a hospital, school, or consortium located in 
30.26 	Minnesota that sponsors and maintains primary organizational and financial responsibility 
30.27 	for a clinical medical education program in Minnesota and which is accountable to the 
30.28 	accrediting body.
30.29 	(e) "Teaching institution" means a hospital, medical center, clinic, or other 
30.30 	organization that conducts a clinical medical education program in Minnesota.
30.31 	(f) "Trainee" means a student or resident involved in a clinical medical education 
30.32 	program.
30.33 	(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time 
30.34 	equivalent counts, that are at training sites located in Minnesota with currently active 
30.35 	medical assistance enrollment status and a National Provider Identification (NPI) number 
31.1 	where training occurs in either an inpatient or ambulatory patient care setting and where 
31.2 	the training is funded, in part, by patient care revenues. Training that occurs in nursing 
31.3 	facility settings is not eligible for funding under this section.
31.4 		Subd. 3.Application process. (a) A clinical medical education program 
31.5 	conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy 
31.6 	practitioners, dentists, chiropractors, or physician assistants is eligible for funds under 
31.7 	subdivision 4 if the program:
31.8 	(1) is funded, in part, by patient care revenues;
31.9 	(2) occurs in patient care settings that face increased financial pressure as a result 
31.10 	of competition with nonteaching patient care entities; and
31.11 	(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
31.12 	A clinical medical education program that trains pediatricians is requested to include 
31.13 	in its program curriculum training in case management and medication management for 
31.14 	children suffering from mental illness to be eligible for funds under subdivision 4.
31.15 	(b) A clinical medical education program for advanced practice nursing is eligible for 
31.16 	funds under subdivision 4 if the program meets the eligibility requirements in paragraph 
31.17 	(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health 
31.18 	Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges 
31.19 	and Universities system or members of the Minnesota Private College Council.
31.20 	(c) Applications must be submitted to the commissioner by a sponsoring institution 
31.21 	on behalf of an eligible clinical medical education program and must be received by 
31.22 	October 31 of each year for distribution in the following year. An application for funds 
31.23 	must contain the following information:
31.24 	(1) the official name and address of the sponsoring institution and the official 
31.25 	name and site address of the clinical medical education programs on whose behalf the 
31.26 	sponsoring institution is applying;
31.27 	(2) the name, title, and business address of those persons responsible for 
31.28 	administering the funds;
31.29 	(3) for each clinical medical education program for which funds are being sought; 
31.30 	the type and specialty orientation of trainees in the program; the name, site address, and 
31.31 	medical assistance provider number and national provider identification number of each 
31.32 	training site used in the program; the federal tax identification number of each training site 
31.33 	used in the program, where available; the total number of trainees at each training site; and 
31.34 	the total number of eligible trainee FTEs at each site; and
32.1 	(4) other supporting information the commissioner deems necessary to determine 
32.2 	program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the 
32.3 	equitable distribution of funds.
32.4 	(d) An application must include the information specified in clauses (1) to (3) for 
32.5 	each clinical medical education program on an annual basis for three consecutive years. 
32.6 	After that time, an application must include the information specified in clauses (1) to (3) 
32.7 	when requested, at the discretion of the commissioner:
32.8 	(1) audited clinical training costs per trainee for each clinical medical education 
32.9 	program when available or estimates of clinical training costs based on audited financial 
32.10 	data;
32.11 	(2) a description of current sources of funding for clinical medical education costs, 
32.12 	including a description and dollar amount of all state and federal financial support, 
32.13 	including Medicare direct and indirect payments; and
32.14 	(3) other revenue received for the purposes of clinical training.
32.15 	(e) An applicant that does not provide information requested by the commissioner 
32.16 	shall not be eligible for funds for the current funding cycle.
32.17 		Subd. 4.Distribution of funds. (a) Following the distribution described under 
32.18 	paragraph (b), The commissioner shall annually distribute the available medical education 
32.19 	funds to all qualifying applicants based on a distribution formula that reflects a summation 
32.20 	of two factors:
32.21 	(1) a public program volume factor, which is determined by the total volume of 
32.22 	public program revenue received by each training site as a percentage of all public 
32.23 	program revenue received by all training sites in the fund pool; and
32.24 	(2) a supplemental public program volume factor, which is determined by providing 
32.25 	a supplemental payment of 20 percent of each training site's grant to training sites whose 
32.26 	public program revenue accounted for at least 0.98 percent of the total public program 
32.27 	revenue received by all eligible training sites. Grants to training sites whose public 
32.28 	program revenue accounted for less than 0.98 percent of the total public program revenue 
32.29 	received by all eligible training sites shall be reduced by an amount equal to the total 
32.30 	value of the supplemental payment.
32.31 	Public program revenue for the distribution formula includes revenue from medical 
32.32 	assistance, prepaid medical assistance, general assistance medical care, and prepaid 
32.33 	general assistance medical care. Training sites that receive no public program revenue 
32.34 	are ineligible for funds available under this subdivision. For purposes of determining 
32.35 	training-site level grants to be distributed under paragraph (a), total statewide average 
32.36 	costs per trainee for medical residents is based on audited clinical training costs per trainee 
33.1 	in primary care clinical medical education programs for medical residents. Total statewide 
33.2 	average costs per trainee for dental residents is based on audited clinical training costs 
33.3 	per trainee in clinical medical education programs for dental students. Total statewide 
33.4 	average costs per trainee for pharmacy residents is based on audited clinical training costs 
33.5 	per trainee in clinical medical education programs for pharmacy students. Training sites 
33.6 	whose training site level grant is less than $1,000, based on the formula described in this 
33.7 	paragraph, are ineligible for funds available under this subdivision.
33.8 	(b) $5,350,000 of the available medical education funds shall be distributed as 
33.9 	follows:
33.10 	(1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
33.11 	(2) $2,075,000 to the University of Minnesota School of Dentistry; and
33.12 	(3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to 
33.13 	the Academic Health Center under this paragraph shall be used for a program to assist 
33.14 	internationally trained physicians who are legal residents and who commit to serving 
33.15 	underserved Minnesota communities in a health professional shortage area to successfully 
33.16 	compete for family medicine residency programs at the University of Minnesota.
33.17 	(c) (b) Funds distributed shall not be used to displace current funding appropriations 
33.18 	from federal or state sources.
33.19 	(d) (c) Funds shall be distributed to the sponsoring institutions indicating the amount 
33.20 	to be distributed to each of the sponsor's clinical medical education programs based on 
33.21 	the criteria in this subdivision and in accordance with the commissioner's approval letter. 
33.22 	Each clinical medical education program must distribute funds allocated under paragraph 
33.23 	(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 
33.24 	institutions, which are accredited through an organization recognized by the Department 
33.25 	of Education or the Centers for Medicare and Medicaid Services, may contract directly 
33.26 	with training sites to provide clinical training. To ensure the quality of clinical training, 
33.27 	those accredited sponsoring institutions must:
33.28 	(1) develop contracts specifying the terms, expectations, and outcomes of the clinical 
33.29 	training conducted at sites; and
33.30 	(2) take necessary action if the contract requirements are not met. Action may 
33.31 	include the withholding of payments under this section or the removal of students from 
33.32 	the site.
33.33 	(e) (d) Any funds not distributed in accordance with the commissioner's approval 
33.34 	letter must be returned to the medical education and research fund within 30 days of 
33.35 	receiving notice from the commissioner. The commissioner shall distribute returned funds 
33.36 	to the appropriate training sites in accordance with the commissioner's approval letter.
34.1 	(f) (e) A maximum of $150,000 of the funds dedicated to the commissioner 
34.2 	under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for 
34.3 	administrative expenses associated with implementing this section.
34.4 		Subd. 5.Report. (a) Sponsoring institutions receiving funds under this section 
34.5 	must sign and submit a medical education grant verification report (GVR) to verify that 
34.6 	the correct grant amount was forwarded to each eligible training site. If the sponsoring 
34.7 	institution fails to submit the GVR by the stated deadline, or to request and meet 
34.8 	the deadline for an extension, the sponsoring institution is required to return the full 
34.9 	amount of funds received to the commissioner within 30 days of receiving notice from 
34.10 	the commissioner. The commissioner shall distribute returned funds to the appropriate 
34.11 	training sites in accordance with the commissioner's approval letter.
34.12 	(b) The reports must provide verification of the distribution of the funds and must 
34.13 	include:
34.14 	(1) the total number of eligible trainee FTEs in each clinical medical education 
34.15 	program;
34.16 	(2) the name of each funded program and, for each program, the dollar amount 
34.17 	distributed to each training site;
34.18 	(3) documentation of any discrepancies between the initial grant distribution notice 
34.19 	included in the commissioner's approval letter and the actual distribution;
34.20 	(4) a statement by the sponsoring institution stating that the completed grant 
34.21 	verification report is valid and accurate; and
34.22 	(5) other information the commissioner, with advice from the advisory committee, 
34.23 	deems appropriate to evaluate the effectiveness of the use of funds for medical education.
34.24 	(c) By February 15 of each year, the commissioner, with advice from the 
34.25 	advisory committee, shall provide an annual summary report to the legislature on the 
34.26 	implementation of this section.
34.27 		Subd. 6.Other available funds. The commissioner is authorized to distribute, in 
34.28 	accordance with subdivision 4, funds made available through:
34.29 	(1) voluntary contributions by employers or other entities;
34.30 	(2) allocations for the commissioner of human services to support medical education 
34.31 	and research; and
34.32 	(3) other sources as identified and deemed appropriate by the legislature for 
34.33 	inclusion in the fund.
34.34 		Subd. 7.Transfers from the commissioner of human services. Of the amount 
34.35 	transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4), 
34.36 	$21,714,000 shall be distributed as follows:
35.1 	(1) $2,157,000 shall be distributed by the commissioner to the University of 
35.2 	Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
35.3 	(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County 
35.4 	Medical Center for clinical medical education;
35.5 	(3) $17,400,000 shall be distributed by the commissioner to the University of 
35.6 	Minnesota Board of Regents for purposes of medical education;
35.7 	(4) $1,121,640 shall be distributed by the commissioner to clinical medical education 
35.8 	dental innovation grants in accordance with subdivision 7a; and
35.9 	(5) the remainder of the amount transferred according to section 256B.69, 
35.10 	subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to 
35.11 	clinical medical education programs that meet the qualifications of subdivision 3 based on 
35.12 	the formula in subdivision 4, paragraph (a).
35.13 		Subd. 7a.Clinical medical education innovations grants. (a) The commissioner 
35.14 	shall award grants to teaching institutions and clinical training sites for projects that 
35.15 	increase dental access for underserved populations and promote innovative clinical 
35.16 	training of dental professionals. In awarding the grants, the commissioner, in consultation 
35.17 	with the commissioner of human services, shall consider the following:
35.18 	(1) potential to successfully increase access to an underserved population;
35.19 	(2) the long-term viability of the project to improve access beyond the period 
35.20 	of initial funding;
35.21 	(3) evidence of collaboration between the applicant and local communities;
35.22 	(4) the efficiency in the use of the funding; and
35.23 	(5) the priority level of the project in relation to state clinical education, access, 
35.24 	and workforce goals.
35.25 	(b) The commissioner shall periodically evaluate the priorities in awarding the 
35.26 	innovations grants in order to ensure that the priorities meet the changing workforce 
35.27 	needs of the state.
35.28 		Subd. 8.Federal financial participation.  The commissioner of human services 
35.29 	shall seek to maximize federal financial participation in payments for medical education 
35.30 	and research costs.
35.31 	The commissioner shall use physician clinic rates where possible to maximize 
35.32 	federal financial participation. Any additional funds that become available must be 
35.33 	distributed under subdivision 4, paragraph (a).
35.34 		Subd. 9.Review of eligible providers. The commissioner and the Medical 
35.35 	Education and Research Costs Advisory Committee may review provider groups included 
35.36 	in the definition of a clinical medical education program to assure that the distribution of 
36.1 	the funds continue to be consistent with the purpose of this section. The results of any 
36.2 	such reviews must be reported to the Legislative Commission on Health Care Access.

36.3 	Sec. 4. [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING 
36.4 	MEASURES.
36.5 		Subdivision 1.Data from providers. (a) By July 1, 2012, the commissioner 
36.6 	shall review currently available quality measures and make recommendations for future 
36.7 	measurement aimed at improving assessment and care related to Alzheimer's disease and 
36.8 	other dementia diagnoses, including improved rates and results of cognitive screening, 
36.9 	rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment 
36.10 	plans.
36.11 	(b) The commissioner may contract with a private entity to complete the 
36.12 	requirements in this subdivision. If the commissioner contracts with a private entity 
36.13 	already under contract through section 62U.02, then the commissioner may use a sole 
36.14 	source contract and is exempt from competitive procurement processes.
36.15 		Subd. 2.Learning collaborative. By July 1, 2012, the commissioner shall 
36.16 	develop a health care home learning collaborative curriculum that includes screening and 
36.17 	education on best practices regarding identification and management of Alzheimer's and 
36.18 	other dementia patients under section 256B.0751, subdivision 5, for providers, clinics, 
36.19 	care coordinators, clinic administrators, patient partners and families, and community 
36.20 	resources including public health.
36.21 		Subd. 3.Comparison data. The commissioner, with the commissioner of human 
36.22 	services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly 
36.23 	review existing and forthcoming literature in order to estimate differences in the outcomes 
36.24 	and costs of current practices for caring for those with Alzheimer's disease and other 
36.25 	dementias, compared to the outcomes and costs resulting from:
36.26 	(1) earlier identification of Alzheimer's and other dementias;
36.27 	(2) improved support of family caregivers; and
36.28 	(3) improved collaboration between medical care management and community-based 
36.29 	supports.
36.30 		Subd. 4.Reporting. By January 15, 2013, the commissioner must report to the 
36.31 	legislature on progress toward establishment and collection of quality measures required 
36.32 	under this section.

36.33 	Sec. 5. Minnesota Statutes 2010, section 103I.101, subdivision 6, is amended to read:
37.1 		Subd. 6.Fees for variances. The commissioner shall charge a nonrefundable 
37.2 	application fee of $215 $235 to cover the administrative cost of processing a request for a 
37.3 	variance or modification of rules adopted by the commissioner under this chapter.

37.4 	Sec. 6. Minnesota Statutes 2010, section 103I.208, subdivision 1, is amended to read:
37.5 		Subdivision 1.Well notification fee. The well notification fee to be paid by a 
37.6 	property owner is:
37.7 	(1) for a new water supply well, $215 $235, which includes the state core function 
37.8 	fee;
37.9 	(2) for a well sealing, $50 $65 for each well, which includes the state core function 
37.10 	fee, except that for monitoring wells constructed on a single property, having depths 
37.11 	within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of 
37.12 	$50 $65; and
37.13 	(3) for construction of a dewatering well, $215 $235, which includes the state core 
37.14 	function fee, for each dewatering well except a dewatering project comprising five or 
37.15 	more dewatering wells shall be assessed a single fee of $1,075 $1,175 for the dewatering 
37.16 	wells recorded on the notification.

37.17 	Sec. 7. Minnesota Statutes 2010, section 103I.208, subdivision 2, is amended to read:
37.18 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
37.19 	(1) for a water supply well that is not in use under a maintenance permit, $175 
37.20 	annually;
37.21 	(2) for construction of a monitoring well, $215 $235, which includes the state 
37.22 	core function fee;
37.23 	(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
37.24 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
37.25 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
37.26 	government" means a statutory or home rule charter city, town, county, or soil and water 
37.27 	conservation district, watershed district, an organization formed for the joint exercise of 
37.28 	powers under section 471.59, a board of health or community health board, or other 
37.29 	special purpose district or authority with local jurisdiction in water and related land 
37.30 	resources management;
37.31 	(5) for monitoring wells used as a leak detection device at a single motor fuel retail 
37.32 	outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 
37.33 	chemical facility site, the construction permit fee is $215 $235, which includes the state 
37.34 	core function fee, per site regardless of the number of wells constructed on the site, and 
38.1 	the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site 
38.2 	regardless of the number of monitoring wells located on site;
38.3 	(6) for a groundwater thermal exchange device, in addition to the notification fee for 
38.4 	water supply wells, $215 $235, which includes the state core function fee;
38.5 	(7) for a vertical heat exchanger with less than ten tons of heating/cooling capacity, 
38.6 	$215 $235;
38.7 	(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, 
38.8 	$425 $475;
38.9 	(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling 
38.10 	capacity, $650 $700;
38.11 	(10) for a dewatering well that is unsealed under a maintenance permit, $175 
38.12 	annually for each dewatering well, except a dewatering project comprising more than five 
38.13 	dewatering wells shall be issued a single permit for $875 annually for dewatering wells 
38.14 	recorded on the permit; and
38.15 	(11) for an elevator boring, $215 $235 for each boring.

38.16 	Sec. 8. Minnesota Statutes 2010, section 103I.235, subdivision 1, is amended to read:
38.17 		Subdivision 1.Disclosure of wells to buyer. (a) Before signing an agreement to 
38.18 	sell or transfer real property, the seller must disclose in writing to the buyer information 
38.19 	about the status and location of all known wells on the property, by delivering to the buyer 
38.20 	either a statement by the seller that the seller does not know of any wells on the property, 
38.21 	or a disclosure statement indicating the legal description and county, and a map drawn 
38.22 	from available information showing the location of each well to the extent practicable. 
38.23 	In the disclosure statement, the seller must indicate, for each well, whether the well is in 
38.24 	use, not in use, or sealed.
38.25 	(b) At the time of closing of the sale, the disclosure statement information, name and 
38.26 	mailing address of the buyer, and the quartile, section, township, and range in which each 
38.27 	well is located must be provided on a well disclosure certificate signed by the seller or a 
38.28 	person authorized to act on behalf of the seller.
38.29 	(c) A well disclosure certificate need not be provided if the seller does not know 
38.30 	of any wells on the property and the deed or other instrument of conveyance contains 
38.31 	the statement: "The Seller certifies that the Seller does not know of any wells on the 
38.32 	described real property."
38.33 	(d) If a deed is given pursuant to a contract for deed, the well disclosure certificate 
38.34 	required by this subdivision shall be signed by the buyer or a person authorized to act on 
38.35 	behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure 
39.1 	certificate is not required if the following statement appears on the deed followed by the 
39.2 	signature of the grantee or, if there is more than one grantee, the signature of at least one 
39.3 	of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the 
39.4 	described real property." The statement and signature of the grantee may be on the front 
39.5 	or back of the deed or on an attached sheet and an acknowledgment of the statement by 
39.6 	the grantee is not required for the deed to be recordable.
39.7 	(e) This subdivision does not apply to the sale, exchange, or transfer of real property:
39.8 	(1) that consists solely of a sale or transfer of severed mineral interests; or
39.9 	(2) that consists of an individual condominium unit as described in chapters 515 
39.10 	and 515B.
39.11 	(f) For an area owned in common under chapter 515 or 515B the association or other 
39.12 	responsible person must report to the commissioner by July 1, 1992, the location and 
39.13 	status of all wells in the common area. The association or other responsible person must 
39.14 	notify the commissioner within 30 days of any change in the reported status of wells.
39.15 	(g) If the seller fails to provide a required well disclosure certificate, the buyer, or 
39.16 	a person authorized to act on behalf of the buyer, may sign a well disclosure certificate 
39.17 	based on the information provided on the disclosure statement required by this section 
39.18 	or based on other available information.
39.19 	(h) A county recorder or registrar of titles may not record a deed or other instrument 
39.20 	of conveyance dated after October 31, 1990, for which a certificate of value is required 
39.21 	under section 272.115, or any deed or other instrument of conveyance dated after October 
39.22 	31, 1990, from a governmental body exempt from the payment of state deed tax, unless 
39.23 	the deed or other instrument of conveyance contains the statement made in accordance 
39.24 	with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all 
39.25 	the information required by paragraph (b) or (d). The county recorder or registrar of titles 
39.26 	must not accept a certificate unless it contains all the required information. The county 
39.27 	recorder or registrar of titles shall note on each deed or other instrument of conveyance 
39.28 	accompanied by a well disclosure certificate that the well disclosure certificate was 
39.29 	received. The notation must include the statement "No wells on property" if the disclosure 
39.30 	certificate states there are no wells on the property. The well disclosure certificate shall not 
39.31 	be filed or recorded in the records maintained by the county recorder or registrar of titles. 
39.32 	After noting "No wells on property" on the deed or other instrument of conveyance, the 
39.33 	county recorder or registrar of titles shall destroy or return to the buyer the well disclosure 
39.34 	certificate. The county recorder or registrar of titles shall collect from the buyer or the 
39.35 	person seeking to record a deed or other instrument of conveyance, a fee of $45 $50
39.36 	for receipt of a completed well disclosure certificate. By the tenth day of each month, 
40.1 	the county recorder or registrar of titles shall transmit the well disclosure certificates 
40.2 	to the commissioner of health. By the tenth day after the end of each calendar quarter, 
40.3 	the county recorder or registrar of titles shall transmit to the commissioner of health 
40.4 	$37.50 $42.50 of the fee for each well disclosure certificate received during the quarter. 
40.5 	The commissioner shall maintain the well disclosure certificate for at least six years. The 
40.6 	commissioner may store the certificate as an electronic image. A copy of that image 
40.7 	shall be as valid as the original.
40.8 	(i) No new well disclosure certificate is required under this subdivision if the buyer 
40.9 	or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed 
40.10 	or other instrument of conveyance that the status and number of wells on the property 
40.11 	have not changed since the last previously filed well disclosure certificate. The following 
40.12 	statement, if followed by the signature of the person making the statement, is sufficient 
40.13 	to comply with the certification requirement of this paragraph: "I am familiar with the 
40.14 	property described in this instrument and I certify that the status and number of wells on 
40.15 	the described real property have not changed since the last previously filed well disclosure 
40.16 	certificate." The certification and signature may be on the front or back of the deed or on 
40.17 	an attached sheet and an acknowledgment of the statement is not required for the deed or 
40.18 	other instrument of conveyance to be recordable.
40.19 	(j) The commissioner in consultation with county recorders shall prescribe the form 
40.20 	for a well disclosure certificate and provide well disclosure certificate forms to county 
40.21 	recorders and registrars of titles and other interested persons.
40.22 	(k) Failure to comply with a requirement of this subdivision does not impair:
40.23 	(1) the validity of a deed or other instrument of conveyance as between the parties 
40.24 	to the deed or instrument or as to any other person who otherwise would be bound by 
40.25 	the deed or instrument; or
40.26 	(2) the record, as notice, of any deed or other instrument of conveyance accepted for 
40.27 	filing or recording contrary to the provisions of this subdivision.

40.28 	Sec. 9. Minnesota Statutes 2010, section 103I.525, subdivision 2, is amended to read:
40.29 		Subd. 2.Certification application fee. (a) The application fee for certification 
40.30 	as a representative of a well contractor is $75. The commissioner may not act on an 
40.31 	application until the application fee is paid.
40.32 	(b) The renewal fee for certification as a representative of a well contractor is $75. 
40.33 	The commissioner may not renew a certification until the renewal fee is paid.

40.34 	Sec. 10. Minnesota Statutes 2010, section 103I.531, subdivision 2, is amended to read:
41.1 		Subd. 2.Certification application fee. (a) The application fee for certification as a 
41.2 	representative of a limited well/boring contractor is $75. The commissioner may not act 
41.3 	on an application until the application fee is paid.
41.4 	(b) The renewal fee for certification as a representative of a limited well/boring 
41.5 	contractor is $75. The commissioner may not renew a certification until the renewal 
41.6 	fee is paid.

41.7 	Sec. 11. Minnesota Statutes 2010, section 103I.535, subdivision 2, is amended to read:
41.8 		Subd. 2.Certification application fee. (a) The application fee for certification as a 
41.9 	representative of an elevator boring contractor is $75. The commissioner may not act on 
41.10 	an application until the application fee is paid.
41.11 	(b) The renewal fee for certification as a representative of an elevator boring 
41.12 	contractor is $75. The commissioner may not renew a certification until the renewal 
41.13 	fee is paid.

41.14 	Sec. 12. Minnesota Statutes 2010, section 103I.541, subdivision 2c, is amended to read:
41.15 		Subd. 2c.Certification application fee. (a) The application fee for certification as a 
41.16 	representative of a monitoring well contractor is $75. The commissioner may not act on 
41.17 	an application until the application fee is paid.
41.18 	(b) The renewal fee for certification as a representative of a monitoring well 
41.19 	contractor is $75. The commissioner may not renew a certification until the renewal 
41.20 	fee is paid.

41.21 	Sec. 13. Minnesota Statutes 2010, section 144.1464, subdivision 1, is amended to read:
41.22 		Subdivision 1.Summer internships. The commissioner of health, through a 
41.23 	contract with a nonprofit organization as required by subdivision 4, shall award grants, 
41.24 	within available appropriations, to hospitals, clinics, nursing facilities, and home care 
41.25 	providers to establish a secondary and postsecondary summer health care intern program. 
41.26 	The purpose of the program is to expose interested secondary and postsecondary pupils to 
41.27 	various careers within the health care profession.

41.28 	Sec. 14. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:
41.29 		Subdivision 1.Definitions. (a) For purposes of this section, the following definitions 
41.30 	apply.
41.31 	(b) "Dentist" means an individual who is licensed to practice dentistry.
41.32 	(c) "Designated rural area" means:
42.1 	(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, 
42.2 	Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, 
42.3 	Rochester, and St. Cloud; or
42.4 	(2) a municipal corporation, as defined under section 471.634, that is physically 
42.5 	located, in whole or in part, in an area defined as a designated rural area under clause (1).
42.6 	an area defined as a small rural area or isolated rural area according to the four category 
42.7 	classifications of the Rural Urban Commuting Area system developed for the United 
42.8 	States Health Resources and Services Administration.
42.9 	(d) "Emergency circumstances" means those conditions that make it impossible for 
42.10 	the participant to fulfill the service commitment, including death, total and permanent 
42.11 	disability, or temporary disability lasting more than two years.
42.12 	(e) "Medical resident" means an individual participating in a medical residency in 
42.13 	family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
42.14 	(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse 
42.15 	anesthetist, advanced clinical nurse specialist, or physician assistant.
42.16 	(g) "Nurse" means an individual who has completed training and received all 
42.17 	licensing or certification necessary to perform duties as a licensed practical nurse or 
42.18 	registered nurse.
42.19 	(h) "Nurse-midwife" means a registered nurse who has graduated from a program of 
42.20 	study designed to prepare registered nurses for advanced practice as nurse-midwives.
42.21 	(i) "Nurse practitioner" means a registered nurse who has graduated from a program 
42.22 	of study designed to prepare registered nurses for advanced practice as nurse practitioners.
42.23 	(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
42.24 	(k) "Physician" means an individual who is licensed to practice medicine in the areas 
42.25 	of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
42.26 	(l) "Physician assistant" means a person licensed under chapter 147A.
42.27 	(m) "Qualified educational loan" means a government, commercial, or foundation 
42.28 	loan for actual costs paid for tuition, reasonable education expenses, and reasonable living 
42.29 	expenses related to the graduate or undergraduate education of a health care professional.
42.30 	(n) "Underserved urban community" means a Minnesota urban area or population 
42.31 	included in the list of designated primary medical care health professional shortage areas 
42.32 	(HPSAs), medically underserved areas (MUAs), or medically underserved populations 
42.33 	(MUPs) maintained and updated by the United States Department of Health and Human 
42.34 	Services.

42.35 	Sec. 15. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:
43.1 		Subd. 2a.Standards. Notwithstanding the exemptions in subdivisions 8 and 9, the 
43.2 	commissioner shall accredit laboratories according to the most current environmental 
43.3 	laboratory accreditation standards under subdivision 1 and as accepted by the accreditation 
43.4 	bodies recognized by the National Environmental Laboratory Accreditation Program 
43.5 	(NELAP) of the NELAC Institute.

43.6 	Sec. 16. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:
43.7 		Subd. 7.Initial accreditation and annual accreditation renewal. (a) The 
43.8 	commissioner shall issue or renew accreditation after receipt of the completed application 
43.9 	and documentation required in this section, provided the laboratory maintains compliance 
43.10 	with the standards specified in subdivision 2a, notwithstanding any exemptions under 
43.11 	subdivisions 8 and 9, and attests to the compliance on the application form.
43.12 	(b) The commissioner shall prorate the fees in subdivision 3 for laboratories 
43.13 	applying for accreditation after December 31. The fees are prorated on a quarterly basis 
43.14 	beginning with the quarter in which the commissioner receives the completed application 
43.15 	from the laboratory.
43.16 	(c) Applications for renewal of accreditation must be received by November 1 and 
43.17 	no earlier than October 1 of each year. The commissioner shall send annual renewal 
43.18 	notices to laboratories 90 days before expiration. Failure to receive a renewal notice does 
43.19 	not exempt laboratories from meeting the annual November 1 renewal date.
43.20 	(d) The commissioner shall issue all accreditations for the calendar year for which 
43.21 	the application is made, and the accreditation shall expire on December 31 of that year.
43.22 	(e) The accreditation of any laboratory that fails to submit a renewal application 
43.23 	and fees to the commissioner expires automatically on December 31 without notice or 
43.24 	further proceeding. Any person who operates a laboratory as accredited after expiration of 
43.25 	accreditation or without having submitted an application and paid the fees is in violation 
43.26 	of the provisions of this section and is subject to enforcement action under sections 
43.27 	144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired 
43.28 	accreditation may reapply under subdivision 6.

43.29 	Sec. 17. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 
43.30 	to read:
43.31 		Subd. 8.Exemption from national standards for quality control and personnel 
43.32 	requirements. Effective January 1, 2012, a laboratory that analyzes samples for 
43.33 	compliance with a permit issued under section 115.03, subdivision 5, may request 
43.34 	exemption from the personnel requirements and specific quality control provisions for 
44.1 	microbiology and chemistry stated in the national standards as incorporated by reference 
44.2 	in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
44.3 	(1) complies with the methodology and quality control requirements, where 
44.4 	available, in the most recent, approved edition of the Standard Methods for the 
44.5 	Examination of Water and Wastewater as published by the Water Environment Federation; 
44.6 	and
44.7 	(2) supplies the name of the person meeting the requirements in section 115.73, or 
44.8 	the personnel requirements in the national standard pursuant to subdivision 2a.
44.9 	A laboratory applying for this exemption shall not apply for simultaneous 
44.10 	accreditation under the national standard.

44.11 	Sec. 18. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision 
44.12 	to read:
44.13 		Subd. 9.Exemption from national standards for proficiency testing frequency.
 44.14 	(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under 
44.15 	the exemption in subdivision 8 must obtain an acceptable proficiency test result for each 
44.16 	of the laboratory's accredited or requested fields of testing. The laboratory must analyze 
44.17 	proficiency samples selected from one of two annual proficiency testing studies scheduled 
44.18 	by the commissioner.
44.19 	(b) If a laboratory fails to successfully complete the first scheduled proficiency 
44.20 	study, the laboratory shall:
44.21 	(1) obtain and analyze a supplemental test sample within 15 days of receiving the 
44.22 	test report for the initial failed attempt; and
44.23 	(2) participate in the second annual study as scheduled by the commissioner.
44.24 	(c) If a laboratory does not submit results or fails two consecutive proficiency 
44.25 	samples, the commissioner will revoke the laboratory's accreditation for the affected 
44.26 	fields of testing.
44.27 	(d) The commissioner may require a laboratory to analyze additional proficiency 
44.28 	testing samples beyond what is required in this subdivision if information available to 
44.29 	the commissioner indicates that the laboratory's analysis for the field of testing does not 
44.30 	meet the requirements for accreditation.
44.31 	(e) The commissioner may collect from laboratories accredited under the exemption 
44.32 	in subdivision 8 any additional costs required to administer this subdivision and 
44.33 	subdivision 8.

45.1 	Sec. 19. Minnesota Statutes 2010, section 144A.102, is amended to read:
45.2 	144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS; 
45.3 	PENALTIES.
45.4 	(a) By January 2000, the commissioner of health shall work with providers to 
45.5 	examine state and federal rules and regulations governing the provision of care in licensed 
45.6 	nursing facilities and apply for federal waivers and identify necessary changes in state 
45.7 	law to:
45.8 	(1) allow the use of civil money penalties imposed upon nursing facilities to abate 
45.9 	any deficiencies identified in a nursing facility's plan of correction; and
45.10 	(2) stop the accrual of any fine imposed by the Health Department when a follow-up 
45.11 	inspection survey is not conducted by the department within the regulatory deadline.
45.12 	(b) By January 2012, the commissioner of health shall work with providers and 
45.13 	the ombudsman for long-term care to examine state and federal rules and regulations 
45.14 	governing the provision of care in licensed nursing facilities and apply for federal waivers 
45.15 	and identify necessary changes in state law to:
45.16 	(1) eliminate the requirement for written plans of correction from nursing homes for 
45.17 	federal deficiencies issued at a scope and severity that is not widespread, harmful, or in 
45.18 	immediate jeopardy; and
45.19 	(2) issue the federal survey form electronically to nursing homes.
45.20 	The commissioner shall issue a report to the legislative chairs of the committees 
45.21 	with jurisdiction over health and human services by January 31, 2012, on the status of 
45.22 	implementation of this paragraph.

45.23 	Sec. 20. Minnesota Statutes 2010, section 144A.61, is amended by adding a 
45.24 	subdivision to read:
45.25 		Subd. 9.Electronic transmission. The commissioner of health must accept 
45.26 	electronic transmission of applications and supporting documentation for interstate 
45.27 	endorsement for the nursing assistant registry.

45.28 	Sec. 21. Minnesota Statutes 2010, section 144E.123, is amended to read:
45.29 	144E.123 PREHOSPITAL CARE DATA.
45.30 		Subdivision 1.Collection and maintenance. A licensee shall collect and provide 
45.31 	prehospital care data to the board in a manner prescribed by the board. At a minimum, 
45.32 	the data must include items identified by the board that are part of the National Uniform 
45.33 	Emergency Medical Services Data Set. A licensee shall maintain prehospital care data 
45.34 	for every response.
46.1 		Subd. 2.Copy to receiving hospital. If a patient is transported to a hospital, a copy 
46.2 	of the ambulance report delineating prehospital medical care given shall be provided 
46.3 	to the receiving hospital.
46.4 		Subd. 3.Review. Prehospital care data may be reviewed by the board or its 
46.5 	designees. The data shall be classified as private data on individuals under chapter 13, the 
46.6 	Minnesota Government Data Practices Act.
46.7 		Subd. 4.Penalty. Failure to report all information required by the board under this 
46.8 	section shall constitute grounds for license revocation.
46.9 		Subd. 5.Working group. By October 1, 2011, the board must convene a working 
46.10 	group composed of six members, three of which must be appointed by the board and three 
46.11 	of which must be appointed by the Minnesota Ambulance Association, to redesign the 
46.12 	board's policies related to collection of data from licenses. The issues to be considered 
46.13 	include, but are not limited to, the following: user-friendly reporting requirements; data 
46.14 	sets; improved accuracy of reported information; appropriate use of information gathered 
46.15 	through the reporting system; and methods for minimizing the financial impact of data 
46.16 	reporting on licenses, particularly for rural volunteer services. The working group must 
46.17 	report its findings and recommendations to the board no later than July 1, 2012.

46.18 	Sec. 22. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:
46.19 		Subd. 3.Requirements for programs; process. (a) Community health boards 
46.20 	and tribal governments that receive funding under this section must submit a plan to 
46.21 	the commissioner describing a multidisciplinary approach to targeted home visiting for 
46.22 	families. The plan must be submitted on forms provided by the commissioner. At a 
46.23 	minimum, the plan must include the following:
46.24 	(1) a description of outreach strategies to families prenatally or at birth;
46.25 	(2) provisions for the seamless delivery of health, safety, and early learning services;
46.26 	(3) methods to promote continuity of services when families move within the state;
46.27 	(4) a description of the community demographics;
46.28 	(5) a plan for meeting outcome measures; and
46.29 	(6) a proposed work plan that includes:
46.30 	(i) coordination to ensure nonduplication of services for children and families;
46.31 	(ii) a description of the strategies to ensure that children and families at greatest risk 
46.32 	receive appropriate services; and
46.33 	(iii) collaboration with multidisciplinary partners including public health, 
46.34 	ECFE, Head Start, community health workers, social workers, community home 
47.1 	visiting programs, school districts, and other relevant partners. Letters of intent from 
47.2 	multidisciplinary partners must be submitted with the plan.
47.3 	(b) Each program that receives funds must accomplish the following program 
47.4 	requirements:
47.5 	(1) use a community-based strategy to provide preventive and early intervention 
47.6 	home visiting services;
47.7 	(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 
47.8 	home visit must occur prenatally or as soon after birth as possible and must include a 
47.9 	public health nursing assessment by a public health nurse;
47.10 	(3) offer, at a minimum, information on infant care, child growth and development, 
47.11 	positive parenting, preventing diseases, preventing exposure to environmental hazards, 
47.12 	and support services available in the community;
47.13 	(4) provide information on and referrals to health care services, if needed, including 
47.14 	information on and assistance in applying for health care coverage for which the child or 
47.15 	family may be eligible; and provide information on preventive services, developmental 
47.16 	assessments, and the availability of public assistance programs as appropriate;
47.17 	(5) provide youth development programs when appropriate;
47.18 	(6) recruit home visitors who will represent, to the extent possible, the races, 
47.19 	cultures, and languages spoken by families that may be served;
47.20 	(7) train and supervise home visitors in accordance with the requirements established 
47.21 	under subdivision 4;
47.22 	(8) maximize resources and minimize duplication by coordinating or contracting 
47.23 	with local social and human services organizations, education organizations, and other 
47.24 	appropriate governmental entities and community-based organizations and agencies;
47.25 	(9) utilize appropriate racial and ethnic approaches to providing home visiting 
47.26 	services; and
47.27 	(10) connect eligible families, as needed, to additional resources available in the 
47.28 	community, including, but not limited to, early care and education programs, health or 
47.29 	mental health services, family literacy programs, employment agencies, social services, 
47.30 	and child care resources and referral agencies.
47.31 	(c) When available, programs that receive funds under this section must offer or 
47.32 	provide the family with a referral to center-based or group meetings that meet at least 
47.33 	once per month for those families identified with additional needs. The meetings must 
47.34 	focus on further enhancing the information, activities, and skill-building addressed during 
47.35 	home visitation; offering opportunities for parents to meet with and support each other; 
48.1 	and offering infants and toddlers a safe, nurturing, and stimulating environment for 
48.2 	socialization and supervised play with qualified teachers.
48.3 	(d) Funds available under this section shall not be used for medical services. The 
48.4 	commissioner shall establish an administrative cost limit for recipients of funds. The 
48.5 	outcome measures established under subdivision 6 must be specified to recipients of 
48.6 	funds at the time the funds are distributed.
48.7 	(e) Data collected on individuals served by the home visiting programs must remain 
48.8 	confidential and must not be disclosed by providers of home visiting services without a 
48.9 	specific informed written consent that identifies disclosures to be made. Upon request, 
48.10 	agencies providing home visiting services must provide recipients with information on 
48.11 	disclosures, including the names of entities and individuals receiving the information and 
48.12 	the general purpose of the disclosure. Prospective and current recipients of home visiting 
48.13 	services must be told and informed in writing that written consent for disclosure of data is 
48.14 	not required for access to home visiting services.
48.15 	(f) Upon initial contact with a family, programs that receive funding under this 
48.16 	section must receive permission from the family to share with other family service 
48.17 	providers information about services the family is receiving and unmet needs of the family 
48.18 	in order to select a lead agency for the family and coordinate available resources. For 
48.19 	purposes of this paragraph, the term "family service providers" includes local public 
48.20 	health, social services, school districts, Head Start programs, health care providers, and 
48.21 	other public agencies.

48.22 	Sec. 23. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision 
48.23 	to read:
48.24 		Subd. 7a.Limited food establishment. "Limited food establishment" means a food 
48.25 	and beverage service establishment that primarily provides beverages that consist of 
48.26 	combining dry mixes and water or ice for immediate service to the consumer. Limited 
48.27 	food establishments must use equipment and utensils that are nontoxic, durable, and retain 
48.28 	their characteristic qualities under normal use conditions and may request a variance for 
48.29 	plumbing requirements from the commissioner.

48.30 	EFFECTIVE DATE. This section is effective the day following final enactment 
48.31 	and applies to applications for licensure submitted on or after that date.

48.32 	Sec. 24. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision 
48.33 	to read:
49.1 		Subd. 5.Variance requests. (a) A person may request a variance from all parts of 
49.2 	Minnesota Rules, chapter 4626, except as provided in paragraph (b) or Minnesota Rules, 
49.3 	chapter 4626. At the time of application for plan review, the person, operator, or submitter 
49.4 	must be notified of the right to request variances.
49.5 	(b) No variance may be requested or approved for the following parts of Minnesota 
49.6 	Rules, chapter 4626:
49.7 	(1) Minnesota Rules, part 4626.0020, subpart 35;
49.8 	(2) Minnesota Rules, parts 4626.0040 to 4626.0060;
49.9 	(3) Minnesota Rules, parts 4626.0065 to 4626.0100;
49.10 	(4) Minnesota Rules, parts 4626.0105 to 4626.0120;
49.11 	(5) Minnesota Rules, part 4626.1565;
49.12 	(6) Minnesota Rules, parts 4626.1590 and 4626.1595; and 
49.13 	(7) Minnesota Rules, parts 4626.1600 to 4626.1675.

49.14 	Sec. 25. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
49.15 		Subdivision 1.Tax and use tax on cigarettes. Revenue received from cigarette 
49.16 	taxes, as well as related penalties, interest, license fees, and miscellaneous sources of 
49.17 	revenue shall be deposited by the commissioner in the state treasury and credited as 
49.18 	follows:
49.19 	(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each 
49.20 	year thereafter must be credited to the Academic Health Center special revenue fund 
49.21 	hereby created and is annually appropriated to the Board of Regents at the University of 
49.22 	Minnesota for Academic Health Center funding at the University of Minnesota; and
49.23 	(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal yearyears 2007 and 
49.24 	each year thereafterthrough fiscal year 2011 and $3,937,000 each year thereafter must be 
49.25 	credited to the medical education and research costs account hereby created in the special 
49.26 	revenue fund and is annually appropriated to the commissioner of health for distribution 
49.27 	under section 62J.692, subdivision 4; and
49.28 	(3) the balance of the revenues derived from taxes, penalties, and interest (under 
49.29 	this chapter) and from license fees and miscellaneous sources of revenue shall be credited 
49.30 	to the general fund.

49.31 	Sec. 26. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY 
49.32 	RESPONSIBILITIES.
 49.33 	(a) The commissioner of health, in consultation with the commissioner of human 
49.34 	services, shall evaluate and recommend options for reorganizing health and human 
50.1 	services regulatory responsibilities in both agencies to provide better efficiency and 
50.2 	operational cost savings while maintaining the protection of the health, safety, and welfare 
50.3 	of the public. Regulatory responsibilities that are to be evaluated are those found in 
50.4 	Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B, 
50.5 	149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50, 
50.6 	144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
50.7 	(b) The evaluation and recommendations shall be submitted in a report to the 
50.8 	legislative committees with jurisdiction over health and human services no later than 
50.9 	February 15, 2012, and shall include, at a minimum, the following:
50.10 	(1) whether the regulatory responsibilities of each agency should be combined into 
50.11 	a separate agency;
50.12 	(2) whether the regulatory responsibilities of each agency should be merged into 
50.13 	an existing agency;
50.14 	(3) what cost savings would result by merging the activities regardless of where 
50.15 	they are located;
50.16 	(4) what additional costs would result if the activities were merged;
50.17 	(5) whether there are additional regulatory responsibilities in both agencies that 
50.18 	should be considered in any reorganization; and
50.19 	(6) for each option recommended, projected cost and a timetable and identification 
50.20 	of the necessary steps and requirements for a successful transition period.

50.21 	Sec. 27. MINNESOTA TASK FORCE ON PREMATURITY.
 50.22 		Subdivision 1.Establishment. The Minnesota Task Force on Prematurity is 
50.23 	established to evaluate and make recommendations on methods for reducing prematurity 
50.24 	and improving premature infant health care in the state.
50.25 		Subd. 2.Membership; meetings; staff. (a) The task force shall be composed of at 
50.26 	least the following members, who serve at the pleasure of their appointing authority:
50.27 	(1) 15 representatives of the Minnesota Prematurity Coalition including, but not 
50.28 	limited to, health care providers who treat pregnant women or neonates, organizations 
50.29 	focused on preterm births, early childhood education and development professionals, and 
50.30 	families affected by prematurity;
50.31 	(2) one representative appointed by the commissioner of human services;
50.32 	(3) two representatives appointed by the commissioner of health;
50.33 	(4) one representative appointed by the commissioner of education; 
50.34 	(5) two members of the house of representatives, one appointed by the speaker of 
50.35 	the house and one appointed by the minority leader; and
51.1 	(6) two members of the senate, appointed according to the rules of the senate.
51.2 	(b) Members of the task force serve without compensation or payment of expenses.
51.3 	(c) The commissioner of health must convene the first meeting of the Minnesota 
51.4 	Task Force on Prematurity by July 31, 2011. The task force must continue to meet at 
51.5 	least quarterly. Staffing and technical assistance shall be provided by the Minnesota 
51.6 	Perinatal Coalition.
51.7 		Subd. 3.Duties. The task force must report the current state of prematurity in 
51.8 	Minnesota and develop recommendations on strategies for reducing prematurity and 
51.9 	improving premature infant health care in the state by considering the following:
51.10 	(1) standards of care for premature infants born less than 37 weeks gestational age, 
51.11 	including recommendations to improve hospital discharge and follow-up care procedures;
51.12 	(2) coordination of information among appropriate professional and advocacy 
51.13 	organizations on measures to improve health care for infants born prematurely;
51.14 	(3) identification and centralization of available resources to improve access and 
51.15 	awareness for caregivers of premature infants;
51.16 	(4) development and dissemination of evidence-based practices through networking 
51.17 	and educational opportunities; 
51.18 	(5) a review of relevant evidence-based research regarding the causes and effects of 
51.19 	premature births in Minnesota;
51.20 	(6) a review of relevant evidence-based research regarding premature infant health 
51.21 	care, including methods for improving quality of and access to care for premature infants;
51.22 	(7) a review of the potential improvements in health status related to the use of 
51.23 	health care homes to provide and coordinate pregnancy-related services; and
51.24 	(8) identification of gaps in public reporting measures and possible effects of these 
51.25 	measures on prematurity rates.
51.26 		Subd. 4.Report; expiration. (a) By November 30, 2011, the task force must submit 
51.27 	a report on the current state of prematurity in Minnesota to the chairs of the legislative 
51.28 	policy committees on health and human services.
51.29 	(b) By January 15, 2013, the task force must report its final recommendations, 
51.30 	including any draft legislation necessary for implementation, to the chairs of the legislative 
51.31 	policy committees on health and human services.
51.32 	(c) This task force expires on January 31, 2013, or upon submission of the final 
51.33 	report required in paragraph (b), whichever is earlier.

51.34 	Sec. 28. NURSING HOME REGULATORY EFFICIENCY.
 52.1 	The commissioner of health must work with long-term care providers, provider 
52.2 	associations, and consumer advocates to clarify for the benefit of providers, survey 
52.3 	teams, and investigators from the office of health facility complaints all of the situations 
52.4 	that providers must report and are required to report to the department under federal 
52.5 	certification regulations and to the common entry point under the Minnesota Vulnerable 
52.6 	Adults Act. The commissioner must produce decision trees, flow sheets, or other 
52.7 	reproducible materials to guide the parties and to reduce the number of unnecessary 
52.8 	reports.

52.9 	Sec. 29.  REPEALER.
 52.10 	(a) Minnesota Statutes 2010, sections 62J.321, subdivision 5a; 62J.381; 62J.41, 
52.11 	subdivisions 1 and 2; and 144.1499, are repealed.
52.12 	(b) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 
52.13 	14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5; 
52.14 	4651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed.

52.15 	Sec. 30. EFFECTIVE DATE.
 52.16 	This article is effective the day following final enactment.

52.17 	ARTICLE 3
52.18 	MISCELLANEOUS

52.19 	Section 1. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to 
52.20 	read:
52.21 		Subd. 4.Special family day care homes. Nonresidential child care programs 
52.22 	serving 14 or fewer children that are conducted at a location other than the license holder's 
52.23 	own residence shall be licensed under this section and the rules governing family day 
52.24 	care or group family day care if:
52.25 	(a) the license holder is the primary provider of care and the nonresidential child 
52.26 	care program is conducted in a dwelling that is located on a residential lot;
52.27 	(b) the license holder is an employer who may or may not be the primary provider 
52.28 	of care, and the purpose for the child care program is to provide child care services to 
52.29 	children of the license holder's employees;
52.30 	(c) the license holder is a church or religious organization;
52.31 	(d) the license holder is a community collaborative child care provider. For 
52.32 	purposes of this subdivision, a community collaborative child care provider is a provider 
53.1 	participating in a cooperative agreement with a community action agency as defined in 
53.2 	section 256E.31; or
53.3 	(e) the license holder is a not-for-profit agency that provides child care in a dwelling 
53.4 	located on a residential lot and the license holder maintains two or more contracts with 
53.5 	community employers or other community organizations to provide child care services. 
53.6 	The county licensing agency may grant a capacity variance to a license holder licensed 
53.7 	under this paragraph to exceed the licensed capacity of 14 children by no more than five 
53.8 	children during transition periods related to the work schedules of parents, if the license 
53.9 	holder meets the following requirements:
53.10 	(1) the program does not exceed a capacity of 14 children more than a cumulative 
53.11 	total of four hours per day;
53.12 	(2) the program meets a one to seven staff-to-child ratio during the variance period;
53.13 	(3) all employees receive at least an extra four hours of training per year than 
53.14 	required in the rules governing family child care each year;
53.15 	(4) the facility has square footage required per child under Minnesota Rules, part 
53.16 	9502.0425;
53.17 	(5) the program is in compliance with local zoning regulations;
53.18 	(6) the program is in compliance with the applicable fire code as follows:
53.19 	(i) if the program serves more than five children older than 2-1/2 years of age, 
53.20 	but no more than five children 2-1/2 years of age or less, the applicable fire code is 
53.21 	educational occupancy, as provided in Group E Occupancy under the Minnesota State 
53.22 	Fire Code 2003, Section 202; or
53.23 	(ii) if the program serves more than five children 2-1/2 years of age or less, the 
53.24 	applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire 
53.25 	Code 2003, Section 202; and
53.26 	(7) any age and capacity limitations required by the fire code inspection and square 
53.27 	footage determinations shall be printed on the license.; or
53.28 	(f) the license holder is the primary provider of care and has located the licensed 
53.29 	child care program in a commercial space, if the license holder meets the following 
53.30 	requirements:
53.31 	(1) the program is in compliance with local zoning regulations;
53.32 	(2) the program is in compliance with the applicable fire code as follows:
53.33 	(i) if the program serves more than five children older than 2-1/2 years of age, 
53.34 	but no more than five children 2-1/2 years of age or less, the applicable fire code is 
53.35 	educational occupancy, as provided in Group E Occupancy under the Minnesota State 
53.36 	Fire Code 2003, Section 202; or
54.1 	(ii) if the program serves more than five children 2-1/2 years of age or less, the 
54.2 	applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire 
54.3 	Code 2003, Section 202;
54.4 	(3) any age and capacity limitations required by the fire code inspection and square 
54.5 	footage determinations are printed on the license; and
54.6 	(4) the license holder prominently displays the license issued by the commissioner 
54.7 	which contains the statement "This special family child care provider is not licensed as a 
54.8 	child care center."

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

54.14 	Sec. 3. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision 
54.15 	to read:
54.16 		Subd. 8.Children's therapeutic services and supports providers. The 
54.17 	commissioner shall recover the cost of background studies required under section 
54.18 	245C.03, subdivision 7, for the purposes of children's therapeutic services and supports 
54.19 	under section 256B.0943, through a fee of no more than $20 per study charged to 
54.20 	the license holder. The fees collected under this subdivision are appropriated to the 
54.21 	commissioner for the purpose of conducting background studies.

54.22 	Sec. 4. Minnesota Statutes 2010, section 256B.0943, is amended by adding a 
54.23 	subdivision to read:
54.24 		Subd. 5a.Background studies. The requirements for background studies under 
54.25 	this section may be met by a children's therapeutic services and supports services agency 
54.26 	through the commissioner's NETStudy system as provided under sections 245C.03, 
54.27 	subdivision 7, and 245C.10, subdivision 8.

54.28 	Sec. 5. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision 
54.29 	to read:
54.30 		Subd. 3a.Spousal contribution. (a) For purposes of this subdivision, the following 
54.31 	terms have the meanings given:
54.32 	(1) "commissioner" means the commissioner of human services;
55.1 	(2) "community spouse" means the spouse, who lives in the community, of an 
55.2 	individual receiving long-term care services in a long-term care facility or home care 
55.3 	services pursuant to the Medicaid waiver for elderly services under section 256B.0915 
55.4 	or the alternative care program under section 256B.0913. A community spouse does not 
55.5 	include a spouse living in the community who receives a monthly income allowance under 
55.6 	section 256B.058, subdivision 2, or who receives home and community-based services 
55.7 	under section 256B.0915, 256B.092, or 256B.49, or the alternative care program under 
55.8 	section 256B.0913;
55.9 	(3) "cost of care" means the actual fee-for-service costs or capitated payments for 
55.10 	the long-term care spouse;
55.11 	(4) "department" means the Department of Human Services;
55.12 	(5) "disabled child" means a blind or permanently and totally disabled son or 
55.13 	daughter of any age based on the Social Security Administration disability standards;
55.14 	(6) "income" means earned and unearned income, attributable to the community 
55.15 	spouse, used to calculate the adjusted gross income on the prior year's income tax return. 
55.16 	Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
55.17 	(7) "long-term care spouse" means the spouse who is receiving long-term care 
55.18 	services in a long-term care facility or home and community based services pursuant 
55.19 	to the Medicaid waiver for elderly services under section 256B.0915 or the alternative 
55.20 	care program under section 256B.0913.
55.21 	(b) The community spouse of a long-term care spouse who receives medical 
55.22 	assistance or alternative care services has an obligation to contribute to the cost of care. 
55.23 	The community spouse must pay a monthly fee on a sliding fee scale based on the 
55.24 	community spouse's income. If a minor or disabled child resides with and receives care 
55.25 	from the community spouse, then no fee shall be assessed.
55.26 	(c) For a community spouse with an income equal to or greater than 250 percent of 
55.27 	the federal poverty guidelines for a family of two and less than 545 percent of the federal 
55.28 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
55.29 	a sliding fee scale established by the commissioner that begins at 7.5 percent of the 
55.30 	community spouse's income and increases to 15 percent for those with an income of up to 
55.31 	545 percent of the federal poverty guidelines for a family of two.
55.32 	(d) For a community spouse with an income equal to or greater than 545 percent of 
55.33 	the federal poverty guidelines for a family of two and less than 750 percent of the federal 
55.34 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
55.35 	a sliding fee scale established by the commissioner that begins at 15 percent of the 
56.1 	community spouse's income and increases to 25 percent for those with an income of up to 
56.2 	750 percent of the federal poverty guidelines for a family of two.
56.3 	(e) For a community spouse with an income equal to or greater than 750 percent of 
56.4 	the federal poverty guidelines for a family of two and less than 975 percent of the federal 
56.5 	poverty guidelines for a family of two, the spousal contribution shall be determined using 
56.6 	a sliding fee scale established by the commissioner that begins at 25 percent of the 
56.7 	community spouse's income and increases to 33 percent for those with an income of up to 
56.8 	975 percent of the federal poverty guidelines for a family of two.
56.9 	(f) For a community spouse with an income equal to or greater than 975 percent of 
56.10 	the federal poverty guidelines for a family of two, the spousal contribution shall be 33 
56.11 	percent of the community spouse's income.
56.12 	(g) The spousal contribution shall be explained in writing at the time eligibility 
56.13 	for medical assistance or alternative care is being determined. In addition to explaining 
56.14 	the formula used to determine the fee, the county or tribal agency shall provide written 
56.15 	information describing how to request a variance for undue hardship, how a contribution 
56.16 	may be reviewed or redetermined, the right to appeal a contribution determination, and 
56.17 	that the consequences for not complying with a request to provide information shall be 
56.18 	an assessment against the community spouse for the full cost of care for the long-term 
56.19 	care spouse.
56.20 	(h) The contribution shall be assessed for each month the long-term care spouse 
56.21 	has a community spouse and is eligible for medical assistance payment of long-term 
56.22 	care services or alternative care.
56.23 	(i) The spousal contribution shall be reviewed at least once every 12 months and 
56.24 	when there is a loss or gain in income in excess of ten percent. Thirty days prior to a 
56.25 	review or redetermination, written notice must be provided to the community spouse 
56.26 	and must contain the amount the spouse is required to contribute, notice of the right to 
56.27 	redetermination and appeal, and the telephone number of the division at the agency that is 
56.28 	responsible for redetermination and review. If, after review, the contribution amount is to 
56.29 	be adjusted, the county or tribal agency shall mail a written notice to the community spouse 
56.30 	30 days in advance of the effective date of the change in the amount of the contribution.
56.31 	(1) The spouse shall notify the county or tribal agency within 30 days of a gain or 
56.32 	loss in income in excess of ten percent and provide the agency supporting documentation 
56.33 	to verify the need for redetermination of the fee.
56.34 	(2) When a spouse requests a review or redetermination of the contribution amount, 
56.35 	a request for information shall be sent to the spouse within ten calendar days after the 
56.36 	county or tribal agency receives the request for review.
57.1 	(3) No action shall be taken on a review or redetermination until the required 
57.2 	information is received by the county or tribal agency.
57.3 	(4) The review of the spousal contribution shall be completed within ten days after 
57.4 	the county or tribal agency receives completed information that verifies a loss or gain in 
57.5 	income in excess of ten percent.
57.6 	(5) An increase in the contribution amount is effective in the month in which the 
57.7 	increase in income occurs.
57.8 	(6) A decrease in the contribution amount is effective in the month the spouse 
57.9 	verifies the reduction in income, retroactive to no longer than six months.
57.10 	(j) In no case shall the spousal contribution exceed the amount of medical assistance 
57.11 	expended or the cost of alternative care services for the care of the long-term care spouse. 
57.12 	Annually, upon redetermination, or at termination of eligibility, the total amount of 
57.13 	medical assistance paid or costs of alternative care for the care of the long-term care spouse 
57.14 	and the total amount of the spousal contribution shall be compared. If the total amount 
57.15 	of the spousal contribution exceeds the total amount of medical assistance expended or 
57.16 	cost of alternative care, then the agency shall reimburse the community spouse the excess 
57.17 	amount if the long-term care spouse is no longer receiving services, or apply the excess 
57.18 	amount to the spousal contribution due until the excess amount is exhausted.
57.19 	(k) A community spouse may request a variance by submitting a written request 
57.20 	and supporting documentation that payment of the calculated contribution would cause 
57.21 	an undue hardship. An undue hardship is defined as the inability to pay the calculated 
57.22 	contribution due to medical expenses incurred by the community spouse. Documentation 
57.23 	must include proof of medical expenses incurred by the community spouse since the last 
57.24 	annual redetermination of the contribution amount that are not reimbursable by any public 
57.25 	or private source, and are a type, regardless of amount, that would be allowable as a 
57.26 	federal tax deduction under the Internal Revenue Code.
57.27 	(1) A spouse who requests a variance from a notice of an increase in the amount 
57.28 	of spousal contribution shall continue to make monthly payments at the lower amount 
57.29 	pending determination of the variance request. A spouse who requests a variance from 
57.30 	the initial determination shall not be required to make a payment pending determination 
57.31 	of the variance request. Payments made pending outcome of the variance request that 
57.32 	result in overpayment must be returned to the spouse, if the long-term care spouse is no 
57.33 	longer receiving services, or applied to the spousal contribution in the current year. If the 
57.34 	variance is denied, the spouse shall pay the additional amount due from the effective date 
57.35 	of the increase or the total amount due from the effective date of the original notice of 
57.36 	determination of the spousal contribution.
58.1 	(2) A spouse who is granted a variance shall sign a written agreement in which the 
58.2 	spouse agrees to report to the county or tribal agency any changes in circumstances that 
58.3 	gave rise to the undue hardship variance.
58.4 	(3) When the county or tribal agency receives a request for a variance, written notice 
58.5 	of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days 
58.6 	after the county or tribal agency receives the financial information required in this clause. 
58.7 	The granting of a variance will necessitate a written agreement between the spouse and the 
58.8 	county or tribal agency with regard to the specific terms of the variance. The variance 
58.9 	will not become effective until the written agreement is signed by the spouse. If the 
58.10 	county or tribal agency denies in whole or in part the request for a variance, the denial 
58.11 	notice shall set forth in writing the reasons for the denial that address the specific hardship 
58.12 	and right to appeal.
58.13 	(4) If a variance is granted, the term of the variance shall not exceed 12 months 
58.14 	unless otherwise determined by the county or tribal agency.
58.15 	(5) Undue hardship does not include action taken by a spouse which divested or 
58.16 	diverted income in order to avoid being assessed a spousal contribution.
58.17 	(l) A spouse aggrieved by an action under this subdivision has the right to appeal 
58.18 	under subdivision 4. If the spouse appeals on or before the effective date of an increase 
58.19 	in the spousal fee, the spouse shall continue to make payments to the county or tribal 
58.20 	agency in the lower amount while the appeal is pending. A spouse appealing an initial 
58.21 	determination of a spousal contribution shall not be required to make monthly payments 
58.22 	pending an appeal decision. Payments made that result in an overpayment shall be 
58.23 	reimbursed to the spouse if the long-term care spouse is no longer receiving services, or 
58.24 	applied to the spousal contribution remaining in the current year. If the county or tribal 
58.25 	agency's determination is affirmed, the community spouse shall pay within 90 calendar 
58.26 	days of the order the total amount due from the effective date of the original notice of 
58.27 	determination of the spousal contribution. The commissioner's order is binding on the 
58.28 	spouse and the agency and shall be implemented subject to section 256.045, subdivision 7. 
58.29 	No additional notice is required to enforce the commissioner's order.
58.30 	(m) If the county or tribal agency finds that notice of the payment obligation was 
58.31 	given to the community spouse and the spouse was determined to be able to pay, but that 
58.32 	the spouse failed or refused to pay, a cause of action exists against the community spouse 
58.33 	for that portion of medical assistance payment of long-term care services or alternative 
58.34 	care services granted after notice was given to the community spouse. The action may be 
58.35 	brought by the county or tribal agency in the county where assistance was granted for the 
58.36 	assistance together with the costs of disbursements incurred due to the action. In addition 
59.1 	to granting the county or tribal agency a money judgment, the court may, upon a motion or 
59.2 	order to show cause, order continuing contributions by a community spouse found able to 
59.3 	repay the county or tribal agency. The order shall be effective only for the period of time 
59.4 	during which a contribution shall be assessed.
59.5 	(n) Counties and tribes are entitled to one-half of the nonfederal share of 
59.6 	contributions made under this section for long-term care spouses on medical assistance 
59.7 	that are directly attributed to county or tribal efforts. Counties and tribes are entitled to 
59.8 	25 percent of the contributions made under this section for long-term care spouses on 
59.9 	alternative care directly attributed to county or tribal efforts.

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

59.11 	Sec. 6. NONEMERGENCY MEDICAL TRANSPORTATION SINGLE 
59.12 	ADMINISTRATIVE STRUCTURE PROPOSAL.
 59.13 	(a) The commissioner of human services shall develop a proposal to create a single 
59.14 	administrative structure for providing nonemergency medical transportation services to 
59.15 	fee-for-service medical assistance recipients. This proposal must consolidate access and 
59.16 	special transportation into one administrative structure with the goal of standardizing 
59.17 	eligibility determination processes, scheduling arrangements, billing procedures, data 
59.18 	collection, and oversight mechanisms in order to enhance coordination, improve 
59.19 	accountability, and lessen confusion.
59.20 	(b) In developing the proposal, the commissioner shall:
59.21 	(1) examine the current responsibilities performed by the counties and the 
59.22 	Department of Human Services and consider the shift in costs if these responsibilities are 
59.23 	changed;
59.24 	(2) identify key performance measures to assess the cost effectiveness of 
59.25 	nonemergency medical transportation statewide, including a process to collect, audit, 
59.26 	and report data;
59.27 	(3) develop a statewide complaint system for medical assistance recipients using 
59.28 	special transportation;
59.29 	(4) establish a standardized billing process;
59.30 	(5) establish a process that provides public input from interested parties before 
59.31 	special transportation eligibility policies are implemented or significantly changed;
59.32 	(6) establish specific eligibility criteria that include the frequency of eligibility 
59.33 	assessments and the length of time a recipient remains eligible for special transportation;
59.34 	(7) develop a reimbursement method to compensate volunteers for no-load miles 
59.35 	when transporting recipients to or from health-related appointments; and
60.1 	(8) establish specific eligibility criteria to maximize the use of public transportation 
60.2 	by recipients who are without a physical, mental, or other impairment that would prohibit 
60.3 	safely accessing and using public transportation.
60.4 	(c) In developing the proposal, the commissioner shall consult with the 
60.5 	nonemergency medical transportation advisory council established under paragraph (d).
60.6 	(d) The commissioner shall establish the nonemergency medical transportation 
60.7 	advisory council to assist the commissioner in developing a single administrative structure 
60.8 	for providing nonemergency medical transportation services. The council shall include, 
60.9 	but not be limited to:
60.10 	(1) one representative each from the Departments of Human Services and 
60.11 	Transportation; 
60.12 	(2) one representative each from the following organizations: the Minnesota State 
60.13 	Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC 
60.14 	of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County 
60.15 	Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit 
60.16 	Association, legal aid, the Minnesota Ambulance Association, the National Alliance on 
60.17 	Mental Illness, Medical Transportation Management, and other transportation providers; 
60.18 	and
60.19 	(3) four members from the house of representatives, two from the majority party 
60.20 	and two from the minority party, appointed by the speaker, and four members from the 
60.21 	senate, two from the majority party and two from the minority party, appointed by the 
60.22 	Subcommittee on Committees of the Committee on Rules and Administration.
60.23 	The council is governed by Minnesota Statutes, section 15.509, except that members 
60.24 	shall not receive per diems. The commissioner of human services shall fund all costs 
60.25 	related to the council from existing resources.
60.26 	(e) The commissioner shall submit the proposal and draft legislation necessary for 
60.27 	implementation to the chairs and ranking minority members of the senate and house of 
60.28 	representatives committees or divisions with jurisdiction over health care policy and 
60.29 	finance by January 15, 2012.

60.30 	ARTICLE 4
60.31 	DEPARTMENT OF HUMAN SERVICES LICENSING

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

61.8 	Sec. 2. Minnesota Statutes 2010, section 245A.10, subdivision 3, is amended to read:
61.9 		Subd. 3.Application fee for initial license or certification. (a) For fees required 
61.10 	under subdivision 1, an applicant for an initial license or certification issued by the 
61.11 	commissioner shall submit a $500 application fee with each new application required 
61.12 	under this subdivision. The application fee shall not be prorated, is nonrefundable, and 
61.13 	is in lieu of the annual license or certification fee that expires on December 31. The 
61.14 	commissioner shall not process an application until the application fee is paid.
61.15 	(b) Except as provided in clauses (1) to (3) (4), an applicant shall apply for a license 
61.16 	to provide services at a specific location.
61.17 	(1) For a license to provide residential-based habilitation services to persons with 
61.18 	developmental disabilities under chapter 245B, an applicant shall submit an application 
61.19 	for each county in which the services will be provided. Upon licensure, the license 
61.20 	holder may provide services to persons in that county plus no more than three persons 
61.21 	at any one time in each of up to ten additional counties. A license holder in one county 
61.22 	may not provide services under the home and community-based waiver for persons with 
61.23 	developmental disabilities to more than three people in a second county without holding 
61.24 	a separate license for that second county. Applicants or licensees providing services 
61.25 	under this clause to not more than three persons remain subject to the inspection fees 
61.26 	established in section 245A.10, subdivision 2, for each location. The license issued by 
61.27 	the commissioner must state the name of each additional county where services are being 
61.28 	provided to persons with developmental disabilities. A license holder must notify the 
61.29 	commissioner before making any changes that would alter the license information listed 
61.30 	under section 245A.04, subdivision 7, paragraph (a), including any additional counties 
61.31 	where persons with developmental disabilities are being served.
61.32 	(2) For a license to provide supported employment, crisis respite, or 
61.33 	semi-independent living services to persons with developmental disabilities under chapter 
61.34 	245B, an applicant shall submit a single application to provide services statewide.
62.1 	(3) For a license to provide independent living assistance for youth under section 
62.2 	245A.22, an applicant shall submit a single application to provide services statewide.
62.3 	(4) For a license for a private agency to provide foster care or adoption services 
62.4 	under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single 
62.5 	application to provide services statewide.

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

62.10
62.11		Licensed Capacity
	Child Care Center
License Fee
	Other Program 
License Fee
	
62.12		1 to 24 persons
	$225$200
		$400
	
62.13		25 to 49 persons
	$340$300
		$600
	
62.14		50 to 74 persons
	$450$400
		$800
	
62.15		75 to 99 persons
	$565$500
		$1,000
	
62.16		100 to 124 persons
	$675$600
		$1,200
	
62.17		125 to 149 persons
	$900$700
		$1,400
	
62.18		150 to 174 persons
	$1,050$800
		$1,600
	
62.19		175 to 199 persons
	$1,200$900
		$1,800
	
62.20
62.21		200 to 224 persons
	$1,350
$1,000
		$2,000
	
62.22
62.23		225 or more persons
	$1,500
$1,100
		$2,500
	
62.24 	(b) A day training and habilitation program serving persons with developmental 
62.25 	disabilities or related conditions shall be assessed apay an annual nonrefundable license 
62.26 	fee based on the following schedule in paragraph (a) unless the license holder serves more 
62.27 	than 50 percent of the same persons at two or more locations in the community.:

62.28		Licensed Capacity
	License Fee
	
62.29		1 to 24 persons
	$800
	
62.30		25 to 49 persons
	$1,000
	
62.31		50 to 74 persons
	$1,200
	
62.32		75 to 99 persons
	$1,400
	
62.33		100 to 124 persons
	$1,600
	
62.34		125 to 149 persons
	$1,800
	
62.35		150 or more persons
	$2,000
	
62.36 	Except as provided in paragraph (c), when a day training and habilitation program 
62.37 	serves more than 50 percent of the same persons in two or more locations in a community, 
62.38 	the day training and habilitation program shall pay a license fee based on the licensed 
63.1 	capacity of the largest facility and the other facility or facilities shall be charged a license 
63.2 	fee based on a licensed capacity of a residential program serving one to 24 persons.
63.3 	(c) When a day training and habilitation program serving persons with developmental 
63.4 	disabilities or related conditions seeks a single license allowed under section 245B.07, 
63.5 	subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed 
63.6 	capacity for each location.
63.7 	(d) A program licensed to provide supported employment services to persons 
63.8 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
63.9 	license fee of $650.
63.10 	(e) A program licensed to provide crisis respite services to persons with 
63.11 	developmental disabilities under chapter 245B shall pay an annual nonrefundable license 
63.12 	fee of $700.
63.13 	(f) A program licensed to provide semi-independent living services to persons 
63.14 	with developmental disabilities under chapter 245B shall pay an annual nonrefundable 
63.15 	license fee of $700.
63.16 	(g) A program licensed to provide residential-based habilitation services under the 
63.17 	home and community-based waiver for persons with developmental disabilities shall pay 
63.18 	an annual license fee that includes a base rate of $690 plus $60 times the number of clients 
63.19 	served on the first day of July of the current license year.
63.20 	(h) A residential program certified by the Department of Health as an intermediate 
63.21 	care facility for persons with developmental disabilities (ICF/MR) and a noncertified 
63.22 	residential program licensed to provide health or rehabilitative services for persons 
63.23 	with developmental disabilities shall pay an annual nonrefundable license fee based on 
63.24 	the following schedule:

63.25		Licensed Capacity
	License Fee
	
63.26		1 to 24 persons
	$535
	
63.27		25 to 49 persons
	$735
	
63.28		50 or more persons
	$935
	
63.29 	(i) A chemical dependency treatment program licensed under Minnesota Rules, parts 
63.30 	9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual 
63.31 	nonrefundable license fee based on the following schedule:

63.32		Licensed Capacity
	License Fee
	
63.33		1 to 24 persons
	$600
	
63.34		25 to 49 persons
	$800
	
63.35		50 to 74 persons
	$1,000
	
63.36		75 to 99 persons
	$1,200
	
63.37		100 or more persons
	$1,400
	
64.1 	(j) A chemical dependency program licensed under Minnesota Rules, parts 
64.2 	9530.6510 to 9530.6590, to provide detoxification services shall pay an annual 
64.3 	nonrefundable license fee based on the following schedule:

64.4		Licensed Capacity
	License Fee
	
64.5		1 to 24 persons
	$760
	
64.6		25 to 49 persons
	$960
	
64.7		50 or more persons
	$1,160
	
64.8 	(k) Except for child foster care, a residential facility licensed under Minnesota 
64.9 	Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee 
64.10 	based on the following schedule:

64.11		Licensed Capacity
	License Fee
	
64.12		1 to 24 persons
	$1,000
	
64.13		25 to 49 persons
	$1,100
	
64.14		50 to 74 persons
	$1,200
	
64.15		75 to 99 persons
	$1,300
	
64.16		100 or more persons
	$1,400
	
64.17 	(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to 
64.18 	9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license 
64.19 	fee based on the following schedule:

64.20		Licensed Capacity
	License Fee
	
64.21		1 to 24 persons
	$2,525
	
64.22		25 or more persons
	$2,725
	
64.23 	(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 
64.24 	9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable 
64.25 	license fee based on the following schedule:

64.26		Licensed Capacity
	License Fee
	
64.27		1 to 24 persons
	$450
	
64.28		25 to 49 persons
	$650
	
64.29		50 to 74 persons
	$850
	
64.30		75 to 99 persons
	$1,050
	
64.31		100 or more persons
	$1,250
	
64.32 	(n) A program licensed to provide independent living assistance for youth under 
64.33 	section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
64.34 	(o) A private agency licensed to provide foster care and adoption services under 
64.35 	Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable 
64.36 	license fee of $875.
65.1 	(p) A program licensed as an adult day care center licensed under Minnesota Rules, 
65.2 	parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on 
65.3 	the following schedule:

65.4		Licensed Capacity
	License Fee
	
65.5		1 to 24 persons
	$500
	
65.6		25 to 49 persons
	$700
	
65.7		50 to 74 persons
	$900
	
65.8		75 to 99 persons
	$1,100
	
65.9		100 or more persons
	$1,300
	
65.10 	(q) A program licensed to provide treatment services to persons with sexual 
65.11 	psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts 
65.12 	9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
65.13 	(r) A mental health center or mental health clinic requesting certification for 
65.14 	purposes of insurance and subscriber contract reimbursement under Minnesota Rules, 
65.15 	parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the 
65.16 	mental health center or mental health clinic provides services at a primary location with 
65.17 	satellite facilities, the satellite facilities shall be certified with the primary location without 
65.18 	an additional charge.

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

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

65.33 	Sec. 6. Minnesota Statutes 2010, section 245A.11, subdivision 2b, is amended to read:
66.1 		Subd. 2b.Adult foster care; family adult day services. An adult foster care 
66.2 	license holder licensed under the conditions in subdivision 2a may also provide family 
66.3 	adult day care for adults age 55 age 18 or over if no persons in the adult foster or family 
66.4 	adult day services program have a serious and persistent mental illness or a developmental 
66.5 	disability. Family adult day services provided in a licensed adult foster care setting must 
66.6 	be provided as specified under section 245A.143. Authorization to provide family adult 
66.7 	day services in the adult foster care setting shall be printed on the license certificate by 
66.8 	the commissioner. Adult foster care homes licensed under this section and family adult 
66.9 	day services licensed under section 245A.143 shall not be subject to licensure by the 
66.10 	commissioner of health under the provisions of chapter 144, 144A, 157, or any other 
66.11 	law requiring facility licensure by the commissioner of health. A separate license is not 
66.12 	required to provide family adult day services in a licensed adult foster care home.

66.13 	Sec. 7. Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read:
66.14 		Subdivision 1.Scope. (a) The licensing standards in this section must be met to 
66.15 	obtain and maintain a license to provide family adult day services. For the purposes of this 
66.16 	section, family adult day services means a program operating fewer than 24 hours per day 
66.17 	that provides functionally impaired adults, none of which are under age 55, have serious 
66.18 	or persistent mental illness, or have developmental disabilities, age 18 or older with an 
66.19 	individualized and coordinated set of services including health services, social services, 
66.20 	and nutritional services that are directed at maintaining or improving the participants' 
66.21 	capabilities for self-care.
66.22 	(b) A family adult day services license shall only be issued when the services are 
66.23 	provided in the license holder's primary residence, and the license holder is the primary 
66.24 	provider of care. The license holder may not serve more than eight adults at one time, 
66.25 	including residents, if any, served under a license issued under Minnesota Rules, parts 
66.26 	9555.5105 to 9555.6265.
66.27 	(c) An adult foster care license holder may provide family adult day services under 
66.28 	the license holder's adult foster care license if the license holder meets the requirements 
66.29 	of this section.
66.30 	(d) When an applicant or license holder submits an application for initial licensure 
66.31 	or relicensure for both adult foster care and family adult day services, the county agency 
66.32 	shall process the request as a single application and shall conduct concurrent routine 
66.33 	licensing inspections.
66.34 	(e) Adult foster care license holders providing family adult day services under their 
66.35 	foster care license on March 30, 2004, shall be permitted to continue providing these 
67.1 	services with no additional requirements until their adult foster care license is due for 
67.2 	renewal. At the time of relicensure, an adult foster care license holder may continue to 
67.3 	provide family adult day services upon demonstration of compliance with this section. 
67.4 	Adult foster care license holders who provide only family adult day services on August 1, 
67.5 	2004, may apply for a license under this section instead of an adult foster care license.

67.6 	Sec. 8. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision 
67.7 	to read:
67.8 		Subd. 9.Human services licensed programs. The commissioner shall recover 
67.9 	the cost of background studies required under section 245C.03, subdivision 1, for all 
67.10 	programs that are licensed by the commissioner, except child foster care and family child 
67.11 	care, through a fee of no more than $20 per study charged to the license holder. The fees 
67.12 	collected under this subdivision are appropriated to the commissioner for the purpose of 
67.13 	conducting background studies.

67.14 	Sec. 9. Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read:
67.15 		Subd. 16a.Medical assistance reimbursement. (a) The commissioner shall 
67.16 	seek federal approval for medical assistance reimbursement of independent living skills 
67.17 	services, foster care waiver service, supported employment, prevocational service, and 
67.18 	structured day service under the home and community-based waiver for persons with a 
67.19 	traumatic brain injury, the community alternatives for disabled individuals waivers, and 
67.20 	the community alternative care waivers.
67.21 	(b) Medical reimbursement shall be made only when the provider demonstrates 
67.22 	evidence of its capacity to meet basic health, safety, and protection standards through 
67.23 	the following methods:
67.24 	(1) for independent living skills services, supported employment, prevocational 
67.25 	service, and structured day service through one of the methods in paragraphs (c) and 
67.26 	(d); and
67.27 	(2) for foster care waiver services through the method in paragraph (e).
67.28 	(c) The provider is licensed to provide services under chapter 245B and agrees 
67.29 	to apply these standards to services funded through the traumatic brain injury, 
67.30 	community alternatives for disabled persons, or community alternative care home and 
67.31 	community-based waivers.
67.32 	(d) The commissioner shall certify that the provider has policies and procedures 
67.33 	governing the following:
67.34 	(1) protection of the consumer's rights and privacy;
68.1 	(2) risk assessment and planning;
68.2 	(3) record keeping and reporting of incidents and emergencies with documentation 
68.3 	of corrective action if needed;
68.4 	(4) service outcomes, regular reviews of progress, and periodic reports;
68.5 	(5) complaint and grievance procedures;
68.6 	(6) service termination or suspension;
68.7 	(7) necessary training and supervision of direct care staff that includes:
68.8 	(i) documentation in personnel files of 20 hours of orientation training in providing 
68.9 	training related to service provision;
68.10 	(ii) training in recognizing the symptoms and effects of certain disabilities, health 
68.11 	conditions, and positive behavioral supports and interventions;
68.12 	(iii) a minimum of five hours of related training annually; and
68.13 	(iv) when applicable:
68.14 	(A) safe medication administration;
68.15 	(B) proper handling of consumer funds; and
68.16 	(C) compliance with prohibitions and standards developed by the commissioner to 
68.17 	satisfy federal requirements regarding the use of restraints and restrictive interventions. 
68.18 	The commissioner shall review at least biennially that each service provider's policies 
68.19 	and procedures governing basic health, safety, and protection of rights continue to meet 
68.20 	minimum standards.
68.21 	(e) The commissioner shall seek federal approval for Medicaid reimbursement 
68.22 	of foster care services under the home and community-based waiver for persons with 
68.23 	a traumatic brain injury, the community alternatives for disabled individuals waiver, 
68.24 	and community alternative care waiver when the provider demonstrates evidence of 
68.25 	its capacity to meet basic health, safety, and protection standards. The commissioner 
68.26 	shall verify that the adult foster care provider is licensed under Minnesota Rules, parts 
68.27 	9555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster 
68.28 	care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and 
68.29 	certify that the provider has policies and procedures that govern:
68.30 	(1) compliance with prohibitions and standards developed by the commissioner to 
68.31 	meet federal requirements regarding the use of restraints and restrictive interventions;
68.32 	(2) documentation of service needs and outcomes, regular reviews of progress, 
68.33 	and periodic reports; and
68.34 	(3) safe medication management and administration.
69.1 	The commissioner shall review at least biennially that each service provider's policies and 
69.2 	procedures governing basic health, safety, and protection of rights standards continue to 
69.3 	meet minimum standards.
69.4 	(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement 
69.5 	of family adult day services under all disability waivers. After the waiver is granted, the 
69.6 	commissioner shall include family adult day services in the common services menu that 
69.7 	is currently under development.

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

69.9 	Sec. 10.  REPEALER.
 69.10 	Minnesota Statutes 2010, section 245A.10, subdivision 5, is repealed.

69.11 	ARTICLE 5
69.12 	HEALTH-RELATED LICENSING

69.13 	Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:
69.14 		Subdivision 1.Renewal fees. All persons practicing chiropractic within this state, 
69.15 	or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the 
69.16 	Board of Chiropractic Examiners a renewal fee set by the board in accordance with section 
69.17 	16A.1283, with a penalty set by the board for each month or portion thereof for which a 
69.18 	license fee is in arrears and upon payment of the renewal and upon compliance with all the 
69.19 	rules of the board, shall be entitled to renewal of their license.

69.20 	Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision 
69.21 	to read:
69.22 		Subd. 4.Animal chiropractic. (a) Animal chiropractic registration fee is $125.
69.23 	(b) Animal chiropractic registration renewal fee is $75.
69.24 	(c) Animal chiropractic inactive renewal fee is $25.

69.25 	Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
69.26 		Subd. 2.Powers. (a) The board is authorized to adopt and, from time to time, revise 
69.27 	rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 
69.28 	provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula 
69.29 	and standards for schools and courses preparing persons for licensure under sections 
69.30 	148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses 
69.31 	at such times as it may deem necessary. It shall approve such schools and courses as 
70.1 	meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine, 
70.2 	license, and renew the license of duly qualified applicants. It shall hold examinations 
70.3 	at least once in each year at such time and place as it may determine. It shall by rule 
70.4 	adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for 
70.5 	registration and renewal of registration as defined in section 148.231. It shall maintain a 
70.6 	record of all persons licensed by the board to practice professional or practical nursing and 
70.7 	all registered nurses who hold Minnesota licensure and registration and are certified as 
70.8 	advanced practice registered nurses. It shall cause the prosecution of all persons violating 
70.9 	sections 148.171 to 148.285 and have power to incur such necessary expense therefor. 
70.10 	It shall register public health nurses who meet educational and other requirements 
70.11 	established by the board by rule, including payment of a fee. Prior to the adoption of rules, 
70.12 	the board shall use the same procedures used by the Department of Health to certify public 
70.13 	health nurses. It shall have power to issue subpoenas, and to compel the attendance of 
70.14 	witnesses and the production of all necessary documents and other evidentiary material. 
70.15 	Any board member may administer oaths to witnesses, or take their affirmation. It shall 
70.16 	keep a record of all its proceedings. 
70.17 	(b) The board shall have access to hospital, nursing home, and other medical records 
70.18 	of a patient cared for by a nurse under review. If the board does not have a written consent 
70.19 	from a patient permitting access to the patient's records, the nurse or facility shall delete 
70.20 	any data in the record that identifies the patient before providing it to the board. The board 
70.21 	shall have access to such other records as reasonably requested by the board to assist the 
70.22 	board in its investigation. Nothing herein may be construed to allow access to any records 
70.23 	protected by section 145.64. The board shall maintain any records obtained pursuant to 
70.24 	this paragraph as investigative data under chapter 13. 
70.25 	(c) The board may accept and expend grants or gifts of money or in-kind services 
70.26 	from a person, a public or private entity, or any other source for purposes consistent with 
70.27 	the board's role and within the scope of its statutory authority.
70.28 	(d) The board may accept registration fees for meetings and conferences conducted 
70.29 	for the purposes of board activities that are within the scope of its authority.

70.30 	Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
70.31 		Subdivision 1.Issuance. Upon receipt of the applicable licensure or reregistration 
70.32 	fee and permit fee, and in accordance with rules of the board, the board may issue 
70.33 	a nonrenewable temporary permit to practice professional or practical nursing to an 
70.34 	applicant for licensure or reregistration who is not the subject of a pending investigation 
71.1 	or disciplinary action, nor disqualified for any other reason, under the following 
71.2 	circumstances:
71.3 	(a) The applicant for licensure by examination under section 148.211, subdivision 
71.4 	1, has graduated from an approved nursing program within the 60 days preceding board 
71.5 	receipt of an affidavit of graduation or transcript and has been authorized by the board to 
71.6 	write the licensure examination for the first time in the United States. The permit holder 
71.7 	must practice professional or practical nursing under the direct supervision of a registered 
71.8 	nurse. The permit is valid from the date of issue until the date the board takes action on 
71.9 	the application or for 60 days whichever occurs first. 
71.10 	(b) The applicant for licensure by endorsement under section 148.211, subdivision 2, 
71.11 	is currently licensed to practice professional or practical nursing in another state, territory, 
71.12 	or Canadian province. The permit is valid from submission of a proper request until the 
71.13 	date of board action on the application or for 60 days, whichever comes first. 
71.14 	(c) (b) The applicant for licensure by endorsement under section 148.211, 
71.15 	subdivision 2, or for reregistration under section 148.231, subdivision 5, is currently 
71.16 	registered in a formal, structured refresher course or its equivalent for nurses that includes 
71.17 	clinical practice. 
71.18 	(d) The applicant for licensure by examination under section 148.211, subdivision 
71.19 	1, who graduated from a nursing program in a country other than the United States or 
71.20 	Canada has completed all requirements for licensure except registering for and taking the 
71.21 	nurse licensure examination for the first time in the United States. The permit holder must 
71.22 	practice professional nursing under the direct supervision of a registered nurse. The permit 
71.23 	is valid from the date of issue until the date the board takes action on the application or for 
71.24 	60 days, whichever occurs first. 

71.25 	Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:
71.26 	148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION; 
71.27 	VERIFICATION.
71.28 		Subdivision 1.Registration. Every person licensed to practice professional or 
71.29 	practical nursing must maintain with the board a current registration for practice as a 
71.30 	registered nurse or licensed practical nurse which must be renewed at regular intervals 
71.31 	established by the board by rule. No certificate of registration shall be issued by the board 
71.32 	to a nurse until the nurse has submitted satisfactory evidence of compliance with the 
71.33 	procedures and minimum requirements established by the board.
71.34 	The fee for periodic registration for practice as a nurse shall be determined by the 
71.35 	board by rule law. A penalty fee shall be added for any application received after the 
72.1 	required date as specified by the board by rule. Upon receipt of the application and the 
72.2 	required fees, the board shall verify the application and the evidence of completion of 
72.3 	continuing education requirements in effect, and thereupon issue to the nurse a certificate 
72.4 	of registration for the next renewal period.
72.5 		Subd. 4.Failure to register. Any person licensed under the provisions of sections 
72.6 	148.171 to 148.285 who fails to register within the required period shall not be entitled to 
72.7 	practice nursing in this state as a registered nurse or licensed practical nurse. 
72.8 		Subd. 5.Reregistration. A person whose registration has lapsed desiring to 
72.9 	resume practice shall make application for reregistration, submit satisfactory evidence of 
72.10 	compliance with the procedures and requirements established by the board, and pay the 
72.11 	registration reregistration fee for the current period to the board. A penalty fee shall be 
72.12 	required from a person who practiced nursing without current registration. Thereupon, the
72.13 	registration certificate shall be issued to the person who shall immediately be placed on 
72.14 	the practicing list as a registered nurse or licensed practical nurse.
72.15 		Subd. 6.Verification. A person licensed under the provisions of sections 148.171 to 
72.16 	148.285 who requests the board to verify a Minnesota license to another state, territory, 
72.17 	or country or to an agency, facility, school, or institution shall pay a fee to the board
72.18 	for each verification. 

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

72.22 	Sec. 7. [148.243] FEE AMOUNTS.
72.23 		Subdivision 1.Licensure by examination. The fee for licensure by examination is 
72.24 	$105.
72.25 		Subd. 2.Reexamination fee. The reexamination fee is $60.
72.26 		Subd. 3.Licensure by endorsement. The fee for licensure by endorsement is $105.
72.27 		Subd. 4.Registration renewal. The fee for registration renewal is $85.
72.28 		Subd. 5.Reregistration. The fee for reregistration is $105.
72.29 		Subd. 6.Replacement license. The fee for a replacement license is $20.
72.30 		Subd. 7.Public health nurse certification. The fee for public health nurse 
72.31 	certification is $30.
72.32 		Subd. 8.Drug Enforcement Administration verification for Advanced Practice 
72.33 	Registered Nurse (APRN). The Drug Enforcement Administration verification for 
72.34 	APRN is $50.
73.1 		Subd. 9.Licensure verification other than through Nursys. The fee for 
73.2 	verification of licensure status other than through Nursys verification is $20.
73.3 		Subd. 10.Verification of examination scores. The fee for verification of 
73.4 	examination scores is $20.
73.5 		Subd. 11.Microfilmed licensure application materials. The fee for a copy of 
73.6 	microfilmed licensure application materials is $20.
73.7 		Subd. 12.Nursing business registration; initial application. The fee for the initial 
73.8 	application for nursing business registration is $100.
73.9 		Subd. 13.Nursing business registration; annual application. The fee for the 
73.10 	annual application for nursing business registration is $25.
73.11 		Subd. 14.Practicing without current registration. The fee for practicing without 
73.12 	current registration is two times the amount of the current registration renewal fee for any 
73.13 	part of the first calendar month, plus the current registration renewal fee for any part of 
73.14 	any subsequent month up to 24 months.
73.15 		Subd. 15.Practicing without current APRN certification. The fee for practicing 
73.16 	without current APRN certification is $200 for the first month or any part thereof, plus 
73.17 	$100 for each subsequent month or part thereof.
73.18 		Subd. 16.Dishonored check fee. The service fee for a dishonored check is as 
73.19 	provided in section 604.113.
73.20 		Subd. 17.Border state registry fee. The initial application fee for border state 
73.21 	registration is $50. Any subsequent notice of employment change to remain or be 
73.22 	reinstated on the registry is $50.

73.23 	Sec. 8. Minnesota Statutes 2010, section 148B.17, is amended to read:
73.24 	148B.17 FEES.
73.25 		Subdivision. 1.Fees; Board of Marriage and Family Therapy. Each board shall 
73.26 	by rule establish The board's fees, including late fees, for licenses and renewals are 
73.27 	established so that the total fees collected by the board will as closely as possible equal 
73.28 	anticipated expenditures during the fiscal biennium, as provided in section 16A.1285. 
73.29 	Fees must be credited to accounts the board's account in the state government special 
73.30 	revenue fund. 
73.31 		Subd. 2.Licensure and application fees. Nonrefundable licensure and application 
73.32 	fees charged by the board are as follows:
73.33 	(1) application fee for national examination is $220;
73.34 	(2) application fee for Licensed Marriage and Family Therapist (LMFT) state 
73.35 	examination is $110;
74.1 	(3) initial LMFT license fee is prorated, but cannot exceed $125;
74.2 	(4) annual renewal fee for LMFT license is $125;
74.3 	(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT 
74.4 	license renewal is $50;
74.5 	(6) application fee for LMFT licensure by reciprocity is $340;
74.6 	(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) 
74.7 	license is $75;
74.8 	(8) annual renewal fee for LAMFT license is $75;
74.9 	(9) late fee for LAMFT renewal is $50;
74.10 	(10) fee for reinstatement of license is $150; and 
74.11 	(11) fee for emeritus status is $125.
74.12 		Subd. 3.Other fees. Other fees charged by the board are as follows:
74.13 	(1) sponsor application fee for approval of a continuing education course is $60;
74.14 	(2) fee for license verification by mail is $10;
74.15 	(3) duplicate license fee is $25;
74.16 	(4) duplicate renewal card fee is $10;
74.17 	(5) fee for licensee mailing list is $60;
74.18 	(6) fee for a rule book is $10; and
74.19 	(7) fees as authorized by section 148B.175, subdivision 6, clause (7).

74.20 	Sec. 9. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:
74.21 		Subd. 2.Fee. Each applicant shall pay a nonrefundable application fee set by 
74.22 	the board under section 148B.17.

74.23 	Sec. 10. Minnesota Statutes 2010, section 148B.52, is amended to read:
74.24 	148B.52 DUTIES OF THE BOARD.
74.25 	(a) The Board of Behavioral Health and Therapy shall:
74.26 	(1) establish by rule appropriate techniques, including examinations and other 
74.27 	methods, for determining whether applicants and licensees are qualified under sections 
74.28 	148B.50 to 148B.593; 
74.29 	(2) establish by rule standards for professional conduct, including adoption of a 
74.30 	Code of Professional Ethics and requirements for continuing education and supervision;
74.31 	(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593; 
74.32 	(4) establish by rule standards for initial education including coursework for 
74.33 	licensure and content of professional education;
75.1 	(5) establish, maintain, and publish annually a register of current licensees and 
75.2 	approved supervisors;
75.3 	(6) establish initial and renewal application and examination fees sufficient to cover 
75.4 	operating expenses of the board and its agents in accordance with section 16A.1283;
75.5 	(7) educate the public about the existence and content of the laws and rules for 
75.6 	licensed professional counselors to enable consumers to file complaints against licensees 
75.7 	who may have violated the rules; and
75.8 	(8) periodically evaluate its rules in order to refine the standards for licensing 
75.9 	professional counselors and to improve the methods used to enforce the board's standards.
75.10 	(b) The board may appoint a professional discipline committee for each occupational 
75.11 	licensure regulated by the board, and may appoint a board member as chair. The 
75.12 	professional discipline committee shall consist of five members representative of the 
75.13 	licensed occupation and shall provide recommendations to the board with regard to rule 
75.14 	techniques, standards, procedures, and related issues specific to the licensed occupation.

75.15 	Sec. 11. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:
75.16 		Subd. 2.Application fees. Each applicant shall submit with a license, advanced 
75.17 	dental therapist certificate, or permit application a nonrefundable fee in the following 
75.18 	amounts in order to administratively process an application:
75.19 	(1) dentist, $140;
75.20 	(2) full faculty dentist, $140;
75.21 	(2) (3) limited faculty dentist, $140;
75.22 	(3) (4) resident dentist or dental provider, $55;
75.23 	(5) advanced dental therapist, $100;
75.24 	(4) (6) dental therapist, $100;
75.25 	(5) (7) dental hygienist, $55;
75.26 	(6) (8) licensed dental assistant, $55; and
75.27 	(7) (9) dental assistant with a permit as described in Minnesota Rules, part 
75.28 	3100.8500, subpart 3, $15.

75.29 	Sec. 12. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:
75.30 		Subd. 3.Initial license or permit fees. Along with the application fee, each of the 
75.31 	following applicants shall submit a separate prorated initial license or permit fee. The 
75.32 	prorated initial fee shall be established by the board based on the number of months of the 
75.33 	applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to 
75.34 	exceed the following monthly fee amounts:
76.1 	(1) dentist or full faculty dentist, $14 times the number of months of the initial term;
76.2 	(2) dental therapist, $10 times the number of months of the initial term;
76.3 	(3) dental hygienist, $5 times the number of months of the initial term;
76.4 	(4) licensed dental assistant, $3 times the number of months of the initial term; and
76.5 	(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 
76.6 	subpart 3, $1 times the number of months of the initial term.

76.7 	Sec. 13. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:
76.8 		Subd. 4.Annual license fees. Each limited faculty or resident dentist shall submit 
76.9 	with an annual license renewal application a fee established by the board not to exceed 
76.10 	the following amounts:
76.11 	(1) limited faculty dentist, $168; and
76.12 	(2) resident dentist or dental provider, $59.

76.13 	Sec. 14. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:
76.14 		Subd. 5.Biennial license or permit fees. Each of the following applicants shall 
76.15 	submit with a biennial license or permit renewal application a fee as established by the 
76.16 	board, not to exceed the following amounts:
76.17 	(1) dentist or full faculty dentist, $336;
76.18 	(2) dental therapist, $180;
76.19 	(3) dental hygienist, $118;
76.20 	(4) licensed dental assistant, $80; and
76.21 	(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, 
76.22 	subpart 3, $24.

76.23 	Sec. 15. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:
76.24 		Subd. 8.Duplicate license or certificate fee. Each applicant shall submit, with 
76.25 	a request for issuance of a duplicate of the original license, or of an annual or biennial 
76.26 	renewal certificate for a license or permit, a fee in the following amounts:
76.27 	(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental 
76.28 	assistant license, $35; and
76.29 	(2) annual or biennial renewal certificates, $10.

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

77.5 	Sec. 17. [151.065] FEE AMOUNTS.
77.6 		Subdivision 1.Application fees. Application fees for licensure and registration 
77.7 	are as follows:
77.8 	(1) pharmacist licensed by examination, $130;
77.9 	(2) pharmacist licensed by reciprocity, $225;
77.10 	(3) pharmacy intern, $30;
77.11 	(4) pharmacy technician, $30;
77.12 	(5) pharmacy, $190;
77.13 	(6) drug wholesaler, legend drugs only, $200;
77.14 	(7) drug wholesaler, legend and nonlegend drugs, $200;
77.15 	(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
77.16 	(9) drug wholesaler, medical gases, $150;
77.17 	(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
77.18 	(11) drug manufacturer, legend drugs only, $200;
77.19 	(12) drug manufacturer, legend and nonlegend drugs, $200;
77.20 	(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
77.21 	(14) drug manufacturer, medical gases, $150;
77.22 	(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
77.23 	(16) medical gas distributor, $75;
77.24 	(17) controlled substance researcher, $50; and
77.25 	(18) pharmacy professional corporation, $100.
77.26 		Subd. 2.Original license fee. The pharmacist original licensure fee, $130.
77.27 		Subd. 3.Annual renewal fees. Annual licensure and registration renewal fees 
77.28 	are as follows:
77.29 	(1) pharmacist, $130;
77.30 	(2) pharmacy technician, $30;
77.31 	(3) pharmacy, $190;
77.32 	(4) drug wholesaler, legend drugs only, $200;
77.33 	(5) drug wholesaler, legend and nonlegend drugs, $200;
77.34 	(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
77.35 	(7) drug wholesaler, medical gases, $150;
78.1 	(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
78.2 	(9) drug manufacturer, legend drugs only, $200;
78.3 	(10) drug manufacturer, legend and nonlegend drugs, $200;
78.4 	(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;
78.5 	(12) drug manufacturer, medical gases, $150;
78.6 	(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
78.7 	(14) medical gas distributor, $75;
78.8 	(15) controlled substance researcher, $50; and
78.9 	(16) pharmacy professional corporation, $45.
78.10 		Subd. 4.Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses 
78.11 	and certificates are as follows:
78.12 	(1) intern affidavit, $15;
78.13 	(2) duplicate small license, $15; and
78.14 	(3) duplicate large certificate, $25.
78.15 		Subd. 5.Late fees. All annual renewal fees are subject to a 50 percent late fee if 
78.16 	the renewal fee and application are not received by the board prior to the date specified 
78.17 	by the board.
78.18 		Subd. 6.Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's 
78.19 	license to lapse may reinstate the license with board approval and upon payment of any 
78.20 	fees and late fees in arrears, up to a maximum of $1,000.
78.21 	(b) A pharmacy technician who has allowed the technician's registration to lapse 
78.22 	may reinstate the registration with board approval and upon payment of any fees and late 
78.23 	fees in arrears, up to a maximum of $90.
78.24 	(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical 
78.25 	gas distributor who has allowed the license of the establishment to lapse may reinstate the 
78.26 	license with board approval and upon payment of any fees and late fees in arrears.
78.27 	(d) A controlled substance researcher who has allowed the researcher's registration 
78.28 	to lapse may reinstate the registration with board approval and upon payment of any fees 
78.29 	and late fees in arrears.
78.30 	(e) A pharmacist owner of a professional corporation who has allowed the 
78.31 	corporation's registration to lapse may reinstate the registration with board approval and 
78.32 	upon payment of any fees and late fees in arrears.

78.33 	Sec. 18. Minnesota Statutes 2010, section 151.07, is amended to read:
78.34 	151.07 MEETINGS; EXAMINATION FEE.
79.1 	The board shall meet at times as may be necessary and as it may determine to 
79.2 	examine applicants for licensure and to transact its other business, giving reasonable 
79.3 	notice of all examinations by mail to known applicants therefor. The secretary shall record 
79.4 	the names of all persons licensed by the board, together with the grounds upon which 
79.5 	the right of each to licensure was claimed. The fee for examination shall be in such the 
79.6 	 amount as the board may determine specified in section 151.065, which fee may in the 
79.7 	discretion of the board be returned to applicants not taking the examination.

79.8 	Sec. 19. Minnesota Statutes 2010, section 151.101, is amended to read:
79.9 	151.101 INTERNSHIP.
79.10 	Upon payment of the fee specified in section 151.065, the board may license register
79.11 	as an intern any natural persons who have satisfied the board that they are of good moral 
79.12 	character, not physically or mentally unfit, and who have successfully completed the 
79.13 	educational requirements for intern licensure registration prescribed by the board. The 
79.14 	board shall prescribe standards and requirements for interns, pharmacist-preceptors, and 
79.15 	internship training but may not require more than one year of such training.
79.16 	The board in its discretion may accept internship experience obtained in another 
79.17 	state provided the internship requirements in such other state are in the opinion of the 
79.18 	board equivalent to those herein provided.

79.19 	Sec. 20. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision 
79.20 	to read:
79.21 		Subd. 3.Registration fee. The board shall not register an individual as a pharmacy 
79.22 	technician unless all applicable fees specified in section 151.065 have been paid.

79.23 	Sec. 21. Minnesota Statutes 2010, section 151.12, is amended to read:
79.24 	151.12 RECIPROCITY; LICENSURE.
79.25 	The board may in its discretion grant licensure without examination to any 
79.26 	pharmacist licensed by the Board of Pharmacy or a similar board of another state which 
79.27 	accords similar recognition to licensees of this state; provided, the requirements for 
79.28 	licensure in such other state are in the opinion of the board equivalent to those herein 
79.29 	provided. The fee for licensure shall be in such the amount as the board may determine by 
79.30 	rule specified in section 151.065.

79.31 	Sec. 22. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
80.1 		Subdivision 1.Renewal fee. Every person licensed by the board as a pharmacist 
80.2 	shall pay to the board a the annual renewal fee to be fixed by it specified in section 
80.3 	151.065. The board may promulgate by rule a charge to be assessed for the delinquent 
80.4 	payment of a fee. the late fee specified in section 151.065 if the renewal fee and 
80.5 	application are not received by the board prior to the date specified by the board. It shall 
80.6 	be unlawful for any person licensed as a pharmacist who refuses or fails to pay such any 
80.7 	applicable  renewal or late fee to practice pharmacy in this state. Every certificate and 
80.8 	license shall expire at the time therein prescribed.

80.9 	Sec. 23. Minnesota Statutes 2010, section 151.19, is amended to read:
80.10 	151.19 REGISTRATION; FEES.
80.11 		Subdivision 1.Pharmacy registration. The board shall require and provide for the 
80.12 	annual registration of every pharmacy now or hereafter doing business within this state. 
80.13 	Upon the payment of a any applicable  fee to be set by the board specified in section 
80.14 	151.065, the board shall issue a registration certificate in such form as it may prescribe to 
80.15 	such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be 
80.16 	displayed in a conspicuous place in the pharmacy for which it is issued and expire on the 
80.17 	30th day of June following the date of issue. It shall be unlawful for any person to conduct 
80.18 	a pharmacy unless such certificate has been issued to the person by the board.
80.19 		Subd. 2.Nonresident pharmacies. The board shall require and provide for an 
80.20 	annual nonresident special pharmacy registration for all pharmacies located outside of this 
80.21 	state that regularly dispense medications for Minnesota residents and mail, ship, or deliver 
80.22 	prescription medications into this state. Nonresident special pharmacy registration shall 
80.23 	be granted by the board upon payment of any applicable fee specified in section 151.065 
80.24 	and the disclosure and certification by a pharmacy:
80.25 	(1) that it is licensed in the state in which the dispensing facility is located and from 
80.26 	which the drugs are dispensed;
80.27 	(2) the location, names, and titles of all principal corporate officers and all 
80.28 	pharmacists who are dispensing drugs to residents of this state;
80.29 	(3) that it complies with all lawful directions and requests for information from 
80.30 	the Board of Pharmacy of all states in which it is licensed or registered, except that it 
80.31 	shall respond directly to all communications from the board concerning emergency 
80.32 	circumstances arising from the dispensing of drugs to residents of this state;
80.33 	(4) that it maintains its records of drugs dispensed to residents of this state so that the 
80.34 	records are readily retrievable from the records of other drugs dispensed;
81.1 	(5) that it cooperates with the board in providing information to the Board of 
81.2 	Pharmacy of the state in which it is licensed concerning matters related to the dispensing 
81.3 	of drugs to residents of this state;
81.4 	(6) that during its regular hours of operation, but not less than six days per week, for 
81.5 	a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate 
81.6 	communication between patients in this state and a pharmacist at the pharmacy who has 
81.7 	access to the patients' records; the toll-free number must be disclosed on the label affixed 
81.8 	to each container of drugs dispensed to residents of this state; and
81.9 	(7) that, upon request of a resident of a long-term care facility located within the 
81.10 	state of Minnesota, the resident's authorized representative, or a contract pharmacy or 
81.11 	licensed health care facility acting on behalf of the resident, the pharmacy will dispense 
81.12 	medications prescribed for the resident in unit-dose packaging or, alternatively, comply 
81.13 	with the provisions of section 151.415, subdivision 5.
81.14 		Subd. 3.Sale of federally restricted medical gases. The board shall require and 
81.15 	provide for the annual registration of every person or establishment not licensed as a 
81.16 	pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted 
81.17 	medical gases. Upon the payment of a any applicable  fee to be set by the board specified 
81.18 	in section 151.065, the board shall issue a registration certificate in such form as it may 
81.19 	prescribe to those persons or places that may be qualified to sell or distribute federally 
81.20 	restricted medical gases. The certificate shall be displayed in a conspicuous place in the 
81.21 	business for which it is issued and expire on the date set by the board. It is unlawful for 
81.22 	a person to sell or distribute federally restricted medical gases unless a certificate has 
81.23 	been issued to that person by the board.

81.24 	Sec. 24. Minnesota Statutes 2010, section 151.25, is amended to read:
81.25 	151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
81.26 	The board shall require and provide for the annual registration of every person 
81.27 	engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes, 
81.28 	now or hereafter doing business with accounts in this state. Upon a payment of a any 
81.29 	applicable fee as set by the board specified in section 151.065, the board shall issue a 
81.30 	registration certificate in such form as it may prescribe to such manufacturer. Such 
81.31 	registration certificate shall be displayed in a conspicuous place in such manufacturer's 
81.32 	or wholesaler's place of business for which it is issued and expire on the date set by the 
81.33 	board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals, 
81.34 	or poisons for medicinal purposes unless such a certificate has been issued to the person 
81.35 	by the board. It shall be unlawful for any person engaged in the manufacture of drugs, 
82.1 	medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell 
82.2 	legend drugs to other than a pharmacy, except as provided in this chapter.

82.3 	Sec. 25. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
82.4 		Subdivision 1.Requirements. All wholesale drug distributors are subject to the 
82.5 	requirements in paragraphs (a) to (f).
82.6 	(a) No person or distribution outlet shall act as a wholesale drug distributor without 
82.7 	first obtaining a license from the board and paying the required any applicable  fee
82.8 	specified in section 151.065.
82.9 	(b) No license shall be issued or renewed for a wholesale drug distributor to operate 
82.10 	unless the applicant agrees to operate in a manner prescribed by federal and state law and 
82.11 	according to the rules adopted by the board.
82.12 	(c) The board may require a separate license for each facility directly or indirectly 
82.13 	owned or operated by the same business entity within the state, or for a parent entity 
82.14 	with divisions, subsidiaries, or affiliate companies within the state, when operations 
82.15 	are conducted at more than one location and joint ownership and control exists among 
82.16 	all the entities.
82.17 	(d) As a condition for receiving and retaining a wholesale drug distributor license 
82.18 	issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has 
82.19 	and will continuously maintain: 
82.20 	(1) adequate storage conditions and facilities;
82.21 	(2) minimum liability and other insurance as may be required under any applicable 
82.22 	federal or state law;
82.23 	(3) a viable security system that includes an after hours central alarm, or comparable 
82.24 	entry detection capability; restricted access to the premises; comprehensive employment 
82.25 	applicant screening; and safeguards against all forms of employee theft;
82.26 	(4) a system of records describing all wholesale drug distributor activities set forth 
82.27 	in section 151.44 for at least the most recent two-year period, which shall be reasonably 
82.28 	accessible as defined by board regulations in any inspection authorized by the board; 
82.29 	(5) principals and persons, including officers, directors, primary shareholders, 
82.30 	and key management executives, who must at all times demonstrate and maintain their 
82.31 	capability of conducting business in conformity with sound financial practices as well 
82.32 	as state and federal law;
82.33 	(6) complete, updated information, to be provided to the board as a condition for 
82.34 	obtaining and retaining a license, about each wholesale drug distributor to be licensed, 
83.1 	including all pertinent corporate licensee information, if applicable, or other ownership, 
83.2 	principal, key personnel, and facilities information found to be necessary by the board;
83.3 	(7) written policies and procedures that assure reasonable wholesale drug distributor 
83.4 	preparation for, protection against, and handling of any facility security or operation 
83.5 	problems, including, but not limited to, those caused by natural disaster or government 
83.6 	emergency, inventory inaccuracies or product shipping and receiving, outdated product 
83.7 	or other unauthorized product control, appropriate disposition of returned goods, and 
83.8 	product recalls;
83.9 	(8) sufficient inspection procedures for all incoming and outgoing product 
83.10 	shipments; and
83.11 	(9) operations in compliance with all federal requirements applicable to wholesale 
83.12 	drug distribution.
83.13 	(e) An agent or employee of any licensed wholesale drug distributor need not seek 
83.14 	licensure under this section.
83.15 	(f) A wholesale drug distributor shall file with the board an annual report, in a 
83.16 	form and on the date prescribed by the board, identifying all payments, honoraria, 
83.17 	reimbursement or other compensation authorized under section 151.461, clauses (3) to 
83.18 	(5), paid to practitioners in Minnesota during the preceding calendar year. The report 
83.19 	shall identify the nature and value of any payments totaling $100 or more, to a particular 
83.20 	practitioner during the year, and shall identify the practitioner. Reports filed under this 
83.21 	provision are public data. 

83.22 	Sec. 26. Minnesota Statutes 2010, section 151.48, is amended to read:
83.23 	151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
83.24 	(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business 
83.25 	in the state without first obtaining a license from the board and paying the required any 
83.26 	applicable fee specified in section 151.065.
83.27 	(b) Application for an out-of-state wholesale drug distributor license under this 
83.28 	section shall be made on a form furnished by the board.
83.29 	(c) No person acting as principal or agent for any out-of-state wholesale drug 
83.30 	distributor may sell or distribute drugs in the state unless the distributor has obtained 
83.31 	a license.
83.32 	(d) The board may adopt regulations that permit out-of-state wholesale drug 
83.33 	distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state 
83.34 	wholesale drug distributor:
84.1 	(1) possesses a valid license granted by another state under legal standards 
84.2 	comparable to those that must be met by a wholesale drug distributor of this state as 
84.3 	prerequisites for obtaining a license under the laws of this state; and
84.4 	(2) can show that the other state would extend reciprocal treatment under its own 
84.5 	laws to a wholesale drug distributor of this state.

84.6 	Sec. 27. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
84.7 		Subd. 3.Research project use of controlled substances. Any qualified person 
84.8 	may use controlled substances in the course of a bona fide research project but cannot 
84.9 	administer or dispense such drugs to human beings unless such drugs are prescribed, 
84.10 	dispensed and administered by a person lawfully authorized to do so. Every person 
84.11 	who engages in research involving the use of such substances shall apply annually for 
84.12 	registration by the state Board of Pharmacy and shall pay any applicable fee specified in 
84.13 	section 151.065, provided that such registration shall not be required if the person is 
84.14 	covered by and has complied with federal laws covering such research projects.

84.15 	Sec. 28. [214.107] HEALTH-RELATED LICENSING BOARDS 
84.16 	ADMINISTRATIVE SERVICES UNIT.
84.17 		Subdivision 1.Establishment. An administrative services unit is established 
84.18 	for the health-related licensing boards in section 214.01, subdivision 2, to perform 
84.19 	administrative, financial, and management functions common to all the boards in a manner 
84.20 	that streamlines services, reduces expenditures, targets the use of state resources, and 
84.21 	meets the mission of public protection.
84.22 		Subd. 2.Authority. The administrative services unit shall act as an agent of the 
84.23 	boards.
84.24 		Subd. 3.Funding. (a) The administrative service unit shall apportion among the 
84.25 	health-related licensing boards an amount to be allocated to each health-related licensing 
84.26 	board. The amount apportioned to each board shall equal each board's share of the annual 
84.27 	operating costs for the unit and shall be deposited into the state government special 
84.28 	revenue fund.
84.29 	(b) The administrative services unit may receive and expend reimbursements for 
84.30 	services performed for other agencies.

84.31 	Sec. 29. REGISTRATION AND LICENSE RENEWALS; HEALTH-RELATED 
84.32 	LICENSING BOARDS.
 85.1 	For licenses and registrations due to be renewed between July 1, 2011, and the day 
85.2 	following final enactment of this section, no health-related licensing board, as defined 
85.3 	in Minnesota Statutes, section 214.01, subdivision 2, shall assess a late fee or initiate 
85.4 	disciplinary action against a licensee or registrant for failure to timely renew a valid 
85.5 	license or registration if the renewal application is submitted to the proper licensing 
85.6 	board by July 31, 2011.

85.7 	Sec. 30. EFFECTIVE DATE.
 85.8 	This article is effective the day following final enactment.

85.9 	ARTICLE 6
85.10 	HEALTH CARE

85.11 	Section 1. Minnesota Statutes 2010, section 13.461, subdivision 24a, is amended to 
85.12 	read:
85.13 		Subd. 24a.Managed care plans. Data provided to the commissioner of human 
85.14 	services by managed care plans relating to contracts and provider payment rates are 
85.15 	classified under section 256B.69, subdivisions 9a and 9b 9c.

85.16 	Sec. 2. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision 
85.17 	to read:
85.18 		Subd. 4g.Waiver of preexisting conditions for persons covered by healthy 
85.19 	Minnesota contribution program. A person may enroll in the comprehensive plan with 
85.20 	a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for 
85.21 	the healthy Minnesota contribution program, and has been denied coverage as described 
85.22 	under section 256L.031, subdivision 6.

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

85.24 	Sec. 3. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:
85.25 		Subd. 9.Growth limits; federal programs. The commissioners of health and 
85.26 	human services shall establish a rate methodology for Medicare and Medicaid risk-based 
85.27 	contracting with health plan companies that is consistent with statewide growth limits. 
85.28 	The methodology shall be presented for review by the Minnesota Health Care Commission 
85.29 	and the Legislative Commission on Health Care Access prior to the submission of a 
85.30 	waiver request to the Centers for Medicare and Medicaid Services and subsequent 
85.31 	implementation of the methodology.

86.1 	Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
86.2 	to read:
86.3 		Subd. 7.Authority to administer Minnesota electronic health record incentives 
86.4 	program. The commissioner of human services shall administer an electronic health 
86.5 	record incentives program according to section 4201 of the American Recovery and 
86.6 	Reinvestment Act, Public Law 111-5 and Code of Federal Regulations, title 42, part 495.

86.7 	Sec. 5. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
86.8 	to read:
86.9 		Subd. 8.Definitions. For purposes of subdivisions 7 to 11, the following terms 
86.10 	have the meanings given.
86.11 	(a) "Certified electronic health record technology" has the same meaning as defined 
86.12 	in Code of Federal Regulations, title 42, part 495.4.
86.13 	(b) "Commissioner" means the commissioner of the Department of Human Services.
86.14 	(c) "National Level Repository" or "NLR" has the same meaning as defined in Code 
86.15 	of Federal Regulations, title 42, part 495.
86.16 	(d) "SMHP" means the state Medicaid health information technology plan.
86.17 	(e) "MEIP" means the Minnesota electronic health record incentive program in 
86.18 	this section.
86.19 	(f) "Pediatrician" means a physician who is certified by either the American Board 
86.20 	of Pediatrics or the American Osteopathic Board of Pediatrics.

86.21 	Sec. 6. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
86.22 	to read:
86.23 		Subd. 9.Registration, application, and payment processing. (a) Eligible 
86.24 	providers and eligible hospitals must successfully complete the NLR registration process 
86.25 	defined by the Centers for Medicare and Medicaid Services before applying for the 
86.26 	Minnesota electronic health record incentives program. 
86.27 	(b) The commissioner shall collect any improper payments made under the 
86.28 	Minnesota electronic health record incentives program.
86.29 	(c) Eligible providers and eligible hospitals enrolled in the Minnesota electronic 
86.30 	health record incentives program must retain all records supporting eligibility for a 
86.31 	minimum of six years.
86.32 	(d) The commissioner shall determine the allowable methodology options to be used 
86.33 	by eligible providers and eligible hospitals for purposes of attesting to and calculating 
86.34 	their Medicaid patient volume per Code of Federal Regulations, title 42, part 495.306.
87.1 	(e) Minnesota electronic health record incentives program payments must be 
87.2 	processed and paid to the tax identification number designated by the eligible provider 
87.3 	or eligible hospital.
87.4 	(f) The payment mechanism for Minnesota electronic health record incentives 
87.5 	program payments must be determined by the commissioner.
87.6 	(g) The commissioner shall determine the 12-month period selected by the state as 
87.7 	referenced in Code of Federal Regulation, title 42, part 495.310(g)(1)(i)(B).

87.8 	Sec. 7. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
87.9 	to read:
87.10 		Subd. 10.Audits. The commissioner is authorized to audit an eligible provider or 
87.11 	eligible hospital that applies for an incentive payment through the Minnesota electronic 
87.12 	health record incentives program, both before and after payment determination. The 
87.13 	commissioner is authorized to use state and federal laws, regulations, and circulars to 
87.14 	develop the department's audit criteria.

87.15 	Sec. 8. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
87.16 	to read:
87.17 		Subd. 11.Provider appeals. An eligible provider or eligible hospital who has 
87.18 	received notification of an adverse action related to the Minnesota electronic health record 
87.19 	incentives program may appeal the action pursuant to subdivision 8.

87.20 	Sec. 9. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
87.21 	to read:
87.22 		Subd. 12.MEIP appeals. An eligible provider or eligible hospital who has received 
87.23 	notice of an appealable issue related to the Minnesota electronic health record incentives 
87.24 	program may appeal the action in accordance with procedures in this section.

87.25 	Sec. 10. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
87.26 	to read:
87.27 		Subd. 13.Definitions. For purposes of subdivisions 12 to 15, the following terms 
87.28 	have the meanings given.
87.29 	(a) "Provider" means an eligible provider or eligible hospital for purposes of the 
87.30 	Minnesota electronic health record incentives program.
87.31 	(b) "Appealable issue" means one or more of the following issues related to the 
87.32 	Minnesota electronic health record incentives program:
88.1 	(1) incentive payments;
88.2 	(2) incentive payment amounts;
88.3 	(3) provider eligibility determination; or
88.4 	(4) demonstration of adopting, implementing, and upgrading, and meaningful use 
88.5 	eligibility for incentives.

88.6 	Sec. 11. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
88.7 	to read:
88.8 		Subd. 14.Filing an appeal. To appeal, the provider shall file with the commissioner 
88.9 	a written notice of appeal. The appeal must be postmarked or received by the 
88.10 	commissioner within 30 days of the date of issuance specified in the notice of action 
88.11 	regarding the appealable issue. The notice of appeal must specify:
88.12 	(1) the appealable issues;
88.13 	(2) each disputed item;
88.14 	(3) the reason for the dispute;
88.15 	(4) the total dollar amount in dispute;
88.16 	(5) the computation that the provider believes is correct;
88.17 	(6) the authority relied upon for each disputed item;
88.18 	(7) the name and address of the person or firm with whom contacts may be made 
88.19 	regarding the appeal; and
88.20 	(8) other information required by the commissioner.

88.21 	Sec. 12. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision 
88.22 	to read:
88.23 		Subd. 15.Appeals review process. (a) Upon receipt of an appeal notice 
88.24 	satisfying subdivision 14, the commissioner shall review the appeal and issue a written 
88.25 	appeal determination on each appealed item with 90 days. Upon mutual agreement, the 
88.26 	commissioner and the provider may extend the time for issuing a determination for a 
88.27 	specified period. The commissioner shall notify the provider by first class mail of the 
88.28 	appeal determination. The appeal determination takes effect upon the date of issuance 
88.29 	specified in the determination.
88.30 	(b) In reviewing the appeal, the commissioner may request additional written or oral 
88.31 	information from the provider.
88.32 	(c) The provider has the right to present information by telephone, in writing, or 
88.33 	in person concerning the appeal to the commissioner prior to the issuance of the appeal 
88.34 	determination within 30 days of the date the appeal was received by the commissioner. 
89.1 	The provider must request an in-person conference in writing, separate from the appeal 
89.2 	letter. Statements made during the review process are not admissible in a contested case 
89.3 	hearing absent an express stipulation by the parties to the contested case.
89.4 	(d) For an appeal item on which the provider disagrees with the appeal determination, 
89.5 	the provider may file with the commissioner a written demand for a contested case 
89.6 	hearing to determine the proper resolution of specified appeal items. The demand must 
89.7 	be postmarked or received by the commissioner within 30 days of the date of issuance 
89.8 	specified in the determination. A contested case demand for an appeal item nullifies 
89.9 	the written appeal determination issued by the commissioner for that appeal item. The 
89.10 	commissioner shall refer any contested case demand to the Office of the Attorney General. 
89.11 	(e) A contested case hearing must be heard by an administrative law judge according 
89.12 	to sections 14.48 to 14.56. In any proceeding under this section, the appealing party must 
89.13 	demonstrate by a preponderance of the evidence that the Minnesota electronic health 
89.14 	record incentives program eligibility determination is incorrect.
89.15 	(f) Regardless of any appeal, the Minnesota electronic health record incentives 
89.16 	program eligibility determination must remain in effect until final resolution of the appeal.
89.17 	(g) The commissioner has discretion to issue to the provider a proposed resolution 
89.18 	for specified appeal items upon a request from the provider filed separately from the 
89.19 	notice of appeal. The proposed resolution is final upon written acceptance by the provider 
89.20 	within 30 days of the date the proposed resolution was mailed to or personally received by 
89.21 	the provider, whichever is earlier.

89.22 	Sec. 13. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:
89.23 		Subd. 9.Review of eligible providers. The commissioner and the Medical 
89.24 	Education and Research Costs Advisory Committee may review provider groups included 
89.25 	in the definition of a clinical medical education program to assure that the distribution of 
89.26 	the funds continue to be consistent with the purpose of this section. The results of any 
89.27 	such reviews must be reported to the Legislative Commission on Health Care Access
89.28 	chairs and ranking minority members of the legislative committees with jurisdiction over 
89.29 	health care policy and finance.

89.30 	Sec. 14. Minnesota Statutes 2010, section 62Q.32, is amended to read:
89.31 	62Q.32 LOCAL OMBUDSPERSON.
89.32 	County board or community health service agencies may establish an office of 
89.33 	ombudsperson to provide a system of consumer advocacy for persons receiving health 
90.1 	care services through a health plan company. The ombudsperson's functions may include, 
90.2 	but are not limited to:
90.3 	(a) mediation or advocacy on behalf of a person accessing the complaint and appeal 
90.4 	procedures to ensure that necessary medical services are provided by the health plan 
90.5 	company; and
90.6 	(b) investigation of the quality of services provided to a person and determine the 
90.7 	extent to which quality assurance mechanisms are needed or any other system change 
90.8 	may be needed. The commissioner of health shall make recommendations for funding 
90.9 	these functions including the amount of funding needed and a plan for distribution. The 
90.10 	commissioner shall submit these recommendations to the Legislative Commission on 
90.11 	Health Care Access by January 15, 1996.

90.12 	Sec. 15. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:
90.13 		Subd. 3.Provider peer grouping. (a) The commissioner shall develop a peer 
90.14 	grouping system for providers based on a combined measure that incorporates both 
90.15 	provider risk-adjusted cost of care and quality of care, and for specific conditions as 
90.16 	determined by the commissioner. In developing this system, the commissioner shall 
90.17 	consult and coordinate with health care providers, health plan companies, state agencies, 
90.18 	and organizations that work to improve health care quality in Minnesota. For purposes of 
90.19 	the final establishment of the peer grouping system, the commissioner shall not contract 
90.20 	with any private entity, organization, or consortium of entities that has or will have a direct 
90.21 	financial interest in the outcome of the system.
90.22 	(b) By no later than October 15, 2010, the commissioner shall disseminate 
90.23 	information to providers on their total cost of care, total resource use, total quality of care, 
90.24 	and the total care results of the grouping developed under this subdivision in comparison 
90.25 	to an appropriate peer group. Any analyses or reports that identify providers may only be 
90.26 	published after the provider has been provided the opportunity by the commissioner to 
90.27 	review the underlying data and submit comments. Providers may be given any data for 
90.28 	which they are the subject of the data. The provider shall have 30 days to review the data 
90.29 	for accuracy and initiate an appeal as specified in paragraph (d).
90.30 	(c) By no later than January 1, 2011, the commissioner shall disseminate information 
90.31 	to providers on their condition-specific cost of care, condition-specific resource use, 
90.32 	condition-specific quality of care, and the condition-specific results of the grouping 
90.33 	developed under this subdivision in comparison to an appropriate peer group. Any 
90.34 	analyses or reports that identify providers may only be published after the provider has 
90.35 	been provided the opportunity by the commissioner to review the underlying data and 
91.1 	submit comments. Providers may be given any data for which they are the subject of the 
91.2 	data. The provider shall have 30 days to review the data for accuracy and initiate an 
91.3 	appeal as specified in paragraph (d).
91.4 	(d) The commissioner shall establish an appeals process to resolve disputes from 
91.5 	providers regarding the accuracy of the data used to develop analyses or reports. When 
91.6 	a provider appeals the accuracy of the data used to calculate the peer grouping system 
91.7 	results, the provider shall:
91.8 	(1) clearly indicate the reason they believe the data used to calculate the peer group 
91.9 	system results are not accurate;
91.10 	(2) provide evidence and documentation to support the reason that data was not 
91.11 	accurate; and
91.12 	(3) cooperate with the commissioner, including allowing the commissioner access to 
91.13 	data necessary and relevant to resolving the dispute.
91.14 	If a provider does not meet the requirements of this paragraph, a provider's appeal shall be 
91.15 	considered withdrawn. The commissioner shall not publish results for a specific provider 
91.16 	under paragraph (e) or (f) while that provider has an unresolved appeal.
91.17 	(e) Beginning January 1, 2011, the commissioner shall, no less than annually, 
91.18 	publish information on providers' total cost, total resource use, total quality, and the results 
91.19 	of the total care portion of the peer grouping process. The results that are published must 
91.20 	be on a risk-adjusted basis.
91.21 	(f) Beginning March 30, 2011, the commissioner shall no less than annually publish 
91.22 	information on providers' condition-specific cost, condition-specific resource use, and 
91.23 	condition-specific quality, and the results of the condition-specific portion of the peer 
91.24 	grouping process. The results that are published must be on a risk-adjusted basis.
91.25 	(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing 
91.26 	information under paragraph (e) or (f), the commissioner shall ensure the scientific 
91.27 	validity and reliability of the results according to the standards described in paragraph (h). 
91.28 	If additional time is needed to establish the scientific validity and reliability of the results, 
91.29 	the commissioner may delay the dissemination of data to providers under paragraph (b) 
91.30 	or (c), or the publication of information under paragraph (e) or (f). If the delay is more 
91.31 	than 60 days, the commissioner shall report in writing to the Legislative Commission on 
91.32 	Health Care Access chairs and ranking minority members of the legislative committees 
91.33 	with jurisdiction over health care policy and finance the following information:
91.34 	(1) the reason for the delay;
91.35 	(2) the actions being taken to resolve the delay and establish the scientific validity 
91.36 	and reliability of the results; and
92.1 	(3) the new dates by which the results shall be disseminated.
92.2 	If there is a delay under this paragraph, the commissioner must disseminate the 
92.3 	information to providers under paragraph (b) or (c) at least 90 days before publishing 
92.4 	results under paragraph (e) or (f).
92.5 	(h) The commissioner's assurance of valid and reliable clinic and hospital peer 
92.6 	grouping performance results shall include, at a minimum, the following:
92.7 	(1) use of the best available evidence, research, and methodologies; and
92.8 	(2) establishment of an explicit minimum reliability threshold developed in 
92.9 	collaboration with the subjects of the data and the users of the data, at a level not below 
92.10 	nationally accepted standards where such standards exist.
92.11 	In achieving these thresholds, the commissioner shall not aggregate clinics that are not 
92.12 	part of the same system or practice group. The commissioner shall consult with and solicit 
92.13 	feedback from representatives of physician clinics and hospitals during the peer grouping 
92.14 	data analysis process to obtain input on the methodological options prior to final analysis 
92.15 	and on the design, development, and testing of provider reports.

92.16 	Sec. 16. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:
92.17 		Subd. 9.Uses of information. (a) By no later than 12 months after the commissioner 
92.18 	publishes the information in subdivision 3, paragraph (e): For product renewals or for 
92.19 	new products that are offered, after 12 months have elapsed from publication by the 
92.20 	commissioner of the information in subdivision 3, paragraph (e):
92.21 	(1) the commissioner of management and budget shall use the information and 
92.22 	methods developed under subdivision 3 to strengthen incentives for members of the state 
92.23 	employee group insurance program to use high-quality, low-cost providers;
92.24 	(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer 
92.25 	health benefits to their employees must offer plans that differentiate providers on their 
92.26 	cost and quality performance and create incentives for members to use better-performing 
92.27 	providers;
92.28 	(3) all health plan companies shall use the information and methods developed 
92.29 	under subdivision 3 to develop products that encourage consumers to use high-quality, 
92.30 	low-cost providers; and
92.31 	(4) health plan companies that issue health plans in the individual market or the 
92.32 	small employer market must offer at least one health plan that uses the information 
92.33 	developed under subdivision 3 to establish financial incentives for consumers to choose 
92.34 	higher-quality, lower-cost providers through enrollee cost-sharing or selective provider 
92.35 	networks.
93.1 	(b) By January 1, 2011, the commissioner of health shall report to the governor 
93.2 	and the legislature on recommendations to encourage health plan companies to promote 
93.3 	widespread adoption of products that encourage the use of high-quality, low-cost providers. 
93.4 	The commissioner's recommendations may include tax incentives, public reporting of 
93.5 	health plan performance, regulatory incentives or changes, and other strategies.

93.6 	Sec. 17. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:
93.7 		Subd. 2.Legislative oversight. Beginning January 15, 2009, the commissioner 
93.8 	of health shall submit to the Legislative Commission on Health Care Access chairs and 
93.9 	ranking minority members of the legislative committees with jurisdiction over health care 
93.10 	policy and finance periodic progress reports on the implementation of this chapter and 
93.11 	sections 256B.0751 to 256B.0754.

93.12 	Sec. 18. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
93.13 	to read:
93.14 		Subd. 33.Contingency contract fees. (a) When the commissioner enters into 
93.15 	a contingency-based contract for the purpose of recovering medical assistance or 
93.16 	MinnesotaCare funds, the commissioner may retain that portion of the recovered funds 
93.17 	equal to the amount of the contingency fee.
93.18 	(b) Amounts attributed to new recoveries under this subdivision are appropriated 
93.19 	to the commissioner to the extent they fulfill the payment terms of the contract with the 
93.20 	vendor and shall be deposited into an account in a fund other than the general fund for 
93.21 	purposes of fulfilling the terms of the vendor contract.

93.22 	EFFECTIVE DATE. This section is effective retroactive from July 1, 2011.

93.23 	Sec. 19. Minnesota Statutes 2010, section 256.969, subdivision 2, is amended to read:
93.24 		Subd. 2.Diagnostic categories. The commissioner shall use to the extent possible 
93.25 	existing diagnostic classification systems, including the system used by the Medicare 
93.26 	program to determine the relative values of inpatient services and case mix indices. The 
93.27 	commissioner may combine diagnostic classifications into diagnostic categories and may 
93.28 	establish separate categories and numbers of categories based on program eligibility or 
93.29 	hospital peer group. Relative values shall be recalculated when the base year is changed. 
93.30 	Relative value determinations shall include paid claims for admissions during each 
93.31 	hospital's base year. The commissioner may extend the time period forward to obtain 
93.32 	sufficiently valid information to establish relative values. Relative value determinations 
93.33 	shall not include property cost data, Medicare crossover data, and data on admissions 
94.1 	that are paid a per day transfer rate under subdivision 14. The computation of the base 
94.2 	year cost per admission must include identified outlier cases and their weighted costs 
94.3 	up to the point that they become outlier cases, but must exclude costs recognized in 
94.4 	outlier payments beyond that point. The commissioner may recategorize the diagnostic 
94.5 	classifications and recalculate relative values and case mix indices to reflect actual hospital 
94.6 	practices, the specific character of specialty hospitals, or to reduce variances within the 
94.7 	diagnostic categories after notice in the State Register and a 30-day comment period. The 
94.8 	commissioner shall recategorize the diagnostic classifications and recalculate relative 
94.9 	values and case mix indices based on the two-year schedule in effect prior to January 1, 
94.10 	2013, reflected in subdivision 2b. The first recategorization shall occur January 1, 2013, 
94.11 	and shall occur every two years after. When rates are not rebased under subdivision 2b, 
94.12 	the commissioner may establish relative values and case mix indices based on charge data 
94.13 	and may update the base year to the most recent data available.

94.14 	Sec. 20. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
94.15 		Subd. 2b.Operating payment rates. In determining operating payment rates for 
94.16 	admissions occurring on or after the rate year beginning January 1, 1991, and every two 
94.17 	years after, or more frequently as determined by the commissioner, the commissioner shall 
94.18 	obtain operating data from an updated base year and establish operating payment rates 
94.19 	per admission for each hospital based on the cost-finding methods and allowable costs of 
94.20 	the Medicare program in effect during the base year. Rates under the general assistance 
94.21 	medical care, medical assistance, and MinnesotaCare programs shall not be rebased to 
94.22 	more current data on January 1, 1997, January 1, 2005, for the first 24 months of the 
94.23 	rebased period beginning January 1, 2009. For the first 24 months of the rebased period 
94.24 	beginning January 1, 2011, rates shall not be rebased, except that a Minnesota long-term 
94.25 	hospital shall be rebased effective January 1, 2011, based on its most recent Medicare cost 
94.26 	report ending on or before September 1, 2008, with the provisions under subdivisions 9 
94.27 	and 23, based on the rates in effect on December 31, 2010. For subsequent rate setting 
94.28 	periods in which the base years are updated, a Minnesota long-term hospital's base year 
94.29 	shall remain within the same period as other hospitals. Effective January 1, 2013, and after,
94.30 	rates shall not be rebased at full value. The base year operating payment rate per admission 
94.31 	is standardized by the case mix index and adjusted by the hospital cost index, relative 
94.32 	values, and disproportionate population adjustment. The cost and charge data used to 
94.33 	establish operating rates shall only reflect inpatient services covered by medical assistance 
94.34 	and shall not include property cost information and costs recognized in outlier payments.

95.1 	Sec. 21. Minnesota Statutes 2010, section 256.969, is amended by adding a subdivision 
95.2 	to read:
95.3 		Subd. 3c.Rateable reduction and readmissions reduction. (a) The total payment 
95.4 	for fee for service admissions occurring on or after September 1, 2011, through June 30, 
95.5 	2015, made to hospitals for inpatient services before third-party liability and spenddown, 
95.6 	is reduced ten percent from the current statutory rates. Facilities defined under subdivision 
95.7 	16, long-term hospitals as determined under the Medicare program, children's hospitals 
95.8 	whose inpatients are predominantly under 18 years of age, and payments under managed 
95.9 	care are excluded from this paragraph.
95.10 	(b) Effective for admissions occurring during calendar year 2010 and each year 
95.11 	after, the commissioner shall calculate a regional readmission rate for admissions to all 
95.12 	hospitals occurring within 30 days of a previous discharge. The commissioner may 
95.13 	adjust the readmission rate taking into account factors such as the medical relationship, 
95.14 	complicating conditions, and sequencing of treatment between the initial admission and 
95.15 	subsequent readmissions.
95.16 	(c) Effective for payments to all hospitals on or after July 1, 2013, through June 30, 
95.17 	2015, the reduction in paragraph (a) is reduced one percentage point for every percentage 
95.18 	point reduction in the overall readmissions rate between the two previous calendar years 
95.19 	to a maximum of five percent.

95.20 	Sec. 22. Minnesota Statutes 2010, section 256B.02, is amended by adding a 
95.21 	subdivision to read:
95.22 		Subd. 16.Termination; terminate. "Termination" or "terminate" for a provider 
95.23 	means a state Medicaid program, state children's health insurance program, or Medicare 
95.24 	program has taken an action to revoke the provider's billing privileges, the provider has 
95.25 	exhausted all appeal rights or the timeline for appeal has expired, there is no expectation 
95.26 	by the provider, Medicaid program, state children's health insurance program, or Medicare 
95.27 	program that the revocation is temporary, the provider will be required to reenroll to 
95.28 	reinstate billing privileges, and the termination occurred for cause, including fraud, 
95.29 	integrity, or quality. 

95.30 	Sec. 23. Minnesota Statutes 2010, section 256B.03, is amended by adding a 
95.31 	subdivision to read:
95.32 		Subd. 4.Prohibition on payments to providers outside of the United States.
 95.33 	Payments for medical assistance must not be made:
95.34 	(1) for services delivered or items supplied outside of the United States; or
96.1 	(2) to a provider, financial institution, or entity located outside of the United States.

96.2 	Sec. 24. Minnesota Statutes 2010, section 256B.03, is amended by adding a 
96.3 	subdivision to read:
96.4 		Subd. 5.Ordering or referring providers. Claims for payments for supplies or 
96.5 	services that are based on an order or referral of a provider must include the ordering or 
96.6 	referring provider's national provider identifier (NPI). Claims for supplies or services 
96.7 	ordered or referred by a vendor who is not enrolled in medical assistance are not covered.

96.8 	Sec. 25. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
96.9 		Subd. 18.Applications for medical assistance. (a) The state agency may 
96.10 	take applications for medical assistance and conduct eligibility determinations for 
96.11 	MinnesotaCare enrollees.
96.12 	(b) The commissioner of human services shall modify the Minnesota health care 
96.13 	programs application form to add a question asking applicants whether they have ever 
96.14 	served in the United States military.

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

96.16 	Sec. 26. Minnesota Statutes 2010, section 256B.04, is amended by adding a 
96.17 	subdivision to read:
96.18 		Subd. 21.Provider enrollment. (a) If the commissioner or the Centers for 
96.19 	Medicare and Medicaid Services determines that a provider is designated "high-risk," the 
96.20 	commissioner may withhold payment from providers within that category upon initial 
96.21 	enrollment for a 90-day period. The withholding for each provider must begin on the date 
96.22 	of the first submission of a claim.
96.23 	(b) The commissioner may require, as a condition of enrollment in medical 
96.24 	assistance, that a provider within a particular industry sector or category establish a 
96.25 	compliance program that contains the core elements established by the Centers for 
96.26 	Medicare and Medicaid Services.
96.27 	(c) The commissioner may revoke the enrollment of an ordering or rendering 
96.28 	provider for a period of not more than one year, if the provider fails to maintain and, 
96.29 	upon request from the commissioner, provide access to documentation relating to written 
96.30 	orders or requests for payment for durable medical equipment, certifications for home 
96.31 	health services, or referrals for other items or services written or ordered by such provider, 
96.32 	when the commissioner has identified a pattern of a lack of documentation. A pattern 
97.1 	means a failure to maintain documentation or provide access to documentation on more 
97.2 	than one occasion.
97.3 	(d) The commissioner shall terminate or deny the enrollment of any individual or 
97.4 	entity if the individual or entity has been terminated from participation in Medicare or 
97.5 	under the Medicaid program or Children's Health Insurance Program of any other state. 
97.6 	(e) As a condition of enrollment in medical assistance, the commissioner shall 
97.7 	require that a provider designated "moderate" or "high-risk" by the Centers for Medicare 
97.8 	and Medicaid Services or the Minnesota Department of Human Services permit the 
97.9 	Centers for Medicare and Medicaid Services, its agents, or its designated contractors and 
97.10 	the state agency, its agents, or its designated contractors to conduct unannounced on-site 
97.11 	inspections of any provider location.
97.12 	(f) As a condition of enrollment in medical assistance, the commissioner shall 
97.13 	require that a high-risk provider, or a person with a direct or indirect ownership interest in 
97.14 	the provider of five percent or higher, consent to criminal background checks, including 
97.15 	fingerprinting, when required to do so under state law or by a determination by the 
97.16 	commissioner or the Centers for Medicare and Medicaid Services that a provider is 
97.17 	designated high-risk for fraud, waste, or abuse. 

97.18 	Sec. 27. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
97.19 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
97.20 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
97.21 	other persons residing lawfully in the United States. Citizens or nationals of the United 
97.22 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
97.23 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
97.24 	Public Law 109-171.
97.25 	(b) "Qualified noncitizen" means a person who meets one of the following 
97.26 	immigration criteria:
97.27 	(1) admitted for lawful permanent residence according to United States Code, title 8;
97.28 	(2) admitted to the United States as a refugee according to United States Code, 
97.29 	title 8, section 1157;
97.30 	(3) granted asylum according to United States Code, title 8, section 1158;
97.31 	(4) granted withholding of deportation according to United States Code, title 8, 
97.32 	section 1253(h);
97.33 	(5) paroled for a period of at least one year according to United States Code, title 8, 
97.34 	section 1182(d)(5);
98.1 	(6) granted conditional entrant status according to United States Code, title 8, 
98.2 	section 1153(a)(7);
98.3 	(7) determined to be a battered noncitizen by the United States Attorney General 
98.4 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
98.5 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
98.6 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
98.7 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
98.8 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
98.9 	Public Law 104-200; or
98.10 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
98.11 	Law 96-422, the Refugee Education Assistance Act of 1980.
98.12 	(c) All qualified noncitizens who were residing in the United States before August 
98.13 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
98.14 	medical assistance with federal financial participation.
98.15 	(d) All qualified noncitizens who entered the United States on or after August 22, 
98.16 	1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for 
98.17 	medical assistance with federal financial participation through November 30, 1996.
98.18 	Beginning December 1, 1996, qualified noncitizens who entered the United States 
98.19 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
98.20 	chapter are eligible for medical assistance with federal participation for five years if they 
98.21 	meet one of the following criteria:
98.22 	(i) refugees admitted to the United States according to United States Code, title 8, 
98.23 	section 1157;
98.24 	(ii) persons granted asylum according to United States Code, title 8, section 1158;
98.25 	(iii) persons granted withholding of deportation according to United States Code, 
98.26 	title 8, section 1253(h);
98.27 	(iv) veterans of the United States armed forces with an honorable discharge for 
98.28 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
98.29 	children; or
98.30 	(v) persons on active duty in the United States armed forces, other than for training, 
98.31 	their spouses and unmarried minor dependent children.
98.32 	Beginning December 1, 1996, qualified noncitizens who do not meet one of the 
98.33 	criteria in items (i) to (v) are eligible for medical assistance without federal financial 
98.34 	participation as described in paragraph (j).
98.35 	Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant 
98.36 	women who are noncitizens described in paragraph (b) or (e) who are lawfully present 
99.1 	in the United States as defined in Code of Federal Regulations, title 8, section 103.12, 
99.2 	and who otherwise meet eligibility requirements of this chapter, are eligible for medical 
99.3 	assistance with federal financial participation as provided by the federal Children's Health 
99.4 	Insurance Program Reauthorization Act of 2009, Public Law 111-3.
99.5 	(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who 
99.6 	are lawfully present in the United States, as defined in Code of Federal Regulations, title 
99.7 	8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are 
99.8 	eligible for medical assistance under clauses (1) to (3). These individuals must cooperate 
99.9 	with the United States Citizenship and Immigration Services to pursue any applicable 
99.10 	immigration status, including citizenship, that would qualify them for medical assistance 
99.11 	with federal financial participation.
99.12 	(1) Persons who were medical assistance recipients on August 22, 1996, are eligible 
99.13 	for medical assistance with federal financial participation through December 31, 1996.
99.14 	(2) Beginning January 1, 1997, persons described in clause (1) are eligible for 
99.15 	medical assistance without federal financial participation as described in paragraph (j).
99.16 	(3) Beginning December 1, 1996, persons residing in the United States prior to 
99.17 	August 22, 1996, who were not receiving medical assistance and persons who arrived on 
99.18 	or after August 22, 1996, are eligible for medical assistance without federal financial 
99.19 	participation as described in paragraph (j).
99.20 	(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this 
99.21 	chapter are eligible for the benefits as provided in paragraphs (g)(f) to (i) (h). For purposes 
99.22 	of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United 
99.23 	States Code, title 8, section 1101(a)(15).
99.24 	(g) (f) Payment shall also be made for care and services that are furnished to 
99.25 	noncitizens, regardless of immigration status, who otherwise meet the eligibility 
99.26 	requirements of this chapter, if such care and services are necessary for the treatment of an 
99.27 	emergency medical condition, except for organ transplants and related care and services 
99.28 	and routine prenatal care.
99.29 	(h) (g) For purposes of this subdivision, the term "emergency medical condition" 
99.30 	means a medical condition that meets the requirements of United States Code, title 42, 
99.31 	section 1396b(v).
99.32 	(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment 
99.33 	of an emergency medical condition are limited to the following:
99.34 	(i) services delivered in an emergency room or by an ambulance service licensed 
99.35 	under chapter 144E that are directly related to the treatment of an emergency medical 
99.36 	condition;
100.1 	(ii) services delivered in an inpatient hospital setting following admission from an 
100.2 	emergency room or clinic for an acute emergency condition; and
100.3 	(iii) follow-up services that are directly related to the original service provided 
100.4 	to treat the emergency medical condition and are covered by the global payment made 
100.5 	to the provider.
100.6 	(2) Services for the treatment of emergency medical conditions do not include:
100.7 	(i) services delivered in an emergency room or inpatient setting to treat a 
100.8 	nonemergency condition;
100.9 	(ii) organ transplants, stem cell transplants, and related care;
100.10 	(iii) services for routine prenatal care;
100.11 	(iv) continuing care, including long-term care, nursing facility services, home health 
100.12 	care, adult day care, day training, or supportive living services;
100.13 	(v) elective surgery;
100.14 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as 
100.15 	part of an emergency room visit;
100.16 	(vii) preventative health care and family planning services;
100.17 	(viii) dialysis;
100.18 	(ix) chemotherapy or therapeutic radiation services;
100.19 	(x) rehabilitation services;
100.20 	(xi) physical, occupational, or speech therapy;
100.21 	(xii) transportation services;
100.22 	(xiii) case management;
100.23 	(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
100.24 	(xv) dental services;
100.25 	(xvi) hospice care;
100.26 	(xvii) audiology services and hearing aids;
100.27 	(xviii) podiatry services;
100.28 	(xix) chiropractic services;
100.29 	(xx) immunizations;
100.30 	(xxi) vision services and eyeglasses;
100.31 	(xxii) waiver services;
100.32 	(xxiii) individualized education programs; or
100.33 	(xxiv) chemical dependency treatment.
100.34 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
100.35 	nonimmigrants, or lawfully present as designated in paragraph (e) and whoin the United 
100.36 	States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by 
101.1 	a group health plan or health insurance coverage according to Code of Federal Regulations, 
101.2 	title 42, section 457.310, and who otherwise meet the eligibility requirements of this 
101.3 	chapter, are eligible for medical assistance through the period of pregnancy, including 
101.4 	labor and delivery, and 60 days postpartum, to the extent federal funds are available under 
101.5 	title XXI of the Social Security Act, and the state children's health insurance program.
101.6 	(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens 
101.7 	lawfully residing in the United States as described in paragraph (e), who are ineligible 
101.8 	for medical assistance with federal financial participation and who otherwise meet the 
101.9 	eligibility requirements of chapter 256B and of this paragraph, are eligible for medical 
101.10 	assistance without federal financial participation. Qualified noncitizens as described 
101.11 	in paragraph (d) are only eligible for medical assistance without federal financial 
101.12 	participation for five years from their date of entry into the United States.
101.13 	(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
101.14 	services from a nonprofit center established to serve victims of torture and are otherwise 
101.15 	ineligible for medical assistance under this chapter are eligible for medical assistance 
101.16 	without federal financial participation. These individuals are eligible only for the period 
101.17 	during which they are receiving services from the center. Individuals eligible under this 
101.18 	paragraph shall not be required to participate in prepaid medical assistance.

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

101.20 	Sec. 28. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
101.21 	subdivision to read:
101.22 		Subd. 3q.Evidence-based childbirth program. (a) The commissioner shall 
101.23 	implement a program to reduce the number of elective inductions of labor prior to 39 
101.24 	weeks' gestation. In this subdivision, the term "elective induction of labor" means the 
101.25 	use of artificial means to stimulate labor in a woman without the presence of a medical 
101.26 	condition affecting the woman or the child that makes the onset of labor a medical 
101.27 	necessity. The program must promote the implementation of policies within hospitals 
101.28 	providing services to recipients of medical assistance or MinnesotaCare that prohibit the 
101.29 	use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by 
101.30 	the attending providers.
101.31 	(b) For all births covered by medical assistance or MinnesotaCare on or after 
101.32 	January 1, 2012, a payment for professional services associated with the delivery of a 
101.33 	child in a hospital must not be made unless the provider has submitted information about 
101.34 	the nature of the labor and delivery including any induction of labor that was performed 
102.1 	in conjunction with that specific birth. The information must be on a form prescribed by 
102.2 	the commissioner.
102.3 	(c) The requirements in paragraph (b) must not apply to deliveries performed 
102.4 	at a hospital that has policies and processes in place that have been approved by the 
102.5 	commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process 
102.6 	for review of hospital induction policies must be established by the commissioner and 
102.7 	review of policies must occur at the discretion of the commissioner. The commissioner's 
102.8 	decision to approve or rescind approval must include verification and review of items 
102.9 	including, but not limited to:
102.10 	(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
102.11 	(2) policies that encourage providers to document and communicate with patients a 
102.12 	final expected date of delivery by 20 weeks' gestation that includes data from ultrasound 
102.13 	measurements as applicable;
102.14 	(3) policies that encourage patient education regarding elective inductions, and 
102.15 	requires documentation of the processes used to educate patients;
102.16 	(4) ongoing quality improvement review as determined by the commissioner; and
102.17 	(5) any data that has been collected by the commissioner.
102.18 	(d) All hospitals must report annually to the commissioner induction information 
102.19 	for all births that were covered by medical assistance or MinnesotaCare in a format and 
102.20 	manner to be established by the commissioner.
102.21 	(e) The commissioner at any time may choose not to implement or may discontinue 
102.22 	any or all aspects of the program if the commissioner is able to determine that hospitals 
102.23 	representing at least 90 percent of births covered by medical assistance or MinnesotaCare 
102.24 	have approved policies in place.

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

102.26 	Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to 
102.27 	read:
102.28 		Subd. 8.Physical therapy. (a) Medical assistance covers physical therapy and 
102.29 	related services, including specialized maintenance therapy. Specialized maintenance 
102.30 	therapy is covered for recipients age 20 and under.
102.31 	(b) Authorization by the commissioner is required to provide medically necessary 
102.32 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
102.33 	threshold where one has been established by the commissioner for a specified service: (1) 
102.34 	80 units of any approved CPT code other than modalities; (2) 20 modality sessions; and 
102.35 	(3) three evaluations or reevaluations. Services provided by a physical therapy assistant 
103.1 	shall be reimbursed at the same rate as services performed by a physical therapist when 
103.2 	the services of the physical therapy assistant are provided under the direction of a physical 
103.3 	therapist who is on the premises. Services provided by a physical therapy assistant that 
103.4 	are provided under the direction of a physical therapist who is not on the premises shall 
103.5 	be reimbursed at 65 percent of the physical therapist rate.

103.6 	EFFECTIVE DATE. The amendment to paragraph (a) is effective January 1, 2012. 
103.7 	The amendment to paragraph (b) is effective March 1, 2012.

103.8 	Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to 
103.9 	read:
103.10 		Subd. 8a.Occupational therapy. (a) Medical assistance covers occupational 
103.11 	therapy and related services, including specialized maintenance therapy. Specialized 
103.12 	maintenance therapy is covered for recipients age 20 and under.
103.13 	(b) Authorization by the commissioner is required to provide medically necessary 
103.14 	services to a recipient beyond any of the following onetime service thresholds, or a lower 
103.15 	threshold where one has been established by the commissioner for a specified service: 
103.16 	(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or 
103.17 	reevaluations. Services provided by an occupational therapy assistant shall be reimbursed 
103.18 	at the same rate as services performed by an occupational therapist when the services of 
103.19 	the occupational therapy assistant are provided under the direction of the occupational 
103.20 	therapist who is on the premises. Services provided by an occupational therapy assistant 
103.21 	that are provided under the direction of an occupational therapist who is not on the 
103.22 	premises shall be reimbursed at 65 percent of the occupational therapist rate.

103.23 	EFFECTIVE DATE. The amendment to paragraph (a) is effective January 1, 2012. 
103.24 	The amendment to paragraph (b) is effective March 1, 2012.

103.25 	Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to 
103.26 	read:
103.27 		Subd. 8b.Speech-language pathology and audiology services. (a) Medical 
103.28 	assistance covers speech-language pathology and related services, including specialized 
103.29 	maintenance therapy. Specialized maintenance therapy is covered for recipients age 
103.30 	20 and under.
103.31 	(b) Authorization by the commissioner is required to provide medically necessary
103.32 	speech-language pathology services to a recipient beyond any of the following 
103.33 	onetime service thresholds, or a lower threshold where one has been established by the 
104.1 	commissioner for a specified service: (1) 50 treatment sessions with any combination of 
104.2 	approved CPT codes; and (2) one evaluation.
104.3 	(c) Medical assistance covers audiology services and related services. Services 
104.4 	provided by a person who has been issued a temporary registration under section 
104.5 	148.5161 shall be reimbursed at the same rate as services performed by a speech-language 
104.6 	pathologist or audiologist as long as the requirements of section 148.5161, subdivision 
104.7 	3, are met.

104.8 	EFFECTIVE DATE. The amendment to paragraph (a) is effective January 1, 2012. 
104.9 	The amendment to paragraph (b) is effective March 1, 2012.

104.10 	Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to 
104.11 	read:
104.12 		Subd. 8c.Care management; rehabilitation services. (a) Effective July 1, 1999, 
104.13 	onetime thresholds shall replace annual thresholds for provision of rehabilitation services 
104.14 	described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount 
104.15 	and description as the thresholds prescribed by the Department of Human Services health 
104.16 	care programs provider manual for calendar year 1997, except they will not be renewed 
104.17 	annually, and they will include sensory skills and cognitive training skills.
104.18 	(b) (a) A care management approach for authorization of rehabilitation services 
104.19 	beyond the threshold described in subdivisions 8, 8a, and 8b  shall be instituted in 
104.20 	conjunction with the onetime thresholds. The care management approach shall require 
104.21 	the provider and the department rehabilitation reviewer to work together directly through 
104.22 	written communication, or telephone communication when appropriate, to establish a 
104.23 	medically necessary care management plan. Authorization for rehabilitation services 
104.24 	shall include approval for up to 12 six months of services at a time without additional 
104.25 	documentation from the provider during the extended period, when the rehabilitation 
104.26 	services are medically necessary due to an ongoing health condition.
104.27 	(c) (b) The commissioner shall implement an expedited five-day turnaround time to 
104.28 	review authorization requests for recipients who need emergency rehabilitation services 
104.29 	and who have exhausted their onetime threshold limit for those services.

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

104.31 	Sec. 33. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to 
104.32 	read:
105.1 		Subd. 8e.Chiropractic services. Payment for chiropractic services is limited to 
105.2 	one annual evaluation and 12 24 visits per year unless prior authorization of a greater 
105.3 	number of visits is obtained.

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

105.5 	Sec. 34. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
105.6 	subdivision to read:
105.7 		Subd. 8f.Acupuncture services. Medical assistance covers acupuncture, as defined 
105.8 	in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by 
105.9 	another Minnesota licensed practitioner for whom acupuncture is within the practitioner's 
105.10 	scope of practice and who has specific acupuncture training or credentialing.

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

105.12 	Sec. 35. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to 
105.13 	read:
105.14 		Subd. 13e.Payment rates. (a) The basis for determining the amount of payment 
105.15 	shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
105.16 	or the maximum allowable cost set by the federal government or by the commissioner 
105.17 	plus the fixed dispensing fee; or the usual and customary price charged to the public. The 
105.18 	amount of payment basis must be reduced to reflect all discount amounts applied to the 
105.19 	charge by any provider/insurer agreement or contract for submitted charges to medical 
105.20 	assistance programs. The net submitted charge may not be greater than the patient liability 
105.21 	for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee 
105.22 	for intravenous solutions which must be compounded by the pharmacist shall be $8 per 
105.23 	bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral 
105.24 	nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral 
105.25 	nutritional products dispensed in quantities greater than one liter. Actual acquisition cost 
105.26 	includes quantity and other special discounts except time and cash discounts. Effective 
105.27 	July 1, 2009, The actual acquisition cost of a drug shall be estimated by the commissioner,
105.28 	at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic 
105.29 	factor drugs shall be estimated at the average wholesale price minus 30 percent. wholesale 
105.30 	acquisition cost plus four percent for independently owned pharmacies located in a 
105.31 	designated rural area within Minnesota, and at wholesale acquisition cost plus two percent 
105.32 	for all other pharmacies. A pharmacy is "independently owned" if it is one of four or 
105.33 	fewer pharmacies under the same ownership nationally. A "designated rural area" means 
106.1 	an area defined as a small rural area or isolated rural area according to the four-category 
106.2 	classification of the Rural Urban Commuting Area system developed for the United States 
106.3 	Health Resources and Services Administration. Wholesale acquisition cost is defined as 
106.4 	the manufacturer's list price for a drug or biological to wholesalers or direct purchasers 
106.5 	in the United States, not including prompt pay or other discounts, rebates, or reductions 
106.6 	in price, for the most recent month for which information is available, as reported in 
106.7 	wholesale price guides or other publications of drug or biological pricing data. The 
106.8 	maximum allowable cost of a multisource drug may be set by the commissioner and it 
106.9 	shall be comparable to, but no higher than, the maximum amount paid by other third-party 
106.10 	payors in this state who have maximum allowable cost programs. Establishment of the 
106.11 	amount of payment for drugs shall not be subject to the requirements of the Administrative 
106.12 	Procedure Act.
106.13 	(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid 
106.14 	to pharmacists for legend drug prescriptions dispensed to residents of long-term care 
106.15 	facilities when a unit dose blister card system, approved by the department, is used. Under 
106.16 	this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. 
106.17 	The National Drug Code (NDC) from the drug container used to fill the blister card must 
106.18 	be identified on the claim to the department. The unit dose blister card containing the 
106.19 	drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, 
106.20 	that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider 
106.21 	will be required to credit the department for the actual acquisition cost of all unused 
106.22 	drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the 
106.23 	manufacturer's unopened package. The commissioner may permit the drug clozapine to be 
106.24 	dispensed in a quantity that is less than a 30-day supply.
106.25 	(c) Whenever a maximum allowable cost has been set for a multisource drug, 
106.26 	payment shall be on the basis of the lower of the usual and customary price charged 
106.27 	to the public or the maximum allowable cost established by the commissioner unless 
106.28 	prior authorization for the brand name product has been granted according to the criteria 
106.29 	established by the Drug Formulary Committee as required by subdivision 13f, paragraph 
106.30 	(a), and the prescriber has indicated "dispense as written" on the prescription in a manner 
106.31 	consistent with section 151.21, subdivision 2.
106.32 	(d) The basis for determining the amount of payment for drugs administered in an 
106.33 	outpatient setting shall be the lower of the usual and customary cost submitted by the 
106.34 	provider or the amount established for Medicare by the106 percent of the average sales 
106.35 	price as determined by the United States Department of Health and Human Services 
106.36 	pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales 
107.1 	price is unavailable, the amount of payment must be lower of the usual and customary cost 
107.2 	submitted by the provider or the wholesale acquisition cost.
107.3 	(e) The commissioner may negotiate lower reimbursement rates for specialty 
107.4 	pharmacy products than the rates specified in paragraph (a). The commissioner may 
107.5 	require individuals enrolled in the health care programs administered by the department 
107.6 	to obtain specialty pharmacy products from providers with whom the commissioner has 
107.7 	negotiated lower reimbursement rates. Specialty pharmacy products are defined as those 
107.8 	used by a small number of recipients or recipients with complex and chronic diseases 
107.9 	that require expensive and challenging drug regimens. Examples of these conditions 
107.10 	include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis 
107.11 	C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms 
107.12 	of cancer. Specialty pharmaceutical products include injectable and infusion therapies, 
107.13 	biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies 
107.14 	that require complex care. The commissioner shall consult with the formulary committee 
107.15 	to develop a list of specialty pharmacy products subject to this paragraph. In consulting 
107.16 	with the formulary committee in developing this list, the commissioner shall take into 
107.17 	consideration the population served by specialty pharmacy products, the current delivery 
107.18 	system and standard of care in the state, and access to care issues. The commissioner shall 
107.19 	have the discretion to adjust the reimbursement rate to prevent access to care issues.
107.20 	(f) Home infusion therapy services provided by home infusion therapy pharmacies 
107.21 	must be paid at rates according to subdivision 8d.

107.22 	EFFECTIVE DATE. This section is effective September 1, 2011, or upon federal 
107.23 	approval, whichever is later.

107.24 	Sec. 36. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to 
107.25 	read:
107.26 		Subd. 13h.Medication therapy management services. (a) Medical assistance 
107.27 	and general assistance medical care cover medication therapy management services for 
107.28 	a recipient taking four three or more prescriptions to treat or prevent two one or more 
107.29 	chronic medical conditions, or; a recipient with a drug therapy problem that is identified
107.30 	by the commissioner or identified by a pharmacist and approved by the commissioner; or 
107.31 	prior authorized by the commissioner that has resulted or is likely to result in significant 
107.32 	nondrug program costs. The commissioner may cover medical therapy management 
107.33 	services under MinnesotaCare if the commissioner determines this is cost-effective. For 
107.34 	purposes of this subdivision, "medication therapy management" means the provision 
108.1 	of the following pharmaceutical care services by a licensed pharmacist to optimize the 
108.2 	therapeutic outcomes of the patient's medications:
108.3 	(1) performing or obtaining necessary assessments of the patient's health status;
108.4 	(2) formulating a medication treatment plan;
108.5 	(3) monitoring and evaluating the patient's response to therapy, including safety 
108.6 	and effectiveness;
108.7 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
108.8 	medication-related problems, including adverse drug events;
108.9 	(5) documenting the care delivered and communicating essential information to 
108.10 	the patient's other primary care providers;
108.11 	(6) providing verbal education and training designed to enhance patient 
108.12 	understanding and appropriate use of the patient's medications;
108.13 	(7) providing information, support services, and resources designed to enhance 
108.14 	patient adherence with the patient's therapeutic regimens; and
108.15 	(8) coordinating and integrating medication therapy management services within the 
108.16 	broader health care management services being provided to the patient.
108.17 	Nothing in this subdivision shall be construed to expand or modify the scope of practice of 
108.18 	the pharmacist as defined in section 151.01, subdivision 27.
108.19 	(b) To be eligible for reimbursement for services under this subdivision, a pharmacist 
108.20 	must meet the following requirements:
108.21 	(1) have a valid license issued under chapter 151;
108.22 	(2) have graduated from an accredited college of pharmacy on or after May 1996, or 
108.23 	completed a structured and comprehensive education program approved by the Board of 
108.24 	Pharmacy and the American Council of Pharmaceutical Education for the provision and 
108.25 	documentation of pharmaceutical care management services that has both clinical and 
108.26 	didactic elements;
108.27 	(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or 
108.28 	have developed a structured patient care process that is offered in a private or semiprivate 
108.29 	patient care area that is separate from the commercial business that also occurs in the 
108.30 	setting, or in home settings, excluding including long-term care and settings, group homes, 
108.31 	if the service is ordered by the provider-directed care coordination team and facilities 
108.32 	providing assisted living services, but excluding skilled nursing facilities; and
108.33 	(4) make use of an electronic patient record system that meets state standards.
108.34 	(c) For purposes of reimbursement for medication therapy management services, 
108.35 	the commissioner may enroll individual pharmacists as medical assistance and general 
108.36 	assistance medical care providers. The commissioner may also establish contact 
109.1 	requirements between the pharmacist and recipient, including limiting the number of 
109.2 	reimbursable consultations per recipient.
109.3 	(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing 
109.4 	within a reasonable geographic distance of the patient, a pharmacist who meets the 
109.5 	requirements may provide the services via two-way interactive video. Reimbursement 
109.6 	shall be at the same rates and under the same conditions that would otherwise apply to 
109.7 	the services provided. To qualify for reimbursement under this paragraph, the pharmacist 
109.8 	providing the services must meet the requirements of paragraph (b), and must be located 
109.9 	within an ambulatory care setting approved by the commissioner. The patient must also 
109.10 	be located within an ambulatory care setting approved by the commissioner. Services 
109.11 	provided under this paragraph may not be transmitted into the patient's residence.
109.12 	(e) The commissioner shall establish a pilot project for an intensive medication 
109.13 	therapy management program for patients identified by the commissioner with multiple 
109.14 	chronic conditions and a high number of medications who are at high risk of preventable 
109.15 	hospitalizations, emergency room use, medication complications, and suboptimal 
109.16 	treatment outcomes due to medication-related problems. For purposes of the pilot 
109.17 	project, medication therapy management services may be provided in a patient's home 
109.18 	or community setting, in addition to other authorized settings. The commissioner may 
109.19 	waive existing payment policies and establish special payment rates for the pilot project. 
109.20 	The pilot project must be designed to produce a net savings to the state compared to the 
109.21 	estimated costs that would otherwise be incurred for similar patients without the program. 
109.22 	The pilot project must begin by January 1, 2010, and end June 30, 2012.

109.23 	EFFECTIVE DATE. This section is effective September 1, 2011, or upon federal 
109.24 	approval, whichever is later.

109.25 	Sec. 37. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to 
109.26 	read:
109.27 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
109.28 	transportation costs incurred solely for obtaining emergency medical care or transportation 
109.29 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
109.30 	care when paid directly to an ambulance company, common carrier, or other recognized 
109.31 	providers of transportation services. Medical transportation must be provided by:
109.32 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
109.33 	(2) special transportation; or
109.34 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
109.35 	carrier, or private automobile.
110.1 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
110.2 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
110.3 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
110.4 	transportation, or private automobile.
110.5 	The commissioner may use an order by the recipient's attending physician to certify that 
110.6 	the recipient requires special transportation services. Special transportation providers shall 
110.7 	perform driver-assisted services for eligible individuals. Driver-assisted service includes 
110.8 	passenger pickup at and return to the individual's residence or place of business, assistance 
110.9 	with admittance of the individual to the medical facility, and assistance in passenger 
110.10 	securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 
110.11 	providers must obtain written documentation from the health care service provider who 
110.12 	is serving the recipient being transported, identifying the time that the recipient arrived. 
110.13 	Special transportation providers may not bill for separate base rates for the continuation of 
110.14 	a trip beyond the original destination. Special transportation providers must take recipients 
110.15 	to the nearest appropriate health care provider, using the most direct route. The minimum 
110.16 	medical assistance reimbursement rates for special transportation services are:
110.17 	(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to 
110.18 	eligible persons who need a wheelchair-accessible van;
110.19 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
110.20 	eligible persons who do not need a wheelchair-accessible van; and
110.21 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
110.22 	special transportation services to eligible persons who need a stretcher-accessible vehicle;
110.23 	(2) the base rates for special transportation services in areas defined under RUCA 
110.24 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
110.25 	11.3 percent; and
110.26 	(3) for special transportation services in areas defined under RUCA to be rural 
110.27 	or super rural areas:
110.28 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
110.29 	percent of the respective mileage rate in clause (1); and
110.30 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
110.31 	112.5 percent of the respective mileage rate in clause (1).
110.32 	(c) For purposes of reimbursement rates for special transportation services under 
110.33 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
110.34 	the urban, rural, or super rural reimbursement rate applies.
111.1 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
111.2 	means a census-tract based classification system under which a geographical area is 
111.3 	determined to be urban, rural, or super rural.
111.4 	(e) Effective for services provided on or after September 1, 2011, nonemergency 
111.5 	transportation rates, including special transportation, taxi, and other commercial carriers, 
111.6 	are reduced 4.5 percent. Payments made to managed care plans and county-based 
111.7 	purchasing plans must be reduced for services provided on or after January 1, 2012, 
111.8 	to reflect this reduction.

111.9 	Sec. 38. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to 
111.10 	read:
111.11 		Subd. 17a.Payment for ambulance services. (a) Medical assistance covers 
111.12 	ambulance services. Providers shall bill ambulance services according to Medicare 
111.13 	criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective 
111.14 	for services rendered on or after July 1, 2001, medical assistance payments for ambulance 
111.15 	services shall be paid at the Medicare reimbursement rate or at the medical assistance 
111.16 	payment rate in effect on July 1, 2000, whichever is greater.
111.17 	(b) Effective for services provided on or after September 1, 2011, ambulance 
111.18 	services payment rates are reduced 4.5 percent. Payments made to managed care plans 
111.19 	and county-based purchasing plans must be reduced for services provided on or after 
111.20 	January 1, 2012, to reflect this reduction.

111.21 	Sec. 39. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to 
111.22 	read:
111.23 		Subd. 18.Bus or taxicab transportation. To the extent authorized by rule of the 
111.24 	state agency, medical assistance covers costs of the most appropriate and cost-effective 
111.25 	form of transportation incurred by any ambulatory eligible person for obtaining 
111.26 	nonemergency medical care.

111.27 	Sec. 40. Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to 
111.28 	read:
111.29 		Subd. 25.Prior authorization required. (a) The commissioner shall publish 
111.30 	in the Minnesota health care programs provider manual and on the department's Web 
111.31 	site a list of health services that require prior authorization, as well as the criteria and 
111.32 	standards used to select health services on the list. The list and the criteria and standards 
111.33 	used to formulate it are not subject to the requirements of sections 14.001 to 14.69. The 
112.1 	commissioner's decision whether prior authorization is required for a health service is not 
112.2 	subject to administrative appeal.
112.3 	(b) The commissioner shall implement a modernized electronic system for providers 
112.4 	to request prior authorization. The modernized electronic system must include at least the 
112.5 	following functionalities:
112.6 	(1) authorizations are recipient-centric, not provider-centric;
112.7 	(2) adequate flexibility to support authorizations for an episode of care, continuous 
112.8 	drug therapy, or for individual onetime services and allows an ordering and a rendering 
112.9 	provider to both submit information into one request;
112.10 	(3) allows providers to review previous authorization requests and determine where 
112.11 	a submitted request is within the authorization process;
112.12 	(4) supports automated workflows that allow providers to securely submit medical 
112.13 	information that can be accessed by medical and pharmacy review vendors as well as 
112.14 	department staff; and
112.15 	(5) supports development of automated clinical algorithms that can verify 
112.16 	information and provide responses in real time.
112.17 	(c) The system described in paragraph (b) shall be completed by March 1, 2012. All 
112.18 	authorization requests submitted on and after March 1, 2012, or upon completion of the 
112.19 	modernized authorization system, whichever is later, must be submitted electronically by 
112.20 	providers, except requests for drugs dispensed by an outpatient pharmacy, services that 
112.21 	are provided outside of the state and surrounding local trade area, and services included 
112.22 	on a service agreement.

112.23 	Sec. 41. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
112.24 	subdivision to read:
112.25 		Subd. 25b.Authorization with third-party liability. (a) Except as otherwise 
112.26 	allowed under this subdivision or required under federal or state regulations, the 
112.27 	commissioner must not consider a request for authorization of a service when the recipient 
112.28 	has coverage from a third-party payer unless the provider requesting authorization has 
112.29 	made a good faith effort to receive payment or authorization from the third-party payer. 
112.30 	A good faith effort is established by supplying with the authorization request to the 
112.31 	commissioner the following:
112.32 	(1) a determination of payment for the service from the third-party payer, a 
112.33 	determination of authorization for the service from the third-party payer, or a verification 
112.34 	of noncoverage of the service by the third-party payer; and
113.1 	(2) the information or records required by the department to document the reason for 
113.2 	the determination or to validate noncoverage from the third-party payer.
113.3 	(b) A provider requesting authorization for services covered by Medicare is not 
113.4 	required to bill Medicare before requesting authorization from the commissioner if the 
113.5 	provider has reason to believe that a service covered by Medicare is not eligible for 
113.6 	payment. The provider must document that, because of recent claim experiences with 
113.7 	Medicare or because of written communication from Medicare, coverage is not available 
113.8 	for the service.
113.9 	(c) Authorization is not required if a third-party payer has made payment that is 
113.10 	equal to or greater than 60 percent of the maximum payment amount for the service 
113.11 	allowed under medical assistance.

113.12 	EFFECTIVE DATE. This section is effective September 1, 2011.

113.13 	Sec. 42. Minnesota Statutes 2010, section 256B.0625, subdivision 31, is amended to 
113.14 	read:
113.15 		Subd. 31.Medical supplies and equipment.  (a) Medical assistance covers medical 
113.16 	supplies and equipment. Separate payment outside of the facility's payment rate shall 
113.17 	be made for wheelchairs and wheelchair accessories for recipients who are residents 
113.18 	of intermediate care facilities for the developmentally disabled. Reimbursement for 
113.19 	wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same 
113.20 	conditions and limitations as coverage for recipients who do not reside in institutions. A 
113.21 	wheelchair purchased outside of the facility's payment rate is the property of the recipient. 
113.22 	The commissioner may set reimbursement rates for specified categories of medical 
113.23 	supplies at levels below the Medicare payment rate.
113.24 	(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies 
113.25 	must enroll as a Medicare provider.
113.26 	(c) When necessary to ensure access to durable medical equipment, prosthetics, 
113.27 	orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare 
113.28 	enrollment requirement if:
113.29 	(1) the vendor supplies only one type of durable medical equipment, prosthetic, 
113.30 	orthotic, or medical supply;
113.31 	(2) the vendor serves ten or fewer medical assistance recipients per year;
113.32 	(3) the commissioner finds that other vendors are not available to provide same or 
113.33 	similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
113.34 	(4) the vendor complies with all screening requirements in this chapter and Code of 
113.35 	Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from 
114.1 	the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare 
114.2 	and Medicaid Services approved national accreditation organization as complying with 
114.3 	the Medicare program's supplier and quality standards and the vendor serves primarily 
114.4 	pediatric patients.
114.5 	(d) Durable medical equipment means a device or equipment that:
114.6 	(1) can withstand repeated use;
114.7 	(2) is generally not useful in the absence of an illness, injury, or disability; and
114.8 	(3) is provided to correct or accommodate a physiological disorder or physical 
114.9 	condition or is generally used primarily for a medical purpose.

114.10 	Sec. 43. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to 
114.11 	read:
114.12 		Subd. 31a.Augmentative and alternative communication systems. (a) Medical 
114.13 	assistance covers augmentative and alternative communication systems consisting of 
114.14 	electronic or nonelectronic devices and the related components necessary to enable a 
114.15 	person with severe expressive communication limitations to produce or transmit messages 
114.16 	or symbols in a manner that compensates for that disability.
114.17 	(b) Until the volume of systems purchased increases to allow a discount price, the 
114.18 	commissioner shall reimburse augmentative and alternative communication manufacturers 
114.19 	and vendors at the manufacturer's suggested retail price for augmentative and alternative 
114.20 	communication systems and related components. The commissioner shall separately 
114.21 	reimburse providers for purchasing and integrating individual communication systems 
114.22 	which are unavailable as a package from an augmentative and alternative communication 
114.23 	vendor. Augmentative and alternative communication systems must be paid the lower 
114.24 	of the: 
114.25 	(1) submitted charge; or
114.26 	(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are 
114.27 	manufacturers of augmentative and alternative communication systems; or
114.28 	(ii) manufacturer's invoice charge plus 20 percent for providers that are not 
114.29 	manufacturers of augmentative and alternative communication systems.
114.30 	(c) Reimbursement rates established by this purchasing program are not subject to 
114.31 	Minnesota Rules, part 9505.0445, item S or T.

114.32 	EFFECTIVE DATE. This section is effective September 1, 2011.

114.33 	Sec. 44. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
114.34 	subdivision to read:
115.1 		Subd. 55.Payment for noncovered services. (a) Except when specifically 
115.2 	prohibited by the commissioner or federal law, a provider may seek payment from the 
115.3 	recipient for services not eligible for payment under the medical assistance program when 
115.4 	the provider, prior to delivering the service, reviews and considers all other available 
115.5 	covered alternatives with the recipient and obtains a signed acknowledgment from the 
115.6 	recipient of the potential of the recipient's liability. The signed acknowledgment must be 
115.7 	in a form approved by the commissioner.
115.8 	(b) Conditions under which a provider must not request payment from the recipient 
115.9 	include, but are not limited to:
115.10 	(1) a service that requires prior authorization, unless authorization has been denied 
115.11 	as not medically necessary and all other therapeutic alternatives have been reviewed;
115.12 	(2) a service for which payment has been denied for reasons relating to billing 
115.13 	requirements;
115.14 	(3) standard shipping or delivery and setup of medical equipment or medical 
115.15 	supplies;
115.16 	(4) services that are included in the recipient's long term care per diem;
115.17 	(5) the recipient is enrolled in the Restricted Recipient Program and the provider is 
115.18 	one of a provider type designated for the recipient's health care services; and
115.19 	(6) the noncovered service is a prescription drug identified by the commissioner as 
115.20 	having the potential for abuse and overuse, except where payment by the recipient is 
115.21 	specifically approved by the commissioner on the date of service based upon compelling 
115.22 	evidence supplied by the prescribing provider that establishes medical necessity for that 
115.23 	particular drug.
115.24 	(c) The payment requested from recipients for noncovered services under this 
115.25 	subdivision must not exceed the provider's usual and customary charge for the actual 
115.26 	service received by the recipient. A recipient must not be billed for the difference between 
115.27 	what medical assistance paid for the service or would pay for a less costly alternative 
115.28 	service.

115.29 	EFFECTIVE DATE. This section is effective September 1, 2011.

115.30 	Sec. 45. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
115.31 	subdivision to read:
115.32 		Subd. 56.Medical service coordination. (a) Medical assistance covers in-reach 
115.33 	community-based service coordination that is performed in a hospital emergency 
115.34 	department as an eligible procedure under a state healthcare program or private insurance 
115.35 	for a frequent user. A frequent user is defined as an individual who has frequented the 
116.1 	hospital emergency department for services three or more times in the previous four 
116.2 	consecutive months. In-reach community-based service coordination includes navigating 
116.3 	services to address a client's mental health, chemical health, social, economic, and housing 
116.4 	needs, or any other activity targeted at reducing the incidence of emergency room and 
116.5 	other nonmedically necessary health care utilization.
116.6 	(b) Reimbursement must be made in 15-minute increments under current Medicaid 
116.7 	mental health social work reimbursement methodology and allowed for up to 60 days 
116.8 	posthospital discharge based upon the specific identified emergency department visit or 
116.9 	inpatient admitting event. A frequent user who is participating in care coordination within 
116.10 	a health care home framework is ineligible for reimbursement under this subdivision. 
116.11 	Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in 
116.12 	social work, public health, corrections, or a related field. The commissioner shall submit 
116.13 	any necessary application for waivers to the Centers for Medicare and Medicaid Services 
116.14 	to implement this subdivision.
116.15 	(c) For the purposes of this subdivision, "in-reach community-based service 
116.16 	coordination" means the practice of a community-based worker with training, knowledge, 
116.17 	skills, and ability to access a continuum of services, including housing, transportation, 
116.18 	chemical and mental health treatment, employment, and peer support services, by working 
116.19 	with an organization's staff to transition an individual back into the individual's living 
116.20 	environment. In-reach community-based service coordination includes working with the 
116.21 	individual during their discharge and for up to a defined amount of time in the individual's 
116.22 	living environment, reducing the individual's need for readmittance.

116.23 	EFFECTIVE DATE. This section is effective retroactive from January 1, 2011.

116.24 	Sec. 46. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
116.25 	subdivision to read:
116.26 		Subd. 57.Payment for Part B Medicare crossover claims. Effective for services 
116.27 	provided on or after January 1, 2012, medical assistance payment for an enrollee's 
116.28 	cost-sharing associated with Medicare Part B is limited to an amount up to the medical 
116.29 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
116.30 	Medicare. Excluded from this limitation are payments for mental health services and 
116.31 	payments for dialysis services provided to end stage renal disease patients. The exclusion 
116.32 	for mental health services does not apply to payments for physician services provided by 
116.33 	psychiatrists and advanced practice nurses with a specialty in mental health.

117.1 	Sec. 47. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
117.2 	subdivision to read:
117.3 		Subd. 58.Early and periodic screening, diagnosis, and treatment services.
 117.4 	Medical assistance covers early and periodic screening, diagnosis, and treatment services 
117.5 	(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate 
117.6 	established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

117.7 	Sec. 48. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
117.8 	subdivision to read:
117.9 		Subd. 59.Services provided by advanced dental therapists and dental 
117.10 	therapists. Medical assistance covers services provided by advanced dental therapists 
117.11 	and dental therapists when provided within the scope of practice identified in sections 
117.12 	150A.105 and 150A.106.

117.13 	EFFECTIVE DATE. This section is effective September 1, 2011.

117.14 	Sec. 49. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to 
117.15 	read:
117.16 		Subdivision 1.Co-payments Cost-sharing. (a) Except as provided in subdivision 
117.17 	2, the medical assistance benefit plan shall include the following co-payments cost-sharing
117.18 	for all recipients, effective for services provided on or after October 1, 2003, and before 
117.19 	January 1, 2009 September 1, 2011:
117.20 	(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes 
117.21 	of this subdivision, a visit means an episode of service which is required because of 
117.22 	a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 
117.23 	ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 
117.24 	midwife, advanced practice nurse, audiologist, optician, or optometrist;
117.25 	(2) $3 for eyeglasses;
117.26 	(3) $6 $3.50 for nonemergency visits to a hospital-based emergency room, except 
117.27 	that this co-payment shall be increased to $20 upon federal approval; and
117.28 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
117.29 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
117.30 	shall apply to antipsychotic drugs when used for the treatment of mental illness.;
117.31 	(5) effective January 1, 2012, a family deductible equal to the maximum amount 
117.32 	allowed under Code of Federal Regulations, title 42, part 447.54; and
118.1 	(b) Except as provided in subdivision 2, the medical assistance benefit plan shall 
118.2 	include the following co-payments for all recipients, effective for services provided on 
118.3 	or after January 1, 2009:
118.4 	(1) $3.50 for nonemergency visits to a hospital-based emergency room;
118.5 	(2) $3 per brand-name drug prescription and $1 per generic drug prescription, 
118.6 	subject to a $7 per month maximum for prescription drug co-payments. No co-payments 
118.7 	shall apply to antipsychotic drugs when used for the treatment of mental illness; and
118.8 	(3) (6) for individuals identified by the commissioner with income at or below 100 
118.9 	percent of the federal poverty guidelines, total monthly co-payments cost-sharing must 
118.10 	not exceed five percent of family income. For purposes of this paragraph, family income 
118.11 	is the total earned and unearned income of the individual and the individual's spouse, if 
118.12 	the spouse is enrolled in medical assistance and also subject to the five percent limit on 
118.13 	co-payments cost-sharing.
118.14 	(c) (b) Recipients of medical assistance are responsible for all co-payments  and 
118.15 	deductibles in this subdivision.

118.16 	Sec. 50. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to 
118.17 	read:
118.18 		Subd. 2.Exceptions. Co-payments and deductibles shall be subject to the following 
118.19 	exceptions:
118.20 	(1) children under the age of 21;
118.21 	(2) pregnant women for services that relate to the pregnancy or any other medical 
118.22 	condition that may complicate the pregnancy;
118.23 	(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or 
118.24 	intermediate care facility for the developmentally disabled;
118.25 	(4) recipients receiving hospice care;
118.26 	(5) 100 percent federally funded services provided by an Indian health service;
118.27 	(6) emergency services;
118.28 	(7) family planning services;
118.29 	(8) services that are paid by Medicare, resulting in the medical assistance program 
118.30 	paying for the coinsurance and deductible; and
118.31 	(9) co-payments that exceed one per day per provider for nonpreventive visits, 
118.32 	eyeglasses, and nonemergency visits to a hospital-based emergency room.

118.33 	EFFECTIVE DATE. This section is effective September 1, 2011, for services 
118.34 	provided on a fee-for-service basis and January 1, 2012, for services provided by a 
118.35 	managed care plan or county-based purchasing plan.

119.1 	Sec. 51. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to 
119.2 	read:
119.3 		Subd. 3.Collection. (a) The medical assistance reimbursement to the provider shall 
119.4 	be reduced by the amount of the co-payment or deductible, except that reimbursements 
119.5 	shall not be reduced:
119.6 	(1) once a recipient has reached the $12 per month maximum or the $7 per month 
119.7 	maximum effective January 1, 2009, for prescription drug co-payments; or
119.8 	(2) for a recipient identified by the commissioner under 100 percent of the federal 
119.9 	poverty guidelines who has met their monthly five percent co-payment cost-sharing limit.
119.10 	(b) The provider collects the co-payment or deductible from the recipient. Providers 
119.11 	may not deny services to recipients who are unable to pay the co-payment or deductible.
119.12 	(c) Medical assistance reimbursement to fee-for-service providers and payments to 
119.13 	managed care plans shall not be increased as a result of the removal of co-payments or 
119.14 	deductibles effective on or after January 1, 2009.

119.15 	EFFECTIVE DATE. This section is effective September 1, 2011, for services 
119.16 	provided on a fee-for-service basis, and January 1, 2012, for services provided by a 
119.17 	managed care plan or county-based purchasing plan.

119.18 	Sec. 52. Minnesota Statutes 2010, section 256B.064, subdivision 2, is amended to read:
119.19 		Subd. 2.Imposition of monetary recovery and sanctions. (a) The commissioner 
119.20 	shall determine any monetary amounts to be recovered and sanctions to be imposed upon 
119.21 	a vendor of medical care under this section. Except as provided in paragraphs (b) and 
119.22 	(d), neither a monetary recovery nor a sanction will be imposed by the commissioner 
119.23 	without prior notice and an opportunity for a hearing, according to chapter 14, on the 
119.24 	commissioner's proposed action, provided that the commissioner may suspend or reduce 
119.25 	payment to a vendor of medical care, except a nursing home or convalescent care facility, 
119.26 	after notice and prior to the hearing if in the commissioner's opinion that action is 
119.27 	necessary to protect the public welfare and the interests of the program.
119.28 	(b) Except for a nursing home or convalescent care facility, when the commissioner 
119.29 	finds good cause not to suspend payments under Code of Federal Regulations, title 42, 
119.30 	section 455.23(e) or (f), the commissioner may shall withhold or reduce payments to a 
119.31 	vendor of medical care without providing advance notice of such withholding or reduction 
119.32 	if either of the following occurs:
119.33 	(1) the vendor is convicted of a crime involving the conduct described in subdivision 
119.34 	1a; or
120.1 	(2) the commissioner receives reliable evidence of fraud or willful misrepresentation 
120.2 	by the vendor. determines there is a credible allegation of fraud for which an investigation 
120.3 	is pending under the program. A credible allegation of fraud is an allegation which has 
120.4 	been verified by the state, from any source, including but not limited to:
120.5 	(i) fraud hotline complaints;
120.6 	(ii) claims data mining; and
120.7 	(iii) patterns identified through provider audits, civil false claims cases, and law 
120.8 	enforcement investigations.
120.9 	Allegations are considered to be credible when they have an indicia of reliability 
120.10 	and the state agency has reviewed all allegations, facts, and evidence carefully and acts 
120.11 	judiciously on a case-by-case basis. 
120.12 	(c) The commissioner must send notice of the withholding or reduction of payments 
120.13 	under paragraph (b) within five days of taking such action unless requested in writing by a 
120.14 	law enforcement agency to temporarily withhold the notice. The notice must:
120.15 	(1) state that payments are being withheld according to paragraph (b);
120.16 	(2) set forth the general allegations as to the nature of the withholding action, but 
120.17 	need not disclose any specific information concerning an ongoing investigation;
120.18 	(2) (3) except in the case of a conviction for conduct described in subdivision 1a, 
120.19 	state that the withholding is for a temporary period and cite the circumstances under which 
120.20 	withholding will be terminated;
120.21 	(3) (4) identify the types of claims to which the withholding applies; and
120.22 	(4) (5) inform the vendor of the right to submit written evidence for consideration by 
120.23 	the commissioner.
120.24 	The withholding or reduction of payments will not continue after the commissioner 
120.25 	determines there is insufficient evidence of fraud or willful misrepresentation by the 
120.26 	vendor, or after legal proceedings relating to the alleged fraud or willful misrepresentation
120.27 	are completed, unless the commissioner has sent notice of intention to impose monetary 
120.28 	recovery or sanctions under paragraph (a).
120.29 	(d) The commissioner may shall suspend or terminate a vendor's participation in 
120.30 	the program without providing advance notice and an opportunity for a hearing when the 
120.31 	suspension or termination is required because of the vendor's exclusion from participation 
120.32 	in Medicare. Within five days of taking such action, the commissioner must send notice of 
120.33 	the suspension or termination. The notice must:
120.34 	(1) state that suspension or termination is the result of the vendor's exclusion from 
120.35 	Medicare;
120.36 	(2) identify the effective date of the suspension or termination; and
121.1 	(3) inform the vendor of the need to be reinstated to Medicare before reapplying for 
121.2 	participation in the program; and.
121.3 	(4) inform the vendor of the right to submit written evidence for consideration by 
121.4 	the commissioner.
121.5 	(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or 
121.6 	sanction is to be imposed, a vendor may request a contested case, as defined in section 
121.7 	14.02, subdivision 3, by filing with the commissioner a written request of appeal. The 
121.8 	appeal request must be received by the commissioner no later than 30 days after the date 
121.9 	the notification of monetary recovery or sanction was mailed to the vendor. The appeal 
121.10 	request must specify: 
121.11 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar 
121.12 	amount involved for each disputed item;
121.13 	(2) the computation that the vendor believes is correct;
121.14 	(3) the authority in statute or rule upon which the vendor relies for each disputed 
121.15 	item;
121.16 	(4) the name and address of the person or entity with whom contacts may be made 
121.17 	regarding the appeal; and
121.18 	(5) other information required by the commissioner.

121.19 	Sec. 53. Minnesota Statutes 2010, section 256B.0641, subdivision 1, is amended to 
121.20 	read:
121.21 		Subdivision 1.Recovery procedures; sources. Notwithstanding section 256B.72
121.22 	or any law or rule to the contrary, when the commissioner or the federal government 
121.23 	determines that an overpayment has been made by the state to any medical assistance 
121.24 	vendor, the commissioner shall recover the overpayment as follows:
121.25 	(1) if the federal share of the overpayment amount is due and owing to the federal 
121.26 	government under federal law and regulations, the commissioner shall recover from the 
121.27 	medical assistance vendor the federal share of the determined overpayment amount paid 
121.28 	to that provider using the schedule of payments required by the federal government;
121.29 	(2) if the overpayment to a medical assistance vendor is due to a retroactive 
121.30 	adjustment made because the medical assistance vendor's temporary payment rate was 
121.31 	higher than the established desk audit payment rate or because of a department error in 
121.32 	calculating a payment rate, the commissioner shall recover from the medical assistance 
121.33 	vendor the total amount of the overpayment within 120 days after the date on which 
121.34 	written notice of the adjustment is sent to the medical assistance vendor or according to a 
121.35 	schedule of payments approved by the commissioner; and
122.1 	(3) a medical assistance vendor is liable for the overpayment amount owed by 
122.2 	a long-term care provider if the vendors or their owners are under common control 
122.3 	or ownership.; and
122.4 	(4) in order to collect past due obligations to the department, the commissioner shall 
122.5 	make any necessary adjustments to payments to a provider or vendor that has the same tax 
122.6 	identification number as is assigned to a provider or vendor with past due obligations.

122.7 	Sec. 54. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to 
122.8 	read:
122.9 		Subd. 4.Alternative models and waivers of requirements. (a) Nothing in this 
122.10 	section shall preclude the continued development of existing medical or health care 
122.11 	home projects currently operating or under development by the commissioner of human 
122.12 	services or preclude the commissioner from establishing alternative models and payment 
122.13 	mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs 
122.14 	under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term 
122.15 	care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and 
122.16 	medical assistance, are in the waiting period for Medicare, or who have other primary 
122.17 	coverage.
122.18 	(b) The commissioner of health shall waive health care home certification 
122.19 	requirements if an applicant demonstrates that compliance with a certification requirement 
122.20 	will create a major financial hardship or is not feasible, and the applicant establishes an 
122.21 	alternative way to accomplish the objectives of the certification requirement.

122.22 	EFFECTIVE DATE. This section is effective September 1, 2011.

122.23 	Sec. 55. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 
122.24 	subdivision to read:
122.25 		Subd. 8.Coordination with local services. The health care home and the county 
122.26 	shall coordinate care and services provided to patients enrolled with a health care home 
122.27 	who have complex medical needs or a disability, and who need and are eligible for 
122.28 	additional local services administered by counties, including but not limited to waivered 
122.29 	services, mental health services, social services, public health services, transportation, and 
122.30 	housing.  The coordination of care and services must be as provided in the plan established 
122.31 	by the patient and health care home.

122.32 	EFFECTIVE DATE. This section is effective September 1, 2011.

123.1 	Sec. 56. Minnesota Statutes 2010, section 256B.196, subdivision 2, is amended to read:
123.2 		Subd. 2.Commissioner's duties. (a) For the purposes of this subdivision and 
123.3 	subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital 
123.4 	services upper payment limit for nonstate government hospitals. The commissioner shall 
123.5 	then determine the amount of a supplemental payment to Hennepin County Medical 
123.6 	Center and Regions Hospital for these services that would increase medical assistance 
123.7 	spending in this category to the aggregate upper payment limit for all nonstate government 
123.8 	hospitals in Minnesota. In making this determination, the commissioner shall allot the 
123.9 	available increases between Hennepin County Medical Center and Regions Hospital 
123.10 	based on the ratio of medical assistance fee-for-service outpatient hospital payments to 
123.11 	the two facilities. The commissioner shall adjust this allotment as necessary based on 
123.12 	federal approvals, the amount of intergovernmental transfers received from Hennepin and 
123.13 	Ramsey Counties, and other factors, in order to maximize the additional total payments. 
123.14 	The commissioner shall inform Hennepin County and Ramsey County of the periodic 
123.15 	intergovernmental transfers necessary to match federal Medicaid payments available 
123.16 	under this subdivision in order to make supplementary medical assistance payments to 
123.17 	Hennepin County Medical Center and Regions Hospital equal to an amount that when 
123.18 	combined with existing medical assistance payments to nonstate governmental hospitals 
123.19 	would increase total payments to hospitals in this category for outpatient services to 
123.20 	the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon 
123.21 	receipt of these periodic transfers, the commissioner shall make supplementary payments 
123.22 	to Hennepin County Medical Center and Regions Hospital.
123.23 	(b) For the purposes of this subdivision and subdivision 3, the commissioner shall 
123.24 	determine an upper payment limit for physicians and other billing professionals affiliated 
123.25 	with Hennepin County Medical Center and with Regions Hospital. The upper payment 
123.26 	limit shall be based on the average commercial rate or be determined using another method 
123.27 	acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall 
123.28 	inform Hennepin County and Ramsey County of the periodic intergovernmental transfers 
123.29 	necessary to match the federal Medicaid payments available under this subdivision in 
123.30 	order to make supplementary payments to physicians and other billing professionals 
123.31 	affiliated with Hennepin County Medical Center and to make supplementary payments 
123.32 	to physicians and other billing professionals affiliated with Regions Hospital through 
123.33 	HealthPartners Medical Group equal to the difference between the established medical 
123.34 	assistance payment for physician and other billing professional services and the upper 
123.35 	payment limit. Upon receipt of these periodic transfers, the commissioner shall make 
123.36 	supplementary payments to physicians of and other billing professionals affiliated with
124.1 	Hennepin Faculty Associates County Medical Center and shall make supplementary 
124.2 	payments to physicians and other billing professionals affiliated with Regions Hospital 
124.3 	through HealthPartners Medical Group.
124.4 	(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make 
124.5 	monthly voluntary intergovernmental transfers to the commissioner in amounts not to 
124.6 	exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from 
124.7 	Ramsey County. The commissioner shall increase the medical assistance capitation 
124.8 	payments to any licensed health plan under contract with the medical assistance program 
124.9 	that agrees to make enhanced payments to Hennepin County Medical Center or Regions 
124.10 	Hospital. The increase shall be in an amount equal to the annual value of the monthly 
124.11 	transfers plus federal financial participation, with each health plan receiving its pro rata 
124.12 	share of the increase based on the pro rata share of medical assistance admissions to 
124.13 	Hennepin County Medical Center and Regions Hospital by those plans. Upon the request 
124.14 	of the commissioner, health plans shall submit individual-level cost data for verification 
124.15 	purposes. The commissioner may ratably reduce these payments on a pro rata basis in 
124.16 	order to satisfy federal requirements for actuarial soundness. If payments are reduced, 
124.17 	transfers shall be reduced accordingly. Any licensed health plan that receives increased 
124.18 	medical assistance capitation payments under the intergovernmental transfer described in 
124.19 	this paragraph shall increase its medical assistance payments to Hennepin County Medical 
124.20 	Center and Regions Hospital by the same amount as the increased payments received in 
124.21 	the capitation payment described in this paragraph.
124.22 	(d) The commissioner shall inform Hennepin County and Ramsey Countythe 
124.23 	transferring governmental entities on an ongoing basis of the need for any changes needed 
124.24 	in the intergovernmental transfers in order to continue the payments under paragraphs (a) 
124.25 	to (c), at their maximum level, including increases in upper payment limits, changes in the 
124.26 	federal Medicaid match, and other factors.
124.27 	(e) The payments in paragraphs (a) to (c) shall be implemented independently of 
124.28 	each other, subject to federal approval and to the receipt of transfers under subdivision 3.

124.29 	Sec. 57. Minnesota Statutes 2010, section 256B.196, subdivision 3, is amended to read:
124.30 		Subd. 3.Intergovernmental transfers. Based on the determination by the 
124.31 	commissioner under subdivision 2, Hennepin County and Ramsey County shall make 
124.32 	periodic intergovernmental transfers to the commissioner for the purposes of subdivision 
124.33 	2, paragraphs (a) to (c) and (b). All of the intergovernmental transfers made by Hennepin 
124.34 	County shall be used to match federal payments to Hennepin County Medical Center 
124.35 	under subdivision 2, paragraph (a);, and to physicians and other billing professionals 
125.1 	 affiliated with Hennepin Faculty Associates County Medical Center under subdivision 
125.2 	2, paragraph (b); and to Metropolitan Health Plan under subdivision 2, paragraph 
125.3 	(c). All of the intergovernmental transfers made by Ramsey County shall be used to 
125.4 	match federal payments to Regions Hospital under subdivision 2, paragraph (a);, and
125.5 	to physicians and other billing professionals affiliated with Regions Hospital through 
125.6 	HealthPartners Medical Group under subdivision 2, paragraph (b); and to HealthPartners 
125.7 	under subdivision 2, paragraph (c).

125.8 	Sec. 58. Minnesota Statutes 2010, section 256B.196, subdivision 5, is amended to read:
125.9 		Subd. 5.Recession period. Each type of intergovernmental transfer in subdivision 
125.10 	2, paragraphs (a) to (d), for payment periods from October 1, 2008, through December 31, 
125.11 	2010 June 30, 2013, is voluntary on the part of Hennepin and Ramsey Counties, meaning 
125.12 	that the transfer must be agreed to, in writing, by the counties prior to any payments being 
125.13 	issued. One agreement on each type of transfer shall cover the entire recession period.

125.14 	Sec. 59. [256B.198] PAYMENTS FOR NONHOSPITAL-BASED 
125.15 	GOVERNMENTAL HEALTH CENTERS.
125.16 	(a) The commissioner may make payments to nonhospital-based health centers 
125.17 	operated by a governmental entity for the difference between the expenditures incurred 
125.18 	by the health center for patients eligible for medical assistance, and the payments to the 
125.19 	health center for medical assistance permitted elsewhere under this chapter.
125.20 	(b) The nonfederal share of payments authorized under paragraph (a) shall be 
125.21 	provided through certified public expenditures authorized under section 256B.199, 
125.22 	paragraph (b).
125.23 	(c) Effective July 1, 2013, or no earlier than 12 months after implementation of a 
125.24 	total cost of care demonstration project, Hennepin County may receive federal matching 
125.25 	funds for certified public expenditures under paragraph (a), if the county participates in 
125.26 	a total cost of care demonstration project under sections 256B.0755 and 256B.0756, or 
125.27 	another total cost of care demonstration project approved by the commissioner, and the 
125.28 	county exceeds the minimum performance threshold established by the commissioner for 
125.29 	the demonstration project. The value of the federal matching funds for the certified public 
125.30 	expenditures allocated to Hennepin County shall be equal to the value of savings achieved 
125.31 	above the minimum performance threshold. The same proportion of federal matching 
125.32 	funds for certified public expenditure allocated to Hennepin County based on savings 
125.33 	achieved under the demonstration project shall continue after the demonstration project 
125.34 	and must continue to be paid to Hennepin County each year thereafter.
126.1 	(d) Beginning July 1, 2014, or no earlier than 12 months after the initial allocation 
126.2 	under paragraph (c) if a portion of the federal matching funds for certified public 
126.3 	expenditure remains with the state, the commissioner shall annually determine if the 
126.4 	savings from county's total cost of care demonstration project exceeded the savings from 
126.5 	the previous year and allocate federal matching funds for certified public expenditures to 
126.6 	Hennepin County equal to the amount of savings achieved above the amount achieved 
126.7 	in the previous year. The proportion of federal matching funds for certified public 
126.8 	expenditure allocated to Hennepin County shall be paid to Hennepin County each 
126.9 	year thereafter, until no federal matching funds for certified public expenditures under 
126.10 	paragraph (a) remain with the state.
126.11 	(e) Nothing under this subdivision precludes Hennepin County from receiving 
126.12 	an additional gain-sharing payment or relieves the county from paying a downside 
126.13 	risk-sharing payment to the state under the demonstration project under section 256B.0755.

126.14 	Sec. 60. Minnesota Statutes 2010, section 256B.199, is amended to read:
126.15 	256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
126.16 	(a) Effective July 1, 2007, the commissioner shall apply for federal matching 
126.17 	funds for the expenditures in paragraphs (b) and (c). Effective September 1, 2011, the 
126.18 	commissioner shall apply for matching funds for expenditures in paragraph (e).
126.19 	(b) The commissioner shall apply for federal matching funds for certified public 
126.20 	expenditures as follows:
126.21 	(1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions 
126.22 	Hospital, the University of Minnesota, and Fairview-University Medical Center shall 
126.23 	report quarterly to the commissioner beginning June 1, 2007, payments made during the 
126.24 	second previous quarter that may qualify for reimbursement under federal law;
126.25 	 (2) based on these reports, the commissioner shall apply for federal matching 
126.26 	funds. These funds are appropriated to the commissioner for the payments under section 
126.27 	256.969, subdivision 27; and
126.28 	 (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform 
126.29 	the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 
126.30 	hospital payment money expected to be available in the current federal fiscal year.
126.31 	(c) The commissioner shall apply for federal matching funds for general assistance 
126.32 	medical care expenditures as follows:
126.33 	(1) for hospital services occurring on or after July 1, 2007, general assistance medical 
126.34 	care expenditures for fee-for-service inpatient and outpatient hospital payments made by 
126.35 	the department shall be used to apply for federal matching funds, except as limited below:
127.1 	(i) only those general assistance medical care expenditures made to an individual 
127.2 	hospital that would not cause the hospital to exceed its individual hospital limits under 
127.3 	section 1923 of the Social Security Act may be considered; and
127.4 	(ii) general assistance medical care expenditures may be considered only to the extent 
127.5 	of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
127.6 	(2) all hospitals must provide any necessary expenditure, cost, and revenue 
127.7 	information required by the commissioner as necessary for purposes of obtaining federal 
127.8 	Medicaid matching funds for general assistance medical care expenditures.
127.9 	(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall 
127.10 	apply for additional federal matching funds available as disproportionate share hospital 
127.11 	payments under the American Recovery and Reinvestment Act of 2009. These funds shall 
127.12 	be made available as the state share of payments under section 256.969, subdivision 28. 
127.13 	The entities required to report certified public expenditures under paragraph (b), clause 
127.14 	(1), shall report additional certified public expenditures as necessary under this paragraph.
127.15 	(e) For services provided on or after September 1, 2011, the commissioner shall 
127.16 	apply for additional federal matching funds available as disproportionate share hospital 
127.17 	payments under the MinnesotaCare program according to the requirements and conditions 
127.18 	of paragraph (c). A hospital may elect on an annual basis to not be a disproportionate 
127.19 	share hospital for purposes of this paragraph, if the hospital does not qualify for a payment 
127.20 	under section 256.969, subdivision 9, paragraph (b).

127.21 	Sec. 61. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
127.22 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
127.23 	and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 
127.24 	January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 
127.25 	renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 
127.26 	31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 
127.27 	issue separate contracts with requirements specific to services to medical assistance 
127.28 	recipients age 65 and older.
127.29 	(b) A prepaid health plan providing covered health services for eligible persons 
127.30 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
127.31 	contract with the commissioner. Requirements applicable to managed care programs 
127.32 	under chapters 256B and 256L established after the effective date of a contract with the 
127.33 	commissioner take effect when the contract is next issued or renewed.
127.34 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
127.35 	shall withhold five percent of managed care plan payments under this section and 
128.1 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
128.2 	assistance program pending completion of performance targets. Each performance target 
128.3 	must be quantifiable, objective, measurable, and reasonably attainable, except in the case 
128.4 	of a performance target based on a federal or state law or rule. Criteria for assessment 
128.5 	of each performance target must be outlined in writing prior to the contract effective 
128.6 	date. The managed care plan must demonstrate, to the commissioner's satisfaction, 
128.7 	that the data submitted regarding attainment of the performance target is accurate. The 
128.8 	commissioner shall periodically change the administrative measures used as performance 
128.9 	targets in order to improve plan performance across a broader range of administrative 
128.10 	services. The performance targets must include measurement of plan efforts to contain 
128.11 	spending on health care services and administrative activities. The commissioner may 
128.12 	adopt plan-specific performance targets that take into account factors affecting only one 
128.13 	plan, including characteristics of the plan's enrollee population. The withheld funds 
128.14 	must be returned no sooner than July of the following year if performance targets in the 
128.15 	contract are achieved. The commissioner may exclude special demonstration projects 
128.16 	under subdivision 23.
128.17 	(d) Effective for services rendered on or after January 1, 2009, through December 
128.18 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
128.19 	under this section and county-based purchasing plan payments under section 256B.692 
128.20 	for the prepaid medical assistance program. The withheld funds must be returned no 
128.21 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
128.22 	exclude special demonstration projects under subdivision 23.
128.23 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
128.24 	shall require that managed care plans use the assessment and authorization processes, 
128.25 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
128.26 	billing processes, and policies consistent with medical assistance fee-for-service or the 
128.27 	Department of Human Services contract requirements consistent with medical assistance 
128.28 	fee-for-service or the Department of Human Services contract requirements for all 
128.29 	personal care assistance services under section 256B.0659.
128.30 	(f) Effective for services rendered on or after January 1, 2010, through December 
128.31 	31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 
128.32 	under this section and county-based purchasing plan payments under section 256B.692 
128.33 	for the prepaid medical assistance program. The withheld funds must be returned no 
128.34 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
128.35 	exclude special demonstration projects under subdivision 23.
129.1 	(g) Effective for services rendered on or after January 1, 2011, through December 
129.2 	31, 2011, the commissioner shall include as part of the performance targets described 
129.3 	in paragraph (c) a reduction in the health plan's emergency room utilization rate for 
129.4 	state health care program enrollees by a measurable rate of five percent from the plan's 
129.5 	utilization rate for state health care program enrollees for the previous calendar year.
129.6 	Effective for services rendered on or after January 1, 2012, the commissioner shall include 
129.7 	as part of the performance targets described in paragraph (c) a reduction in the health 
129.8 	plan's emergency department utilization rate for medical assistance and MinnesotaCare 
129.9 	enrollees, as determined by the commissioner. To earn the return of the withhold each 
129.10 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
129.11 	reduction of no less than ten percent of the plan's emergency department utilization rate for 
129.12 	medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared 
129.13 	to the previous calendar year until the final performance target is reached.
129.14 	The withheld funds must be returned no sooner than July 1 and no later than July 
129.15 	31 of the following calendar year if the managed care plan or county-based purchasing 
129.16 	plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 
129.17 	rate was achieved.
129.18 	The withhold described in this paragraph shall continue for each consecutive 
129.19 	contract period until the plan's emergency room utilization rate for state health care 
129.20 	program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 
129.21 	for state health care program enrollees for calendar year 2009 medical assistance and 
129.22 	MinnesotaCare enrollees for calendar year 2011. Hospitals shall cooperate with the health 
129.23 	plans in meeting this performance target and shall accept payment withholds that may be 
129.24 	returned to the hospitals if the performance target is achieved. The commissioner shall 
129.25 	structure the withhold so that the commissioner returns a portion of the withheld funds 
129.26 	in amounts commensurate with achieved reductions in utilization less than the targeted 
129.27 	amount. The withhold in this paragraph does not apply to county-based purchasing plans.
129.28 	(h)  Effective for services rendered on or after January 1, 2012, the commissioner 
129.29 	shall include as part of the performance targets described in paragraph (c) a reduction 
129.30 	in the plan's hospitalization admission rate for medical assistance and MinnesotaCare 
129.31 	enrollees, as determined by the commissioner. To earn the return of the withhold each 
129.32 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
129.33 	reduction of no less than five percent of the plan's hospital admission rate for medical 
129.34 	assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared to the 
129.35 	previous calendar year until the final performance target is reached.
130.1 	The withheld funds must be returned no sooner than July 1 and no later than July 
130.2 	31 of the following calendar year if the managed care plan or county-based purchasing 
130.3 	plan demonstrates to the satisfaction of the commissioner that this reduction in the 
130.4 	hospitalization rate was achieved.
130.5 	The withhold described in this paragraph shall continue until there is a 25 percent 
130.6 	reduction in the hospital admission rate compared to the hospital admission rates in 
130.7 	calendar year 2011, as determined by the commissioner. The hospital admissions in this 
130.8 	performance target do not include the admissions applicable to the subsequent hospital 
130.9 	admission performance target under paragraph (i). Hospitals shall cooperate with the 
130.10 	plans in meeting this performance target and shall accept payment withholds that may be 
130.11 	returned to the hospitals if the performance target is achieved.
130.12 	(i) Effective for services rendered on or after January 1, 2012, the commissioner 
130.13 	shall include as part of the performance targets described in paragraph (c) a reduction in 
130.14 	the plan's hospitalization admission rates for subsequent hospitalizations within 30 days 
130.15 	of a previous hospitalization of a patient regardless of the reason, for medical assistance 
130.16 	and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of 
130.17 	the withhold each year, the managed care plan or county-based purchasing plan must 
130.18 	achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance 
130.19 	and MinnesotaCare enrollees, excluding Medicare enrollees, of no less than five percent 
130.20 	compared to the previous calendar year until the final performance target is reached.
130.21 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
130.22 	of the following calendar year if the managed care plan or county-based purchasing plan 
130.23 	demonstrates to the satisfaction of the commissioner that a qualifying reduction in the 
130.24 	subsequent hospitalization rate was achieved.
130.25 	The withhold described in this paragraph must continue for each consecutive 
130.26 	contract period until the plan's subsequent hospitalization rate for medical assistance and 
130.27 	MinnesotaCare enrollees, excluding Medicare enrollees, is reduced by 25 percent of the 
130.28 	plan's subsequent hospitalization rate for calendar year 2011. Hospitals shall cooperate 
130.29 	with the plans in meeting this performance target and shall accept payment withholds that 
130.30 	must be returned to the hospitals if the performance target is achieved.
130.31 	(j) Effective for services rendered on or after January 1, 2011, through December 31, 
130.32 	2011, the commissioner shall withhold 4.5 percent of managed care plan payments under 
130.33 	this section and county-based purchasing plan payments under section 256B.692 for the 
130.34 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
130.35 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
130.36 	special demonstration projects under subdivision 23.
131.1 	(i) (k)  Effective for services rendered on or after January 1, 2012, through December 
131.2 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
131.3 	under this section and county-based purchasing plan payments under section 256B.692 
131.4 	for the prepaid medical assistance program. The withheld funds must be returned no 
131.5 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
131.6 	exclude special demonstration projects under subdivision 23.
131.7 	(j) (l)  Effective for services rendered on or after January 1, 2013, through December 
131.8 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
131.9 	under this section and county-based purchasing plan payments under section 256B.692 
131.10 	for the prepaid medical assistance program. The withheld funds must be returned no 
131.11 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
131.12 	exclude special demonstration projects under subdivision 23.
131.13 	(k) (m)  Effective for services rendered on or after January 1, 2014, the commissioner 
131.14 	shall withhold three percent of managed care plan payments under this section and 
131.15 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
131.16 	assistance program. The withheld funds must be returned no sooner than July 1 and 
131.17 	no later than July 31 of the following year. The commissioner may exclude special 
131.18 	demonstration projects under subdivision 23.
131.19 	(l) (n)  A managed care plan or a county-based purchasing plan under section 
131.20 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
131.21 	under this section that is reasonably expected to be returned.
131.22 	(m) (o)  Contracts between the commissioner and a prepaid health plan are exempt 
131.23 	from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
131.24 	(a), and 7.
131.25 	(n) (p)  The return of the withhold under paragraphs (d), (f), and (h) (j)  to (k) (m)  is 
131.26 	not subject to the requirements of paragraph (c).

131.27 	Sec. 62. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:
131.28 		Subd. 5c.Medical education and research fund. (a) The commissioner of human 
131.29 	services shall transfer each year to the medical education and research fund established 
131.30 	under section 62J.692, an amount specified in this subdivision. The commissioner shall 
131.31 	calculate the following:
131.32 	(1) an amount equal to the reduction in the prepaid medical assistance payments as 
131.33 	specified in this clause. Until January 1, 2002, the county medical assistance capitation 
131.34 	base rate prior to plan specific adjustments and after the regional rate adjustments under 
131.35 	subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining 
132.1 	metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after 
132.2 	January 1, 2002, the county medical assistance capitation base rate prior to plan specific 
132.3 	adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining 
132.4 	metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing 
132.5 	facility and elderly waiver payments and demonstration project payments operating 
132.6 	under subdivision 23 are excluded from this reduction. The amount calculated under 
132.7 	this clause shall not be adjusted for periods already paid due to subsequent changes to 
132.8 	the capitation payments;
132.9 	(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this 
132.10 	section;
132.11 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
132.12 	paid under this section; and
132.13 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
132.14 	under this section.
132.15 	(b) This subdivision shall be effective upon approval of a federal waiver which 
132.16 	allows federal financial participation in the medical education and research fund. Effective 
132.17 	July 1, 2009, and thereafter, The transfers required byamount specified under paragraph 
132.18 	(a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009. 
132.19 	Any excess shall first reduce the amounts otherwise required to be transferredspecified 
132.20 	under paragraph (a), clauses (2) to (4). Any excess following this reduction shall 
132.21 	proportionally reduce the transfersamount specified under paragraph (a), clause (1).
132.22 	(c) Beginning July September 1, 2009 2011, of the amounts amount in paragraph 
132.23 	(a), the commissioner shall transfer $21,714,000 each fiscal year to the medical education 
132.24 	and research fund. The balance of the transfers under paragraph (a) shall be transferred to 
132.25 	the medical education and research fund no earlier than July 1 of the following fiscal year.
132.26 	(d) Beginning September 1, 2011, of the amount in paragraph (a), following the 
132.27 	transfer under paragraph (c), the commissioner shall transfer to the medical education 
132.28 	research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 in fiscal year 
132.29 	2014 and thereafter.

132.30 	Sec. 63. Minnesota Statutes 2010, section 256B.69, is amended by adding a 
132.31 	subdivision to read:
132.32 		Subd. 9c.Managed care financial reporting. (a) The commissioner shall collect 
132.33 	detailed data regarding financials, provider payments, provider rate methodologies, and 
132.34 	other data as determined by the commissioner and managed care and county-based 
132.35 	purchasing plans that are required to be submitted under this section. The commissioner, 
133.1 	in consultation with the commissioners of health and commerce, and in consultation 
133.2 	with managed care plans and county-based purchasing plans, shall set uniform criteria, 
133.3 	definitions, and standards for the data to be submitted, and shall require managed care and 
133.4 	county-based purchasing plans to comply with these criteria, definitions, and standards 
133.5 	when submitting data under this section. In carrying out the responsibilities of this 
133.6 	subdivision, the commissioner shall ensure that the data collection is implemented in an 
133.7 	integrated and coordinated manner that avoids unnecessary duplication of effort. To the 
133.8 	extent possible, the commissioner shall use existing data sources and streamline data 
133.9 	collection in order to reduce public and private sector administrative costs. Nothing in 
133.10 	this subdivision shall allow release of information that is nonpublic data pursuant to 
133.11 	section 13.02.
133.12 	(b) Each managed care and county-based purchasing plan must annually provide 
133.13 	to the commissioner the following information on state public programs, in the form 
133.14 	and manner specified by the commissioner, according to guidelines developed by the 
133.15 	commissioner in consultation with managed care plans and county-based purchasing 
133.16 	plans under contract:
133.17 	(1) administrative expenses by category and subcategory consistent with 
133.18 	administrative expense reporting to other state and federal regulatory agencies, by 
133.19 	program;
133.20 	(2) revenues by program, including investment income;
133.21 	(3) nonadministrative service payments, provider payments, and reimbursement 
133.22 	rates by provider type or service category, by program, paid by the managed care plan 
133.23 	under this section or the county-based purchasing plan under section 256B.692 to 
133.24 	providers and vendors for administrative services under contract with the plan, including 
133.25 	but not limited to:
133.26 	(i) individual-level provider payment and reimbursement rate data;
133.27 	(ii) provider reimbursement rate methodologies by provider type, by program, 
133.28 	including a description of alternative payment arrangements and payments outside the 
133.29 	claims process;
133.30 	(iii) data on implementation of legislatively mandated provider rate changes; and
133.31 	(iv) individual-level provider payment and reimbursement rate data and plan-specific 
133.32 	provider reimbursement rate methodologies by provider type, by program, including 
133.33 	alternative payment arrangements and payments outside the claims process, provided to 
133.34 	the commissioner under this subdivision are nonpublic data as defined in section 13.02;
133.35 	(4) data on the amount of reinsurance or transfer of risk by program; and
133.36 	(5) contribution to reserve, by program.
134.1 	(c) In the event a report is published or released based on data provided under 
134.2 	this subdivision, the commissioner shall provide the report to managed care plans and 
134.3 	county-based purchasing plans 30 days prior to the publication or release of the report. 
134.4 	Managed care plans and county-based purchasing plans shall have 30 days to review the 
134.5 	report and provide comment to the commissioner.

134.6 	Sec. 64. Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:
134.7 		Subd. 28.Medicare special needs plans; medical assistance basic health care.
 134.8 	(a) The commissioner may contract with qualified Medicare-approved special needs 
134.9 	plans to provide medical assistance basic health care services to persons with disabilities, 
134.10 	including those with developmental disabilities. Basic health care services include:
134.11 	(1) those services covered by the medical assistance state plan except for ICF/MR 
134.12 	services, home and community-based waiver services, case management for persons with 
134.13 	developmental disabilities under section 256B.0625, subdivision 20a, and personal care 
134.14 	and certain home care services defined by the commissioner in consultation with the 
134.15 	stakeholder group established under paragraph (d); and
134.16 	(2) basic health care services may also include risk for up to 100 days of nursing 
134.17 	facility services for persons who reside in a noninstitutional setting and home health 
134.18 	services related to rehabilitation as defined by the commissioner after consultation with 
134.19 	the stakeholder group.
134.20 	The commissioner may exclude other medical assistance services from the basic 
134.21 	health care benefit set. Enrollees in these plans can access any excluded services on the 
134.22 	same basis as other medical assistance recipients who have not enrolled.
134.23 	Unless a person is otherwise required to enroll in managed care, enrollment in these 
134.24 	plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 
134.25 	enrollment with an option to opt out is not voluntary enrollment.
134.26 	(b) Beginning January 1, 2007, the commissioner may contract with qualified 
134.27 	Medicare special needs plans to provide basic health care services under medical 
134.28 	assistance to persons who are dually eligible for both Medicare and Medicaid and those 
134.29 	Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 
134.30 	The commissioner shall consult with the stakeholder group under paragraph (d) in 
134.31 	developing program specifications for these services. The commissioner shall report to 
134.32 	the chairs of the house of representatives and senate committees with jurisdiction over 
134.33 	health and human services policy and finance by February 1, 2007, on implementation 
134.34 	of these programs and the need for increased funding for the ombudsman for managed 
134.35 	care and other consumer assistance and protections needed due to enrollment in managed 
135.1 	care of persons with disabilities. Payment for Medicaid services provided under this 
135.2 	subdivision for the months of May and June will be made no earlier than July 1 of the 
135.3 	same calendar year.
135.4 	(c) Notwithstanding subdivision 4, beginning January 1, 2008 2012, the 
135.5 	commissioner may expand contracting under this subdivision to all shall enroll persons 
135.6 	with disabilities not otherwise required to enroll in managed care under this section, 
135.7 	unless the individual chooses to opt out of enrollment. The commissioner shall establish 
135.8 	enrollment and opt out procedures consistent with applicable enrollment procedures under 
135.9 	this subdivision.
135.10 	(d) The commissioner shall establish a state-level stakeholder group to provide 
135.11 	advice on managed care programs for persons with disabilities, including both MnDHO 
135.12 	and contracts with special needs plans that provide basic health care services as described 
135.13 	in paragraphs (a) and (b). The stakeholder group shall provide advice on program 
135.14 	expansions under this subdivision and subdivision 23, including:
135.15 	(1) implementation efforts;
135.16 	(2) consumer protections; and
135.17 	(3) program specifications such as quality assurance measures, data collection and 
135.18 	reporting, and evaluation of costs, quality, and results.
135.19 	(e) Each plan under contract to provide medical assistance basic health care services 
135.20 	shall establish a local or regional stakeholder group, including representatives of the 
135.21 	counties covered by the plan, members, consumer advocates, and providers, for advice on 
135.22 	issues that arise in the local or regional area.
135.23 	(f) The commissioner is prohibited from providing the names of potential enrollees 
135.24 	to health plans for marketing purposes. The commissioner may shall mail no more than 
135.25 	two sets of marketing materials per contract year to potential enrollees on behalf of health 
135.26 	plans, in which case at the health plan's request. The marketing materials shall be mailed 
135.27 	by the commissioner within 30 days of receipt of these materials from the health plan. The 
135.28 	health plans shall cover any costs incurred by the commissioner for mailing marketing 
135.29 	materials.

135.30 	Sec. 65. Minnesota Statutes 2010, section 256B.69, is amended by adding a 
135.31 	subdivision to read:
135.32 		Subd. 30.Payment reduction. (a) Beginning September 1, 2011, the commissioner 
135.33 	shall reduce payments and limit future rate increases paid to managed care plans and 
135.34 	county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved 
135.35 	on a statewide aggregate basis by program. The commissioner may use competitive 
136.1 	bidding, payment reductions, or other reductions to achieve the reductions and limits 
136.2 	in this subdivision.
136.3 	(b) Beginning September 1, 2011, the commissioner shall reduce payments to 
136.4 	managed care plans and county-based purchasing plans as follows:
136.5 	(1) 2.0 percent for medical assistance elderly basic care. This shall not apply 
136.6 	to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
136.7 	services;
136.8 	(2) 2.82 percent for medical assistance families and children;
136.9 	(3) 10.1 percent for medical assistance adults without children; and
136.10 	(4) 6.0 percent for MinnesotaCare families and children.
136.11 	(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed 
136.12 	care plans and county-based purchasing plans for calendar year 2012 to a percentage of 
136.13 	the rates in effect on August 31, 2011, as follows:
136.14 	(1) 98 percent for medical assistance elderly basic care. This shall not apply to 
136.15 	Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
136.16 	services;
136.17 	(2) 97.18 percent for medical assistance families and children;
136.18 	(3) 89.9 percent for medical assistance adults without children; and
136.19 	(4) 94 percent for MinnesotaCare families and children.
136.20 	(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit 
136.21 	the maximum annual trend increases to rates paid to managed care plans and county-based 
136.22 	purchasing plans as follows:
136.23 	(1) 7.5 percent for medical assistance elderly basic care. This shall not apply 
136.24 	to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
136.25 	services;
136.26 	(2) 5.0 percent for medical assistance special needs basic care;
136.27 	(3) 2.0 percent for medical assistance families and children;
136.28 	(4) 3.0 percent for medical assistance adults without children;
136.29 	(5) 3.0 percent for MinnesotaCare families and children; and
136.30 	(6) 3.0 percent for MinnesotaCare adults without children.
136.31 	(e) The commissioner may limit trend increases to less than the maximum. 
136.32 	Beginning July 1, 2014, the commissioner shall limit the maximum annual trend increases 
136.33 	to rates paid to managed care plans and county-based purchasing plans as follows for 
136.34 	calendar years 2014 and 2015:
137.1 	(1) 7.5 percent for medical assistance elderly basic care. This shall not apply 
137.2 	to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver 
137.3 	services;
137.4 	(2) 5.0 percent for medical assistance special needs basic care;
137.5 	(3) 2.0 percent for medical assistance families and children;
137.6 	(4) 3.0 percent for medical assistance adults without children;
137.7 	(5) 3.0 percent for MinnesotaCare families and children; and
137.8 	(6) 4.0 percent for MinnesotaCare adults without children.
137.9 	The commissioner may limit trend increases to less than the maximum.

137.10 	Sec. 66. Minnesota Statutes 2010, section 256B.76, subdivision 1, is amended to read:
137.11 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on 
137.12 	or after October 1, 1992, the commissioner shall make payments for physician services 
137.13 	as follows:
137.14 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
137.15 	procedural coding system codes titled "office and other outpatient services," "preventive 
137.16 	medicine new and established patient," "delivery, antepartum, and postpartum care," 
137.17 	"critical care," cesarean delivery and pharmacologic management provided to psychiatric 
137.18 	patients, and level three codes for enhanced services for prenatal high risk, shall be paid 
137.19 	at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 
137.20 	30, 1992. If the rate on any procedure code within these categories is different than the 
137.21 	rate that would have been paid under the methodology in section 256B.74, subdivision 2, 
137.22 	then the larger rate shall be paid;
137.23 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
137.24 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
137.25 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
137.26 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
137.27 	except that payment rates for home health agency services shall be the rates in effect 
137.28 	on September 30, 1992.
137.29 	(b) Effective for services rendered on or after January 1, 2000, payment rates for 
137.30 	physician and professional services shall be increased by three percent over the rates 
137.31 	in effect on December 31, 1999, except for home health agency and family planning 
137.32 	agency services. The increases in this paragraph shall be implemented January 1, 2000, 
137.33 	for managed care.
137.34 	(c) Effective for services rendered on or after July 1, 2009, payment rates for 
137.35 	physician and professional services shall be reduced by five percent, except that for the 
138.1 	period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent 
138.2 	for the medical assistance and general assistance medical care programs, over the rates in 
138.3 	effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply 
138.4 	to office or other outpatient visits, preventive medicine visits and family planning visits 
138.5 	billed by physicians, advanced practice nurses, or physician assistants in a family planning 
138.6 	agency or in one of the following primary care practices: general practice, general internal 
138.7 	medicine, general pediatrics, general geriatrics, and family medicine. This reduction 
138.8 	and the reductions in paragraph (d) do not apply to federally qualified health centers, 
138.9 	rural health centers, and Indian health services. Effective October 1, 2009, payments 
138.10 	made to managed care plans and county-based purchasing plans under sections 256B.69, 
138.11 	256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.
138.12 	(d) Effective for services rendered on or after July 1, 2010, payment rates for 
138.13 	physician and professional services shall be reduced an additional seven percent over 
138.14 	the five percent reduction in rates described in paragraph (c). This additional reduction 
138.15 	does not apply to physical therapy services, occupational therapy services, and speech 
138.16 	pathology and related services provided on or after July 1, 2010. This additional reduction 
138.17 	does not apply to physician services billed by a psychiatrist or an advanced practice nurse 
138.18 	with a specialty in mental health. Effective October 1, 2010, payments made to managed 
138.19 	care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 
138.20 	256L.12 shall reflect the payment reduction described in this paragraph.
138.21 	(e) Effective for services rendered on or after September 1, 2011, through June 30, 
138.22 	2013, payment rates for physician and professional services shall be reduced three percent 
138.23 	from the rates in effect on August 31, 2011. This reduction does not apply to physical 
138.24 	therapy services, occupational therapy services, and speech pathology and related services.

138.25 	Sec. 67. Minnesota Statutes 2010, section 256B.76, subdivision 2, is amended to read:
138.26 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after 
138.27 	October 1, 1992, the commissioner shall make payments for dental services as follows:
138.28 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 
138.29 	percent above the rate in effect on June 30, 1992; and
138.30 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 
138.31 	percentile of 1989, less the percent in aggregate necessary to equal the above increases.
138.32 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
138.33 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
139.1 	(c) Effective for services rendered on or after January 1, 2000, payment rates for 
139.2 	dental services shall be increased by three percent over the rates in effect on December 
139.3 	31, 1999.
139.4 	(d) Effective for services provided on or after January 1, 2002, payment for 
139.5 	diagnostic examinations and dental x-rays provided to children under age 21 shall be the 
139.6 	lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
139.7 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 
139.8 	2000, for managed care.
139.9 	(f) Effective for dental services rendered on or after October 1, 2010, by a 
139.10 	state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based 
139.11 	on the Medicare principles of reimbursement. This payment shall be effective for services 
139.12 	rendered on or after January 1, 2011, to recipients enrolled in managed care plans or 
139.13 	county-based purchasing plans.
139.14 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics 
139.15 	in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal 
139.16 	year, a supplemental state payment equal to the difference between the total payments 
139.17 	in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated 
139.18 	services for the operation of the dental clinics.
139.19 	(h) If the cost-based payment system for state-operated dental clinics described in 
139.20 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
139.21 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
139.22 	receive the critical access dental reimbursement rate as described under subdivision 4, 
139.23 	paragraph (a).
139.24 	(i) Effective for services rendered on or after September 1, 2011, through June 30, 
139.25 	2013, payment rates for dental services shall be reduced by three percent. This reduction 
139.26 	does not apply to state-operated dental clinics in paragraph (f).

139.27 	Sec. 68. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
139.28 		Subd. 4.Critical access dental providers.  (a) Effective for dental services 
139.29 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
139.30 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
139.31 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
139.32 	increase reimbursement by 30 percent above the reimbursement rate that would otherwise 
139.33 	be paid to the critical access dental provider. The commissioner shall pay the managed 
139.34 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
139.35 	reimbursements to critical access dental providers as approved by the commissioner.
140.1 	(b) The commissioner shall designate the following dentists and dental clinics as 
140.2 	critical access dental providers:
140.3 	(1) nonprofit community clinics that:
140.4 	(i) have nonprofit status in accordance with chapter 317A;
140.5 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
140.6 	501(c)(3);
140.7 	(iii) are established to provide oral health services to patients who are low income, 
140.8 	uninsured, have special needs, and are underserved;
140.9 	(iv) have professional staff familiar with the cultural background of the clinic's 
140.10 	patients;
140.11 	(v) charge for services on a sliding fee scale designed to provide assistance to 
140.12 	low-income patients based on current poverty income guidelines and family size;
140.13 	(vi) do not restrict access or services because of a patient's financial limitations 
140.14 	or public assistance status; and
140.15 	(vii) have free care available as needed;
140.16 	(2) federally qualified health centers, rural health clinics, and public health clinics;
140.17 	(3) county owned and operated hospital-based dental clinics;
140.18 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
140.19 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
140.20 	patients who are uninsured or covered by medical assistance, general assistance medical 
140.21 	care, or MinnesotaCare; and
140.22 	(5) a dental clinic associated with an oral health or dental education program owned 
140.23 	and operated by the University of Minnesota or an institution within the Minnesota State 
140.24 	Colleges and Universities system.
140.25 	 (c) The commissioner may designate a dentist or dental clinic as a critical access 
140.26 	dental provider if the dentist or dental clinic is willing to provide care to patients covered 
140.27 	by medical assistance, general assistance medical care, or MinnesotaCare at a level which 
140.28 	significantly increases access to dental care in the service area.
140.29 	(d) Notwithstanding paragraph (a), critical access payments must not be made for 
140.30 	dental services provided from April 1, 2010, through June 30, 2010.

140.31 	EFFECTIVE DATE. This section is effective September 1, 2011.

140.32 	Sec. 69. Minnesota Statutes 2010, section 256B.766, is amended to read:
140.33 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
141.1 	(a) Effective for services provided on or after July 1, 2009, total payments for basic 
141.2 	care services, shall be reduced by three percent, except that for the period July 1, 2009, 
141.3 	through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical 
141.4 	assistance and general assistance medical care programs, prior to third-party liability and 
141.5 	spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical 
141.6 	therapy services, occupational therapy services, and speech-language pathology and 
141.7 	related services as basic care services. The reduction in this paragraph shall apply to 
141.8 	physical therapy services, occupational therapy services, and speech-language pathology 
141.9 	and related services provided on or after July 1, 2010.
141.10 	(b) Payments made to managed care plans and county-based purchasing plans shall 
141.11 	be reduced for services provided on or after October 1, 2009, to reflect the reduction 
141.12 	effective July 1, 2009, and payments made to the plans shall be reduced effective October 
141.13 	1, 2010, to reflect the reduction effective July 1, 2010.
141.14 	(c) Effective for services provided on or after September 1, 2011, through June 30, 
141.15 	2013, total payments for outpatient hospital facility fees shall be reduced by five percent 
141.16 	from the rates in effect on August 31, 2011.
141.17 	(d) Effective for services provided on or after September 1, 2011, through June 
141.18 	30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies 
141.19 	and durable medical equipment not subject to a volume purchase contract, prosthetics 
141.20 	and orthotics, renal dialysis services, laboratory services, public health nursing services, 
141.21 	physical therapy services, occupational therapy services, speech therapy services, 
141.22 	eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume 
141.23 	purchase contract, anesthesia services, and hospice services shall be reduced by three 
141.24 	percent from the rates in effect on August 31, 2011.
141.25 	(e) This section does not apply to physician and professional services, inpatient 
141.26 	hospital services, family planning services, mental health services, dental services, 
141.27 	prescription drugs, medical transportation, federally qualified health centers, rural health 
141.28 	centers, Indian health services, and Medicare cost-sharing.

141.29 	Sec. 70. [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE 
141.30 	DEMONSTRATION PROJECT.
141.31 		Subdivision 1.Establishment and implementation. The commissioner of human 
141.32 	services shall contract with a Minnesota-based academic or clinical research institution or 
141.33 	institutions specializing in providing complementary and alternative medicine education 
141.34 	and clinical services to establish and implement a five-year demonstration project in 
141.35 	conjunction with federally qualified health centers or federally qualified health center 
142.1 	"look-alikes" as defined in section 145.9269, to improve the quality and cost-effectiveness 
142.2 	of care provided under medical assistance to enrollees with neck and back problems. 
142.3 	The demonstration project must maximize the use of complementary and alternative 
142.4 	medicine-oriented primary care providers, including but not limited to physicians and 
142.5 	chiropractors.  The demonstration project must be designed to significantly improve 
142.6 	physical and mental health for enrollees who present with neck and back problems 
142.7 	while decreasing medical treatment costs. The commissioner, in consultation with the 
142.8 	commissioner of health, shall deliver services through the demonstration project beginning 
142.9 	January 1, 2012, or upon federal approval, whichever is later.
142.10 		Subd. 2.RFP and project criteria. The commissioner shall develop and issue a 
142.11 	request for proposal (RFP) for the demonstration project. The RFP must require the 
142.12 	academic or clinical research institution or institutions selected to demonstrate a proven 
142.13 	track record over at least five years of conducting high-quality, federally funded clinical 
142.14 	research. The RFP shall specify the state costs directly related to the requirements of this 
142.15 	section and shall require that the selected institution pay those costs to the state. The 
142.16 	institution and the federally qualified health centers and federally qualified health center 
142.17 	"look-alikes" shall also:
142.18 	(1) provide patient education, provider education, and enrollment training 
142.19 	components on health and lifestyle issues in order to promote enrollee responsibility for 
142.20 	health care decisions, enhance productivity, prepare enrollees to reenter the workforce, 
142.21 	and reduce future health care expenditures;
142.22 	(2) use high-quality and cost-effective integrated disease management that includes 
142.23 	the best practices of traditional and complementary and alternative medicine;
142.24 	(3) incorporate holistic medical care, appropriate nutrition, exercise, medications, 
142.25 	and conflict resolution techniques;
142.26 	(4) include a provider education component that makes use of professional 
142.27 	organizations representing chiropractors, nurses, and other primary care providers 
142.28 	and provides appropriate educational materials and activities in order to improve the 
142.29 	integration of traditional medical care with licensed chiropractic services and other 
142.30 	alternative health care services and achieve program enrollment objectives; and
142.31 	(5) provide to the commissioner the information and data necessary for the 
142.32 	commissioner to prepare the annual reports required under subdivision 6.
142.33 		Subd. 3.Enrollment. Enrollees from the program shall be selected by the 
142.34 	commissioner from current enrollees in the prepaid medical assistance program who 
142.35 	have, or are determined to be at significant risk of developing, neck and back problems. 
142.36 	Participation in the demonstration project shall be voluntary.  The commissioner shall 
143.1 	seek to enroll, over the term of the demonstration project, ten percent of current and 
143.2 	future medical assistance enrollees who have, or are determined to be at significant risk 
143.3 	of developing, neck and back problems.
143.4 		Subd. 4.Federal approval. The commissioner shall seek any federal waivers and 
143.5 	approvals necessary to implement the demonstration project.
143.6 		Subd. 5.Project costs. The commissioner shall require the academic or clinical 
143.7 	research institution or institutions selected, federally qualified health centers, and federally 
143.8 	qualified health center "look-alikes" to fund all costs of the demonstration project. 
143.9 	Amounts received under subdivision 2 are appropriated to the commissioner for the 
143.10 	purposes of this section.
143.11 		Subd. 6.Annual reports. The commissioner, beginning December 15, 2012, and 
143.12 	each December 15 thereafter through December 15, 2015, shall report annually to the 
143.13 	legislature on the functional and mental improvements of the populations served by the 
143.14 	demonstration project, patient satisfaction, and the cost-effectiveness of the program. The 
143.15 	reports must also include data on hospital admissions, days in hospital, rates of outpatient 
143.16 	surgery and other services, and drug utilization. The report, due December 15, 2015, must 
143.17 	include recommendations on whether the demonstration project should be continued 
143.18 	and expanded.

143.19 	Sec. 71. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:
143.20 		Subd. 3.Financial management. (a) The commissioner shall manage spending for 
143.21 	the MinnesotaCare program in a manner that maintains a minimum reserve. As part of 
143.22 	each state revenue and expenditure forecast, the commissioner must make an assessment 
143.23 	of the expected expenditures for the covered services for the remainder of the current 
143.24 	biennium and for the following biennium. The estimated expenditure, including the 
143.25 	reserve, shall be compared to an estimate of the revenues that will be available in the health 
143.26 	care access fund. Based on this comparison, and after consulting with the chairs of the 
143.27 	house of representatives Ways and Means Committee and the senate Finance Committee, 
143.28 	and the Legislative Commission on Health Care Access, the commissioner shall, as 
143.29 	necessary, make the adjustments specified in paragraph (b) to ensure that expenditures 
143.30 	remain within the limits of available revenues for the remainder of the current biennium 
143.31 	and for the following biennium. The commissioner shall not hire additional staff using 
143.32 	appropriations from the health care access fund until the commissioner of management 
143.33 	and budget makes a determination that the adjustments implemented under paragraph (b) 
143.34 	are sufficient to allow MinnesotaCare expenditures to remain within the limits of available 
143.35 	revenues for the remainder of the current biennium and for the following biennium.
144.1 	(b) The adjustments the commissioner shall use must be implemented in this order: 
144.2 	first, stop enrollment of single adults and households without children; second, upon 45 
144.3 	days' notice, stop coverage of single adults and households without children already 
144.4 	enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium 
144.5 	subsidy amounts by ten percent for families with gross annual income above 200 percent 
144.6 	of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium 
144.7 	subsidy amounts by ten percent for families with gross annual income at or below 200 
144.8 	percent; and fifth, require applicants to be uninsured for at least six months prior to 
144.9 	eligibility in the MinnesotaCare program. If these measures are insufficient to limit the 
144.10 	expenditures to the estimated amount of revenue, the commissioner shall further limit 
144.11 	enrollment or decrease premium subsidies.

144.12 	Sec. 72. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:
144.13 		Subd. 5.Co-payments and coinsurance Cost-sharing. (a) Except as provided 
144.14 	in paragraphs (b) and (c), the MinnesotaCare benefit plan shall include the following 
144.15 	co-payments and coinsurance cost-sharing requirements for all enrollees:
144.16 	(1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 
144.17 	subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
144.18 	(2) $3 per prescription for adult enrollees;
144.19 	(3) $25 for eyeglasses for adult enrollees;
144.20 	(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
144.21 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
144.22 	established illness, and which is delivered in an ambulatory setting by a physician or 
144.23 	physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
144.24 	audiologist, optician, or optometrist; and
144.25 	(5) $6 for nonemergency visits to a hospital-based emergency room for services 
144.26 	provided through December 31, 2010, and $3.50 effective January 1, 2011; and
144.27 	(6) a family deductible equal to the maximum amount allowed under Code of 
144.28 	Federal Regulations, title 42, part 447.54.
144.29 	(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 
144.30 	children under the age of 21.
144.31 	(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
144.32 	(d) Paragraph (a), clause (4), does not apply to mental health services.
144.33 	(e) Adult enrollees with family gross income that exceeds 200 percent of the federal 
144.34 	poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 
145.1 	and who are not pregnant shall be financially responsible for the coinsurance amount, if 
145.2 	applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
145.3 	(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 
145.4 	or changes from one prepaid health plan to another during a calendar year, any charges 
145.5 	submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 
145.6 	expenses incurred by the enrollee for inpatient services, that were submitted or incurred 
145.7 	prior to enrollment, or prior to the change in health plans, shall be disregarded.
145.8 	(g) MinnesotaCare reimbursements to fee-for-service providers and payments to 
145.9 	managed care plans or county-based purchasing plans shall not be increased as a result of 
145.10 	the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.

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

145.12 	Sec. 73. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
145.13 		Subdivision 1.Defined contributions to enrollees. (a) Beginning July 1, 2012, the 
145.14 	commissioner shall provide each MinnesotaCare enrollee eligible under section 256L.04, 
145.15 	subdivision 7, with family income equal to or greater than 200 percent of the federal 
145.16 	poverty guidelines with a monthly defined contribution to purchase health coverage under 
145.17 	a health plan as defined in section 62A.011, subdivision 3.
145.18 	(b) Enrollees eligible under this section shall not be charged premiums under 
145.19 	section 256L.15 and are exempt from the managed care enrollment requirement of section 
145.20 	256L.12.
145.21 	(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees 
145.22 	eligible under this section unless otherwise provided in this section. Covered services, cost 
145.23 	sharing, disenrollment for nonpayment of premium, enrollee appeal rights and complaint 
145.24 	procedures, and the effective date of coverage for enrollees eligible under this section shall 
145.25 	be as provided under the terms of the health plan purchased by the enrollee.
145.26 	(d) Unless otherwise provided in this section, all MinnesotaCare requirements 
145.27 	related to eligibility, income and asset methodology, income reporting, and program 
145.28 	administration, continue to apply to enrollees obtaining coverage under this section.
145.29 		Subd. 2.Use of defined contribution; health plan requirements. (a) An enrollee 
145.30 	may use up to the monthly defined contribution to pay premiums for coverage under a 
145.31 	health plan as defined in section 62A.011, subdivision 3.
145.32 	(b) An enrollee must select a health plan within three calendar months of approval of 
145.33 	MinnesotaCare eligibility. If a health plan is not selected and purchased within this time 
145.34 	period, the enrollee must reapply and must meet all eligibility criteria.
145.35 	(c) A health plan purchased under this section must:
146.1 	(1) provide coverage for mental health and chemical dependency treatment services; 
146.2 	and
146.3 	(2) comply with the coverage limitations specified in section 256L.03, subdivision 
146.4 	1, the second paragraph.
146.5 		Subd. 3.Determination of defined contribution amount. (a) The commissioner 
146.6 	shall determine the defined contribution sliding scale using the base contribution specified 
146.7 	in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale 
146.8 	for defined contributions that provides:
146.9 	(1) persons with household incomes equal to 200 percent of the federal poverty 
146.10 	guidelines with a defined contribution of 93 percent of the base contribution;
146.11 	(2) persons with household incomes equal to 250 percent of the federal poverty 
146.12 	guidelines with a defined contribution of 80 percent of the base contribution; and
146.13 	(3) persons with household incomes in evenly spaced increments between the 
146.14 	percentages of the federal poverty guideline or income level specified in clauses (1) and 
146.15 	(2) with a base contribution that is a percentage interpolated from the defined contribution 
146.16 	percentages specified in clauses (1) and (2).

146.17	19-29
	$125
	
146.18	30-34
	$135
	
146.19	35-39
	$140
	
146.20	40-44
	$175
	
146.21	45-49
	$215
	
146.22	50-54
	$295
	
146.23	55-59
	$345
	
146.24	60+
	$360
	
146.25 	(b) The commissioner shall multiply the defined contribution amounts developed 
146.26 	under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual 
146.27 	health plan by a health plan company and who purchase coverage through the Minnesota 
146.28 	Comprehensive Health Association.
146.29 		Subd. 4.Administration by commissioner. (a) The commissioner shall administer 
146.30 	the defined contributions. The commissioner shall:
146.31 	(1) calculate and process defined contributions for enrollees; and
146.32 	(2) pay the defined contribution amount to health plan companies or the Minnesota 
146.33 	Comprehensive Health Association, as applicable, for enrollee health plan coverage.
146.34 	(b) Nonpayment of a health plan premium shall result in disenrollment from 
146.35 	MinnesotaCare effective the first day of the calendar month following the calendar month 
146.36 	for which the premium was due. Persons disenrolled for nonpayment or who voluntarily 
146.37 	terminate coverage may not reenroll until four calendar months have elapsed.
147.1 		Subd. 5.Assistance to enrollees. The commissioner of human services, in 
147.2 	consultation with the commissioner of commerce, shall develop an efficient and 
147.3 	cost-effective method of referring eligible applicants to professional insurance agent 
147.4 	associations.
147.5 		Subd. 6.Minnesota Comprehensive Health Association (MCHA). Beginning 
147.6 	July 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual health 
147.7 	market by a health plan company in accordance with section 62A.65 are eligible 
147.8 	for coverage through a health plan offered by the Minnesota Comprehensive Health 
147.9 	Association and may enroll in MCHA in accordance with section 62E.14. Any difference 
147.10 	between the revenue and actual covered losses to MCHA related to the implementation of 
147.11 	this section are appropriated annually to the commissioner of human services from the 
147.12 	health care access fund and shall be paid to MCHA.
147.13 		Subd. 7.Federal approval. The commissioner shall seek federal financial 
147.14 	participation for the adult enrollees eligible under this section.

147.15 	Sec. 74. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:
147.16 		Subdivision 1.Families with children. (a) Families with children with family 
147.17 	income equal to or less than 275 percent of the federal poverty guidelines for the 
147.18 	applicable family size shall be eligible for MinnesotaCare according to this section. All 
147.19 	other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers 
147.20 	to enrollment under section 256L.07, shall apply unless otherwise specified.
147.21 	(b) Parents who enroll in the MinnesotaCare program must also enroll their children, 
147.22 	if the children are eligible. Children may be enrolled separately without enrollment by 
147.23 	parents. However, if one parent in the household enrolls, both parents must enroll, unless 
147.24 	other insurance is available. If one child from a family is enrolled, all children must 
147.25 	be enrolled, unless other insurance is available. If one spouse in a household enrolls, 
147.26 	the other spouse in the household must also enroll, unless other insurance is available. 
147.27 	Families cannot choose to enroll only certain uninsured members.
147.28 	(c) Beginning October 1, 2003, the dependent sibling definition no longer applies 
147.29 	to the MinnesotaCare program. These persons are no longer counted in the parental 
147.30 	household and may apply as a separate household.
147.31 	(d) Beginning July 1, 2010, or upon federal approval, whichever is later, Parents are 
147.32 	not eligible for MinnesotaCare if their gross income exceeds $57,500.
147.33 	(e) Children formerly enrolled in medical assistance and automatically deemed 
147.34 	eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt 
147.35 	from the requirements of this section until renewal.
148.1 	(f) [Reserved.]

148.2 	Sec. 75. Minnesota Statutes 2010, section 256L.04, subdivision 10, is amended to read:
148.3 		Subd. 10.Citizenship requirements. Eligibility for MinnesotaCare is limited 
148.4 	to citizens or nationals of the United States, qualified noncitizens, and other persons 
148.5 	residing lawfully in the United States as described in section 256B.06, subdivision 4, 
148.6 	paragraphs (a) to (e) and (j) defined in Code of Federal Regulations, title 8, section 103.12. 
148.7 	Undocumented noncitizens and nonimmigrants are ineligible for MinnesotaCare. For 
148.8 	purposes of this subdivision, a nonimmigrant is an individual in one or more of the classes 
148.9 	listed in United States Code, title 8, section 1101(a)(15), and an undocumented noncitizen 
148.10 	is an individual who resides in the United States without the approval or acquiescence 
148.11 	of the United States Citizenship and Immigration Services. Families with children who 
148.12 	are citizens or nationals of the United States must cooperate in obtaining satisfactory 
148.13 	documentary evidence of citizenship or nationality according to the requirements of the 
148.14 	federal Deficit Reduction Act of 2005, Public Law 109-171.

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

148.16 	Sec. 76. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:
148.17 		Subd. 3a.Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility 
148.18 	must be renewed every 12 months. The 12-month period begins in the month after the 
148.19 	month the application is approved.
148.20 	(b) Each new period of eligibility must take into account any changes in 
148.21 	circumstances that impact eligibility and premium amount. An enrollee must provide all 
148.22 	the information needed to redetermine eligibility by the first day of the month that ends 
148.23 	the eligibility period. If there is no change in circumstances, the enrollee may renew 
148.24 	eligibility at designated locations that include community clinics and health care providers' 
148.25 	offices. The designated sites shall forward the renewal forms to the commissioner. The 
148.26 	commissioner may establish criteria and timelines for sites to forward applications to the 
148.27 	commissioner or county agencies. The premium for the new period of eligibility must be 
148.28 	received as provided in section 256L.06 in order for eligibility to continue.
148.29 	(c) An enrollee who fails to submit renewal forms and related documentation 
148.30 	necessary for verification of continued eligibility in a timely manner shall remain eligible 
148.31 	for one additional month beyond the end of the current eligibility period before being 
148.32 	disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the 
148.33 	additional month.
149.1 	(d) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, 
149.2 	the first period of renewal begins the month the enrollee turns 21 years of age.

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

149.4 	Sec. 77. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision 
149.5 	to read:
149.6 		Subd. 6.Referral of veterans. The commissioner shall ensure that all applicants 
149.7 	for MinnesotaCare who identify themselves as veterans are referred to a county veterans 
149.8 	service officer for assistance in applying to the United States Department of Veterans 
149.9 	Affairs for any veterans benefits for which they may be eligible.

149.10 	Sec. 78. Minnesota Statutes 2010, section 256L.09, subdivision 2, is amended to read:
149.11 		Subd. 2.Residency requirement. (a) To be eligible for health coverage under 
149.12 	the MinnesotaCare program, adults without children must be permanent residents of 
149.13 	Minnesota.
149.14 	(b) To be eligible for health coverage under the MinnesotaCare program, pregnant 
149.15 	women, individuals, and families, andwith children must meet the residency requirements 
149.16 	as provided by Code of Federal Regulations, title 42, section 435.403, except that the 
149.17 	provisions of section 256B.056, subdivision 1, shall apply upon receipt of federal approval. 

149.18 	EFFECTIVE DATE. This section is effective the day following final enactment 
149.19 	or upon federal approval of federal financial participation for adults without children, 
149.20 	whichever is later. The commissioner shall notify the revisor of statutes when federal 
149.21 	approval is obtained.

149.22 	Sec. 79. Minnesota Statutes 2010, section 256L.11, subdivision 6, is amended to read:
149.23 		Subd. 6.Enrollees 18 or older. Payment by the MinnesotaCare program for 
149.24 	inpatient hospital services provided to MinnesotaCare enrollees eligible under section 
149.25 	256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 2, 
149.26 	with family gross income that exceeds 175 percent of the federal poverty guidelines 
149.27 	and who are not pregnant, who are 18 years old or older on the date of admission to the 
149.28 	inpatient hospital must be in accordance with paragraphs (a) and (b). Payment for adults 
149.29 	who are not pregnant and are eligible under section 256L.04, subdivisions 1 and 2, and 
149.30 	whose incomes are equal to or less than 175 percent of the federal poverty guidelines, 
149.31 	shall be as provided for under paragraph (c).
150.1 	(a) If the medical assistance rate minus any co-payment required under section 
150.2 	256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's 
150.3 	benefit limit under section 256L.03, subdivision 3, payment must be the medical 
150.4 	assistance rate minus any co-payment required under section 256L.03, subdivision 4. The 
150.5 	hospital must not seek payment from the enrollee in addition to the co-payment. The 
150.6 	MinnesotaCare payment plus the co-payment must be treated as payment in full.
150.7 	(b) If the medical assistance rate minus any co-payment required under section 
150.8 	256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit 
150.9 	under section 256L.03, subdivision 3, payment must be the lesser of:
150.10 	(1) the amount remaining in the enrollee's benefit limit; or
150.11 	(2) charges submitted for the inpatient hospital services less any co-payment 
150.12 	established under section 256L.03, subdivision 4.
150.13 	The hospital may seek payment from the enrollee for the amount by which usual and 
150.14 	customary charges exceed the payment under this paragraph. If payment is reduced under 
150.15 	section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the 
150.16 	enrollee for the amount of the reduction.
150.17 	(c) For admissions occurring on or after July 1, 2011, for single adults and 
150.18 	households without children who are eligible under section 256L.04, subdivision 7, the 
150.19 	commissioner shall pay hospitals directly, up to the medical assistance payment rate, 
150.20 	for inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus 
150.21 	any co-payment required under section 256L.03, subdivision 5. Inpatient services paid 
150.22 	directly by the commissioner under this paragraph do not include chemical dependency 
150.23 	hospital-based and residential treatment.

150.24 	Sec. 80. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
150.25 		Subd. 7.Critical access dental providers. Effective for dental services provided 
150.26 	to MinnesotaCare enrollees on or after January 1, 2007, through August 31, 2011, the 
150.27 	commissioner shall increase payment rates to dentists and dental clinics deemed by the 
150.28 	commissioner to be critical access providers under section 256B.76, subdivision 4, by 50 
150.29 	percent above the payment rate that would otherwise be paid to the provider. Effective for 
150.30 	dental services provided on or after September 1, 2011, the commissioner shall increase 
150.31 	the payment rate by 30 percent above the payment rate that would otherwise be paid to 
150.32 	the provider. The commissioner shall pay the prepaid health plans under contract with 
150.33 	the commissioner amounts sufficient to reflect this rate increase. The prepaid health plan 
150.34 	must pass this rate increase to providers who have been identified by the commissioner as 
150.35 	critical access dental providers under section 256B.76, subdivision 4.

151.1 	Sec. 81. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
151.2 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
151.3 	per capita, where possible. The commissioner may allow health plans to arrange for 
151.4 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
151.5 	an independent actuary to determine appropriate rates.
151.6 	(b) For services rendered on or after January 1, 2004, the commissioner shall 
151.7 	withhold five percent of managed care plan payments and county-based purchasing 
151.8 	plan payments under this section pending completion of performance targets. Each 
151.9 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
151.10 	except in the case of a performance target based on a federal or state law or rule. Criteria 
151.11 	for assessment of each performance target must be outlined in writing prior to the 
151.12 	contract effective date. The managed care plan must demonstrate, to the commissioner's 
151.13 	satisfaction, that the data submitted regarding attainment of the performance target is 
151.14 	accurate. The commissioner shall periodically change the administrative measures used 
151.15 	as performance targets in order to improve plan performance across a broader range of 
151.16 	administrative services. The performance targets must include measurement of plan 
151.17 	efforts to contain spending on health care services and administrative activities. The 
151.18 	commissioner may adopt plan-specific performance targets that take into account factors 
151.19 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
151.20 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
151.21 	following calendar year if performance targets in the contract are achieved.
151.22 	(c) For services rendered on or after January 1, 2011, the commissioner shall 
151.23 	withhold an additional three percent of managed care plan or county-based purchasing 
151.24 	plan payments under this section. The withheld funds must be returned no sooner than 
151.25 	July 1 and no later than July 31 of the following calendar year. The return of the withhold 
151.26 	under this paragraph is not subject to the requirements of paragraph (b).
151.27 	(d) Effective for services rendered on or after January 1, 2011,  through December 
151.28 	31, 2011, the commissioner shall include as part of the performance targets described in 
151.29 	paragraph (b) a reduction in the plan's emergency room utilization rate for state health care 
151.30 	program enrollees by a measurable rate of five percent from the plan's utilization rate for 
151.31 	the previous calendar year. Effective for services rendered on or after January 1, 2012, the 
151.32 	commissioner shall include as part of the performance targets described in paragraph (b) a 
151.33 	reduction in the health plan's emergency department utilization rate for medical assistance 
151.34 	and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of 
151.35 	the withhold each year, the managed care plan or county-based purchasing plan must 
151.36 	achieve a qualifying reduction of no less than ten percent of the plan's utilization rate for 
152.1 	medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared 
152.2 	to the previous calendar year, until the final performance target is reached. 
152.3 	The withheld funds must be returned no sooner than July 1 and no later than July 
152.4 	31 of the following calendar year if the managed care plan  or county-based purchasing 
152.5 	plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization 
152.6 	rate was achieved.
152.7 	The withhold described in this paragraph shall continue for each consecutive 
152.8 	contract period until the plan's emergency room utilization rate for state health care 
152.9 	program enrollees is reduced by 25 percent of the plan's emergency room utilization rate 
152.10 	for state health care program enrollees for calendar year 2009 medical assistance and 
152.11 	MinnesotaCare enrollees for calendar year 2011. Hospitals shall cooperate with the health 
152.12 	plans in meeting this performance target and shall accept payment withholds that may 
152.13 	be returned to the hospitals if the performance target is achieved. The commissioner 
152.14 	shall structure the withhold so that the commissioner returns a portion of the withheld 
152.15 	funds in amounts commensurate with achieved reductions in utilization less than the 
152.16 	targeted amount. The withhold described in this paragraph does not apply to county-based 
152.17 	purchasing plans.
152.18 	(e) Effective for services rendered on or after January 1, 2012, the commissioner 
152.19 	shall include as part of the performance targets described in paragraph (b) a reduction 
152.20 	in the plan's hospitalization admission rate for medical assistance and MinnesotaCare 
152.21 	enrollees, as determined by the commissioner. To earn the return of the withhold each 
152.22 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
152.23 	reduction of no less than five percent of the plan's hospital admission rate for medical 
152.24 	assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared to the 
152.25 	previous calendar year, until the final performance target is reached.
152.26 	The withheld funds must be returned no sooner than July 1 and no later than July 
152.27 	31 of the following calendar year if the managed care plan or county-based purchasing 
152.28 	plan demonstrates to the satisfaction of the commissioner that this reduction in the 
152.29 	hospitalization rate was achieved.
152.30 	The withhold described in this paragraph shall continue until there is a 25 percent 
152.31 	reduction in the hospitals admission rate compared to the hospital admission rate for 
152.32 	calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the 
152.33 	plans in meeting this performance target and shall accept payment withholds that may be 
152.34 	returned to the hospitals if the performance target is achieved. The hospital admissions 
152.35 	in this performance target do not include the admissions applicable to the subsequent 
152.36 	hospital admission performance target under paragraph (f).
153.1 	(f) Effective for services provided on or after January 1, 2012, the commissioner 
153.2 	shall include as part of the performance targets described in paragraph (b) a reduction 
153.3 	in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a 
153.4 	previous hospitalization of a patient regardless of the reason, for medical assistance and 
153.5 	MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the 
153.6 	withhold each year, the managed care plan or county-based purchasing plan must achieve 
153.7 	a qualifying reduction of the subsequent hospital admissions rate for medical assistance 
153.8 	and MinnesotaCare enrollees, excluding Medicare enrollees, of no less than five percent 
153.9 	compared to the previous calendar year until the final performance target is reached.
153.10 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
153.11 	of the following calendar year if the managed care plan or county-based purchasing plan 
153.12 	demonstrates to the satisfaction of the commissioner that a reduction in the subsequent 
153.13 	hospitalization rate was achieved.
153.14 	The withhold described in this paragraph must continue for each consecutive 
153.15 	contract period until the plan's subsequent hospitalization rate for medical assistance and 
153.16 	MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization 
153.17 	rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this 
153.18 	performance target and shall accept payment withholds that must be returned to the 
153.19 	hospitals if the performance target is achieved.
153.20 	(g) A managed care plan or a county-based purchasing plan under section 256B.692 
153.21 	may include as admitted assets under section 62D.044 any amount withheld under this 
153.22 	section that is reasonably expected to be returned.

153.23 	Sec. 82. Minnesota Statutes 2010, section 256L.15, subdivision 1, is amended to read:
153.24 		Subdivision 1.Premium determination. (a) Families with children and individuals 
153.25 	shall pay a premium determined according to subdivision 2.
153.26 	(b) Pregnant women and children under age two are exempt from the provisions 
153.27 	of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment 
153.28 	for failure to pay premiums. For pregnant women, this exemption continues until the 
153.29 	first day of the month following the 60th day postpartum. Women who remain enrolled 
153.30 	during pregnancy or the postpartum period, despite nonpayment of premiums, shall be 
153.31 	disenrolled on the first of the month following the 60th day postpartum for the penalty 
153.32 	period that otherwise applies under section 256L.06, unless they begin paying premiums.
153.33 	(c) Members of the military and their families who meet the eligibility criteria 
153.34 	for MinnesotaCare upon eligibility approval made within 24 months following the end 
153.35 	of the member's tour of active duty shall have their premiums paid by the commissioner. 
154.1 	The effective date of coverage for an individual or family who meets the criteria of this 
154.2 	paragraph shall be the first day of the month following the month in which eligibility is 
154.3 	approved. This exemption applies for 12 months. This paragraph expires June 30, 2010. 
154.4 	If the expiration of this provision is in violation of section 5001 of Public Law 111-5, this 
154.5 	provision will expire on the date when it is no longer subject to section 5001 of Public Law 
154.6 	111-5. The commissioner of human services shall notify the revisor of statutes of that date.

154.7 	Sec. 83. Minnesota Statutes 2010, section 295.52, is amended by adding a subdivision 
154.8 	to read:
154.9 		Subd. 8.Contingent reduction in tax rate. (a) By December 1 of each year, 
154.10 	beginning in 2011, the commissioner of management and budget shall determine the 
154.11 	projected balance in the health care access fund for the biennium.
154.12 	(b) If the commissioner of management and budget determines that the projected 
154.13 	balance in the health care access fund for the biennium reflects a ratio of revenues to 
154.14 	expenditures and transfers greater than 125 percent, and if the actual cash balance in the 
154.15 	fund is adequate, as determined by the commissioner of management and budget, the 
154.16 	commissioner, in consultation with the commissioner of revenue, shall reduce the tax rates 
154.17 	levied under subdivisions 1, 1a, 2, 3, and 4, for the subsequent calendar year sufficient 
154.18 	to reduce the structural balance in the fund. The rate may be reduced to the extent that 
154.19 	the projected revenues for the biennium do not exceed 125 percent of expenditures and 
154.20 	transfers. The new rate shall be rounded to the nearest one-tenth of one percent. The rate 
154.21 	reduction under this paragraph expires at the end of each calendar year and is subject to an 
154.22 	annual redetermination by the commissioner of management and budget.
154.23 	(c) For purposes of the analysis defined in paragraph (b), the commissioner of 
154.24 	management and budget shall include projected revenues, notwithstanding the repeal of 
154.25 	the tax imposed under this section effective January 1, 2020.

154.26 	Sec. 84. Laws 2009, chapter 79, article 5, section 17, the effective date, as amended by 
154.27 	Laws 2010, First Special Session chapter 1, article 24, section 9, is amended to read:

154.28 	EFFECTIVE DATE. This section is effective January 1, 2011 October 1, 2019, or 
154.29 	upon federal approval and on the date when it is no longer subject to the maintenance of 
154.30 	effort requirements of section 5001 of Public Law 111-5 the date it is no longer subject 
154.31 	to the maintenance of effort requirement in Public Law 111-148. The commissioner of 
154.32 	human services shall notify the revisor of statutes of that date.

155.1 	Sec. 85. Laws 2009, chapter 79, article 5, section 18, the effective date, as amended by 
155.2 	Laws 2010, First Special Session chapter 1, article 24, section 10, is amended to read:

155.3 	EFFECTIVE DATE. This section is effective upon federal approval and on the 
155.4 	date when it is no longer subject to the maintenance of effort requirements of section 
155.5 	5001 of Public Law 111-5 January 1, 2014, or upon the date it is no longer subject to the 
155.6 	maintenance of effort requirement in Public Law 111-148. The commissioner of human 
155.7 	services shall notify the revisor of statutes when federal approval is obtained.

155.8 	Sec. 86. Laws 2009, chapter 79, article 5, section 22, the effective date, as amended by 
155.9 	Laws 2010, First Special Session chapter 1, article 24, section 11, is amended to read:

155.10 	EFFECTIVE DATE. This section is effective for periods of ineligibility established 
155.11 	on or after January 1, 2011 2014, unless it is in violation of section 5001 of Public Law 
155.12 	111-5. If it is in violation of that section, then it shall be effective on the date when it is 
155.13 	no longer subject to maintenance of effort requirements of section 5001 of Public Law 
155.14 	111-5 or upon the date it is no longer subject to the maintenance of effort requirement 
155.15 	in Public Law 111-148. The commissioner of human services shall notify the revisor of 
155.16 	statutes of that date.

155.17 	Sec. 87. Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by 
155.18 	Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read:

155.19 	EFFECTIVE DATE. The section is effective July 1, 2011 January 1, 2014, or 
155.20 	upon the date it is no longer subject to the maintenance effort requirement in Public Law 
155.21 	111-148.

155.22 	Sec. 88. Laws 2009, chapter 173, article 1, section 17, the effective date, as amended 
155.23 	by Laws 2010, First Special Session chapter 1, article 24, section 13, is amended to read:

155.24 	EFFECTIVE DATE. This section is effective for pooled trust accounts established 
155.25 	on or after January 1, 2011 2014, unless it is in violation of section 5001 of Public Law 
155.26 	111-5 or upon the date it is no longer subject to the maintenance of effort requirement in 
155.27 	Public Law 111-148. If it is in violation of that section, then it shall be effective on the 
155.28 	date when it is no longer subject to maintenance of effort requirements of section 5001 
155.29 	of Public Law 111-5. The commissioner of human services shall notify the revisor of 
155.30 	statutes of that date.

156.1 	Sec. 89. PLAN TO COORDINATE CARE FOR CHILDREN WITH HIGH-COST 
156.2 	MENTAL HEALTH CONDITIONS.
 156.3 	The commissioner of human services shall develop and submit to the legislature 
156.4 	by January 15, 2012, a plan to provide care coordination to medical assistance and 
156.5 	MinnesotaCare enrollees who are children with high-cost mental health conditions. For 
156.6 	purposes of this section, a child has a "high-cost mental health condition" if mental health 
156.7 	and medical expenses over the past year totalled $100,000 or more. For purposes of this 
156.8 	section, "care coordination" means collaboration between an advanced practice nurse and 
156.9 	primary care physicians and specialists to manage care; development of mental health 
156.10 	management plans for recurrent mental health issues; oversight and coordination of all 
156.11 	aspects of care in partnership with families; organization of medical, treatment, and 
156.12 	therapy information into a summary of critical information; coordination and appropriate 
156.13 	sequencing of evaluations and multiple appointments; information and assistance with 
156.14 	accessing resources; and telephone triage for behavior or other problems.

156.15 	Sec. 90. REGULATORY SIMPLIFICATION AND REDUCTION OF 
156.16 	PROVIDER REPORTING AND DATA SUBMITTAL REQUIREMENTS.
 156.17 		Subdivision 1.Regulatory simplification and report reduction work group. The 
156.18 	commissioner of management and budget shall convene a regulatory simplification and 
156.19 	report reduction work group of persons designated by the commissioners of health, human 
156.20 	services, and commerce to eliminate redundant, unnecessary, and obsolete state mandated 
156.21 	reporting or data submittal requirements for health care providers or group purchasers 
156.22 	related to health care costs, quality, utilization, access, or patient encounters or related to 
156.23 	provider or group purchaser, monitoring, finances, and regulation.  For purposes of this 
156.24 	section, the term "health care providers or group purchasers" has the meaning provided 
156.25 	in Minnesota Statutes, section 62J.03, subdivisions 6 and 8, except that it also includes 
156.26 	nursing homes.
156.27 		Subd. 2.Plan development and other duties. (a) The commissioner of 
156.28 	management and budget, in consultation with the work group, shall develop a plan for 
156.29 	regulatory simplification and report reduction activities of the commissioners of health, 
156.30 	human services, and commerce that considers collection and regulation of the following 
156.31 	in a coordinated manner:
156.32 	(1) encounter data;
156.33 	(2) group purchaser provider network data;
156.34 	(3) financial reporting;
157.1 	(4) reporting and documentation requirements relating to member communications 
157.2 	and marketing materials;
157.3 	(5) state regulation and oversight of group purchasers;
157.4 	(6) requirements and procedures for denial, termination, or reduction of services 
157.5 	and member appeals and grievances; and
157.6 	(7) state performance improvement projects, requirements, and procedures.
157.7 	(b) The commissioners of health, human services, and commerce, following 
157.8 	consultation with the work group, shall present to the legislature by February 15, 2012, 
157.9 	proposals to implement their recommendations.
157.10 		Subd. 3.New reporting and other duties. (a) The commissioner of management 
157.11 	and budget, in consultation with the work group and the commissioners of health, human 
157.12 	services, and commerce, shall develop criteria to be used by the commissioners in 
157.13 	determining whether to establish new reporting and data submittal requirements. These 
157.14 	criteria must support the establishment of new reporting and data submittal requirements 
157.15 	only:
157.16 	(1) if required by a federal agency or state statute;
157.17 	(2) if needed for a state regulatory audit or corrective action plan;
157.18 	(3) if needed to monitor or protect public health;
157.19 	(4) if needed to manage the cost and quality of Minnesota's public health insurance 
157.20 	programs; or
157.21 	(5) if a review and analysis by the commissioner of the relevant agency has 
157.22 	documented the necessity, importance, and administrative cost of the requirement, and 
157.23 	has determined that the information sought cannot be efficiently obtained through another 
157.24 	state or federal report.
157.25 	(b) The commissioners of health, human services, and commerce, following 
157.26 	consultation with the work group, may propose to the legislature new provider and group 
157.27 	purchaser reporting and data submittal requirements to take effect on or after July 1, 2012. 
157.28 	These proposals shall include an analysis of the extent to which the requirements meet 
157.29 	the criteria developed under paragraph (a).

157.30 	Sec. 91. SPECIALIZED MAINTENANCE THERAPY.
 157.31 	The commissioner of human services shall evaluate whether providing medical 
157.32 	assistance coverage for specialized maintenance therapy for enrollees with serious and 
157.33 	persistent mental illness who are at risk of hospitalization will improve the quality of 
157.34 	care and lower medical assistance spending by reducing rates of hospitalization. The 
157.35 	commissioner shall present findings and recommendations to the chairs and ranking 
158.1 	minority members of the legislative committees with jurisdiction over health and human 
158.2 	services finance and policy by December 15, 2011.

158.3 	Sec. 92. REDUCING HOSPITALIZATION RATES.
 158.4 	The commissioner of human services, by January 15, 2012, shall present 
158.5 	recommendations to the legislature to reduce hospitalization rates for state health care 
158.6 	program enrollees who are children with high-cost medical conditions.

158.7 	Sec. 93. MEDICAID FRAUD PREVENTION AND DETECTION.
 158.8 		Subdivision 1.Request for proposals. By December 31, 2011, the commissioner 
158.9 	of human services shall issue a request for proposals to prevent and detect Medicaid 
158.10 	fraud and mispayment. The request for proposals shall require the vendor to provide 
158.11 	data analytics capabilities, including, but not limited to, predictive modeling techniques 
158.12 	and other forms of advanced analytics, technical assistance, claims review, and medical 
158.13 	record and documentation investigations, to detect and investigate improper payments 
158.14 	both before and after payments are made.
158.15 		Subd. 2.Proof of concept phase. The selected vendor, at no cost to the state, shall 
158.16 	be required to apply its analytics and investigations on a subset of data provided by the 
158.17 	commissioner to demonstrate the direct recoveries of the solution.
158.18 		Subd. 3.Data confidentiality. Data provided by the commissioner to the vendor 
158.19 	under this section must maintain the confidentiality of the information.
158.20 		Subd. 4.Full implementation phase. The request for proposal must require the 
158.21 	commissioner to implement the recommendations provided by the vendor if the work 
158.22 	done under the requirements of subdivision 2 provides recoveries directly related to the 
158.23 	investigations to the state. After full implementation, the vendor shall be paid from 
158.24 	recoveries directly attributable to the work done by the vendor, according to the terms and 
158.25 	performance measures negotiated in the contract.
158.26 		Subd. 5.Selection of vendor. The commissioner of human services shall select a 
158.27 	vendor from the responses to the request for proposal by January 31, 2012.
158.28 		Subd. 6.Progress report. The commissioner shall provide a report describing the 
158.29 	progress made under this section to the governor and the chairs and ranking minority 
158.30 	members of the legislative committees with jurisdiction over the Department of Human 
158.31 	Services by June 15, 2012. The report shall provide a dynamic scoring analysis of the 
158.32 	work described in the report.

158.33 	Sec. 94. CAPITATION PAYMENT DELAY.
 159.1 	The commissioner shall delay $135,000,000 of the medical assistance and 
159.2 	MinnesotaCare capitation payment to managed care plans and county-based purchasing 
159.3 	plans due in May 2013 and the payment due in April 2013 for special needs basic care 
159.4 	until July 1, 2013. The payment shall be made no earlier than July 1, 2013, and no later 
159.5 	than July 31, 2013.
159.6 	The commissioner shall delay $135,000,000 of the medical assistance and 
159.7 	MinnesotaCare capitation payment to managed care plans and county-based purchasing 
159.8 	plans due in the second quarter of calendar year 2015 and the April 2015 payment for 
159.9 	special needs basic care until July 1, 2015. The payment shall be made no earlier than July 
159.10 	1, 2015, and no later than July 31, 2015.

159.11 	Sec. 95. MINNESOTA AUTISM SPECTRUM DISORDER TASK FORCE.
 159.12 		Subdivision 1.Members. (a) The Autism Spectrum Disorder Task Force is 
159.13 	composed of 19 members, appointed as follows:
159.14 	(1) two members of the senate, one appointed by the majority leader and one 
159.15 	appointed by the minority leader;
159.16 	(2) two members of the house of representatives, one from the majority party, 
159.17 	appointed by the speaker of the house, and one from the minority party, appointed by 
159.18 	the minority leader; 
159.19 	(3) two members who are family members of individuals with autism spectrum 
159.20 	disorder (ASD), one of whom shall be appointed by the majority leader of the senate, and 
159.21 	one of whom shall be appointed by the speaker of the house;
159.22 	(4) one member appointed by the Minnesota chapter of the American Academy of 
159.23 	Pediatrics who is a developmental behavioral pediatrician; 
159.24 	(5) one member appointed by the Minnesota Academy of Family Physicians who is 
159.25 	a family practice physician;
159.26 	(6) one member appointed by the Minnesota Psychological Association who is a 
159.27 	neuropsychologist;
159.28 	(7) one member appointed by the majority leader of the senate who represents a 
159.29 	minority autism community;
159.30 	(8) one member representing the directors of public school student support services;
159.31 	(9) one member appointed by the Minnesota Council of Health Plans;
159.32 	(10) three members who represent autism advocacy groups, two of whom shall be 
159.33 	appointed by the speaker of the house and one of whom shall be appointed by the majority 
159.34 	leader of the senate; and
160.1 	(11) one member appointed by each of the respective commissioners of the 
160.2 	following departments: education, employment and economic development, health, and 
160.3 	human services.
160.4 	(b) Appointments must be made by September 1, 2011. The senate member 
160.5 	appointed by the majority leader of the senate shall convene the first meeting of the 
160.6 	task force no later than October 1, 2011. The task force shall elect a chair from among 
160.7 	members at the first meeting. The task force shall meet at least six times per year.
160.8 		Subd. 2.Duties. (a) The task force shall develop an autism spectrum disorder 
160.9 	statewide strategic plan that focuses on improving awareness, early diagnosis, and 
160.10 	intervention and on ensuring delivery of treatment and services for individuals diagnosed 
160.11 	with an autism spectrum disorder, including the coordination and accessibility of 
160.12 	cost-effective treatments and services throughout the individual's lifetime.
160.13 	(b) The task force shall coordinate with existing efforts relating to autism spectrum 
160.14 	disorders at the Departments of Education, Employment and Economic Development, 
160.15 	Health, and Human Services and at the University of Minnesota and other agencies and 
160.16 	organizations as the task force deems appropriate.
160.17 		Subd. 3.Report. The task force shall submit its strategic plan to the legislature 
160.18 	by January 15, 2013. The task force shall continue to provide assistance with the 
160.19 	implementation of the strategic plan, as approved by the legislature, and shall submit 
160.20 	a progress report by January 15, 2014, and by January 15, 2015, on the status of 
160.21 	implementation of the strategic plan, including any draft legislation necessary for 
160.22 	implementation.
160.23 		Subd. 4.Expiration. The task force expires June 30, 2015, unless extended by law.

160.24 	Sec. 96. COMPETITIVE BIDDING PILOT.
 160.25 	For managed care contracts effective January 1, 2012, the commissioner of 
160.26 	human services is required to establish a competitive price bidding pilot for nonelderly, 
160.27 	nondisabled adults and children in medical assistance and MinnesotaCare in the 
160.28 	seven-county metropolitan area. The pilot must allow a minimum of two managed care 
160.29 	organizations to serve the metropolitan area. The pilot shall expire after two full calendar 
160.30 	years on December 31, 2013. The commissioner of human service shall conduct an 
160.31 	evaluation of the pilot to determine the cost-effectiveness and impacts to provider access 
160.32 	at the end of the two-year period.

160.33 	Sec. 97.  REPEALER.
 161.1 		Subdivision 1.Legislative Oversight Commission.  Minnesota Statutes 2010, 
161.2 	section 62J.07, subdivisions 1, 2, and 3, are repealed.
161.3 		Subd. 2.Children formally under medical assistance. Minnesota Statutes 2010, 
161.4 	section 256L.07, subdivision 7,exempting eligibility for children formally under 
161.5 	medical assistance, is repealed retroactively from October 1, 2008, and federal approval 
161.6 	is no longer necessary.
161.7 		Subd. 3.Extending medical assistance. Minnesota Statutes 2010, section 
161.8 	256B.057, subdivision 2c,(extended medical assistance for certain children) is 
161.9 	repealed.
161.10 		Subd. 4. Minnesota Statutes 2010, section 256B.69, subdivision 9b, is repealed.
161.11 		Subd. 5. The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9, 
161.12 	(renewal rolling month and premium grace month) are repealed.
161.13 		Subd. 6.MinnesotaCare provider taxes. Minnesota Statutes 2010, sections 
161.14 	13.4967, subdivision 3; 295.50, subdivisions 1, 1a, 2, 2a, 3, 4, 6, 6a, 7, 9b, 9c, 10a, 10b, 
161.15 	12b, 13, 14, and 15; 295.51, subdivisions 1 and 1a; 295.52, subdivisions 1, 1a, 2, 3, 4, 
161.16 	4a, 5, 6, and 7; 295.53, subdivisions 1, 2, 3, and 4a; 295.54; 295.55; 295.56; 295.57; 
161.17 	295.58; 295.581; 295.582; and 295.59, are repealed effective for gross revenues received 
161.18 	after December 31, 2019.
161.19 		Subd. 7.Renewal of medical assistance eligibility. The amendment in Laws 2009, 
161.20 	chapter 79, article 5, section 62, is repealed retroactively from July 1, 2009.

161.21 	Sec. 98. EFFECTIVE DATE.
 161.22 	This article is effective the day following final enactment unless another effective 
161.23 	date is specified in this article.

161.24 	ARTICLE 7
161.25 	CONTINUING CARE

161.26 	Section 1. Minnesota Statutes 2010, section 245A.03, subdivision 7, as amended by 
161.27 	Laws 2011, chapter 86, section 4, is amended to read:
161.28 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an 
161.29 	initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 
161.30 	2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
161.31 	9555.6265, under this chapter for a physical location that will not be the primary residence 
161.32 	of the license holder for the entire period of licensure. If a license is issued during this 
161.33 	moratorium, and the license holder changes the license holder's primary residence away 
162.1 	from the physical location of the foster care license, the commissioner shall revoke the 
162.2 	license according to section 245A.07. Exceptions to the moratorium include:
162.3 	(1) foster care settings that are required to be registered under chapter 144D;
162.4 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, 
162.5 	and determined to be needed by the commissioner under paragraph (b);
162.6 	(3) new foster care licenses determined to be needed by the commissioner under 
162.7 	paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or 
162.8 	restructuring of state-operated services that limits the capacity of state-operated facilities;
162.9 	(4) new foster care licenses determined to be needed by the commissioner under 
162.10 	paragraph (b) for persons requiring hospital level care; or
162.11 	(5) new foster care licenses determined to be needed by the commissioner for the 
162.12 	transition of people from personal care assistance to the home and community-based 
162.13 	services.
162.14 	(b) The commissioner shall determine the need for newly licensed foster care homes 
162.15 	as defined under this subdivision. As part of the determination, the commissioner shall 
162.16 	consider the availability of foster care capacity in the area in which the licensee seeks to 
162.17 	operate, and the recommendation of the local county board. The determination by the 
162.18 	commissioner must be final. A determination of need is not required for a change in 
162.19 	ownership at the same address.
162.20 	(c) Residential settings that would otherwise be subject to the moratorium established 
162.21 	in paragraph (a), that are in the process of receiving an adult or child foster care license as 
162.22 	of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult 
162.23 	or child foster care license. For this paragraph, all of the following conditions must be met 
162.24 	to be considered in the process of receiving an adult or child foster care license:
162.25 	(1) participants have made decisions to move into the residential setting, including 
162.26 	documentation in each participant's care plan;
162.27 	(2) the provider has purchased housing or has made a financial investment in the 
162.28 	property;
162.29 	(3) the lead agency has approved the plans, including costs for the residential setting 
162.30 	for each individual;
162.31 	(4) the completion of the licensing process, including all necessary inspections, is 
162.32 	the only remaining component prior to being able to provide services; and
162.33 	(5) the needs of the individuals cannot be met within the existing capacity in that 
162.34 	county.
163.1 	To qualify for the process under this paragraph, the lead agency must submit 
163.2 	documentation to the commissioner by August 1, 2009, that all of the above criteria are 
163.3 	met.
163.4 	(d) The commissioner shall study the effects of the license moratorium under this 
163.5 	subdivision and shall report back to the legislature by January 15, 2011. This study shall 
163.6 	include, but is not limited to the following:
163.7 	(1) the overall capacity and utilization of foster care beds where the physical location 
163.8 	is not the primary residence of the license holder prior to and after implementation 
163.9 	of the moratorium;
163.10 	(2) the overall capacity and utilization of foster care beds where the physical 
163.11 	location is the primary residence of the license holder prior to and after implementation 
163.12 	of the moratorium; and
163.13 	(3) the number of licensed and occupied ICF/MR beds prior to and after 
163.14 	implementation of the moratorium.
163.15 	(e) When a foster care recipient moves out of a foster home that is not the primary 
163.16 	residence of the license holder according to section 256B.49, subdivision 15, paragraph 
163.17 	(f), the county shall immediately inform the Department of Human Services Licensing 
163.18 	Division, and the department shall immediately decrease the licensed capacity for the 
163.19 	home. A decreased licensed capacity according to this paragraph is not subject to appeal 
163.20 	under this chapter.

163.21 	Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
163.22 		Subd. 24.Disability Linkage Line. The commissioner shall establish the Disability 
163.23 	Linkage Line, ato serve as Minnesota's neutral access point for statewide consumer
163.24 	disability information, referral, and assistance system for people with disabilities and 
163.25 	chronic illnesses that. The Disability Linkage Line shall:
163.26 	(1) deliver information and assistance based on national and state standards;
163.27 	(1) provides (2) provide information about state and federal eligibility requirements, 
163.28 	benefits, and service options;
163.29 	(3) provide benefits and options counseling;
163.30 	(2) makes (4) make referrals to appropriate support entities;
163.31 	(3) delivers information and assistance based on national and state standards;
163.32 	(4) assists (5) educate people to on their options so they can make well-informed 
163.33 	decisions choices; and
163.34 	(5) supports (6) help support the timely resolution of service access and benefit 
163.35 	issues.;
164.1 	(7) inform people of their long-term community services and supports;
164.2 	(8) provide necessary resources and supports that can lead to employment and 
164.3 	increased economic stability of people with disabilities; and
164.4 	(9) serve as the technical assistance and help center for the Web-based tool, 
164.5 	Minnesota's Disability Benefits 101.org.

164.6 	Sec. 3. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
164.7 		Subd. 29.State medical review team. (a) To ensure the timely processing of 
164.8 	determinations of disability by the commissioner's state medical review team under 
164.9 	sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph 
164.10 	(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence 
164.11 	submitted by county agencies with a referral and seek additional information from 
164.12 	providers, applicants, and enrollees to support the determination of disability where 
164.13 	necessary. Disability shall be determined according to the rules of title XVI and title 
164.14 	XIX of the Social Security Act and pertinent rules and policies of the Social Security 
164.15 	Administration.
164.16 	(b) Prior to a denial or withdrawal of a requested determination of disability due 
164.17 	to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is 
164.18 	necessary and appropriate to a determination of disability, and (2) assist applicants and 
164.19 	enrollees to obtain the evidence, including, but not limited to, medical examinations 
164.20 	and electronic medical records.
164.21 	(c) The commissioner shall provide the chairs of the legislative committees with 
164.22 	jurisdiction over health and human services finance and budget the following information 
164.23 	on the activities of the state medical review team by February 1 of each year:
164.24 	(1) the number of applications to the state medical review team that were denied, 
164.25 	approved, or withdrawn;
164.26 	(2) the average length of time from receipt of the application to a decision;
164.27 	(3) the number of appeals, appeal results, and the length of time taken from the date 
164.28 	the person involved requested an appeal for a written decision to be made on each appeal;
164.29 	(4) for applicants, their age, health coverage at the time of application, hospitalization 
164.30 	history within three months of application, and whether an application for Social Security 
164.31 	or Supplemental Security Income benefits is pending; and
164.32 	(5) specific information on the medical certification, licensure, or other credentials 
164.33 	of the person or persons performing the medical review determinations and length of 
164.34 	time in that position.
165.1 	(d) Any appeal made under section 256.045, subdivision 3, of a disability 
165.2 	determination made by the state medical review team must be decided according to the 
165.3 	timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is 
165.4 	not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the 
165.5 	appeal must be immediately reviewed by the chief appeals referee.

165.6 	Sec. 4. Minnesota Statutes 2010, section 256B.04, is amended by adding a subdivision 
165.7 	to read:
165.8 		Subd. 20.Money Follows the Person Rebalancing demonstration project. In 
165.9 	accordance with federal law governing Money Follows the Person Rebalancing funds, 
165.10 	amounts equal to the value of enhanced federal funding resulting from the operation of the 
165.11 	demonstration project grant must be transferred from the medical assistance account in 
165.12 	the general fund to an account in the special revenue fund. Funds in the special revenue 
165.13 	fund account do not cancel and are appropriated to the commissioner to carry out the 
165.14 	goals of the Money Follows the Person Rebalancing demonstration project as required 
165.15 	under the approved federal plan for the use of the funds, and may be transferred to the 
165.16 	medical assistance account if applicable.

165.17 	Sec. 5. Minnesota Statutes 2010, section 256B.05, is amended by adding a subdivision 
165.18 	to read:
165.19 		Subd. 5.Obligation of local agency to process medical assistance applications 
165.20 	within established timelines. The local agency must act on an application for medical 
165.21 	assistance within ten working days of receipt of all information needed to act on the 
165.22 	application but no later than required under Minnesota Rules, part 9505.0090, subparts 
165.23 	2 and 3.

165.24 	Sec. 6. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
165.25 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
165.26 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
165.27 	member of a household with two family members, husband and wife, or parent and child, 
165.28 	the household must not own more than $6,000 in assets, plus $200 for each additional 
165.29 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
165.30 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
165.31 	time of an eligibility redetermination. The accumulation of the clothing and personal 
165.32 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
165.33 	the time of the eligibility redetermination. The value of assets that are not considered in 
166.1 	determining eligibility for medical assistance is the value of those assets excluded under 
166.2 	the supplemental security income program for aged, blind, and disabled persons, with 
166.3 	the following exceptions:
166.4 	(1) household goods and personal effects are not considered;
166.5 	(2) capital and operating assets of a trade or business that the local agency determines 
166.6 	are necessary to the person's ability to earn an income are not considered;
166.7 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
166.8 	security income program;
166.9 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
166.10 	the supplemental security income program. Burial expenses funded by annuity contracts 
166.11 	or life insurance policies must irrevocably designate the individual's estate as contingent 
166.12 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
166.13 	(5) effective upon federal approval, for a person who no longer qualifies as an 
166.14 	employed person with a disability due to loss of earnings, assets allowed while eligible 
166.15 	for medical assistance under section 256B.057, subdivision 9, are not considered for 12 
166.16 	months, beginning with the first month of ineligibility as an employed person with a 
166.17 	disability, to the extent that the person's total assets remain within the allowed limits of 
166.18 	section 256B.057, subdivision 9, paragraph (c) (d).
166.19 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
166.20 	15.

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

166.22 	Sec. 7. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
166.23 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid 
166.24 	for a person who is employed and who:
166.25 	(1) but for excess earnings or assets, meets the definition of disabled under the 
166.26 	Supplemental Security Income program;
166.27 	(2) is at least 16 but less than 65 years of age;
166.28 	(3) meets the asset limits in paragraph (c) (d); and
166.29 	(4) pays a premium and other obligations under paragraph (e).
166.30 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
166.31 	for medical assistance under this subdivision, a person must have more than $65 of earned 
166.32 	income. Earned income must have Medicare, Social Security, and applicable state and 
166.33 	federal taxes withheld. The person must document earned income tax withholding. Any 
166.34 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
166.35 	determinations.
167.1 	(b) (c) After the month of enrollment, a person enrolled in medical assistance under 
167.2 	this subdivision who:
167.3 	(1) is temporarily unable to work and without receipt of earned income due to a 
167.4 	medical condition, as verified by a physician, may retain eligibility for up to four calendar 
167.5 	months; or
167.6 	(2) effective January 1, 2004, loses employment for reasons not attributable to the 
167.7 	enrollee, and is without receipt of earned income may retain eligibility for up to four 
167.8 	consecutive months after the month of job loss. To receive a four-month extension, 
167.9 	enrollees must verify the medical condition or provide notification of job loss. All other 
167.10 	eligibility requirements must be met and the enrollee must pay all calculated premium 
167.11 	costs for continued eligibility.
167.12 	(c) (d) For purposes of determining eligibility under this subdivision, a person's 
167.13 	assets must not exceed $20,000, excluding:
167.14 	(1) all assets excluded under section 256B.056;
167.15 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 
167.16 	Keogh plans, and pension plans; and
167.17 	(3) medical expense accounts set up through the person's employer.; and
167.18 	(4) spousal assets, including spouse's share of jointly held assets.
167.19 	(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65 
167.20 	earned income disregard. To be eligible, a person applying for medical assistance under 
167.21 	this subdivision must have earned income above the disregard level.
167.22 	(2) Effective January 1, 2004, to be considered earned income, Medicare, Social 
167.23 	Security, and applicable state and federal income taxes must be withheld. To be eligible, 
167.24 	a person must document earned income tax withholding.
167.25 	(e)(1) A person whose earned and unearned income is equal to or greater than 100 
167.26 	percent of federal poverty guidelines for the applicable family size must pay a premium 
167.27 	to be eligible for medical assistance under this subdivision. (e) All enrollees must pay a 
167.28 	premium to be eligible for medical assistance under this subdivision, except as provided 
167.29 	under section 256.01, subdivision 18b.
167.30 	(1) An enrollee must pay the greater of a $65 premium or the premium shall be
167.31 	calculated based on the person's gross earned and unearned income and the applicable 
167.32 	family size using a sliding fee scale established by the commissioner, which begins at 
167.33 	one percent of income at 100 percent of the federal poverty guidelines and increases 
167.34 	to 7.5 percent of income for those with incomes at or above 300 percent of the federal 
167.35 	poverty guidelines. 
168.1 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
168.2 	poverty guidelines shall be effective for premiums due in July of each year.
168.3 	(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for 
168.4 	medical assistance under this subdivision. An enrollee shall pay the greater of a $35 
168.5 	premium or the premium calculated in clause (1).
168.6 	(3) Effective November 1, 2003, All enrollees who receive unearned income must 
168.7 	pay one-half of one five percent of unearned income in addition to the premium amount, 
168.8 	except as provided under section 256.01, subdivision 18b.
168.9 	(4) Effective November 1, 2003, for enrollees whose income does not exceed 200 
168.10 	percent of the federal poverty guidelines and who are also enrolled in Medicare, the 
168.11 	commissioner must reimburse the enrollee for Medicare Part B premiums under section 
168.12 	256B.0625, subdivision 15, paragraph (a).
168.13 	(5) (4) Increases in benefits under title II of the Social Security Act shall not be 
168.14 	counted as income for purposes of this subdivision until July 1 of each year.
168.15 	(f) A person's eligibility and premium shall be determined by the local county 
168.16 	agency. Premiums must be paid to the commissioner. All premiums are dedicated to 
168.17 	the commissioner.
168.18 	(g) Any required premium shall be determined at application and redetermined at 
168.19 	the enrollee's six-month income review or when a change in income or household size is 
168.20 	reported. Enrollees must report any change in income or household size within ten days 
168.21 	of when the change occurs. A decreased premium resulting from a reported change in 
168.22 	income or household size shall be effective the first day of the next available billing month 
168.23 	after the change is reported. Except for changes occurring from annual cost-of-living 
168.24 	increases, a change resulting in an increased premium shall not affect the premium amount 
168.25 	until the next six-month review.
168.26 	(h) Premium payment is due upon notification from the commissioner of the 
168.27 	premium amount required. Premiums may be paid in installments at the discretion of 
168.28 	the commissioner.
168.29 	(i) Nonpayment of the premium shall result in denial or termination of medical 
168.30 	assistance unless the person demonstrates good cause for nonpayment. Good cause exists 
168.31 	if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 
168.32 	D, are met. Except when an installment agreement is accepted by the commissioner, 
168.33 	all persons disenrolled for nonpayment of a premium must pay any past due premiums 
168.34 	as well as current premiums due prior to being reenrolled. Nonpayment shall include 
168.35 	payment with a returned, refused, or dishonored instrument. The commissioner may 
169.1 	require a guaranteed form of payment as the only means to replace a returned, refused, 
169.2 	or dishonored instrument.
169.3 	(j) The commissioner shall notify enrollees annually beginning at least 24 months 
169.4 	before the person's 65th birthday of the medical assistance eligibility rules affecting 
169.5 	income, assets, and treatment of a spouse's income and assets that will be applied upon 
169.6 	reaching age 65.
169.7 	(k) For enrollees whose income does not exceed 200 percent of the federal poverty 
169.8 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse 
169.9 	the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, 
169.10 	paragraph (a).

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

169.13 	Sec. 8. Minnesota Statutes 2010, section 256B.0625, subdivision 19a, is amended to 
169.14 	read:
169.15 		Subd. 19a.Personal care assistance services. Medical assistance covers personal 
169.16 	care assistance services in a recipient's home. Effective January 1, 2010, to qualify for 
169.17 	personal care assistance services, a recipient must require assistance and be determined 
169.18 	dependent in one activity of daily living as defined in section 256B.0659, subdivision 1, 
169.19 	paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1, 
169.20 	paragraph (c). Beginning July 1, 2011, to qualify for personal care assistance services, a 
169.21 	recipient must require assistance and be determined dependent in at least two activities 
169.22 	of daily living as defined in section 256B.0659. Recipients or responsible parties must 
169.23 	be able to identify the recipient's needs, direct and evaluate task accomplishment, and 
169.24 	provide for health and safety. Approved hours may be used outside the home when normal 
169.25 	life activities take them outside the home. To use personal care assistance services at 
169.26 	school, the recipient or responsible party must provide written authorization in the care 
169.27 	plan identifying the chosen provider and the daily amount of services to be used at school. 
169.28 	Total hours for services, whether actually performed inside or outside the recipient's 
169.29 	home, cannot exceed that which is otherwise allowed for personal care assistance services 
169.30 	in an in-home setting according to sections 256B.0651 to 256B.0656. Medical assistance 
169.31 	does not cover personal care assistance services for residents of a hospital, nursing facility, 
169.32 	intermediate care facility, health care facility licensed by the commissioner of health, or 
169.33 	unless a resident who is otherwise eligible is on leave from the facility and the facility 
169.34 	either pays for the personal care assistance services or forgoes the facility per diem for the 
169.35 	leave days that personal care assistance services are used. All personal care assistance 
170.1 	services must be provided according to sections 256B.0651 to 256B.0656. Personal care 
170.2 	assistance services may not be reimbursed if the personal care assistant is the spouse or 
170.3 	paid guardian of the recipient or the parent of a recipient under age 18, or the responsible 
170.4 	party or the family foster care provider of a recipient who cannot direct the recipient's own 
170.5 	care unless, in the case of a foster care provider, a county or state case manager visits 
170.6 	the recipient as needed, but not less than every six months, to monitor the health and 
170.7 	safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding 
170.8 	the provisions of section 256B.0659, the unpaid guardian or conservator of an adult, 
170.9 	who is not the responsible party and not the personal care provider organization, may be 
170.10 	reimbursed to provide personal care assistance services to the recipient if the guardian or 
170.11 	conservator meets all criteria for a personal care assistant according to section 256B.0659, 
170.12 	and shall not be considered to have a service provider interest for purposes of participation 
170.13 	on the screening team under section 256B.092, subdivision 7.

170.14 	Sec. 9. Minnesota Statutes 2010, section 256B.0652, subdivision 6, is amended to read:
170.15 		Subd. 6. Authorization; personal care assistance and qualified professional.
 170.16 	(a) All personal care assistance services, supervision by a qualified professional, and 
170.17 	additional services beyond the limits established in subdivision 11, must be authorized 
170.18 	by the commissioner or the commissioner's designee before services begin except for the 
170.19 	assessments established in subdivision 11 and section 256B.0911. The authorization for 
170.20 	personal care assistance and qualified professional services under section 256B.0659 must 
170.21 	be completed within 30 days after receiving a complete request.
170.22 	(b) The amount of personal care assistance services authorized must be based 
170.23 	on the recipient's home care rating. The home care rating shall be determined by the 
170.24 	commissioner or the commissioner's designee based on information submitted to the 
170.25 	commissioner identifying the following for recipients with dependencies in two or more 
170.26 	activities of daily living:
170.27 	(1) total number of dependencies of activities of daily living as defined in section 
170.28 	256B.0659;
170.29 	(2) presence of complex health-related needs as defined in section 256B.0659; and
170.30 	(3) presence of Level I behavior as defined in section 256B.0659.
170.31 	(c) For purposes meeting the criteria in paragraph (b), the methodology to determine 
170.32 	total time for personal care assistance services for each home care rating is based on 
170.33 	the median paid units per day for each home care rating from fiscal year 2007 data for 
170.34 	the personal care assistance program. Each home care rating has a base level of hours 
171.1 	assigned. Additional time is added through the assessment and identification of the 
171.2 	following:
171.3 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
171.4 	living as defined in section 256B.0659;
171.5 	(2) 30 additional minutes per day for each complex health-related function as 
171.6 	defined in section 256B.0659; and
171.7 	(3) 30 additional minutes per day for each behavior issue as defined in section 
171.8 	256B.0659, subdivision 4, paragraph (d).
171.9 	(d) Effective July 1, 2011, the home care rating for recipients who have a dependency 
171.10 	in one activity of daily living or Level I behavior shall equal no more than two units per 
171.11 	day. Recipients with this home care rating are not subject to the methodology in paragraph 
171.12 	(c) and are not eligible for more than two units per day.
171.13 	(e) A limit of 96 units of qualified professional supervision may be authorized for 
171.14 	each recipient receiving personal care assistance services. A request to the commissioner 
171.15 	to exceed this total in a calendar year must be requested by the personal care provider 
171.16 	agency on a form approved by the commissioner.

171.17 	Sec. 10. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to 
171.18 	read:
171.19 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant 
171.20 	must meet the following requirements:
171.21 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years 
171.22 	of age with these additional requirements:
171.23 	(i) supervision by a qualified professional every 60 days; and
171.24 	(ii) employment by only one personal care assistance provider agency responsible 
171.25 	for compliance with current labor laws;
171.26 	(2) be employed by a personal care assistance provider agency;
171.27 	(3) enroll with the department as a personal care assistant after clearing a background 
171.28 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
171.29 	services, the personal care assistance provider agency must initiate a background study on 
171.30 	the personal care assistant under chapter 245C, and the personal care assistance provider 
171.31 	agency must have received a notice from the commissioner that the personal care assistant 
171.32 	is:
171.33 	(i) not disqualified under section 245C.14; or
171.34 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
171.35 	disqualification under section 245C.22;
172.1 	(4) be able to effectively communicate with the recipient and personal care 
172.2 	assistance provider agency;
172.3 	(5) be able to provide covered personal care assistance services according to the 
172.4 	recipient's personal care assistance care plan, respond appropriately to recipient needs, 
172.5 	and report changes in the recipient's condition to the supervising qualified professional 
172.6 	or physician;
172.7 	(6) not be a consumer of personal care assistance services;
172.8 	(7) maintain daily written records including, but not limited to, time sheets under 
172.9 	subdivision 12;
172.10 	(8) effective January 1, 2010, complete standardized training as determined 
172.11 	by the commissioner before completing enrollment. The training must be available 
172.12 	in languages other than English and to those who need accommodations due to 
172.13 	disabilities. Personal care assistant training must include successful completion of the 
172.14 	following training components: basic first aid, vulnerable adult, child maltreatment, 
172.15 	OSHA universal precautions, basic roles and responsibilities of personal care assistants 
172.16 	including information about assistance with lifting and transfers for recipients, emergency 
172.17 	preparedness, orientation to positive behavioral practices, fraud issues, and completion of 
172.18 	time sheets. Upon completion of the training components, the personal care assistant must 
172.19 	demonstrate the competency to provide assistance to recipients;
172.20 	(9) complete training and orientation on the needs of the recipient within the first 
172.21 	seven days after the services begin; and
172.22 	(10) be limited to providing and being paid for up to 275 hours per month, except 
172.23 	that this limit shall be 275 hours per month for the period July 1, 2009, through June 30, 
172.24 	2011, of personal care assistance services regardless of the number of recipients being 
172.25 	served or the number of personal care assistance provider agencies enrolled with. The 
172.26 	number of hours worked per day shall not be disallowed by the department unless in 
172.27 	violation of the law.
172.28 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
172.29 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
172.30 	(c) Effective January 1, 2010, Persons who do not qualify as a personal care assistant 
172.31 	include parents and stepparents of minors, spouses, paid legal guardians, family foster 
172.32 	care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or 
172.33 	staff of a residential setting. When the personal care assistant is a relative of the recipient, 
172.34 	the commissioner shall pay 80 percent of the provider rate. For purposes of this section, 
172.35 	relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or 
172.36 	older, an adult child, a grandparent, or a grandchild. 

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

173.2 	Sec. 11. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to 
173.3 	read:
173.4 		Subd. 28.Personal care assistance provider agency; required documentation.
 173.5 	(a) Required documentation must be completed and kept in the personal care assistance 
173.6 	provider agency file or the recipient's home residence. The required documentation 
173.7 	consists of:
173.8 	(1) employee files, including:
173.9 	(i) applications for employment;
173.10 	(ii) background study requests and results;
173.11 	(iii) orientation records about the agency policies;
173.12 	(iv) trainings completed with demonstration of competence;
173.13 	(v) supervisory visits;
173.14 	(vi) evaluations of employment; and
173.15 	(vii) signature on fraud statement;
173.16 	(2) recipient files, including:
173.17 	(i) demographics;
173.18 	(ii) emergency contact information and emergency backup plan;
173.19 	(iii) personal care assistance service plan;
173.20 	(iv) personal care assistance care plan;
173.21 	(v) month-to-month service use plan;
173.22 	(vi) all communication records;
173.23 	(vii) start of service information, including the written agreement with recipient; and
173.24 	(viii) date the home care bill of rights was given to the recipient;
173.25 	(3) agency policy manual, including:
173.26 	(i) policies for employment and termination;
173.27 	(ii) grievance policies with resolution of consumer grievances;
173.28 	(iii) staff and consumer safety;
173.29 	(iv) staff misconduct; and
173.30 	(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and 
173.31 	resolution of consumer grievances;
173.32 	(4) time sheets for each personal care assistant along with completed activity sheets 
173.33 	for each recipient served; and
173.34 	(5) agency marketing and advertising materials and documentation of marketing 
173.35 	activities and costs; and
174.1 	(6) for each personal care assistant, whether or not the personal care assistant is 
174.2 	providing care to a relative as defined in subdivision 11.
174.3 	(b) The commissioner may assess a fine of up to $500 on provider agencies that do 
174.4 	not consistently comply with the requirements of this subdivision.

174.5 	Sec. 12. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to 
174.6 	read:
174.7 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
174.8 	(a) "Long-term care consultation services" means:
174.9 	(1) assistance in identifying services needed to maintain an individual in the most 
174.10 	inclusive environment;
174.11 	(2) providing recommendations on cost-effective community services that are 
174.12 	available to the individual;
174.13 	(3) development of an individual's person-centered community support plan;
174.14 	(4) providing information regarding eligibility for Minnesota health care programs;
174.15 	(5) face-to-face long-term care consultation assessments, which may be completed 
174.16 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
174.17 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
174.18 	residence;
174.19 	(6) federally mandated screening to determine the need for an institutional level of 
174.20 	care under subdivision 4a;
174.21 	(7) determination of home and community-based waiver service eligibility including 
174.22 	level of care determination for individuals who need an institutional level of care as 
174.23 	defined under section 144.0724, subdivision 11, determined under section 256B.0911, 
174.24 	subdivision 4a, paragraph (d), or 256B.092, service eligibility including state plan home 
174.25 	care services identified in sections 256B.0625, subdivisions 6, 7, and 19, paragraphs 
174.26 	(a) and (c), and 256B.0657, based on assessment and support plan development with 
174.27 	appropriate referrals, including the option for consumer-directed community supports;
174.28 	(8) providing recommendations for nursing facility placement when there are no 
174.29 	cost-effective community services available; and
174.30 	(9) assistance to transition people back to community settings after facility 
174.31 	admission.
174.32 	(b) "Long-term care options counseling" means the services provided by the linkage 
174.33 	lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes 
174.34 	telephone assistance and follow up once a long-term care consultation assessment has 
174.35 	been completed.
175.1 	(c) "Minnesota health care programs" means the medical assistance program under 
175.2 	chapter 256B and the alternative care program under section 256B.0913.
175.3 	(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health 
175.4 	plans administering long-term care consultation assessment and support planning services.

175.5 	Sec. 13. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to 
175.6 	read:
175.7 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
175.8 	services planning, or other assistance intended to support community-based living, 
175.9 	including persons who need assessment in order to determine waiver or alternative care 
175.10 	program eligibility, must be visited by a long-term care consultation team within 15 
175.11 	calendar days after the date on which an assessment was requested or recommended. After 
175.12 	January 1, 2011, these requirements also apply to personal care assistance services, private 
175.13 	duty nursing, and home health agency services, on timelines established in subdivision 5. 
175.14 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
175.15 	(b) The county may utilize a team of either the social worker or public health nurse, 
175.16 	or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 
175.17 	assessment in a face-to-face interview. The consultation team members must confer 
175.18 	regarding the most appropriate care for each individual screened or assessed.
175.19 	(c) The assessment must be comprehensive and include a person-centered 
175.20 	assessment of the health, psychological, functional, environmental, and social needs of 
175.21 	referred individuals and provide information necessary to develop a support plan that 
175.22 	meets the consumers needs, using an assessment form provided by the commissioner.
175.23 	(d) The assessment must be conducted in a face-to-face interview with the person 
175.24 	being assessed and the person's legal representative, as required by legally executed 
175.25 	documents, and other individuals as requested by the person, who can provide information 
175.26 	on the needs, strengths, and preferences of the person necessary to develop a support plan 
175.27 	that ensures the person's health and safety, but who is not a provider of service or has any 
175.28 	financial interest in the provision of services.
175.29 	(e) The person, or the person's legal representative, must be provided with written 
175.30 	recommendations for community-based services, including consumer-directed options, 
175.31 	or institutional care that include documentation that the most cost-effective alternatives 
175.32 	available were offered to the individual, and alternatives to residential settings, including, 
175.33 	but not limited to, foster care settings that are not the primary residence of the license 
175.34 	holder. For purposes of this requirement, "cost-effective alternatives" means community 
175.35 	services and living arrangements that cost the same as or less than institutional care.
176.1 	(f) If the person chooses to use community-based services, the person or the person's 
176.2 	legal representative must be provided with a written community support plan, regardless 
176.3 	of whether the individual is eligible for Minnesota health care programs. A person may 
176.4 	request assistance in identifying community supports without participating in a complete 
176.5 	assessment. Upon a request for assistance identifying community support, the person must 
176.6 	be transferred or referred to the services available under sections 256.975, subdivision 7, 
176.7 	and 256.01, subdivision 24, for telephone assistance and follow up.
176.8 	(g) The person has the right to make the final decision between institutional 
176.9 	placement and community placement after the recommendations have been provided, 
176.10 	except as provided in subdivision 4a, paragraph (c).
176.11 	(h) The team must give the person receiving assessment or support planning, or 
176.12 	the person's legal representative, materials, and forms supplied by the commissioner 
176.13 	containing the following information:
176.14 	(1) the need for and purpose of preadmission screening if the person selects nursing 
176.15 	facility placement;
176.16 	(2) the role of the long-term care consultation assessment and support planning in 
176.17 	waiver and alternative care program eligibility determination;
176.18 	(3) information about Minnesota health care programs;
176.19 	(4) the person's freedom to accept or reject the recommendations of the team;
176.20 	(5) the person's right to confidentiality under the Minnesota Government Data 
176.21 	Practices Act, chapter 13;
176.22 	(6) the long-term care consultant's decision regarding the person's need for 
176.23 	institutional level of care as determined under criteria established in section 144.0724, 
176.24 	subdivision 11, or 256B.092; and
176.25 	(7) the person's right to appeal the decision regarding the need for nursing facility 
176.26 	level of care or the county's final decisions regarding public programs eligibility according 
176.27 	to section 256.045, subdivision 3.
176.28 	(i) Face-to-face assessment completed as part of eligibility determination for 
176.29 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
176.30 	community alternative care, and traumatic brain injury waiver programs under sections 
176.31 	256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 
176.32 	than 60 calendar days after the date of assessment. The effective eligibility start date 
176.33 	for these programs can never be prior to the date of assessment. If an assessment was 
176.34 	completed more than 60 days before the effective waiver or alternative care program 
176.35 	eligibility start date, assessment and support plan information must be updated in a 
176.36 	face-to-face visit and documented in the department's Medicaid Management Information 
177.1 	System (MMIS). The effective date of program eligibility in this case cannot be prior to 
177.2 	the date the updated assessment is completed.

177.3 	Sec. 14. Minnesota Statutes 2010, section 256B.0911, subdivision 3c, is amended to 
177.4 	read:
177.5 		Subd. 3c.Transition to Consultation for housing with services. (a) Housing 
177.6 	with services establishments offering or providing assisted living under chapter 144G 
177.7 	shall inform all prospective residents of the availability of and contact information 
177.8 	for transitional consultation services under this subdivision prior to executing a lease 
177.9 	or contract with the prospective resident. The purpose of transitional long-term care 
177.10 	consultation for registered housing with services is to support persons with current or 
177.11 	anticipated long-term care needs in making informed choices among options that include 
177.12 	the most cost-effective and least restrictive settings, and to delay spenddown to eligibility 
177.13 	for publicly funded programs by connecting people to alternative services in their homes 
177.14 	before transition to housing with services. Regardless of the consultation,. Prospective 
177.15 	residents maintain the right to choose housing with services or assisted living if that 
177.16 	option is their preference.
177.17 	(b) Transitional consultation Registered housing with services establishments 
177.18 	shall inform all prospective residents of the availability of long-term care consultation 
177.19 	and the need to receive and verify the consultation prior to signing a lease or contract. 
177.20 	Long-term care consultation for registered housing with  services are is  provided as 
177.21 	determined by the commissioner of human services in partnership with county long-term 
177.22 	care consultation units, and the Area Agencies on Aging, and are a combination of 
177.23 	telephone-based and in-person assistance provided under models developed by the 
177.24 	commissioner. The consultation shall be performed in a manner that provides objective 
177.25 	and complete information. Transitional consultation. The service is delivered under a 
177.26 	partnership between lead agencies as defined in subdivision 1a, paragraph (d), and the 
177.27 	Area Agencies on Aging, and is a point of entry to a combination of telephone-based 
177.28 	long-term care options counseling provided by Senior LinkAge Line and in-person 
177.29 	long-term care consultation provided by lead agencies. The point of entry service must be 
177.30 	provided within five working days of the request of the prospective resident as follows:
177.31 	(1) the consultation must be provided by a qualified professional as determined by 
177.32 	the commissioner shall be performed in a manner that provides objective and complete 
177.33 	information;
177.34 	(2) the consultation must include a review of the prospective resident's reasons for 
177.35 	considering assisted living housing with services, the prospective resident's personal 
178.1 	goals, a discussion of the prospective resident's immediate and projected long-term care 
178.2 	needs, and alternative community services or assisted living housing with services settings 
178.3 	that may meet the prospective resident's needs; and
178.4 	(3) the prospective resident shall be informed of the availability of long-term care 
178.5 	consultation services described in subdivision 3a that are available a face-to-face visit at 
178.6 	no charge to the prospective resident to assist the prospective resident in assessment and 
178.7 	planning to meet the prospective resident's long-term care needs. The Senior LinkAge Line 
178.8 	and long-term care consultation team shall give the highest priority to referrals who are at 
178.9 	highest risk of nursing facility placement or as needed for determining eligibility.; and
178.10 	(4) verification of counseling shall be generated and provided to the prospective 
178.11 	resident by Senior LinkAge Line upon completion of the telephone-based counseling.
178.12 	(c) Housing with services establishments registered under chapter 144D shall:
178.13 	(1) inform all prospective residents of the availability of and contact information for 
178.14 	consultation services under this subdivision;
178.15 	(2) except for individuals seeking lease-only arrangements in subsidized housing 
178.16 	settings, receive a copy of the verification of counseling prior to executing a lease or 
178.17 	service contract with the prospective resident, and prior to executing a service contract 
178.18 	with individuals who have previously entered into lease-only arrangements; and
178.19 	(3) retain a copy of the verification of counseling as part of the resident's file.

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

178.21 	Sec. 15. Minnesota Statutes 2010, section 256B.0911, subdivision 4a, is amended to 
178.22 	read:
178.23 		Subd. 4a.Preadmission screening activities related to nursing facility 
178.24 	admissions. (a) All applicants to Medicaid certified nursing facilities, including certified 
178.25 	boarding care facilities, must be screened prior to admission regardless of income, assets, 
178.26 	or funding sources for nursing facility care, except as described in subdivision 4b. The 
178.27 	purpose of the screening is to determine the need for nursing facility level of care as 
178.28 	described in paragraph (d) and to complete activities required under federal law related to 
178.29 	mental illness and developmental disability as outlined in paragraph (b).
178.30 	(b) A person who has a diagnosis or possible diagnosis of mental illness or 
178.31 	developmental disability must receive a preadmission screening before admission 
178.32 	regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need 
178.33 	for further evaluation and specialized services, unless the admission prior to screening is 
178.34 	authorized by the local mental health authority or the local developmental disabilities case 
178.35 	manager, or unless authorized by the county agency according to Public Law 101-508.
179.1 	The following criteria apply to the preadmission screening:
179.2 	(1) the county must use forms and criteria developed by the commissioner to identify 
179.3 	persons who require referral for further evaluation and determination of the need for 
179.4 	specialized services; and
179.5 	(2) the evaluation and determination of the need for specialized services must be 
179.6 	done by:
179.7 	(i) a qualified independent mental health professional, for persons with a primary or 
179.8 	secondary diagnosis of a serious mental illness; or
179.9 	(ii) a qualified developmental disability professional, for persons with a primary or 
179.10 	secondary diagnosis of developmental disability. For purposes of this requirement, a 
179.11 	qualified developmental disability professional must meet the standards for a qualified 
179.12 	developmental disability professional under Code of Federal Regulations, title 42, section 
179.13 	483.430.
179.14 	(c) The local county mental health authority or the state developmental disability 
179.15 	authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 
179.16 	nursing facility if the individual does not meet the nursing facility level of care criteria or 
179.17 	needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 
179.18 	purposes of this section, "specialized services" for a person with developmental disability 
179.19 	means active treatment as that term is defined under Code of Federal Regulations, title 
179.20 	42, section 483.440 (a)(1).
179.21 	(d) The determination of the need for nursing facility level of care must be made 
179.22 	according to criteria established developed by the commissioner, and in section 144.0724, 
179.23 	subdivision 11, and256B.092, using forms developed by the commissioner. Effective no 
179.24 	sooner than on or after July 1, 2012, for individuals age 21 and older, and on or after 
179.25 	October 1, 2019, for individuals under age 21, the determination of need for nursing 
179.26 	facility level of care shall be based on criteria in section 144.0724, subdivision 11. In 
179.27 	assessing a person's needs, consultation team members shall have a physician available for 
179.28 	consultation and shall consider the assessment of the individual's attending physician, if 
179.29 	any. The individual's physician must be included if the physician chooses to participate. 
179.30 	Other personnel may be included on the team as deemed appropriate by the county.

179.31 	Sec. 16. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to 
179.32 	read:
179.33 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 179.34 	(a) Funding for services under the alternative care program is available to persons who 
179.35 	meet the following criteria:
180.1 	(1) the person has been determined by a community assessment under section 
180.2 	256B.0911 to be a person who would require the level of care provided in a nursing 
180.3 	facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for 
180.4 	the provision of services under the alternative care program. Effective January 1, 2011, 
180.5 	this determination must be made according to the criteria established in section 144.0724, 
180.6 	subdivision 11;
180.7 	(2) the person is age 65 or older;
180.8 	(3) the person would be eligible for medical assistance within 135 days of admission 
180.9 	to a nursing facility;
180.10 	(4) the person is not ineligible for the payment of long-term care services by the 
180.11 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
180.12 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
180.13 	(5) the person needs long-term care services that are not funded through other 
180.14 	state or federal funding, or other health insurance or other third-party insurance such as 
180.15 	long-term care insurance;
180.16 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
180.17 	care services funded by the program for this person does not exceed 75 percent of the 
180.18 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
180.19 	does not prohibit the alternative care client from payment for additional services, but in no 
180.20 	case may the cost of additional services purchased under this section exceed the difference 
180.21 	between the client's monthly service limit defined under section 256B.0915, subdivision 
180.22 	3, and the alternative care program monthly service limit defined in this paragraph. If 
180.23 	care-related supplies and equipment or environmental modifications and adaptations are or 
180.24 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
180.25 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
180.26 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
180.27 	limit established in this paragraph, the annual cost of the alternative care services shall be 
180.28 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
180.29 	times the monthly limit described in this paragraph;
180.30 	(7) for individuals assigned a case mix classification A as described under section 
180.31 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
180.32 	living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming, 
180.33 	or walking, or (iii) a dependency score of less than three if eating is the only dependency
180.34 	and eating when the dependency score in eating is three or greater as determined by 
180.35 	an assessment performed under section 256B.0911, the monthly cost of alternative 
180.36 	care services funded by the program cannot exceed $600 $593 per month for all new 
181.1 	participants enrolled in the program on or after July 1, 2009 2011. This monthly limit 
181.2 	shall be applied to all other participants who meet this criteria at reassessment. This 
181.3 	monthly limit shall be increased annually as described in section 256B.0915, subdivision 
181.4 	3a, paragraph (a). This monthly limit does not prohibit the alternative care client from 
181.5 	payment for additional services, but in no case may the cost of additional services 
181.6 	purchased exceed the difference between the client's monthly service limit defined in this 
181.7 	clause and the limit described in clause (6) for case mix classification A; and
181.8 	(8) the person is making timely payments of the assessed monthly fee.
181.9 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
181.10 	agrees to:
181.11 	(i) the appointment of a representative payee;
181.12 	(ii) automatic payment from a financial account;
181.13 	(iii) the establishment of greater family involvement in the financial management of 
181.14 	payments; or
181.15 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
181.16 	The lead agency may extend the client's eligibility as necessary while making 
181.17 	arrangements to facilitate payment of past-due amounts and future premium payments. 
181.18 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
181.19 	reinstated for a period of 30 days.
181.20 	(b) Alternative care funding under this subdivision is not available for a person 
181.21 	who is a medical assistance recipient or who would be eligible for medical assistance 
181.22 	without a spenddown or waiver obligation. A person whose initial application for medical 
181.23 	assistance and the elderly waiver program is being processed may be served under the 
181.24 	alternative care program for a period up to 60 days. If the individual is found to be eligible 
181.25 	for medical assistance, medical assistance must be billed for services payable under the 
181.26 	federally approved elderly waiver plan and delivered from the date the individual was 
181.27 	found eligible for the federally approved elderly waiver plan. Notwithstanding this 
181.28 	provision, alternative care funds may not be used to pay for any service the cost of which: 
181.29 	(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 
181.30 	or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 
181.31 	to participate in the federally approved elderly waiver program under the special income 
181.32 	standard provision.
181.33 	(c) Alternative care funding is not available for a person who resides in a licensed 
181.34 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
181.35 	for case management services which are provided in support of the discharge planning 
182.1 	process for a nursing home resident or certified boarding care home resident to assist with 
182.2 	a relocation process to a community-based setting.
182.3 	(d) Alternative care funding is not available for a person whose income is greater 
182.4 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
182.5 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
182.6 	year for which alternative care eligibility is determined, who would be eligible for the 
182.7 	elderly waiver with a waiver obligation.

182.8 	Sec. 17. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to 
182.9 	read:
182.10 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
182.11 	waivered services to an individual elderly waiver client except for individuals described 
182.12 	in paragraph (b) shall be the weighted average monthly nursing facility rate of the case 
182.13 	mix resident class to which the elderly waiver client would be assigned under Minnesota 
182.14 	Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance 
182.15 	as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in 
182.16 	which the resident assessment system as described in section 256B.438 for nursing home 
182.17 	rate determination is implemented. Effective on the first day of the state fiscal year in 
182.18 	which the resident assessment system as described in section 256B.438 for nursing home 
182.19 	rate determination is implemented and the first day of each subsequent state fiscal year, the 
182.20 	monthly limit for the cost of waivered services to an individual elderly waiver client shall 
182.21 	be the rate of the case mix resident class to which the waiver client would be assigned 
182.22 	under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the 
182.23 	previous state fiscal year, adjusted by the greater of any legislatively adopted home and 
182.24 	community-based services percentage rate increase or the average statewide percentage 
182.25 	increase in nursing facility payment rates adjustment.
182.26 	(b) The monthly limit for the cost of waivered services to an individual elderly 
182.27 	waiver client assigned to a case mix classification A under paragraph (a) with:
182.28 	(1) no dependencies in activities of daily living,; or
182.29 	(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
182.30 	walking, or (3) a dependency score of less than three if eating is the only dependency,
182.31 	and eating when the dependency score in eating is three or greater as determined by an 
182.32 	assessment performed under section 256B.0911
182.33 	 shall be the lower of the case mix classification amount for case mix A as determined 
182.34 	under paragraph (a) or the case mix classification amount for case mix A$1,750 per 
182.35 	month effective on October July 1, 2008 2011, per month for all new participants enrolled 
183.1 	in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all 
183.2 	other participants who meet this criteria at reassessment. This monthly limit shall be 
183.3 	increased annually as described in paragraph (a).
183.4 	(c) If extended medical supplies and equipment or environmental modifications are 
183.5 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
183.6 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
183.7 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
183.8 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
183.9 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
183.10 	services as described in paragraph (a) or (b).

183.11 	Sec. 18. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to 
183.12 	read:
183.13 		Subd. 3b.Cost limits for elderly waiver applicants who reside in a nursing 
183.14 	facility. (a) For a person who is a nursing facility resident at the time of requesting a 
183.15 	determination of eligibility for elderly waivered services, a monthly conversion budget 
183.16 	limit for the cost of elderly waivered services may be requested. The monthly conversion 
183.17 	budget limit for the cost of elderly waiver services shall be the resident class assigned 
183.18 	under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing 
183.19 	facility where the resident currently resides until July 1 of the state fiscal year in which 
183.20 	the resident assessment system as described in section 256B.438 for nursing home rate 
183.21 	determination is implemented. Effective on July 1 of the state fiscal year in which the 
183.22 	resident assessment system as described in section 256B.438 for nursing home rate 
183.23 	determination is implemented, the monthly conversion budget limit for the cost of elderly 
183.24 	waiver services shall be based on the per diem nursing facility rate as determined by the 
183.25 	resident assessment system as described in section 256B.438 for that resident residents
183.26 	in the nursing facility where the resident elderly waiver applicant currently resides 
183.27 	multiplied. The monthly conversion budget limit shall be calculated by multiplying the 
183.28 	per diem by 365 and,  divided by 12, less and reduced by  the recipient's maintenance needs 
183.29 	allowance as described in subdivision 1d. The initially approved monthly conversion rate 
183.30 	may budget limit shall be adjusted by the greater of any subsequent legislatively adopted 
183.31 	home and community-based services percentage rate increase or the average statewide 
183.32 	percentage increase in nursing facility payment rates annually as described in subdivision 
183.33 	3a, paragraph (a). The limit under this subdivision only applies to persons discharged from 
183.34 	a nursing facility after a minimum 30-day stay and found eligible for waivered services 
183.35 	on or after July 1, 1997. For conversions from the nursing home to the elderly waiver 
184.1 	with consumer directed community support services, the conversion rate limit is equal to 
184.2 	the nursing facility rate per diem used to calculate the monthly conversion budget limit 
184.3 	must be reduced by a percentage equal to the percentage difference between the consumer 
184.4 	directed services budget limit that would be assigned according to the federally approved 
184.5 	waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
184.6 	(b) The following costs must be included in determining the total monthly costs 
184.7 	for the waiver client:
184.8 	(1) cost of all waivered services, including extended medical specialized supplies 
184.9 	and equipment and environmental modifications and accessibility adaptations; and
184.10 	(2) cost of skilled nursing, home health aide, and personal care services reimbursable 
184.11 	by medical assistance.

184.12 	Sec. 19. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to 
184.13 	read:
184.14 		Subd. 3e.Customized living service rate. (a) Payment for customized living 
184.15 	services shall be a monthly rate authorized by the lead agency within the parameters 
184.16 	established by the commissioner. The payment agreement must delineate the amount of 
184.17 	each component service included in the recipient's customized living service plan. The 
184.18 	lead agency shall ensure that there is a documented need within the parameters established 
184.19 	by the commissioner for all component customized living services authorized.
184.20 	(b) The payment rate must be based on the amount of component services to be 
184.21 	provided utilizing component rates established by the commissioner. Counties and tribes 
184.22 	shall use tools issued by the commissioner to develop and document customized living 
184.23 	service plans and rates.
184.24 	(c) Component service rates must not exceed payment rates for comparable elderly 
184.25 	waiver or medical assistance services and must reflect economies of scale. Customized 
184.26 	living services must not include rent or raw food costs.
184.27 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
184.28 	individualized monthly authorized payment for the customized living service plan shall 
184.29 	not exceed 50 percent of the greater of either the statewide or any of the geographic 
184.30 	groups' weighted average monthly nursing facility rate of the case mix resident class 
184.31 	to which the elderly waiver eligible client would be assigned under Minnesota Rules, 
184.32 	parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 
184.33 	in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 
184.34 	resident assessment system as described in section 256B.438 for nursing home rate 
184.35 	determination is implemented. Effective on July 1 of the state fiscal year in which 
185.1 	the resident assessment system as described in section 256B.438 for nursing home 
185.2 	rate determination is implemented and July 1 of each subsequent state fiscal year, the 
185.3 	individualized monthly authorized payment for the services described in this clause shall 
185.4 	not exceed the limit which was in effect on June 30 of the previous state fiscal year 
185.5 	updated annually based on legislatively adopted changes to all service rate maximums for 
185.6 	home and community-based service providers.
185.7 	(e) Effective July 1, 2011, the individualized monthly payment for the customized 
185.8 	living service plan for individuals described in subdivision 3a, paragraph (b), must be the 
185.9 	monthly authorized payment limit for customized living for individuals classified as case 
185.10 	mix A, reduced by 25 percent. This rate limit must be applied to all new participants 
185.11 	enrolled in the program on or after July 1, 2011, who meet the criteria described in 
185.12 	subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 
185.13 	meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
185.14 	(e) (f) Customized living services are delivered by a provider licensed by the 
185.15 	Department of Health as a class A or class F home care provider and provided in a 
185.16 	building that is registered as a housing with services establishment under chapter 144D.
185.17 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
185.18 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
185.19 	family for additional units of any allowable component service beyond those available 
185.20 	under the service rate limits described in paragraph (d), nor for additional units of any 
185.21 	allowable component service beyond those approved in the service plan by the lead agency.

185.22 	Sec. 20. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to 
185.23 	read:
185.24 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The 
185.25 	payment rate for 24-hour customized living services is a monthly rate authorized by the 
185.26 	lead agency within the parameters established by the commissioner of human services. 
185.27 	The payment agreement must delineate the amount of each component service included in 
185.28 	each recipient's customized living service plan. The lead agency shall ensure that there is a 
185.29 	documented need within the parameters established by the commissioner for all component 
185.30 	customized living services authorized. The lead agency shall not authorize 24-hour 
185.31 	customized living services unless there is a documented need for 24-hour supervision.
185.32 	(b) For purposes of this section, "24-hour supervision" means that the recipient 
185.33 	requires assistance due to needs related to one or more of the following:
185.34 	(1) intermittent assistance with toileting, positioning, or transferring;
185.35 	(2) cognitive or behavioral issues;
186.1 	(3) a medical condition that requires clinical monitoring; or
186.2 	(4) for all new participants enrolled in the program on or after January July 1, 2011, 
186.3 	and all other participants at their first reassessment after January July 1, 2011, dependency 
186.4 	in at least two three of the following activities of daily living as determined by assessment 
186.5 	under section 256B.0911: bathing; dressing; grooming; walking; or eating when the 
186.6 	dependency score in eating is three or greater; and needs medication management and at 
186.7 	least 50 hours of service per month. The lead agency shall ensure that the frequency and 
186.8 	mode of supervision of the recipient and the qualifications of staff providing supervision 
186.9 	are described and meet the needs of the recipient.
186.10 	(c) The payment rate for 24-hour customized living services must be based on the 
186.11 	amount of component services to be provided utilizing component rates established by the 
186.12 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
186.13 	and document customized living plans and authorize rates.
186.14 	(d) Component service rates must not exceed payment rates for comparable elderly 
186.15 	waiver or medical assistance services and must reflect economies of scale.
186.16 	(e) The individually authorized 24-hour customized living payments, in combination 
186.17 	with the payment for other elderly waiver services, including case management, must not 
186.18 	exceed the recipient's community budget cap specified in subdivision 3a. Customized 
186.19 	living services must not include rent or raw food costs.
186.20 	(f) The individually authorized 24-hour customized living payment rates shall not 
186.21 	exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 
186.22 	living services in effect and in the Medicaid management information systems on March 
186.23 	31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 
186.24 	to 9549.0059, to which elderly waiver service clients are assigned. When there are 
186.25 	fewer than 50 authorizations in effect in the case mix resident class, the commissioner 
186.26 	shall multiply the calculated service payment rate maximum for the A classification by 
186.27 	the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 
186.28 	9549.0059, to determine the applicable payment rate maximum. Service payment rate 
186.29 	maximums shall be updated annually based on legislatively adopted changes to all service 
186.30 	rates for home and community-based service providers.
186.31 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 
186.32 	may establish alternative payment rate systems for 24-hour customized living services in 
186.33 	housing with services establishments which are freestanding buildings with a capacity of 
186.34 	16 or fewer, by applying a single hourly rate for covered component services provided 
186.35 	in either:
186.36 	(1) licensed corporate adult foster homes; or
187.1 	(2) specialized dementia care units which meet the requirements of section 144D.065 
187.2 	and in which:
187.3 	(i) each resident is offered the option of having their own apartment; or
187.4 	(ii) the units are licensed as board and lodge establishments with maximum capacity 
187.5 	of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
187.6 	subparts 1, 2, 3, and 4, item A.
187.7 	(h) A provider may not bill or otherwise charge an elderly waiver participant or their 
187.8 	family for additional units of any allowable component service beyond those available 
187.9 	under the service rate limits described in paragraph (e), nor for additional units of any 
187.10 	allowable component service beyond those approved in the service plan by the lead agency.

187.11 	Sec. 21. Minnesota Statutes 2010, section 256B.0915, subdivision 5, is amended to 
187.12 	read:
187.13 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client 
187.14 	shall receive an initial assessment of strengths, informal supports, and need for services 
187.15 	in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 
187.16 	client served under the elderly waiver must be conducted at least every 12 months and 
187.17 	at other times when the case manager determines that there has been significant change 
187.18 	in the client's functioning. This may include instances where the client is discharged 
187.19 	from the hospital. There must be a determination that the client requires nursing facility 
187.20 	level of care as defined in section 144.0724, subdivision 11 256B.0911, subdivision 4a, 
187.21 	paragraph (d), at initial and subsequent assessments to initiate and maintain participation 
187.22 	in the waiver program.
187.23 	(b) Regardless of other assessments identified in section 144.0724, subdivision 
187.24 	4, as appropriate to determine nursing facility level of care for purposes of medical 
187.25 	assistance payment for nursing facility services, only face-to-face assessments conducted 
187.26 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
187.27 	level of care determination will be accepted for purposes of initial and ongoing access to 
187.28 	waiver service payment.

187.29 	Sec. 22. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to 
187.30 	read:
187.31 		Subd. 10.Waiver payment rates; managed care organizations. The 
187.32 	commissioner shall adjust the elderly waiver capitation payment rates for managed care 
187.33 	organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum 
187.34 	service rate limits for customized living services and 24-hour customized living services 
188.1 	under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical 
188.2 	assistance rates paid to customized living providers by managed care organizations under 
188.3 	this section shall not exceed the maximum service rate limits and component rates as 
188.4 	determined by the commissioner under subdivisions 3e and 3h.

188.5 	Sec. 23. [256B.0961] STATE QUALITY ASSURANCE, QUALITY 
188.6 	IMPROVEMENT, AND LICENSING SYSTEM.
188.7 		Subdivision 1.Scope. (a) In order to improve the quality of services provided to 
188.8 	Minnesotans with disabilities and to meet the requirements of the federally approved 
188.9 	home and community-based waivers under section 1915c of the Social Security Act, a 
188.10 	State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans 
188.11 	receiving disability services is enacted. This system is a partnership between the 
188.12 	Department of Human Services and the State Quality Council established under 
188.13 	subdivision 3.
188.14 	(b) This system is a result of the recommendations from the Department of Human 
188.15 	Services' licensing and alternative quality assurance study mandated under Laws 2005, 
188.16 	First Special Session chapter 4, article 7, section 57, and presented to the legislature 
188.17 	in February 2007.
188.18 	(c) The disability services eligible under this section include:
188.19 	(1) the home and community-based services waiver programs for persons with 
188.20 	developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, 
188.21 	including traumatic brain injuries and services for those who qualify for nursing facility 
188.22 	level of care or hospital facility level of care;
188.23 	(2) home care services under section 256B.0651;
188.24 	(3) family support grants under section 252.32;
188.25 	(4) consumer support grants under section 256.476;
188.26 	(5) semi-independent living services under section 252.275; and
188.27 	(6) services provided through an intermediate care facility for the developmentally 
188.28 	disabled.
188.29 	(d) For purposes of this section, the following definitions apply:
188.30 	(1) "commissioner" means the commissioner of human services;
188.31 	(2) "council" means the State Quality Council under subdivision 3;
188.32 	(3) "Quality Assurance Commission" means the commission under section 
188.33 	256B.0951; and
188.34 	(4) "system" means the State Quality Assurance, Quality Improvement and 
188.35 	Licensing System under this section.
189.1 		Subd. 2.Duties of the commissioner of human services. (a) The commissioner of 
189.2 	human services shall establish the State Quality Council under subdivision 3.
189.3 	(b) The commissioner shall initially delegate authority to perform licensing 
189.4 	functions and activities according to section 245A.16 to a host county in Region 10. The 
189.5 	commissioner must not license or reimburse a participating facility, program, or service 
189.6 	located in Region 10 if the commissioner has received notification from the host county 
189.7 	that the facility, program, or service has failed to qualify for licensure.
189.8 	(c) The commissioner may conduct random licensing inspections based on outcomes 
189.9 	adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services 
189.10 	eligible under this section. The role of the random inspections is to verify that the system 
189.11 	protects the safety and well-being of persons served and maintains the availability of 
189.12 	high-quality services for persons with disabilities.
189.13 	(d) The commissioner shall ensure that the federal home and community-based 
189.14 	waiver requirements are met and that incidents that may have jeopardized safety and health 
189.15 	or violated services-related assurances, civil and human rights, and other protections 
189.16 	designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and 
189.17 	acted upon in a timely manner.
189.18 	(e) The commissioner shall seek a federal waiver by July 1, 2012 to allow 
189.19 	intermediate care facilities for persons with developmental disabilities to participate in 
189.20 	this system.
189.21 		Subd. 3.State Quality Council. (a) There is hereby created a State Quality 
189.22 	Council which must define regional quality councils, and carry out a community-based, 
189.23 	person-directed quality review component, and a comprehensive system for effective 
189.24 	incident reporting, investigation, analysis, and follow-up.
189.25 	(b) By August 1, 2011, the commissioner of human services shall appoint the 
189.26 	members of the initial State Quality Council. Members shall include representatives 
189.27 	from the following groups:
189.28 	(1) disability service recipients and their family members; 
189.29 	(2) during the first two years of the State Quality Council, there must be at least three 
189.30 	members from the Region 10 stakeholders. As regional quality councils are formed under 
189.31 	subdivision 4, each regional quality council shall appoint one member;
189.32 	(3) disability service providers;
189.33 	(4) disability advocacy groups; and
189.34 	(5) county human services agencies and staff from the Department of Human 
189.35 	Services and Ombudsman for Mental Health and Developmental Disabilities.
190.1 	(c) Members of the council who do not receive a salary or wages from an employer 
190.2 	for time spent on council duties may receive a per diem payment when performing council 
190.3 	duties and functions.
190.4 	(d) The State Quality Council shall:
190.5 	(1) assist the Department of Human Services in fulfilling federally mandated 
190.6 	obligations by monitoring disability service quality and quality assurance and 
190.7 	improvement practices in Minnesota; and
190.8 	(2) establish state quality improvement priorities with methods for achieving results 
190.9 	and provide an annual report to the legislative committees with jurisdiction over policy 
190.10 	and funding of disability services on the outcomes, improvement priorities, and activities 
190.11 	undertaken by the commission during the previous state fiscal year.
190.12 	(e) The State Quality Council, in partnership with the commissioner, shall:
190.13 	(1) approve and direct implementation of the community-based, person-directed 
190.14 	system established in this section;
190.15 	(2) recommend an appropriate method of funding this system, and determine the 
190.16 	feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
190.17 	(3) approve measurable outcomes in the areas of health and safety, consumer 
190.18 	evaluation, education and training, providers, and systems;
190.19 	(4) establish variable licensure periods not to exceed three years based on outcomes 
190.20 	achieved; and
190.21 	(5) in cooperation with the Quality Assurance Commission, design a transition plan 
190.22 	for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
190.23 	(f) The State Quality Council shall notify the commissioner of human services that a 
190.24 	facility, program, or service has been reviewed by quality assurance team members under 
190.25 	subdivision 4, paragraph (b), clause (13), and qualifies for a license.
190.26 	(g) The State Quality Council, in partnership with the commissioner, shall establish 
190.27 	an ongoing review process for the system. The review shall take into account the 
190.28 	comprehensive nature of the system which is designed to evaluate the broad spectrum of 
190.29 	licensed and unlicensed entities that provide services to persons with disabilities. The 
190.30 	review shall address efficiencies and effectiveness of the system.
190.31 	(h) The State Quality Council may recommend to the commissioner certain 
190.32 	variances from the standards governing licensure of programs for persons with disabilities 
190.33 	in order to improve the quality of services so long as the recommended variances do 
190.34 	not adversely affect the health or safety of persons being served or compromise the 
190.35 	qualifications of staff to provide services.
191.1 	(i) The safety standards, rights, or procedural protections referenced under 
191.2 	subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make 
191.3 	recommendations to the commissioner or to the legislature in the report required under 
191.4 	paragraph (c) regarding alternatives or modifications to the safety standards, rights, or 
191.5 	procedural protections referenced under subdivision 2, paragraph (c).
191.6 	(j) The State Quality Council may hire staff to perform the duties assigned in this 
191.7 	subdivision.
191.8 		Subd. 4.Regional quality councils. (a) The commissioner shall establish, as 
191.9 	selected by the State Quality Council, regional quality councils of key stakeholders, 
191.10 	including regional representatives of:
191.11 	(1) disability service recipients and their family members;
191.12 	(2) disability service providers;
191.13 	(3) disability advocacy groups; and
191.14 	(4) county human services agencies and staff from the Department of Human 
191.15 	Services and Ombudsman for Mental Health and Developmental Disabilities.
191.16 	(b) Each regional quality council shall:
191.17 	(1) direct and monitor the community-based, person-directed quality assurance 
191.18 	system in this section;
191.19 	(2) approve a training program for quality assurance team members under clause 
191.20 	(13);
191.21 	(3) review summary reports from quality assurance team reviews and make 
191.22 	recommendations to the State Quality Council regarding program licensure;
191.23 	(4) make recommendations to the State Quality Council regarding the system;
191.24 	(5) resolve complaints between the quality assurance teams, counties, providers, 
191.25 	persons receiving services, their families, and legal representatives;
191.26 	(6) analyze and review quality outcomes and critical incident data reporting 
191.27 	incidents of life safety concerns immediately to the Department of Human Services 
191.28 	licensing division;
191.29 	(7) provide information and training programs for persons with disabilities and their 
191.30 	families and legal representatives on service options and quality expectations;
191.31 	(8) disseminate information and resources developed to other regional quality 
191.32 	councils;
191.33 	(9) respond to state-level priorities;
191.34 	(10) establish regional priorities for quality improvement;
191.35 	(11) submit an annual report to the State Quality Council on the status, outcomes, 
191.36 	improvement priorities, and activities in the region;
192.1 	(12) choose a representative to participate on the State Quality Council and assume 
192.2 	other responsibilities consistent with the priorities of the State Quality Council; and
192.3 	(13) recruit, train, and assign duties to members of quality assurance teams, taking 
192.4 	into account the size of the service provider, the number of services to be reviewed, 
192.5 	the skills necessary for the team members to complete the process, and ensure that no 
192.6 	team member has a financial, personal, or family relationship with the facility, program, 
192.7 	or service being reviewed or with anyone served at the facility, program, or service. 
192.8 	Quality assurance teams must be comprised of county staff, persons receiving services 
192.9 	or the person's families, legal representatives, members of advocacy organizations, 
192.10 	providers, and other involved community members. Team members must complete 
192.11 	the training program approved by the regional quality council and must demonstrate 
192.12 	performance-based competency. Team members may be paid a per diem and reimbursed 
192.13 	for expenses related to their participation in the quality assurance process.
192.14 	(c) The commissioner shall monitor the safety standards, rights, and procedural 
192.15 	protections for the monitoring of psychotropic medications and those identified under 
192.16 	sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2) 
192.17 	and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause 
192.18 	(7); 626.556; and 626.557.
192.19 	(d) The regional quality councils may hire staff to perform the duties assigned in 
192.20 	this subdivision.
192.21 	(e) The regional quality councils may charge fees for their services.
192.22 	(f) The quality assurance process undertaken by a regional quality council consists of 
192.23 	an evaluation by a quality assurance team of the facility, program, or service. The process 
192.24 	must include an evaluation of a random sample of persons served. The sample must be 
192.25 	representative of each service provided. The sample size must be at least five percent but 
192.26 	not less than two persons served. All persons must be given the opportunity to be included 
192.27 	in the quality assurance process in addition to those chosen for the random sample.
192.28 	(g) A facility, program, or service may contest a licensing decision of the regional 
192.29 	quality council as permitted under chapter 245A.
192.30 		Subd. 5.Annual survey of service recipients. The commissioner, in consultation 
192.31 	with the State Quality Council, shall conduct an annual independent statewide survey 
192.32 	of service recipients, randomly selected, to determine the effectiveness and quality 
192.33 	of disability services. The survey must be consistent with the system performance 
192.34 	expectations of the Centers for Medicare and Medicaid Services (CMS) Quality 
192.35 	Framework. The survey must analyze whether desired outcomes for persons with different 
192.36 	demographic, diagnostic, health, and functional needs, who are receiving different types 
193.1 	of services in different settings and with different costs, have been achieved. Annual 
193.2 	statewide and regional reports of the results must be published and used to assist regions, 
193.3 	counties, and providers to plan and measure the impact of quality improvement activities.
193.4 		Subd. 6.Mandated reporters. Members of the State Quality Council under 
193.5 	subdivision 3, the regional quality councils under subdivision 4, and quality assurance 
193.6 	team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as 
193.7 	defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16.

193.8 	EFFECTIVE DATE. (a) Subdivisions 1 to 6 are effective July 1, 2011.
193.9 	(b) The jurisdictions of the regional quality councils in subdivision 4 must be 
193.10 	defined, with implementation dates, by July 1, 2012. During the biennium beginning July 
193.11 	1, 2011, the Quality Assurance Commission shall continue to implement the alternative 
193.12 	licensing system under this section.

193.13 	Sec. 24. Minnesota Statutes 2010, section 256B.19, subdivision 1e, is amended to read:
193.14 		Subd. 1e.Additional local share of certain nursing facility costs. Beginning 
193.15 	January October  1, 2011, participating local government governmental  entities that own 
193.16 	the physical plant or are the license holders of nursing facilities receiving rate adjustments 
193.17 	under section 256B.441, subdivision 55a, shall be responsible for paying the portion of 
193.18 	nonfederal costs calculated under section 256B.441, subdivision 55a, paragraph (d) (e). 
193.19 	Payments of the nonfederal share shall be made monthly submitted to the commissioner in 
193.20 	amounts determined in accordance with section 256B.441, subdivision 55a, paragraph (d). 
193.21 	Payments for each month beginning in January 2011 through September 2015 shall be due
193.22 	by the 15th day of the following month prior to payment to the nursing facility for that 
193.23 	month's services. If any providerparticipating governmental entity obligated to pay an 
193.24 	amount under this subdivision is more than two months delinquent in the does not make 
193.25 	 timely payment of the monthly installment, the commissioner may withhold payments, 
193.26 	penalties, and interest in accordance with the methods outlined in section 256.9657, 
193.27 	subdivision 7a. shall revoke participation under this subdivision and end payments 
193.28 	determined under section 256B.441, subdivision 55a, to the participating nursing facility 
193.29 	effective on the first day of the month for which timely payment was not received. In the 
193.30 	event of revocation, the nursing facility may not bill, collect, or retain the amount allowed 
193.31 	in section 256B.441, subdivision 55a, from private-pay residents for days of service on or 
193.32 	after the first day of the month following the month in which the revocation occurred.

193.33 	Sec. 25. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to 
193.34 	read:
194.1 		Subd. 2r.Payment restrictions on leave days. (a) Effective July 1, 1993, the 
194.2 	commissioner shall limit payment for leave days in a nursing facility to 79 percent of that 
194.3 	nursing facility's total payment rate for the involved resident. 
194.4 	(b) For services rendered on or after July 1, 2003, for facilities reimbursed under this 
194.5 	section or section 256B.434, the commissioner shall limit payment for leave days in a 
194.6 	nursing facility to 60 percent of that nursing facility's total payment rate for the involved 
194.7 	resident.
194.8 	(c) For services rendered on or after July 1, 2011, for facilities reimbursed under 
194.9 	this chapter, the commissioner shall limit payment for leave days in a nursing facility 
194.10 	to 30 percent of that nursing facility's total payment rate for the involved resident, and 
194.11 	shall allow this payment only when the occupancy of the nursing facility, inclusive of 
194.12 	bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules, 
194.13 	part 9505.0415.

194.14 	Sec. 26. Minnesota Statutes 2010, section 256B.431, subdivision 2t, is amended to 
194.15 	read:
194.16 		Subd. 2t.Payment limitation. For services rendered on or after July 1, 2003, 
194.17 	for facilities reimbursed under this section or section 256B.434 chapter, the Medicaid 
194.18 	program shall only pay a co-payment during a Medicare-covered skilled nursing facility 
194.19 	stay if the Medicare rate less the resident's co-payment responsibility is less than the 
194.20 	Medicaid RUG-III case-mix payment rate, or, beginning January 1, 2012, the Medicaid 
194.21 	RUG-IV case-mix payment rate. The amount that shall be paid by the Medicaid program 
194.22 	is equal to the amount by which the Medicaid RUG-III or RUG-IV case-mix payment 
194.23 	rate exceeds the Medicare rate less the co-payment responsibility. Health plans paying 
194.24 	for nursing home services under section 256B.69, subdivision 6a, may limit payments as 
194.25 	allowed under this subdivision.

194.26 	Sec. 27. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to 
194.27 	read:
194.28 		Subd. 32.Payment during first 90 30 days. (a) For rate years beginning on or after 
194.29 	July 1, 2001, the total payment rate for a facility reimbursed under this section, section 
194.30 	256B.434, or any other section for the first 90 paid days after admission shall be:
194.31 	(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical 
194.32 	assistance rate for each case mix class;
194.33 	(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent 
194.34 	of the facility's medical assistance rate for each case mix class;
195.1 	(3) beginning with the 91st paid day after admission, the payment rate shall be the 
195.2 	rate otherwise determined under this section, section 256B.434, or any other section; and
195.3 	(4) payments under this paragraph apply to admissions occurring on or after July 1, 
195.4 	2001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
195.5 	(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for 
195.6 	a facility reimbursed under this section, section 256B.434, or any other section shall be:
195.7 	(1) for the first 30 calendar days after admission, the rate shall be 120 percent of 
195.8 	the facility's medical assistance rate for each RUG class;
195.9 	(2) beginning with the 31st calendar day after admission, the payment rate shall be 
195.10 	the rate otherwise determined under this section, section 256B.434, or any other section; 
195.11 	and
195.12 	(3) payments under this paragraph apply to admissions occurring on or after July 
195.13 	1, 2003 2011.
195.14 	(c) Effective January 1, 2004, (b)  The enhanced rates under this subdivision shall not 
195.15 	be allowed if a resident has resided during the previous 30 calendar days in:
195.16 	(1) the same nursing facility;
195.17 	(2) a nursing facility owned or operated by a related party; or
195.18 	(3) a nursing facility or part of a facility that closed or was in the process of closing.

195.19 	Sec. 28. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:
195.20 		Subd. 4.Alternate rates for nursing facilities. (a) For nursing facilities which 
195.21 	have their payment rates determined under this section rather than section 256B.431, the 
195.22 	commissioner shall establish a rate under this subdivision. The nursing facility must enter 
195.23 	into a written contract with the commissioner.
195.24 	(b) A nursing facility's case mix payment rate for the first rate year of a facility's 
195.25 	contract under this section is the payment rate the facility would have received under 
195.26 	section 256B.431.
195.27 	(c) A nursing facility's case mix payment rates for the second and subsequent years 
195.28 	of a facility's contract under this section are the previous rate year's contract payment 
195.29 	rates plus an inflation adjustment and, for facilities reimbursed under this section or 
195.30 	section 256B.431, an adjustment to include the cost of any increase in Health Department 
195.31 	licensing fees for the facility taking effect on or after July 1, 2001. The index for the 
195.32 	inflation adjustment must be based on the change in the Consumer Price Index-All Items 
195.33 	(United States City average) (CPI-U) forecasted by the commissioner of management and 
195.34 	budget's national economic consultant, as forecasted in the fourth quarter of the calendar 
195.35 	year preceding the rate year. The inflation adjustment must be based on the 12-month 
196.1 	period from the midpoint of the previous rate year to the midpoint of the rate year for 
196.2 	which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 
196.3 	2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, 
196.4 	July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, October 1, 2011, and 
196.5 	October 1, 2012. this paragraph shall apply only to the property-related payment rate, 
196.6 	except that adjustments to include the cost of any increase in Health Department licensing 
196.7 	fees taking effect on or after July 1, 2001, shall be provided. For the rate years beginning 
196.8 	on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall 
196.9 	be suspended. Beginning in 2005, adjustment to the property payment rate under this 
196.10 	section and section 256B.431 shall be effective on October 1. In determining the amount 
196.11 	of the property-related payment rate adjustment under this paragraph, the commissioner 
196.12 	shall determine the proportion of the facility's rates that are property-related based on the 
196.13 	facility's most recent cost report.
196.14 	(d) The commissioner shall develop additional incentive-based payments of up to 
196.15 	five percent above a facility's operating payment rate for achieving outcomes specified 
196.16 	in a contract. The commissioner may solicit contract amendments and implement those 
196.17 	which, on a competitive basis, best meet the state's policy objectives. The commissioner 
196.18 	shall limit the amount of any incentive payment and the number of contract amendments 
196.19 	under this paragraph to operate the incentive payments within funds appropriated for this 
196.20 	purpose. The contract amendments may specify various levels of payment for various 
196.21 	levels of performance. Incentive payments to facilities under this paragraph may be in the 
196.22 	form of time-limited rate adjustments or onetime supplemental payments. In establishing 
196.23 	the specified outcomes and related criteria, the commissioner shall consider the following 
196.24 	state policy objectives:
196.25 	(1) successful diversion or discharge of residents to the residents' prior home or other 
196.26 	community-based alternatives;
196.27 	(2) adoption of new technology to improve quality or efficiency;
196.28 	(3) improved quality as measured in the Nursing Home Report Card;
196.29 	(4) reduced acute care costs; and
196.30 	(5) any additional outcomes proposed by a nursing facility that the commissioner 
196.31 	finds desirable.
196.32 	(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 
196.33 	take action to come into compliance with existing or pending requirements of the life 
196.34 	safety code provisions or federal regulations governing sprinkler systems must receive 
196.35 	reimbursement for the costs associated with compliance if all of the following conditions 
196.36 	are met:
197.1 	(1) the expenses associated with compliance occurred on or after January 1, 2005, 
197.2 	and before December 31, 2008;
197.3 	(2) the costs were not otherwise reimbursed under subdivision 4f or section 
197.4 	144A.071 or 144A.073; and
197.5 	(3) the total allowable costs reported under this paragraph are less than the minimum 
197.6 	threshold established under section 256B.431, subdivision 15, paragraph (e), and 
197.7 	subdivision 16.
197.8 	The commissioner shall use money appropriated for this purpose to provide to qualifying 
197.9 	nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 
197.10 	2008. Nursing facilities that have spent money or anticipate the need to spend money 
197.11 	to satisfy the most recent life safety code requirements by (1) installing a sprinkler 
197.12 	system or (2) replacing all or portions of an existing sprinkler system may submit to the 
197.13 	commissioner by June 30, 2007, on a form provided by the commissioner the actual 
197.14 	costs of a completed project or the estimated costs, based on a project bid, of a planned 
197.15 	project. The commissioner shall calculate a rate adjustment equal to the allowable 
197.16 	costs of the project divided by the resident days reported for the report year ending 
197.17 	September 30, 2006. If the costs from all projects exceed the appropriation for this 
197.18 	purpose, the commissioner shall allocate the money appropriated on a pro rata basis 
197.19 	to the qualifying facilities by reducing the rate adjustment determined for each facility 
197.20 	by an equal percentage. Facilities that used estimated costs when requesting the rate 
197.21 	adjustment shall report to the commissioner by January 31, 2009, on the use of this 
197.22 	money on a form provided by the commissioner. If the nursing facility fails to provide 
197.23 	the report, the commissioner shall recoup the money paid to the facility for this purpose. 
197.24 	If the facility reports expenditures allowable under this subdivision that are less than 
197.25 	the amount received in the facility's annualized rate adjustment, the commissioner shall 
197.26 	recoup the difference.

197.27 	Sec. 29. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
197.28 		Subd. 6.Planned closure rate adjustment. (a) The commissioner of human 
197.29 	services shall calculate the amount of the planned closure rate adjustment available under 
197.30 	subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
197.31 	(1) the amount available is the net reduction of nursing facility beds multiplied 
197.32 	by $2,080;
197.33 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
197.34 	closure rate adjustment must be identified;
198.1 	(3) capacity days are determined by multiplying the number determined under 
198.2 	clause (2) by 365; and
198.3 	(4) the planned closure rate adjustment is the amount available in clause (1), divided 
198.4 	by capacity days determined under clause (3).
198.5 	(b) A planned closure rate adjustment under this section is effective on the first day 
198.6 	of the month following completion of closure of the facility designated for closure in the 
198.7 	application and becomes part of the nursing facility's total operating payment rate.
198.8 	(c) Applicants may use the planned closure rate adjustment to allow for a property 
198.9 	payment for a new nursing facility or an addition to an existing nursing facility or as an 
198.10 	operating payment rate adjustment. Applications approved under this subdivision are 
198.11 	exempt from other requirements for moratorium exceptions under section 144A.073, 
198.12 	subdivisions 2 and 3.
198.13 	(d) Upon the request of a closing facility, the commissioner must allow the facility a 
198.14 	closure rate adjustment as provided under section 144A.161, subdivision 10.
198.15 	(e) A facility that has received a planned closure rate adjustment may reassign it 
198.16 	to another facility that is under the same ownership at any time within three years of its 
198.17 	effective date. The amount of the adjustment shall be computed according to paragraph (a).
198.18 	(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, 
198.19 	the commissioner shall recalculate planned closure rate adjustments for facilities that 
198.20 	delicense beds under this section on or after July 1, 2001, to reflect the increase in the per 
198.21 	bed dollar amount. The recalculated planned closure rate adjustment shall be effective 
198.22 	from the date the per bed dollar amount is increased.
198.23 	(g) For planned closures approved after June 30, 2009, the commissioner of human 
198.24 	services shall calculate the amount of the planned closure rate adjustment available under 
198.25 	subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
198.26 	(h) Beginning July 16, 2011, the commissioner shall no longer accept applications 
198.27 	for planned closure rate adjustments under subdivision 3.

198.28 	Sec. 30. Minnesota Statutes 2010, section 256B.438, subdivision 1, is amended to read:
198.29 		Subdivision 1.Scope. This section establishes the method and criteria used to 
198.30 	determine resident reimbursement classifications based upon the assessments of residents 
198.31 	of nursing homes and boarding care homes whose payment rates are established under 
198.32 	section 256B.431, 256B.434, or 256B.435256B.441 or any other section. Resident 
198.33 	reimbursement classifications shall be established according to the 34 group, resource 
198.34 	utilization groups, version III or RUG-III model as described in section 144.0724. 
198.35 	Reimbursement classifications established under this section shall be implemented 
199.1 	after June 30, 2002, but no later than January 1, 2003. Reimbursement classifications 
199.2 	established under this section shall be implemented no earlier than six weeks after the 
199.3 	commissioner mails notices of payment rates to the facilities. Effective January 1, 2012, 
199.4 	resident reimbursement classifications shall be established according to the 48 group, 
199.5 	resource utilization groups, RUG-IV model under section 144.0724.

199.6 	Sec. 31. Minnesota Statutes 2010, section 256B.438, subdivision 3, is amended to read:
199.7 		Subd. 3.Case mix indices. (a) The commissioner of human services shall assign a 
199.8 	case mix index to each resident class based on the Centers for Medicare and Medicaid 
199.9 	Services staff time measurement study and adjusted for Minnesota-specific wage indices. 
199.10 	The case mix indices assigned to each resident class shall be published in the Minnesota 
199.11 	State Register at least 120 days prior to the implementation of the 34 group, RUG-III 
199.12 	resident classification system.
199.13 	(b) An index maximization approach shall be used to classify residents.
199.14 	(c) After implementation of the revised case mix system, the commissioner of 
199.15 	human services may annually rebase case mix indices and base rates using more current 
199.16 	data on average wage rates and staff time measurement studies. This rebasing shall be 
199.17 	calculated under subdivision 7, paragraph (b). The commissioner shall publish in the 
199.18 	Minnesota State Register adjusted case mix indices at least 45 days prior to the effective 
199.19 	date of the adjusted case mix indices.
199.20 	(d) Upon implementation of the 48-group RUG-IV resident classification system, the 
199.21 	commissioner of human services shall assign a case mix index to each resident class based 
199.22 	on the Centers for Medicare and Medicaid Services staff time measurement study. The 
199.23 	case mix indices assigned to each resident class shall be published in the State Register at 
199.24 	least 120 days prior to the implementation of the RUG-IV resident classification system.

199.25 	Sec. 32. Minnesota Statutes 2010, section 256B.438, subdivision 4, is amended to read:
199.26 		Subd. 4.Resident assessment schedule. (a) Nursing facilities shall conduct and 
199.27 	submit case mix assessments according to the schedule established by the commissioner 
199.28 	of health under section 144.0724, subdivisions 4 and 5.
199.29 	(b) The resident reimbursement classifications established under section 144.0724, 
199.30 	subdivision 3, shall be effective the day of admission for new admission assessments. 
199.31 	The effective date for significant change assessments shall be the assessment reference 
199.32 	date. The effective date for annual and quarterly assessments shall be the first day of the 
199.33 	month following assessment reference date.
200.1 	(c) Effective October 1, 2006, the commissioner shall rebase payment rates 
200.2 	to account for the change in the resident assessment schedule in section 144.0724, 
200.3 	subdivision 4, paragraph (b), clause (4), in a facility specific budget neutral manner, 
200.4 	according to subdivision 7, paragraph (b).
200.5 	(d) Effective January 1, 2012, the commissioner shall determine payment rates 
200.6 	to account for the transition to RUG-IV, in a facility-specific, revenue-neutral manner, 
200.7 	according to subdivision 8, paragraph (b).

200.8 	Sec. 33. Minnesota Statutes 2010, section 256B.438, is amended by adding a 
200.9 	subdivision to read:
200.10 		Subd. 8.Rate determination upon transition to RUG-IV payment rates. (a) The 
200.11 	commissioner of human services shall determine payment rates at the time of transition 
200.12 	to the RUG-IV-based payment model in a facility-specific, revenue-neutral manner. To 
200.13 	transition from the current calculation methodology to the RUG-IV-based methodology, 
200.14 	nursing facilities shall report to the commissioner of human services the private pay 
200.15 	and Medicaid resident days classified according to the categories defined in subdivision 
200.16 	3, paragraphs (a) and (d), for the six-month reporting period ending June 30, 2011. This 
200.17 	report must be submitted to the commissioner, in a form prescribed by the commissioner, 
200.18 	by August 15, 2011. The commissioner of human services shall use this data to compute 
200.19 	the standardized days for the RUG-III and RUG-IV classification systems.
200.20 	(b) The commissioner of human services shall determine the case mix adjusted 
200.21 	component for the January 1, 2012, rate as follows:
200.22 	(1) using the September 30, 2010, cost report, determine the case mix portion of the 
200.23 	operating cost for each facility;
200.24 	(2) multiply the 36 operating payment rates in effect on December 31, 2011, by the 
200.25 	number of private pay and Medicaid resident days assigned to each group for the reporting 
200.26 	period ending June 30, 2011, and compute the total;
200.27 	(3) compute the product of the amounts in clauses (1) and (2);
200.28 	(4) determine the private pay and Medicaid RUG standardized days for the reporting 
200.29 	period ending June 30, 2011, using the new indices calculated under subdivision 3, 
200.30 	paragraph (d);
200.31 	(5) divide the amount determined in clause (3) by the amount in clause (4), which 
200.32 	shall be the default rate (DDF) unadjusted case mix component of the rate under the 
200.33 	RUG-IV method; and
201.1 	(6) determine the case mix adjusted component of each operating rate by multiplying 
201.2 	the default rate (DDF) unadjusted case mix component by the case mix weight in 
201.3 	subdivision 3, paragraph (d), for each RUG-IV group.
201.4 	(c) The noncase mix components will be allocated to each RUG group as a constant 
201.5 	amount to determine the operating payment rate.

201.6 	Sec. 34. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to 
201.7 	read:
201.8 		Subd. 50a.Determination of proximity adjustments. (a) For a nursing facility 
201.9 	located in close proximity to another nursing facility of the same facility group type but in 
201.10 	a different peer group and that has higher limits for care-related or other operating costs, 
201.11 	the commissioner shall adjust the limits in accordance with clauses (1) to (4):
201.12 	(1) determine the difference between the limits;
201.13 	(2) determine the distance between the two facilities, by the shortest driving route. If 
201.14 	the distance exceeds 20 miles, no adjustment shall be made;
201.15 	(3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a 
201.16 	percentage; and
201.17 	(4) increase the limits for the nursing facility with the lower limits by the value 
201.18 	determined in clause (1) multiplied by the value determined in clause (3).
201.19 	(b) Effective October 1, 2011, nursing facilities located no more than one-quarter 
201.20 	mile from a peer group with higher limits under either subdivision 50 or 51, may receive 
201.21 	an operating rate adjustment. The operating payment rates of a lower-limit peer group 
201.22 	facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer 
201.23 	group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer 
201.24 	group facility. Peer groups are those defined in subdivision 30. The nearest facility must 
201.25 	be determined by the most direct driving route.

201.26 	Sec. 35. Minnesota Statutes 2010, section 256B.441, subdivision 55a, is amended to 
201.27 	read:
201.28 		Subd. 55a.Alternative to phase-in for publicly owned nursing facilities. (a) For 
201.29 	operating payment rates implemented between January October 1, 2011, and September 
201.30 	30, 2015 the day before the phase-in under subdivision 55 is complete, the commissioner 
201.31 	shall allow nursing facilities whose physical plant is owned or whose license is held by a 
201.32 	city, county, or hospital district to apply for a higher payment rate under this section if the 
201.33 	local government governmental  entity agrees to pay a specified portion of the nonfederal 
201.34 	share of medical assistance costs. Nursing facilities that apply shall be eligible to select an 
202.1 	operating payment rate, with a weight of 1.00, up to the rate calculated in subdivision 54, 
202.2 	without application of the phase-in under subdivision 55. The rates for the other RUG's 
202.3 	levels RUGs shall be computed as provided under subdivision 54.
202.4 	(b) For operating payment rates implemented beginning the day when the phase-in 
202.5 	under subdivision 55 is complete, the commissioner shall allow nursing facilities whose 
202.6 	physical plant is owned or whose license is held by a city, county, or hospital district to 
202.7 	apply for a higher payment rate under this section if the local governmental entity agrees 
202.8 	to pay a specified portion of the nonfederal share of medical assistance costs. Nursing 
202.9 	facilities that apply are eligible to select an operating payment rate with a weight of 1.00, 
202.10 	up to an amount determined by the commissioner to be allowable under the Medicare upper 
202.11 	payment limit test. The rates for the other RUGs shall be computed under subdivision 54. 
202.12 	The rate increase allowed in this paragraph shall take effect only upon federal approval.
202.13 	(c) Rates determined under this subdivision shall take effect beginning January
202.14 	October  1, 2011, based on cost reports for the rate reporting  year ending September 30, 
202.15 	2009 2010, and in future rate years, rates determined for nursing facilities participating 
202.16 	under this subdivision shall take effect on October 1 of each year, based on the most 
202.17 	recent available cost report.
202.18 	(c) (d)  Eligible nursing facilities that wish to participate under this subdivision shall 
202.19 	make an application to the commissioner by September 30, 2010. Participation under this 
202.20 	subdivision is irrevocable. If paragraph (a) does not result in a rate greater than what 
202.21 	would have been provided without application of this subdivision, a facility's rates shall be 
202.22 	calculated as otherwise provided and no payment by the local government entity shall be 
202.23 	required under paragraph (d) August 31, 2011, or by June 30 of any subsequent year.
202.24 	(d) (e)  For each participating nursing facility, the public entity that owns the physical 
202.25 	plant or is the license holder of the nursing facility shall pay to the state the entire 
202.26 	nonfederal share of medical assistance payments received as a result of the difference 
202.27 	between the nursing facility's payment rate under subdivision 54, paragraph (a) or (b), 
202.28 	and the rates that the nursing facility would otherwise be paid without application of this 
202.29 	subdivision under subdivision 54 or 55 as determined by the commissioner.
202.30 	(e) (f)  The commissioner may, at any time, reduce the payments under this 
202.31 	subdivision based on the commissioner's determination that the payments shall cause 
202.32 	nursing facility rates to exceed the state's Medicare upper payment limit or any other 
202.33 	federal limitation. If the commissioner determines a reduction is necessary, the 
202.34 	commissioner shall reduce all payment rates for participating nursing facilities by a 
202.35 	percentage applied to the amount of increase they would otherwise receive under this 
202.36 	subdivision and shall notify participating facilities of the reductions. If payments to a 
203.1 	nursing facility are reduced, payments under section 256B.19, subdivision 1e, shall be 
203.2 	reduced accordingly.

203.3 	Sec. 36. Minnesota Statutes 2010, section 256B.441, is amended by adding a 
203.4 	subdivision to read:
203.5 		Subd. 61.Rate increase for low-rate facilities. Effective October 1, 2011, 
203.6 	operating payment rates of all nursing facilities that are reimbursed under this section or 
203.7 	section 256B.434 shall be increased for a resource utilization group rate with a weight 
203.8 	of 1.00 by up to 2.45 percent, but not to exceed for the same resource utilization group 
203.9 	weight the rate of the facility at the 18th percentile of all nursing facilities in the state. The 
203.10 	percentage of the operating payment rate for each facility to be case-mix adjusted shall be 
203.11 	equal to the percentage that is case-mix adjusted in that facility's operating payment rate 
203.12 	on the preceding September 30.

203.13 	Sec. 37. Minnesota Statutes 2010, section 256B.441, is amended by adding a 
203.14 	subdivision to read:
203.15 		Subd. 62.Repeal of rebased operating payment rates. Notwithstanding 
203.16 	subdivision 54 or 55, no further steps toward phase-in of rebased operating payment 
203.17 	rates shall be taken.

203.18 	Sec. 38. Minnesota Statutes 2010, section 256B.49, subdivision 12, is amended to read:
203.19 		Subd. 12.Informed choice. Persons who are determined likely to require the 
203.20 	level of care provided in a nursing facility as determined under sections 144.0724, 
203.21 	subdivision 11, and section256B.0911, or a hospital shall be informed of the home and 
203.22 	community-based support alternatives to the provision of inpatient hospital services or 
203.23 	nursing facility services. Each person must be given the choice of either institutional or 
203.24 	home and community-based services using the provisions described in section 256B.77, 
203.25 	subdivision 2, paragraph (p).

203.26 	Sec. 39. Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read:
203.27 		Subd. 14.Assessment and reassessment. (a) Assessments of each recipient's 
203.28 	strengths, informal support systems, and need for services shall be completed within 20 
203.29 	working days of the recipient's request as provided in section 256B.0911. Reassessment 
203.30 	of each recipient's strengths, support systems, and need for services shall be conducted 
203.31 	at least every 12 months and at other times when there has been a significant change in 
203.32 	the recipient's functioning.
204.1 	(b) There must be a determination that the client requires a hospital level of care or a 
204.2 	nursing facility level of care as defined in section 144.0724, subdivision 11 256B.0911, 
204.3 	subdivision 4a, paragraph (d), at initial and subsequent assessments to initiate and 
204.4 	maintain participation in the waiver program.
204.5 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
204.6 	appropriate to determine nursing facility level of care for purposes of medical assistance 
204.7 	payment for nursing facility services, only face-to-face assessments conducted according 
204.8 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
204.9 	determination or a nursing facility level of care determination must be accepted for 
204.10 	purposes of initial and ongoing access to waiver services payment.
204.11 	(d) Persons with developmental disabilities who apply for services under the nursing 
204.12 	facility level waiver programs shall be screened for the appropriate level of care according 
204.13 	to section 256B.092.
204.14 	(e) Recipients who are found eligible for home and community-based services under 
204.15 	this section before their 65th birthday may remain eligible for these services after their 
204.16 	65th birthday if they continue to meet all other eligibility factors.
204.17 	(f) The commissioner shall develop criteria to identify recipients whose level of 
204.18 	functioning is reasonably expected to improve and reassess these recipients to establish 
204.19 	a baseline assessment. Recipients who meet these criteria must have a comprehensive 
204.20 	transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be 
204.21 	reassessed every six months until there has been no significant change in the recipient's 
204.22 	functioning for at least 12 months. After there has been no significant change in the 
204.23 	recipient's functioning for at least 12 months, reassessments of the recipient's strengths, 
204.24 	informal support systems, and need for services shall be conducted at least every 12 
204.25 	months and at other times when there has been a significant change in the recipient's 
204.26 	functioning. Counties, case managers, and service providers are responsible for conducting 
204.27 	these reassessments and shall complete the reassessments out of existing funds.

204.28 	EFFECTIVE DATE. Paragraph (f) is effective July 1, 2013.

204.29 	Sec. 40. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:
204.30 		Subd. 15.Individualized service plan; comprehensive transitional service plan; 
204.31 	maintenance service plan. (a) Each recipient of home and community-based waivered 
204.32 	services shall be provided a copy of the written service plan which:
204.33 	(1) is developed and signed by the recipient within ten working days of the 
204.34 	completion of the assessment;
204.35 	(2) meets the assessed needs of the recipient;
205.1 	(3) reasonably ensures the health and safety of the recipient;
205.2 	(4) promotes independence;
205.3 	(5) allows for services to be provided in the most integrated settings; and
205.4 	(6) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
205.5 	paragraph (p), of service and support providers.
205.6 	(b) In developing the comprehensive transitional service plan, the individual 
205.7 	receiving services, the case manager, and the guardian, if applicable, will identify 
205.8 	the transitional service plan fundamental service outcome and anticipated timeline to 
205.9 	achieve this outcome. Within the first 20 days following a recipient's request for an 
205.10 	assessment or reassessment, the transitional service planning team must be identified. A 
205.11 	team leader must be identified who will be responsible for assigning responsibility and 
205.12 	communicating with team members to ensure implementation of the transition plan and 
205.13 	ongoing assessment and communication process. The team leader should be an individual, 
205.14 	such as the case manager or guardian, who has the opportunity to follow the recipient to 
205.15 	the next level of service.
205.16 	Within ten days following an assessment, a comprehensive transitional service plan 
205.17 	must be developed incorporating elements of a comprehensive functional assessment and 
205.18 	including short-term measurable outcomes and timelines for achievement of and reporting 
205.19 	on these outcomes. Functional milestones must also be identified and reported according 
205.20 	to the timelines agreed upon by the transitional service planning team. In addition, the 
205.21 	comprehensive transitional service plan must identify additional supports that may assist 
205.22 	in the achievement of the fundamental service outcome such as the development of greater 
205.23 	natural community support, increased collaboration among agencies, and technological 
205.24 	supports.
205.25 	The timelines for reporting on functional milestones will prompt a reassessment of 
205.26 	services provided, the units of services, rates, and appropriate service providers. It is 
205.27 	the responsibility of the transitional service planning team leader to review functional 
205.28 	milestone reporting to determine if the milestones are consistent with observable skills 
205.29 	and that milestone achievement prompts any needed changes to the comprehensive 
205.30 	transitional service plan.
205.31 	For those whose fundamental transitional service outcome involves the need to 
205.32 	procure housing, a plan for the recipient to seek the resources necessary to secure the least 
205.33 	restrictive housing possible should be incorporated into the plan, including employment 
205.34 	and public supports such as housing access and shelter needy funding.
205.35 	(c) Counties and other agencies responsible for funding community placement and 
205.36 	ongoing community supportive services are responsible for the implementation of the 
206.1 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
206.2 	effective transitional service delivery and efficient utilization of funding resources.
206.3 	(d) Following one year of transitional services, the transitional services planning 
206.4 	team will make a determination as to whether or not the individual receiving services 
206.5 	requires the current level of continuous and consistent support in order to maintain the 
206.6 	recipient's current level of functioning. Recipients who are determined to have not had 
206.7 	a significant change in functioning for 12 months must move from a transitional to a 
206.8 	maintenance service plan. Recipients on a maintenance service plan must be reassessed 
206.9 	to determine if the recipient would benefit from a transitional service plan at least every 
206.10 	12 months and at other times when there has been a significant change in the recipient's 
206.11 	functioning. This assessment should consider any changes to technological or natural 
206.12 	community supports.
206.13 	(b) (e) When a county is evaluating denials, reductions, or terminations of home 
206.14 	and community-based services under section 256B.49 for an individual, the case manager 
206.15 	shall offer to meet with the individual or the individual's guardian in order to discuss the 
206.16 	prioritization of service needs within the individualized service plan, comprehensive 
206.17 	transitional service plan, or maintenance service plan. The reduction in the authorized 
206.18 	services for an individual due to changes in funding for waivered services may not exceed 
206.19 	the amount needed to ensure medically necessary services to meet the individual's health, 
206.20 	safety, and welfare.
206.21 	(f) At the time of reassessment, local agency case managers shall assess each 
206.22 	recipient of community alternatives for disabled individuals or traumatic brain injury 
206.23 	waivered services currently residing in a licensed adult foster home that is not the primary 
206.24 	residence of the license holder, or in which the license holder is not the primary caregiver, 
206.25 	to determine if that recipient could appropriately be served in a community-living setting. 
206.26 	If appropriate for the recipient, the case manager shall offer the recipient, through a 
206.27 	person-centered planning process, the option to receive alternative housing and service 
206.28 	options. In the event that the recipient chooses to transfer from the adult foster home, 
206.29 	the vacated bed shall not be filled with another recipient of waiver services and group 
206.30 	residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a), 
206.31 	clauses (3) and (4), and the licensed capacity shall be reduced accordingly. If the adult 
206.32 	foster home becomes no longer viable due to these transfers, the county agency, with the 
206.33 	assistance of the department, shall facilitate a consolidation of settings or closure. This 
206.34 	reassessment process shall be completed by June 30, 2012.

206.35 	EFFECTIVE DATE. Paragraphs (b), (c), and (d) are effective July 1, 2013.

207.1 	Sec. 41. Minnesota Statutes 2010, section 256B.49, is amended by adding a 
207.2 	subdivision to read:
207.3 		Subd. 23.Community-living settings. "Community-living settings" means a 
207.4 	single-family home or apartment where the service recipient or their family owns or rents, 
207.5 	as demonstrated by a lease agreement, and maintains control over the individual unit. 
207.6 	Community-living settings are subject to the following:
207.7 	(1) individuals are not required to receive services;
207.8 	(2) individuals are not required to have a disability or specific diagnosis to live 
207.9 	in the community-living setting;
207.10 	(3) individuals may hire service providers of their choice;
207.11 	(4) individuals may choose whether to share their household and with whom; 
207.12 	(5) the home or apartment must include living, sleeping, bathing, and cooking areas;
207.13 	(6) individuals must have lockable access and egress;
207.14 	(7) individuals must be free to receive visitors and leave the settings at times and for 
207.15 	durations of their own choosing;
207.16 	(8) leases must not reserve the right to assign units or change unit assignments; and 
207.17 	(9) access to the greater community must be easily facilitated based on the 
207.18 	individual's needs and preferences.

207.19 	Sec. 42. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
207.20 	subdivision to read:
207.21 		Subd. 9.ICF/DD rate increase. Effective July 1, 2011, the commissioner shall 
207.22 	increase the daily rate to $138.23 at an intermediate care facility for the developmentally 
207.23 	disabled located in Clearwater County and classified as a class A facility with 15 beds.

207.24 	Sec. 43. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
207.25 	subdivision to read:
207.26 		Subd. 10.ICF/DD rate adjustment. For each facility reimbursed under this section, 
207.27 	except for a facility located in Clearwater County and classified as a class A facility with 
207.28 	15 beds, the commissioner shall decrease operating payment rates equal to 0.095 percent of 
207.29 	the operating payment rates in effect on June 30, 2011. For each facility, the commissioner 
207.30 	shall apply the rate reduction, based on occupied beds, using the percentage specified 
207.31 	in this subdivision multiplied by the total payment rate, including the variable rate but 
207.32 	excluding the property-related payment rate, in effect on the preceding date. The total rate 
207.33 	reduction shall include the adjustment provided in section 256B.501, subdivision 12.

208.1 	Sec. 44. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
208.2 	subdivision to read:
208.3 		Subd. 11.ICF/DD rate decrease effective July 1, 2011. For each facility 
208.4 	reimbursed under this section, the commissioner shall decrease operating payments equal 
208.5 	to 1.5 percent of the operating payment rates in effect on June 30, 2011. For each facility, 
208.6 	the commissioner shall apply the rate reduction, based on occupied beds, using the 
208.7 	percentage specified in this subdivision multiplied by the total payment rate, including the 
208.8 	variable rate but excluding the property-related payment rate, in effect on the preceding 
208.9 	date. The total rate reduction shall include the adjustment provided in section 256B.501, 
208.10 	subdivision 12.

208.11 	Sec. 45. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
208.12 	subdivision to read:
208.13 		Subd. 12.ICF/DD rate increase effective July 1, 2013. For each facility 
208.14 	reimbursed under this section, the commissioner shall increase operating payments equal 
208.15 	to one-half percent of the operating payment rates in effect on June 30, 2013. For each 
208.16 	facility, the commissioner shall apply the rate increase, based on occupied beds, using the 
208.17 	percentage specified in this subdivision multiplied by the total payment rate, including the 
208.18 	variable rate but excluding the property-related payment rate, in effect on the preceding 
208.19 	date. The total rate increase shall include the adjustment provided in section 256B.501, 
208.20 	subdivision 12.

208.21 	Sec. 46. Minnesota Statutes 2010, section 256B.5012, is amended by adding a 
208.22 	subdivision to read:
208.23 		Subd. 13.ICF/DD rate decrease effective July 1, 2012. Notwithstanding 
208.24 	subdivision 12, for each facility reimbursed under this section, the commissioner shall 
208.25 	decrease operating payments equal to 1.67 percent of the operating payment rates in effect 
208.26 	on June 30, 2012. For each facility, the commissioner shall apply the rate reduction based 
208.27 	on occupied beds, using the percentage specified in this subdivision multiplied by the total 
208.28 	payment rate, including the variable rate but excluding the property-related payment rate, 
208.29 	in effect on the preceding date. The total rate reduction shall include the adjustment 
208.30 	provided in section 256B.501, subdivision 12.

208.31 	EFFECTIVE DATE. This section is effective July 1, 2012, if the federal approval 
208.32 	required under section 52 has not been obtained by June 30, 2012.

209.1 	Sec. 47. Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by 
209.2 	Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read:

209.3 	EFFECTIVE DATE. The section is effective July 1, 2011 on or after January 1, 
209.4 	2014, for individuals age 21 and older, and on or after October 1, 2019, for individuals 
209.5 	under age 21.

209.6 	Sec. 48. Laws 2009, chapter 79, article 8, section 51, the effective date, as amended by 
209.7 	Laws 2010, First Special Session chapter 1, article 17, section 14, is amended to read:

209.8 	EFFECTIVE DATE. This section is effective July 1, 2011 2012, or upon federal 
209.9 	approval, whichever is later.

209.10 	Sec. 49. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by 
209.11 	Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special 
209.12 	Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read:

209.13	Subd. 8.Continuing Care Grants
 					
209.14 	The amounts that may be spent from the 
209.15 	appropriation for each purpose are as follows:

209.16	(a) Aging and Adult Services Grants
		13,499,000
		15,805,000
	
209.17 	Base Adjustment. The general fund base is 
209.18 	increased by $5,751,000 in fiscal year 2012 
209.19 	and $6,705,000 in fiscal year 2013.
209.20 	Information and Assistance 
209.21 	Reimbursement. Federal administrative 
209.22 	reimbursement obtained from information 
209.23 	and assistance services provided by the 
209.24 	Senior LinkAge or Disability Linkage lines 
209.25 	to people who are identified as eligible for 
209.26 	medical assistance shall be appropriated to 
209.27 	the commissioner for this activity.
209.28 	Community Service Development Grant 
209.29 	Reduction. Funding for community service 
209.30 	development grants must be reduced by 
209.31 	$260,000 for fiscal year 2010; $284,000 in 
209.32 	fiscal year 2011; $43,000 in fiscal year 2012; 
210.1 	and $43,000 in fiscal year 2013. Base level 
210.2 	funding shall be restored in fiscal year 2014.
210.3 	Community Service Development Grant 
210.4 	Community Initiative. Funding for 
210.5 	community service development grants shall 
210.6 	be used to offset the cost of aging support 
210.7 	grants. Base level funding shall be restored 
210.8 	in fiscal year 2014.
210.9 	Senior Nutrition Use of Federal Funds.
210.10 	For fiscal year 2010, general fund grants 
210.11 	for home-delivered meals and congregate 
210.12 	dining shall be reduced by $500,000. The 
210.13 	commissioner must replace these general 
210.14 	fund reductions with equal amounts from 
210.15 	federal funding for senior nutrition from the 
210.16 	American Recovery and Reinvestment Act 
210.17 	of 2009.

210.18	(b) Alternative Care Grants
		50,234,000
		48,576,000
	
210.19 	Base Adjustment. The general fund base is 
210.20 	decreased by $3,598,000 in fiscal year 2012 
210.21 	and $3,470,000 in fiscal year 2013.
210.22 	Alternative Care Transfer. Any money 
210.23 	allocated to the alternative care program that 
210.24 	is not spent for the purposes indicated does 
210.25 	not cancel but must be transferred to the 
210.26 	medical assistance account.

210.27
210.28	(c) Medical Assistance Grants; Long-Term 
Care Facilities.
		367,444,000
		419,749,000

210.29
210.30	(d) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		853,567,000
		1,039,517,000
	
210.31 	Manage Growth in TBI and CADI 
210.32 	Waivers. During the fiscal years beginning 
210.33 	on July 1, 2009, and July 1, 2010, the 
210.34 	commissioner shall allocate money for home 
210.35 	and community-based waiver programs 
211.1 	under Minnesota Statutes, section 256B.49, 
211.2 	to ensure a reduction in state spending that is 
211.3 	equivalent to limiting the caseload growth of 
211.4 	the TBI waiver to 12.5 allocations per month 
211.5 	each year of the biennium and the CADI 
211.6 	waiver to 95 allocations per month each year 
211.7 	of the biennium. Limits do not apply: (1) 
211.8 	when there is an approved plan for nursing 
211.9 	facility bed closures for individuals under 
211.10 	age 65 who require relocation due to the 
211.11 	bed closure; (2) to fiscal year 2009 waiver 
211.12 	allocations delayed due to unallotment; or (3) 
211.13 	to transfers authorized by the commissioner 
211.14 	from the personal care assistance program 
211.15 	of individuals having a home care rating 
211.16 	of "CS," "MT," or "HL." Priorities for the 
211.17 	allocation of funds must be for individuals 
211.18 	anticipated to be discharged from institutional 
211.19 	settings or who are at imminent risk of a 
211.20 	placement in an institutional setting.
211.21 	Manage Growth in DD Waiver. The 
211.22 	commissioner shall manage the growth in 
211.23 	the DD waiver by limiting the allocations 
211.24 	included in the February 2009 forecast to 15 
211.25 	additional diversion allocations each month 
211.26 	for the calendar years that begin on January 
211.27 	1, 2010, and January 1, 2011. Additional 
211.28 	allocations must be made available for 
211.29 	transfers authorized by the commissioner 
211.30 	from the personal care program of individuals 
211.31 	having a home care rating of "CS," "MT," 
211.32 	or "HL."
211.33 	Adjustment to Lead Agency Waiver 
211.34 	Allocations. Prior to the availability of the 
211.35 	alternative license defined in Minnesota 
211.36 	Statutes, section 245A.11, subdivision 8, 
212.1 	the commissioner shall reduce lead agency 
212.2 	waiver allocations for the purposes of 
212.3 	implementing a moratorium on corporate 
212.4 	foster care.
212.5 	Alternatives to Personal Care Assistance 
212.6 	Services. Base level funding of $3,237,000 
212.7 	in fiscal year 2012 and $4,856,000 in 
212.8 	fiscal year 2013 is to implement alternative 
212.9 	services to personal care assistance services 
212.10 	for persons with mental health and other 
212.11 	behavioral challenges who can benefit 
212.12 	from other services that more appropriately 
212.13 	meet their needs and assist them in living 
212.14 	independently in the community. These 
212.15 	services may include, but not be limited to, a 
212.16 	1915(i) state plan option.

212.17	(e) Mental Health Grants

212.18	Appropriations by Fund
	
212.19	General
	77,739,000
	77,739,000
	
212.20	Health Care Access
	750,000
	750,000
	
212.21	Lottery Prize
	1,508,000
	1,508,000
	
212.22 	Funding Usage. Up to 75 percent of a fiscal 
212.23 	year's appropriation for adult mental health 
212.24 	grants may be used to fund allocations in that 
212.25 	portion of the fiscal year ending December 
212.26 	31.

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

212.28	(g) Chemical Dependency Entitlement Grants
		111,303,000
		122,822,000
	
212.29 	Payments for Substance Abuse Treatment.
212.30 	For placements beginning during fiscal years 
212.31 	2010 and 2011, county-negotiated rates and 
212.32 	provider claims to the consolidated chemical 
212.33 	dependency fund must not exceed the lesser 
212.34 	of:
213.1 	(1) rates charged for these services on 
213.2 	January 1, 2009; or
213.3 	(2) 160 percent of the average rate on January 
213.4 	1, 2009, for each group of vendors with 
213.5 	similar attributes.
213.6 	Rates for fiscal years 2010 and 2011 must 
213.7 	not exceed 160 percent of the average rate on 
213.8 	January 1, 2009, for each group of vendors 
213.9 	with similar attributes.
213.10 	Effective July 1, 2010, rates that were above 
213.11 	the average rate on January 1, 2009, are 
213.12 	reduced by five percent from the rates in 
213.13 	effect on June 1, 2010. Rates below the 
213.14 	average rate on January 1, 2009, are reduced 
213.15 	by 1.8 percent from the rates in effect on 
213.16 	June 1, 2010. Services provided under 
213.17 	this section by state-operated services are 
213.18 	exempt from the rate reduction. For services 
213.19 	provided in fiscal years 2012 and 2013, the 
213.20 	statewide aggregate payment under the new 
213.21 	rate methodology to be developed under 
213.22 	Minnesota Statutes, section 254B.12, must 
213.23 	not exceed the projected aggregate payment 
213.24 	under the rates in effect for fiscal year 2011 
213.25 	excluding the rate reduction for rates that 
213.26 	were below the average on January 1, 2009, 
213.27 	plus a state share increase of $3,787,000 for 
213.28 	fiscal year 2012 and $5,023,000 for fiscal 
213.29 	year 2013. Notwithstanding any provision 
213.30 	to the contrary in this article, this provision 
213.31 	expires on June 30, 2013.
213.32 	Chemical Dependency Special Revenue 
213.33 	Account. For fiscal year 2010, $750,000 
213.34 	must be transferred from the consolidated 
213.35 	chemical dependency treatment fund 
214.1 	administrative account and deposited into the 
214.2 	general fund.
214.3 	County CD Share of MA Costs for 
214.4 	ARRA Compliance. Notwithstanding the 
214.5 	provisions of Minnesota Statutes, chapter 
214.6 	254B, for chemical dependency services 
214.7 	provided during the period October 1, 2008, 
214.8 	to December 31, 2010, and reimbursed by 
214.9 	medical assistance at the enhanced federal 
214.10 	matching rate provided under the American 
214.11 	Recovery and Reinvestment Act of 2009, the 
214.12 	county share is 30 percent of the nonfederal 
214.13 	share. This provision is effective the day 
214.14 	following final enactment.

214.15
214.16	(h) Chemical Dependency Nonentitlement 
Grants
		1,729,000
		1,729,000

214.17	(i) Other Continuing Care Grants
		19,201,000
		17,528,000
	
214.18 	Base Adjustment. The general fund base is 
214.19 	increased by $2,639,000 in fiscal year 2012 
214.20 	and increased by $3,854,000 in fiscal year 
214.21 	2013.
214.22 	Technology Grants. $650,000 in fiscal 
214.23 	year 2010 and $1,000,000 in fiscal year 
214.24 	2011 are for technology grants, case 
214.25 	consultation, evaluation, and consumer 
214.26 	information grants related to developing and 
214.27 	supporting alternatives to shift-staff foster 
214.28 	care residential service models.
214.29 	Other Continuing Care Grants; HIV 
214.30 	Grants. Money appropriated for the HIV 
214.31 	drug and insurance grant program in fiscal 
214.32 	year 2010 may be used in either year of the 
214.33 	biennium.
214.34 	Quality Assurance Commission. Effective 
214.35 	July 1, 2009, state funding for the quality 
215.1 	assurance commission under Minnesota 
215.2 	Statutes, section 256B.0951, is canceled.

215.3 	Sec. 50. NURSING FACILITY PILOT PROJECT.
 215.4 		Subdivision 1.Report. The commissioner of human services, in consultation with 
215.5 	the commissioner of health, stakeholders, and experts, shall provide to the legislature 
215.6 	recommendations by November 15, 2011, on how to develop a project to demonstrate a 
215.7 	new approach to caring for certain individuals in nursing facilities.
215.8 		Subd. 2.Contents of report. The recommendations shall address the:
215.9 	(1) nature of the demonstration in terms of timing, size, qualifications to participate, 
215.10 	participation selection criteria and postdemonstration options for the demonstration and 
215.11 	for participating facilities;
215.12 	(2) nature of needed new form of licensure;
215.13 	(3) characteristics of the individuals the new model is intended to serve and 
215.14 	comparison of these characteristics with those individuals served by existing models of 
215.15 	care;
215.16 	(4) quality standards for licensure addressing management, types and amounts of 
215.17 	staffing, safety, infection control, care processes, quality improvement, and resident rights;
215.18 	(5) characteristics of inspection process;
215.19 	(6) funding for inspection process;
215.20 	(7) enforcement authorities;
215.21 	(8) role of Medicare;
215.22 	(9) participation in the elderly waiver program, including rate setting;
215.23 	(10) nature of any federal approval or waiver requirements and the method and 
215.24 	timing of obtaining them;
215.25 	(11) consumer rights; and
215.26 	(12) methods and resources needed to evaluate the effectiveness of the model with 
215.27 	regards to cost and quality.

215.28 	Sec. 51. PROVIDER RATE AND GRANT REDUCTIONS.
 215.29 	(a) The commissioner of human services shall decrease grants, allocations, 
215.30 	reimbursement rates, individual limits, and rate limits, as applicable, by 1.5 percent 
215.31 	effective July 1, 2011, through June 30, 2013, for services rendered on or after those 
215.32 	dates. Beginning July 1, 2013, the commissioner of human services shall decrease grants, 
215.33 	allocations, reimbursement rate individual limits, and rate limits, as applicable, by 1.0 
215.34 	percent for services rendered on or after those dates. County or tribal contracts for services 
216.1 	specified in this section must be amended to pass through these rate reductions within 
216.2 	60 days of the effective date of the decrease and must be retroactive from the effective 
216.3 	date of the rate decrease.
216.4 	(b) The rate changes described in this section must be provided to:
216.5 	(1) home and community-based waivered services for persons with developmental 
216.6 	disabilities or related conditions, including consumer-directed community supports, under 
216.7 	Minnesota Statutes, section 256B.501, except for corporate foster care and customized 
216.8 	living services otherwise reduced in this article;
216.9 	(2) home and community-based waivered services for the elderly, including 
216.10 	consumer-directed community supports, under Minnesota Statutes, section 256B.0915, 
216.11 	except for corporate foster care and customized living services otherwise reduced in 
216.12 	this article;
216.13 	(3) waivered services under community alternatives for disabled individuals, 
216.14 	including consumer-directed community supports, under Minnesota Statutes, section 
216.15 	256B.49, except for corporate foster care and customized living services otherwise 
216.16 	reduced in this article;
216.17 	(4) community alternative care waivered services, including consumer-directed 
216.18 	community supports, under Minnesota Statutes, section 256B.49;
216.19 	(5) traumatic brain injury waivered services, including consumer-directed 
216.20 	community supports, under Minnesota Statutes, section 256B.49;
216.21 	(6) nursing services and home health services under Minnesota Statutes, section 
216.22 	256B.0625, subdivision 6a;
216.23 	(7) personal care services and qualified professional supervision of personal care 
216.24 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
216.25 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
216.26 	subdivision 7;
216.27 	(9) day training and habilitation services for adults with developmental disabilities 
216.28 	or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 
216.29 	additional cost of rate adjustments on day training and habilitation services, provided as a 
216.30 	social service under Minnesota Statutes, section 256M.60;
216.31 	(10) alternative care services under Minnesota Statutes, section 256B.0913;
216.32 	(11) living skills training programs for persons with intractable epilepsy who need 
216.33 	assistance in the transition to independent living under Laws 1988, chapter 689;
216.34 	(12) semi-independent living services (SILS) under Minnesota Statutes, section 
216.35 	252.275, including SILS funding under county social services grants formerly funded 
216.36 	under Minnesota Statutes, chapter 256I;
217.1 	(13) consumer support grants under Minnesota Statutes, section 256.476;
217.2 	(14) family support grants under Minnesota Statutes, section 252.32;
217.3 	(15) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917 
217.4 	except for grants in subdivision 14, and 256B.0928;
217.5 	(16) disability linkage line grants under Minnesota Statutes, section 256.01, 
217.6 	subdivision 24;
217.7 	(17) housing access grants under Minnesota Statutes, section 256B.0658;
217.8 	(18) self-advocacy grants under Laws 2009, chapter 101; and
217.9 	(19) technology grants under Laws 2009, chapter 79.
217.10 	(c) Notwithstanding paragraph (b), clause (9), effective July 1, 2011, through June 
217.11 	30, 2013, payment rates shall be increased by one-half percent for day training and 
217.12 	habilitation services under Minnesota Statutes, sections 252.40 to 252.46, including the 
217.13 	additional cost of rate adjustments on day training and habilitation services, produced as a 
217.14 	social service under Minnesota Statutes, section 256M.60.
217.15 	(d) A managed care plan receiving state payments for the services in this section must 
217.16 	include these decreases in their payments to providers. To implement the rate reductions 
217.17 	in this section, capitation rates paid by the commissioner to managed care organizations 
217.18 	under Minnesota Statutes, section 256B.69, shall reflect a three percent reduction for the 
217.19 	specified services for the period of January 1, 2012, through June 30, 2012, and a 1.5 
217.20 	percent reduction for those services on and after July 1, 2012. The commissioner of 
217.21 	human services shall make adjustments as necessary and consistent with paragraph (a).

217.22 	Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.
 217.23 	The commissioner shall seek any necessary federal approval in order to implement 
217.24 	the changes to the level of care criteria in Minnesota Statutes, section 144.0724, 
217.25 	subdivision 11, on July 1, 2012.

217.26 	Sec. 53. MEDICAL ASSISTANCE REFORM WAIVER.
 217.27 		Subdivision 1.Intent. It is the intent of the legislature to reform components of 
217.28 	the medical assistance program for seniors and people with disabilities or other complex 
217.29 	needs, and medical assistance enrollees in general, in order to achieve better outcomes, 
217.30 	such as community integration and independence; improved health; reduced reliance 
217.31 	on institutional care; maintained or obtained employment and housing; and long-term 
217.32 	sustainability of needed services through better alignment of available services that most 
217.33 	effectively meet people's needs, including other state agencies' services.
218.1 		Subd. 2.Proposal. The commissioner shall develop a proposal to the United States 
218.2 	Department of Health and Human Services, which shall include any necessary waivers, 
218.3 	state plan amendments, requests for new funding or realignment of existing funds, and 
218.4 	any other federal authority that may be necessary for the projects specified in subdivision 
218.5 	4. The commissioner shall ensure all projects are budget neutral or result in savings to 
218.6 	the state budget, considering cost changes across all divisions and other agencies that are 
218.7 	affected.
218.8 		Subd. 3.Legislative proposals; rules. The commissioner shall report to the 
218.9 	members of the legislative committees having jurisdiction over human services issues by 
218.10 	January 15, 2012, regarding the progress of this waiver, and make recommendations 
218.11 	regarding any legislative changes necessary to accomplish the projects in subdivision 4.
218.12 		Subd. 4.Projects. The commissioner shall request permission and funding to 
218.13 	further the following initiatives.
218.14 	(a) Health care delivery demonstration projects. This project involves testing 
218.15 	alternative payment and service delivery models in accordance with Minnesota Statutes, 
218.16 	sections 256B.0755 and 256B.0756. These demonstrations will allow the Minnesota 
218.17 	Department of Human Services to engage in alternative payment arrangements with 
218.18 	provider organizations that provide services to a specified patient population for an agreed 
218.19 	upon total cost of care or risk/gain sharing payment arrangement, but are not limited 
218.20 	to these models of care delivery or payment. Quality of care and patient experience 
218.21 	will be measured and incorporated into payment models alongside the cost of care. 
218.22 	Demonstration sites should include Minnesota health care programs fee-for-services 
218.23 	recipients and managed care enrollees and support a robust primary care model and 
218.24 	improved care coordination for recipients.
218.25 	(b) Promote personal responsibility and encourage and reward healthy outcomes. 
218.26 	This project provides Medicaid funding to provide individual and group incentives to 
218.27 	encourage healthy behavior, prevent the onset of chronic disease, and reward healthy 
218.28 	outcomes. Focus areas may include diabetes prevention and management, tobacco 
218.29 	cessation, reducing weight, lowering cholesterol, and lowering blood pressure.
218.30 	(c) Encourage utilization of high quality, cost-effective care. This project creates 
218.31 	incentives through Medicaid and MinnesotaCare enrollee cost-sharing and other means to 
218.32 	encourage the utilization of high-quality, low-cost, high-value providers, as determined by 
218.33 	the state's provider peer grouping initiative under Minnesota Statutes, section 62U.04.
218.34 	(d) Adults without children. This proposal includes requesting federal authority to 
218.35 	impose a limit on assets for adults without children in medical assistance, as defined in 
218.36 	Minnesota Statutes, section 256B.055, subdivision 15, who have a household income 
219.1 	equal to or less than 75 percent of the federal poverty limit, consistent with Minnesota 
219.2 	Statutes, section 256L.17, subdivision 2, and to impose a 180-day durational residency 
219.3 	requirement in MinnesotaCare, consistent with Minnesota Statutes, section 256B.056, 
219.4 	subdivision 3c, for adults without children, regardless of income.
219.5 	(e) Empower and encourage work, housing, and independence. This project provides 
219.6 	services and supports for individuals who have an identified health or disabling condition 
219.7 	but are not yet certified as disabled, in order to delay or prevent permanent disability, 
219.8 	reduce the need for intensive health care and long-term care services and supports, and to 
219.9 	help maintain or obtain employment or assist in return to work. Benefits may include:
219.10 	(1) coordination with health care homes or health care coordinators;
219.11 	(2) assessment for wellness, housing needs, employment, planning, and goal setting; 
219.12 	(3) training services; 
219.13 	(4) job placement services;
219.14 	(5) career counseling;
219.15 	(6) benefit counseling;
219.16 	(7) worker supports and coaching;
219.17 	(8) assessment of workplace accommodations;
219.18 	(9) transitional housing services; and
219.19 	(10) assistance in maintaining housing.
219.20 	(f) Redesign home and community-based services. This project realigns existing 
219.21 	funding, services, and supports for people with disabilities and older Minnesotans to 
219.22 	ensure community integration and a more sustainable service system. This may involve 
219.23 	changes that promote a range of services to flexibly respond to the following needs: 
219.24 	(1) provide people less expensive alternatives to medical assistance services;
219.25 	(2) offer more flexible and updated community support services under the Medicaid 
219.26 	state plan;
219.27 	(3) provide an individual budget and increased opportunity for self-direction;
219.28 	(4) strengthen family and caregiver support services;
219.29 	(5) allow persons to pool resources or save funds beyond a fiscal year to cover 
219.30 	unexpected needs or foster development of needed services;
219.31 	(6) use of home and community-based waiver programs for people whose needs 
219.32 	cannot be met with the expanded Medicaid state plan community support service options;
219.33 	(7) target access to residential care for those with higher needs;
219.34 	(8) develop capacity within the community for crisis intervention and prevention;
219.35 	(9) redesign case management;
220.1 	(10) offer life planning services for families to plan for the future of their child 
220.2 	with a disability;
220.3 	(11) enhance self-advocacy and life planning for people with disabilities;
220.4 	(12) improve information and assistance to inform long-term care decisions; and
220.5 	(13) increase quality assurance, performance measurement, and outcome-based 
220.6 	reimbursement.
220.7 	This project may include different levels of long-term supports that allow seniors to 
220.8 	remain in their homes and communities, and expand care transitions from acute care to 
220.9 	community care to prevent hospitalizations and nursing home placement. The levels 
220.10 	of support for seniors may range from basic community services for those with lower 
220.11 	needs, access to residential services if a person has higher needs, and targets access to 
220.12 	nursing home care to those with rehabilitation or high medical needs. This may involve 
220.13 	the establishment of medical need thresholds to accommodate the level of support 
220.14 	needed; provision of a long-term care consultation to persons seeking residential services, 
220.15 	regardless of payer source; adjustment of incentives to providers and care coordination 
220.16 	organizations to achieve desired outcomes; and a required coordination with medical 
220.17 	assistance basic care benefit and Medicare/Medigap benefit. This proposal will improve 
220.18 	access to housing and improve capacity to maintain individuals in their existing home; 
220.19 	adjust screening and assessment tools, as needed; improve transition and relocation 
220.20 	efforts; seek federal financial participation for alternative care and essential community 
220.21 	supports; and provide Medigap coverage for people having lower needs.
220.22 	(g) Coordinate and streamline services for people with complex needs, including 
220.23 	those with multiple diagnoses of physical, mental, and developmental conditions. This 
220.24 	project will coordinate and streamline medical assistance benefits for people with complex 
220.25 	needs and multiple diagnoses. It would include changes that:
220.26 	(1) develop community-based service provider capacity to serve the needs of this 
220.27 	group;
220.28 	(2) build assessment and care coordination expertise specific to people with multiple 
220.29 	diagnoses;
220.30 	(3) adopt service delivery models that allow coordinated access to a range of services 
220.31 	for people with complex needs;
220.32 	(4) reduce administrative complexity;
220.33 	(5) measure the improvements in the state's ability to respond to the needs of this 
220.34 	population; and
220.35 	(6) increase the cost-effectiveness for the state budget.
221.1 	(h) Implement nursing home level of care criteria. This project involves obtaining 
221.2 	any necessary federal approval in order to implement the changes to the level of care 
221.3 	criteria in Minnesota Statutes, section 144.0724, subdivision 11, and implement further 
221.4 	changes necessary to achieve reform of the home and community-based service system.
221.5 	(i) Improve integration of Medicare and Medicaid. This project involves reducing 
221.6 	fragmentation in the health care delivery system to improve care for people eligible for 
221.7 	both Medicare and Medicaid, and to align fiscal incentives between primary, acute, and 
221.8 	long-term care. The proposal may include:
221.9 	(1) requesting an exception to the new Medicare methodology for payment 
221.10 	adjustment for fully integrated special needs plans for dual eligible individuals;
221.11 	(2) testing risk adjustment models that may be more favorable to capturing the 
221.12 	needs of frail dually eligible individuals;
221.13 	(3) requesting an exemption from the Medicare bidding process for fully integrated 
221.14 	special needs plans for the dually eligible;
221.15 	(4) modifying the Medicare bid process to recognize additional costs of health 
221.16 	home services; and
221.17 	(5) requesting permission for risk-sharing and gain-sharing.
221.18 	(j) Intensive residential treatment services. This project would involve providing 
221.19 	intensive residential treatment services for individuals who have serious mental illness 
221.20 	and who have other complex needs. This proposal would allow such individuals to remain 
221.21 	in these settings after mental health symptoms have stabilized, in order to maintain their 
221.22 	mental health and avoid more costly or unnecessary hospital or other residential care due 
221.23 	to their other complex conditions. The commissioner may pursue a specialized rate for 
221.24 	projects created under this section.
221.25 	(k) Seek federal Medicaid matching funds for Anoka Metro Regional Treatment 
221.26 	Center (AMRTC). This project involves seeking Medicaid reimbursement for medical 
221.27 	services provided to patients to AMRTC, including requesting a waiver of United States 
221.28 	Code, title 42, section 1396d, which prohibits Medicaid reimbursement for expenditures 
221.29 	for services provided by hospitals with more than 16 beds that are primarily focused on 
221.30 	the treatment of mental illness. This waiver would allow AMRTC to serve as a statewide 
221.31 	resource to provide diagnostics and treatment for people with the most complex conditions.
221.32 	(l) Waivers to allow Medicaid eligibility for children under age 21 receiving care 
221.33 	in residential facilities. This proposal would seek Medicaid reimbursement for any 
221.34 	Medicaid-covered service for children who are placed in residential settings that are 
221.35 	determined to be "institutions for mental diseases," under United States Code, title 42, 
221.36 	section 1396d.
222.1 		Subd. 5.Federal funds. The commissioner is authorized to accept and expend 
222.2 	federal funds that support the purposes of this section.

222.3 	Sec. 54. CONTINGENCY PROVIDER RATE AND GRANT REDUCTIONS.
 222.4 	(a) Notwithstanding any other rate reduction in this article, the commissioner of 
222.5 	human services shall decrease grants, allocations, reimbursement rates, individual limits, 
222.6 	and rate limits, as applicable, by 1.67 percent effective July 1, 2012, for services rendered 
222.7 	on or after those dates. County or tribal contracts for services specified in this section must 
222.8 	be amended to pass through these rate reductions within 60 days of the effective date of 
222.9 	the decrease, and must be retroactive from the effective date of the rate decrease.
222.10 	(b) The rate changes described in this section must be provided to:
222.11 	(1) home and community-based waivered services for persons with developmental 
222.12 	disabilities or related conditions, including consumer-directed community supports, under 
222.13 	Minnesota Statutes, section 256B.501;
222.14 	(2) home and community-based waivered services for the elderly, including 
222.15 	consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
222.16 	(3) waivered services under community alternatives for disabled individuals, 
222.17 	including consumer-directed community supports, under Minnesota Statutes, section 
222.18 	256B.49;
222.19 	(4) community alternative care waivered services, including consumer-directed 
222.20 	community supports, under Minnesota Statutes, section 256B.49;
222.21 	(5) traumatic brain injury waivered services, including consumer-directed 
222.22 	community supports, under Minnesota Statutes, section 256B.49;
222.23 	(6) nursing services and home health services under Minnesota Statutes, section 
222.24 	256B.0625, subdivision 6a;
222.25 	(7) personal care services and qualified professional supervision of personal care 
222.26 	services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
222.27 	(8) private duty nursing services under Minnesota Statutes, section 256B.0625, 
222.28 	subdivision 7;
222.29 	(9) day training and habilitation services for adults with developmental disabilities 
222.30 	or related conditions, under Minnesota Statutes, sections 252.40 to 252.46, including the 
222.31 	additional cost of rate adjustments on day training and habilitation services, provided as a 
222.32 	social service under Minnesota Statutes, section 256M.60; and
222.33 	(10) alternative care services under Minnesota Statutes, section 256B.0913.
222.34 	(c) A managed care plan receiving state payments for the services in this section 
222.35 	must include these decreases in their payments to providers. To implement the rate 
223.1 	reductions in this section, capitation rates paid by the commissioner to managed care 
223.2 	organizations under Minnesota Statutes, section 256B.69, shall reflect a 2.34 percent 
223.3 	reduction for the specified services for the period of January 1, 2013, through June 30, 
223.4 	2013, and a 1.67 percent reduction for those services on and after July 1, 2013.
223.5 	The above payment rate reduction, allocation rates, and rate limits shall expire for 
223.6 	services rendered on December 31, 2013.

223.7 	EFFECTIVE DATE. This section is effective July 1, 2012, if the federal approval 
223.8 	required under section 52 has not been obtained by June 30, 2012.

223.9 	ARTICLE 8
223.10 	CHEMICAL AND MENTAL HEALTH

223.11 	Section 1. Minnesota Statutes 2010, section 246B.10, is amended to read:
223.12 	246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.
223.13 	The civilly committed sex offender's county shall pay to the state a portion of the 
223.14 	cost of care provided in the Minnesota sex offender program to a civilly committed sex 
223.15 	offender who has legally settled in that county. A county's payment must be made from 
223.16 	the county's own sources of revenue and payments must equal ten 25 percent of the cost of 
223.17 	care, as determined by the commissioner, for each day or portion of a day, that the civilly 
223.18 	committed sex offender spends at the facility. If payments received by the state under this 
223.19 	chapter exceed 90 75 percent of the cost of care, the county is responsible for paying the 
223.20 	state the remaining amount. The county is not entitled to reimbursement from the civilly 
223.21 	committed sex offender, the civilly committed sex offender's estate, or from the civilly 
223.22 	committed sex offender's relatives, except as provided in section 246B.07.

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

223.25 	Sec. 2. Minnesota Statutes 2010, section 253B.212, is amended to read:
223.26 	253B.212 COMMITMENT; RED LAKE BAND OF CHIPPEWA INDIANS; 
223.27 	WHITE EARTH BAND OF OJIBWE.
223.28 		Subdivision 1.Cost of care; commitment by tribal court order; Red Lake 
223.29 	Band of Chippewa Indians. The commissioner of human services may contract with 
223.30 	and receive payment from the Indian Health Service of the United States Department of 
223.31 	Health and Human Services for the care and treatment of those members of the Red 
223.32 	Lake Band of Chippewa Indians who have been committed by tribal court order to the 
224.1 	Indian Health Service for care and treatment of mental illness, developmental disability, or 
224.2 	chemical dependency. The contract shall provide that the Indian Health Service may not 
224.3 	transfer any person for admission to a regional center unless the commitment procedure 
224.4 	utilized by the tribal court provided due process protections similar to those afforded 
224.5 	by sections 253B.05 to 253B.10.
224.6 		Subd. 1a.Cost of care; commitment by tribal court order; White Earth Band of 
224.7 	Ojibwe Indians. The commissioner of human services may contract with and receive 
224.8 	payment from the Indian Health Service of the United States Department of Health and 
224.9 	Human Services for the care and treatment of those members of the White Earth Band 
224.10 	of Ojibwe Indians who have been committed by tribal court order to the Indian Health 
224.11 	Service for care and treatment of mental illness, developmental disability, or chemical 
224.12 	dependency. The tribe may also contract directly with the commissioner for treatment 
224.13 	of those members of the White Earth Band who have been committed by tribal court 
224.14 	order to the White Earth Department of Health for care and treatment of mental illness, 
224.15 	developmental disability, or chemical dependency. The contract shall provide that the 
224.16 	Indian Health Service and the White Earth Band shall not transfer any person for admission 
224.17 	to a regional center unless the commitment procedure utilized by the tribal court provided 
224.18 	due process protections similar to those afforded by sections 253B.05 to 253B.10.
224.19 		Subd. 2.Effect given to tribal commitment order. When, under an agreement 
224.20 	entered into pursuant to subdivision 1 subdivisions 1 or 1a, the Indian Health Service 
224.21 	applies to a regional center for admission of a person committed to the jurisdiction of the 
224.22 	health service by the tribal court as a person who is mentally ill, developmentally disabled, 
224.23 	or chemically dependent, the commissioner may treat the patient with the consent of 
224.24 	the Indian Health Service.
224.25 	A person admitted to a regional center pursuant to this section has all the rights 
224.26 	accorded by section 253B.03. In addition, treatment reports, prepared in accordance with 
224.27 	the requirements of section 253B.12, subdivision 1, shall be filed with the Indian Health 
224.28 	Service within 60 days of commencement of the patient's stay at the facility. A subsequent 
224.29 	treatment report shall be filed with the Indian Health Service within six months of the 
224.30 	patient's admission to the facility or prior to discharge, whichever comes first. Provisional 
224.31 	discharge or transfer of the patient may be authorized by the head of the treatment facility 
224.32 	only with the consent of the Indian Health Service. Discharge from the facility to the 
224.33 	Indian Health Service may be authorized by the head of the treatment facility after notice 
224.34 	to and consultation with the Indian Health Service.

224.35 	Sec. 3. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
225.1 		Subd. 4.Division of costs. Except for services provided by a county under 
225.2 	section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03, 
225.3 	subdivision 4, paragraph (b), the county shall, out of local money, pay the state for 
225.4 	16.14 22.95 percent of the cost of chemical dependency services, including those services 
225.5 	provided to persons eligible for medical assistance under chapter 256B and general 
225.6 	assistance medical care under chapter 256D. Counties may use the indigent hospitalization 
225.7 	levy for treatment and hospital payments made under this section. 16.14 22.95 percent 
225.8 	of any state collections from private or third-party pay, less 15 percent for the cost of 
225.9 	payment and collections, must be distributed to the county that paid for a portion of the 
225.10 	treatment under this section.

225.11 	EFFECTIVE DATE. This section is effective for claims processed beginning 
225.12 	July 1, 2011.

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

225.21 	Sec. 5. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:
225.22 		Subd. 2.Allocation of collections. The commissioner shall allocate all federal 
225.23 	financial participation collections to a special revenue account. The commissioner shall 
225.24 	allocate 83.86 77.05 percent of patient payments and third-party payments to the special 
225.25 	revenue account and 16.14 22.95 percent to the county financially responsible for the 
225.26 	patient.

225.27 	EFFECTIVE DATE. This section is effective for claims processed beginning 
225.28 	July 1, 2011.

225.29 	Sec. 6. Minnesota Statutes 2010, section 256B.0625, subdivision 41, is amended to 
225.30 	read:
225.31 		Subd. 41.Residential services for children with severe emotional disturbance.
 225.32 	Medical assistance covers rehabilitative services in accordance with section 256B.0945
226.1 	that are provided by a county or an American Indian tribe through a residential facility, 
226.2 	for children who have been diagnosed with severe emotional disturbance and have been 
226.3 	determined to require the level of care provided in a residential facility.

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

226.5 	Sec. 7. Minnesota Statutes 2010, section 256B.0945, subdivision 4, is amended to read:
226.6 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, 
226.7 	payments to counties for residential services provided by a residential facility shall only 
226.8 	be made of federal earnings for services provided under this section, and the nonfederal 
226.9 	share of costs for services provided under this section shall be paid by the county from 
226.10 	sources other than federal funds or funds used to match other federal funds. Payment to 
226.11 	counties for services provided according to this section shall be a proportion of the per 
226.12 	day contract rate that relates to rehabilitative mental health services and shall not include 
226.13 	payment for costs or services that are billed to the IV-E program as room and board.
226.14 	(b) Per diem rates paid to providers under this section by prepaid plans shall be 
226.15 	the proportion of the per-day contract rate that relates to rehabilitative mental health 
226.16 	services and shall not include payment for group foster care costs or services that are 
226.17 	billed to the county of financial responsibility. Services provided in facilities located in 
226.18 	bordering states are eligible for reimbursement on a fee-for-service basis only as described 
226.19 	in paragraph (a) and are not covered under prepaid health plans.
226.20 	(c) Payment for mental health rehabilitative services provided under this section by 
226.21 	or under contract with an American Indian tribe or tribal organization or by agencies 
226.22 	operated by or under contract with an American Indian tribe or tribal organization must 
226.23 	be made according to section 256B.0625, subdivision 34, or other relevant federally 
226.24 	approved rate-setting methodology.
226.25 	(d) The commissioner shall set aside a portion not to exceed five percent of the 
226.26 	federal funds earned for county expenditures under this section to cover the state costs of 
226.27 	administering this section. Any unexpended funds from the set-aside shall be distributed 
226.28 	to the counties in proportion to their earnings under this section.

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

226.30 	Sec. 8. COMMUNITY MENTAL HEALTH SERVICES; USE OF BEHAVIORAL 
226.31 	HEALTH HOSPITALS.
 226.32 	The commissioner shall issue a written report to the chairs and ranking minority 
226.33 	members of the house of representatives and senate committees with jurisdiction over 
227.1 	health and human services by December 31, 2011, on how the community behavioral 
227.2 	health hospital facilities will be fully utilized to meet the mental health needs of regions 
227.3 	in which the hospitals are located. The commissioner must consult with the regional 
227.4 	planning work groups for adult mental health and must include the recommendations of 
227.5 	the work groups in the legislative report. The report must address future use of community 
227.6 	behavioral health hospitals that are not certified as Medicaid eligible by CMS or have a less 
227.7 	than 65 percent licensed bed occupancy rate, and using the facilities for another purpose 
227.8 	that will meet the mental health needs of residents of the region. The regional planning 
227.9 	work groups shall work with the commissioner to prioritize the needs of their regions. 
227.10 	These priorities, by region, must be included in the commissioner's report to the legislature.

227.11 	Sec. 9. INTEGRATED DUAL DIAGNOSIS TREATMENT.
 227.12 	(a) The commissioner shall require individuals who perform chemical dependency 
227.13 	assessments or mental health diagnostic assessments to use screening tools approved 
227.14 	by the commissioner in order to identify whether an individual who is the subject of 
227.15 	the assessment screens positive for co-occurring mental health or chemical dependency 
227.16 	disorders. Screening for co-occurring disorders must begin no later than December 31, 
227.17 	2011.
227.18 	(b) The commissioner shall adopt rules as necessary to implement this section. The 
227.19 	commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing 
227.20 	a certification process for integrated dual disorder treatment providers and a system 
227.21 	through which individuals receive integrated dual diagnosis treatment if assessed as having 
227.22 	both a substance use disorder and either a serious mental illness or emotional disturbance.
227.23 	(c) The commissioner shall apply for any federal waivers necessary to secure, to the 
227.24 	extent allowed by law, federal financial participation for the provision of integrated dual 
227.25 	diagnosis treatment to persons with co-occurring disorders. 

227.26 	Sec. 10. REGIONAL TREATMENT CENTERS; EMPLOYEES; REPORT.
 227.27 	The commissioner shall issue a report to the legislative committees with jurisdiction 
227.28 	over health and human services finance no later than December 31, 2011, which provides 
227.29 	the number of employees in management positions at the Anoka-Metro Regional 
227.30 	Treatment Center and the Minnesota Security Hospital at St. Peter and the ratio of 
227.31 	management to direct-care staff for each facility.

228.1 	ARTICLE 9
228.2 	REDESIGNING SERVICE DELIVERY

228.3 	Section 1. Minnesota Statutes 2010, section 256.01, subdivision 14b, is amended to 
228.4 	read:
228.5 		Subd. 14b.American Indian child welfare projects. (a) The commissioner of 
228.6 	human services may authorize projects to test tribal delivery of child welfare services to 
228.7 	American Indian children and their parents and custodians living on the reservation. 
228.8 	The commissioner has authority to solicit and determine which tribes may participate 
228.9 	in a project. Grants may be issued to Minnesota Indian tribes to support the projects. 
228.10 	The commissioner may waive existing state rules as needed to accomplish the projects. 
228.11 	Notwithstanding section 626.556, the commissioner may authorize projects to use 
228.12 	alternative methods of investigating and assessing reports of child maltreatment, provided 
228.13 	that the projects comply with the provisions of section 626.556 dealing with the rights 
228.14 	of individuals who are subjects of reports or investigations, including notice and appeal 
228.15 	rights and data practices requirements. The commissioner may seek any federal approvals 
228.16 	necessary to carry out the projects as well as seek and use any funds available to the 
228.17 	commissioner, including use of federal funds, foundation funds, existing grant funds, 
228.18 	and other funds. The commissioner is authorized to advance state funds as necessary to 
228.19 	operate the projects. Federal reimbursement applicable to the projects is appropriated 
228.20 	to the commissioner for the purposes of the projects. The projects must be required to 
228.21 	address responsibility for safety, permanency, and well-being of children.
228.22 	(b) For the purposes of this section, "American Indian child" means a person under 
228.23 	18 years of age who is a tribal member or eligible for membership in one of the tribes 
228.24 	chosen for a project under this subdivision and who is residing on the reservation of 
228.25 	that tribe.
228.26 	(c) In order to qualify for an American Indian child welfare project, a tribe must:
228.27 	(1) be one of the existing tribes with reservation land in Minnesota;
228.28 	(2) have a tribal court with jurisdiction over child custody proceedings;
228.29 	(3) have a substantial number of children for whom determinations of maltreatment 
228.30 	have occurred;
228.31 	(4) have capacity to respond to reports of abuse and neglect under section 626.556;
228.32 	(5) provide a wide range of services to families in need of child welfare services; and
228.33 	(6) have a tribal-state title IV-E agreement in effect.
229.1 	(d) Grants awarded under this section may be used for the nonfederal costs of 
229.2 	providing child welfare services to American Indian children on the tribe's reservation, 
229.3 	including costs associated with:
229.4 	(1) assessment and prevention of child abuse and neglect;
229.5 	(2) family preservation;
229.6 	(3) facilitative, supportive, and reunification services;
229.7 	(4) out-of-home placement for children removed from the home for child protective 
229.8 	purposes; and
229.9 	(5) other activities and services approved by the commissioner that further the goals 
229.10 	of providing safety, permanency, and well-being of American Indian children.
229.11 	(e) When a tribe has initiated a project and has been approved by the commissioner 
229.12 	to assume child welfare responsibilities for American Indian children of that tribe under 
229.13 	this section, the affected county social service agency is relieved of responsibility for 
229.14 	responding to reports of abuse and neglect under section 626.556 for those children 
229.15 	during the time within which the tribal project is in effect and funded. The commissioner 
229.16 	shall work with tribes and affected counties to develop procedures for data collection, 
229.17 	evaluation, and clarification of ongoing role and financial responsibilities of the county 
229.18 	and tribe for child welfare services prior to initiation of the project. Children who have not 
229.19 	been identified by the tribe as participating in the project shall remain the responsibility 
229.20 	of the county. Nothing in this section shall alter responsibilities of the county for law 
229.21 	enforcement or court services.
229.22 	(f) Participating tribes may conduct children's mental health screenings under section 
229.23 	245.4874, subdivision 1, paragraph (a), clause (14), for children who are eligible for the 
229.24 	initiative and living on the reservation and who meet one of the following criteria:
229.25 	(1) the child must be receiving child protective services;
229.26 	(2) the child must be in foster care; or
229.27 	(3) the child's parents must have had parental rights suspended or terminated.
229.28 	Tribes may access reimbursement from available state funds for conducting the screenings. 
229.29 	Nothing in this section shall alter responsibilities of the county for providing services 
229.30 	under section 245.487.
229.31 	(g) Participating tribes may establish a local child mortality review panel. In 
229.32 	establishing a local child mortality review panel, the tribe agrees to conduct local child 
229.33 	mortality reviews for child deaths or near-fatalities occurring on the reservation under 
229.34 	subdivision 12. Tribes with established child mortality review panels shall have access 
229.35 	to nonpublic data and shall protect nonpublic data under subdivision 12, paragraphs (c) 
229.36 	to (e). The tribe shall provide written notice to the commissioner and affected counties 
230.1 	when a local child mortality review panel has been established and shall provide data upon 
230.2 	request of the commissioner for purposes of sharing nonpublic data with members of the 
230.3 	state child mortality review panel in connection to an individual case.
230.4 	(h) The commissioner shall collect information on outcomes relating to child safety, 
230.5 	permanency, and well-being of American Indian children who are served in the projects. 
230.6 	Participating tribes must provide information to the state in a format and completeness 
230.7 	deemed acceptable by the state to meet state and federal reporting requirements.
230.8 	(i) In consultation with the White Earth Band, the commissioner shall develop 
230.9 	and submit to the chairs and ranking minority members of the legislative committees 
230.10 	with jurisdiction over health and human services a plan to transfer legal responsibility 
230.11 	for providing child protective services to White Earth Band member children residing in 
230.12 	Hennepin County to the White Earth Band. The plan shall include a financing proposal, 
230.13 	definitions of key terms, statutory amendments required, and other provisions required to 
230.14 	implement the plan. The commissioner shall submit the plan by January 15, 2012.

230.15 	Sec. 2. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 
230.16 	to read:
230.17 		Subd. 30.Provision of required materials in alternative formats. (a) For the 
230.18 	purposes of this subdivision, "alternative format" means a medium other than paper and 
230.19 	"prepaid health plan" means managed care plans and county-based purchasing plans.
230.20 	(b) A prepaid health plan may provide in an alternative format a provider directory 
230.21 	and certificate of coverage, or materials otherwise required to be available in writing 
230.22 	under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's 
230.23 	contract with the prepaid health plan, if the following conditions are met:
230.24 	(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the 
230.25 	enrollee that:
230.26 	(i) an alternative format is available and the enrollee affirmatively requests of 
230.27 	the prepaid health plan that the provider directory, certificate of coverage, or materials 
230.28 	otherwise required under Code of Federal Regulations, title 42, section 438.10, or under 
230.29 	the commissioner's contract with the prepaid health plan be provided in an alternative 
230.30 	format; and
230.31 	(ii) a record of the enrollee request is retained by the prepaid health plan in the 
230.32 	form of written direction from the enrollee or a documented telephone call followed by a 
230.33 	confirmation letter to the enrollee from the prepaid health plan that explains that the 
230.34 	enrollee may change the request at any time;
231.1 	(2) the materials are sent to a secure electronic mailbox and are made available at a 
231.2 	password-protected secure electronic Web site or on a data storage device if the materials 
231.3 	contain enrollee data that is individually identifiable;
231.4 	(3) the enrollee is provided a customer service number on the enrollee's membership 
231.5 	card that may be called to request a paper version of the materials provided in an 
231.6 	alternative format; and
231.7 	(4) the materials provided in an alternative format meets all other requirements of 
231.8 	the commissioner regarding content, size of the typeface, and any required time frames 
231.9 	for distribution. "Required time frames for distribution" must permit sufficient time for 
231.10 	prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' 
231.11 	requests for the materials.
231.12 	(c) A prepaid health plan may provide in an alternative format its primary care 
231.13 	network list to the commissioner and to local agencies within its service area. The 
231.14 	commissioner or local agency, as applicable, shall inform a potential enrollee of the 
231.15 	availability of a prepaid health plan's primary care network list in an alternative format. If 
231.16 	the potential enrollee requests an alternative format of the prepaid health plan's primary 
231.17 	care network list, a record of that request shall be retained by the commissioner or local 
231.18 	agency. The potential enrollee is permitted to withdraw the request at any time.
231.19 	The prepaid health plan shall submit sufficient paper versions of the primary 
231.20 	care network list to the commissioner and to local agencies within its service area to 
231.21 	accommodate potential enrollee requests for paper versions of the primary care network 
231.22 	list.
231.23 	(d) A prepaid health plan may provide in an alternative format materials otherwise 
231.24 	required to be available in writing under Code of Federal Regulations, title 42, section 
231.25 	438.10, or under the commissioner's contract with the prepaid health plan, if the conditions 
231.26 	of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in 
231.27 	managed care.
231.28 	(e) The commissioner shall seek any federal Medicaid waivers within 90 days after 
231.29 	the effective date of this subdivision that are necessary to provide alternative formats of 
231.30 	required material to enrollees of prepaid health plans as authorized under this subdivision.
231.31 	(f) The commissioner shall consult with managed care plans, county-based 
231.32 	purchasing plans, counties, and other interested parties to determine how materials 
231.33 	required to be made available to enrollees under Code of Federal Regulations, title 42, 
231.34 	section 438.10, or under the commissioner's contract with a prepaid health plan may 
231.35 	be provided in an alternative format on the basis that the enrollee has not opted in to 
231.36 	receive the alternative format. The commissioner shall consult with managed care 
232.1 	plans, county-based purchasing plans, counties, and other interested parties to develop 
232.2 	recommendations relating to the conditions that must be met for an opt-out process 
232.3 	to be granted.

232.4 	Sec. 3. Minnesota Statutes 2010, section 256D.09, subdivision 6, is amended to read:
232.5 		Subd. 6.Recovery of overpayments. (a) If an amount of general assistance or 
232.6 	family general assistance is paid to a recipient in excess of the payment due, it shall be 
232.7 	recoverable by the county agency. The agency shall give written notice to the recipient of 
232.8 	its intention to recover the overpayment.
232.9 	(b) Except as provided for interim assistance in section 256D.06, subdivision 
232.10 	5, when an overpayment occurs, the county agency shall recover the overpayment 
232.11 	from a current recipient by reducing the amount of aid payable to the assistance unit of 
232.12 	which the recipient is a member, for one or more monthly assistance payments, until 
232.13 	the overpayment is repaid. All county agencies in the state shall reduce the assistance 
232.14 	payment by three percent of the assistance unit's standard of need in nonfraud cases and 
232.15 	ten percent where fraud has occurred, or the amount of the monthly payment, whichever is 
232.16 	less, for all overpayments.
232.17 	(c) In cases when there is both an overpayment and underpayment, the county 
232.18 	agency shall offset one against the other in correcting the payment.
232.19 	(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual, 
232.20 	in addition to the aid reductions provided in this subdivision, to include further voluntary 
232.21 	reductions in the grant level agreed to in writing by the individual, until the total amount 
232.22 	of the overpayment is repaid.
232.23 	(e) The county agency shall make reasonable efforts to recover overpayments to 
232.24 	persons no longer on assistance under standards adopted in rule by the commissioner 
232.25 	of human services. The county agency need not attempt to recover overpayments of 
232.26 	less than $35 paid to an individual no longer on assistance if the individual does not 
232.27 	receive assistance again within three years, unless the individual has been convicted of 
232.28 	violating section 256.98.
232.29 	(f) Establishment of an overpayment is limited to 12 months prior to the month of 
232.30 	discovery due to agency error and six years prior to the month of discovery due to client 
232.31 	error or an intentional program violation determined under section 256.046.

232.32 	Sec. 4. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
232.33 		Subd. 3.Overpayment of monthly grants and recovery of ATM errors. (a) When 
232.34 	the county agency determines that an overpayment of the recipient's monthly payment 
233.1 	of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment 
233.2 	to the recipient. If the person is no longer receiving Minnesota supplemental aid, the 
233.3 	county agency may request voluntary repayment or pursue civil recovery. If the person is 
233.4 	receiving Minnesota supplemental aid, the county agency shall recover the overpayment 
233.5 	by withholding an amount equal to three percent of the standard of assistance for the 
233.6 	recipient or the total amount of the monthly grant, whichever is less. 
233.7 	(b) Establishment of an overpayment is limited to 12 months from the date of 
233.8 	discovery due to agency error. Establishment of an overpayment is limited to six years 
233.9 	prior to the month of discovery due to client error or an intentional program violation 
233.10 	determined under section 256.046.
233.11 	(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment 
233.12 	is a result of an automated teller machine (ATM) dispensing funds in error to the recipient, 
233.13 	the agency may recover the ATM error by immediately withdrawing funds from the 
233.14 	recipient's electronic benefit transfer account, up to the amount of the error. 
233.15 	(d) Residents of nursing homes, regional treatment centers, andlicensed residential 
233.16 	facilities with negotiated rates shall not have overpayments recovered from their personal 
233.17 	needs allowance.

233.18 	Sec. 5. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
233.19 		Subdivision 1.Scope of overpayment. (a) When a participant or former participant 
233.20 	receives an overpayment due to agency, client, or ATM error, or due to assistance received 
233.21 	while an appeal is pending and the participant or former participant is determined 
233.22 	ineligible for assistance or for less assistance than was received, the county agency must 
233.23 	recoup or recover the overpayment using the following methods:
233.24 	(1) reconstruct each affected budget month and corresponding payment month;
233.25 	(2) use the policies and procedures that were in effect for the payment month; and
233.26 	(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the 
233.27 	calculation of the overpayment when the unit has not reported within two calendar months 
233.28 	following the end of the month in which the income was received. 
233.29 	(b) Establishment of an overpayment is limited to 12 months prior to the month of 
233.30 	discovery due to agency error. Establishment of an overpayment is limited to six years 
233.31 	prior to the month of discovery due to client error or an intentional program violation 
233.32 	determined under section 256.046.

233.33 	Sec. 6. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
234.1 		Subd. 10.Food stamp program; Maternal and Child Nutrition Act. (a) The local 
234.2 	social services agency shall establish and administer the food stamp program according 
234.3 	to rules of the commissioner of human services, the supervision of the commissioner as 
234.4 	specified in section 256.01, and all federal laws and regulations. The commissioner of 
234.5 	human services shall monitor food stamp program delivery on an ongoing basis to ensure 
234.6 	that each county complies with federal laws and regulations. Program requirements to be 
234.7 	monitored include, but are not limited to, number of applications, number of approvals, 
234.8 	number of cases pending, length of time required to process each application and deliver 
234.9 	benefits, number of applicants eligible for expedited issuance, length of time required 
234.10 	to process and deliver expedited issuance, number of terminations and reasons for 
234.11 	terminations, client profiles by age, household composition and income level and sources, 
234.12 	and the use of phone certification and home visits. The commissioner shall determine the 
234.13 	county-by-county and statewide participation rate.
234.14 	(b) On July 1 of each year, the commissioner of human services shall determine a 
234.15 	statewide and county-by-county food stamp program participation rate. The commissioner 
234.16 	may designate a different agency to administer the food stamp program in a county if the 
234.17 	agency administering the program fails to increase the food stamp program participation 
234.18 	rate among families or eligible individuals, or comply with all federal laws and regulations 
234.19 	governing the food stamp program. The commissioner shall review agency performance 
234.20 	annually to determine compliance with this paragraph.
234.21 	(c) A person who commits any of the following acts has violated section 256.98 or 
234.22 	609.821, or both, and is subject to both the criminal and civil penalties provided under 
234.23 	those sections:
234.24 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
234.25 	willful statement or misrepresentation, or intentional concealment of a material fact, food 
234.26 	stamps or vouchers issued according to sections 145.891 to 145.897 to which the person 
234.27 	is not entitled or in an amount greater than that to which that person is entitled or which 
234.28 	specify nutritional supplements to which that person is not entitled; or
234.29 	(2) presents or causes to be presented, coupons or vouchers issued according to 
234.30 	sections 145.891 to 145.897 for payment or redemption knowing them to have been 
234.31 	received, transferred or used in a manner contrary to existing state or federal law; or
234.32 	(3) willfully uses, possesses, or transfers food stamp coupons, authorization to 
234.33 	purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner 
234.34 	contrary to existing state or federal law, rules, or regulations; or
234.35 	(4) buys or sells food stamp coupons, authorization to purchase cards, other 
234.36 	assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, 
235.1 	or any food obtained through the redemption of vouchers issued according to sections 
235.2 	145.891 to 145.897 for cash or consideration other than eligible food.
235.3 	(d) A peace officer or welfare fraud investigator may confiscate food stamps, 
235.4 	authorization to purchase cards, or other assistance transaction devices found in the 
235.5 	possession of any person who is neither a recipient of the food stamp program nor 
235.6 	otherwise authorized to possess and use such materials. Confiscated property shall be 
235.7 	disposed of as the commissioner may direct and consistent with state and federal food 
235.8 	stamp law. The confiscated property must be retained for a period of not less than 30 days 
235.9 	to allow any affected person to appeal the confiscation under section 256.045.
235.10 	(e) Food stamp overpayment claims which are due in whole or in part to client error 
235.11 	shall be established by the county agency for a period of six years from the date of any 
235.12 	resultant overpayment Establishment of an overpayment is limited to 12 months prior to 
235.13 	the month of discovery due to agency error. Establishment of an overpayment is limited 
235.14 	to six years prior to the month of discovery due to client error or an intentional program 
235.15 	violation determined under section 256.046.
235.16 	(f) With regard to the federal tax revenue offset program only, recovery incentives 
235.17 	authorized by the federal food and consumer service shall be retained at the rate of 50 
235.18 	percent by the state agency and 50 percent by the certifying county agency.
235.19 	(g) A peace officer, welfare fraud investigator, federal law enforcement official, 
235.20 	or the commissioner of health may confiscate vouchers found in the possession of any 
235.21 	person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise 
235.22 	authorized to possess and use such vouchers. Confiscated property shall be disposed of 
235.23 	as the commissioner of health may direct and consistent with state and federal law. The 
235.24 	confiscated property must be retained for a period of not less than 30 days.
235.25 	(h) The commissioner of human services may seek a waiver from the United States 
235.26 	Department of Agriculture to allow the state to specify foods that may and may not be 
235.27 	purchased in Minnesota with benefits funded by the federal Food Stamp Program. The 
235.28 	commissioner shall consult with the members of the house of representatives and senate 
235.29 	policy committees having jurisdiction over food support issues in developing the waiver. 
235.30 	The commissioner, in consultation with the commissioners of health and education, shall 
235.31 	develop a broad public health policy related to improved nutrition and health status. The 
235.32 	commissioner must seek legislative approval prior to implementing the waiver.

235.33 	Sec. 7. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:
235.34 		Subd. 4.Essential human services or essential services. "Essential human 
235.35 	services" or "essential services" means assistance and services to recipients or potential 
236.1 	recipients of public welfare and other services delivered by counties or tribes that are 
236.2 	mandated in federal and state law that are to be available in all counties of the state.

236.3 	Sec. 8. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:
236.4 		Subd. 5.Service delivery authority. "Service delivery authority" means a single 
236.5 	county, or group consortium of counties operating by execution of a joint powers 
236.6 	agreement under section 471.59 or other contractual agreement, that has voluntarily 
236.7 	chosen by resolution of the county board of commissioners to participate in the redesign 
236.8 	under this chapter or has been assigned by the commissioner pursuant to section 402A.18. 
236.9 	A service delivery authority includes an Indian tribe or group of tribes that have voluntarily 
236.10 	chosen by resolution of tribal government to participate in redesign under this chapter.

236.11 	Sec. 9. Minnesota Statutes 2010, section 402A.15, is amended to read:
236.12 	402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME 
236.13 	REFORMS.
236.14 		Subdivision 1.Duties. (a) The Steering Committee on Performance and Outcome 
236.15 	Reforms shall develop a uniform process to establish and review performance and outcome 
236.16 	standards for all essential human services based on the current level of resources available, 
236.17 	and to shall develop appropriate reporting measures and a uniform accountability process 
236.18 	for responding to a county's or human service delivery authority's failure to make adequate 
236.19 	progress on achieving performance measures. The accountability process shall focus on 
236.20 	the performance measures rather than inflexible implementation requirements.
236.21 	(b) The steering committee shall:
236.22 	(1) by November 1, 2009, establish an agreed-upon list of essential services;
236.23 	(2) by February 15, 2010, develop and recommend to the legislature a uniform, 
236.24 	graduated process, in addition to the remedies identified in section 402A.18, for responding 
236.25 	to a county's failure to make adequate progress on achieving performance measures; and
236.26 	(3) by December 15, 2012, for each essential service, make recommendations 
236.27 	to the legislature regarding (1) (i) performance measures and goals based on those 
236.28 	measures for each essential service, (2) and (ii) a system for reporting on the performance 
236.29 	measures and goals, and (3) appropriate resources, including funding, needed to achieve 
236.30 	those performance measures and goals. The resource recommendations shall take into 
236.31 	consideration program demand and the unique differences of local areas in geography and 
236.32 	the populations served. Priority shall be given to services with the greatest variation in 
236.33 	availability and greatest administrative demands. By January 15 of each year starting 
236.34 	January 15, 2011, the steering committee shall report its recommendations to the governor 
237.1 	and legislative committees with jurisdiction over health and human services. As part of its 
237.2 	report, the steering committee shall, as appropriate, recommend statutory provisions, rules 
237.3 	and requirements, and reports that should be repealed or eliminated.
237.4 	(c) As far as possible, the performance measures, reporting system, and funding 
237.5 	shall be consistent across program areas. The development of performance measures shall 
237.6 	consider the manner in which data will be collected and performance will be reported. 
237.7 	The steering committee shall consider state and local administrative costs related to 
237.8 	collecting data and reporting outcomes when developing performance measures. The 
237.9 	steering committee shall correlate the performance measures and goals to available levels 
237.10 	of resources, including state and local funding. The steering committee shall also identify 
237.11 	and incorporate federal performance measures in its recommendations for those program 
237.12 	areas where federal funding is contingent on meeting federal performance standards. The 
237.13 	steering committee shall take into consideration that the goal of implementing changes 
237.14 	to program monitoring and reporting the progress toward achieving outcomes is to 
237.15 	significantly minimize the cost of administrative requirements and to allow funds freed 
237.16 	by reduced administrative expenditures to be used to provide additional services, allow 
237.17 	flexibility in service design and management, and focus energies on achieving program 
237.18 	and client outcomes.
237.19 	(d) In making its recommendations, the steering committee shall consider input from 
237.20 	the council established in section 402A.20. The steering committee shall review the 
237.21 	measurable goals established in a memorandum of understanding entered into under 
237.22 	section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied 
237.23 	as statewide performance outcomes.
237.24 	(e) The steering committee shall form work groups that include persons who provide 
237.25 	or receive essential services and representatives of organizations who advocate on behalf 
237.26 	of those persons.
237.27 	(f) By December 15, 2009, the steering committee shall establish a three-year 
237.28 	schedule for completion of its work. The schedule shall be published on the Department of 
237.29 	Human Services Web site and reported to the legislative committees with jurisdiction over 
237.30 	health and human services. In addition, the commissioner shall post quarterly updates on 
237.31 	the progress of the steering committee on the Department of Human Services Web site.
237.32 		Subd. 2.Composition. (a) The steering committee shall include:
237.33 	(1) the commissioner of human services, or designee, and two additional 
237.34 	representatives of the department;
237.35 	(2) two county commissioners, representative of rural and urban counties, selected 
237.36 	by the Association of Minnesota Counties;
238.1 	(3) two county directors of human services, representative of rural and urban 
238.2 	counties, selected by the Minnesota Association of County Social Service Administrators; 
238.3 	and
238.4 	(4) three clients or client advocates representing different populations receiving 
238.5 	services from the Department of Human Services, who are appointed by the commissioner.
238.6 	(b) The commissioner, or designee, and a county commissioner shall serve as 
238.7 	cochairs of the committee. The committee shall be convened within 60 days of May 
238.8 	15, 2009.
238.9 	(c) State agency staff shall serve as informational resources and staff to the steering 
238.10 	committee. Statewide county associations may assemble county program data as required.
238.11 	(d) To promote information sharing and coordination between the steering committee 
238.12 	and council, one of the county representatives from paragraph (a), clause (2), and one of the 
238.13 	county representatives from paragraph (a), clause (3), must also serve as a representative 
238.14 	on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

238.15 	Sec. 10. Minnesota Statutes 2010, section 402A.18, is amended to read:
238.16 	402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET 
238.17 	PERFORMANCE OUTCOMES.
238.18 		Subdivision 1.Underperforming county; specific service. If the commissioner 
238.19 	determines that a county or service delivery authority is deficient in achieving minimum 
238.20 	performance outcomes for a specific essential service, the commissioner may impose the 
238.21 	following remedies and adjust state and federal program allocations accordingly:
238.22 	(1) voluntary incorporation of the administration and operation of the specific 
238.23 	essential service with an existing service delivery authority or another county. A 
238.24 	service delivery authority or county incorporating an underperforming county shall 
238.25 	not be financially liable for the costs associated with remedying performance outcome 
238.26 	deficiencies;
238.27 	(2) mandatory incorporation of the administration and operation of the specific 
238.28 	essential service with an existing service delivery authority or another county. A 
238.29 	service delivery authority or county incorporating an underperforming county shall 
238.30 	not be financially liable for the costs associated with remedying performance outcome 
238.31 	deficiencies; or 
238.32 	(3) transfer of authority for program administration and operation of the specific 
238.33 	essential service to the commissioner.
238.34 		Subd. 2.Underperforming county; more than one-half of service services. If 
238.35 	the commissioner determines that a county or service delivery authority is deficient in 
239.1 	achieving minimum performance outcomes for more than one-half of the defined essential 
239.2 	service services, the commissioner may impose the following remedies:
239.3 	(1) voluntary incorporation of the administration and operation of the specific
239.4 	essential service services with an existing service delivery authority or another county. 
239.5 	A service delivery authority or county incorporating an underperforming county shall 
239.6 	not be financially liable for the costs associated with remedying performance outcome 
239.7 	deficiencies;
239.8 	(2) mandatory incorporation of the administration and operation of the specific
239.9 	essential service services with an existing service delivery authority or another county. 
239.10 	A service delivery authority or county incorporating an underperforming county shall 
239.11 	not be financially liable for the costs associated with remedying performance outcome 
239.12 	deficiencies; or 
239.13 	(3) transfer of authority for program administration and operation of the specific
239.14 	essential service services to the commissioner.
239.15 		Subd. 2a.Financial responsibility of underperforming county. A county subject 
239.16 	to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of 
239.17 	the essential service or essential services the amount of nonfederal and nonstate funding 
239.18 	needed to remedy performance outcome deficiencies.
239.19 		Subd. 3.Conditions prior to imposing remedies. Before the commissioner may 
239.20 	impose the remedies authorized under this section, the following conditions must be met:
239.21 	(1) the county or service delivery authority determined by the commissioner 
239.22 	to be deficient in achieving minimum performance outcomes has the opportunity, in 
239.23 	coordination with the council, to develop a program outcome improvement plan. The 
239.24 	program outcome improvement plan must be developed no later than six months from the 
239.25 	date of the deficiency determination; and
239.26 	(2) the council has conducted an assessment of the program outcome improvement 
239.27 	plan to determine if the county or service delivery authority has made satisfactory 
239.28 	progress toward performance outcomes and has made a recommendation about remedies 
239.29 	to the commissioner. The review assessment and recommendation must be made to the 
239.30 	commissioner within 12 months from the date of the deficiency determination.

239.31 	Sec. 11. Minnesota Statutes 2010, section 402A.20, is amended to read:
239.32 	402A.20 COUNCIL.
239.33 		Subdivision 1.Council. (a) The State-County Results, Accountability, and Service 
239.34 	Delivery Redesign Council is established. Appointed council members must be appointed 
239.35 	by their respective agencies, associations, or governmental units by November 1, 2009. 
240.1 	The council shall be cochaired by the commissioner of human services, or designee, and a 
240.2 	county representative from paragraph (b), clause (4) or (5), appointed by the Association 
240.3 	of Minnesota Counties. Recommendations of the council must be approved by a majority 
240.4 	of the voting council members. The provisions of section 15.059 do not apply to this 
240.5 	council, and this council does not expire.
240.6 	(b) The council must consist of the following members:
240.7 	(1) two legislators appointed by the speaker of the house, one from the minority 
240.8 	and one from the majority;
240.9 	(2) two legislators appointed by the Senate Rules Committee, one from the majority 
240.10 	and one from the minority;
240.11 	(3) the commissioner of human services, or designee, and three employees from 
240.12 	the department;
240.13 	(4) two county commissioners appointed by the Association of Minnesota Counties;
240.14 	(5) two county representatives appointed by the Minnesota Association of County 
240.15 	Social Service Administrators; 
240.16 	(6) one representative appointed by AFSCME as a nonvoting member; and
240.17 	(7) one representative appointed by the Teamsters as a nonvoting member.
240.18 	(c) Administrative support to the council may be provided by the Association of 
240.19 	Minnesota Counties and affiliates.
240.20 	(d) Member agencies and associations are responsible for initial and subsequent 
240.21 	appointments to the council.
240.22 		Subd. 2.Council duties. The council shall:
240.23 	(1) provide review of the service delivery redesign process, including proposed 
240.24 	memoranda of understanding to establish a service delivery authority to conduct and 
240.25 	administer experimental projects to test new methods and procedures of delivering 
240.26 	services;
240.27 	(2) certify, in accordance with section 402A.30, subdivision 4, the formation of 
240.28 	a service delivery authority, including the memorandum of understanding in section 
240.29 	402A.30, subdivision 2, paragraph (b);
240.30 	(3) ensure the consistency of the memorandum of understanding entered into 
240.31 	under section 402A.30, subdivision 2, paragraph (b), with the performance standards 
240.32 	recommended by the steering committee and enacted by the legislature;
240.33 	(4) (2) ensure the consistency of the memorandum of understanding, to the extent 
240.34 	appropriate, or with other memorandum of understanding entered into by other service 
240.35 	delivery authorities; 
241.1 	(3) review and make recommendations on applications from a service delivery 
241.2 	authority for waivers of statutory or rule program requirements that are needed for 
241.3 	flexibility to determine the most cost-effective means of achieving specified measurable 
241.4 	goals in a redesign of human services delivery;
241.5 	(5) (4) establish a process to take public input on the service delivery framework 
241.6 	specified in the memorandum of understanding in section 402A.30, subdivision 2, 
241.7 	paragraph (b) scope of essential services over which a service delivery authority has 
241.8 	jurisdiction;
241.9 	(6) (5) form work groups as necessary to carry out the duties of the council under the 
241.10 	redesign;
241.11 	(7) (6) serve as a forum for resolving conflicts among participating counties and 
241.12 	tribes or between participating counties or tribes and the commissioner of human services, 
241.13 	provided nothing in this section is intended to create a formal binding legal process;
241.14 	(8) (7) engage in the program improvement process established in section 402A.18, 
241.15 	subdivision 3; and
241.16 	(9) (8) identify and recommend incentives for counties and tribes to participate in 
241.17 	human services service delivery authorities.
241.18 		Subd. 3.Program evaluation. By December 15, 2014, the council shall request 
241.19 	consideration by the legislative auditor for a reevaluation under section 3.971, subdivision 
241.20 	7, of those aspects of the program evaluation of human services administration reported 
241.21 	in January 2007 affected by this chapter.

241.22 	Sec. 12. [402A.35] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
241.23 		Subdivision 1.Requirements for establishing a service delivery authority.
 241.24 	(a) A county, tribe, or consortium of counties is eligible to establish a service delivery 
241.25 	authority if:
241.26 	(1) the county, tribe, or consortium of counties is:
241.27 	(i) a single county with a population of 55,000 or more;
241.28 	(ii) a consortium of counties with a total combined population of 55,000 or more;
241.29 	(iii) a consortium of four or more counties in reasonable geographic proximity 
241.30 	without regard to population; or
241.31 	(iv) one or more tribes with a total combined population of 25,000 or more.
241.32 	The council may recommend that the commissioner of human services exempt a 
241.33 	single county, tribe, or consortium of counties from the minimum population standard if 
241.34 	the county, tribe, or consortium of counties can demonstrate that it can otherwise meet 
241.35 	the requirements of this chapter.
242.1 	(b) A service delivery authority shall:
242.2 	(1) comply with current state and federal law, including any existing federal or state 
242.3 	performance measures and performance measures under section 402A.15 when they are 
242.4 	enacted into law, except where waivers are approved by the commissioner. Nothing 
242.5 	in this subdivision requires the establishment of performance measures under section 
242.6 	402A.15 prior to a service delivery authority participating in the service delivery redesign 
242.7 	under this chapter;
242.8 	(2) define the scope of essential services over which the service delivery authority 
242.9 	has jurisdiction;
242.10 	(3) designate a single administrative structure to oversee the delivery of those 
242.11 	services included in a proposal for a redesigned service or services and identify a single 
242.12 	administrative agent for purposes of contact and communication with the department;
242.13 	(4) identify the waivers from statutory or rule program requirements that are needed 
242.14 	to ensure greater local control and flexibility to determine the most cost-effective means of 
242.15 	achieving specified measurable goals that the participating service delivery authority is 
242.16 	expected to achieve;
242.17 	(5) set forth a reasonable level of targeted reductions in overhead and administrative 
242.18 	costs for each service delivery authority participating in the service delivery redesign;
242.19 	(6) set forth the terms under which a county, tribe, or consortium of counties 
242.20 	may withdraw from participation. In the case of withdrawal of any or all parties or 
242.21 	the dissolution of the service delivery authority, the employees shall continue to be 
242.22 	represented by the same exclusive representative or representatives and continue to be 
242.23 	covered by the same collective bargaining union agreement until a new agreement is 
242.24 	negotiated or the collective bargaining agreement term ends; and
242.25 	(7) set forth a structure for managing the terms and conditions of employment of the 
242.26 	employees as provided in section 402A.40.
242.27 	(c) Once a county, tribe, or consortium of counties establishes a service delivery 
242.28 	authority, no county, tribe, or consortium of counties that is a member of the service 
242.29 	delivery authority may participate as a member of any other service delivery authority. 
242.30 	The service delivery authority may allow an additional county, a tribe, or a consortium of 
242.31 	counties to join the service delivery authority subject to the approval of the council and 
242.32 	the commissioner.
242.33 	(d) Nothing in this chapter precludes local governments from using sections 465.81 
242.34 	and 465.82 to establish procedures for local governments to merge, with the consent 
242.35 	of the voters. Nothing in this chapter limits the authority of a county board or tribal 
242.36 	council to enter into contractual agreements for services not covered by the provisions 
243.1 	of a memorandum of understanding establishing a service delivery authority with other 
243.2 	agencies or with other units of government.
243.3 		Subd. 2.Relief from statutory requirements. (a) Unless otherwise identified in 
243.4 	the memorandum of understanding, any county, tribe, or consortium of counties forming a 
243.5 	service delivery authority is exempt from the provisions of sections 245.465; 245.4835; 
243.6 	245.4874; 245.492, subdivision 2; 245.4932; 256F.13; 256J.626, subdivision 2, paragraph 
243.7 	(b); and 256M.30.
243.8 	(b) This subdivision does not preclude any county, tribe, or consortium of counties 
243.9 	forming a service delivery authority from requesting additional waivers from statutory and 
243.10 	rule requirements to ensure greater local control and flexibility.
243.11 		Subd. 3.Duties. The service delivery authority shall:
243.12 	(1) within the scope of essential services set forth in the memorandum of 
243.13 	understanding establishing the authority, carry out the responsibilities required of local 
243.14 	agencies under chapter 393 and human services boards under chapter 402;
243.15 	(2) manage the public resources devoted to human services and other public services 
243.16 	delivered or purchased by the counties or tribes that are subsidized or regulated by the 
243.17 	Department of Human Services under chapters 245 to 261;
243.18 	(3) employ staff to assist in carrying out its duties;
243.19 	(4) develop and maintain a continuity of operations plan to ensure the continued 
243.20 	operation or resumption of essential human services functions in the event of any business 
243.21 	interruption according to local, state, and federal emergency planning requirements;
243.22 	(5) receive and expend funds received for the redesign process under the 
243.23 	memorandum of understanding;
243.24 	(6) plan and deliver services directly or through contract with other governmental, 
243.25 	tribal, or nongovernmental providers;
243.26 	(7) rent, purchase, sell, and otherwise dispose of real and personal property as 
243.27 	necessary to carry out the redesign; and
243.28 	(8) carry out any other service designated as a responsibility of a county.
243.29 		Subd. 4.Process for establishing a service delivery authority. (a) The county, 
243.30 	tribe, or consortium of counties meeting the requirements of section 402A.30 and 
243.31 	proposing to establish a service delivery authority shall present to the council:
243.32 	(1) in conjunction with the commissioner, a proposed memorandum of understanding 
243.33 	meeting the requirements of subdivision 1, paragraph (b), and outlining:
243.34 	(i) the details of the proposal;
244.1 	(ii) the state, tribal, and local resources, which may include, but are not limited to, 
244.2 	funding, administrative and technology support, and other requirements necessary for 
244.3 	the service delivery authority; and
244.4 	(iii) the relief available to the service delivery authority if the resource commitments 
244.5 	identified in item (ii) are not met; and
244.6 	(2) a board resolution from the board of commissioners of each participating county 
244.7 	stating the county's intent to participate, or in the case of a tribe, a resolution from tribal 
244.8 	government, stating the tribe's intent to participate.
244.9 	(b) After the council has considered and recommended approval of a proposed 
244.10 	memorandum of understanding, the commissioner may finalize and execute the 
244.11 	memorandum of understanding.
244.12 		Subd. 5.Commissioner authority to seek waivers. The commissioner may use the 
244.13 	authority under section 256.01, subdivision 2, paragraph (l), to grant waivers identified as 
244.14 	part of a proposed service delivery authority under subdivision 1, paragraph (b), clause 
244.15 	(4), except that waivers granted under this section must be approved by the council under 
244.16 	section 402A.20 rather than the Legislative Advisory Committee.

244.17 	Sec. 13. [402A.40] TRANSITION TO NEW BARGAINING UNIT STRUCTURE.
244.18 		Subdivision 1.Application of section. Notwithstanding the provisions of section 
244.19 	179A.12 or any other law, this section governs, where contrary to other law, the initial 
244.20 	certification and decertification, if any, of exclusive representatives for service delivery 
244.21 	authorities. Employees of a service delivery authority are public employees under section 
244.22 	179A.03, subdivision 14. Service delivery authorities are public employers under section 
244.23 	179A.03, subdivision 15.
244.24 		Subd. 2.Existing majority. The commissioner of the Minnesota Bureau of 
244.25 	Mediation Services shall certify an employee organization for employees of a service 
244.26 	delivery authority as exclusive representative for an appropriate unit upon a petition 
244.27 	filed with the commissioner by the organization demonstrating that the petitioner is 
244.28 	certified pursuant to section 179A.12 as the exclusive representative of a majority of the 
244.29 	employees included within the unit as of that date. Two or more employee organizations 
244.30 	that represent the employees in a unit may petition jointly under this subdivision, provided 
244.31 	that any organization may withdraw from a joint certification in favor of the remaining 
244.32 	organizations on 30 days' notice to the remaining organizations, the employer, and the 
244.33 	commissioner, without affecting the rights and obligations of the remaining organizations 
244.34 	or the employer. The commissioner shall make a determination on a timely petition within 
244.35 	45 days of its receipt.
245.1 		Subd. 3.No existing majority. (a) If no exclusive representative is certified under 
245.2 	subdivision 2, the commissioner shall certify an employee organization as exclusive 
245.3 	representative for an appropriate unit established upon a petition filed by the organization 
245.4 	within the time period provided in subdivision 2 demonstrating that the petitioner is 
245.5 	certified under section 179A.12 as the exclusive representative of fewer than a majority 
245.6 	of the employees included within the unit if no other employee organization so certified 
245.7 	has filed a petition within the time period provided in subdivision 2 and a majority of the 
245.8 	employees in the unit are represented by employee organizations under section 179A.12 
245.9 	on the date of the petition. Two or more employee organizations, each of which represents 
245.10 	employees included in the unit may petition jointly under this paragraph, provided that 
245.11 	any organization may withdraw from a joint certification in favor of the remaining 
245.12 	organizations on 30 days' notice to the remaining organizations, the employer, and the 
245.13 	commissioner without affecting the rights and obligations of the remaining organizations 
245.14 	or the employer. The commissioner shall make a determination on a timely petition within 
245.15 	45 days of its receipt.
245.16 	(b) If no exclusive representative is certified under paragraph (a) or subdivision 2, 
245.17 	and an employee organization petitions the commissioner within 90 days of the creation of 
245.18 	the service delivery authority demonstrating that a majority of the employees included 
245.19 	within an appropriate unit wish to be represented by the petitioner, where this majority 
245.20 	is evidenced by current dues deduction rights, signed statements from employees in 
245.21 	counties within the service delivery authority that are not currently represented by any 
245.22 	employee organization plainly indicating that the signatories wish to be represented for 
245.23 	collective bargaining purposes by the petitioner rather than by any other organization, 
245.24 	or a combination of those, the commissioner shall certify the petitioner as exclusive 
245.25 	representative of the employees in the unit. The commissioner shall make a determination 
245.26 	on a timely petition within 45 days of its receipt.
245.27 	(c) If no exclusive representative is certified under paragraph (a) or (b) or subdivision 
245.28 	2, and an employee organization petitions the commissioner subsequent to the creation 
245.29 	of the service delivery authority demonstrating that at least 30 percent of the employees 
245.30 	included within an appropriate unit wish to be represented by the petitioner, where this 30 
245.31 	percent is evidenced by current dues deduction rights, signed statements from employees 
245.32 	in counties within the service delivery authority that are not currently represented by any 
245.33 	employee organization plainly indicating that the signatories wish to be represented for 
245.34 	collective bargaining purposes by the petitioner rather than by any other organization, or a 
245.35 	combination of those, the commissioner shall conduct a secret ballot election to determine 
245.36 	the wishes of the majority. The election must be conducted within 45 days of receipt or 
246.1 	final decision on any petitions filed pursuant to subdivision 2, whichever is later. The 
246.2 	election is governed by section 179A.12, where not inconsistent with other provisions 
246.3 	of this section.
246.4 		Subd. 4.Decertification. The commissioner may not consider a petition for 
246.5 	decertification of an exclusive representative certified under this section for one year after 
246.6 	certification, unless section 179A.20, subdivision 6, applies.
246.7 		Subd. 5.Continuing contract. (a) The terms and conditions of collective 
246.8 	bargaining agreements covering the employees of service delivery authorities remain in 
246.9 	effect until a successor agreement becomes effective or, if no employee organization 
246.10 	petitions to represent the employees of the service delivery authority, until six months 
246.11 	after the establishment of the service delivery authority.
246.12 	(b) Any accrued leave, including but not limited to sick leave, vacation time, 
246.13 	compensatory leave or paid time off, or severance pay benefits accumulated under policies 
246.14 	of the previously employing county or a collective bargaining agreement between the 
246.15 	previously employing county and an exclusive representative shall continue to apply in the 
246.16 	newly created service delivery authority for the employees of the previously employing 
246.17 	county. An employee who was eligible for the benefits of the Family and Medical Leave 
246.18 	Act at the previously employing county shall continue to be eligible at the newly created 
246.19 	service delivery authority.
246.20 	(c) If it is necessary, prior to the negotiation of a new collective bargaining 
246.21 	agreement, to lay off an employee of a service delivery authority and if two or more 
246.22 	employees previously performed the work, seniority based on continuous length of 
246.23 	service with a service delivery authority member county shall be the determining factor 
246.24 	in determining which qualified employee shall be offered the job by the service delivery 
246.25 	authority. An employee whose work is being transferred to the service delivery authority 
246.26 	shall have the option of being laid off.
246.27 		Subd. 6.Contract and representation responsibilities. (a) The exclusive 
246.28 	representatives of units of employees certified prior to the creation of the service delivery 
246.29 	authority remain responsible for administration of their contracts and for other contractual 
246.30 	duties and have the right to dues and fair share fee deduction and other contractual 
246.31 	privileges and rights until a contract is agreed upon with the service delivery authority. 
246.32 	Exclusive representatives of service delivery authority employees certified after the 
246.33 	creation of the service delivery authority are immediately upon certification responsible 
246.34 	for bargaining on behalf of employees within the unit. They are also responsible for 
246.35 	administering grievances arising under previous contracts covering employees included 
246.36 	within the unit that remain unresolved upon agreement with the service delivery authority 
247.1 	on a contract. Where the employer does not object, these responsibilities may be varied by 
247.2 	agreement between the outgoing and incoming exclusive representatives. All other rights 
247.3 	and duties of representation begin upon the creation of a service delivery authority, except 
247.4 	that exclusive representatives certified upon or after the creation of the service delivery 
247.5 	authority shall immediately, upon certification, have the right to all employer information 
247.6 	and all forms of access to employees within the bargaining unit which would be permitted 
247.7 	to the current contract holder, including the rights in section 179A.07, subdivision 6. This 
247.8 	section does not affect an existing collective bargaining contract. Incoming exclusive 
247.9 	representatives are immediately, upon certification, responsible for bargaining on behalf of 
247.10 	all previously unrepresented employees assigned to their units.
247.11 	(b) Nothing in this section prevents an exclusive representative certified after 
247.12 	the effective dates of these provisions from assessing fair share or dues deductions 
247.13 	immediately upon certification if the employees were unrepresented for collective 
247.14 	bargaining purposes before that certification.

247.15 	Sec. 14. COUNTY ELECTRONIC VERIFICATION PROCEDURES.
 247.16 	The commissioner of human services shall define which public assistance program 
247.17 	requirements may be electronically verified for the purposes of determining eligibility, 
247.18 	and shall also define procedures for electronic verification. The commissioner of human 
247.19 	services shall report back to the chairs and ranking minority members of the legislative 
247.20 	committees with jurisdiction over these issues by January 15, 2012, with draft legislation 
247.21 	to implement the procedures if legislation is necessary for purposes of implementation.

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

247.29 	Sec. 16. ALTERNATIVE STRATEGIES FOR CERTAIN 
247.30 	REDETERMINATIONS.
 247.31 	The commissioner of human services shall develop and implement by July 15, 
247.32 	2012, a simplified process to redetermine eligibility for recipient populations in the 
247.33 	medical assistance, Minnesota supplemental aid, food support, and group residential 
248.1 	housing programs who are eligible based upon disability or age, and who are expected to 
248.2 	experience minimal change in income or assets from month to month. The commissioner 
248.3 	shall apply for any federal waivers needed to implement this section.

248.4 	Sec. 17. SIMPLIFICATION OF ELIGIBILITY AND ENROLLMENT 
248.5 	PROCESS.
 248.6 	(a) The commissioner of human services shall issue a request for information for an 
248.7 	integrated service delivery system for health care programs, food support, cash assistance, 
248.8 	and child care. The commissioner shall determine, in consultation with partners in 
248.9 	paragraph (c), if the products meet departments' and counties' functions. The request for 
248.10 	information may incorporate a performance-based vendor financing option in which the 
248.11 	vendor shares the risk of the project's success. The health care system must be developed 
248.12 	in phases with the capacity to integrate food support, cash assistance, and child care 
248.13 	programs as funds are available. The request for information must require that the system:
248.14 	(1) streamline eligibility determinations and case processing to support statewide 
248.15 	eligibility processing;
248.16 	(2) enable interested persons to determine eligibility for each program, and to apply 
248.17 	for programs online in a manner that the applicant will be asked only those questions 
248.18 	relevant to the programs for which the person is applying;
248.19 	(3) leverage technology that has been operational in other state environments with 
248.20 	similar requirements; and
248.21 	(4) include Web-based application, worker application processing support, and the 
248.22 	opportunity for expansion.
248.23 	(b) The commissioner shall issue a final report, including the implementation plan, 
248.24 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
248.25 	over health and human services no later than January 31, 2012.
248.26 	(c) The commissioner shall partner with counties, a service delivery authority 
248.27 	established under Minnesota Statutes, chapter 402A, the Office of Enterprise Technology, 
248.28 	other state agencies, and service partners to develop an integrated service delivery 
248.29 	framework, which will simplify and streamline human services eligibility and enrollment 
248.30 	processes. The primary objectives for the simplification effort include significantly 
248.31 	improved eligibility processing productivity resulting in reduced time for eligibility 
248.32 	determination and enrollment, increased customer service for applicants and recipients of 
248.33 	services, increased program integrity, and greater administrative flexibility.
249.1 	(d) The commissioner, along with a county representative appointed by the 
249.2 	Association of Minnesota Counties, shall report specific implementation progress to the 
249.3 	legislature annually beginning May 15, 2012.
249.4 	(e) The commissioner shall work with the Minnesota Association of County Social 
249.5 	Service Administrators and the Office of Enterprise Technology to develop collaborative 
249.6 	task forces, as necessary, to support implementation of the service delivery components 
249.7 	under this paragraph. The commissioner must evaluate, develop, and include as part 
249.8 	of the integrated eligibility and enrollment service delivery framework, the following 
249.9 	minimum components:
249.10 	(1) screening tools for applicants to determine potential eligibility as part of an 
249.11 	online application process;
249.12 	(2) the capacity to use databases to electronically verify application and renewal 
249.13 	data as required by law;
249.14 	(3) online accounts accessible by applicants and enrollees;
249.15 	(4) an interactive voice response system, available statewide, that provides case 
249.16 	information for applicants, enrollees, and authorized third parties;
249.17 	(5) an electronic document management system that provides electronic transfer of 
249.18 	all documents required for eligibility and enrollment processes; and
249.19 	(6) a centralized customer contact center that applicants, enrollees, and authorized 
249.20 	third parties can use statewide to receive program information, application assistance, 
249.21 	and case information, report changes, make cost-sharing payments, and conduct other 
249.22 	eligibility and enrollment transactions.
249.23 	(f) Subject to a legislative appropriation, the commissioner of human services shall 
249.24 	issue a request for proposal for the appropriate phase of an integrated service delivery 
249.25 	system for health care programs, food support, cash assistance, and child care.

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

249.27 	Sec. 18. WHITE EARTH BAND OF OJIBWE HUMAN SERVICES PROJECT.
 249.28 	(a) The commissioner of human services, in consultation with the White Earth Band 
249.29 	of Ojibwe, shall transfer legal responsibility to the tribe for providing human services to 
249.30 	tribal members and their families who reside on or off the reservation in Mahnomen 
249.31 	County. The transfer shall include:
249.32 	(1) financing, including federal and state funds, grants, and foundation funds; and
249.33 	(2) services to eligible tribal members and families defined as it applies to state 
249.34 	programs being transferred to the tribe.
250.1 	(b) The determination as to which programs will be transferred to the tribe and 
250.2 	the timing of the transfer of the programs shall be made by a consensus decision of the 
250.3 	governing body of the tribe and the commissioner. The commissioner shall waive existing 
250.4 	rules and seek all federal approvals and waivers as needed to carry out the transfer.
250.5 	(c) When the commissioner approves transfer of programs and the tribe assumes 
250.6 	responsibility under this section, Mahnomen County is relieved of responsibility for 
250.7 	providing program services to tribal members and their families who live on or off the 
250.8 	reservation while the tribal project is in effect and funded, except that a family member 
250.9 	who is not a White Earth member may choose to receive services through the tribe or the 
250.10 	county. The commissioner shall have authority to redirect funds provided to Mahnomen 
250.11 	County for these services, including administrative expenses, to the White Earth Band 
250.12 	of Ojibwe Indians.
250.13 	(d) Upon the successful transfer of legal responsibility for providing human services 
250.14 	for tribal members and their families who reside on and off the reservation in Mahnomen 
250.15 	County, the commissioner and the White Earth Band of Ojibwe shall develop a plan to 
250.16 	transfer legal responsibility for providing human services for tribal members and their 
250.17 	families who reside on or off reservation in Clearwater and Becker Counties.
250.18 	(e) No later than January 15, 2012, the commissioner shall submit a written 
250.19 	report detailing the transfer progress to the chairs and ranking minority members of the 
250.20 	legislative committees with jurisdiction over health and human services. If legislation is 
250.21 	needed to fully complete the transfer of legal responsibility for providing human services, 
250.22 	the commissioner shall submit proposed legislation along with the written report.

250.23 	Sec. 19.  REPEALER.
 250.24 	(a) Minnesota Statutes 2010, sections 402A.30; and 402A.45, are repealed.
250.25 	(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.

250.26 	ARTICLE 10
250.27 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

250.28	Section 1.  SUMMARY OF APPROPRIATIONS.
 	
250.29 	The amounts shown in this section summarize direct appropriations, by fund, made 
250.30 	in this article.

250.31			2012
		2013
		Total
	
250.32	General
	$
	5,734,374,000
	$
	5,661,437,000
	$
	11,395,811,000
	
250.33
250.34	State Government Special 
Revenue
		66,851,000
		66,769,000
		133,620,000
	
251.1	Health Care Access
		356,381,000
		362,595,000
		718,976,000
	
251.2	Federal TANF
		277,091,000
		279,814,000
		556,905,000
	
251.3	Lottery Prize
		1,665,000
		1,665,000
		3,330,000
	
251.4	Special Revenue
		500,000
		1,000,000
		1,500,000
	
251.5	Total
	$
	6,436,862,000
	$
	6,373,280,000
	$
	12,810,142,000

251.6	Sec. 2. HUMAN SERVICES APPROPRIATIONS.
 	
251.7 	The sums shown in the columns marked "Appropriations" are appropriated to the 
251.8 	agencies and for the purposes specified in this article. The appropriations are from the 
251.9 	general fund, or another named fund, and are available for the fiscal years indicated 
251.10 	for each purpose. The figures "2012" and "2013" used in this article mean that the 
251.11 	appropriations listed under them are available for the fiscal year ending June 30, 2012, or 
251.12 	June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal 
251.13 	year 2013. "The biennium" is fiscal years 2012 and 2013.

251.14				APPROPRIATIONS
	
251.15				Available for the Year
	
251.16				Ending June 30
	
251.17					2012
		2013

251.18
251.19	Sec. 3. COMMISSIONER OF HUMAN 
SERVICES

251.20	Subdivision 1.Total Appropriation
 	$
	6,259,280,000
	$
	6,212,085,000

251.21	Appropriations by Fund
	
251.22		2012
	2013
	
251.23	General
	5,657,737,000
	5,584,471,000
	
251.24
251.25	State Government 
Special Revenue
	3,565,000
	3,565,000
	
251.26	Health Care Access
	330,435,000
	353,283,000
	
251.27	Federal TANF
	265,378,000
	268,101,000
	
251.28	Lottery Prize
	1,665,000
	1,665,000
	
251.29	Special Revenue
	500,000
	1,000,000
	
251.30 	Receipts for Systems Projects. 
251.31 	Appropriations and federal receipts for 
251.32 	information systems projects for MAXIS, 
251.33 	PRISM, MMIS, and SSIS must be deposited 
251.34 	in the state systems account authorized in 
251.35 	Minnesota Statutes, section 256.014. Money 
251.36 	appropriated for computer projects approved 
251.37 	by the Minnesota Office of Enterprise 
252.1 	Technology, funded by the legislature, 
252.2 	and approved by the commissioner 
252.3 	of management and budget, may be 
252.4 	transferred from one project to another 
252.5 	and from development to operations as the 
252.6 	commissioner of human services considers 
252.7 	necessary. Any unexpended balance in 
252.8 	the appropriation for these projects does 
252.9 	not cancel but is available for ongoing 
252.10 	development and operations.
252.11 	Nonfederal Share Transfers. The 
252.12 	nonfederal share of activities for which 
252.13 	federal administrative reimbursement is 
252.14 	appropriated to the commissioner may be 
252.15 	transferred to the special revenue fund.
252.16 	TANF Maintenance of Effort.
252.17 	(a) In order to meet the basic maintenance 
252.18 	of effort (MOE) requirements of the TANF 
252.19 	block grant specified under Code of Federal 
252.20 	Regulations, title 45, section 263.1, the 
252.21 	commissioner may only report nonfederal 
252.22 	money expended for allowable activities 
252.23 	listed in the following clauses as TANF/MOE 
252.24 	expenditures:
252.25 	(1) MFIP cash, diversionary work program, 
252.26 	and food assistance benefits under Minnesota 
252.27 	Statutes, chapter 256J;
252.28 	(2) the child care assistance programs 
252.29 	under Minnesota Statutes, sections 119B.03 
252.30 	and 119B.05, and county child care 
252.31 	administrative costs under Minnesota 
252.32 	Statutes, section 119B.15;
252.33 	(3) state and county MFIP administrative 
252.34 	costs under Minnesota Statutes, chapters 
252.35 	256J and 256K;
253.1 	(4) state, county, and tribal MFIP 
253.2 	employment services under Minnesota 
253.3 	Statutes, chapters 256J and 256K;
253.4 	(5) expenditures made on behalf of legal 
253.5 	noncitizen MFIP recipients who qualify for 
253.6 	the MinnesotaCare program under Minnesota 
253.7 	Statutes, chapter 256L;
253.8 	(6) qualifying working family credit 
253.9 	expenditures under Minnesota Statutes, 
253.10 	section 290.0671; and
253.11 	(7) qualifying Minnesota education credit 
253.12 	expenditures under Minnesota Statutes, 
253.13 	section 290.0674.
253.14 	(b) The commissioner shall ensure that 
253.15 	sufficient qualified nonfederal expenditures 
253.16 	are made each year to meet the state's 
253.17 	TANF/MOE requirements. For the activities 
253.18 	listed in paragraph (a), clauses (2) to 
253.19 	(7), the commissioner may only report 
253.20 	expenditures that are excluded from the 
253.21 	definition of assistance under Code of 
253.22 	Federal Regulations, title 45, section 260.31.
253.23 	(c) For fiscal years beginning with state fiscal 
253.24 	year 2003, the commissioner shall assure 
253.25 	that the maintenance of effort used by the 
253.26 	commissioner of management and budget 
253.27 	for the February and November forecasts 
253.28 	required under Minnesota Statutes, section 
253.29 	16A.103, contains expenditures under 
253.30 	paragraph (a), clause (1), equal to at least 16 
253.31 	percent of the total required under Code of 
253.32 	Federal Regulations, title 45, section 263.1.
253.33 	(d) Minnesota Statutes, section 256.011, 
253.34 	subdivision 3, which requires that federal 
253.35 	grants or aids secured or obtained under that 
254.1 	subdivision be used to reduce any direct 
254.2 	appropriations provided by law, do not apply 
254.3 	if the grants or aids are federal TANF funds.
254.4 	(e) For the federal fiscal years beginning on 
254.5 	or after October 1, 2007, the commissioner 
254.6 	may not claim an amount of TANF/MOE in 
254.7 	excess of the 75 percent standard in Code 
254.8 	of Federal Regulations, title 45, section 
254.9 	263.1(a)(2), except:
254.10 	(1) to the extent necessary to meet the 80 
254.11 	percent standard under Code of Federal 
254.12 	Regulations, title 45, section 263.1(a)(1), 
254.13 	if it is determined by the commissioner 
254.14 	that the state will not meet the TANF work 
254.15 	participation target rate for the current year; 
254.16 	(2) to provide any additional amounts 
254.17 	under Code of Federal Regulations, title 45, 
254.18 	section 264.5, that relate to replacement of 
254.19 	TANF funds due to the operation of TANF 
254.20 	penalties; and
254.21 	(3) to provide any additional amounts that 
254.22 	may contribute to avoiding or reducing 
254.23 	TANF work participation penalties through 
254.24 	the operation of the excess MOE provisions 
254.25 	of Code of Federal Regulations, title 45, 
254.26 	section 261.43(a)(2). 
254.27 	For the purposes of clauses (1) to (3), 
254.28 	the commissioner may supplement the 
254.29 	MOE claim with working family credit 
254.30 	expenditures or other qualified expenditures 
254.31 	to the extent such expenditures are otherwise 
254.32 	available after considering the expenditures 
254.33 	allowed in this subdivision. 
255.1 	(f) Notwithstanding any contrary provision 
255.2 	in this article, paragraphs (a) to (e) expire 
255.3 	June 30, 2015.
255.4 	Working Family Credit Expenditures 
255.5 	as TANF/MOE. The commissioner may 
255.6 	claim as TANF maintenance of effort up to 
255.7 	$6,707,000 per year of working family credit 
255.8 	expenditures for fiscal years 2012 and 2013.
255.9 	Working Family Credit Expenditures 
255.10 	to be Claimed for TANF/MOE. The 
255.11 	commissioner may count the following 
255.12 	amounts of working family credit 
255.13 	expenditures as TANF/MOE:
255.14 	(1) fiscal year 2012, $23,692,000;
255.15 	(2) fiscal year 2013, $44,969,000;
255.16 	(3) fiscal year 2014, $32,579,000; and
255.17 	(4) fiscal year 2015, $32,476,000.
255.18 	Notwithstanding any contrary provision in 
255.19 	this article, this rider expires June 30, 2015.
255.20 	TANF Transfer to Federal Child Care 
255.21 	and Development Fund. (a) The following 
255.22 	TANF fund amounts are appropriated 
255.23 	to the commissioner for purposes of 
255.24 	MFIP/Transition Year Child Care Assistance 
255.25 	under Minnesota Statutes, section 119B.05:
255.26 	(1) fiscal year 2012, $10,020,000;
255.27 	(2) fiscal year 2013, $28,020,000;
255.28 	(3) fiscal year 2014, $14,020,000; and
255.29 	(4) fiscal year 2015, $14,020,000.
255.30 	(b) The commissioner shall authorize the 
255.31 	transfer of sufficient TANF funds to the 
255.32 	federal child care and development fund to 
255.33 	meet this appropriation and shall ensure that 
256.1 	all transferred funds are expended according 
256.2 	to federal child care and development fund 
256.3 	regulations.
256.4 	Food Stamps Employment and Training 
256.5 	Funds. (a) Notwithstanding Minnesota 
256.6 	Statutes, sections 256D.051, subdivisions 1a, 
256.7 	6b, and 6c, and 256J.626, federal food stamps 
256.8 	employment and training funds received 
256.9 	as reimbursement for child care assistance 
256.10 	program expenditures must be deposited in 
256.11 	the general fund. The amount of funds must 
256.12 	be limited to $500,000 per year in fiscal 
256.13 	years 2012 through 2015, contingent upon 
256.14 	approval by the federal Food and Nutrition 
256.15 	Service.
256.16 	(b) Consistent with the receipt of these 
256.17 	federal funds, the commissioner may 
256.18 	adjust the level of working family credit 
256.19 	expenditures claimed as TANF maintenance 
256.20 	of effort. Notwithstanding any contrary 
256.21 	provision in this article, this rider expires 
256.22 	June 30, 2015.
256.23 	ARRA Food Support Benefit Increases. 
256.24 	The funds provided for food support benefit 
256.25 	increases under the Supplemental Nutrition 
256.26 	Assistance Program provisions of the 
256.27 	American Recovery and Reinvestment Act 
256.28 	(ARRA) of 2009 must be used for benefit 
256.29 	increases beginning July 1, 2009.
256.30 	Supplemental Security Interim Assistance 
256.31 	Reimbursement Funds. $2,800,000 of 
256.32 	uncommitted revenue available to the 
256.33 	commissioner of human services for SSI 
256.34 	advocacy and outreach services must be 
257.1 	transferred to and deposited into the general 
257.2 	fund by October 1, 2011.

257.3	Subd. 2.Central Office Operations
 					
257.4 	The amounts that may be spent from this 
257.5 	appropriation for each purpose are as follows:

257.6	(a) Operations

257.7	Appropriations by Fund
	
257.8	General
	78,621,000
	77,551,000
	
257.9	Health Care Access
	11,508,000
	11,508,000
	
257.10
257.11	State Government 
Special Revenue
	3,440,000
	3,440,000
	
257.12	Federal TANF
	222,000
	222,000
	
257.13 	DHS Receipt Center Accounting. The 
257.14 	commissioner is authorized to transfer 
257.15 	appropriations to, and account for DHS 
257.16 	receipt center operations in, the special 
257.17 	revenue fund.
257.18 	Administrative Recovery; Set-Aside. The 
257.19 	commissioner may invoice local entities 
257.20 	through the SWIFT accounting system as an 
257.21 	alternative means to recover the actual cost 
257.22 	of administering the following provisions:
257.23 	(1) Minnesota Statutes, section 125A.744, 
257.24 	subdivision 3;
257.25 	(2) Minnesota Statutes, section 245.495, 
257.26 	paragraph (b);
257.27 	(3) Minnesota Statutes, section 256B.0625, 
257.28 	subdivision 20, paragraph (k);
257.29 	(4) Minnesota Statutes, section 256B.0924, 
257.30 	subdivision 6, paragraph (g);
257.31 	(5) Minnesota Statutes, section 256B.0945, 
257.32 	subdivision 4, paragraph (d); and
257.33 	(6) Minnesota Statutes, section 256F.10, 
257.34 	subdivision 6, paragraph (b).
258.1 	Payments for Cost Settlements. The 
258.2 	commissioner is authorized to use amounts 
258.3 	repaid to the general assistance medical care 
258.4 	program under Minnesota Statutes 2009 
258.5 	Supplement, section 256D.03, subdivision 
258.6 	3, to pay cost settlements for claims for 
258.7 	services provided prior to June 1, 2010. 
258.8 	Notwithstanding any contrary provision in 
258.9 	this article, this provision does not expire.
258.10 	Base Adjustment. The general fund base 
258.11 	for fiscal year 2014 shall be increased by 
258.12 	$75,000 and decreased by $14,000 in fiscal 
258.13 	year 2015.
258.14 	Human Services Licensing Activities. 
258.15 	$3,000,000 each year of the biennium is 
258.16 	appropriated from the state government 
258.17 	special revenue fund to the commissioner 
258.18 	for human services licensing activities under 
258.19 	Minnesota Statutes, chapter 245A.
258.20 	Streamlined Eligibility Determination 
258.21 	System for Minnesota Health Care 
258.22 	Programs. Of this appropriation, $900,000 
258.23 	in fiscal year 2012 and $1,600,000 in fiscal 
258.24 	year 2013 are for transfer to the state systems 
258.25 	account authorized in Minnesota Statutes, 
258.26 	section 256.014, for the development and 
258.27 	implementation of a streamlined eligibility 
258.28 	determination system for Minnesota health 
258.29 	care programs. This streamlined eligibility 
258.30 	determination system will: enhance customer 
258.31 	service for applicants and enrollees; 
258.32 	incorporate eligibility changes in a timely 
258.33 	manner; promote ongoing program integrity; 
258.34 	and integrate Minnesota health care programs 
259.1 	into the health insurance exchange authorized 
259.2 	under Minnesota Statutes, chapter 62V.
259.3 	Child Support Cost Recovery Fees. The 
259.4 	commissioner shall transfer nonfederal share 
259.5 	fee revenue of $31,000 in fiscal year 2012 
259.6 	only to the PRISM special revenue account 
259.7 	to offset PRISM system costs of increasing 
259.8 	the child support cost recovery fees.

259.9	(b) Children and Families

259.10	Appropriations by Fund
	
259.11	General
	9,452,000
	9,337,000
	
259.12	Federal TANF
	2,160,000
	2,160,000
	
259.13 	Financial Institution Data Match and 
259.14 	Payment of Fees. The commissioner is 
259.15 	authorized to allocate up to $310,000 each 
259.16 	year in fiscal years 2012 and 2013 from the 
259.17 	PRISM special revenue account to make 
259.18 	payments to financial institutions in exchange 
259.19 	for performing data matches between account 
259.20 	information held by financial institutions 
259.21 	and the public authority's database of child 
259.22 	support obligors as authorized by Minnesota 
259.23 	Statutes, section 13B.06, subdivision 7.
259.24 	Base Adjustment. The general fund base 
259.25 	is decreased by $47,000 in fiscal years 2014 
259.26 	and 2015.

259.27	(c) Health Care

259.28	Appropriations by Fund
	
259.29	General
	16,551,000
	16,538,000
	
259.30	Health Care Access
	22,941,000
	23,563,000
	
259.31 	Minnesota Senior Health Options 
259.32 	Reimbursement. Federal administrative 
259.33 	reimbursement resulting from the Minnesota 
259.34 	senior health options project is appropriated 
259.35 	to the commissioner for this activity.
260.1 	Utilization Review. Federal administrative 
260.2 	reimbursement resulting from prior 
260.3 	authorization and inpatient admission 
260.4 	certification by a professional review 
260.5 	organization shall be dedicated to the 
260.6 	commissioner for these purposes. A portion 
260.7 	of these funds must be used for activities to 
260.8 	decrease unnecessary pharmaceutical costs 
260.9 	in medical assistance.
260.10 	Base Adjustment. The general fund base 
260.11 	shall be decreased by $2,000 in fiscal year 
260.12 	2014 and $114,000 in fiscal year 2015.
260.13 	The health care access fund base is increased 
260.14 	by $142,000 in fiscal year 2014 and $16,000 
260.15 	in fiscal year 2015.

260.16	(d) Continuing Care

260.17	Appropriations by Fund
	
260.18	General
	17,873,000
	17,769,000
	
260.19
260.20	State Government 
Special Revenue
	125,000
	125,000
	
260.21 	Region 10 Administrative Expenses.
260.22 	$100,000 is appropriated each fiscal 
260.23 	year, beginning in fiscal year 2012, for 
260.24 	the administration of the State Quality 
260.25 	Improvement and Licensing System under 
260.26 	Minnesota Statutes, section 256B.0961.
260.27 	Base Adjustment. The general fund base is 
260.28 	decreased by $257,000 in fiscal year 2014 
260.29 	and $254,000 in fiscal year 2015.

260.30	(e) Chemical and Mental Health

260.31	Appropriations by Fund
	
260.32	General
	4,194,000
	4,194,000
	
260.33	Lottery Prize
	157,000
	157,000

260.34	Subd. 3.Forecasted Programs
 					
261.1 	The amounts that may be spent from this 
261.2 	appropriation for each purpose are as follows:

261.3	(a) MFIP/DWP Grants

261.4	Appropriations by Fund
	
261.5	General
	84,680,000
	91,978,000
	
261.6	Federal TANF
	84,425,000
	75,417,000

261.7	(b) MFIP Child Care Assistance Grants
		55,456,000
		30,923,000

261.8	(c) General Assistance Grants
		49,192,000
		46,938,000
	
261.9 	General Assistance Standard. The 
261.10 	commissioner shall set the monthly standard 
261.11 	of assistance for general assistance units 
261.12 	consisting of an adult recipient who is 
261.13 	childless and unmarried or living apart 
261.14 	from parents or a legal guardian at $203. 
261.15 	The commissioner may reduce this amount 
261.16 	according to Laws 1997, chapter 85, article 
261.17 	3, section 54.
261.18 	Emergency General Assistance. The 
261.19 	amount appropriated for emergency general 
261.20 	assistance funds is limited to no more 
261.21 	than $6,689,812 in fiscal year 2012 and 
261.22 	$6,729,812 in fiscal year 2013. Funds 
261.23 	to counties shall be allocated by the 
261.24 	commissioner using the allocation method 
261.25 	specified in Minnesota Statutes, section 
261.26 	256D.06.

261.27	(d) Minnesota Supplemental Aid Grants
		38,095,000
		39,120,000

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

261.29	(f) MinnesotaCare Grants
		295,046,000
		317,272,000
	
261.30 	This appropriation is from the health care 
261.31 	access fund.

261.32	(g) Medical Assistance Grants
		4,501,582,000
		4,437,282,000
	
262.1 	Managed Care Incentive Payments. The 
262.2 	commissioner shall not make managed care 
262.3 	incentive payments for expanding preventive 
262.4 	services during fiscal years beginning July 1, 
262.5 	2011, and July 1, 2012.
262.6 	Reduction of Rates for Congregate 
262.7 	Living for Individuals with Lower Needs. 
262.8 	Beginning October 1, 2011, lead agencies 
262.9 	must reduce rates in effect on January 1, 
262.10 	2011, by ten percent for individuals with 
262.11 	lower needs living in foster care settings 
262.12 	where the license holder does not share 
262.13 	the residence with recipients on the CADI 
262.14 	and DD waivers and customized living 
262.15 	settings for CADI. Lead agencies must adjust 
262.16 	contracts within 60 days of the effective date.
262.17 	Reduction of Lead Agency Waiver 
262.18 	Allocations to Implement Rate Reductions 
262.19 	for Congregate Living for Individuals 
262.20 	with Lower Needs. Beginning October 1, 
262.21 	2011, the commissioner shall reduce lead 
262.22 	agency waiver allocations to implement the 
262.23 	reduction of rates for individuals with lower 
262.24 	needs living in foster care settings where the 
262.25 	license holder does not share the residence 
262.26 	with recipients on the CADI and DD waivers 
262.27 	and customized living settings for CADI.
262.28 	Reduce customized living and 24-hour 
262.29 	customized living component rates.
262.30 	Effective July 1, 2011, the commissioner 
262.31 	shall reduce elderly waiver customized living 
262.32 	and 24-hour customized living component 
262.33 	service spending by five percent through 
262.34 	reductions in component rates and service 
262.35 	rate limits. The commissioner shall adjust 
263.1 	the elderly waiver capitation payment 
263.2 	rates for managed care organizations paid 
263.3 	under Minnesota Statutes, section 256B.69, 
263.4 	subdivisions 6a and 23, to reflect reductions 
263.5 	in component spending for customized living 
263.6 	services and 24-hour customized living 
263.7 	services under Minnesota Statutes, section 
263.8 	256B.0915, subdivisions 3e and 3h, for the 
263.9 	contract period beginning January 1, 2012. 
263.10 	To implement the reduction specified in 
263.11 	this provision, capitation rates paid by the 
263.12 	commissioner to managed care organizations 
263.13 	under Minnesota Statutes, section 256B.69, 
263.14 	shall reflect a ten percent reduction for the 
263.15 	specified services for the period January 1, 
263.16 	2012, to June 30, 2012, and a five percent 
263.17 	reduction for those services on or after July 
263.18 	1, 2012.
263.19 	Limit Growth in the Developmental 
263.20 	Disability Waiver. The commissioner 
263.21 	shall limit growth in the developmental 
263.22 	disability waiver to six diversion allocations 
263.23 	per month beginning July 1, 2011, through 
263.24 	June 30, 2013, and 15 diversion allocations 
263.25 	per month beginning July 1, 2013, through 
263.26 	June 30, 2015. Waiver allocations shall 
263.27 	be targeted to individuals who meet the 
263.28 	priorities for accessing waiver services 
263.29 	identified in Minnesota Statutes, 256B.092, 
263.30 	subdivision 12. The limits do not include 
263.31 	conversions from intermediate care facilities 
263.32 	for persons with developmental disabilities. 
263.33 	Notwithstanding any contrary provisions in 
263.34 	this article, this paragraph expires June 30, 
263.35 	2015.
264.1 	Limit Growth in the Community 
264.2 	Alternatives for Disabled Individuals 
264.3 	Waiver. The commissioner shall limit 
264.4 	growth in the community alternatives for 
264.5 	disabled individuals waiver to 60 allocations 
264.6 	per month beginning July 1, 2011, through 
264.7 	June 30, 2013, and 85 allocations per 
264.8 	month beginning July 1, 2013, through 
264.9 	June 30, 2015. Waiver allocations must 
264.10 	be targeted to individuals who meet the 
264.11 	priorities for accessing waiver services 
264.12 	identified in Minnesota Statutes, section 
264.13 	256B.49, subdivision 11a. The limits include 
264.14 	conversions and diversions, unless the 
264.15 	commissioner has approved a plan to convert 
264.16 	funding due to the closure or downsizing 
264.17 	of a residential facility or nursing facility 
264.18 	to serve directly affected individuals on 
264.19 	the community alternatives for disabled 
264.20 	individuals waiver. Notwithstanding any 
264.21 	contrary provisions in this article, this 
264.22 	paragraph expires June 30, 2015.
264.23 	Personal Care Assistance Relative 
264.24 	Care. The commissioner shall adjust the 
264.25 	capitation payment rates for managed care 
264.26 	organizations paid under Minnesota Statutes, 
264.27 	section 256B.69, to reflect the rate reductions 
264.28 	for personal care assistance provided by 
264.29 	a relative pursuant to Minnesota Statutes, 
264.30 	section 256B.0659, subdivision 11.

264.31	(h) Alternative Care Grants
		46,421,000
		46,035,000
	
264.32 	Alternative Care Transfer. Any money 
264.33 	allocated to the alternative care program that 
264.34 	is not spent for the purposes indicated does 
265.1 	not cancel but shall be transferred to the 
265.2 	medical assistance account.

265.3	(i) Chemical Dependency Entitlement Grants
		94,675,000
		93,298,000

265.4	Subd. 4.Grant Programs
 					
265.5 	The amounts that may be spent from this 
265.6 	appropriation for each purpose are as follows:

265.7	(a) Support Services Grants

265.8	Appropriations by Fund
	
265.9	General
	8,715,000
	8,715,000
	
265.10	Federal TANF
	100,525,000
	94,611,000
	
265.11 	MFIP Consolidated Fund Grants. The 
265.12 	TANF fund base is reduced by $10,000,000 
265.13 	each year beginning in fiscal year 2012.
265.14 	Subsidized Employment Funding Through 
265.15 	ARRA. The commissioner is authorized to 
265.16 	apply for TANF emergency fund grants for 
265.17 	subsidized employment activities. Growth 
265.18 	in expenditures for subsidized employment 
265.19 	within the supported work program and the 
265.20 	MFIP consolidated fund over the amount 
265.21 	expended in the calendar year quarters in 
265.22 	the TANF emergency fund base year shall 
265.23 	be used to leverage the TANF emergency 
265.24 	fund grants for subsidized employment and 
265.25 	to fund supported work. The commissioner 
265.26 	shall develop procedures to maximize 
265.27 	reimbursement of these expenditures over the 
265.28 	TANF emergency fund base year quarters, 
265.29 	and may contract directly with employers 
265.30 	and providers to maximize these TANF 
265.31 	emergency fund grants.

265.32
265.33	(b) Basic Sliding Fee Child Care Assistance 
Grants
		37,144,000
		38,678,000
	
266.1 	Base Adjustment. The general fund base is 
266.2 	decreased by $990,000 in fiscal year 2014 
266.3 	and $979,000 in fiscal year 2015.
266.4 	Child Care and Development Fund 
266.5 	Unexpended Balance. In addition to 
266.6 	the amount provided in this section, the 
266.7 	commissioner shall expend $5,000,000 
266.8 	in fiscal year 2012 from the federal child 
266.9 	care and development fund unexpended 
266.10 	balance for basic sliding fee child care under 
266.11 	Minnesota Statutes, section 119B.03. The 
266.12 	commissioner shall ensure that all child 
266.13 	care and development funds are expended 
266.14 	according to the federal child care and 
266.15 	development fund regulations.

266.16	(c) Child Care Development Grants
		774,000
		774,000
	
266.17 	Base Adjustment. The general fund base is 
266.18 	increased by $713,000 in fiscal years 2014 
266.19 	and 2015.

266.20	(d) Child Support Enforcement Grants
		50,000
		50,000
	
266.21 	Federal Child Support Demonstration 
266.22 	Grants. Federal administrative 
266.23 	reimbursement resulting from the federal 
266.24 	child support grant expenditures authorized 
266.25 	under section 1115a of the Social Security 
266.26 	Act is appropriated to the commissioner for 
266.27 	this activity.

266.28	(e) Children's Services Grants

266.29	Appropriations by Fund
	
266.30	General
	47,949,000
	48,507,000
	
266.31	Federal TANF
	140,000
	140,000
	
266.32 	Adoption Assistance and Relative Custody 
266.33 	Assistance Transfer.  The commissioner 
266.34 	may transfer unencumbered appropriation 
267.1 	balances for adoption assistance and relative 
267.2 	custody assistance between fiscal years and 
267.3 	between programs.
267.4 	Privatized Adoption Grants. Federal 
267.5 	reimbursement for privatized adoption grant 
267.6 	and foster care recruitment grant expenditures 
267.7 	is appropriated to the commissioner for 
267.8 	adoption grants and foster care and adoption 
267.9 	administrative purposes.
267.10 	Adoption Assistance Incentive Grants.
267.11 	Federal funds available during fiscal year 
267.12 	2012 and fiscal year 2013 for adoption 
267.13 	incentive grants are appropriated to the 
267.14 	commissioner for these purposes.

267.15	(f) Children and Community Services Grants
		53,301,000
		53,301,000

267.16	(g) Children and Economic Support Grants

267.17	Appropriations by Fund
	
267.18	General
	16,103,000
	16,180,000
	
267.19	Federal TANF
	700,000
	0
	
267.20 	Long-Term Homeless Services. $700,000 
267.21 	is appropriated from the federal TANF 
267.22 	fund for the biennium beginning July 
267.23 	1, 2011, to the commissioner of human 
267.24 	services for long-term homeless services 
267.25 	for low-income homeless families under 
267.26 	Minnesota Statutes, section 256K.26. This 
267.27 	is a onetime appropriation and is not added 
267.28 	to the base.
267.29 	Base Adjustment. The general fund base is 
267.30 	increased by $42,000 in fiscal year 2014 and 
267.31 	$43,000 in fiscal year 2015.
267.32 	Minnesota Food Assistance Program. 
267.33 	$333,000 in fiscal year 2012 and $408,000 in 
267.34 	fiscal year 2013 are to increase the general 
268.1 	fund base for the Minnesota food assistance 
268.2 	program. Unexpended funds for fiscal year 
268.3 	2012 do not cancel but are available to the 
268.4 	commissioner for this purpose in fiscal year 
268.5 	2013.

268.6	(h) Health Care Grants

268.7	Appropriations by Fund
	
268.8	General
	26,000
	66,000
	
268.9	Health Care Access
	190,000
	190,000
	
268.10 	Base Adjustment.  The general fund base is 
268.11 	increased by $24,000 in each of fiscal years 
268.12 	2014 and 2015.

268.13	(i) Aging and Adult Services Grants
		12,154,000
		11,456,000
	
268.14 	Aging Grants Reduction. Effective July 
268.15 	1, 2011, funding for grants made under 
268.16 	Minnesota Statutes, sections 256.9754 and 
268.17 	256B.0917, subdivision 13, is reduced by 
268.18 	$3,600,000 for each year of the biennium. 
268.19 	These reductions are onetime and do 
268.20 	not affect base funding for the 2014-2015 
268.21 	biennium. Grants made during the 2012-2013 
268.22 	biennium under Minnesota Statutes, section 
268.23 	256B.9754, must not be used for new 
268.24 	construction or building renovation.
268.25 	Essential Community Support Grant 
268.26 	Delay. Upon federal approval to implement 
268.27 	the nursing facility level of care on July 
268.28 	1, 2013, essential community supports 
268.29 	grants under Minnesota Statutes, section 
268.30 	256B.0917, subdivision 14, are reduced by 
268.31 	$6,410,000 in fiscal year 2013. Base level 
268.32 	funding is increased by $5,541,000 in fiscal 
268.33 	year 2014 and $6,410,000 in fiscal year 2015.
268.34 	Base Level Adjustment.  The general fund 
268.35 	base is increased by $10,035,000 in fiscal 
269.1 	year 2014 and increased by $10,901,000 in 
269.2 	fiscal year 2015.

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

269.4	(k) Disabilities Grants
		15,945,000
		18,284,000
	
269.5 	Grants for Housing Access Services. In 
269.6 	fiscal year 2012, the commissioner shall 
269.7 	make available a total of $161,000 in housing 
269.8 	access services grants to individuals who 
269.9 	relocate from an adult foster care home to 
269.10 	a community living setting for assistance 
269.11 	with completion of rental applications or 
269.12 	lease agreements; assistance with publicly 
269.13 	financed housing options; development of 
269.14 	household budgets; and assistance with 
269.15 	funding affordable furnishings and related 
269.16 	household matters.
269.17 	HIV Grants. The general fund appropriation 
269.18 	for the HIV drug and insurance grant 
269.19 	program shall be reduced by $2,425,000 in 
269.20 	fiscal year 2012 and increased by $2,425,000 
269.21 	in fiscal year 2014. These adjustments are 
269.22 	onetime and shall not be applied to the base. 
269.23 	Notwithstanding any contrary provision, this 
269.24 	provision expires June 30, 2014.
269.25 	Region 10. Of this appropriation, $100,000 
269.26 	each year is for a grant provided under 
269.27 	Minnesota Statutes, section 256B.0961.
269.28 	Base Level Adjustment.  The general fund 
269.29 	base is increased by $2,944,000 in fiscal year 
269.30 	2014 and $653,000 in fiscal year 2015.
269.31 	Local Planning Grants for Creating 
269.32 	Alternatives to Congregate Living for 
269.33 	Individuals with Lower Needs. The 
269.34 	commissioner shall make available a total 
270.1 	of $250,000 per year in local planning 
270.2 	grants, beginning July 1, 2011, to assist 
270.3 	lead agencies and provider organizations in 
270.4 	developing alternatives to congregate living 
270.5 	within the available level of resources for the 
270.6 	home and community-based services waivers 
270.7 	for persons with disabilities.
270.8 	Disability Linkage Line. Of this 
270.9 	appropriation, $125,000 in fiscal year 2012 
270.10 	and $300,000 in fiscal year 2013 are for 
270.11 	assistance to people with disabilities who are 
270.12 	considering enrolling in managed care.

270.13	(l) Adult Mental Health Grants

270.14	Appropriations by Fund
	
270.15	General
	70,570,000
	70,570,000
	
270.16	Health Care Access
	750,000
	750,000
	
270.17	Lottery Prize
	1,508,000
	1,508,000
	
270.18 	Funding Usage. Up to 75 percent of a fiscal 
270.19 	year's appropriation for adult mental health 
270.20 	grants may be used to fund allocations in that 
270.21 	portion of the fiscal year ending December 
270.22 	31.
270.23 	Base Adjustment. The general fund base is 
270.24 	increased by $200,000 in fiscal years 2014 
270.25 	and 2015.

270.26	(m) Children's Mental Health Grants
		16,457,000
		16,457,000
	
270.27 	Funding Usage. Up to 75 percent of a fiscal 
270.28 	year's appropriation for children's mental 
270.29 	health grants may be used to fund allocations 
270.30 	in that portion of the fiscal year ending 
270.31 	December 31.
270.32 	Base Adjustment. The general fund base is 
270.33 	increased by $225,000 in fiscal years 2014 
270.34 	and 2015.

271.1
271.2	(n) Chemical Dependency Nonentitlement 
Grants
		1,336,000
		1,336,000

271.3	Subd. 5.State-Operated Services
 					
271.4 	Transfer Authority Related to 
271.5 	State-Operated Services. Money 
271.6 	appropriated for state-operated services 
271.7 	may be transferred between fiscal years 
271.8 	of the biennium with the approval of the 
271.9 	commissioner of management and budget.

271.10	(a) State-Operated Services Mental Health

271.11	Appropriations by Fund
	
271.12	General
	117,407,000
	115,135,000
	
271.13	Special Revenue
	500,000
	1,000,000
	
271.14 	Utilization of State-Operated Services 
271.15 	Account. Up to $599,000 of the funds 
271.16 	available in miscellaneous accounts 
271.17 	associated with closed regional treatment 
271.18 	centers shall transfer to the state-operated 
271.19 	services account established under Minnesota 
271.20 	Statutes, section 246.18, subdivision 8. 
271.21 	By June 30, 2013, $3,200,000 must be 
271.22 	transferred from this account to the general 
271.23 	fund.
271.24 	State-Operated Services Mental Health 
271.25 	Housing and Other Supports. $500,000 
271.26 	in fiscal year 2012 and $1,000,000 in 
271.27 	fiscal year 2013 are appropriated from 
271.28 	the account established under Minnesota 
271.29 	Statutes, section 246.18, subdivision 8, for 
271.30 	housing and other supports for persons with 
271.31 	mental illness and other complex conditions. 
271.32 	These appropriations are onetime. For the 
271.33 	2014-2015 biennium, base level funding for 
271.34 	this activity is $1,000,000 each year from the 
271.35 	general fund. Notwithstanding any contrary 
272.1 	provision in this article, this paragraph 
272.2 	expires June 30, 2015.
272.3 	Community Behavioral Health 
272.4 	Hospital-Willmar. The commissioner 
272.5 	shall not close the Community Behavioral 
272.6 	Health Hospital-Willmar before March 31, 
272.7 	2012.
272.8 	Base Adjustment. The general fund base 
272.9 	is increased by $1,000,000 in each of fiscal 
272.10 	years 2014 and 2015.

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

272.12	Subd. 6.Sex Offender Program
 		70,416,000
		73,412,000
	
272.13 	Transfer Authority Related to Minnesota 
272.14 	Sex Offender Program. Money 
272.15 	appropriated for the Minnesota sex offender 
272.16 	program may be transferred between fiscal 
272.17 	years of the biennium with the approval 
272.18 	of the commissioner of management and 
272.19 	budget.

272.20	Subd. 7.Technical Activities
 		77,206,000
		95,551,000
	
272.21 	This appropriation is from the federal TANF 
272.22 	fund.
272.23 	Base Level Adjustment.  The TANF fund 
272.24 	base is decreased by $13,643,000 in fiscal 
272.25 	year 2014 and decreased by $13,216,000 in 
272.26 	fiscal year 2015.

272.27	Sec. 4. COMMISSIONER OF HEALTH

272.28	Subdivision 1.Total Appropriation
 	$
	154,797,000
	$
	138,481,000

272.29	Appropriations by Fund
	
272.30		2012
	2013
	
272.31	General
	71,451,000
	71,780,000
	
272.32
272.33	State Government 
Special Revenue
	45,687,000
	45,676,000
	
273.1	Health Care Access
	25,946,000
	9,312,000
	
273.2	Federal TANF
	11,713,000
	11,713,000
	
273.3 	The amounts that may be spent for each 
273.4 	purpose are specified in the following 
273.5 	subdivisions.

273.6
273.7	Subd. 2.Community and Family Health 
Promotion

273.8	Appropriations by Fund
	
273.9	General
	45,577,000
	46,030,000
	
273.10
273.11	State Government 
Special Revenue
	1,033,000
	1,033,000
	
273.12	Health Care Access
	16,719,000
	1,719,000
	
273.13	Federal TANF
	11,713,000
	11,713,000
	
273.14 	TANF Appropriations. (1) $1,156,000 of 
273.15 	the TANF funds is appropriated each year of 
273.16 	the biennium to the commissioner for family 
273.17 	planning grants under Minnesota Statutes, 
273.18 	section 145.925.
273.19 	(2) $3,579,000 of the TANF funds is 
273.20 	appropriated each year of the biennium to 
273.21 	the commissioner for home visiting and 
273.22 	nutritional services listed under Minnesota 
273.23 	Statutes, section 145.882, subdivision 7, 
273.24 	clauses (6) and (7). Funds must be distributed 
273.25 	to community health boards according to 
273.26 	Minnesota Statutes, section 145A.131, 
273.27 	subdivision 1.
273.28 	(3) $2,000,000 of the TANF funds is 
273.29 	appropriated each year of the biennium to 
273.30 	the commissioner for decreasing racial and 
273.31 	ethnic disparities in infant mortality rates 
273.32 	under Minnesota Statutes, section 145.928, 
273.33 	subdivision 7.
273.34 	(4) $4,978,000 of the TANF funds is 
273.35 	appropriated each year of the biennium to the 
273.36 	commissioner for the family home visiting 
274.1 	grant program according to Minnesota 
274.2 	Statutes, section 145A.17. $4,000,000 of the 
274.3 	funding must be distributed to community 
274.4 	health boards according to Minnesota 
274.5 	Statutes, section 145A.131, subdivision 1. 
274.6 	$978,000 of the funding must be distributed 
274.7 	to tribal governments based on Minnesota 
274.8 	Statutes, section 145A.14, subdivision 2a.
274.9 	(5) The commissioner may use up to 6.23 
274.10 	percent of the funds appropriated each fiscal 
274.11 	year to conduct the ongoing evaluations 
274.12 	required under Minnesota Statutes, section 
274.13 	145A.17, subdivision 7, and training and 
274.14 	technical assistance as required under 
274.15 	Minnesota Statutes, section 145A.17, 
274.16 	subdivisions 4 and 5.
274.17 	TANF Carryforward. Any unexpended 
274.18 	balance of the TANF appropriation in the 
274.19 	first year of the biennium does not cancel but 
274.20 	is available for the second year.
274.21 	Statewide Health Improvement Program. 
274.22 	 (a) $15,000,000 in the biennium ending June 
274.23 	30, 2013, is appropriated from the health 
274.24 	care access fund for the statewide health 
274.25 	improvement program and is available until 
274.26 	expended. Notwithstanding Minnesota 
274.27 	Statutes, sections 144.396, and 145.928, the 
274.28 	commissioner may use tobacco prevention 
274.29 	grant funding and grant funding under 
274.30 	Minnesota Statutes, section 145.928, to 
274.31 	support the statewide health improvement 
274.32 	program. The commissioner may focus the 
274.33 	program geographically or on a specific 
274.34 	goal of tobacco use reduction or on 
274.35 	reducing obesity. By February 15, 2013, the 
275.1 	commissioner shall report to the chairs of 
275.2 	the health and human services committee 
275.3 	on progress toward meeting the goals of the 
275.4 	program as outlined in Minnesota Statutes, 
275.5 	section 145.986, and estimate the dollar 
275.6 	value of the reduced health care costs for 
275.7 	both public and private payers.
275.8 	(b) By February 15, 2012, the commissioner 
275.9 	shall develop a plan to implement 
275.10 	evidence-based strategies from the statewide 
275.11 	health improvement program as part of 
275.12 	hospital community benefit programs 
275.13 	and health maintenance organizations 
275.14 	collaboration plans. The implementation 
275.15 	plan shall include an advisory board 
275.16 	to determine priority needs for health 
275.17 	improvement in reducing obesity and 
275.18 	tobacco use in Minnesota and to review 
275.19 	and approve hospital community benefit 
275.20 	activities reported under Minnesota Statutes, 
275.21 	section 144.699, and health maintenance 
275.22 	organizations collaboration plans in 
275.23 	Minnesota Statutes, section 62Q.075. The 
275.24 	commissioner shall consult with hospital 
275.25 	and health maintenance organizations in 
275.26 	creating and implementing the plan. The 
275.27 	plan described in this paragraph shall be 
275.28 	implemented by July 1, 2012.
275.29 	(c) The commissioners of Minnesota 
275.30 	management and budget, human services, 
275.31 	and health shall include in each forecast 
275.32 	beginning February of 2013 a report that 
275.33 	identifies an estimated dollar value of the 
275.34 	health care savings in the state health care 
275.35 	programs that are directly attributable to the 
275.36 	strategies funded from the statewide health 
276.1 	improvement program. The report shall 
276.2 	include a description of methodologies and 
276.3 	assumptions used to calculate the estimate.
276.4 	Funding Usage. Up to 75 percent of the 
276.5 	fiscal year 2012 appropriation for local public 
276.6 	health grants may be used to fund calendar 
276.7 	year 2011 allocations for this program and 
276.8 	up to 75 percent of the fiscal year 2013 
276.9 	appropriation may be used for calendar year 
276.10 	2012 allocations. The fiscal year 2014 base 
276.11 	shall be increased by $5,193,000.
276.12 	Base Level Adjustment. The general fund 
276.13 	base is increased by $5,188,000 in fiscal year 
276.14 	2014 and decreased by $5,000 in 2015.

276.15	Subd. 3.Policy Quality and Compliance

276.16	Appropriations by Fund
	
276.17	General
	9,704,000
	9,532,000
	
276.18
276.19	State Government 
Special Revenue
	14,026,000
	14,083,000
	
276.20	Health Care Access
	9,227,000
	7,593,000
	
276.21 	Medical Education and Research 
276.22 	Costs (MERC) Fund Transfers. The 
276.23 	commissioner of management and budget 
276.24 	shall transfer $9,800,000 from the MERC 
276.25 	fund to the general fund by October 1, 2011.
276.26 	White Earth Urban Clinic Needs 
276.27 	Assessment. $100,000 is appropriated in 
276.28 	fiscal year 2012 from the general fund for a 
276.29 	needs assessment for a health clinic or other 
276.30 	health care needs of the White Earth Tribe 
276.31 	in the Twin Cities metropolitan area. The 
276.32 	results of this assessment shall be reported to 
276.33 	the legislature by February 15, 2012.
276.34 	Comprehensive Advanced Life Support.
276.35 	Of the general fund appropriation, $31,000 
277.1 	each year is added to the base of the 
277.2 	comprehensive advanced life support 
277.3 	(CALS) program under Minnesota Statutes, 
277.4 	section 144.6062.
277.5 	Unused Federal Match Funds. Of the 
277.6 	funds appropriated in Laws 2009, chapter 
277.7 	79, article 13, section 4, subdivision 3, for 
277.8 	state matching funds for the federal Health 
277.9 	Information Technology for Economic and 
277.10 	Clinical Health Act, $2,800,000 is transferred 
277.11 	to the health care access fund by October 1, 
277.12 	2011.
277.13 	Administrative Reports. Of the general 
277.14 	fund appropriation, $82,000 in fiscal year 
277.15 	2012 and $10,000 in fiscal year 2013 
277.16 	are for transfer to the commissioner of 
277.17 	management and budget for the reduction of 
277.18 	the administrative report study.
277.19 	Base Level Adjustment. The state 
277.20 	government special revenue fund base shall 
277.21 	be reduced by $141,000 in fiscal years 2014 
277.22 	and 2015. The health care access base shall 
277.23 	be increased by $1,900,000 in fiscal year 
277.24 	2014 and by $1,300,000 in fiscal year 2015.

277.25	Subd. 4.Health Protection

277.26	Appropriations by Fund
	
277.27	General
	9,370,000
	9,370,000
	
277.28
277.29	State Government 
Special Revenue
	30,628,000
	30,560,000

277.30	Subd. 5.Administrative Support Services
 		6,800,000
		6,848,000

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

277.32
277.33
277.34	Sec. 6. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	1,655,000
	$
	1,655,000
	
278.1 	Funds appropriated for fiscal year 2011 are 
278.2 	available until expended.

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

278.4	Sec. 8. HEALTH-RELATED BOARDS

278.5	Subdivision 1.Total Appropriation
 	$
	17,599,000
	$
	17,528,000
	
278.6 	This appropriation is from the state 
278.7 	government special revenue fund. The 
278.8 	amounts that may be spent for each  purpose 
278.9 	are specified in the following subdivisions.

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

278.11	Subd. 3.Board of Dentistry
 		1,829,000
		1,814,000
	
278.12 	Health Professional Services Program. Of 
278.13 	this appropriation, $704,000 in fiscal year 
278.14 	2012 and $704,000 in fiscal year 2013 from 
278.15 	the state government special revenue fund are 
278.16 	for the health professional services program.

278.17
278.18	Subd. 4.Board of Dietetic and Nutrition 
Practice
 		110,000
		110,000

278.19
278.20	Subd. 5.Board of Marriage and Family 
Therapy
 		192,000
		167,000
	
278.21 	Rulemaking. Of this appropriation, $25,000 
278.22 	in fiscal year 2012 is for rulemaking. This is 
278.23 	a onetime appropriation.

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

278.25	Subd. 7.Board of Nursing
 		3,545,000
		3,545,000

278.26
278.27	Subd. 8.Board of Nursing Home 
Administrators
 		2,153,000
		2,145,000
	
278.28 	Rulemaking. Of this appropriation, $44,000 
278.29 	in fiscal year 2012 is for rulemaking. This is 
278.30 	a onetime appropriation.
278.31 	Electronic Licensing System Adaptors.
278.32 	Of this appropriation, $761,000 in fiscal 
279.1 	year 2013 from the state government special 
279.2 	revenue fund is to the administrative services 
279.3 	unit to cover the costs to connect to the 
279.4 	e-licensing system. Minnesota Statutes, 
279.5 	section 16E.22. Base level funding  for this 
279.6 	activity in fiscal year 2014 shall be  $100,000. 
279.7 	Base level funding for this activity in fiscal 
279.8 	year 2015 shall be $50,000.
279.9 	Development and Implementation of a 
279.10 	Disciplinary, Regulatory, Licensing and 
279.11 	Information Management System. Of this 
279.12 	appropriation, $800,000 in fiscal  year 2012 
279.13 	and $300,000 in fiscal year 2013 are  for the 
279.14 	development of a shared system. Base level 
279.15 	funding for this activity in fiscal year 2014 
279.16 	shall be $50,000.
279.17 	Administrative Services Unit - Operating 
279.18 	Costs. Of this appropriation, $526,000 
279.19 	in fiscal year 2012 and $526,000 in 
279.20 	fiscal year 2013 are for operating costs 
279.21 	of the administrative services unit. The 
279.22 	administrative services unit may receive 
279.23 	and expend reimbursements for services 
279.24 	performed by other agencies.
279.25 	Administrative Services Unit - Retirement 
279.26 	Costs. Of this appropriation in fiscal year 
279.27 	2012, $225,000 is for onetime retirement 
279.28 	costs in the health-related boards. This 
279.29 	funding may be transferred to the health 
279.30 	boards incurring those costs for their 
279.31 	payment. These funds are available either 
279.32 	year of the biennium.
279.33 	Administrative Services Unit - Volunteer 
279.34 	Health Care Provider Program. Of this 
279.35 	appropriation, $150,000 in fiscal year 2012 
280.1 	and $150,000 in fiscal year 2013 are to pay 
280.2 	for medical professional liability coverage 
280.3 	required under Minnesota Statutes, section 
280.4 	214.40.
280.5 	Administrative Services Unit - Contested 
280.6 	Cases and Other Legal Proceedings. Of 
280.7 	this appropriation, $200,000 in fiscal year 
280.8 	2012 and $200,000 in fiscal year 2013 are 
280.9 	for costs of contested case hearings and other 
280.10 	unanticipated costs of legal proceedings 
280.11 	involving health-related boards funded 
280.12 	under this section. Upon certification of a 
280.13 	health-related board to the administrative 
280.14 	services unit that the costs will be incurred 
280.15 	and that there is insufficient money available 
280.16 	to pay for the costs out of money currently 
280.17 	available to that board, the administrative 
280.18 	services unit is authorized to transfer money 
280.19 	from this appropriation to the board for 
280.20 	payment of those costs with the approval 
280.21 	of the commissioner of management and 
280.22 	budget. This appropriation does not cancel. 
280.23 	Any unencumbered and unspent balances 
280.24 	remain available for these expenditures in 
280.25 	subsequent fiscal years.
280.26 	Base Adjustment. The State Government 
280.27 	Special Revenue Fund base is decreased by 
280.28 	$911,000 in fiscal year 2014 and $1,011,000 
280.29 	in fiscal year 2015.

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

280.31	Subd. 10.Board of Pharmacy
 		2,341,000
		2,344,000
	
280.32 	Prescription Electronic Reporting. Of 
280.33 	this appropriation, $356,000 in fiscal year 
280.34 	2012 and $356,000 in fiscal year 2013 from 
280.35 	the state government special revenue fund 
281.1 	are to the board to operate the prescription 
281.2 	electronic reporting system in Minnesota 
281.3 	Statutes, section 152.126. Base level funding 
281.4 	for this activity in fiscal year 2014 shall be 
281.5 	$356,000.

281.6	Subd. 11.Board of Physical Therapy
 		389,000
		345,000
	
281.7 	Rulemaking. Of this appropriation, $44,000 
281.8 	in fiscal year 2012 is for rulemaking. This is 
281.9 	a onetime appropriation.

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

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

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

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

281.14
281.15	Subd. 16.Board of Behavioral Health and 
Therapy
 		414,000
		414,000

281.16
281.17	Sec. 9. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	2,742,000
	$
	2,742,000
	
281.18 	Regional Grants. $585,000 in fiscal year 
281.19 	2012 and $585,000 in fiscal year 2013 are 
281.20 	for regional emergency medical services 
281.21 	programs, to be distributed equally to the 
281.22 	eight emergency medical service regions. 
281.23 	Notwithstanding Minnesota Statutes, section 
281.24 	144E.50, 100 percent of the appropriation 
281.25 	shall be granted to the emergency medical 
281.26 	service regions.
281.27 	Cooper/Sams Volunteer Ambulance 
281.28 	Program. $700,000 in fiscal year 2012 and 
281.29 	$700,000 in fiscal year 2013 are for the 
281.30 	Cooper/Sams volunteer ambulance program 
281.31 	under Minnesota Statutes, section 144E.40.
281.32 	(a) Of this amount, $611,000 in fiscal year 
281.33 	2012 and $611,000 in fiscal year 2013 
282.1 	are for the ambulance service personnel 
282.2 	longevity award and incentive program, 
282.3 	under Minnesota Statutes, section 144E.40. 
282.4 	(b) Of this amount, $89,000 in fiscal year 
282.5 	2012 and $89,000 in fiscal year 2013 are 
282.6 	for the operations of the ambulance service 
282.7 	personnel longevity award and incentive 
282.8 	program, under Minnesota Statutes, section 
282.9 	144E.40. 
282.10 	Ambulance Training Grant. $361,000 in 
282.11 	fiscal year 2012 and $361,000 in fiscal year 
282.12 	2013 are for training grants.
282.13 	EMSRB Board Operations. $1,096,000 in 
282.14 	fiscal year 2012 and $1,096,000 in fiscal year 
282.15 	2013 are for operations.

282.16 	Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
282.17 	to read:
282.18 		Subd. 34.Federal administrative reimbursement dedicated. Federal 
282.19 	administrative reimbursement resulting from the following activities is appropriated to the 
282.20 	commissioner for the designated purposes:
282.21 	(1) reimbursement for the Minnesota senior health options project; and
282.22 	(2) reimbursement related to prior authorization and inpatient admission certification 
282.23 	by a professional review organization. A portion of these funds must be used for activities 
282.24 	to decrease unnecessary pharmaceutical costs in medical assistance.

282.25 	Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 
282.26 	6, is amended to read:

282.27	Subd. 6.Continuing Care Grants

282.28	(a) Aging and Adult Services Grants
		(3,600,000)
		(3,600,000)
	
282.29 	Community Service/Service Development 
282.30 	Grants Reduction. Effective retroactively 
282.31 	from July 1, 2009, funding for grants made 
282.32 	under Minnesota Statutes, sections 256.9754
282.33 	and 256B.0917, subdivision 13, is reduced 
283.1 	by $5,807,000 for each year of the biennium. 
283.2 	Grants made during the biennium under 
283.3 	Minnesota Statutes, section 256.9754, shall 
283.4 	not be used for new construction or building 
283.5 	renovation.
283.6 	Aging Grants Delay. Aging grants must be 
283.7 	reduced by $917,000 in fiscal year 2011 and 
283.8 	increased by $917,000 in fiscal year 2012. 
283.9 	These adjustments are onetime and must not 
283.10 	be applied to the base. This provision expires 
283.11 	June 30, 2012.

283.12
283.13	(b) Medical Assistance Long-Term Care 
Facilities Grants
		(3,827,000)
		(2,745,000)
	
283.14 	ICF/MR Variable Rates Suspension.
283.15 	Effective retroactively from July 1, 2009, 
283.16 	to June 30, 2010, no new variable rates 
283.17 	shall be authorized for intermediate care 
283.18 	facilities for persons with developmental 
283.19 	disabilities under Minnesota Statutes, section 
283.20 	256B.5013, subdivision 1.
283.21 	ICF/MR Occupancy Rate Adjustment 
283.22 	Suspension. Effective retroactively from 
283.23 	July 1, 2009, to June 30, 2011, approval 
283.24 	of new applications for occupancy rate 
283.25 	adjustments for unoccupied short-term 
283.26 	beds under Minnesota Statutes, section 
283.27 	256B.5013, subdivision 7, is suspended.

283.28
283.29	(c) Medical Assistance Long-Term Care 
Waivers and Home Care Grants
		(2,318,000)
		(5,807,000)
	
283.30 	Developmental Disability Waiver Acuity 
283.31 	Factor. Effective retroactively from January 
283.32 	1, 2010, the January 1, 2010, one percent 
283.33 	growth factor in the developmental disability 
283.34 	waiver allocations under Minnesota Statutes, 
283.35 	section 256B.092, subdivisions 4 and 5, 
284.1 	that is attributable to changes in acuity, is 
284.2 	suspended to June 30, 2011 eliminated. 
284.3 	Notwithstanding any law to the contrary, this 
284.4 	provision does not expire.

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

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

284.7
284.8	(f) Chemical Dependency Nonentitlement 
Grants
		(393,000)
		(393,000)

284.9284.10
	(g) Other Continuing Care Grants
		-0-
		(2,500,000)
(1,414,000)
	
284.11 	Other Continuing Care Grants Delay.
284.12 	Other continuing care grants must be reduced 
284.13 	by $1,414,000 in fiscal year 2011 and 
284.14 	increased by $1,414,000 in fiscal year 2012. 
284.15 	These adjustments are onetime and must not 
284.16 	be applied to the base. This provision expires 
284.17 	June 30, 2012.

284.18	(h) Deaf and Hard-of-Hearing Grants
		-0-
		(169,000)
	
284.19 	Deaf and Hard-of-Hearing Grants Delay.
284.20 	Effective retroactively from July 1, 2010, 
284.21 	deaf and hard-of-hearing grants must be 
284.22 	reduced by $169,000 in fiscal year 2011 and 
284.23 	increased by $169,000 in fiscal year 2012. 
284.24 	These adjustments are onetime and must not 
284.25 	be applied to the base. This provision expires 
284.26 	June 30, 2012.

284.27 	Sec. 12. TRANSFERS.
 284.28 		Subdivision 1.Grants. The commissioner of human services, with the approval 
284.29 	of the commissioner of management and budget, and after notification of the chairs of 
284.30 	the senate health and human services budget and policy committee and the house of 
284.31 	representatives health and human services finance committee, may transfer unencumbered 
284.32 	appropriation balances for the biennium ending June 30, 2013, within fiscal years among 
284.33 	the MFIP; general assistance; general assistance medical care under Minnesota Statutes, 
284.34 	section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under 
285.1 	Minnesota Statutes, section 119B.05; Minnesota supplemental aid; MinnesotaCare, 
285.2 	and group residential housing programs, and the entitlement portion of the chemical 
285.3 	dependency consolidated treatment fund, and between fiscal years of the biennium.
285.4 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative 
285.5 	money may be transferred within the Departments of Health and Human Services as the 
285.6 	commissioners consider necessary, with the advance approval of the commissioner of 
285.7 	management and budget. The commissioner shall inform the chairs of the senate health 
285.8 	and human services budget and policy committee and the house of representatives health 
285.9 	and human services finance committee quarterly about transfers made under this provision.

285.10 	Sec. 13. DONATIONS TO STATE.
 285.11 	A donation to the state from a health maintenance organization to reduce the 
285.12 	projected state budget deficit for the fiscal year 2012-2013 biennium shall qualify as 
285.13 	an authorized expense of a health maintenance organization under Minnesota Statutes, 
285.14 	section 62D.12, subdivision 9a, clause (4), and shall be deposited in the general fund.

285.15 	Sec. 14. FEDERAL MATCHING FUNDS; NONHOSPITAL-BASED 
285.16 	GOVERNMENTAL HEALTH CENTERS.
 285.17 	The commissioner of human services shall apply for federal matching funds to be 
285.18 	deposited in the general fund as a nondedicated revenue based on Minnesota Statutes, 
285.19 	section 256B.198, until the requirements of Minnesota Statutes, section 256B.198, 
285.20 	paragraph (c), are met.

285.21 	Sec. 15. INDIRECT COSTS NOT TO FUND PROGRAMS.
 285.22 	The commissioners of health and human services shall not use indirect cost 
285.23 	allocations to pay for the operational costs of any program for which they are responsible.

285.24 	Sec. 16. EXPIRATION OF UNCODIFIED LANGUAGE.
 285.25 	All uncodified language contained in this article expires on June 30, 2013, unless a 
285.26 	different expiration date is explicit.

285.27 	ARTICLE 11
285.28 	EFFECTIVE DATES

285.29 	Section 1. EFFECTIVE DATE; RELATIONSHIP TO OTHER 
285.30 	APPROPRIATIONS.
 286.1 	Unless another effective date is specified, this act is effective retroactively from July 
286.2 	1, 2011, and supersedes and replaces funding authorized by order of the Second Judicial 
286.3 	District Court in Case No. 62-CV-11-5203.