1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 22941.2A bill for an act1.3relating to state government; making adjustments to health and human 1.4services appropriations; making changes to provisions related to health care, 1.5the Department of Health, children and family services, continuing care, 1.6chemical dependency, child support, background studies, homelessness, and 1.7vulnerable children and adults; providing for data sharing; requiring eligibility 1.8determinations; requiring the University of Minnesota to request funding for 1.9rural primary care training; providing for the release of medical assistance liens; 1.10requiring reporting of potential welfare fraud; providing penalties; providing 1.11appointments; providing grants; requiring studies and reports; appropriating 1.12money;amending Minnesota Statutes 2010, sections 62D.02, subdivision 3; 1.1362D.05, subdivision 6; 62D.12, subdivision 1; 62J.496, subdivision 2; 62Q.80; 1.1462U.04, subdivisions 1, 2, 4, 5; 119B.13, subdivision 3a; 144.1222, by adding 1.15a subdivision; 144.292, subdivision 6; 144.293, subdivision 2; 144.298, 1.16subdivision 2; 144A.351; 144D.04, subdivision 2; 145.906; 245.697, subdivision 1.171; 245A.03, by adding a subdivision; 245A.10, by adding a subdivision; 245A.11, 1.18subdivision 7; 245B.07, subdivision 1; 245C.04, subdivision 6; 245C.05, 1.19subdivision 7; 252.27, subdivision 2a; 254A.19, by adding a subdivision; 1.20256.01, by adding subdivisions; 256.9831, subdivision 2; 256B.056, subdivision 1.211a; 256B.0625, subdivisions 9, 28a, by adding subdivisions; 256B.0659, 1.22by adding a subdivision; 256B.0751, by adding a subdivision; 256B.0754, 1.23subdivision 2; 256B.0915, subdivision 3g; 256B.092, subdivisions 1b, 7, by 1.24adding subdivisions; 256B.0943, subdivision 9; 256B.431, subdivision 17e, 1.25by adding a subdivision; 256B.441, by adding a subdivision; 256B.49, by 1.26adding a subdivision; 256B.69, subdivision 9, by adding subdivisions; 256D.06, 1.27subdivision 1b; 256D.44, subdivision 5; 256E.37, subdivision 1; 256I.05, 1.28subdivision 1e; 256J.08, by adding a subdivision; 256J.26, subdivision 1, by 1.29adding a subdivision; 256J.45, subdivision 2; 256J.50, by adding a subdivision; 1.30256J.521, subdivision 2; 256L.07, subdivision 3; 462A.29; 514.981, subdivision 1.315; 518A.40, subdivision 4; Minnesota Statutes 2011 Supplement, sections 1.3262E.14, subdivision 4g; 62U.04, subdivisions 3, 9; 119B.13, subdivision 7; 1.33245A.03, subdivision 7; 256.045, subdivision 3; 256.987, subdivisions 1, 1.342, by adding subdivisions; 256B.056, subdivision 3; 256B.057, subdivision 1.359; 256B.0625, subdivisions 8, 8a, 8b, 38; 256B.0911, subdivisions 3a, 3c; 1.36256B.0915, subdivisions 3e, 3h; 256B.097, subdivision 3; 256B.49, subdivisions 1.3714, 15, 23; 256B.5012, subdivision 13; 256B.69, subdivisions 5a, 5c; 256E.35, 1.38subdivisions 5, 6; 256I.05, subdivision 1a; 256J.49, subdivision 13; 256L.031, 1.39subdivisions 2, 3, 6; 256L.12, subdivision 9; 256M.40, subdivision 1; Laws 1.402010, chapter 374, section 1; Laws 2011, First Special Session chapter 9, article 1.417, sections 52; 54; article 9, section 18; article 10, section 3, subdivisions 1, 3, 4; 1.42proposing coding for new law in Minnesota Statutes, chapters 144; 256B; 626.2.1April 23, 20122.2The Honorable Kurt Zellers2.3Speaker of the House of Representatives2.4The Honorable Michelle L. Fischbach2.5President of the Senate2.6We, the undersigned conferees for H. F. No. 2294 report that we have agreed upon 2.7the items in dispute and recommend as follows:2.8That the Senate recede from its amendments and that H. F. No. 2294 be further 2.9amended as follows:2.10Delete everything after the enacting clause and insert:2.11"ARTICLE 12.12HEALTH CARE2.13    Section 1. Minnesota Statutes 2011 Supplement, section 62E.14, subdivision 4g, is 2.14amended to read:2.15    Subd. 4g. Waiver of preexisting conditions for persons covered by healthy 2.16Minnesota contribution program. A person may enroll in the comprehensive plan with 2.17a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for 2.18the healthy Minnesota contribution program, and has been denied coverage as described 2.19under section 
         256L.031, subdivision 6. The six-month durational residency requirement 2.20specified in section 62E.02, subdivision 13, does not apply to individuals enrolled in the 2.21healthy Minnesota contribution program.2.22    Sec. 2. Minnesota Statutes 2010, section 72A.201, subdivision 8, is amended to read:2.23    Subd. 8. Standards for claim denial. The following acts by an insurer, adjuster, or 2.24self-insured, or self-insurance administrator constitute unfair settlement practices:2.25(1) denying a claim or any element of a claim on the grounds of a specific policy 2.26provision, condition, or exclusion, without informing the insured of the policy provision, 2.27condition, or exclusion on which the denial is based;2.28(2) denying a claim without having made a reasonable investigation of the claim;2.29(3) denying a liability claim because the insured has requested that the claim be 2.30denied;2.31(4) denying a liability claim because the insured has failed or refused to report the 2.32claim, unless an independent evaluation of available information indicates there is no 2.33liability;2.34(5) denying a claim without including the following information:2.35(i) the basis for the denial;3.1(ii) the name, address, and telephone number of the insurer's claim service office 3.2or the claim representative of the insurer to whom the insured or claimant may take any 3.3questions or complaints about the denial;3.4(iii) the claim number and the policy number of the insured; and3.5(iv) if the denied claim is a fire claim, the insured's right to file with the Department 3.6of Commerce a complaint regarding the denial, and the address and telephone number 3.7of the Department of Commerce;3.8(6) denying a claim because the insured or claimant failed to exhibit the damaged 3.9property unless:3.10(i) the insurer, within a reasonable time period, made a written demand upon the 3.11insured or claimant to exhibit the property; and3.12(ii) the demand was reasonable under the circumstances in which it was made;3.13(7) denying a claim by an insured or claimant based on the evaluation of a chemical 3.14dependency claim reviewer selected by the insurer unless the reviewer meets the 3.15qualifications specified under subdivision 8a. An insurer that selects chemical dependency 3.16reviewers to conduct claim evaluations must annually file with the commissioner of 3.17commerce a report containing the specific evaluation standards and criteria used in these 3.18evaluations. The report must be filed at the same time its annual statement is submitted 3.19under section 
         60A.13. The report must also include the number of evaluations performed 3.20on behalf of the insurer during the reporting period, the types of evaluations performed, 3.21the results, the number of appeals of denials based on these evaluations, the results of 3.22these appeals, and the number of complaints filed in a court of competent jurisdiction.3.23EFFECTIVE DATE.This section is effective the day following final enactment.3.24    Sec. 3. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 3.25subdivision to read:3.26    Subd. 18c.Nonemergency Medical Transportation Advisory Committee.3.27(a) The Nonemergency Medical Transportation Advisory Committee shall advise the 3.28commissioner on the administration of nonemergency medical transportation covered 3.29under medical assistance. The advisory committee shall meet at least quarterly and may 3.30meet more frequently as required by the commissioner. The advisory committee shall 3.31annually elect a chair from among its members, who shall work with the commissioner or 3.32the commissioner's designee to establish the agenda for each meeting. The commissioner, 3.33or the commissioner's designee, shall attend all advisory committee meetings.3.34(b) The Nonemergency Medical Transportation Advisory Committee shall advise 3.35and make recommendations to the commissioner on:4.1(1) the development of, and periodic updates to, a policy manual for nonemergency 4.2medical transportation services;4.3(2) policies and a funding source for reimbursing no-load miles;4.4(3) policies to prevent waste, fraud, and abuse, and to improve the efficiency of the 4.5nonemergency medical transportation system;4.6(4) other issues identified in the 2011 evaluation report by the Office of the 4.7Legislative Auditor on medical nonemergency transportation; and4.8(5) other aspects of the nonemergency medical transportation system, as requested 4.9by the commissioner.4.10(c) The Nonemergency Medical Transportation Advisory Committee shall 4.11coordinate its activities with the Minnesota Council on Transportation Access established 4.12under section 174.285. The chair of the advisory committee, or the chair's designee, shall 4.13attend all meetings of the Minnesota Council on Transportation Access.4.14(d) The Nonemergency Medical Transportation Advisory Committee shall expire 4.15December 1, 2014.4.16    Sec. 4. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 4.17subdivision to read:4.18    Subd. 18d.Advisory committee members.(a) The Nonemergency Medical 4.19Transportation Advisory Committee consists of:4.20(1) two voting members who represent counties, at least one of whom must represent 4.21a county or counties other than Anoka, Carver, Chisago, Dakota, Hennepin, Isanti, 4.22Ramsey, Scott, Sherburne, Washington, and Wright;4.23(2) four voting members who represent medical assistance recipients, including 4.24persons with physical and developmental disabilities, persons with mental illness, seniors, 4.25children, and low-income individuals;4.26(3) four voting members who represent providers that deliver nonemergency medical 4.27transportation services to medical assistance enrollees;4.28(4) two voting members of the house of representatives, one from the majority 4.29party and one from the minority party, appointed by the speaker of the house, and two 4.30voting members from the senate, one from the majority party and one from the minority 4.31party, appointed by the Subcommittee on Committees of the Committee on Rules and 4.32Administration;4.33(5) one voting member who represents demonstration providers as defined in section 4.34256B.69, subdivision 2;5.1(6) one voting member who represents an organization that contracts with state or 5.2local governments to coordinate transportation services for medical assistance enrollees; 5.3and5.4(7) the commissioner of transportation or the commissioner's designee, who shall 5.5serve as a voting member.5.6(b) Members of the advisory committee shall not be employed by the Department of 5.7Human Services. Members of the advisory committee shall receive no compensation.5.8    Sec. 5. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 5.9subdivision to read:5.10    Subd. 18e.Single administrative structure and delivery system.(a) The 5.11commissioner shall implement a single administrative structure and delivery system for 5.12nonemergency medical transportation, beginning July 1, 2013. The single administrative 5.13structure and delivery system must:5.14(1) eliminate the distinction between access transportation services and special 5.15transportation services;5.16(2) enable all medical assistance recipients to follow the same process to obtain 5.17nonemergency medical transportation, regardless of their level of need;5.18(3) provide a single oversight framework for all providers of nonemergency medical 5.19transportation; and5.20(4) provide flexibility in service delivery, recognizing that clients fall along a 5.21continuum of needs and resources.5.22(b) The commissioner shall present to the legislature, by January 15, 2013, any draft 5.23legislation necessary to implement the single administrative structure and delivery system 5.24for nonemergency medical transportation.5.25(c) In developing the single administrative structure and delivery system and 5.26the draft legislation, the commissioner shall consult with the Nonemergency Medical 5.27Transportation Advisory Committee.5.28    Sec. 6. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 5.29subdivision to read:5.30    Subd. 18f.Enrollee assessment process.(a) The commissioner, in consultation 5.31with the Nonemergency Medical Transportation Advisory Committee, shall develop and 5.32implement, by July 1, 2013, a comprehensive, statewide, standard assessment process 5.33for medical assistance enrollees seeking nonemergency medical transportation services. 5.34The assessment process must identify a client's level of needs, abilities, and resources, 6.1and match the client with the mode of transportation in the client's service area that best 6.2meets those needs.6.3(b) The assessment process must:6.4(1) address mental health diagnoses when determining the most appropriate mode of 6.5transportation;6.6(2) base decisions on clearly defined criteria that are available to clients, providers, 6.7and counties;6.8(3) be standardized across the state and be aligned with other similar existing 6.9processes;6.10(4) allow for extended periods of eligibility for certain types of nonemergency 6.11transportation, when a client's condition is unlikely to change; and6.12(5) increase the use of public transportation when appropriate and cost-effective, 6.13including offering monthly bus passes to clients.6.14    Sec. 7. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 6.15subdivision to read:6.16    Subd. 18g.Use of standardized measures.The commissioner, in consultation 6.17with the Nonemergency Medical Transportation Advisory Committee, shall establish 6.18performance measures to assess the cost-effectiveness and quality of nonemergency 6.19medical transportation. At a minimum, performance measures should include the number 6.20of unique participants served by type of transportation provider, number of trips provided 6.21by type of transportation provider, and cost per trip by type of transportation provider. The 6.22commissioner must also consider the measures identified in the January 2012 Department 6.23of Human Services report to the legislature on nonemergency medical transportation. 6.24Beginning in calendar year 2013, the commissioner shall collect, audit, and analyze 6.25performance data on nonemergency medical transportation annually and report this 6.26information on the agency's Web site. The commissioner shall periodically supplement 6.27this information with the results of consumer surveys of the quality of services, and shall 6.28make these survey findings available to the public on the agency Web site.6.29    Sec. 8. Minnesota Statutes 2010, section 256B.0625, subdivision 28a, is amended to 6.30read:6.31    Subd. 28a. Licensed physician assistant services.(a) Medical assistance covers 6.32services performed by a licensed physician assistant if the service is otherwise covered 6.33under this chapter as a physician service and if the service is within the scope of practice 6.34of a licensed physician assistant as defined in section 
         147A.09.7.1(b) Licensed physician assistants, who are supervised by a physician certified by 7.2the American Board of Psychiatry and Neurology or eligible for board certification in 7.3psychiatry, may bill for medication management and evaluation and management services 7.4provided to medical assistance enrollees in inpatient hospital settings, consistent with 7.5their authorized scope of practice, as defined in section 147A.09, with the exception of 7.6performing psychotherapy, diagnostic assessments, or providing clinical supervision.7.7    Sec. 9. Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 38, 7.8is amended to read:7.9    Subd. 38.  Payments for mental health services. Payments for mental 7.10health services covered under the medical assistance program that are provided by 7.11masters-prepared mental health professionals shall be 80 percent of the rate paid to 7.12doctoral-prepared professionals. Payments for mental health services covered under 7.13the medical assistance program that are provided by masters-prepared mental health 7.14professionals employed by community mental health centers shall be 100 percent of the 7.15rate paid to doctoral-prepared professionals. Payments for mental health services covered 7.16under the medical assistance program that are provided by physician assistants shall be 7.1780.4 percent of the base rate paid to psychiatrists.7.18    Sec. 10. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 1, 7.19is amended to read:7.20    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical 7.21assistance benefit plan shall include the following cost-sharing for all recipients, effective 7.22for services provided on or after September 1, 2011:7.23    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes 7.24of this subdivision, a visit means an episode of service which is required because of 7.25a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 7.26ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 7.27midwife, advanced practice nurse, audiologist, optician, or optometrist;7.28    (2) $3 for eyeglasses;7.29    (3) $3.50 for nonemergency visits to a hospital-based emergency room, except that 7.30this co-payment shall be increased to $20 upon federal approval;7.31    (4) $3 per brand-name drug prescription and $1 per generic drug prescription, 7.32subject to a $12 per month maximum for prescription drug co-payments. No co-payments 7.33shall apply to antipsychotic drugs when used for the treatment of mental illness;8.1(5) effective January 1, 2012, a family deductible equal to the maximum amount 8.2allowed under Code of Federal Regulations, title 42, part 
         447.54; and8.3    (6) for individuals identified by the commissioner with income at or below 100 8.4percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five 8.5percent of family income. For purposes of this paragraph, family income is the total 8.6earned and unearned income of the individual and the individual's spouse, if the spouse is 8.7enrolled in medical assistance and also subject to the five percent limit on cost-sharing.8.8    (b) Recipients of medical assistance are responsible for all co-payments and 8.9deductibles in this subdivision.8.10(c) Notwithstanding paragraph (b), the commissioner, through the contracting 8.11process under sections 256B.69 and 256B.692, may allow managed care plans and 8.12county-based purchasing plans to waive the family deductible under paragraph (a), 8.13clause (5). The value of the family deductible shall not be included in the capitation 8.14payment to managed care plans and county-based purchasing plans. Managed care plans 8.15and county-based purchasing plans shall certify annually to the commissioner the dollar 8.16value of the family deductible.8.17(d) Notwithstanding paragraph (b), the commissioner may waive the collection of 8.18the family deductible described under paragraph (a), clause (5), from individuals and 8.19allow long-term care and waivered service providers to assume responsibility for payment.8.20EFFECTIVE DATE.Paragraph (c) is effective January 1, 2012. Paragraph (d) 8.21is effective July 1, 2012.8.22    Sec. 11. Minnesota Statutes 2010, section 256B.0751, is amended by adding a 8.23subdivision to read:8.24    Subd. 9.Pediatric care coordination.The commissioner shall implement a 8.25pediatric care coordination service for children with high-cost medical or high-cost 8.26psychiatric conditions who are at risk of recurrent hospitalization or emergency room use 8.27for acute, chronic, or psychiatric illness, who receive medical assistance services. Care 8.28coordination services must be targeted to children not already receiving care coordination 8.29through another service and may include but are not limited to the provision of health 8.30care home services to children admitted to hospitals that do not currently provide care 8.31coordination. Care coordination services must be provided by care coordinators who 8.32are directly linked to provider teams in the care delivery setting, but who may be part 8.33of a community care team shared by multiple primary care providers or practices. For 8.34purposes of this subdivision, the commissioner shall, to the extent possible, use the 9.1existing health care home certification and payment structure established under this 9.2section and section 256B.0753.9.3    Sec. 12. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a, 9.4is amended to read:9.5    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section 9.6and section 
         256L.12 shall be entered into or renewed on a calendar year basis beginning 9.7January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 9.8renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 9.931, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 9.10issue separate contracts with requirements specific to services to medical assistance 9.11recipients age 65 and older.9.12    (b) A prepaid health plan providing covered health services for eligible persons 9.13pursuant to chapters 256B and 256L is responsible for complying with the terms of its 9.14contract with the commissioner. Requirements applicable to managed care programs 9.15under chapters 256B and 256L established after the effective date of a contract with the 9.16commissioner take effect when the contract is next issued or renewed.9.17    (c) Effective for services rendered on or after January 1, 2003, the commissioner 9.18shall withhold five percent of managed care plan payments under this section and 9.19county-based purchasing plan payments under section 
         256B.692 for the prepaid medical 9.20assistance program pending completion of performance targets. Each performance target 9.21must be quantifiable, objective, measurable, and reasonably attainable, except in the case 9.22of a performance target based on a federal or state law or rule. Criteria for assessment 9.23of each performance target must be outlined in writing prior to the contract effective 9.24date. Clinical or utilization performance targets and their related criteria must consider 9.25evidence-based research and reasonable interventions when available or applicable to the 9.26populations served, and must be developed with input from external clinical experts 9.27and stakeholders, including managed care plans, county-based purchasing plans, and 9.28providers. The managed care or county-based purchasing plan must demonstrate, 9.29to the commissioner's satisfaction, that the data submitted regarding attainment of 9.30the performance target is accurate. The commissioner shall periodically change the 9.31administrative measures used as performance targets in order to improve plan performance 9.32across a broader range of administrative services. The performance targets must include 9.33measurement of plan efforts to contain spending on health care services and administrative 9.34activities. The commissioner may adopt plan-specific performance targets that take into 9.35account factors affecting only one plan, including characteristics of the plan's enrollee 10.1population. The withheld funds must be returned no sooner than July of the following 10.2year if performance targets in the contract are achieved. The commissioner may exclude 10.3special demonstration projects under subdivision 23.10.4    (d) Effective for services rendered on or after January 1, 2009, through December 10.531, 2009, the commissioner shall withhold three percent of managed care plan payments 10.6under this section and county-based purchasing plan payments under section 
         256B.692 10.7for the prepaid medical assistance program. The withheld funds must be returned no 10.8sooner than July 1 and no later than July 31 of the following year. The commissioner may 10.9exclude special demonstration projects under subdivision 23.10.10(e) Effective for services provided on or after January 1, 2010, the commissioner 10.11shall require that managed care plans use the assessment and authorization processes, 10.12forms, timelines, standards, documentation, and data reporting requirements, protocols, 10.13billing processes, and policies consistent with medical assistance fee-for-service or the 10.14Department of Human Services contract requirements consistent with medical assistance 10.15fee-for-service or the Department of Human Services contract requirements for all 10.16personal care assistance services under section 
         256B.0659.10.17(f) Effective for services rendered on or after January 1, 2010, through December 10.1831, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 10.19under this section and county-based purchasing plan payments under section 
         256B.692 10.20for the prepaid medical assistance program. The withheld funds must be returned no 10.21sooner than July 1 and no later than July 31 of the following year. The commissioner may 10.22exclude special demonstration projects under subdivision 23.10.23(g) Effective for services rendered on or after January 1, 2011, through December 10.2431, 2011, the commissioner shall include as part of the performance targets described 10.25in paragraph (c) a reduction in the health plan's emergency room utilization rate for 10.26state health care program enrollees by a measurable rate of five percent from the plan's 10.27utilization rate for state health care program enrollees for the previous calendar year. 10.28Effective for services rendered on or after January 1, 2012, the commissioner shall include 10.29as part of the performance targets described in paragraph (c) a reduction in the health 10.30plan's emergency department utilization rate for medical assistance and MinnesotaCare 10.31enrollees, as determined by the commissioner. For 2012, the reduction shall be based on 10.32the health plan's utilization in 2009. To earn the return of the withhold each subsequent 10.33year, the managed care plan or county-based purchasing plan must achieve a qualifying 10.34reduction of no less than ten percent of the plan's emergency department utilization 10.35rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees10.36in programs described in subdivisions 23 and 28, compared to the previous calendar11.1measurement year until the final performance target is reached. When measuring 11.2performance, the commissioner must consider the difference in health risk in a managed 11.3care or county-based purchasing plan's membership in the baseline year compared to the 11.4measurement year, and work with the managed care or county-based purchasing plan to 11.5account for differences that they agree are significant.11.6The withheld funds must be returned no sooner than July 1 and no later than July 31 11.7of the following calendar year if the managed care plan or county-based purchasing plan 11.8demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 11.9was achieved. The commissioner shall structure the withhold so that the commissioner 11.10returns a portion of the withheld funds in amounts commensurate with achieved reductions 11.11in utilization less than the target amount.11.12The withhold described in this paragraph shall continue for each consecutive 11.13contract period until the plan's emergency room utilization rate for state health care 11.14program enrollees is reduced by 25 percent of the plan's emergency room utilization 11.15rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009. 11.16Hospitals shall cooperate with the health plans in meeting this performance target and 11.17shall accept payment withholds that may be returned to the hospitals if the performance 11.18target is achieved.11.19(h) Effective for services rendered on or after January 1, 2012, the commissioner 11.20shall include as part of the performance targets described in paragraph (c) a reduction in the 11.21plan's hospitalization admission rate for medical assistance and MinnesotaCare enrollees, 11.22as determined by the commissioner. To earn the return of the withhold each year, the 11.23managed care plan or county-based purchasing plan must achieve a qualifying reduction 11.24of no less than five percent of the plan's hospital admission rate for medical assistance 11.25and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 11.26subdivisions 23 and 28, compared to the previous calendar year until the final performance 11.27target is reached. When measuring performance, the commissioner must consider the 11.28difference in health risk in a managed care or county-based purchasing plan's membership 11.29in the baseline year compared to the measurement year, and work with the managed care 11.30or county-based purchasing plan to account for differences that they agree are significant.11.31The withheld funds must be returned no sooner than July 1 and no later than July 11.3231 of the following calendar year if the managed care plan or county-based purchasing 11.33plan demonstrates to the satisfaction of the commissioner that this reduction in the 11.34hospitalization rate was achieved. The commissioner shall structure the withhold so that 11.35the commissioner returns a portion of the withheld funds in amounts commensurate with 11.36achieved reductions in utilization less than the targeted amount.12.1The withhold described in this paragraph shall continue until there is a 25 percent 12.2reduction in the hospital admission rate compared to the hospital admission rates in 12.3calendar year 2011, as determined by the commissioner. The hospital admissions in this 12.4performance target do not include the admissions applicable to the subsequent hospital 12.5admission performance target under paragraph (i). Hospitals shall cooperate with the 12.6plans in meeting this performance target and shall accept payment withholds that may be 12.7returned to the hospitals if the performance target is achieved.12.8(i) Effective for services rendered on or after January 1, 2012, the commissioner 12.9shall include as part of the performance targets described in paragraph (c) a reduction in 12.10the plan's hospitalization admission rates for subsequent hospitalizations within 30 days 12.11of a previous hospitalization of a patient regardless of the reason, for medical assistance 12.12and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of 12.13the withhold each year, the managed care plan or county-based purchasing plan must 12.14achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance 12.15and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 12.16subdivisions 23 and 28, of no less than five percent compared to the previous calendar 12.17year until the final performance target is reached.12.18The withheld funds must be returned no sooner than July 1 and no later than July 12.1931 of the following calendar year if the managed care plan or county-based purchasing 12.20plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in 12.21the subsequent hospitalization rate was achieved. The commissioner shall structure the 12.22withhold so that the commissioner returns a portion of the withheld funds in amounts 12.23commensurate with achieved reductions in utilization less that the targeted amount.12.24The withhold described in this paragraph must continue for each consecutive 12.25contract period until the plan's subsequent hospitalization rate for medical assistance 12.26and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 12.27subdivisions 23 and 28, is reduced by 25 percent of the plan's subsequent hospitalization 12.28rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this 12.29performance target and shall accept payment withholds that must be returned to the 12.30hospitals if the performance target is achieved.12.31(j) Effective for services rendered on or after January 1, 2011, through December 31, 12.322011, the commissioner shall withhold 4.5 percent of managed care plan payments under 12.33this section and county-based purchasing plan payments under section 
         256B.692 for the 12.34prepaid medical assistance program. The withheld funds must be returned no sooner than 12.35July 1 and no later than July 31 of the following year. The commissioner may exclude 12.36special demonstration projects under subdivision 23.13.1(k) Effective for services rendered on or after January 1, 2012, through December 13.231, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 13.3under this section and county-based purchasing plan payments under section 
         256B.692 13.4for the prepaid medical assistance program. The withheld funds must be returned no 13.5sooner than July 1 and no later than July 31 of the following year. The commissioner may 13.6exclude special demonstration projects under subdivision 23.13.7(l) Effective for services rendered on or after January 1, 2013, through December 31, 13.82013, the commissioner shall withhold 4.5 percent of managed care plan payments under 13.9this section and county-based purchasing plan payments under section 
         256B.692 for the 13.10prepaid medical assistance program. The withheld funds must be returned no sooner than 13.11July 1 and no later than July 31 of the following year. The commissioner may exclude 13.12special demonstration projects under subdivision 23.13.13(m) Effective for services rendered on or after January 1, 2014, the commissioner 13.14shall withhold three percent of managed care plan payments under this section and 13.15county-based purchasing plan payments under section 
         256B.692 for the prepaid medical 13.16assistance program. The withheld funds must be returned no sooner than July 1 and 13.17no later than July 31 of the following year. The commissioner may exclude special 13.18demonstration projects under subdivision 23.13.19(n) A managed care plan or a county-based purchasing plan under section 
         256B.692 13.20may include as admitted assets under section 
         62D.044 any amount withheld under this 13.21section that is reasonably expected to be returned.13.22(o) Contracts between the commissioner and a prepaid health plan are exempt from 13.23the set-aside and preference provisions of section 
         16C.16, subdivisions 6, paragraph 13.24(a), and 7.13.25(p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject 13.26to the requirements of paragraph (c).13.27    Sec. 13. Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:13.28    Subd. 9. Reporting. (a) Each demonstration provider shall submit information as 13.29required by the commissioner, including data required for assessing client satisfaction, 13.30quality of care, cost, and utilization of services for purposes of project evaluation. The 13.31commissioner shall also develop methods of data reporting and collection in order to 13.32provide aggregate enrollee information on encounters and outcomes to determine access 13.33and quality assurance. Required information shall be specified before the commissioner 13.34contracts with a demonstration provider.14.1(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate 14.2spending data for major categories of service as reported to the commissioners of 14.3health and commerce under section 
         62D.08, subdivision 3, clause (a), and criteria for 14.4service authorization and service use are public data that the commissioner shall make 14.5available and use in public reports. The commissioner shall require each health plan and 14.6county-based purchasing plan to provide:14.7(1) encounter data for each service provided, using standard codes and unit of 14.8service definitions set by the commissioner, in a form that the commissioner can report by 14.9age, eligibility groups, and health plan; and14.10(2) criteria, written policies, and procedures required to be disclosed under section 14.1162M.10
         , subdivision 7, and Code of Federal Regulations, title 42, part 
         438.210(b)(1), used 14.12for each type of service for which authorization is required.14.13(c) Each demonstration provider shall report to the commissioner on the extent to 14.14which providers employed by or under contract with the demonstration provider use 14.15patient-centered decision-making tools or procedures designed to engage patients early 14.16in the decision-making process and the steps taken by the demonstration provider to 14.17encourage their use.14.18    Sec. 14. Minnesota Statutes 2010, section 256B.69, is amended by adding a 14.19subdivision to read:14.20    Subd. 9d.Financial audit.(a) The legislative auditor shall contract with an audit 14.21firm to conduct a biennial independent third-party financial audit of the information 14.22required to be provided by managed care plans and county-based purchasing plans under 14.23subdivision 9c, paragraph (b). The audit shall be conducted in accordance with generally 14.24accepted government auditing standards issued by the United States Government 14.25Accountability Office. The contract with the audit firm shall be designed and administered 14.26so as to render the independent third-party audit eligible for a federal subsidy, if available. 14.27The contract shall require the audit to include a determination of compliance with 14.28the federal Medicaid rate certification process. The contract shall require the audit to 14.29determine if the administrative expenses and investment income reported by the managed 14.30care plans and county-based purchasing plans are compliant with state and federal law.14.31(b) For purposes of this subdivision, "independent third-party" means an audit firm 14.32that is independent in accordance with government auditing standards issued by the United 14.33States Government Accountability Office and licensed in accordance with chapter 326A. 14.34An audit firm under contract to provide services in accordance with this subdivision must 15.1not have provided services to a managed care plan or county-based purchasing plan during 15.2the period for which the audit is being conducted.15.3(c) The commissioner shall require in the request for bids and resulting contracts 15.4with managed care plans and county-based purchasing plans under this section and section 15.5256B.692, that each managed care plan and county-based purchasing plan submit to 15.6and fully cooperate with the independent third-party financial audit of the information 15.7required under subdivision 9c, paragraph (b). Each contract with a managed care plan 15.8or county-based purchasing plan under this section or section 256B.692, must provide 15.9the commissioner and the audit firm contracting with the legislative auditor access to all 15.10data required to complete the audit. For purposes of this subdivision, the contracting 15.11audit firm shall have the same investigative power as the legislative auditor under section 15.123.978, subdivision 2.15.13(d) Each managed care plan and county-based purchasing plan providing services 15.14under this section shall provide to the commissioner biweekly encounter data and claims 15.15data for state public health care programs and shall participate in a quality assurance 15.16program that verifies the timeliness, completeness, accuracy, and consistency of the data 15.17provided. The commissioner shall develop written protocols for the quality assurance 15.18program and shall make the protocols publicly available. The commissioner shall contract 15.19for an independent third-party audit to evaluate the quality assurance protocols as to 15.20the capacity of the protocols to ensure complete and accurate data and to evaluate the 15.21commissioner's implementation of the protocols. The audit firm under contract to provide 15.22this evaluation must meet the requirements in paragraph (b).15.23(e) Upon completion of the audit under paragraph (a) and receipt by the legislative 15.24auditor, the legislative auditor shall provide copies of the audit report to the commissioner, 15.25the state auditor, the attorney general, and the chairs and ranking minority members of the 15.26health and human services finance committees of the legislature. Upon completion of the 15.27evaluation under paragraph (d), the commissioner shall provide copies of the report to 15.28the legislative auditor and the chairs and ranking minority members of the health finance 15.29committees of the legislature.15.30(f) Any actuary under contract with the commissioner to provide actuarial services 15.31must meet the independence requirements under the professional code for fellows in the 15.32Society of Actuaries and must not have provided actuarial services to a managed care plan 15.33or county-based purchasing plan that is under contract with the commissioner pursuant to 15.34this section and section 256B.692 during the period in which the actuarial services are 15.35being provided. An actuary or actuarial firm meeting the requirements of this paragraph 15.36must certify and attest to the rates paid to the managed care plans and county-based 16.1purchasing plans under this section and section 256B.692, and the certification and 16.2attestation must be auditable.16.3(g) Nothing in this subdivision shall allow the release of information that is 16.4nonpublic data pursuant to section 13.02.16.5EFFECTIVE DATE.This section is effective the day following final enactment 16.6and applies to the managed care and county-based purchasing plan contracts that are 16.7effective January 1, 2014, and biennially thereafter.16.8    Sec. 15. Minnesota Statutes 2010, section 256B.69, is amended by adding a 16.9subdivision to read:16.10    Subd. 32.Initiatives to reduce incidence of low birth weight.The commissioner 16.11shall require managed care and county-based purchasing plans, as a condition of contract, 16.12to implement strategies to reduce the incidence of low birth weight in geographic areas 16.13identified by the commissioner as having a higher than average incidence of low birth 16.14weight. The strategies must coordinate health care with social services and the local 16.15public health system. Each plan shall develop and report to the commissioner outcome 16.16measures related to reducing the incidence of low birth weight. The commissioner shall 16.17consider the outcomes reported when considering plan participation in the competitive 16.18bidding program established under subdivision 33.16.19    Sec. 16. Minnesota Statutes 2010, section 256B.69, is amended by adding a 16.20subdivision to read:16.21    Subd. 33.Competitive bidding.(a) For managed care contracts effective on or 16.22after January 1, 2014, the commissioner may utilize a competitive price bidding program 16.23for nonelderly, nondisabled adults and children in medical assistance and MinnesotaCare 16.24in the seven-county metropolitan area. The program must allow a minimum of two 16.25managed care plans to serve the metropolitan area.16.26(b) In designing the competitive bid program, the commissioner shall consider, and 16.27incorporate where appropriate, the procedures and criteria used in the competitive bidding 16.28pilot authorized under Laws 2011, First Special Session chapter 9, article 6, section 96. 16.29The pilot program operating in Hennepin County under the authority of section 256B.0756 16.30shall continue to be exempt from competitive bid.16.31(c) The commissioner shall use past performance data as a factor in selecting vendors 16.32and shall consider this information, along with competitive bid and other information, in 16.33determining whether to contract with a managed care plan under this subdivision. Where 16.34possible, the assessment of past performance in serving persons on public programs shall 17.1be based on encounter data submitted to the commissioner. The commissioner shall 17.2evaluate past performance based on both the health outcomes of care and success rates 17.3in securing participation in recommended preventive and early diagnostic care. Data 17.4provided by managed care plans must be provided in a uniform manner as specified by 17.5the commissioner and must include only data on medical assistance and MinnesotaCare 17.6enrollees. The data submitted must include health outcome measures on reducing the 17.7incidence of low birth weight established by the managed care plan under subdivision 32.17.8    Sec. 17. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 4, is 17.9amended to read:17.10    Subd. 4. Critical access dental providers.  (a) Effective for dental services 17.11rendered on or after January 1, 2002, the commissioner shall increase reimbursements 17.12to dentists and dental clinics deemed by the commissioner to be critical access dental 17.13providers. For dental services rendered on or after July 1, 2007, the commissioner shall 17.14increase reimbursement by 30 percent above the reimbursement rate that would otherwise 17.15be paid to the critical access dental provider. The commissioner shall pay the managed 17.16care plans and county-based purchasing plans in amounts sufficient to reflect increased 17.17reimbursements to critical access dental providers as approved by the commissioner.17.18(b) The commissioner shall designate the following dentists and dental clinics as 17.19critical access dental providers:17.20    (1) nonprofit community clinics that:17.21(i) have nonprofit status in accordance with chapter 317A;17.22(ii) have tax exempt status in accordance with the Internal Revenue Code, section 17.23501(c)(3);17.24(iii) are established to provide oral health services to patients who are low income, 17.25uninsured, have special needs, and are underserved;17.26(iv) have professional staff familiar with the cultural background of the clinic's 17.27patients;17.28(v) charge for services on a sliding fee scale designed to provide assistance to 17.29low-income patients based on current poverty income guidelines and family size;17.30(vi) do not restrict access or services because of a patient's financial limitations 17.31or public assistance status; and17.32(vii) have free care available as needed;17.33    (2) federally qualified health centers, rural health clinics, and public health clinics;17.34    (3) county owned and operated hospital-based dental clinics;18.1(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 18.2accordance with chapter 317A with more than 10,000 patient encounters per year with 18.3patients who are uninsured or covered by medical assistance, general assistance medical 18.4care, or MinnesotaCare; and18.5(5) a dental clinic owned and operated by the University of Minnesota or the 18.6Minnesota State Colleges and Universities system.18.7     (c) The commissioner may designate a dentist or dental clinic as a critical access 18.8dental provider if the dentist or dental clinic is willing to provide care to patients covered 18.9by medical assistance, general assistance medical care, or MinnesotaCare at a level which 18.10significantly increases access to dental care in the service area.18.11(d) Notwithstanding paragraph (a), critical access payments must not be made for 18.12dental services provided from April 1, 2010, through June 30, 2010. A designated critical 18.13access clinic shall receive the reimbursement rate specified in paragraph (a) for dental 18.14services provided off-site at a private dental office if the following requirements are met:18.15(1) the designated critical access dental clinic is located within a health professional 18.16shortage area as defined under the Code of Federal Regulations, title 42, part 5, and 18.17the United States Code, title 42, section 254E, and is located outside the seven-county 18.18metropolitan area;18.19(2) the designated critical access dental clinic is not able to provide the service 18.20and refers the patient to the off-site dentist;18.21(3) the service, if provided at the critical access dental clinic, would be reimbursed 18.22at the critical access reimbursement rate;18.23(4) the dentist and allied dental professionals providing the services off-site are 18.24licensed and in good standing under chapter 150A;18.25(5) the dentist providing the services is enrolled as a medical assistance provider;18.26(6) the critical access dental clinic submits the claim for services provided off-site 18.27and receives the payment for the services; and18.28(7) the critical access dental clinic maintains dental records for each claim submitted 18.29under this paragraph, including the name of the dentist, the off-site location, and the 18.30license number of the dentist and allied dental professionals providing the services.18.31EFFECTIVE DATE.This section is effective July 1, 2012, or upon federal 18.32approval, whichever is later.18.33    Sec. 18. Minnesota Statutes 2011 Supplement, section 256L.03, subdivision 5, is 18.34amended to read:19.1    Subd. 5. Cost-sharing. (a) Except as provided in paragraphs (b) and (c), the 19.2MinnesotaCare benefit plan shall include the following cost-sharing requirements for all 19.3enrollees:19.4    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 19.5subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;19.6    (2) $3 per prescription for adult enrollees;19.7    (3) $25 for eyeglasses for adult enrollees;19.8    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 19.9episode of service which is required because of a recipient's symptoms, diagnosis, or 19.10established illness, and which is delivered in an ambulatory setting by a physician or 19.11physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 19.12audiologist, optician, or optometrist;19.13    (5) $6 for nonemergency visits to a hospital-based emergency room for services 19.14provided through December 31, 2010, and $3.50 effective January 1, 2011; and19.15(6) a family deductible equal to the maximum amount allowed under Code of 19.16Federal Regulations, title 42, part 
         447.54.19.17    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 19.18children under the age of 21.19.19    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.19.20    (d) Paragraph (a), clause (4), does not apply to mental health services.19.21    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal 19.22poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, 19.23and who are not pregnant shall be financially responsible for the coinsurance amount, if 19.24applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.19.25    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 19.26or changes from one prepaid health plan to another during a calendar year, any charges 19.27submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 19.28expenses incurred by the enrollee for inpatient services, that were submitted or incurred 19.29prior to enrollment, or prior to the change in health plans, shall be disregarded.19.30(g) MinnesotaCare reimbursements to fee-for-service providers and payments to 19.31managed care plans or county-based purchasing plans shall not be increased as a result of 19.32the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.19.33(h) The commissioner, through the contracting process under section 256L.12, 19.34may allow managed care plans and county-based purchasing plans to waive the family 19.35deductible under paragraph (a), clause (6). The value of the family deductible shall not be 19.36included in the capitation payment to managed care plans and county-based purchasing 20.1plans. Managed care plans and county-based purchasing plans shall certify annually to the 20.2commissioner the dollar value of the family deductible.20.3EFFECTIVE DATE.This section is effective January 1, 2012.20.4    Sec. 19. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 2, 20.5is amended to read:20.6    Subd. 2. Use of defined contribution; health plan requirements. (a) An enrollee 20.7may use up to the monthly defined contribution to pay premiums for coverage under 20.8a health plan as defined in section 
         62A.011, subdivision 3, or as provided in section 20.9256L.031, subdivision 6.20.10    (b) An enrollee must select a health plan within three four calendar months of 20.11approval of MinnesotaCare eligibility. If a health plan is not selected and purchased 20.12within this time period, the enrollee must reapply and must meet all eligibility criteria.20.13The commissioner may determine criteria under which an enrollee has more than four 20.14calendar months to select a health plan.20.15    (c) A health plan Coverage purchased under this section must:20.16    (1) provide coverage for include mental health and chemical dependency treatment 20.17services; and20.18    (2) comply with the coverage limitations specified in section 
         256L.03, subdivision 20.191, the second paragraph.20.20    Sec. 20. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 3, 20.21is amended to read:20.22    Subd. 3. Determination of defined contribution amount. (a) The commissioner 20.23shall determine the defined contribution sliding scale using the base contribution specified 20.24in paragraph (b) this paragraph for the specified age ranges. The commissioner shall use a 20.25sliding scale for defined contributions that provides:20.26    (1) persons with household incomes equal to 200 percent of the federal poverty 20.27guidelines with a defined contribution of 93 percent of the base contribution;20.28    (2) persons with household incomes equal to 250 percent of the federal poverty 20.29guidelines with a defined contribution of 80 percent of the base contribution; and20.30    (3) persons with household incomes in evenly spaced increments between the 20.31percentages of the federal poverty guideline or income level specified in clauses (1) and 20.32(2) with a base contribution that is a percentage interpolated from the defined contribution 20.33percentages specified in clauses (1) and (2).

21.119-29$12521.230-34$13521.335-39$14021.440-44$17521.545-49$21521.650-54$29521.755-59$34521.860+$360

21.9    (b) The commissioner shall multiply the defined contribution amounts developed 21.10under paragraph (a) by 
         1.20 for enrollees who are denied coverage under an individual 21.11health plan by a health plan company and who purchase coverage through the Minnesota 21.12Comprehensive Health Association.21.13    Sec. 21. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 6, 21.14is amended to read:21.15    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning 21.16July 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual 21.17health market by a health plan company in accordance with section 62A.65 are eligible 21.18for coverage through a health plan offered by the Minnesota Comprehensive Health 21.19Association and may enroll in MCHA in accordance with section 
         62E.14. Any difference 21.20between the revenue and actual covered losses to MCHA related to the implementation of 21.21this section are appropriated annually to the commissioner of human services from the 21.22health care access fund and shall be paid to MCHA.21.23    Sec. 22. Minnesota Statutes 2010, section 256L.07, subdivision 3, is amended to read:21.24    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the 21.25MinnesotaCare program must have no health coverage while enrolled or for at least four 21.26months prior to application and renewal. Children enrolled in the original children's health 21.27plan and children in families with income equal to or less than 150 percent of the federal 21.28poverty guidelines, who have other health insurance, are eligible if the coverage:21.29    (1) lacks two or more of the following:21.30    (i) basic hospital insurance;21.31    (ii) medical-surgical insurance;21.32    (iii) prescription drug coverage;21.33    (iv) dental coverage; or21.34    (v) vision coverage;21.35    (2) requires a deductible of $100 or more per person per year; or22.1    (3) lacks coverage because the child has exceeded the maximum coverage for a 22.2particular diagnosis or the policy excludes a particular diagnosis.22.3    The commissioner may change this eligibility criterion for sliding scale premiums 22.4in order to remain within the limits of available appropriations. The requirement of no 22.5health coverage does not apply to newborns.22.6    (b) Coverage purchased as provided under section 256L.031, subdivision 2, medical 22.7assistance, general assistance medical care, and the Civilian Health and Medical Program 22.8of the Uniformed Service, CHAMPUS, or other coverage provided under United States 22.9Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health 22.10coverage for purposes of the four-month requirement described in this subdivision.22.11    (c) For purposes of this subdivision, an applicant or enrollee who is entitled to 22.12Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social 22.13Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to 22.14have health coverage. An applicant or enrollee who is entitled to premium-free Medicare 22.15Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility 22.16for MinnesotaCare.22.17    (d) Applicants who were recipients of medical assistance or general assistance 22.18medical care within one month of application must meet the provisions of this subdivision 22.19and subdivision 2.22.20    (e) Cost-effective health insurance that was paid for by medical assistance is not 22.21considered health coverage for purposes of the four-month requirement under this 22.22section, except if the insurance continued after medical assistance no longer considered it 22.23cost-effective or after medical assistance closed.22.24    Sec. 23. Minnesota Statutes 2011 Supplement, section 256L.12, subdivision 9, is 22.25amended to read:22.26    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective, 22.27per capita, where possible. The commissioner may allow health plans to arrange for 22.28inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 22.29an independent actuary to determine appropriate rates.22.30    (b) For services rendered on or after January 1, 2004, the commissioner shall 22.31withhold five percent of managed care plan payments and county-based purchasing 22.32plan payments under this section pending completion of performance targets. Each 22.33performance target must be quantifiable, objective, measurable, and reasonably attainable, 22.34except in the case of a performance target based on a federal or state law or rule. Criteria 22.35for assessment of each performance target must be outlined in writing prior to the contract 23.1effective date. Clinical or utilization performance targets and their related criteria must 23.2consider evidence-based research and reasonable interventions, when available or 23.3applicable to the populations served, and must be developed with input from external 23.4clinical experts and stakeholders, including managed care plans, county-based purchasing 23.5plans, and providers. The managed care plan must demonstrate, to the commissioner's 23.6satisfaction, that the data submitted regarding attainment of the performance target is 23.7accurate. The commissioner shall periodically change the administrative measures used 23.8as performance targets in order to improve plan performance across a broader range of 23.9administrative services. The performance targets must include measurement of plan 23.10efforts to contain spending on health care services and administrative activities. The 23.11commissioner may adopt plan-specific performance targets that take into account factors 23.12affecting only one plan, such as characteristics of the plan's enrollee population. The 23.13withheld funds must be returned no sooner than July 1 and no later than July 31 of the 23.14following calendar year if performance targets in the contract are achieved.23.15(c) For services rendered on or after January 1, 2011, the commissioner shall 23.16withhold an additional three percent of managed care plan or county-based purchasing 23.17plan payments under this section. The withheld funds must be returned no sooner than 23.18July 1 and no later than July 31 of the following calendar year. The return of the withhold 23.19under this paragraph is not subject to the requirements of paragraph (b).23.20(d) Effective for services rendered on or after January 1, 2011, through December 23.2131, 2011, the commissioner shall include as part of the performance targets described in 23.22paragraph (b) a reduction in the plan's emergency room utilization rate for state health care 23.23program enrollees by a measurable rate of five percent from the plan's utilization rate for 23.24the previous calendar year. Effective for services rendered on or after January 1, 2012, 23.25the commissioner shall include as part of the performance targets described in paragraph 23.26(b) a reduction in the health plan's emergency department utilization rate for medical 23.27assistance and MinnesotaCare enrollees, as determined by the commissioner. For 2012, 23.28the reductions shall be based on the health plan's utilization in 2009. To earn the return of 23.29the withhold each subsequent year, the managed care plan or county-based purchasing 23.30plan must achieve a qualifying reduction of no less than ten percent of the plan's utilization 23.31rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees in 23.32programs described in section 256B.69, subdivisions 23 and 28, compared to the previous 23.33calendar measurement year, until the final performance target is reached. When measuring 23.34performance, the commissioner must consider the difference in health risk in a managed 23.35care or county-based purchasing plan's membership in the baseline year compared to the 24.1measurement year, and work with the managed care or county-based purchasing plan to 24.2account for differences that they agree are significant.24.3The withheld funds must be returned no sooner than July 1 and no later than July 31 24.4of the following calendar year if the managed care plan or county-based purchasing plan 24.5demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 24.6was achieved. The commissioner shall structure the withhold so that the commissioner 24.7returns a portion of the withheld funds in amounts commensurate with achieved reductions 24.8in utilization less than the targeted amount.24.9The withhold described in this paragraph shall continue for each consecutive 24.10contract period until the plan's emergency room utilization rate for state health care 24.11program enrollees is reduced by 25 percent of the plan's emergency room utilization 24.12rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009. 24.13Hospitals shall cooperate with the health plans in meeting this performance target and 24.14shall accept payment withholds that may be returned to the hospitals if the performance 24.15target is achieved.24.16(e) Effective for services rendered on or after January 1, 2012, the commissioner 24.17shall include as part of the performance targets described in paragraph (b) a reduction 24.18in the plan's hospitalization admission rate for medical assistance and MinnesotaCare 24.19enrollees, as determined by the commissioner. To earn the return of the withhold 24.20each year, the managed care plan or county-based purchasing plan must achieve a 24.21qualifying reduction of no less than five percent of the plan's hospital admission rate 24.22for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees24.23in programs described in section 256B.69, subdivisions 23 and 28, compared to the 24.24previous calendar year, until the final performance target is reached. When measuring 24.25performance, the commissioner must consider the difference in health risk in a managed 24.26care or county-based purchasing plan's membership in the baseline year compared to the 24.27measurement year, and work with the managed care or county-based purchasing plan to 24.28account for differences that they agree are significant.24.29The withheld funds must be returned no sooner than July 1 and no later than July 24.3031 of the following calendar year if the managed care plan or county-based purchasing 24.31plan demonstrates to the satisfaction of the commissioner that this reduction in the 24.32hospitalization rate was achieved. The commissioner shall structure the withhold so that 24.33the commissioner returns a portion of the withheld funds in amounts commensurate with 24.34achieved reductions in utilization less than the targeted amount.24.35The withhold described in this paragraph shall continue until there is a 25 percent 24.36reduction in the hospitals admission rate compared to the hospital admission rate for 25.1calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the 25.2plans in meeting this performance target and shall accept payment withholds that may be 25.3returned to the hospitals if the performance target is achieved. The hospital admissions 25.4in this performance target do not include the admissions applicable to the subsequent 25.5hospital admission performance target under paragraph (f).25.6(f) Effective for services provided on or after January 1, 2012, the commissioner 25.7shall include as part of the performance targets described in paragraph (b) a reduction 25.8in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a 25.9previous hospitalization of a patient regardless of the reason, for medical assistance and 25.10MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the 25.11withhold each year, the managed care plan or county-based purchasing plan must achieve 25.12a qualifying reduction of the subsequent hospital admissions rate for medical assistance 25.13and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 25.14section 256B.69, subdivisions 23 and 28, of no less than five percent compared to the 25.15previous calendar year until the final performance target is reached.25.16The withheld funds must be returned no sooner than July 1 and no later than July 31 25.17of the following calendar year if the managed care plan or county-based purchasing plan 25.18demonstrates to the satisfaction of the commissioner that a reduction in the subsequent 25.19hospitalization rate was achieved. The commissioner shall structure the withhold so that 25.20the commissioner returns a portion of the withheld funds in amounts commensurate with 25.21achieved reductions in utilization less than the targeted amount.25.22The withhold described in this paragraph must continue for each consecutive 25.23contract period until the plan's subsequent hospitalization rate for medical assistance and 25.24MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization 25.25rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this 25.26performance target and shall accept payment withholds that must be returned to the 25.27hospitals if the performance target is achieved.25.28(g) A managed care plan or a county-based purchasing plan under section 
         256B.692 25.29may include as admitted assets under section 
         62D.044 any amount withheld under this 25.30section that is reasonably expected to be returned.25.31    Sec. 24. NONEMERGENCY MEDICAL TRANSPORTATION SERVICES 25.32REQUEST FOR INFORMATION.25.33(a) The commissioner of human services shall issue a request for information 25.34from vendors about potential solutions for the management of nonemergency medical 25.35transportation (NEMT) services provided to recipients of Minnesota health care programs. 26.1The request for information must require vendors to submit responses by November 1, 26.22012. The request for information shall seek information from vendors, including but not 26.3limited to, the following aspects:26.4(1) administration of the NEMT program within a single administrative structure, 26.5that may include a statewide or regionalized solution;26.6(2) oversight of transportation services;26.7(3) a process for assessing an individual's level of need;26.8(4) methods that promote the appropriate use of public transportation; and26.9(5) an electronic system that assists providers in managing services to clients and is 26.10consistent with the recommendations in the 2011 evaluation report by the Office of the 26.11Legislative Auditor on NEMT, related to the use of data to inform decision-making and 26.12reduce waste and fraud.26.13(b) The commissioner shall provide the information obtained from the request for 26.14information to the chairs and ranking minority members of the legislative committees with 26.15jurisdiction over health and human services policy and financing by November 15, 2012.26.16    Sec. 25. PHYSICIAN ASSISTANTS AND OUTPATIENT MENTAL HEALTH.26.17The commissioner of human services shall convene a group of interested 26.18stakeholders to assist the commissioner in developing recommendations on how to 26.19improve access to, and the quality of, outpatient mental health services for medical 26.20assistance enrollees through the use of physician assistants. The commissioner shall report 26.21these recommendations to the chairs and ranking minority members of the legislative 26.22committees with jurisdiction over health care policy and financing by January 15, 2013.26.23    Sec. 26. HEALTH SERVICES ADVISORY COUNCIL.26.24The Health Services Advisory Council shall review currently available literature 26.25regarding the efficacy of various treatments for autism spectrum disorder, including 26.26an evaluation of age-based variation in the appropriateness of existing medical and 26.27behavioral interventions. The council shall recommend to the commissioner of human 26.28services authorization criteria for services based on existing evidence. The council may 26.29recommend coverage with ongoing collection of outcomes evidence in circumstances 26.30where evidence is currently unavailable, or where the strength of the evidence is low. The 26.31council shall make this recommendation by December 31, 2012.26.32    Sec. 27. REPORTING REQUIREMENTS.27.1    Subdivision 1.Evidence-based childbirth program.The commissioner of human 27.2services may discontinue the evidence-based childbirth program and shall discontinue all 27.3affiliated reporting requirements established under Minnesota Statutes, section 256B.0625, 27.4subdivision 3g, once the commissioner determines that hospitals representing at least 90 27.5percent of births covered by medical assistance or MinnesotaCare have approved policies 27.6and processes in place that prohibit elective inductions prior to 39 weeks' gestation.27.7    Subd. 2.Provider networks.The commissioner of health, the commissioner of 27.8commerce, and the commissioner of human services shall merge reporting requirements 27.9for health maintenance organizations and county-based purchasing plans related to 27.10Minnesota Department of Health oversight of network adequacy under Minnesota 27.11Statutes, section 62D.124, and the provider network list reported to the Department of 27.12Human Services under Minnesota Rules, part 4685.2100. The commissioners shall work 27.13with health maintenance organizations and county-based purchasing plans to ensure that 27.14the report merger is done in a manner that simplifies health maintenance organization and 27.15county-based purchasing plan reporting processes.27.16EFFECTIVE DATE.This section is effective the day following final enactment.27.17    Sec. 28. EMERGENCY MEDICAL ASSISTANCE STUDY.27.18(a) The commissioner of human services shall develop a plan to provide coordinated 27.19and cost-effective health care and coverage for individuals who meet eligibility standards 27.20for emergency medical assistance and who are ineligible for other state public programs. 27.21The commissioner shall consult with relevant stakeholders in the development of the plan. 27.22The commissioner shall consider the following elements:27.23(1) strategies to provide individuals with the most appropriate care in the appropriate 27.24setting, utilizing higher quality and lower cost providers;27.25(2) payment mechanisms to encourage providers to manage the care of these 27.26populations, and to produce lower cost of care and better patient outcomes;27.27(3) ensure coverage and payment options that address the unique needs of those 27.28needing episodic care, chronic care, and long-term care services;27.29(4) strategies for coordinating health care and nonhealth care services, and 27.30integrating with existing coverage; and27.31(5) other issues and strategies to ensure cost-effective and coordinated delivery 27.32of coverage and services.28.1(b) The commissioner shall submit the plan to the chairs and ranking minority 28.2members of the legislative committees with jurisdiction over health and human services 28.3policy and financing by January 15, 2013.28.4    Sec. 29. EMERGENCY MEDICAL CONDITION COVERAGE EXCEPTIONS.28.5(a) Notwithstanding Minnesota Statutes, section 256B.06, subdivision 4, paragraph 28.6(h), clause (2), the following services are covered as emergency medical conditions under 28.7Minnesota Statutes, section 256B.06, subdivision 4, paragraph (f):28.8(1) dialysis services provided in a hospital or free-standing dialysis facility; and28.9(2) surgery and the administration of chemotherapy, radiation, and related services 28.10necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission 28.11and requires surgery, chemotherapy, or radiation treatment.28.12(b) Coverage under paragraph (a) is effective May 1, 2012, until June 30, 2013.28.13    Sec. 30. COST-SHARING REQUIREMENTS STUDY.28.14The commissioner of human services, in consultation with managed care 28.15plans, county-based purchasing plans, and other relevant stakeholders, shall develop 28.16recommendations to implement a revised cost-sharing structure for state public health 28.17care programs that ensures application of meaningful cost-sharing requirements within 28.18the limits of title 42, Code of Federal Regulations, section 447.54, for enrollees in these 28.19programs. The commissioner shall report to the chairs and ranking minority members of 28.20the legislative committees with jurisdiction over these issues by January 15, 2013, with 28.21draft legislation to implement these recommendations effective January 1, 2014.28.22    Sec. 31. STUDY OF MANAGED CARE.28.23(a) The commissioner of human services must contract with an independent 28.24vendor with demonstrated expertise in evaluating Medicaid managed care programs to 28.25evaluate the value of managed care for state public health care programs provided under 28.26Minnesota Statutes, sections 256B.69, 256B.692, and 256L.12. Determination of the 28.27value of managed care must include consideration of the following, as compared to a 28.28fee-for-service program:28.29(1) the satisfaction of state public health care program recipients and providers;28.30(2) the ability to measure and improve health outcomes of recipients;28.31(3) the access to health services for recipients;28.32(4) the availability of additional services such as care coordination, case 28.33management, disease management, transportation, and after-hours nurse lines;29.1(5) actual and potential cost savings to the state;29.2(6) the level of alignment with state and federal health reform policies, including a 29.3health benefit exchange for individuals not enrolled in state public health care programs; 29.4and29.5(7) the ability to use different provider payment models that provide incentives for 29.6cost-effective health care.29.7(b) The evaluation described in paragraph (a) must also consider the need to continue 29.8the requirement for health maintenance organizations to participate in the medical 29.9assistance and MinnesotaCare programs as a condition of licensure under Minnesota 29.10Statutes, section 62D.04, subdivision 5, and under Minnesota Statutes, section 256B.0644, 29.11in terms of continued stability and access to services for enrollees of these programs.29.12(c) A preliminary report of the evaluation must be submitted to the chairs and 29.13ranking minority members of the health and human services legislative committees by 29.14February 15, 2013, and the final report must be submitted by July 1, 2013.29.15    Sec. 32. REPEALER.29.16    Subdivision 1.Summary of complaints and grievances.(a) Minnesota Rules, part 29.174685.2000, is repealed effective the day following final enactment.29.18    Subd. 2.Medical necessity denials and appeals.Minnesota Statutes 2010, section 29.1962M.09, subdivision 9, is repealed effective the day following final enactment.29.20    Subd. 3.Salary reports.Minnesota Statutes 2010, section 62Q.64, is repealed 29.21effective the day following final enactment.29.22ARTICLE 229.23DEPARTMENT OF HEALTH29.24    Section 1. Minnesota Statutes 2010, section 62Q.80, is amended to read:29.2562Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM.29.26    Subdivision 1. Scope. (a) Any community-based health care initiative may develop 29.27and operate community-based health care coverage programs that offer to eligible 29.28individuals and their dependents the option of purchasing through their employer health 29.29care coverage on a fixed prepaid basis without meeting the requirements of chapter 60A, 29.3062A, 62C, 62D, 62M, 62N, 62Q, 62T, or 62U, or any other law or rule that applies to 29.31entities licensed under these chapters.29.32(b) Each initiative shall establish health outcomes to be achieved through the 29.33programs and performance measurements in order to determine whether these outcomes 29.34have been met. The outcomes must include, but are not limited to:30.1(1) a reduction in uncompensated care provided by providers participating in the 30.2community-based health network;30.3(2) an increase in the delivery of preventive health care services; and30.4(3) health improvement for enrollees with chronic health conditions through the 30.5management of these conditions.30.6In establishing performance measurements, the initiative shall use measures that are 30.7consistent with measures published by nonprofit Minnesota or national organizations that 30.8produce and disseminate health care quality measures.30.9(c) Any program established under this section shall not constitute a financial 30.10liability for the state, in that any financial risk involved in the operation or termination 30.11of the program shall be borne by the community-based initiative and the participating 30.12health care providers.30.13    Subd. 1a.Demonstration project.The commissioner of health and the 30.14commissioner of human services shall award demonstration project grants to 30.15community-based health care initiatives to develop and operate community-based health 30.16care coverage programs in Minnesota. The demonstration projects shall extend for five 30.17years and must comply with the requirements of this section.30.18    Subd. 2. Definitions.  For purposes of this section, the following definitions apply:30.19(a) "Community-based" means located in or primarily relating to the community, 30.20as determined by the board of a community-based health initiative that is served by the 30.21community-based health care coverage program.30.22(b) "Community-based health care coverage program" or "program" means a 30.23program administered by a community-based health initiative that provides health care 30.24services through provider members of a community-based health network or combination 30.25of networks to eligible individuals and their dependents who are enrolled in the program.30.26(c) "Community-based health initiative" or "initiative" means a nonprofit corporation 30.27that is governed by a board that has at least 80 percent of its members residing in the 30.28community and includes representatives of the participating network providers and 30.29employers, or a county-based purchasing organization as defined in section 
         256B.692.30.30(d) "Community-based health network" means a contract-based network of health 30.31care providers organized by the community-based health initiative to provide or support 30.32the delivery of health care services to enrollees of the community-based health care 30.33coverage program on a risk-sharing or nonrisk-sharing basis.30.34(e) "Dependent" means an eligible employee's spouse or unmarried child who is 30.35under the age of 19 years.31.1    Subd. 3. Approval.  (a) Prior to the operation of a community-based health 31.2care coverage program, a community-based health initiative, defined in subdivision 31.32, paragraph (c), and receiving funds from the Department of Health, shall submit to 31.4the commissioner of health for approval the community-based health care coverage 31.5program developed by the initiative. Each community-based health initiative as defined 31.6in subdivision 2, paragraph (c), and receiving State Health Access Program (SHAP) 31.7grant funding shall submit to the commissioner of human services for approval prior 31.8to its operation the community-based health care coverage programs developed by the 31.9initiatives. The commissioners commissioner shall ensure that each program meets 31.10the federal grant requirements and any requirements described in this section and is 31.11actuarially sound based on a review of appropriate records and methods utilized by the 31.12community-based health initiative in establishing premium rates for the community-based 31.13health care coverage programs.31.14    (b) Prior to approval, the commissioner shall also ensure that:31.15    (1) the benefits offered comply with subdivision 8 and that there are adequate 31.16numbers of health care providers participating in the community-based health network to 31.17deliver the benefits offered under the program;31.18    (2) the activities of the program are limited to activities that are exempt under this 31.19section or otherwise from regulation by the commissioner of commerce;31.20    (3) the complaint resolution process meets the requirements of subdivision 10; and31.21    (4) the data privacy policies and procedures comply with state and federal law.31.22    Subd. 4. Establishment.  The initiative shall establish and operate upon approval 31.23by the commissioners commissioner of health and human services community-based 31.24health care coverage programs. The operational structure established by the initiative 31.25shall include, but is not limited to:31.26    (1) establishing a process for enrolling eligible individuals and their dependents;31.27    (2) collecting and coordinating premiums from enrollees and employers of enrollees;31.28    (3) providing payment to participating providers;31.29    (4) establishing a benefit set according to subdivision 8 and establishing premium 31.30rates and cost-sharing requirements;31.31    (5) creating incentives to encourage primary care and wellness services; and31.32    (6) initiating disease management services, as appropriate.31.33    Subd. 5. Qualifying employees.  To be eligible for the community-based health 31.34care coverage program, an individual must:31.35(1) reside in or work within the designated community-based geographic area 31.36served by the program;32.1(2) be employed by a qualifying employer, be an employee's dependent, or be 32.2self-employed on a full-time basis;32.3(3) not be enrolled in or have currently available health coverage, except for 32.4catastrophic health care coverage; and32.5(4) not be eligible for or enrolled in medical assistance or general assistance medical 32.6care, and not be enrolled in MinnesotaCare or Medicare.32.7    Subd. 6. Qualifying employers.  (a) To qualify for participation in the 32.8community-based health care coverage program, an employer must:32.9(1) employ at least one but no more than 50 employees at the time of initial 32.10enrollment in the program;32.11(2) pay its employees a median wage that equals 350 percent of the federal poverty 32.12guidelines or less for an individual; and32.13(3) not have offered employer-subsidized health coverage to its employees for 32.14at least 12 months prior to the initial enrollment in the program. For purposes of this 32.15section, "employer-subsidized health coverage" means health care coverage for which the 32.16employer pays at least 50 percent of the cost of coverage for the employee.32.17(b) To participate in the program, a qualifying employer agrees to:32.18(1) offer health care coverage through the program to all eligible employees and 32.19their dependents regardless of health status;32.20(2) participate in the program for an initial term of at least one year;32.21(3) pay a percentage of the premium established by the initiative for the employee; 32.22and32.23(4) provide the initiative with any employee information deemed necessary by the 32.24initiative to determine eligibility and premium payments.32.25    Subd. 7. Participating providers. Any health care provider participating in the 32.26community-based health network must accept as payment in full the payment rate 32.27established by the initiatives and may not charge to or collect from an enrollee any amount 32.28in access of this amount for any service covered under the program.32.29    Subd. 8. Coverage.  (a) The initiatives shall establish the health care benefits offered 32.30through the community-based health care coverage programs. The benefits established 32.31shall include, at a minimum:32.32(1) child health supervision services up to age 18, as defined under section 
         62A.047; 32.33and32.34(2) preventive services, including:32.35(i) health education and wellness services;32.36(ii) health supervision, evaluation, and follow-up;33.1(iii) immunizations; and33.2(iv) early disease detection.33.3(b) Coverage of health care services offered by the program may be limited to 33.4participating health care providers or health networks. All services covered under the 33.5programs must be services that are offered within the scope of practice of the participating 33.6health care providers.33.7(c) The initiatives may establish cost-sharing requirements. Any co-payment or 33.8deductible provisions established may not discriminate on the basis of age, sex, race, 33.9disability, economic status, or length of enrollment in the programs.33.10(d) If any of the initiatives amends or alters the benefits offered through the program 33.11from the initial offering, that initiative must notify the commissioners commissioner of 33.12health and human services and all enrollees of the benefit change.33.13    Subd. 9. Enrollee information. (a) The initiatives must provide an individual or 33.14family who enrolls in the program a clear and concise written statement that includes 33.15the following information:33.16(1) health care services that are covered under the program;33.17(2) any exclusions or limitations on the health care services covered, including any 33.18cost-sharing arrangements or prior authorization requirements;33.19(3) a list of where the health care services can be obtained and that all health 33.20care services must be provided by or through a participating health care provider or 33.21community-based health network;33.22(4) a description of the program's complaint resolution process, including how to 33.23submit a complaint; how to file a complaint with the commissioner of health; and how to 33.24obtain an external review of any adverse decisions as provided under subdivision 10;33.25(5) the conditions under which the program or coverage under the program may 33.26be canceled or terminated; and33.27(6) a precise statement specifying that this program is not an insurance product and, 33.28as such, is exempt from state regulation of insurance products.33.29(b) The commissioners commissioner of health and human services must approve a 33.30copy of the written statement prior to the operation of the program.33.31    Subd. 10. Complaint resolution process. (a) The initiatives must establish 33.32a complaint resolution process. The process must make reasonable efforts to resolve 33.33complaints and to inform complainants in writing of the initiative's decision within 60 33.34days of receiving the complaint. Any decision that is adverse to the enrollee shall include 33.35a description of the right to an external review as provided in paragraph (c) and how to 33.36exercise this right.34.1(b) The initiatives must report any complaint that is not resolved within 60 days to 34.2the commissioner of health.34.3(c) The initiatives must include in the complaint resolution process the ability of an 34.4enrollee to pursue the external review process provided under section 
         62Q.73 with any 34.5decision rendered under this external review process binding on the initiatives.34.6    Subd. 11. Data privacy. The initiatives shall establish data privacy policies and 34.7procedures for the program that comply with state and federal data privacy laws.34.8    Subd. 12. Limitations on enrollment. (a) The initiatives may limit enrollment in 34.9the program. If enrollment is limited, a waiting list must be established.34.10(b) The initiatives shall not restrict or deny enrollment in the program except for 34.11nonpayment of premiums, fraud or misrepresentation, or as otherwise permitted under 34.12this section.34.13(c) The initiatives may require a certain percentage of participation from eligible 34.14employees of a qualifying employer before coverage can be offered through the program.34.15    Subd. 13. Report.  Each initiative shall submit quarterlyan annual status reports34.16report to the commissioner of health on January 15, April 15, July 15, and October 15 of 34.17each year, with the first report due January 15, 2008. Each initiative receiving funding 34.18from the Department of Human Services shall submit status reports to the commissioner 34.19of human services as defined in the terms of the contract with the Department of Human 34.20Services. Each status report shall include:34.21    (1) the financial status of the program, including the premium rates, cost per member 34.22per month, claims paid out, premiums received, and administrative expenses;34.23    (2) a description of the health care benefits offered and the services utilized;34.24    (3) the number of employers participating, the number of employees and dependents 34.25covered under the program, and the number of health care providers participating;34.26    (4) a description of the health outcomes to be achieved by the program and a status 34.27report on the performance measurements to be used and collected; and34.28    (5) any other information requested by the commissioners commissioner of health, 34.29human services, or commerce or the legislature.34.30    Subd. 14.Sunset.This section expires August 31, 2014.34.31    Sec. 2. Minnesota Statutes 2011 Supplement, section 144.1222, subdivision 5, is 34.32amended to read:34.33    Subd. 5. Swimming pond exemption Exemptions. (a) A public swimming pond 34.34in existence before January 1, 2008, is not a public pool for purposes of this section and 35.1section 
         157.16, and is exempt from the requirements for public swimming pools under 35.2Minnesota Rules, chapter 4717.35.3(b) A naturally treated swimming pool located in the city of Minneapolis is not 35.4a public pool for purposes of this section and section 157.16, and is exempt from the 35.5requirements for public swimming pools under Minnesota Rules, chapter 4717.35.6    (b) (c) Notwithstanding paragraph paragraphs (a) and (b), a public swimming pond 35.7and a naturally treated swimming pool must meet the requirements for public pools 35.8described in subdivisions 1c and 1d.35.9    (c) (d) For purposes of this subdivision, a "public swimming pond" means an 35.10artificial body of water contained within a lined, sand-bottom basin, intended for public 35.11swimming, relaxation, or recreational use that includes a water circulation system for 35.12maintaining water quality and does not include any portion of a naturally occurring lake 35.13or stream.35.14(e) For purposes of this subdivision, a "naturally treated swimming pool" means an 35.15artificial body of water contained in a basin, intended for public swimming, relaxation, or 35.16recreational use that uses a chemical free filtration system for maintaining water quality 35.17through natural processes, including the use of plants, beneficial bacteria, and microbes.35.18EFFECTIVE DATE.This section is effective the day following final enactment.35.19    Sec. 3. [144.1225] ADVANCED DIAGNOSTIC IMAGING SERVICES.35.20    Subdivision 1.Definition.For purposes of this section, "advanced diagnostic 35.21imaging services" has the meaning given in United States Code, title 42, section 1395M, 35.22except that it does not include x-ray, ultrasound, or fluoroscopy.35.23    Subd. 2.Accreditation required.(a)(1) Except as otherwise provided in paragraph 35.24(b), advanced diagnostic imaging services eligible for reimbursement from any source, 35.25including, but not limited to, the individual receiving such services and any individual 35.26or group insurance contract, plan, or policy delivered in this state, including, but not 35.27limited to, private health insurance plans, workers' compensation insurance, motor vehicle 35.28insurance, the State Employee Group Insurance Program (SEGIP), and other state health 35.29care programs, shall be reimbursed only if the facility at which the service has been 35.30conducted and processed is accredited by one of the following entities:35.31(i) American College of Radiology (ACR);35.32(ii) Intersocietal Accreditation Commission (IAC);35.33(iii) the Joint Commission; or36.1(iv) other relevant accreditation organization designated by the secretary of the 36.2United States Department of Health and Human Services pursuant to United States Code, 36.3title 42, section 1395M.36.4(2) All accreditation standards recognized under this section must include, but are 36.5not limited to:36.6(i) provisions establishing qualifications of the physician;36.7(ii) standards for quality control and routine performance monitoring by a medical 36.8physicist;36.9(iii) qualifications of the technologist, including minimum standards of supervised 36.10clinical experience;36.11(iv) guidelines for personnel and patient safety; and36.12(v) standards for initial and ongoing quality control using clinical image review 36.13and quantitative testing.36.14(b) Any facility that performs advanced diagnostic imaging services and is eligible 36.15to receive reimbursement for such services from any source in paragraph (a)(1) must 36.16obtain accreditation by August 1, 2013. Thereafter, all facilities that provide advanced 36.17diagnostic imaging services in the state must obtain accreditation prior to commencing 36.18operations and must, at all times, maintain accreditation with an accrediting organization 36.19as provided in paragraph (a).36.20    Subd. 3.Reporting.(a) Advanced diagnostic imaging facilities and providers 36.21of advanced diagnostic imaging services must annually report to the commissioner 36.22demonstration of accreditation as required under this section.36.23(b) The commissioner may promulgate any rules necessary to administer the 36.24reporting required under paragraph (a).36.25    Sec. 4. Minnesota Statutes 2010, section 144.292, subdivision 6, is amended to read:36.26    Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for 36.27purposes of reviewing current medical care, the provider must not charge a fee.36.28    (b) When a provider or its representative makes copies of patient records upon a 36.29patient's request under this section, the provider or its representative may charge the 36.30patient or the patient's representative no more than 75 cents per page, plus $10 for time 36.31spent retrieving and copying the records, unless other law or a rule or contract provide for 36.32a lower maximum charge. This limitation does not apply to x-rays. The provider may 36.33charge a patient no more than the actual cost of reproducing x-rays, plus no more than 36.34$10 for the time spent retrieving and copying the x-rays.37.1    (c) The respective maximum charges of 75 cents per page and $10 for time provided 37.2in this subdivision are in effect for calendar year 1992 and may be adjusted annually each 37.3calendar year as provided in this subdivision. The permissible maximum charges shall 37.4change each year by an amount that reflects the change, as compared to the previous year, 37.5in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 37.6published by the Department of Labor.37.7    (d) A provider or its representative may charge the $10 retrieval fee, but must not 37.8charge a per page fee to provide copies of records requested by a patient or the patient's 37.9authorized representative if the request for copies of records is for purposes of appealing 37.10a denial of Social Security disability income or Social Security disability benefits under 37.11title II or title XVI of the Social Security Act; except that no fee shall be charged to a 37.12person who is receiving public assistance, who is represented by an attorney on behalf of 37.13a civil legal services program or a volunteer attorney program based on indigency. For 37.14the purpose of further appeals, a patient may receive no more than two medical record 37.15updates without charge, but only for medical record information previously not provided. 37.16For purposes of this paragraph, a patient's authorized representative does not include units 37.17of state government engaged in the adjudication of Social Security disability claims.37.18    Sec. 5. Minnesota Statutes 2010, section 144.298, subdivision 2, is amended to read:37.19    Subd. 2. Liability of provider or other person. A person who does any of the 37.20following is liable to the patient for compensatory damages caused by an unauthorized 37.21release or an intentional, unauthorized access, plus costs and reasonable attorney fees:37.22    (1) negligently or intentionally requests or releases a health record in violation 37.23of sections 
         144.291 to 
         144.297;37.24    (2) forges a signature on a consent form or materially alters the consent form of 37.25another person without the person's consent; or37.26    (3) obtains a consent form or the health records of another person under false 37.27pretenses; or37.28(4) intentionally violates sections 144.291 to 144.297 by intentionally accessing a 37.29record locator service without authorization.37.30    Sec. 6. Minnesota Statutes 2010, section 144.5509, is amended to read:37.31144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.37.32    (a) A radiation therapy facility may be constructed only by an entity owned, 37.33operated, or controlled by a hospital licensed according to sections 
         144.50 to 
         144.56 either 37.34alone or in cooperation with another entity.38.1    (b) Notwithstanding paragraph (a), there shall be a moratorium on the construction 38.2of any radiation therapy facility located in the following counties: Hennepin, Ramsey, 38.3Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns, 38.4Chisago, Isanti, and Wright. This paragraph does not apply to the relocation or 38.5reconstruction of an existing facility owned by a hospital if the relocation or reconstruction 38.6is within one mile of the existing facility. This paragraph does not apply to a radiation 38.7therapy facility that is being built attached to a community hospital in Wright County and 38.8meets the following conditions prior to August 1, 2007: the capital expenditure report 38.9required under Minnesota Statutes, section 
         62J.17, has been filed with the commissioner 38.10of health; a timely construction schedule is developed, stipulating dates for beginning, 38.11achieving various stages, and completing construction; and all zoning and building permits 38.12applied for. Beginning January 1, 2013, this paragraph does not apply to any construction 38.13necessary to relocate a radiation therapy machine from a community hospital-owned 38.14radiation therapy facility located in the city of Maplewood to a community hospital 38.15campus in the city of Woodbury within the same health system. This paragraph expires 38.16August 1, 2014.38.17(c) Notwithstanding paragraph (a), after August 1, 2014, the construction of a 38.18radiation therapy facility located in any of the following counties: Hennepin, Ramsey, 38.19Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns, 38.20Chisago, Isanti, and Wright, may occur only if the following requirements are met:38.21(1) the entity constructing the radiation therapy facility is controlled by or is under 38.22common control with a hospital licensed under sections 144.50 to 144.56; and38.23(2) the new radiation therapy facility is located at least seven miles from an existing 38.24radiation therapy facility.38.25(d) Any referring physician located within a county identified in paragraph (c) must 38.26provide each patient who is in need of radiation therapy services with a list of all radiation 38.27therapy facilities located within the counties identified in paragraph (c). Physicians 38.28with a financial interest in any radiation therapy facility must disclose to the patient the 38.29existence of the interest.38.30(e) For purposes of this section, "controlled by" or "under common control with" 38.31means the possession, direct or indirect, of the power to direct or cause the direction of the 38.32policies, operations, or activities of an entity, through the ownership of, or right to vote 38.33or to direct the disposition of shares, membership interests, or ownership interests of 38.34the entity.39.1(f) For purposes of this section, "financial interest in any radiation therapy facility" 39.2means a direct or indirect ownership or investment interest in a radiation therapy facility 39.3or a compensation arrangement with a radiation therapy facility.39.4(g) This section does not apply to the relocation or reconstruction of an existing 39.5radiation therapy facility if:39.6(1) the relocation or reconstruction of the facility remains owned by the same entity;39.7(2) the relocation or reconstruction is located within one mile of the existing facility; 39.8and39.9(3) the period in which the existing facility is closed and the relocated or 39.10reconstructed facility begins providing services does not exceed 12 months.39.11    Sec. 7. [145.8811] MATERNAL AND CHILD HEALTH ADVISORY TASK 39.12FORCE.39.13    Subdivision 1.Composition of task force.The commissioner shall establish and 39.14appoint a Maternal and Child Health Advisory Task Force consisting of 15 members 39.15who will provide equal representation from:39.16(1) professionals with expertise in maternal and child health services;39.17(2) representatives of community health boards as defined in section 145A.02, 39.18subdivision 5; and39.19(3) consumer representatives interested in the health of mothers and children.39.20No members shall be employees of the Minnesota Department of Health. Section 39.2115.059 governs the Maternal and Child Health Advisory Task Force. Notwithstanding 39.22section 15.059, the Maternal and Child Health Advisory Task Force expires June 30, 2015.39.23    Subd. 2.Duties.The advisory task force shall meet on a regular basis to perform 39.24the following duties:39.25(1) review and report on the health care needs of mothers and children throughout 39.26the state of Minnesota;39.27(2) review and report on the type, frequency, and impact of maternal and child health 39.28care services provided to mothers and children under existing maternal and child health 39.29care programs, including programs administered by the commissioner of health;39.30(3) establish, review, and report to the commissioner a list of program guidelines 39.31and criteria which the advisory task force considers essential to providing an effective 39.32maternal and child health care program to low-income populations and high-risk persons 39.33and fulfilling the purposes defined in section 145.88;39.34(4) make recommendations to the commissioner for the use of other federal and state 39.35funds available to meet maternal and child health needs;40.1(5) make recommendations to the commissioner of health on priorities for funding 40.2the following maternal and child health services:40.3(i) prenatal, delivery, and postpartum care;40.4(ii) comprehensive health care for children, especially from birth through five 40.5years of age;40.6(iii) adolescent health services;40.7(iv) family planning services;40.8(v) preventive dental care;40.9(vi) special services for chronically ill and disabled children; and40.10(vii) any other services that promote the health of mothers and children; and40.11(6) establish, in consultation with the commissioner and the State Community Health 40.12Advisory Committee established under section 145A.10, subdivision 10, paragraph (a), 40.13statewide outcomes that will improve the health status of mothers and children as required 40.14in section 145A.12, subdivision 7.40.15    Sec. 8. Minnesota Statutes 2010, section 145.906, is amended to read:40.16145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.40.17(a) The commissioner of health shall work with health care facilities, licensed health 40.18and mental health care professionals, the women, infants, and children (WIC) program, 40.19mental health advocates, consumers, and families in the state to develop materials and 40.20information about postpartum depression, including treatment resources, and develop 40.21policies and procedures to comply with this section.40.22(b) Physicians, traditional midwives, and other licensed health care professionals 40.23providing prenatal care to women must have available to women and their families 40.24information about postpartum depression.40.25(c) Hospitals and other health care facilities in the state must provide departing new 40.26mothers and fathers and other family members, as appropriate, with written information 40.27about postpartum depression, including its symptoms, methods of coping with the illness, 40.28and treatment resources.40.29(d) Information about postpartum depression, including its symptoms, potential 40.30impact on families, and treatment resources, must be available at WIC sites.40.31    Sec. 9. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY 40.32RESPONSIBILITIES.41.1Relating to the evaluations and legislative report completed pursuant to Laws 41.22011, First Special Session chapter 9, article 2, section 26, the following activities must 41.3be completed:41.4(1) the commissioners of health and human services must update, revise, and 41.5link the contents of their Web sites related to supervised living facilities, intermediate 41.6care facilities for the developmentally disabled, nursing facilities, board and lodging 41.7establishments, and human services licensed programs so that consumers and providers 41.8can access consistent clear information about the regulations affecting these facilities; and41.9(2) the commissioner of management and budget, in consultation with the 41.10commissioners of health and human services, must evaluate and recommend options 41.11for administering health and human services regulations. The evaluation and 41.12recommendations must be submitted in a report to the chairs and ranking minority 41.13members of the health and human services legislative committees no later than August 1, 41.142013, and shall at a minimum: (i) identify and evaluate the regulatory responsibilities of 41.15the Departments of Health and Human Services to determine whether to reorganize these 41.16regulatory responsibilities to improve how the state administers health and human services 41.17regulatory functions, or whether there are ways to improve these regulatory activities 41.18without reorganizing; (ii) describe and evaluate the multiple roles of the Department of 41.19Human Services as a direct provider of care services, a regulator, and a payor for state 41.20program services; and (iii) for long-term care regulated in both departments, evaluate and 41.21make recommendations for reasonable client risk assessments, planning for client risk 41.22reductions, and determining reasonable assumptions of client risks in relation to directing 41.23health care, client health care rights, provider liabilities, and provider responsibilities to 41.24provide minimum standards of care.41.25    Sec. 10. HEALTH RECORD ACCESS STUDY.41.26The commissioner of health, in consultation with the Minnesota e-Health Advisory 41.27Committee, shall study the following:41.28(1) the extent to which providers have audit procedures in place to monitor use of 41.29representation of consent and unauthorized access to a patient's health records in violation 41.30of Minnesota Statutes, sections 144.291 to 144.297;41.31(2) the feasibility of informing patients if an intentional, unauthorized access of 41.32their health records occurs; and41.33(3) the feasibility of providing patients with a copy of a provider's audit log showing 41.34who has accessed their health records.42.1The commissioner shall report study findings and any relevant patient privacy and 42.2other recommendations to the legislature by February 15, 2013.42.3    Sec. 11. REPORTING PREVALENCE OF SEXUAL VIOLENCE.42.4The commissioner of health must routinely report to the public and to the legislature 42.5data on the prevalence and incidence of sexual violence in Minnesota, to the extent 42.6federal funding is available for this purpose. The commissioner must use existing data 42.7provided by the Centers for Disease Control and Prevention, or other source as identified 42.8by commissioner.42.9EFFECTIVE DATE.This section is effective the day following final enactment.42.10    Sec. 12. LICENSED HOME CARE PROVIDERS.42.11By February 1, 2013, the commissioner of health must report recommendations to 42.12the legislature as to development of a comprehensive home care plan to increase inspection 42.13and oversight of licensed home care providers under Minnesota Statutes, chapter 144A.42.14    Sec. 13. EVALUATION OF HEALTH AND COMMERCE REGULATORY 42.15RESPONSIBILITIES.42.16The commissioner of health, in consultation with the commissioner of commerce, 42.17shall report to the legislature by February 15, 2013, on recommendations to maximize 42.18administrative efficiency in the regulation of health maintenance organizations, 42.19county-based purchasers, insurance carriers, and related entities while maintaining quality 42.20health outcomes, regulatory stability, and price stability.42.21    Sec. 14. STUDY OF RADIATION THERAPY FACILITIES CAPACITY.42.22(a) To the extent of available appropriations, the commissioner of health shall 42.23conduct a study of the following: (1) current treatment capacity of the existing radiation 42.24therapy facilities within the state; (2) the present need for radiation therapy services based 42.25on population demographics and new cancer cases; and (3) the projected need in the next 42.26ten years for radiation therapy services and whether the current facilities can sustain 42.27this projected need.42.28(b) The commissioner may contract with a qualified entity to conduct the study. The 42.29study shall be completed by March 15, 2013, and the results shall be submitted to the 42.30chairs and ranking minority members of the health and human services committees of 42.31the legislature.43.1    Sec. 15. MERC DISTRIBUTION.43.2(a) For the distribution of funds for fiscal year 2013, as required under Minnesota 43.3Statutes, section 62J.692, subdivision 4, the commissioner of health shall distribute 43.4$300,000 to Gillette Children's Specialty Healthcare before following the distribution 43.5described under Minnesota Statutes, section 62J.692, subdivision 4, paragraph (a).43.6(b) This section is effective upon federal approval.43.7ARTICLE 343.8CHILDREN AND FAMILY SERVICES43.9    Section 1. Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is 43.10amended to read:43.11    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers 43.12must not be reimbursed for more than ten full-day absent days per child, excluding 43.13holidays, in a fiscal year. Legal nonlicensed family child care providers must not be 43.14reimbursed for absent days. If a child attends for part of the time authorized to be in care in 43.15a day, but is absent for part of the time authorized to be in care in that same day, the absent 43.16time must be reimbursed but the time must not count toward the ten absent day limit. 43.17Child care providers must only be reimbursed for absent days if the provider has a written 43.18policy for child absences and charges all other families in care for similar absences.43.19(b) Notwithstanding paragraph (a), children in families may exceed the ten absent 43.20days limit if at least one parent is: (1) under the age of 21; (2) does not have a high school 43.21or general equivalency diploma; and (3) is a student in a school district or another similar 43.22program that provides or arranges for child care, parenting support, social services, career 43.23and employment supports, and academic support to achieve high school graduation, upon 43.24request of the program and approval of the county. If a child attends part of an authorized 43.25day, payment to the provider must be for the full amount of care authorized for that day.43.26    (b)(c) Child care providers must be reimbursed for up to ten federal or state 43.27holidays or designated holidays per year when the provider charges all families for these 43.28days and the holiday or designated holiday falls on a day when the child is authorized to 43.29be in attendance. Parents may substitute other cultural or religious holidays for the ten 43.30recognized state and federal holidays. Holidays do not count toward the ten absent day 43.31limit.43.32    (c)(d) A family or child care provider must not be assessed an overpayment for an 43.33absent day payment unless (1) there was an error in the amount of care authorized for the 43.34family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 43.35the family or provider did not timely report a change as required under law.44.1    (d)(e) The provider and family shall receive notification of the number of absent 44.2days used upon initial provider authorization for a family and ongoing notification of the 44.3number of absent days used as of the date of the notification.44.4EFFECTIVE DATE.This section is effective January 1, 2013.44.5    Sec. 2. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 44.6to read:44.7    Subd. 18c.Drug convictions.(a) The state court administrator shall provide a 44.8report every six months by electronic means to the commissioner of human services, 44.9including the name, address, date of birth, and, if available, driver's license or state 44.10identification card number, date of sentence, effective date of the sentence, and county in 44.11which the conviction occurred of each person convicted of a felony under chapter 152 44.12during the previous six months.44.13(b) The commissioner shall determine whether the individuals who are the subject of 44.14the data reported under paragraph (a) are receiving public assistance under chapter 256D 44.15or 256J, and if the individual is receiving assistance under chapter 256D or 256J, the 44.16commissioner shall instruct the county to proceed under section 256D.024 or 256J.26, 44.17whichever is applicable, for this individual.44.18(c) The commissioner shall not retain any data received under paragraph (a) or (d) 44.19that does not relate to an individual receiving publicly funded assistance under chapter 44.20256D or 256J.44.21(d) In addition to the routine data transfer under paragraph (a), the state court 44.22administrator shall provide a onetime report of the data fields under paragraph (a) for 44.23individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until 44.24the date of the data transfer. The commissioner shall perform the tasks identified under 44.25paragraph (b) related to this data and shall retain the data according to paragraph (c).44.26EFFECTIVE DATE.This section is effective July 1, 2013.44.27    Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 44.28to read:44.29    Subd. 18d.Data sharing with the Department of Human Services; multiple 44.30identification cards.(a) The commissioner of public safety shall, on a monthly basis, 44.31provide the commissioner of human services with the first, middle, and last name, 44.32the address, date of birth, and driver's license or state identification card number of all 44.33applicants and holders whose drivers' licenses and state identification cards have been 45.1canceled under section 171.14, paragraph (a), clauses (2) or (3), by the commissioner of 45.2public safety. After the initial data report has been provided by the commissioner of 45.3public safety to the commissioner of human services under this paragraph, subsequent 45.4reports shall only include cancellations that occurred after the end date of the cancellations 45.5represented in the previous data report.45.6(b) The commissioner of human services shall compare the information provided 45.7under paragraph (a) with the commissioner's data regarding recipients of all public 45.8assistance programs managed by the Department of Human Services to determine whether 45.9any individual with multiple identification cards issued by the Department of Public 45.10Safety has illegally or improperly enrolled in any public assistance program managed by 45.11the Department of Human Services.45.12(c) If the commissioner of human services determines that an applicant or recipient 45.13has illegally or improperly enrolled in any public assistance program, the commissioner 45.14shall provide all due process protections to the individual before terminating the individual 45.15from the program according to applicable statute and notifying the county attorney.45.16EFFECTIVE DATE.This section is effective July 1, 2013.45.17    Sec. 4. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 45.18to read:45.19    Subd. 18e.Data sharing with the Department of Human Services; legal 45.20presence date.(a) The commissioner of public safety shall, on a monthly basis, provide 45.21the commissioner of human services with the first, middle, and last name, address, date of 45.22birth, and driver's license or state identification number of all applicants and holders of 45.23drivers' licenses and state identification cards whose temporary legal presence date has 45.24expired and as a result the driver's license or identification card has been accordingly 45.25canceled under section 171.14 by the commissioner of public safety.45.26(b) The commissioner of human services shall use the information provided under 45.27paragraph (a) to determine whether the eligibility of any recipients of public assistance 45.28programs managed by the Department of Human Services has changed as a result of the 45.29status change in the Department of Public Safety data.45.30(c) If the commissioner of human services determines that a recipient has illegally or 45.31improperly received benefits from any public assistance program, the commissioner shall 45.32provide all due process protections to the individual before terminating the individual from 45.33the program according to applicable statute and notifying the county attorney.45.34EFFECTIVE DATE.This section is effective July 1, 2013.46.1    Sec. 5. Minnesota Statutes 2010, section 256.9831, subdivision 2, is amended to read:46.2    Subd. 2. Financial transaction cards. The commissioner shall take all actions 46.3necessary to ensure that no person may obtain benefits under chapter 256 or, 256D, or 256J46.4through the use of a financial transaction card, as defined in section 
         609.821, subdivision 46.51
         , paragraph (a), at a terminal located in or attached to a gambling establishment, liquor 46.6store, tobacco store, or tattoo parlor.46.7    Sec. 6. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is 46.8amended to read:46.9    Subdivision 1. Electronic benefit transfer (EBT) card. Cash benefits for the 46.10general assistance and Minnesota supplemental aid programs under chapter 256D and 46.11programs under chapter 256J must be issued on a separate an EBT card with the name of 46.12the head of household printed on the card. The card must include the following statement: 46.13"It is unlawful to use this card to purchase tobacco products or alcoholic beverages." This 46.14card must be issued within 30 calendar days of an eligibility determination. During the 46.15initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT 46.16card without a name printed on the card. This card may be the same card on which food 46.17support benefits are issued and does not need to meet the requirements of this section.46.18    Sec. 7. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 2, is 46.19amended to read:46.20    Subd. 2. Prohibited purchases.An individual with an EBT debit cardholders in46.21card issued for one of the programs listed under subdivision 1 are is prohibited from using 46.22the EBT debit card to purchase tobacco products and alcoholic beverages, as defined in 46.23section 
         340A.101, subdivision 2. It is unlawful for an EBT cardholder to purchase or 46.24attempt to purchase tobacco products or alcoholic beverages with the cardholder's EBT 46.25card. Any unlawful use prohibited purchases made under this subdivision shall constitute 46.26fraud unlawful use and result in disqualification of the cardholder from the program under 46.27section 256.98, subdivision 8 as provided in subdivision 4.46.28    Sec. 8. Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a 46.29subdivision to read:46.30    Subd. 3.EBT use restricted to certain states.EBT debit cardholders in programs 46.31listed under subdivision 1 are prohibited from using the cash portion of the EBT card at 46.32vendors and automatic teller machines located outside of Minnesota, Iowa, North Dakota, 46.33South Dakota, or Wisconsin. This subdivision does not apply to the food portion.47.1EFFECTIVE DATE.This section is effective March 1, 2013.47.2    Sec. 9. Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a 47.3subdivision to read:47.4    Subd. 4.Disqualification.(a) Any person found to be guilty of purchasing tobacco 47.5products or alcoholic beverages with their EBT debit card by a federal or state court or 47.6by an administrative hearing determination, or waiver thereof, through a disqualification 47.7consent agreement, or as part of any approved diversion plan under section 401.065, or 47.8any court-ordered stay which carries with it any probationary or other conditions, in 47.9the: (1) Minnesota family investment program and any affiliated program to include the 47.10diversionary work program and the work participation cash benefit program under chapter 47.11256J; (2) general assistance program under chapter 256D; or (3) Minnesota supplemental 47.12aid program under chapter 256D, shall be disqualified from all of the listed programs.47.13(b) The needs of the disqualified individual shall not be taken into consideration 47.14in determining the grant level for that assistance unit: (1) for one year after the first 47.15offense; (2) for two years after the second offense; and (3) permanently after the third or 47.16subsequent offense.47.17(c) The period of program disqualification shall begin on the date stipulated on the 47.18advance notice of disqualification without possibility for postponement for administrative 47.19stay or administrative hearing and shall continue through completion unless and until the 47.20findings upon which the sanctions were imposed are reversed by a court of competent 47.21jurisdiction. The period for which sanctions are imposed is not subject to review.47.22EFFECTIVE DATE.This section is effective June 1, 2012.47.23    Sec. 10. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:47.24    Subd. 1b. Earned income savings account. In addition to the $50 disregard 47.25required under subdivision 1, the county agency shall disregard an additional earned 47.26income up to a maximum of $150 $500 per month for: (1) persons residing in facilities 47.27licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to 47.289530.4000, and for whom discharge and work are part of a treatment plan; (2) persons 47.29living in supervised apartments with services funded under Minnesota Rules, parts 47.309535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan; 47.31and (3) persons residing in group residential housing, as that term is defined in section 47.32256I.03, subdivision 3
         , for whom the county agency has approved a discharge plan 47.33which includes work. The additional amount disregarded must be placed in a separate 47.34savings account by the eligible individual, to be used upon discharge from the residential 48.1facility into the community. For individuals residing in a chemical dependency program 48.2licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from 48.3the savings account require the signature of the individual and for those individuals with 48.4an authorized representative payee, the signature of the payee. A maximum of $1,00048.5$2,000, including interest, of the money in the savings account must be excluded from 48.6the resource limits established by section 
         256D.08, subdivision 1, clause (1). Amounts in 48.7that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If 48.8excluded money is removed from the savings account by the eligible individual at any 48.9time before the individual is discharged from the facility into the community, the money is 48.10income to the individual in the month of receipt and a resource in subsequent months. If 48.11an eligible individual moves from a community facility to an inpatient hospital setting, 48.12the separate savings account is an excluded asset for up to 18 months. During that time, 48.13amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to 48.14the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the 48.1518-month period, the entire account must be applied to the patient's cost of care.48.16EFFECTIVE DATE.This section is effective October 1, 2012.48.17    Sec. 11. Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 5, is 48.18amended to read:48.19    Subd. 5. Household eligibility; participation. (a) To be eligible for state or TANF48.20matching funds in the family assets for independence initiative, a household must meet the 48.21eligibility requirements of the federal Assets for Independence Act, Public Law 105-285, 48.22in Title IV, section 408 of that act.48.23(b) Each participating household must sign a family asset agreement that includes 48.24the amount of scheduled deposits into its savings account, the proposed use, and the 48.25proposed savings goal. A participating household must agree to complete an economic 48.26literacy training program.48.27Participating households may only deposit money that is derived from household 48.28earned income or from state and federal income tax credits.48.29    Sec. 12. Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 6, is 48.30amended to read:48.31    Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a 48.32participating household must transfer funds withdrawn from a family asset account to its 48.33matching fund custodial account held by the fiscal agent, according to the family asset 49.1agreement. The fiscal agent must determine if the match request is for a permissible use 49.2consistent with the household's family asset agreement.49.3The fiscal agent must ensure the household's custodial account contains the 49.4applicable matching funds to match the balance in the household's account, including 49.5interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches 49.6must be provided as follows:49.7(1) from state grant and TANF funds, a matching contribution of $1.50 for every 49.8$1 of funds withdrawn from the family asset account equal to the lesser of $720 per 49.9year or a $3,000 lifetime limit; and49.10(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1 49.11of funds withdrawn from the family asset account equal to the lesser of $720 per year or 49.12a $3,000 lifetime limit.49.13(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a 49.14direct payment to the vendor of the goods or services for the permissible use.49.15    Sec. 13. Minnesota Statutes 2010, section 256E.37, subdivision 1, is amended to read:49.16    Subdivision 1. Grant authority. The commissioner may make grants to state 49.17agencies and political subdivisions to construct or rehabilitate facilities for early childhood 49.18programs, crisis nurseries, or parenting time centers. The following requirements apply:49.19    (1) The facilities must be owned by the state or a political subdivision, but may 49.20be leased under section 
         16A.695 to organizations that operate the programs. The 49.21commissioner must prescribe the terms and conditions of the leases.49.22    (2) A grant for an individual facility must not exceed $500,000 for each program 49.23that is housed in the facility, up to a maximum of $2,000,000 for a facility that houses 49.24three programs or more. Programs include Head Start, School Readiness, Early Childhood 49.25Family Education, licensed child care, and other early childhood intervention programs.49.26    (3) State appropriations must be matched on a 50 percent basis with nonstate funds. 49.27The matching requirement must apply program wide and not to individual grants.49.28(4) At least 80 percent of grant funds must be distributed to facilities located in 49.29counties not included in the definition under section 473.121, subdivision 4.49.30    Sec. 14. Minnesota Statutes 2011 Supplement, section 256I.05, subdivision 1a, is 49.31amended to read:49.32    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section 49.33256I.04, subdivision 3
         , the county agency may negotiate a payment not to exceed $426.37 49.34for other services necessary to provide room and board provided by the group residence 50.1if the residence is licensed by or registered by the Department of Health, or licensed by 50.2the Department of Human Services to provide services in addition to room and board, 50.3and if the provider of services is not also concurrently receiving funding for services for 50.4a recipient under a home and community-based waiver under title XIX of the Social 50.5Security Act; or funding from the medical assistance program under section 
         256B.0659, 50.6for personal care services for residents in the setting; or residing in a setting which 50.7receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is 50.8available for other necessary services through a home and community-based waiver, or 50.9personal care services under section 
         256B.0659, then the GRH rate is limited to the rate 50.10set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary 50.11service rate exceed $426.37. The registration and licensure requirement does not apply to 50.12establishments which are exempt from state licensure because they are located on Indian 50.13reservations and for which the tribe has prescribed health and safety requirements. Service 50.14payments under this section may be prohibited under rules to prevent the supplanting of 50.15federal funds with state funds. The commissioner shall pursue the feasibility of obtaining 50.16the approval of the Secretary of Health and Human Services to provide home and 50.17community-based waiver services under title XIX of the Social Security Act for residents 50.18who are not eligible for an existing home and community-based waiver due to a primary 50.19diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is 50.20determined to be cost-effective.50.21(b) The commissioner is authorized to make cost-neutral transfers from the GRH 50.22fund for beds under this section to other funding programs administered by the department 50.23after consultation with the county or counties in which the affected beds are located. 50.24The commissioner may also make cost-neutral transfers from the GRH fund to county 50.25human service agencies for beds permanently removed from the GRH census under a plan 50.26submitted by the county agency and approved by the commissioner. The commissioner 50.27shall report the amount of any transfers under this provision annually to the legislature.50.28(c) The provisions of paragraph (b) do not apply to a facility that has its 50.29reimbursement rate established under section 
         256B.431, subdivision 4, paragraph (c).50.30    (d) Counties must not negotiate supplementary service rates with providers of group 50.31residential housing that are licensed as board and lodging with special services and that 50.32do not encourage a policy of sobriety on their premises and make referrals to available 50.33community services for volunteer and employment opportunities for residents.50.34    Sec. 15. Minnesota Statutes 2010, section 256I.05, subdivision 1e, is amended to read:51.1    Subd. 1e. Supplementary rate for certain facilities.(a) Notwithstanding the 51.2provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall 51.3negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to 51.4exceed $700 per month, including any legislatively authorized inflationary adjustments, 51.5for a group residential housing provider that:51.6(1) is located in Hennepin County and has had a group residential housing contract 51.7with the county since June 1996;51.8(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 51.926-bed facility; and51.10(3) serves a chemically dependent clientele, providing 24 hours per day supervision 51.11and limiting a resident's maximum length of stay to 13 months out of a consecutive 51.1224-month period.51.13(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a 51.14supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 51.15per month, including any legislatively authorized inflationary adjustments, of a group 51.16residential provider that:51.17(1) is located in St. Louis County and has had a group residential housing contract 51.18with the county since 2006;51.19(2) operates a 62-bed facility; and51.20(3) serves a chemically dependent adult male clientele, providing 24 hours per 51.21day supervision and limiting a resident's maximum length of stay to 13 months out of 51.22a consecutive 24-month period.51.23(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency 51.24shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not 51.25to exceed $700 per month, including any legislatively authorized inflationary adjustments, 51.26for the group residential provider described under paragraphs (a) and (b), not to exceed 51.27an additional 115 beds.51.28EFFECTIVE DATE.This section is effective July 1, 2013.51.29    Sec. 16. Minnesota Statutes 2010, section 256J.26, subdivision 1, is amended to read:51.30    Subdivision 1. Person convicted of drug offenses. (a) Applicants or participants51.31An individual who have has been convicted of a felony level drug offense committed after 51.32July 1, 1997, may, if otherwise eligible, receive MFIP benefits subject to the following 51.33conditions: during the previous ten years from the date of application or recertification is 51.34subject to the following:52.1(1) Benefits for the entire assistance unit must be paid in vendor form for shelter and 52.2utilities during any time the applicant is part of the assistance unit.52.3(2) The convicted applicant or participant shall be subject to random drug testing as 52.4a condition of continued eligibility and following any positive test for an illegal controlled 52.5substance is subject to the following sanctions:52.6(i) for failing a drug test the first time, the residual amount of the participant's grant 52.7after making vendor payments for shelter and utility costs, if any, must be reduced by an 52.8amount equal to 30 percent of the MFIP standard of need for an assistance unit of the same 52.9size. When a sanction under this subdivision is in effect, the job counselor must attempt 52.10to meet with the person face-to-face. During the face-to-face meeting, the job counselor 52.11must explain the consequences of a subsequent drug test failure and inform the participant 52.12of the right to appeal the sanction under section 
         256J.40. If a face-to-face meeting is 52.13not possible, the county agency must send the participant a notice of adverse action as 52.14provided in section 
         256J.31, subdivisions 4 and 5, and must include the information 52.15required in the face-to-face meeting; or52.16(ii) for failing a drug test two times, the participant is permanently disqualified from 52.17receiving MFIP assistance, both the cash and food portions. The assistance unit's MFIP 52.18grant must be reduced by the amount which would have otherwise been made available to 52.19the disqualified participant. Disqualification under this item does not make a participant 52.20ineligible for food stamps or food support. Before a disqualification under this provision is 52.21imposed, the job counselor must attempt to meet with the participant face-to-face. During 52.22the face-to-face meeting, the job counselor must identify other resources that may be 52.23available to the participant to meet the needs of the family and inform the participant of 52.24the right to appeal the disqualification under section 
         256J.40. If a face-to-face meeting is 52.25not possible, the county agency must send the participant a notice of adverse action as 52.26provided in section 
         256J.31, subdivisions 4 and 5, and must include the information 52.27required in the face-to-face meeting.52.28(3) A participant who fails a drug test the first time and is under a sanction due to 52.29other MFIP program requirements is considered to have more than one occurrence of 52.30noncompliance and is subject to the applicable level of sanction as specified under section 52.31256J.46, subdivision 1
         , paragraph (d).52.32(b) Applicants requesting only food stamps or food support or participants receiving 52.33only food stamps or food support, who have been convicted of a drug offense that 52.34occurred after July 1, 1997, may, if otherwise eligible, receive food stamps or food support 52.35if the convicted applicant or participant is subject to random drug testing as a condition 53.1of continued eligibility. Following a positive test for an illegal controlled substance, the 53.2applicant is subject to the following sanctions:53.3(1) for failing a drug test the first time, food stamps or food support shall be reduced 53.4by an amount equal to 30 percent of the applicable food stamp or food support allotment. 53.5When a sanction under this clause is in effect, a job counselor must attempt to meet with 53.6the person face-to-face. During the face-to-face meeting, a job counselor must explain 53.7the consequences of a subsequent drug test failure and inform the participant of the right 53.8to appeal the sanction under section 
         256J.40. If a face-to-face meeting is not possible, 53.9a county agency must send the participant a notice of adverse action as provided in 53.10section 
         256J.31, subdivisions 4 and 5, and must include the information required in the 53.11face-to-face meeting; and53.12(2) for failing a drug test two times, the participant is permanently disqualified from 53.13receiving food stamps or food support. Before a disqualification under this provision is 53.14imposed, a job counselor must attempt to meet with the participant face-to-face. During 53.15the face-to-face meeting, the job counselor must identify other resources that may be 53.16available to the participant to meet the needs of the family and inform the participant of 53.17the right to appeal the disqualification under section 
         256J.40. If a face-to-face meeting 53.18is not possible, a county agency must send the participant a notice of adverse action as 53.19provided in section 
         256J.31, subdivisions 4 and 5, and must include the information 53.20required in the face-to-face meeting.53.21(c) (b) For the purposes of this subdivision, "drug offense" means an offense that 53.22occurred after July 1, 1997, during the previous ten years from the date of application 53.23or recertification of sections 
         152.021 to 
         152.025, 
         152.0261, 
         152.0262, or152.096, or 53.24152.137. Drug offense also means a conviction in another jurisdiction of the possession, 53.25use, or distribution of a controlled substance, or conspiracy to commit any of these 53.26offenses, if the offense occurred after July 1, 1997, during the previous ten years from 53.27the date of application or recertification and the conviction is a felony offense in that 53.28jurisdiction, or in the case of New Jersey, a high misdemeanor.53.29EFFECTIVE DATE.This section is effective October 1, 2012, for all new MFIP 53.30applicants who apply on or after that date and for all recertifications occurring on or 53.31after that date.53.32    Sec. 17. Minnesota Statutes 2010, section 256J.26, is amended by adding a subdivision 53.33to read:53.34    Subd. 5.Vendor payment; uninhabitable units.Upon discovery by the county 53.35that a unit has been deemed uninhabitable under section 504B.131, the county shall 54.1immediately notify the landlord to return the vendor paid rent under this section for the 54.2month in which the discovery occurred. The county shall cease future rent payments for 54.3the uninhabitable housing units until the landlord demonstrates the premises are fit for 54.4the intended use. A landlord who is required to return vendor paid rent or is prohibited 54.5from receiving future rent under this subdivision may not take an eviction action against 54.6anyone in the assistance unit.54.7    Sec. 18. Minnesota Statutes 2010, section 256J.575, subdivision 1, is amended to read:54.8    Subdivision 1. Purpose.(a) The Family stabilization services serve families who 54.9are not making significant progress within the regular employment and training services 54.10track of the Minnesota family investment program (MFIP) due to a variety of barriers to 54.11employment.54.12    (b) The goal of the services is to stabilize and improve the lives of families at risk 54.13of long-term welfare dependency or family instability due to employment barriers such 54.14as physical disability, mental disability, age, or providing care for a disabled household 54.15member. These services promote and support families to achieve the greatest possible 54.16degree of self-sufficiency.54.17    Sec. 19. Minnesota Statutes 2010, section 256J.575, subdivision 2, is amended to read:54.18    Subd. 2. Definitions. The terms used in this section have the meanings given them 54.19in paragraphs (a) to (d) and (b).54.20    (a) "Case manager" means the county-designated staff person or employment 54.21services counselor.54.22    (b) "Case management" "Family stabilization services" means the services54.23programs, activities, and services provided by or through the county agency or through the 54.24employment services agency to participating families, including. Services include, but 54.25are not limited to, assessment as defined in section 256J.521, subdivision 1, information,54.26referrals, and assistance in the preparation and implementation of a family stabilization 54.27plan under subdivision 5.54.28    (c) (b) "Family stabilization plan" means a plan developed by a case manager 54.29and with the participant, which identifies the participant's most appropriate path to 54.30unsubsidized employment, family stability, and barrier reduction, taking into account the 54.31family's circumstances.54.32    (d) "Family stabilization services" means programs, activities, and services in this 54.33section that provide participants and their family members with assistance regarding, 54.34but not limited to:55.1    (1) obtaining and retaining unsubsidized employment;55.2    (2) family stability;55.3    (3) economic stability; and55.4    (4) barrier reduction.55.5    The goal of the services is to achieve the greatest degree of economic self-sufficiency 55.6and family well-being possible for the family under the circumstances.55.7    Sec. 20. Minnesota Statutes 2010, section 256J.575, subdivision 5, is amended to read:55.8    Subd. 5. Case management; Family stabilization plans; coordinated services.55.9    (a) The county agency or employment services provider shall provide family stabilization 55.10services to families through a case management model. A case manager shall be assigned 55.11to each participating family within 30 days after the family is determined to be eligible 55.12for family stabilization services. The case manager, with the full involvement of the 55.13participant, shall recommend, and the county agency shall establish and modify as 55.14necessary, a family stabilization plan for each participating family. Once a participant 55.15has been determined eligible for family stabilization services, the county agency or 55.16employment services provider must attempt to meet with the participant to develop a 55.17plan within 30 days.55.18(b) If a participant is already assigned to a county case manager or a 55.19county-designated case manager in social services, disability services, or housing services 55.20that case manager already assigned may be the case manager for purposes of these services.55.21    (b) The family stabilization plan must include:55.22    (1) each participant's plan for long-term self-sufficiency, including an employment 55.23goal where applicable;55.24    (2) an assessment of each participant's strengths and barriers, and any special 55.25circumstances of the participant's family that impact, or are likely to impact, the 55.26participant's progress towards the goals in the plan; and55.27    (3) an identification of the services, supports, education, training, and 55.28accommodations needed to reduce or overcome any barriers to enable the family to 55.29achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.55.30    (c) The case manager and the participant shall meet within 30 days of the family's 55.31referral to the case manager. The initial family stabilization plan must be completed within 55.3230 days of the first meeting with the case manager. The case manager shall establish a 55.33schedule for periodic review of the family stabilization plan that includes personal contact 55.34with the participant at least once per month. In addition, the case manager shall review 55.35and, if necessary, modify the plan under the following circumstances:56.1    (1) there is a lack of satisfactory progress in achieving the goals of the plan;56.2    (2) the participant has lost unsubsidized or subsidized employment;56.3    (3) a family member has failed or is unable to comply with a family stabilization 56.4plan requirement;56.5    (4) services, supports, or other activities required by the plan are unavailable;56.6    (5) changes to the plan are needed to promote the well-being of the children; or56.7    (6) the participant and case manager determine that the plan is no longer appropriate 56.8for any other reason.56.9(c) Participants determined eligible for family stabilization services must have 56.10access to employment and training services under sections 256J.515 to 256J.575, to the 56.11extent these services are available to other MFIP participants.56.12    Sec. 21. Minnesota Statutes 2010, section 256J.575, subdivision 6, is amended to read:56.13    Subd. 6. Cooperation with services requirements.(a) A participant who is eligible 56.14for family stabilization services under this section shall comply with paragraphs (b) to (d).56.15    (b) Participants shall engage in family stabilization plan services for the appropriate 56.16number of hours per week that the activities are scheduled and available, based on the 56.17needs of the participant and the participant's family, unless good cause exists for not 56.18doing so, as defined in section 
         256J.57, subdivision 1. The appropriate number of hours 56.19must be based on the participant's plan.56.20    (c) The case manager county agency or employment services agency shall review 56.21the participant's progress toward the goals in the family stabilization plan every six 56.22months to determine whether conditions have changed, including whether revisions to 56.23the plan are needed.56.24    (d) A participant's requirement to comply with any or all family stabilization plan 56.25requirements under this subdivision is excused when the case management services, 56.26training and educational services, or family support services identified in the participant's 56.27family stabilization plan are unavailable for reasons beyond the control of the participant, 56.28including when money appropriated is not sufficient to provide the services.56.29    Sec. 22. Minnesota Statutes 2010, section 256J.575, subdivision 8, is amended to read:56.30    Subd. 8. Funding. (a) The commissioner of human services shall treat MFIP 56.31expenditures made to or on behalf of any minor child under this section, who is part of a 56.32household that meets criteria in subdivision 3, as expenditures under a separately funded 56.33state program. These expenditures shall not count toward the state's maintenance of effort 56.34requirements under the federal TANF program.57.1    (b) A family is no longer part of a separately funded program under this section if 57.2the caregiver no longer meets the criteria for family stabilization services in subdivision 57.33, or if it is determined at recertification that a caregiver with a child under the age of six 57.4is working at least 87 hours per month in paid or unpaid employment, or a caregiver 57.5without a child under the age of six is working at least 130 hours per month in paid or 57.6unpaid employment, whichever occurs sooner.57.7    Sec. 23. [626.5533] REPORTING POTENTIAL WELFARE FRAUD.57.8    Subdivision 1.Reports required.A peace officer must report to the head of the 57.9officer's department every arrest where the person arrested possesses more than one 57.10welfare electronic benefit transfer card. Each report must include all of the following:57.11(1) the name of the suspect;57.12(2) the suspect's drivers license or state identification card number, where available;57.13(3) the suspect's home address;57.14(4) the number on each card;57.15(5) the name on each electronic benefit card in the possession of the suspect, in cases 57.16where the card has a name printed on it;57.17(6) the date of the alleged offense;57.18(7) the location of the alleged offense;57.19(8) the alleged offense; and57.20(9) any other information the commissioner of human services deems necessary.57.21    Subd. 2.Use of information collected.The head of a local law enforcement agency 57.22or state law enforcement department that employs peace officers licensed under section 57.23626.843 must forward the report required under subdivision 1 to the commissioner of 57.24human services within 30 days of receiving the report. The commissioner of human 57.25services shall use the report to determine whether the suspect is authorized to possess any 57.26of the electronic benefit cards found in the suspect's possession.57.27    Subd. 3.Reporting forms.The commissioner of human services, in consultation 57.28with the superintendent of the Bureau of Criminal Apprehension, shall adopt reporting 57.29forms to be used by law enforcement agencies in making the reports required under this 57.30section.57.31    Sec. 24. Minnesota Statutes 2010, section 626.556, is amended by adding a subdivision 57.32to read:57.33    Subd. 10n.Required referral to early intervention services.A child under 57.34age three who is involved in a substantiated case of maltreatment shall be referred for 58.1screening under the Individuals with Disabilities Education Act, part C. Parents must be 58.2informed that the evaluation and acceptance of services are voluntary. The commissioner 58.3of human services shall monitor referral rates by county and annually report the 58.4information to the legislature beginning March 15, 2014. Refusal to have a child screened 58.5is not a basis for a child in need of protection or services petition under chapter 260C.58.6    Sec. 25. Laws 2010, chapter 374, section 1, is amended to read:58.7    Section 1. LADDER OUT OF POVERTY ASSET DEVELOPMENT AND 58.8FINANCIAL LITERACY TASK FORCE.58.9    Subdivision 1. Creation. (a) The task force consists of the following members:58.10(1) four senators, including two members of the majority party and two members of 58.11the minority party, appointed by the Subcommittee on Committees of the Committee on 58.12Rules and Administration of the senate;58.13(2) four members of the house of representatives, including two members of the 58.14majority party, appointed by the speaker of the house, and two members of the minority 58.15party, appointed by the minority leader; and58.16(3) the commissioner of the Minnesota Department of Commerce or the 58.17commissioner's designee; and.58.18(4) the attorney general or the attorney general's designee.58.19(b) The task force shall ensure that representatives of the following have the 58.20opportunity to meet with and present views to the task force: the attorney general; credit 58.21unions; independent community banks; state and federal financial institutions; community 58.22action agencies; faith-based financial counseling agencies; faith-based social justice 58.23organizations; legal services organizations representing low-income persons; nonprofit 58.24organizations providing free tax preparation services as part of the volunteer income tax 58.25assistance program; relevant state and local agencies; University of Minnesota faculty 58.26involved in personal and family financial education; philanthropic organizations that have 58.27as one of their missions combating predatory lending; organizations representing older 58.28Minnesotans; and organizations representing the interests of women, Latinos and Latinas, 58.29African-Americans, Asian-Americans, American Indians, and immigrants.58.30    Subd. 2. Duties. (a) At a minimum, the task force must identify specific policies, 58.31strategies, and actions to: reduce asset poverty and increase household financial security 58.32by improving opportunities for households to earn, learn, save, invest, and protect 58.33assets through expansion of such asset building opportunities as the Family Assets for 58.34Independence in Minnesota (FAIM) program and Earned Income Tax Credit (EITC) 58.35program.59.1(1) increase opportunities for poor and near-poor families and individuals to acquire 59.2assets and create and build wealth;59.3(2) expand the utilization of Family Assets for Independence in Minnesota (FAIM) 59.4or other culturally specific individual development account programs;59.5(3) reduce or eliminate predatory financial practices in Minnesota through regulatory 59.6actions, legislative enactments, and the development and deployment of alternative, 59.7nonpredatory financial products;59.8(4) provide incentives or assistance to private sector financial institutions to 59.9offer additional programs and services that provide alternatives to and education about 59.10predatory financial products;59.11(5) provide financial literacy information to low-income families and individuals at 59.12the time the recipient has the ability, opportunity, and motivation to receive, understand, 59.13and act on the information provided; and59.14(6) identify incentives and mechanisms to increase community engagement in 59.15combating poverty and helping poor and near-poor families and individuals to acquire 59.16assets and create and build wealth.59.17For purposes of this section, "asset poverty" means an individual's or family's 59.18inability to meet fixed financial obligations and other financial requirements of daily living 59.19with existing assets for a three-month period in the event of a disruption in income or 59.20extraordinary economic emergency.59.21(b) By June 1, 2012 During the 2013 and 2014 legislative sessions, the task force 59.22must provide the legislature with written recommendations and any draft legislation59.23necessary to implement the recommendations to the chairs and ranking minority members 59.24of the legislative committees and divisions with jurisdiction over commerce and consumer 59.25protection fulfill the duties enumerated in paragraph (a). The recommendations may 59.26include draft legislation.59.27    Subd. 3. Administrative provisions. (a) The director of the Legislative 59.28Coordinating Commission, or a designee of the director, must convene the initial meeting 59.29of the task force by September 15, 2010. The members of the task force must elect a chair 59.30or cochairs from the legislative members at the initial meeting.59.31(b) Members of the task force serve without compensation or payment of expenses 59.32except as provided in this paragraph. To the extent possible, meetings of the task force 59.33shall be scheduled on dates when legislative members of the task force are able to 59.34attend legislative meetings that would make them eligible to receive legislative per diem 59.35payments.60.1(c) The task force expires June 1, 2012, or upon the submission of the report required 60.2under subdivision 3, whichever is earlier 2014.60.3(d) The task force may accept gifts and grants, which are accepted on behalf of the 60.4state and constitute donations to the state. The funds must be deposited in an account in 60.5the special revenue fund and are appropriated to the Legislative Coordinating Commission 60.6for purposes of the task force.60.7(e) The Legislative Coordinating Commission shall provide fiscal services to the 60.8task force as needed under this subdivision.60.9    Subd. 4. Deadline for appointments and designations. The appointments and 60.10designations authorized under this section must be completed no later than August 15, 60.112010 2012.60.12EFFECTIVE DATE.This section is effective the day following final enactment.60.13    Sec. 26. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 60.141, is amended to read:

60.15Subdivision 1.Total Appropriation$6,259,280,000$6,212,085,000

60.16Appropriations by Fund60.172012201360.18General5,657,737,0005,584,471,00060.1960.20State Government 
                  		Special Revenue3,565,0003,565,00060.21Health Care Access330,435,000353,283,00060.22Federal TANF265,378,000268,101,00060.23Lottery Prize1,665,0001,665,00060.24Special Revenue500,0001,000,000

60.25Receipts for Systems Projects. 60.26Appropriations and federal receipts for 60.27information systems projects for MAXIS, 60.28PRISM, MMIS, and SSIS must be deposited 60.29in the state systems account authorized in 60.30Minnesota Statutes, section 
         256.014. Money 60.31appropriated for computer projects approved 60.32by the Minnesota Office of Enterprise 60.33Technology, funded by the legislature, 60.34and approved by the commissioner 60.35of management and budget, may be 61.1transferred from one project to another 61.2and from development to operations as the 61.3commissioner of human services considers 61.4necessary. Any unexpended balance in 61.5the appropriation for these projects does 61.6not cancel but is available for ongoing 61.7development and operations.61.8Nonfederal Share Transfers. The 61.9nonfederal share of activities for which 61.10federal administrative reimbursement is 61.11appropriated to the commissioner may be 61.12transferred to the special revenue fund.61.13TANF Maintenance of Effort.61.14(a) In order to meet the basic maintenance 61.15of effort (MOE) requirements of the TANF 61.16block grant specified under Code of Federal 61.17Regulations, title 45, section 263.1, the 61.18commissioner may only report nonfederal 61.19money expended for allowable activities 61.20listed in the following clauses as TANF/MOE 61.21expenditures:61.22(1) MFIP cash, diversionary work program, 61.23and food assistance benefits under Minnesota 61.24Statutes, chapter 256J;61.25(2) the child care assistance programs 61.26under Minnesota Statutes, sections 
         119B.0361.27and 
         119B.05, and county child care 61.28administrative costs under Minnesota 61.29Statutes, section 
         119B.15;61.30(3) state and county MFIP administrative 61.31costs under Minnesota Statutes, chapters 61.32256J and 256K;62.1(4) state, county, and tribal MFIP 62.2employment services under Minnesota 62.3Statutes, chapters 256J and 256K;62.4(5) expenditures made on behalf of legal 62.5noncitizen MFIP recipients who qualify for 62.6the MinnesotaCare program under Minnesota 62.7Statutes, chapter 256L;62.8(6) qualifying working family credit 62.9expenditures under Minnesota Statutes, 62.10section 
         290.0671; and62.11(7) qualifying Minnesota education credit 62.12expenditures under Minnesota Statutes, 62.13section 
         290.0674.62.14(b) The commissioner shall ensure that 62.15sufficient qualified nonfederal expenditures 62.16are made each year to meet the state's 62.17TANF/MOE requirements. For the activities 62.18listed in paragraph (a), clauses (2) to 62.19(7), the commissioner may only report 62.20expenditures that are excluded from the 62.21definition of assistance under Code of 62.22Federal Regulations, title 45, section 
         260.31.62.23(c) For fiscal years beginning with state fiscal 62.24year 2003, the commissioner shall assure 62.25that the maintenance of effort used by the 62.26commissioner of management and budget 62.27for the February and November forecasts 62.28required under Minnesota Statutes, section 62.2916A.103
         , contains expenditures under 62.30paragraph (a), clause (1), equal to at least 16 62.31percent of the total required under Code of 62.32Federal Regulations, title 45, section 263.1.62.33(d) Minnesota Statutes, section 
         256.011, 62.34subdivision 3
         , which requires that federal 63.1grants or aids secured or obtained under that 63.2subdivision be used to reduce any direct 63.3appropriations provided by law, do not apply 63.4if the grants or aids are federal TANF funds.63.5(e) For the federal fiscal years beginning on 63.6or after October 1, 2007, the commissioner 63.7may not claim an amount of TANF/MOE in 63.8excess of the 75 percent standard in Code 63.9of Federal Regulations, title 45, section 63.10263.1(a)(2), except:63.11(1) to the extent necessary to meet the 80 63.12percent standard under Code of Federal 63.13Regulations, title 45, section 263.1(a)(1), 63.14if it is determined by the commissioner 63.15that the state will not meet the TANF work 63.16participation target rate for the current year;63.17(2) to provide any additional amounts 63.18under Code of Federal Regulations, title 45, 63.19section 264.5, that relate to replacement of 63.20TANF funds due to the operation of TANF 63.21penalties; and63.22(3) to provide any additional amounts that 63.23may contribute to avoiding or reducing 63.24TANF work participation penalties through 63.25the operation of the excess MOE provisions 63.26of Code of Federal Regulations, title 45, 63.27section 
         261.43 (a)(2).63.28For the purposes of clauses (1) to (3), 63.29the commissioner may supplement the 63.30MOE claim with working family credit 63.31expenditures or other qualified expenditures 63.32to the extent such expenditures are otherwise 63.33available after considering the expenditures 63.34allowed in this subdivision.64.1(f) Notwithstanding any contrary provision 64.2in this article, paragraphs (a) to (e) expire 64.3June 30, 2015.64.4Working Family Credit Expenditures 64.5as TANF/MOE. The commissioner may 64.6claim as TANF maintenance of effort up to 64.7$6,707,000 per year of working family credit 64.8expenditures for fiscal years 2012 and 2013.64.9Working Family Credit Expenditures 64.10to be Claimed for TANF/MOE. The 64.11commissioner may count the following 64.12amounts of working family credit 64.13expenditures as TANF/MOE:64.14(1) fiscal year 2012, $23,692,000;64.15(2) fiscal year 2013, $44,969,00064.16$51,978,000;64.17(3) fiscal year 2014, $32,579,00064.18$43,576,000; and64.19(4) fiscal year 2015, $32,476,00064.20$43,548,000.64.21Notwithstanding any contrary provision in 64.22this article, this rider expires June 30, 2015.64.23TANF Transfer to Federal Child Care 64.24and Development Fund. (a) The following 64.25TANF fund amounts are appropriated 64.26to the commissioner for purposes of 64.27MFIP/Transition Year Child Care Assistance 64.28under Minnesota Statutes, section 
         119B.05:64.29(1) fiscal year 2012, $10,020,000;64.30(2) fiscal year 2013, $28,020,00064.31$28,022,000;64.32(3) fiscal year 2014, $14,020,00064.33$14,030,000; and65.1(4) fiscal year 2015, $14,020,00065.2$14,030,000.65.3(b) The commissioner shall authorize the 65.4transfer of sufficient TANF funds to the 65.5federal child care and development fund to 65.6meet this appropriation and shall ensure that 65.7all transferred funds are expended according 65.8to federal child care and development fund 65.9regulations.65.10Food Stamps Employment and Training 65.11Funds. (a) Notwithstanding Minnesota 65.12Statutes, sections 
         256D.051, subdivisions 1a, 65.136b, and 6c, and 
         256J.626, federal food stamps 65.14employment and training funds received 65.15as reimbursement for child care assistance 65.16program expenditures must be deposited in 65.17the general fund. The amount of funds must 65.18be limited to $500,000 per year in fiscal 65.19years 2012 through 2015, contingent upon 65.20approval by the federal Food and Nutrition 65.21Service.65.22(b) Consistent with the receipt of these 65.23federal funds, the commissioner may 65.24adjust the level of working family credit 65.25expenditures claimed as TANF maintenance 65.26of effort. Notwithstanding any contrary 65.27provision in this article, this rider expires 65.28June 30, 2015.65.29ARRA Food Support Benefit Increases. 65.30The funds provided for food support benefit 65.31increases under the Supplemental Nutrition 65.32Assistance Program provisions of the 65.33American Recovery and Reinvestment Act 65.34(ARRA) of 2009 must be used for benefit 65.35increases beginning July 1, 2009.66.1Supplemental Security Interim Assistance 66.2Reimbursement Funds. $2,800,000 of 66.3uncommitted revenue available to the 66.4commissioner of human services for SSI 66.5advocacy and outreach services must be 66.6transferred to and deposited into the general 66.7fund by October 1, 2011.66.8    Sec. 27. MINNESOTA VISIBLE CHILD WORK GROUP.66.9    Subdivision 1.Purpose.The Minnesota visible child work group is established to 66.10identify and recommend issues that should be addressed in a statewide, comprehensive 66.11plan to improve the well-being of children who are homeless or have experienced 66.12homelessness.66.13    Subd. 2.Membership.The members of the Minnesota visible child work group 66.14include: (1) two members of the Minnesota house of representatives appointed by 66.15the speaker of the house, one member from the majority party and one member from 66.16the minority party; (2) two members of the Minnesota senate appointed by the senate 66.17Subcommittee on Committees of the Committee on Rules and Administration, one 66.18member from the majority party and one member from the minority party; (3) three 66.19representatives from family shelter, transitional housing, and supportive housing providers 66.20appointed by the governor; (4) two individuals appointed by the governor who have 66.21experienced homelessness; (5) three housing and child advocates appointed by the 66.22governor; (6) three representatives from the business or philanthropic community; and (7) 66.23children's cabinet members, or their designees. Work group membership should include 66.24people from rural, suburban, and urban areas of the state.66.25    Subd. 3.Duties.The work group shall: (1) recommend goals and objectives for a 66.26comprehensive, statewide plan to improve the well-being of children who are homeless or 66.27who have experienced homelessness; (2) recommend a definition of "child well-being"; 66.28(3) identify evidence-based interventions and best practices improving the well-being 66.29of young children; (4) plan implementation timelines and ways to measure progress, 66.30including measures of child well-being from birth through adolescence; (5) identify ways 66.31to address issues of collaboration and coordination across systems, including education, 66.32health, human services, and housing; (6) recommend the type of data and information 66.33necessary to develop, effectively implement, and monitor a strategic plan; (7) examine and 66.34make recommendations regarding funding to implement an effective plan; and (8) provide 67.1recommendations for ongoing reports on the well-being of children, monitoring progress 67.2in implementing the statewide comprehensive plan, and any other issues determined to be 67.3relevant to achieving the goals of this section.67.4    Subd. 4.Work group convening and facilitation.The work group must be 67.5organized, scheduled, and facilitated by the staff of a nonprofit child advocacy, outreach, 67.6research, and youth development organization focusing on a wide range of issues 67.7affecting children who are vulnerable, and a nonprofit organization working to provide 67.8safe, affordable, and sustainable homes for children and families in the seven-county 67.9metropolitan area through partnerships with the public and private sector. These two 67.10organizations will also be responsible for preparing and submitting the work group's 67.11recommendations.67.12    Subd. 5.Report.The work group shall make recommendations under subdivision 67.133 to the legislative committees with jurisdiction over education, housing, health, and 67.14human services policy and finance by December 15, 2012. The recommendations must 67.15also be submitted to the children's cabinet to provide the foundation for a statewide 67.16visible child plan.67.17    Subd. 6.Expiration.The Minnesota visible child work group expires on June 67.1830, 2013.67.19    Sec. 28. UNIFORM ASSET LIMIT REQUIREMENTS.67.20The commissioner of human services, in consultation with county human 67.21services representatives, shall analyze the differences in asset limit requirements across 67.22human services assistance programs, including group residential housing, Minnesota 67.23supplemental aid, general assistance, Minnesota family investment program, diversionary 67.24work program, the federal Supplemental Nutrition Assistance Program, state food 67.25assistance programs, and child care programs. The goal of the analysis is to establish a 67.26consistent asset limit across human services programs and minimize the administrative 67.27burdens on counties in implementing asset tests. The commissioner shall report its 67.28findings and conclusions to the legislative committees with jurisdiction over health and 67.29human services policy and finance by January 15, 2013, and include draft legislation 67.30establishing a uniform asset limit for human services assistance programs.67.31    Sec. 29. DIRECTIONS TO THE COMMISSIONER.67.32The commissioner of human services, in consultation with the commissioner of 67.33public safety, shall report to the chairs and ranking minority members of the legislative 68.1committees with jurisdiction over health and human services policy and finance regarding 68.2the implementation of Minnesota Statutes, section 256.01, subdivisions 18c, 18d, and 18e, 68.3the number of persons affected, and fiscal impact by program by December 1, 2013.68.4EFFECTIVE DATE.This section is effective July 1, 2013.68.5    Sec. 30. REVISOR INSTRUCTION.68.6The revisor of statutes shall change the term "assistance transaction card" or 68.7similar terms to "electronic benefit transaction" or similar terms wherever they appear in 68.8Minnesota Statutes, chapter 256. The revisor may make changes necessary to correct the 68.9punctuation, grammar, or structure of the remaining text and preserve its meaning.68.10ARTICLE 468.11CONTINUING CARE68.12    Section 1. Minnesota Statutes 2010, section 62J.496, subdivision 2, is amended to read:68.13    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:68.14(1) federally qualified health centers;68.15    (2) community clinics, as defined under section 
         145.9268;68.16    (3) nonprofit or local unit of government hospitals licensed under sections 
         144.50 68.17to 
         144.56;68.18(4) individual or small group physician practices that are focused primarily on 68.19primary care;68.20    (5) nursing facilities licensed under sections 
         144A.01 to 
         144A.27;68.21(6) local public health departments as defined in chapter 145A; and68.22    (7) other providers of health or health care services approved by the commissioner 68.23for which interoperable electronic health record capability would improve quality of 68.24care, patient safety, or community health.68.25(b) The commissioner shall administer the loan fund to prioritize support and 68.26assistance to:68.27(1) critical access hospitals;68.28(2) federally qualified health centers;68.29(3) entities that serve uninsured, underinsured, and medically underserved 68.30individuals, regardless of whether such area is urban or rural; and68.31(4) individual or small group practices that are primarily focused on primary care.;68.32(5) nursing facilities certified to participate in the medical assistance program; and69.1(6) providers enrolled in the elderly waiver program of customized living or 24-hour 69.2customized living of the medical assistance program, if at least half of their annual 69.3operating revenue is paid under the medical assistance program.69.4    (c) An eligible applicant must submit a loan application to the commissioner of 69.5health on forms prescribed by the commissioner. The application must include, at a 69.6minimum:69.7    (1) the amount of the loan requested and a description of the purpose or project 69.8for which the loan proceeds will be used;69.9    (2) a quote from a vendor;69.10    (3) a description of the health care entities and other groups participating in the 69.11project;69.12    (4) evidence of financial stability and a demonstrated ability to repay the loan; and69.13    (5) a description of how the system to be financed interoperates or plans in the 69.14future to interoperate with other health care entities and provider groups located in the 69.15same geographical area;69.16(6) a plan on how the certified electronic health record technology will be maintained 69.17and supported over time; and69.18(7) any other requirements for applications included or developed pursuant to 69.19section 3014 of the HITECH Act.69.20    Sec. 2. Minnesota Statutes 2010, section 144A.073, is amended by adding a 69.21subdivision to read:69.22    Subd. 13.Moratorium exception funding.In fiscal year 2013, the commissioner 69.23of health may approve moratorium exception projects under this section for which the full 69.24annualized state share of medical assistance costs does not exceed $1,000,000.69.25    Sec. 3. Minnesota Statutes 2010, section 144A.351, is amended to read:69.26144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: 69.27REPORT REQUIRED.69.28    The commissioners of health and human services, with the cooperation of counties 69.29and in consultation with stakeholders, including persons who need or are using long-term 69.30care services and supports, lead agencies, regional entities, senior, disability, and mental 69.31health organization representatives, service providers, and community members shall 69.32prepare a report to the legislature by August 15, 2004 2013, and biennially thereafter, 69.33regarding the status of the full range of long-term care services and supports for the 70.1elderly and children and adults with disabilities and mental illnesses in Minnesota. The 70.2report shall address:70.3    (1) demographics and need for long-term care services and supports in Minnesota;70.4    (2) summary of county and regional reports on long-term care gaps, surpluses, 70.5imbalances, and corrective action plans;70.6    (3) status of long-term care services and mental illnesses, housing options, and 70.7supports by county and region including:70.8    (i) changes in availability of the range of long-term care services and housing 70.9options;70.10    (ii) access problems, including access to the least restrictive and most integrated 70.11services and settings, regarding long-term care services; and70.12    (iii) comparative measures of long-term care services availability, including serving 70.13people in their home areas near family, and progress changes over time; and70.14    (4) recommendations regarding goals for the future of long-term care services and 70.15supports, policy and fiscal changes, and resource development and transition needs.70.16    Sec. 4. Minnesota Statutes 2010, section 144D.04, subdivision 2, is amended to read:70.17    Subd. 2. Contents of contract.  A housing with services contract, which need not be 70.18entitled as such to comply with this section, shall include at least the following elements 70.19in itself or through supporting documents or attachments:70.20(1) the name, street address, and mailing address of the establishment;70.21(2) the name and mailing address of the owner or owners of the establishment and, if 70.22the owner or owners is not a natural person, identification of the type of business entity 70.23of the owner or owners;70.24(3) the name and mailing address of the managing agent, through management 70.25agreement or lease agreement, of the establishment, if different from the owner or owners;70.26(4) the name and address of at least one natural person who is authorized to accept 70.27service of process on behalf of the owner or owners and managing agent;70.28(5) a statement describing the registration and licensure status of the establishment 70.29and any provider providing health-related or supportive services under an arrangement 70.30with the establishment;70.31(6) the term of the contract;70.32(7) a description of the services to be provided to the resident in the base rate to be 70.33paid by resident, including a delineation of the portion of the base rate that constitutes rent 70.34and a delineation of charges for each service included in the base rate;71.1(8) a description of any additional services, including home care services, available 71.2for an additional fee from the establishment directly or through arrangements with the 71.3establishment, and a schedule of fees charged for these services;71.4(9) a description of the process through which the contract may be modified, 71.5amended, or terminated, including whether a move to a different room or sharing a room 71.6would be required in the event that the tenant can no longer pay the current rent;71.7(10) a description of the establishment's complaint resolution process available 71.8to residents including the toll-free complaint line for the Office of Ombudsman for 71.9Long-Term Care;71.10(11) the resident's designated representative, if any;71.11(12) the establishment's referral procedures if the contract is terminated;71.12(13) requirements of residency used by the establishment to determine who may 71.13reside or continue to reside in the housing with services establishment;71.14(14) billing and payment procedures and requirements;71.15(15) a statement regarding the ability of residents to receive services from service 71.16providers with whom the establishment does not have an arrangement;71.17(16) a statement regarding the availability of public funds for payment for residence 71.18or services in the establishment; and71.19(17) a statement regarding the availability of and contact information for 71.20long-term care consultation services under section 
         256B.0911 in the county in which the 71.21establishment is located.71.22    Sec. 5. Minnesota Statutes 2010, section 245A.03, is amended by adding a subdivision 71.23to read:71.24    Subd. 6a.Adult foster care homes serving people with mental illness; 71.25certification.(a) The commissioner of human services shall issue a mental health 71.26certification for adult foster care homes licensed under this chapter and Minnesota Rules, 71.27parts 9555.5105 to 9555.6265, that serve people with mental illness where the home is not 71.28the primary residence of the license holder when a provider is determined to have met 71.29the requirements under paragraph (b). This certification is voluntary for license holders. 71.30The certification shall be printed on the license, and identified on the commissioner's 71.31public Web site.71.32(b) The requirements for certification are:71.33(1) all staff working in the adult foster care home have received at least seven hours 71.34of annual training covering all of the following topics:71.35(i) mental health diagnoses;72.1(ii) mental health crisis response and de-escalation techniques;72.2(iii) recovery from mental illness;72.3(iv) treatment options including evidence-based practices;72.4(v) medications and their side effects;72.5(vi) co-occurring substance abuse and health conditions; and72.6(vii) community resources;72.7(2) a mental health professional, as defined in section 245.462, subdivision 18, or 72.8a mental health practitioner as defined in section 245.462, subdivision 17, are available 72.9for consultation and assistance;72.10(3) there is a plan and protocol in place to address a mental health crisis; and72.11(4) each individual's Individual Placement Agreement identifies who is providing 72.12clinical services and their contact information, and includes an individual crisis prevention 72.13and management plan developed with the individual.72.14(c) License holders seeking certification under this subdivision must request this 72.15certification on forms provided by the commissioner and must submit the request to the 72.16county licensing agency in which the home is located. The county licensing agency must 72.17forward the request to the commissioner with a county recommendation regarding whether 72.18the commissioner should issue the certification.72.19(d) Ongoing compliance with the certification requirements under paragraph (b) 72.20shall be reviewed by the county licensing agency at each licensing review. When a county 72.21licensing agency determines that the requirements of paragraph (b) are not met, the county 72.22shall inform the commissioner, and the commissioner will remove the certification.72.23(e) A denial of the certification or the removal of the certification based on a 72.24determination that the requirements under paragraph (b) have not been met by the adult 72.25foster care license holder are not subject to appeal. A license holder that has been denied a 72.26certification or that has had a certification removed may again request certification when 72.27the license holder is in compliance with the requirements of paragraph (b).72.28    Sec. 6. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is 72.29amended to read:72.30    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an 72.31initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 72.322960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 72.339555.6265, under this chapter for a physical location that will not be the primary residence 72.34of the license holder for the entire period of licensure. If a license is issued during this 72.35moratorium, and the license holder changes the license holder's primary residence away 73.1from the physical location of the foster care license, the commissioner shall revoke the 73.2license according to section 
         245A.07. Exceptions to the moratorium include:73.3(1) foster care settings that are required to be registered under chapter 144D;73.4(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, 73.5and determined to be needed by the commissioner under paragraph (b);73.6(3) new foster care licenses determined to be needed by the commissioner under 73.7paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or 73.8restructuring of state-operated services that limits the capacity of state-operated facilities;73.9(4) new foster care licenses determined to be needed by the commissioner under 73.10paragraph (b) for persons requiring hospital level care; or73.11(5) new foster care licenses determined to be needed by the commissioner for the 73.12transition of people from personal care assistance to the home and community-based 73.13services.73.14(b) The commissioner shall determine the need for newly licensed foster care homes 73.15as defined under this subdivision. As part of the determination, the commissioner shall 73.16consider the availability of foster care capacity in the area in which the licensee seeks to 73.17operate, and the recommendation of the local county board. The determination by the 73.18commissioner must be final. A determination of need is not required for a change in 73.19ownership at the same address.73.20    (c) Residential settings that would otherwise be subject to the moratorium established 73.21in paragraph (a), that are in the process of receiving an adult or child foster care license as 73.22of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult 73.23or child foster care license. For this paragraph, all of the following conditions must be met 73.24to be considered in the process of receiving an adult or child foster care license:73.25    (1) participants have made decisions to move into the residential setting, including 73.26documentation in each participant's care plan;73.27    (2) the provider has purchased housing or has made a financial investment in the 73.28property;73.29    (3) the lead agency has approved the plans, including costs for the residential setting 73.30for each individual;73.31    (4) the completion of the licensing process, including all necessary inspections, is 73.32the only remaining component prior to being able to provide services; and73.33    (5) the needs of the individuals cannot be met within the existing capacity in that 73.34county.74.1To qualify for the process under this paragraph, the lead agency must submit 74.2documentation to the commissioner by August 1, 2009, that all of the above criteria are 74.3met.74.4(d) The commissioner shall study the effects of the license moratorium under this 74.5subdivision and shall report back to the legislature by January 15, 2011. This study shall 74.6include, but is not limited to the following:74.7(1) the overall capacity and utilization of foster care beds where the physical location 74.8is not the primary residence of the license holder prior to and after implementation 74.9of the moratorium;74.10(2) the overall capacity and utilization of foster care beds where the physical 74.11location is the primary residence of the license holder prior to and after implementation 74.12of the moratorium; and74.13(3) the number of licensed and occupied ICF/MR beds prior to and after 74.14implementation of the moratorium.74.15(e) When a foster care recipient moves out of a foster home that is not the primary 74.16residence of the license holder according to section 
         256B.49, subdivision 15, paragraph 74.17(f), the county shall immediately inform the Department of Human Services Licensing 74.18Division, and. The department shall immediately decrease the statewide licensed 74.19capacity for the home foster care settings where the physical location is not the primary 74.20residence of the license holder, if the voluntary changes described in paragraph (g) are 74.21not sufficient to meet the savings required by reductions in licensed bed capacity under 74.22Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f), 74.23and maintain statewide long-term care residential services capacity within budgetary 74.24limits. Implementation of the statewide licensed capacity reduction shall begin on July 1, 74.252013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the needs 74.26determination process. Under this paragraph, the commissioner has the authority to reduce 74.27unused licensed capacity of a current foster care program to accomplish the consolidation 74.28or closure of settings. A decreased licensed capacity according to this paragraph is not 74.29subject to appeal under this chapter.74.30(f) Residential settings that would otherwise be subject to the decreased license 74.31capacity established in paragraph (e) shall be exempt under the following circumstances:74.32(1) until August 1, 2013, the license holder's beds occupied by residents whose 74.33primary diagnosis is mental illness and the license holder is:74.34(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental 74.35health services (ARMHS) as defined in section 256B.0623;75.1(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 75.29520.0870;75.3(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 75.49520.0870; or75.5(iv) a provider of intensive residential treatment services (IRTS) licensed under 75.6Minnesota Rules, parts 9520.0500 to 9520.0670; or75.7(2) the license holder is certified under the requirements in subdivision 6a.75.8(g) A resource need determination process, managed at the state level, using the 75.9available reports required by section 144A.351, and other data and information shall 75.10be used to determine where the reduced capacity required under paragraph (e) will be 75.11implemented. The commissioner shall consult with the stakeholders described in section 75.12144A.351, and employ a variety of methods to improve the state's capacity to meet 75.13long-term care service needs within budgetary limits, including seeking proposals from 75.14service providers or lead agencies to change service type, capacity, or location to improve 75.15services, increase the independence of residents, and better meet needs identified by the 75.16long-term care services reports and statewide data and information. By February 1 of each 75.17year, the commissioner shall provide information and data on the overall capacity of 75.18licensed long-term care services, actions taken under this subdivision to manage statewide 75.19long-term care services and supports resources, and any recommendations for change to 75.20the legislative committees with jurisdiction over health and human services budget.75.21    Sec. 7. Minnesota Statutes 2010, section 245A.11, subdivision 2a, is amended to read:75.22    Subd. 2a. Adult foster care license capacity. (a) The commissioner shall issue 75.23adult foster care licenses with a maximum licensed capacity of four beds, including 75.24nonstaff roomers and boarders, except that the commissioner may issue a license with a 75.25capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).75.26(b) An adult foster care license holder may have a maximum license capacity of five 75.27if all persons in care are age 55 or over and do not have a serious and persistent mental 75.28illness or a developmental disability.75.29(c) The commissioner may grant variances to paragraph (b) to allow a foster care 75.30provider with a licensed capacity of five persons to admit an individual under the age of 55 75.31if the variance complies with section 
         245A.04, subdivision 9, and approval of the variance 75.32is recommended by the county in which the licensed foster care provider is located.75.33(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth 75.34bed for emergency crisis services for a person with serious and persistent mental illness 75.35or a developmental disability, regardless of age, if the variance complies with section 76.1245A.04, subdivision 9
         , and approval of the variance is recommended by the county in 76.2which the licensed foster care provider is located.76.3(e) The commissioner may grant a variance to paragraph (b) to allow for the 76.4use of a fifth bed for respite services, as defined in section 245A.02, for persons with 76.5disabilities, regardless of age, if the variance complies with section 245A.03, subdivision 76.67, and section 245A.04, subdivision 9, and approval of the variance is recommended by 76.7the county in which the licensed foster care provider is licensed. Respite care may be 76.8provided under the following conditions:76.9(1) staffing ratios cannot be reduced below the approved level for the individuals 76.10being served in the home on a permanent basis;76.11(2) no more than two different individuals can be accepted for respite services in 76.12any calendar month and the total respite days may not exceed 120 days per program in 76.13any calendar year;76.14(3) the person receiving respite services must have his or her own bedroom, which 76.15could be used for alternative purposes when not used as a respite bedroom, and cannot be 76.16the room of another person who lives in the foster care home; and76.17(4) individuals living in the foster care home must be notified when the variance 76.18is approved. The provider must give 60 days' notice in writing to the residents and their 76.19legal representatives prior to accepting the first respite placement. Notice must be given to 76.20residents at least two days prior to service initiation, or as soon as the license holder is 76.21able if they receive notice of the need for respite less than two days prior to initiation, 76.22each time a respite client will be served, unless the requirement for this notice is waived 76.23by the resident or legal guardian.76.24(e) If the 2009 legislature adopts a rate reduction that impacts providers of adult 76.25foster care services, (f) The commissioner may issue an adult foster care license with a 76.26capacity of five adults if the fifth bed does not increase the overall statewide capacity of 76.27licensed adult foster care beds in homes that are not the primary residence of the license 76.28holder, over the licensed capacity in such homes on July 1, 2009, as identified in a plan 76.29submitted to the commissioner by the county, when the capacity is recommended by 76.30the county licensing agency of the county in which the facility is located and if the 76.31recommendation verifies that:76.32(1) the facility meets the physical environment requirements in the adult foster 76.33care licensing rule;76.34(2) the five-bed living arrangement is specified for each resident in the resident's:76.35(i) individualized plan of care;76.36(ii) individual service plan under section 
         256B.092, subdivision 1b, if required; or77.1(iii) individual resident placement agreement under Minnesota Rules, part 77.29555.5105, subpart 19, if required;77.3(3) the license holder obtains written and signed informed consent from each 77.4resident or resident's legal representative documenting the resident's informed choice 77.5to remain living in the home and that the resident's refusal to consent would not have 77.6resulted in service termination; and77.7(4) the facility was licensed for adult foster care before March 1, 2009 2011.77.8(f) (g) The commissioner shall not issue a new adult foster care license under 77.9paragraph (e) (f) after June 30, 2011 2016. The commissioner shall allow a facility with 77.10an adult foster care license issued under paragraph (e) (f) before June 30, 2011 2016, to 77.11continue with a capacity of five adults if the license holder continues to comply with the 77.12requirements in paragraph (e) (f).77.13    Sec. 8. Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:77.14    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The 77.15commissioner may grant a variance under section 
         245A.04, subdivision 9, to rule parts 77.16requiring a caregiver to be present in an adult foster care home during normal sleeping 77.17hours to allow for alternative methods of overnight supervision. The commissioner may 77.18grant the variance if the local county licensing agency recommends the variance and the 77.19county recommendation includes documentation verifying that:77.20    (1) the county has approved the license holder's plan for alternative methods of 77.21providing overnight supervision and determined the plan protects the residents' health, 77.22safety, and rights;77.23    (2) the license holder has obtained written and signed informed consent from 77.24each resident or each resident's legal representative documenting the resident's or legal 77.25representative's agreement with the alternative method of overnight supervision; and77.26    (3) the alternative method of providing overnight supervision, which may include 77.27the use of technology, is specified for each resident in the resident's: (i) individualized 77.28plan of care; (ii) individual service plan under section 
         256B.092, subdivision 1b, if 77.29required; or (iii) individual resident placement agreement under Minnesota Rules, part 77.309555.5105, subpart 19, if required.77.31    (b) To be eligible for a variance under paragraph (a), the adult foster care license 77.32holder must not have had a licensing action conditional license issued under section 77.33245A.06
         , or any other licensing sanction issued under section245A.07 during the prior 24 77.34months based on failure to provide adequate supervision, health care services, or resident 77.35safety in the adult foster care home.78.1    (c) A license holder requesting a variance under this subdivision to utilize 78.2technology as a component of a plan for alternative overnight supervision may request 78.3the commissioner's review in the absence of a county recommendation. Upon receipt of 78.4such a request from a license holder, the commissioner shall review the variance request 78.5with the county.78.6    Sec. 9. Minnesota Statutes 2010, section 245A.11, subdivision 7a, is amended to read:78.7    Subd. 7a. Alternate overnight supervision technology; adult foster care license.78.8    (a) The commissioner may grant an applicant or license holder an adult foster care license 78.9for a residence that does not have a caregiver in the residence during normal sleeping 78.10hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses 78.11monitoring technology to alert the license holder when an incident occurs that may 78.12jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 78.13holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 78.14to 9555.6265, and the requirements under this subdivision. The license printed by the 78.15commissioner must state in bold and large font:78.16    (1) that the facility is under electronic monitoring; and78.17    (2) the telephone number of the county's common entry point for making reports of 78.18suspected maltreatment of vulnerable adults under section 
         626.557, subdivision 9.78.19(b) Applications for a license under this section must be submitted directly to 78.20the Department of Human Services licensing division. The licensing division must 78.21immediately notify the host county and lead county contract agency and the host county 78.22licensing agency. The licensing division must collaborate with the county licensing 78.23agency in the review of the application and the licensing of the program.78.24    (c) Before a license is issued by the commissioner, and for the duration of the 78.25license, the applicant or license holder must establish, maintain, and document the 78.26implementation of written policies and procedures addressing the requirements in 78.27paragraphs (d) through (f).78.28    (d) The applicant or license holder must have policies and procedures that:78.29    (1) establish characteristics of target populations that will be admitted into the home, 78.30and characteristics of populations that will not be accepted into the home;78.31    (2) explain the discharge process when a foster care recipient requires overnight 78.32supervision or other services that cannot be provided by the license holder due to the 78.33limited hours that the license holder is on site;78.34    (3) describe the types of events to which the program will respond with a physical 78.35presence when those events occur in the home during time when staff are not on site, and 79.1how the license holder's response plan meets the requirements in paragraph (e), clause 79.2(1) or (2);79.3    (4) establish a process for documenting a review of the implementation and 79.4effectiveness of the response protocol for the response required under paragraph (e), 79.5clause (1) or (2). The documentation must include:79.6    (i) a description of the triggering incident;79.7    (ii) the date and time of the triggering incident;79.8    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);79.9    (iv) whether the response met the resident's needs;79.10    (v) whether the existing policies and response protocols were followed; and79.11    (vi) whether the existing policies and protocols are adequate or need modification.79.12    When no physical presence response is completed for a three-month period, the 79.13license holder's written policies and procedures must require a physical presence response 79.14drill to be conducted for which the effectiveness of the response protocol under paragraph 79.15(e), clause (1) or (2), will be reviewed and documented as required under this clause; and79.16    (5) establish that emergency and nonemergency phone numbers are posted in a 79.17prominent location in a common area of the home where they can be easily observed by a 79.18person responding to an incident who is not otherwise affiliated with the home.79.19    (e) The license holder must document and include in the license application which 79.20response alternative under clause (1) or (2) is in place for responding to situations that 79.21present a serious risk to the health, safety, or rights of people receiving foster care services 79.22in the home:79.23    (1) response alternative (1) requires only the technology to provide an electronic 79.24notification or alert to the license holder that an event is underway that requires a response. 79.25Under this alternative, no more than ten minutes will pass before the license holder will be 79.26physically present on site to respond to the situation; or79.27    (2) response alternative (2) requires the electronic notification and alert system 79.28under alternative (1), but more than ten minutes may pass before the license holder is 79.29present on site to respond to the situation. Under alternative (2), all of the following 79.30conditions are met:79.31    (i) the license holder has a written description of the interactive technological 79.32applications that will assist the license holder in communicating with and assessing the 79.33needs related to the care, health, and safety of the foster care recipients. This interactive 79.34technology must permit the license holder to remotely assess the well being of the foster 79.35care recipient without requiring the initiation of the foster care recipient. Requiring the 79.36foster care recipient to initiate a telephone call does not meet this requirement;80.1(ii) the license holder documents how the remote license holder is qualified and 80.2capable of meeting the needs of the foster care recipients and assessing foster care 80.3recipients' needs under item (i) during the absence of the license holder on site;80.4(iii) the license holder maintains written procedures to dispatch emergency response 80.5personnel to the site in the event of an identified emergency; and80.6    (iv) each foster care recipient's individualized plan of care, individual service plan 80.7under section 
         256B.092, subdivision 1b, if required, or individual resident placement 80.8agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the 80.9maximum response time, which may be greater than ten minutes, for the license holder 80.10to be on site for that foster care recipient.80.11    (f) All Each foster care recipient's placement agreements agreement, individual 80.12service agreements, and plans applicable to the foster care recipientagreement, and plan 80.13must clearly state that the adult foster care license category is a program without the 80.14presence of a caregiver in the residence during normal sleeping hours; the protocols in 80.15place for responding to situations that present a serious risk to the health, safety, or rights 80.16of foster care recipients under paragraph (e), clause (1) or (2); and a signed informed 80.17consent from each foster care recipient or the person's legal representative documenting 80.18the person's or legal representative's agreement with placement in the program. If 80.19electronic monitoring technology is used in the home, the informed consent form must 80.20also explain the following:80.21    (1) how any electronic monitoring is incorporated into the alternative supervision 80.22system;80.23    (2) the backup system for any electronic monitoring in times of electrical outages or 80.24other equipment malfunctions;80.25    (3) how the license holder is caregivers are trained on the use of the technology;80.26    (4) the event types and license holder response times established under paragraph (e);80.27    (5) how the license holder protects the foster care recipient's privacy related to 80.28electronic monitoring and related to any electronically recorded data generated by the 80.29monitoring system. A foster care recipient may not be removed from a program under 80.30this subdivision for failure to consent to electronic monitoring. The consent form must 80.31explain where and how the electronically recorded data is stored, with whom it will be 80.32shared, and how long it is retained; and80.33    (6) the risks and benefits of the alternative overnight supervision system.80.34    The written explanations under clauses (1) to (6) may be accomplished through 80.35cross-references to other policies and procedures as long as they are explained to the 80.36person giving consent, and the person giving consent is offered a copy.81.1(g) Nothing in this section requires the applicant or license holder to develop or 81.2maintain separate or duplicative policies, procedures, documentation, consent forms, or 81.3individual plans that may be required for other licensing standards, if the requirements of 81.4this section are incorporated into those documents.81.5(h) The commissioner may grant variances to the requirements of this section 81.6according to section 
         245A.04, subdivision 9.81.7(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning 81.8under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and 81.9contractors affiliated with the license holder.81.10(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to 81.11remotely determine what action the license holder needs to take to protect the well-being 81.12of the foster care recipient.81.13(k) The commissioner shall evaluate license applications using the requirements 81.14in paragraphs (d) to (f). The commissioner shall provide detailed application forms, 81.15including a checklist of criteria needed for approval.81.16(l) To be eligible for a license under paragraph (a), the adult foster care license holder 81.17must not have had a conditional license issued under section 245A.06 or any licensing 81.18sanction under section 245A.07 during the prior 24 months based on failure to provide 81.19adequate supervision, health care services, or resident safety in the adult foster care home.81.20(m) The commissioner shall review an application for an alternative overnight 81.21supervision license within 60 days of receipt of the application. When the commissioner 81.22receives an application that is incomplete because the applicant failed to submit required 81.23documents or that is substantially deficient because the documents submitted do not meet 81.24licensing requirements, the commissioner shall provide the applicant written notice 81.25that the application is incomplete or substantially deficient. In the written notice to the 81.26applicant, the commissioner shall identify documents that are missing or deficient and 81.27give the applicant 45 days to resubmit a second application that is substantially complete. 81.28An applicant's failure to submit a substantially complete application after receiving 81.29notice from the commissioner is a basis for license denial under section 245A.05. The 81.30commissioner shall complete subsequent review within 30 days.81.31(n) Once the application is considered complete under paragraph (m), the 81.32commissioner will approve or deny an application for an alternative overnight supervision 81.33license within 60 days.81.34(o) For the purposes of this subdivision, "supervision" means:81.35(1) oversight by a caregiver as specified in the individual resident's place agreement 81.36and awareness of the resident's needs and activities; and82.1(2) the presence of a caregiver in a residence during normal sleeping hours, unless a 82.2determination has been made and documented in the individual's support plan that the 82.3individual does not require the presence of a caregiver during normal sleeping hours.82.4    Sec. 10. Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:82.5    Subdivision 1. Consumer data file. The license holder must maintain the following 82.6information for each consumer:82.7(1) identifying information that includes date of birth, medications, legal 82.8representative, history, medical, and other individual-specific information, and names and 82.9telephone numbers of contacts;82.10(2) consumer health information, including individual medication administration 82.11and monitoring information;82.12(3) the consumer's individual service plan. When a consumer's case manager does 82.13not provide a current individual service plan, the license holder shall make a written 82.14request to the case manager to provide a copy of the individual service plan and inform 82.15the consumer or the consumer's legal representative of the right to an individual service 82.16plan and the right to appeal under section 
         256.045. In the event the case manager fails 82.17to provide an individual service plan after a written request from the license holder, the 82.18license holder shall not be sanctioned or penalized financially for not having a current 82.19individual service plan in the consumer's data file;82.20(4) copies of assessments, analyses, summaries, and recommendations;82.21(5) progress review reports;82.22(6) incidents involving the consumer;82.23(7) reports required under section 
         245B.05, subdivision 7;82.24(8) discharge summary, when applicable;82.25(9) record of other license holders serving the consumer that includes a contact 82.26person and telephone numbers, services being provided, services that require coordination 82.27between two license holders, and name of staff responsible for coordination;82.28(10) information about verbal aggression directed at the consumer by another 82.29consumer; and82.30(11) information about self-abuse.82.31    Sec. 11. Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:82.32    Subd. 6. Unlicensed home and community-based waiver providers of service to 82.33seniors and individuals with disabilities. (a) Providers required to initiate background 83.1studies under section 
         256B.4912 must initiate a study before the individual begins in a 83.2position allowing direct contact with persons served by the provider.83.3(b) The commissioner shall conduct Except as provided in paragraph (c), the 83.4providers must initiate a background study annually of an individual required to be studied 83.5under section 
         245C.03, subdivision 6.83.6(c) After an initial background study under this subdivision is initiated on an 83.7individual by a provider of both services licensed by the commissioner and the unlicensed 83.8services under this subdivision, a repeat annual background study is not required if:83.9(1) the provider maintains compliance with the requirements of section 245C.07, 83.10paragraph (a), regarding one individual with one address and telephone number as the 83.11person to receive sensitive background study information for the multiple programs that 83.12depend on the same background study, and that the individual who is designated to receive 83.13the sensitive background information is capable of determining, upon the request of the 83.14commissioner, whether a background study subject is providing direct contact services 83.15in one or more of the provider's programs or services and, if so, at which location or 83.16locations; and83.17(2) the individual who is the subject of the background study provides direct 83.18contact services under the provider's licensed program for at least 40 hours per year so 83.19the individual will be recognized by a probation officer or corrections agent to prompt 83.20a report to the commissioner regarding criminal convictions as required under section 83.21245C.05, subdivision 7.83.22    Sec. 12. Minnesota Statutes 2010, section 245C.05, subdivision 7, is amended to read:83.23    Subd. 7. Probation officer and corrections agent. (a) A probation officer or 83.24corrections agent shall notify the commissioner of an individual's conviction if the 83.25individual is:83.26    (1) has been affiliated with a program or facility regulated by the Department of 83.27Human Services or Department of Health, a facility serving children or youth licensed by 83.28the Department of Corrections, or any type of home care agency or provider of personal 83.29care assistance services within the preceding year; and83.30    (2) has been convicted of a crime constituting a disqualification under section 83.31245C.14
         .83.32    (b) For the purpose of this subdivision, "conviction" has the meaning given it 83.33in section 
         609.02, subdivision 5.83.34    (c) The commissioner, in consultation with the commissioner of corrections, shall 83.35develop forms and information necessary to implement this subdivision and shall provide 84.1the forms and information to the commissioner of corrections for distribution to local 84.2probation officers and corrections agents.84.3    (d) The commissioner shall inform individuals subject to a background study that 84.4criminal convictions for disqualifying crimes will be reported to the commissioner by the 84.5corrections system.84.6    (e) A probation officer, corrections agent, or corrections agency is not civilly or 84.7criminally liable for disclosing or failing to disclose the information required by this 84.8subdivision.84.9    (f) Upon receipt of disqualifying information, the commissioner shall provide the 84.10notice required under section 
         245C.17, as appropriate, to agencies on record as having 84.11initiated a background study or making a request for documentation of the background 84.12study status of the individual.84.13    (g) This subdivision does not apply to family child care programs.84.14    Sec. 13. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:84.15    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 84.16child, including a child determined eligible for medical assistance without consideration of 84.17parental income, must contribute to the cost of services used by making monthly payments 84.18on a sliding scale based on income, unless the child is married or has been married, 84.19parental rights have been terminated, or the child's adoption is subsidized according to 84.20section 
         259.67 or through title IV-E of the Social Security Act. The parental contribution 84.21is a partial or full payment for medical services provided for diagnostic, therapeutic, 84.22curing, treating, mitigating, rehabilitation, maintenance, and personal care services as 84.23defined in United States Code, title 26, section 213, needed by the child with a chronic 84.24illness or disability.84.25    (b) For households with adjusted gross income equal to or greater than 100 percent 84.26of federal poverty guidelines, the parental contribution shall be computed by applying the 84.27following schedule of rates to the adjusted gross income of the natural or adoptive parents:84.28    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 84.29poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 84.30contribution is $4 per month;84.31    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 84.32poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 84.33the parental contribution shall be determined using a sliding fee scale established by the 84.34commissioner of human services which begins at one percent of adjusted gross income 84.35at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 85.1gross income for those with adjusted gross income up to 545 percent of federal poverty 85.2guidelines;85.3    (3) if the adjusted gross income is greater than 545 percent of federal poverty 85.4guidelines and less than 675 percent of federal poverty guidelines, the parental 85.5contribution shall be 7.5 percent of adjusted gross income;85.6    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 85.7poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 85.8contribution shall be determined using a sliding fee scale established by the commissioner 85.9of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 85.10federal poverty guidelines and increases to ten percent of adjusted gross income for those 85.11with adjusted gross income up to 975 percent of federal poverty guidelines; and85.12    (5) if the adjusted gross income is equal to or greater than 975 percent of federal 85.13poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 85.14income.85.15    If the child lives with the parent, the annual adjusted gross income is reduced by 85.16$2,400 prior to calculating the parental contribution. If the child resides in an institution 85.17specified in section 
         256B.35, the parent is responsible for the personal needs allowance 85.18specified under that section in addition to the parental contribution determined under this 85.19section. The parental contribution is reduced by any amount required to be paid directly to 85.20the child pursuant to a court order, but only if actually paid.85.21    (c) The household size to be used in determining the amount of contribution under 85.22paragraph (b) includes natural and adoptive parents and their dependents, including the 85.23child receiving services. Adjustments in the contribution amount due to annual changes 85.24in the federal poverty guidelines shall be implemented on the first day of July following 85.25publication of the changes.85.26    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 85.27natural or adoptive parents determined according to the previous year's federal tax form, 85.28except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 85.29have been used to purchase a home shall not be counted as income.85.30    (e) The contribution shall be explained in writing to the parents at the time eligibility 85.31for services is being determined. The contribution shall be made on a monthly basis 85.32effective with the first month in which the child receives services. Annually upon 85.33redetermination or at termination of eligibility, if the contribution exceeded the cost of 85.34services provided, the local agency or the state shall reimburse that excess amount to 85.35the parents, either by direct reimbursement if the parent is no longer required to pay a 85.36contribution, or by a reduction in or waiver of parental fees until the excess amount is 86.1exhausted. All reimbursements must include a notice that the amount reimbursed may be 86.2taxable income if the parent paid for the parent's fees through an employer's health care 86.3flexible spending account under the Internal Revenue Code, section 125, and that the 86.4parent is responsible for paying the taxes owed on the amount reimbursed.86.5    (f) The monthly contribution amount must be reviewed at least every 12 months; 86.6when there is a change in household size; and when there is a loss of or gain in income 86.7from one month to another in excess of ten percent. The local agency shall mail a written 86.8notice 30 days in advance of the effective date of a change in the contribution amount. 86.9A decrease in the contribution amount is effective in the month that the parent verifies a 86.10reduction in income or change in household size.86.11    (g) Parents of a minor child who do not live with each other shall each pay the 86.12contribution required under paragraph (a). An amount equal to the annual court-ordered 86.13child support payment actually paid on behalf of the child receiving services shall be 86.14deducted from the adjusted gross income of the parent making the payment prior to 86.15calculating the parental contribution under paragraph (b).86.16    (h) The contribution under paragraph (b) shall be increased by an additional five 86.17percent if the local agency determines that insurance coverage is available but not 86.18obtained for the child. For purposes of this section, "available" means the insurance is a 86.19benefit of employment for a family member at an annual cost of no more than five percent 86.20of the family's annual income. For purposes of this section, "insurance" means health 86.21and accident insurance coverage, enrollment in a nonprofit health service plan, health 86.22maintenance organization, self-insured plan, or preferred provider organization.86.23    Parents who have more than one child receiving services shall not be required 86.24to pay more than the amount for the child with the highest expenditures. There shall 86.25be no resource contribution from the parents. The parent shall not be required to pay 86.26a contribution in excess of the cost of the services provided to the child, not counting 86.27payments made to school districts for education-related services. Notice of an increase in 86.28fee payment must be given at least 30 days before the increased fee is due.86.29    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 86.30in the 12 months prior to July 1:86.31    (1) the parent applied for insurance for the child;86.32    (2) the insurer denied insurance;86.33    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 86.34a complaint or appeal, in writing, to the commissioner of health or the commissioner of 86.35commerce, or litigated the complaint or appeal; and86.36    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.87.1    For purposes of this section, "insurance" has the meaning given in paragraph (h).87.2    A parent who has requested a reduction in the contribution amount under this 87.3paragraph shall submit proof in the form and manner prescribed by the commissioner or 87.4county agency, including, but not limited to, the insurer's denial of insurance, the written 87.5letter or complaint of the parents, court documents, and the written response of the insurer 87.6approving insurance. The determinations of the commissioner or county agency under this 87.7paragraph are not rules subject to chapter 14.87.8(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 201387.92015, the parental contribution shall be computed by applying the following contribution 87.10schedule to the adjusted gross income of the natural or adoptive parents:87.11(1) if the adjusted gross income is equal to or greater than 100 percent of federal 87.12poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 87.13contribution is $4 per month;87.14(2) if the adjusted gross income is equal to or greater than 175 percent of federal 87.15poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, 87.16the parental contribution shall be determined using a sliding fee scale established by the 87.17commissioner of human services which begins at one percent of adjusted gross income 87.18at 175 percent of federal poverty guidelines and increases to eight percent of adjusted 87.19gross income for those with adjusted gross income up to 525 percent of federal poverty 87.20guidelines;87.21(3) if the adjusted gross income is greater than 525 percent of federal poverty 87.22guidelines and less than 675 percent of federal poverty guidelines, the parental 87.23contribution shall be 9.5 percent of adjusted gross income;87.24(4) if the adjusted gross income is equal to or greater than 675 percent of federal 87.25poverty guidelines and less than 900 percent of federal poverty guidelines, the parental 87.26contribution shall be determined using a sliding fee scale established by the commissioner 87.27of human services which begins at 9.5 percent of adjusted gross income at 675 percent of 87.28federal poverty guidelines and increases to 12 percent of adjusted gross income for those 87.29with adjusted gross income up to 900 percent of federal poverty guidelines; and87.30(5) if the adjusted gross income is equal to or greater than 900 percent of federal 87.31poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross 87.32income. If the child lives with the parent, the annual adjusted gross income is reduced by 87.33$2,400 prior to calculating the parental contribution. If the child resides in an institution 87.34specified in section 
         256B.35, the parent is responsible for the personal needs allowance 87.35specified under that section in addition to the parental contribution determined under this 88.1section. The parental contribution is reduced by any amount required to be paid directly to 88.2the child pursuant to a court order, but only if actually paid.88.3    Sec. 14. Minnesota Statutes 2010, section 256.975, subdivision 7, is amended to read:88.4    Subd. 7. Consumer information and assistance and long-term care options 88.5counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 88.6statewide service to aid older Minnesotans and their families in making informed choices 88.7about long-term care options and health care benefits. Language services to persons with 88.8limited English language skills may be made available. The service, known as Senior 88.9LinkAge Line, must be available during business hours through a statewide toll-free 88.10number and must also be available through the Internet.88.11    (b) The service must provide long-term care options counseling by assisting older 88.12adults, caregivers, and providers in accessing information and options counseling about 88.13choices in long-term care services that are purchased through private providers or available 88.14through public options. The service must:88.15    (1) develop a comprehensive database that includes detailed listings in both 88.16consumer- and provider-oriented formats;88.17    (2) make the database accessible on the Internet and through other telecommunication 88.18and media-related tools;88.19    (3) link callers to interactive long-term care screening tools and make these tools 88.20available through the Internet by integrating the tools with the database;88.21    (4) develop community education materials with a focus on planning for long-term 88.22care and evaluating independent living, housing, and service options;88.23    (5) conduct an outreach campaign to assist older adults and their caregivers in 88.24finding information on the Internet and through other means of communication;88.25    (6) implement a messaging system for overflow callers and respond to these callers 88.26by the next business day;88.27    (7) link callers with county human services and other providers to receive more 88.28in-depth assistance and consultation related to long-term care options;88.29    (8) link callers with quality profiles for nursing facilities and other providers 88.30developed by the commissioner of health;88.31    (9) incorporate information about the availability of housing options, as well as 88.32registered housing with services and consumer rights within the MinnesotaHelp.info 88.33network long-term care database to facilitate consumer comparison of services and costs 88.34among housing with services establishments and with other in-home services and to 88.35support financial self-sufficiency as long as possible. Housing with services establishments 89.1and their arranged home care providers shall provide information that will facilitate price 89.2comparisons, including delineation of charges for rent and for services available. The 89.3commissioners of health and human services shall align the data elements required by 89.4section 
         144G.06, the Uniform Consumer Information Guide, and this section to provide 89.5consumers standardized information and ease of comparison of long-term care options. 89.6The commissioner of human services shall provide the data to the Minnesota Board on 89.7Aging for inclusion in the MinnesotaHelp.info network long-term care database;89.8(10) provide long-term care options counseling. Long-term care options counselors 89.9shall:89.10(i) for individuals not eligible for case management under a public program or public 89.11funding source, provide interactive decision support under which consumers, family 89.12members, or other helpers are supported in their deliberations to determine appropriate 89.13long-term care choices in the context of the consumer's needs, preferences, values, and 89.14individual circumstances, including implementing a community support plan;89.15(ii) provide Web-based educational information and collateral written materials to 89.16familiarize consumers, family members, or other helpers with the long-term care basics, 89.17issues to be considered, and the range of options available in the community;89.18(iii) provide long-term care futures planning, which means providing assistance to 89.19individuals who anticipate having long-term care needs to develop a plan for the more 89.20distant future; and89.21(iv) provide expertise in benefits and financing options for long-term care, including 89.22Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 89.23private pay options, and ways to access low or no-cost services or benefits through 89.24volunteer-based or charitable programs; and89.25(11) using risk management and support planning protocols, provide long-term care 89.26options counseling to current residents of nursing homes deemed appropriate for discharge 89.27by the commissioner. In order to meet this requirement, the commissioner shall provide 89.28designated Senior LinkAge Line contact centers with a list of nursing home residents 89.29appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall 89.30provide these residents, if they indicate a preference to receive long-term care options 89.31counseling, with initial assessment, review of risk factors, independent living support 89.32consultation, or referral to:89.33(i) long-term care consultation services under section 
         256B.0911;89.34(ii) designated care coordinators of contracted entities under section 
         256B.035 for 89.35persons who are enrolled in a managed care plan; or90.1(iii) the long-term care consultation team for those who are appropriate for relocation 90.2service coordination due to high-risk factors or psychological or physical disability.; and90.3(12) develop referral protocols and processes that will assist certified health care 90.4homes and hospitals to identify at-risk older adults and determine when to refer these 90.5individuals to the Senior LinkAge Line for long-term care options counseling under this 90.6section. The commissioner is directed to work with the commissioner of health to develop 90.7protocols that would comply with the health care home designation criteria and protocols 90.8available at the time of hospital discharge. The commissioner shall keep a record of the 90.9number of people who choose long-term care options counseling as a result of this section.90.10    Sec. 15. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to 90.11read:90.12    Subd. 1a. Income and assets generally. Unless specifically required by state 90.13law or rule or federal law or regulation, the methodologies used in counting income 90.14and assets to determine eligibility for medical assistance for persons whose eligibility 90.15category is based on blindness, disability, or age of 65 or more years, the methodologies 90.16for the supplemental security income program shall be used, except as provided under 90.17subdivision 3, paragraph (a), clause (6). Increases in benefits under title II of the Social 90.18Security Act shall not be counted as income for purposes of this subdivision until July 1 of 90.19each year. Effective upon federal approval, for children eligible under section 
         256B.055, 90.20subdivision 12
         , or for home and community-based waiver services whose eligibility 90.21for medical assistance is determined without regard to parental income, child support 90.22payments, including any payments made by an obligor in satisfaction of or in addition 90.23to a temporary or permanent order for child support, and Social Security payments are 90.24not counted as income. For families and children, which includes all other eligibility 90.25categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as 90.26required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 90.27(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the 90.28earned income disregards and deductions are limited to those in subdivision 1c. For these 90.29purposes, a "methodology" does not include an asset or income standard, or accounting 90.30method, or method of determining effective dates.90.31EFFECTIVE DATE.This section is effective April 1, 2012.90.32    Sec. 16. Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3, 90.33is amended to read:91.1    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for 91.2medical assistance, a person must not individually own more than $3,000 in assets, or if a 91.3member of a household with two family members, husband and wife, or parent and child, 91.4the household must not own more than $6,000 in assets, plus $200 for each additional 91.5legal dependent. In addition to these maximum amounts, an eligible individual or family 91.6may accrue interest on these amounts, but they must be reduced to the maximum at the 91.7time of an eligibility redetermination. The accumulation of the clothing and personal 91.8needs allowance according to section 
         256B.35 must also be reduced to the maximum at 91.9the time of the eligibility redetermination. The value of assets that are not considered in 91.10determining eligibility for medical assistance is the value of those assets excluded under 91.11the supplemental security income program for aged, blind, and disabled persons, with 91.12the following exceptions:91.13(1) household goods and personal effects are not considered;91.14(2) capital and operating assets of a trade or business that the local agency determines 91.15are necessary to the person's ability to earn an income are not considered;91.16(3) motor vehicles are excluded to the same extent excluded by the supplemental 91.17security income program;91.18(4) assets designated as burial expenses are excluded to the same extent excluded by 91.19the supplemental security income program. Burial expenses funded by annuity contracts 91.20or life insurance policies must irrevocably designate the individual's estate as contingent 91.21beneficiary to the extent proceeds are not used for payment of selected burial expenses; and91.22(5) for a person who no longer qualifies as an employed person with a disability due 91.23to loss of earnings, assets allowed while eligible for medical assistance under section 91.24256B.057, subdivision 9
         , are not considered for 12 months, beginning with the first month 91.25of ineligibility as an employed person with a disability, to the extent that the person's total 91.26assets remain within the allowed limits of section 
         256B.057, subdivision 9, paragraph 91.27(d).; and91.28    (6) when a person enrolled in medical assistance under section 256B.057, subdivision 91.299, is age 65 or older and has been enrolled during each of the 24 consecutive months 91.30before the person's 65th birthday, the assets owned by the person and the person's spouse 91.31must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), 91.32when determining eligibility for medical assistance under section 256B.055, subdivision 91.337. The income of a spouse of a person enrolled in medical assistance under section 91.34256B.057, subdivision 9, during each of the 24 consecutive months before the person's 91.3565th birthday must be disregarded when determining eligibility for medical assistance 91.36under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to 92.1the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013 92.2is required to have qualified for medical assistance under section 256B.057, subdivision 9, 92.3prior to age 65 for at least 20 months in the 24 months prior to reaching age 65.92.4(b) No asset limit shall apply to persons eligible under section 
         256B.055, subdivision 92.515.92.6EFFECTIVE DATE.This section is effective April 1, 2012.92.7    Sec. 17. Minnesota Statutes 2011 Supplement, section 256B.057, subdivision 9, 92.8is amended to read:92.9    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid 92.10for a person who is employed and who:92.11    (1) but for excess earnings or assets, meets the definition of disabled under the 92.12Supplemental Security Income program;92.13    (2) is at least 16 but less than 65 years of age;92.14    (3) meets the asset limits in paragraph (d); and92.15    (4) (3) pays a premium and other obligations under paragraph (e).92.16    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 92.17for medical assistance under this subdivision, a person must have more than $65 of earned 92.18income. Earned income must have Medicare, Social Security, and applicable state and 92.19federal taxes withheld. The person must document earned income tax withholding. Any 92.20spousal income or assets shall be disregarded for purposes of eligibility and premium 92.21determinations.92.22    (c) After the month of enrollment, a person enrolled in medical assistance under 92.23this subdivision who:92.24    (1) is temporarily unable to work and without receipt of earned income due to a 92.25medical condition, as verified by a physician; or92.26    (2) loses employment for reasons not attributable to the enrollee, and is without 92.27receipt of earned income may retain eligibility for up to four consecutive months after the 92.28month of job loss. To receive a four-month extension, enrollees must verify the medical 92.29condition or provide notification of job loss. All other eligibility requirements must be met 92.30and the enrollee must pay all calculated premium costs for continued eligibility.92.31    (d) For purposes of determining eligibility under this subdivision, a person's assets 92.32must not exceed $20,000, excluding:92.33    (1) all assets excluded under section 
         256B.056;92.34    (2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 92.35Keogh plans, and pension plans;93.1    (3) medical expense accounts set up through the person's employer; and93.2    (4) spousal assets, including spouse's share of jointly held assets.93.3    (e) All enrollees must pay a premium to be eligible for medical assistance under this 93.4subdivision, except as provided under section 
         256.01, subdivision 18b.93.5    (1) An enrollee must pay the greater of a $65 premium or the premium calculated 93.6based on the person's gross earned and unearned income and the applicable family size 93.7using a sliding fee scale established by the commissioner, which begins at one percent of 93.8income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of 93.9income for those with incomes at or above 300 percent of the federal poverty guidelines.93.10    (2) Annual adjustments in the premium schedule based upon changes in the federal 93.11poverty guidelines shall be effective for premiums due in July of each year.93.12    (3) All enrollees who receive unearned income must pay five percent of unearned 93.13income in addition to the premium amount, except as provided under section 
         256.01, 93.14subdivision 18b
         .93.15    (4) Increases in benefits under title II of the Social Security Act shall not be counted 93.16as income for purposes of this subdivision until July 1 of each year.93.17    (f) A person's eligibility and premium shall be determined by the local county 93.18agency. Premiums must be paid to the commissioner. All premiums are dedicated to 93.19the commissioner.93.20    (g) Any required premium shall be determined at application and redetermined at 93.21the enrollee's six-month income review or when a change in income or household size is 93.22reported. Enrollees must report any change in income or household size within ten days 93.23of when the change occurs. A decreased premium resulting from a reported change in 93.24income or household size shall be effective the first day of the next available billing month 93.25after the change is reported. Except for changes occurring from annual cost-of-living 93.26increases, a change resulting in an increased premium shall not affect the premium amount 93.27until the next six-month review.93.28    (h) Premium payment is due upon notification from the commissioner of the 93.29premium amount required. Premiums may be paid in installments at the discretion of 93.30the commissioner.93.31    (i) Nonpayment of the premium shall result in denial or termination of medical 93.32assistance unless the person demonstrates good cause for nonpayment. Good cause exists 93.33if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 93.34D, are met. Except when an installment agreement is accepted by the commissioner, 93.35all persons disenrolled for nonpayment of a premium must pay any past due premiums 93.36as well as current premiums due prior to being reenrolled. Nonpayment shall include 94.1payment with a returned, refused, or dishonored instrument. The commissioner may 94.2require a guaranteed form of payment as the only means to replace a returned, refused, 94.3or dishonored instrument.94.4    (j) The commissioner shall notify enrollees annually beginning at least 24 months 94.5before the person's 65th birthday of the medical assistance eligibility rules affecting 94.6income, assets, and treatment of a spouse's income and assets that will be applied upon 94.7reaching age 65.94.8    (k) For enrollees whose income does not exceed 200 percent of the federal poverty 94.9guidelines and who are also enrolled in Medicare, the commissioner shall reimburse 94.10the enrollee for Medicare part B premiums under section 
         256B.0625, subdivision 15, 94.11paragraph (a).94.12EFFECTIVE DATE.This section is effective April 1, 2012.94.13    Sec. 18. Minnesota Statutes 2011 Supplement, section 256B.0659, subdivision 11, 94.14is amended to read:94.15    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant 94.16must meet the following requirements:94.17    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years 94.18of age with these additional requirements:94.19    (i) supervision by a qualified professional every 60 days; and94.20    (ii) employment by only one personal care assistance provider agency responsible 94.21for compliance with current labor laws;94.22    (2) be employed by a personal care assistance provider agency;94.23    (3) enroll with the department as a personal care assistant after clearing a background 94.24study. Except as provided in subdivision 11a, before a personal care assistant provides 94.25services, the personal care assistance provider agency must initiate a background study on 94.26the personal care assistant under chapter 245C, and the personal care assistance provider 94.27agency must have received a notice from the commissioner that the personal care assistant 94.28is:94.29    (i) not disqualified under section 
         245C.14; or94.30    (ii) is disqualified, but the personal care assistant has received a set aside of the 94.31disqualification under section 
         245C.22;94.32    (4) be able to effectively communicate with the recipient and personal care 94.33assistance provider agency;94.34    (5) be able to provide covered personal care assistance services according to the 94.35recipient's personal care assistance care plan, respond appropriately to recipient needs, 95.1and report changes in the recipient's condition to the supervising qualified professional 95.2or physician;95.3    (6) not be a consumer of personal care assistance services;95.4    (7) maintain daily written records including, but not limited to, time sheets under 95.5subdivision 12;95.6    (8) effective January 1, 2010, complete standardized training as determined 95.7by the commissioner before completing enrollment. The training must be available 95.8in languages other than English and to those who need accommodations due to 95.9disabilities. Personal care assistant training must include successful completion of the 95.10following training components: basic first aid, vulnerable adult, child maltreatment, 95.11OSHA universal precautions, basic roles and responsibilities of personal care assistants 95.12including information about assistance with lifting and transfers for recipients, emergency 95.13preparedness, orientation to positive behavioral practices, fraud issues, and completion of 95.14time sheets. Upon completion of the training components, the personal care assistant must 95.15demonstrate the competency to provide assistance to recipients;95.16    (9) complete training and orientation on the needs of the recipient within the first 95.17seven days after the services begin; and95.18    (10) be limited to providing and being paid for up to 275 hours per month, except 95.19that this limit shall be 275 hours per month for the period July 1, 2009, through June 30, 95.202011, of personal care assistance services regardless of the number of recipients being 95.21served or the number of personal care assistance provider agencies enrolled with. The 95.22number of hours worked per day shall not be disallowed by the department unless in 95.23violation of the law.95.24    (b) A legal guardian may be a personal care assistant if the guardian is not being paid 95.25for the guardian services and meets the criteria for personal care assistants in paragraph (a).95.26    (c) Persons who do not qualify as a personal care assistant include parents and 95.27stepparents of minors, spouses, paid legal guardians, family foster care providers, except 95.28as otherwise allowed in section 
         256B.0625, subdivision 19a, or staff of a residential 95.29setting. When the personal care assistant is a relative of the recipient, the commissioner 95.30shall pay 80 percent of the provider rate. This rate reduction is effective July 1, 2013. For 95.31purposes of this section, relative means the parent or adoptive parent of an adult child, a 95.32sibling aged 16 years or older, an adult child, a grandparent, or a grandchild.95.33    Sec. 19. Minnesota Statutes 2010, section 256B.0659, is amended by adding a 95.34subdivision to read:96.1    Subd. 31.Commissioner's access.When the commissioner is investigating a 96.2possible overpayment of Medicaid funds, the commissioner must be given immediate 96.3access without prior notice to the office during regular business hours and to 96.4documentation and records related to services provided and submission of claims for 96.5services provided. Denying the commissioner access to records is cause for immediate 96.6suspension of payment and/or terminating the personal care provider organization's 96.7enrollment according to section 256B.064.96.8    Sec. 20. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3a, 96.9is amended to read:96.10    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 96.11services planning, or other assistance intended to support community-based living, 96.12including persons who need assessment in order to determine waiver or alternative care 96.13program eligibility, must be visited by a long-term care consultation team within 15 96.14calendar days after the date on which an assessment was requested or recommended. After 96.15January 1, 2011, these requirements also apply to personal care assistance services, private 96.16duty nursing, and home health agency services, on timelines established in subdivision 5. 96.17Face-to-face assessments must be conducted according to paragraphs (b) to (i).96.18    (b) The county may utilize a team of either the social worker or public health nurse, 96.19or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 96.20assessment in a face-to-face interview. The consultation team members must confer 96.21regarding the most appropriate care for each individual screened or assessed.96.22    (c) The assessment must be comprehensive and include a person-centered 96.23assessment of the health, psychological, functional, environmental, and social needs of 96.24referred individuals and provide information necessary to develop a support plan that 96.25meets the consumers needs, using an assessment form provided by the commissioner.96.26    (d) The assessment must be conducted in a face-to-face interview with the person 96.27being assessed and the person's legal representative, as required by legally executed 96.28documents, and other individuals as requested by the person, who can provide information 96.29on the needs, strengths, and preferences of the person necessary to develop a support plan 96.30that ensures the person's health and safety, but who is not a provider of service or has any 96.31financial interest in the provision of services. For persons who are to be assessed for 96.32elderly waiver customized living services under section 256B.0915, with the permission 96.33of the person being assessed or the person's designated or legal representative, the client's 96.34current or proposed provider of services may submit a copy of the provider's nursing 96.35assessment or written report outlining their recommendations regarding the client's care 97.1needs. The person conducting the assessment will notify the provider of the date by which 97.2this information is to be submitted. This information shall be provided to the person 97.3conducting the assessment prior to the assessment.97.4    (e) The person, or the person's legal representative, must be provided with written 97.5recommendations for community-based services, including consumer-directed options, 97.6or institutional care that include documentation that the most cost-effective alternatives 97.7available were offered to the individual, and alternatives to residential settings, including, 97.8but not limited to, foster care settings that are not the primary residence of the license 97.9holder. For purposes of this requirement, "cost-effective alternatives" means community 97.10services and living arrangements that cost the same as or less than institutional care.97.11    (f) If the person chooses to use community-based services, the person or the person's 97.12legal representative must be provided with a written community support plan, regardless 97.13of whether the individual is eligible for Minnesota health care programs. A person may 97.14request assistance in identifying community supports without participating in a complete 97.15assessment. Upon a request for assistance identifying community support, the person must 97.16be transferred or referred to the services available under sections 
         256.975, subdivision 7, 97.17and 
         256.01, subdivision 24, for telephone assistance and follow up.97.18    (g) The person has the right to make the final decision between institutional 97.19placement and community placement after the recommendations have been provided, 97.20except as provided in subdivision 4a, paragraph (c).97.21    (h) The team must give the person receiving assessment or support planning, or 97.22the person's legal representative, materials, and forms supplied by the commissioner 97.23containing the following information:97.24    (1) the need for and purpose of preadmission screening if the person selects nursing 97.25facility placement;97.26    (2) the role of the long-term care consultation assessment and support planning in 97.27waiver and alternative care program eligibility determination;97.28    (3) information about Minnesota health care programs;97.29    (4) the person's freedom to accept or reject the recommendations of the team;97.30    (5) the person's right to confidentiality under the Minnesota Government Data 97.31Practices Act, chapter 13;97.32    (6) the long-term care consultant's decision regarding the person's need for 97.33institutional level of care as determined under criteria established in section 
         144.0724, 97.34subdivision 11
         , or 
         256B.092; and98.1    (7) the person's right to appeal the decision regarding the need for nursing facility 98.2level of care or the county's final decisions regarding public programs eligibility according 98.3to section 
         256.045, subdivision 3.98.4    (i) Face-to-face assessment completed as part of eligibility determination for 98.5the alternative care, elderly waiver, community alternatives for disabled individuals, 98.6community alternative care, and traumatic brain injury waiver programs under sections 98.7256B.0915
         , 
         256B.0917, and 
         256B.49 is valid to establish service eligibility for no more 98.8than 60 calendar days after the date of assessment. The effective eligibility start date 98.9for these programs can never be prior to the date of assessment. If an assessment was 98.10completed more than 60 days before the effective waiver or alternative care program 98.11eligibility start date, assessment and support plan information must be updated in a 98.12face-to-face visit and documented in the department's Medicaid Management Information 98.13System (MMIS). The effective date of program eligibility in this case cannot be prior to 98.14the date the updated assessment is completed.98.15    Sec. 21. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c, 98.16is amended to read:98.17    Subd. 3c. Consultation for housing with services. (a) The purpose of long-term 98.18care consultation for registered housing with services is to support persons with current or 98.19anticipated long-term care needs in making informed choices among options that include 98.20the most cost-effective and least restrictive settings. Prospective residents maintain the 98.21right to choose housing with services or assisted living if that option is their preference.98.22    (b) Registered housing with services establishments shall inform all prospective 98.23residents or the prospective resident's designated or legal representative of the availability 98.24of long-term care consultation and the need to receive and verify the consultation prior 98.25to signing a lease or contract. Long-term care consultation for registered housing with 98.26services is provided as determined by the commissioner of human services. The service 98.27is delivered under a partnership between lead agencies as defined in subdivision 1a, 98.28paragraph (d), and the Area Agencies on Aging, and is a point of entry to a combination 98.29of telephone-based long-term care options counseling provided by Senior LinkAge Line 98.30and in-person long-term care consultation provided by lead agencies. The point of entry 98.31service must be provided within five working days of the request of the prospective 98.32resident as follows:98.33    (1) the consultation shall be conducted with the prospective resident, or in the 98.34alternative, the resident's designated or legal representative, if:98.35(i) the resident verbally requests; or99.1(ii) the registered housing with services provider has documentation of the 99.2designated or legal representative's authority to enter into a lease or contract on behalf of 99.3the prospective resident and accepts the documentation in good faith;99.4(2) the consultation shall be performed in a manner that provides objective and 99.5complete information;99.6    (2) (3) the consultation must include a review of the prospective resident's reasons 99.7for considering housing with services, the prospective resident's personal goals, a 99.8discussion of the prospective resident's immediate and projected long-term care needs, 99.9and alternative community services or housing with services settings that may meet the 99.10prospective resident's needs;99.11    (3) (4) the prospective resident shall be informed of the availability of a face-to-face 99.12visit at no charge to the prospective resident to assist the prospective resident in assessment 99.13and planning to meet the prospective resident's long-term care needs; and99.14(4) (5) verification of counseling shall be generated and provided to the prospective 99.15resident by Senior LinkAge Line upon completion of the telephone-based counseling.99.16(c) Housing with services establishments registered under chapter 144D shall:99.17(1) inform all prospective residents or the prospective resident's designated or legal 99.18representative of the availability of and contact information for consultation services 99.19under this subdivision;99.20(2) except for individuals seeking lease-only arrangements in subsidized housing 99.21settings, receive a copy of the verification of counseling prior to executing a lease or 99.22service contract with the prospective resident, and prior to executing a service contract 99.23with individuals who have previously entered into lease-only arrangements; and99.24(3) retain a copy of the verification of counseling as part of the resident's file.99.25(d) Emergency admissions to registered housing with services establishments prior 99.26to consultation under paragraph (b) are permitted according to policies established by 99.27the commissioner.99.28    Sec. 22. Minnesota Statutes 2010, section 256B.0911, is amended by adding a 99.29subdivision to read:99.30    Subd. 3d.Exemptions.Individuals shall be exempt from the requirements outlined 99.31in subdivision 3c in the following circumstances:99.32(1) the individual is seeking a lease-only arrangement in a subsidized housing setting;99.33(2) the individual has previously received a long-term care consultation assessment 99.34under this section. In this instance, the assessor who completes the long-term care 99.35consultation will issue a verification code and provide it to the individual;100.1(3) the individual is receiving or is being evaluated for hospice services from a 100.2hospice provider licensed under sections 144A.75 to 144A.755; or100.3(4) the individual has used financial planning services and created a long-term care 100.4plan as defined by the commissioner in the 12 months prior to signing a lease or contract 100.5with a registered housing with services establishment.100.6    Sec. 23. Minnesota Statutes 2010, section 256B.0911, is amended by adding a 100.7subdivision to read:100.8    Subd. 3e.Consultation at hospital discharge.(a) Hospitals shall refer all 100.9individuals described in paragraph (b) prior to discharge from an inpatient hospital stay 100.10to the Senior LinkAge Line for long-term care options counseling. Hospitals shall make 100.11these referrals using referral protocols and processes developed under section 256.975, 100.12subdivision 7. The purpose of the counseling is to support persons with current or 100.13anticipated long-term care needs in making informed choices among options that include 100.14the most cost-effective and least restrictive setting.100.15(b) The individuals who shall be referred under paragraph (a) include older adults 100.16who are at risk of nursing home placement. Protocols for identifying at-risk individuals 100.17shall be developed under section 256.975, subdivision 7, paragraph (b), clause (12).100.18(c) Counseling provided under this subdivision shall meet the requirements for the 100.19consultation required under section 256B.0911, subdivision 3c.100.20EFFECTIVE DATE.This section is effective October 1, 2012.100.21    Sec. 24. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3e, 100.22is amended to read:100.23    Subd. 3e. Customized living service rate. (a) Payment for customized living 100.24services shall be a monthly rate authorized by the lead agency within the parameters 100.25established by the commissioner. The payment agreement must delineate the amount of 100.26each component service included in the recipient's customized living service plan. The 100.27lead agency, with input from the provider of customized living services, shall ensure that 100.28there is a documented need within the parameters established by the commissioner for all 100.29component customized living services authorized.100.30(b) The payment rate must be based on the amount of component services to be 100.31provided utilizing component rates established by the commissioner. Counties and tribes 100.32shall use tools issued by the commissioner to develop and document customized living 100.33service plans and rates.101.1(c) Component service rates must not exceed payment rates for comparable elderly 101.2waiver or medical assistance services and must reflect economies of scale. Customized 101.3living services must not include rent or raw food costs.101.4    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the 101.5individualized monthly authorized payment for the customized living service plan shall 101.6not exceed 50 percent of the greater of either the statewide or any of the geographic 101.7groups' weighted average monthly nursing facility rate of the case mix resident class 101.8to which the elderly waiver eligible client would be assigned under Minnesota Rules, 101.9parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 101.10in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 101.11resident assessment system as described in section 
         256B.438 for nursing home rate 101.12determination is implemented. Effective on July 1 of the state fiscal year in which 101.13the resident assessment system as described in section 
         256B.438 for nursing home 101.14rate determination is implemented and July 1 of each subsequent state fiscal year, the 101.15individualized monthly authorized payment for the services described in this clause shall 101.16not exceed the limit which was in effect on June 30 of the previous state fiscal year 101.17updated annually based on legislatively adopted changes to all service rate maximums for 101.18home and community-based service providers.101.19(e) Effective July 1, 2011, the individualized monthly payment for the customized 101.20living service plan for individuals described in subdivision 3a, paragraph (b), must be the 101.21monthly authorized payment limit for customized living for individuals classified as case 101.22mix A, reduced by 25 percent. This rate limit must be applied to all new participants 101.23enrolled in the program on or after July 1, 2011, who meet the criteria described in 101.24subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 101.25meet the criteria described in subdivision 3a, paragraph (b), at reassessment.101.26    (f) Customized living services are delivered by a provider licensed by the 101.27Department of Health as a class A or class F home care provider and provided in a 101.28building that is registered as a housing with services establishment under chapter 144D. 101.29Licensed home care providers are subject to section 
         256B.0651, subdivision 14.101.30(g) A provider may not bill or otherwise charge an elderly waiver participant or their 101.31family for additional units of any allowable component service beyond those available 101.32under the service rate limits described in paragraph (d), nor for additional units of any 101.33allowable component service beyond those approved in the service plan by the lead agency.101.34    Sec. 25. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3h, 101.35is amended to read:102.1    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The 102.2payment rate for 24-hour customized living services is a monthly rate authorized by the 102.3lead agency within the parameters established by the commissioner of human services. 102.4The payment agreement must delineate the amount of each component service included 102.5in each recipient's customized living service plan. The lead agency, with input from 102.6the provider of customized living services, shall ensure that there is a documented need 102.7within the parameters established by the commissioner for all component customized 102.8living services authorized. The lead agency shall not authorize 24-hour customized living 102.9services unless there is a documented need for 24-hour supervision.102.10(b) For purposes of this section, "24-hour supervision" means that the recipient 102.11requires assistance due to needs related to one or more of the following:102.12    (1) intermittent assistance with toileting, positioning, or transferring;102.13    (2) cognitive or behavioral issues;102.14    (3) a medical condition that requires clinical monitoring; or102.15    (4) for all new participants enrolled in the program on or after July 1, 2011, and 102.16all other participants at their first reassessment after July 1, 2011, dependency in at 102.17least three of the following activities of daily living as determined by assessment under 102.18section 
         256B.0911: bathing; dressing; grooming; walking; or eating when the dependency 102.19score in eating is three or greater; and needs medication management and at least 50 102.20hours of service per month. The lead agency shall ensure that the frequency and mode 102.21of supervision of the recipient and the qualifications of staff providing supervision are 102.22described and meet the needs of the recipient.102.23(c) The payment rate for 24-hour customized living services must be based on the 102.24amount of component services to be provided utilizing component rates established by the 102.25commissioner. Counties and tribes will use tools issued by the commissioner to develop 102.26and document customized living plans and authorize rates.102.27(d) Component service rates must not exceed payment rates for comparable elderly 102.28waiver or medical assistance services and must reflect economies of scale.102.29(e) The individually authorized 24-hour customized living payments, in combination 102.30with the payment for other elderly waiver services, including case management, must not 102.31exceed the recipient's community budget cap specified in subdivision 3a. Customized 102.32living services must not include rent or raw food costs.102.33(f) The individually authorized 24-hour customized living payment rates shall not 102.34exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 102.35living services in effect and in the Medicaid management information systems on March 102.3631, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 103.1to 9549.0059, to which elderly waiver service clients are assigned. When there are 103.2fewer than 50 authorizations in effect in the case mix resident class, the commissioner 103.3shall multiply the calculated service payment rate maximum for the A classification by 103.4the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 103.59549.0059, to determine the applicable payment rate maximum. Service payment rate 103.6maximums shall be updated annually based on legislatively adopted changes to all service 103.7rates for home and community-based service providers.103.8    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 103.9may establish alternative payment rate systems for 24-hour customized living services in 103.10housing with services establishments which are freestanding buildings with a capacity of 103.1116 or fewer, by applying a single hourly rate for covered component services provided 103.12in either:103.13    (1) licensed corporate adult foster homes; or103.14    (2) specialized dementia care units which meet the requirements of section 
         144D.065 103.15and in which:103.16    (i) each resident is offered the option of having their own apartment; or103.17    (ii) the units are licensed as board and lodge establishments with maximum capacity 103.18of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 103.19subparts 1, 2, 3, and 4, item A.103.20(h) 24-hour customized living services are delivered by a provider licensed by 103.21the Department of Health as a class A or class F home care provider and provided in a 103.22building that is registered as a housing with services establishment under chapter 144D. 103.23Licensed home care providers are subject to section 256B.0651, subdivision 14.103.24(h) (i) A provider may not bill or otherwise charge an elderly waiver participant 103.25or their family for additional units of any allowable component service beyond those 103.26available under the service rate limits described in paragraph (e), nor for additional 103.27units of any allowable component service beyond those approved in the service plan 103.28by the lead agency.103.29    Sec. 26. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to 103.30read:103.31    Subd. 1b. Individual service plan.(a) The individual service plan must:103.32(1) include the results of the assessment information on the person's need for service, 103.33including identification of service needs that will be or that are met by the person's 103.34relatives, friends, and others, as well as community services used by the general public;104.1(2) identify the person's preferences for services as stated by the person, the person's 104.2legal guardian or conservator, or the parent if the person is a minor;104.3(3) identify long- and short-range goals for the person;104.4(4) identify specific services and the amount and frequency of the services to be 104.5provided to the person based on assessed needs, preferences, and available resources. 104.6The individual service plan shall also specify other services the person needs that are 104.7not available;104.8(5) identify the need for an individual program plan to be developed by the provider 104.9according to the respective state and federal licensing and certification standards, and 104.10additional assessments to be completed or arranged by the provider after service initiation;104.11(6) identify provider responsibilities to implement and make recommendations for 104.12modification to the individual service plan;104.13(7) include notice of the right to request a conciliation conference or a hearing 104.14under section 
         256.045;104.15(8) be agreed upon and signed by the person, the person's legal guardian 104.16or conservator, or the parent if the person is a minor, and the authorized county 104.17representative; and104.18(9) be reviewed by a health professional if the person has overriding medical needs 104.19that impact the delivery of services.104.20(b) Service planning formats developed for interagency planning such as transition, 104.21vocational, and individual family service plans may be substituted for service planning 104.22formats developed by county agencies.104.23(c) Approved, written, and signed changes to a consumer's services that meet the 104.24criteria in this subdivision shall be an addendum to that consumer's individual service plan.104.25    Sec. 27. Minnesota Statutes 2010, section 256B.092, subdivision 7, is amended to read:104.26    Subd. 7. Screening teams.(a) For persons with developmental disabilities, 104.27screening teams shall be established which shall evaluate the need for the level of care 104.28provided by residential-based habilitation services, residential services, training and 104.29habilitation services, and nursing facility services. The evaluation shall address whether 104.30home and community-based services are appropriate for persons who are at risk of 104.31placement in an intermediate care facility for persons with developmental disabilities, or 104.32for whom there is reasonable indication that they might require this level of care. The 104.33screening team shall make an evaluation of need within 60 working days of a request for 104.34service by a person with a developmental disability, and within five working days of 105.1an emergency admission of a person to an intermediate care facility for persons with 105.2developmental disabilities.105.3(b) The screening team shall consist of the case manager for persons with 105.4developmental disabilities, the person, the person's legal guardian or conservator, or the 105.5parent if the person is a minor, and a qualified developmental disability professional, as 105.6defined in the Code of Federal Regulations, title 42, section 483.430, as amended through 105.7June 3, 1988. The case manager may also act as the qualified developmental disability 105.8professional if the case manager meets the federal definition.105.9(c) County social service agencies may contract with a public or private agency 105.10or individual who is not a service provider for the person for the public guardianship 105.11representation required by the screening or individual service planning process. The 105.12contract shall be limited to public guardianship representation for the screening and 105.13individual service planning activities. The contract shall require compliance with the 105.14commissioner's instructions and may be for paid or voluntary services.105.15(d) For persons determined to have overriding health care needs and are 105.16seeking admission to a nursing facility or an ICF/MR, or seeking access to home and 105.17community-based waivered services, a registered nurse must be designated as either the 105.18case manager or the qualified developmental disability professional.105.19(e) For persons under the jurisdiction of a correctional agency, the case manager 105.20must consult with the corrections administrator regarding additional health, safety, and 105.21supervision needs.105.22(f) The case manager, with the concurrence of the person, the person's legal guardian 105.23or conservator, or the parent if the person is a minor, may invite other individuals to 105.24attend meetings of the screening team. With the permission of the person being screened 105.25or the person's designated legal representative, the person's current provider of services 105.26may submit a written report outlining their recommendations regarding the person's care 105.27needs prepared by a direct service employee with at least 20 hours of service to that client. 105.28The screening team must notify the provider of the date by which this information is to 105.29be submitted. This information must be provided to the screening team and the person 105.30or the person's legal representative and must be considered prior to the finalization of 105.31the screening.105.32(g) No member of the screening team shall have any direct or indirect service 105.33provider interest in the case.105.34(h) Nothing in this section shall be construed as requiring the screening team 105.35meeting to be separate from the service planning meeting.106.1    Sec. 28. Minnesota Statutes 2011 Supplement, section 256B.097, subdivision 3, 106.2is amended to read:106.3    Subd. 3. State Quality Council. (a) There is hereby created a State Quality 106.4Council which must define regional quality councils, and carry out a community-based, 106.5person-directed quality review component, and a comprehensive system for effective 106.6incident reporting, investigation, analysis, and follow-up.106.7    (b) By August 1, 2011, the commissioner of human services shall appoint the 106.8members of the initial State Quality Council. Members shall include representatives 106.9from the following groups:106.10    (1) disability service recipients and their family members;106.11    (2) during the first two years of the State Quality Council, there must be at least three 106.12members from the Region 10 stakeholders. As regional quality councils are formed under 106.13subdivision 4, each regional quality council shall appoint one member;106.14    (3) disability service providers;106.15    (4) disability advocacy groups; and106.16    (5) county human services agencies and staff from the Department of Human 106.17Services and Ombudsman for Mental Health and Developmental Disabilities.106.18    (c) Members of the council who do not receive a salary or wages from an employer 106.19for time spent on council duties may receive a per diem payment when performing council 106.20duties and functions.106.21    (d) The State Quality Council shall:106.22    (1) assist the Department of Human Services in fulfilling federally mandated 106.23obligations by monitoring disability service quality and quality assurance and 106.24improvement practices in Minnesota; and106.25    (2) establish state quality improvement priorities with methods for achieving results 106.26and provide an annual report to the legislative committees with jurisdiction over policy 106.27and funding of disability services on the outcomes, improvement priorities, and activities 106.28undertaken by the commission during the previous state fiscal year;106.29(3) identify issues pertaining to financial and personal risk that impede Minnesotans 106.30with disabilities from optimizing choice of community-based services; and106.31(4) recommend to the chairs and ranking minority members of the legislative 106.32committees with jurisdiction over human services and civil law by January 15, 2013, 106.33statutory and rule changes related to the findings under clause (3) that promote 106.34individualized service and housing choices balanced with appropriate individualized 106.35protection.106.36    (e) The State Quality Council, in partnership with the commissioner, shall:107.1    (1) approve and direct implementation of the community-based, person-directed 107.2system established in this section;107.3    (2) recommend an appropriate method of funding this system, and determine the 107.4feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;107.5    (3) approve measurable outcomes in the areas of health and safety, consumer 107.6evaluation, education and training, providers, and systems;107.7    (4) establish variable licensure periods not to exceed three years based on outcomes 107.8achieved; and107.9    (5) in cooperation with the Quality Assurance Commission, design a transition plan 107.10for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.107.11    (f) The State Quality Council shall notify the commissioner of human services that a 107.12facility, program, or service has been reviewed by quality assurance team members under 107.13subdivision 4, paragraph (b), clause (13), and qualifies for a license.107.14    (g) The State Quality Council, in partnership with the commissioner, shall establish 107.15an ongoing review process for the system. The review shall take into account the 107.16comprehensive nature of the system which is designed to evaluate the broad spectrum of 107.17licensed and unlicensed entities that provide services to persons with disabilities. The 107.18review shall address efficiencies and effectiveness of the system.107.19    (h) The State Quality Council may recommend to the commissioner certain 107.20variances from the standards governing licensure of programs for persons with disabilities 107.21in order to improve the quality of services so long as the recommended variances do 107.22not adversely affect the health or safety of persons being served or compromise the 107.23qualifications of staff to provide services.107.24    (i) The safety standards, rights, or procedural protections referenced under 107.25subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make 107.26recommendations to the commissioner or to the legislature in the report required under 107.27paragraph (c) regarding alternatives or modifications to the safety standards, rights, or 107.28procedural protections referenced under subdivision 2, paragraph (c).107.29    (j) The State Quality Council may hire staff to perform the duties assigned in this 107.30subdivision.107.31    Sec. 29. Minnesota Statutes 2010, section 256B.431, subdivision 17e, is amended to 107.32read:107.33    Subd. 17e. Replacement-costs-new per bed limit effective October 1, 2007.107.34    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), 107.35for a total replacement, as defined in subdivision 17d, authorized under section 108.1144A.071
          or 
         144A.073 after July 1, 1999, any building project that is a relocation, 108.2renovation, upgrading, or conversion completed on or after July 1, 2001, or any 108.3building project eligible for reimbursement under section 
         256B.434, subdivision 4f, the 108.4replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed 108.5rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating 108.6the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 108.79549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be 108.8adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 108.92000. These amounts must be increased annually as specified in subdivision 3f, paragraph 108.10(a), beginning October 1, 2012.108.11    Sec. 30. Minnesota Statutes 2010, section 256B.431, is amended by adding a 108.12subdivision to read:108.13    Subd. 45.Rate adjustments for some moratorium exception projects.108.14Notwithstanding any other law to the contrary, money available for moratorium exception 108.15projects under section 144A.073, subdivisions 2 and 11, shall be used to fund the 108.16incremental rate increases resulting from this section for any nursing facility with a 108.17moratorium exception project approved under section 144A.073, and completed after 108.18August 30, 2010, where the replacement-costs-new limits under subdivision 17e were 108.19higher at any time after project approval than at the time of project completion. The 108.20commissioner shall calculate the property rate increase for these facilities using the highest 108.21set of limits; however, any rate increase under this section shall not be effective until on 108.22or after the effective date of this section, contingent upon federal approval. No property 108.23rate decrease shall result from this section.108.24EFFECTIVE DATE.This section is effective upon federal approval.108.25    Sec. 31. Minnesota Statutes 2010, section 256B.434, subdivision 10, is amended to 108.26read:108.27    Subd. 10. Exemptions. (a) To the extent permitted by federal law, (1) a facility that 108.28has entered into a contract under this section is not required to file a cost report, as defined 108.29in Minnesota Rules, part 9549.0020, subpart 13, for any year after the base year that is the 108.30basis for the calculation of the contract payment rate for the first rate year of the alternative 108.31payment demonstration project contract; and (2) a facility under contract is not subject 108.32to audits of historical costs or revenues, or paybacks or retroactive adjustments based on 108.33these costs or revenues, except audits, paybacks, or adjustments relating to the cost report 108.34that is the basis for calculation of the first rate year under the contract.109.1(b) A facility that is under contract with the commissioner under this section is 109.2not subject to the moratorium on licensure or certification of new nursing home beds in 109.3section 
         144A.071, unless the project results in a net increase in bed capacity or involves 109.4relocation of beds from one site to another. Contract payment rates must not be adjusted 109.5to reflect any additional costs that a nursing facility incurs as a result of a construction 109.6project undertaken under this paragraph. In addition, as a condition of entering into a 109.7contract under this section, a nursing facility must agree that any future medical assistance 109.8payments for nursing facility services will not reflect any additional costs attributable to 109.9the sale of a nursing facility under this section and to construction undertaken under 109.10this paragraph that otherwise would not be authorized under the moratorium in section 109.11144A.073
         . Nothing in this section prevents a nursing facility participating in the 109.12alternative payment demonstration project under this section from seeking approval of 109.13an exception to the moratorium through the process established in section 
         144A.073, 109.14and if approved the facility's rates shall be adjusted to reflect the cost of the project. 109.15Nothing in this section prevents a nursing facility participating in the alternative payment 109.16demonstration project from seeking legislative approval of an exception to the moratorium 109.17under section 
         144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the 109.18cost of the project.109.19(c) Notwithstanding section 256B.48, subdivision 6, paragraphs (c), (d), and (e), 109.20and pursuant to any terms and conditions contained in the facility's contract, a nursing 109.21facility that is under contract with the commissioner under this section is in compliance 109.22with section 256B.48, subdivision 6, paragraph (b), if the facility is Medicare certified.109.23(d)(c) Notwithstanding paragraph (a), if by April 1, 1996, the health care financing 109.24administration has not approved a required waiver, or the Centers for Medicare and 109.25Medicaid Services otherwise requires cost reports to be filed prior to the waiver's approval, 109.26the commissioner shall require a cost report for the rate year.109.27(e) (d) A facility that is under contract with the commissioner under this section 109.28shall be allowed to change therapy arrangements from an unrelated vendor to a related 109.29vendor during the term of the contract. The commissioner may develop reasonable 109.30requirements designed to prevent an increase in therapy utilization for residents enrolled 109.31in the medical assistance program.109.32(f) (e) Nursing facilities participating in the alternative payment system 109.33demonstration project must either participate in the alternative payment system quality 109.34improvement program established by the commissioner or submit information on their 109.35own quality improvement process to the commissioner for approval. Nursing facilities 109.36that have had their own quality improvement process approved by the commissioner 110.1must report results for at least one key area of quality improvement annually to the 110.2commissioner.110.3    Sec. 32. Minnesota Statutes 2010, section 256B.441, is amended by adding a 110.4subdivision to read:110.5    Subd. 63.Critical access nursing facilities.(a) The commissioner, in consultation 110.6with the commissioner of health, may designate certain nursing facilities as critical access 110.7nursing facilities. The designation shall be granted on a competitive basis, within the 110.8limits of funds appropriated for this purpose.110.9(b) The commissioner shall request proposals from nursing facilities every two years. 110.10Proposals must be submitted in the form and according to the timelines established by 110.11the commissioner. In selecting applicants to designate, the commissioner, in consultation 110.12with the commissioner of health, and with input from stakeholders, shall develop criteria 110.13designed to preserve access to nursing facility services in isolated areas, rebalance 110.14long-term care, and improve quality.110.15(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing 110.16facilities designated as critical access nursing facilities:110.17(1) partial rebasing, with operating payment rates being the sum of 60 percent of the 110.18operating payment rate determined in accordance with subdivision 54 and 40 percent of the 110.19operating payment rate that would have been allowed had the facility not been designated;110.20(2) enhanced payments for leave days. Notwithstanding section 256B.431, 110.21subdivision 2r, upon designation as a critical access nursing facility, the commissioner 110.22shall limit payment for leave days to 60 percent of that nursing facility's total payment rate 110.23for the involved resident, and shall allow this payment only when the occupancy of the 110.24nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;110.25(3) two designated critical access nursing facilities, with up to 100 beds in active 110.26service, may jointly apply to the commissioner of health for a waiver of Minnesota 110.27Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The 110.28commissioner of health will consider each waiver request independently based on the 110.29criteria under Minnesota Rules, part 4658.0040;110.30(4) the minimum threshold under section 256B.431, subdivisions 3f, paragraph (a), 110.31and 17e, shall be 40 percent of the amount that would otherwise apply; and110.32(5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based 110.33rate limits under subdivision 50 shall apply to designated critical access nursing facilities.111.1(d) Designation of a critical access nursing facility shall be for a period of two 111.2years, after which the benefits allowed under paragraph (c) shall be removed. Designated 111.3facilities may apply for continued designation.111.4EFFECTIVE DATE.This section is effective the day following final enactment.111.5    Sec. 33. Minnesota Statutes 2010, section 256B.48, is amended by adding a 111.6subdivision to read:111.7    Subd. 6a.Referrals to Medicare providers required.Notwithstanding subdivision 111.81, nursing facility providers that do not participate in or accept Medicare assignment 111.9must refer and document the referral of dual eligible recipients for whom placement is 111.10requested and for whom the resident would be qualified for a Medicare-covered stay to 111.11Medicare providers. The commissioner shall audit nursing facilities that do not accept 111.12Medicare and determine if dual eligible individuals with Medicare qualifying stays have 111.13been admitted. If such a determination is made, the commissioner shall deny Medicaid 111.14payment for the first 20 days of that resident's stay.111.15    Sec. 34. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 14, 111.16is amended to read:111.17    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's 111.18strengths, informal support systems, and need for services shall be completed within 20 111.19working days of the recipient's request as provided in section 
         256B.0911. Reassessment of 111.20each recipient's strengths, support systems, and need for services shall be conducted at 111.21least every 12 months and at other times when there has been a significant change in the 111.22recipient's functioning. With the permission of the recipient or the recipient's designated 111.23legal representative, the recipient's current provider of services may submit a written 111.24report outlining their recommendations regarding the recipient's care needs prepared by 111.25a direct service employee with at least 20 hours of service to that client. The person 111.26conducting the assessment or reassessment must notify the provider of the date by which 111.27this information is to be submitted. This information shall be provided to the person 111.28conducting the assessment and the person or the person's legal representative and must be 111.29considered prior to the finalization of the assessment or reassessment.111.30(b) There must be a determination that the client requires a hospital level of care or a 111.31nursing facility level of care as defined in section 
         256B.0911, subdivision 4a, paragraph 111.32(d), at initial and subsequent assessments to initiate and maintain participation in the 111.33waiver program.112.1(c) Regardless of other assessments identified in section 
         144.0724, subdivision 4, as 112.2appropriate to determine nursing facility level of care for purposes of medical assistance 112.3payment for nursing facility services, only face-to-face assessments conducted according 112.4to section 
         256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 112.5determination or a nursing facility level of care determination must be accepted for 112.6purposes of initial and ongoing access to waiver services payment.112.7(d) Persons with developmental disabilities who apply for services under the nursing 112.8facility level waiver programs shall be screened for the appropriate level of care according 112.9to section 
         256B.092.112.10(e) Recipients who are found eligible for home and community-based services under 112.11this section before their 65th birthday may remain eligible for these services after their 112.1265th birthday if they continue to meet all other eligibility factors.112.13(f) The commissioner shall develop criteria to identify recipients whose level of 112.14functioning is reasonably expected to improve and reassess these recipients to establish 112.15a baseline assessment. Recipients who meet these criteria must have a comprehensive 112.16transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be 112.17reassessed every six months until there has been no significant change in the recipient's 112.18functioning for at least 12 months. After there has been no significant change in the 112.19recipient's functioning for at least 12 months, reassessments of the recipient's strengths, 112.20informal support systems, and need for services shall be conducted at least every 12 112.21months and at other times when there has been a significant change in the recipient's 112.22functioning. Counties, case managers, and service providers are responsible for 112.23conducting these reassessments and shall complete the reassessments out of existing funds.112.24    Sec. 35. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15, 112.25is amended to read:112.26    Subd. 15. Individualized service plan; comprehensive transitional service plan; 112.27maintenance service plan. (a) Each recipient of home and community-based waivered 112.28services shall be provided a copy of the written service plan which:112.29(1) is developed and signed by the recipient within ten working days of the 112.30completion of the assessment;112.31(2) meets the assessed needs of the recipient;112.32(3) reasonably ensures the health and safety of the recipient;112.33(4) promotes independence;112.34(5) allows for services to be provided in the most integrated settings; and113.1(6) provides for an informed choice, as defined in section 
         256B.77, subdivision 2, 113.2paragraph (p), of service and support providers.113.3(b) In developing the comprehensive transitional service plan, the individual 113.4receiving services, the case manager, and the guardian, if applicable, will identify 113.5the transitional service plan fundamental service outcome and anticipated timeline to 113.6achieve this outcome. Within the first 20 days following a recipient's request for an 113.7assessment or reassessment, the transitional service planning team must be identified. A 113.8team leader must be identified who will be responsible for assigning responsibility and 113.9communicating with team members to ensure implementation of the transition plan and 113.10ongoing assessment and communication process. The team leader should be an individual, 113.11such as the case manager or guardian, who has the opportunity to follow the recipient to 113.12the next level of service.113.13Within ten days following an assessment, a comprehensive transitional service plan 113.14must be developed incorporating elements of a comprehensive functional assessment and 113.15including short-term measurable outcomes and timelines for achievement of and reporting 113.16on these outcomes. Functional milestones must also be identified and reported according 113.17to the timelines agreed upon by the transitional service planning team. In addition, the 113.18comprehensive transitional service plan must identify additional supports that may assist 113.19in the achievement of the fundamental service outcome such as the development of greater 113.20natural community support, increased collaboration among agencies, and technological 113.21supports.113.22The timelines for reporting on functional milestones will prompt a reassessment of 113.23services provided, the units of services, rates, and appropriate service providers. It is 113.24the responsibility of the transitional service planning team leader to review functional 113.25milestone reporting to determine if the milestones are consistent with observable skills 113.26and that milestone achievement prompts any needed changes to the comprehensive 113.27transitional service plan.113.28For those whose fundamental transitional service outcome involves the need to 113.29procure housing, a plan for the recipient to seek the resources necessary to secure the least 113.30restrictive housing possible should be incorporated into the plan, including employment 113.31and public supports such as housing access and shelter needy funding.113.32(c) Counties and other agencies responsible for funding community placement and 113.33ongoing community supportive services are responsible for the implementation of the 113.34comprehensive transitional service plans. Oversight responsibilities include both ensuring 113.35effective transitional service delivery and efficient utilization of funding resources.114.1(d) Following one year of transitional services, the transitional services planning 114.2team will make a determination as to whether or not the individual receiving services 114.3requires the current level of continuous and consistent support in order to maintain the 114.4recipient's current level of functioning. Recipients who are determined to have not had 114.5a significant change in functioning for 12 months must move from a transitional to a 114.6maintenance service plan. Recipients on a maintenance service plan must be reassessed 114.7to determine if the recipient would benefit from a transitional service plan at least every 114.812 months and at other times when there has been a significant change in the recipient's 114.9functioning. This assessment should consider any changes to technological or natural 114.10community supports.114.11(e) When a county is evaluating denials, reductions, or terminations of home and 114.12community-based services under section 
         256B.49 for an individual, the case manager 114.13shall offer to meet with the individual or the individual's guardian in order to discuss the 114.14prioritization of service needs within the individualized service plan, comprehensive 114.15transitional service plan, or maintenance service plan. The reduction in the authorized 114.16services for an individual due to changes in funding for waivered services may not exceed 114.17the amount needed to ensure medically necessary services to meet the individual's health, 114.18safety, and welfare.114.19(f) At the time of reassessment, local agency case managers shall assess each 114.20recipient of community alternatives for disabled individuals or traumatic brain injury 114.21waivered services currently residing in a licensed adult foster home that is not the primary 114.22residence of the license holder, or in which the license holder is not the primary caregiver, 114.23to determine if that recipient could appropriately be served in a community-living setting. 114.24If appropriate for the recipient, the case manager shall offer the recipient, through a 114.25person-centered planning process, the option to receive alternative housing and service 114.26options. In the event that the recipient chooses to transfer from the adult foster home, 114.27the vacated bed shall not be filled with another recipient of waiver services and group 114.28residential housing, unlessand the licensed capacity shall be reduced accordingly, unless 114.29the savings required by the licensed bed closure reductions under Laws 2011, First Special 114.30Session chapter 9, article 7, sections 1 and 40, paragraph (f), for foster care settings where 114.31the physical location is not the primary residence of the license holder are met through 114.32voluntary changes described in section 245A.03, subdivision 7, paragraph (g), or as 114.33provided under section 245A.03, subdivision 7, paragraph (a), clauses (3) and (4), and the 114.34licensed capacity shall be reduced accordingly. If the adult foster home becomes no longer 114.35viable due to these transfers, the county agency, with the assistance of the department, 115.1shall facilitate a consolidation of settings or closure. This reassessment process shall be 115.2completed by June 30, 2012 July 1, 2013.115.3    Sec. 36. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 23, 115.4is amended to read:115.5    Subd. 23. Community-living settings. "Community-living settings" means a 115.6single-family home or apartment where the service recipient or their family owns or rents, 115.7as demonstrated by a lease agreement, and maintains control over the individual unit as 115.8demonstrated by the lease agreement, or has a plan for transition of a lease from a service 115.9provider to the individual. Within two years of signing the initial lease, the service provider 115.10shall transfer the lease to the individual. In the event the landlord denies the transfer, the 115.11commissioner may approve an exception within sufficient time to ensure the continued 115.12occupancy by the individual. Community-living settings are subject to the following:115.13(1) individuals are not required to receive services;115.14(2) individuals are not required to have a disability or specific diagnosis to live 115.15in the community-living setting;115.16(3) individuals may hire service providers of their choice;115.17(4) individuals may choose whether to share their household and with whom;115.18(5) the home or apartment must include living, sleeping, bathing, and cooking areas;115.19(6) individuals must have lockable access and egress;115.20(7) individuals must be free to receive visitors and leave the settings at times and for 115.21durations of their own choosing;115.22(8) leases must not reserve the right to assign units or change unit assignments; and115.23(9) access to the greater community must be easily facilitated based on the 115.24individual's needs and preferences.115.25    Sec. 37. [256B.492] HOME AND COMMUNITY-BASED SETTINGS FOR 115.26PEOPLE WITH DISABILITIES.115.27(a) Individuals receiving services under a home and community-based waiver under 115.28Minnesota Statutes, section 256B.092 or 256B.49, may receive services in the following 115.29settings:115.30(1) an individual's own home or family home;115.31(2) a licensed adult foster care setting of up to five people; and115.32(3) community living settings as defined in Minnesota Statutes, section 256B.49, 115.33subdivision 23, where individuals with disabilities may reside in all of the units in a 116.1building of four or fewer units, and no more than the greater of four or 25 percent of the 116.2units in a multifamily building of more than four units.116.3(b) The settings in paragraph (a) must not:116.4(1) be located in a building that is a publicly or privately operated facility that 116.5provides institutional treatment or custodial care;116.6(2) be located in a building on the grounds of or adjacent to a public or private 116.7institution;116.8(3) be a housing complex designed expressly around an individual's diagnosis or 116.9disability;116.10(4) be segregated based on a disability, either physically or because of setting 116.11characteristics, from the larger community; and116.12(5) have the qualities of an institution which include, but are not limited to: 116.13regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions 116.14agreed to and documented in the person's individual service plan shall not result in a 116.15residence having the qualities of an institution as long as the restrictions for the person are 116.16not imposed upon others in the same residence and are the least restrictive alternative, 116.17imposed for the shortest possible time to meet the person's needs.116.18(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which 116.19individuals receive services under a home and community-based waiver as of the effective 116.20date of this section and the setting does not meet the criteria of this section.116.21(d) Notwithstanding paragraph (c), a program in Hennepin County established as 116.22part of a Hennepin County demonstration project is qualified for the exception allowed 116.23under paragraph (c).116.24(e) The commissioner shall submit an amendment to the waiver plan no later than 116.25December 31, 2012.116.26    Sec. 38. [256B.493] ADULT FOSTER CARE PLANNED CLOSURE.116.27    Subdivision 1.Commissioner's duties; report.The commissioner of human 116.28services shall solicit proposals for the conversion of services provided for persons with 116.29disabilities in settings licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, to 116.30other types of community settings in conjunction with the closure of identified licensed 116.31adult foster care settings.116.32    Subd. 2.Planned closure process needs determination.The commissioner shall 116.33announce and implement a program for planned closure of adult foster care homes. 116.34Planned closure shall be the preferred method for achieving necessary budgetary savings 116.35required by the licensed bed closure budget reduction in section 245A.03, subdivision 7, 117.1paragraph (e). If additional closures are required to achieve the necessary savings, the 117.2commissioner shall use the process and priorities in section 245A.03, subdivision 7, 117.3paragraph (e).117.4    Subd. 3.Application process.(a) The commissioner shall establish a process for 117.5the application, review, and approval of proposals from license holders for the closure of 117.6adult foster care settings.117.7(b) When an application for a planned closure rate adjustment is submitted, the 117.8license holder shall provide written notification within five working days to the lead 117.9agencies responsible for authorizing the licensed services for the residents of the affected 117.10adult foster care settings. This notification shall be deemed confidential until the license 117.11holder has received approval of the application by the commissioner.117.12    Subd. 4.Review and approval process.(a) To be considered for approval, an 117.13application must include:117.14(1) a description of the proposed closure plan, which must identify the home or 117.15homes, and occupied beds for which a planned closure rate adjustment is requested;117.16(2) the proposed timetable for any proposed closure, including the proposed dates 117.17for notification to residents and the affected lead agencies, commencement of closure, 117.18and completion of closure;117.19(3) the proposed relocation plan jointly developed by the counties of financial 117.20responsibility, the residents and their legal representatives, if any, who wish to continue to 117.21receive services from the provider, and the providers for current residents of any adult 117.22foster care home designated for closure; and117.23(4) documentation in a format approved by the commissioner that all the adult foster 117.24care homes receiving a planned closure rate adjustment under the plan have accepted joint 117.25and several liability for recovery of overpayments under section 256B.0641, subdivision 117.262, for the facilities designated for closure under this plan.117.27(b) In reviewing and approving closure proposals, the commissioner shall give first 117.28priority to proposals that:117.29(1) target counties and geographic areas which have:117.30(i) need for other types of services;117.31(ii) need for specialized services;117.32(iii) higher than average per capita use of foster care settings where the license 117.33holder does not reside; or117.34(iv) residents not living in the geographic area of their choice;117.35(2) demonstrate savings of medical assistance expenditures; and118.1(3) demonstrate that alternative services are based on the recipient's choice of 118.2provider and are consistent with federal law, state law, and federally approved waiver 118.3plans.118.4The commissioner shall also consider any information provided by service 118.5recipients, their legal representatives, family members, or the lead agency on the impact of 118.6the planned closure on the recipients and the services they need.118.7(c) The commissioner shall select proposals that best meet the criteria established in 118.8this subdivision for planned closure of adult foster care settings. The commissioner shall 118.9notify license holders of the selections approved by the commissioner.118.10(d) For each proposal approved by the commissioner, a contract must be established 118.11between the commissioner, the counties of financial responsibility, and the participating 118.12license holder.118.13    Subd. 5.Notification of approved proposal.(a) Once the license holder receives 118.14notification from the commissioner that the proposal has been approved, the license holder 118.15shall provide written notification within five working days to:118.16(1) the lead agencies responsible for authorizing the licensed services for the 118.17residents of the affected adult foster care settings; and118.18(2) current and prospective residents, any legal representatives, and family members 118.19involved.118.20(b) This notification must occur at least 45 days prior to the implementation of 118.21the closure proposal.118.22    Subd. 6.Adjustment to rates.(a) For purposes of this section, the commissioner 118.23shall establish enhanced medical assistance payment rates under sections 256B.092 and 118.24256B.49, to facilitate an orderly transition for persons with disabilities from adult foster 118.25care to other community-based settings.118.26(b) The enhanced payment rate shall be effective the day after the first resident has 118.27moved until the day the last resident has moved, not to exceed six months.118.28    Sec. 39. Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13, 118.29is amended to read:118.30    Subd. 13. ICF/DD rate decrease effective July 1, 2012 2013. Notwithstanding 118.31subdivision 12, and if the commissioner has not received federal approval before July 1, 118.322013, of the Long-Term Care Realignment Waiver application submitted under Laws 118.332011, First Special Session chapter 9, article 7, section 52, or only receives approval to 118.34implement portions of the waiver request, for each facility reimbursed under this section 118.35for services provided from July 1, 2013, through December 31, 2013, the commissioner 119.1shall decrease operating payments equal up to 1.67 percent of the operating payment rates 119.2in effect on June 30, 2012 2013. The commissioner shall prorate the reduction in the 119.3event that only portions of the waiver request are approved and after application of the 119.4continuing care provider payment delay provision in article 6, section 2, subdivision 4, 119.5paragraph (f). For each facility, the commissioner shall apply the rate reduction based on 119.6occupied beds, using the percentage specified in this subdivision multiplied by the total 119.7payment rate, including the variable rate but excluding the property-related payment rate, 119.8in effect on the preceding date. The total rate reduction shall include the adjustment 119.9provided in section 
         256B.501, subdivision 12.119.10    Sec. 40. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:119.11    Subd. 5. Special needs. In addition to the state standards of assistance established in 119.12subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 119.13Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 119.14center, or a group residential housing facility.119.15    (a) The county agency shall pay a monthly allowance for medically prescribed 119.16diets if the cost of those additional dietary needs cannot be met through some other 119.17maintenance benefit. The need for special diets or dietary items must be prescribed by 119.18a licensed physician. Costs for special diets shall be determined as percentages of the 119.19allotment for a one-person household under the thrifty food plan as defined by the United 119.20States Department of Agriculture. The types of diets and the percentages of the thrifty 119.21food plan that are covered are as follows:119.22    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;119.23    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 119.24of thrifty food plan;119.25    (3) controlled protein diet, less than 40 grams and requires special products, 125 119.26percent of thrifty food plan;119.27    (4) low cholesterol diet, 25 percent of thrifty food plan;119.28    (5) high residue diet, 20 percent of thrifty food plan;119.29    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;119.30    (7) gluten-free diet, 25 percent of thrifty food plan;119.31    (8) lactose-free diet, 25 percent of thrifty food plan;119.32    (9) antidumping diet, 15 percent of thrifty food plan;119.33    (10) hypoglycemic diet, 15 percent of thrifty food plan; or119.34    (11) ketogenic diet, 25 percent of thrifty food plan.120.1    (b) Payment for nonrecurring special needs must be allowed for necessary home 120.2repairs or necessary repairs or replacement of household furniture and appliances using 120.3the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 120.4as long as other funding sources are not available.120.5    (c) A fee for guardian or conservator service is allowed at a reasonable rate 120.6negotiated by the county or approved by the court. This rate shall not exceed five percent 120.7of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 120.8guardian or conservator is a member of the county agency staff, no fee is allowed.120.9    (d) The county agency shall continue to pay a monthly allowance of $68 for 120.10restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 120.111990, and who eats two or more meals in a restaurant daily. The allowance must continue 120.12until the person has not received Minnesota supplemental aid for one full calendar month 120.13or until the person's living arrangement changes and the person no longer meets the criteria 120.14for the restaurant meal allowance, whichever occurs first.120.15    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 120.16is allowed for representative payee services provided by an agency that meets the 120.17requirements under SSI regulations to charge a fee for representative payee services. This 120.18special need is available to all recipients of Minnesota supplemental aid regardless of 120.19their living arrangement.120.20    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the 120.21maximum allotment authorized by the federal Food Stamp Program for a single individual 120.22which is in effect on the first day of July of each year will be added to the standards of 120.23assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 120.24as shelter needy and are: (i) relocating from an institution, or an adult mental health 120.25residential treatment program under section 
         256B.0622; (ii) eligible for the self-directed 120.26supports option as defined under section 
         256B.0657, subdivision 2; or (iii) home and 120.27community-based waiver recipients living in their own home or rented or leased apartment 120.28which is not owned, operated, or controlled by a provider of service not related by blood 120.29or marriage, unless allowed under paragraph (g).120.30    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 120.31shelter needy benefit under this paragraph is considered a household of one. An eligible 120.32individual who receives this benefit prior to age 65 may continue to receive the benefit 120.33after the age of 65.120.34    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 120.35exceed 40 percent of the assistance unit's gross income before the application of this 120.36special needs standard. "Gross income" for the purposes of this section is the applicant's or 121.1recipient's income as defined in section 
         256D.35, subdivision 10, or the standard specified 121.2in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 121.3state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 121.4considered shelter needy for purposes of this paragraph.121.5(g) Notwithstanding this subdivision, to access housing and services as provided 121.6in paragraph (f), the recipient may choose housing that may be owned, operated, or 121.7controlled by the recipient's service provider. In a multifamily building of four or more 121.8units, the maximum number of apartments that may be used by recipients of this program 121.9shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. of 121.10more than four units, the maximum number of units that may be used by recipients of this 121.11program shall be the greater of four units of 25 percent of the units in the building. In 121.12multifamily buildings of four or fewer units, all of the units may be used by recipients 121.13of this program. When housing is controlled by the service provider, the individual may 121.14choose their own service provider as provided in section 256B.49, subdivision 23, clause 121.15(3). When the housing is controlled by the service provider, the service provider shall 121.16implement a plan with the recipient to transition the lease to the recipient's name. Within 121.17two years of signing the initial lease, the service provider shall transfer the lease entered 121.18into under this subdivision to the recipient. In the event the landlord denies this transfer, 121.19the commissioner may approve an exception within sufficient time to ensure the continued 121.20occupancy by the recipient. This paragraph expires June 30, 2016.121.21    Sec. 41. Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to 121.22read:121.23    Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.121.24The commissioner shall seek any necessary federal approval in order to implement 121.25the changes to the level of care criteria in Minnesota Statutes, section 
         144.0724, 121.26subdivision 11
         , on or after July 1, 2012, for adults and children.121.27EFFECTIVE DATE.This section is effective the day following final enactment.121.28    Sec. 42. Laws 2011, First Special Session chapter 9, article 7, section 54, is amended to 121.29read:121.30    Sec. 54. CONTINGENCY PROVIDER RATE AND GRANT REDUCTIONS.121.31(a) Notwithstanding any other rate reduction in this article, if the commissioner of 121.32human services has not received federal approval before July 1, 2013, of the long-term 121.33care realignment waiver application submitted under Laws 2011, First Special Session 121.34chapter 9, article 7, section 52, or only receives approval to implement portions of the 122.1waiver request, the commissioner of human services shall decrease grants, allocations, 122.2reimbursement rates, individual limits, and rate limits, as applicable, by 1.67 percent 122.3effective July 1, 2012 2013, for services rendered on or after those dates from July 1, 122.42013, through December 31, 2013. The commissioner shall prorate the reduction in the 122.5event that only portions of the waiver request are approved and after application of the 122.6continuing care provider payment delay provision in article 6, section 2, subdivision 4, 122.7paragraph (f). County or tribal contracts for services specified in this section must be 122.8amended to pass through these rate reductions within 60 days of the effective date of the 122.9decrease, and must be retroactive from the effective date of the rate decrease.122.10(b) The rate changes described in this section must be provided to:122.11(1) home and community-based waivered services for persons with developmental 122.12disabilities or related conditions, including consumer-directed community supports, under 122.13Minnesota Statutes, section 
         256B.501;122.14(2) home and community-based waivered services for the elderly, including 122.15consumer-directed community supports, under Minnesota Statutes, section 
         256B.0915;122.16(3) waivered services under community alternatives for disabled individuals, 122.17including consumer-directed community supports, under Minnesota Statutes, section 122.18256B.49
         ;122.19(4) community alternative care waivered services, including consumer-directed 122.20community supports, under Minnesota Statutes, section 
         256B.49;122.21(5) traumatic brain injury waivered services, including consumer-directed 122.22community supports, under Minnesota Statutes, section 
         256B.49;122.23(6) nursing services and home health services under Minnesota Statutes, section 122.24256B.0625, subdivision 6a
         ;122.25(7) personal care services and qualified professional supervision of personal care 122.26services under Minnesota Statutes, section 
         256B.0625, subdivisions 6a and 19a;122.27(8) private duty nursing services under Minnesota Statutes, section 
         256B.0625, 122.28subdivision 7
         ;122.29(9) day training and habilitation services for adults with developmental disabilities 122.30or related conditions, under Minnesota Statutes, sections 
         252.40 to 
         252.46, including the 122.31additional cost of rate adjustments on day training and habilitation services, provided as a 122.32social service under Minnesota Statutes, section 
         256M.60; and122.33(10) alternative care services under Minnesota Statutes, section 
         256B.0913.122.34(c) A managed care plan receiving state payments for the services in this section 122.35must include these decreases in their payments to providers. To implement the rate 122.36reductions in this section, capitation rates paid by the commissioner to managed care 123.1organizations under Minnesota Statutes, section 
         256B.69, shall reflect up to a 2.34 1.67123.2percent reduction for the specified services for the period of January 1, 2013, through 123.3June 30, 2013, and a 1.67 percent reduction for those services on and after July 1 July 1, 123.42013, through December 31, 2013.123.5The above payment rate reduction, allocation rates, and rate limits shall expire for 123.6services rendered on December 31, 2013.123.7    Sec. 43. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 123.83, is amended to read:

123.9Subd. 3.Forecasted Programs

123.10The amounts that may be spent from this 123.11appropriation for each purpose are as follows:

123.12(a) MFIP/DWP Grants

123.13Appropriations by Fund123.14General84,680,00091,978,000123.15Federal TANF84,425,00075,417,000

123.16(b) MFIP Child Care Assistance Grants55,456,00030,923,000

123.17(c) General Assistance Grants49,192,00046,938,000

123.18General Assistance Standard. The 123.19commissioner shall set the monthly standard 123.20of assistance for general assistance units 123.21consisting of an adult recipient who is 123.22childless and unmarried or living apart 123.23from parents or a legal guardian at $203. 123.24The commissioner may reduce this amount 123.25according to Laws 1997, chapter 85, article 123.263, section 54.123.27Emergency General Assistance. The 123.28amount appropriated for emergency general 123.29assistance funds is limited to no more 123.30than $6,689,812 in fiscal year 2012 and 123.31$6,729,812 in fiscal year 2013. Funds 123.32to counties shall be allocated by the 123.33commissioner using the allocation method 124.1specified in Minnesota Statutes, section 124.2256D.06
         .

124.3(d) Minnesota Supplemental Aid Grants38,095,00039,120,000

124.4(e) Group Residential Housing Grants121,080,000129,238,000

124.5(f) MinnesotaCare Grants295,046,000317,272,000

124.6This appropriation is from the health care 124.7access fund.

124.8(g) Medical Assistance Grants4,501,582,0004,437,282,000

124.9Managed Care Incentive Payments. The 124.10commissioner shall not make managed care 124.11incentive payments for expanding preventive 124.12services during fiscal years beginning July 1, 124.132011, and July 1, 2012.124.14Reduction of Rates for Congregate 124.15Living for Individuals with Lower Needs. 124.16Beginning October 1, 2011, lead agencies 124.17must reduce rates in effect on January 1, 124.182011, by ten percent for individuals with 124.19lower needs living in foster care settings 124.20where the license holder does not share the 124.21residence with recipients on the CADI and 124.22DD waivers and customized living settings 124.23for CADI. Lead agencies shall consult 124.24with providers to review individual service 124.25plans and identify changes or modifications 124.26to reduce the utilization of services while 124.27maintaining the health and safety of the 124.28individual receiving services. Lead agencies 124.29must adjust contracts within 60 days of the 124.30effective date. If federal waiver approval 124.31is obtained under the long-term care 124.32realignment waiver application submitted 124.33on February 13, 2012, and federal financial 124.34participation is authorized for the alternative 125.1care program, the commissioner shall adjust 125.2this payment rate reduction from ten to five 125.3percent for services rendered on or after 125.4July 1, 2012, or the first day of the month 125.5following federal approval, whichever is 125.6later.125.7Reduction of Lead Agency Waiver 125.8Allocations to Implement Rate Reductions 125.9for Congregate Living for Individuals 125.10with Lower Needs. Beginning October 1, 125.112011, the commissioner shall reduce lead 125.12agency waiver allocations to implement the 125.13reduction of rates for individuals with lower 125.14needs living in foster care settings where the 125.15license holder does not share the residence 125.16with recipients on the CADI and DD waivers 125.17and customized living settings for CADI.125.18Reduce customized living and 24-hour 125.19customized living component rates.125.20Effective July 1, 2011, the commissioner 125.21shall reduce elderly waiver customized living 125.22and 24-hour customized living component 125.23service spending by five percent through 125.24reductions in component rates and service 125.25rate limits. The commissioner shall adjust 125.26the elderly waiver capitation payment 125.27rates for managed care organizations paid 125.28under Minnesota Statutes, section 
         256B.69, 125.29subdivisions 6a
          and 23, to reflect reductions 125.30in component spending for customized living 125.31services and 24-hour customized living 125.32services under Minnesota Statutes, section 125.33256B.0915, subdivisions 3e
          and 3h, for the 125.34contract period beginning January 1, 2012. 125.35To implement the reduction specified in 125.36this provision, capitation rates paid by the 126.1commissioner to managed care organizations 126.2under Minnesota Statutes, section 
         256B.69, 126.3shall reflect a ten percent reduction for the 126.4specified services for the period January 1, 126.52012, to June 30, 2012, and a five percent 126.6reduction for those services on or after July 126.71, 2012.126.8Limit Growth in the Developmental 126.9Disability Waiver. The commissioner 126.10shall limit growth in the developmental 126.11disability waiver to six diversion allocations 126.12per month beginning July 1, 2011, through 126.13June 30, 2013, and 15 diversion allocations 126.14per month beginning July 1, 2013, through 126.15June 30, 2015. Waiver allocations shall 126.16be targeted to individuals who meet the 126.17priorities for accessing waiver services 126.18identified in Minnesota Statutes, 
         256B.092, 126.19subdivision 12
         . The limits do not include 126.20conversions from intermediate care facilities 126.21for persons with developmental disabilities. 126.22Notwithstanding any contrary provisions in 126.23this article, this paragraph expires June 30, 126.242015.126.25Limit Growth in the Community 126.26Alternatives for Disabled Individuals 126.27Waiver. The commissioner shall limit 126.28growth in the community alternatives for 126.29disabled individuals waiver to 60 allocations 126.30per month beginning July 1, 2011, through 126.31June 30, 2013, and 85 allocations per 126.32month beginning July 1, 2013, through 126.33June 30, 2015. Waiver allocations must 126.34be targeted to individuals who meet the 126.35priorities for accessing waiver services 126.36identified in Minnesota Statutes, section 127.1256B.49, subdivision 11a
         . The limits include 127.2conversions and diversions, unless the 127.3commissioner has approved a plan to convert 127.4funding due to the closure or downsizing 127.5of a residential facility or nursing facility 127.6to serve directly affected individuals on 127.7the community alternatives for disabled 127.8individuals waiver. Notwithstanding any 127.9contrary provisions in this article, this 127.10paragraph expires June 30, 2015.127.11Personal Care Assistance Relative 127.12Care. The commissioner shall adjust the 127.13capitation payment rates for managed care 127.14organizations paid under Minnesota Statutes, 127.15section 
         256B.69, to reflect the rate reductions 127.16for personal care assistance provided by 127.17a relative pursuant to Minnesota Statutes, 127.18section 
         256B.0659, subdivision 11. This rate 127.19reduction is effective July 1, 2013.

127.20(h) Alternative Care Grants46,421,00046,035,000

127.21Alternative Care Transfer. Any money 127.22allocated to the alternative care program that 127.23is not spent for the purposes indicated does 127.24not cancel but shall be transferred to the 127.25medical assistance account.

127.26(i) Chemical Dependency Entitlement Grants94,675,00093,298,000

127.27    Sec. 44. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 127.284, is amended to read:

127.29Subd. 4.Grant Programs

127.30The amounts that may be spent from this 127.31appropriation for each purpose are as follows:

127.32(a) Support Services Grants

128.1Appropriations by Fund128.2General8,715,0008,715,000128.3Federal TANF100,525,00094,611,000

128.4MFIP Consolidated Fund Grants. The 128.5TANF fund base is reduced by $10,000,000 128.6each year beginning in fiscal year 2012.128.7Subsidized Employment Funding Through 128.8ARRA. The commissioner is authorized to 128.9apply for TANF emergency fund grants for 128.10subsidized employment activities. Growth 128.11in expenditures for subsidized employment 128.12within the supported work program and the 128.13MFIP consolidated fund over the amount 128.14expended in the calendar year quarters in 128.15the TANF emergency fund base year shall 128.16be used to leverage the TANF emergency 128.17fund grants for subsidized employment and 128.18to fund supported work. The commissioner 128.19shall develop procedures to maximize 128.20reimbursement of these expenditures over the 128.21TANF emergency fund base year quarters, 128.22and may contract directly with employers 128.23and providers to maximize these TANF 128.24emergency fund grants.

128.25128.26(b) Basic Sliding Fee Child Care Assistance Grants37,144,00038,678,000

128.27Base Adjustment. The general fund base is 128.28decreased by $990,000 in fiscal year 2014 128.29and $979,000 in fiscal year 2015.128.30Child Care and Development Fund 128.31Unexpended Balance. In addition to 128.32the amount provided in this section, the 128.33commissioner shall expend $5,000,000 128.34in fiscal year 2012 from the federal child 128.35care and development fund unexpended 129.1balance for basic sliding fee child care under 129.2Minnesota Statutes, section 
         119B.03. The 129.3commissioner shall ensure that all child 129.4care and development funds are expended 129.5according to the federal child care and 129.6development fund regulations.

129.7(c) Child Care Development Grants774,000774,000

129.8Base Adjustment. The general fund base is 129.9increased by $713,000 in fiscal years 2014 129.10and 2015.

129.11(d) Child Support Enforcement Grants50,00050,000

129.12Federal Child Support Demonstration 129.13Grants. Federal administrative 129.14reimbursement resulting from the federal 129.15child support grant expenditures authorized 129.16under section 1115a of the Social Security 129.17Act is appropriated to the commissioner for 129.18this activity.

129.19(e) Children's Services Grants

129.20Appropriations by Fund129.21General47,949,00048,507,000129.22Federal TANF140,000140,000

129.23Adoption Assistance and Relative Custody 129.24Assistance Transfer. The commissioner 129.25may transfer unencumbered appropriation 129.26balances for adoption assistance and relative 129.27custody assistance between fiscal years and 129.28between programs.129.29Privatized Adoption Grants. Federal 129.30reimbursement for privatized adoption grant 129.31and foster care recruitment grant expenditures 129.32is appropriated to the commissioner for 129.33adoption grants and foster care and adoption 129.34administrative purposes.130.1Adoption Assistance Incentive Grants.130.2Federal funds available during fiscal year 130.32012 and fiscal year 2013 for adoption 130.4incentive grants are appropriated to the 130.5commissioner for these purposes.

130.6(f) Children and Community Services Grants53,301,00053,301,000

130.7(g) Children and Economic Support Grants

130.8Appropriations by Fund130.9General16,103,00016,180,000130.10Federal TANF700,0000

130.11Long-Term Homeless Services. $700,000 130.12is appropriated from the federal TANF 130.13fund for the biennium beginning July 130.141, 2011, to the commissioner of human 130.15services for long-term homeless services 130.16for low-income homeless families under 130.17Minnesota Statutes, section 
         256K.26. This 130.18is a onetime appropriation and is not added 130.19to the base.130.20Base Adjustment. The general fund base is 130.21increased by $42,000 in fiscal year 2014 and 130.22$43,000 in fiscal year 2015.130.23Minnesota Food Assistance Program. 130.24$333,000 in fiscal year 2012 and $408,000 in 130.25fiscal year 2013 are to increase the general 130.26fund base for the Minnesota food assistance 130.27program. Unexpended funds for fiscal year 130.282012 do not cancel but are available to the 130.29commissioner for this purpose in fiscal year 130.302013.

130.31(h) Health Care Grants

130.32Appropriations by Fund130.33General26,00066,000130.34Health Care Access190,000190,000

131.1Base Adjustment. The general fund base is 131.2increased by $24,000 in each of fiscal years 131.32014 and 2015.

131.4(i) Aging and Adult Services Grants12,154,00011,456,000

131.5Aging Grants Reduction. Effective July 131.61, 2011, funding for grants made under 131.7Minnesota Statutes, sections 
         256.9754 and 131.8256B.0917, subdivision 13
         , is reduced by 131.9$3,600,000 for each year of the biennium. 131.10These reductions are onetime and do 131.11not affect base funding for the 2014-2015 131.12biennium. Grants made during the 2012-2013 131.13biennium under Minnesota Statutes, section 131.14256B.9754
         , must not be used for new 131.15construction or building renovation.131.16Essential Community Support Grant 131.17Delay. Upon federal approval to implement 131.18the nursing facility level of care on July 131.191, 2013, essential community supports 131.20grants under Minnesota Statutes, section 131.21256B.0917, subdivision 14
         , are reduced by 131.22$6,410,000 in fiscal year 2013. Base level 131.23funding is increased by $5,541,000 in fiscal 131.24year 2014 and $6,410,000 in fiscal year 2015.131.25Base Level Adjustment. The general fund 131.26base is increased by $10,035,000 in fiscal 131.27year 2014 and increased by $10,901,000 in 131.28fiscal year 2015.

131.29(j) Deaf and Hard-of-Hearing Grants1,936,0001,767,000

131.30(k) Disabilities Grants15,945,00018,284,000

131.31Grants for Housing Access Services. In 131.32fiscal year 2012, the commissioner shall 131.33make available a total of $161,000 in housing 131.34access services grants to individuals who 132.1relocate from an adult foster care home to 132.2a community living setting for assistance 132.3with completion of rental applications or 132.4lease agreements; assistance with publicly 132.5financed housing options; development of 132.6household budgets; and assistance with 132.7funding affordable furnishings and related 132.8household matters.132.9HIV Grants. The general fund appropriation 132.10for the HIV drug and insurance grant 132.11program shall be reduced by $2,425,000 in 132.12fiscal year 2012 and increased by $2,425,000 132.13in fiscal year 2014. These adjustments are 132.14onetime and shall not be applied to the base. 132.15Notwithstanding any contrary provision, this 132.16provision expires June 30, 2014.132.17Region 10. Of this appropriation, $100,000 132.18each year is for a grant provided under 132.19Minnesota Statutes, section 
         256B.097.132.20Base Level Adjustment. The general fund 132.21base is increased by $2,944,000 in fiscal year 132.222014 and $653,000 in fiscal year 2015.132.23Local Planning Grants for Creating 132.24Alternatives to Congregate Living for 132.25Individuals with Lower Needs. (1) The 132.26commissioner shall make available a total 132.27of $250,000 per year in local planning 132.28grants, beginning July 1, 2011, to assist 132.29lead agencies and provider organizations in 132.30developing alternatives to congregate living 132.31within the available level of resources for the 132.32home and community-based services waivers 132.33for persons with disabilities.132.34(2) Notwithstanding clause (1), for fiscal 132.35years 2012 and 2013 only, the appropriation 133.1of $250,000 for fiscal year 2012 carries 133.2forward to fiscal year 2013, effective the day 133.3following final enactment.133.4Of the appropriations available for fiscal 133.5year 2013, $100,000 is for administrative 133.6functions related to the planning process 133.7required under Minnesota Statutes, sections 133.8144A.351 and 245A.03, subdivision 7, 133.9paragraphs (e) and (g), and $400,000 is for 133.10grants required to accomplish that planning 133.11process.133.12(3) Base funding for the grants under clause 133.13(1) is not affected by the appropriations 133.14under clause (2).133.15Disability Linkage Line. Of this 133.16appropriation, $125,000 in fiscal year 2012 133.17and $300,000 in fiscal year 2013 are for 133.18assistance to people with disabilities who are 133.19considering enrolling in managed care.

133.20(l) Adult Mental Health Grants

133.21Appropriations by Fund133.22General70,570,00070,570,000133.23Health Care Access750,000750,000133.24Lottery Prize1,508,0001,508,000

133.25Funding Usage. Up to 75 percent of a fiscal 133.26year's appropriation for adult mental health 133.27grants may be used to fund allocations in that 133.28portion of the fiscal year ending December 133.2931.133.30Base Adjustment. The general fund base is 133.31increased by $200,000 in fiscal years 2014 133.32and 2015.

133.33(m) Children's Mental Health Grants16,457,00016,457,000

134.1Funding Usage. Up to 75 percent of a fiscal 134.2year's appropriation for children's mental 134.3health grants may be used to fund allocations 134.4in that portion of the fiscal year ending 134.5December 31.134.6Base Adjustment. The general fund base is 134.7increased by $225,000 in fiscal years 2014 134.8and 2015.

134.9134.10(n) Chemical Dependency Nonentitlement Grants1,336,0001,336,000

134.11    Sec. 45. INDEPENDENT LIVING SERVICES BILLING.134.12The commissioner shall allow for daily rate and 15-minute increment billing for 134.13independent living services under the brain injury (BI) and CADI waivers. If necessary to 134.14comply with this requirement, the commissioner shall submit a waiver amendment to the 134.15state plan no later than December 31, 2012.134.16    Sec. 46. HOME AND COMMUNITY-BASED SERVICES WAIVERS 134.17AMENDMENT FOR EXCEPTION.134.18    By September 1, 2012, the commissioner of human services shall submit 134.19amendments to the home and community-based waiver plans consistent with the definition 134.20of home and community-based settings under Minnesota Statutes, section 256B.492, 134.21including a request to allow an exception for those settings that serve persons with 134.22disabilities under a home and community-based service waiver in more than 25 percent 134.23of the units in a building as of January 1, 2012, but otherwise meet the definition under 134.24Minnesota Statutes, section 256B.492.134.25    Sec. 47. COMMISSIONER TO SEEK AMENDMENT FOR EXCEPTION 134.26TO CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET 134.27METHODOLOGY.134.28By July 1, 2012, the commissioner shall request an amendment to the home and 134.29community-based services waivers authorized under Minnesota Statutes, sections 134.30256B.092 and 256B.49, to establish an exception to the consumer-directed community 134.31supports budget methodology to provide up to 20 percent more funds for those 134.32participants who have their 21st birthday and graduate from high school during 2013 and 134.33are authorized for more services under consumer-directed community supports prior to 135.1graduation than what they are eligible to receive under the current consumer-directed 135.2community supports budget methodology. The exception is limited to those who can 135.3demonstrate that they will have to leave consumer-directed community supports and use 135.4other waiver services because their need for day or employment supports cannot be met 135.5within the consumer-directed community supports budget limits. The commissioner 135.6shall consult with the stakeholder group authorized under Minnesota Statutes, section 135.7256B.0657, subdivision 11, to implement this provision. The exception process shall be 135.8effective upon federal approval for persons eligible during 2013 and 2014.135.9EFFECTIVE DATE.This section is effective the day following final enactment.135.10    Sec. 48. DIRECTION TO OMBUDSMAN FOR LONG-TERM CARE.135.11The ombudsman for long-term care shall:135.12(1) research the existence of differential treatment based on source of payment in 135.13assisted living settings;135.14(2) convene stakeholders to provide technical assistance and expertise in studying 135.15and addressing these issues, including but not limited to consumers, health care and 135.16housing providers, advocates representing seniors and younger persons with disabilities or 135.17mental health challenges, county representatives, and representatives of the Departments 135.18of Health and Human Services; and135.19(3) submit a report of findings to the legislature no later than January 31, 2013, 135.20with recommendations for the development of policies and procedures to prevent and 135.21remedy instances of discrimination based on participation in or potential eligibility for 135.22medical assistance.135.23    Sec. 49. LICENSING PERSONAL CARE ATTENDANT SERVICES.135.24    The commissioner of human services shall study the feasibility of licensing personal 135.25care attendant services and issue a report to the legislature no later than January 15, 2013, 135.26that includes recommendations and proposed legislation for licensure and oversight of 135.27these services.135.28    Sec. 50. AUTISM HOUSING WITH SUPPORTS STUDY.135.29The commissioner of human services, in consultation with the commissioners of 135.30education, health, and employment and economic development, shall complete a study 135.31to determine one or more models of housing with supports that involve coordination or 135.32integration across the human services, educational, and vocational systems for children 135.33with a diagnosis of autistic disorder as defined by diagnostic code 299.0 in the Diagnostic 136.1and Statistical Manual of Mental Disorders (DSM-IV). This study must include research 136.2on recent efforts undertaken or under consideration in other states to address the housing 136.3and long-term support needs of children with severe autism, including a campus model. 136.4The study shall result in an implementation plan that responds to the housing and service 136.5needs of persons with autism. The study is due to the chairs and ranking minority 136.6members of the legislative committees with jurisdiction over health and human services 136.7by January 15, 2013.136.8    Sec. 51. REPEALER.136.9(a) Minnesota Statutes 2010, sections 144A.073, subdivision 9; and 256B.48, 136.10subdivision 6, are repealed.136.11(b) Minnesota Rules, part 4640.0800, subpart 4, is repealed.136.12ARTICLE 5136.13MISCELLANEOUS136.14    Section 1. Minnesota Statutes 2010, section 62A.047, is amended to read:136.1562A.047 CHILDREN'S HEALTH SUPERVISION SERVICES AND 136.16PRENATAL CARE SERVICES.136.17A policy of individual or group health and accident insurance regulated under this 136.18chapter, or individual or group subscriber contract regulated under chapter 62C, health 136.19maintenance contract regulated under chapter 62D, or health benefit certificate regulated 136.20under chapter 64B, issued, renewed, or continued to provide coverage to a Minnesota 136.21resident, must provide coverage for child health supervision services and prenatal care 136.22services. The policy, contract, or certificate must specifically exempt reasonable and 136.23customary charges for child health supervision services and prenatal care services from a 136.24deductible, co-payment, or other coinsurance or dollar limitation requirement. Nothing 136.25in this section prohibits a health carrier that has a network of providers from imposing 136.26a deductible, co-payment, or other coinsurance or dollar limitation requirement for 136.27child health supervision services and prenatal care services that are delivered by an 136.28out-of-network provider. This section does not prohibit the use of policy waiting periods 136.29or preexisting condition limitations for these services. Minimum benefits may be limited 136.30to one visit payable to one provider for all of the services provided at each visit cited in 136.31this section subject to the schedule set forth in this section. Nothing in this section applies 136.32to a commercial health insurance policy issued as a companion to a health maintenance 136.33organization contract, a policy designed primarily to provide coverage payable on a per 136.34diem, fixed indemnity, or nonexpense incurred basis, or a policy that provides only 137.1accident coverage Nothing in this section applies to a policy designed primarily to provide 137.2coverage payable on a per diem, fixed indemnity, or non-expense-incurred basis, or a 137.3policy that provides only accident coverage.137.4"Child health supervision services" means pediatric preventive services, appropriate 137.5immunizations, developmental assessments, and laboratory services appropriate to the age 137.6of a child from birth to age six, and appropriate immunizations from ages six to 18, as 137.7defined by Standards of Child Health Care issued by the American Academy of Pediatrics. 137.8Reimbursement must be made for at least five child health supervision visits from birth 137.9to 12 months, three child health supervision visits from 12 months to 24 months, once a 137.10year from 24 months to 72 months.137.11"Prenatal care services" means the comprehensive package of medical and 137.12psychosocial support provided throughout the pregnancy, including risk assessment, 137.13serial surveillance, prenatal education, and use of specialized skills and technology, 137.14when needed, as defined by Standards for Obstetric-Gynecologic Services issued by the 137.15American College of Obstetricians and Gynecologists.137.16EFFECTIVE DATE.The amendments to this section are effective for policies 137.17issued on or after August 1, 2012, and expire June 30, 2013.137.18    Sec. 2. Minnesota Statutes 2010, section 245.697, subdivision 1, is amended to read:137.19    Subdivision 1. Creation. (a) A State Advisory Council on Mental Health is created. 137.20The council must have 30 members appointed by the governor in accordance with federal 137.21requirements. In making the appointments, the governor shall consider appropriate 137.22representation of communities of color. The council must be composed of:137.23(1) the assistant commissioner of mental health for the department of human services;137.24(2) a representative of the Department of Human Services responsible for the 137.25medical assistance program;137.26(3) one member of each of the four core mental health professional disciplines137.27(psychiatry, psychology, social work, nursing); following professions:137.28(i) psychiatry;137.29(ii) psychology;137.30(iii) social work;137.31(iv) nursing;137.32(v) marriage and family therapy; and137.33(vi) professional clinical counseling;138.1(4) one representative from each of the following advocacy groups: Mental Health 138.2Association of Minnesota, NAMI-MN, Mental Health Consumer/Survivor Network of 138.3Minnesota, and Minnesota Disability Law Center;138.4(5) providers of mental health services;138.5(6) consumers of mental health services;138.6(7) family members of persons with mental illnesses;138.7(8) legislators;138.8(9) social service agency directors;138.9(10) county commissioners; and138.10(11) other members reflecting a broad range of community interests, including 138.11family physicians, or members as the United States Secretary of Health and Human 138.12Services may prescribe by regulation or as may be selected by the governor.138.13(b) The council shall select a chair. Terms, compensation, and removal of members 138.14and filling of vacancies are governed by section 
         15.059. Notwithstanding provisions 138.15of section 
         15.059, the council and its subcommittee on children's mental health do not 138.16expire. The commissioner of human services shall provide staff support and supplies 138.17to the council.138.18    Sec. 3. Minnesota Statutes 2010, section 254A.19, is amended by adding a subdivision 138.19to read:138.20    Subd. 4.Civil commitments.A Rule 25 assessment, under Minnesota Rules, 138.21part 9530.6615, does not need to be completed for an individual being committed as a 138.22chemically dependent person, as defined in section 253B.02, and for the duration of a civil 138.23commitment under section 253B.065, 253B.09, or 253B.095 in order for a county to 138.24access consolidated chemical dependency treatment funds under section 254B.04. The 138.25county must determine if the individual meets the financial eligibility requirements for the 138.26consolidated chemical dependency treatment funds under section 254B.04. Nothing in 138.27this subdivision prohibits placement in a treatment facility or treatment program governed 138.28under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.138.29    Sec. 4. Minnesota Statutes 2010, section 256B.0943, subdivision 9, is amended to read:138.30    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a 138.31certified provider entity must ensure that:138.32    (1) each individual provider's caseload size permits the provider to deliver services 138.33to both clients with severe, complex needs and clients with less intensive needs. The 138.34provider's caseload size should reasonably enable the provider to play an active role in 139.1service planning, monitoring, and delivering services to meet the client's and client's 139.2family's needs, as specified in each client's individual treatment plan;139.3    (2) site-based programs, including day treatment and preschool programs, provide 139.4staffing and facilities to ensure the client's health, safety, and protection of rights, and that 139.5the programs are able to implement each client's individual treatment plan;139.6    (3) a day treatment program is provided to a group of clients by a multidisciplinary 139.7team under the clinical supervision of a mental health professional. The day treatment 139.8program must be provided in and by: (i) an outpatient hospital accredited by the Joint 139.9Commission on Accreditation of Health Organizations and licensed under sections 
         144.50 139.10to 
         144.55; (ii) a community mental health center under section 
         245.62; or (iii) an entity 139.11that is under contract with the county boardcertified under subdivision 4 to operate a 139.12program that meets the requirements of section 
         245.4712, subdivision 2, or245.4884, 139.13subdivision 2
         , and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 139.14program must stabilize the client's mental health status while developing and improving 139.15the client's independent living and socialization skills. The goal of the day treatment 139.16program must be to reduce or relieve the effects of mental illness and provide training to 139.17enable the client to live in the community. The program must be available at least one day 139.18a week for a two-hour time block. The two-hour time block must include at least one hour 139.19of individual or group psychotherapy. The remainder of the structured treatment program 139.20may include individual or group psychotherapy, and individual or group skills training, if 139.21included in the client's individual treatment plan. Day treatment programs are not part of 139.22inpatient or residential treatment services. A day treatment program may provide fewer 139.23than the minimally required hours for a particular child during a billing period in which 139.24the child is transitioning into, or out of, the program; and139.25    (4) a therapeutic preschool program is a structured treatment program offered 139.26to a child who is at least 33 months old, but who has not yet reached the first day of 139.27kindergarten, by a preschool multidisciplinary team in a day program licensed under 139.28Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available two 139.29hours per day, five days per week, and 12 months of each calendar year. The structured 139.30treatment program may include individual or group psychotherapy and individual or 139.31group skills training, if included in the client's individual treatment plan. A therapeutic 139.32preschool program may provide fewer than the minimally required hours for a particular 139.33child during a billing period in which the child is transitioning into, or out of, the program.139.34    (b) A provider entity must deliver the service components of children's therapeutic 139.35services and supports in compliance with the following requirements:140.1    (1) individual, family, and group psychotherapy must be delivered as specified in 140.2Minnesota Rules, part 9505.0323;140.3    (2) individual, family, or group skills training must be provided by a mental health 140.4professional or a mental health practitioner who has a consulting relationship with a 140.5mental health professional who accepts full professional responsibility for the training;140.6    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis 140.7through arrangements for direct intervention and support services to the child and the 140.8child's family. Crisis assistance must utilize resources designed to address abrupt or 140.9substantial changes in the functioning of the child or the child's family as evidenced by 140.10a sudden change in behavior with negative consequences for well being, a loss of usual 140.11coping mechanisms, or the presentation of danger to self or others;140.12    (4) mental health behavioral aide services must be medically necessary treatment 140.13services, identified in the child's individual treatment plan and individual behavior plan, 140.14which are performed minimally by a paraprofessional qualified according to subdivision 140.157, paragraph (b), clause (3), and which are designed to improve the functioning of the 140.16child in the progressive use of developmentally appropriate psychosocial skills. Activities 140.17involve working directly with the child, child-peer groupings, or child-family groupings 140.18to practice, repeat, reintroduce, and master the skills defined in subdivision 1, paragraph 140.19(p), as previously taught by a mental health professional or mental health practitioner 140.20including:140.21(i) providing cues or prompts in skill-building peer-to-peer or parent-child 140.22interactions so that the child progressively recognizes and responds to the cues 140.23independently;140.24(ii) performing as a practice partner or role-play partner;140.25(iii) reinforcing the child's accomplishments;140.26(iv) generalizing skill-building activities in the child's multiple natural settings;140.27(v) assigning further practice activities; and140.28(vi) intervening as necessary to redirect the child's target behavior and to de-escalate 140.29behavior that puts the child or other person at risk of injury.140.30A mental health behavioral aide must document the delivery of services in written 140.31progress notes. The mental health behavioral aide must implement treatment strategies 140.32in the individual treatment plan and the individual behavior plan. The mental health 140.33behavioral aide must document the delivery of services in written progress notes. Progress 140.34notes must reflect implementation of the treatment strategies, as performed by the mental 140.35health behavioral aide and the child's responses to the treatment strategies; and140.36    (5) direction of a mental health behavioral aide must include the following:141.1    (i) a clinical supervision plan approved by the responsible mental health professional;141.2    (ii) ongoing on-site observation by a mental health professional or mental health 141.3practitioner for at least a total of one hour during every 40 hours of service provided 141.4to a child; and141.5    (iii) immediate accessibility of the mental health professional or mental health 141.6practitioner to the mental health behavioral aide during service provision.141.7    Sec. 5. Minnesota Statutes 2010, section 518A.40, subdivision 4, is amended to read:141.8    Subd. 4. Change in child care. (a) When a court order provides for child care 141.9expenses, and child care support is not assigned under section 
         256.741, the public 141.10authority, if the public authority provides child support enforcement services, must may141.11suspend collecting the amount allocated for child care expenses when:141.12    (1) either party informs the public authority that no child care costs are being 141.13incurred; and:141.14    (2) (1) the public authority verifies the accuracy of the information with the obligee.; 141.15or141.16(2) the obligee fails to respond within 30 days of the date of a written request 141.17from the public authority for information regarding child care costs. A written or oral 141.18response from the obligee that child care costs are being incurred is sufficient for the 141.19public authority to continue collecting child care expenses.141.20The suspension is effective as of the first day of the month following the date that the 141.21public authority received the verification either verified the information with the obligee 141.22or the obligee failed to respond. The public authority will resume collecting child care 141.23expenses when either party provides information that child care costs have resumed are 141.24incurred, or when a child care support assignment takes effect under section 
         256.741, 141.25subdivision 4. The resumption is effective as of the first day of the month after the date 141.26that the public authority received the information.141.27    (b) If the parties provide conflicting information to the public authority regarding 141.28whether child care expenses are being incurred, or if the public authority is unable to 141.29verify with the obligee that no child care costs are being incurred, the public authority will 141.30continue or resume collecting child care expenses. Either party, by motion to the court, 141.31may challenge the suspension, continuation, or resumption of the collection of child care 141.32expenses under this subdivision. If the public authority suspends collection activities 141.33for the amount allocated for child care expenses, all other provisions of the court order 141.34remain in effect.142.1    (c) In cases where there is a substantial increase or decrease in child care expenses, 142.2the parties may modify the order under section 
         518A.39.142.3    Sec. 6. Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 8, 142.4is amended to read:

142.5142.6Subd. 8.Board of Nursing Home Administrators2,153,0002,145,000

142.7Rulemaking. Of this appropriation, $44,000 142.8in fiscal year 2012 is for rulemaking. This is 142.9a onetime appropriation.142.10Electronic Licensing System Adaptors.142.11Of this appropriation, $761,000 in fiscal 142.12year 2013 from the state government special 142.13revenue fund is to the administrative services 142.14unit to cover the costs to connect to the 142.15e-licensing system. Minnesota Statutes, 142.16section 
         16E.22. Base level funding for this 142.17activity in fiscal year 2014 shall be $100,000. 142.18Base level funding for this activity in fiscal 142.19year 2015 shall be $50,000.142.20Development and Implementation of a 142.21Disciplinary, Regulatory, Licensing and 142.22Information Management System. Of this 142.23appropriation, $800,000 in fiscal year 2012 142.24and $300,000 in fiscal year 2013 are for the 142.25development of a shared system. Base level 142.26funding for this activity in fiscal year 2014 142.27shall be $50,000.142.28Administrative Services Unit - Operating 142.29Costs. Of this appropriation, $526,000 142.30in fiscal year 2012 and $526,000 in 142.31fiscal year 2013 are for operating costs 142.32of the administrative services unit. The 142.33administrative services unit may receive 143.1and expend reimbursements for services 143.2performed by other agencies.143.3Administrative Services Unit - Retirement 143.4Costs. Of this appropriation in fiscal year 143.52012, $225,000 is for onetime retirement 143.6costs in the health-related boards. This 143.7funding may be transferred to the health 143.8boards incurring those costs for their 143.9payment. These funds are available either 143.10year of the biennium.143.11Administrative Services Unit - Volunteer 143.12Health Care Provider Program. Of this 143.13appropriation, $150,000 in fiscal year 2012 143.14and $150,000 in fiscal year 2013 are to pay 143.15for medical professional liability coverage 143.16required under Minnesota Statutes, section 143.17214.40
         .143.18Administrative Services Unit - Contested 143.19Cases and Other Legal Proceedings. Of 143.20this appropriation, $200,000 in fiscal year 143.212012 and $200,000 in fiscal year 2013 are 143.22for costs of contested case hearings and other 143.23unanticipated costs of legal proceedings 143.24involving health-related boards funded 143.25under this section. Upon certification of a 143.26health-related board to the administrative 143.27services unit that the costs will be incurred 143.28and that there is insufficient money available 143.29to pay for the costs out of money currently 143.30available to that board, the administrative 143.31services unit is authorized to transfer money 143.32from this appropriation to the board for 143.33payment of those costs with the approval 143.34of the commissioner of management and 143.35budget. This appropriation does not cancel. 144.1Any unencumbered and unspent balances 144.2remain available for these expenditures in 144.3subsequent fiscal years.144.4Base Adjustment. The State Government 144.5Special Revenue Fund base is decreased by 144.6$911,000 in fiscal year 2014 and $1,011,000144.7$961,000 in fiscal year 2015.144.8    Sec. 7. FOSTER CARE FOR INDIVIDUALS WITH AUTISM.144.9The commissioner of human services shall identify and coordinate with one or more 144.10counties that agree to issue a foster care license and authorize funding for people with 144.11autism who are currently receiving home and community-based services under Minnesota 144.12Statutes, section 256B.092 or 256B.49. Children eligible under this section must be in an 144.13out-of-home placement approved by the lead agency that has legal responsibility for the 144.14placement. Nothing in this section must be construed as restricting an individual's choice 144.15of provider. The commissioner will assist the interested county or counties with obtaining 144.16necessary capacity within the moratorium under Minnesota Statutes, section 245A.03, 144.17subdivision 7. The commissioner shall coordinate with the interested counties and issue a 144.18request for information to identify providers who have the training and skills to meet the 144.19needs of the individuals identified in this section.144.20    Sec. 8. CHEMICAL HEALTH INTEGRATED MODEL OF CARE 144.21DEVELOPMENT.144.22(a) The commissioner of human services, in partnership with the counties, tribes, 144.23and stakeholders, shall develop a community-based integrated model of care to improve 144.24the effectiveness and efficiency of the service continuum for chemically dependent 144.25individuals. The plan shall identify methods to reduce duplication of efforts, promote 144.26scientifically supported practices, and improve efficiency. This plan shall consider the 144.27potential for geographically or demographically disparate impact on individuals who need 144.28chemical dependency services.144.29(b) The commissioner shall provide the chairs and ranking minority members of the 144.30legislative committees with jurisdiction over health and human services a report detailing 144.31necessary statutory and rule changes and a proposed pilot project to implement the plan no 144.32later than March 15, 2013.144.33    Sec. 9. BIENNIAL BUDGET REQUEST; UNIVERSITY OF MINNESOTA.145.1Beginning in 2013, as part of the biennial budget request submitted to the 145.2Department of Management and Budget and the legislature, the Board of Regents of the 145.3University of Minnesota is encouraged to include a request for funding for rural primary 145.4care training by family practice residence programs to prepare doctors for the practice 145.5of primary care medicine in rural areas of the state. The funding request should provide 145.6for ongoing support of rural primary care training through the University of Minnesota's 145.7general operation and maintenance funding or through dedicated health science funding.145.8ARTICLE 6145.9HEALTH AND HUMAN SERVICES APPROPRIATIONS

145.10Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

145.11The sums shown in the columns marked "Appropriations" are added to or, if shown 145.12in parentheses, subtracted from the appropriations in Laws 2011, First Special Session 145.13chapter 9, article 10, to the agencies and for the purposes specified in this article. The 145.14appropriations are from the general fund or other named fund and are available for the 145.15fiscal years indicated for each purpose. The figures "2012" and "2013" used in this 145.16article mean that the addition to or subtraction from the appropriation listed under them 145.17is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively. 145.18Supplemental appropriations and reductions to appropriations for the fiscal year ending 145.19June 30, 2012, are effective the day following final enactment unless a different effective 145.20date is explicit.

145.21APPROPRIATIONS145.22Available for the Year145.23Ending June 30145.2420122013

145.25145.26Sec. 2. COMMISSIONER OF HUMAN SERVICES

145.27Subdivision 1.Total Appropriation$1,352,000$19,849,000

145.28Appropriations by Fund145.2920122013145.30General803,0009,680,000145.31Health Care Access-0- 3,000145.32Federal TANF-0- 7,453,000145.33Special Revenue549,0002,713,000

145.34Subd. 2.Central Office Operations

145.35(a) Operations118,000356,000

146.1Base Level Adjustment. The general fund 146.2base is increased by $91,000 in fiscal year 146.32014 and $44,000 in fiscal year 2015.

146.4(b) Health Care24,000346,000

146.5This is a onetime appropriation.146.6Managed Care Audit Activities. In fiscal 146.7year 2014, and in each even-numbered year 146.8thereafter, the commissioner shall transfer 146.9from the health care access fund $1,740,000 146.10to the legislative auditor for managed care 146.11audit services under Minnesota Statutes, 146.12section 256B.69, subdivision 9d. This is 146.13a biennial appropriation. The health care 146.14access fund base is increased by $1,842,000 146.15in fiscal year 2014. Notwithstanding any 146.16contrary provision in this article, this 146.17paragraph does not expire.

146.18(c) Continuing Care19,000375,000

146.19Base Level Adjustment. The general fund 146.20base is decreased by $159,000 in fiscal years 146.212014 and 2015.

146.22Subd. 3.Chemical and Mental Health19,00068,000

146.23Base Level Adjustment. The general fund 146.24base is decreased by $68,000 in fiscal years 146.252014 and 2015.

146.26Subd. 4.Forecasted Programs

146.27(a) MFIP/DWP Grants

146.28Appropriations by Fund146.2920122013146.30General-0-(7,009,000)146.31Federal TANF-0-7,000,000

146.32(b) General Assistance Grants-0-(8,000)

146.33(c) Minnesota Supplemental Aid Grants-0-152,000

147.1(d) MinnesotaCare Grants-0-3,000

147.2This appropriation is from the health care 147.3access fund.

147.4(e) Group Residential Housing Grants-0-(202,000)

147.5(f) Medical Assistance Grants623,00014,303,000

147.6PCA Relative Care Payment Recovery.147.7Notwithstanding any law to the contrary, and 147.8if, at the conclusion of the HealthStar Home 147.9Health, Inc et al v. Commissioner of Human 147.10Services litigation, the PCA relative rate 147.11reduction under Minnesota Statutes, section 147.12256B.0659, subdivision 11, paragraph (c), 147.13is upheld, the commissioner is prohibited 147.14from recovering the difference between the 147.15100 percent rate paid to providers and the 147.1680 percent rate, during the period of the 147.17temporary injunction issued on October 26, 147.182011. This section does not prohibit the 147.19commissioner from recovering any other 147.20overpayments from providers.147.21Long-Term Care Realignment Waiver 147.22Conformity. Notwithstanding Minnesota 147.23Statutes, section 256B.0916, subdivision 14, 147.24and upon federal approval of the long-term 147.25care realignment waiver application, 147.26essential community support grants must be 147.27made available in a manner that is consistent 147.28with the state's long-term care realignment 147.29waiver application submitted on February 147.3013, 2012. The commissioner is authorized 147.31to use increased federal matching funds 147.32resulting from approval of the long-term care 147.33realignment waiver as necessary to meet 147.34the fiscal year 2013 demand for essential 148.1community support grants administered in a 148.2manner that is consistent with the terms and 148.3conditions of the long-term care realignment 148.4waiver, and that amount of federal funds is 148.5appropriated to the commissioner for this 148.6purpose.148.7Continuing Care Provider Payment 148.8Delay. The commissioner of human services 148.9shall delay the last payment or payments 148.10in fiscal year 2013 to providers listed in 148.11Minnesota Statutes 2011 Supplement, 148.12section 256B.5012, subdivision 13, and 148.13Laws 2011, First Special Session chapter 148.149, article 7, section 54, paragraph (b), 148.15by up to $20,688,000. In calculating the 148.16actual payment amounts to be delayed, the 148.17commissioner must reduce the $20,688,000 148.18amount by any cash basis state share 148.19savings to be realized in fiscal year 2013 148.20from implementing the long-term care 148.21realignment waiver before July 1, 2013. 148.22The commissioner shall make the delayed 148.23payments in July 2013. Notwithstanding 148.24any contrary provision in this article, this 148.25provision expires on August 1, 2013.148.26Critical Access Nursing Facilities 148.27Designation. $500,000 is appropriated in 148.28fiscal year 2013 for critical access nursing 148.29facilities under Minnesota Statutes, section 148.30256B.441, subdivision 63. This is a onetime 148.31appropriation and is available until expended.

148.32Subd. 5.Grant Programs

148.33(a) Children and Economic Support Grants-0-450,000

148.34Long-Term Homeless Supportive Services.148.35$200,000 in fiscal year 2013 from the TANF 149.1fund is for long-term homeless supportive 149.2services for low-income families under 149.3Minnesota Statutes, section 256K.26. This is 149.4a onetime appropriation.149.5Family Assets for Independence Program.149.6$250,000 in fiscal year 2013 from the 149.7TANF fund is for grants for the family 149.8assets for independence program under 149.9Minnesota Statutes, section 256E.35. This 149.10appropriation must be used to serve families 149.11with income below 200 percent of the federal 149.12poverty guidelines and minor children in the 149.13household. This is a onetime appropriation 149.14and is available until June 30, 2014.149.15TANF Transfer to Federal Child Care 149.16and Development Fund. (1) In addition 149.17to the amount provided in this section, the 149.18commissioner shall transfer TANF funds to 149.19basic sliding fee child care assistance under 149.20Minnesota Statutes, section 119B.03:149.21(i) fiscal year 2013, $1,000; and149.22(ii) fiscal year 2014 and ongoing, $6,000.149.23(2) The commissioner shall authorize the 149.24transfer of sufficient TANF funds to the 149.25federal child care and development fund to 149.26meet this appropriation and shall ensure that 149.27all transferred funds are expended according 149.28to federal child care and development fund 149.29regulations.

149.30(b) Aging and Adult Services Grants-0-999,000

149.31In fiscal year 2013, upon federal approval 149.32to implement the nursing facility level 149.33of care under Minnesota Statutes, section 149.34144.0724, subdivision 11, $999,000 is for 150.1essential community supports grants. This is 150.2a onetime appropriation.

150.3(c) Disabilities Grants-0-300,000

150.4Intractable Epilepsy. This appropriation 150.5includes $65,000 for living skills training 150.6programs for persons with intractable 150.7epilepsy who need assistance in the transition 150.8to independent living under Laws 1988, 150.9chapter 689, article 2, section 251. This 150.10appropriation is ongoing.150.11Self-advocacy Network for Persons with 150.12Disabilities.150.13(1) $50,000 is appropriated in fiscal year 150.142013 to establish and maintain a statewide 150.15self-advocacy network for persons with 150.16intellectual and developmental disabilities. 150.17This is a onetime appropriation and is 150.18available until expended.150.19(2) The self-advocacy network must focus on 150.20ensuring that persons with disabilities are:150.21(i) informed of and educated about their legal 150.22rights in the areas of education, employment, 150.23housing, transportation, and voting; and150.24(ii) educated and trained to self-advocate for 150.25their rights under law.150.26(3) Self-advocacy network activities under 150.27this section include but are not limited to:150.28(i) education and training, including 150.29preemployment and workplace skills;150.30(ii) establishment and maintenance of a 150.31communication and information exchange 150.32system for self-advocacy groups; and151.1(iii) financial and technical assistance to 151.2self-advocacy groups.151.3Base Level Adjustment. The general fund 151.4base is increased by $23,000 in fiscal year 151.52014 and decreased by $235,000 in fiscal 151.6year 2015.

151.7Subd. 6.State-Operated Services549,0002,713,000

151.8Minnesota Specialty Health Services - 151.9Willmar. $549,000 in fiscal year 2012 151.10and $2,713,000 in fiscal year 2013 from 151.11the account established under Minnesota 151.12Statutes, section 246.18, subdivision 8, is 151.13for continued operation of the Minnesota 151.14Specialty Health Services - Willmar. These 151.15appropriations are onetime from the special 151.16revenue fund. Closure of the facility shall 151.17not occur prior to June 30, 2013.

151.18Subd. 7.Technical Activities-0-3,000

151.19This appropriation is from the TANF fund.151.20Base Level Adjustment. The TANF fund 151.21base is increased by $13,000 in fiscal years 151.222014 and 2015.

151.23Sec. 3. COMMISSIONER OF HEALTH

151.24Subdivision 1.Total Appropriation$-0-$501,000

151.25Appropriations by Fund151.2620122013151.27General-0-364,000151.28Health Care Access-0-137,000

151.29151.30Subd. 2.Community and Family Health Promotions-0-200,000

151.31Autism Study. $200,000 is for the 151.32commissioner of health, in partnership with 151.33the University of Minnesota, to conduct a 152.1qualitative study focused on cultural and 152.2resource-based aspects of autism spectrum 152.3disorders (ASD) that are unique to the 152.4Somali community. By February 15, 152.52014, the commissioner shall report the 152.6findings of this study to the legislature. The 152.7report must include recommendations as to 152.8establishment of a population-based public 152.9health surveillance system for ASD. This is a 152.10onetime appropriation and is available until 152.11June 30, 2014.

152.12Subd. 3.Policy Quality and Compliance

152.13Appropriations by Fund152.1420122013152.15General-0-164,000152.16Health Care Access-0-137,000

152.17Web Site Changes. $36,000 is for 152.18Web site changes required as part of the 152.19evaluation of health and human services 152.20regulatory responsibilities. This is a onetime 152.21appropriation and must be shared with the 152.22Department of Human Services through an 152.23interagency agreement.152.24Management and Budget. $100,000 is for 152.25transfer to the commissioner of management 152.26and budget for the evaluation of health and 152.27human services regulatory responsibilities. 152.28This is a onetime appropriation.152.29Nursing Facility Moratorium Exceptions.152.30In fiscal year 2013, $8,000 is for 152.31administrative costs related to review 152.32of moratorium exception projects under 152.33Minnesota Statutes, section 144A.073, 152.34subdivision 13. This is a onetime 152.35appropriation.153.1Health Record Access Study. $20,000 153.2in fiscal year 2013 is for the health record 153.3access study. This is a onetime appropriation.153.4Radiation Therapy Facilities Study. In 153.5fiscal year 2013, $137,000 from the health 153.6care access fund is for a study of radiation 153.7therapy facilities capacity. This is a onetime 153.8appropriation.

153.9153.10Sec. 4. BOARD OF NURSING HOME ADMINISTRATORS$-0-$10,000

153.11Administrative Services Unit. This 153.12appropriation is to provide a grant to the 153.13Minnesota Ambulance Association to 153.14coordinate and prepare an assessment of 153.15the extent and costs of uncompensated care 153.16as a direct result of emergency responses 153.17on interstate highways in Minnesota. 153.18The study will collect appropriate 153.19information from medical response units 153.20and ambulance services regulated under 153.21Minnesota Statutes, chapter 144E, and to 153.22the extent possible, firefighting agencies. 153.23In preparing the assessment, the Minnesota 153.24Ambulance Association shall consult with 153.25its membership, the Minnesota Fire Chiefs 153.26Association, the Office of the State Fire 153.27Marshal, and the Emergency Medical 153.28Services Regulatory Board. The findings 153.29of the assessment will be reported to the 153.30chairs and ranking minority members of the 153.31legislative committees with jurisdiction over 153.32health and public safety by January 1, 2013.153.33    Sec. 5. MANAGED CARE ORGANIZATION EXCESS PROFITS.154.1Excess profits of managed care organizations paid to the commissioner of human 154.2services in fiscal year 2013 shall be deposited in the funds from which the payments 154.3originated. These amounts are estimated to be $27,740,000 for the general fund and 154.4$7,300,000 for the health care access fund.154.5    Sec. 6. EXPIRATION OF UNCODIFIED LANGUAGE.154.6All uncodified language contained in this article expires on June 30, 2013, unless a 154.7different expiration date is explicit.154.8    Sec. 7. EFFECTIVE DATE.154.9The provisions in this article are effective July 1, 2012, unless a different effective 154.10date is explicit."154.11Delete the title and insert:154.12"A bill for an act154.13relating to state government; making adjustments to health and human services 154.14appropriations; making changes to provisions related to health care, the 154.15Department of Health, children and family services, continuing care, background 154.16studies, chemical dependency, and child support; requiring reporting of potential 154.17welfare fraud; providing for data sharing; requiring eligibility determinations; 154.18providing rulemaking authority; providing penalties; encouraging the University 154.19of Minnesota to request funding for rural primary care training; requiring studies 154.20and reports; providing appointments; appropriating money;amending Minnesota 154.21Statutes 2010, sections 62A.047; 62J.496, subdivision 2; 62Q.80; 72A.201, 154.22subdivision 8; 144.292, subdivision 6; 144.298, subdivision 2; 144.5509; 154.23144A.073, by adding a subdivision; 144A.351; 144D.04, subdivision 2; 145.906; 154.24245.697, subdivision 1; 245A.03, by adding a subdivision; 245A.11, subdivisions 154.252a, 7, 7a; 245B.07, subdivision 1; 245C.04, subdivision 6; 245C.05, subdivision 154.267; 252.27, subdivision 2a; 254A.19, by adding a subdivision; 256.01, by adding 154.27subdivisions; 256.975, subdivision 7; 256.9831, subdivision 2; 256B.056, 154.28subdivision 1a; 256B.0625, subdivision 28a, by adding subdivisions; 256B.0659, 154.29by adding a subdivision; 256B.0751, by adding a subdivision; 256B.0911, by 154.30adding subdivisions; 256B.092, subdivisions 1b, 7; 256B.0943, subdivision 9; 154.31256B.431, subdivision 17e, by adding a subdivision; 256B.434, subdivision 154.3210; 256B.441, by adding a subdivision; 256B.48, by adding a subdivision; 154.33256B.69, subdivision 9, by adding subdivisions; 256D.06, subdivision 1b; 154.34256D.44, subdivision 5; 256E.37, subdivision 1; 256I.05, subdivision 1e; 154.35256J.26, subdivision 1, by adding a subdivision; 256J.575, subdivisions 1, 2, 5, 154.366, 8; 256L.07, subdivision 3; 518A.40, subdivision 4; 626.556, by adding a 154.37subdivision; Minnesota Statutes 2011 Supplement, sections 62E.14, subdivision 154.384g; 119B.13, subdivision 7; 144.1222, subdivision 5; 245A.03, subdivision 7; 154.39256.987, subdivisions 1, 2, by adding subdivisions; 256B.056, subdivision 3; 154.40256B.057, subdivision 9; 256B.0625, subdivision 38; 256B.0631, subdivision 154.411; 256B.0659, subdivision 11; 256B.0911, subdivisions 3a, 3c; 256B.0915, 154.42subdivisions 3e, 3h; 256B.097, subdivision 3; 256B.49, subdivisions 14, 15, 23; 154.43256B.5012, subdivision 13; 256B.69, subdivision 5a; 256B.76, subdivision 4; 154.44256E.35, subdivisions 5, 6; 256I.05, subdivision 1a; 256L.03, subdivision 5; 154.45256L.031, subdivisions 2, 3, 6; 256L.12, subdivision 9; Laws 2010, chapter 374, 154.46section 1; Laws 2011, First Special Session chapter 9, article 7, sections 52; 54; 154.47article 10, sections 3, subdivisions 1, 3, 4; 8, subdivision 8; proposing coding 154.48for new law in Minnesota Statutes, chapters 144; 145; 256B; 626; repealing 155.1Minnesota Statutes 2010, sections 62M.09, subdivision 9; 62Q.64; 144A.073, 155.2subdivision 9; 256B.48, subdivision 6; Minnesota Rules, parts 4640.0800, 155.3subpart 4; 4685.2000."

156.1We request the adoption of this report and repassage of the bill.156.2House Conferees:156.3
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                     						156.4Jim AbelerSteve Gottwalt156.5
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                     						156.6Mary KiffmeyerJoe Schomacker156.7
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                     						156.8Thomas Huntley156.9Senate Conferees:156.10
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                     						156.11David W. HannJulie A. Rosen156.12
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                     						156.13Michelle R. BensonSean Nienow156.14
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                     						156.15Tony Lourey