1.1A bill for an act1.2relating to state government; making adjustments to health and human services 1.3appropriations; making changes to provisions related to health care, the 1.4Department of Health, children and family services, continuing care; providing 1.5for data sharing; requiring eligibility determinations; encouraging the University 1.6of Minnesota to request funding for rural primary care training; providing grants; 1.7requiring studies and reports; appropriating money;amending Minnesota Statutes 1.82010, sections 43A.316, subdivision 5; 62A.047; 62A.21, subdivision 2a; 1.962D.02, subdivision 3; 62D.05, subdivision 6; 62D.101, subdivision 2a; 62D.12, 1.10subdivision 1; 62J.26, subdivisions 3, 5, by adding a subdivision; 62J.496, 1.11subdivision 2; 62Q.80; 62U.04, subdivisions 1, 2, 4, 5; 144.5509; 144A.073, by 1.12adding a subdivision; 144A.351; 145.906; 245A.03, by adding a subdivision; 1.13245A.11, subdivisions 2a, 7, 7a; 245B.07, subdivision 1; 245C.04, subdivision 6; 1.14245C.05, subdivision 7; 256.01, by adding subdivisions; 256.975, subdivision 7; 1.15256B.056, subdivision 1a; 256B.0625, subdivision 9, by adding a subdivision; 1.16256B.0754, subdivision 2; 256B.0911, by adding a subdivision; 256B.092, 1.17subdivision 1b; 256B.0943, subdivision 9; 256B.431, subdivision 17e, by adding 1.18a subdivision; 256B.434, subdivision 10; 256B.441, by adding a subdivision; 1.19256B.48, by adding a subdivision; 256B.76, by adding a subdivision; 256D.06, 1.20subdivision 1b; 256D.44, subdivision 5; 626.556, by adding a subdivision; 1.21Minnesota Statutes 2011 Supplement, sections 62U.04, subdivisions 3, 9; 1.22119B.13, subdivision 7; 144.1222, subdivision 5; 245A.03, subdivision 7; 1.23256.987, subdivision 1; 256B.056, subdivision 3; 256B.057, subdivision 1.249; 256B.0625, subdivision 17; 256B.0631, subdivisions 1, 2; 256B.0659, 1.25subdivision 11; 256B.0911, subdivisions 3a, 3c; 256B.0915, subdivisions 3e, 3h; 1.26256B.097, subdivision 3; 256B.49, subdivisions 15, 23; 256B.69, subdivisions 1.275a, 9c; 256B.76, subdivisions 1, 2, 4; 256B.766; 256L.12, subdivision 9; Laws 1.282011, First Special Session chapter 9, article 7, section 52; article 10, sections 1.293, subdivisions 1, 3, 4; 4, subdivision 2; 8, subdivision 8; proposing coding 1.30for new law in Minnesota Statutes, chapters 62Q; 144; 148; 256B; repealing 1.31Minnesota Statutes 2010, sections 62D.04, subdivision 5; 144A.073, subdivision 1.329; 256B.0644; 256B.48, subdivision 6; Minnesota Statutes 2011 Supplement, 1.33section 256B.5012, subdivision 13; Laws 2011, First Special Session chapter 1.349, article 7, section 54.1.35BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:2.1ARTICLE 12.2HEALTH CARE2.3    Section 1. Minnesota Statutes 2010, section 256B.0625, subdivision 9, is amended to 2.4read:2.5    Subd. 9. Dental services. (a) Medical assistance covers dental services.2.6(b) Medical assistance dental coverage for nonpregnant adults is limited to the 2.7following services:2.8(1) comprehensive exams, limited to once every five years;2.9(2) periodic exams, limited to one per year;2.10(3) limited exams;2.11(4) bitewing x-rays, limited to one per year;2.12(5) periapical x-rays;2.13(6) panoramic x-rays, limited to one every five years except (1) when medically 2.14necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma 2.15or (2) once every two years for patients who cannot cooperate for intraoral film due to 2.16a developmental disability or medical condition that does not allow for intraoral film 2.17placement;2.18(7) prophylaxis, limited to one per year;2.19(8) application of fluoride varnish, limited to one per year;2.20(9) posterior fillings, all at the amalgam rate;2.21(10) anterior fillings;2.22(11) endodontics, limited to root canals on the anterior and premolars only;2.23(12) removable prostheses, each dental arch limited to one every six years including 2.24repairs and the replacement of each dental arch limited to one every six years;2.25(13) oral surgery, limited to extractions, biopsies, and incision and drainage of 2.26abscesses;2.27(14) palliative treatment and sedative fillings for relief of pain; and2.28(15) full-mouth debridement, limited to one every five years.2.29(c) In addition to the services specified in paragraph (b), medical assistance 2.30covers the following services for adults, if provided in an outpatient hospital setting or 2.31freestanding ambulatory surgical center as part of outpatient dental surgery:2.32(1) periodontics, limited to periodontal scaling and root planing once every two 2.33years;2.34(2) general anesthesia; and2.35(3) full-mouth survey once every five years.3.1(d) Medical assistance covers medically necessary dental services for children and 3.2pregnant women. The following guidelines apply:3.3(1) posterior fillings are paid at the amalgam rate;3.4(2) application of sealants are covered once every five years per permanent molar for 3.5children only;3.6(3) application of fluoride varnish is covered once every six months; and3.7(4) orthodontia is eligible for coverage for children only.3.8(e) In addition to the services specified in paragraphs (b) and (c), medical assistance 3.9covers the following services for developmentally disabled adults:3.10(1) house calls or extended care facility calls for on-site delivery of covered services;3.11(2) behavioral management when additional staff time is required to accommodate 3.12behavioral challenges and sedation is not used;3.13(3) oral or IV conscious sedation, if the covered dental service cannot be performed 3.14safely without it or would otherwise require the service to be performed under general 3.15anesthesia in a hospital or surgical center; and3.16(4) prophylaxis, in accordance with an appropriate individualized treatment plan 3.17formulated by a licensed dentist, but no more than four times per year.3.18EFFECTIVE DATE.The amendment to paragraph (b) is effective January 1, 2013.3.19    Sec. 2. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 3.20subdivision to read:3.21    Subd. 60.Community paramedic services.(a) Medical assistance covers services 3.22provided by community paramedics who are certified under section 144E.28, subdivision 3.239, when the services are provided in accordance with this subdivision to an eligible 3.24recipient as defined in paragraph (b).3.25(b) For purposes of this subdivision, an eligible recipient is defined as an individual 3.26who has received hospital emergency department services three or more times in a period 3.27of four consecutive months in the past 12 months or an individual who has been identified 3.28by the individual's primary health care provider for whom community paramedic services 3.29identified in paragraph (c) would likely prevent admission to or would allow discharge 3.30from a nursing facility; or would likely prevent readmission to a hospital or nursing facility.3.31(c) Payment for services provided by a community paramedic under this subdivision 3.32must be a part of a care plan ordered by a primary health care provider in consultation with 3.33the medical director of an ambulance service and must be billed by an eligible provider 3.34enrolled in medical assistance that employs or contracts with the community paramedic. 3.35The care plan must ensure that the services provided by a community paramedic are 4.1coordinated with other community health providers and local public health agencies and 4.2that community paramedic services do not duplicate services already provided to the 4.3patient, including home health and waiver services. Community paramedic services 4.4shall include health assessment, chronic disease monitoring and education, medication 4.5compliance, immunizations and vaccinations, laboratory specimen collection, hospital 4.6discharge follow-up care, and minor medical procedures approved by the ambulance 4.7medical director.4.8(d) Services provided by a community paramedic to an eligible recipient who is 4.9also receiving care coordination services must be in consultation with the providers of 4.10the recipient's care coordination services.4.11(e) The commissioner shall seek the necessary federal approval to implement this 4.12subdivision.4.13EFFECTIVE DATE.This section is effective July 1, 2012, or upon federal 4.14approval, whichever is later.4.15    Sec. 3. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 1, 4.16is amended to read:4.17    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical 4.18assistance benefit plan shall include the following cost-sharing for all recipients, effective 4.19for services provided on or after September 1, 2011:4.20    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes 4.21of this subdivision, a visit means an episode of service which is required because of 4.22a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 4.23ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 4.24midwife, advanced practice nurse, audiologist, optician, or optometrist;4.25    (2) $3 for eyeglasses;4.26    (3) $3.50 for nonemergency visits to a hospital-based emergency room, except that 4.27this co-payment shall be increased to $20 upon federal approval;4.28    (4) $3 per brand-name drug prescription and $1 per generic drug prescription, 4.29subject to a $12 per month maximum for prescription drug co-payments. No co-payments 4.30shall apply to antipsychotic drugs when used for the treatment of mental illness;4.31(5) effective January 1, 2012, a family deductible equal to the maximum amount 4.32allowed under Code of Federal Regulations, title 42, part 
         447.54; and4.33    (6) for individuals identified by the commissioner with income at or below 100 4.34percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five 4.35percent of family income. For purposes of this paragraph, family income is the total 5.1earned and unearned income of the individual and the individual's spouse, if the spouse is 5.2enrolled in medical assistance and also subject to the five percent limit on cost-sharing.5.3    (b) Recipients of medical assistance are responsible for all co-payments and 5.4deductibles in this subdivision.5.5(c) Notwithstanding paragraph (b), a prepaid health plan may waive the family 5.6deductible described under paragraph (a), clause (5), within the existing capitation rates 5.7on an ongoing basis.5.8EFFECTIVE DATE.This section is effective January 1, 2012.5.9    Sec. 4. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a, is 5.10amended to read:5.11    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section 5.12and section 
         256L.12 shall be entered into or renewed on a calendar year basis beginning 5.13January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 5.14renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 5.1531, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 5.16issue separate contracts with requirements specific to services to medical assistance 5.17recipients age 65 and older.5.18    (b) A prepaid health plan providing covered health services for eligible persons 5.19pursuant to chapters 256B and 256L is responsible for complying with the terms of its 5.20contract with the commissioner. Requirements applicable to managed care programs 5.21under chapters 256B and 256L established after the effective date of a contract with the 5.22commissioner take effect when the contract is next issued or renewed.5.23    (c) Effective for services rendered on or after January 1, 2003, the commissioner 5.24shall withhold five percent of managed care plan payments under this section and 5.25county-based purchasing plan payments under section 
         256B.692 for the prepaid medical 5.26assistance program pending completion of performance targets. Each performance target 5.27must be quantifiable, objective, measurable, and reasonably attainable, except in the case 5.28of a performance target based on a federal or state law or rule. Criteria for assessment 5.29of each performance target must be outlined in writing prior to the contract effective 5.30date. Clinical or utilization performance targets and their related criteria must consider 5.31evidence-based research and reasonable interventions when available or applicable to the 5.32populations served, and must be developed with input from external clinical experts 5.33and stakeholders, including managed care plans, county-based purchasing plans, and 5.34providers. The managed care or county-based purchasing plan must demonstrate, 5.35to the commissioner's satisfaction, that the data submitted regarding attainment of 6.1the performance target is accurate. The commissioner shall periodically change the 6.2administrative measures used as performance targets in order to improve plan performance 6.3across a broader range of administrative services. The performance targets must include 6.4measurement of plan efforts to contain spending on health care services and administrative 6.5activities. The commissioner may adopt plan-specific performance targets that take into 6.6account factors affecting only one plan, including characteristics of the plan's enrollee 6.7population. The withheld funds must be returned no sooner than July of the following 6.8year if performance targets in the contract are achieved. The commissioner may exclude 6.9special demonstration projects under subdivision 23.6.10    (d) Effective for services rendered on or after January 1, 2009, through December 6.1131, 2009, the commissioner shall withhold three percent of managed care plan payments 6.12under this section and county-based purchasing plan payments under section 
         256B.692 6.13for the prepaid medical assistance program. The withheld funds must be returned no 6.14sooner than July 1 and no later than July 31 of the following year. The commissioner may 6.15exclude special demonstration projects under subdivision 23.6.16(e) Effective for services provided on or after January 1, 2010, the commissioner 6.17shall require that managed care plans use the assessment and authorization processes, 6.18forms, timelines, standards, documentation, and data reporting requirements, protocols, 6.19billing processes, and policies consistent with medical assistance fee-for-service or the 6.20Department of Human Services contract requirements consistent with medical assistance 6.21fee-for-service or the Department of Human Services contract requirements for all 6.22personal care assistance services under section 
         256B.0659.6.23(f) Effective for services rendered on or after January 1, 2010, through December 6.2431, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 6.25under this section and county-based purchasing plan payments under section 
         256B.692 6.26for the prepaid medical assistance program. The withheld funds must be returned no 6.27sooner than July 1 and no later than July 31 of the following year. The commissioner may 6.28exclude special demonstration projects under subdivision 23.6.29(g) Effective for services rendered on or after January 1, 2011, through December 6.3031, 2011, the commissioner shall include as part of the performance targets described 6.31in paragraph (c) a reduction in the health plan's emergency room utilization rate for 6.32state health care program enrollees by a measurable rate of five percent from the plan's 6.33utilization rate for state health care program enrollees for the previous calendar year. 6.34Effective for services rendered on or after January 1, 2012, the commissioner shall include 6.35as part of the performance targets described in paragraph (c) a reduction in the health 6.36plan's emergency department utilization rate for medical assistance and MinnesotaCare 7.1enrollees, as determined by the commissioner. For 2012, the reduction shall be based on 7.2the health plan's utilization in 2009. To earn the return of the withhold each subsequent 7.3year, the managed care plan or county-based purchasing plan must achieve a qualifying 7.4reduction of no less than ten percent of the plan's emergency department utilization 7.5rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees7.6in programs described in subdivisions 23 and 28, compared to the previous calendar7.7measurement year until the final performance target is reached. When measuring 7.8performance, the commissioner must consider the difference in health risk in a managed 7.9care or county-based purchasing plan's membership in the baseline year compared to the 7.10measurement year, and work with the managed care or county-based purchasing plan to 7.11account for differences that they agree are significant.7.12The withheld funds must be returned no sooner than July 1 and no later than July 31 7.13of the following calendar year if the managed care plan or county-based purchasing plan 7.14demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 7.15was achieved. The commissioner shall structure the withhold so that the commissioner 7.16returns a portion of the withheld funds in amounts commensurate with achieved reductions 7.17in utilization less than the target amount.7.18The withhold described in this paragraph shall continue for each consecutive 7.19contract period until the plan's emergency room utilization rate for state health care 7.20program enrollees is reduced by 25 percent of the plan's emergency room utilization 7.21rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009. 7.22Hospitals shall cooperate with the health plans in meeting this performance target and 7.23shall accept payment withholds that may be returned to the hospitals if the performance 7.24target is achieved.7.25(h) Effective for services rendered on or after January 1, 2012, the commissioner 7.26shall include as part of the performance targets described in paragraph (c) a reduction in the 7.27plan's hospitalization admission rate for medical assistance and MinnesotaCare enrollees, 7.28as determined by the commissioner. To earn the return of the withhold each year, the 7.29managed care plan or county-based purchasing plan must achieve a qualifying reduction 7.30of no less than five percent of the plan's hospital admission rate for medical assistance 7.31and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 7.32subdivisions 23 and 28, compared to the previous calendar year until the final performance 7.33target is reached. When measuring performance, the commissioner must consider the 7.34difference in health risk in a managed care or county-based purchasing plan's membership 7.35in the baseline year compared to the measurement year, and work with the managed care 7.36or county-based purchasing plan to account for differences that they agree are significant.8.1The withheld funds must be returned no sooner than July 1 and no later than July 8.231 of the following calendar year if the managed care plan or county-based purchasing 8.3plan demonstrates to the satisfaction of the commissioner that this reduction in the 8.4hospitalization rate was achieved. The commissioner shall structure the withhold so that 8.5the commissioner returns a portion of the withheld funds in amounts commensurate with 8.6achieved reductions in utilization less than the targeted amount.8.7The withhold described in this paragraph shall continue until there is a 25 percent 8.8reduction in the hospital admission rate compared to the hospital admission rates in 8.9calendar year 2011, as determined by the commissioner. The hospital admissions in this 8.10performance target do not include the admissions applicable to the subsequent hospital 8.11admission performance target under paragraph (i). Hospitals shall cooperate with the 8.12plans in meeting this performance target and shall accept payment withholds that may be 8.13returned to the hospitals if the performance target is achieved.8.14(i) Effective for services rendered on or after January 1, 2012, the commissioner 8.15shall include as part of the performance targets described in paragraph (c) a reduction in 8.16the plan's hospitalization admission rates for subsequent hospitalizations within 30 days 8.17of a previous hospitalization of a patient regardless of the reason, for medical assistance 8.18and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of 8.19the withhold each year, the managed care plan or county-based purchasing plan must 8.20achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance 8.21and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 8.22subdivisions 23 and 28, of no less than five percent compared to the previous calendar 8.23year until the final performance target is reached.8.24The withheld funds must be returned no sooner than July 1 and no later than July 8.2531 of the following calendar year if the managed care plan or county-based purchasing 8.26plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in 8.27the subsequent hospitalization rate was achieved. The commissioner shall structure the 8.28withhold so that the commissioner returns a portion of the withheld funds in amounts 8.29commensurate with achieved reductions in utilization less that the targeted amount.8.30The withhold described in this paragraph must continue for each consecutive 8.31contract period until the plan's subsequent hospitalization rate for medical assistance 8.32and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 8.33subdivisions 23 and 28, is reduced by 25 percent of the plan's subsequent hospitalization 8.34rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this 8.35performance target and shall accept payment withholds that must be returned to the 8.36hospitals if the performance target is achieved.9.1(j) Effective for services rendered on or after January 1, 2011, through December 31, 9.22011, the commissioner shall withhold 4.5 percent of managed care plan payments under 9.3this section and county-based purchasing plan payments under section 
         256B.692 for the 9.4prepaid medical assistance program. The withheld funds must be returned no sooner than 9.5July 1 and no later than July 31 of the following year. The commissioner may exclude 9.6special demonstration projects under subdivision 23.9.7(k) Effective for services rendered on or after January 1, 2012, through December 9.831, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 9.9under this section and county-based purchasing plan payments under section 
         256B.692 9.10for the prepaid medical assistance program. The withheld funds must be returned no 9.11sooner than July 1 and no later than July 31 of the following year. The commissioner may 9.12exclude special demonstration projects under subdivision 23.9.13(l) Effective for services rendered on or after January 1, 2013, through December 31, 9.142013, the commissioner shall withhold 4.5 percent of managed care plan payments under 9.15this section and county-based purchasing plan payments under section 
         256B.692 for the 9.16prepaid medical assistance program. The withheld funds must be returned no sooner than 9.17July 1 and no later than July 31 of the following year. The commissioner may exclude 9.18special demonstration projects under subdivision 23.9.19(m) Effective for services rendered on or after January 1, 2014, the commissioner 9.20shall withhold three percent of managed care plan payments under this section and 9.21county-based purchasing plan payments under section 
         256B.692 for the prepaid medical 9.22assistance program. The withheld funds must be returned no sooner than July 1 and 9.23no later than July 31 of the following year. The commissioner may exclude special 9.24demonstration projects under subdivision 23.9.25(n) A managed care plan or a county-based purchasing plan under section 
         256B.692 9.26may include as admitted assets under section 
         62D.044 any amount withheld under this 9.27section that is reasonably expected to be returned.9.28(o) Contracts between the commissioner and a prepaid health plan are exempt from 9.29the set-aside and preference provisions of section 
         16C.16, subdivisions 6, paragraph 9.30(a), and 7.9.31(p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject 9.32to the requirements of paragraph (c).9.33    Sec. 5. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 9c, is 9.34amended to read:10.1    Subd. 9c. Managed care financial reporting. (a) The commissioner shall collect 10.2detailed data regarding financials, provider payments, provider rate methodologies, and 10.3other data as determined by the commissioner and managed care and county-based 10.4purchasing plans that are required to be submitted under this section. The commissioner, 10.5in consultation with the commissioners of health and commerce, and in consultation 10.6with managed care plans and county-based purchasing plans, shall set uniform criteria, 10.7definitions, and standards for the data to be submitted, and shall require managed care and 10.8county-based purchasing plans to comply with these criteria, definitions, and standards 10.9when submitting data under this section. In carrying out the responsibilities of this 10.10subdivision, the commissioner shall ensure that the data collection is implemented in an 10.11integrated and coordinated manner that avoids unnecessary duplication of effort. To the 10.12extent possible, the commissioner shall use existing data sources and streamline data 10.13collection in order to reduce public and private sector administrative costs. Nothing in 10.14this subdivision shall allow release of information that is nonpublic data pursuant to 10.15section 
         13.02.10.16(b) Each managed care and county-based purchasing plan must annually provide 10.17to the commissioner the following information on state public programs, in the form 10.18and manner specified by the commissioner, according to guidelines developed by the 10.19commissioner in consultation with managed care plans and county-based purchasing 10.20plans under contract:10.21(1) administrative expenses by category and subcategory consistent with 10.22administrative expense reporting to other state and federal regulatory agencies, by 10.23program;10.24(2) revenues by program, including investment income;10.25(3) nonadministrative service payments, provider payments, and reimbursement 10.26rates by provider type or service category, by program, paid by the managed care plan 10.27under this section or the county-based purchasing plan under section 
         256B.692 to 10.28providers and vendors for administrative services under contract with the plan, including 10.29but not limited to:10.30(i) individual-level provider payment and reimbursement rate data;10.31(ii) provider reimbursement rate methodologies by provider type, by program, 10.32including a description of alternative payment arrangements and payments outside the 10.33claims process;10.34(iii) data on implementation of legislatively mandated provider rate changes; and10.35(iv) individual-level provider payment and reimbursement rate data and plan-specific 10.36provider reimbursement rate methodologies by provider type, by program, including 11.1alternative payment arrangements and payments outside the claims process, provided to 11.2the commissioner under this subdivision are nonpublic data as defined in section 
         13.02;11.3(4) data on the amount of reinsurance or transfer of risk by program; and11.4(5) contribution to reserve, by program.11.5(c) In the event a report is published or released based on data provided under 11.6this subdivision, the commissioner shall provide the report to managed care plans and 11.7county-based purchasing plans 30 days prior to the publication or release of the report. 11.8Managed care plans and county-based purchasing plans shall have 30 days to review the 11.9report and provide comment to the commissioner.11.10(d) The legislative auditor shall contract for the audit required under this paragraph. 11.11The commissioner shall require, in the request for bids and the resulting contracts for 11.12coverage to be provided under this section, that each managed care and county-based 11.13purchasing plan submit to and fully cooperate with an annual independent third-party 11.14financial audit of the information required under paragraph (b). For purposes of 11.15this paragraph, "independent third party" means an audit firm that is independent in 11.16accordance with Government Auditing Standards issued by the United States Government 11.17Accountability Office and licensed in accordance with chapter 326A. In no case shall 11.18the audit firm conducting the audit provide services to a managed care or county-based 11.19purchasing plan at the same time as the audit is being conducted or have provided services 11.20to a managed care or county-based purchasing plan during the prior three years.11.21(e) The audit of the information required under paragraph (b) shall be conducted 11.22by an independent third-party firm in accordance with generally accepted government 11.23auditing standards issued by the United States Government Accountability Office.11.24(f) A managed care or county-based purchasing plan that provides services under 11.25this section shall provide to the commissioner biweekly encounter and claims data at 11.26a detailed level and shall participate in a quality assurance program that verifies the 11.27timeliness, completeness, accuracy, and consistency of data provided. The commissioner 11.28shall have written protocols for the quality assurance program that are publicly available. 11.29The commissioner shall contract with an independent third-party auditing firm to evaluate 11.30the quality assurance protocols, the capacity of those protocols to assure complete and 11.31accurate data, and the commissioner's implementation of the protocols.11.32(g) Contracts awarded under this section to a managed care or county-based 11.33purchasing plan must provide that the commissioner and the contracted auditor shall have 11.34unlimited access to any and all data required to complete the audit and that this access 11.35shall be enforceable in a court of competent jurisdiction through the process of injunctive 11.36or other appropriate relief.12.1(h) Any actuary or actuarial firm must meet the independence requirements under 12.2the professional code for fellows in the Society of Actuaries when providing actuarial 12.3services to the commissioner in connection with this subdivision and providing services to 12.4any managed care or county-based purchasing plan participating in this subdivision during 12.5the term of the actuary's work for the commissioner under this subdivision.12.6(i) The actuary or actuarial firm referenced in paragraph (h) shall certify and attest 12.7to the rates paid to managed care plans and county-based purchasing plans under this 12.8section, and the certification and attestation must be auditable.12.9(j) The independent third-party audit shall include a determination of compliance 12.10with the federal Medicaid rate certification process.12.11(k) The legislative auditor's contract with the independent third-party auditing firm 12.12shall be designed and administered so as to render the independent third-party audit 12.13eligible for a federal subsidy if available for that purpose. The independent third-party 12.14auditing firm shall have the same powers as the legislative auditor under section 3.978, 12.15subdivision 2.12.16(l) Upon completion of the audit, and its receipt by the legislative auditor, the 12.17legislative auditor shall provide copies of the audit report to the commissioner, the state 12.18auditor, the attorney general, and the chairs and ranking minority members of the health 12.19finance committees of the legislature.12.20EFFECTIVE DATE.This section is effective the day following final enactment 12.21and applies to contracts, and the contracting process, for contracts that are effective 12.22January 1, 2013, and thereafter.12.23    Sec. 6. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 4, is 12.24amended to read:12.25    Subd. 4. Critical access dental providers.  (a) Effective for dental services 12.26rendered on or after January 1, 2002, the commissioner shall increase reimbursements 12.27to dentists and dental clinics deemed by the commissioner to be critical access dental 12.28providers. For dental services rendered on or after July 1, 2007, the commissioner shall 12.29increase reimbursement by 30 percent above the reimbursement rate that would otherwise 12.30be paid to the critical access dental provider. The commissioner shall pay the managed 12.31care plans and county-based purchasing plans in amounts sufficient to reflect increased 12.32reimbursements to critical access dental providers as approved by the commissioner.12.33(b) The commissioner shall designate the following dentists and dental clinics as 12.34critical access dental providers:12.35    (1) nonprofit community clinics that:13.1(i) have nonprofit status in accordance with chapter 317A;13.2(ii) have tax exempt status in accordance with the Internal Revenue Code, section 13.3501(c)(3);13.4(iii) are established to provide oral health services to patients who are low income, 13.5uninsured, have special needs, and are underserved;13.6(iv) have professional staff familiar with the cultural background of the clinic's 13.7patients;13.8(v) charge for services on a sliding fee scale designed to provide assistance to 13.9low-income patients based on current poverty income guidelines and family size;13.10(vi) do not restrict access or services because of a patient's financial limitations 13.11or public assistance status; and13.12(vii) have free care available as needed;13.13    (2) federally qualified health centers, rural health clinics, and public health clinics;13.14    (3) county owned and operated hospital-based dental clinics;13.15(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 13.16accordance with chapter 317A with more than 10,000 patient encounters per year with 13.17patients who are uninsured or covered by medical assistance, general assistance medical 13.18care, or MinnesotaCare; and13.19(5) a dental clinic owned and operated by the University of Minnesota or the 13.20Minnesota State Colleges and Universities system.13.21     (c) The commissioner may designate a dentist or dental clinic as a critical access 13.22dental provider if the dentist or dental clinic is willing to provide care to patients covered 13.23by medical assistance, general assistance medical care, or MinnesotaCare at a level which 13.24significantly increases access to dental care in the service area.13.25(d) Notwithstanding paragraph (a), critical access payments must not be made for 13.26dental services provided from April 1, 2010, through June 30, 2010. A designated critical 13.27access clinic shall receive the reimbursement rate specified in paragraph (a) for dental 13.28services provided off-site at a private dental office if the following requirements are met:13.29(1) the designated critical access dental clinic is located within a health professional 13.30shortage area as defined under the Code of Federal Regulations, title 42, part 5, and 13.31the United States Code, title 42, section 254E, and is located outside the seven-county 13.32metropolitan area;13.33(2) the designated critical access dental clinic is not able to provide the service 13.34and refers the patient to the off-site dentist;13.35(3) the service, if provided at the critical access dental clinic, would be reimbursed 13.36at the critical access reimbursement rate;14.1(4) the dentist and allied dental professionals providing the services off-site are 14.2licensed and in good standing under chapter 150A;14.3(5) the dentist providing the services is enrolled as a medical assistance provider;14.4(6) the critical access dental clinic submits the claim for services provided off-site 14.5and receives the payment for the services; and14.6(7) the critical access dental clinic maintains dental records for each claim submitted 14.7under this paragraph, including the name of the dentist, the off-site location, and the 14.8license number of the dentist and allied dental professionals providing the services.14.9EFFECTIVE DATE.This section is effective July 1, 2012, or upon federal 14.10approval, whichever is later.14.11    Sec. 7. Minnesota Statutes 2010, section 256B.76, is amended by adding a subdivision 14.12to read:14.13    Subd. 7a.Volunteer dental providers.(a) A volunteer dentist who is not enrolled 14.14as a medical assistance provider; is providing volunteer services for a nonprofit or 14.15government-owned dental provider enrolled as a medical assistance dental provider; and 14.16is not receiving payment for services provided, shall complete and submit a volunteer 14.17agreement form as prescribed by the commissioner. The volunteer agreement shall be 14.18used to enroll the dentist in medical assistance only for the purpose of providing volunteer 14.19services. The volunteer agreement shall specify that a volunteer dentist:14.20(1) will not appear in the Minnesota health care programs provider directory;14.21(2) will not receive payment for the services they provide to Minnesota health care 14.22program patients; and14.23(3) is not required to serve Minnesota health care program patients when providing 14.24nonvolunteer services in a private practice.14.25(b) A volunteer dentist enrolled under this subdivision shall not otherwise be enrolled 14.26in or receive payments from Minnesota health care programs as a fee-for-service provider.14.27(c) The volunteer dentist shall be notified by the dental provider for which they 14.28are providing services that medical assistance is being billed for the volunteer services 14.29provided.14.30    Sec. 8. Minnesota Statutes 2011 Supplement, section 256L.12, subdivision 9, is 14.31amended to read:14.32    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective, 14.33per capita, where possible. The commissioner may allow health plans to arrange for 15.1inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 15.2an independent actuary to determine appropriate rates.15.3    (b) For services rendered on or after January 1, 2004, the commissioner shall 15.4withhold five percent of managed care plan payments and county-based purchasing 15.5plan payments under this section pending completion of performance targets. Each 15.6performance target must be quantifiable, objective, measurable, and reasonably attainable, 15.7except in the case of a performance target based on a federal or state law or rule. Criteria 15.8for assessment of each performance target must be outlined in writing prior to the contract 15.9effective date. Clinical or utilization performance targets and their related criteria must 15.10consider evidence-based research and reasonable interventions, when available or 15.11applicable to the populations served, and must be developed with input from external 15.12clinical experts and stakeholders, including managed care plans, county-based purchasing 15.13plans, and providers. The managed care plan must demonstrate, to the commissioner's 15.14satisfaction, that the data submitted regarding attainment of the performance target is 15.15accurate. The commissioner shall periodically change the administrative measures used 15.16as performance targets in order to improve plan performance across a broader range of 15.17administrative services. The performance targets must include measurement of plan 15.18efforts to contain spending on health care services and administrative activities. The 15.19commissioner may adopt plan-specific performance targets that take into account factors 15.20affecting only one plan, such as characteristics of the plan's enrollee population. The 15.21withheld funds must be returned no sooner than July 1 and no later than July 31 of the 15.22following calendar year if performance targets in the contract are achieved.15.23(c) For services rendered on or after January 1, 2011, the commissioner shall 15.24withhold an additional three percent of managed care plan or county-based purchasing 15.25plan payments under this section. The withheld funds must be returned no sooner than 15.26July 1 and no later than July 31 of the following calendar year. The return of the withhold 15.27under this paragraph is not subject to the requirements of paragraph (b).15.28(d) Effective for services rendered on or after January 1, 2011, through December 15.2931, 2011, the commissioner shall include as part of the performance targets described in 15.30paragraph (b) a reduction in the plan's emergency room utilization rate for state health care 15.31program enrollees by a measurable rate of five percent from the plan's utilization rate for 15.32the previous calendar year. Effective for services rendered on or after January 1, 2012, 15.33the commissioner shall include as part of the performance targets described in paragraph 15.34(b) a reduction in the health plan's emergency department utilization rate for medical 15.35assistance and MinnesotaCare enrollees, as determined by the commissioner. For 2012, 15.36the reductions shall be based on the health plan's utilization in 2009. To earn the return of 16.1the withhold each subsequent year, the managed care plan or county-based purchasing 16.2plan must achieve a qualifying reduction of no less than ten percent of the plan's utilization 16.3rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees in 16.4programs described in section 256B.69, subdivisions 23 and 28, compared to the previous 16.5calendar measurement year, until the final performance target is reached. When measuring 16.6performance, the commissioner must consider the difference in health risk in a managed 16.7care or county-based purchasing plan's membership in the baseline year compared to the 16.8measurement year, and work with the managed care or county-based purchasing plan to 16.9account for differences that they agree are significant.16.10The withheld funds must be returned no sooner than July 1 and no later than July 31 16.11of the following calendar year if the managed care plan or county-based purchasing plan 16.12demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 16.13was achieved. The commissioner shall structure the withhold so that the commissioner 16.14returns a portion of the withheld funds in amounts commensurate with achieved reductions 16.15in utilization less than the targeted amount.16.16The withhold described in this paragraph shall continue for each consecutive 16.17contract period until the plan's emergency room utilization rate for state health care 16.18program enrollees is reduced by 25 percent of the plan's emergency room utilization 16.19rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009. 16.20Hospitals shall cooperate with the health plans in meeting this performance target and 16.21shall accept payment withholds that may be returned to the hospitals if the performance 16.22target is achieved.16.23(e) Effective for services rendered on or after January 1, 2012, the commissioner 16.24shall include as part of the performance targets described in paragraph (b) a reduction 16.25in the plan's hospitalization admission rate for medical assistance and MinnesotaCare 16.26enrollees, as determined by the commissioner. To earn the return of the withhold 16.27each year, the managed care plan or county-based purchasing plan must achieve a 16.28qualifying reduction of no less than five percent of the plan's hospital admission rate 16.29for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees16.30in programs described in section 256B.69, subdivisions 23 and 28, compared to the 16.31previous calendar year, until the final performance target is reached. When measuring 16.32performance, the commissioner must consider the difference in health risk in a managed 16.33care or county-based purchasing plan's membership in the baseline year compared to the 16.34measurement year, and work with the managed care or county-based purchasing plan to 16.35account for differences that they agree are significant.17.1The withheld funds must be returned no sooner than July 1 and no later than July 17.231 of the following calendar year if the managed care plan or county-based purchasing 17.3plan demonstrates to the satisfaction of the commissioner that this reduction in the 17.4hospitalization rate was achieved. The commissioner shall structure the withhold so that 17.5the commissioner returns a portion of the withheld funds in amounts commensurate with 17.6achieved reductions in utilization less than the targeted amount.17.7The withhold described in this paragraph shall continue until there is a 25 percent 17.8reduction in the hospitals admission rate compared to the hospital admission rate for 17.9calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the 17.10plans in meeting this performance target and shall accept payment withholds that may be 17.11returned to the hospitals if the performance target is achieved. The hospital admissions 17.12in this performance target do not include the admissions applicable to the subsequent 17.13hospital admission performance target under paragraph (f).17.14(f) Effective for services provided on or after January 1, 2012, the commissioner 17.15shall include as part of the performance targets described in paragraph (b) a reduction 17.16in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a 17.17previous hospitalization of a patient regardless of the reason, for medical assistance and 17.18MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the 17.19withhold each year, the managed care plan or county-based purchasing plan must achieve 17.20a qualifying reduction of the subsequent hospital admissions rate for medical assistance 17.21and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 17.22section 256B.69, subdivisions 23 and 28, of no less than five percent compared to the 17.23previous calendar year until the final performance target is reached.17.24The withheld funds must be returned no sooner than July 1 and no later than July 31 17.25of the following calendar year if the managed care plan or county-based purchasing plan 17.26demonstrates to the satisfaction of the commissioner that a reduction in the subsequent 17.27hospitalization rate was achieved. The commissioner shall structure the withhold so that 17.28the commissioner returns a portion of the withheld funds in amounts commensurate with 17.29achieved reductions in utilization less than the targeted amount.17.30The withhold described in this paragraph must continue for each consecutive 17.31contract period until the plan's subsequent hospitalization rate for medical assistance and 17.32MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization 17.33rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this 17.34performance target and shall accept payment withholds that must be returned to the 17.35hospitals if the performance target is achieved.18.1(g) A managed care plan or a county-based purchasing plan under section 
         256B.692 18.2may include as admitted assets under section 
         62D.044 any amount withheld under this 18.3section that is reasonably expected to be returned.18.4    Sec. 9. EMERGENCY MEDICAL CONDITION DIALYSIS COVERAGE 18.5EXCEPTION.18.6(a) Notwithstanding Minnesota Statutes, section 256B.06, subdivision 4, paragraph 18.7(h), clause (2), dialysis services provided in a hospital or freestanding dialysis facility 18.8shall be covered as an emergency medical condition under Minnesota Statutes, section 18.9256B.06, subdivision 4, paragraph (f).18.10(b) Coverage under paragraph (a) is effective May 1, 2012, until June 30, 2013.18.11EFFECTIVE DATE.This section is effective the day following final enactment.18.12    Sec. 10. COST-SHARING REQUIREMENTS STUDY.18.13The commissioner of human services, in consultation with managed care plans, 18.14county-based purchasing plans, and other stakeholders, shall develop recommendations 18.15to implement a revised cost-sharing structure for state public health care programs that 18.16ensures application of meaningful cost-sharing requirements within the limits of title 18.1742, Code of Federal Regulations, section 447.54, for enrollees in these programs. The 18.18commissioner shall report to the chairs and ranking minority members of the legislative 18.19committees with jurisdiction over these issues by January 15, 2013, with draft legislation 18.20to implement these recommendations effective January 1, 2014.18.21    Sec. 11. STUDY OF MANAGED CARE.18.22The commissioner of human services must contract with an independent vendor 18.23with demonstrated expertise in evaluating Medicaid managed care programs to evaluate 18.24the value of managed care for state public health care programs provided under 18.25Minnesota Statutes, sections 256B.69, 256B.692, and 256L.12. The evaluation must be 18.26completed and reported to the legislature by January 15, 2013. Determination of the 18.27value of managed care must include consideration of the following, as compared to a 18.28fee-for-service program:18.29(1) the satisfaction of state public health care program recipients and providers;18.30(2) the ability to measure and improve health outcomes of recipients;18.31(3) the access to health services for recipients;18.32(4) the availability of additional services such as care coordination, case 18.33management, disease management, transportation, and after-hours nurse lines;19.1(5) actual and potential cost savings to the state;19.2(6) the level of alignment with state and federal health reform policies, including a 19.3health benefit exchange for individuals not enrolled in state public health care programs; 19.4and19.5(7) the ability to use different provider payment models that provide incentives for 19.6cost-effective health care.19.7    Sec. 12. STUDY OF FOR-PROFIT HEALTH MAINTENANCE 19.8ORGANIZATIONS.19.9The commissioner of health shall contract with an entity with expertise in health 19.10economics and health care delivery and quality to study the efficiency, costs, service 19.11quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to 19.12not-for-profit health maintenance organizations operating in Minnesota and other states. 19.13The study findings must address whether the state could: (1) reduce medical assistance 19.14and MinnesotaCare costs and costs of providing coverage to state employees; and (2) 19.15maintain or improve the quality of care provided to state health care program enrollees 19.16and state employees if for-profit health maintenance organizations were allowed to operate 19.17in the state. In comparing for-profit health maintenance organizations operating in other 19.18states with not-for-profit health maintenance organizations operating in Minnesota, the 19.19entity must consider differences in regulatory oversight, benefit requirements, network 19.20standards, human resource costs, and assessments, fees, and taxes that may impact the 19.21cost and quality comparisons. The commissioner shall require the entity under contract to 19.22report study findings to the commissioner and the legislature by January 15, 2013.19.23    Sec. 13.  REPEALER.19.24Minnesota Statutes 2010, sections 62D.04, subdivision 5; and 256B.0644, are 19.25repealed effective January 1, 2013.19.26ARTICLE 219.27DEPARTMENT OF HEALTH19.28    Section 1. Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:19.29    Subd. 3. Commissioner of health commerce or commissioner. "Commissioner of 19.30health commerce" or "commissioner" means the state commissioner of health commerce19.31or a designee.19.32    Sec. 2. Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:20.1    Subd. 6. Supplemental benefits. (a) A health maintenance organization may, as 20.2a supplemental benefit, provide coverage to its enrollees for health care services and 20.3supplies received from providers who are not employed by, under contract with, or 20.4otherwise affiliated with the health maintenance organization. Supplemental benefits may 20.5be provided if the following conditions are met:20.6(1) a health maintenance organization desiring to offer supplemental benefits must at 20.7all times comply with the requirements of sections 
         62D.041 and 
         62D.042;20.8(2) a health maintenance organization offering supplemental benefits must maintain 20.9an additional surplus in the first year supplemental benefits are offered equal to the 20.10lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of 20.11the second year supplemental benefits are offered, the health maintenance organization 20.12must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the 20.13supplemental benefit expenses. At the end of the third year benefits are offered and every 20.14year after that, the health maintenance organization must maintain an additional surplus 20.15equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses. 20.16When in the judgment of the commissioner the health maintenance organization's surplus 20.17is inadequate, the commissioner may require the health maintenance organization to 20.18maintain additional surplus;20.19(3) claims relating to supplemental benefits must be processed in accordance with 20.20the requirements of section 
         72A.201; and20.21(4) in marketing supplemental benefits, the health maintenance organization shall 20.22fully disclose and describe to enrollees and potential enrollees the nature and extent of the 20.23supplemental coverage, and any claims filing and other administrative responsibilities in 20.24regard to supplemental benefits.20.25(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer 20.26rules relating to this subdivision, including: rules insuring that these benefits are 20.27supplementary and not substitutes for comprehensive health maintenance services by 20.28addressing percentage of out-of-plan coverage; rules relating to the establishment of 20.29necessary financial reserves; rules relating to marketing practices; and other rules necessary 20.30for the effective and efficient administration of this subdivision. The commissioner, in 20.31adopting rules, shall give consideration to existing laws and rules administered and 20.32enforced by the Department of Commerce relating to health insurance plans.20.33    Sec. 3. Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:20.34    Subdivision 1. False representations. No health maintenance organization or 20.35representative thereof may cause or knowingly permit the use of advertising or solicitation 21.1which is untrue or misleading, or any form of evidence of coverage which is deceptive. 21.2Each health maintenance organization shall be subject to sections 
         72A.17 to 
         72A.32, 21.3relating to the regulation of trade practices, except (a) to the extent that the nature of a 21.4health maintenance organization renders such sections clearly inappropriate and (b) that 21.5enforcement shall be by the commissioner of health and not by the commissioner of 21.6commerce. Every health maintenance organization shall be subject to sections 
         8.31 and 21.7325F.69
         .21.8    Sec. 4. Minnesota Statutes 2010, section 62Q.80, is amended to read:21.962Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM.21.10    Subdivision 1. Scope. (a) Any community-based health care initiative may develop 21.11and operate community-based health care coverage programs that offer to eligible 21.12individuals and their dependents the option of purchasing through their employer health 21.13care coverage on a fixed prepaid basis without meeting the requirements of chapter 60A, 21.1462A, 62C, 62D, 62M, 62N, 62Q, 62T, or 62U, or any other law or rule that applies to 21.15entities licensed under these chapters.21.16(b) Each initiative shall establish health outcomes to be achieved through the 21.17programs and performance measurements in order to determine whether these outcomes 21.18have been met. The outcomes must include, but are not limited to:21.19(1) a reduction in uncompensated care provided by providers participating in the 21.20community-based health network;21.21(2) an increase in the delivery of preventive health care services; and21.22(3) health improvement for enrollees with chronic health conditions through the 21.23management of these conditions.21.24In establishing performance measurements, the initiative shall use measures that are 21.25consistent with measures published by nonprofit Minnesota or national organizations that 21.26produce and disseminate health care quality measures.21.27(c) Any program established under this section shall not constitute a financial 21.28liability for the state, in that any financial risk involved in the operation or termination 21.29of the program shall be borne by the community-based initiative and the participating 21.30health care providers.21.31    Subd. 1a.Demonstration project.The commissioner of health and the 21.32commissioner of human services shall award demonstration project grants to 21.33community-based health care initiatives to develop and operate community-based health 21.34care coverage programs in Minnesota. The demonstration projects shall extend for five 21.35years and must comply with the requirements of this section.22.1    Subd. 2. Definitions.  For purposes of this section, the following definitions apply:22.2(a) "Community-based" means located in or primarily relating to the community, 22.3as determined by the board of a community-based health initiative that is served by the 22.4community-based health care coverage program.22.5(b) "Community-based health care coverage program" or "program" means a 22.6program administered by a community-based health initiative that provides health care 22.7services through provider members of a community-based health network or combination 22.8of networks to eligible individuals and their dependents who are enrolled in the program.22.9(c) "Community-based health initiative" or "initiative" means a nonprofit corporation 22.10that is governed by a board that has at least 80 percent of its members residing in the 22.11community and includes representatives of the participating network providers and 22.12employers, or a county-based purchasing organization as defined in section 
         256B.692.22.13(d) "Community-based health network" means a contract-based network of health 22.14care providers organized by the community-based health initiative to provide or support 22.15the delivery of health care services to enrollees of the community-based health care 22.16coverage program on a risk-sharing or nonrisk-sharing basis.22.17(e) "Dependent" means an eligible employee's spouse or unmarried child who is 22.18under the age of 19 years.22.19    Subd. 3. Approval.  (a) Prior to the operation of a community-based health 22.20care coverage program, a community-based health initiative, defined in subdivision 22.212, paragraph (c), and receiving funds from the Department of Health, shall submit to 22.22the commissioner of health for approval the community-based health care coverage 22.23program developed by the initiative. Each community-based health initiative as defined 22.24in subdivision 2, paragraph (c), and receiving State Health Access Program (SHAP) 22.25grant funding shall submit to the commissioner of human services for approval prior 22.26to its operation the community-based health care coverage programs developed by the 22.27initiatives. The commissioners commissioner shall ensure that each program meets 22.28the federal grant requirements and any requirements described in this section and is 22.29actuarially sound based on a review of appropriate records and methods utilized by the 22.30community-based health initiative in establishing premium rates for the community-based 22.31health care coverage programs.22.32    (b) Prior to approval, the commissioner shall also ensure that:22.33    (1) the benefits offered comply with subdivision 8 and that there are adequate 22.34numbers of health care providers participating in the community-based health network to 22.35deliver the benefits offered under the program;23.1    (2) the activities of the program are limited to activities that are exempt under this 23.2section or otherwise from regulation by the commissioner of commerce;23.3    (3) the complaint resolution process meets the requirements of subdivision 10; and23.4    (4) the data privacy policies and procedures comply with state and federal law.23.5    Subd. 4. Establishment.  The initiative shall establish and operate upon approval 23.6by the commissioners commissioner of health and human services community-based 23.7health care coverage programs. The operational structure established by the initiative 23.8shall include, but is not limited to:23.9    (1) establishing a process for enrolling eligible individuals and their dependents;23.10    (2) collecting and coordinating premiums from enrollees and employers of enrollees;23.11    (3) providing payment to participating providers;23.12    (4) establishing a benefit set according to subdivision 8 and establishing premium 23.13rates and cost-sharing requirements;23.14    (5) creating incentives to encourage primary care and wellness services; and23.15    (6) initiating disease management services, as appropriate.23.16    Subd. 5. Qualifying employees.  To be eligible for the community-based health 23.17care coverage program, an individual must:23.18(1) reside in or work within the designated community-based geographic area 23.19served by the program;23.20(2) be employed by a qualifying employer, be an employee's dependent, or be 23.21self-employed on a full-time basis;23.22(3) not be enrolled in or have currently available health coverage, except for 23.23catastrophic health care coverage; and23.24(4) not be eligible for or enrolled in medical assistance or general assistance medical 23.25care, and not be enrolled in MinnesotaCare or Medicare.23.26    Subd. 6. Qualifying employers.  (a) To qualify for participation in the 23.27community-based health care coverage program, an employer must:23.28(1) employ at least one but no more than 50 employees at the time of initial 23.29enrollment in the program;23.30(2) pay its employees a median wage that equals 350 percent of the federal poverty 23.31guidelines or less for an individual; and23.32(3) not have offered employer-subsidized health coverage to its employees for 23.33at least 12 months prior to the initial enrollment in the program. For purposes of this 23.34section, "employer-subsidized health coverage" means health care coverage for which the 23.35employer pays at least 50 percent of the cost of coverage for the employee.23.36(b) To participate in the program, a qualifying employer agrees to:24.1(1) offer health care coverage through the program to all eligible employees and 24.2their dependents regardless of health status;24.3(2) participate in the program for an initial term of at least one year;24.4(3) pay a percentage of the premium established by the initiative for the employee; 24.5and24.6(4) provide the initiative with any employee information deemed necessary by the 24.7initiative to determine eligibility and premium payments.24.8    Subd. 7. Participating providers. Any health care provider participating in the 24.9community-based health network must accept as payment in full the payment rate 24.10established by the initiatives and may not charge to or collect from an enrollee any amount 24.11in access of this amount for any service covered under the program.24.12    Subd. 8. Coverage.  (a) The initiatives shall establish the health care benefits offered 24.13through the community-based health care coverage programs. The benefits established 24.14shall include, at a minimum:24.15(1) child health supervision services up to age 18, as defined under section 
         62A.047; 24.16and24.17(2) preventive services, including:24.18(i) health education and wellness services;24.19(ii) health supervision, evaluation, and follow-up;24.20(iii) immunizations; and24.21(iv) early disease detection.24.22(b) Coverage of health care services offered by the program may be limited to 24.23participating health care providers or health networks. All services covered under the 24.24programs must be services that are offered within the scope of practice of the participating 24.25health care providers.24.26(c) The initiatives may establish cost-sharing requirements. Any co-payment or 24.27deductible provisions established may not discriminate on the basis of age, sex, race, 24.28disability, economic status, or length of enrollment in the programs.24.29(d) If any of the initiatives amends or alters the benefits offered through the program 24.30from the initial offering, that initiative must notify the commissioners commissioner of 24.31health and human services and all enrollees of the benefit change.24.32    Subd. 9. Enrollee information. (a) The initiatives must provide an individual or 24.33family who enrolls in the program a clear and concise written statement that includes 24.34the following information:24.35(1) health care services that are covered under the program;25.1(2) any exclusions or limitations on the health care services covered, including any 25.2cost-sharing arrangements or prior authorization requirements;25.3(3) a list of where the health care services can be obtained and that all health 25.4care services must be provided by or through a participating health care provider or 25.5community-based health network;25.6(4) a description of the program's complaint resolution process, including how to 25.7submit a complaint; how to file a complaint with the commissioner of health; and how to 25.8obtain an external review of any adverse decisions as provided under subdivision 10;25.9(5) the conditions under which the program or coverage under the program may 25.10be canceled or terminated; and25.11(6) a precise statement specifying that this program is not an insurance product and, 25.12as such, is exempt from state regulation of insurance products.25.13(b) The commissioners commissioner of health and human services must approve a 25.14copy of the written statement prior to the operation of the program.25.15    Subd. 10. Complaint resolution process. (a) The initiatives must establish 25.16a complaint resolution process. The process must make reasonable efforts to resolve 25.17complaints and to inform complainants in writing of the initiative's decision within 60 25.18days of receiving the complaint. Any decision that is adverse to the enrollee shall include 25.19a description of the right to an external review as provided in paragraph (c) and how to 25.20exercise this right.25.21(b) The initiatives must report any complaint that is not resolved within 60 days to 25.22the commissioner of health.25.23(c) The initiatives must include in the complaint resolution process the ability of an 25.24enrollee to pursue the external review process provided under section 
         62Q.73 with any 25.25decision rendered under this external review process binding on the initiatives.25.26    Subd. 11. Data privacy. The initiatives shall establish data privacy policies and 25.27procedures for the program that comply with state and federal data privacy laws.25.28    Subd. 12. Limitations on enrollment. (a) The initiatives may limit enrollment in 25.29the program. If enrollment is limited, a waiting list must be established.25.30(b) The initiatives shall not restrict or deny enrollment in the program except for 25.31nonpayment of premiums, fraud or misrepresentation, or as otherwise permitted under 25.32this section.25.33(c) The initiatives may require a certain percentage of participation from eligible 25.34employees of a qualifying employer before coverage can be offered through the program.25.35    Subd. 13. Report.  Each initiative shall submit quarterly an annual status reports25.36to the commissioner of health on January 15, April 15, July 15, and October 15 of each 26.1year, with the first report due January 15, 2008. Each initiative receiving funding from the 26.2Department of Human Services shall submit status reports to the commissioner of human 26.3services as defined in the terms of the contract with the Department of Human Services.26.4Each status report shall include:26.5    (1) the financial status of the program, including the premium rates, cost per member 26.6per month, claims paid out, premiums received, and administrative expenses;26.7    (2) a description of the health care benefits offered and the services utilized;26.8    (3) the number of employers participating, the number of employees and dependents 26.9covered under the program, and the number of health care providers participating;26.10    (4) a description of the health outcomes to be achieved by the program and a status 26.11report on the performance measurements to be used and collected; and26.12    (5) any other information requested by the commissioners of health, human services,26.13or commerce or the legislature.26.14    Subd. 14.Sunset.This section expires August 31, 2014.26.15    Sec. 5. Minnesota Statutes 2010, section 62U.04, subdivision 1, is amended to read:26.16    Subdivision 1. Development of tools to improve costs and quality outcomes.26.17    The commissioner of health shall develop a plan to create transparent prices, encourage 26.18greater provider innovation and collaboration across points on the health continuum 26.19in cost-effective, high-quality care delivery, reduce the administrative burden on 26.20providers and health plans associated with submitting and processing claims, and provide 26.21comparative information to consumers on variation in health care cost and quality across 26.22providers. The development must be complete by January 1, 2010.26.23    Sec. 6. Minnesota Statutes 2010, section 62U.04, subdivision 2, is amended to read:26.24    Subd. 2. Calculation of health care costs and quality. The commissioner of health 26.25shall develop a uniform method of calculating providers' relative cost of care, defined as a 26.26measure of health care spending including resource use and unit prices, and relative quality 26.27of care. In developing this method, the commissioner must address the following issues:26.28    (1) provider attribution of costs and quality;26.29    (2) appropriate adjustment for outlier or catastrophic cases;26.30    (3) appropriate risk adjustment to reflect differences in the demographics and health 26.31status across provider patient populations, using generally accepted and transparent risk 26.32adjustment methodologies and case mix adjustment;26.33    (4) specific types of providers that should be included in the calculation;26.34    (5) specific types of services that should be included in the calculation;27.1    (6) appropriate adjustment for variation in payment rates;27.2    (7) the appropriate provider level for analysis;27.3    (8) payer mix adjustments, including variation across providers in the percentage of 27.4revenue received from government programs; and27.5    (9) other factors that the commissioner determines and the advisory committee, 27.6established under subdivision 3, determine are needed to ensure validity and comparability 27.7of the analysis.27.8    Sec. 7. Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 3, is 27.9amended to read:27.10    Subd. 3. Provider peer grouping; system development; advisory committee.27.11    (a) The commissioner shall develop a peer grouping system for providers based on a 27.12combined measure that incorporates both provider risk-adjusted cost of care and quality of 27.13care, and for specific conditions as determined by the commissioner. In developing this 27.14system, the commissioner shall consult and coordinate with health care providers, health 27.15plan companies, state agencies, and organizations that work to improve health care quality 27.16in Minnesota. For purposes of the final establishment of the peer grouping system, the 27.17commissioner shall not contract with any private entity, organization, or consortium of 27.18entities that has or will have a direct financial interest in the outcome of the system.27.19(b) The commissioner shall establish an advisory committee comprised of 27.20representatives of health care providers, health plan companies, consumers, state agencies, 27.21employers, academic researchers, and organizations that work to improve health care 27.22quality in Minnesota. The advisory committee shall meet no fewer than three times 27.23per year. The commissioner shall consult with the advisory committee in developing 27.24and administering the peer grouping system, including but not limited to the following 27.25activities:27.26(1) establishing peer groups;27.27(2) selecting quality measures;27.28(3) recommending thresholds for completeness of data and statistical significance 27.29for the purposes of public release of provider peer grouping results;27.30(4) considering whether adjustments are necessary for facilities that provide medical 27.31education, level 1 trauma services, neonatal intensive care, or inpatient psychiatric care;27.32(5) recommending inclusion or exclusion of other costs; and27.33(6) adopting patient attribution and quality and cost-scoring methodologies.27.34    Subd. 3a.Provider peer grouping; dissemination of data to providers.(b) By 27.35no later than October 15, 2010, (a) The commissioner shall disseminate information 28.1to providers on their total cost of care, total resource use, total quality of care, and the 28.2total care results of the grouping developed under this subdivision 3 in comparison to an 28.3appropriate peer group. Data used for this analysis must be the most recent data available. 28.4Any analyses or reports that identify providers may only be published after the provider 28.5has been provided the opportunity by the commissioner to review the underlying data in 28.6order to verify, consistent with the recommendations developed pursuant to subdivision 28.73c, paragraph (d), and adopted by the commissioner the accuracy and representativeness 28.8of any analyses or reports  and submit comments to the commissioner or initiate an appeal 28.9under subdivision 3b. Providers may Upon request, providers shall be given any data for 28.10which they are the subject of the data. The provider shall have 30 60 days to review the 28.11data for accuracy and initiate an appeal as specified in paragraph (d) subdivision 3b.28.12    (c) By no later than January 1, 2011, (b) The commissioner shall disseminate 28.13information to providers on their condition-specific cost of care, condition-specific 28.14resource use, condition-specific quality of care, and the condition-specific results of the 28.15grouping developed under this subdivision 3 in comparison to an appropriate peer group.28.16Data used for this analysis must be the most recent data available. Any analyses or 28.17reports that identify providers may only be published after the provider has been provided 28.18the opportunity by the commissioner to review the underlying data in order to verify, 28.19consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d), 28.20and adopted by the commissioner the accuracy and representativeness of any analyses or 28.21reports  and submit comments to the commissioner or initiate an appeal under subdivision 28.223b. Providers may Upon request, providers shall be given any data for which they are the 28.23subject of the data. The provider shall have 30 60 days to review the data for accuracy and 28.24initiate an appeal as specified in paragraph (d) subdivision 3b.28.25    Subd. 3b.Provider peer grouping; appeals process.(d) The commissioner shall 28.26establish an appeals a process to resolve disputes from providers regarding the accuracy 28.27of the data used to develop analyses or reports or errors in the application of standards 28.28or methodology established by the commissioner in consultation with the advisory 28.29committee. When a provider appeals the accuracy of the data used to calculate the peer 28.30grouping system results submits an appeal, the provider shall:28.31(1) clearly indicate the reason they believe the data used to calculate the peer group 28.32system results are not accurate or reasons for the appeal;28.33(2) provide any evidence and, calculations, or documentation to support the reason 28.34that data was not accurate for the appeal; and28.35(3) cooperate with the commissioner, including allowing the commissioner access to 28.36data necessary and relevant to resolving the dispute.29.1The commissioner shall cooperate with the provider during the data review period 29.2specified in subdivisions 3a and 3c by giving the provider information necessary for the 29.3preparation of an appeal.29.4If a provider does not meet the requirements of this paragraph subdivision, a provider's 29.5appeal shall be considered withdrawn. The commissioner shall not publish peer grouping29.6results for a specific provider under paragraph (e) or (f) while that provider has an 29.7unresolved appeal until the appeal has been resolved.29.8    Subd. 3c.Provider peer grouping; publication of information for the public.29.9    (e) Beginning January 1, 2011, the commissioner shall, no less than annually, publish 29.10information on providers' total cost, total resource use, total quality, and the results of 29.11the total care portion of the peer grouping process. The results that are published must 29.12be on a risk-adjusted basis. (a) The commissioner may publicly release summary data 29.13related to the peer grouping system as long as the data do not contain information or 29.14descriptions from which the identity of individual hospitals, clinics, or other providers 29.15may be discerned.29.16(f) Beginning March 30, 2011, the commissioner shall no less than annually publish 29.17information on providers' condition-specific cost, condition-specific resource use, and 29.18condition-specific quality, and the results of the condition-specific portion of the peer 29.19grouping process. The results that are published must be on a risk-adjusted basis. (b) The 29.20commissioner may publicly release analyses or results related to the peer grouping system 29.21that identify hospitals, clinics, or other providers only if the following criteria are met:29.22(1) the results, data, and summaries, including any graphical depictions of provider 29.23performance, have been distributed to providers at least 120 days prior to publication; 29.24(2) the commissioner has provided an opportunity for providers to verify and review 29.25data for which the provider is the subject consistent with the recommendations developed 29.26pursuant to paragraph (d) and adopted by the commissioner; 29.27(3) the results meet thresholds of validity, reliability, statistical significance, 29.28representativeness, and other standards that reflect the recommendations of the advisory 29.29committee, established under subdivision 3; and29.30(4) any public report or other usage of the analyses, report, or data used by the 29.31state clearly notifies consumers about how to use and interpret the results, including 29.32any limitations of the data and analysis.29.33(g) (c) After publishing the first public report, the commissioner shall, no less 29.34frequently than annually, publish information on providers' total cost, total resource use, 29.35total quality, and the results of the total care portion of the peer grouping process, as well 29.36as information on providers' condition-specific cost, condition-specific resource use, 30.1and condition-specific quality, and the results of the condition-specific portion of the 30.2peer grouping process. The results that are published must be on a risk-adjusted basis, 30.3including case mix adjustments.30.4(d) The commissioner shall convene a work group comprised of representatives 30.5of physician clinics, hospitals, their respective statewide associations, and other 30.6relevant stakeholder organizations to make recommendations on data to be made 30.7available to hospitals and physician clinics to allow for verification of the accuracy and 30.8representativeness of the provider peer grouping results.30.9    Subd. 3d.Provider peer grouping; standards for dissemination and publication.30.10(a) Prior to disseminating data to providers under paragraph (b) or (c) subdivision 3a or 30.11publishing information under paragraph (e) or (f) subdivision 3c, the commissioner, in 30.12consultation with the advisory committee, shall ensure the scientific and statistical validity 30.13and reliability of the results according to the standards described in paragraph (h) (b). 30.14If additional time is needed to establish the scientific validity, statistical significance,30.15and reliability of the results, the commissioner may delay the dissemination of data to 30.16providers under paragraph (b) or (c) subdivision 3a, or the publication of information under 30.17paragraph (e) or (f) subdivision 3c. If the delay is more than 60 days, the commissioner 30.18shall report in writing to the chairs and ranking minority members of the legislative 30.19committees with jurisdiction over health care policy and finance the following information:30.20(1) the reason for the delay;30.21(2) the actions being taken to resolve the delay and establish the scientific validity 30.22and reliability of the results; and30.23(3) the new dates by which the results shall be disseminated.30.24If there is a delay under this paragraph, The commissioner must disseminate the 30.25information to providers under paragraph (b) or (c) subdivision 3a at least 90 120 days 30.26before publishing results under paragraph (e) or (f) subdivision 3c.30.27(h) (b) The commissioner's assurance of valid, timely, and reliable clinic and hospital 30.28peer grouping performance results shall include, at a minimum, the following:30.29(1) use of the best available evidence, research, and methodologies; and30.30(2) establishment of an explicit minimum reliability threshold thresholds for both 30.31quality and costs developed in collaboration with the subjects of the data and the users of 30.32the data, at a level not below nationally accepted standards where such standards exist.30.33In achieving these thresholds, the commissioner shall not aggregate clinics that are not 30.34part of the same system or practice group. The commissioner shall consult with and 30.35solicit feedback from the advisory committee and representatives of physician clinics 30.36and hospitals during the peer grouping data analysis process to obtain input on the 31.1methodological options prior to final analysis and on the design, development, and testing 31.2of provider reports.31.3    Sec. 8. Minnesota Statutes 2010, section 62U.04, subdivision 4, is amended to read:31.4    Subd. 4. Encounter data. (a) Beginning July 1, 2009, and every six months 31.5thereafter, all health plan companies and third-party administrators shall submit encounter 31.6data to a private entity designated by the commissioner of health. The data shall be 31.7submitted in a form and manner specified by the commissioner subject to the following 31.8requirements:31.9    (1) the data must be de-identified data as described under the Code of Federal 31.10Regulations, title 45, section 
         164.514;31.11    (2) the data for each encounter must include an identifier for the patient's health care 31.12home if the patient has selected a health care home; and31.13    (3) except for the identifier described in clause (2), the data must not include 31.14information that is not included in a health care claim or equivalent encounter information 31.15transaction that is required under section 
         62J.536.31.16    (b) The commissioner or the commissioner's designee shall only use the data 31.17submitted under paragraph (a) for thepurpose of carrying out its responsibilities in this 31.18section, and must maintain the data that it receives according to the provisions of this 31.19section. to carry out its responsibilities in this section, including supplying the data to 31.20providers so they can verify their results of the peer grouping process consistent with the 31.21recommendations developed pursuant to subdivision 3c, paragraph (d), and adopted by 31.22the commissioner and, if necessary, submit comments to the commissioner or initiate 31.23an appeal.31.24    (c) Data on providers collected under this subdivision are private data on individuals 31.25or nonpublic data, as defined in section 
         13.02. Notwithstanding the definition of summary 31.26data in section 
         13.02, subdivision 19, summary data prepared under this subdivision 31.27may be derived from nonpublic data. The commissioner or the commissioner's designee 31.28shall establish procedures and safeguards to protect the integrity and confidentiality of 31.29any data that it maintains.31.30    (d) The commissioner or the commissioner's designee shall not publish analyses or 31.31reports that identify, or could potentially identify, individual patients.31.32    Sec. 9. Minnesota Statutes 2010, section 62U.04, subdivision 5, is amended to read:31.33    Subd. 5. Pricing data. (a) Beginning July 1, 2009, and annually on January 1 31.34thereafter, all health plan companies and third-party administrators shall submit data 32.1on their contracted prices with health care providers to a private entity designated by 32.2the commissioner of health for the purposes of performing the analyses required under 32.3this subdivision. The data shall be submitted in the form and manner specified by the 32.4commissioner of health.32.5    (b) The commissioner or the commissioner's designee shall only use the data 32.6submitted under this subdivision for the purpose of carrying out its responsibilities under 32.7this section to carry out its responsibilities under this section, including supplying the 32.8data to providers so they can verify their results of the peer grouping process consistent 32.9with the recommendations developed pursuant to subdivision 3c, paragraph (d), and 32.10adopted by the commissioner and, if necessary, submit comments to the commissioner or 32.11initiate an appeal.32.12    (c) Data collected under this subdivision are nonpublic data as defined in section 32.1313.02
         . Notwithstanding the definition of summary data in section 
         13.02, subdivision 19, 32.14summary data prepared under this section may be derived from nonpublic data. The 32.15commissioner shall establish procedures and safeguards to protect the integrity and 32.16confidentiality of any data that it maintains.32.17    Sec. 10. Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 9, is 32.18amended to read:32.19    Subd. 9. Uses of information.(a) For product renewals or for new products that 32.20are offered, after 12 months have elapsed from publication by the commissioner of the 32.21information in subdivision 3, paragraph (e):32.22    (1) the commissioner of management and budget shall may use the information and 32.23methods developed under subdivision 3 subdivisions 3 to 3d to strengthen incentives for 32.24members of the state employee group insurance program to use high-quality, low-cost 32.25providers;32.26    (2) all political subdivisions, as defined in section 
         13.02, subdivision 11, that offer 32.27health benefits to their employees must may offer plans that differentiate providers on their 32.28cost and quality performance and create incentives for members to use better-performing 32.29providers;32.30    (3) all health plan companies shall may use the information and methods developed 32.31under subdivision 3 subdivisions 3 to 3d to develop products that encourage consumers to 32.32use high-quality, low-cost providers; and32.33    (4) health plan companies that issue health plans in the individual market or the 32.34small employer market must may offer at least one health plan that uses the information 32.35developed under subdivision 3 subdivisions 3 to 3d to establish financial incentives for 33.1consumers to choose higher-quality, lower-cost providers through enrollee cost-sharing 33.2or selective provider networks.33.3    (b) By January 1, 2011, the commissioner of health shall report to the governor 33.4and the legislature on recommendations to encourage health plan companies to promote 33.5widespread adoption of products that encourage the use of high-quality, low-cost providers. 33.6The commissioner's recommendations may include tax incentives, public reporting of 33.7health plan performance, regulatory incentives or changes, and other strategies.33.8    Sec. 11. Minnesota Statutes 2011 Supplement, section 144.1222, subdivision 5, 33.9is amended to read:33.10    Subd. 5. Swimming pond exemption Exemptions. (a) A public swimming pond 33.11in existence before January 1, 2008, is not a public pool for purposes of this section and 33.12section 
         157.16, and is exempt from the requirements for public swimming pools under 33.13Minnesota Rules, chapter 4717.33.14(b) A naturally treated swimming pool located in the city of Minneapolis is not 33.15a public pool for purposes of this section and section 157.16, and is exempt from the 33.16requirements for public swimming pools under Minnesota Rules, chapter 4717.33.17    (b) (c) Notwithstanding paragraph paragraphs (a) and (b), a public swimming pond 33.18and a naturally treated swimming pool must meet the requirements for public pools 33.19described in subdivisions 1c and 1d.33.20    (c) (d) For purposes of this subdivision, a "public swimming pond" means an 33.21artificial body of water contained within a lined, sand-bottom basin, intended for public 33.22swimming, relaxation, or recreational use that includes a water circulation system for 33.23maintaining water quality and does not include any portion of a naturally occurring lake 33.24or stream.33.25(e) For purposes of this subdivision, a "naturally treated swimming pool" means an 33.26artificial body of water contained in a basin, intended for public swimming, relaxation, or 33.27recreational use that uses a chemical free filtration system for maintaining water quality 33.28through natural processes, including the use of plants, beneficial bacteria, and microbes.33.29EFFECTIVE DATE.This section is effective the day following final enactment.33.30    Sec. 12. Minnesota Statutes 2010, section 144.5509, is amended to read:33.31144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.34.1    (a) A radiation therapy facility may be constructed only by an entity owned, 34.2operated, or controlled by a hospital licensed according to sections 
         144.50 to 
         144.56 either 34.3alone or in cooperation with another entity. This paragraph expires August 1, 2014.34.4    (b) Notwithstanding paragraph (a), there shall be a moratorium on the construction 34.5of any radiation therapy facility located in the following counties: Hennepin, Ramsey, 34.6Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns, 34.7Chisago, Isanti, and Wright. This paragraph does not apply to the relocation or 34.8reconstruction of an existing facility owned by a hospital if the relocation or reconstruction 34.9is within one mile of the existing facility. This paragraph does not apply to a radiation 34.10therapy facility that is being built attached to a community hospital in Wright County and 34.11meets the following conditions prior to August 1, 2007: the capital expenditure report 34.12required under Minnesota Statutes, section 
         62J.17, has been filed with the commissioner 34.13of health; a timely construction schedule is developed, stipulating dates for beginning, 34.14achieving various stages, and completing construction; and all zoning and building permits 34.15applied for. Beginning January 1, 2013, this paragraph does not apply to any construction 34.16necessary to relocate a radiation therapy machine from a community hospital-owned 34.17radiation therapy facility located in the city of Maplewood to a community hospital 34.18campus in the city of Woodbury within the same health system. This paragraph expires 34.19August 1, 2014.34.20(c) After August 1, 2014, a radiation therapy facility may be constructed only if the 34.21following requirements are met:34.22(1) the entity constructing the radiation therapy facility is controlled by or is under 34.23common control with a hospital licensed under sections 144.50 to 144.56; and34.24(2) the new radiation therapy facility is located at least seven miles from an existing 34.25radiation therapy facility.34.26(d) Any referring physician must provide each patient who is in need of radiation 34.27therapy services with a list of all radiation therapy facilities located within the following 34.28counties: Hennepin, Ramsey, Dakota, Washington, Anoka, Carver, Scott, St. Louis, 34.29Sherburne, Benton, Stearns, Chisago, Isanti, and Wright. Physicians with a financial 34.30interest in any radiation therapy facility must disclose to the patient the existence of the 34.31interest.34.32(e) For purposes of this section, "controlled by" or "under common control with" 34.33means the possession, direct or indirect, of the power to direct or cause the direction of the 34.34policies, operations, or activities of an entity, through the ownership of, or right to vote 34.35or to direct the disposition of shares, membership interests, or ownership interests of 34.36the entity.35.1(f) For purposes of this section, "financial interest in any radiation therapy facility" 35.2means a direct or indirect ownership or investment interest in a radiation therapy facility 35.3or a compensation arrangement with a radiation therapy facility.35.4(g) This section does not apply to the relocation or reconstruction of an existing 35.5radiation therapy facility if:35.6(1) the relocation or reconstruction of the facility remains owned by the same entity;35.7(2) the relocation or reconstruction is located within one mile of the existing facility; 35.8and35.9(3) the period in which the existing facility is closed and the relocated or 35.10reconstructed facility begins providing services does not exceed 12 months.35.11    Sec. 13. Minnesota Statutes 2010, section 145.906, is amended to read:35.12145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.35.13(a) The commissioner of health shall work with health care facilities, licensed health 35.14and mental health care professionals, the women, infants, and children (WIC) program, 35.15mental health advocates, consumers, and families in the state to develop materials and 35.16information about postpartum depression, including treatment resources, and develop 35.17policies and procedures to comply with this section.35.18(b) Physicians, traditional midwives, and other licensed health care professionals 35.19providing prenatal care to women must have available to women and their families 35.20information about postpartum depression.35.21(c) Hospitals and other health care facilities in the state must provide departing new 35.22mothers and fathers and other family members, as appropriate, with written information 35.23about postpartum depression, including its symptoms, methods of coping with the illness, 35.24and treatment resources.35.25(d) Information about postpartum depression, including its symptoms, potential 35.26impact on families, and treatment resources must be available at WIC sites.35.27    Sec. 14. Minnesota Statutes 2010, section 256B.0754, subdivision 2, is amended to 35.28read:35.29    Subd. 2. Payment reform. By no later than 12 months after the commissioner of 35.30health publishes the information in section 
         62U.04, subdivision 3, paragraph (e) 62U.04, 35.31subdivision 3c, paragraph (b), the commissioner of human services shall may use the 35.32information and methods developed under section 
         62U.04 to establish a payment system 35.33that:35.34    (1) rewards high-quality, low-cost providers;36.1    (2) creates enrollee incentives to receive care from high-quality, low-cost providers; 36.2and36.3    (3) fosters collaboration among providers to reduce cost shifting from one part of 36.4the health continuum to another.36.5    Sec. 15. Laws 2011, First Special Session chapter 9, article 10, section 4, subdivision 36.62, is amended to read:

36.736.8Subd. 2.Community and Family Health Promotion

36.9Appropriations by Fund36.10General45,577,00046,030,00036.1136.12State Government 
                  		Special Revenue1,033,0001,033,00036.13Health Care Access16,719,0001,719,00036.14Federal TANF11,713,00011,713,000

36.15TANF Appropriations. (1) $1,156,000 of 36.16the TANF funds is appropriated each year of 36.17the biennium to the commissioner for family 36.18planning grants under Minnesota Statutes, 36.19section 
         145.925.36.20(2) $3,579,000 of the TANF funds is 36.21appropriated each year of the biennium to 36.22the commissioner for home visiting and 36.23nutritional services listed under Minnesota 36.24Statutes, section 
         145.882, subdivision 7, 36.25clauses (6) and (7). Funds must be distributed 36.26to community health boards according to 36.27Minnesota Statutes, section 
         145A.131, 36.28subdivision 1
         .36.29(3) $2,000,000 of the TANF funds is 36.30appropriated each year of the biennium to 36.31the commissioner for decreasing racial and 36.32ethnic disparities in infant mortality rates 36.33under Minnesota Statutes, section 
         145.928, 36.34subdivision 7
         .37.1(4) $4,978,000 of the TANF funds is 37.2appropriated each year of the biennium to the 37.3commissioner for the family home visiting 37.4grant program according to Minnesota 37.5Statutes, section 
         145A.17. $4,000,000 of the 37.6funding must be distributed to community 37.7health boards according to Minnesota 37.8Statutes, section 
         145A.131, subdivision 1. 37.9$978,000 of the funding must be distributed 37.10to tribal governments based on Minnesota 37.11Statutes, section 
         145A.14, subdivision 2a.37.12(5) The commissioner may use up to 6.23 37.13percent of the funds appropriated each fiscal 37.14year to conduct the ongoing evaluations 37.15required under Minnesota Statutes, section 37.16145A.17, subdivision 7
         , and training and 37.17technical assistance as required under 37.18Minnesota Statutes, section 
         145A.17, 37.19subdivisions 4
          and 5.37.20TANF Carryforward. Any unexpended 37.21balance of the TANF appropriation in the 37.22first year of the biennium does not cancel but 37.23is available for the second year.37.24Statewide Health Improvement Program.37.25(a) $15,000,000 in the biennium ending June 37.2630, 2013, is appropriated from the health 37.27care access fund for the statewide health 37.28improvement program and is available until 37.29expended. Notwithstanding Minnesota 37.30Statutes, sections 
         144.396, and 
         145.928, the 37.31commissioner may use tobacco prevention 37.32grant funding and grant funding under 37.33Minnesota Statutes, section 
         145.928, to 37.34support the statewide health improvement 37.35program. The commissioner may focus the 38.1program geographically or on a specific 38.2goal of tobacco use reduction or on 38.3reducing obesity. By February 15, 2013, the 38.4commissioner shall report to the chairs of 38.5the health and human services committee 38.6on progress toward meeting the goals of the 38.7program as outlined in Minnesota Statutes, 38.8section 145.986, and estimate the dollar 38.9value of the reduced health care costs for 38.10both public and private payers.38.11(b) By February 15, 2012, the commissioner 38.12shall develop a plan to implement 38.13evidence-based strategies from the statewide 38.14health improvement program as part of 38.15hospital community benefit programs 38.16and health maintenance organizations 38.17collaboration plans. The implementation 38.18plan shall include an advisory board 38.19to determine priority needs for health 38.20improvement in reducing obesity and 38.21tobacco use in Minnesota and to review 38.22and approve hospital community benefit 38.23activities reported under Minnesota Statutes, 38.24section 144.699, and health maintenance 38.25organizations collaboration plans in 38.26Minnesota Statutes, section 62Q.075. The 38.27commissioner shall consult with hospital 38.28and health maintenance organizations in 38.29creating and implementing the plan. The 38.30plan described in this paragraph shall be 38.31implemented by July 1, 2012.38.32(c) The commissioners of Minnesota 38.33management and budget, human services, 38.34and health shall include in each forecast 38.35beginning February of 2013 a report that 38.36identifies an estimated dollar value of the 39.1health care savings in the state health care 39.2programs that are directly attributable to the 39.3strategies funded from the statewide health 39.4improvement program. The report shall 39.5include a description of methodologies and 39.6assumptions used to calculate the estimate.39.7Funding Usage. Up to 75 percent of the 39.8fiscal year 2012 appropriation for local public 39.9health grants may be used to fund calendar 39.10year 2011 allocations for this program and 39.11up to 75 percent of the fiscal year 2013 39.12appropriation may be used for calendar year 39.132012 allocations. The fiscal year 2014 base 39.14shall be increased by $5,193,000.39.15Base Level Adjustment. The general fund 39.16base is increased by $5,188,000 in fiscal year 39.172014 and decreased by $5,000 in 2015.39.18    Sec. 16. STUDY OF RADIATION THERAPY FACILITIES CAPACITY.39.19(a) To the extent of available appropriations, the commissioner of health shall 39.20conduct a study of the following: (1) current treatment capacity of the existing radiation 39.21therapy facilities within the state; (2) the present need for radiation therapy services based 39.22on population demographics and new cancer cases; and (3) the projected need in the next 39.23ten years for radiation therapy services and whether the current facilities can sustain 39.24this projected need.39.25(b) The commissioner may contract with a qualified entity to conduct the study. The 39.26study shall be completed by March 15, 2013, and the results shall be submitted to the 39.27chairs and ranking minority members of the health and human services committees of 39.28the legislature.39.29    Sec. 17. REVISOR'S INSTRUCTION.39.30The revisor of statutes shall change the terms "commissioner of health" or similar 39.31term to "commissioner of commerce" or similar term and "department of health" or similar 39.32term to "department of commerce" or similar term wherever necessary in Minnesota 39.33Statutes, chapters 62A to 62U, and other relevant statutes as needed to signify the transfer 40.1of regulatory jurisdiction of health maintenance organizations from the commissioner of 40.2health to the commissioner of commerce.40.3    Sec. 18. EFFECTIVE DATE.40.4Sections 5 to 10 and 14 are effective July 1, 2012, and apply to all information 40.5provided or released to the public or to health care providers, pursuant to Minnesota 40.6Statutes, section 62U.04, on or after that date. Section 7 shall be implemented by the 40.7commissioner of health within available resources.40.8ARTICLE 340.9CHILDREN AND FAMILY SERVICES40.10    Section 1. Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is 40.11amended to read:40.12    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers 40.13must not be reimbursed for more than ten full-day absent days per child, excluding 40.14holidays, in a fiscal year. Legal nonlicensed family child care providers must not be 40.15reimbursed for absent days. If a child attends for part of the time authorized to be in care in 40.16a day, but is absent for part of the time authorized to be in care in that same day, the absent 40.17time must be reimbursed but the time must not count toward the ten absent day limit. 40.18Child care providers must only be reimbursed for absent days if the provider has a written 40.19policy for child absences and charges all other families in care for similar absences.40.20(b)  Notwithstanding paragraph (a), children in families may exceed the ten absent 40.21days limit if at least one parent is: (1) under the age of 21; (2) does not have a high school 40.22or general equivalency diploma; and (3) is a student in a school district or another similar 40.23program that provides or arranges for child care, parenting support, social services, career 40.24and employment supports, and academic support to achieve high school graduation, upon 40.25request of the program and approval of the county. If a child attends part of an authorized 40.26day, payment to the provider must be for the full amount of care authorized for that day.40.27    (b)(c) Child care providers must be reimbursed for up to ten federal or state 40.28holidays or designated holidays per year when the provider charges all families for these 40.29days and the holiday or designated holiday falls on a day when the child is authorized to 40.30be in attendance. Parents may substitute other cultural or religious holidays for the ten 40.31recognized state and federal holidays. Holidays do not count toward the ten absent day 40.32limit.40.33    (c)(d) A family or child care provider must not be assessed an overpayment for an 40.34absent day payment unless (1) there was an error in the amount of care authorized for the 41.1family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 41.2the family or provider did not timely report a change as required under law.41.3    (d)(e) The provider and family shall receive notification of the number of absent 41.4days used upon initial provider authorization for a family and ongoing notification of the 41.5number of absent days used as of the date of the notification.41.6EFFECTIVE DATE.This section is effective January 1, 2013.41.7    Sec. 2. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 41.8to read:41.9    Subd. 18c.Drug convictions.(a) The state court administrator shall provide a 41.10report every six months by electronic means to the commissioner of human services, 41.11including the name, address, date of birth, and, if available, driver's license or state 41.12identification card number, date of sentence, effective date of the sentence, and county in 41.13which the conviction occurred of each person convicted of a felony under chapter 152 41.14during the previous six months.41.15(b) The commissioner shall determine whether the individuals who are the subject of 41.16the data reported under paragraph (a) are receiving public assistance under chapter 256D 41.17or 256J, and if the individual is receiving assistance under chapter 256D or 256J, the 41.18commissioner shall instruct the county to proceed under section 256D.024 or 256J.26, 41.19whichever is applicable, for this individual.41.20(c) The commissioner shall not retain any data received under paragraph (a) or (d) 41.21that does not relate to an individual receiving publicly funded assistance under chapter 41.22256D or 256J.41.23(d) In addition to the routine data transfer under paragraph (a), the state court 41.24administrator shall provide a onetime report of the data fields under paragraph (a) for 41.25individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until 41.26the date of the data transfer. The commissioner shall perform the tasks identified under 41.27paragraph (b) related to this data and shall retain the data according to paragraph (c).41.28EFFECTIVE DATE.This section is effective January 1, 2013.41.29    Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 41.30to read:41.31    Subd. 18d.Data sharing with the Department of Human Services; multiple 41.32identification cards.(a) The commissioner of public safety shall, on a monthly basis, 41.33provide the commissioner of human services with the first, middle, and last name, 42.1the address, date of birth, and driver's license or state identification card number of all 42.2applicants and holders whose drivers' licenses and state identification cards have been 42.3canceled under section 171.14, paragraph (a), clauses (2) or (3), by the commissioner of 42.4public safety. After the initial data report has been provided by the commissioner of 42.5public safety to the commissioner of human services under this paragraph, subsequent 42.6reports shall only include cancellations that occurred after the end date of the cancellations 42.7represented in the previous data report.42.8(b) The commissioner of human services shall compare the information provided 42.9under paragraph (a) with the commissioner's data regarding recipients of all public 42.10assistance programs managed by the Department of Human Services to determine whether 42.11any person with multiple identification cards issued by the Department of Public Safety 42.12has illegally or improperly enrolled in any public assistance program managed by the 42.13Department of Human Services.42.14(c) If the commissioner of human services determines that an applicant or recipient 42.15has illegally or improperly enrolled in any public assistance program, the commissioner 42.16shall provide all due process protections to the individual before terminating the individual 42.17from the program according to applicable statute and notifying the county attorney.42.18EFFECTIVE DATE.This section is effective January 1, 2013.42.19    Sec. 4. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 42.20to read:42.21    Subd. 18e.Data sharing with the Department of Human Services; legal 42.22presence date.(a) The commissioner of public safety shall, on a monthly basis, provide 42.23the commissioner of human services with the first, middle, and last name, address, date of 42.24birth, and driver's license or state identification number of all applicants and holders of 42.25drivers' licenses and state identification cards whose temporary legal presence date has 42.26expired and whose driver's license or identification card has been canceled under section 42.27171.14 by the commissioner of public safety.42.28(b) The commissioner of human services shall use the information provided under 42.29paragraph (a) to determine whether the eligibility of any recipients of public assistance 42.30programs managed by the Department of Human Services has changed as a result of the 42.31status change in the Department of Public Safety data.42.32(c) If the commissioner of human services determines that a recipient has illegally or 42.33improperly received benefits from any public assistance program, the commissioner shall 42.34provide all due process protections to the individual before terminating the individual from 42.35the program according to applicable statute and notifying the county attorney.43.1EFFECTIVE DATE.This section is effective January 1, 2013.43.2    Sec. 5. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is 43.3amended to read:43.4    Subdivision 1. Electronic benefit transfer (EBT) card. Cash benefits for the 43.5general assistance and Minnesota supplemental aid programs under chapter 256D and 43.6programs under chapter 256J must be issued on a separate an EBT card with the name of 43.7the head of household printed on the card. The card must include the following statement: 43.8"It is unlawful to use this card to purchase tobacco products or alcoholic beverages." This 43.9card must be issued within 30 calendar days of an eligibility determination. During the 43.10initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT 43.11card without a name printed on the card. This card may be the same card on which food 43.12support benefits are issued and does not need to meet the requirements of this section.43.13    Sec. 6. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:43.14    Subd. 1b. Earned income savings account. In addition to the $50 disregard 43.15required under subdivision 1, the county agency shall disregard an additional earned 43.16income up to a maximum of $150 $500 per month for: (1) persons residing in facilities 43.17licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to 43.189530.4000, and for whom discharge and work are part of a treatment plan; (2) persons 43.19living in supervised apartments with services funded under Minnesota Rules, parts 43.209535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan; 43.21and (3) persons residing in group residential housing, as that term is defined in section 43.22256I.03, subdivision 3
         , for whom the county agency has approved a discharge plan 43.23which includes work. The additional amount disregarded must be placed in a separate 43.24savings account by the eligible individual, to be used upon discharge from the residential 43.25facility into the community. For individuals residing in a chemical dependency program 43.26licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from 43.27the savings account require the signature of the individual and for those individuals with 43.28an authorized representative payee, the signature of the payee. A maximum of $1,00043.29$2,000, including interest, of the money in the savings account must be excluded from 43.30the resource limits established by section 
         256D.08, subdivision 1, clause (1). Amounts in 43.31that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If 43.32excluded money is removed from the savings account by the eligible individual at any 43.33time before the individual is discharged from the facility into the community, the money is 43.34income to the individual in the month of receipt and a resource in subsequent months. If 44.1an eligible individual moves from a community facility to an inpatient hospital setting, 44.2the separate savings account is an excluded asset for up to 18 months. During that time, 44.3amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to 44.4the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the 44.518-month period, the entire account must be applied to the patient's cost of care.44.6EFFECTIVE DATE.This section is effective October 1, 2012.44.7    Sec. 7. Minnesota Statutes 2010, section 626.556, is amended by adding a subdivision 44.8to read:44.9    Subd. 10n.Required referral to early intervention services.A child under 44.10age three who is involved in a substantiated case of maltreatment shall be referred for 44.11screening under the Individuals with Disabilities Education Act, part C. Parents must be 44.12informed that the evaluation and acceptance of services are voluntary. The commissioner 44.13of human services shall monitor referral rates by county and annually report the 44.14information to the legislature beginning March 15, 2014. Refusal to have a child screened 44.15is not a basis for a child in need of protection or services petition under chapter 260C.44.16    Sec. 8. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 1, 44.17is amended to read:

44.18Subdivision 1.Total Appropriation$6,259,280,000$6,212,085,000

44.19Appropriations by Fund44.202012201344.21General5,657,737,0005,584,471,00044.2244.23State Government 
                  		Special Revenue3,565,0003,565,00044.24Health Care Access330,435,000353,283,00044.25Federal TANF265,378,000268,101,00044.26Lottery Prize1,665,0001,665,00044.27Special Revenue500,0001,000,000

44.28Receipts for Systems Projects. 44.29Appropriations and federal receipts for 44.30information systems projects for MAXIS, 44.31PRISM, MMIS, and SSIS must be deposited 44.32in the state systems account authorized in 44.33Minnesota Statutes, section 
         256.014. Money 44.34appropriated for computer projects approved 45.1by the Minnesota Office of Enterprise 45.2Technology, funded by the legislature, 45.3and approved by the commissioner 45.4of management and budget, may be 45.5transferred from one project to another 45.6and from development to operations as the 45.7commissioner of human services considers 45.8necessary. Any unexpended balance in 45.9the appropriation for these projects does 45.10not cancel but is available for ongoing 45.11development and operations.45.12Nonfederal Share Transfers. The 45.13nonfederal share of activities for which 45.14federal administrative reimbursement is 45.15appropriated to the commissioner may be 45.16transferred to the special revenue fund.45.17TANF Maintenance of Effort.45.18(a) In order to meet the basic maintenance 45.19of effort (MOE) requirements of the TANF 45.20block grant specified under Code of Federal 45.21Regulations, title 45, section 263.1, the 45.22commissioner may only report nonfederal 45.23money expended for allowable activities 45.24listed in the following clauses as TANF/MOE 45.25expenditures:45.26(1) MFIP cash, diversionary work program, 45.27and food assistance benefits under Minnesota 45.28Statutes, chapter 256J;45.29(2) the child care assistance programs 45.30under Minnesota Statutes, sections 
         119B.0345.31and 
         119B.05, and county child care 45.32administrative costs under Minnesota 45.33Statutes, section 
         119B.15;46.1(3) state and county MFIP administrative 46.2costs under Minnesota Statutes, chapters 46.3256J and 256K;46.4(4) state, county, and tribal MFIP 46.5employment services under Minnesota 46.6Statutes, chapters 256J and 256K;46.7(5) expenditures made on behalf of legal 46.8noncitizen MFIP recipients who qualify for 46.9the MinnesotaCare program under Minnesota 46.10Statutes, chapter 256L;46.11(6) qualifying working family credit 46.12expenditures under Minnesota Statutes, 46.13section 
         290.0671; and46.14(7) qualifying Minnesota education credit 46.15expenditures under Minnesota Statutes, 46.16section 
         290.0674.46.17(b) The commissioner shall ensure that 46.18sufficient qualified nonfederal expenditures 46.19are made each year to meet the state's 46.20TANF/MOE requirements. For the activities 46.21listed in paragraph (a), clauses (2) to 46.22(7), the commissioner may only report 46.23expenditures that are excluded from the 46.24definition of assistance under Code of 46.25Federal Regulations, title 45, section 
         260.31.46.26(c) For fiscal years beginning with state fiscal 46.27year 2003, the commissioner shall assure 46.28that the maintenance of effort used by the 46.29commissioner of management and budget 46.30for the February and November forecasts 46.31required under Minnesota Statutes, section 46.3216A.103
         , contains expenditures under 46.33paragraph (a), clause (1), equal to at least 16 46.34percent of the total required under Code of 46.35Federal Regulations, title 45, section 263.1.47.1(d) Minnesota Statutes, section 
         256.011, 47.2subdivision 3
         , which requires that federal 47.3grants or aids secured or obtained under that 47.4subdivision be used to reduce any direct 47.5appropriations provided by law, do not apply 47.6if the grants or aids are federal TANF funds.47.7(e) For the federal fiscal years beginning on 47.8or after October 1, 2007, the commissioner 47.9may not claim an amount of TANF/MOE in 47.10excess of the 75 percent standard in Code 47.11of Federal Regulations, title 45, section 47.12263.1(a)(2), except:47.13(1) to the extent necessary to meet the 80 47.14percent standard under Code of Federal 47.15Regulations, title 45, section 263.1(a)(1), 47.16if it is determined by the commissioner 47.17that the state will not meet the TANF work 47.18participation target rate for the current year; 47.19(2) to provide any additional amounts 47.20under Code of Federal Regulations, title 45, 47.21section 264.5, that relate to replacement of 47.22TANF funds due to the operation of TANF 47.23penalties; and47.24(3) to provide any additional amounts that 47.25may contribute to avoiding or reducing 47.26TANF work participation penalties through 47.27the operation of the excess MOE provisions 47.28of Code of Federal Regulations, title 45, 47.29section 
         261.43 (a)(2). 47.30For the purposes of clauses (1) to (3), 47.31the commissioner may supplement the 47.32MOE claim with working family credit 47.33expenditures or other qualified expenditures 47.34to the extent such expenditures are otherwise 48.1available after considering the expenditures 48.2allowed in this subdivision. 48.3(f) Notwithstanding any contrary provision 48.4in this article, paragraphs (a) to (e) expire 48.5June 30, 2015.48.6Working Family Credit Expenditures 48.7as TANF/MOE. The commissioner may 48.8claim as TANF maintenance of effort up to 48.9$6,707,000 per year of working family credit 48.10expenditures for fiscal years 2012 and 2013.48.11Working Family Credit Expenditures 48.12to be Claimed for TANF/MOE. The 48.13commissioner may count the following 48.14amounts of working family credit 48.15expenditures as TANF/MOE:48.16(1) fiscal year 2012, $23,692,00048.17$23,761,000;48.18(2) fiscal year 2013, $44,969,00048.19$48,738,000;48.20(3) fiscal year 2014, $32,579,00048.21$32,665,000; and48.22(4) fiscal year 2015, $32,476,00048.23$32,590,000.48.24Notwithstanding any contrary provision in 48.25this article, this rider expires June 30, 2015.48.26TANF Transfer to Federal Child Care 48.27and Development Fund. (a) The following 48.28TANF fund amounts are appropriated 48.29to the commissioner for purposes of 48.30MFIP/Transition Year Child Care Assistance 48.31under Minnesota Statutes, section 
         119B.05:48.32(1) fiscal year 2012, $10,020,000;48.33(2) fiscal year 2013, $28,020,000;49.1(3) fiscal year 2014, $14,020,000; and49.2(4) fiscal year 2015, $14,020,000.49.3(b) The commissioner shall authorize the 49.4transfer of sufficient TANF funds to the 49.5federal child care and development fund to 49.6meet this appropriation and shall ensure that 49.7all transferred funds are expended according 49.8to federal child care and development fund 49.9regulations.49.10Food Stamps Employment and Training 49.11Funds. (a) Notwithstanding Minnesota 49.12Statutes, sections 
         256D.051, subdivisions 1a, 49.136b, and 6c, and 
         256J.626, federal food stamps 49.14employment and training funds received 49.15as reimbursement for child care assistance 49.16program expenditures must be deposited in 49.17the general fund. The amount of funds must 49.18be limited to $500,000 per year in fiscal 49.19years 2012 through 2015, contingent upon 49.20approval by the federal Food and Nutrition 49.21Service.49.22(b) Consistent with the receipt of these 49.23federal funds, the commissioner may 49.24adjust the level of working family credit 49.25expenditures claimed as TANF maintenance 49.26of effort. Notwithstanding any contrary 49.27provision in this article, this rider expires 49.28June 30, 2015.49.29ARRA Food Support Benefit Increases. 49.30The funds provided for food support benefit 49.31increases under the Supplemental Nutrition 49.32Assistance Program provisions of the 49.33American Recovery and Reinvestment Act 49.34(ARRA) of 2009 must be used for benefit 49.35increases beginning July 1, 2009.50.1Supplemental Security Interim Assistance 50.2Reimbursement Funds. $2,800,000 of 50.3uncommitted revenue available to the 50.4commissioner of human services for SSI 50.5advocacy and outreach services must be 50.6transferred to and deposited into the general 50.7fund by October 1, 2011.50.8    Sec. 9. DIRECTIONS TO THE COMMISSIONER.50.9The commissioner of human services, in consultation with the commissioner of 50.10public safety, shall report to the chairs and ranking minority members of the legislative 50.11committees with jurisdiction over health and human services policy and finance regarding 50.12the implementation of Minnesota Statutes, section 256.01, subdivisions 18d, 18e, and 18f, 50.13the number of persons affected, and fiscal impact by program by April 1, 2013.50.14EFFECTIVE DATE.This section is effective January 1, 2013.50.15ARTICLE 450.16CONTINUING CARE50.17    Section 1. Minnesota Statutes 2010, section 62J.496, subdivision 2, is amended to read:50.18    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:50.19(1) federally qualified health centers;50.20    (2) community clinics, as defined under section 
         145.9268;50.21    (3) nonprofit or local unit of government hospitals licensed under sections 
         144.50 50.22to 
         144.56;50.23(4) individual or small group physician practices that are focused primarily on 50.24primary care;50.25    (5) nursing facilities licensed under sections 
         144A.01 to 
         144A.27;50.26(6) local public health departments as defined in chapter 145A; and50.27    (7) other providers of health or health care services approved by the commissioner 50.28for which interoperable electronic health record capability would improve quality of 50.29care, patient safety, or community health.50.30(b) The commissioner shall administer the loan fund to prioritize support and 50.31assistance to:50.32(1) critical access hospitals;50.33(2) federally qualified health centers;51.1(3) entities that serve uninsured, underinsured, and medically underserved 51.2individuals, regardless of whether such area is urban or rural; and51.3(4) individual or small group practices that are primarily focused on primary care;51.4(5) nursing facilities certified to participate in the medical assistance program; and51.5(6) providers enrolled in the elderly waiver program of customized living or 24-hour 51.6customized living of the medical assistance program, if at least half of their annual 51.7operating revenue is paid under that medical assistance program.51.8    (c) An eligible applicant must submit a loan application to the commissioner of 51.9health on forms prescribed by the commissioner. The application must include, at a 51.10minimum:51.11    (1) the amount of the loan requested and a description of the purpose or project 51.12for which the loan proceeds will be used;51.13    (2) a quote from a vendor;51.14    (3) a description of the health care entities and other groups participating in the 51.15project;51.16    (4) evidence of financial stability and a demonstrated ability to repay the loan; and51.17    (5) a description of how the system to be financed interoperates or plans in the 51.18future to interoperate with other health care entities and provider groups located in the 51.19same geographical area;51.20(6) a plan on how the certified electronic health record technology will be maintained 51.21and supported over time; and51.22(7) any other requirements for applications included or developed pursuant to 51.23section 3014 of the HITECH Act.51.24    Sec. 2. [144.595] HOSPITAL FUTILITY POLICY.51.25(a) A hospital licensed under sections 144.50 to 144.56 that adopts or implements a 51.26futility policy that applies to treatment of any child, from birth to 18 years of age, must 51.27disclose the futility policy to the parents of children treated at the hospital when the 51.28hospital identifies the need for a formal process to address concerns over the proposed 51.29treatment of a child. The hospital must, upon request of a parent of a patient or prospective 51.30patient, provide a copy of the current policy, if any.51.31(b) For purposes of this section, a "futility policy" is any written policy that 51.32encourages or allows hospital employees, or other medical professionals who provide 51.33care to patients at the hospital, to withhold or discontinue treatment for a patient on the 51.34grounds of medical futility.52.1    Sec. 3. Minnesota Statutes 2010, section 144A.073, is amended by adding a 52.2subdivision to read:52.3    Subd. 13.Moratorium exception funding.In fiscal year 2013, the commissioner 52.4of health may approve moratorium exception projects under this section for which the full 52.5annualized state share of medical assistance costs does not exceed $1,000,000.52.6    Sec. 4. Minnesota Statutes 2010, section 144A.351, is amended to read:52.7144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: 52.8REPORT REQUIRED.52.9    The commissioners of health and human services, with the cooperation of counties 52.10andstakeholders, including persons who need or are using long-term care services and 52.11supports; lead agencies; regional entities,;senior, mental health, and disability organization 52.12representatives; services providers; and community members, including representatives of 52.13local business and faith communities shall prepare a report to the legislature by August 15, 52.142004 2013, and biennially thereafter, regarding the status of the full range of long-term 52.15care services and supports for the elderly and children and adults with disabilities and 52.16mental illnesses in Minnesota. The report shall address:52.17    (1) demographics and need for long-term care services and supports in Minnesota;52.18    (2) summary of county and regional reports on long-term care gaps, surpluses, 52.19imbalances, and corrective action plans;52.20    (3) status of long-term care services by county and region including:52.21    (i) changes in availability of the range of long-term care services and housing 52.22options;52.23    (ii) access problems regarding long-term care services; and52.24    (iii) comparative measures of long-term care services availability and progress52.25changes over time; and52.26    (4) recommendations regarding goals for the future of long-term care services, 52.27policy  and fiscal changes, and resource needs.52.28    Sec. 5. Minnesota Statutes 2010, section 245A.03, is amended by adding a subdivision 52.29to read:52.30    Subd. 6a.Adult foster care homes serving people with mental illness; 52.31certification.(a) The commissioner of human services shall issue a mental health 52.32certification for adult foster care homes licensed under this chapter and Minnesota Rules, 52.33parts 9555.5105 to 9555.6265, that serve people with mental illness where the home is not 52.34the primary residence of the license holder when a provider is determined to have met 53.1the requirements under paragraph (b). This certification is voluntary for license holders. 53.2The certification shall be printed on the license, and identified on the commissioner's 53.3public Web site.53.4(b) The requirements for certification are:53.5(1) all staff working in the adult foster care home have received at least seven hours 53.6of annual training covering all of the following topics:53.7(i) mental health diagnoses;53.8(ii) mental health crisis response and de-escalation techniques;53.9(iii) recovery from mental illness;53.10(iv) treatment options including evidence-based practices;53.11(v) medications and their side effects;53.12(vi) co-occurring substance abuse and health conditions; and53.13(vii) community resources;53.14(2) a mental health professional, as defined in section 245.462, subdivision 18, or 53.15a mental health practitioner as defined in section 245.462, subdivision 17, are available 53.16for consultation and assistance;53.17(3) there is a plan and protocol in place to address a mental health crisis; and53.18(4) each individual's Individual Placement Agreement identifies who is providing 53.19clinical services and their contact information, and includes an individual crisis prevention 53.20and management plan developed with the individual.53.21(c) License holders seeking certification under this subdivision must request this 53.22certification on forms provided by the commissioner and must submit the request to the 53.23county licensing agency in which the home is located. The county licensing agency must 53.24forward the request to the commissioner with a county recommendation regarding whether 53.25the commissioner should issue the certification.53.26(d) Ongoing compliance with the certification requirements under paragraph (b) 53.27shall be reviewed by the county licensing agency at each licensing review. When a county 53.28licensing agency determines that the requirements of paragraph (b) are not met, the county 53.29shall inform the commissioner, and the commissioner will remove the certification.53.30(e) A denial of the certification or the removal of the certification based on a 53.31determination that the requirements under paragraph (b) have not been met by the adult 53.32foster care license holder are not subject to appeal. A license holder that has been denied a 53.33certification or that has had a certification removed may again request certification when 53.34the license holder is in compliance with the requirements of paragraph (b).54.1    Sec. 6. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is 54.2amended to read:54.3    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an 54.4initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 54.52960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 54.69555.6265, under this chapter for a physical location that will not be the primary residence 54.7of the license holder for the entire period of licensure. If a license is issued during this 54.8moratorium, and the license holder changes the license holder's primary residence away 54.9from the physical location of the foster care license, the commissioner shall revoke the 54.10license according to section 
         245A.07. Exceptions to the moratorium include:54.11(1) foster care settings that are required to be registered under chapter 144D;54.12(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, 54.13and determined to be needed by the commissioner under paragraph (b);54.14(3) new foster care licenses determined to be needed by the commissioner under 54.15paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or 54.16restructuring of state-operated services that limits the capacity of state-operated facilities;54.17(4) new foster care licenses determined to be needed by the commissioner under 54.18paragraph (b) for persons requiring hospital level care; or54.19(5) new foster care licenses determined to be needed by the commissioner for the 54.20transition of people from personal care assistance to the home and community-based 54.21services.54.22(b) The commissioner shall determine the need for newly licensed foster care homes 54.23as defined under this subdivision. As part of the determination, the commissioner shall 54.24consider the availability of foster care capacity in the area in which the licensee seeks to 54.25operate, and the recommendation of the local county board. The determination by the 54.26commissioner must be final. A determination of need is not required for a change in 54.27ownership at the same address.54.28    (c) Residential settings that would otherwise be subject to the moratorium established 54.29in paragraph (a), that are in the process of receiving an adult or child foster care license as 54.30of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult 54.31or child foster care license. For this paragraph, all of the following conditions must be met 54.32to be considered in the process of receiving an adult or child foster care license:54.33    (1) participants have made decisions to move into the residential setting, including 54.34documentation in each participant's care plan;54.35    (2) the provider has purchased housing or has made a financial investment in the 54.36property;55.1    (3) the lead agency has approved the plans, including costs for the residential setting 55.2for each individual;55.3    (4) the completion of the licensing process, including all necessary inspections, is 55.4the only remaining component prior to being able to provide services; and55.5    (5) the needs of the individuals cannot be met within the existing capacity in that 55.6county.55.7To qualify for the process under this paragraph, the lead agency must submit 55.8documentation to the commissioner by August 1, 2009, that all of the above criteria are 55.9met.55.10(d) The commissioner shall study the effects of the license moratorium under this 55.11subdivision and shall report back to the legislature by January 15, 2011. This study shall 55.12include, but is not limited to the following:55.13(1) the overall capacity and utilization of foster care beds where the physical location 55.14is not the primary residence of the license holder prior to and after implementation 55.15of the moratorium;55.16(2) the overall capacity and utilization of foster care beds where the physical 55.17location is the primary residence of the license holder prior to and after implementation 55.18of the moratorium; and55.19(3) the number of licensed and occupied ICF/MR beds prior to and after 55.20implementation of the moratorium.55.21(e) When a foster care recipient moves out of a foster home that is not the primary 55.22residence of the license holder according to section 
         256B.49, subdivision 15, paragraph 55.23(f), the county shall immediately inform the Department of Human Services Licensing 55.24Division, and. The department shall immediately decrease the licensed capacity for the 55.25home, if the voluntary changes described in paragraph (g) are not sufficient to meet the 55.26savings required by 2011 reductions in licensed bed capacity and maintain statewide 55.27long-term care residential services capacity within budgetary limits. The commissioner 55.28shall delicense up to 128 beds by June 30, 2013, using the needs determination process. 55.29Under this paragraph, the commissioner has the authority to reduce unused licensed 55.30capacity of a current foster care program to accomplish the consolidation or closure of 55.31settings. A decreased licensed capacity according to this paragraph is not subject to appeal 55.32under this chapter.55.33(f) Residential settings that would otherwise be subject to the decreased license 55.34capacity established in paragraph (e) shall be exempt under the following circumstances:55.35(1) until August 1, 2013, the license holder's beds occupied by residents whose 55.36primary diagnosis is mental illness and the license holder is:56.1(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental 56.2health services (ARMHS) as defined in section 256B.0623;56.3(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 56.49520.0870;56.5(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 56.69520.0870; or56.7(iv) a provider of intensive residential treatment services (IRTS) licensed under 56.8Minnesota Rules, parts 9520.0500 to 9520.0670; or56.9(2) the license holder is certified under the requirements in subdivision 6a.56.10(g) A resource need determination process, managed at the state level, using the 56.11available reports required by section 144A.351, and other data and information shall 56.12be used to determine where the reduced capacity required under paragraph (e) will be 56.13implemented. The commissioner shall consult with the stakeholders described in section 56.14144A.351, and employ a variety of methods to improve the state's capacity to meet 56.15long-term care service needs within budgetary limits, including seeking proposals from 56.16service providers or lead agencies to change service type, capacity, or location to improve 56.17services, increase the independence of residents, and better meet needs identified by the 56.18long-term care services reports and statewide data and information. By February 1 of each 56.19year, the commissioner shall provide information and data on the overall capacity of 56.20licensed long-term care services, actions taken under this subdivision to manage statewide 56.21long-term care services and supports resources, and any recommendations for change to 56.22the legislative committees with jurisdiction over health and human services budget.56.23    Sec. 7. Minnesota Statutes 2010, section 245A.11, subdivision 2a, is amended to read:56.24    Subd. 2a. Adult foster care license capacity. (a) The commissioner shall issue 56.25adult foster care licenses with a maximum licensed capacity of four beds, including 56.26nonstaff roomers and boarders, except that the commissioner may issue a license with a 56.27capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).56.28(b) An adult foster care license holder may have a maximum license capacity of five 56.29if all persons in care are age 55 or over and do not have a serious and persistent mental 56.30illness or a developmental disability.56.31(c) The commissioner may grant variances to paragraph (b) to allow a foster care 56.32provider with a licensed capacity of five persons to admit an individual under the age of 55 56.33if the variance complies with section 
         245A.04, subdivision 9, and approval of the variance 56.34is recommended by the county in which the licensed foster care provider is located.57.1(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth 57.2bed for emergency crisis services for a person with serious and persistent mental illness 57.3or a developmental disability, regardless of age, if the variance complies with section 57.4245A.04, subdivision 9
         , and approval of the variance is recommended by the county in 57.5which the licensed foster care provider is located.57.6(e) The commissioner may grant a variance to paragraph (b) to allow for the 57.7use of a fifth bed for respite services, as defined in section 245A.02, for persons with 57.8disabilities, regardless of age, if the variance complies with section 245A.03, subdivision 57.97, and section 245A.04, subdivision 9, and approval of the variance is recommended by 57.10the county in which the licensed foster care provider is licensed. Respite care may be 57.11provided under the following conditions:57.12(1) staffing ratios cannot be reduced below the approved level for the individuals 57.13being served in the home on a permanent basis;57.14(2) no more than two different individuals can be accepted for respite services in 57.15any calendar month and the total respite days may not exceed 120 days per program in 57.16any calendar year;57.17(3) the person receiving respite services must have his or her own bedroom, which 57.18could be used for alternative purposes when not used as a respite bedroom, and cannot be 57.19the room of another person who lives in the foster care home; and57.20(4) individuals living in the foster care home must be notified when the variance 57.21is approved. The provider must give 60 days' notice in writing to the residents and their 57.22legal representatives prior to accepting the first respite placement. Notice must be given to 57.23residents at least two days prior to service initiation, or as soon as the license holder is 57.24able if they receive notice of the need for respite less than two days prior to initiation, 57.25each time a respite client will be served, unless the requirement for this notice is waived 57.26by the resident or legal guardian.57.27(e) If the 2009 legislature adopts a rate reduction that impacts providers of adult 57.28foster care services, (f)  The commissioner may issue an adult foster care license with a 57.29capacity of five adults if the fifth bed does not increase the overall statewide capacity of 57.30licensed adult foster care beds in homes that are not the primary residence of the license 57.31holder, over the licensed capacity in such homes on July 1, 2009, as identified in a plan 57.32submitted to the commissioner by the county, when the capacity is recommended by 57.33the county licensing agency of the county in which the facility is located and if the 57.34recommendation verifies that:57.35(1) the facility meets the physical environment requirements in the adult foster 57.36care licensing rule;58.1(2) the five-bed living arrangement is specified for each resident in the resident's:58.2(i) individualized plan of care;58.3(ii) individual service plan under section 
         256B.092, subdivision 1b, if required; or58.4(iii) individual resident placement agreement under Minnesota Rules, part 58.59555.5105, subpart 19, if required;58.6(3) the license holder obtains written and signed informed consent from each 58.7resident or resident's legal representative documenting the resident's informed choice 58.8to remain living in the home and that the resident's refusal to consent would not have 58.9resulted in service termination; and58.10(4) the facility was licensed for adult foster care before March 1, 2009 2011.58.11(f) (g) The commissioner shall not issue a new adult foster care license under 58.12paragraph (e) (f) after June 30, 2011 2016. The commissioner shall allow a facility with 58.13an adult foster care license issued under paragraph (e) (f) before June 30, 2011 2016, to 58.14continue with a capacity of five adults if the license holder continues to comply with the 58.15requirements in paragraph (e) (f).58.16    Sec. 8. Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:58.17    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The 58.18commissioner may grant a variance under section 
         245A.04, subdivision 9, to rule parts 58.19requiring a caregiver to be present in an adult foster care home during normal sleeping 58.20hours to allow for alternative methods of overnight supervision. The commissioner may 58.21grant the variance if the local county licensing agency recommends the variance and the 58.22county recommendation includes documentation verifying that:58.23    (1) the county has approved the license holder's plan for alternative methods of 58.24providing overnight supervision and determined the plan protects the residents' health, 58.25safety, and rights;58.26    (2) the license holder has obtained written and signed informed consent from 58.27each resident or each resident's legal representative documenting the resident's or legal 58.28representative's agreement with the alternative method of overnight supervision; and58.29    (3) the alternative method of providing overnight supervision, which may include 58.30the use of technology, is specified for each resident in the resident's: (i) individualized 58.31plan of care; (ii) individual service plan under section 
         256B.092, subdivision 1b, if 58.32required; or (iii) individual resident placement agreement under Minnesota Rules, part 58.339555.5105, subpart 19, if required.58.34    (b) To be eligible for a variance under paragraph (a), the adult foster care license 58.35holder must not have had a licensing action conditional license issued under section 59.1245A.06
         , or any other licensing sanction issued under section245A.07 during the prior 24 59.2months based on failure to provide adequate supervision, health care services, or resident 59.3safety in the adult foster care home.59.4    (c) A license holder requesting a variance under this subdivision to utilize 59.5technology as a component of a plan for alternative overnight supervision may request 59.6the commissioner's review in the absence of a county recommendation. Upon receipt of 59.7such a request from a license holder, the commissioner shall review the variance request 59.8with the county.59.9    Sec. 9. Minnesota Statutes 2010, section 245A.11, subdivision 7a, is amended to read:59.10    Subd. 7a. Alternate overnight supervision technology; adult foster care license.59.11    (a) The commissioner may grant an applicant or license holder an adult foster care license 59.12for a residence that does not have a caregiver in the residence during normal sleeping 59.13hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses 59.14monitoring technology to alert the license holder when an incident occurs that may 59.15jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 59.16holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 59.17to 9555.6265, and the requirements under this subdivision. The license printed by the 59.18commissioner must state in bold and large font:59.19    (1) that the facility is under electronic monitoring; and59.20    (2) the telephone number of the county's common entry point for making reports of 59.21suspected maltreatment of vulnerable adults under section 
         626.557, subdivision 9.59.22(b) Applications for a license under this section must be submitted directly to 59.23the Department of Human Services licensing division. The licensing division must 59.24immediately notify the host county and lead county contract agency and the host county 59.25licensing agency. The licensing division must collaborate with the county licensing 59.26agency in the review of the application and the licensing of the program.59.27    (c) Before a license is issued by the commissioner, and for the duration of the 59.28license, the applicant or license holder must establish, maintain, and document the 59.29implementation of written policies and procedures addressing the requirements in 59.30paragraphs (d) through (f).59.31    (d) The applicant or license holder must have policies and procedures that:59.32    (1) establish characteristics of target populations that will be admitted into the home, 59.33and characteristics of populations that will not be accepted into the home;60.1    (2) explain the discharge process when a foster care recipient requires overnight 60.2supervision or other services that cannot be provided by the license holder due to the 60.3limited hours that the license holder is on site;60.4    (3) describe the types of events to which the program will respond with a physical 60.5presence when those events occur in the home during time when staff are not on site, and 60.6how the license holder's response plan meets the requirements in paragraph (e), clause 60.7(1) or (2);60.8    (4) establish a process for documenting a review of the implementation and 60.9effectiveness of the response protocol for the response required under paragraph (e), 60.10clause (1) or (2). The documentation must include:60.11    (i) a description of the triggering incident;60.12    (ii) the date and time of the triggering incident;60.13    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);60.14    (iv) whether the response met the resident's needs;60.15    (v) whether the existing policies and response protocols were followed; and60.16    (vi) whether the existing policies and protocols are adequate or need modification.60.17    When no physical presence response is completed for a three-month period, the 60.18license holder's written policies and procedures must require a physical presence response 60.19drill to be conducted for which the effectiveness of the response protocol under paragraph 60.20(e), clause (1) or (2), will be reviewed and documented as required under this clause; and60.21    (5) establish that emergency and nonemergency phone numbers are posted in a 60.22prominent location in a common area of the home where they can be easily observed by a 60.23person responding to an incident who is not otherwise affiliated with the home.60.24    (e) The license holder must document and include in the license application which 60.25response alternative under clause (1) or (2) is in place for responding to situations that 60.26present a serious risk to the health, safety, or rights of people receiving foster care services 60.27in the home:60.28    (1) response alternative (1) requires only the technology to provide an electronic 60.29notification or alert to the license holder that an event is underway that requires a response. 60.30Under this alternative, no more than ten minutes will pass before the license holder will be 60.31physically present on site to respond to the situation; or60.32    (2) response alternative (2) requires the electronic notification and alert system 60.33under alternative (1), but more than ten minutes may pass before the license holder is 60.34present on site to respond to the situation. Under alternative (2), all of the following 60.35conditions are met:61.1    (i) the license holder has a written description of the interactive technological 61.2applications that will assist the license holder in communicating with and assessing the 61.3needs related to the care, health, and safety of the foster care recipients. This interactive 61.4technology must permit the license holder to remotely assess the well being of the foster 61.5care recipient without requiring the initiation of the foster care recipient. Requiring the 61.6foster care recipient to initiate a telephone call does not meet this requirement;61.7(ii) the license holder documents how the remote license holder is qualified and 61.8capable of meeting the needs of the foster care recipients and assessing foster care 61.9recipients' needs under item (i) during the absence of the license holder on site;61.10(iii) the license holder maintains written procedures to dispatch emergency response 61.11personnel to the site in the event of an identified emergency; and61.12    (iv) each foster care recipient's individualized plan of care, individual service plan 61.13under section 
         256B.092, subdivision 1b, if required, or individual resident placement 61.14agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the 61.15maximum response time, which may be greater than ten minutes, for the license holder 61.16to be on site for that foster care recipient.61.17    (f) All Each foster care recipient's placement agreements agreement, individual 61.18service agreements, and plans applicable to the foster care recipient agreement, and plan 61.19must clearly state that the adult foster care license category is a program without the 61.20presence of a caregiver in the residence during normal sleeping hours; the protocols in 61.21place for responding to situations that present a serious risk to the health, safety, or rights 61.22of foster care recipients under paragraph (e), clause (1) or (2); and a signed informed 61.23consent from each foster care recipient or the person's legal representative documenting 61.24the person's or legal representative's agreement with placement in the program. If 61.25electronic monitoring technology is used in the home, the informed consent form must 61.26also explain the following:61.27    (1) how any electronic monitoring is incorporated into the alternative supervision 61.28system;61.29    (2) the backup system for any electronic monitoring in times of electrical outages or 61.30other equipment malfunctions;61.31    (3) how the license holder is caregivers are trained on the use of the technology;61.32    (4) the event types and license holder response times established under paragraph (e);61.33    (5) how the license holder protects the foster care recipient's privacy related to 61.34electronic monitoring and related to any electronically recorded data generated by the 61.35monitoring system. A foster care recipient may not be removed from a program under 61.36this subdivision for failure to consent to electronic monitoring. The consent form must 62.1explain where and how the electronically recorded data is stored, with whom it will be 62.2shared, and how long it is retained; and62.3    (6) the risks and benefits of the alternative overnight supervision system.62.4    The written explanations under clauses (1) to (6) may be accomplished through 62.5cross-references to other policies and procedures as long as they are explained to the 62.6person giving consent, and the person giving consent is offered a copy.62.7(g) Nothing in this section requires the applicant or license holder to develop or 62.8maintain separate or duplicative policies, procedures, documentation, consent forms, or 62.9individual plans that may be required for other licensing standards, if the requirements of 62.10this section are incorporated into those documents.62.11(h) The commissioner may grant variances to the requirements of this section 62.12according to section 
         245A.04, subdivision 9.62.13(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning 62.14under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and 62.15contractors affiliated with the license holder.62.16(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to 62.17remotely determine what action the license holder needs to take to protect the well-being 62.18of the foster care recipient.62.19(k) The commissioner shall evaluate license applications using the requirements 62.20in paragraphs (d) to (f). The commissioner shall provide detailed application forms, 62.21including a checklist of criteria needed for approval.62.22(l) To be eligible for a license under paragraph (a), the adult foster care license holder 62.23must not have had a conditional license issued under section 245A.06 or any licensing 62.24sanction under section 245A.07 during the prior 24 months based on failure to provide 62.25adequate supervision, health care services, or resident safety in the adult foster care home.62.26(m) The commissioner shall review an application for an alternative overnight 62.27supervision license within 60 days of receipt of the application. When the commissioner 62.28receives an application that is incomplete because the applicant failed to submit required 62.29documents or that is substantially deficient because the documents submitted do not meet 62.30licensing requirements, the commissioner shall provide the applicant written notice 62.31that the application is incomplete or substantially deficient. In the written notice to the 62.32applicant, the commissioner shall identify documents that are missing or deficient and 62.33give the applicant 45 days to resubmit a second application that is substantially complete. 62.34An applicant's failure to submit a substantially complete application after receiving 62.35notice from the commissioner is a basis for license denial under section 245A.05. The 62.36commissioner shall complete subsequent review within 30 days.63.1(n) Once the application is considered complete under paragraph (m), the 63.2commissioner will approve or deny an application for an alternative overnight supervision 63.3license within 60 days.63.4(o) For the purposes of this subdivision, "supervision" means:63.5(1) oversight by a caregiver as specified in the individual resident's place agreement 63.6and awareness of the resident's needs and activities; and63.7(2) the presence of a caregiver in a residence during normal sleeping hours, unless a 63.8determination has been made and documented in the individual's support plan that the 63.9individual does not require the presence of a caregiver during normal sleeping hours.63.10    Sec. 10. Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:63.11    Subdivision 1. Consumer data file. The license holder must maintain the following 63.12information for each consumer:63.13(1) identifying information that includes date of birth, medications, legal 63.14representative, history, medical, and other individual-specific information, and names and 63.15telephone numbers of contacts;63.16(2) consumer health information, including individual medication administration 63.17and monitoring information;63.18(3) the consumer's individual service plan. When a consumer's case manager does 63.19not provide a current individual service plan, the license holder shall make a written 63.20request to the case manager to provide a copy of the individual service plan and inform 63.21the consumer or the consumer's legal representative of the right to an individual service 63.22plan and the right to appeal under section 
         256.045;. In the event the case manager fails 63.23to provide an individual service plan after a written request from the license holder, the 63.24license holder shall not be sanctioned or penalized financially for not having a current 63.25individual service plan in the consumer's data file;63.26(4) copies of assessments, analyses, summaries, and recommendations;63.27(5) progress review reports;63.28(6) incidents involving the consumer;63.29(7) reports required under section 
         245B.05, subdivision 7;63.30(8) discharge summary, when applicable;63.31(9) record of other license holders serving the consumer that includes a contact 63.32person and telephone numbers, services being provided, services that require coordination 63.33between two license holders, and name of staff responsible for coordination;63.34(10) information about verbal aggression directed at the consumer by another 63.35consumer; and64.1(11) information about self-abuse.64.2    Sec. 11. Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:64.3    Subd. 6. Unlicensed home and community-based waiver providers of service to 64.4seniors and individuals with disabilities. (a) Providers required to initiate background 64.5studies under section 
         256B.4912 must initiate a study before the individual begins in a 64.6position allowing direct contact with persons served by the provider.64.7(b) The commissioner shall conduct Except as provided in paragraph (c), the 64.8providers must initiate a background study annually of an individual required to be studied 64.9under section 
         245C.03, subdivision 6.64.10(c) After an initial background study under this subdivision is initiated on an 64.11individual by a provider of both services licensed by the commissioner and the unlicensed 64.12services under this subdivision, a repeat annual background study is not required if:64.13(1) the provider maintains compliance with the requirements of section 245C.07, 64.14paragraph (a), regarding one individual with one address and telephone number as the 64.15person to receive sensitive background study information for the multiple programs that 64.16depend on the same background study, and that the individual who is designated to receive 64.17the sensitive background information is capable of determining, upon the request of the 64.18commissioner, whether a background study subject is providing direct contact services 64.19in one or more of the provider's programs or services and, if so, at which location or 64.20locations; and64.21(2) the individual who is the subject of the background study provides direct 64.22contact services under the provider's licensed program for at least 40 hours per year so 64.23the individual will be recognized by a probation officer or corrections agent to prompt 64.24a report to the commissioner regarding criminal convictions as required under section 64.25245C.05, subdivision 7.64.26    Sec. 12. Minnesota Statutes 2010, section 245C.05, subdivision 7, is amended to read:64.27    Subd. 7. Probation officer and corrections agent. (a) A probation officer or 64.28corrections agent shall notify the commissioner of an individual's conviction if the 64.29individual is:64.30    (1) has been affiliated with a program or facility regulated by the Department of 64.31Human Services or Department of Health, a facility serving children or youth licensed by 64.32the Department of Corrections, or any type of home care agency or provider of personal 64.33care assistance services within the preceding year; and65.1    (2) has been convicted of a crime constituting a disqualification under section 65.2245C.14
         .65.3    (b) For the purpose of this subdivision, "conviction" has the meaning given it 65.4in section 
         609.02, subdivision 5.65.5    (c) The commissioner, in consultation with the commissioner of corrections, shall 65.6develop forms and information necessary to implement this subdivision and shall provide 65.7the forms and information to the commissioner of corrections for distribution to local 65.8probation officers and corrections agents.65.9    (d) The commissioner shall inform individuals subject to a background study that 65.10criminal convictions for disqualifying crimes will be reported to the commissioner by the 65.11corrections system.65.12    (e) A probation officer, corrections agent, or corrections agency is not civilly or 65.13criminally liable for disclosing or failing to disclose the information required by this 65.14subdivision.65.15    (f) Upon receipt of disqualifying information, the commissioner shall provide the 65.16notice required under section 
         245C.17, as appropriate, to agencies on record as having 65.17initiated a background study or making a request for documentation of the background 65.18study status of the individual.65.19    (g) This subdivision does not apply to family child care programs.65.20    Sec. 13. Minnesota Statutes 2010, section 256.975, subdivision 7, is amended to read:65.21    Subd. 7. Consumer information and assistance and long-term care options 65.22counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 65.23statewide service to aid older Minnesotans and their families in making informed choices 65.24about long-term care options and health care benefits. Language services to persons with 65.25limited English language skills may be made available. The service, known as Senior 65.26LinkAge Line, must be available during business hours through a statewide toll-free 65.27number and must also be available through the Internet.65.28    (b) The service must provide long-term care options counseling by assisting older 65.29adults, caregivers, and providers in accessing information and options counseling about 65.30choices in long-term care services that are purchased through private providers or available 65.31through public options. The service must:65.32    (1) develop a comprehensive database that includes detailed listings in both 65.33consumer- and provider-oriented formats;65.34    (2) make the database accessible on the Internet and through other telecommunication 65.35and media-related tools;66.1    (3) link callers to interactive long-term care screening tools and make these tools 66.2available through the Internet by integrating the tools with the database;66.3    (4) develop community education materials with a focus on planning for long-term 66.4care and evaluating independent living, housing, and service options;66.5    (5) conduct an outreach campaign to assist older adults and their caregivers in 66.6finding information on the Internet and through other means of communication;66.7    (6) implement a messaging system for overflow callers and respond to these callers 66.8by the next business day;66.9    (7) link callers with county human services and other providers to receive more 66.10in-depth assistance and consultation related to long-term care options;66.11    (8) link callers with quality profiles for nursing facilities and other providers 66.12developed by the commissioner of health;66.13    (9) incorporate information about the availability of housing options, as well as 66.14registered housing with services and consumer rights within the MinnesotaHelp.info 66.15network long-term care database to facilitate consumer comparison of services and costs 66.16among housing with services establishments and with other in-home services and to 66.17support financial self-sufficiency as long as possible. Housing with services establishments 66.18and their arranged home care providers shall provide information that will facilitate price 66.19comparisons, including delineation of charges for rent and for services available. The 66.20commissioners of health and human services shall align the data elements required by 66.21section 
         144G.06, the Uniform Consumer Information Guide, and this section to provide 66.22consumers standardized information and ease of comparison of long-term care options. 66.23The commissioner of human services shall provide the data to the Minnesota Board on 66.24Aging for inclusion in the MinnesotaHelp.info network long-term care database;66.25(10) provide long-term care options counseling. Long-term care options counselors 66.26shall:66.27(i) for individuals not eligible for case management under a public program or public 66.28funding source, provide interactive decision support under which consumers, family 66.29members, or other helpers are supported in their deliberations to determine appropriate 66.30long-term care choices in the context of the consumer's needs, preferences, values, and 66.31individual circumstances, including implementing a community support plan;66.32(ii) provide Web-based educational information and collateral written materials to 66.33familiarize consumers, family members, or other helpers with the long-term care basics, 66.34issues to be considered, and the range of options available in the community;67.1(iii) provide long-term care futures planning, which means providing assistance to 67.2individuals who anticipate having long-term care needs to develop a plan for the more 67.3distant future; and67.4(iv) provide expertise in benefits and financing options for long-term care, including 67.5Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 67.6private pay options, and ways to access low or no-cost services or benefits through 67.7volunteer-based or charitable programs; and67.8(11) using risk management and support planning protocols, provide long-term care 67.9options counseling to current residents of nursing homes deemed appropriate for discharge 67.10by the commissioner. In order to meet this requirement, the commissioner shall provide 67.11designated Senior LinkAge Line contact centers with a list of nursing home residents 67.12appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall 67.13provide these residents, if they indicate a preference to receive long-term care options 67.14counseling, with initial assessment, review of risk factors, independent living support 67.15consultation, or referral to:67.16(i) long-term care consultation services under section 
         256B.0911;67.17(ii) designated care coordinators of contracted entities under section 
         256B.035 for 67.18persons who are enrolled in a managed care plan; or67.19(iii) the long-term care consultation team for those who are appropriate for relocation 67.20service coordination due to high-risk factors or psychological or physical disability; and67.21(12) develop referral protocols and processes that will assist certified health care 67.22homes and hospitals to identify at-risk older adults and determine when to refer these 67.23individuals to the Senior LinkAge Line for long-term care options counseling under this 67.24section. The commissioner is directed to work with the commissioner of health to develop 67.25protocols that would comply with the health care home designation criteria and protocols 67.26available at the time of hospital discharge.67.27EFFECTIVE DATE.This section is effective is effective July 1, 2013.67.28    Sec. 14. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to 67.29read:67.30    Subd. 1a. Income and assets generally. Unless specifically required by state 67.31law or rule or federal law or regulation, the methodologies used in counting income 67.32and assets to determine eligibility for medical assistance for persons whose eligibility 67.33category is based on blindness, disability, or age of 65 or more years, the methodologies 67.34for the supplemental security income program shall be used, except as provided under 67.35subdivision 3, paragraph (a), clause (6). Increases in benefits under title II of the Social 68.1Security Act shall not be counted as income for purposes of this subdivision until July 1 of 68.2each year. Effective upon federal approval, for children eligible under section 
         256B.055, 68.3subdivision 12
         , or for home and community-based waiver services whose eligibility 68.4for medical assistance is determined without regard to parental income, child support 68.5payments, including any payments made by an obligor in satisfaction of or in addition 68.6to a temporary or permanent order for child support, and Social Security payments are 68.7not counted as income. For families and children, which includes all other eligibility 68.8categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as 68.9required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 68.10(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the 68.11earned income disregards and deductions are limited to those in subdivision 1c. For these 68.12purposes, a "methodology" does not include an asset or income standard, or accounting 68.13method, or method of determining effective dates.68.14EFFECTIVE DATE.This section is effective April 1, 2012.68.15    Sec. 15. Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3, 68.16is amended to read:68.17    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for 68.18medical assistance, a person must not individually own more than $3,000 in assets, or if a 68.19member of a household with two family members, husband and wife, or parent and child, 68.20the household must not own more than $6,000 in assets, plus $200 for each additional 68.21legal dependent. In addition to these maximum amounts, an eligible individual or family 68.22may accrue interest on these amounts, but they must be reduced to the maximum at the 68.23time of an eligibility redetermination. The accumulation of the clothing and personal 68.24needs allowance according to section 
         256B.35 must also be reduced to the maximum at 68.25the time of the eligibility redetermination. The value of assets that are not considered in 68.26determining eligibility for medical assistance is the value of those assets excluded under 68.27the supplemental security income program for aged, blind, and disabled persons, with 68.28the following exceptions:68.29(1) household goods and personal effects are not considered;68.30(2) capital and operating assets of a trade or business that the local agency determines 68.31are necessary to the person's ability to earn an income are not considered;68.32(3) motor vehicles are excluded to the same extent excluded by the supplemental 68.33security income program;68.34(4) assets designated as burial expenses are excluded to the same extent excluded by 68.35the supplemental security income program. Burial expenses funded by annuity contracts 69.1or life insurance policies must irrevocably designate the individual's estate as contingent 69.2beneficiary to the extent proceeds are not used for payment of selected burial expenses; and69.3(5) for a person who no longer qualifies as an employed person with a disability due 69.4to loss of earnings, assets allowed while eligible for medical assistance under section 69.5256B.057, subdivision 9
         , are not considered for 12 months, beginning with the first month 69.6of ineligibility as an employed person with a disability, to the extent that the person's total 69.7assets remain within the allowed limits of section 
         256B.057, subdivision 9, paragraph 69.8(d).; and69.9    (6) when a person enrolled in medical assistance under section 256B.057, subdivision 69.109, is age 65 or older and has been enrolled during each of the 24 consecutive months 69.11before the person's 65th birthday, the assets owned by the person and the person's spouse 69.12must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), 69.13when determining eligibility for medical assistance under section 256B.055, subdivision 69.147. The income of a spouse of a person enrolled in medical assistance under section 69.15256B.057, subdivision 9, during each of the 24 consecutive months before the person's 69.1665th birthday must be disregarded when determining eligibility for medical assistance 69.17under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to 69.18the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013 69.19is required to have qualified for medical assistance under section 256B.057, subdivision 9, 69.20prior to age 65 for at least 20 months in the 24 months prior to reaching age 65.69.21(b) No asset limit shall apply to persons eligible under section 
         256B.055, subdivision 69.2215.69.23    Sec. 16. Minnesota Statutes 2011 Supplement, section 256B.057, subdivision 9, 69.24is amended to read:69.25    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid 69.26for a person who is employed and who:69.27    (1) but for excess earnings or assets, meets the definition of disabled under the 69.28Supplemental Security Income program;69.29    (2) is at least 16 but less than 65 years of age;69.30    (3) meets the asset limits in paragraph (d); and69.31    (4) (3) pays a premium and other obligations under paragraph (e).69.32    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 69.33for medical assistance under this subdivision, a person must have more than $65 of earned 69.34income. Earned income must have Medicare, Social Security, and applicable state and 69.35federal taxes withheld. The person must document earned income tax withholding. Any 70.1spousal income or assets shall be disregarded for purposes of eligibility and premium 70.2determinations.70.3    (c) After the month of enrollment, a person enrolled in medical assistance under 70.4this subdivision who:70.5    (1) is temporarily unable to work and without receipt of earned income due to a 70.6medical condition, as verified by a physician; or70.7    (2) loses employment for reasons not attributable to the enrollee, and is without 70.8receipt of earned income may retain eligibility for up to four consecutive months after the 70.9month of job loss. To receive a four-month extension, enrollees must verify the medical 70.10condition or provide notification of job loss. All other eligibility requirements must be met 70.11and the enrollee must pay all calculated premium costs for continued eligibility.70.12    (d) For purposes of determining eligibility under this subdivision, a person's assets 70.13must not exceed $20,000, excluding:70.14    (1) all assets excluded under section 
         256B.056;70.15    (2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, 70.16Keogh plans, and pension plans;70.17    (3) medical expense accounts set up through the person's employer; and70.18    (4) spousal assets, including spouse's share of jointly held assets.70.19    (e) All enrollees must pay a premium to be eligible for medical assistance under this 70.20subdivision, except as provided under section 
         256.01, subdivision 18b.70.21    (1) An enrollee must pay the greater of a $65 premium or the premium calculated 70.22based on the person's gross earned and unearned income and the applicable family size 70.23using a sliding fee scale established by the commissioner, which begins at one percent of 70.24income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of 70.25income for those with incomes at or above 300 percent of the federal poverty guidelines.70.26    (2) Annual adjustments in the premium schedule based upon changes in the federal 70.27poverty guidelines shall be effective for premiums due in July of each year.70.28    (3) All enrollees who receive unearned income must pay five percent of unearned 70.29income in addition to the premium amount, except as provided under section 
         256.01, 70.30subdivision 18b
         .70.31    (4) Increases in benefits under title II of the Social Security Act shall not be counted 70.32as income for purposes of this subdivision until July 1 of each year.70.33    (f) A person's eligibility and premium shall be determined by the local county 70.34agency. Premiums must be paid to the commissioner. All premiums are dedicated to 70.35the commissioner.71.1    (g) Any required premium shall be determined at application and redetermined at 71.2the enrollee's six-month income review or when a change in income or household size is 71.3reported. Enrollees must report any change in income or household size within ten days 71.4of when the change occurs. A decreased premium resulting from a reported change in 71.5income or household size shall be effective the first day of the next available billing month 71.6after the change is reported. Except for changes occurring from annual cost-of-living 71.7increases, a change resulting in an increased premium shall not affect the premium amount 71.8until the next six-month review.71.9    (h) Premium payment is due upon notification from the commissioner of the 71.10premium amount required. Premiums may be paid in installments at the discretion of 71.11the commissioner.71.12    (i) Nonpayment of the premium shall result in denial or termination of medical 71.13assistance unless the person demonstrates good cause for nonpayment. Good cause exists 71.14if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to 71.15D, are met. Except when an installment agreement is accepted by the commissioner, 71.16all persons disenrolled for nonpayment of a premium must pay any past due premiums 71.17as well as current premiums due prior to being reenrolled. Nonpayment shall include 71.18payment with a returned, refused, or dishonored instrument. The commissioner may 71.19require a guaranteed form of payment as the only means to replace a returned, refused, 71.20or dishonored instrument.71.21    (j) The commissioner shall notify enrollees annually beginning at least 24 months 71.22before the person's 65th birthday of the medical assistance eligibility rules affecting 71.23income, assets, and treatment of a spouse's income and assets that will be applied upon 71.24reaching age 65.71.25    (k) For enrollees whose income does not exceed 200 percent of the federal poverty 71.26guidelines and who are also enrolled in Medicare, the commissioner shall reimburse 71.27the enrollee for Medicare part B premiums under section 
         256B.0625, subdivision 15, 71.28paragraph (a).71.29EFFECTIVE DATE.This section is effective April 1, 2012.71.30    Sec. 17. Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 17, 71.31is amended to read:71.32    Subd. 17. Transportation costs. (a) Medical assistance covers medical 71.33transportation costs incurred solely for obtaining emergency medical care or transportation 71.34costs incurred by eligible persons in obtaining emergency or nonemergency medical 72.1care when paid directly to an ambulance company, common carrier, or other recognized 72.2providers of transportation services. Medical transportation must be provided by:72.3(1) an ambulance, as defined in section 
         144E.001, subdivision 2;72.4(2) special transportation; or72.5(3) common carrier including, but not limited to, bus, taxicab, other commercial 72.6carrier, or private automobile.72.7(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 72.8part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 72.9would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 72.10transportation, or private automobile.72.11The commissioner may use an order by the recipient's attending physician to certify that 72.12the recipient requires special transportation services. Special transportation providers shall 72.13perform driver-assisted services for eligible individuals. Driver-assisted service includes 72.14passenger pickup at and return to the individual's residence or place of business, assistance 72.15with admittance of the individual to the medical facility, and assistance in passenger 72.16securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 72.17providers must obtain written documentation from the health care service provider who 72.18is serving the recipient being transported, identifying the time that the recipient arrived. 72.19Special transportation providers may not bill for separate base rates for the continuation of 72.20a trip beyond the original destination. Special transportation providers must take recipients 72.21to the nearest appropriate health care provider, using the most direct route. The minimum 72.22medical assistance reimbursement rates for special transportation services are:72.23(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to 72.24eligible persons who need a wheelchair-accessible van;72.25(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 72.26eligible persons who do not need a wheelchair-accessible van; and72.27(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 72.28special transportation services to eligible persons who need a stretcher-accessible vehicle;72.29(2) the base rates for special transportation services in areas defined under RUCA 72.30to be super rural shall be equal to the reimbursement rate established in clause (1) plus 72.3111.3 percent; and72.32(3) for special transportation services in areas defined under RUCA to be rural 72.33or super rural areas:72.34(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 72.35percent of the respective mileage rate in clause (1); and73.1(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 73.2112.5 percent of the respective mileage rate in clause (1).73.3(c) For purposes of reimbursement rates for special transportation services under 73.4paragraph (b), the zip code of the recipient's place of residence shall determine whether 73.5the urban, rural, or super rural reimbursement rate applies.73.6(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 73.7means a census-tract based classification system under which a geographical area is 73.8determined to be urban, rural, or super rural.73.9(e) Effective for services provided on or after September 1, 2011, nonemergency 73.10transportation rates, including special transportation, taxi, and other commercial carriers, 73.11are reduced 4.5 percent. Payments made to managed care plans and county-based 73.12purchasing plans must be reduced for services provided on or after January 1, 2012, 73.13to reflect this reduction.73.14(f) Outside of a metropolitan county as defined in section 473.121, subdivision 4, 73.15reimbursement rates under this subdivision may be adjusted monthly by the commissioner 73.16when the statewide average price of regular grade gasoline is over $3 per gallon, as 73.17calculated by Oil Price Information Service. The rate adjustment shall be a one-percent 73.18increase or decrease for each corresponding $0.10 increase or decrease in the statewide 73.19average price of regular grade gasoline.73.20    Sec. 18. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 2, 73.21is amended to read:73.22    Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following 73.23exceptions:73.24(1) children under the age of 21;73.25(2) pregnant women for services that relate to the pregnancy or any other medical 73.26condition that may complicate the pregnancy;73.27(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or 73.28intermediate care facility for the developmentally disabled;73.29(4) recipients receiving hospice care;73.30(5) 100 percent federally funded services provided by an Indian health service;73.31(6) emergency services;73.32(7) family planning services;73.33(8) services that are paid by Medicare, resulting in the medical assistance program 73.34paying for the coinsurance and deductible; and74.1(9) co-payments that exceed one per day per provider for nonpreventive visits, 74.2eyeglasses, and nonemergency visits to a hospital-based emergency room; and74.3(10) home and community-based waiver services for persons with developmental 74.4disabilities under section 256B.501; home and community-based waiver services for the 74.5elderly under section 256B.0915; waivered services under community alternatives for 74.6disabled individuals under section 256B.49; community alternative care waivered services 74.7under section 256B.49; traumatic brain injury waivered services under section 256B.49; 74.8nursing services and home health services under section 256B.0625, subdivision 6a; 74.9personal care services and nursing supervision of personal care services under section 74.10256B.0625, subdivision 19a; private duty nursing services under section 256B.0625, 74.11subdivision 7; personal care assistance services under section 256B.0659; and day training 74.12and habilitation services for adults with developmental disabilities under sections 252.40 74.13to 252.46.74.14EFFECTIVE DATE.This section is effective July 1, 2013.74.15    Sec. 19. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3a, 74.16is amended to read:74.17    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 74.18services planning, or other assistance intended to support community-based living, 74.19including persons who need assessment in order to determine waiver or alternative care 74.20program eligibility, must be visited by a long-term care consultation team within 15 74.21calendar days after the date on which an assessment was requested or recommended. After 74.22January 1, 2011, these requirements also apply to personal care assistance services, private 74.23duty nursing, and home health agency services, on timelines established in subdivision 5. 74.24Face-to-face assessments must be conducted according to paragraphs (b) to (i).74.25    (b) The county may utilize a team of either the social worker or public health nurse, 74.26or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the 74.27assessment in a face-to-face interview. The consultation team members must confer 74.28regarding the most appropriate care for each individual screened or assessed.74.29    (c) The assessment must be comprehensive and include a person-centered 74.30assessment of the health, psychological, functional, environmental, and social needs of 74.31referred individuals and provide information necessary to develop a support plan that 74.32meets the consumers needs, using an assessment form provided by the commissioner.74.33    (d) The assessment must be conducted in a face-to-face interview with the person 74.34being assessed and the person's legal representative, as required by legally executed 74.35documents, and other individuals as requested by the person, who can provide information 75.1on the needs, strengths, and preferences of the person necessary to develop a support plan 75.2that ensures the person's health and safety, but who is not a provider of service or has any 75.3financial interest in the provision of services. For persons who are to be assessed for 75.4elderly waiver customized living services under section 256B.0915, with the permission 75.5of the person being assessed or the person's designated or legal representative, the client's 75.6current or proposed provider of services may submit a copy of the provider's nursing 75.7assessment or written report outlining their recommendations regarding the client's care 75.8needs. The person conducting the assessment will notify the provider of the date by which 75.9this information is to be submitted. This information shall be provided to the person 75.10conducting the assessment prior to the assessment.75.11    (e) The person, or the person's legal representative, must be provided with written 75.12recommendations for community-based services, including consumer-directed options, 75.13or institutional care that include documentation that the most cost-effective alternatives 75.14available were offered to the individual, and alternatives to residential settings, including, 75.15but not limited to, foster care settings that are not the primary residence of the license 75.16holder. For purposes of this requirement, "cost-effective alternatives" means community 75.17services and living arrangements that cost the same as or less than institutional care.75.18    (f) If the person chooses to use community-based services, the person or the person's 75.19legal representative must be provided with a written community support plan, regardless 75.20of whether the individual is eligible for Minnesota health care programs. A person may 75.21request assistance in identifying community supports without participating in a complete 75.22assessment. Upon a request for assistance identifying community support, the person must 75.23be transferred or referred to the services available under sections 
         256.975, subdivision 7, 75.24and 
         256.01, subdivision 24, for telephone assistance and follow up.75.25    (g) The person has the right to make the final decision between institutional 75.26placement and community placement after the recommendations have been provided, 75.27except as provided in subdivision 4a, paragraph (c).75.28    (h) The team must give the person receiving assessment or support planning, or 75.29the person's legal representative, materials, and forms supplied by the commissioner 75.30containing the following information:75.31    (1) the need for and purpose of preadmission screening if the person selects nursing 75.32facility placement;75.33    (2) the role of the long-term care consultation assessment and support planning in 75.34waiver and alternative care program eligibility determination;75.35    (3) information about Minnesota health care programs;75.36    (4) the person's freedom to accept or reject the recommendations of the team;76.1    (5) the person's right to confidentiality under the Minnesota Government Data 76.2Practices Act, chapter 13;76.3    (6) the long-term care consultant's decision regarding the person's need for 76.4institutional level of care as determined under criteria established in section 
         144.0724, 76.5subdivision 11
         , or 
         256B.092; and76.6    (7) the person's right to appeal the decision regarding the need for nursing facility 76.7level of care or the county's final decisions regarding public programs eligibility according 76.8to section 
         256.045, subdivision 3.76.9    (i) Face-to-face assessment completed as part of eligibility determination for 76.10the alternative care, elderly waiver, community alternatives for disabled individuals, 76.11community alternative care, and traumatic brain injury waiver programs under sections 76.12256B.0915
         , 
         256B.0917, and 
         256B.49 is valid to establish service eligibility for no more 76.13than 60 calendar days after the date of assessment. The effective eligibility start date 76.14for these programs can never be prior to the date of assessment. If an assessment was 76.15completed more than 60 days before the effective waiver or alternative care program 76.16eligibility start date, assessment and support plan information must be updated in a 76.17face-to-face visit and documented in the department's Medicaid Management Information 76.18System (MMIS). The effective date of program eligibility in this case cannot be prior to 76.19the date the updated assessment is completed.76.20    Sec. 20. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c, 76.21is amended to read:76.22    Subd. 3c. Consultation for housing with services. (a) The purpose of long-term 76.23care consultation for registered housing with services is to support persons with current or 76.24anticipated long-term care needs in making informed choices among options that include 76.25the most cost-effective and least restrictive settings. Prospective residents maintain the 76.26right to choose housing with services or assisted living if that option is their preference.76.27    (b) Registered housing with services establishments shall inform all prospective 76.28residents or the prospective resident's designated or legal representative of the availability 76.29of long-term care consultation and the need to receive and verify the consultation prior 76.30to signing a lease or contract requirement for long-term care options counseling and the 76.31opportunity to decline long-term care options counseling. Prospective residents declining 76.32long-term care options counseling are required to sign a waiver form designated by the 76.33commissioner and supplied by the provider. The housing with services establishment shall 76.34maintain copies of signed waiver forms or verification that the consultation was conducted 76.35for audit for a period of three years. Long-term care consultation for registered housing 77.1with services is provided as determined by the commissioner of human services. The 77.2service is delivered under a partnership between lead agencies as defined in subdivision 1a, 77.3paragraph (d), and the Area Agencies on Aging, and is a point of entry to a combination 77.4of telephone-based long-term care options counseling provided by Senior LinkAge Line 77.5and in-person long-term care consultation provided by lead agencies. The point of entry 77.6service must be provided within five working days of the request of the prospective 77.7resident as follows:77.8    (1) the consultation shall be conducted with the prospective resident, or in the 77.9alternative, the resident's designated or legal representative, if:77.10(i) the resident verbally requests; or77.11(ii) the registered housing with services provider has documentation of the 77.12designated or legal representative's authority to enter into a lease or contract on behalf of 77.13the prospective resident and accepts the documentation in good faith;77.14(2) the consultation shall be performed in a manner that provides objective and 77.15complete information;77.16    (2) (3)  the consultation must include a review of the prospective resident's reasons 77.17for considering housing with services, the prospective resident's personal goals, a 77.18discussion of the prospective resident's immediate and projected long-term care needs, 77.19and alternative community services or housing with services settings that may meet the 77.20prospective resident's needs;77.21    (3) (4)  the prospective resident shall be informed of the availability of a face-to-face 77.22visit at no charge to the prospective resident to assist the prospective resident in assessment 77.23and planning to meet the prospective resident's long-term care needs; and77.24(4) (5)  verification of counseling shall be generated and provided to the prospective 77.25resident by Senior LinkAge Line upon completion of the telephone-based counseling.77.26(c) Housing with services establishments registered under chapter 144D shall:77.27(1) inform all prospective residents or the prospective resident's designated or legal 77.28representative of the availability of and contact information for consultation services 77.29under this subdivision;77.30(2) except for individuals seeking lease-only arrangements in subsidized housing 77.31settings, receive a copy of the verification of counseling prior to executing a lease or 77.32service contract with the prospective resident, and prior to executing a service contract 77.33with individuals who have previously entered into lease-only arrangements; and77.34(3) retain a copy of the verification of counseling as part of the resident's file.77.35EFFECTIVE DATE.This section is effective July 1, 2013.78.1    Sec. 21. Minnesota Statutes 2010, section 256B.0911, is amended by adding a 78.2subdivision to read:78.3    Subd. 3d.Exemptions.Individuals shall be exempt from the requirements outlined 78.4in subdivision 3c in the following circumstances:78.5(1) the individual is seeking a lease-only arrangement in a subsidized housing 78.6setting; or78.7(2) the individual has previously received a long-term care consultation assessment 78.8under this section. In this instance, the assessor who completes the long-term care 78.9consultation will issue a verification code and provide it to the individual.78.10EFFECTIVE DATE.This section is effective July 1, 2013.78.11    Sec. 22. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3e, 78.12is amended to read:78.13    Subd. 3e. Customized living service rate. (a) Payment for customized living 78.14services shall be a monthly rate authorized by the lead agency within the parameters 78.15established by the commissioner. The payment agreement must delineate the amount of 78.16each component service included in the recipient's customized living service plan. The 78.17lead agency, with input from the provider of customized living services,  shall ensure that 78.18there is a documented need within the parameters established by the commissioner for all 78.19component customized living services authorized.78.20(b) The payment rate must be based on the amount of component services to be 78.21provided utilizing component rates established by the commissioner. Counties and tribes 78.22shall use tools issued by the commissioner to develop and document customized living 78.23service plans and rates.78.24(c) Component service rates must not exceed payment rates for comparable elderly 78.25waiver or medical assistance services and must reflect economies of scale. Customized 78.26living services must not include rent or raw food costs.78.27    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the 78.28individualized monthly authorized payment for the customized living service plan shall 78.29not exceed 50 percent of the greater of either the statewide or any of the geographic 78.30groups' weighted average monthly nursing facility rate of the case mix resident class 78.31to which the elderly waiver eligible client would be assigned under Minnesota Rules, 78.32parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described 78.33in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the 78.34resident assessment system as described in section 
         256B.438 for nursing home rate 78.35determination is implemented. Effective on July 1 of the state fiscal year in which 79.1the resident assessment system as described in section 
         256B.438 for nursing home 79.2rate determination is implemented and July 1 of each subsequent state fiscal year, the 79.3individualized monthly authorized payment for the services described in this clause shall 79.4not exceed the limit which was in effect on June 30 of the previous state fiscal year 79.5updated annually based on legislatively adopted changes to all service rate maximums for 79.6home and community-based service providers.79.7(e) Effective July 1, 2011, the individualized monthly payment for the customized 79.8living service plan for individuals described in subdivision 3a, paragraph (b), must be the 79.9monthly authorized payment limit for customized living for individuals classified as case 79.10mix A, reduced by 25 percent. This rate limit must be applied to all new participants 79.11enrolled in the program on or after July 1, 2011, who meet the criteria described in 79.12subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who 79.13meet the criteria described in subdivision 3a, paragraph (b), at reassessment.79.14    (f) Customized living services are delivered by a provider licensed by the 79.15Department of Health as a class A or class F home care provider and provided in a 79.16building that is registered as a housing with services establishment under chapter 144D. 79.17Licensed home care providers are subject to section 
         256B.0651, subdivision 14.79.18(g) A provider may not bill or otherwise charge an elderly waiver participant or their 79.19family for additional units of any allowable component service beyond those available 79.20under the service rate limits described in paragraph (d), nor for additional units of any 79.21allowable component service beyond those approved in the service plan by the lead agency.79.22    Sec. 23. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3h, 79.23is amended to read:79.24    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The 79.25payment rate for 24-hour customized living services is a monthly rate authorized by the 79.26lead agency within the parameters established by the commissioner of human services. 79.27The payment agreement must delineate the amount of each component service included 79.28in each recipient's customized living service plan. The lead agency, with input from 79.29the provider of customized living services,  shall ensure that there is a documented need 79.30within the parameters established by the commissioner for all component customized 79.31living services authorized. The lead agency shall not authorize 24-hour customized living 79.32services unless there is a documented need for 24-hour supervision.79.33(b) For purposes of this section, "24-hour supervision" means that the recipient 79.34requires assistance due to needs related to one or more of the following:79.35    (1) intermittent assistance with toileting, positioning, or transferring;80.1    (2) cognitive or behavioral issues;80.2    (3) a medical condition that requires clinical monitoring; or80.3    (4) for all new participants enrolled in the program on or after July 1, 2011, and 80.4all other participants at their first reassessment after July 1, 2011, dependency in at 80.5least three of the following activities of daily living as determined by assessment under 80.6section 
         256B.0911: bathing; dressing; grooming; walking; or eating when the dependency 80.7score in eating is three or greater; and needs medication management and at least 50 80.8hours of service per month. The lead agency shall ensure that the frequency and mode 80.9of supervision of the recipient and the qualifications of staff providing supervision are 80.10described and meet the needs of the recipient.80.11(c) The payment rate for 24-hour customized living services must be based on the 80.12amount of component services to be provided utilizing component rates established by the 80.13commissioner. Counties and tribes will use tools issued by the commissioner to develop 80.14and document customized living plans and authorize rates.80.15(d) Component service rates must not exceed payment rates for comparable elderly 80.16waiver or medical assistance services and must reflect economies of scale.80.17(e) The individually authorized 24-hour customized living payments, in combination 80.18with the payment for other elderly waiver services, including case management, must not 80.19exceed the recipient's community budget cap specified in subdivision 3a. Customized 80.20living services must not include rent or raw food costs.80.21(f) The individually authorized 24-hour customized living payment rates shall not 80.22exceed the 95 percentile of statewide monthly authorizations for 24-hour customized 80.23living services in effect and in the Medicaid management information systems on March 80.2431, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 80.25to 9549.0059, to which elderly waiver service clients are assigned. When there are 80.26fewer than 50 authorizations in effect in the case mix resident class, the commissioner 80.27shall multiply the calculated service payment rate maximum for the A classification by 80.28the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 80.299549.0059, to determine the applicable payment rate maximum. Service payment rate 80.30maximums shall be updated annually based on legislatively adopted changes to all service 80.31rates for home and community-based service providers.80.32    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner 80.33may establish alternative payment rate systems for 24-hour customized living services in 80.34housing with services establishments which are freestanding buildings with a capacity of 80.3516 or fewer, by applying a single hourly rate for covered component services provided 80.36in either:81.1    (1) licensed corporate adult foster homes; or81.2    (2) specialized dementia care units which meet the requirements of section 
         144D.065 81.3and in which:81.4    (i) each resident is offered the option of having their own apartment; or81.5    (ii) the units are licensed as board and lodge establishments with maximum capacity 81.6of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 81.7subparts 1, 2, 3, and 4, item A.81.8(h) A provider may not bill or otherwise charge an elderly waiver participant or their 81.9family for additional units of any allowable component service beyond those available 81.10under the service rate limits described in paragraph (e), nor for additional units of any 81.11allowable component service beyond those approved in the service plan by the lead agency.81.12    Sec. 24. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to 81.13read:81.14    Subd. 1b. Individual service plan.(a) The individual service plan must:81.15(1) include the results of the assessment information on the person's need for service, 81.16including identification of service needs that will be or that are met by the person's 81.17relatives, friends, and others, as well as community services used by the general public;81.18(2) identify the person's preferences for services as stated by the person, the person's 81.19legal guardian or conservator, or the parent if the person is a minor;81.20(3) identify long- and short-range goals for the person;81.21(4) identify specific services and the amount and frequency of the services to be 81.22provided to the person based on assessed needs, preferences, and available resources. 81.23The individual service plan shall also specify other services the person needs that are 81.24not available;81.25(5) identify the need for an individual program plan to be developed by the provider 81.26according to the respective state and federal licensing and certification standards, and 81.27additional assessments to be completed or arranged by the provider after service initiation;81.28(6) identify provider responsibilities to implement and make recommendations for 81.29modification to the individual service plan;81.30(7) include notice of the right to request a conciliation conference or a hearing 81.31under section 
         256.045;81.32(8) be agreed upon and signed by the person, the person's legal guardian 81.33or conservator, or the parent if the person is a minor, and the authorized county 81.34representative; and82.1(9) be reviewed by a health professional if the person has overriding medical needs 82.2that impact the delivery of services.82.3(b) Service planning formats developed for interagency planning such as transition, 82.4vocational, and individual family service plans may be substituted for service planning 82.5formats developed by county agencies.82.6(c) Approved, written, and signed changes to a consumer's services that meet the 82.7criteria in this subdivision shall be an addendum to that consumer's individual service plan.82.8    Sec. 25. Minnesota Statutes 2011 Supplement, section 256B.097, subdivision 3, 82.9is amended to read:82.10    Subd. 3. State Quality Council. (a) There is hereby created a State Quality 82.11Council which must define regional quality councils, and carry out a community-based, 82.12person-directed quality review component, and a comprehensive system for effective 82.13incident reporting, investigation, analysis, and follow-up.82.14    (b) By August 1, 2011, the commissioner of human services shall appoint the 82.15members of the initial State Quality Council. Members shall include representatives 82.16from the following groups:82.17    (1) disability service recipients and their family members;82.18    (2) during the first two years of the State Quality Council, there must be at least three 82.19members from the Region 10 stakeholders. As regional quality councils are formed under 82.20subdivision 4, each regional quality council shall appoint one member;82.21    (3) disability service providers;82.22    (4) disability advocacy groups; and82.23    (5) county human services agencies and staff from the Department of Human 82.24Services and Ombudsman for Mental Health and Developmental Disabilities.82.25    (c) Members of the council who do not receive a salary or wages from an employer 82.26for time spent on council duties may receive a per diem payment when performing council 82.27duties and functions.82.28    (d) The State Quality Council shall:82.29    (1) assist the Department of Human Services in fulfilling federally mandated 82.30obligations by monitoring disability service quality and quality assurance and 82.31improvement practices in Minnesota; and82.32    (2) establish state quality improvement priorities with methods for achieving results 82.33and provide an annual report to the legislative committees with jurisdiction over policy 82.34and funding of disability services on the outcomes, improvement priorities, and activities 82.35undertaken by the commission during the previous state fiscal year;83.1(3) identify issues pertaining to financial and personal risk that impede Minnesotans 83.2with disabilities from optimizing choice of community-based services; and83.3(4) recommend to the chairs and ranking minority members of the legislative 83.4committees with jurisdiction over human services and civil law by January 15, 2013, 83.5statutory and rule changes related to the findings under clause (3) that promote 83.6individualized service and housing choices balanced with appropriate individualized 83.7protection.83.8    (e) The State Quality Council, in partnership with the commissioner, shall:83.9    (1) approve and direct implementation of the community-based, person-directed 83.10system established in this section;83.11    (2) recommend an appropriate method of funding this system, and determine the 83.12feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;83.13    (3) approve measurable outcomes in the areas of health and safety, consumer 83.14evaluation, education and training, providers, and systems;83.15    (4) establish variable licensure periods not to exceed three years based on outcomes 83.16achieved; and83.17    (5) in cooperation with the Quality Assurance Commission, design a transition plan 83.18for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.83.19    (f) The State Quality Council shall notify the commissioner of human services that a 83.20facility, program, or service has been reviewed by quality assurance team members under 83.21subdivision 4, paragraph (b), clause (13), and qualifies for a license.83.22    (g) The State Quality Council, in partnership with the commissioner, shall establish 83.23an ongoing review process for the system. The review shall take into account the 83.24comprehensive nature of the system which is designed to evaluate the broad spectrum of 83.25licensed and unlicensed entities that provide services to persons with disabilities. The 83.26review shall address efficiencies and effectiveness of the system.83.27    (h) The State Quality Council may recommend to the commissioner certain 83.28variances from the standards governing licensure of programs for persons with disabilities 83.29in order to improve the quality of services so long as the recommended variances do 83.30not adversely affect the health or safety of persons being served or compromise the 83.31qualifications of staff to provide services.83.32    (i) The safety standards, rights, or procedural protections referenced under 83.33subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make 83.34recommendations to the commissioner or to the legislature in the report required under 83.35paragraph (c) regarding alternatives or modifications to the safety standards, rights, or 83.36procedural protections referenced under subdivision 2, paragraph (c).84.1    (j) The State Quality Council may hire staff to perform the duties assigned in this 84.2subdivision.84.3    Sec. 26. Minnesota Statutes 2010, section 256B.431, subdivision 17e, is amended to 84.4read:84.5    Subd. 17e. Replacement-costs-new per bed limit effective October 1, 2007.84.6    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), 84.7for a total replacement, as defined in subdivision 17d, authorized under section 84.8144A.071
          or 
         144A.073 after July 1, 1999, any building project that is a relocation, 84.9renovation, upgrading, or conversion completed on or after July 1, 2001, or any 84.10building project eligible for reimbursement under section 
         256B.434, subdivision 4f, the 84.11replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed 84.12rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating 84.13the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 84.149549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be 84.15adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 84.162000. These amounts must be increased annually as specified in subdivision 3f, paragraph 84.17(a), beginning October 1, 2012.84.18    Sec. 27. Minnesota Statutes 2010, section 256B.431, is amended by adding a 84.19subdivision to read:84.20    Subd. 45.Rate adjustments for some moratorium exception projects.84.21Notwithstanding any other law to the contrary, money available for moratorium exception 84.22projects under section 144A.073, subdivisions 2 and 11, shall be used to fund the 84.23incremental rate increases resulting from this section for any nursing facility with a 84.24moratorium exception project approved under section 144A.073, and completed after 84.25August 30, 2010, where the replacement-costs-new limits under subdivision 17e were 84.26higher at any time after project approval than at the time of project completion. The 84.27commissioner shall calculate the property rate increase for these facilities using the highest 84.28set of limits; however, any rate increase under this section shall not be effective until on 84.29or after the effective date of this section, contingent upon federal approval. No property 84.30rate decrease shall result from this section.84.31EFFECTIVE DATE.This section is effective upon federal approval.84.32    Sec. 28. Minnesota Statutes 2010, section 256B.434, subdivision 10, is amended to 84.33read:85.1    Subd. 10. Exemptions. (a) To the extent permitted by federal law, (1) a facility that 85.2has entered into a contract under this section is not required to file a cost report, as defined 85.3in Minnesota Rules, part 9549.0020, subpart 13, for any year after the base year that is the 85.4basis for the calculation of the contract payment rate for the first rate year of the alternative 85.5payment demonstration project contract; and (2) a facility under contract is not subject 85.6to audits of historical costs or revenues, or paybacks or retroactive adjustments based on 85.7these costs or revenues, except audits, paybacks, or adjustments relating to the cost report 85.8that is the basis for calculation of the first rate year under the contract.85.9(b) A facility that is under contract with the commissioner under this section is 85.10not subject to the moratorium on licensure or certification of new nursing home beds in 85.11section 
         144A.071, unless the project results in a net increase in bed capacity or involves 85.12relocation of beds from one site to another. Contract payment rates must not be adjusted 85.13to reflect any additional costs that a nursing facility incurs as a result of a construction 85.14project undertaken under this paragraph. In addition, as a condition of entering into a 85.15contract under this section, a nursing facility must agree that any future medical assistance 85.16payments for nursing facility services will not reflect any additional costs attributable to 85.17the sale of a nursing facility under this section and to construction undertaken under 85.18this paragraph that otherwise would not be authorized under the moratorium in section 85.19144A.073
         . Nothing in this section prevents a nursing facility participating in the 85.20alternative payment demonstration project under this section from seeking approval of 85.21an exception to the moratorium through the process established in section 
         144A.073, 85.22and if approved the facility's rates shall be adjusted to reflect the cost of the project. 85.23Nothing in this section prevents a nursing facility participating in the alternative payment 85.24demonstration project from seeking legislative approval of an exception to the moratorium 85.25under section 
         144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the 85.26cost of the project.85.27(c) Notwithstanding section 256B.48, subdivision 6, paragraphs (c), (d), and (e), 85.28and pursuant to any terms and conditions contained in the facility's contract, a nursing 85.29facility that is under contract with the commissioner under this section is in compliance 85.30with section 256B.48, subdivision 6, paragraph (b), if the facility is Medicare certified.85.31(d) (c) Notwithstanding paragraph (a), if by April 1, 1996, the health care financing 85.32administration has not approved a required waiver, or the Centers for Medicare and 85.33Medicaid Services otherwise requires cost reports to be filed prior to the waiver's approval, 85.34the commissioner shall require a cost report for the rate year.85.35(e) (d) A facility that is under contract with the commissioner under this section 85.36shall be allowed to change therapy arrangements from an unrelated vendor to a related 86.1vendor during the term of the contract. The commissioner may develop reasonable 86.2requirements designed to prevent an increase in therapy utilization for residents enrolled 86.3in the medical assistance program.86.4(f) (e) Nursing facilities participating in the alternative payment system 86.5demonstration project must either participate in the alternative payment system quality 86.6improvement program established by the commissioner or submit information on their 86.7own quality improvement process to the commissioner for approval. Nursing facilities 86.8that have had their own quality improvement process approved by the commissioner 86.9must report results for at least one key area of quality improvement annually to the 86.10commissioner.86.11    Sec. 29. Minnesota Statutes 2010, section 256B.441, is amended by adding a 86.12subdivision to read:86.13    Subd. 63.Critical access nursing facilities.(a) The commissioner, in consultation 86.14with the commissioner of health, may designate certain nursing facilities as critical access 86.15nursing facilities. The designation shall be granted on a competitive basis, within the 86.16limits of funds appropriated for this purpose.86.17(b) The commissioner shall request proposals from nursing facilities every two years. 86.18Proposals must be submitted in the form and according to the timelines established by 86.19the commissioner. In selecting applicants to designate, the commissioner, in consultation 86.20with the commissioner of health, and with input from stakeholders, shall develop criteria 86.21designed to preserve access to nursing facility services in isolated areas, rebalance 86.22long-term care, and improve quality.86.23(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing 86.24facilities designated as critical access nursing facilities:86.25(1) partial rebasing, with operating payment rates being the sum of 60 percent of the 86.26operating payment rate determined in accordance with subdivision 54 and 40 percent of the 86.27operating payment rate that would have been allowed had the facility not been designated;86.28(2) enhanced payments for leave days. Notwithstanding section 256B.431, 86.29subdivision 2r, upon designation as a critical access nursing facility, the commissioner 86.30shall limit payment for leave days to 60 percent of that nursing facility's total payment rate 86.31for the involved resident, and shall allow this payment only when the occupancy of the 86.32nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;86.33(3) two designated critical access nursing facilities, with up to 100 beds in active 86.34service, may jointly apply to the commissioner of health for a waiver of Minnesota 86.35Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The 87.1commissioner of health will consider each waiver request independently based on the 87.2criteria under Minnesota Rules, part 4658.0040;87.3(4) the minimum threshold under section 256B.431, subdivisions 3f, paragraph (a), 87.4and 17e, shall be 40 percent of the amount that would otherwise apply; and87.5(5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based 87.6rate limits under subdivision 50 shall apply to designated critical access nursing facilities.87.7(d) Designation of a critical access nursing facility shall be for a period of two 87.8years, after which the benefits allowed under paragraph (c) shall be removed. Designated 87.9facilities may apply for continued designation.87.10EFFECTIVE DATE.This section is effective the day following final enactment.87.11    Sec. 30. Minnesota Statutes 2010, section 256B.48, is amended by adding a 87.12subdivision to read:87.13    Subd. 6a.Referrals to Medicare providers required.Notwithstanding subdivision 87.141, nursing facility providers that do not participate in or accept Medicare assignment 87.15must refer and document the referral of dual eligible recipients for whom placement is 87.16requested and for whom the resident would be qualified for a Medicare-covered stay to 87.17Medicare providers. The commissioner shall audit nursing facilities that do not accept 87.18Medicare and determine if dual eligible individuals with Medicare qualifying stays have 87.19been admitted. If such a determination is made, the commissioner shall deny Medicaid 87.20payment for the first 20 days of that resident's stay.87.21    Sec. 31. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15, 87.22is amended to read:87.23    Subd. 15. Individualized service plan; comprehensive transitional service plan; 87.24maintenance service plan. (a) Each recipient of home and community-based waivered 87.25services shall be provided a copy of the written service plan which:87.26(1) is developed and signed by the recipient within ten working days of the 87.27completion of the assessment;87.28(2) meets the assessed needs of the recipient;87.29(3) reasonably ensures the health and safety of the recipient;87.30(4) promotes independence;87.31(5) allows for services to be provided in the most integrated settings; and87.32(6) provides for an informed choice, as defined in section 
         256B.77, subdivision 2, 87.33paragraph (p), of service and support providers.88.1(b) In developing the comprehensive transitional service plan, the individual 88.2receiving services, the case manager, and the guardian, if applicable, will identify 88.3the transitional service plan fundamental service outcome and anticipated timeline to 88.4achieve this outcome. Within the first 20 days following a recipient's request for an 88.5assessment or reassessment, the transitional service planning team must be identified. A 88.6team leader must be identified who will be responsible for assigning responsibility and 88.7communicating with team members to ensure implementation of the transition plan and 88.8ongoing assessment and communication process. The team leader should be an individual, 88.9such as the case manager or guardian, who has the opportunity to follow the recipient to 88.10the next level of service.88.11Within ten days following an assessment, a comprehensive transitional service plan 88.12must be developed incorporating elements of a comprehensive functional assessment and 88.13including short-term measurable outcomes and timelines for achievement of and reporting 88.14on these outcomes. Functional milestones must also be identified and reported according 88.15to the timelines agreed upon by the transitional service planning team. In addition, the 88.16comprehensive transitional service plan must identify additional supports that may assist 88.17in the achievement of the fundamental service outcome such as the development of greater 88.18natural community support, increased collaboration among agencies, and technological 88.19supports.88.20The timelines for reporting on functional milestones will prompt a reassessment of 88.21services provided, the units of services, rates, and appropriate service providers. It is 88.22the responsibility of the transitional service planning team leader to review functional 88.23milestone reporting to determine if the milestones are consistent with observable skills 88.24and that milestone achievement prompts any needed changes to the comprehensive 88.25transitional service plan.88.26For those whose fundamental transitional service outcome involves the need to 88.27procure housing, a plan for the recipient to seek the resources necessary to secure the least 88.28restrictive housing possible should be incorporated into the plan, including employment 88.29and public supports such as housing access and shelter needy funding.88.30(c) Counties and other agencies responsible for funding community placement and 88.31ongoing community supportive services are responsible for the implementation of the 88.32comprehensive transitional service plans. Oversight responsibilities include both ensuring 88.33effective transitional service delivery and efficient utilization of funding resources.88.34(d) Following one year of transitional services, the transitional services planning 88.35team will make a determination as to whether or not the individual receiving services 88.36requires the current level of continuous and consistent support in order to maintain the 89.1recipient's current level of functioning. Recipients who are determined to have not had 89.2a significant change in functioning for 12 months must move from a transitional to a 89.3maintenance service plan. Recipients on a maintenance service plan must be reassessed 89.4to determine if the recipient would benefit from a transitional service plan at least every 89.512 months and at other times when there has been a significant change in the recipient's 89.6functioning. This assessment should consider any changes to technological or natural 89.7community supports.89.8(e) When a county is evaluating denials, reductions, or terminations of home and 89.9community-based services under section 
         256B.49 for an individual, the case manager 89.10shall offer to meet with the individual or the individual's guardian in order to discuss the 89.11prioritization of service needs within the individualized service plan, comprehensive 89.12transitional service plan, or maintenance service plan. The reduction in the authorized 89.13services for an individual due to changes in funding for waivered services may not exceed 89.14the amount needed to ensure medically necessary services to meet the individual's health, 89.15safety, and welfare.89.16(f) At the time of reassessment, local agency case managers shall assess each 89.17recipient of community alternatives for disabled individuals or traumatic brain injury 89.18waivered services currently residing in a licensed adult foster home that is not the primary 89.19residence of the license holder, or in which the license holder is not the primary caregiver, 89.20to determine if that recipient could appropriately be served in a community-living setting. 89.21If appropriate for the recipient, the case manager shall offer the recipient, through a 89.22person-centered planning process, the option to receive alternative housing and service 89.23options. In the event that the recipient chooses to transfer from the adult foster home, 89.24the vacated bed shall not be filled with another recipient of waiver services and group 89.25residential housing, unless and the licensed capacity shall be reduced accordingly, unless 89.26the savings required by the 2011 licensed bed closure reductions for foster care settings 89.27where the physical location is not the primary residence of the license holder are met 89.28through voluntary changes described in section 245A.03, subdivision 7, paragraph (g), 89.29or as provided under section 245A.03, subdivision 7, paragraph (a), clauses (3) and (4), 89.30and the licensed capacity shall be reduced accordingly. If the adult foster home becomes 89.31no longer viable due to these transfers, the county agency, with the assistance of the 89.32department, shall facilitate a consolidation of settings or closure. This reassessment 89.33process shall be completed by June 30, 2012 July 1, 2013.89.34    Sec. 32. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 23, 89.35is amended to read:90.1    Subd. 23. Community-living settings. "Community-living settings" means a 90.2single-family home or apartment where the service recipient or their family owns or rents, 90.3as demonstrated by a lease agreement, and maintains control over the individual unit as 90.4demonstrated by the lease agreement, or has a plan for transition of a lease from a service 90.5provider to the individual. Within two years of signing the initial lease, the service provider 90.6shall transfer the lease to the individual. In the event the landlord denies the transfer, the 90.7commissioner may approve an exception within sufficient time to ensure the continued 90.8occupancy by the individual. Community-living settings are subject to the following:90.9(1) individuals are not required to receive services;90.10(2) individuals are not required to have a disability or specific diagnosis to live in the 90.11community-living setting, unless state or federal funding requires it;90.12(3) individuals may hire service providers of their choice;90.13(4) individuals may choose whether to share their household and with whom;90.14(5) the home or apartment must include living, sleeping, bathing, and cooking areas;90.15(6) individuals must have lockable access and egress;90.16(7) individuals must be free to receive visitors and leave the settings at times and for 90.17durations of their own choosing;90.18(8) leases must not reserve the right to assign units or change unit assignments; and90.19(9) access to the greater community must be easily facilitated based on the 90.20individual's needs and preferences.90.21    Sec. 33. [256B.492] ADULT FOSTER CARE VOLUNTARY CLOSURE.90.22    Subdivision 1.Commissioner's duties; report. The commissioner of human 90.23services shall ask providers of adult foster care services to present proposals for the 90.24conversion of services provided for persons with developmental disabilities in settings 90.25licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, to services to other 90.26community settings in conjunction with the cessation of operations and closure of 90.27identified facilities.90.28    Subd. 2.Inventory of foster care capacity. The commissioner of human services 90.29shall submit to the legislature by February 15, 2013, a report that includes:90.30(1) an inventory of the assessed needs of all individuals with disabilities receiving 90.31foster care services under section 256B.092;90.32(2) an inventory of total licensed foster care capacity for adults and children 90.33available in Minnesota as of January 1, 2013; and90.34(3) a comparison of the needs of individuals receiving services in foster care settings 90.35and nonfoster care settings.91.1The report will also contain recommendations on developing a profile of individuals 91.2requiring foster care services and the projected level of foster care capacity needed 91.3to serve that population.91.4    Subd. 3.Voluntary closure process need determination.If the report required in 91.5subdivision 2 determines the existing supply of foster care capacity is higher than needed 91.6to meet the needs of individuals requiring that level of care, the commissioner shall, 91.7within the limits of available appropriations, announce and implement a program for 91.8closure of adult foster care homes.91.9    Subd. 4.Application process.(a) The commissioner shall establish a process of 91.10application, review, and approval for licensees to submit proposals for the closure of 91.11facilities.91.12(b) A licensee shall notify the following parties in writing when an application for a 91.13planned closure adjustment is submitted:91.14(1) the county social services agency; and91.15(2) current and prospective residents and their families.91.16(c) After providing written notice, and prior to admission, the licensee must fully 91.17inform prospective residents and their families of the intent to close operations and of 91.18the relocation plan.91.19    Subd. 5.Review and approval process.(a) To be considered for approval, an 91.20application must include:91.21(1) a description of the proposed closure plan, which must include identification of 91.22the home or homes to receive a planned closure rate adjustment; 91.23(2) the proposed timetable for any proposed closure, including the proposed dates for 91.24announcement to residents and the affected county social service agency, commencement 91.25of closure, and completion of closure;91.26(3) the proposed relocation plan jointly developed by the county of financial 91.27responsibility and the providers for current residents of any facility designated for closure; 91.28and91.29(4) documentation in a format approved by the commissioner that all the adult foster 91.30care homes receiving a planned closure rate adjustment under the plan have accepted joint 91.31and several liability for recovery of overpayments under section 256B.0641, subdivision 91.322, for the facilities designated for closure under the plan.91.33(c) In reviewing and approving closure proposals, the commissioner shall give first 91.34priority to proposals that:91.35(1) result in the closing of a facility;91.36(2) demonstrate savings of medical assistance expenditures; and92.1(3) demonstrate that alternative placements will be developed based on individual 92.2resident needs and applicable federal and state rules.92.3The commissioner shall also consider any information provided by residents, their 92.4family, or the county social services agency on the impact of the planned closure on 92.5the services they receive.92.6(d) The commissioner shall select proposals that best meet the criteria established 92.7in this subdivision within the appropriation made available for planned closure of adult 92.8foster care facilities. The commissioner shall notify licensees of the selections made and 92.9approved by the commissioner.92.10(e) For each proposal approved by the commissioner, a contract must be established 92.11between the commissioner, the county of financial responsibility, and the participating 92.12licensee.92.13    Subd. 6.Adjustment to rates.(a) For purposes of this section, the commissioner 92.14shall establish an enhanced payment rate under section 256B.0913 to facilitate an orderly 92.15transition for persons with developmental disabilities from adult foster care to other 92.16community-based settings.92.17(b) The maximum length the commissioner may establish an enhanced rate is six 92.18months.92.19(c) The commissioner shall allocate funds, up to a total of $450 in state and federal 92.20funds per adult foster care home bed that is closing, to be used for relocation costs incurred 92.21by counties under this process92.22(d) The commissioner shall analyze the fiscal impact of the closure of each facility 92.23on medical assistance expenditures. Any savings is allocated to the medical assistance 92.24program.92.25    Sec. 34. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:92.26    Subd. 5. Special needs. In addition to the state standards of assistance established in 92.27subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 92.28Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 92.29center, or a group residential housing facility.92.30    (a) The county agency shall pay a monthly allowance for medically prescribed 92.31diets if the cost of those additional dietary needs cannot be met through some other 92.32maintenance benefit. The need for special diets or dietary items must be prescribed by 92.33a licensed physician. Costs for special diets shall be determined as percentages of the 92.34allotment for a one-person household under the thrifty food plan as defined by the United 93.1States Department of Agriculture. The types of diets and the percentages of the thrifty 93.2food plan that are covered are as follows:93.3    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;93.4    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 93.5of thrifty food plan;93.6    (3) controlled protein diet, less than 40 grams and requires special products, 125 93.7percent of thrifty food plan;93.8    (4) low cholesterol diet, 25 percent of thrifty food plan;93.9    (5) high residue diet, 20 percent of thrifty food plan;93.10    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;93.11    (7) gluten-free diet, 25 percent of thrifty food plan;93.12    (8) lactose-free diet, 25 percent of thrifty food plan;93.13    (9) antidumping diet, 15 percent of thrifty food plan;93.14    (10) hypoglycemic diet, 15 percent of thrifty food plan; or93.15    (11) ketogenic diet, 25 percent of thrifty food plan.93.16    (b) Payment for nonrecurring special needs must be allowed for necessary home 93.17repairs or necessary repairs or replacement of household furniture and appliances using 93.18the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 93.19as long as other funding sources are not available.93.20    (c) A fee for guardian or conservator service is allowed at a reasonable rate 93.21negotiated by the county or approved by the court. This rate shall not exceed five percent 93.22of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 93.23guardian or conservator is a member of the county agency staff, no fee is allowed.93.24    (d) The county agency shall continue to pay a monthly allowance of $68 for 93.25restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 93.261990, and who eats two or more meals in a restaurant daily. The allowance must continue 93.27until the person has not received Minnesota supplemental aid for one full calendar month 93.28or until the person's living arrangement changes and the person no longer meets the criteria 93.29for the restaurant meal allowance, whichever occurs first.93.30    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 93.31is allowed for representative payee services provided by an agency that meets the 93.32requirements under SSI regulations to charge a fee for representative payee services. This 93.33special need is available to all recipients of Minnesota supplemental aid regardless of 93.34their living arrangement.93.35    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the 93.36maximum allotment authorized by the federal Food Stamp Program for a single individual 94.1which is in effect on the first day of July of each year will be added to the standards of 94.2assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 94.3as shelter needy and are: (i) relocating from an institution, or an adult mental health 94.4residential treatment program under section 
         256B.0622; (ii) eligible for the self-directed 94.5supports option as defined under section 
         256B.0657, subdivision 2; or (iii) home and 94.6community-based waiver recipients living in their own home or rented or leased apartment 94.7which is not owned, operated, or controlled by a provider of service not related by blood 94.8or marriage, unless allowed under paragraph (g).94.9    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 94.10shelter needy benefit under this paragraph is considered a household of one. An eligible 94.11individual who receives this benefit prior to age 65 may continue to receive the benefit 94.12after the age of 65.94.13    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 94.14exceed 40 percent of the assistance unit's gross income before the application of this 94.15special needs standard. "Gross income" for the purposes of this section is the applicant's or 94.16recipient's income as defined in section 
         256D.35, subdivision 10, or the standard specified 94.17in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 94.18state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 94.19considered shelter needy for purposes of this paragraph.94.20(g) Notwithstanding this subdivision, to access housing and services as provided 94.21in paragraph (f), the recipient may choose housing that may be owned, operated, or 94.22controlled by the recipient's service provider. In a multifamily building of four or more 94.23units, the maximum number of apartments that may be used by recipients of this program 94.24shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. of 94.25more than four units, the maximum number of units that may be used by recipients of this 94.26program shall be the greater of four units of 25 percent of the units in the building. In 94.27multifamily buildings of four or fewer units, all of the units may be used by recipients 94.28of this program. When housing is controlled by the service provider, the individual may 94.29choose their own service provider as provided in section 256B.49, subdivision 23, clause 94.30(3). When the housing is controlled by the service provider, the service provider shall 94.31implement a plan with the recipient to transition the lease to the recipient's name. Within 94.32two years of signing the initial lease, the service provider shall transfer the lease entered 94.33into under this subdivision to the recipient. In the event the landlord denies this transfer, 94.34the commissioner may approve an exception within sufficient time to ensure the continued 94.35occupancy by the recipient. This paragraph expires June 30, 2016.95.1    Sec. 35. Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to 95.2read:95.3    Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.95.4The commissioner shall seek any necessary federal approval in order to implement 95.5the changes to the level of care criteria in Minnesota Statutes, section 
         144.0724, 95.6subdivision 11
         , on or after July 1, 2012, for adults and children.95.7EFFECTIVE DATE.This section is effective the day following final enactment.95.8    Sec. 36. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 95.93, is amended to read:

95.10Subd. 3.Forecasted Programs

95.11The amounts that may be spent from this 95.12appropriation for each purpose are as follows:

95.13(a) MFIP/DWP Grants

95.14Appropriations by Fund95.15General84,680,00091,978,00095.16Federal TANF84,425,00075,417,000

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

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

95.19General Assistance Standard. The 95.20commissioner shall set the monthly standard 95.21of assistance for general assistance units 95.22consisting of an adult recipient who is 95.23childless and unmarried or living apart 95.24from parents or a legal guardian at $203. 95.25The commissioner may reduce this amount 95.26according to Laws 1997, chapter 85, article 95.273, section 54.95.28Emergency General Assistance. The 95.29amount appropriated for emergency general 95.30assistance funds is limited to no more 95.31than $6,689,812 in fiscal year 2012 and 95.32$6,729,812 in fiscal year 2013. Funds 95.33to counties shall be allocated by the 96.1commissioner using the allocation method 96.2specified in Minnesota Statutes, section 96.3256D.06
         .

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

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

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

96.7This appropriation is from the health care 96.8access fund.

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

96.10Managed Care Incentive Payments. The 96.11commissioner shall not make managed care 96.12incentive payments for expanding preventive 96.13services during fiscal years beginning July 1, 96.142011, and July 1, 2012.96.15Reduction of Rates for Congregate 96.16Living for Individuals with Lower Needs. 96.17Beginning October 1, 2011, lead agencies 96.18must reduce rates in effect on January 1, 96.192011, by ten percent for individuals with 96.20lower needs living in foster care settings 96.21where the license holder does not share the 96.22residence with recipients on the CADI and 96.23DD waivers and customized living settings 96.24for CADI.  Lead agencies shall consult 96.25with providers to review individual service 96.26plans and identify changes or modifications 96.27to reduce the utilization of services while 96.28maintaining the health and safety of the 96.29individual receiving services. Lead agencies 96.30must adjust contracts within 60 days of the 96.31effective date.96.32Reduction of Lead Agency Waiver 96.33Allocations to Implement Rate Reductions 96.34for Congregate Living for Individuals 97.1with Lower Needs. Beginning October 1, 97.22011, the commissioner shall reduce lead 97.3agency waiver allocations to implement the 97.4reduction of rates for individuals with lower 97.5needs living in foster care settings where the 97.6license holder does not share the residence 97.7with recipients on the CADI and DD waivers 97.8and customized living settings for CADI.97.9Reduce customized living and 24-hour 97.10customized living component rates.97.11Effective July 1, 2011, the commissioner 97.12shall reduce elderly waiver customized living 97.13and 24-hour customized living component 97.14service spending by five percent through 97.15reductions in component rates and service 97.16rate limits. The commissioner shall adjust 97.17the elderly waiver capitation payment 97.18rates for managed care organizations paid 97.19under Minnesota Statutes, section 
         256B.69, 97.20subdivisions 6a
          and 23, to reflect reductions 97.21in component spending for customized living 97.22services and 24-hour customized living 97.23services under Minnesota Statutes, section 97.24256B.0915, subdivisions 3e
          and 3h, for the 97.25contract period beginning January 1, 2012. 97.26To implement the reduction specified in 97.27this provision, capitation rates paid by the 97.28commissioner to managed care organizations 97.29under Minnesota Statutes, section 
         256B.69, 97.30shall reflect a ten percent reduction for the 97.31specified services for the period January 1, 97.322012, to June 30, 2012, and a five percent 97.33reduction for those services on or after July 97.341, 2012.97.35Limit Growth in the Developmental 97.36Disability Waiver. The commissioner 98.1shall limit growth in the developmental 98.2disability waiver to six diversion allocations 98.3per month beginning July 1, 2011, through 98.4June 30, 2013, and 15 diversion allocations 98.5per month beginning July 1, 2013, through 98.6June 30, 2015. Waiver allocations shall 98.7be targeted to individuals who meet the 98.8priorities for accessing waiver services 98.9identified in Minnesota Statutes, 
         256B.092, 98.10subdivision 12
         . The limits do not include 98.11conversions from intermediate care facilities 98.12for persons with developmental disabilities. 98.13Notwithstanding any contrary provisions in 98.14this article, this paragraph expires June 30, 98.152015.98.16Limit Growth in the Community 98.17Alternatives for Disabled Individuals 98.18Waiver. The commissioner shall limit 98.19growth in the community alternatives for 98.20disabled individuals waiver to 60 allocations 98.21per month beginning July 1, 2011, through 98.22June 30, 2013, and 85 allocations per 98.23month beginning July 1, 2013, through 98.24June 30, 2015. Waiver allocations must 98.25be targeted to individuals who meet the 98.26priorities for accessing waiver services 98.27identified in Minnesota Statutes, section 98.28256B.49, subdivision 11a
         . The limits include 98.29conversions and diversions, unless the 98.30commissioner has approved a plan to convert 98.31funding due to the closure or downsizing 98.32of a residential facility or nursing facility 98.33to serve directly affected individuals on 98.34the community alternatives for disabled 98.35individuals waiver. Notwithstanding any 99.1contrary provisions in this article, this 99.2paragraph expires June 30, 2015.99.3Personal Care Assistance Relative 99.4Care. The commissioner shall adjust the 99.5capitation payment rates for managed care 99.6organizations paid under Minnesota Statutes, 99.7section 
         256B.69, to reflect the rate reductions 99.8for personal care assistance provided by 99.9a relative pursuant to Minnesota Statutes, 99.10section 
         256B.0659, subdivision 11.

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

99.12Alternative Care Transfer. Any money 99.13allocated to the alternative care program that 99.14is not spent for the purposes indicated does 99.15not cancel but shall be transferred to the 99.16medical assistance account.

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

99.18    Sec. 37. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 99.194, is amended to read:

99.20Subd. 4.Grant Programs

99.21The amounts that may be spent from this 99.22appropriation for each purpose are as follows:

99.23(a) Support Services Grants

99.24Appropriations by Fund99.25General8,715,0008,715,00099.26Federal TANF100,525,00094,611,000

99.27MFIP Consolidated Fund Grants. The 99.28TANF fund base is reduced by $10,000,000 99.29each year beginning in fiscal year 2012.99.30Subsidized Employment Funding Through 99.31ARRA. The commissioner is authorized to 99.32apply for TANF emergency fund grants for 99.33subsidized employment activities. Growth 100.1in expenditures for subsidized employment 100.2within the supported work program and the 100.3MFIP consolidated fund over the amount 100.4expended in the calendar year quarters in 100.5the TANF emergency fund base year shall 100.6be used to leverage the TANF emergency 100.7fund grants for subsidized employment and 100.8to fund supported work. The commissioner 100.9shall develop procedures to maximize 100.10reimbursement of these expenditures over the 100.11TANF emergency fund base year quarters, 100.12and may contract directly with employers 100.13and providers to maximize these TANF 100.14emergency fund grants.

100.15100.16(b) Basic Sliding Fee Child Care Assistance Grants37,144,00038,678,000

100.17Base Adjustment. The general fund base is 100.18decreased by $990,000 in fiscal year 2014 100.19and $979,000 in fiscal year 2015.100.20Child Care and Development Fund 100.21Unexpended Balance. In addition to 100.22the amount provided in this section, the 100.23commissioner shall expend $5,000,000 100.24in fiscal year 2012 from the federal child 100.25care and development fund unexpended 100.26balance for basic sliding fee child care under 100.27Minnesota Statutes, section 
         119B.03. The 100.28commissioner shall ensure that all child 100.29care and development funds are expended 100.30according to the federal child care and 100.31development fund regulations.

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

100.33Base Adjustment. The general fund base is 100.34increased by $713,000 in fiscal years 2014 100.35and 2015.

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

101.2Federal Child Support Demonstration 101.3Grants. Federal administrative 101.4reimbursement resulting from the federal 101.5child support grant expenditures authorized 101.6under section 1115a of the Social Security 101.7Act is appropriated to the commissioner for 101.8this activity.

101.9(e) Children's Services Grants

101.10Appropriations by Fund101.11General47,949,00048,507,000101.12Federal TANF140,000140,000

101.13Adoption Assistance and Relative Custody 101.14Assistance Transfer. The commissioner 101.15may transfer unencumbered appropriation 101.16balances for adoption assistance and relative 101.17custody assistance between fiscal years and 101.18between programs.101.19Privatized Adoption Grants. Federal 101.20reimbursement for privatized adoption grant 101.21and foster care recruitment grant expenditures 101.22is appropriated to the commissioner for 101.23adoption grants and foster care and adoption 101.24administrative purposes.101.25Adoption Assistance Incentive Grants.101.26Federal funds available during fiscal year 101.272012 and fiscal year 2013 for adoption 101.28incentive grants are appropriated to the 101.29commissioner for these purposes.

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

101.31(g) Children and Economic Support Grants

101.32Appropriations by Fund101.33General16,103,00016,180,000101.34Federal TANF700,0000

102.1Long-Term Homeless Services. $700,000 102.2is appropriated from the federal TANF 102.3fund for the biennium beginning July 102.41, 2011, to the commissioner of human 102.5services for long-term homeless services 102.6for low-income homeless families under 102.7Minnesota Statutes, section 
         256K.26. This 102.8is a onetime appropriation and is not added 102.9to the base.102.10Base Adjustment. The general fund base is 102.11increased by $42,000 in fiscal year 2014 and 102.12$43,000 in fiscal year 2015.102.13Minnesota Food Assistance Program. 102.14$333,000 in fiscal year 2012 and $408,000 in 102.15fiscal year 2013 are to increase the general 102.16fund base for the Minnesota food assistance 102.17program. Unexpended funds for fiscal year 102.182012 do not cancel but are available to the 102.19commissioner for this purpose in fiscal year 102.202013.

102.21(h) Health Care Grants

102.22Appropriations by Fund102.23General26,00066,000102.24Health Care Access190,000190,000

102.25Base Adjustment. The general fund base is 102.26increased by $24,000 in each of fiscal years 102.272014 and 2015.

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

102.29Aging Grants Reduction. Effective July 102.301, 2011, funding for grants made under 102.31Minnesota Statutes, sections 
         256.9754 and 102.32256B.0917, subdivision 13
         , is reduced by 102.33$3,600,000 for each year of the biennium. 102.34These reductions are onetime and do 102.35not affect base funding for the 2014-2015 103.1biennium. Grants made during the 2012-2013 103.2biennium under Minnesota Statutes, section 103.3256B.9754
         , must not be used for new 103.4construction or building renovation.103.5Essential Community Support Grant 103.6Delay. Upon federal approval to implement 103.7the nursing facility level of care on July 103.81, 2013, essential community supports 103.9grants under Minnesota Statutes, section 103.10256B.0917, subdivision 14
         , are reduced by 103.11$6,410,000 in fiscal year 2013. Base level 103.12funding is increased by $5,541,000 in fiscal 103.13year 2014 and $6,410,000 in fiscal year 2015.103.14Base Level Adjustment. The general fund 103.15base is increased by $10,035,000 in fiscal 103.16year 2014 and increased by $10,901,000 in 103.17fiscal year 2015.

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

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

103.20Grants for Housing Access Services. In 103.21fiscal year 2012, the commissioner shall 103.22make available a total of $161,000 in housing 103.23access services grants to individuals who 103.24relocate from an adult foster care home to 103.25a community living setting for assistance 103.26with completion of rental applications or 103.27lease agreements; assistance with publicly 103.28financed housing options; development of 103.29household budgets; and assistance with 103.30funding affordable furnishings and related 103.31household matters.103.32HIV Grants. The general fund appropriation 103.33for the HIV drug and insurance grant 103.34program shall be reduced by $2,425,000 in 103.35fiscal year 2012 and increased by $2,425,000 104.1in fiscal year 2014. These adjustments are 104.2onetime and shall not be applied to the base. 104.3Notwithstanding any contrary provision, this 104.4provision expires June 30, 2014.104.5Region 10. Of this appropriation, $100,000 104.6each year is for a grant provided under 104.7Minnesota Statutes, section 
         256B.097.104.8Base Level Adjustment. The general fund 104.9base is increased by $2,944,000 in fiscal year 104.102014 and $653,000 in fiscal year 2015.104.11Local Planning Grants for Creating 104.12Alternatives to Congregate Living for 104.13Individuals with Lower Needs.  (1) The 104.14commissioner shall make available a total 104.15of $250,000 per year in local planning 104.16grants, beginning July 1, 2011, to assist 104.17lead agencies and provider organizations in 104.18developing alternatives to congregate living 104.19within the available level of resources for the 104.20home and community-based services waivers 104.21for persons with disabilities.104.22(2) Notwithstanding clause (1), for fiscal 104.23years 2012 and 2013 only, the appropriation 104.24of $250,000 for fiscal year 2012 carries 104.25forward to fiscal year 2013, effective the day 104.26following final enactment.104.27Of the appropriations available for fiscal 104.28year 2013, $100,000 is for administrative 104.29functions related to the planning process 104.30required under Minnesota Statutes, sections 104.31144A.351 and 245A.03, subdivision 7, 104.32paragraphs (e) and (g), and $400,000 is for 104.33grants required to accomplish that planning 104.34process.105.1(3) Base funding for the grants under clause 105.2(1) is not affected by the appropriations 105.3under clause (2).105.4Disability Linkage Line. Of this 105.5appropriation, $125,000 in fiscal year 2012 105.6and $300,000 in fiscal year 2013 are for 105.7assistance to people with disabilities who are 105.8considering enrolling in managed care.

105.9(l) Adult Mental Health Grants

105.10Appropriations by Fund105.11General70,570,00070,570,000105.12Health Care Access750,000750,000105.13Lottery Prize1,508,0001,508,000

105.14Funding Usage. Up to 75 percent of a fiscal 105.15year's appropriation for adult mental health 105.16grants may be used to fund allocations in that 105.17portion of the fiscal year ending December 105.1831.105.19Base Adjustment. The general fund base is 105.20increased by $200,000 in fiscal years 2014 105.21and 2015.

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

105.23Funding Usage. Up to 75 percent of a fiscal 105.24year's appropriation for children's mental 105.25health grants may be used to fund allocations 105.26in that portion of the fiscal year ending 105.27December 31.105.28Base Adjustment. The general fund base is 105.29increased by $225,000 in fiscal years 2014 105.30and 2015.

105.31105.32(n) Chemical Dependency Nonentitlement Grants1,336,0001,336,000

105.33    Sec. 38. COMMISSIONER AUTHORITY TO REDUCE 2011 CONGREGATE 105.34CARE LOW NEED RATE CUT.106.1During fiscal years 2013 and 2014, the commissioner shall reduce the 2011 reduction 106.2of rates for congregate living for individuals with lower needs to the extent the actions 106.3taken under Minnesota Statutes, section 245A.03, subdivision 7, paragraph (g), produce 106.4savings beyond the amount needed to meet the licensed bed closure savings requirements 106.5of Minnesota Statutes, section 245A.03, subdivision 7, paragraph (e). Each February 1, 106.6the commissioner shall report to the chairs and ranking minority members of the health 106.7and human services finance committees on any reductions provided under this section. 106.8EFFECTIVE DATE.This section is effective July 1, 2012, and expires June 30, 106.92014.106.10    Sec. 39. HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH 106.11DISABILITIES.106.12(a) Individuals receiving services under a home and community-based waiver under 106.13Minnesota Statutes, section 256B.092 or 256B.49, may receive services in the following 106.14settings:106.15(1) an individual's own home or family home;106.16(2) a licensed adult foster care setting of up to five people; and 106.17(3) community living settings as defined in Minnesota Statutes, section 256B.49, 106.18subdivision 23, where individuals with disabilities may reside in all of the units in a 106.19building of four or fewer units no more than the greater of four or 25 percent of the units 106.20in a multifamily building of more than four units.106.21The above settings must not:106.22(1) be located in a building that is a publicly or privately operated facility that 106.23provides institutional treatment or custodial care;106.24(2) be located in a building on the grounds of or adjacent to a public institution;106.25(3) be a housing complex designed expressly around an individual's diagnosis or 106.26disability unless state or federal funding for housing requires it;106.27(4) be segregated based on a disability, either physically or because of setting 106.28characteristics, from the larger community; and106.29(5) have the qualities of an institution, unless specifically required in the individual's 106.30plan developed with the lead agency case manager and legal guardian. The qualities of an 106.31institution include, but are not limited to:106.32(i) regimented meal and sleep times;106.33(ii) limitations on visitors; and106.34(iii) lack of privacy.107.1(b) The provisions of paragraph (a) do not apply to any setting in which residents 107.2receive services under a home and community-based waiver as of June 30, 2013, and 107.3which has been delivering those services for at least one year.107.4(c) Notwithstanding paragraph (b), a program in Hennepin County established as 107.5part of a Hennepin County demonstration project is qualified for the exception allowed 107.6under paragraph (b).107.7(d) The commissioner shall submit an amendment to the waiver plan no later than 107.8December 31, 2012.107.9    Sec. 40. INDEPENDENT LIVING SERVICES BILLING.107.10The commissioner shall allow for daily rate and 15-minute increment billing for 107.11independent living services under the brain injury (BI) and CADI waivers. If necessary to 107.12comply with this requirement, the commissioner shall submit a waiver amendment to the 107.13state plan no later than December 31, 2012.107.14    Sec. 41.  REPEALER.107.15(a) Minnesota Statutes 2010, sections 144A.073, subdivision 9; and 256B.48, 107.16subdivision 6, and Laws 2011, First Special Session chapter 9, article 7, section 54,  are 107.17repealed.107.18(b) Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13, is 107.19repealed.107.20ARTICLE 5107.21MISCELLANEOUS107.22    Section 1. Minnesota Statutes 2010, section 43A.316, subdivision 5, is amended to 107.23read:107.24    Subd. 5. Public employee participation. (a) Participation in the program is subject 107.25to the conditions in this subdivision.107.26(b) Each exclusive representative for an eligible employer determines whether the 107.27employees it represents will participate in the program. The exclusive representative shall 107.28give the employer notice of intent to participate at least 30 days before the expiration date 107.29of the collective bargaining agreement preceding the collective bargaining agreement that 107.30covers the date of entry into the program. The exclusive representative and the eligible 107.31employer shall give notice to the commissioner of the determination to participate in the 107.32program at least 30 days before entry into the program. Entry into the program is governed 107.33by a schedule established by the commissioner. Employees of an eligible employer that is 108.1not participating in the program as of the date of enactment shall not be allowed to enter 108.2the program until January 1, 2015, except that a city that has received a formal written bid 108.3from the program as of the date of enactment shall be allowed to enter the program based 108.4on the bid if the city so chooses.108.5(c) Employees not represented by exclusive representatives may become members of 108.6the program upon a determination of an eligible employer to include these employees in the 108.7program. Either all or none of the employer's unrepresented employees must participate. 108.8The eligible employer shall give at least 30 days' notice to the commissioner before 108.9entering the program. Entry into the program is governed by a schedule established by the 108.10commissioner.  Employees of an eligible employer that is not participating in the program 108.11as of the date of enactment shall not be allowed to enter the program until January 1, 2015, 108.12except that a city that has received a formal written bid from the program as of the date of 108.13enactment shall be allowed to enter the program based on the bid if the city so chooses.108.14(d) Participation in the program is for a two-year term. Participation is automatically 108.15renewed for an additional two-year term unless the exclusive representative, or the 108.16employer for unrepresented employees, gives the commissioner notice of withdrawal 108.17at least 30 days before expiration of the participation period. A group that withdraws 108.18must wait two years before rejoining. An exclusive representative, or employer for 108.19unrepresented employees, may also withdraw if premiums increase 50 percent or more 108.20from one insurance year to the next.108.21(e) The exclusive representative shall give the employer notice of intent to withdraw 108.22to the commissioner at least 30 days before the expiration date of a collective bargaining 108.23agreement that includes the date on which the term of participation expires.108.24(f) Each participating eligible employer shall notify the commissioner of names of 108.25individuals who will be participating within two weeks of the commissioner receiving 108.26notice of the parties' intent to participate. The employer shall also submit other information 108.27as required by the commissioner for administration of the program.108.28EFFECTIVE DATE.This section is effective the day following final enactment.108.29    Sec. 2. Minnesota Statutes 2010, section 62A.047, is amended to read:108.3062A.047 CHILDREN'S HEALTH SUPERVISION SERVICES AND 108.31PRENATAL CARE SERVICES.108.32A policy of individual or group health and accident insurance regulated under this 108.33chapter, or individual or group subscriber contract regulated under chapter 62C, health 108.34maintenance contract regulated under chapter 62D, or health benefit certificate regulated 109.1under chapter 64B, issued, renewed, or continued to provide coverage to a Minnesota 109.2resident, must provide coverage for child health supervision services and prenatal care 109.3services. The policy, contract, or certificate must specifically exempt reasonable and 109.4customary charges for child health supervision services and prenatal care services from a 109.5deductible, co-payment, or other coinsurance or dollar limitation requirement. Nothing 109.6in this section prohibits a health plan company that has a network of providers from 109.7imposing a deductible, co-payment, or other coinsurance or dollar limitation requirement 109.8for child health supervision services and prenatal care services that are delivered by an 109.9out-of-network provider. This section does not prohibit the use of policy waiting periods 109.10or preexisting condition limitations for these services. Minimum benefits may be limited 109.11to one visit payable to one provider for all of the services provided at each visit cited in 109.12this section subject to the schedule set forth in this section. Nothing in this section applies 109.13to a commercial health insurance policy issued as a companion to a health maintenance 109.14organization contract, a policy designed primarily to provide coverage payable on a per 109.15diem, fixed indemnity, or nonexpense incurred basis, or a policy that provides only 109.16accident coverage Nothing in this section applies to a policy designed primarily to provide 109.17coverage payable on a per diem, fixed indemnity, or non-expense-incurred basis, or a 109.18policy that provides only accident coverage. Nothing in this section prevents a health 109.19plan company from using reasonable medical management techniques to determine the 109.20frequency, method, treatment, or setting for child health supervision services and prenatal 109.21care services.109.22"Child health supervision services" means pediatric preventive services, appropriate 109.23immunizations, developmental assessments, and laboratory services appropriate to the age 109.24of a child from birth to age six, and appropriate immunizations from ages six to 18, as 109.25defined by Standards of Child Health Care issued by the American Academy of Pediatrics. 109.26Reimbursement must be made for at least five child health supervision visits from birth 109.27to 12 months, three child health supervision visits from 12 months to 24 months, once a 109.28year from 24 months to 72 months.109.29"Prenatal care services" means the comprehensive package of medical and 109.30psychosocial support provided throughout the pregnancy, including risk assessment, 109.31serial surveillance, prenatal education, and use of specialized skills and technology, 109.32when needed, as defined by Standards for Obstetric-Gynecologic Services issued by the 109.33American College of Obstetricians and Gynecologists.109.34EFFECTIVE DATE.This section is effective August 1, 2012.109.35    Sec. 3. Minnesota Statutes 2010, section 62A.21, subdivision 2a, is amended to read:110.1    Subd. 2a. Continuation privilege. Every policy described in subdivision 1 shall 110.2contain a provision which permits continuation of coverage under the policy for the 110.3insured's former spouse and dependent children upon entry of a valid decree of dissolution 110.4of marriage. The coverage shall be continued until the earlier of the following dates:110.5    (a) the date the insured's former spouse becomes covered under any other group 110.6health plan; or110.7    (b) the date coverage would otherwise terminate under the policy.110.8    If the coverage is provided under a group policy, any required premium contributions 110.9for the coverage shall be paid by the insured on a monthly basis to the group policyholder 110.10for remittance to the insurer. The policy must require the group policyholder to, upon 110.11request, provide the insured with written verification from the insurer of the cost of this 110.12coverage promptly at the time of eligibility for this coverage and at any time during 110.13the continuation period. In no event shall the amount of premium charged exceed 102 110.14percent of the cost to the plan for such period of coverage for other similarly situated 110.15spouses and dependent children with respect to whom the marital relationship has not 110.16dissolved, without regard to whether such cost is paid by the employer or employee The 110.17required premium amount for continuation of the coverage shall be calculated in the same 110.18manner as provided under section 4980B of the Internal Revenue Code, its implementing 110.19regulations and Internal Revenue Service rulings on section 4980B.110.20    Upon request by the insured's former spouse or dependent child, a health carrier 110.21must provide the instructions necessary to enable the child or former spouse to elect 110.22continuation of coverage.110.23EFFECTIVE DATE.This section is effective August 1, 2012.110.24    Sec. 4. Minnesota Statutes 2010, section 62D.101, subdivision 2a, is amended to read:110.25    Subd. 2a. Continuation privilege. Every health maintenance contract as described 110.26in subdivision 1 shall contain a provision which permits continuation of coverage under 110.27the contract for the enrollee's former spouse and children upon entry of a valid decree of 110.28dissolution of marriage. The coverage shall be continued until the earlier of the following 110.29dates:110.30    (a) the date the enrollee's former spouse becomes covered under another group 110.31plan or Medicare; or110.32    (b) the date coverage would otherwise terminate under the health maintenance 110.33contract.110.34    If coverage is provided under a group policy, any required premium contributions 110.35for the coverage shall be paid by the enrollee on a monthly basis to the group contract 111.1holder to be paid to the health maintenance organization. The contract must require the 111.2group contract holder to, upon request, provide the enrollee with written verification from 111.3the insurer of the cost of this coverage promptly at the time of eligibility for this coverage 111.4and at any time during the continuation period. In no event shall the fee charged exceed 111.5102 percent of the cost to the plan for the period of coverage for other similarly situated 111.6spouses and dependent children when the marital relationship has not dissolved, regardless 111.7of whether the cost is paid by the employer or employee The required premium amount 111.8for continuation of the coverage shall be calculated in the same manner as provided under 111.9section 4980B in the Internal Revenue Code, its implementing regulations and Internal 111.10Revenue Service rulings on section 4980B.111.11EFFECTIVE DATE.This section is effective August 1, 2012.111.12    Sec. 5. Minnesota Statutes 2010, section 62J.26, subdivision 3, is amended to read:111.13    Subd. 3. Requests for evaluation. (a) Whenever a legislative measure containing 111.14a mandated health benefit proposal is introduced as a bill or offered as an amendment 111.15to a bill, or is likely to be introduced as a bill or offered as an amendment, a the chair 111.16of any standing the legislative committee that has jurisdiction over the subject matter 111.17of the proposal may must request that the commissioner complete an evaluation of the 111.18proposal under this section, to inform any committee of floor action by either house of 111.19the legislature.111.20(b) The commissioner must conduct an evaluation described in subdivision 2 of each 111.21mandated health benefit proposal for which an evaluation is requested under paragraph (a), 111.22unless the commissioner determines under paragraph (c) or subdivision 4 that priorities 111.23and resources do not permit its evaluation introduced as a bill or offered as an amendment 111.24to a bill as requested under paragraph (a).111.25(c) If requests for evaluation of multiple proposals are received, the commissioner 111.26must consult with the chairs of the standing legislative committees having jurisdiction 111.27over the subject matter of the mandated health benefit proposals to prioritize the requests 111.28and establish a reporting date for each proposal to be evaluated. The commissioner 111.29is not required to direct an unreasonable quantity of the commissioner's resources to 111.30these evaluations.111.31    Sec. 6. Minnesota Statutes 2010, section 62J.26, subdivision 5, is amended to read:111.32    Subd. 5. Report to legislature. The commissioner must submit a written report on 111.33the evaluation to the legislature no later than 180 30 days after the request. The report 111.34must be submitted in compliance with sections 
         3.195 and 
         3.197.112.1    Sec. 7. Minnesota Statutes 2010, section 62J.26, is amended by adding a subdivision to 112.2read:112.3    Subd. 6.Evaluation of mandated health benefits.(a) The commissioner of 112.4commerce, in consultation with the commissioners of health and management and budget, 112.5shall evaluate each mandated health benefit currently required in Minnesota Statutes or 112.6Rules in accordance with the evaluation process described in subdivision 2.112.7(b) For purposes of this subdivision, a "mandated health benefit" means a statutory 112.8or administrative requirement that a health plan do the following:112.9(1) provide coverage or increase the amount of coverage for the treatment of a 112.10particular disease, condition, or other health care need;112.11(2) provide coverage or increase the amount of coverage of a particular type of 112.12health care treatment or service, or of equipment, supplies, or drugs used in connection 112.13with a health care treatment or service; or112.14(3) provide coverage for care delivered by a specific type of provider.112.15(c) The commissioner must submit a written report on the evaluation of existing state 112.16mandated health benefits to the legislature by December 31, 2015.112.17EFFECTIVE DATE.This section is effective July 1, 2013.112.18    Sec. 8. [62Q.026] CERTAIN FEDERALLY NONQUALIFIED HEALTH PLANS; 112.19SALE PERMITTED.112.20    Subdivision 1.Definitions.(a) For purposes of this section, the terms defined 112.21in this section have the meanings given.112.22(b) "Commissioner" means the commissioner of commerce.112.23(c) "Health plan" has the meaning given in section 62Q.01, subdivision 3.112.24(d) "Health plan company" has the meaning given in section 62Q.01, subdivision 4.112.25(e) "Nonqualified health plan" means any health plan not certified by the federal 112.26Secretary of Health and Human Services in accordance with the Patient Protection and 112.27Affordable Care Act of 2010, as amended.112.28(f) "Qualified health plan" means a health plan certified by the federal Secretary of 112.29Health and Human Services for eligibility to be sold inside health benefit exchanges in 112.30accordance with the Patient Protection and Affordable Care Act of 2010, as amended.112.31    Subd. 2.Sale of nonqualified health plan permitted.A health plan company 112.32authorized under Minnesota law to offer, issue, sell, or renew a health plan in Minnesota 112.33may do so regardless of whether the health plan is a qualified or nonqualified health plan 112.34under the federal Patient Protection and Affordable Care Act of 2010, as amended. No 112.35statute or rule of this state shall be interpreted as providing to the contrary.113.1EFFECTIVE DATE.This section is effective the day following final enactment.113.2    Sec. 9. [148.2855] NURSE LICENSURE COMPACT.113.3The Nurse Licensure Compact is enacted into law and entered into with all other 113.4jurisdictions legally joining in it, in the form substantially as follows:113.5ARTICLE 1113.6DEFINITIONS113.7As used in this compact:113.8(a) "Adverse action" means a home or remote state action.113.9(b) "Alternative program" means a voluntary, nondisciplinary monitoring program 113.10approved by a nurse licensing board.113.11(c) "Coordinated licensure information system" means an integrated process for 113.12collecting, storing, and sharing information on nurse licensure and enforcement activities 113.13related to nurse licensure laws, which is administered by a nonprofit organization 113.14composed of and controlled by state nurse licensing boards.113.15(d) "Current significant investigative information" means:113.16(1) investigative information that a licensing board, after a preliminary inquiry that 113.17includes notification and an opportunity for the nurse to respond if required by state law, 113.18has reason to believe is not groundless and, if proved true, would indicate more than a 113.19minor infraction; or113.20(2) investigative information that indicates that the nurse represents an immediate 113.21threat to public health and safety regardless of whether the nurse has been notified and 113.22had an opportunity to respond.113.23(e) "Home state" means the party state which is the nurse's primary state of residence.113.24(f) "Home state action" means any administrative, civil, equitable, or criminal 113.25action permitted by the home state's laws which are imposed on a nurse by the home 113.26state's licensing board or other authority including actions against an individual's license 113.27such as revocation, suspension, probation, or any other action which affects a nurse's 113.28authorization to practice.113.29(g) "Licensing board" means a party state's regulatory body responsible for issuing 113.30nurse licenses.113.31(h) "Multistate licensure privilege" means current, official authority from a 113.32remote state permitting the practice of nursing as either a registered nurse or a licensed 113.33practical/vocational nurse in the party state. All party states have the authority, according 113.34to existing state due process law, to take actions against the nurse's privilege such as 114.1revocation, suspension, probation, or any other action which affects a nurse's authorization 114.2to practice.114.3(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those 114.4terms are defined by each party state's practice laws.114.5(j) "Party state" means any state that has adopted this compact.114.6(k) "Remote state" means a party state other than the home state:114.7(1) where the patient is located at the time nursing care is provided; or114.8(2) in the case of the practice of nursing not involving a patient, in the party state 114.9where the recipient of nursing practice is located.114.10(l) "Remote state action" means:114.11(1) any administrative, civil, equitable, or criminal action permitted by a remote 114.12state's laws which are imposed on a nurse by the remote state's licensing board or other 114.13authority including actions against an individual's multistate licensure privilege to practice 114.14in the remote state; and114.15(2) cease and desist and other injunctive or equitable orders issued by remote states 114.16or the licensing boards of those states.114.17(m) "State" means a state, territory, or possession of the United States, the District of 114.18Columbia, or the Commonwealth of Puerto Rico.114.19(n) "State practice laws" means individual party state laws and regulations that 114.20govern the practice of nursing, define the scope of nursing practice, and create the 114.21methods and grounds for imposing discipline. State practice laws does not include the 114.22initial qualifications for licensure or requirements necessary to obtain and retain a license, 114.23except for qualifications or requirements of the home state.114.24ARTICLE 2114.25GENERAL PROVISIONS AND JURISDICTION114.26(a) A license to practice registered nursing issued by a home state to a resident in 114.27that state will be recognized by each party state as authorizing a multistate licensure 114.28privilege to practice as a registered nurse in the party state. A license to practice licensed 114.29practical/vocational nursing issued by a home state to a resident in that state will be 114.30recognized by each party state as authorizing a multistate licensure privilege to practice 114.31as a licensed practical/vocational nurse in the party state. In order to obtain or retain a 114.32license, an applicant must meet the home state's qualifications for licensure and license 114.33renewal as well as all other applicable state laws.114.34(b) Party states may, according to state due process laws, limit or revoke the 114.35multistate licensure privilege of any nurse to practice in their state and may take any other 114.36actions under their applicable state laws necessary to protect the health and safety of 115.1their citizens. If a party state takes such action, it shall promptly notify the administrator 115.2of the coordinated licensure information system. The administrator of the coordinated 115.3licensure information system shall promptly notify the home state of any such actions by 115.4remote states.115.5(c) Every nurse practicing in a party state must comply with the state practice laws of 115.6the state in which the patient is located at the time care is rendered. In addition, the practice 115.7of nursing is not limited to patient care, but shall include all nursing practice as defined by 115.8the state practice laws of the party state. The practice of nursing will subject a nurse to the 115.9jurisdiction of the nurse licensing board, the courts, and the laws in the party state.115.10(d) This compact does not affect additional requirements imposed by states for 115.11advanced practice registered nursing. However, a multistate licensure privilege to practice 115.12registered nursing granted by a party state shall be recognized by other party states as a 115.13license to practice registered nursing if one is required by state law as a precondition for 115.14qualifying for advanced practice registered nurse authorization.115.15(e) Individuals not residing in a party state shall continue to be able to apply for 115.16nurse licensure as provided for under the laws of each party state. However, the license 115.17granted to these individuals will not be recognized as granting the privilege to practice 115.18nursing in any other party state unless explicitly agreed to by that party state.115.19ARTICLE 3115.20APPLICATIONS FOR LICENSURE IN A PARTY STATE115.21(a) Upon application for a license, the licensing board in a party state shall ascertain, 115.22through the coordinated licensure information system, whether the applicant has ever held 115.23or is the holder of a license issued by any other state, whether there are any restrictions 115.24on the multistate licensure privilege, and whether any other adverse action by a state 115.25has been taken against the license.115.26(b) A nurse in a party state shall hold licensure in only one party state at a time, 115.27issued by the home state.115.28(c) A nurse who intends to change primary state of residence may apply for licensure 115.29in the new home state in advance of the change. However, new licenses will not be 115.30issued by a party state until after a nurse provides evidence of change in primary state of 115.31residence satisfactory to the new home state's licensing board.115.32(d) When a nurse changes primary state of residence by:115.33(1) moving between two party states, and obtains a license from the new home state, 115.34the license from the former home state is no longer valid;116.1(2) moving from a nonparty state to a party state, and obtains a license from the new 116.2home state, the individual state license issued by the nonparty state is not affected and will 116.3remain in full force if so provided by the laws of the nonparty state; or116.4(3) moving from a party state to a nonparty state, the license issued by the prior 116.5home state converts to an individual state license, valid only in the former home state, 116.6without the multistate licensure privilege to practice in other party states.116.7ARTICLE 4116.8ADVERSE ACTIONS116.9In addition to the general provisions described in article 2, the provisions in this 116.10article apply.116.11(a) The licensing board of a remote state shall promptly report to the administrator 116.12of the coordinated licensure information system any remote state actions including the 116.13factual and legal basis for the action, if known. The licensing board of a remote state shall 116.14also promptly report any significant current investigative information yet to result in a 116.15remote state action. The administrator of the coordinated licensure information system 116.16shall promptly notify the home state of any reports.116.17(b) The licensing board of a party state shall have the authority to complete any 116.18pending investigation for a nurse who changes primary state of residence during the 116.19course of the investigation. The board shall also have the authority to take appropriate 116.20action, and shall promptly report the conclusion of the investigation to the administrator 116.21of the coordinated licensure information system. The administrator of the coordinated 116.22licensure information system shall promptly notify the new home state of any action.116.23(c) A remote state may take adverse action affecting the multistate licensure 116.24privilege to practice within that party state. However, only the home state shall have the 116.25power to impose adverse action against the license issued by the home state.116.26(d) For purposes of imposing adverse actions, the licensing board of the home state 116.27shall give the same priority and effect to reported conduct received from a remote state as 116.28it would if the conduct had occurred within the home state. In so doing, it shall apply its 116.29own state laws to determine appropriate action.116.30(e) The home state may take adverse action based on the factual findings of the 116.31remote state, provided each state follows its own procedures for imposing the adverse 116.32action.116.33(f) Nothing in this compact shall override a party state's decision that participation 116.34in an alternative program may be used in lieu of licensure action and that participation 116.35shall remain nonpublic if required by the party state's laws.117.1Party states must require nurses who enter any alternative programs to agree not to 117.2practice in any other party state during the term of the alternative program without prior 117.3authorization from the other party state.117.4ARTICLE 5117.5ADDITIONAL AUTHORITIES INVESTED IN 117.6PARTY STATE NURSE LICENSING BOARDS117.7Notwithstanding any other laws, party state nurse licensing boards shall have the 117.8authority to:117.9(1) if otherwise permitted by state law, recover from the affected nurse the costs of 117.10investigation and disposition of cases resulting from any adverse action taken against 117.11that nurse;117.12(2) issue subpoenas for both hearings and investigations which require the attendance 117.13and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse 117.14licensing board in a party state for the attendance and testimony of witnesses, and the 117.15production of evidence from another party state, shall be enforced in the latter state by 117.16any court of competent jurisdiction according to the practice and procedure of that court 117.17applicable to subpoenas issued in proceedings pending before it. The issuing authority 117.18shall pay any witness fees, travel expenses, mileage, and other fees required by the service 117.19statutes of the state where the witnesses and evidence are located;117.20(3) issue cease and desist orders to limit or revoke a nurse's authority to practice 117.21in the nurse's state; and117.22(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).117.23ARTICLE 6117.24COORDINATED LICENSURE INFORMATION SYSTEM117.25(a) All party states shall participate in a cooperative effort to create a coordinated 117.26database of all licensed registered nurses and licensed practical/vocational nurses. This 117.27system shall include information on the licensure and disciplinary history of each 117.28nurse, as contributed by party states, to assist in the coordination of nurse licensure and 117.29enforcement efforts.117.30(b) Notwithstanding any other provision of law, all party states' licensing boards shall 117.31promptly report adverse actions, actions against multistate licensure privileges, any current 117.32significant investigative information yet to result in adverse action, denials of applications, 117.33and the reasons for the denials to the coordinated licensure information system.117.34(c) Current significant investigative information shall be transmitted through the 117.35coordinated licensure information system only to party state licensing boards.118.1(d) Notwithstanding any other provision of law, all party states' licensing boards 118.2contributing information to the coordinated licensure information system may designate 118.3information that may not be shared with nonparty states or disclosed to other entities or 118.4individuals without the express permission of the contributing state.118.5(e) Any personally identifiable information obtained by a party state's licensing 118.6board from the coordinated licensure information system may not be shared with nonparty 118.7states or disclosed to other entities or individuals except to the extent permitted by the 118.8laws of the party state contributing the information.118.9(f) Any information contributed to the coordinated licensure information system that 118.10is subsequently required to be expunged by the laws of the party state contributing that 118.11information shall also be expunged from the coordinated licensure information system.118.12(g) The compact administrators, acting jointly with each other and in consultation 118.13with the administrator of the coordinated licensure information system, shall formulate 118.14necessary and proper procedures for the identification, collection, and exchange of 118.15information under this compact.118.16ARTICLE 7118.17COMPACT ADMINISTRATION AND118.18INTERCHANGE OF INFORMATION118.19(a) The head or designee of the nurse licensing board of each party state shall be the 118.20administrator of this compact for that state.118.21(b) The compact administrator of each party state shall furnish to the compact 118.22administrator of each other party state any information and documents including, but not 118.23limited to, a uniform data set of investigations, identifying information, licensure data, and 118.24disclosable alternative program participation information to facilitate the administration of 118.25this compact.118.26(c) Compact administrators shall have the authority to develop uniform rules to 118.27facilitate and coordinate implementation of this compact. These uniform rules shall be 118.28adopted by party states under the authority in article 5, clause (4).118.29ARTICLE 8118.30IMMUNITY118.31A party state or the officers, employees, or agents of a party state's nurse licensing 118.32board who acts in good faith according to the provisions of this compact shall not be 118.33liable for any act or omission while engaged in the performance of their duties under 118.34this compact. Good faith shall not include willful misconduct, gross negligence, or 118.35recklessness.118.36ARTICLE 9119.1ENACTMENT, WITHDRAWAL, AND AMENDMENT119.2(a) This compact shall become effective for each state when it has been enacted by 119.3that state. Any party state may withdraw from this compact by repealing the nurse licensure 119.4compact, but no withdrawal shall take effect until six months after the withdrawing state 119.5has given notice of the withdrawal to the executive heads of all other party states.119.6(b) No withdrawal shall affect the validity or applicability by the licensing boards 119.7of states remaining party to the compact of any report of adverse action occurring prior 119.8to the withdrawal.119.9(c) Nothing contained in this compact shall be construed to invalidate or prevent any 119.10nurse licensure agreement or other cooperative arrangement between a party state and a 119.11nonparty state that is made according to the other provisions of this compact.119.12(d) This compact may be amended by the party states. No amendment to this 119.13compact shall become effective and binding upon the party states until it is enacted into 119.14the laws of all party states.119.15ARTICLE 10119.16CONSTRUCTION AND SEVERABILITY119.17(a) This compact shall be liberally construed to effectuate the purposes of the 119.18compact. The provisions of this compact shall be severable and if any phrase, clause, 119.19sentence, or provision of this compact is declared to be contrary to the constitution of any 119.20party state or of the United States or the applicability thereof to any government, agency, 119.21person, or circumstance is held invalid, the validity of the remainder of this compact and 119.22the applicability of it to any government, agency, person, or circumstance shall not be 119.23affected by it. If this compact is held contrary to the constitution of any party state, the 119.24compact shall remain in full force and effect for the remaining party states and in full force 119.25and effect for the party state affected as to all severable matters.119.26(b) In the event party states find a need for settling disputes arising under this 119.27compact:119.28(1) the party states may submit the issues in dispute to an arbitration panel which 119.29shall be comprised of an individual appointed by the compact administrator in the home 119.30state, an individual appointed by the compact administrator in the remote states involved, 119.31and an individual mutually agreed upon by the compact administrators of the party states 119.32involved in the dispute; and119.33(2) the decision of a majority of the arbitrators shall be final and binding.119.34EFFECTIVE DATE.This section is effective upon implementation of the 119.35coordinated licensure information system defined in section 148.2855, but no sooner 119.36than July 1, 2013.120.1    Sec. 10. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO 120.2EXISTING LAWS.120.3(a) A nurse practicing professional or practical nursing in Minnesota under the 120.4authority of section 148.2855 shall have the same obligations, privileges, and rights as if 120.5the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section 120.6148.2855, the Board of Nursing shall comply with and follow all laws and rules with 120.7respect to registered and licensed practical nurses practicing professional or practical 120.8nursing in Minnesota under the authority of section 148.2855, and all such individuals 120.9shall be governed and regulated as if they were licensed by the board.120.10(b) Section 148.2855 does not relieve employers of nurses from complying with 120.11statutorily imposed obligations.120.12(c) Section 148.2855 does not supersede existing state labor laws.120.13(d) For purposes of the Minnesota Government Data Practices Act, chapter 13, 120.14an individual not licensed as a nurse under sections 148.171 to 148.285 who practices 120.15professional or practical nursing in Minnesota under the authority of section 148.2855 is 120.16considered to be a licensee of the board.120.17(e) Uniform rules developed by the compact administrators shall not be subject 120.18to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101, 120.1914.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.120.20(f) Proceedings brought against an individual's multistate privilege shall be 120.21adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject 120.22to judicial review as provided for in sections 14.63 to 14.69.120.23(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4; 120.24144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917, 120.25subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40, 120.26subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are 120.27licensed as registered or licensed practical nurses in the home state shall be considered 120.28to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to 120.29registered nurses or the practice of professional nursing, then only holders of a multistate 120.30privilege who are licensed as registered nurses in the home state shall be considered 120.31licensees.120.32(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557 120.33apply to individuals not licensed as registered or licensed practical nurses under sections 120.34148.171 to 148.285 who practice professional or practical nursing in Minnesota under 120.35the authority of section 148.2855.121.1(i) The board may take action against an individual's multistate privilege based on 121.2the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or 121.3requiring the board to take corrective or disciplinary action.121.4(j) The board may take all forms of disciplinary action provided for in section 121.5148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision 121.66, against an individual's multistate privilege.121.7(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals 121.8who practice professional or practical nursing in Minnesota under the authority of section 121.9148.2855.121.10(l) The cooperation requirements of section 148.265 apply to individuals who 121.11practice professional or practical nursing in Minnesota under the authority of section 121.12148.2855.121.13(m) The provisions of section 148.283 shall not apply to individuals who practice 121.14professional or practical nursing in Minnesota under the authority of section 148.2855.121.15(n) Complaints against individuals who practice professional or practical nursing 121.16in Minnesota under the authority of section 148.2855 shall be handled as provided in 121.17sections 214.10 and 214.103.121.18(o) All provisions of section 148.2855 authorizing or requiring the board to provide 121.19data to party states are authorized by section 214.10, subdivision 8, paragraph (d).121.20(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a 121.21remote state any active investigative data regarding a complaint investigation against a 121.22nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable 121.23assurances from the remote state that the data will be maintained with the same protections 121.24as provided in Minnesota law.121.25(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice 121.26professional or practical nursing in Minnesota under the authority of section 148.2855 121.27when the practice involves direct physical contact between the nurse and a patient.121.28(r) A nurse practicing professional or practical nursing in Minnesota under the 121.29authority of section 148.2855 must comply with any criminal background check required 121.30under Minnesota law.121.31EFFECTIVE DATE.This section is effective upon implementation of the 121.32coordinated licensure information system defined in section 148.2855, but no sooner 121.33than July 1, 2013.121.34    Sec. 11. [148.2857] WITHDRAWAL FROM COMPACT.122.1The governor may withdraw the state from the compact in section 148.2855 if 122.2the Board of Nursing notifies the governor that a party state to the compact changed 122.3the party state's requirements for nurse licensure after July 1, 2012, and that the party 122.4state's requirements, as changed, are substantially lower than the requirements for nurse 122.5licensure in this state.122.6EFFECTIVE DATE.This section is effective upon implementation of the 122.7coordinated licensure information system defined in section 148.2855, but no sooner 122.8than July 1, 2013.122.9    Sec. 12. [148.2858] MISCELLANEOUS PROVISIONS.122.10(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board" 122.11means the executive director of the board.122.12(b) The Board of Nursing shall have the authority to recover from a nurse practicing 122.13professional or practical nursing in Minnesota under the authority of section 148.2855 122.14the costs of investigation and disposition of cases resulting from any adverse action 122.15taken against the nurse.122.16(c) The board may implement a system of identifying individuals who practice 122.17professional or practical nursing in Minnesota under the authority of section 148.2855.122.18EFFECTIVE DATE.This section is effective upon implementation of the 122.19coordinated licensure information system defined in section 148.2855, but no sooner 122.20than July 1, 2013.122.21    Sec. 13. [148.2859] NURSE LICENSURE COMPACT ADVISORY 122.22COMMITTEE.122.23    Subdivision 1.Establishment; membership.A Nurse Licensure Compact Advisory 122.24Committee is established to advise the compact administrator in the implementation of 122.25section 148.2855. Members of the advisory committee shall be appointed by the board 122.26and shall be composed of representatives of Minnesota nursing organizations, Minnesota 122.27licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses 122.28who provide home care, Minnesota licensed advanced practice registered nurses, and 122.29public members as defined in section 214.02.122.30    Subd. 2.Duties.The advisory committee shall advise the compact administrator in 122.31the implementation of section 148.2855.122.32    Subd. 3.Organization.The advisory committee shall be organized and 122.33administered under section 15.059.123.1EFFECTIVE DATE.This section is effective upon implementation of the 123.2coordinated licensure information system defined in section 148.2855, but no sooner 123.3than July 1, 2013.123.4    Sec. 14. Minnesota Statutes 2010, section 256B.0943, subdivision 9, is amended to 123.5read:123.6    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a 123.7certified provider entity must ensure that:123.8    (1) each individual provider's caseload size permits the provider to deliver services 123.9to both clients with severe, complex needs and clients with less intensive needs. The 123.10provider's caseload size should reasonably enable the provider to play an active role in 123.11service planning, monitoring, and delivering services to meet the client's and client's 123.12family's needs, as specified in each client's individual treatment plan;123.13    (2) site-based programs, including day treatment and preschool programs, provide 123.14staffing and facilities to ensure the client's health, safety, and protection of rights, and that 123.15the programs are able to implement each client's individual treatment plan;123.16    (3) a day treatment program is provided to a group of clients by a multidisciplinary 123.17team under the clinical supervision of a mental health professional. The day treatment 123.18program must be provided in and by: (i) an outpatient hospital accredited by the Joint 123.19Commission on Accreditation of Health Organizations and licensed under sections 
         144.50 123.20to 
         144.55; (ii) a community mental health center under section 
         245.62; or (iii) an entity 123.21that is under contract with the county boardcertified under subdivision 4 to operate a 123.22program that meets the requirements of section 
         245.4712, subdivision 2, or245.4884, 123.23subdivision 2
         , and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 123.24program must stabilize the client's mental health status while developing and improving 123.25the client's independent living and socialization skills. The goal of the day treatment 123.26program must be to reduce or relieve the effects of mental illness and provide training to 123.27enable the client to live in the community. The program must be available at least one day 123.28a week for a two-hour time block. The two-hour time block must include at least one hour 123.29of individual or group psychotherapy. The remainder of the structured treatment program 123.30may include individual or group psychotherapy, and individual or group skills training, if 123.31included in the client's individual treatment plan. Day treatment programs are not part of 123.32inpatient or residential treatment services. A day treatment program may provide fewer 123.33than the minimally required hours for a particular child during a billing period in which 123.34the child is transitioning into, or out of, the program; and124.1    (4) a therapeutic preschool program is a structured treatment program offered 124.2to a child who is at least 33 months old, but who has not yet reached the first day of 124.3kindergarten, by a preschool multidisciplinary team in a day program licensed under 124.4Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available two 124.5hours per day, five days per week, and 12 months of each calendar year. The structured 124.6treatment program may include individual or group psychotherapy and individual or 124.7group skills training, if included in the client's individual treatment plan. A therapeutic 124.8preschool program may provide fewer than the minimally required hours for a particular 124.9child during a billing period in which the child is transitioning into, or out of, the program.124.10    (b) A provider entity must deliver the service components of children's therapeutic 124.11services and supports in compliance with the following requirements:124.12    (1) individual, family, and group psychotherapy must be delivered as specified in 124.13Minnesota Rules, part 9505.0323;124.14    (2) individual, family, or group skills training must be provided by a mental health 124.15professional or a mental health practitioner who has a consulting relationship with a 124.16mental health professional who accepts full professional responsibility for the training;124.17    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis 124.18through arrangements for direct intervention and support services to the child and the 124.19child's family. Crisis assistance must utilize resources designed to address abrupt or 124.20substantial changes in the functioning of the child or the child's family as evidenced by 124.21a sudden change in behavior with negative consequences for well being, a loss of usual 124.22coping mechanisms, or the presentation of danger to self or others;124.23    (4) mental health behavioral aide services must be medically necessary treatment 124.24services, identified in the child's individual treatment plan and individual behavior plan, 124.25which are performed minimally by a paraprofessional qualified according to subdivision 124.267, paragraph (b), clause (3), and which are designed to improve the functioning of the 124.27child in the progressive use of developmentally appropriate psychosocial skills. Activities 124.28involve working directly with the child, child-peer groupings, or child-family groupings 124.29to practice, repeat, reintroduce, and master the skills defined in subdivision 1, paragraph 124.30(p), as previously taught by a mental health professional or mental health practitioner 124.31including:124.32(i) providing cues or prompts in skill-building peer-to-peer or parent-child 124.33interactions so that the child progressively recognizes and responds to the cues 124.34independently;124.35(ii) performing as a practice partner or role-play partner;124.36(iii) reinforcing the child's accomplishments;125.1(iv) generalizing skill-building activities in the child's multiple natural settings;125.2(v) assigning further practice activities; and125.3(vi) intervening as necessary to redirect the child's target behavior and to de-escalate 125.4behavior that puts the child or other person at risk of injury.125.5A mental health behavioral aide must document the delivery of services in written 125.6progress notes. The mental health behavioral aide must implement treatment strategies 125.7in the individual treatment plan and the individual behavior plan. The mental health 125.8behavioral aide must document the delivery of services in written progress notes. Progress 125.9notes must reflect implementation of the treatment strategies, as performed by the mental 125.10health behavioral aide and the child's responses to the treatment strategies; and125.11    (5) direction of a mental health behavioral aide must include the following:125.12    (i) a clinical supervision plan approved by the responsible mental health professional;125.13    (ii) ongoing on-site observation by a mental health professional or mental health 125.14practitioner for at least a total of one hour during every 40 hours of service provided 125.15to a child; and125.16    (iii) immediate accessibility of the mental health professional or mental health 125.17practitioner to the mental health behavioral aide during service provision.125.18    Sec. 15. Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 125.198, is amended to read:

125.20125.21Subd. 8.Board of Nursing Home Administrators2,153,0002,145,000

125.22Rulemaking. Of this appropriation, $44,000 125.23in fiscal year 2012 is for rulemaking. This is 125.24a onetime appropriation.125.25Electronic Licensing System Adaptors.125.26Of this appropriation, $761,000 in fiscal 125.27year 2013 from the state government special 125.28revenue fund is to the administrative services 125.29unit to cover the costs to connect to the 125.30e-licensing system. Minnesota Statutes, 125.31section 
         16E.22. Base level funding for this 125.32activity in fiscal year 2014 shall be $100,000. 125.33Base level funding for this activity in fiscal 125.34year 2015 shall be $50,000.126.1Development and Implementation of a 126.2Disciplinary, Regulatory, Licensing and 126.3Information Management System. Of this 126.4appropriation, $800,000 in fiscal year 2012 126.5and $300,000 in fiscal year 2013 are for the 126.6development of a shared system. Base level 126.7funding for this activity in fiscal year 2014 126.8shall be $50,000.126.9Administrative Services Unit - Operating 126.10Costs. Of this appropriation, $526,000 126.11in fiscal year 2012 and $526,000 in 126.12fiscal year 2013 are for operating costs 126.13of the administrative services unit. The 126.14administrative services unit may receive 126.15and expend reimbursements for services 126.16performed by other agencies.126.17Administrative Services Unit - Retirement 126.18Costs. Of this appropriation in fiscal year 126.192012, $225,000 is for onetime retirement 126.20costs in the health-related boards. This 126.21funding may be transferred to the health 126.22boards incurring those costs for their 126.23payment. These funds are available either 126.24year of the biennium.126.25Administrative Services Unit - Volunteer 126.26Health Care Provider Program. Of this 126.27appropriation, $150,000 in fiscal year 2012 126.28and $150,000 in fiscal year 2013 are to pay 126.29for medical professional liability coverage 126.30required under Minnesota Statutes, section 126.31214.40
         .126.32Administrative Services Unit - Contested 126.33Cases and Other Legal Proceedings. Of 126.34this appropriation, $200,000 in fiscal year 126.352012 and $200,000 in fiscal year 2013 are 127.1for costs of contested case hearings and other 127.2unanticipated costs of legal proceedings 127.3involving health-related boards funded 127.4under this section. Upon certification of a 127.5health-related board to the administrative 127.6services unit that the costs will be incurred 127.7and that there is insufficient money available 127.8to pay for the costs out of money currently 127.9available to that board, the administrative 127.10services unit is authorized to transfer money 127.11from this appropriation to the board for 127.12payment of those costs with the approval 127.13of the commissioner of management and 127.14budget. This appropriation does not cancel. 127.15Any unencumbered and unspent balances 127.16remain available for these expenditures in 127.17subsequent fiscal years.127.18Base Adjustment. The State Government 127.19Special Revenue Fund base is decreased by 127.20$911,000 in fiscal year 2014 and $1,011,000127.21$961,000 in fiscal year 2015.127.22    Sec. 16. BIENNIAL BUDGET REQUEST; UNIVERSITY OF MINNESOTA.127.23Beginning in 2013, as part of the biennial budget request submitted to the 127.24Department of Management and Budget, and the legislature, the Board of Regents of the 127.25University of Minnesota is encouraged to include a request for funding for rural primary 127.26care training by family practice residence programs to prepare doctors for the practice 127.27of primary care medicine in rural areas of the state. The funding request should provide 127.28for ongoing support of rural primary care training through the University of Minnesota's 127.29general operation and maintenance funding or through dedicated health science funding.127.30ARTICLE 6127.31HEALTH AND HUMAN SERVICES APPROPRIATIONS

127.32Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

127.33The sums shown in the columns marked "Appropriations" are added to or, if shown 127.34in parentheses, subtracted from the appropriations in Laws 2011, First Special Session 128.1chapter 9, article 10, to the agencies and for the purposes specified in this article. The 128.2appropriations are from the general fund or other named fund and are available for the 128.3fiscal years indicated for each purpose. The figures "2012" and "2013" used in this 128.4article mean that the addition to or subtraction from the appropriation listed under them 128.5is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively. 128.6Supplemental appropriations and reductions to appropriations for the fiscal year ending 128.7June 30, 2012, are effective the day following final enactment unless a different effective 128.8date is explicit.

128.9APPROPRIATIONS128.10Available for the Year128.11Ending June 30128.1220122013

128.13128.14Sec. 2. COMMISSIONER OF HUMAN SERVICES

128.15Subdivision 1.Total Appropriation$69,000$ 5,163,000

128.16Appropriations by Fund128.1720122013128.18General-0-(668,000)128.19Health Care Access-0- 1,176,000128.20Federal TANF82,000 4,655,000

128.21Subd. 2.Central Office Operations

128.22(a) Operations-0-502,000

128.23Base Level Adjustment. The general fund 128.24base is decreased by $104,000 in fiscal year 128.252014 and $107,000 in fiscal year 2015.

128.26(b) Health Care-0-473,000

128.27Appropriations by Fund128.2820122013128.29General-0-473,000128.30Health Care Access-0-1,153,000

128.31The general fund appropriation is a onetime 128.32appropriation.128.33In fiscal year 2013, the commissioner 128.34shall transfer from the health care access 128.35fund $870,000 to the legislative auditor 129.1for managed care audit activities under 129.2Minnesota Statutes, section 256B.69, 129.3subdivision 9c. This is an ongoing transfer. 129.4Beginning in fiscal year 2014, the base 129.5amount for this transfer is $1,740,000.129.6Base Adjustment. The health care access 129.7fund base is increased by $689,000 in fiscal 129.8years 2014 and 2015.

129.9(c) Continuing Care-0- 375,000

129.10Base Level Adjustment. The general fund 129.11base is decreased by $249,000 in fiscal year 129.122014 and $269,000 in fiscal year 2015.

129.13Subd. 3.Forecasted Programs

129.14(a) MFIP/DWP Grants

129.15Appropriations by Fund129.1620122013129.17General(82,000)(4,660,000)129.18Federal TANF82,000 4,655,000

129.19(b) MFIP Child Care Assistance Grants-0-2,000

129.20(c) General Assistance Grants-0-(41,000)

129.21(d) Minnesota Supplemental Aid Grants-0-154,000

129.22(e) Group Residential Housing Grants-0-(199,000)

129.23(f) MinnesotaCare Grants-0-23,000

129.24This appropriation is from the health care 129.25access fund.

129.26(g) Medical Assistance Grants82,0002,725,000

129.27Continuing Care Provider Fiscal Year 129.282013 Payment Delay. The commissioner 129.29of human services shall delay the last 129.30payment or payments in fiscal year 2013 by 129.31up to $22,854,000 to the following service 129.32providers:130.1(1) home and community-based waivered 130.2services for persons with developmental 130.3disabilities or related conditions, including 130.4consumer-directed community supports, 130.5under Minnesota Statutes, section 256B.501;130.6(2) home and community-based waivered 130.7services for the elderly, including 130.8consumer-directed community supports, 130.9under Minnesota Statutes, section 130.10256B.0915;130.11(3) waivered services under community 130.12alternatives for disabled individuals, 130.13including consumer-directed community 130.14supports, under Minnesota Statutes, section 130.15256B.49;130.16(4) community alternative care waivered 130.17services, including consumer-directed 130.18community supports, under Minnesota 130.19Statutes, section 256B.49;130.20(5) traumatic brain injury waivered services, 130.21including consumer-directed community 130.22supports, under Minnesota Statutes, section 130.23256B.49;130.24(6) nursing services and home health 130.25services under Minnesota Statutes, section 130.26256B.0625, subdivision 6a;130.27(7) personal care services and qualified 130.28professional supervision of personal care 130.29services under Minnesota Statutes, section 130.30256B.0625, subdivisions 6a and 19a;130.31(8) private duty nursing services under 130.32Minnesota Statutes, section 256B.0625, 130.33subdivision 7;131.1(9) day training and habilitation services for 131.2adults with developmental disabilities or 131.3related conditions under Minnesota Statutes, 131.4sections 252.40 to 252.46, including the 131.5additional cost of rate adjustments on day 131.6training and habilitation services, provided 131.7as a social service under Minnesota Statutes, 131.8section 256M.60;131.9(10) alternative care services under 131.10Minnesota Statutes, section 256B.0913;131.11(11) managed care organizations under 131.12Minnesota Statutes, section 256B.69, 131.13receiving state payments for services in 131.14clauses (1) to (10); and131.15(12) intermediate care facilities for persons 131.16with developmental disabilities under 131.17Minnesota Statutes, section 256B.5012, 131.18subdivision 13.131.19In calculating the actual payment amounts to 131.20be delayed, the commissioner must reduce 131.21the $22,854,000 amount by any cash basis 131.22state share savings to be realized in fiscal 131.23year 2013 from implementing the long-term 131.24care realignment waiver before July 1, 2013. 131.25The commissioner shall make the delayed 131.26payments in July 2013. Notwithstanding 131.27any contrary provisions in this article, this 131.28provision expires on August 1, 2013.131.29Critical Access Nursing Facilities 131.30Designation. $1,000,000 is appropriated in 131.31fiscal year 2013 from the general fund to 131.32the commissioner of human services for the 131.33purposes of critical access nursing facilities 131.34under Minnesota Statutes, section 256B.441, 132.1subdivision 63. This appropriation is 132.2ongoing and is added to the base.

132.3Subd. 4.Grant Programs

132.4(a) Basic Sliding Fee Child Care Grants-0-1,000

132.5Base Level Adjustment. The general fund 132.6base is increased by $5,000 in fiscal years 132.72014 and 2015.

132.8(b) Disabilities Grants-0--0-

132.9This appropriation includes $65,000 for 132.10living skills training programs for persons 132.11with intractable epilepsy who need  assistance 132.12in the transition to independent living under 132.13Laws 1988, chapter 689, article 2, section 132.14251. This appropriation is ongoing and 132.15added to the general fund base.132.16Base Level Adjustment. The general fund 132.17base is increased by $476,000 in fiscal year 132.182014 and $65,000 in fiscal year 2015.

132.19Sec. 3. COMMISSIONER OF HEALTH

132.20Policy Quality and Compliance-0-(1,185,000)

132.21Appropriations by Fund132.2220122013132.23General-0-127,000132.24132.25State Government Special Revenue-0-(1,449,000)132.26Health Care Access-0-137,000

132.27In fiscal year 2013, $137,000 from the health 132.28care access fund is for a study of radiation 132.29therapy facilities capacity. This is a onetime 132.30appropriation.132.31In fiscal year 2015, the commissioner shall 132.32transfer from the general fund $59,000, 132.33including $40,000 for SEGIP activities to the 132.34commissioner of management and budget for 133.1actuarial and consulting services to support 133.2the Department of Commerce evaluation of 133.3mandated health benefits under Minnesota 133.4Statutes, section 62J.26, subdivision 6. 133.5This is a onetime transfer. Notwithstanding 133.6section 7, this paragraph expires on June 30, 133.72015.133.8The general fund base is decreased by 133.9$105,000 in fiscal year 2014 and $46,000 in 133.10fiscal year 2015.

133.11Sec. 4. BOARD OF NURSING$-0-$149,000

133.12This appropriation is from the state 133.13government special revenue fund for the 133.14nurse licensure compact.133.15Base Level Adjustment. The state 133.16government special revenue fund base is 133.17decreased by $143,000 in fiscal years 2014 133.18and 2015.

133.19Sec. 5. COMMISSIONER OF COMMERCE

133.20Subdivision 1.Total Appropriation$-0-$1,727,000

133.21Appropriations by Fund133.2220122013133.23General-0-60,000133.24133.25State Government Special Revenue-0-1,449,000133.26Special Revenue-0-218,000

133.27In fiscal year 2013, $8,000 from the general 133.28fund is for additional form review filings 133.29under Minnesota Statutes, section 62A.047. 133.30This is a onetime appropriation.133.31In fiscal year 2013, $22,000 from the general 133.32fund is for relocation costs related to the 133.33transfer of health maintenance organization 134.1regulatory activities. This is a onetime 134.2appropriation.134.3In fiscal year 2013, $30,000 from the 134.4general fund is for ongoing information 134.5technology expenses related to the transfer of 134.6health maintenance organization regulatory 134.7activities.134.8$1,449,000 from the state government special 134.9revenue fund is for health maintenance 134.10organization regulatory activities transferred 134.11from the Department of Health. This is an 134.12ongoing appropriation.134.13$218,000 from the special revenue fund is 134.14for expenses related to health maintenance 134.15organization regulatory activities for the 134.16interagency agreement with the Department 134.17of Human Services.134.18The general fund base is increased by 134.19$960,000 in fiscal years 2014 and 2015 for 134.20the evaluation of mandated health benefits 134.21under Minnesota Statutes, section 62J.26, 134.22subdivision 6. The base for this purpose 134.23beginning in fiscal year 2016 is $330,000.

134.24134.25Sec. 6. EMERGENCY MEDICAL SERVICES REGULATORY BOARD$-0-$10,000

134.26This appropriation is to provide a grant to 134.27the Minnesota Ambulance Association to 134.28coordinate and prepare an assessment of 134.29the extent and costs of uncompensated care 134.30as a direct result of emergency responses 134.31on interstate highways in Minnesota. 134.32The study will collect appropriate 134.33information from medical response units 134.34and ambulance services regulated under 134.35Minnesota Statutes, chapter 144E, and to 135.1the extent possible, firefighting agencies. 135.2In preparing the assessment, the Minnesota 135.3Ambulance Association shall consult with 135.4its membership, the Minnesota Fire Chiefs 135.5Association, the Office of the State Fire 135.6Marshal, and the Emergency Medical 135.7Services Regulatory Board. The findings 135.8of the assessment will be reported to the 135.9chairs and ranking minority members of the 135.10legislative committees with jurisdiction over 135.11health and public safety by January 1, 2013.135.12    Sec. 7. EXPIRATION OF UNCODIFIED LANGUAGE.135.13All uncodified language contained in this article expires on June 30, 2013, unless a 135.14different expiration date is explicit.135.15    Sec. 8. EFFECTIVE DATE.135.16The provisions in this article are effective July 1, 2012, unless a different effective 135.17date is explicit.135.18ARTICLE 7135.19CONTINGENT APPROPRIATIONS

135.20Section 1. APPROPRIATIONS.

135.21The sums shown in the columns marked "Appropriations" are added to or, if shown 135.22in parentheses, subtracted from the appropriations in Laws 2011, First Special Session 135.23chapter 9, article 10, to the agencies and for the purposes specified in this article. The 135.24appropriations are from the general fund or other named fund and are available for the 135.25fiscal years indicated for each purpose. The figures "2012" and "2013" used in this 135.26article mean that the addition to or subtraction from the appropriation listed under them 135.27is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively. 135.28Supplemental appropriations and reductions to appropriations for the fiscal year ending 135.29June 30, 2012, are effective the day following final enactment unless a different effective 135.30date is explicit.

135.31APPROPRIATIONS135.32Available for the Year136.1Ending June 30136.220122013

136.3136.4Sec. 2. COMMISSIONER OF HUMAN SERVICES$721,000$21,153,000

136.5(a) Operations118,00011,000

136.6In fiscal years 2012 and 2013 only, the 136.7commissioner shall transfer $11,000 to the 136.8commissioner of education for activities 136.9related to developing a plan for a residential 136.10campus for individuals with autism.136.11Base Adjustment. The general fund base 136.12is reduced by $11,000 in fiscal years 2014 136.13and 2015.

136.14(b) Health Care24,000(110,000)

136.15Base Adjustment.  The general fund base is 136.16increased by $110,000 in fiscal years 2014 136.17and 2015.

136.18(c) Continuing Care19,000-0-

136.19This is a onetime appropriation.

136.20(d) Chemical and Mental Health19,00068,000

136.21Base Adjustment. The general fund base 136.22is decreased by $68,000 in fiscal years 2014 136.23and 2015.

136.24(e) Medical Assistance Grants541,00019,935,000

136.25(f) Aging and Adult Services Grants-0-999,000

136.26In fiscal year 2013, upon federal approval 136.27to implement the nursing facility level 136.28of care under Minnesota Statutes, section 136.29144.0724, subdivision 11, $999,000 is for 136.30essential community supports grants. This is 136.31a onetime appropriation.

136.32(g) Disabilities Grants-0-250,000

137.1This is a onetime appropriation.137.2    Sec. 3. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is 137.3amended to read:137.4    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an 137.5initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 137.62960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 137.79555.6265, under this chapter for a physical location that will not be the primary residence 137.8of the license holder for the entire period of licensure. If a license is issued during this 137.9moratorium, and the license holder changes the license holder's primary residence away 137.10from the physical location of the foster care license, the commissioner shall revoke the 137.11license according to section 
         245A.07. Exceptions to the moratorium include:137.12(1) foster care settings that are required to be registered under chapter 144D;137.13(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, 137.14and determined to be needed by the commissioner under paragraph (b);137.15(3) new foster care licenses determined to be needed by the commissioner under 137.16paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or 137.17restructuring of state-operated services that limits the capacity of state-operated facilities;137.18(4) new foster care licenses determined to be needed by the commissioner under 137.19paragraph (b) for persons requiring hospital level care; or137.20(5) new foster care licenses determined to be needed by the commissioner for the 137.21transition of people from personal care assistance to the home and community-based 137.22services.137.23(b) The commissioner shall determine the need for newly licensed foster care homes 137.24as defined under this subdivision. As part of the determination, the commissioner shall 137.25consider the availability of foster care capacity in the area in which the licensee seeks to 137.26operate, and the recommendation of the local county board. The determination by the 137.27commissioner must be final. A determination of need is not required for a change in 137.28ownership at the same address.137.29    (c) Residential settings that would otherwise be subject to the moratorium established 137.30in paragraph (a), that are in the process of receiving an adult or child foster care license as 137.31of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult 137.32or child foster care license. For this paragraph, all of the following conditions must be met 137.33to be considered in the process of receiving an adult or child foster care license:137.34    (1) participants have made decisions to move into the residential setting, including 137.35documentation in each participant's care plan;138.1    (2) the provider has purchased housing or has made a financial investment in the 138.2property;138.3    (3) the lead agency has approved the plans, including costs for the residential setting 138.4for each individual;138.5    (4) the completion of the licensing process, including all necessary inspections, is 138.6the only remaining component prior to being able to provide services; and138.7    (5) the needs of the individuals cannot be met within the existing capacity in that 138.8county.138.9To qualify for the process under this paragraph, the lead agency must submit 138.10documentation to the commissioner by August 1, 2009, that all of the above criteria are 138.11met.138.12(d) The commissioner shall study the effects of the license moratorium under this 138.13subdivision and shall report back to the legislature by January 15, 2011. This study shall 138.14include, but is not limited to the following:138.15(1) the overall capacity and utilization of foster care beds where the physical location 138.16is not the primary residence of the license holder prior to and after implementation 138.17of the moratorium;138.18(2) the overall capacity and utilization of foster care beds where the physical 138.19location is the primary residence of the license holder prior to and after implementation 138.20of the moratorium; and138.21(3) the number of licensed and occupied ICF/MR beds prior to and after 138.22implementation of the moratorium.138.23(e) When a foster care recipient moves out of a foster home that is not the primary 138.24residence of the license holder according to section 
         256B.49, subdivision 15, paragraph 138.25(f), the county shall immediately inform the Department of Human Services Licensing 138.26Division, and the department shall immediately decrease the statewide licensed capacity 138.27for the home foster care settings where the physical location is not the primary residence 138.28of the license holder. A decreased licensed capacity according to this paragraph is not 138.29subject to appeal under this chapter. A needs determination process, managed at the state 138.30level, with county input, will determine where the reduced capacity will occur.138.31    Sec. 4. Minnesota Statutes 2011 Supplement, section 256B.0659, subdivision 11, 138.32is amended to read:138.33    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant 138.34must meet the following requirements:139.1    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years 139.2of age with these additional requirements:139.3    (i) supervision by a qualified professional every 60 days; and139.4    (ii) employment by only one personal care assistance provider agency responsible 139.5for compliance with current labor laws;139.6    (2) be employed by a personal care assistance provider agency;139.7    (3) enroll with the department as a personal care assistant after clearing a background 139.8study. Except as provided in subdivision 11a, before a personal care assistant provides 139.9services, the personal care assistance provider agency must initiate a background study on 139.10the personal care assistant under chapter 245C, and the personal care assistance provider 139.11agency must have received a notice from the commissioner that the personal care assistant 139.12is:139.13    (i) not disqualified under section 
         245C.14; or139.14    (ii) is disqualified, but the personal care assistant has received a set aside of the 139.15disqualification under section 
         245C.22;139.16    (4) be able to effectively communicate with the recipient and personal care 139.17assistance provider agency;139.18    (5) be able to provide covered personal care assistance services according to the 139.19recipient's personal care assistance care plan, respond appropriately to recipient needs, 139.20and report changes in the recipient's condition to the supervising qualified professional 139.21or physician;139.22    (6) not be a consumer of personal care assistance services;139.23    (7) maintain daily written records including, but not limited to, time sheets under 139.24subdivision 12;139.25    (8) effective January 1, 2010, complete standardized training as determined 139.26by the commissioner before completing enrollment. The training must be available 139.27in languages other than English and to those who need accommodations due to 139.28disabilities. Personal care assistant training must include successful completion of the 139.29following training components: basic first aid, vulnerable adult, child maltreatment, 139.30OSHA universal precautions, basic roles and responsibilities of personal care assistants 139.31including information about assistance with lifting and transfers for recipients, emergency 139.32preparedness, orientation to positive behavioral practices, fraud issues, and completion of 139.33time sheets. Upon completion of the training components, the personal care assistant must 139.34demonstrate the competency to provide assistance to recipients;139.35    (9) complete training and orientation on the needs of the recipient within the first 139.36seven days after the services begin; and140.1    (10) be limited to providing and being paid for up to 275 hours per month, except 140.2that this limit shall be 275 hours per month for the period July 1, 2009, through June 30, 140.32011, of personal care assistance services regardless of the number of recipients being 140.4served or the number of personal care assistance provider agencies enrolled with. The 140.5number of hours worked per day shall not be disallowed by the department unless in 140.6violation of the law.140.7    (b) A legal guardian may be a personal care assistant if the guardian is not being paid 140.8for the guardian services and meets the criteria for personal care assistants in paragraph (a).140.9    (c) Persons who do not qualify as a personal care assistant include parents and 140.10stepparents of minors, spouses, paid legal guardians, family foster care providers, except 140.11as otherwise allowed in section 
         256B.0625, subdivision 19a, or staff of a residential 140.12setting. When the personal care assistant is a relative of the recipient, the commissioner 140.13shall pay 80 percent of the provider rate. This rate reduction is effective July 1, 2013. For 140.14purposes of this section, relative means the parent or adoptive parent of an adult child, a 140.15sibling aged 16 years or older, an adult child, a grandparent, or a grandchild.140.16    Sec. 5. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15, is 140.17amended to read:140.18    Subd. 15. Individualized service plan; comprehensive transitional service plan; 140.19maintenance service plan. (a) Each recipient of home and community-based waivered 140.20services shall be provided a copy of the written service plan which:140.21(1) is developed and signed by the recipient within ten working days of the 140.22completion of the assessment;140.23(2) meets the assessed needs of the recipient;140.24(3) reasonably ensures the health and safety of the recipient;140.25(4) promotes independence;140.26(5) allows for services to be provided in the most integrated settings; and140.27(6) provides for an informed choice, as defined in section 
         256B.77, subdivision 2, 140.28paragraph (p), of service and support providers.140.29(b) In developing the comprehensive transitional service plan, the individual 140.30receiving services, the case manager, and the guardian, if applicable, will identify 140.31the transitional service plan fundamental service outcome and anticipated timeline to 140.32achieve this outcome. Within the first 20 days following a recipient's request for an 140.33assessment or reassessment, the transitional service planning team must be identified. A 140.34team leader must be identified who will be responsible for assigning responsibility and 140.35communicating with team members to ensure implementation of the transition plan and 141.1ongoing assessment and communication process. The team leader should be an individual, 141.2such as the case manager or guardian, who has the opportunity to follow the recipient to 141.3the next level of service.141.4Within ten days following an assessment, a comprehensive transitional service plan 141.5must be developed incorporating elements of a comprehensive functional assessment and 141.6including short-term measurable outcomes and timelines for achievement of and reporting 141.7on these outcomes. Functional milestones must also be identified and reported according 141.8to the timelines agreed upon by the transitional service planning team. In addition, the 141.9comprehensive transitional service plan must identify additional supports that may assist 141.10in the achievement of the fundamental service outcome such as the development of greater 141.11natural community support, increased collaboration among agencies, and technological 141.12supports.141.13The timelines for reporting on functional milestones will prompt a reassessment of 141.14services provided, the units of services, rates, and appropriate service providers. It is 141.15the responsibility of the transitional service planning team leader to review functional 141.16milestone reporting to determine if the milestones are consistent with observable skills 141.17and that milestone achievement prompts any needed changes to the comprehensive 141.18transitional service plan.141.19For those whose fundamental transitional service outcome involves the need to 141.20procure housing, a plan for the recipient to seek the resources necessary to secure the least 141.21restrictive housing possible should be incorporated into the plan, including employment 141.22and public supports such as housing access and shelter needy funding.141.23(c) Counties and other agencies responsible for funding community placement and 141.24ongoing community supportive services are responsible for the implementation of the 141.25comprehensive transitional service plans. Oversight responsibilities include both ensuring 141.26effective transitional service delivery and efficient utilization of funding resources.141.27(d) Following one year of transitional services, the transitional services planning 141.28team will make a determination as to whether or not the individual receiving services 141.29requires the current level of continuous and consistent support in order to maintain the 141.30recipient's current level of functioning. Recipients who are determined to have not had 141.31a significant change in functioning for 12 months must move from a transitional to a 141.32maintenance service plan. Recipients on a maintenance service plan must be reassessed 141.33to determine if the recipient would benefit from a transitional service plan at least every 141.3412 months and at other times when there has been a significant change in the recipient's 141.35functioning. This assessment should consider any changes to technological or natural 141.36community supports.142.1(e) When a county is evaluating denials, reductions, or terminations of home and 142.2community-based services under section 
         256B.49 for an individual, the case manager 142.3shall offer to meet with the individual or the individual's guardian in order to discuss the 142.4prioritization of service needs within the individualized service plan, comprehensive 142.5transitional service plan, or maintenance service plan. The reduction in the authorized 142.6services for an individual due to changes in funding for waivered services may not exceed 142.7the amount needed to ensure medically necessary services to meet the individual's health, 142.8safety, and welfare.142.9(f) At the time of reassessment, local agency case managers shall assess each 142.10recipient of community alternatives for disabled individuals or traumatic brain injury 142.11waivered services currently residing in a licensed adult foster home that is not the primary 142.12residence of the license holder, or in which the license holder is not the primary caregiver, 142.13to determine if that recipient could appropriately be served in a community-living setting. 142.14If appropriate for the recipient, the case manager shall offer the recipient, through a 142.15person-centered planning process, the option to receive alternative housing and service 142.16options. In the event that the recipient chooses to transfer from the adult foster home, 142.17the vacated bed shall not be filled with another recipient of waiver services and group 142.18residential housing, unless provided under section 
         245A.03, subdivision 7, paragraph (a), 142.19clauses (3) and (4), and the statewide licensed capacity shall be reduced accordingly. If 142.20the adult foster home becomes no longer viable due to these transfers, the county agency, 142.21with the assistance of the department, shall facilitate a consolidation of settings or closure. 142.22This reassessment process shall be completed by June 30, 2012 2013. The results of the 142.23assessments shall be used in the statewide needs determination process. Implementation 142.24of the statewide licensed capacity reduction shall begin on July 1, 2013.142.25    Sec. 6. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 1, is 142.26amended to read:142.27    Subdivision 1. Physician reimbursement.  (a) Effective for services rendered on 142.28or after October 1, 1992, the commissioner shall make payments for physician services 142.29as follows:142.30    (1) payment for level one Centers for Medicare and Medicaid Services' common 142.31procedural coding system codes titled "office and other outpatient services," "preventive 142.32medicine new and established patient," "delivery, antepartum, and postpartum care," 142.33"critical care," cesarean delivery and pharmacologic management provided to psychiatric 142.34patients, and level three codes for enhanced services for prenatal high risk, shall be paid 142.35at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 143.130, 1992. If the rate on any procedure code within these categories is different than the 143.2rate that would have been paid under the methodology in section 
         256B.74, subdivision 2, 143.3then the larger rate shall be paid;143.4    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 143.5or (ii) 15.4 percent above the rate in effect on June 30, 1992; and143.6    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 143.7percentile of 1989, less the percent in aggregate necessary to equal the above increases 143.8except that payment rates for home health agency services shall be the rates in effect 143.9on September 30, 1992.143.10    (b) Effective for services rendered on or after January 1, 2000, payment rates for 143.11physician and professional services shall be increased by three percent over the rates 143.12in effect on December 31, 1999, except for home health agency and family planning 143.13agency services. The increases in this paragraph shall be implemented January 1, 2000, 143.14for managed care.143.15(c) Effective for services rendered on or after July 1, 2009, payment rates for 143.16physician and professional services shall be reduced by five percent, except that for the 143.17period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent 143.18for the medical assistance and general assistance medical care programs, over the rates in 143.19effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply 143.20to office or other outpatient visits, preventive medicine visits and family planning visits 143.21billed by physicians, advanced practice nurses, or physician assistants in a family planning 143.22agency or in one of the following primary care practices: general practice, general internal 143.23medicine, general pediatrics, general geriatrics, and family medicine. This reduction 143.24and the reductions in paragraph (d) do not apply to federally qualified health centers, 143.25rural health centers, and Indian health services. Effective October 1, 2009, payments 143.26made to managed care plans and county-based purchasing plans under sections 
         256B.69, 143.27256B.692
         , and 
         256L.12 shall reflect the payment reduction described in this paragraph.143.28(d) Effective for services rendered on or after July 1, 2010, payment rates for 143.29physician and professional services shall be reduced an additional seven percent over 143.30the five percent reduction in rates described in paragraph (c). This additional reduction 143.31does not apply to physical therapy services, occupational therapy services, and speech 143.32pathology and related services provided on or after July 1, 2010. This additional reduction 143.33does not apply to physician services billed by a psychiatrist or an advanced practice nurse 143.34with a specialty in mental health. Effective October 1, 2010, payments made to managed 143.35care plans and county-based purchasing plans under sections 
         256B.69, 
         256B.692, and 143.36256L.12
          shall reflect the payment reduction described in this paragraph.144.1(e) Effective for services rendered on or after September 1, 2011, through June 144.230, 2013 2012, payment rates for physician and professional services shall be reduced 144.3three percent from the rates in effect on August 31, 2011. This reduction does not apply 144.4to physical therapy services, occupational therapy services, and speech pathology and 144.5related services.144.6    Sec. 7. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 2, is 144.7amended to read:144.8    Subd. 2. Dental reimbursement.  (a) Effective for services rendered on or after 144.9October 1, 1992, the commissioner shall make payments for dental services as follows:144.10    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 144.11percent above the rate in effect on June 30, 1992; and144.12    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 144.13percentile of 1989, less the percent in aggregate necessary to equal the above increases.144.14    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 144.15shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.144.16    (c) Effective for services rendered on or after January 1, 2000, payment rates for 144.17dental services shall be increased by three percent over the rates in effect on December 144.1831, 1999.144.19    (d) Effective for services provided on or after January 1, 2002, payment for 144.20diagnostic examinations and dental x-rays provided to children under age 21 shall be the 144.21lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.144.22    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 144.232000, for managed care.144.24(f) Effective for dental services rendered on or after October 1, 2010, by a 144.25state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based 144.26on the Medicare principles of reimbursement. This payment shall be effective for services 144.27rendered on or after January 1, 2011, to recipients enrolled in managed care plans or 144.28county-based purchasing plans.144.29(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics 144.30in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal 144.31year, a supplemental state payment equal to the difference between the total payments 144.32in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated 144.33services for the operation of the dental clinics.144.34(h) If the cost-based payment system for state-operated dental clinics described in 144.35paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 145.1designated as critical access dental providers under subdivision 4, paragraph (b), and shall 145.2receive the critical access dental reimbursement rate as described under subdivision 4, 145.3paragraph (a).145.4(i) Effective for services rendered on or after September 1, 2011, through June 30, 145.52013 2012, payment rates for dental services shall be reduced by three percent. This 145.6reduction does not apply to state-operated dental clinics in paragraph (f).145.7    Sec. 8. Minnesota Statutes 2011 Supplement, section 256B.766, is amended to read:145.8256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.145.9(a) Effective for services provided on or after July 1, 2009, total payments for basic 145.10care services, shall be reduced by three percent, except that for the period July 1, 2009, 145.11through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical 145.12assistance and general assistance medical care programs, prior to third-party liability and 145.13spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical 145.14therapy services, occupational therapy services, and speech-language pathology and 145.15related services as basic care services. The reduction in this paragraph shall apply to 145.16physical therapy services, occupational therapy services, and speech-language pathology 145.17and related services provided on or after July 1, 2010.145.18(b) Payments made to managed care plans and county-based purchasing plans shall 145.19be reduced for services provided on or after October 1, 2009, to reflect the reduction 145.20effective July 1, 2009, and payments made to the plans shall be reduced effective October 145.211, 2010, to reflect the reduction effective July 1, 2010.145.22(c) Effective for services provided on or after September 1, 2011, through June 30, 145.232013 2012, total payments for outpatient hospital facility fees shall be reduced by five 145.24percent from the rates in effect on August 31, 2011.145.25(d) Effective for services provided on or after September 1, 2011, through June 30, 145.262013 2012, total payments for ambulatory surgery centers facility fees, medical supplies 145.27and durable medical equipment not subject to a volume purchase contract, prosthetics 145.28and orthotics, renal dialysis services, laboratory services, public health nursing services, 145.29physical therapy services, occupational therapy services, speech therapy services, 145.30eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume 145.31purchase contract, anesthesia services, and hospice services shall be reduced by three 145.32percent from the rates in effect on August 31, 2011.145.33(e) This section does not apply to physician and professional services, inpatient 145.34hospital services, family planning services, mental health services, dental services, 146.1prescription drugs, medical transportation, federally qualified health centers, rural health 146.2centers, Indian health services, and Medicare cost-sharing.146.3    Sec. 9. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 3, 146.4is amended to read:

146.5Subd. 3.Forecasted Programs

146.6The amounts that may be spent from this 146.7appropriation for each purpose are as follows:

146.8(a) MFIP/DWP Grants

146.9Appropriations by Fund146.10General84,680,00091,978,000146.11Federal TANF84,425,00075,417,000

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

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

146.14General Assistance Standard. The 146.15commissioner shall set the monthly standard 146.16of assistance for general assistance units 146.17consisting of an adult recipient who is 146.18childless and unmarried or living apart 146.19from parents or a legal guardian at $203. 146.20The commissioner may reduce this amount 146.21according to Laws 1997, chapter 85, article 146.223, section 54.146.23Emergency General Assistance. The 146.24amount appropriated for emergency general 146.25assistance funds is limited to no more 146.26than $6,689,812 in fiscal year 2012 and 146.27$6,729,812 in fiscal year 2013. Funds 146.28to counties shall be allocated by the 146.29commissioner using the allocation method 146.30specified in Minnesota Statutes, section 146.31256D.06
         .

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

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

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

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

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

147.5Managed Care Incentive Payments. The 147.6commissioner shall not make managed care 147.7incentive payments for expanding preventive 147.8services during fiscal years beginning July 1, 147.92011, and July 1, 2012.147.10Reduction of Rates for Congregate 147.11Living for Individuals with Lower Needs. 147.12Beginning October 1, 2011, lead agencies 147.13must reduce rates in effect on January 1, 147.142011, by ten up to five  percent for individuals 147.15with lower needs living in foster care settings 147.16where the license holder does not share 147.17the residence with recipients on the CADI 147.18and DD waivers and customized living 147.19settings for CADI. Lead agencies must adjust 147.20contracts within 60 days of the effective date.147.21Reduction of Lead Agency Waiver 147.22Allocations to Implement Rate Reductions 147.23for Congregate Living for Individuals 147.24with Lower Needs. Beginning October 1, 147.252011, the commissioner shall reduce lead 147.26agency waiver allocations to implement the 147.27reduction of rates for individuals with lower 147.28needs living in foster care settings where the 147.29license holder does not share the residence 147.30with recipients on the CADI and DD waivers 147.31and customized living settings for CADI.147.32Reduce customized living and 24-hour 147.33customized living component rates.147.34Effective July 1, 2011, the commissioner 148.1shall reduce elderly waiver customized living 148.2and 24-hour customized living component 148.3service spending by five percent through 148.4reductions in component rates and service 148.5rate limits. The commissioner shall adjust 148.6the elderly waiver capitation payment 148.7rates for managed care organizations paid 148.8under Minnesota Statutes, section 
         256B.69, 148.9subdivisions 6a
          and 23, to reflect reductions 148.10in component spending for customized living 148.11services and 24-hour customized living 148.12services under Minnesota Statutes, section 148.13256B.0915, subdivisions 3e
          and 3h, for the 148.14contract period beginning January 1, 2012. 148.15To implement the reduction specified in 148.16this provision, capitation rates paid by the 148.17commissioner to managed care organizations 148.18under Minnesota Statutes, section 
         256B.69, 148.19shall reflect a ten percent reduction for the 148.20specified services for the period January 1, 148.212012, to June 30, 2012, and a five percent 148.22reduction for those services on or after July 148.231, 2012.148.24Limit Growth in the Developmental 148.25Disability Waiver. The commissioner 148.26shall limit growth in the developmental 148.27disability waiver to six diversion allocations 148.28per month beginning July 1, 2011, through 148.29June 30, 2013, and 15 diversion allocations 148.30per month beginning July 1, 2013, through 148.31June 30, 2015. Waiver allocations shall 148.32be targeted to individuals who meet the 148.33priorities for accessing waiver services 148.34identified in Minnesota Statutes, 
         256B.092, 148.35subdivision 12
         . The limits do not include 148.36conversions from intermediate care facilities 149.1for persons with developmental disabilities. 149.2Notwithstanding any contrary provisions in 149.3this article, this paragraph expires June 30, 149.42015.149.5Limit Growth in the Community 149.6Alternatives for Disabled Individuals 149.7Waiver. The commissioner shall limit 149.8growth in the community alternatives for 149.9disabled individuals waiver to 60 allocations 149.10per month beginning July 1, 2011, through 149.11June 30, 2013, and 85 allocations per 149.12month beginning July 1, 2013, through 149.13June 30, 2015. Waiver allocations must 149.14be targeted to individuals who meet the 149.15priorities for accessing waiver services 149.16identified in Minnesota Statutes, section 149.17256B.49, subdivision 11a
         . The limits include 149.18conversions and diversions, unless the 149.19commissioner has approved a plan to convert 149.20funding due to the closure or downsizing 149.21of a residential facility or nursing facility 149.22to serve directly affected individuals on 149.23the community alternatives for disabled 149.24individuals waiver. Notwithstanding any 149.25contrary provisions in this article, this 149.26paragraph expires June 30, 2015.149.27Personal Care Assistance Relative 149.28Care. The commissioner shall adjust the 149.29capitation payment rates for managed care 149.30organizations paid under Minnesota Statutes, 149.31section 
         256B.69, to reflect the rate reductions 149.32for personal care assistance provided by 149.33a relative pursuant to Minnesota Statutes, 149.34section 
         256B.0659, subdivision 11. This rate 149.35reduction is effective July 1, 2013.

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

150.2Alternative Care Transfer. Any money 150.3allocated to the alternative care program that 150.4is not spent for the purposes indicated does 150.5not cancel but shall be transferred to the 150.6medical assistance account.

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

150.8    Sec. 10. EMERGENCY MEDICAL ASSISTANCE STUDY.150.9(a) The commissioner of human services shall develop a plan to provide coordinated 150.10and cost-effective health care and coverage for individuals who meet eligibility standards 150.11for emergency medical assistance and who are ineligible for other state public programs. 150.12The commissioner shall consult with relevant stakeholders in the development of the plan. 150.13The commissioner shall consider the following elements:150.14(1) strategies to provide individuals with the most appropriate care in the appropriate 150.15setting, utilizing higher quality and lower cost providers;150.16(2) payment mechanisms to encourage providers to manage the care of these 150.17populations, and to produce lower cost of care and better patient outcomes;150.18(3) ensure coverage and payment options that address the unique needs of those 150.19needing episodic care, chronic care, and long-term care services;150.20(4) strategies for coordinating health care and nonhealth care services, and 150.21integrating with existing coverage; and150.22(5) other issues and strategies to ensure cost-effective and coordinated delivery 150.23of coverage and services.150.24(b) The commissioner shall submit the plan to the chairs and ranking minority 150.25members of the legislative committees with jurisdiction over health and human services 150.26policy and financing by January 15, 2013.150.27    Sec. 11. EMERGENCY MEDICAL CONDITION CANCER TREATMENT 150.28COVERAGE EXCEPTION.150.29(a) Notwithstanding Minnesota Statutes, section 256B.06, subdivision 4, paragraph 150.30(h), clause (2), surgery and the administration of chemotherapy, radiation, and related 150.31services necessary to treat cancer shall be covered as an emergency medical condition 150.32under Minnesota Statutes, section 256B.06, paragraph (f), if the recipient has a cancer 151.1diagnosis that is not in remission and requires surgery, chemotherapy, or radiation 151.2treatment.151.3(b) Coverage under paragraph (a) is effective May 1, 2012, until June 30, 2013.151.4    Sec. 12. INSTRUCTIONS TO THE COMMISSIONERS TO DEVELOP A PLAN 151.5FOR AN AUTISM RESIDENTIAL CAMPUS.151.6(a) The commissioner of human services, in consultation with the commissioners 151.7of education and employment and economic development, shall develop a plan to create 151.8a residential campus providing 24-hour supervision for individuals with a diagnosis of 151.9autistic disorder as defined by diagnostic code 299.0 in the Diagnostic and Statistical 151.10Manual of Mental Disorders (DSM-IV). This plan must identify how the costs and 151.11programming will be shared between the agencies so that the social, educational, sensory, 151.12and vocational needs of the individuals served by the program will be met.151.13(b) The plan must be developed no later than August 31, 2012.151.14    Sec. 13. INSTRUCTIONS TO THE COMMISSIONER TO REQUEST A 151.15WAIVER AND CREATE AND FUND AN AUTISM RESIDENTIAL CAMPUS.151.16(a) The commissioner of human services shall develop a proposal to the United 151.17States Department of Health and Human Services which shall include any necessary 151.18waivers, state plan amendments, and any other federal authority that may be necessary to 151.19create and fund the program in paragraph (b).151.20(b) The commissioner shall request authority to create and fund a residential campus 151.21program to serve individuals to age 21 who are diagnosed with autistic disorder as defined 151.22by diagnostic code 299.0 in the Diagnostic and Statistical Manual of Mental Disorders 151.23(DSM-IV), and who are able to live in a supported housing environment that provides 151.2424-hour supervision. The program must:151.25(1) provide continuous on-site supervision;151.26(2) provide sensory or other therapeutic programming as appropriate for each 151.27resident; and151.28(3) incorporate independent living skills, socialization skills, and vocational skills, 151.29as appropriate for each resident.151.30(c) The commissioner shall submit the proposal no later than January 1, 2013.151.31    Sec. 14. STUDY OF PERSONAL CARE ASSISTANCE AND OTHER 151.32UNLICENSED ATTENDANT SERVICES PROCEDURES.152.1The commissioner of human services shall assign the department's office of 152.2inspector general to evaluate and make recommendations regarding state policies and 152.3statutory directives to control improper billing and fraud in personal care attendant and 152.4other unlicensed attendant services reimbursed through the department. The evaluation 152.5must review:152.6(1) the care provided by personal care attendants, behavioral aides, and other 152.7unlicensed attendant care services reimbursed through the department;152.8(2) investigations completed in recent years by the department's surveillance and 152.9integrity review division and the attorney general's office Medicaid fraud control unit to 152.10determine patterns of improper billing and fraud;152.11(3) whether there are appropriate standards for an objective assessment or for 152.12determining a medical basis for client service eligibility; and152.13(4) current policies and other requirements related to supervision and verification of 152.14services to clients.152.15The study may involve unannounced site visits to enrolled providers and recipients 152.16of services in this study. The commissioner shall report to the chairs and ranking minority 152.17members of the legislative committees with jurisdiction over these issues with draft 152.18legislation to implement these recommendations by February 15, 2013.152.19    Sec. 15. STUDY OF PERSONAL CARE ASSISTANCE SERVICE MODEL.152.20The commissioner of human services shall study the current service model of 152.21personal care assistance services and any current gaps that exist in the program. The 152.22report shall include an analysis of the utilization of additional services by personal care 152.23assistance recipients, the effects of access to care coordination services, eligibility criteria, 152.24and the results of reductions in personal care assistance services. The results of this study 152.25will become part of medical assistance reform work under Minnesota Statutes, section 152.26256B.021. The commissioner shall report the findings of this study to the chairs and 152.27ranking minority members of the legislative committees with jurisdiction over these 152.28issues by February 15, 2013.152.29    Sec. 16. EFFECTIVE DATE.152.30This article is effective upon receipt by the commissioner of money from managed 152.31care organizations pursuant to contract agreements to return any surplus in excess of one 152.32percent. If the money is received after June 30, 2012, amounts appropriated in fiscal 152.33year 2012 are available in fiscal year 2013.