1.1 	A bill for an act
1.2 	relating to state government; making adjustments to health and human services 
1.3 	appropriations; making changes to provisions related to health care, the 
1.4 	Department of Health, children and family services, continuing care; providing 
1.5 	for data sharing; requiring eligibility determinations; providing grants; requiring 
1.6 	studies and reports; appropriating money;amending Minnesota Statutes 2010, 
1.7 	sections 43A.316, subdivision 5; 62A.047; 62A.21, subdivision 2a; 62D.02, 
1.8 	subdivision 3; 62D.05, subdivision 6; 62D.101, subdivision 2a; 62D.12, 
1.9 	subdivision 1; 62J.26, subdivisions 3, 5, by adding a subdivision; 62J.496, 
1.10 	subdivision 2; 62Q.80; 62U.04, subdivisions 1, 2, 4, 5; 72A.201, subdivision 8; 
1.11 	144.5509; 144A.073, by adding a subdivision; 144A.351; 145.906; 245A.03, by 
1.12 	adding a subdivision; 245A.11, subdivisions 2a, 7, 7a; 245B.07, subdivision 1; 
1.13 	245C.04, subdivision 6; 245C.05, subdivision 7; 256.01, by adding subdivisions; 
1.14 	256.975, subdivision 7; 256B.056, subdivision 1a; 256B.0625, subdivision 9, 
1.15 	by adding a subdivision; 256B.0644; 256B.0754, subdivision 2; 256B.0911, 
1.16 	by adding a subdivision; 256B.092, subdivision 1b; 256B.431, subdivision 
1.17 	17e, by adding a subdivision; 256B.434, subdivision 10; 256B.441, by adding 
1.18 	a subdivision; 256B.48, by adding a subdivision; 256B.69, by adding a 
1.19 	subdivision; 256D.06, subdivision 1b; 256D.44, subdivision 5; 626.556, by 
1.20 	adding a subdivision; Minnesota Statutes 2011 Supplement, sections 62U.04, 
1.21 	subdivisions 3, 9; 119B.13, subdivision 7; 144.1222, subdivision 5; 245A.03, 
1.22 	subdivision 7; 256.987, subdivision 1; 256B.056, subdivision 3; 256B.06, 
1.23 	subdivision 4; 256B.0625, subdivision 17; 256B.0631, subdivisions 1, 2; 
1.24 	256B.0911, subdivision 3c; 256B.097, subdivision 3; 256B.49, subdivisions 15, 
1.25 	23; 256B.69, subdivisions 5a, 9c; 256B.76, subdivision 4; 256L.12, subdivision 
1.26 	9; Laws 2011, First Special Session chapter 9, article 7, section 52; article 10, 
1.27 	sections 3, subdivisions 1, 3, 4; 4, subdivision 2; 8, subdivision 8; proposing 
1.28 	coding for new law in Minnesota Statutes, chapters 148; 256B; repealing 
1.29 	Minnesota Statutes 2010, sections 62D.04, subdivision 5; 62M.09, subdivision 9; 
1.30 	62Q.64; 144A.073, subdivision 9; 256B.48, subdivision 6; Minnesota Statutes 
1.31 	2011 Supplement, section 256B.5012, subdivision 13; Laws 2011, First Special 
1.32 	Session chapter 9, article 7, section 54; Minnesota Rules, part 4685.2000.
1.33 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.1 	ARTICLE 1
2.2 	HEALTH CARE

2.3 	Section 1. Minnesota Statutes 2010, section 72A.201, subdivision 8, is amended to 
2.4 	read:
2.5 		Subd. 8.Standards for claim denial. The following acts by an insurer, adjuster, or 
2.6 	self-insured, or self-insurance administrator constitute unfair settlement practices:
2.7 	(1) denying a claim or any element of a claim on the grounds of a specific policy 
2.8 	provision, condition, or exclusion, without informing the insured of the policy provision, 
2.9 	condition, or exclusion on which the denial is based;
2.10 	(2) denying a claim without having made a reasonable investigation of the claim;
2.11 	(3) denying a liability claim because the insured has requested that the claim be 
2.12 	denied;
2.13 	(4) denying a liability claim because the insured has failed or refused to report the 
2.14 	claim, unless an independent evaluation of available information indicates there is no 
2.15 	liability;
2.16 	(5) denying a claim without including the following information:
2.17 	(i) the basis for the denial;
2.18 	(ii) the name, address, and telephone number of the insurer's claim service office 
2.19 	or the claim representative of the insurer to whom the insured or claimant may take any 
2.20 	questions or complaints about the denial;
2.21 	(iii) the claim number and the policy number of the insured; and
2.22 	(iv) if the denied claim is a fire claim, the insured's right to file with the Department 
2.23 	of Commerce a complaint regarding the denial, and the address and telephone number 
2.24 	of the Department of Commerce;
2.25 	(6) denying a claim because the insured or claimant failed to exhibit the damaged 
2.26 	property unless:
2.27 	(i) the insurer, within a reasonable time period, made a written demand upon the 
2.28 	insured or claimant to exhibit the property; and
2.29 	(ii) the demand was reasonable under the circumstances in which it was made;
2.30 	(7) denying a claim by an insured or claimant based on the evaluation of a chemical 
2.31 	dependency claim reviewer selected by the insurer unless the reviewer meets the 
2.32 	qualifications specified under subdivision 8a. An insurer that selects chemical dependency 
2.33 	reviewers to conduct claim evaluations must annually file with the commissioner of 
2.34 	commerce a report containing the specific evaluation standards and criteria used in these 
2.35 	evaluations. The report must be filed at the same time its annual statement is submitted 
3.1 	under section 60A.13. The report must also include the number of evaluations performed 
3.2 	on behalf of the insurer during the reporting period, the types of evaluations performed, 
3.3 	the results, the number of appeals of denials based on these evaluations, the results of 
3.4 	these appeals, and the number of complaints filed in a court of competent jurisdiction.

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

3.6 	Sec. 2. Minnesota Statutes 2011 Supplement, section 256B.06, subdivision 4, is 
3.7 	amended to read:
3.8 		Subd. 4.Citizenship requirements. (a) Eligibility for medical assistance is limited 
3.9 	to citizens of the United States, qualified noncitizens as defined in this subdivision, and 
3.10 	other persons residing lawfully in the United States. Citizens or nationals of the United 
3.11 	States must cooperate in obtaining satisfactory documentary evidence of citizenship or 
3.12 	nationality according to the requirements of the federal Deficit Reduction Act of 2005, 
3.13 	Public Law 109-171.
3.14 	(b) "Qualified noncitizen" means a person who meets one of the following 
3.15 	immigration criteria:
3.16 	(1) admitted for lawful permanent residence according to United States Code, title 8;
3.17 	(2) admitted to the United States as a refugee according to United States Code, 
3.18 	title 8, section 1157;
3.19 	(3) granted asylum according to United States Code, title 8, section 1158;
3.20 	(4) granted withholding of deportation according to United States Code, title 8, 
3.21 	section 1253(h);
3.22 	(5) paroled for a period of at least one year according to United States Code, title 8, 
3.23 	section 1182(d)(5);
3.24 	(6) granted conditional entrant status according to United States Code, title 8, 
3.25 	section 1153(a)(7);
3.26 	(7) determined to be a battered noncitizen by the United States Attorney General 
3.27 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
3.28 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
3.29 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United 
3.30 	States Attorney General according to the Illegal Immigration Reform and Immigrant 
3.31 	Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, 
3.32 	Public Law 104-200; or
3.33 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
3.34 	Law 96-422, the Refugee Education Assistance Act of 1980.
4.1 	(c) All qualified noncitizens who were residing in the United States before August 
4.2 	22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for 
4.3 	medical assistance with federal financial participation.
4.4 	(d) Beginning December 1, 1996, qualified noncitizens who entered the United 
4.5 	States on or after August 22, 1996, and who otherwise meet the eligibility requirements 
4.6 	of this chapter are eligible for medical assistance with federal participation for five years 
4.7 	if they meet one of the following criteria:
4.8 	(1) refugees admitted to the United States according to United States Code, title 8, 
4.9 	section 1157;
4.10 	(2) persons granted asylum according to United States Code, title 8, section 1158;
4.11 	(3) persons granted withholding of deportation according to United States Code, 
4.12 	title 8, section 1253(h);
4.13 	(4) veterans of the United States armed forces with an honorable discharge for 
4.14 	a reason other than noncitizen status, their spouses and unmarried minor dependent 
4.15 	children; or
4.16 	(5) persons on active duty in the United States armed forces, other than for training, 
4.17 	their spouses and unmarried minor dependent children.
4.18 	 Beginning July 1, 2010, children and pregnant women who are noncitizens 
4.19 	described in paragraph (b) or who are lawfully present in the United States as defined 
4.20 	in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet 
4.21 	eligibility requirements of this chapter, are eligible for medical assistance with federal 
4.22 	financial participation as provided by the federal Children's Health Insurance Program 
4.23 	Reauthorization Act of 2009, Public Law 111-3.
4.24 	(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
4.25 	are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this 
4.26 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States 
4.27 	Code, title 8, section 1101(a)(15).
4.28 	(f) Payment shall also be made for care and services that are furnished to noncitizens, 
4.29 	regardless of immigration status, who otherwise meet the eligibility requirements of 
4.30 	this chapter, if such care and services are necessary for the treatment of an emergency 
4.31 	medical condition.
4.32 	(g) For purposes of this subdivision, the term "emergency medical condition" means 
4.33 	a medical condition that meets the requirements of United States Code, title 42, section 
4.34 	1396b(v).
4.35 	(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment 
4.36 	of an emergency medical condition are limited to the following:
5.1 	(i) services delivered in an emergency room or by an ambulance service licensed 
5.2 	under chapter 144E that are directly related to the treatment of an emergency medical 
5.3 	condition;
5.4 	(ii) services delivered in an inpatient hospital setting following admission from an 
5.5 	emergency room or clinic for an acute emergency condition; and
5.6 	(iii) follow-up services that are directly related to the original service provided to 
5.7 	treat the emergency medical condition and are covered by the global payment made to 
5.8 	the provider.; and
5.9 	(iv) dialysis services provided in a hospital or freestanding dialysis facility.
5.10 	(2) Services for the treatment of emergency medical conditions do not include:
5.11 	(i) services delivered in an emergency room or inpatient setting to treat a 
5.12 	nonemergency condition;
5.13 	(ii) organ transplants, stem cell transplants, and related care;
5.14 	(iii) services for routine prenatal care;
5.15 	(iv) continuing care, including long-term care, nursing facility services, home health 
5.16 	care, adult day care, day training, or supportive living services;
5.17 	(v) elective surgery;
5.18 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as 
5.19 	part of an emergency room visit;
5.20 	(vii) preventative health care and family planning services;
5.21 	(viii) dialysis;
5.22 	(ix) chemotherapy or therapeutic radiation services;
5.23 	(x)(ix) rehabilitation services;
5.24 	(xi)(x) physical, occupational, or speech therapy;
5.25 	(xii)(xi) transportation services;
5.26 	(xiii)(xii) case management;
5.27 	(xiv)(xiii) prosthetics, orthotics, durable medical equipment, or medical supplies;
5.28 	(xv)(xiv) dental services;
5.29 	(xvi)(xv) hospice care;
5.30 	(xvii)(xvi) audiology services and hearing aids;
5.31 	(xviii)(xvii) podiatry services;
5.32 	(xix)(xviii) chiropractic services;
5.33 	(xx)(xix) immunizations;
5.34 	(xxi)(xx) vision services and eyeglasses;
5.35 	(xxii)(xxi) waiver services;
5.36 	(xxiii)(xxii) individualized education programs; or
6.1 	(xxiv) (xxiii)  chemical dependency treatment.
6.2 	(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, 
6.3 	nonimmigrants, or lawfully present in the United States as defined in Code of Federal 
6.4 	Regulations, title 8, section 103.12, are not covered by a group health plan or health 
6.5 	insurance coverage according to Code of Federal Regulations, title 42, section 457.310, 
6.6 	and who otherwise meet the eligibility requirements of this chapter, are eligible for 
6.7 	medical assistance through the period of pregnancy, including labor and delivery, and 60 
6.8 	days postpartum, to the extent federal funds are available under title XXI of the Social 
6.9 	Security Act, and the state children's health insurance program.
6.10 	(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation 
6.11 	services from a nonprofit center established to serve victims of torture and are otherwise 
6.12 	ineligible for medical assistance under this chapter are eligible for medical assistance 
6.13 	without federal financial participation. These individuals are eligible only for the period 
6.14 	during which they are receiving services from the center. Individuals eligible under this 
6.15 	paragraph shall not be required to participate in prepaid medical assistance.

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

6.17 	Sec. 3. Minnesota Statutes 2010, section 256B.0625, subdivision 9, is amended to read:
6.18 		Subd. 9.Dental services. (a) Medical assistance covers dental services.
6.19 	(b) Medical assistance dental coverage for nonpregnant adults is limited to the 
6.20 	following services:
6.21 	(1) comprehensive exams, limited to once every five years;
6.22 	(2) periodic exams, limited to one per year;
6.23 	(3) limited exams;
6.24 	(4) bitewing x-rays, limited to one per year;
6.25 	(5) periapical x-rays;
6.26 	(6) panoramic x-rays, limited to one every five years except (1) when medically 
6.27 	necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma 
6.28 	or (2) once every two years for patients who cannot cooperate for intraoral film due to 
6.29 	a developmental disability or medical condition that does not allow for intraoral film 
6.30 	placement;
6.31 	(7) prophylaxis, limited to one per year;
6.32 	(8) application of fluoride varnish, limited to one per year;
6.33 	(9) posterior fillings, all at the amalgam rate;
6.34 	(10) anterior fillings;
6.35 	(11) endodontics, limited to root canals on the anterior and premolars only;
7.1 	(12) removable prostheses, each dental arch limited to one every six years including 
7.2 	repairs and the replacement of each dental arch limited to one every six years;
7.3 	(13) oral surgery, limited to extractions, biopsies, and incision and drainage of 
7.4 	abscesses;
7.5 	(14) palliative treatment and sedative fillings for relief of pain; and
7.6 	(15) full-mouth debridement, limited to one every five years.
7.7 	(c) In addition to the services specified in paragraph (b), medical assistance 
7.8 	covers the following services for adults, if provided in an outpatient hospital setting or 
7.9 	freestanding ambulatory surgical center as part of outpatient dental surgery:
7.10 	(1) periodontics, limited to periodontal scaling and root planing once every two 
7.11 	years;
7.12 	(2) general anesthesia; and
7.13 	(3) full-mouth survey once every five years.
7.14 	(d) Medical assistance covers medically necessary dental services for children and 
7.15 	pregnant women. The following guidelines apply:
7.16 	(1) posterior fillings are paid at the amalgam rate;
7.17 	(2) application of sealants are covered once every five years per permanent molar for 
7.18 	children only;
7.19 	(3) application of fluoride varnish is covered once every six months; and
7.20 	(4) orthodontia is eligible for coverage for children only.
7.21 	(e) In addition to the services specified in paragraphs (b) and (c), medical assistance 
7.22 	covers the following services for developmentally disabled adults:
7.23 	(1) house calls or extended care facility calls for on-site delivery of covered services;
7.24 	(2) behavioral management when additional staff time is required to accommodate 
7.25 	behavioral challenges and sedation is not used;
7.26 	(3) oral or IV conscious sedation, if the covered dental service cannot be performed 
7.27 	safely without it or would otherwise require the service to be performed under general 
7.28 	anesthesia in a hospital or surgical center; and
7.29 	(4) prophylaxis, in accordance with an appropriate individualized treatment plan 
7.30 	formulated by a licensed dentist, but no more than four times per year.

7.31 	EFFECTIVE DATE. The amendment to paragraph (b) is effective January 1, 2013.

7.32 	Sec. 4. Minnesota Statutes 2010, section 256B.0625, is amended by adding a 
7.33 	subdivision to read:
7.34 		Subd. 60.Community paramedic services. (a) Medical assistance covers services 
7.35 	provided by community paramedics who are certified under section 144E.28, subdivision 
8.1 	9, when the services are provided in accordance with this subdivision to an eligible 
8.2 	recipient as defined in paragraph (b).
8.3 	(b) For purposes of this subdivision, an eligible recipient is defined as an individual 
8.4 	who has received hospital emergency department services three or more times in a period 
8.5 	of four consecutive months in the past 12 months or an individual who has been identified 
8.6 	by the individual's primary health care provider for whom community paramedic services 
8.7 	identified in paragraph (c) would likely prevent admission to or would allow discharge 
8.8 	from a nursing facility; or would likely prevent readmission to a hospital or nursing facility.
8.9 	(c) Payment for services provided by a community paramedic under this subdivision 
8.10 	must be a part of a care plan ordered by a primary health care provider in consultation with 
8.11 	the medical director of an ambulance service and must be billed by an eligible provider 
8.12 	enrolled in medical assistance that employs or contracts with the community paramedic. 
8.13 	The care plan must ensure that the services provided by a community paramedic are 
8.14 	coordinated with other community health providers and local public health agencies and 
8.15 	that community paramedic services do not duplicate services already provided to the 
8.16 	patient, including home health and waiver services. Community paramedic services 
8.17 	shall include health assessment, chronic disease monitoring and education, medication 
8.18 	compliance, immunizations and vaccinations, laboratory specimen collection, hospital 
8.19 	discharge follow-up care, and minor medical procedures approved by the ambulance 
8.20 	medical director.
8.21 	(d) Services provided by a community paramedic to an eligible recipient who is 
8.22 	also receiving care coordination services must be in consultation with the providers of 
8.23 	the recipient's care coordination services.
8.24 	(e) The commissioner shall seek the necessary federal approval to implement this 
8.25 	subdivision.

8.26 	EFFECTIVE DATE. This section is effective July 1, 2012, or upon federal 
8.27 	approval, whichever is later.

8.28 	Sec. 5. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 1, 
8.29 	is amended to read:
8.30 		Subdivision 1.Cost-sharing. (a) Except as provided in subdivision 2, the medical 
8.31 	assistance benefit plan shall include the following cost-sharing for all recipients, effective 
8.32 	for services provided on or after September 1, 2011:
8.33 	(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes 
8.34 	of this subdivision, a visit means an episode of service which is required because of 
8.35 	a recipient's symptoms, diagnosis, or established illness, and which is delivered in an 
9.1 	ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse 
9.2 	midwife, advanced practice nurse, audiologist, optician, or optometrist;
9.3 	(2) $3 for eyeglasses;
9.4 	(3) $3.50 for nonemergency visits to a hospital-based emergency room, except that 
9.5 	this co-payment shall be increased to $20 upon federal approval;
9.6 	(4) $3 per brand-name drug prescription and $1 per generic drug prescription, 
9.7 	subject to a $12 per month maximum for prescription drug co-payments. No co-payments 
9.8 	shall apply to antipsychotic drugs when used for the treatment of mental illness;
9.9 	(5) effective January 1, 2012, a family deductible equal to the maximum amount 
9.10 	allowed under Code of Federal Regulations, title 42, part 447.54; and
9.11 	(6) for individuals identified by the commissioner with income at or below 100 
9.12 	percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five 
9.13 	percent of family income. For purposes of this paragraph, family income is the total 
9.14 	earned and unearned income of the individual and the individual's spouse, if the spouse is 
9.15 	enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
9.16 	(b) Recipients of medical assistance are responsible for all co-payments and 
9.17 	deductibles in this subdivision.
9.18 	(c) Notwithstanding paragraph (b), a prepaid health plan may waive the family 
9.19 	deductible described under paragraph (a), clause (5), within the existing capitation rates 
9.20 	on an ongoing basis.

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

9.22 	Sec. 6. Minnesota Statutes 2010, section 256B.0644, is amended to read:
9.23 	256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 
9.24 	PROGRAMS.
9.25 	(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a 
9.26 	health maintenance organization, as defined in chapter 62D, must participate as a provider 
9.27 	or contractor in the medical assistance program, general assistance medical care program,
9.28 	and MinnesotaCare as a condition of participating as a provider in health insurance plans 
9.29 	and programs or contractor for state employees established under section 43A.18, the 
9.30 	public employees insurance program under section 43A.316, for health insurance plans 
9.31 	offered to local statutory or home rule charter city, county, and school district employees, 
9.32 	the workers' compensation system under section 176.135, and insurance plans provided 
9.33 	through the Minnesota Comprehensive Health Association under sections 62E.01 to 
9.34 	62E.19. The limitations on insurance plans offered to local government employees shall 
10.1 	not be applicable in geographic areas where provider participation is limited by managed 
10.2 	care contracts with the Department of Human Services. For purposes of this section, a 
10.3 	health maintenance organization, as defined in chapter 62D, is not a vendor of medical 
10.4 	care.
10.5 	(b) For providers other than health maintenance organizations, Participation in the 
10.6 	medical assistance program means that:
10.7 	 (1) the provider accepts new medical assistance, general assistance medical care,
10.8 	and MinnesotaCare patients;
10.9 	(2) for providers other than dental service providers, at least 20 percent of the 
10.10 	provider's patients are covered by medical assistance, general assistance medical care,
10.11 	and MinnesotaCare as their primary source of coverage; or
10.12 	(3) for dental service providers, at least ten percent of the provider's patients are 
10.13 	covered by medical assistance, general assistance medical care, and MinnesotaCare as 
10.14 	their primary source of coverage, or the provider accepts new medical assistance and 
10.15 	MinnesotaCare patients who are children with special health care needs. For purposes 
10.16 	of this section, "children with special health care needs" means children up to age 18 
10.17 	who: (i) require health and related services beyond that required by children generally; 
10.18 	and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 
10.19 	condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 
10.20 	cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 
10.21 	neurological diseases; visual impairment or deafness; Down syndrome and other genetic 
10.22 	disorders; autism; fetal alcohol syndrome; and other conditions designated by the 
10.23 	commissioner after consultation with representatives of pediatric dental providers and 
10.24 	consumers.
10.25 	(c) Patients seen on a volunteer basis by the provider at a location other than 
10.26 	the provider's usual place of practice may be considered in meeting the participation 
10.27 	requirement in this section. The commissioner shall establish participation requirements 
10.28 	for health maintenance organizations. The commissioner shall provide lists of participating 
10.29 	medical assistance providers on a quarterly basis to the commissioner of management and 
10.30 	budget, the commissioner of labor and industry, and the commissioner of commerce. Each 
10.31 	of the commissioners shall develop and implement procedures to exclude as participating 
10.32 	providers in the program or programs under their jurisdiction those providers who do 
10.33 	not participate in the medical assistance program. The commissioner of management 
10.34 	and budget shall implement this section through contracts with participating health and 
10.35 	dental carriers.
11.1 	(d) For purposes of paragraphs (a) and (b), participation in the general assistance 
11.2 	medical care program applies only to pharmacy providers.

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

11.4 	Sec. 7. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a, is 
11.5 	amended to read:
11.6 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
11.7 	and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 
11.8 	January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 
11.9 	renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 
11.10 	31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 
11.11 	issue separate contracts with requirements specific to services to medical assistance 
11.12 	recipients age 65 and older.
11.13 	(b) A prepaid health plan providing covered health services for eligible persons 
11.14 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
11.15 	contract with the commissioner. Requirements applicable to managed care programs 
11.16 	under chapters 256B and 256L established after the effective date of a contract with the 
11.17 	commissioner take effect when the contract is next issued or renewed.
11.18 	(c) Effective for services rendered on or after January 1, 2003, the commissioner 
11.19 	shall withhold five percent of managed care plan payments under this section and 
11.20 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
11.21 	assistance program pending completion of performance targets. Each performance target 
11.22 	must be quantifiable, objective, measurable, and reasonably attainable, except in the case 
11.23 	of a performance target based on a federal or state law or rule. Criteria for assessment 
11.24 	of each performance target must be outlined in writing prior to the contract effective 
11.25 	date. Clinical or utilization performance targets and their related criteria must consider 
11.26 	evidence-based research and reasonable interventions when available or applicable to the 
11.27 	populations served, and must be developed with input from external clinical experts 
11.28 	and stakeholders, including managed care plans, county-based purchasing plans, and 
11.29 	providers. The managed care or county-based purchasing plan must demonstrate, 
11.30 	to the commissioner's satisfaction, that the data submitted regarding attainment of 
11.31 	the performance target is accurate. The commissioner shall periodically change the 
11.32 	administrative measures used as performance targets in order to improve plan performance 
11.33 	across a broader range of administrative services. The performance targets must include 
11.34 	measurement of plan efforts to contain spending on health care services and administrative 
11.35 	activities. The commissioner may adopt plan-specific performance targets that take into 
12.1 	account factors affecting only one plan, including characteristics of the plan's enrollee 
12.2 	population. The withheld funds must be returned no sooner than July of the following 
12.3 	year if performance targets in the contract are achieved. The commissioner may exclude 
12.4 	special demonstration projects under subdivision 23.
12.5 	(d) Effective for services rendered on or after January 1, 2009, through December 
12.6 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
12.7 	under this section and county-based purchasing plan payments under section 256B.692 
12.8 	for the prepaid medical assistance program. The withheld funds must be returned no 
12.9 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
12.10 	exclude special demonstration projects under subdivision 23.
12.11 	(e) Effective for services provided on or after January 1, 2010, the commissioner 
12.12 	shall require that managed care plans use the assessment and authorization processes, 
12.13 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
12.14 	billing processes, and policies consistent with medical assistance fee-for-service or the 
12.15 	Department of Human Services contract requirements consistent with medical assistance 
12.16 	fee-for-service or the Department of Human Services contract requirements for all 
12.17 	personal care assistance services under section 256B.0659.
12.18 	(f) Effective for services rendered on or after January 1, 2010, through December 
12.19 	31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 
12.20 	under this section and county-based purchasing plan payments under section 256B.692 
12.21 	for the prepaid medical assistance program. The withheld funds must be returned no 
12.22 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
12.23 	exclude special demonstration projects under subdivision 23.
12.24 	(g) Effective for services rendered on or after January 1, 2011, through December 
12.25 	31, 2011, the commissioner shall include as part of the performance targets described 
12.26 	in paragraph (c) a reduction in the health plan's emergency room utilization rate for 
12.27 	state health care program enrollees by a measurable rate of five percent from the plan's 
12.28 	utilization rate for state health care program enrollees for the previous calendar year. 
12.29 	Effective for services rendered on or after January 1, 2012, the commissioner shall include 
12.30 	as part of the performance targets described in paragraph (c) a reduction in the health 
12.31 	plan's emergency department utilization rate for medical assistance and MinnesotaCare 
12.32 	enrollees, as determined by the commissioner. For 2012, the reduction shall be based on 
12.33 	the health plan's utilization in 2009. To earn the return of the withhold each subsequent 
12.34 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
12.35 	reduction of no less than ten percent of the plan's emergency department utilization 
12.36 	rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees
13.1 	in programs described in subdivisions 23 and 28, compared to the previous calendar
13.2 	measurement year until the final performance target is reached. When measuring 
13.3 	performance, the commissioner must consider the difference in health risk in a managed 
13.4 	care or county-based purchasing plan's membership in the baseline year compared to the 
13.5 	measurement year, and work with the managed care or county-based purchasing plan to 
13.6 	account for differences that they agree are significant.
13.7 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
13.8 	of the following calendar year if the managed care plan or county-based purchasing plan 
13.9 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
13.10 	was achieved. The commissioner shall structure the withhold so that the commissioner 
13.11 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
13.12 	in utilization less than the target amount.
13.13 	The withhold described in this paragraph shall continue for each consecutive 
13.14 	contract period until the plan's emergency room utilization rate for state health care 
13.15 	program enrollees is reduced by 25 percent of the plan's emergency room utilization 
13.16 	rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009. 
13.17 	Hospitals shall cooperate with the health plans in meeting this performance target and 
13.18 	shall accept payment withholds that may be returned to the hospitals if the performance 
13.19 	target is achieved.
13.20 	(h) Effective for services rendered on or after January 1, 2012, the commissioner 
13.21 	shall include as part of the performance targets described in paragraph (c) a reduction in the 
13.22 	plan's hospitalization admission rate for medical assistance and MinnesotaCare enrollees, 
13.23 	as determined by the commissioner. To earn the return of the withhold each year, the 
13.24 	managed care plan or county-based purchasing plan must achieve a qualifying reduction 
13.25 	of no less than five percent of the plan's hospital admission rate for medical assistance 
13.26 	and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 
13.27 	subdivisions 23 and 28, compared to the previous calendar year until the final performance 
13.28 	target is reached. When measuring performance, the commissioner must consider the 
13.29 	difference in health risk in a managed care or county-based purchasing plan's membership 
13.30 	in the baseline year compared to the measurement year, and work with the managed care 
13.31 	or county-based purchasing plan to account for differences that they agree are significant.
13.32 	The withheld funds must be returned no sooner than July 1 and no later than July 
13.33 	31 of the following calendar year if the managed care plan or county-based purchasing 
13.34 	plan demonstrates to the satisfaction of the commissioner that this reduction in the 
13.35 	hospitalization rate was achieved. The commissioner shall structure the withhold so that 
14.1 	the commissioner returns a portion of the withheld funds in amounts commensurate with 
14.2 	achieved reductions in utilization less than the targeted amount.
14.3 	The withhold described in this paragraph shall continue until there is a 25 percent 
14.4 	reduction in the hospital admission rate compared to the hospital admission rates in 
14.5 	calendar year 2011, as determined by the commissioner. The hospital admissions in this 
14.6 	performance target do not include the admissions applicable to the subsequent hospital 
14.7 	admission performance target under paragraph (i). Hospitals shall cooperate with the 
14.8 	plans in meeting this performance target and shall accept payment withholds that may be 
14.9 	returned to the hospitals if the performance target is achieved.
14.10 	(i) Effective for services rendered on or after January 1, 2012, the commissioner 
14.11 	shall include as part of the performance targets described in paragraph (c) a reduction in 
14.12 	the plan's hospitalization admission rates for subsequent hospitalizations within 30 days 
14.13 	of a previous hospitalization of a patient regardless of the reason, for medical assistance 
14.14 	and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of 
14.15 	the withhold each year, the managed care plan or county-based purchasing plan must 
14.16 	achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance 
14.17 	and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 
14.18 	subdivisions 23 and 28, of no less than five percent compared to the previous calendar 
14.19 	year until the final performance target is reached.
14.20 	The withheld funds must be returned no sooner than July 1 and no later than July 
14.21 	31 of the following calendar year if the managed care plan or county-based purchasing 
14.22 	plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in 
14.23 	the subsequent hospitalization rate was achieved. The commissioner shall structure the 
14.24 	withhold so that the commissioner returns a portion of the withheld funds in amounts 
14.25 	commensurate with achieved reductions in utilization less that the targeted amount.
14.26 	The withhold described in this paragraph must continue for each consecutive 
14.27 	contract period until the plan's subsequent hospitalization rate for medical assistance 
14.28 	and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 
14.29 	subdivisions 23 and 28, is reduced by 25 percent of the plan's subsequent hospitalization 
14.30 	rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this 
14.31 	performance target and shall accept payment withholds that must be returned to the 
14.32 	hospitals if the performance target is achieved.
14.33 	(j) Effective for services rendered on or after January 1, 2011, through December 31, 
14.34 	2011, the commissioner shall withhold 4.5 percent of managed care plan payments under 
14.35 	this section and county-based purchasing plan payments under section 256B.692 for the 
14.36 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
15.1 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
15.2 	special demonstration projects under subdivision 23.
15.3 	(k) Effective for services rendered on or after January 1, 2012, through December 
15.4 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
15.5 	under this section and county-based purchasing plan payments under section 256B.692 
15.6 	for the prepaid medical assistance program. The withheld funds must be returned no 
15.7 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
15.8 	exclude special demonstration projects under subdivision 23.
15.9 	(l) Effective for services rendered on or after January 1, 2013, through December 31, 
15.10 	2013, the commissioner shall withhold 4.5 percent of managed care plan payments under 
15.11 	this section and county-based purchasing plan payments under section 256B.692 for the 
15.12 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
15.13 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
15.14 	special demonstration projects under subdivision 23.
15.15 	(m) Effective for services rendered on or after January 1, 2014, the commissioner 
15.16 	shall withhold three percent of managed care plan payments under this section and 
15.17 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
15.18 	assistance program. The withheld funds must be returned no sooner than July 1 and 
15.19 	no later than July 31 of the following year. The commissioner may exclude special 
15.20 	demonstration projects under subdivision 23.
15.21 	(n) A managed care plan or a county-based purchasing plan under section 256B.692 
15.22 	may include as admitted assets under section 62D.044 any amount withheld under this 
15.23 	section that is reasonably expected to be returned.
15.24 	(o) Contracts between the commissioner and a prepaid health plan are exempt from 
15.25 	the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
15.26 	(a), and 7.
15.27 	(p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject 
15.28 	to the requirements of paragraph (c).

15.29 	Sec. 8. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 9c, is 
15.30 	amended to read:
15.31 		Subd. 9c.Managed care financial reporting. (a) The commissioner shall collect 
15.32 	detailed data regarding financials, provider payments, provider rate methodologies, and 
15.33 	other data as determined by the commissioner and managed care and county-based 
15.34 	purchasing plans that are required to be submitted under this section. The commissioner, 
15.35 	in consultation with the commissioners of health and commerce, and in consultation 
16.1 	with managed care plans and county-based purchasing plans, shall set uniform criteria, 
16.2 	definitions, and standards for the data to be submitted, and shall require managed care and 
16.3 	county-based purchasing plans to comply with these criteria, definitions, and standards 
16.4 	when submitting data under this section. In carrying out the responsibilities of this 
16.5 	subdivision, the commissioner shall ensure that the data collection is implemented in an 
16.6 	integrated and coordinated manner that avoids unnecessary duplication of effort. To the 
16.7 	extent possible, the commissioner shall use existing data sources and streamline data 
16.8 	collection in order to reduce public and private sector administrative costs. Nothing in 
16.9 	this subdivision shall allow release of information that is nonpublic data pursuant to 
16.10 	section 13.02.
16.11 	(b) Each managed care and county-based purchasing plan must annually provide 
16.12 	to the commissioner the following information on state public programs, in the form 
16.13 	and manner specified by the commissioner, according to guidelines developed by the 
16.14 	commissioner in consultation with managed care plans and county-based purchasing 
16.15 	plans under contract:
16.16 	(1) administrative expenses by category and subcategory consistent with 
16.17 	administrative expense reporting to other state and federal regulatory agencies, by 
16.18 	program;
16.19 	(2) revenues by program, including investment income;
16.20 	(3) nonadministrative service payments, provider payments, and reimbursement 
16.21 	rates by provider type or service category, by program, paid by the managed care plan 
16.22 	under this section or the county-based purchasing plan under section 256B.692 to 
16.23 	providers and vendors for administrative services under contract with the plan, including 
16.24 	but not limited to:
16.25 	(i) individual-level provider payment and reimbursement rate data;
16.26 	(ii) provider reimbursement rate methodologies by provider type, by program, 
16.27 	including a description of alternative payment arrangements and payments outside the 
16.28 	claims process;
16.29 	(iii) data on implementation of legislatively mandated provider rate changes; and
16.30 	(iv) individual-level provider payment and reimbursement rate data and plan-specific 
16.31 	provider reimbursement rate methodologies by provider type, by program, including 
16.32 	alternative payment arrangements and payments outside the claims process, provided to 
16.33 	the commissioner under this subdivision are nonpublic data as defined in section 13.02;
16.34 	(4) data on the amount of reinsurance or transfer of risk by program; and
16.35 	(5) contribution to reserve, by program.
17.1 	(c) In the event a report is published or released based on data provided under 
17.2 	this subdivision, the commissioner shall provide the report to managed care plans and 
17.3 	county-based purchasing plans 30 days prior to the publication or release of the report. 
17.4 	Managed care plans and county-based purchasing plans shall have 30 days to review the 
17.5 	report and provide comment to the commissioner.
17.6 	(d) The legislative auditor shall contract for the audit required under this paragraph. 
17.7 	The commissioner shall require, in the request for bids and the resulting contracts for 
17.8 	coverage to be provided under this section, that each managed care and county-based 
17.9 	purchasing plan submit to and fully cooperate with an annual independent third-party 
17.10 	financial audit of the information required under paragraph (b). For purposes of 
17.11 	this paragraph, "independent third party" means an audit firm that is independent in 
17.12 	accordance with Government Auditing Standards issued by the United States Government 
17.13 	Accountability Office and licensed in accordance with chapter 326A. In no case shall 
17.14 	the audit firm conducting the audit provide services to a managed care or county-based 
17.15 	purchasing plan at the same time as the audit is being conducted or have provided services 
17.16 	to a managed care or county-based purchasing plan during the prior three years.
17.17 	(e) The audit of the information required under paragraph (b) shall be conducted 
17.18 	by an independent third-party firm in accordance with generally accepted government 
17.19 	auditing standards issued by the United States Government Accountability Office.
17.20 	(f) A managed care or county-based purchasing plan that provides services under 
17.21 	this section shall provide to the commissioner biweekly encounter and claims data at 
17.22 	a detailed level and shall participate in a quality assurance program that verifies the 
17.23 	timeliness, completeness, accuracy, and consistency of data provided. The commissioner 
17.24 	shall have written protocols for the quality assurance program that are publicly available. 
17.25 	The commissioner shall contract with an independent third-party auditing firm to evaluate 
17.26 	the quality assurance protocols, the capacity of those protocols to assure complete and 
17.27 	accurate data, and the commissioner's implementation of the protocols.
17.28 	(g) Contracts awarded under this section to a managed care or county-based 
17.29 	purchasing plan must provide that the commissioner and the contracted auditor shall have 
17.30 	unlimited access to any and all data required to complete the audit and that this access 
17.31 	shall be enforceable in a court of competent jurisdiction through the process of injunctive 
17.32 	or other appropriate relief.
17.33 	(h) Any actuary or actuarial firm must meet the independence requirements under 
17.34 	the professional code for fellows in the Society of Actuaries when providing actuarial 
17.35 	services to the commissioner in connection with this subdivision and providing services to 
18.1 	any managed care or county-based purchasing plan participating in this subdivision during 
18.2 	the term of the actuary's work for the commissioner under this subdivision.
18.3 	(i) The actuary or actuarial firm referenced in paragraph (h) shall certify and attest 
18.4 	to the rates paid to managed care plans and county-based purchasing plans under this 
18.5 	section, and the certification and attestation must be auditable.
18.6 	(j) The independent third-party audit shall include a determination of compliance 
18.7 	with the federal Medicaid rate certification process.
18.8 	(k) The legislative auditor's contract with the independent third-party auditing firm 
18.9 	shall be designed and administered so as to render the independent third-party audit 
18.10 	eligible for a federal subsidy if available for that purpose. The independent third-party 
18.11 	auditing firm shall have the same powers as the legislative auditor under section 3.978, 
18.12 	subdivision 2.
18.13 	(l) Upon completion of the audit, and its receipt by the legislative auditor, the 
18.14 	legislative auditor shall provide copies of the audit report to the commissioner, the state 
18.15 	auditor, the attorney general, and the chairs and ranking minority members of the health 
18.16 	finance committees of the legislature.
18.17 	(m) The commissioner shall annually assess managed care and county-based 
18.18 	purchasing plans for agency costs related to implementing paragraphs (d) to (l), which 
18.19 	have been approved as reasonable by the commissioner of management and budget. 
18.20 	The assessment for each plan shall be in proportion to that plan's share of total medical 
18.21 	assistance and MinnesotaCare enrollment under this section, section 256B.692, and 
18.22 	section 256L.12.

18.23 	EFFECTIVE DATE. This section is effective the day following final enactment 
18.24 	and applies to contracts, and the contracting process, for contracts that are effective 
18.25 	January 1, 2013, and thereafter.

18.26 	Sec. 9. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision 
18.27 	to read:
18.28 		Subd. 9d.Savings from report elimination. Managed care and county-based 
18.29 	purchasing plans shall use the savings resulting from the elimination or modification 
18.30 	of specified reporting requirements to pay the assessment required by subdivision 9c, 
18.31 	paragraph (m).

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

19.1 	Sec. 10. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 4, is 
19.2 	amended to read:
19.3 		Subd. 4.Critical access dental providers.  (a) Effective for dental services 
19.4 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
19.5 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
19.6 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
19.7 	increase reimbursement by 30 percent above the reimbursement rate that would otherwise 
19.8 	be paid to the critical access dental provider. The commissioner shall pay the managed 
19.9 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
19.10 	reimbursements to critical access dental providers as approved by the commissioner.
19.11 	(b) The commissioner shall designate the following dentists and dental clinics as 
19.12 	critical access dental providers:
19.13 	(1) nonprofit community clinics that:
19.14 	(i) have nonprofit status in accordance with chapter 317A;
19.15 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
19.16 	501(c)(3);
19.17 	(iii) are established to provide oral health services to patients who are low income, 
19.18 	uninsured, have special needs, and are underserved;
19.19 	(iv) have professional staff familiar with the cultural background of the clinic's 
19.20 	patients;
19.21 	(v) charge for services on a sliding fee scale designed to provide assistance to 
19.22 	low-income patients based on current poverty income guidelines and family size;
19.23 	(vi) do not restrict access or services because of a patient's financial limitations 
19.24 	or public assistance status; and
19.25 	(vii) have free care available as needed;
19.26 	(2) federally qualified health centers, rural health clinics, and public health clinics;
19.27 	(3) county owned and operated hospital-based dental clinics;
19.28 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
19.29 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
19.30 	patients who are uninsured or covered by medical assistance, general assistance medical 
19.31 	care, or MinnesotaCare; and
19.32 	(5) a dental clinic owned and operated by the University of Minnesota or the 
19.33 	Minnesota State Colleges and Universities system.
19.34 	 (c) The commissioner may designate a dentist or dental clinic as a critical access 
19.35 	dental provider if the dentist or dental clinic is willing to provide care to patients covered 
20.1 	by medical assistance, general assistance medical care, or MinnesotaCare at a level which 
20.2 	significantly increases access to dental care in the service area.
20.3 	(d) Notwithstanding paragraph (a), critical access payments must not be made for 
20.4 	dental services provided from April 1, 2010, through June 30, 2010. A designated critical 
20.5 	access clinic shall receive the reimbursement rate specified in paragraph (a) for dental 
20.6 	services provided off-site at a private dental office if the following requirements are met:
20.7 	(1) the designated critical access dental clinic is located within a health professional 
20.8 	shortage area as defined under the Code of Federal Regulations, title 42, part 5, and 
20.9 	the United States Code, title 42, section 254E, and is located outside the seven-county 
20.10 	metropolitan area;
20.11 	(2) the designated critical access dental clinic is not able to provide the service 
20.12 	and refers the patient to the off-site dentist;
20.13 	(3) the service, if provided at the critical access dental clinic, would be reimbursed 
20.14 	at the critical access reimbursement rate;
20.15 	(4) the dentist and allied dental professionals providing the services off-site are 
20.16 	licensed and in good standing under chapter 150A;
20.17 	(5) the dentist providing the services is enrolled as a medical assistance provider;
20.18 	(6) the critical access dental clinic submits the claim for services provided off-site 
20.19 	and receives the payment for the services; and
20.20 	(7) the critical access dental clinic maintains dental records for each claim submitted 
20.21 	under this paragraph, including the name of the dentist, the off-site location, and the 
20.22 	license number of the dentist and allied dental professionals providing the services.

20.23 	EFFECTIVE DATE. This section is effective July 1, 2012, or upon federal 
20.24 	approval, whichever is later.

20.25 	Sec. 11. Minnesota Statutes 2011 Supplement, section 256L.12, subdivision 9, is 
20.26 	amended to read:
20.27 		Subd. 9.Rate setting; performance withholds. (a) Rates will be prospective, 
20.28 	per capita, where possible. The commissioner may allow health plans to arrange for 
20.29 	inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with 
20.30 	an independent actuary to determine appropriate rates.
20.31 	(b) For services rendered on or after January 1, 2004, the commissioner shall 
20.32 	withhold five percent of managed care plan payments and county-based purchasing 
20.33 	plan payments under this section pending completion of performance targets. Each 
20.34 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
20.35 	except in the case of a performance target based on a federal or state law or rule. Criteria 
21.1 	for assessment of each performance target must be outlined in writing prior to the contract 
21.2 	effective date. Clinical or utilization performance targets and their related criteria must 
21.3 	consider evidence-based research and reasonable interventions, when available or 
21.4 	applicable to the populations served, and must be developed with input from external 
21.5 	clinical experts and stakeholders, including managed care plans, county-based purchasing 
21.6 	plans, and providers. The managed care plan must demonstrate, to the commissioner's 
21.7 	satisfaction, that the data submitted regarding attainment of the performance target is 
21.8 	accurate. The commissioner shall periodically change the administrative measures used 
21.9 	as performance targets in order to improve plan performance across a broader range of 
21.10 	administrative services. The performance targets must include measurement of plan 
21.11 	efforts to contain spending on health care services and administrative activities. The 
21.12 	commissioner may adopt plan-specific performance targets that take into account factors 
21.13 	affecting only one plan, such as characteristics of the plan's enrollee population. The 
21.14 	withheld funds must be returned no sooner than July 1 and no later than July 31 of the 
21.15 	following calendar year if performance targets in the contract are achieved.
21.16 	(c) For services rendered on or after January 1, 2011, the commissioner shall 
21.17 	withhold an additional three percent of managed care plan or county-based purchasing 
21.18 	plan payments under this section. The withheld funds must be returned no sooner than 
21.19 	July 1 and no later than July 31 of the following calendar year. The return of the withhold 
21.20 	under this paragraph is not subject to the requirements of paragraph (b).
21.21 	(d) Effective for services rendered on or after January 1, 2011, through December 
21.22 	31, 2011, the commissioner shall include as part of the performance targets described in 
21.23 	paragraph (b) a reduction in the plan's emergency room utilization rate for state health care 
21.24 	program enrollees by a measurable rate of five percent from the plan's utilization rate for 
21.25 	the previous calendar year. Effective for services rendered on or after January 1, 2012, 
21.26 	the commissioner shall include as part of the performance targets described in paragraph 
21.27 	(b) a reduction in the health plan's emergency department utilization rate for medical 
21.28 	assistance and MinnesotaCare enrollees, as determined by the commissioner. For 2012, 
21.29 	the reductions shall be based on the health plan's utilization in 2009. To earn the return of 
21.30 	the withhold each subsequent year, the managed care plan or county-based purchasing 
21.31 	plan must achieve a qualifying reduction of no less than ten percent of the plan's utilization 
21.32 	rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees in 
21.33 	programs described in section 256B.69, subdivisions 23 and 28, compared to the previous 
21.34 	calendar measurement year, until the final performance target is reached. When measuring 
21.35 	performance, the commissioner must consider the difference in health risk in a managed 
21.36 	care or county-based purchasing plan's membership in the baseline year compared to the 
22.1 	measurement year, and work with the managed care or county-based purchasing plan to 
22.2 	account for differences that they agree are significant.
22.3 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
22.4 	of the following calendar year if the managed care plan or county-based purchasing plan 
22.5 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
22.6 	was achieved. The commissioner shall structure the withhold so that the commissioner 
22.7 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
22.8 	in utilization less than the targeted amount.
22.9 	The withhold described in this paragraph shall continue for each consecutive 
22.10 	contract period until the plan's emergency room utilization rate for state health care 
22.11 	program enrollees is reduced by 25 percent of the plan's emergency room utilization 
22.12 	rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009. 
22.13 	Hospitals shall cooperate with the health plans in meeting this performance target and 
22.14 	shall accept payment withholds that may be returned to the hospitals if the performance 
22.15 	target is achieved.
22.16 	(e) Effective for services rendered on or after January 1, 2012, the commissioner 
22.17 	shall include as part of the performance targets described in paragraph (b) a reduction 
22.18 	in the plan's hospitalization admission rate for medical assistance and MinnesotaCare 
22.19 	enrollees, as determined by the commissioner. To earn the return of the withhold 
22.20 	each year, the managed care plan or county-based purchasing plan must achieve a 
22.21 	qualifying reduction of no less than five percent of the plan's hospital admission rate 
22.22 	for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees
22.23 	in programs described in section 256B.69, subdivisions 23 and 28, compared to the 
22.24 	previous calendar year, until the final performance target is reached. When measuring 
22.25 	performance, the commissioner must consider the difference in health risk in a managed 
22.26 	care or county-based purchasing plan's membership in the baseline year compared to the 
22.27 	measurement year, and work with the managed care or county-based purchasing plan to 
22.28 	account for differences that they agree are significant.
22.29 	The withheld funds must be returned no sooner than July 1 and no later than July 
22.30 	31 of the following calendar year if the managed care plan or county-based purchasing 
22.31 	plan demonstrates to the satisfaction of the commissioner that this reduction in the 
22.32 	hospitalization rate was achieved. The commissioner shall structure the withhold so that 
22.33 	the commissioner returns a portion of the withheld funds in amounts commensurate with 
22.34 	achieved reductions in utilization less than the targeted amount.
22.35 	The withhold described in this paragraph shall continue until there is a 25 percent 
22.36 	reduction in the hospitals admission rate compared to the hospital admission rate for 
23.1 	calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the 
23.2 	plans in meeting this performance target and shall accept payment withholds that may be 
23.3 	returned to the hospitals if the performance target is achieved. The hospital admissions 
23.4 	in this performance target do not include the admissions applicable to the subsequent 
23.5 	hospital admission performance target under paragraph (f).
23.6 	(f) Effective for services provided on or after January 1, 2012, the commissioner 
23.7 	shall include as part of the performance targets described in paragraph (b) a reduction 
23.8 	in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a 
23.9 	previous hospitalization of a patient regardless of the reason, for medical assistance and 
23.10 	MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the 
23.11 	withhold each year, the managed care plan or county-based purchasing plan must achieve 
23.12 	a qualifying reduction of the subsequent hospital admissions rate for medical assistance 
23.13 	and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in 
23.14 	section 256B.69, subdivisions 23 and 28, of no less than five percent compared to the 
23.15 	previous calendar year until the final performance target is reached.
23.16 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
23.17 	of the following calendar year if the managed care plan or county-based purchasing plan 
23.18 	demonstrates to the satisfaction of the commissioner that a reduction in the subsequent 
23.19 	hospitalization rate was achieved. The commissioner shall structure the withhold so that 
23.20 	the commissioner returns a portion of the withheld funds in amounts commensurate with 
23.21 	achieved reductions in utilization less than the targeted amount.
23.22 	The withhold described in this paragraph must continue for each consecutive 
23.23 	contract period until the plan's subsequent hospitalization rate for medical assistance and 
23.24 	MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization 
23.25 	rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this 
23.26 	performance target and shall accept payment withholds that must be returned to the 
23.27 	hospitals if the performance target is achieved.
23.28 	(g) A managed care plan or a county-based purchasing plan under section 256B.692 
23.29 	may include as admitted assets under section 62D.044 any amount withheld under this 
23.30 	section that is reasonably expected to be returned.

23.31 	Sec. 12. COST-SHARING REQUIREMENTS STUDY.
 23.32 	The commissioner of human services, in consultation with managed care plans, 
23.33 	county-based purchasing plans, and other stakeholders, shall develop recommendations 
23.34 	to implement a revised cost-sharing structure for state public health care programs that 
23.35 	ensures application of meaningful cost-sharing requirements within the limits of title 
24.1 	42, Code of Federal Regulations, section 447.54, for enrollees in these programs. The 
24.2 	commissioner shall report to the chairs and ranking minority members of the legislative 
24.3 	committees with jurisdiction over these issues by January 15, 2013, with draft legislation 
24.4 	to implement these recommendations effective January 1, 2014.

24.5 	Sec. 13. STUDY OF MANAGED CARE.
 24.6 	The commissioner of human services must contract with an independent vendor 
24.7 	with demonstrated expertise in evaluating Medicaid managed care programs to evaluate 
24.8 	the value of managed care for state public health care programs provided under 
24.9 	Minnesota Statutes, sections 256B.69, 256B.692, and 256L.12. The evaluation must be 
24.10 	completed and reported to the legislature by January 15, 2013. Determination of the 
24.11 	value of managed care must include consideration of the following, as compared to a 
24.12 	fee-for-service program:
24.13 	(1) the satisfaction of state public health care program recipients and providers;
24.14 	(2) the ability to measure and improve health outcomes of recipients;
24.15 	(3) the access to health services for recipients;
24.16 	(4) the availability of additional services such as care coordination, case 
24.17 	management, disease management, transportation, and after-hours nurse lines;
24.18 	(5) actual and potential cost savings to the state;
24.19 	(6) the level of alignment with state and federal health reform policies, including a 
24.20 	health benefit exchange for individuals not enrolled in state public health care programs; 
24.21 	and
24.22 	(7) the ability to use different provider payment models that provide incentives for 
24.23 	cost-effective health care.

24.24 	Sec. 14. STUDY OF FOR-PROFIT HEALTH MAINTENANCE 
24.25 	ORGANIZATIONS.
 24.26 	The commissioner of health shall contract with an entity with expertise in health 
24.27 	economics and health care delivery and quality to study the efficiency, costs, service 
24.28 	quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to 
24.29 	not-for-profit health maintenance organizations operating in Minnesota and other states. 
24.30 	The study findings must address whether the state could: (1) reduce medical assistance 
24.31 	and MinnesotaCare costs and costs of providing coverage to state employees; and (2) 
24.32 	maintain or improve the quality of care provided to state health care program enrollees 
24.33 	and state employees if for-profit health maintenance organizations were allowed to operate 
24.34 	in the state. In comparing for-profit health maintenance organizations operating in other 
25.1 	states with not-for-profit health maintenance organizations operating in Minnesota, the 
25.2 	entity must consider differences in regulatory oversight, benefit requirements, network 
25.3 	standards, human resource costs, and assessments, fees, and taxes that may impact the 
25.4 	cost and quality comparisons. The commissioner shall require the entity under contract to 
25.5 	report study findings to the commissioner and the legislature by January 15, 2013.

25.6 	Sec. 15. REPORTING REQUIREMENTS.
 25.7 		Subdivision 1.Evidence-based childbirth program. The commissioner of human 
25.8 	services may discontinue the evidence-based childbirth program and shall discontinue all 
25.9 	affiliated reporting requirements established under Minnesota Statutes, section 256B.0625, 
25.10 	subdivision 3g, once the commissioner determines that hospitals representing at least 90 
25.11 	percent of births covered by Medical Assistance or MinnesotaCare have approved policies 
25.12 	and processes in place that prohibit elective inductions prior to 39 weeks' gestation.
25.13 		Subd. 2.Provider networks. The commissioner of health, the commissioner of 
25.14 	commerce, and the commissioner of human services shall merge reporting requirements 
25.15 	for health maintenance organizations and county-based purchasing plans related to 
25.16 	Minnesota Department of Health oversight of network adequacy under Minnesota 
25.17 	Statutes, section 62D.124, and the provider network list reported to the Department of 
25.18 	Human Services under Minnesota Rules, part 4685.2100. The commissioners shall work 
25.19 	with health maintenance organizations and county-based purchasing plans to ensure that 
25.20 	the report merger is done in a manner that simplifies health maintenance organization and 
25.21 	county-based purchasing plan reporting processes.

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

25.23 	Sec. 16. REPORT ELIMINATION SAVINGS.
 25.24 	Managed care plans and county-based purchasing plans shall use the savings 
25.25 	resulting from the elimination or modification of reporting requirements under Minnesota 
25.26 	Statutes, sections 62D.124; 62M.09, subdivision 9; 62Q.64; 72A.201, subdivision 8; 
25.27 	256B.0625, subdivision 3g; and Minnesota Rules, parts 4685.2000; and 4685.2100, to 
25.28 	pay the assessment required in Minnesota Statutes, section 256B.69, subdivision 9c, 
25.29 	paragraph (m).

25.30 	Sec. 17.  REPEALER.
 25.31 		Subdivision 1.Summary of complaints and grievances. Minnesota Rules, part 
25.32 	4685.2000, is repealed effective the day following final enactment.
26.1 		Subd. 2.Medical necessity denials and appeals. Minnesota Statutes 2010, section 
26.2 	62M.09, subdivision 9, is repealed effective the day following final enactment.
26.3 		Subd. 3.Salary reports. Minnesota Statutes 2010, section 62Q.64, is repealed 
26.4 	effective the day following final enactment.
26.5 		Subd. 4.Mandatory HMO participation as provider in public programs.
 26.6 	Minnesota Statutes 2010, section 62D.04, subdivision 5, is repealed effective January 
26.7 	1, 2013.

26.8 	ARTICLE 2
26.9 	DEPARTMENT OF HEALTH

26.10 	Section 1. Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:
26.11 		Subd. 3.Commissioner of health commerce or commissioner. "Commissioner of 
26.12 	health commerce" or "commissioner" means the state commissioner of health commerce
26.13 	or a designee.

26.14 	Sec. 2. Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:
26.15 		Subd. 6.Supplemental benefits. (a) A health maintenance organization may, as 
26.16 	a supplemental benefit, provide coverage to its enrollees for health care services and 
26.17 	supplies received from providers who are not employed by, under contract with, or 
26.18 	otherwise affiliated with the health maintenance organization. Supplemental benefits may 
26.19 	be provided if the following conditions are met:
26.20 	(1) a health maintenance organization desiring to offer supplemental benefits must at 
26.21 	all times comply with the requirements of sections 62D.041 and 62D.042;
26.22 	(2) a health maintenance organization offering supplemental benefits must maintain 
26.23 	an additional surplus in the first year supplemental benefits are offered equal to the 
26.24 	lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of 
26.25 	the second year supplemental benefits are offered, the health maintenance organization 
26.26 	must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the 
26.27 	supplemental benefit expenses. At the end of the third year benefits are offered and every 
26.28 	year after that, the health maintenance organization must maintain an additional surplus 
26.29 	equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses. 
26.30 	When in the judgment of the commissioner the health maintenance organization's surplus 
26.31 	is inadequate, the commissioner may require the health maintenance organization to 
26.32 	maintain additional surplus;
26.33 	(3) claims relating to supplemental benefits must be processed in accordance with 
26.34 	the requirements of section 72A.201; and
27.1 	(4) in marketing supplemental benefits, the health maintenance organization shall 
27.2 	fully disclose and describe to enrollees and potential enrollees the nature and extent of the 
27.3 	supplemental coverage, and any claims filing and other administrative responsibilities in 
27.4 	regard to supplemental benefits.
27.5 	(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer 
27.6 	rules relating to this subdivision, including: rules insuring that these benefits are 
27.7 	supplementary and not substitutes for comprehensive health maintenance services by 
27.8 	addressing percentage of out-of-plan coverage; rules relating to the establishment of 
27.9 	necessary financial reserves; rules relating to marketing practices; and other rules necessary 
27.10 	for the effective and efficient administration of this subdivision. The commissioner, in 
27.11 	adopting rules, shall give consideration to existing laws and rules administered and 
27.12 	enforced by the Department of Commerce relating to health insurance plans.

27.13 	Sec. 3. Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:
27.14 		Subdivision 1.False representations. No health maintenance organization or 
27.15 	representative thereof may cause or knowingly permit the use of advertising or solicitation 
27.16 	which is untrue or misleading, or any form of evidence of coverage which is deceptive. 
27.17 	Each health maintenance organization shall be subject to sections 72A.17 to 72A.32, 
27.18 	relating to the regulation of trade practices, except (a) to the extent that the nature of a 
27.19 	health maintenance organization renders such sections clearly inappropriate and (b) that 
27.20 	enforcement shall be by the commissioner of health and not by the commissioner of 
27.21 	commerce. Every health maintenance organization shall be subject to sections 8.31 and 
27.22 	325F.69.

27.23 	Sec. 4. Minnesota Statutes 2010, section 62Q.80, is amended to read:
27.24 	62Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM.
27.25 		Subdivision 1.Scope. (a) Any community-based health care initiative may develop 
27.26 	and operate community-based health care coverage programs that offer to eligible 
27.27 	individuals and their dependents the option of purchasing through their employer health 
27.28 	care coverage on a fixed prepaid basis without meeting the requirements of chapter 60A, 
27.29 	62A, 62C, 62D, 62M, 62N, 62Q, 62T, or 62U, or any other law or rule that applies to 
27.30 	entities licensed under these chapters.
27.31 	(b) Each initiative shall establish health outcomes to be achieved through the 
27.32 	programs and performance measurements in order to determine whether these outcomes 
27.33 	have been met. The outcomes must include, but are not limited to:
28.1 	(1) a reduction in uncompensated care provided by providers participating in the 
28.2 	community-based health network;
28.3 	(2) an increase in the delivery of preventive health care services; and
28.4 	(3) health improvement for enrollees with chronic health conditions through the 
28.5 	management of these conditions.
28.6 	In establishing performance measurements, the initiative shall use measures that are 
28.7 	consistent with measures published by nonprofit Minnesota or national organizations that 
28.8 	produce and disseminate health care quality measures.
28.9 	(c) Any program established under this section shall not constitute a financial 
28.10 	liability for the state, in that any financial risk involved in the operation or termination 
28.11 	of the program shall be borne by the community-based initiative and the participating 
28.12 	health care providers.
28.13 		Subd. 1a.Demonstration project. The commissioner of health and the 
28.14 	commissioner of human services shall award demonstration project grants to 
28.15 	community-based health care initiatives to develop and operate community-based health 
28.16 	care coverage programs in Minnesota. The demonstration projects shall extend for five 
28.17 	years and must comply with the requirements of this section.
28.18 		Subd. 2.Definitions.  For purposes of this section, the following definitions apply:
28.19 	(a) "Community-based" means located in or primarily relating to the community, 
28.20 	as determined by the board of a community-based health initiative that is served by the 
28.21 	community-based health care coverage program.
28.22 	(b) "Community-based health care coverage program" or "program" means a 
28.23 	program administered by a community-based health initiative that provides health care 
28.24 	services through provider members of a community-based health network or combination 
28.25 	of networks to eligible individuals and their dependents who are enrolled in the program.
28.26 	(c) "Community-based health initiative" or "initiative" means a nonprofit corporation 
28.27 	that is governed by a board that has at least 80 percent of its members residing in the 
28.28 	community and includes representatives of the participating network providers and 
28.29 	employers, or a county-based purchasing organization as defined in section 256B.692.
28.30 	(d) "Community-based health network" means a contract-based network of health 
28.31 	care providers organized by the community-based health initiative to provide or support 
28.32 	the delivery of health care services to enrollees of the community-based health care 
28.33 	coverage program on a risk-sharing or nonrisk-sharing basis.
28.34 	(e) "Dependent" means an eligible employee's spouse or unmarried child who is 
28.35 	under the age of 19 years.
29.1 		Subd. 3.Approval.  (a) Prior to the operation of a community-based health 
29.2 	care coverage program, a community-based health initiative, defined in subdivision 
29.3 	2, paragraph (c), and receiving funds from the Department of Health, shall submit to 
29.4 	the commissioner of health for approval the community-based health care coverage 
29.5 	program developed by the initiative. Each community-based health initiative as defined 
29.6 	in subdivision 2, paragraph (c), and receiving State Health Access Program (SHAP) 
29.7 	grant funding shall submit to the commissioner of human services for approval prior 
29.8 	to its operation the community-based health care coverage programs developed by the 
29.9 	initiatives. The commissioners commissioner shall ensure that each program meets 
29.10 	the federal grant requirements and any requirements described in this section and is 
29.11 	actuarially sound based on a review of appropriate records and methods utilized by the 
29.12 	community-based health initiative in establishing premium rates for the community-based 
29.13 	health care coverage programs.
29.14 	(b) Prior to approval, the commissioner shall also ensure that:
29.15 	(1) the benefits offered comply with subdivision 8 and that there are adequate 
29.16 	numbers of health care providers participating in the community-based health network to 
29.17 	deliver the benefits offered under the program;
29.18 	(2) the activities of the program are limited to activities that are exempt under this 
29.19 	section or otherwise from regulation by the commissioner of commerce;
29.20 	(3) the complaint resolution process meets the requirements of subdivision 10; and
29.21 	(4) the data privacy policies and procedures comply with state and federal law.
29.22 		Subd. 4.Establishment.  The initiative shall establish and operate upon approval 
29.23 	by the commissioners commissioner of health and human services community-based 
29.24 	health care coverage programs. The operational structure established by the initiative 
29.25 	shall include, but is not limited to:
29.26 	(1) establishing a process for enrolling eligible individuals and their dependents;
29.27 	(2) collecting and coordinating premiums from enrollees and employers of enrollees;
29.28 	(3) providing payment to participating providers;
29.29 	(4) establishing a benefit set according to subdivision 8 and establishing premium 
29.30 	rates and cost-sharing requirements;
29.31 	(5) creating incentives to encourage primary care and wellness services; and
29.32 	(6) initiating disease management services, as appropriate.
29.33 		Subd. 5.Qualifying employees.  To be eligible for the community-based health 
29.34 	care coverage program, an individual must:
29.35 	(1) reside in or work within the designated community-based geographic area 
29.36 	served by the program;
30.1 	(2) be employed by a qualifying employer, be an employee's dependent, or be 
30.2 	self-employed on a full-time basis;
30.3 	(3) not be enrolled in or have currently available health coverage, except for 
30.4 	catastrophic health care coverage; and
30.5 	(4) not be eligible for or enrolled in medical assistance or general assistance medical 
30.6 	care, and not be enrolled in MinnesotaCare or Medicare.
30.7 		Subd. 6.Qualifying employers.  (a) To qualify for participation in the 
30.8 	community-based health care coverage program, an employer must:
30.9 	(1) employ at least one but no more than 50 employees at the time of initial 
30.10 	enrollment in the program;
30.11 	(2) pay its employees a median wage that equals 350 percent of the federal poverty 
30.12 	guidelines or less for an individual; and
30.13 	(3) not have offered employer-subsidized health coverage to its employees for 
30.14 	at least 12 months prior to the initial enrollment in the program. For purposes of this 
30.15 	section, "employer-subsidized health coverage" means health care coverage for which the 
30.16 	employer pays at least 50 percent of the cost of coverage for the employee.
30.17 	(b) To participate in the program, a qualifying employer agrees to:
30.18 	(1) offer health care coverage through the program to all eligible employees and 
30.19 	their dependents regardless of health status;
30.20 	(2) participate in the program for an initial term of at least one year;
30.21 	(3) pay a percentage of the premium established by the initiative for the employee; 
30.22 	and
30.23 	(4) provide the initiative with any employee information deemed necessary by the 
30.24 	initiative to determine eligibility and premium payments.
30.25 		Subd. 7.Participating providers. Any health care provider participating in the 
30.26 	community-based health network must accept as payment in full the payment rate 
30.27 	established by the initiatives and may not charge to or collect from an enrollee any amount 
30.28 	in access of this amount for any service covered under the program.
30.29 		Subd. 8.Coverage.  (a) The initiatives shall establish the health care benefits offered 
30.30 	through the community-based health care coverage programs. The benefits established 
30.31 	shall include, at a minimum:
30.32 	(1) child health supervision services up to age 18, as defined under section 62A.047; 
30.33 	and
30.34 	(2) preventive services, including:
30.35 	(i) health education and wellness services;
30.36 	(ii) health supervision, evaluation, and follow-up;
31.1 	(iii) immunizations; and
31.2 	(iv) early disease detection.
31.3 	(b) Coverage of health care services offered by the program may be limited to 
31.4 	participating health care providers or health networks. All services covered under the 
31.5 	programs must be services that are offered within the scope of practice of the participating 
31.6 	health care providers.
31.7 	(c) The initiatives may establish cost-sharing requirements. Any co-payment or 
31.8 	deductible provisions established may not discriminate on the basis of age, sex, race, 
31.9 	disability, economic status, or length of enrollment in the programs.
31.10 	(d) If any of the initiatives amends or alters the benefits offered through the program 
31.11 	from the initial offering, that initiative must notify the commissioners commissioner of 
31.12 	health and human services and all enrollees of the benefit change.
31.13 		Subd. 9.Enrollee information. (a) The initiatives must provide an individual or 
31.14 	family who enrolls in the program a clear and concise written statement that includes 
31.15 	the following information:
31.16 	(1) health care services that are covered under the program;
31.17 	(2) any exclusions or limitations on the health care services covered, including any 
31.18 	cost-sharing arrangements or prior authorization requirements;
31.19 	(3) a list of where the health care services can be obtained and that all health 
31.20 	care services must be provided by or through a participating health care provider or 
31.21 	community-based health network;
31.22 	(4) a description of the program's complaint resolution process, including how to 
31.23 	submit a complaint; how to file a complaint with the commissioner of health; and how to 
31.24 	obtain an external review of any adverse decisions as provided under subdivision 10;
31.25 	(5) the conditions under which the program or coverage under the program may 
31.26 	be canceled or terminated; and
31.27 	(6) a precise statement specifying that this program is not an insurance product and, 
31.28 	as such, is exempt from state regulation of insurance products.
31.29 	(b) The commissioners commissioner of health and human services must approve a 
31.30 	copy of the written statement prior to the operation of the program.
31.31 		Subd. 10.Complaint resolution process. (a) The initiatives must establish 
31.32 	a complaint resolution process. The process must make reasonable efforts to resolve 
31.33 	complaints and to inform complainants in writing of the initiative's decision within 60 
31.34 	days of receiving the complaint. Any decision that is adverse to the enrollee shall include 
31.35 	a description of the right to an external review as provided in paragraph (c) and how to 
31.36 	exercise this right.
32.1 	(b) The initiatives must report any complaint that is not resolved within 60 days to 
32.2 	the commissioner of health.
32.3 	(c) The initiatives must include in the complaint resolution process the ability of an 
32.4 	enrollee to pursue the external review process provided under section 62Q.73 with any 
32.5 	decision rendered under this external review process binding on the initiatives.
32.6 		Subd. 11.Data privacy. The initiatives shall establish data privacy policies and 
32.7 	procedures for the program that comply with state and federal data privacy laws.
32.8 		Subd. 12.Limitations on enrollment. (a) The initiatives may limit enrollment in 
32.9 	the program. If enrollment is limited, a waiting list must be established.
32.10 	(b) The initiatives shall not restrict or deny enrollment in the program except for 
32.11 	nonpayment of premiums, fraud or misrepresentation, or as otherwise permitted under 
32.12 	this section.
32.13 	(c) The initiatives may require a certain percentage of participation from eligible 
32.14 	employees of a qualifying employer before coverage can be offered through the program.
32.15 		Subd. 13.Report.  Each initiative shall submit quarterly an annual status reports
32.16 	to the commissioner of health on January 15, April 15, July 15, and October 15 of each 
32.17 	year, with the first report due January 15, 2008. Each initiative receiving funding from the 
32.18 	Department of Human Services shall submit status reports to the commissioner of human 
32.19 	services as defined in the terms of the contract with the Department of Human Services.
32.20 	Each status report shall include:
32.21 	(1) the financial status of the program, including the premium rates, cost per member 
32.22 	per month, claims paid out, premiums received, and administrative expenses;
32.23 	(2) a description of the health care benefits offered and the services utilized;
32.24 	(3) the number of employers participating, the number of employees and dependents 
32.25 	covered under the program, and the number of health care providers participating;
32.26 	(4) a description of the health outcomes to be achieved by the program and a status 
32.27 	report on the performance measurements to be used and collected; and
32.28 	(5) any other information requested by the commissioners of health, human services,
32.29 	or commerce or the legislature.
32.30 		Subd. 14.Sunset. This section expires August 31, 2014.

32.31 	Sec. 5. Minnesota Statutes 2010, section 62U.04, subdivision 1, is amended to read:
32.32 		Subdivision 1.Development of tools to improve costs and quality outcomes.
 32.33 	The commissioner of health shall develop a plan to create transparent prices, encourage 
32.34 	greater provider innovation and collaboration across points on the health continuum 
32.35 	in cost-effective, high-quality care delivery, reduce the administrative burden on 
33.1 	providers and health plans associated with submitting and processing claims, and provide 
33.2 	comparative information to consumers on variation in health care cost and quality across 
33.3 	providers. The development must be complete by January 1, 2010.

33.4 	Sec. 6. Minnesota Statutes 2010, section 62U.04, subdivision 2, is amended to read:
33.5 		Subd. 2.Calculation of health care costs and quality. The commissioner of health 
33.6 	shall develop a uniform method of calculating providers' relative cost of care, defined as a 
33.7 	measure of health care spending including resource use and unit prices, and relative quality 
33.8 	of care. In developing this method, the commissioner must address the following issues:
33.9 	(1) provider attribution of costs and quality;
33.10 	(2) appropriate adjustment for outlier or catastrophic cases;
33.11 	(3) appropriate risk adjustment to reflect differences in the demographics and health 
33.12 	status across provider patient populations, using generally accepted and transparent risk 
33.13 	adjustment methodologies and case mix adjustment;
33.14 	(4) specific types of providers that should be included in the calculation;
33.15 	(5) specific types of services that should be included in the calculation;
33.16 	(6) appropriate adjustment for variation in payment rates;
33.17 	(7) the appropriate provider level for analysis;
33.18 	(8) payer mix adjustments, including variation across providers in the percentage of 
33.19 	revenue received from government programs; and
33.20 	(9) other factors that the commissioner determines and the advisory committee, 
33.21 	established under subdivision 3, determine are needed to ensure validity and comparability 
33.22 	of the analysis.

33.23 	Sec. 7. Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 3, is 
33.24 	amended to read:
33.25 		Subd. 3.Provider peer grouping; system development; advisory committee.
 33.26 	(a) The commissioner shall develop a peer grouping system for providers based on a 
33.27 	combined measure that incorporates both provider risk-adjusted cost of care and quality of 
33.28 	care, and for specific conditions as determined by the commissioner. In developing this 
33.29 	system, the commissioner shall consult and coordinate with health care providers, health 
33.30 	plan companies, state agencies, and organizations that work to improve health care quality 
33.31 	in Minnesota. For purposes of the final establishment of the peer grouping system, the 
33.32 	commissioner shall not contract with any private entity, organization, or consortium of 
33.33 	entities that has or will have a direct financial interest in the outcome of the system.
34.1 	(b) The commissioner shall establish an advisory committee comprised of 
34.2 	representatives of health care providers, health plan companies, consumers, state agencies, 
34.3 	employers, academic researchers, and organizations that work to improve health care 
34.4 	quality in Minnesota. The advisory committee shall meet no fewer than three times 
34.5 	per year. The commissioner shall consult with the advisory committee in developing 
34.6 	and administering the peer grouping system, including but not limited to the following 
34.7 	activities:
34.8 	(1) establishing peer groups;
34.9 	(2) selecting quality measures;
34.10 	(3) recommending thresholds for completeness of data and statistical significance 
34.11 	for the purposes of public release of provider peer grouping results;
34.12 	(4) considering whether adjustments are necessary for facilities that provide medical 
34.13 	education, level 1 trauma services, neonatal intensive care, or inpatient psychiatric care;
34.14 	(5) recommending inclusion or exclusion of other costs; and
34.15 	(6) adopting patient attribution and quality and cost-scoring methodologies.
34.16 		Subd. 3a.Provider peer grouping; dissemination of data to providers. (b) By 
34.17 	no later than October 15, 2010, (a) The commissioner shall disseminate information 
34.18 	to providers on their total cost of care, total resource use, total quality of care, and the 
34.19 	total care results of the grouping developed under this subdivision 3 in comparison to an 
34.20 	appropriate peer group. Data used for this analysis must be the most recent data available. 
34.21 	Any analyses or reports that identify providers may only be published after the provider 
34.22 	has been provided the opportunity by the commissioner to review the underlying data in 
34.23 	order to verify, consistent with the recommendations developed pursuant to subdivision 
34.24 	3c, paragraph (d), and adopted by the commissioner the accuracy and representativeness 
34.25 	of any analyses or reports  and submit comments to the commissioner or initiate an appeal 
34.26 	under subdivision 3b. Providers may Upon request, providers shall be given any data for 
34.27 	which they are the subject of the data. The provider shall have 30 60 days to review the 
34.28 	data for accuracy and initiate an appeal as specified in paragraph (d) subdivision 3b.
34.29 	(c) By no later than January 1, 2011, (b) The commissioner shall disseminate 
34.30 	information to providers on their condition-specific cost of care, condition-specific 
34.31 	resource use, condition-specific quality of care, and the condition-specific results of the 
34.32 	grouping developed under this subdivision 3 in comparison to an appropriate peer group.
34.33 	Data used for this analysis must be the most recent data available. Any analyses or 
34.34 	reports that identify providers may only be published after the provider has been provided 
34.35 	the opportunity by the commissioner to review the underlying data in order to verify, 
34.36 	consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d), 
35.1 	and adopted by the commissioner the accuracy and representativeness of any analyses or 
35.2 	reports  and submit comments to the commissioner or initiate an appeal under subdivision 
35.3 	3b. Providers may Upon request, providers shall be given any data for which they are the 
35.4 	subject of the data. The provider shall have 30 60 days to review the data for accuracy and 
35.5 	initiate an appeal as specified in paragraph (d) subdivision 3b.
35.6 		Subd. 3b.Provider peer grouping; appeals process. (d) The commissioner shall 
35.7 	establish an appeals a process to resolve disputes from providers regarding the accuracy 
35.8 	of the data used to develop analyses or reports or errors in the application of standards 
35.9 	or methodology established by the commissioner in consultation with the advisory 
35.10 	committee. When a provider appeals the accuracy of the data used to calculate the peer 
35.11 	grouping system results submits an appeal, the provider shall:
35.12 	(1) clearly indicate the reason they believe the data used to calculate the peer group 
35.13 	system results are not accurate or reasons for the appeal;
35.14 	(2) provide any evidence and, calculations, or documentation to support the reason 
35.15 	that data was not accurate for the appeal; and
35.16 	(3) cooperate with the commissioner, including allowing the commissioner access to 
35.17 	data necessary and relevant to resolving the dispute.
35.18 	The commissioner shall cooperate with the provider during the data review period 
35.19 	specified in subdivisions 3a and 3c by giving the provider information necessary for the 
35.20 	preparation of an appeal.
35.21 	If a provider does not meet the requirements of this paragraph subdivision, a provider's 
35.22 	appeal shall be considered withdrawn. The commissioner shall not publish peer grouping
35.23 	results for a specific provider under paragraph (e) or (f) while that provider has an 
35.24 	unresolved appeal until the appeal has been resolved.
35.25 		Subd. 3c.Provider peer grouping; publication of information for the public.
 35.26 	(e) Beginning January 1, 2011, the commissioner shall, no less than annually, publish 
35.27 	information on providers' total cost, total resource use, total quality, and the results of 
35.28 	the total care portion of the peer grouping process. The results that are published must 
35.29 	be on a risk-adjusted basis. (a) The commissioner may publicly release summary data 
35.30 	related to the peer grouping system as long as the data do not contain information or 
35.31 	descriptions from which the identity of individual hospitals, clinics, or other providers 
35.32 	may be discerned.
35.33 	(f) Beginning March 30, 2011, the commissioner shall no less than annually publish 
35.34 	information on providers' condition-specific cost, condition-specific resource use, and 
35.35 	condition-specific quality, and the results of the condition-specific portion of the peer 
35.36 	grouping process. The results that are published must be on a risk-adjusted basis. (b) The 
36.1 	commissioner may publicly release analyses or results related to the peer grouping system 
36.2 	that identify hospitals, clinics, or other providers only if the following criteria are met:
36.3 	(1) the results, data, and summaries, including any graphical depictions of provider 
36.4 	performance, have been distributed to providers at least 120 days prior to publication; 
36.5 	(2) the commissioner has provided an opportunity for providers to verify and review 
36.6 	data for which the provider is the subject consistent with the recommendations developed 
36.7 	pursuant to paragraph (d) and adopted by the commissioner; 
36.8 	(3) the results meet thresholds of validity, reliability, statistical significance, 
36.9 	representativeness, and other standards that reflect the recommendations of the advisory 
36.10 	committee, established under subdivision 3; and
36.11 	(4) any public report or other usage of the analyses, report, or data used by the 
36.12 	state clearly notifies consumers about how to use and interpret the results, including 
36.13 	any limitations of the data and analysis.
36.14 	(g) (c) After publishing the first public report, the commissioner shall, no less 
36.15 	frequently than annually, publish information on providers' total cost, total resource use, 
36.16 	total quality, and the results of the total care portion of the peer grouping process, as well 
36.17 	as information on providers' condition-specific cost, condition-specific resource use, 
36.18 	and condition-specific quality, and the results of the condition-specific portion of the 
36.19 	peer grouping process. The results that are published must be on a risk-adjusted basis, 
36.20 	including case mix adjustments.
36.21 	(d) The commissioner shall convene a work group comprised of representatives 
36.22 	of physician clinics, hospitals, their respective statewide associations, and other 
36.23 	relevant stakeholder organizations to make recommendations on data to be made 
36.24 	available to hospitals and physician clinics to allow for verification of the accuracy and 
36.25 	representativeness of the provider peer grouping results.
36.26 		Subd. 3d.Provider peer grouping; standards for dissemination and publication.
 36.27 	(a) Prior to disseminating data to providers under paragraph (b) or (c) subdivision 3a or 
36.28 	publishing information under paragraph (e) or (f) subdivision 3c, the commissioner, in 
36.29 	consultation with the advisory committee, shall ensure the scientific and statistical validity 
36.30 	and reliability of the results according to the standards described in paragraph (h) (b). 
36.31 	If additional time is needed to establish the scientific validity, statistical significance,
36.32 	and reliability of the results, the commissioner may delay the dissemination of data to 
36.33 	providers under paragraph (b) or (c) subdivision 3a, or the publication of information under 
36.34 	paragraph (e) or (f) subdivision 3c. If the delay is more than 60 days, the commissioner 
36.35 	shall report in writing to the chairs and ranking minority members of the legislative 
36.36 	committees with jurisdiction over health care policy and finance the following information:
37.1 	(1) the reason for the delay;
37.2 	(2) the actions being taken to resolve the delay and establish the scientific validity 
37.3 	and reliability of the results; and
37.4 	(3) the new dates by which the results shall be disseminated.
37.5 	If there is a delay under this paragraph, The commissioner must disseminate the 
37.6 	information to providers under paragraph (b) or (c) subdivision 3a at least 90 120 days 
37.7 	before publishing results under paragraph (e) or (f) subdivision 3c.
37.8 	(h) (b) The commissioner's assurance of valid, timely, and reliable clinic and hospital 
37.9 	peer grouping performance results shall include, at a minimum, the following:
37.10 	(1) use of the best available evidence, research, and methodologies; and
37.11 	(2) establishment of an explicit minimum reliability threshold thresholds for both 
37.12 	quality and costs developed in collaboration with the subjects of the data and the users of 
37.13 	the data, at a level not below nationally accepted standards where such standards exist.
37.14 	In achieving these thresholds, the commissioner shall not aggregate clinics that are not 
37.15 	part of the same system or practice group. The commissioner shall consult with and 
37.16 	solicit feedback from the advisory committee and representatives of physician clinics 
37.17 	and hospitals during the peer grouping data analysis process to obtain input on the 
37.18 	methodological options prior to final analysis and on the design, development, and testing 
37.19 	of provider reports.

37.20 	Sec. 8. Minnesota Statutes 2010, section 62U.04, subdivision 4, is amended to read:
37.21 		Subd. 4.Encounter data. (a) Beginning July 1, 2009, and every six months 
37.22 	thereafter, all health plan companies and third-party administrators shall submit encounter 
37.23 	data to a private entity designated by the commissioner of health. The data shall be 
37.24 	submitted in a form and manner specified by the commissioner subject to the following 
37.25 	requirements:
37.26 	(1) the data must be de-identified data as described under the Code of Federal 
37.27 	Regulations, title 45, section 164.514;
37.28 	(2) the data for each encounter must include an identifier for the patient's health care 
37.29 	home if the patient has selected a health care home; and
37.30 	(3) except for the identifier described in clause (2), the data must not include 
37.31 	information that is not included in a health care claim or equivalent encounter information 
37.32 	transaction that is required under section 62J.536.
37.33 	(b) The commissioner or the commissioner's designee shall only use the data 
37.34 	submitted under paragraph (a) for thepurpose of carrying out its responsibilities in this 
37.35 	section, and must maintain the data that it receives according to the provisions of this 
38.1 	section. to carry out its responsibilities in this section, including supplying the data to 
38.2 	providers so they can verify their results of the peer grouping process consistent with the 
38.3 	recommendations developed pursuant to subdivision 3c, paragraph (d), and adopted by 
38.4 	the commissioner and, if necessary, submit comments to the commissioner or initiate 
38.5 	an appeal.
38.6 	(c) Data on providers collected under this subdivision are private data on individuals 
38.7 	or nonpublic data, as defined in section 13.02. Notwithstanding the definition of summary 
38.8 	data in section 13.02, subdivision 19, summary data prepared under this subdivision 
38.9 	may be derived from nonpublic data. The commissioner or the commissioner's designee 
38.10 	shall establish procedures and safeguards to protect the integrity and confidentiality of 
38.11 	any data that it maintains.
38.12 	(d) The commissioner or the commissioner's designee shall not publish analyses or 
38.13 	reports that identify, or could potentially identify, individual patients.

38.14 	Sec. 9. Minnesota Statutes 2010, section 62U.04, subdivision 5, is amended to read:
38.15 		Subd. 5.Pricing data. (a) Beginning July 1, 2009, and annually on January 1 
38.16 	thereafter, all health plan companies and third-party administrators shall submit data 
38.17 	on their contracted prices with health care providers to a private entity designated by 
38.18 	the commissioner of health for the purposes of performing the analyses required under 
38.19 	this subdivision. The data shall be submitted in the form and manner specified by the 
38.20 	commissioner of health.
38.21 	(b) The commissioner or the commissioner's designee shall only use the data 
38.22 	submitted under this subdivision for the purpose of carrying out its responsibilities under 
38.23 	this section to carry out its responsibilities under this section, including supplying the 
38.24 	data to providers so they can verify their results of the peer grouping process consistent 
38.25 	with the recommendations developed pursuant to subdivision 3c, paragraph (d), and 
38.26 	adopted by the commissioner and, if necessary, submit comments to the commissioner or 
38.27 	initiate an appeal.
38.28 	(c) Data collected under this subdivision are nonpublic data as defined in section 
38.29 	13.02. Notwithstanding the definition of summary data in section 13.02, subdivision 19, 
38.30 	summary data prepared under this section may be derived from nonpublic data. The 
38.31 	commissioner shall establish procedures and safeguards to protect the integrity and 
38.32 	confidentiality of any data that it maintains.

38.33 	Sec. 10. Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 9, is 
38.34 	amended to read:
39.1 		Subd. 9.Uses of information. (a) For product renewals or for new products that 
39.2 	are offered, after 12 months have elapsed from publication by the commissioner of the 
39.3 	information in subdivision 3, paragraph (e):
39.4 	(1) the commissioner of management and budget shall may use the information and 
39.5 	methods developed under subdivision 3 subdivisions 3 to 3d to strengthen incentives for 
39.6 	members of the state employee group insurance program to use high-quality, low-cost 
39.7 	providers;
39.8 	(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer 
39.9 	health benefits to their employees must may offer plans that differentiate providers on their 
39.10 	cost and quality performance and create incentives for members to use better-performing 
39.11 	providers;
39.12 	(3) all health plan companies shall may use the information and methods developed 
39.13 	under subdivision 3 subdivisions 3 to 3d to develop products that encourage consumers to 
39.14 	use high-quality, low-cost providers; and
39.15 	(4) health plan companies that issue health plans in the individual market or the 
39.16 	small employer market must may offer at least one health plan that uses the information 
39.17 	developed under subdivision 3 subdivisions 3 to 3d to establish financial incentives for 
39.18 	consumers to choose higher-quality, lower-cost providers through enrollee cost-sharing 
39.19 	or selective provider networks.
39.20 	(b) By January 1, 2011, the commissioner of health shall report to the governor 
39.21 	and the legislature on recommendations to encourage health plan companies to promote 
39.22 	widespread adoption of products that encourage the use of high-quality, low-cost providers. 
39.23 	The commissioner's recommendations may include tax incentives, public reporting of 
39.24 	health plan performance, regulatory incentives or changes, and other strategies.

39.25 	Sec. 11. Minnesota Statutes 2011 Supplement, section 144.1222, subdivision 5, 
39.26 	is amended to read:
39.27 		Subd. 5.Swimming pond exemption Exemptions. (a) A public swimming pond 
39.28 	in existence before January 1, 2008, is not a public pool for purposes of this section and 
39.29 	section 157.16, and is exempt from the requirements for public swimming pools under 
39.30 	Minnesota Rules, chapter 4717.
39.31 	(b) A naturally treated swimming pool located in the city of Minneapolis is not 
39.32 	a public pool for purposes of this section and section 157.16, and is exempt from the 
39.33 	requirements for public swimming pools under Minnesota Rules, chapter 4717.
40.1 	(b) (c) Notwithstanding paragraph paragraphs (a) and (b), a public swimming pond 
40.2 	and a naturally treated swimming pool must meet the requirements for public pools 
40.3 	described in subdivisions 1c and 1d.
40.4 	(c) (d) For purposes of this subdivision, a "public swimming pond" means an 
40.5 	artificial body of water contained within a lined, sand-bottom basin, intended for public 
40.6 	swimming, relaxation, or recreational use that includes a water circulation system for 
40.7 	maintaining water quality and does not include any portion of a naturally occurring lake 
40.8 	or stream.
40.9 	(e) For purposes of this subdivision, a "naturally treated swimming pool" means an 
40.10 	artificial body of water contained in a basin, intended for public swimming, relaxation, or 
40.11 	recreational use that uses a chemical free filtration system for maintaining water quality 
40.12 	through natural processes, including the use of plants, beneficial bacteria, and microbes.

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

40.14 	Sec. 12. Minnesota Statutes 2010, section 144.5509, is amended to read:
40.15 	144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.
40.16 	(a) A radiation therapy facility may be constructed only by an entity owned, 
40.17 	operated, or controlled by a hospital licensed according to sections 144.50 to 144.56 either 
40.18 	alone or in cooperation with another entity. This paragraph expires August 1, 2014.
40.19 	(b) Notwithstanding paragraph (a), there shall be a moratorium on the construction 
40.20 	of any radiation therapy facility located in the following counties: Hennepin, Ramsey, 
40.21 	Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns, 
40.22 	Chisago, Isanti, and Wright. This paragraph does not apply to the relocation or 
40.23 	reconstruction of an existing facility owned by a hospital if the relocation or reconstruction 
40.24 	is within one mile of the existing facility. This paragraph does not apply to a radiation 
40.25 	therapy facility that is being built attached to a community hospital in Wright County and 
40.26 	meets the following conditions prior to August 1, 2007: the capital expenditure report 
40.27 	required under Minnesota Statutes, section 62J.17, has been filed with the commissioner 
40.28 	of health; a timely construction schedule is developed, stipulating dates for beginning, 
40.29 	achieving various stages, and completing construction; and all zoning and building permits 
40.30 	applied for. Beginning January 1, 2013, this paragraph does not apply to any construction 
40.31 	necessary to relocate a radiation therapy machine from a community hospital-owned 
40.32 	radiation therapy facility located in the city of Maplewood to a community hospital 
40.33 	campus in the city of Woodbury within the same health system. This paragraph expires 
40.34 	August 1, 2014.
41.1 	(c) After August 1, 2014, a radiation therapy facility may be constructed only if the 
41.2 	following requirements are met:
41.3 	(1) the entity constructing the radiation therapy facility is controlled by or is under 
41.4 	common control with a hospital licensed under sections 144.50 to 144.56; and
41.5 	(2) the new radiation therapy facility is located at least seven miles from an existing 
41.6 	radiation therapy facility.
41.7 	(d) Any referring physician must provide each patient who is in need of radiation 
41.8 	therapy services with a list of all radiation therapy facilities located within the following 
41.9 	counties: Hennepin, Ramsey, Dakota, Washington, Anoka, Carver, Scott, St. Louis, 
41.10 	Sherburne, Benton, Stearns, Chisago, Isanti, and Wright. Physicians with a financial 
41.11 	interest in any radiation therapy facility must disclose to the patient the existence of the 
41.12 	interest.
41.13 	(e) For purposes of this section, "controlled by" or "under common control with" 
41.14 	means the possession, direct or indirect, of the power to direct or cause the direction of the 
41.15 	policies, operations, or activities of an entity, through the ownership of, or right to vote 
41.16 	or to direct the disposition of shares, membership interests, or ownership interests of 
41.17 	the entity.
41.18 	(f) For purposes of this section, "financial interest in any radiation therapy facility" 
41.19 	means a direct or indirect ownership or investment interest in a radiation therapy facility 
41.20 	or a compensation arrangement with a radiation therapy facility.
41.21 	(g) This section does not apply to the relocation or reconstruction of an existing 
41.22 	radiation therapy facility if:
41.23 	(1) the relocation or reconstruction of the facility remains owned by the same entity;
41.24 	(2) the relocation or reconstruction is located within one mile of the existing facility; 
41.25 	and
41.26 	(3) the period in which the existing facility is closed and the relocated or 
41.27 	reconstructed facility begins providing services does not exceed 12 months.

41.28 	Sec. 13. Minnesota Statutes 2010, section 145.906, is amended to read:
41.29 	145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
41.30 	(a) The commissioner of health shall work with health care facilities, licensed health 
41.31 	and mental health care professionals, the women, infants, and children (WIC) program, 
41.32 	mental health advocates, consumers, and families in the state to develop materials and 
41.33 	information about postpartum depression, including treatment resources, and develop 
41.34 	policies and procedures to comply with this section.
42.1 	(b) Physicians, traditional midwives, and other licensed health care professionals 
42.2 	providing prenatal care to women must have available to women and their families 
42.3 	information about postpartum depression.
42.4 	(c) Hospitals and other health care facilities in the state must provide departing new 
42.5 	mothers and fathers and other family members, as appropriate, with written information 
42.6 	about postpartum depression, including its symptoms, methods of coping with the illness, 
42.7 	and treatment resources.
42.8 	(d) Information about postpartum depression, including its symptoms, potential 
42.9 	impact on families, and treatment resources must be available at WIC sites.

42.10 	Sec. 14. Minnesota Statutes 2010, section 256B.0754, subdivision 2, is amended to 
42.11 	read:
42.12 		Subd. 2.Payment reform. By no later than 12 months after the commissioner of 
42.13 	health publishes the information in section 62U.04, subdivision 3, paragraph (e) 62U.04, 
42.14 	subdivision 3c, paragraph (b), the commissioner of human services shall may use the 
42.15 	information and methods developed under section 62U.04 to establish a payment system 
42.16 	that:
42.17 	(1) rewards high-quality, low-cost providers;
42.18 	(2) creates enrollee incentives to receive care from high-quality, low-cost providers; 
42.19 	and
42.20 	(3) fosters collaboration among providers to reduce cost shifting from one part of 
42.21 	the health continuum to another.

42.22 	Sec. 15. Laws 2011, First Special Session chapter 9, article 10, section 4, subdivision 
42.23 	2, is amended to read:

42.24
42.25	Subd. 2.Community and Family Health 
Promotion

42.26	Appropriations by Fund
	
42.27	General
	45,577,000
	46,030,000
	
42.28
42.29	State Government 
Special Revenue
	1,033,000
	1,033,000
	
42.30	Health Care Access
	16,719,000
	1,719,000
	
42.31	Federal TANF
	11,713,000
	11,713,000
	
42.32 	TANF Appropriations. (1) $1,156,000 of 
42.33 	the TANF funds is appropriated each year of 
42.34 	the biennium to the commissioner for family 
43.1 	planning grants under Minnesota Statutes, 
43.2 	section 145.925.
43.3 	(2) $3,579,000 of the TANF funds is 
43.4 	appropriated each year of the biennium to 
43.5 	the commissioner for home visiting and 
43.6 	nutritional services listed under Minnesota 
43.7 	Statutes, section 145.882, subdivision 7, 
43.8 	clauses (6) and (7). Funds must be distributed 
43.9 	to community health boards according to 
43.10 	Minnesota Statutes, section 145A.131, 
43.11 	subdivision 1.
43.12 	(3) $2,000,000 of the TANF funds is 
43.13 	appropriated each year of the biennium to 
43.14 	the commissioner for decreasing racial and 
43.15 	ethnic disparities in infant mortality rates 
43.16 	under Minnesota Statutes, section 145.928, 
43.17 	subdivision 7.
43.18 	(4) $4,978,000 of the TANF funds is 
43.19 	appropriated each year of the biennium to the 
43.20 	commissioner for the family home visiting 
43.21 	grant program according to Minnesota 
43.22 	Statutes, section 145A.17. $4,000,000 of the 
43.23 	funding must be distributed to community 
43.24 	health boards according to Minnesota 
43.25 	Statutes, section 145A.131, subdivision 1. 
43.26 	$978,000 of the funding must be distributed 
43.27 	to tribal governments based on Minnesota 
43.28 	Statutes, section 145A.14, subdivision 2a.
43.29 	(5) The commissioner may use up to 6.23 
43.30 	percent of the funds appropriated each fiscal 
43.31 	year to conduct the ongoing evaluations 
43.32 	required under Minnesota Statutes, section 
43.33 	145A.17, subdivision 7, and training and 
43.34 	technical assistance as required under 
44.1 	Minnesota Statutes, section 145A.17, 
44.2 	subdivisions 4 and 5.
44.3 	TANF Carryforward. Any unexpended 
44.4 	balance of the TANF appropriation in the 
44.5 	first year of the biennium does not cancel but 
44.6 	is available for the second year.
44.7 	Statewide Health Improvement Program.
44.8 	(a) $15,000,000 in the biennium ending June 
44.9 	30, 2013, is appropriated from the health 
44.10 	care access fund for the statewide health 
44.11 	improvement program and is available until 
44.12 	expended. Notwithstanding Minnesota 
44.13 	Statutes, sections 144.396, and 145.928, the 
44.14 	commissioner may use tobacco prevention 
44.15 	grant funding and grant funding under 
44.16 	Minnesota Statutes, section 145.928, to 
44.17 	support the statewide health improvement 
44.18 	program. The commissioner may focus the 
44.19 	program geographically or on a specific 
44.20 	goal of tobacco use reduction or on 
44.21 	reducing obesity. By February 15, 2013, the 
44.22 	commissioner shall report to the chairs of 
44.23 	the health and human services committee 
44.24 	on progress toward meeting the goals of the 
44.25 	program as outlined in Minnesota Statutes, 
44.26 	section 145.986, and estimate the dollar 
44.27 	value of the reduced health care costs for 
44.28 	both public and private payers.
44.29 	(b) By February 15, 2012, the commissioner 
44.30 	shall develop a plan to implement 
44.31 	evidence-based strategies from the statewide 
44.32 	health improvement program as part of 
44.33 	hospital community benefit programs 
44.34 	and health maintenance organizations 
44.35 	collaboration plans. The implementation 
45.1 	plan shall include an advisory board 
45.2 	to determine priority needs for health 
45.3 	improvement in reducing obesity and 
45.4 	tobacco use in Minnesota and to review 
45.5 	and approve hospital community benefit 
45.6 	activities reported under Minnesota Statutes, 
45.7 	section 144.699, and health maintenance 
45.8 	organizations collaboration plans in 
45.9 	Minnesota Statutes, section 62Q.075. The 
45.10 	commissioner shall consult with hospital 
45.11 	and health maintenance organizations in 
45.12 	creating and implementing the plan. The 
45.13 	plan described in this paragraph shall be 
45.14 	implemented by July 1, 2012.
45.15 	(c) The commissioners of Minnesota 
45.16 	management and budget, human services, 
45.17 	and health shall include in each forecast 
45.18 	beginning February of 2013 a report that 
45.19 	identifies an estimated dollar value of the 
45.20 	health care savings in the state health care 
45.21 	programs that are directly attributable to the 
45.22 	strategies funded from the statewide health 
45.23 	improvement program. The report shall 
45.24 	include a description of methodologies and 
45.25 	assumptions used to calculate the estimate.
45.26 	Funding Usage. Up to 75 percent of the 
45.27 	fiscal year 2012 appropriation for local public 
45.28 	health grants may be used to fund calendar 
45.29 	year 2011 allocations for this program and 
45.30 	up to 75 percent of the fiscal year 2013 
45.31 	appropriation may be used for calendar year 
45.32 	2012 allocations. The fiscal year 2014 base 
45.33 	shall be increased by $5,193,000.
46.1 	Base Level Adjustment. The general fund 
46.2 	base is increased by $5,188,000 in fiscal year 
46.3 	2014 and decreased by $5,000 in 2015.

46.4 	Sec. 16. STUDY OF RADIATION THERAPY FACILITIES CAPACITY.
 46.5 	(a) To the extent of available appropriations, the commissioner of health shall 
46.6 	conduct a study of the following: (1) current treatment capacity of the existing radiation 
46.7 	therapy facilities within the state; (2) the present need for radiation therapy services based 
46.8 	on population demographics and new cancer cases; and (3) the projected need in the next 
46.9 	ten years for radiation therapy services and whether the current facilities can sustain 
46.10 	this projected need.
46.11 	(b) The commissioner may contract with a qualified entity to conduct the study. The 
46.12 	study shall be completed by March 15, 2013, and the results shall be submitted to the 
46.13 	chairs and ranking minority members of the health and human services committees of 
46.14 	the legislature.

46.15 	Sec. 17. REVISOR'S INSTRUCTION.
 46.16 	The revisor of statutes shall change the terms "commissioner of health" or similar 
46.17 	term to "commissioner of commerce" or similar term and "department of health" or similar 
46.18 	term to "department of commerce" or similar term wherever necessary in Minnesota 
46.19 	Statutes, chapters 62A to 62U, and other relevant statutes as needed to signify the transfer 
46.20 	of regulatory jurisdiction of health maintenance organizations from the commissioner of 
46.21 	health to the commissioner of commerce.

46.22 	Sec. 18. EFFECTIVE DATE.
 46.23 	Sections 5 to 10 and 14 are effective July 1, 2012, and apply to all information 
46.24 	provided or released to the public or to health care providers, pursuant to Minnesota 
46.25 	Statutes, section 62U.04, on or after that date. Section 7 shall be implemented by the 
46.26 	commissioner of health within available resources.

46.27 	ARTICLE 3
46.28 	CHILDREN AND FAMILY SERVICES

46.29 	Section 1. Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is 
46.30 	amended to read:
46.31 		Subd. 7.Absent days. (a) Licensed child care providers and license-exempt centers 
46.32 	must not be reimbursed for more than ten full-day absent days per child, excluding 
47.1 	holidays, in a fiscal year. Legal nonlicensed family child care providers must not be 
47.2 	reimbursed for absent days. If a child attends for part of the time authorized to be in care in 
47.3 	a day, but is absent for part of the time authorized to be in care in that same day, the absent 
47.4 	time must be reimbursed but the time must not count toward the ten absent day limit. 
47.5 	Child care providers must only be reimbursed for absent days if the provider has a written 
47.6 	policy for child absences and charges all other families in care for similar absences.
47.7 	(b)  Notwithstanding paragraph (a), children in families may exceed the ten absent 
47.8 	days limit if at least one parent is: (1) under the age of 21; (2) does not have a high school 
47.9 	or general equivalency diploma; and (3) is a student in a school district or another similar 
47.10 	program that provides or arranges for child care, parenting support, social services, career 
47.11 	and employment supports, and academic support to achieve high school graduation, upon 
47.12 	request of the program and approval of the county. If a child attends part of an authorized 
47.13 	day, payment to the provider must be for the full amount of care authorized for that day.
47.14 	(b)(c) Child care providers must be reimbursed for up to ten federal or state 
47.15 	holidays or designated holidays per year when the provider charges all families for these 
47.16 	days and the holiday or designated holiday falls on a day when the child is authorized to 
47.17 	be in attendance. Parents may substitute other cultural or religious holidays for the ten 
47.18 	recognized state and federal holidays. Holidays do not count toward the ten absent day 
47.19 	limit.
47.20 	(c)(d) A family or child care provider must not be assessed an overpayment for an 
47.21 	absent day payment unless (1) there was an error in the amount of care authorized for the 
47.22 	family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 
47.23 	the family or provider did not timely report a change as required under law.
47.24 	(d)(e) The provider and family shall receive notification of the number of absent 
47.25 	days used upon initial provider authorization for a family and ongoing notification of the 
47.26 	number of absent days used as of the date of the notification.

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

47.28 	Sec. 2. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
47.29 	to read:
47.30 		Subd. 18d.Drug convictions. (a) The state court administrator shall provide a 
47.31 	report every six months by electronic means to the commissioner of human services, 
47.32 	including the name, address, date of birth, and, if available, driver's license or state 
47.33 	identification card number, date of sentence, effective date of the sentence, and county in 
47.34 	which the conviction occurred of each person convicted of a felony under chapter 152 
47.35 	during the previous six months.
48.1 	(b) The commissioner shall determine whether the individuals who are the subject of 
48.2 	the data reported under paragraph (a) are receiving public assistance under chapter 256D 
48.3 	or 256J, and if the individual is receiving assistance under chapter 256D or 256J, the 
48.4 	commissioner shall instruct the county to proceed under section 256D.024 or 256J.26, 
48.5 	whichever is applicable, for this individual.
48.6 	(c) The commissioner shall not retain any data received under paragraph (a) or (d) 
48.7 	that does not relate to an individual receiving publicly funded assistance under chapter 
48.8 	256D or 256J.
48.9 	(d) In addition to the routine data transfer under paragraph (a), the state court 
48.10 	administrator shall provide a onetime report of the data fields under paragraph (a) for 
48.11 	individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until 
48.12 	the date of the data transfer. The commissioner shall perform the tasks identified under 
48.13 	paragraph (b) related to this data and shall retain the data according to paragraph (c).

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

48.15 	Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
48.16 	to read:
48.17 		Subd. 18e.Data sharing with the Department of Human Services; multiple 
48.18 	identification cards. (a) The commissioner of public safety shall, on a monthly basis, 
48.19 	provide the commissioner of human services with the first, middle, and last name, 
48.20 	the address, date of birth, and driver's license or state identification card number of all 
48.21 	applicants and holders whose drivers' licenses and state identification cards have been 
48.22 	canceled under section 171.14, paragraph (a), clauses (2) or (3), by the commissioner of 
48.23 	public safety. After the initial data report has been provided by the commissioner of 
48.24 	public safety to the commissioner of human services under this paragraph, subsequent 
48.25 	reports shall only include cancellations that occurred after the end date of the cancellations 
48.26 	represented in the previous data report.
48.27 	(b) The commissioner of human services shall compare the information provided 
48.28 	under paragraph (a) with the commissioner's data regarding recipients of all public 
48.29 	assistance programs managed by the Department of Human Services to determine whether 
48.30 	any person with multiple identification cards issued by the Department of Public Safety 
48.31 	has illegally or improperly enrolled in any public assistance program managed by the 
48.32 	Department of Human Services.
48.33 	(c) If the commissioner of human services determines that an applicant or recipient 
48.34 	has illegally or improperly enrolled in any public assistance program, the commissioner 
49.1 	shall provide all due process protections to the individual before terminating the individual 
49.2 	from the program according to applicable statute and notifying the county attorney.

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

49.4 	Sec. 4. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision 
49.5 	to read:
49.6 		Subd. 18f.Data sharing with the Department of Human Services; legal presence 
49.7 	status. (a) The commissioner of public safety shall, on a monthly basis, provide the 
49.8 	commissioner of human services with the first, middle, and last name, address, date of 
49.9 	birth, and driver's license or state identification number of all applicants and holders of 
49.10 	drivers' licenses and state identification cards whose temporary legal presence status has 
49.11 	expired and whose driver's license or identification card has been canceled under section 
49.12 	171.14 by the commissioner of public safety.
49.13 	(b) The commissioner of human services shall use the information provided under 
49.14 	paragraph (a) to determine whether the eligibility of any recipients of public assistance 
49.15 	programs managed by the Department of Human Services has changed as a result of the 
49.16 	status change in the Department of Public Safety data.
49.17 	(c) If the commissioner of human services determines that a recipient has illegally or 
49.18 	improperly received benefits from any public assistance program, the commissioner shall 
49.19 	provide all due process protections to the individual before terminating the individual from 
49.20 	the program according to applicable statute and notifying the county attorney.

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

49.22 	Sec. 5. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is 
49.23 	amended to read:
49.24 		Subdivision 1.Electronic benefit transfer (EBT) card. Cash benefits for the 
49.25 	general assistance and Minnesota supplemental aid programs under chapter 256D and 
49.26 	programs under chapter 256J must be issued on a separate an EBT card with the name of 
49.27 	the head of household printed on the card. The card must include the following statement: 
49.28 	"It is unlawful to use this card to purchase tobacco products or alcoholic beverages." This 
49.29 	card must be issued within 30 calendar days of an eligibility determination. During the 
49.30 	initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT 
49.31 	card without a name printed on the card. This card may be the same card on which food 
49.32 	support benefits are issued and does not need to meet the requirements of this section.

50.1 	Sec. 6. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:
50.2 		Subd. 1b.Earned income savings account. In addition to the $50 disregard 
50.3 	required under subdivision 1, the county agency shall disregard an additional earned 
50.4 	income up to a maximum of $150 $500 per month for: (1) persons residing in facilities 
50.5 	licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to 
50.6 	9530.4000, and for whom discharge and work are part of a treatment plan; (2) persons 
50.7 	living in supervised apartments with services funded under Minnesota Rules, parts 
50.8 	9535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan; 
50.9 	and (3) persons residing in group residential housing, as that term is defined in section 
50.10 	256I.03, subdivision 3, for whom the county agency has approved a discharge plan 
50.11 	which includes work. The additional amount disregarded must be placed in a separate 
50.12 	savings account by the eligible individual, to be used upon discharge from the residential 
50.13 	facility into the community. For individuals residing in a chemical dependency program 
50.14 	licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from 
50.15 	the savings account require the signature of the individual and for those individuals with 
50.16 	an authorized representative payee, the signature of the payee. A maximum of $1,000
50.17 	$2,000, including interest, of the money in the savings account must be excluded from 
50.18 	the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in 
50.19 	that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If 
50.20 	excluded money is removed from the savings account by the eligible individual at any 
50.21 	time before the individual is discharged from the facility into the community, the money is 
50.22 	income to the individual in the month of receipt and a resource in subsequent months. If 
50.23 	an eligible individual moves from a community facility to an inpatient hospital setting, 
50.24 	the separate savings account is an excluded asset for up to 18 months. During that time, 
50.25 	amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to 
50.26 	the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the 
50.27 	18-month period, the entire account must be applied to the patient's cost of care.

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

50.29 	Sec. 7. Minnesota Statutes 2010, section 626.556, is amended by adding a subdivision 
50.30 	to read:
50.31 		Subd. 10n.Required referral to early intervention services. A child under 
50.32 	age three who is involved in a substantiated case of maltreatment shall be referred for 
50.33 	screening under the Individuals with Disabilities Education Act, part C. Parents must be 
50.34 	informed that the evaluation and acceptance of services are voluntary. The commissioner 
50.35 	of human services shall monitor referral rates by county and annually report the 
51.1 	information to the legislature beginning March 15, 2014. Refusal to have a child screened 
51.2 	is not a basis for a child in need of protection or services petition under chapter 260C.

51.3 	Sec. 8. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 1, 
51.4 	is amended to read:

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

51.6	Appropriations by Fund
	
51.7		2012
	2013
	
51.8	General
	5,657,737,000
	5,584,471,000
	
51.951.10
	State Government 
Special Revenue
	3,565,000
	3,565,000
	
51.11	Health Care Access
	330,435,000
	353,283,000
	
51.12	Federal TANF
	265,378,000
	268,101,000
	
51.13	Lottery Prize
	1,665,000
	1,665,000
	
51.14	Special Revenue
	500,000
	1,000,000
	
51.15 	Receipts for Systems Projects. 
51.16 	Appropriations and federal receipts for 
51.17 	information systems projects for MAXIS, 
51.18 	PRISM, MMIS, and SSIS must be deposited 
51.19 	in the state systems account authorized in 
51.20 	Minnesota Statutes, section 256.014. Money 
51.21 	appropriated for computer projects approved 
51.22 	by the Minnesota Office of Enterprise 
51.23 	Technology, funded by the legislature, 
51.24 	and approved by the commissioner 
51.25 	of management and budget, may be 
51.26 	transferred from one project to another 
51.27 	and from development to operations as the 
51.28 	commissioner of human services considers 
51.29 	necessary. Any unexpended balance in 
51.30 	the appropriation for these projects does 
51.31 	not cancel but is available for ongoing 
51.32 	development and operations.
51.33 	Nonfederal Share Transfers. The 
51.34 	nonfederal share of activities for which 
51.35 	federal administrative reimbursement is 
52.1 	appropriated to the commissioner may be 
52.2 	transferred to the special revenue fund.
52.3 	TANF Maintenance of Effort.
52.4 	(a) In order to meet the basic maintenance 
52.5 	of effort (MOE) requirements of the TANF 
52.6 	block grant specified under Code of Federal 
52.7 	Regulations, title 45, section 263.1, the 
52.8 	commissioner may only report nonfederal 
52.9 	money expended for allowable activities 
52.10 	listed in the following clauses as TANF/MOE 
52.11 	expenditures:
52.12 	(1) MFIP cash, diversionary work program, 
52.13 	and food assistance benefits under Minnesota 
52.14 	Statutes, chapter 256J;
52.15 	(2) the child care assistance programs 
52.16 	under Minnesota Statutes, sections 119B.03
52.17 	and 119B.05, and county child care 
52.18 	administrative costs under Minnesota 
52.19 	Statutes, section 119B.15;
52.20 	(3) state and county MFIP administrative 
52.21 	costs under Minnesota Statutes, chapters 
52.22 	256J and 256K;
52.23 	(4) state, county, and tribal MFIP 
52.24 	employment services under Minnesota 
52.25 	Statutes, chapters 256J and 256K;
52.26 	(5) expenditures made on behalf of legal 
52.27 	noncitizen MFIP recipients who qualify for 
52.28 	the MinnesotaCare program under Minnesota 
52.29 	Statutes, chapter 256L;
52.30 	(6) qualifying working family credit 
52.31 	expenditures under Minnesota Statutes, 
52.32 	section 290.0671; and
53.1 	(7) qualifying Minnesota education credit 
53.2 	expenditures under Minnesota Statutes, 
53.3 	section 290.0674.
53.4 	(b) The commissioner shall ensure that 
53.5 	sufficient qualified nonfederal expenditures 
53.6 	are made each year to meet the state's 
53.7 	TANF/MOE requirements. For the activities 
53.8 	listed in paragraph (a), clauses (2) to 
53.9 	(7), the commissioner may only report 
53.10 	expenditures that are excluded from the 
53.11 	definition of assistance under Code of 
53.12 	Federal Regulations, title 45, section 260.31.
53.13 	(c) For fiscal years beginning with state fiscal 
53.14 	year 2003, the commissioner shall assure 
53.15 	that the maintenance of effort used by the 
53.16 	commissioner of management and budget 
53.17 	for the February and November forecasts 
53.18 	required under Minnesota Statutes, section 
53.19 	16A.103, contains expenditures under 
53.20 	paragraph (a), clause (1), equal to at least 16 
53.21 	percent of the total required under Code of 
53.22 	Federal Regulations, title 45, section 263.1.
53.23 	(d) Minnesota Statutes, section 256.011, 
53.24 	subdivision 3, which requires that federal 
53.25 	grants or aids secured or obtained under that 
53.26 	subdivision be used to reduce any direct 
53.27 	appropriations provided by law, do not apply 
53.28 	if the grants or aids are federal TANF funds.
53.29 	(e) For the federal fiscal years beginning on 
53.30 	or after October 1, 2007, the commissioner 
53.31 	may not claim an amount of TANF/MOE in 
53.32 	excess of the 75 percent standard in Code 
53.33 	of Federal Regulations, title 45, section 
53.34 	263.1(a)(2), except:
54.1 	(1) to the extent necessary to meet the 80 
54.2 	percent standard under Code of Federal 
54.3 	Regulations, title 45, section 263.1(a)(1), 
54.4 	if it is determined by the commissioner 
54.5 	that the state will not meet the TANF work 
54.6 	participation target rate for the current year; 
54.7 	(2) to provide any additional amounts 
54.8 	under Code of Federal Regulations, title 45, 
54.9 	section 264.5, that relate to replacement of 
54.10 	TANF funds due to the operation of TANF 
54.11 	penalties; and
54.12 	(3) to provide any additional amounts that 
54.13 	may contribute to avoiding or reducing 
54.14 	TANF work participation penalties through 
54.15 	the operation of the excess MOE provisions 
54.16 	of Code of Federal Regulations, title 45, 
54.17 	section 261.43 (a)(2). 
54.18 	For the purposes of clauses (1) to (3), 
54.19 	the commissioner may supplement the 
54.20 	MOE claim with working family credit 
54.21 	expenditures or other qualified expenditures 
54.22 	to the extent such expenditures are otherwise 
54.23 	available after considering the expenditures 
54.24 	allowed in this subdivision. 
54.25 	(f) Notwithstanding any contrary provision 
54.26 	in this article, paragraphs (a) to (e) expire 
54.27 	June 30, 2015.
54.28 	Working Family Credit Expenditures 
54.29 	as TANF/MOE. The commissioner may 
54.30 	claim as TANF maintenance of effort up to 
54.31 	$6,707,000 per year of working family credit 
54.32 	expenditures for fiscal years 2012 and 2013.
54.33 	Working Family Credit Expenditures 
54.34 	to be Claimed for TANF/MOE. The 
54.35 	commissioner may count the following 
55.1 	amounts of working family credit 
55.2 	expenditures as TANF/MOE:
55.3 	(1) fiscal year 2012, $23,692,000
55.4 	$23,761,000;
55.5 	(2) fiscal year 2013, $44,969,000
55.6 	$48,738,000;
55.7 	(3) fiscal year 2014, $32,579,000
55.8 	$32,665,000; and
55.9 	(4) fiscal year 2015, $32,476,000
55.10 	$32,590,000.
55.11 	Notwithstanding any contrary provision in 
55.12 	this article, this rider expires June 30, 2015.
55.13 	TANF Transfer to Federal Child Care 
55.14 	and Development Fund. (a) The following 
55.15 	TANF fund amounts are appropriated 
55.16 	to the commissioner for purposes of 
55.17 	MFIP/Transition Year Child Care Assistance 
55.18 	under Minnesota Statutes, section 119B.05:
55.19 	(1) fiscal year 2012, $10,020,000;
55.20 	(2) fiscal year 2013, $28,020,000;
55.21 	(3) fiscal year 2014, $14,020,000; and
55.22 	(4) fiscal year 2015, $14,020,000.
55.23 	(b) The commissioner shall authorize the 
55.24 	transfer of sufficient TANF funds to the 
55.25 	federal child care and development fund to 
55.26 	meet this appropriation and shall ensure that 
55.27 	all transferred funds are expended according 
55.28 	to federal child care and development fund 
55.29 	regulations.
55.30 	Food Stamps Employment and Training 
55.31 	Funds. (a) Notwithstanding Minnesota 
55.32 	Statutes, sections 256D.051, subdivisions 1a, 
55.33 	6b, and 6c, and 256J.626, federal food stamps 
56.1 	employment and training funds received 
56.2 	as reimbursement for child care assistance 
56.3 	program expenditures must be deposited in 
56.4 	the general fund. The amount of funds must 
56.5 	be limited to $500,000 per year in fiscal 
56.6 	years 2012 through 2015, contingent upon 
56.7 	approval by the federal Food and Nutrition 
56.8 	Service.
56.9 	(b) Consistent with the receipt of these 
56.10 	federal funds, the commissioner may 
56.11 	adjust the level of working family credit 
56.12 	expenditures claimed as TANF maintenance 
56.13 	of effort. Notwithstanding any contrary 
56.14 	provision in this article, this rider expires 
56.15 	June 30, 2015.
56.16 	ARRA Food Support Benefit Increases. 
56.17 	The funds provided for food support benefit 
56.18 	increases under the Supplemental Nutrition 
56.19 	Assistance Program provisions of the 
56.20 	American Recovery and Reinvestment Act 
56.21 	(ARRA) of 2009 must be used for benefit 
56.22 	increases beginning July 1, 2009.
56.23 	Supplemental Security Interim Assistance 
56.24 	Reimbursement Funds. $2,800,000 of 
56.25 	uncommitted revenue available to the 
56.26 	commissioner of human services for SSI 
56.27 	advocacy and outreach services must be 
56.28 	transferred to and deposited into the general 
56.29 	fund by October 1, 2011.

56.30 	Sec. 9. DIRECTIONS TO THE COMMISSIONER.
 56.31 	The commissioner of human services, in consultation with the commissioner of 
56.32 	public safety, shall report to the chairs and ranking minority members of the legislative 
56.33 	committees with jurisdiction over health and human services policy and finance regarding 
57.1 	the implementation of Minnesota Statutes, section 256.01, subdivisions 18d, 18e, and 18f, 
57.2 	the number of persons affected, and fiscal impact by program by April 1, 2013.

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

57.4 	ARTICLE 4
57.5 	CONTINUING CARE

57.6 	Section 1. Minnesota Statutes 2010, section 62J.496, subdivision 2, is amended to read:
57.7 		Subd. 2.Eligibility. (a) "Eligible borrower" means one of the following:
57.8 	(1) federally qualified health centers;
57.9 	(2) community clinics, as defined under section 145.9268;
57.10 	(3) nonprofit or local unit of government hospitals licensed under sections 144.50 
57.11 	to 144.56;
57.12 	(4) individual or small group physician practices that are focused primarily on 
57.13 	primary care;
57.14 	(5) nursing facilities licensed under sections 144A.01 to 144A.27;
57.15 	(6) local public health departments as defined in chapter 145A; and
57.16 	(7) other providers of health or health care services approved by the commissioner 
57.17 	for which interoperable electronic health record capability would improve quality of 
57.18 	care, patient safety, or community health.
57.19 	(b) The commissioner shall administer the loan fund to prioritize support and 
57.20 	assistance to:
57.21 	(1) critical access hospitals;
57.22 	(2) federally qualified health centers;
57.23 	(3) entities that serve uninsured, underinsured, and medically underserved 
57.24 	individuals, regardless of whether such area is urban or rural; and
57.25 	(4) individual or small group practices that are primarily focused on primary care;
57.26 	(5) nursing facilities certified to participate in the medical assistance program; and
57.27 	(6) providers enrolled in the elderly waiver program of customized living or 24-hour 
57.28 	customized living of the medical assistance program, if at least half of their annual 
57.29 	operating revenue is paid under that medical assistance program.
57.30 	(c) An eligible applicant must submit a loan application to the commissioner of 
57.31 	health on forms prescribed by the commissioner. The application must include, at a 
57.32 	minimum:
57.33 	(1) the amount of the loan requested and a description of the purpose or project 
57.34 	for which the loan proceeds will be used;
58.1 	(2) a quote from a vendor;
58.2 	(3) a description of the health care entities and other groups participating in the 
58.3 	project;
58.4 	(4) evidence of financial stability and a demonstrated ability to repay the loan; and
58.5 	(5) a description of how the system to be financed interoperates or plans in the 
58.6 	future to interoperate with other health care entities and provider groups located in the 
58.7 	same geographical area;
58.8 	(6) a plan on how the certified electronic health record technology will be maintained 
58.9 	and supported over time; and
58.10 	(7) any other requirements for applications included or developed pursuant to 
58.11 	section 3014 of the HITECH Act.

58.12 	Sec. 2. Minnesota Statutes 2010, section 144A.073, is amended by adding a 
58.13 	subdivision to read:
58.14 		Subd. 13.Moratorium exception funding. In fiscal year 2013, the commissioner 
58.15 	of health may approve moratorium exception projects under this section for which the full 
58.16 	annualized state share of medical assistance costs does not exceed $1,000,000.

58.17 	Sec. 3. Minnesota Statutes 2010, section 144A.351, is amended to read:
58.18 	144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: 
58.19 	REPORT REQUIRED.
58.20 	The commissioners of health and human services, with the cooperation of counties 
58.21 	andstakeholders, including persons who need or are using long-term care services and 
58.22 	supports; lead agencies; regional entities,;senior, mental health, and disability organization 
58.23 	representatives; services providers; and community members, including representatives of 
58.24 	local business and faith communities shall prepare a report to the legislature by August 15, 
58.25 	2004 2013, and biennially thereafter, regarding the status of the full range of long-term 
58.26 	care services and supports for the elderly and children and adults with disabilities and 
58.27 	mental illnesses in Minnesota. The report shall address:
58.28 	(1) demographics and need for long-term care services and supports in Minnesota;
58.29 	(2) summary of county and regional reports on long-term care gaps, surpluses, 
58.30 	imbalances, and corrective action plans;
58.31 	(3) status of long-term care services by county and region including:
58.32 	(i) changes in availability of the range of long-term care services and housing 
58.33 	options;
58.34 	(ii) access problems regarding long-term care services; and
59.1 	(iii) comparative measures of long-term care services availability and progress
59.2 	changes over time; and
59.3 	(4) recommendations regarding goals for the future of long-term care services, 
59.4 	policy  and fiscal changes, and resource needs.

59.5 	Sec. 4. Minnesota Statutes 2010, section 245A.03, is amended by adding a subdivision 
59.6 	to read:
59.7 		Subd. 6a.Adult foster care homes serving people with mental illness; 
59.8 	certification. (a) The commissioner of human services shall issue a mental health 
59.9 	certification for adult foster care homes licensed under this chapter and Minnesota Rules, 
59.10 	parts 9555.5105 to 9555.6265, that serve people with mental illness where the home is not 
59.11 	the primary residence of the license holder when a provider is determined to have met 
59.12 	the requirements under paragraph (b). This certification is voluntary for license holders. 
59.13 	The certification shall be printed on the license, and identified on the commissioner's 
59.14 	public Web site.
59.15 	(b) The requirements for certification are:
59.16 	(1) all staff working in the adult foster care home have received at least seven hours 
59.17 	of annual training covering all of the following topics:
59.18 	(i) mental health diagnoses;
59.19 	(ii) mental health crisis response and de-escalation techniques;
59.20 	(iii) recovery from mental illness;
59.21 	(iv) treatment options including evidence-based practices;
59.22 	(v) medications and their side effects;
59.23 	(vi) co-occurring substance abuse and health conditions; and
59.24 	(vii) community resources;
59.25 	(2) a mental health professional, as defined in section 245.462, subdivision 18, or 
59.26 	a mental health practitioner as defined in section 245.462, subdivision 17, are available 
59.27 	for consultation and assistance;
59.28 	(3) there is a plan and protocol in place to address a mental health crisis; and
59.29 	(4) each individual's Individual Placement Agreement identifies who is providing 
59.30 	clinical services and their contact information, and includes an individual crisis prevention 
59.31 	and management plan developed with the individual.
59.32 	(c) License holders seeking certification under this subdivision must request this 
59.33 	certification on forms provided by the commissioner and must submit the request to the 
59.34 	county licensing agency in which the home is located. The county licensing agency must 
60.1 	forward the request to the commissioner with a county recommendation regarding whether 
60.2 	the commissioner should issue the certification.
60.3 	(d) Ongoing compliance with the certification requirements under paragraph (b) 
60.4 	shall be reviewed by the county licensing agency at each licensing review. When a county 
60.5 	licensing agency determines that the requirements of paragraph (b) are not met, the county 
60.6 	shall inform the commissioner, and the commissioner will remove the certification.
60.7 	(e) A denial of the certification or the removal of the certification based on a 
60.8 	determination that the requirements under paragraph (b) have not been met by the adult 
60.9 	foster care license holder are not subject to appeal. A license holder that has been denied a 
60.10 	certification or that has had a certification removed may again request certification when 
60.11 	the license holder is in compliance with the requirements of paragraph (b).

60.12 	Sec. 5. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is 
60.13 	amended to read:
60.14 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an 
60.15 	initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 
60.16 	2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 
60.17 	9555.6265, under this chapter for a physical location that will not be the primary residence 
60.18 	of the license holder for the entire period of licensure. If a license is issued during this 
60.19 	moratorium, and the license holder changes the license holder's primary residence away 
60.20 	from the physical location of the foster care license, the commissioner shall revoke the 
60.21 	license according to section 245A.07. Exceptions to the moratorium include:
60.22 	(1) foster care settings that are required to be registered under chapter 144D;
60.23 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, 
60.24 	and determined to be needed by the commissioner under paragraph (b);
60.25 	(3) new foster care licenses determined to be needed by the commissioner under 
60.26 	paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or 
60.27 	restructuring of state-operated services that limits the capacity of state-operated facilities;
60.28 	(4) new foster care licenses determined to be needed by the commissioner under 
60.29 	paragraph (b) for persons requiring hospital level care; or
60.30 	(5) new foster care licenses determined to be needed by the commissioner for the 
60.31 	transition of people from personal care assistance to the home and community-based 
60.32 	services.
60.33 	(b) The commissioner shall determine the need for newly licensed foster care homes 
60.34 	as defined under this subdivision. As part of the determination, the commissioner shall 
60.35 	consider the availability of foster care capacity in the area in which the licensee seeks to 
61.1 	operate, and the recommendation of the local county board. The determination by the 
61.2 	commissioner must be final. A determination of need is not required for a change in 
61.3 	ownership at the same address.
61.4 	(c) Residential settings that would otherwise be subject to the moratorium established 
61.5 	in paragraph (a), that are in the process of receiving an adult or child foster care license as 
61.6 	of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult 
61.7 	or child foster care license. For this paragraph, all of the following conditions must be met 
61.8 	to be considered in the process of receiving an adult or child foster care license:
61.9 	(1) participants have made decisions to move into the residential setting, including 
61.10 	documentation in each participant's care plan;
61.11 	(2) the provider has purchased housing or has made a financial investment in the 
61.12 	property;
61.13 	(3) the lead agency has approved the plans, including costs for the residential setting 
61.14 	for each individual;
61.15 	(4) the completion of the licensing process, including all necessary inspections, is 
61.16 	the only remaining component prior to being able to provide services; and
61.17 	(5) the needs of the individuals cannot be met within the existing capacity in that 
61.18 	county.
61.19 	To qualify for the process under this paragraph, the lead agency must submit 
61.20 	documentation to the commissioner by August 1, 2009, that all of the above criteria are 
61.21 	met.
61.22 	(d) The commissioner shall study the effects of the license moratorium under this 
61.23 	subdivision and shall report back to the legislature by January 15, 2011. This study shall 
61.24 	include, but is not limited to the following:
61.25 	(1) the overall capacity and utilization of foster care beds where the physical location 
61.26 	is not the primary residence of the license holder prior to and after implementation 
61.27 	of the moratorium;
61.28 	(2) the overall capacity and utilization of foster care beds where the physical 
61.29 	location is the primary residence of the license holder prior to and after implementation 
61.30 	of the moratorium; and
61.31 	(3) the number of licensed and occupied ICF/MR beds prior to and after 
61.32 	implementation of the moratorium.
61.33 	(e) When a foster care recipient moves out of a foster home that is not the primary 
61.34 	residence of the license holder according to section 256B.49, subdivision 15, paragraph 
61.35 	(f), the county shall immediately inform the Department of Human Services Licensing 
61.36 	Division, and. The department shall immediately decrease the licensed capacity for the 
62.1 	home, if the voluntary changes described in paragraph (g) are not sufficient to meet the 
62.2 	savings required by 2011 reductions in licensed bed capacity and maintain statewide 
62.3 	long-term care residential services capacity within budgetary limits. The commissioner 
62.4 	shall delicense up to 128 beds by June 30, 2013, using the needs determination process. 
62.5 	Under this paragraph, the commissioner has the authority to reduce unused licensed 
62.6 	capacity of a current foster care program to accomplish the consolidation or closure of 
62.7 	settings. A decreased licensed capacity according to this paragraph is not subject to appeal 
62.8 	under this chapter.
62.9 	(f) Residential settings that would otherwise be subject to the decreased license 
62.10 	capacity established in paragraph (e) shall be exempt under the following circumstances:
62.11 	(1) until August 1, 2013, the beds of a license holder whose primary diagnosis is 
62.12 	mental illness and the license holder is:
62.13 	(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental 
62.14 	health services (ARMHS) as defined in section 256B.0623;
62.15 	(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 
62.16 	9520.0870;
62.17 	(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 
62.18 	9520.0870; or
62.19 	(iv) a provider of intensive residential treatment services (IRTS) licensed under 
62.20 	Minnesota Rules, parts 9520.0500 to 9520.0670; or
62.21 	(2) the license holder is certified under the requirements in subdivision 6a.
62.22 	(g) A resource need determination process, managed at the state level, using the 
62.23 	available reports required by section 144A.351, and other data and information shall 
62.24 	be used to determine where the reduced capacity required under paragraph (e) will be 
62.25 	implemented. The commissioner shall consult with the stakeholders described in section 
62.26 	144A.351, and employ a variety of methods to improve the state's capacity to meet 
62.27 	long-term care service needs within budgetary limits, including seeking proposals from 
62.28 	service providers or lead agencies to change service type, capacity, or location to improve 
62.29 	services, increase the independence of residents, and better meet needs identified by the 
62.30 	long-term care services reports and statewide data and information. By February 1 of each 
62.31 	year, the commissioner shall provide information and data on the overall capacity of 
62.32 	licensed long-term care services, actions taken under this subdivision to manage statewide 
62.33 	long-term care services and supports resources, and any recommendations for change to 
62.34 	the legislative committees with jurisdiction over health and human services budget.

62.35 	Sec. 6. Minnesota Statutes 2010, section 245A.11, subdivision 2a, is amended to read:
63.1 		Subd. 2a.Adult foster care license capacity. (a) The commissioner shall issue 
63.2 	adult foster care licenses with a maximum licensed capacity of four beds, including 
63.3 	nonstaff roomers and boarders, except that the commissioner may issue a license with a 
63.4 	capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).
63.5 	(b) An adult foster care license holder may have a maximum license capacity of five 
63.6 	if all persons in care are age 55 or over and do not have a serious and persistent mental 
63.7 	illness or a developmental disability.
63.8 	(c) The commissioner may grant variances to paragraph (b) to allow a foster care 
63.9 	provider with a licensed capacity of five persons to admit an individual under the age of 55 
63.10 	if the variance complies with section 245A.04, subdivision 9, and approval of the variance 
63.11 	is recommended by the county in which the licensed foster care provider is located.
63.12 	(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth 
63.13 	bed for emergency crisis services for a person with serious and persistent mental illness 
63.14 	or a developmental disability, regardless of age, if the variance complies with section 
63.15 	245A.04, subdivision 9, and approval of the variance is recommended by the county in 
63.16 	which the licensed foster care provider is located.
63.17 	(e) The commissioner may grant a variance to paragraph (b) to allow for the 
63.18 	use of a fifth bed for respite services, as defined in section 245A.02, for persons with 
63.19 	disabilities, regardless of age, if the variance complies with section 245A.03, subdivision 
63.20 	7, and section 245A.04, subdivision 9, and approval of the variance is recommended by 
63.21 	the county in which the licensed foster care provider is licensed. Respite care may be 
63.22 	provided under the following conditions:
63.23 	(1) staffing ratios cannot be reduced below the approved level for the individuals 
63.24 	being served in the home on a permanent basis;
63.25 	(2) no more than two different individuals can be accepted for respite services in 
63.26 	any calendar month and the total respite days may not exceed 120 days per program in 
63.27 	any calendar year;
63.28 	(3) the person receiving respite services must have his or her own bedroom, which 
63.29 	could be used for alternative purposes when not used as a respite bedroom, and cannot be 
63.30 	the room of another person who lives in the foster care home; and
63.31 	(4) individuals living in the foster care home must be notified when the variance 
63.32 	is approved. The provider must give 60 days' notice in writing to the residents and their 
63.33 	legal representatives prior to accepting the first respite placement. Notice must be given to 
63.34 	residents at least two days prior to service initiation, or as soon as the license holder is 
63.35 	able if they receive notice of the need for respite less than two days prior to initiation, 
64.1 	each time a respite client will be served, unless the requirement for this notice is waived 
64.2 	by the resident or legal guardian.
64.3 	(e) If the 2009 legislature adopts a rate reduction that impacts providers of adult 
64.4 	foster care services, (f)  The commissioner may issue an adult foster care license with a 
64.5 	capacity of five adults if the fifth bed does not increase the overall statewide capacity of 
64.6 	licensed adult foster care beds in homes that are not the primary residence of the license 
64.7 	holder, over the licensed capacity in such homes on July 1, 2009, as identified in a plan 
64.8 	submitted to the commissioner by the county, when the capacity is recommended by 
64.9 	the county licensing agency of the county in which the facility is located and if the 
64.10 	recommendation verifies that:
64.11 	(1) the facility meets the physical environment requirements in the adult foster 
64.12 	care licensing rule;
64.13 	(2) the five-bed living arrangement is specified for each resident in the resident's:
64.14 	(i) individualized plan of care;
64.15 	(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
64.16 	(iii) individual resident placement agreement under Minnesota Rules, part 
64.17 	9555.5105, subpart 19, if required;
64.18 	(3) the license holder obtains written and signed informed consent from each 
64.19 	resident or resident's legal representative documenting the resident's informed choice 
64.20 	to remain living in the home and that the resident's refusal to consent would not have 
64.21 	resulted in service termination; and
64.22 	(4) the facility was licensed for adult foster care before March 1, 2009 2011.
64.23 	(f) (g) The commissioner shall not issue a new adult foster care license under 
64.24 	paragraph (e) (f) after June 30, 2011 2016. The commissioner shall allow a facility with 
64.25 	an adult foster care license issued under paragraph (e) (f) before June 30, 2011 2016, to 
64.26 	continue with a capacity of five adults if the license holder continues to comply with the 
64.27 	requirements in paragraph (e) (f).

64.28 	Sec. 7. Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:
64.29 		Subd. 7.Adult foster care; variance for alternate overnight supervision. (a) The 
64.30 	commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts 
64.31 	requiring a caregiver to be present in an adult foster care home during normal sleeping 
64.32 	hours to allow for alternative methods of overnight supervision. The commissioner may 
64.33 	grant the variance if the local county licensing agency recommends the variance and the 
64.34 	county recommendation includes documentation verifying that:
65.1 	(1) the county has approved the license holder's plan for alternative methods of 
65.2 	providing overnight supervision and determined the plan protects the residents' health, 
65.3 	safety, and rights;
65.4 	(2) the license holder has obtained written and signed informed consent from 
65.5 	each resident or each resident's legal representative documenting the resident's or legal 
65.6 	representative's agreement with the alternative method of overnight supervision; and
65.7 	(3) the alternative method of providing overnight supervision, which may include 
65.8 	the use of technology, is specified for each resident in the resident's: (i) individualized 
65.9 	plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if 
65.10 	required; or (iii) individual resident placement agreement under Minnesota Rules, part 
65.11 	9555.5105, subpart 19, if required.
65.12 	(b) To be eligible for a variance under paragraph (a), the adult foster care license 
65.13 	holder must not have had a licensing action conditional license issued under section 
65.14 	245A.06, or any other licensing sanction issued under section245A.07 during the prior 24 
65.15 	months based on failure to provide adequate supervision, health care services, or resident 
65.16 	safety in the adult foster care home.
65.17 	(c) A license holder requesting a variance under this subdivision to utilize 
65.18 	technology as a component of a plan for alternative overnight supervision may request 
65.19 	the commissioner's review in the absence of a county recommendation. Upon receipt of 
65.20 	such a request from a license holder, the commissioner shall review the variance request 
65.21 	with the county.

65.22 	Sec. 8. Minnesota Statutes 2010, section 245A.11, subdivision 7a, is amended to read:
65.23 		Subd. 7a.Alternate overnight supervision technology; adult foster care license.
 65.24 	(a) The commissioner may grant an applicant or license holder an adult foster care license 
65.25 	for a residence that does not have a caregiver in the residence during normal sleeping 
65.26 	hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses 
65.27 	monitoring technology to alert the license holder when an incident occurs that may 
65.28 	jeopardize the health, safety, or rights of a foster care recipient. The applicant or license 
65.29 	holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 
65.30 	to 9555.6265, and the requirements under this subdivision. The license printed by the 
65.31 	commissioner must state in bold and large font:
65.32 	(1) that the facility is under electronic monitoring; and
65.33 	(2) the telephone number of the county's common entry point for making reports of 
65.34 	suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
66.1 	(b) Applications for a license under this section must be submitted directly to 
66.2 	the Department of Human Services licensing division. The licensing division must 
66.3 	immediately notify the host county and lead county contract agency and the host county 
66.4 	licensing agency. The licensing division must collaborate with the county licensing 
66.5 	agency in the review of the application and the licensing of the program.
66.6 	(c) Before a license is issued by the commissioner, and for the duration of the 
66.7 	license, the applicant or license holder must establish, maintain, and document the 
66.8 	implementation of written policies and procedures addressing the requirements in 
66.9 	paragraphs (d) through (f).
66.10 	(d) The applicant or license holder must have policies and procedures that:
66.11 	(1) establish characteristics of target populations that will be admitted into the home, 
66.12 	and characteristics of populations that will not be accepted into the home;
66.13 	(2) explain the discharge process when a foster care recipient requires overnight 
66.14 	supervision or other services that cannot be provided by the license holder due to the 
66.15 	limited hours that the license holder is on site;
66.16 	(3) describe the types of events to which the program will respond with a physical 
66.17 	presence when those events occur in the home during time when staff are not on site, and 
66.18 	how the license holder's response plan meets the requirements in paragraph (e), clause 
66.19 	(1) or (2);
66.20 	(4) establish a process for documenting a review of the implementation and 
66.21 	effectiveness of the response protocol for the response required under paragraph (e), 
66.22 	clause (1) or (2). The documentation must include:
66.23 	(i) a description of the triggering incident;
66.24 	(ii) the date and time of the triggering incident;
66.25 	(iii) the time of the response or responses under paragraph (e), clause (1) or (2);
66.26 	(iv) whether the response met the resident's needs;
66.27 	(v) whether the existing policies and response protocols were followed; and
66.28 	(vi) whether the existing policies and protocols are adequate or need modification.
66.29 	When no physical presence response is completed for a three-month period, the 
66.30 	license holder's written policies and procedures must require a physical presence response 
66.31 	drill to be conducted for which the effectiveness of the response protocol under paragraph 
66.32 	(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
66.33 	(5) establish that emergency and nonemergency phone numbers are posted in a 
66.34 	prominent location in a common area of the home where they can be easily observed by a 
66.35 	person responding to an incident who is not otherwise affiliated with the home.
67.1 	(e) The license holder must document and include in the license application which 
67.2 	response alternative under clause (1) or (2) is in place for responding to situations that 
67.3 	present a serious risk to the health, safety, or rights of people receiving foster care services 
67.4 	in the home:
67.5 	(1) response alternative (1) requires only the technology to provide an electronic 
67.6 	notification or alert to the license holder that an event is underway that requires a response. 
67.7 	Under this alternative, no more than ten minutes will pass before the license holder will be 
67.8 	physically present on site to respond to the situation; or
67.9 	(2) response alternative (2) requires the electronic notification and alert system 
67.10 	under alternative (1), but more than ten minutes may pass before the license holder is 
67.11 	present on site to respond to the situation. Under alternative (2), all of the following 
67.12 	conditions are met:
67.13 	(i) the license holder has a written description of the interactive technological 
67.14 	applications that will assist the license holder in communicating with and assessing the 
67.15 	needs related to the care, health, and safety of the foster care recipients. This interactive 
67.16 	technology must permit the license holder to remotely assess the well being of the foster 
67.17 	care recipient without requiring the initiation of the foster care recipient. Requiring the 
67.18 	foster care recipient to initiate a telephone call does not meet this requirement;
67.19 	(ii) the license holder documents how the remote license holder is qualified and 
67.20 	capable of meeting the needs of the foster care recipients and assessing foster care 
67.21 	recipients' needs under item (i) during the absence of the license holder on site;
67.22 	(iii) the license holder maintains written procedures to dispatch emergency response 
67.23 	personnel to the site in the event of an identified emergency; and
67.24 	(iv) each foster care recipient's individualized plan of care, individual service plan 
67.25 	under section 256B.092, subdivision 1b, if required, or individual resident placement 
67.26 	agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the 
67.27 	maximum response time, which may be greater than ten minutes, for the license holder 
67.28 	to be on site for that foster care recipient.
67.29 	(f) All Each foster care recipient's placement agreements agreement, individual 
67.30 	service agreements, and plans applicable to the foster care recipient agreement, and plan 
67.31 	must clearly state that the adult foster care license category is a program without the 
67.32 	presence of a caregiver in the residence during normal sleeping hours; the protocols in 
67.33 	place for responding to situations that present a serious risk to the health, safety, or rights 
67.34 	of foster care recipients under paragraph (e), clause (1) or (2); and a signed informed 
67.35 	consent from each foster care recipient or the person's legal representative documenting 
67.36 	the person's or legal representative's agreement with placement in the program. If 
68.1 	electronic monitoring technology is used in the home, the informed consent form must 
68.2 	also explain the following:
68.3 	(1) how any electronic monitoring is incorporated into the alternative supervision 
68.4 	system;
68.5 	(2) the backup system for any electronic monitoring in times of electrical outages or 
68.6 	other equipment malfunctions;
68.7 	(3) how the license holder is caregivers are trained on the use of the technology;
68.8 	(4) the event types and license holder response times established under paragraph (e);
68.9 	(5) how the license holder protects the foster care recipient's privacy related to 
68.10 	electronic monitoring and related to any electronically recorded data generated by the 
68.11 	monitoring system. A foster care recipient may not be removed from a program under 
68.12 	this subdivision for failure to consent to electronic monitoring. The consent form must 
68.13 	explain where and how the electronically recorded data is stored, with whom it will be 
68.14 	shared, and how long it is retained; and
68.15 	(6) the risks and benefits of the alternative overnight supervision system.
68.16 	The written explanations under clauses (1) to (6) may be accomplished through 
68.17 	cross-references to other policies and procedures as long as they are explained to the 
68.18 	person giving consent, and the person giving consent is offered a copy.
68.19 	(g) Nothing in this section requires the applicant or license holder to develop or 
68.20 	maintain separate or duplicative policies, procedures, documentation, consent forms, or 
68.21 	individual plans that may be required for other licensing standards, if the requirements of 
68.22 	this section are incorporated into those documents.
68.23 	(h) The commissioner may grant variances to the requirements of this section 
68.24 	according to section 245A.04, subdivision 9.
68.25 	(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning 
68.26 	under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and 
68.27 	contractors affiliated with the license holder.
68.28 	(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to 
68.29 	remotely determine what action the license holder needs to take to protect the well-being 
68.30 	of the foster care recipient.
68.31 	(k) The commissioner shall evaluate license applications using the requirements 
68.32 	in paragraphs (d) to (f). The commissioner shall provide detailed application forms, 
68.33 	including a checklist of criteria needed for approval.
68.34 	(l) To be eligible for a license under paragraph (a), the adult foster care license holder 
68.35 	must not have had a conditional license issued under section 245A.06 or any licensing 
69.1 	sanction under section 245A.07 during the prior 24 months based on failure to provide 
69.2 	adequate supervision, health care services, or resident safety in the adult foster care home.
69.3 	(m) The commissioner shall review an application for an alternative overnight 
69.4 	supervision license within 60 days of receipt of the application. When the commissioner 
69.5 	receives an application that is incomplete because the applicant failed to submit required 
69.6 	documents or that is substantially deficient because the documents submitted do not meet 
69.7 	licensing requirements, the commissioner shall provide the applicant written notice 
69.8 	that the application is incomplete or substantially deficient. In the written notice to the 
69.9 	applicant, the commissioner shall identify documents that are missing or deficient and 
69.10 	give the applicant 45 days to resubmit a second application that is substantially complete. 
69.11 	An applicant's failure to submit a substantially complete application after receiving 
69.12 	notice from the commissioner is a basis for license denial under section 245A.05. The 
69.13 	commissioner shall complete subsequent review within 30 days.
69.14 	(n) Once the application is considered complete under paragraph (m), the 
69.15 	commissioner will approve or deny an application for an alternative overnight supervision 
69.16 	license within 60 days.
69.17 	(o) For the purposes of this subdivision, "supervision" means:
69.18 	(1) oversight by a caregiver as specified in the individual resident's place agreement 
69.19 	and awareness of the resident's needs and activities; and
69.20 	(2) the presence of a caregiver in a residence during normal sleeping hours, unless a 
69.21 	determination has been made and documented in the individual's support plan that the 
69.22 	individual does not require the presence of a caregiver during normal sleeping hours.

69.23 	Sec. 9. Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:
69.24 		Subdivision 1.Consumer data file. The license holder must maintain the following 
69.25 	information for each consumer:
69.26 	(1) identifying information that includes date of birth, medications, legal 
69.27 	representative, history, medical, and other individual-specific information, and names and 
69.28 	telephone numbers of contacts;
69.29 	(2) consumer health information, including individual medication administration 
69.30 	and monitoring information;
69.31 	(3) the consumer's individual service plan. When a consumer's case manager does 
69.32 	not provide a current individual service plan, the license holder shall make a written 
69.33 	request to the case manager to provide a copy of the individual service plan and inform 
69.34 	the consumer or the consumer's legal representative of the right to an individual service 
69.35 	plan and the right to appeal under section 256.045;. In the event the case manager fails 
70.1 	to provide an individual service plan after a written request from the license holder, the 
70.2 	license holder shall not be sanctioned or penalized financially for not having a current 
70.3 	individual service plan in the consumer's data file;
70.4 	(4) copies of assessments, analyses, summaries, and recommendations;
70.5 	(5) progress review reports;
70.6 	(6) incidents involving the consumer;
70.7 	(7) reports required under section 245B.05, subdivision 7;
70.8 	(8) discharge summary, when applicable;
70.9 	(9) record of other license holders serving the consumer that includes a contact 
70.10 	person and telephone numbers, services being provided, services that require coordination 
70.11 	between two license holders, and name of staff responsible for coordination;
70.12 	(10) information about verbal aggression directed at the consumer by another 
70.13 	consumer; and
70.14 	(11) information about self-abuse.

70.15 	Sec. 10. Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:
70.16 		Subd. 6.Unlicensed home and community-based waiver providers of service to 
70.17 	seniors and individuals with disabilities. (a) Providers required to initiate background 
70.18 	studies under section 256B.4912 must initiate a study before the individual begins in a 
70.19 	position allowing direct contact with persons served by the provider.
70.20 	(b) The commissioner shall conduct Except as provided in paragraph (c), the 
70.21 	providers must initiate a background study annually of an individual required to be studied 
70.22 	under section 245C.03, subdivision 6.
70.23 	(c) After an initial background study under this subdivision is initiated on an 
70.24 	individual by a provider of both services licensed by the commissioner and the unlicensed 
70.25 	services under this subdivision, a repeat annual background study is not required if:
70.26 	(1) the provider maintains compliance with the requirements of section 245C.07, 
70.27 	paragraph (a), regarding one individual with one address and telephone number as the 
70.28 	person to receive sensitive background study information for the multiple programs that 
70.29 	depend on the same background study, and that the individual who is designated to receive 
70.30 	the sensitive background information is capable of determining, upon the request of the 
70.31 	commissioner, whether a background study subject is providing direct contact services 
70.32 	in one or more of the provider's programs or services and, if so, at which location or 
70.33 	locations; and
70.34 	(2) the individual who is the subject of the background study provides direct 
70.35 	contact services under the provider's licensed program for at least 40 hours per year so 
71.1 	the individual will be recognized by a probation officer or corrections agent to prompt 
71.2 	a report to the commissioner regarding criminal convictions as required under section 
71.3 	245C.05, subdivision 7.

71.4 	Sec. 11. Minnesota Statutes 2010, section 245C.05, subdivision 7, is amended to read:
71.5 		Subd. 7.Probation officer and corrections agent. (a) A probation officer or 
71.6 	corrections agent shall notify the commissioner of an individual's conviction if the 
71.7 	individual is:
71.8 	(1) has been affiliated with a program or facility regulated by the Department of 
71.9 	Human Services or Department of Health, a facility serving children or youth licensed by 
71.10 	the Department of Corrections, or any type of home care agency or provider of personal 
71.11 	care assistance services within the preceding year; and
71.12 	(2) has been convicted of a crime constituting a disqualification under section 
71.13 	245C.14.
71.14 	(b) For the purpose of this subdivision, "conviction" has the meaning given it 
71.15 	in section 609.02, subdivision 5.
71.16 	(c) The commissioner, in consultation with the commissioner of corrections, shall 
71.17 	develop forms and information necessary to implement this subdivision and shall provide 
71.18 	the forms and information to the commissioner of corrections for distribution to local 
71.19 	probation officers and corrections agents.
71.20 	(d) The commissioner shall inform individuals subject to a background study that 
71.21 	criminal convictions for disqualifying crimes will be reported to the commissioner by the 
71.22 	corrections system.
71.23 	(e) A probation officer, corrections agent, or corrections agency is not civilly or 
71.24 	criminally liable for disclosing or failing to disclose the information required by this 
71.25 	subdivision.
71.26 	(f) Upon receipt of disqualifying information, the commissioner shall provide the 
71.27 	notice required under section 245C.17, as appropriate, to agencies on record as having 
71.28 	initiated a background study or making a request for documentation of the background 
71.29 	study status of the individual.
71.30 	(g) This subdivision does not apply to family child care programs.

71.31 	Sec. 12. Minnesota Statutes 2010, section 256.975, subdivision 7, is amended to read:
71.32 		Subd. 7.Consumer information and assistance and long-term care options 
71.33 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
71.34 	statewide service to aid older Minnesotans and their families in making informed choices 
72.1 	about long-term care options and health care benefits. Language services to persons with 
72.2 	limited English language skills may be made available. The service, known as Senior 
72.3 	LinkAge Line, must be available during business hours through a statewide toll-free 
72.4 	number and must also be available through the Internet.
72.5 	(b) The service must provide long-term care options counseling by assisting older 
72.6 	adults, caregivers, and providers in accessing information and options counseling about 
72.7 	choices in long-term care services that are purchased through private providers or available 
72.8 	through public options. The service must:
72.9 	(1) develop a comprehensive database that includes detailed listings in both 
72.10 	consumer- and provider-oriented formats;
72.11 	(2) make the database accessible on the Internet and through other telecommunication 
72.12 	and media-related tools;
72.13 	(3) link callers to interactive long-term care screening tools and make these tools 
72.14 	available through the Internet by integrating the tools with the database;
72.15 	(4) develop community education materials with a focus on planning for long-term 
72.16 	care and evaluating independent living, housing, and service options;
72.17 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
72.18 	finding information on the Internet and through other means of communication;
72.19 	(6) implement a messaging system for overflow callers and respond to these callers 
72.20 	by the next business day;
72.21 	(7) link callers with county human services and other providers to receive more 
72.22 	in-depth assistance and consultation related to long-term care options;
72.23 	(8) link callers with quality profiles for nursing facilities and other providers 
72.24 	developed by the commissioner of health;
72.25 	(9) incorporate information about the availability of housing options, as well as 
72.26 	registered housing with services and consumer rights within the MinnesotaHelp.info 
72.27 	network long-term care database to facilitate consumer comparison of services and costs 
72.28 	among housing with services establishments and with other in-home services and to 
72.29 	support financial self-sufficiency as long as possible. Housing with services establishments 
72.30 	and their arranged home care providers shall provide information that will facilitate price 
72.31 	comparisons, including delineation of charges for rent and for services available. The 
72.32 	commissioners of health and human services shall align the data elements required by 
72.33 	section 144G.06, the Uniform Consumer Information Guide, and this section to provide 
72.34 	consumers standardized information and ease of comparison of long-term care options. 
72.35 	The commissioner of human services shall provide the data to the Minnesota Board on 
72.36 	Aging for inclusion in the MinnesotaHelp.info network long-term care database;
73.1 	(10) provide long-term care options counseling. Long-term care options counselors 
73.2 	shall:
73.3 	(i) for individuals not eligible for case management under a public program or public 
73.4 	funding source, provide interactive decision support under which consumers, family 
73.5 	members, or other helpers are supported in their deliberations to determine appropriate 
73.6 	long-term care choices in the context of the consumer's needs, preferences, values, and 
73.7 	individual circumstances, including implementing a community support plan;
73.8 	(ii) provide Web-based educational information and collateral written materials to 
73.9 	familiarize consumers, family members, or other helpers with the long-term care basics, 
73.10 	issues to be considered, and the range of options available in the community;
73.11 	(iii) provide long-term care futures planning, which means providing assistance to 
73.12 	individuals who anticipate having long-term care needs to develop a plan for the more 
73.13 	distant future; and
73.14 	(iv) provide expertise in benefits and financing options for long-term care, including 
73.15 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
73.16 	private pay options, and ways to access low or no-cost services or benefits through 
73.17 	volunteer-based or charitable programs; and
73.18 	(11) using risk management and support planning protocols, provide long-term care 
73.19 	options counseling to current residents of nursing homes deemed appropriate for discharge 
73.20 	by the commissioner. In order to meet this requirement, the commissioner shall provide 
73.21 	designated Senior LinkAge Line contact centers with a list of nursing home residents 
73.22 	appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall 
73.23 	provide these residents, if they indicate a preference to receive long-term care options 
73.24 	counseling, with initial assessment, review of risk factors, independent living support 
73.25 	consultation, or referral to:
73.26 	(i) long-term care consultation services under section 256B.0911;
73.27 	(ii) designated care coordinators of contracted entities under section 256B.035 for 
73.28 	persons who are enrolled in a managed care plan; or
73.29 	(iii) the long-term care consultation team for those who are appropriate for relocation 
73.30 	service coordination due to high-risk factors or psychological or physical disability; and
73.31 	(12) develop referral protocols and processes that will assist certified health care 
73.32 	homes and hospitals to identify at-risk older adults and determine when to refer these 
73.33 	individuals to the Senior LinkAge Line for long-term care options counseling under this 
73.34 	section. The commissioner is directed to work with the commissioner of health to develop 
73.35 	protocols that would comply with the health care home designation criteria and protocols 
73.36 	available at the time of hospital discharge.

74.1 	EFFECTIVE DATE. This section is effective is effective July 1, 2013.

74.2 	Sec. 13. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to 
74.3 	read:
74.4 		Subd. 1a.Income and assets generally. Unless specifically required by state 
74.5 	law or rule or federal law or regulation, the methodologies used in counting income 
74.6 	and assets to determine eligibility for medical assistance for persons whose eligibility 
74.7 	category is based on blindness, disability, or age of 65 or more years, the methodologies 
74.8 	for the supplemental security income program shall be used, except as provided under 
74.9 	subdivision 3, paragraph (a), clause (6). Increases in benefits under title II of the Social 
74.10 	Security Act shall not be counted as income for purposes of this subdivision until July 1 of 
74.11 	each year. Effective upon federal approval, for children eligible under section 256B.055, 
74.12 	subdivision 12, or for home and community-based waiver services whose eligibility 
74.13 	for medical assistance is determined without regard to parental income, child support 
74.14 	payments, including any payments made by an obligor in satisfaction of or in addition 
74.15 	to a temporary or permanent order for child support, and Social Security payments are 
74.16 	not counted as income. For families and children, which includes all other eligibility 
74.17 	categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as 
74.18 	required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 
74.19 	(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the 
74.20 	earned income disregards and deductions are limited to those in subdivision 1c. For these 
74.21 	purposes, a "methodology" does not include an asset or income standard, or accounting 
74.22 	method, or method of determining effective dates.

74.23 	Sec. 14. Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3, 
74.24 	is amended to read:
74.25 		Subd. 3.Asset limitations for individuals and families. (a) To be eligible for 
74.26 	medical assistance, a person must not individually own more than $3,000 in assets, or if a 
74.27 	member of a household with two family members, husband and wife, or parent and child, 
74.28 	the household must not own more than $6,000 in assets, plus $200 for each additional 
74.29 	legal dependent. In addition to these maximum amounts, an eligible individual or family 
74.30 	may accrue interest on these amounts, but they must be reduced to the maximum at the 
74.31 	time of an eligibility redetermination. The accumulation of the clothing and personal 
74.32 	needs allowance according to section 256B.35 must also be reduced to the maximum at 
74.33 	the time of the eligibility redetermination. The value of assets that are not considered in 
74.34 	determining eligibility for medical assistance is the value of those assets excluded under 
75.1 	the supplemental security income program for aged, blind, and disabled persons, with 
75.2 	the following exceptions:
75.3 	(1) household goods and personal effects are not considered;
75.4 	(2) capital and operating assets of a trade or business that the local agency determines 
75.5 	are necessary to the person's ability to earn an income are not considered;
75.6 	(3) motor vehicles are excluded to the same extent excluded by the supplemental 
75.7 	security income program;
75.8 	(4) assets designated as burial expenses are excluded to the same extent excluded by 
75.9 	the supplemental security income program. Burial expenses funded by annuity contracts 
75.10 	or life insurance policies must irrevocably designate the individual's estate as contingent 
75.11 	beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
75.12 	(5) for a person who no longer qualifies as an employed person with a disability due 
75.13 	to loss of earnings, assets allowed while eligible for medical assistance under section 
75.14 	256B.057, subdivision 9, are not considered for 12 months, beginning with the first month 
75.15 	of ineligibility as an employed person with a disability, to the extent that the person's total 
75.16 	assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d).;
75.17 	(6) when a person enrolled in medical assistance under section 256B.057, subdivision 
75.18 	9, reaches age 65 and has been enrolled during each of the 24 consecutive months before 
75.19 	the person's 65th birthday, the assets owned by the person and the person's spouse must 
75.20 	be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when 
75.21 	determining eligibility for medical assistance under section 256B.055, subdivision 7. The 
75.22 	income of a spouse of a person enrolled in medical assistance under section 256B.057, 
75.23 	subdivision 9, during each of the 24 consecutive months before the person's 65th birthday 
75.24 	must be disregarded when determining eligibility for medical assistance under section 
75.25 	256B.055, subdivision 7, when the person reaches age 65. Persons eligible under this 
75.26 	clause are not subject to the provisions in section 256B.059; and
75.27 	(7) notwithstanding the requirements of clause (6), persons whose 65th birthday 
75.28 	occurs in 2012 or 2013 are required to have qualified for medical assistance under section 
75.29 	256B.057, subdivision 9, prior to age 65 for at least 20 months in the 24 months prior 
75.30 	to reaching age 65.
75.31 	(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 
75.32 	15.

75.33 	Sec. 15. Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 17, 
75.34 	is amended to read:
76.1 		Subd. 17.Transportation costs. (a) Medical assistance covers medical 
76.2 	transportation costs incurred solely for obtaining emergency medical care or transportation 
76.3 	costs incurred by eligible persons in obtaining emergency or nonemergency medical 
76.4 	care when paid directly to an ambulance company, common carrier, or other recognized 
76.5 	providers of transportation services. Medical transportation must be provided by:
76.6 	(1) an ambulance, as defined in section 144E.001, subdivision 2;
76.7 	(2) special transportation; or
76.8 	(3) common carrier including, but not limited to, bus, taxicab, other commercial 
76.9 	carrier, or private automobile.
76.10 	(b) Medical assistance covers special transportation, as defined in Minnesota Rules, 
76.11 	part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 
76.12 	would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 
76.13 	transportation, or private automobile.
76.14 	The commissioner may use an order by the recipient's attending physician to certify that 
76.15 	the recipient requires special transportation services. Special transportation providers shall 
76.16 	perform driver-assisted services for eligible individuals. Driver-assisted service includes 
76.17 	passenger pickup at and return to the individual's residence or place of business, assistance 
76.18 	with admittance of the individual to the medical facility, and assistance in passenger 
76.19 	securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation 
76.20 	providers must obtain written documentation from the health care service provider who 
76.21 	is serving the recipient being transported, identifying the time that the recipient arrived. 
76.22 	Special transportation providers may not bill for separate base rates for the continuation of 
76.23 	a trip beyond the original destination. Special transportation providers must take recipients 
76.24 	to the nearest appropriate health care provider, using the most direct route. The minimum 
76.25 	medical assistance reimbursement rates for special transportation services are:
76.26 	(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to 
76.27 	eligible persons who need a wheelchair-accessible van;
76.28 	(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to 
76.29 	eligible persons who do not need a wheelchair-accessible van; and
76.30 	(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 
76.31 	special transportation services to eligible persons who need a stretcher-accessible vehicle;
76.32 	(2) the base rates for special transportation services in areas defined under RUCA 
76.33 	to be super rural shall be equal to the reimbursement rate established in clause (1) plus 
76.34 	11.3 percent; and
76.35 	(3) for special transportation services in areas defined under RUCA to be rural 
76.36 	or super rural areas:
77.1 	(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125 
77.2 	percent of the respective mileage rate in clause (1); and
77.3 	(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to 
77.4 	112.5 percent of the respective mileage rate in clause (1).
77.5 	(c) For purposes of reimbursement rates for special transportation services under 
77.6 	paragraph (b), the zip code of the recipient's place of residence shall determine whether 
77.7 	the urban, rural, or super rural reimbursement rate applies.
77.8 	(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA" 
77.9 	means a census-tract based classification system under which a geographical area is 
77.10 	determined to be urban, rural, or super rural.
77.11 	(e) Effective for services provided on or after September 1, 2011, nonemergency 
77.12 	transportation rates, including special transportation, taxi, and other commercial carriers, 
77.13 	are reduced 4.5 percent. Payments made to managed care plans and county-based 
77.14 	purchasing plans must be reduced for services provided on or after January 1, 2012, 
77.15 	to reflect this reduction.
77.16 	(f) Outside of a metropolitan county as defined in section 473.121, subdivision 4, 
77.17 	reimbursement rates under this subdivision may be adjusted monthly by the commissioner 
77.18 	when the statewide average price of regular grade gasoline is over $3 per gallon, as 
77.19 	calculated by Oil Price Information Service. The rate adjustment shall be a one-percent 
77.20 	increase or decrease for each corresponding $0.10 increase or decrease in the statewide 
77.21 	average price of regular grade gasoline.

77.22 	Sec. 16. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 2, 
77.23 	is amended to read:
77.24 		Subd. 2.Exceptions. Co-payments and deductibles shall be subject to the following 
77.25 	exceptions:
77.26 	(1) children under the age of 21;
77.27 	(2) pregnant women for services that relate to the pregnancy or any other medical 
77.28 	condition that may complicate the pregnancy;
77.29 	(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or 
77.30 	intermediate care facility for the developmentally disabled;
77.31 	(4) recipients receiving hospice care;
77.32 	(5) 100 percent federally funded services provided by an Indian health service;
77.33 	(6) emergency services;
77.34 	(7) family planning services;
78.1 	(8) services that are paid by Medicare, resulting in the medical assistance program 
78.2 	paying for the coinsurance and deductible; and
78.3 	(9) co-payments that exceed one per day per provider for nonpreventive visits, 
78.4 	eyeglasses, and nonemergency visits to a hospital-based emergency room; and
78.5 	(10) home and community-based waiver services for persons with developmental 
78.6 	disabilities under section 256B.501; home and community-based waiver services for the 
78.7 	elderly under section 256B.0915; waivered services under community alternatives for 
78.8 	disabled individuals under section 256B.49; community alternative care waivered services 
78.9 	under section 256B.49; traumatic brain injury waivered services under section 256B.49; 
78.10 	nursing services and home health services under section 256B.0625, subdivision 6a; 
78.11 	personal care services and nursing supervision of personal care services under section 
78.12 	256B.0625, subdivision 19a; private duty nursing services under section 256B.0625, 
78.13 	subdivision 7; personal care assistance services under section 256B.0659; and day training 
78.14 	and habilitation services for adults with developmental disabilities under sections 252.40 
78.15 	to 252.46.

78.16 	EFFECTIVE DATE. This section is effective July 1, 2013.

78.17 	Sec. 17. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c, 
78.18 	is amended to read:
78.19 		Subd. 3c.Consultation for housing with services. (a) The purpose of long-term 
78.20 	care consultation for registered housing with services is to support persons with current or 
78.21 	anticipated long-term care needs in making informed choices among options that include 
78.22 	the most cost-effective and least restrictive settings. Prospective residents maintain the 
78.23 	right to choose housing with services or assisted living if that option is their preference.
78.24 	(b) Registered housing with services establishments shall inform all prospective 
78.25 	residents or the prospective resident's designated or legal representative of the availability 
78.26 	of long-term care consultation and the need to receive and verify the consultation prior 
78.27 	to signing a lease or contract requirement for long-term care options counseling and the 
78.28 	opportunity to decline long-term care options counseling. Prospective residents declining 
78.29 	long-term care options counseling are required to sign a waiver form designated by the 
78.30 	commissioner and supplied by the provider. The housing with services establishment shall 
78.31 	maintain copies of signed waiver forms or verification that the consultation was conducted 
78.32 	for audit for a period of three years. Long-term care consultation for registered housing 
78.33 	with services is provided as determined by the commissioner of human services. The 
78.34 	service is delivered under a partnership between lead agencies as defined in subdivision 1a, 
78.35 	paragraph (d), and the Area Agencies on Aging, and is a point of entry to a combination 
79.1 	of telephone-based long-term care options counseling provided by Senior LinkAge Line 
79.2 	and in-person long-term care consultation provided by lead agencies. The point of entry 
79.3 	service must be provided within five working days of the request of the prospective 
79.4 	resident as follows:
79.5 	(1) the consultation shall be conducted with the prospective resident, or in the 
79.6 	alternative, the resident's designated or legal representative, if:
79.7 	(i) the resident verbally requests; or
79.8 	(ii) the registered housing with services provider has documentation of the 
79.9 	designated or legal representative's authority to enter into a lease or contract on behalf of 
79.10 	the prospective resident and accepts the documentation in good faith;
79.11 	(2) the consultation shall be performed in a manner that provides objective and 
79.12 	complete information;
79.13 	(2) (3)  the consultation must include a review of the prospective resident's reasons 
79.14 	for considering housing with services, the prospective resident's personal goals, a 
79.15 	discussion of the prospective resident's immediate and projected long-term care needs, 
79.16 	and alternative community services or housing with services settings that may meet the 
79.17 	prospective resident's needs;
79.18 	(3) (4)  the prospective resident shall be informed of the availability of a face-to-face 
79.19 	visit at no charge to the prospective resident to assist the prospective resident in assessment 
79.20 	and planning to meet the prospective resident's long-term care needs; and
79.21 	(4) (5)  verification of counseling shall be generated and provided to the prospective 
79.22 	resident by Senior LinkAge Line upon completion of the telephone-based counseling.
79.23 	(c) Housing with services establishments registered under chapter 144D shall:
79.24 	(1) inform all prospective residents or the prospective resident's designated or legal 
79.25 	representative of the availability of and contact information for consultation services 
79.26 	under this subdivision;
79.27 	(2) except for individuals seeking lease-only arrangements in subsidized housing 
79.28 	settings, receive a copy of the verification of counseling prior to executing a lease or 
79.29 	service contract with the prospective resident, and prior to executing a service contract 
79.30 	with individuals who have previously entered into lease-only arrangements; and
79.31 	(3) retain a copy of the verification of counseling as part of the resident's file.

79.32 	EFFECTIVE DATE. This section is effective July 1, 2013.

79.33 	Sec. 18. Minnesota Statutes 2010, section 256B.0911, is amended by adding a 
79.34 	subdivision to read:
80.1 		Subd. 3d.Exemptions. Individuals shall be exempt from the requirements outlined 
80.2 	in subdivision 3c in the following circumstances:
80.3 	(1) the individual is seeking a lease-only arrangement in a subsidized housing 
80.4 	setting; or
80.5 	(2) the individual has previously received a long-term care consultation assessment 
80.6 	under this section. In this instance, the assessor who completes the long-term care 
80.7 	consultation will issue a verification code and provide it to the individual.

80.8 	EFFECTIVE DATE. This section is effective July 1, 2013.

80.9 	Sec. 19. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to 
80.10 	read:
80.11 		Subd. 1b.Individual service plan. (a) The individual service plan must:
80.12 	(1) include the results of the assessment information on the person's need for service, 
80.13 	including identification of service needs that will be or that are met by the person's 
80.14 	relatives, friends, and others, as well as community services used by the general public;
80.15 	(2) identify the person's preferences for services as stated by the person, the person's 
80.16 	legal guardian or conservator, or the parent if the person is a minor;
80.17 	(3) identify long- and short-range goals for the person;
80.18 	(4) identify specific services and the amount and frequency of the services to be 
80.19 	provided to the person based on assessed needs, preferences, and available resources. 
80.20 	The individual service plan shall also specify other services the person needs that are 
80.21 	not available;
80.22 	(5) identify the need for an individual program plan to be developed by the provider 
80.23 	according to the respective state and federal licensing and certification standards, and 
80.24 	additional assessments to be completed or arranged by the provider after service initiation;
80.25 	(6) identify provider responsibilities to implement and make recommendations for 
80.26 	modification to the individual service plan;
80.27 	(7) include notice of the right to request a conciliation conference or a hearing 
80.28 	under section 256.045;
80.29 	(8) be agreed upon and signed by the person, the person's legal guardian 
80.30 	or conservator, or the parent if the person is a minor, and the authorized county 
80.31 	representative; and
80.32 	(9) be reviewed by a health professional if the person has overriding medical needs 
80.33 	that impact the delivery of services.
81.1 	(b) Service planning formats developed for interagency planning such as transition, 
81.2 	vocational, and individual family service plans may be substituted for service planning 
81.3 	formats developed by county agencies.
81.4 	(c) Approved, written, and signed changes to a consumer's services that meet the 
81.5 	criteria in this subdivision shall be an addendum to that consumer's individual service plan.

81.6 	Sec. 20. Minnesota Statutes 2011 Supplement, section 256B.097, subdivision 3, 
81.7 	is amended to read:
81.8 		Subd. 3.State Quality Council. (a) There is hereby created a State Quality 
81.9 	Council which must define regional quality councils, and carry out a community-based, 
81.10 	person-directed quality review component, and a comprehensive system for effective 
81.11 	incident reporting, investigation, analysis, and follow-up.
81.12 	(b) By August 1, 2011, the commissioner of human services shall appoint the 
81.13 	members of the initial State Quality Council. Members shall include representatives 
81.14 	from the following groups:
81.15 	(1) disability service recipients and their family members;
81.16 	(2) during the first two years of the State Quality Council, there must be at least three 
81.17 	members from the Region 10 stakeholders. As regional quality councils are formed under 
81.18 	subdivision 4, each regional quality council shall appoint one member;
81.19 	(3) disability service providers;
81.20 	(4) disability advocacy groups; and
81.21 	(5) county human services agencies and staff from the Department of Human 
81.22 	Services and Ombudsman for Mental Health and Developmental Disabilities.
81.23 	(c) Members of the council who do not receive a salary or wages from an employer 
81.24 	for time spent on council duties may receive a per diem payment when performing council 
81.25 	duties and functions.
81.26 	(d) The State Quality Council shall:
81.27 	(1) assist the Department of Human Services in fulfilling federally mandated 
81.28 	obligations by monitoring disability service quality and quality assurance and 
81.29 	improvement practices in Minnesota; and
81.30 	(2) establish state quality improvement priorities with methods for achieving results 
81.31 	and provide an annual report to the legislative committees with jurisdiction over policy 
81.32 	and funding of disability services on the outcomes, improvement priorities, and activities 
81.33 	undertaken by the commission during the previous state fiscal year;
81.34 	(3) identify issues pertaining to financial and personal risk that impede Minnesotans 
81.35 	with disabilities from optimizing choice of community-based services; and
82.1 	(4) recommend to the chairs and ranking minority members of the legislative 
82.2 	committees with jurisdiction over human services and civil law by January 15, 2013, 
82.3 	statutory and rule changes related to the findings under clause (3) that promote 
82.4 	individualized service and housing choices balanced with appropriate individualized 
82.5 	protection.
82.6 	(e) The State Quality Council, in partnership with the commissioner, shall:
82.7 	(1) approve and direct implementation of the community-based, person-directed 
82.8 	system established in this section;
82.9 	(2) recommend an appropriate method of funding this system, and determine the 
82.10 	feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
82.11 	(3) approve measurable outcomes in the areas of health and safety, consumer 
82.12 	evaluation, education and training, providers, and systems;
82.13 	(4) establish variable licensure periods not to exceed three years based on outcomes 
82.14 	achieved; and
82.15 	(5) in cooperation with the Quality Assurance Commission, design a transition plan 
82.16 	for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
82.17 	(f) The State Quality Council shall notify the commissioner of human services that a 
82.18 	facility, program, or service has been reviewed by quality assurance team members under 
82.19 	subdivision 4, paragraph (b), clause (13), and qualifies for a license.
82.20 	(g) The State Quality Council, in partnership with the commissioner, shall establish 
82.21 	an ongoing review process for the system. The review shall take into account the 
82.22 	comprehensive nature of the system which is designed to evaluate the broad spectrum of 
82.23 	licensed and unlicensed entities that provide services to persons with disabilities. The 
82.24 	review shall address efficiencies and effectiveness of the system.
82.25 	(h) The State Quality Council may recommend to the commissioner certain 
82.26 	variances from the standards governing licensure of programs for persons with disabilities 
82.27 	in order to improve the quality of services so long as the recommended variances do 
82.28 	not adversely affect the health or safety of persons being served or compromise the 
82.29 	qualifications of staff to provide services.
82.30 	(i) The safety standards, rights, or procedural protections referenced under 
82.31 	subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make 
82.32 	recommendations to the commissioner or to the legislature in the report required under 
82.33 	paragraph (c) regarding alternatives or modifications to the safety standards, rights, or 
82.34 	procedural protections referenced under subdivision 2, paragraph (c).
82.35 	(j) The State Quality Council may hire staff to perform the duties assigned in this 
82.36 	subdivision.

83.1 	Sec. 21. Minnesota Statutes 2010, section 256B.431, subdivision 17e, is amended to 
83.2 	read:
83.3 		Subd. 17e.Replacement-costs-new per bed limit effective October 1, 2007.
 83.4 	Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), 
83.5 	for a total replacement, as defined in subdivision 17d, authorized under section 
83.6 	144A.071 or 144A.073 after July 1, 1999, any building project that is a relocation, 
83.7 	renovation, upgrading, or conversion completed on or after July 1, 2001, or any 
83.8 	building project eligible for reimbursement under section 256B.434, subdivision 4f, the 
83.9 	replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed 
83.10 	rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating 
83.11 	the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 
83.12 	9549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be 
83.13 	adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 
83.14 	2000. These amounts must be increased annually as specified in subdivision 3f, paragraph 
83.15 	(a), beginning October 1, 2012.

83.16 	Sec. 22. Minnesota Statutes 2010, section 256B.431, is amended by adding a 
83.17 	subdivision to read:
83.18 		Subd. 45.Rate adjustments for some moratorium exception projects.
 83.19 	Notwithstanding any other law to the contrary, money available for moratorium exception 
83.20 	projects under section 144A.073, subdivisions 2 and 11, shall be used to fund the 
83.21 	incremental rate increases resulting from this section for any nursing facility with a 
83.22 	moratorium exception project approved under section 144A.073, and completed after 
83.23 	August 30, 2010, where the replacement-costs-new limits under subdivision 17e were 
83.24 	higher at any time after project approval than at the time of project completion. The 
83.25 	commissioner shall calculate the property rate increase for these facilities using the highest 
83.26 	set of limits; however, any rate increase under this section shall not be effective until on 
83.27 	or after the effective date of this section, contingent upon federal approval. No property 
83.28 	rate decrease shall result from this section.

83.29 	EFFECTIVE DATE. This section is effective upon federal approval.

83.30 	Sec. 23. Minnesota Statutes 2010, section 256B.434, subdivision 10, is amended to 
83.31 	read:
83.32 		Subd. 10.Exemptions. (a) To the extent permitted by federal law, (1) a facility that 
83.33 	has entered into a contract under this section is not required to file a cost report, as defined 
83.34 	in Minnesota Rules, part 9549.0020, subpart 13, for any year after the base year that is the 
84.1 	basis for the calculation of the contract payment rate for the first rate year of the alternative 
84.2 	payment demonstration project contract; and (2) a facility under contract is not subject 
84.3 	to audits of historical costs or revenues, or paybacks or retroactive adjustments based on 
84.4 	these costs or revenues, except audits, paybacks, or adjustments relating to the cost report 
84.5 	that is the basis for calculation of the first rate year under the contract.
84.6 	(b) A facility that is under contract with the commissioner under this section is 
84.7 	not subject to the moratorium on licensure or certification of new nursing home beds in 
84.8 	section 144A.071, unless the project results in a net increase in bed capacity or involves 
84.9 	relocation of beds from one site to another. Contract payment rates must not be adjusted 
84.10 	to reflect any additional costs that a nursing facility incurs as a result of a construction 
84.11 	project undertaken under this paragraph. In addition, as a condition of entering into a 
84.12 	contract under this section, a nursing facility must agree that any future medical assistance 
84.13 	payments for nursing facility services will not reflect any additional costs attributable to 
84.14 	the sale of a nursing facility under this section and to construction undertaken under 
84.15 	this paragraph that otherwise would not be authorized under the moratorium in section 
84.16 	144A.073. Nothing in this section prevents a nursing facility participating in the 
84.17 	alternative payment demonstration project under this section from seeking approval of 
84.18 	an exception to the moratorium through the process established in section 144A.073, 
84.19 	and if approved the facility's rates shall be adjusted to reflect the cost of the project. 
84.20 	Nothing in this section prevents a nursing facility participating in the alternative payment 
84.21 	demonstration project from seeking legislative approval of an exception to the moratorium 
84.22 	under section 144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the 
84.23 	cost of the project.
84.24 	(c) Notwithstanding section 256B.48, subdivision 6, paragraphs (c), (d), and (e), 
84.25 	and pursuant to any terms and conditions contained in the facility's contract, a nursing 
84.26 	facility that is under contract with the commissioner under this section is in compliance 
84.27 	with section 256B.48, subdivision 6, paragraph (b), if the facility is Medicare certified.
84.28 	(d) (c) Notwithstanding paragraph (a), if by April 1, 1996, the health care financing 
84.29 	administration has not approved a required waiver, or the Centers for Medicare and 
84.30 	Medicaid Services otherwise requires cost reports to be filed prior to the waiver's approval, 
84.31 	the commissioner shall require a cost report for the rate year.
84.32 	(e) (d) A facility that is under contract with the commissioner under this section 
84.33 	shall be allowed to change therapy arrangements from an unrelated vendor to a related 
84.34 	vendor during the term of the contract. The commissioner may develop reasonable 
84.35 	requirements designed to prevent an increase in therapy utilization for residents enrolled 
84.36 	in the medical assistance program.
85.1 	(f) (e) Nursing facilities participating in the alternative payment system 
85.2 	demonstration project must either participate in the alternative payment system quality 
85.3 	improvement program established by the commissioner or submit information on their 
85.4 	own quality improvement process to the commissioner for approval. Nursing facilities 
85.5 	that have had their own quality improvement process approved by the commissioner 
85.6 	must report results for at least one key area of quality improvement annually to the 
85.7 	commissioner.

85.8 	Sec. 24. Minnesota Statutes 2010, section 256B.441, is amended by adding a 
85.9 	subdivision to read:
85.10 		Subd. 63.Critical access nursing facilities. (a) The commissioner, in consultation 
85.11 	with the commissioner of health, may designate certain nursing facilities as critical access 
85.12 	nursing facilities. The designation shall be granted on a competitive basis, within the 
85.13 	limits of funds appropriated for this purpose.
85.14 	(b) The commissioner shall request proposals from nursing facilities every two years. 
85.15 	Proposals must be submitted in the form and according to the timelines established by 
85.16 	the commissioner. In selecting applicants to designate, the commissioner, in consultation 
85.17 	with the commissioner of health, and with input from stakeholders, shall develop criteria 
85.18 	designed to preserve access to nursing facility services in isolated areas, rebalance 
85.19 	long-term care, and improve quality.
85.20 	(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing 
85.21 	facilities designated as critical access nursing facilities:
85.22 	(1) partial rebasing, with operating payment rates being the sum of 60 percent of the 
85.23 	operating payment rate determined in accordance with subdivision 54 and 40 percent of the 
85.24 	operating payment rate that would have been allowed had the facility not been designated;
85.25 	(2) enhanced payments for leave days. Notwithstanding section 256B.431, 
85.26 	subdivision 2r, upon designation as a critical access nursing facility, the commissioner 
85.27 	shall limit payment for leave days to 60 percent of that nursing facility's total payment rate 
85.28 	for the involved resident, and shall allow this payment only when the occupancy of the 
85.29 	nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;
85.30 	(3) two designated critical access nursing facilities, with up to 100 beds in active 
85.31 	service, may jointly apply to the commissioner of health for a waiver of Minnesota 
85.32 	Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The 
85.33 	commissioner of health will consider each waiver request independently based on the 
85.34 	criteria under Minnesota Rules, part 4658.0040;
86.1 	(4) the minimum threshold under section 256B.431, subdivisions 3f, paragraph (a), 
86.2 	and 17e, shall be 40 percent of the amount that would otherwise apply; and
86.3 	(5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based 
86.4 	rate limits under subdivision 50 shall apply to designated critical access nursing facilities.
86.5 	(d) Designation of a critical access nursing facility shall be for a period of two 
86.6 	years, after which the benefits allowed under paragraph (c) shall be removed. Designated 
86.7 	facilities may apply for continued designation.

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

86.9 	Sec. 25. Minnesota Statutes 2010, section 256B.48, is amended by adding a 
86.10 	subdivision to read:
86.11 		Subd. 6a.Referrals to Medicare providers required. Notwithstanding subdivision 
86.12 	1, nursing facility providers that do not participate in or accept Medicare assignment 
86.13 	must refer and document the referral of dual eligible recipients for whom placement is 
86.14 	requested and for whom the resident would be qualified for a Medicare-covered stay to 
86.15 	Medicare providers. The commissioner shall audit nursing facilities that do not accept 
86.16 	Medicare and determine if dual eligible individuals with Medicare qualifying stays have 
86.17 	been admitted. If such a determination is made, the commissioner shall deny Medicaid 
86.18 	payment for the first 20 days of that resident's stay.

86.19 	Sec. 26. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15, 
86.20 	is amended to read:
86.21 		Subd. 15.Individualized service plan; comprehensive transitional service plan; 
86.22 	maintenance service plan. (a) Each recipient of home and community-based waivered 
86.23 	services shall be provided a copy of the written service plan which:
86.24 	(1) is developed and signed by the recipient within ten working days of the 
86.25 	completion of the assessment;
86.26 	(2) meets the assessed needs of the recipient;
86.27 	(3) reasonably ensures the health and safety of the recipient;
86.28 	(4) promotes independence;
86.29 	(5) allows for services to be provided in the most integrated settings; and
86.30 	(6) provides for an informed choice, as defined in section 256B.77, subdivision 2, 
86.31 	paragraph (p), of service and support providers.
86.32 	(b) In developing the comprehensive transitional service plan, the individual 
86.33 	receiving services, the case manager, and the guardian, if applicable, will identify 
86.34 	the transitional service plan fundamental service outcome and anticipated timeline to 
87.1 	achieve this outcome. Within the first 20 days following a recipient's request for an 
87.2 	assessment or reassessment, the transitional service planning team must be identified. A 
87.3 	team leader must be identified who will be responsible for assigning responsibility and 
87.4 	communicating with team members to ensure implementation of the transition plan and 
87.5 	ongoing assessment and communication process. The team leader should be an individual, 
87.6 	such as the case manager or guardian, who has the opportunity to follow the recipient to 
87.7 	the next level of service.
87.8 	Within ten days following an assessment, a comprehensive transitional service plan 
87.9 	must be developed incorporating elements of a comprehensive functional assessment and 
87.10 	including short-term measurable outcomes and timelines for achievement of and reporting 
87.11 	on these outcomes. Functional milestones must also be identified and reported according 
87.12 	to the timelines agreed upon by the transitional service planning team. In addition, the 
87.13 	comprehensive transitional service plan must identify additional supports that may assist 
87.14 	in the achievement of the fundamental service outcome such as the development of greater 
87.15 	natural community support, increased collaboration among agencies, and technological 
87.16 	supports.
87.17 	The timelines for reporting on functional milestones will prompt a reassessment of 
87.18 	services provided, the units of services, rates, and appropriate service providers. It is 
87.19 	the responsibility of the transitional service planning team leader to review functional 
87.20 	milestone reporting to determine if the milestones are consistent with observable skills 
87.21 	and that milestone achievement prompts any needed changes to the comprehensive 
87.22 	transitional service plan.
87.23 	For those whose fundamental transitional service outcome involves the need to 
87.24 	procure housing, a plan for the recipient to seek the resources necessary to secure the least 
87.25 	restrictive housing possible should be incorporated into the plan, including employment 
87.26 	and public supports such as housing access and shelter needy funding.
87.27 	(c) Counties and other agencies responsible for funding community placement and 
87.28 	ongoing community supportive services are responsible for the implementation of the 
87.29 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
87.30 	effective transitional service delivery and efficient utilization of funding resources.
87.31 	(d) Following one year of transitional services, the transitional services planning 
87.32 	team will make a determination as to whether or not the individual receiving services 
87.33 	requires the current level of continuous and consistent support in order to maintain the 
87.34 	recipient's current level of functioning. Recipients who are determined to have not had 
87.35 	a significant change in functioning for 12 months must move from a transitional to a 
87.36 	maintenance service plan. Recipients on a maintenance service plan must be reassessed 
88.1 	to determine if the recipient would benefit from a transitional service plan at least every 
88.2 	12 months and at other times when there has been a significant change in the recipient's 
88.3 	functioning. This assessment should consider any changes to technological or natural 
88.4 	community supports.
88.5 	(e) When a county is evaluating denials, reductions, or terminations of home and 
88.6 	community-based services under section 256B.49 for an individual, the case manager 
88.7 	shall offer to meet with the individual or the individual's guardian in order to discuss the 
88.8 	prioritization of service needs within the individualized service plan, comprehensive 
88.9 	transitional service plan, or maintenance service plan. The reduction in the authorized 
88.10 	services for an individual due to changes in funding for waivered services may not exceed 
88.11 	the amount needed to ensure medically necessary services to meet the individual's health, 
88.12 	safety, and welfare.
88.13 	(f) At the time of reassessment, local agency case managers shall assess each 
88.14 	recipient of community alternatives for disabled individuals or traumatic brain injury 
88.15 	waivered services currently residing in a licensed adult foster home that is not the primary 
88.16 	residence of the license holder, or in which the license holder is not the primary caregiver, 
88.17 	to determine if that recipient could appropriately be served in a community-living setting. 
88.18 	If appropriate for the recipient, the case manager shall offer the recipient, through a 
88.19 	person-centered planning process, the option to receive alternative housing and service 
88.20 	options. In the event that the recipient chooses to transfer from the adult foster home, 
88.21 	the vacated bed shall not be filled with another recipient of waiver services and group 
88.22 	residential housing, unless and the licensed capacity shall be reduced accordingly, unless 
88.23 	the savings required by the 2011 licensed bed closure reductions for foster care settings 
88.24 	where the physical location is not the primary residence of the license holder are met 
88.25 	through voluntary changes described in section 245A.03, subdivision 7, paragraph (g), 
88.26 	or as provided under section 245A.03, subdivision 7, paragraph (a), clauses (3) and (4), 
88.27 	and the licensed capacity shall be reduced accordingly. If the adult foster home becomes 
88.28 	no longer viable due to these transfers, the county agency, with the assistance of the 
88.29 	department, shall facilitate a consolidation of settings or closure. This reassessment 
88.30 	process shall be completed by June 30, 2012 July 1, 2013.

88.31 	Sec. 27. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 23, 
88.32 	is amended to read:
88.33 		Subd. 23.Community-living settings. "Community-living settings" means a 
88.34 	single-family home or apartment where the service recipient or their family owns or rents, 
88.35 	as demonstrated by a lease agreement, and maintains control over the individual unit as 
89.1 	demonstrated by the lease agreement, or has a plan for transition of a lease from a service 
89.2 	provider to the individual. Within two years of signing the initial lease, the service provider 
89.3 	shall transfer the lease to the individual. In the event the landlord denies the transfer, the 
89.4 	commissioner may approve an exception within sufficient time to ensure the continued 
89.5 	occupancy by the individual. Community-living settings are subject to the following:
89.6 	(1) individuals are not required to receive services;
89.7 	(2) individuals are not required to have a disability or specific diagnosis to live in the 
89.8 	community-living setting, unless state or federal funding requires it;
89.9 	(3) individuals may hire service providers of their choice;
89.10 	(4) individuals may choose whether to share their household and with whom;
89.11 	(5) the home or apartment must include living, sleeping, bathing, and cooking areas;
89.12 	(6) individuals must have lockable access and egress;
89.13 	(7) individuals must be free to receive visitors and leave the settings at times and for 
89.14 	durations of their own choosing;
89.15 	(8) leases must not reserve the right to assign units or change unit assignments; and
89.16 	(9) access to the greater community must be easily facilitated based on the 
89.17 	individual's needs and preferences.

89.18 	Sec. 28. [256B.492] ADULT FOSTER CARE VOLUNTARY CLOSURE.
89.19 		Subdivision 1.Commissioner's duties; report.  The commissioner of human 
89.20 	services shall ask providers of adult foster care services to present proposals for the 
89.21 	conversion of services provided for persons with developmental disabilities in settings 
89.22 	licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, to services to other 
89.23 	community settings in conjunction with the cessation of operations and closure of 
89.24 	identified facilities.
89.25 		Subd. 2.Inventory of foster care capacity.  The commissioner of human services 
89.26 	shall submit to the legislature by February 15, 2013, a report that includes:
89.27 	(1) an inventory of the assessed needs of all individuals with disabilities receiving 
89.28 	foster care services under section 256B.092;
89.29 	(2) an inventory of total licensed foster care capacity for adults and children 
89.30 	available in Minnesota as of January 1, 2013; and
89.31 	(3) a comparison of the needs of individuals receiving services in foster care settings 
89.32 	and nonfoster care settings.
89.33 	The report will also contain recommendations on developing a profile of individuals 
89.34 	requiring foster care services and the projected level of foster care capacity needed 
89.35 	to serve that population.
90.1 		Subd. 3.Voluntary closure process need determination. If the report required in 
90.2 	subdivision 2 determines the existing supply of foster care capacity is higher than needed 
90.3 	to meet the needs of individuals requiring that level of care, the commissioner shall, 
90.4 	within the limits of available appropriations, announce and implement a program for 
90.5 	closure of adult foster care homes.
90.6 		Subd. 4.Application process. (a) The commissioner shall establish a process of 
90.7 	application, review, and approval for licensees to submit proposals for the closure of 
90.8 	facilities.
90.9 	(b) A licensee shall notify the following parties in writing when an application for a 
90.10 	planned closure adjustment is submitted:
90.11 	(1) the county social services agency; and
90.12 	(2) current and prospective residents and their families.
90.13 	(c) After providing written notice, and prior to admission, the licensee must fully 
90.14 	inform prospective residents and their families of the intent to close operations and of 
90.15 	the relocation plan.
90.16 		Subd. 5.Review and approval process. (a) To be considered for approval, an 
90.17 	application must include:
90.18 	(1) a description of the proposed closure plan, which must include identification of 
90.19 	the home or homes to receive a planned closure rate adjustment; 
90.20 	(2) the proposed timetable for any proposed closure, including the proposed dates for 
90.21 	announcement to residents and the affected county social service agency, commencement 
90.22 	of closure, and completion of closure;
90.23 	(3) the proposed relocation plan jointly developed by the county of financial 
90.24 	responsibility and the providers for current residents of any facility designated for closure; 
90.25 	and
90.26 	(4) documentation in a format approved by the commissioner that all the adult foster 
90.27 	care homes receiving a planned closure rate adjustment under the plan have accepted joint 
90.28 	and several liability for recovery of overpayments under section 256B.0641, subdivision 
90.29 	2, for the facilities designated for closure under the plan.
90.30 	(c) In reviewing and approving closure proposals, the commissioner shall give first 
90.31 	priority to proposals that:
90.32 	(1) result in the closing of a facility;
90.33 	(2) demonstrate savings of medical assistance expenditures; and
90.34 	(3) demonstrate that alternative placements will be developed based on individual 
90.35 	resident needs and applicable federal and state rules.
91.1 	The commissioner shall also consider any information provided by residents, their 
91.2 	family, or the county social services agency on the impact of the planned closure on 
91.3 	the services they receive.
91.4 	(d) The commissioner shall select proposals that best meet the criteria established 
91.5 	in this subdivision within the appropriation made available for planned closure of adult 
91.6 	foster care facilities. The commissioner shall notify licensees of the selections made and 
91.7 	approved by the commissioner.
91.8 	(e) For each proposal approved by the commissioner, a contract must be established 
91.9 	between the commissioner, the county of financial responsibility, and the participating 
91.10 	licensee.
91.11 		Subd. 6.Adjustment to rates. (a) For purposes of this section, the commissioner 
91.12 	shall establish an enhanced payment rate under section 256B.0913 to facilitate an orderly 
91.13 	transition for persons with developmental disabilities from adult foster care to other 
91.14 	community-based settings.
91.15 	(b) The maximum length the commissioner may establish an enhanced rate is six 
91.16 	months.
91.17 	(c) The commissioner shall allocate funds, up to a total of $450 in state and federal 
91.18 	funds per adult foster care home bed that is closing, to be used for relocation costs incurred 
91.19 	by counties under this process
91.20 	(d) The commissioner shall analyze the fiscal impact of the closure of each facility 
91.21 	on medical assistance expenditures. Any savings is allocated to the medical assistance 
91.22 	program.

91.23 	Sec. 29. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
91.24 		Subd. 5.Special needs. In addition to the state standards of assistance established in 
91.25 	subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 
91.26 	Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
91.27 	center, or a group residential housing facility.
91.28 	(a) The county agency shall pay a monthly allowance for medically prescribed 
91.29 	diets if the cost of those additional dietary needs cannot be met through some other 
91.30 	maintenance benefit. The need for special diets or dietary items must be prescribed by 
91.31 	a licensed physician. Costs for special diets shall be determined as percentages of the 
91.32 	allotment for a one-person household under the thrifty food plan as defined by the United 
91.33 	States Department of Agriculture. The types of diets and the percentages of the thrifty 
91.34 	food plan that are covered are as follows:
91.35 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
92.1 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 
92.2 	of thrifty food plan;
92.3 	(3) controlled protein diet, less than 40 grams and requires special products, 125 
92.4 	percent of thrifty food plan;
92.5 	(4) low cholesterol diet, 25 percent of thrifty food plan;
92.6 	(5) high residue diet, 20 percent of thrifty food plan;
92.7 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
92.8 	(7) gluten-free diet, 25 percent of thrifty food plan;
92.9 	(8) lactose-free diet, 25 percent of thrifty food plan;
92.10 	(9) antidumping diet, 15 percent of thrifty food plan;
92.11 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
92.12 	(11) ketogenic diet, 25 percent of thrifty food plan.
92.13 	(b) Payment for nonrecurring special needs must be allowed for necessary home 
92.14 	repairs or necessary repairs or replacement of household furniture and appliances using 
92.15 	the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 
92.16 	as long as other funding sources are not available.
92.17 	(c) A fee for guardian or conservator service is allowed at a reasonable rate 
92.18 	negotiated by the county or approved by the court. This rate shall not exceed five percent 
92.19 	of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 
92.20 	guardian or conservator is a member of the county agency staff, no fee is allowed.
92.21 	(d) The county agency shall continue to pay a monthly allowance of $68 for 
92.22 	restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 
92.23 	1990, and who eats two or more meals in a restaurant daily. The allowance must continue 
92.24 	until the person has not received Minnesota supplemental aid for one full calendar month 
92.25 	or until the person's living arrangement changes and the person no longer meets the criteria 
92.26 	for the restaurant meal allowance, whichever occurs first.
92.27 	(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 
92.28 	is allowed for representative payee services provided by an agency that meets the 
92.29 	requirements under SSI regulations to charge a fee for representative payee services. This 
92.30 	special need is available to all recipients of Minnesota supplemental aid regardless of 
92.31 	their living arrangement.
92.32 	(f)(1) Notwithstanding the language in this subdivision, an amount equal to the 
92.33 	maximum allotment authorized by the federal Food Stamp Program for a single individual 
92.34 	which is in effect on the first day of July of each year will be added to the standards of 
92.35 	assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify 
92.36 	as shelter needy and are: (i) relocating from an institution, or an adult mental health 
93.1 	residential treatment program under section 256B.0622; (ii) eligible for the self-directed 
93.2 	supports option as defined under section 256B.0657, subdivision 2; or (iii) home and 
93.3 	community-based waiver recipients living in their own home or rented or leased apartment 
93.4 	which is not owned, operated, or controlled by a provider of service not related by blood 
93.5 	or marriage, unless allowed under paragraph (g).
93.6 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the 
93.7 	shelter needy benefit under this paragraph is considered a household of one. An eligible 
93.8 	individual who receives this benefit prior to age 65 may continue to receive the benefit 
93.9 	after the age of 65.
93.10 	(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 
93.11 	exceed 40 percent of the assistance unit's gross income before the application of this 
93.12 	special needs standard. "Gross income" for the purposes of this section is the applicant's or 
93.13 	recipient's income as defined in section 256D.35, subdivision 10, or the standard specified 
93.14 	in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 
93.15 	state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 
93.16 	considered shelter needy for purposes of this paragraph.
93.17 	(g) Notwithstanding this subdivision, to access housing and services as provided 
93.18 	in paragraph (f), the recipient may choose housing that may be owned, operated, or 
93.19 	controlled by the recipient's service provider. In a multifamily building of four or more 
93.20 	units, the maximum number of apartments that may be used by recipients of this program 
93.21 	shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. of 
93.22 	more than four units, the maximum number of units that may be used by recipients of this 
93.23 	program shall be the greater of four units of 25 percent of the units in the building. In 
93.24 	multifamily buildings of four or fewer units, all of the units may be used by recipients 
93.25 	of this program. When housing is controlled by the service provider, the individual may 
93.26 	choose their own service provider as provided in section 256B.49, subdivision 23, clause 
93.27 	(3). When the housing is controlled by the service provider, the service provider shall 
93.28 	implement a plan with the recipient to transition the lease to the recipient's name. Within 
93.29 	two years of signing the initial lease, the service provider shall transfer the lease entered 
93.30 	into under this subdivision to the recipient. In the event the landlord denies this transfer, 
93.31 	the commissioner may approve an exception within sufficient time to ensure the continued 
93.32 	occupancy by the recipient. This paragraph expires June 30, 2016.

93.33 	Sec. 30. Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to 
93.34 	read:
93.35 	Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.
 94.1 	The commissioner shall seek any necessary federal approval in order to implement 
94.2 	the changes to the level of care criteria in Minnesota Statutes, section 144.0724, 
94.3 	subdivision 11, on or after July 1, 2012, for adults and children.

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

94.5 	Sec. 31. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 
94.6 	3, is amended to read:

94.7	Subd. 3.Forecasted Programs
 					
94.8 	The amounts that may be spent from this 
94.9 	appropriation for each purpose are as follows:

94.10	(a) MFIP/DWP Grants

94.11	Appropriations by Fund
	
94.12	General
	84,680,000
	91,978,000
	
94.13	Federal TANF
	84,425,000
	75,417,000

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

94.15	(c) General Assistance Grants
		49,192,000
		46,938,000
	
94.16 	General Assistance Standard. The 
94.17 	commissioner shall set the monthly standard 
94.18 	of assistance for general assistance units 
94.19 	consisting of an adult recipient who is 
94.20 	childless and unmarried or living apart 
94.21 	from parents or a legal guardian at $203. 
94.22 	The commissioner may reduce this amount 
94.23 	according to Laws 1997, chapter 85, article 
94.24 	3, section 54.
94.25 	Emergency General Assistance. The 
94.26 	amount appropriated for emergency general 
94.27 	assistance funds is limited to no more 
94.28 	than $6,689,812 in fiscal year 2012 and 
94.29 	$6,729,812 in fiscal year 2013. Funds 
94.30 	to counties shall be allocated by the 
94.31 	commissioner using the allocation method 
94.32 	specified in Minnesota Statutes, section 
94.33 	256D.06.

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

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

95.3	(f) MinnesotaCare Grants
		295,046,000
		317,272,000
	
95.4 	This appropriation is from the health care 
95.5 	access fund.

95.6	(g) Medical Assistance Grants
		4,501,582,000
		4,437,282,000
	
95.7 	Managed Care Incentive Payments. The 
95.8 	commissioner shall not make managed care 
95.9 	incentive payments for expanding preventive 
95.10 	services during fiscal years beginning July 1, 
95.11 	2011, and July 1, 2012.
95.12 	Reduction of Rates for Congregate 
95.13 	Living for Individuals with Lower Needs. 
95.14 	Beginning October 1, 2011, lead agencies 
95.15 	must reduce rates in effect on January 1, 
95.16 	2011, by ten percent for individuals with 
95.17 	lower needs living in foster care settings 
95.18 	where the license holder does not share the 
95.19 	residence with recipients on the CADI and 
95.20 	DD waivers and customized living settings 
95.21 	for CADI.  Lead agencies shall consult 
95.22 	with providers to review individual service 
95.23 	plans and identify changes or modifications 
95.24 	to reduce the utilization of services while 
95.25 	maintaining the health and safety of the 
95.26 	individual receiving services. Lead agencies 
95.27 	must adjust contracts within 60 days of the 
95.28 	effective date.
95.29 	Reduction of Lead Agency Waiver 
95.30 	Allocations to Implement Rate Reductions 
95.31 	for Congregate Living for Individuals 
95.32 	with Lower Needs. Beginning October 1, 
95.33 	2011, the commissioner shall reduce lead 
95.34 	agency waiver allocations to implement the 
96.1 	reduction of rates for individuals with lower 
96.2 	needs living in foster care settings where the 
96.3 	license holder does not share the residence 
96.4 	with recipients on the CADI and DD waivers 
96.5 	and customized living settings for CADI.
96.6 	Reduce customized living and 24-hour 
96.7 	customized living component rates.
96.8 	Effective July 1, 2011, the commissioner 
96.9 	shall reduce elderly waiver customized living 
96.10 	and 24-hour customized living component 
96.11 	service spending by five percent through 
96.12 	reductions in component rates and service 
96.13 	rate limits. The commissioner shall adjust 
96.14 	the elderly waiver capitation payment 
96.15 	rates for managed care organizations paid 
96.16 	under Minnesota Statutes, section 256B.69, 
96.17 	subdivisions 6a and 23, to reflect reductions 
96.18 	in component spending for customized living 
96.19 	services and 24-hour customized living 
96.20 	services under Minnesota Statutes, section 
96.21 	256B.0915, subdivisions 3e and 3h, for the 
96.22 	contract period beginning January 1, 2012. 
96.23 	To implement the reduction specified in 
96.24 	this provision, capitation rates paid by the 
96.25 	commissioner to managed care organizations 
96.26 	under Minnesota Statutes, section 256B.69, 
96.27 	shall reflect a ten percent reduction for the 
96.28 	specified services for the period January 1, 
96.29 	2012, to June 30, 2012, and a five percent 
96.30 	reduction for those services on or after July 
96.31 	1, 2012.
96.32 	Limit Growth in the Developmental 
96.33 	Disability Waiver. The commissioner 
96.34 	shall limit growth in the developmental 
96.35 	disability waiver to six diversion allocations 
96.36 	per month beginning July 1, 2011, through 
97.1 	June 30, 2013, and 15 diversion allocations 
97.2 	per month beginning July 1, 2013, through 
97.3 	June 30, 2015. Waiver allocations shall 
97.4 	be targeted to individuals who meet the 
97.5 	priorities for accessing waiver services 
97.6 	identified in Minnesota Statutes, 256B.092, 
97.7 	subdivision 12. The limits do not include 
97.8 	conversions from intermediate care facilities 
97.9 	for persons with developmental disabilities. 
97.10 	Notwithstanding any contrary provisions in 
97.11 	this article, this paragraph expires June 30, 
97.12 	2015.
97.13 	Limit Growth in the Community 
97.14 	Alternatives for Disabled Individuals 
97.15 	Waiver. The commissioner shall limit 
97.16 	growth in the community alternatives for 
97.17 	disabled individuals waiver to 60 allocations 
97.18 	per month beginning July 1, 2011, through 
97.19 	June 30, 2013, and 85 allocations per 
97.20 	month beginning July 1, 2013, through 
97.21 	June 30, 2015. Waiver allocations must 
97.22 	be targeted to individuals who meet the 
97.23 	priorities for accessing waiver services 
97.24 	identified in Minnesota Statutes, section 
97.25 	256B.49, subdivision 11a. The limits include 
97.26 	conversions and diversions, unless the 
97.27 	commissioner has approved a plan to convert 
97.28 	funding due to the closure or downsizing 
97.29 	of a residential facility or nursing facility 
97.30 	to serve directly affected individuals on 
97.31 	the community alternatives for disabled 
97.32 	individuals waiver. Notwithstanding any 
97.33 	contrary provisions in this article, this 
97.34 	paragraph expires June 30, 2015.
97.35 	Personal Care Assistance Relative 
97.36 	Care. The commissioner shall adjust the 
98.1 	capitation payment rates for managed care 
98.2 	organizations paid under Minnesota Statutes, 
98.3 	section 256B.69, to reflect the rate reductions 
98.4 	for personal care assistance provided by 
98.5 	a relative pursuant to Minnesota Statutes, 
98.6 	section 256B.0659, subdivision 11.

98.7	(h) Alternative Care Grants
		46,421,000
		46,035,000
	
98.8 	Alternative Care Transfer. Any money 
98.9 	allocated to the alternative care program that 
98.10 	is not spent for the purposes indicated does 
98.11 	not cancel but shall be transferred to the 
98.12 	medical assistance account.

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

98.14 	Sec. 32. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 
98.15 	4, is amended to read:

98.16	Subd. 4.Grant Programs
 					
98.17 	The amounts that may be spent from this 
98.18 	appropriation for each purpose are as follows:

98.19	(a) Support Services Grants

98.20	Appropriations by Fund
	
98.21	General
	8,715,000
	8,715,000
	
98.22	Federal TANF
	100,525,000
	94,611,000
	
98.23 	MFIP Consolidated Fund Grants. The 
98.24 	TANF fund base is reduced by $10,000,000 
98.25 	each year beginning in fiscal year 2012.
98.26 	Subsidized Employment Funding Through 
98.27 	ARRA. The commissioner is authorized to 
98.28 	apply for TANF emergency fund grants for 
98.29 	subsidized employment activities. Growth 
98.30 	in expenditures for subsidized employment 
98.31 	within the supported work program and the 
98.32 	MFIP consolidated fund over the amount 
98.33 	expended in the calendar year quarters in 
99.1 	the TANF emergency fund base year shall 
99.2 	be used to leverage the TANF emergency 
99.3 	fund grants for subsidized employment and 
99.4 	to fund supported work. The commissioner 
99.5 	shall develop procedures to maximize 
99.6 	reimbursement of these expenditures over the 
99.7 	TANF emergency fund base year quarters, 
99.8 	and may contract directly with employers 
99.9 	and providers to maximize these TANF 
99.10 	emergency fund grants.

99.11
99.12	(b) Basic Sliding Fee Child Care Assistance 
Grants
		37,144,000
		38,678,000
	
99.13 	Base Adjustment. The general fund base is 
99.14 	decreased by $990,000 in fiscal year 2014 
99.15 	and $979,000 in fiscal year 2015.
99.16 	Child Care and Development Fund 
99.17 	Unexpended Balance. In addition to 
99.18 	the amount provided in this section, the 
99.19 	commissioner shall expend $5,000,000 
99.20 	in fiscal year 2012 from the federal child 
99.21 	care and development fund unexpended 
99.22 	balance for basic sliding fee child care under 
99.23 	Minnesota Statutes, section 119B.03. The 
99.24 	commissioner shall ensure that all child 
99.25 	care and development funds are expended 
99.26 	according to the federal child care and 
99.27 	development fund regulations.

99.28	(c) Child Care Development Grants
		774,000
		774,000
	
99.29 	Base Adjustment. The general fund base is 
99.30 	increased by $713,000 in fiscal years 2014 
99.31 	and 2015.

99.32	(d) Child Support Enforcement Grants
		50,000
		50,000
	
99.33 	Federal Child Support Demonstration 
99.34 	Grants. Federal administrative 
99.35 	reimbursement resulting from the federal 
100.1 	child support grant expenditures authorized 
100.2 	under section 1115a of the Social Security 
100.3 	Act is appropriated to the commissioner for 
100.4 	this activity.

100.5	(e) Children's Services Grants

100.6	Appropriations by Fund
	
100.7	General
	47,949,000
	48,507,000
	
100.8	Federal TANF
	140,000
	140,000
	
100.9 	Adoption Assistance and Relative Custody 
100.10 	Assistance Transfer. The commissioner 
100.11 	may transfer unencumbered appropriation 
100.12 	balances for adoption assistance and relative 
100.13 	custody assistance between fiscal years and 
100.14 	between programs.
100.15 	Privatized Adoption Grants. Federal 
100.16 	reimbursement for privatized adoption grant 
100.17 	and foster care recruitment grant expenditures 
100.18 	is appropriated to the commissioner for 
100.19 	adoption grants and foster care and adoption 
100.20 	administrative purposes.
100.21 	Adoption Assistance Incentive Grants.
100.22 	Federal funds available during fiscal year 
100.23 	2012 and fiscal year 2013 for adoption 
100.24 	incentive grants are appropriated to the 
100.25 	commissioner for these purposes.

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

100.27	(g) Children and Economic Support Grants

100.28	Appropriations by Fund
	
100.29	General
	16,103,000
	16,180,000
	
100.30	Federal TANF
	700,000
	0
	
100.31 	Long-Term Homeless Services. $700,000 
100.32 	is appropriated from the federal TANF 
100.33 	fund for the biennium beginning July 
100.34 	1, 2011, to the commissioner of human 
101.1 	services for long-term homeless services 
101.2 	for low-income homeless families under 
101.3 	Minnesota Statutes, section 256K.26. This 
101.4 	is a onetime appropriation and is not added 
101.5 	to the base.
101.6 	Base Adjustment. The general fund base is 
101.7 	increased by $42,000 in fiscal year 2014 and 
101.8 	$43,000 in fiscal year 2015.
101.9 	Minnesota Food Assistance Program. 
101.10 	$333,000 in fiscal year 2012 and $408,000 in 
101.11 	fiscal year 2013 are to increase the general 
101.12 	fund base for the Minnesota food assistance 
101.13 	program. Unexpended funds for fiscal year 
101.14 	2012 do not cancel but are available to the 
101.15 	commissioner for this purpose in fiscal year 
101.16 	2013.

101.17	(h) Health Care Grants

101.18	Appropriations by Fund
	
101.19	General
	26,000
	66,000
	
101.20	Health Care Access
	190,000
	190,000
	
101.21 	Base Adjustment. The general fund base is 
101.22 	increased by $24,000 in each of fiscal years 
101.23 	2014 and 2015.

101.24	(i) Aging and Adult Services Grants
		12,154,000
		11,456,000
	
101.25 	Aging Grants Reduction. Effective July 
101.26 	1, 2011, funding for grants made under 
101.27 	Minnesota Statutes, sections 256.9754 and 
101.28 	256B.0917, subdivision 13, is reduced by 
101.29 	$3,600,000 for each year of the biennium. 
101.30 	These reductions are onetime and do 
101.31 	not affect base funding for the 2014-2015 
101.32 	biennium. Grants made during the 2012-2013 
101.33 	biennium under Minnesota Statutes, section 
101.34 	256B.9754, must not be used for new 
101.35 	construction or building renovation.
102.1 	Essential Community Support Grant 
102.2 	Delay. Upon federal approval to implement 
102.3 	the nursing facility level of care on July 
102.4 	1, 2013, essential community supports 
102.5 	grants under Minnesota Statutes, section 
102.6 	256B.0917, subdivision 14, are reduced by 
102.7 	$6,410,000 in fiscal year 2013. Base level 
102.8 	funding is increased by $5,541,000 in fiscal 
102.9 	year 2014 and $6,410,000 in fiscal year 2015.
102.10 	Base Level Adjustment. The general fund 
102.11 	base is increased by $10,035,000 in fiscal 
102.12 	year 2014 and increased by $10,901,000 in 
102.13 	fiscal year 2015.

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

102.15	(k) Disabilities Grants
		15,945,000
		18,284,000
	
102.16 	Grants for Housing Access Services. In 
102.17 	fiscal year 2012, the commissioner shall 
102.18 	make available a total of $161,000 in housing 
102.19 	access services grants to individuals who 
102.20 	relocate from an adult foster care home to 
102.21 	a community living setting for assistance 
102.22 	with completion of rental applications or 
102.23 	lease agreements; assistance with publicly 
102.24 	financed housing options; development of 
102.25 	household budgets; and assistance with 
102.26 	funding affordable furnishings and related 
102.27 	household matters.
102.28 	HIV Grants. The general fund appropriation 
102.29 	for the HIV drug and insurance grant 
102.30 	program shall be reduced by $2,425,000 in 
102.31 	fiscal year 2012 and increased by $2,425,000 
102.32 	in fiscal year 2014. These adjustments are 
102.33 	onetime and shall not be applied to the base. 
102.34 	Notwithstanding any contrary provision, this 
102.35 	provision expires June 30, 2014.
103.1 	Region 10. Of this appropriation, $100,000 
103.2 	each year is for a grant provided under 
103.3 	Minnesota Statutes, section 256B.097.
103.4 	Base Level Adjustment. The general fund 
103.5 	base is increased by $2,944,000 in fiscal year 
103.6 	2014 and $653,000 in fiscal year 2015.
103.7 	Local Planning Grants for Creating 
103.8 	Alternatives to Congregate Living for 
103.9 	Individuals with Lower Needs.  (1) The 
103.10 	commissioner shall make available a total 
103.11 	of $250,000 per year in local planning 
103.12 	grants, beginning July 1, 2011, to assist 
103.13 	lead agencies and provider organizations in 
103.14 	developing alternatives to congregate living 
103.15 	within the available level of resources for the 
103.16 	home and community-based services waivers 
103.17 	for persons with disabilities.
103.18 	(2) Notwithstanding clause (1), for fiscal 
103.19 	years 2012 and 2013 only, the appropriation 
103.20 	of $250,000 for fiscal year 2012 carries 
103.21 	forward to fiscal year 2013, effective the day 
103.22 	following final enactment.
103.23 	Of the total appropriations available for fiscal 
103.24 	year 2013, $100,000 is for administrative 
103.25 	functions related to the planning process 
103.26 	required under Minnesota Statutes, sections 
103.27 	144A.351 and 245A.03, subdivision 7, 
103.28 	paragraphs (e) and (g), and $400,000 is for 
103.29 	grants required to accomplish that planning 
103.30 	process.
103.31 	(3) Base funding for the grants under clause 
103.32 	(1) is not affected by the appropriations 
103.33 	under clause (2).
103.34 	Disability Linkage Line. Of this 
103.35 	appropriation, $125,000 in fiscal year 2012 
104.1 	and $300,000 in fiscal year 2013 are for 
104.2 	assistance to people with disabilities who are 
104.3 	considering enrolling in managed care.

104.4	(l) Adult Mental Health Grants

104.5	Appropriations by Fund
	
104.6	General
	70,570,000
	70,570,000
	
104.7	Health Care Access
	750,000
	750,000
	
104.8	Lottery Prize
	1,508,000
	1,508,000
	
104.9 	Funding Usage. Up to 75 percent of a fiscal 
104.10 	year's appropriation for adult mental health 
104.11 	grants may be used to fund allocations in that 
104.12 	portion of the fiscal year ending December 
104.13 	31.
104.14 	Base Adjustment. The general fund base is 
104.15 	increased by $200,000 in fiscal years 2014 
104.16 	and 2015.

104.17	(m) Children's Mental Health Grants
		16,457,000
		16,457,000
	
104.18 	Funding Usage. Up to 75 percent of a fiscal 
104.19 	year's appropriation for children's mental 
104.20 	health grants may be used to fund allocations 
104.21 	in that portion of the fiscal year ending 
104.22 	December 31.
104.23 	Base Adjustment. The general fund base is 
104.24 	increased by $225,000 in fiscal years 2014 
104.25 	and 2015.

104.26
104.27	(n) Chemical Dependency Nonentitlement 
Grants
		1,336,000
		1,336,000

104.28 	Sec. 33. COMMISSIONER AUTHORITY TO REDUCE 2011 CONGREGATE 
104.29 	CARE LOW NEED RATE CUT.
 104.30 	During fiscal years 2013 and 2014, the commissioner shall reduce the 2011 reduction 
104.31 	of rates for congregate living for individuals with lower needs to the extent the actions 
104.32 	taken under Minnesota Statutes, section 245A.03, subdivision 7, paragraph (g), produce 
104.33 	savings beyond the amount needed to meet the licensed bed closure savings requirements 
104.34 	of Minnesota Statutes, section 245A.03, subdivision 7, paragraph (e). Each February 1, 
105.1 	the commissioner shall report to the chairs and ranking minority members of the health 
105.2 	and human services finance committees on any reductions provided under this section. 

105.3 	EFFECTIVE DATE. This section is effective July 1, 2012, and expires June 30, 
105.4 	2014.

105.5 	Sec. 34. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.
 105.6 	(a) By June 1, 2012, the commissioner of human services shall seek federal approval 
105.7 	as part of the MA reform waiver request required under Minnesota Statutes, section 
105.8 	256B.021 to:
105.9 	(1) authorize persons who have been eligible for medical assistance under Minnesota 
105.10 	Statutes, section 256B.057, subdivision 9, for each of the 24 consecutive months prior 
105.11 	to reaching age 65, to continue to qualify for medical assistance under Minnesota 
105.12 	Statutes, section 256B.057, subdivision 9, beyond their 65th birthday as long as the other 
105.13 	requirements of Minnesota Statutes, section 256B.057, subdivision 9, are met;
105.14 	(2) authorize federal funding under the waiver from April 1, 2012, until federal 
105.15 	approval is obtained for persons who turn age 65 in 2012 and who have been enrolled in 
105.16 	medical assistance under Minnesota Statutes, section 256B.057, subdivision 9, for at least 
105.17 	20 months within the 24 months prior to reaching age 65 to continue to qualify for medical 
105.18 	assistance under Minnesota Statutes, section 256B.057, subdivision 9. If federal approval 
105.19 	of clause (1) is not granted, then for temporary federal funding until 30 days after any 
105.20 	federal denial is made public through the disability stakeholders electronic notice list; and
105.21 	(3) notwithstanding the requirements of clause (1), persons whose 65th birthday 
105.22 	occurs in 2012 or 2013 are required to have qualified for medical assistance under 
105.23 	Minnesota Statutes, section 256B.057, subdivision 9, prior to age 65 for at least 20 months 
105.24 	in the 24 months prior to reaching age 65.
105.25 	(b) Money shall be appropriated from the state general fund until federal approval is 
105.26 	granted for individuals eligible for medical assistance under paragraph (a), clause (2).
105.27 	This section shall expire when federal approval is granted or 30 days after a federal 
105.28 	denial.

105.29 	Sec. 35. CONTINUATION OF MEDICAL ASSISTANCE FOR EMPLOYED 
105.30 	PERSONS WITH DISABILITIES WHILE WAIVER REQUEST IS PENDING.
 105.31 	Persons eligible for medical assistance under Minnesota Statutes, section 245A.07, 
105.32 	subdivision 7, paragraph (a), clause (2), shall be allowed to continue to qualify for 
105.33 	Minnesota Statutes, section 256B.057, subdivision 9, until the federal approval requested 
105.34 	under Minnesota Statutes, section 245A.07, subdivision 7, is granted, or until 30 days after 
106.1 	any federal denial is made public through the disability stakeholders electronic notice list. 
106.2 	This section shall expire June 30, 2013.

106.3 	Sec. 36. SCOPE OF FISCAL ANALYSIS.
 106.4 	As provided in Minnesota Statutes, section 256B.021, subdivision 1, the fiscal 
106.5 	analysis for sections 2 and 4 to 7 shall include the cost of other state agencies' services or 
106.6 	programs, as well as federal programs used by persons who would have to spend down 
106.7 	their retirement savings and monthly income if not allowed to continue using medical 
106.8 	assistance for employed persons with disabilities income and asset provisions after age 65.

106.9 	Sec. 37. HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH 
106.10 	DISABILITIES.
 106.11 	(a) Individuals receiving services under a home and community-based waiver under 
106.12 	Minnesota Statutes, section 256B.092 or 256B.49, may receive services in the following 
106.13 	settings:
106.14 	(1) an individual's own home or family home;
106.15 	(2) a licensed adult foster care setting of up to five people; and 
106.16 	(3) community living settings as defined in Minnesota Statutes, section 256B.49, 
106.17 	subdivision 23, where individuals with disabilities may reside in all of the units in a 
106.18 	building of four or fewer units no more than the greater of four or 25 percent of the units 
106.19 	in a multifamily building of more than four units.
106.20 	The above settings must not:
106.21 	(1) be located in a building that is a publicly or privately operated facility that 
106.22 	provides institutional treatment or custodial care;
106.23 	(2) be located in a building on the grounds of or adjacent to a public institution;
106.24 	(3) be a housing complex designed expressly around an individual's diagnosis or 
106.25 	disability unless state or federal funding for housing requires it;
106.26 	(4) be segregated based on a disability, either physically or because of setting 
106.27 	characteristics, from the larger community; and
106.28 	(5) have the qualities of an institution, unless specifically required in the individual's 
106.29 	plan developed with the lead agency case manager and legal guardian. The qualities of an 
106.30 	institution include, but are not limited to:
106.31 	(i) regimented meal and sleep times;
106.32 	(ii) limitations on visitors; and
106.33 	(iii) lack of privacy.
107.1 	(b) The provisions of paragraph (a) do not apply to any setting in which residents 
107.2 	receive services under a home and community-based waiver as of June 30, 2013, and 
107.3 	which has been delivering those services for at least one year.
107.4 	(c) Notwithstanding paragraph (b), a program in Hennepin County established as 
107.5 	part of a Hennepin County demonstration project is qualified for the exception allowed 
107.6 	under paragraph (b).
107.7 	(d) The commissioner shall submit an amendment to the waiver plan no later than 
107.8 	December 31, 2012.

107.9 	Sec. 38. INDEPENDENT LIVING SERVICES BILLING.
 107.10 	The commissioner shall allow for daily rate and 15-minute increment billing for 
107.11 	independent living services under the brain injury (BI) and CADI waivers. If necessary to 
107.12 	comply with this requirement, the commissioner shall submit a waiver amendment to the 
107.13 	state plan no later than December 31, 2012.

107.14 	Sec. 39.  REPEALER.
 107.15 	(a) Minnesota Statutes 2010, sections 144A.073, subdivision 9; and 256B.48, 
107.16 	subdivision 6, and Laws 2011, First Special Session chapter 9, article 7, section 54,  are 
107.17 	repealed.
107.18 	(b) Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13, is 
107.19 	repealed.

107.20 	ARTICLE 5
107.21 	MISCELLANEOUS

107.22 	Section 1. Minnesota Statutes 2010, section 43A.316, subdivision 5, is amended to 
107.23 	read:
107.24 		Subd. 5.Public employee participation. (a) Participation in the program is subject 
107.25 	to the conditions in this subdivision.
107.26 	(b) Each exclusive representative for an eligible employer determines whether the 
107.27 	employees it represents will participate in the program. The exclusive representative shall 
107.28 	give the employer notice of intent to participate at least 30 days before the expiration date 
107.29 	of the collective bargaining agreement preceding the collective bargaining agreement that 
107.30 	covers the date of entry into the program. The exclusive representative and the eligible 
107.31 	employer shall give notice to the commissioner of the determination to participate in the 
107.32 	program at least 30 days before entry into the program. Entry into the program is governed 
107.33 	by a schedule established by the commissioner. Employees of an eligible employer that is 
108.1 	not participating in the program as of the date of enactment shall not be allowed to enter 
108.2 	the program until January 1, 2015, except that a city that has received a formal written bid 
108.3 	from the program as of the date of enactment shall be allowed to enter the program based 
108.4 	on the bid if the city so chooses.
108.5 	(c) Employees not represented by exclusive representatives may become members of 
108.6 	the program upon a determination of an eligible employer to include these employees in the 
108.7 	program. Either all or none of the employer's unrepresented employees must participate. 
108.8 	The eligible employer shall give at least 30 days' notice to the commissioner before 
108.9 	entering the program. Entry into the program is governed by a schedule established by the 
108.10 	commissioner.  Employees of an eligible employer that is not participating in the program 
108.11 	as of the date of enactment shall not be allowed to enter the program until January 1, 2015, 
108.12 	except that a city that has received a formal written bid from the program as of the date of 
108.13 	enactment 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 
108.15 	renewed for an additional two-year term unless the exclusive representative, or the 
108.16 	employer for unrepresented employees, gives the commissioner notice of withdrawal 
108.17 	at least 30 days before expiration of the participation period. A group that withdraws 
108.18 	must wait two years before rejoining. An exclusive representative, or employer for 
108.19 	unrepresented employees, may also withdraw if premiums increase 50 percent or more 
108.20 	from one insurance year to the next.
108.21 	(e) The exclusive representative shall give the employer notice of intent to withdraw 
108.22 	to the commissioner at least 30 days before the expiration date of a collective bargaining 
108.23 	agreement 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 
108.25 	individuals who will be participating within two weeks of the commissioner receiving 
108.26 	notice of the parties' intent to participate. The employer shall also submit other information 
108.27 	as required by the commissioner for administration of the program.

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

108.29 	Sec. 2. Minnesota Statutes 2010, section 62A.047, is amended to read:
108.30 	62A.047 CHILDREN'S HEALTH SUPERVISION SERVICES AND 
108.31 	PRENATAL CARE SERVICES.
108.32 	A policy of individual or group health and accident insurance regulated under this 
108.33 	chapter, or individual or group subscriber contract regulated under chapter 62C, health 
108.34 	maintenance contract regulated under chapter 62D, or health benefit certificate regulated 
109.1 	under chapter 64B, issued, renewed, or continued to provide coverage to a Minnesota 
109.2 	resident, must provide coverage for child health supervision services and prenatal care 
109.3 	services. The policy, contract, or certificate must specifically exempt reasonable and 
109.4 	customary charges for child health supervision services and prenatal care services from a 
109.5 	deductible, co-payment, or other coinsurance or dollar limitation requirement. Nothing 
109.6 	in this section prohibits a health plan company that has a network of providers from 
109.7 	imposing a deductible, co-payment, or other coinsurance or dollar limitation requirement 
109.8 	for child health supervision services and prenatal care services that are delivered by an 
109.9 	out-of-network provider. This section does not prohibit the use of policy waiting periods 
109.10 	or preexisting condition limitations for these services. Minimum benefits may be limited 
109.11 	to one visit payable to one provider for all of the services provided at each visit cited in 
109.12 	this section subject to the schedule set forth in this section. Nothing in this section applies 
109.13 	to a commercial health insurance policy issued as a companion to a health maintenance 
109.14 	organization contract, a policy designed primarily to provide coverage payable on a 
109.15 	per diem, fixed indemnity, or nonexpense incurred basis, or a policy that provides 
109.16 	only accident coverage Nothing in this section prevents a health plan company from 
109.17 	using reasonable medical management techniques to determine the frequency, method, 
109.18 	treatment, or setting for child health supervision services and prenatal care services.
109.19 	"Child health supervision services" means pediatric preventive services, appropriate 
109.20 	immunizations, developmental assessments, and laboratory services appropriate to the age 
109.21 	of a child from birth to age six, and appropriate immunizations from ages six to 18, as 
109.22 	defined by Standards of Child Health Care issued by the American Academy of Pediatrics. 
109.23 	Reimbursement must be made for at least five child health supervision visits from birth 
109.24 	to 12 months, three child health supervision visits from 12 months to 24 months, once a 
109.25 	year from 24 months to 72 months.
109.26 	"Prenatal care services" means the comprehensive package of medical and 
109.27 	psychosocial support provided throughout the pregnancy, including risk assessment, 
109.28 	serial surveillance, prenatal education, and use of specialized skills and technology, 
109.29 	when needed, as defined by Standards for Obstetric-Gynecologic Services issued by the 
109.30 	American College of Obstetricians and Gynecologists.

109.31 	Sec. 3. Minnesota Statutes 2010, section 62A.21, subdivision 2a, is amended to read:
109.32 		Subd. 2a.Continuation privilege. Every policy described in subdivision 1 shall 
109.33 	contain a provision which permits continuation of coverage under the policy for the 
109.34 	insured's former spouse and dependent children upon entry of a valid decree of dissolution 
109.35 	of marriage. The coverage shall be continued until the earlier of the following dates:
110.1 	(a) the date the insured's former spouse becomes covered under any other group 
110.2 	health plan; or
110.3 	(b) the date coverage would otherwise terminate under the policy.
110.4 	If the coverage is provided under a group policy, any required premium contributions 
110.5 	for the coverage shall be paid by the insured on a monthly basis to the group policyholder 
110.6 	for remittance to the insurer. The policy must require the group policyholder to, upon 
110.7 	request, provide the insured with written verification from the insurer of the cost of this 
110.8 	coverage promptly at the time of eligibility for this coverage and at any time during 
110.9 	the continuation period. In no event shall the amount of premium charged exceed 102 
110.10 	percent of the cost to the plan for such period of coverage for other similarly situated 
110.11 	spouses and dependent children with respect to whom the marital relationship has not 
110.12 	dissolved, without regard to whether such cost is paid by the employer or employee The 
110.13 	required premium amount for continuation of the coverage shall be calculated in the same 
110.14 	manner as provided under section 4980B of the Internal Revenue Code, its implementing 
110.15 	regulations and Internal Revenue Service rulings on section 4980B.
110.16 	Upon request by the insured's former spouse or dependent child, a health carrier 
110.17 	must provide the instructions necessary to enable the child or former spouse to elect 
110.18 	continuation of coverage.

110.19 	Sec. 4. Minnesota Statutes 2010, section 62D.101, subdivision 2a, is amended to read:
110.20 		Subd. 2a.Continuation privilege. Every health maintenance contract as described 
110.21 	in subdivision 1 shall contain a provision which permits continuation of coverage under 
110.22 	the contract for the enrollee's former spouse and children upon entry of a valid decree of 
110.23 	dissolution of marriage. The coverage shall be continued until the earlier of the following 
110.24 	dates:
110.25 	(a) the date the enrollee's former spouse becomes covered under another group 
110.26 	plan or Medicare; or
110.27 	(b) the date coverage would otherwise terminate under the health maintenance 
110.28 	contract.
110.29 	If coverage is provided under a group policy, any required premium contributions 
110.30 	for the coverage shall be paid by the enrollee on a monthly basis to the group contract 
110.31 	holder to be paid to the health maintenance organization. The contract must require the 
110.32 	group contract holder to, upon request, provide the enrollee with written verification from 
110.33 	the insurer of the cost of this coverage promptly at the time of eligibility for this coverage 
110.34 	and at any time during the continuation period. In no event shall the fee charged exceed 
110.35 	102 percent of the cost to the plan for the period of coverage for other similarly situated 
111.1 	spouses and dependent children when the marital relationship has not dissolved, regardless 
111.2 	of whether the cost is paid by the employer or employee The required premium amount 
111.3 	for continuation of the coverage shall be calculated in the same manner as provided under 
111.4 	section 4980B in the Internal Revenue Code, its implementing regulations and Internal 
111.5 	Revenue Service rulings on section 4980B.

111.6 	Sec. 5. Minnesota Statutes 2010, section 62J.26, subdivision 3, is amended to read:
111.7 		Subd. 3.Requests for evaluation. (a) Whenever a legislative measure containing 
111.8 	a mandated health benefit proposal is introduced as a bill or offered as an amendment 
111.9 	to a bill, or is likely to be introduced as a bill or offered as an amendment, a the chair 
111.10 	of any standing the legislative committee that has jurisdiction over the subject matter 
111.11 	of the proposal may must request that the commissioner complete an evaluation of the 
111.12 	proposal under this section, to inform any committee of floor action by either house of 
111.13 	the legislature.
111.14 	(b) The commissioner must conduct an evaluation described in subdivision 2 of each 
111.15 	mandated health benefit proposal for which an evaluation is requested under paragraph (a), 
111.16 	unless the commissioner determines under paragraph (c) or subdivision 4 that priorities 
111.17 	and resources do not permit its evaluation introduced as a bill or offered as an amendment 
111.18 	to a bill as requested under paragraph (a).
111.19 	(c) If requests for evaluation of multiple proposals are received, the commissioner 
111.20 	must consult with the chairs of the standing legislative committees having jurisdiction 
111.21 	over the subject matter of the mandated health benefit proposals to prioritize the requests 
111.22 	and establish a reporting date for each proposal to be evaluated. The commissioner 
111.23 	is not required to direct an unreasonable quantity of the commissioner's resources to 
111.24 	these evaluations.

111.25 	Sec. 6. Minnesota Statutes 2010, section 62J.26, subdivision 5, is amended to read:
111.26 		Subd. 5.Report to legislature. The commissioner must submit a written report on 
111.27 	the evaluation to the legislature no later than 180 30 days after the request. The report 
111.28 	must be submitted in compliance with sections 3.195 and 3.197.

111.29 	Sec. 7. Minnesota Statutes 2010, section 62J.26, is amended by adding a subdivision to 
111.30 	read:
111.31 		Subd. 6.Evaluation of mandated health benefits. (a) The commissioner of 
111.32 	commerce, in consultation with the commissioners of health and management and budget, 
112.1 	shall evaluate each mandated health benefit currently required in Minnesota Statutes or 
112.2 	Rules in accordance with the evaluation process described in subdivision 2.
112.3 	(b) For purposes of this subdivision, a "mandated health benefit" means a statutory 
112.4 	or administrative requirement that a health plan do the following:
112.5 	(1) provide coverage or increase the amount of coverage for the treatment of a 
112.6 	particular disease, condition, or other health care need;
112.7 	(2) provide coverage or increase the amount of coverage of a particular type of 
112.8 	health care treatment or service, or of equipment, supplies, or drugs used in connection 
112.9 	with a health care treatment or service; or
112.10 	(3) provide coverage for care delivered by a specific type of provider.
112.11 	(c) The commissioner must submit a written report on the evaluation of existing state 
112.12 	mandated health benefits to the legislature by December 31, 2015.

112.13 	EFFECTIVE DATE. This section is effective July 1, 2013.

112.14 	Sec. 8. [148.2855] NURSE LICENSURE COMPACT.
112.15 	The Nurse Licensure Compact is enacted into law and entered into with all other 
112.16 	jurisdictions legally joining in it, in the form substantially as follows:
112.17 	ARTICLE 1
112.18 	DEFINITIONS
112.19 	As used in this compact:
112.20 	(a) "Adverse action" means a home or remote state action.
112.21 	(b) "Alternative program" means a voluntary, nondisciplinary monitoring program 
112.22 	approved by a nurse licensing board.
112.23 	(c) "Coordinated licensure information system" means an integrated process for 
112.24 	collecting, storing, and sharing information on nurse licensure and enforcement activities 
112.25 	related to nurse licensure laws, which is administered by a nonprofit organization 
112.26 	composed of and controlled by state nurse licensing boards.
112.27 	(d) "Current significant investigative information" means:
112.28 	(1) investigative information that a licensing board, after a preliminary inquiry that 
112.29 	includes notification and an opportunity for the nurse to respond if required by state law, 
112.30 	has reason to believe is not groundless and, if proved true, would indicate more than a 
112.31 	minor infraction; or
112.32 	(2) investigative information that indicates that the nurse represents an immediate 
112.33 	threat to public health and safety regardless of whether the nurse has been notified and 
112.34 	had an opportunity to respond.
112.35 	(e) "Home state" means the party state which is the nurse's primary state of residence.
113.1 	(f) "Home state action" means any administrative, civil, equitable, or criminal 
113.2 	action permitted by the home state's laws which are imposed on a nurse by the home 
113.3 	state's licensing board or other authority including actions against an individual's license 
113.4 	such as revocation, suspension, probation, or any other action which affects a nurse's 
113.5 	authorization to practice.
113.6 	(g) "Licensing board" means a party state's regulatory body responsible for issuing 
113.7 	nurse licenses.
113.8 	(h) "Multistate licensure privilege" means current, official authority from a 
113.9 	remote state permitting the practice of nursing as either a registered nurse or a licensed 
113.10 	practical/vocational nurse in the party state. All party states have the authority, according 
113.11 	to existing state due process law, to take actions against the nurse's privilege such as 
113.12 	revocation, suspension, probation, or any other action which affects a nurse's authorization 
113.13 	to practice.
113.14 	(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those 
113.15 	terms are defined by each party state's practice laws.
113.16 	(j) "Party state" means any state that has adopted this compact.
113.17 	(k) "Remote state" means a party state other than the home state:
113.18 	(1) where the patient is located at the time nursing care is provided; or
113.19 	(2) in the case of the practice of nursing not involving a patient, in the party state 
113.20 	where the recipient of nursing practice is located.
113.21 	(l) "Remote state action" means:
113.22 	(1) any administrative, civil, equitable, or criminal action permitted by a remote 
113.23 	state's laws which are imposed on a nurse by the remote state's licensing board or other 
113.24 	authority including actions against an individual's multistate licensure privilege to practice 
113.25 	in the remote state; and
113.26 	(2) cease and desist and other injunctive or equitable orders issued by remote states 
113.27 	or the licensing boards of those states.
113.28 	(m) "State" means a state, territory, or possession of the United States, the District of 
113.29 	Columbia, or the Commonwealth of Puerto Rico.
113.30 	(n) "State practice laws" means individual party state laws and regulations that 
113.31 	govern the practice of nursing, define the scope of nursing practice, and create the 
113.32 	methods and grounds for imposing discipline. State practice laws does not include the 
113.33 	initial qualifications for licensure or requirements necessary to obtain and retain a license, 
113.34 	except for qualifications or requirements of the home state.
113.35 	ARTICLE 2
113.36 	GENERAL PROVISIONS AND JURISDICTION
114.1 	(a) A license to practice registered nursing issued by a home state to a resident in 
114.2 	that state will be recognized by each party state as authorizing a multistate licensure 
114.3 	privilege to practice as a registered nurse in the party state. A license to practice licensed 
114.4 	practical/vocational nursing issued by a home state to a resident in that state will be 
114.5 	recognized by each party state as authorizing a multistate licensure privilege to practice 
114.6 	as a licensed practical/vocational nurse in the party state. In order to obtain or retain a 
114.7 	license, an applicant must meet the home state's qualifications for licensure and license 
114.8 	renewal as well as all other applicable state laws.
114.9 	(b) Party states may, according to state due process laws, limit or revoke the 
114.10 	multistate licensure privilege of any nurse to practice in their state and may take any other 
114.11 	actions under their applicable state laws necessary to protect the health and safety of 
114.12 	their citizens. If a party state takes such action, it shall promptly notify the administrator 
114.13 	of the coordinated licensure information system. The administrator of the coordinated 
114.14 	licensure information system shall promptly notify the home state of any such actions by 
114.15 	remote states.
114.16 	(c) Every nurse practicing in a party state must comply with the state practice laws of 
114.17 	the state in which the patient is located at the time care is rendered. In addition, the practice 
114.18 	of nursing is not limited to patient care, but shall include all nursing practice as defined by 
114.19 	the state practice laws of the party state. The practice of nursing will subject a nurse to the 
114.20 	jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
114.21 	(d) This compact does not affect additional requirements imposed by states for 
114.22 	advanced practice registered nursing. However, a multistate licensure privilege to practice 
114.23 	registered nursing granted by a party state shall be recognized by other party states as a 
114.24 	license to practice registered nursing if one is required by state law as a precondition for 
114.25 	qualifying for advanced practice registered nurse authorization.
114.26 	(e) Individuals not residing in a party state shall continue to be able to apply for 
114.27 	nurse licensure as provided for under the laws of each party state. However, the license 
114.28 	granted to these individuals will not be recognized as granting the privilege to practice 
114.29 	nursing in any other party state unless explicitly agreed to by that party state.
114.30 	ARTICLE 3
114.31 	APPLICATIONS FOR LICENSURE IN A PARTY STATE
114.32 	(a) Upon application for a license, the licensing board in a party state shall ascertain, 
114.33 	through the coordinated licensure information system, whether the applicant has ever held 
114.34 	or is the holder of a license issued by any other state, whether there are any restrictions 
114.35 	on the multistate licensure privilege, and whether any other adverse action by a state 
114.36 	has been taken against the license.
115.1 	(b) A nurse in a party state shall hold licensure in only one party state at a time, 
115.2 	issued by the home state.
115.3 	(c) A nurse who intends to change primary state of residence may apply for licensure 
115.4 	in the new home state in advance of the change. However, new licenses will not be 
115.5 	issued by a party state until after a nurse provides evidence of change in primary state of 
115.6 	residence satisfactory to the new home state's licensing board.
115.7 	(d) When a nurse changes primary state of residence by:
115.8 	(1) moving between two party states, and obtains a license from the new home state, 
115.9 	the license from the former home state is no longer valid;
115.10 	(2) moving from a nonparty state to a party state, and obtains a license from the new 
115.11 	home state, the individual state license issued by the nonparty state is not affected and will 
115.12 	remain in full force if so provided by the laws of the nonparty state; or
115.13 	(3) moving from a party state to a nonparty state, the license issued by the prior 
115.14 	home state converts to an individual state license, valid only in the former home state, 
115.15 	without the multistate licensure privilege to practice in other party states.
115.16 	ARTICLE 4
115.17 	ADVERSE ACTIONS
115.18 	In addition to the general provisions described in article 2, the provisions in this 
115.19 	article apply.
115.20 	(a) The licensing board of a remote state shall promptly report to the administrator 
115.21 	of the coordinated licensure information system any remote state actions including the 
115.22 	factual and legal basis for the action, if known. The licensing board of a remote state shall 
115.23 	also promptly report any significant current investigative information yet to result in a 
115.24 	remote state action. The administrator of the coordinated licensure information system 
115.25 	shall promptly notify the home state of any reports.
115.26 	(b) The licensing board of a party state shall have the authority to complete any 
115.27 	pending investigation for a nurse who changes primary state of residence during the 
115.28 	course of the investigation. The board shall also have the authority to take appropriate 
115.29 	action, and shall promptly report the conclusion of the investigation to the administrator 
115.30 	of the coordinated licensure information system. The administrator of the coordinated 
115.31 	licensure information system shall promptly notify the new home state of any action.
115.32 	(c) A remote state may take adverse action affecting the multistate licensure 
115.33 	privilege to practice within that party state. However, only the home state shall have the 
115.34 	power to impose adverse action against the license issued by the home state.
115.35 	(d) For purposes of imposing adverse actions, the licensing board of the home state 
115.36 	shall give the same priority and effect to reported conduct received from a remote state as 
116.1 	it would if the conduct had occurred within the home state. In so doing, it shall apply its 
116.2 	own state laws to determine appropriate action.
116.3 	(e) The home state may take adverse action based on the factual findings of the 
116.4 	remote state, provided each state follows its own procedures for imposing the adverse 
116.5 	action.
116.6 	(f) Nothing in this compact shall override a party state's decision that participation 
116.7 	in an alternative program may be used in lieu of licensure action and that participation 
116.8 	shall remain nonpublic if required by the party state's laws.
116.9 	Party states must require nurses who enter any alternative programs to agree not to 
116.10 	practice in any other party state during the term of the alternative program without prior 
116.11 	authorization from the other party state.
116.12 	ARTICLE 5
116.13 	ADDITIONAL AUTHORITIES INVESTED IN 
116.14 	PARTY STATE NURSE LICENSING BOARDS
116.15 	Notwithstanding any other laws, party state nurse licensing boards shall have the 
116.16 	authority to:
116.17 	(1) if otherwise permitted by state law, recover from the affected nurse the costs of 
116.18 	investigation and disposition of cases resulting from any adverse action taken against 
116.19 	that nurse;
116.20 	(2) issue subpoenas for both hearings and investigations which require the attendance 
116.21 	and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse 
116.22 	licensing board in a party state for the attendance and testimony of witnesses, and the 
116.23 	production of evidence from another party state, shall be enforced in the latter state by 
116.24 	any court of competent jurisdiction according to the practice and procedure of that court 
116.25 	applicable to subpoenas issued in proceedings pending before it. The issuing authority 
116.26 	shall pay any witness fees, travel expenses, mileage, and other fees required by the service 
116.27 	statutes of the state where the witnesses and evidence are located;
116.28 	(3) issue cease and desist orders to limit or revoke a nurse's authority to practice 
116.29 	in the nurse's state; and
116.30 	(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).
116.31 	ARTICLE 6
116.32 	COORDINATED LICENSURE INFORMATION SYSTEM
116.33 	(a) All party states shall participate in a cooperative effort to create a coordinated 
116.34 	database of all licensed registered nurses and licensed practical/vocational nurses. This 
116.35 	system shall include information on the licensure and disciplinary history of each 
117.1 	nurse, as contributed by party states, to assist in the coordination of nurse licensure and 
117.2 	enforcement efforts.
117.3 	(b) Notwithstanding any other provision of law, all party states' licensing boards shall 
117.4 	promptly report adverse actions, actions against multistate licensure privileges, any current 
117.5 	significant investigative information yet to result in adverse action, denials of applications, 
117.6 	and the reasons for the denials to the coordinated licensure information system.
117.7 	(c) Current significant investigative information shall be transmitted through the 
117.8 	coordinated licensure information system only to party state licensing boards.
117.9 	(d) Notwithstanding any other provision of law, all party states' licensing boards 
117.10 	contributing information to the coordinated licensure information system may designate 
117.11 	information that may not be shared with nonparty states or disclosed to other entities or 
117.12 	individuals without the express permission of the contributing state.
117.13 	(e) Any personally identifiable information obtained by a party state's licensing 
117.14 	board from the coordinated licensure information system may not be shared with nonparty 
117.15 	states or disclosed to other entities or individuals except to the extent permitted by the 
117.16 	laws of the party state contributing the information.
117.17 	(f) Any information contributed to the coordinated licensure information system that 
117.18 	is subsequently required to be expunged by the laws of the party state contributing that 
117.19 	information shall also be expunged from the coordinated licensure information system.
117.20 	(g) The compact administrators, acting jointly with each other and in consultation 
117.21 	with the administrator of the coordinated licensure information system, shall formulate 
117.22 	necessary and proper procedures for the identification, collection, and exchange of 
117.23 	information under this compact.
117.24 	ARTICLE 7
117.25 	COMPACT ADMINISTRATION AND
117.26 	INTERCHANGE OF INFORMATION
117.27 	(a) The head or designee of the nurse licensing board of each party state shall be the 
117.28 	administrator of this compact for that state.
117.29 	(b) The compact administrator of each party state shall furnish to the compact 
117.30 	administrator of each other party state any information and documents including, but not 
117.31 	limited to, a uniform data set of investigations, identifying information, licensure data, and 
117.32 	disclosable alternative program participation information to facilitate the administration of 
117.33 	this compact.
117.34 	(c) Compact administrators shall have the authority to develop uniform rules to 
117.35 	facilitate and coordinate implementation of this compact. These uniform rules shall be 
117.36 	adopted by party states under the authority in article 5, clause (4).
118.1 	ARTICLE 8
118.2 	IMMUNITY
118.3 	A party state or the officers, employees, or agents of a party state's nurse licensing 
118.4 	board who acts in good faith according to the provisions of this compact shall not be 
118.5 	liable for any act or omission while engaged in the performance of their duties under 
118.6 	this compact. Good faith shall not include willful misconduct, gross negligence, or 
118.7 	recklessness.
118.8 	ARTICLE 9
118.9 	ENACTMENT, WITHDRAWAL, AND AMENDMENT
118.10 	(a) This compact shall become effective for each state when it has been enacted by 
118.11 	that state. Any party state may withdraw from this compact by repealing the nurse licensure 
118.12 	compact, but no withdrawal shall take effect until six months after the withdrawing state 
118.13 	has given notice of the withdrawal to the executive heads of all other party states.
118.14 	(b) No withdrawal shall affect the validity or applicability by the licensing boards 
118.15 	of states remaining party to the compact of any report of adverse action occurring prior 
118.16 	to the withdrawal.
118.17 	(c) Nothing contained in this compact shall be construed to invalidate or prevent any 
118.18 	nurse licensure agreement or other cooperative arrangement between a party state and a 
118.19 	nonparty state that is made according to the other provisions of this compact.
118.20 	(d) This compact may be amended by the party states. No amendment to this 
118.21 	compact shall become effective and binding upon the party states until it is enacted into 
118.22 	the laws of all party states.
118.23 	ARTICLE 10
118.24 	CONSTRUCTION AND SEVERABILITY
118.25 	(a) This compact shall be liberally construed to effectuate the purposes of the 
118.26 	compact. The provisions of this compact shall be severable and if any phrase, clause, 
118.27 	sentence, or provision of this compact is declared to be contrary to the constitution of any 
118.28 	party state or of the United States or the applicability thereof to any government, agency, 
118.29 	person, or circumstance is held invalid, the validity of the remainder of this compact and 
118.30 	the applicability of it to any government, agency, person, or circumstance shall not be 
118.31 	affected by it. If this compact is held contrary to the constitution of any party state, the 
118.32 	compact shall remain in full force and effect for the remaining party states and in full force 
118.33 	and effect for the party state affected as to all severable matters.
118.34 	(b) In the event party states find a need for settling disputes arising under this 
118.35 	compact:
119.1 	(1) the party states may submit the issues in dispute to an arbitration panel which 
119.2 	shall be comprised of an individual appointed by the compact administrator in the home 
119.3 	state, an individual appointed by the compact administrator in the remote states involved, 
119.4 	and an individual mutually agreed upon by the compact administrators of the party states 
119.5 	involved in the dispute; and
119.6 	(2) the decision of a majority of the arbitrators shall be final and binding.

119.7 	EFFECTIVE DATE. This section is effective upon implementation of the 
119.8 	coordinated licensure information system defined in section 148.2855, but no sooner 
119.9 	than July 1, 2013.

119.10 	Sec. 9. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO 
119.11 	EXISTING LAWS.
119.12 	(a) A nurse practicing professional or practical nursing in Minnesota under the 
119.13 	authority of section 148.2855 shall have the same obligations, privileges, and rights as if 
119.14 	the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section 
119.15 	148.2855, the Board of Nursing shall comply with and follow all laws and rules with 
119.16 	respect to registered and licensed practical nurses practicing professional or practical 
119.17 	nursing in Minnesota under the authority of section 148.2855, and all such individuals 
119.18 	shall be governed and regulated as if they were licensed by the board.
119.19 	(b) Section 148.2855 does not relieve employers of nurses from complying with 
119.20 	statutorily imposed obligations.
119.21 	(c) Section 148.2855 does not supersede existing state labor laws.
119.22 	(d) For purposes of the Minnesota Government Data Practices Act, chapter 13, 
119.23 	an individual not licensed as a nurse under sections 148.171 to 148.285 who practices 
119.24 	professional or practical nursing in Minnesota under the authority of section 148.2855 is 
119.25 	considered to be a licensee of the board.
119.26 	(e) Uniform rules developed by the compact administrators shall not be subject 
119.27 	to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101, 
119.28 	14.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
119.29 	(f) Proceedings brought against an individual's multistate privilege shall be 
119.30 	adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject 
119.31 	to judicial review as provided for in sections 14.63 to 14.69.
119.32 	(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4; 
119.33 	144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917, 
119.34 	subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40, 
119.35 	subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are 
120.1 	licensed as registered or licensed practical nurses in the home state shall be considered 
120.2 	to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to 
120.3 	registered nurses or the practice of professional nursing, then only holders of a multistate 
120.4 	privilege who are licensed as registered nurses in the home state shall be considered 
120.5 	licensees.
120.6 	(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557 
120.7 	apply to individuals not licensed as registered or licensed practical nurses under sections 
120.8 	148.171 to 148.285 who practice professional or practical nursing in Minnesota under 
120.9 	the authority of section 148.2855.
120.10 	(i) The board may take action against an individual's multistate privilege based on 
120.11 	the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or 
120.12 	requiring the board to take corrective or disciplinary action.
120.13 	(j) The board may take all forms of disciplinary action provided for in section 
120.14 	148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision 
120.15 	6, against an individual's multistate privilege.
120.16 	(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals 
120.17 	who practice professional or practical nursing in Minnesota under the authority of section 
120.18 	148.2855.
120.19 	(l) The cooperation requirements of section 148.265 apply to individuals who 
120.20 	practice professional or practical nursing in Minnesota under the authority of section 
120.21 	148.2855.
120.22 	(m) The provisions of section 148.283 shall not apply to individuals who practice 
120.23 	professional or practical nursing in Minnesota under the authority of section 148.2855.
120.24 	(n) Complaints against individuals who practice professional or practical nursing 
120.25 	in Minnesota under the authority of section 148.2855 shall be handled as provided in 
120.26 	sections 214.10 and 214.103.
120.27 	(o) All provisions of section 148.2855 authorizing or requiring the board to provide 
120.28 	data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
120.29 	(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a 
120.30 	remote state any active investigative data regarding a complaint investigation against a 
120.31 	nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable 
120.32 	assurances from the remote state that the data will be maintained with the same protections 
120.33 	as provided in Minnesota law.
120.34 	(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice 
120.35 	professional or practical nursing in Minnesota under the authority of section 148.2855 
120.36 	when the practice involves direct physical contact between the nurse and a patient.
121.1 	(r) A nurse practicing professional or practical nursing in Minnesota under the 
121.2 	authority of section 148.2855 must comply with any criminal background check required 
121.3 	under Minnesota law.

121.4 	EFFECTIVE DATE. This section is effective upon implementation of the 
121.5 	coordinated licensure information system defined in section 148.2855, but no sooner 
121.6 	than July 1, 2013.

121.7 	Sec. 10. [148.2857] WITHDRAWAL FROM COMPACT.
121.8 	The governor may withdraw the state from the compact in section 148.2855 if 
121.9 	the Board of Nursing notifies the governor that a party state to the compact changed 
121.10 	the party state's requirements for nurse licensure after July 1, 2012, and that the party 
121.11 	state's requirements, as changed, are substantially lower than the requirements for nurse 
121.12 	licensure in this state.

121.13 	EFFECTIVE DATE. This section is effective upon implementation of the 
121.14 	coordinated licensure information system defined in section 148.2855, but no sooner 
121.15 	than July 1, 2013.

121.16 	Sec. 11. [148.2858] MISCELLANEOUS PROVISIONS.
121.17 	(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board" 
121.18 	means the executive director of the board.
121.19 	(b) The Board of Nursing shall have the authority to recover from a nurse practicing 
121.20 	professional or practical nursing in Minnesota under the authority of section 148.2855 
121.21 	the costs of investigation and disposition of cases resulting from any adverse action 
121.22 	taken against the nurse.
121.23 	(c) The board may implement a system of identifying individuals who practice 
121.24 	professional or practical nursing in Minnesota under the authority of section 148.2855.

121.25 	EFFECTIVE DATE. This section is effective upon implementation of the 
121.26 	coordinated licensure information system defined in section 148.2855, but no sooner 
121.27 	than July 1, 2013.

121.28 	Sec. 12. [148.2859] NURSE LICENSURE COMPACT ADVISORY 
121.29 	COMMITTEE.
121.30 		Subdivision 1.Establishment; membership. A Nurse Licensure Compact Advisory 
121.31 	Committee is established to advise the compact administrator in the implementation of 
121.32 	section 148.2855. Members of the advisory committee shall be appointed by the board 
122.1 	and shall be composed of representatives of Minnesota nursing organizations, Minnesota 
122.2 	licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses 
122.3 	who provide home care, Minnesota licensed advanced practice registered nurses, and 
122.4 	public members as defined in section 214.02.
122.5 		Subd. 2.Duties. The advisory committee shall advise the compact administrator in 
122.6 	the implementation of section 148.2855.
122.7 		Subd. 3.Organization. The advisory committee shall be organized and 
122.8 	administered under section 15.059.

122.9 	EFFECTIVE DATE. This section is effective upon implementation of the 
122.10 	coordinated licensure information system defined in section 148.2855, but no sooner 
122.11 	than July 1, 2013.

122.12 	Sec. 13. Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 
122.13 	8, is amended to read:

122.14
122.15	Subd. 8.Board of Nursing Home 
Administrators
 		2,153,000
		2,145,000
	
122.16 	Rulemaking. Of this appropriation, $44,000 
122.17 	in fiscal year 2012 is for rulemaking. This is 
122.18 	a onetime appropriation.
122.19 	Electronic Licensing System Adaptors.
122.20 	Of this appropriation, $761,000 in fiscal 
122.21 	year 2013 from the state government special 
122.22 	revenue fund is to the administrative services 
122.23 	unit to cover the costs to connect to the 
122.24 	e-licensing system. Minnesota Statutes, 
122.25 	section 16E.22. Base level funding for this 
122.26 	activity in fiscal year 2014 shall be $100,000. 
122.27 	Base level funding for this activity in fiscal 
122.28 	year 2015 shall be $50,000.
122.29 	Development and Implementation of a 
122.30 	Disciplinary, Regulatory, Licensing and 
122.31 	Information Management System. Of this 
122.32 	appropriation, $800,000 in fiscal year 2012 
122.33 	and $300,000 in fiscal year 2013 are for the 
122.34 	development of a shared system. Base level 
123.1 	funding for this activity in fiscal year 2014 
123.2 	shall be $50,000.
123.3 	Administrative Services Unit - Operating 
123.4 	Costs. Of this appropriation, $526,000 
123.5 	in fiscal year 2012 and $526,000 in 
123.6 	fiscal year 2013 are for operating costs 
123.7 	of the administrative services unit. The 
123.8 	administrative services unit may receive 
123.9 	and expend reimbursements for services 
123.10 	performed by other agencies.
123.11 	Administrative Services Unit - Retirement 
123.12 	Costs. Of this appropriation in fiscal year 
123.13 	2012, $225,000 is for onetime retirement 
123.14 	costs in the health-related boards. This 
123.15 	funding may be transferred to the health 
123.16 	boards incurring those costs for their 
123.17 	payment. These funds are available either 
123.18 	year of the biennium.
123.19 	Administrative Services Unit - Volunteer 
123.20 	Health Care Provider Program. Of this 
123.21 	appropriation, $150,000 in fiscal year 2012 
123.22 	and $150,000 in fiscal year 2013 are to pay 
123.23 	for medical professional liability coverage 
123.24 	required under Minnesota Statutes, section 
123.25 	214.40.
123.26 	Administrative Services Unit - Contested 
123.27 	Cases and Other Legal Proceedings. Of 
123.28 	this appropriation, $200,000 in fiscal year 
123.29 	2012 and $200,000 in fiscal year 2013 are 
123.30 	for costs of contested case hearings and other 
123.31 	unanticipated costs of legal proceedings 
123.32 	involving health-related boards funded 
123.33 	under this section. Upon certification of a 
123.34 	health-related board to the administrative 
123.35 	services unit that the costs will be incurred 
124.1 	and that there is insufficient money available 
124.2 	to pay for the costs out of money currently 
124.3 	available to that board, the administrative 
124.4 	services unit is authorized to transfer money 
124.5 	from this appropriation to the board for 
124.6 	payment of those costs with the approval 
124.7 	of the commissioner of management and 
124.8 	budget. This appropriation does not cancel. 
124.9 	Any unencumbered and unspent balances 
124.10 	remain available for these expenditures in 
124.11 	subsequent fiscal years.
124.12 	Base Adjustment. The State Government 
124.13 	Special Revenue Fund base is decreased by 
124.14 	$911,000 in fiscal year 2014 and $1,011,000
124.15 	$961,000 in fiscal year 2015.

124.16 	Sec. 14. BIENNIAL BUDGET REQUEST; UNIVERSITY OF MINNESOTA.
 124.17 	Beginning in 2013, as part of the biennial budget request submitted to the 
124.18 	Department of Management and Budget, and the legislature, the Board of Regents of the 
124.19 	University of Minnesota is encouraged to include a request for funding for rural primary 
124.20 	care training by family practice residence programs to prepare doctors for the practice 
124.21 	of primary care medicine in rural areas of the state. The funding request should provide 
124.22 	for ongoing support of rural primary care training through the University of Minnesota's 
124.23 	general operation and maintenance funding or through dedicated health science funding.

124.24 	ARTICLE 6
124.25 	HEALTH AND HUMAN SERVICES APPROPRIATIONS

124.26	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
124.27 	The sums shown in the columns marked "Appropriations" are added to or, if shown 
124.28 	in parentheses, subtracted from the appropriations in Laws 2011, First Special Session 
124.29 	chapter 9, article 10, to the agencies and for the purposes specified in this article. The 
124.30 	appropriations are from the general fund or other named fund and are available for the 
124.31 	fiscal years indicated for each purpose. The figures "2012" and "2013" used in this 
124.32 	article mean that the addition to or subtraction from the appropriation listed under them 
124.33 	is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively. 
124.34 	Supplemental appropriations and reductions to appropriations for the fiscal year ending 
125.1 	June 30, 2012, are effective the day following final enactment unless a different effective 
125.2 	date is explicit.

125.3				APPROPRIATIONS
	
125.4				Available for the Year
	
125.5				Ending June 30
	
125.6					2012
		2013

125.7
125.8	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

125.9	Subdivision 1.Total Appropriation
 	$
	69,000
	$
	3,833,000

125.10	Appropriations by Fund
	
125.11		2012
	2013
	
125.12	General
	-0-
	46,000
	
125.13	Health Care Access
	-0-
	23,000
	
125.14	Federal TANF
	69,000
	3,764,000

125.15	Subd. 2.Central Office Operations

125.16	(a) Operations
		-0-
		502,000
	
125.17 	Base Level Adjustment. The general fund 
125.18 	base is decreased by $104,000 in fiscal year 
125.19 	2014 and $107,000 in fiscal year 2015.

125.20	(b) Health Care
		-0-
		473,000
	
125.21 	This is a onetime appropriation.

125.22	(c) Continuing Care
		-0-
		275,000
	
125.23 	Base Level Adjustment. The general fund 
125.24 	base is decreased by $149,000 in fiscal year 
125.25 	2014 and $169,000 in fiscal year 2015.

125.26	Subd. 3.Forecasted Programs

125.27	(a) MFIP/DWP Grants

125.28	Appropriations by Fund
	
125.29		2012
	2013
	
125.30	General
	(69,000)
	(3,769,000)
	
125.31	Federal TANF
	69,000
	3,764,000

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

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

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

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

126.3	(f) MinnesotaCare Grants
		-0-
		23,000
	
126.4 	This appropriation is from the health care 
126.5 	access fund.

126.6	(g) Medical Assistance Grants
		69,000
		2,583,000
	
126.7 	Continuing Care Provider Fiscal Year 
126.8 	2013 Payment Delay. The commissioner 
126.9 	of human services shall delay the last 
126.10 	payment or payments in fiscal year 2013 by 
126.11 	up to $22,854,000 to the following service 
126.12 	providers:
126.13 	(1) home and community-based waivered 
126.14 	services for persons with developmental 
126.15 	disabilities or related conditions, including 
126.16 	consumer-directed community supports, 
126.17 	under Minnesota Statutes, section 256B.501;
126.18 	(2) home and community-based waivered 
126.19 	services for the elderly, including 
126.20 	consumer-directed community supports, 
126.21 	under Minnesota Statutes, section 
126.22 	256B.0915;
126.23 	(3) waivered services under community 
126.24 	alternatives for disabled individuals, 
126.25 	including consumer-directed community 
126.26 	supports, under Minnesota Statutes, section 
126.27 	256B.49;
126.28 	(4) community alternative care waivered 
126.29 	services, including consumer-directed 
126.30 	community supports, under Minnesota 
126.31 	Statutes, section 256B.49;
126.32 	(5) traumatic brain injury waivered services, 
126.33 	including consumer-directed community 
127.1 	supports, under Minnesota Statutes, section 
127.2 	256B.49;
127.3 	(6) nursing services and home health 
127.4 	services under Minnesota Statutes, section 
127.5 	256B.0625, subdivision 6a;
127.6 	(7) personal care services and qualified 
127.7 	professional supervision of personal care 
127.8 	services under Minnesota Statutes, section 
127.9 	256B.0625, subdivisions 6a and 19a;
127.10 	(8) private duty nursing services under 
127.11 	Minnesota Statutes, section 256B.0625, 
127.12 	subdivision 7;
127.13 	(9) day training and habilitation services for 
127.14 	adults with developmental disabilities or 
127.15 	related conditions under Minnesota Statutes, 
127.16 	sections 252.40 to 252.46, including the 
127.17 	additional cost of rate adjustments on day 
127.18 	training and habilitation services, provided 
127.19 	as a social service under Minnesota Statutes, 
127.20 	section 256M.60;
127.21 	(10) alternative care services under 
127.22 	Minnesota Statutes, section 256B.0913;
127.23 	(11) managed care organizations under 
127.24 	Minnesota Statutes, section 256B.69, 
127.25 	receiving state payments for services in 
127.26 	clauses (1) to (10); and
127.27 	(12) intermediate care facilities for persons 
127.28 	with developmental disabilities under 
127.29 	Minnesota Statutes, section 256B.5012, 
127.30 	subdivision 13.
127.31 	In calculating the actual payment amounts to 
127.32 	be delayed, the commissioner must reduce 
127.33 	the $22,854,000 amount by any cash basis 
127.34 	state share savings to be realized in fiscal 
128.1 	year 2013 from implementing the long-term 
128.2 	care realignment waiver before July 1, 2013. 
128.3 	The commissioner shall make the delayed 
128.4 	payments in July 2013. Notwithstanding 
128.5 	any contrary provisions in this article, this 
128.6 	provision expires on August 1, 2013.
128.7 	Critical Access Nursing Facilities 
128.8 	Designation. $1,000,000 is appropriated in 
128.9 	fiscal year 2013 from the general fund to 
128.10 	the commissioner of human services for the 
128.11 	purposes of critical access nursing facilities 
128.12 	under Minnesota Statutes, section 256B.441, 
128.13 	subdivision 63. This appropriation is 
128.14 	ongoing and is added to the base.

128.15	Subd. 4.Grant Programs

128.16	(a) Basic Sliding Fee Child Care Grants
		-0-
		1,000
	
128.17 	Base Level Adjustment. The general fund 
128.18 	base is increased by $5,000 in fiscal years 
128.19 	2014 and 2015.

128.20	(b) Disabilities Grants
		-0-
		65,000
	
128.21 	This appropriation is for living skills training 
128.22 	programs for persons with intractable 
128.23 	epilepsy who need  assistance in the transition 
128.24 	to independent living under Laws 1988, 
128.25 	chapter 689, article 2, section 251. This 
128.26 	appropriation is ongoing and added to the 
128.27 	general fund base.
128.28 	Base Level Adjustment. The general fund 
128.29 	base is increased by $411,000 in fiscal year 
128.30 	2014.

128.31	Sec. 3. COMMISSIONER OF HEALTH

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

129.1	Appropriations by Fund
	
129.2		2012
	2013
	
129.3	General
	-0-
	127,000
	
129.4
129.5	State Government 
Special Revenue
	-0-
	(1,449,000)
	
129.6	Health Care Access
	-0-
	137,000
	
129.7 	In fiscal year 2013, $137,000 from the health 
129.8 	care access fund is for a study of radiation 
129.9 	therapy facilities capacity. This is a onetime 
129.10 	appropriation.
129.11 	In fiscal year 2015, the commissioner shall 
129.12 	transfer from the general fund $59,000, 
129.13 	including $40,000 for SEGIP activities to the 
129.14 	commissioner of management and budget for 
129.15 	actuarial and consulting services to support 
129.16 	the Department of Commerce evaluation of 
129.17 	mandated health benefits under Minnesota 
129.18 	Statutes, section 62J.26, subdivision 6. This 
129.19 	is a onetime transfer.
129.20 	The general fund base is decreased by 
129.21 	$105,000 in fiscal year 2014 and $46,000 in 
129.22 	fiscal year 2015.

129.23	Sec. 4. BOARD OF NURSING
 	$
	-0-
	$
	149,000
	
129.24 	This appropriation is from the state 
129.25 	government special revenue fund for the 
129.26 	nurse licensure compact.
129.27 	Base Level Adjustment. The state 
129.28 	government special revenue fund base is 
129.29 	decreased by $143,000 in fiscal years 2014 
129.30 	and 2015.

129.31	Sec. 5. COMMISSIONER OF COMMERCE

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

129.33	Appropriations by Fund
	
129.34		2012
	2013
	
130.1	General
	-0-
	60,000
	
130.2
130.3	State Government 
Special Revenue
	-0-
	1,449,000
	
130.4	Special Revenue
	-0-
	218,000
	
130.5 	In fiscal year 2013, $8,000 from the general 
130.6 	fund is for additional form review filings 
130.7 	under Minnesota Statutes, section 62A.047. 
130.8 	This is a onetime appropriation.
130.9 	In fiscal year 2013, $22,000 from the general 
130.10 	fund is for relocation costs related to the 
130.11 	transfer of health maintenance organization 
130.12 	regulatory activities. This is a onetime 
130.13 	appropriation.
130.14 	In fiscal year 2013, $30,000 from the 
130.15 	general fund is for ongoing information 
130.16 	technology expenses related to the transfer of 
130.17 	health maintenance organization regulatory 
130.18 	activities.
130.19 	$1,449,000 from the state government special 
130.20 	revenue fund is for health maintenance 
130.21 	organization regulatory activities transferred 
130.22 	from the Department of Health. This is an 
130.23 	ongoing appropriation.
130.24 	$218,000 from the special revenue fund is 
130.25 	for expenses related to health maintenance 
130.26 	organization regulatory activities for the 
130.27 	interagency agreement with the Department 
130.28 	of Human Services.
130.29 	The general fund base is increased by 
130.30 	$960,000 in fiscal years 2014 and 2015 for 
130.31 	the evaluation of mandated health benefits 
130.32 	under Minnesota Statutes, section 62J.26, 
130.33 	subdivision 6. The base for this purpose 
130.34 	beginning in fiscal year 2016 is $330,000.

131.1
131.2	Sec. 6. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	-0-
	$
	10,000
	
131.3 	This appropriation is to provide a grant to 
131.4 	the Minnesota Ambulance Association to 
131.5 	coordinate and prepare an assessment of 
131.6 	the extent and costs of uncompensated care 
131.7 	as a direct result of emergency responses 
131.8 	on interstate highways in Minnesota. 
131.9 	The study will collect appropriate 
131.10 	information from medical response units 
131.11 	and ambulance services regulated under 
131.12 	Minnesota Statutes, chapter 144E, and to 
131.13 	the extent possible, firefighting agencies. 
131.14 	In preparing the assessment, the Minnesota 
131.15 	Ambulance Association shall consult with 
131.16 	its membership, the Minnesota Fire Chiefs 
131.17 	Association, the Office of the State Fire 
131.18 	Marshal, and the Emergency Medical 
131.19 	Services Regulatory Board. The findings 
131.20 	of the assessment will be reported to the 
131.21 	chairs and ranking minority members of the 
131.22 	legislative committees with jurisdiction over 
131.23 	health and public safety by January 1, 2013.

131.24 	Sec. 7. EXPIRATION OF UNCODIFIED LANGUAGE.
 131.25 	All uncodified language contained in this article expires on June 30, 2013, unless a 
131.26 	different expiration date is explicit.

131.27 	Sec. 8. EFFECTIVE DATE.
 131.28 	The provisions in this article are effective July 1, 2012, unless a different effective 
131.29 	date is explicit.