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Office of the Revisor of Statutes

HF 1362A

Conference Committee Report - 86th Legislature (2009 - 2010) Posted on 01/15/2013 08:25pm

KEY: stricken = removed, old language.
underscored = added, new language.
1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 1362
1.2A bill for an act
1.3relating to state government; establishing the health and human services budget;
1.4making changes to licensing; Minnesota family investment program, children,
1.5and adult supports; child support; the Department of Health; health care
1.6programs; making technical changes; chemical and mental health; continuing
1.7care programs; establishing the State-County Results, Accountability, and
1.8Service Delivery Redesign; public health; health-related fees; making forecast
1.9adjustments; creating work groups and pilot projects; requiring reports;
1.10decreasing provider reimbursements; increasing fees; appropriating money to
1.11various state agencies for health and human services provisions;amending
1.12Minnesota Statutes 2008, sections 62J.495; 62J.496; 62J.497, subdivisions
1.131, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision 2;
1.14125A.744, subdivision 3; 144.0724, subdivisions 2, 4, 8, by adding subdivisions;
1.15144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision 1a; 144.125,
1.16subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; 144.9501,
1.17subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions 1g, 4;
1.18144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by adding
1.19a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; 144.98,
1.20subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision 1; 144A.073, by
1.21adding a subdivision; 144A.44, subdivision 2; 144A.46, subdivision 1; 148.108;
1.22148.6445, by adding a subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180,
1.23subdivisions 1, 2, 3, 5; 153A.17; 156.015; 157.15, by adding a subdivision;
1.24157.16; 157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470,
1.25subdivision 1; 245.4871, subdivision 27; 245.488, subdivision 1; 245.4885,
1.26subdivision 1; 245A.03, by adding a subdivision; 245A.10, subdivisions 2, 3,
1.274, 5, by adding subdivisions; 245A.11, subdivision 2a, by adding a subdivision;
1.28245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, subdivisions 1,
1.293; 245C.05, subdivision 4; 245C.08, subdivision 2; 245C.10, subdivision 3,
1.30by adding subdivisions; 245C.17, by adding a subdivision; 245C.20; 245C.21,
1.31subdivision 1a; 245C.23, subdivision 2; 246.50, subdivision 5, by adding
1.32subdivisions; 246.51, by adding subdivisions; 246.511; 246.52; 246B.01, by
1.33adding subdivisions; 252.46, by adding a subdivision; 252.50, subdivision
1.341; 254A.02, by adding a subdivision; 254A.16, by adding a subdivision;
1.35254B.03, subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision
1.361; 254B.09, subdivision 2; 256.01, subdivision 2b, by adding subdivisions;
1.37256.045, subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions
1.382, 6; 256.963, by adding a subdivision; 256.969, subdivision 3a; 256.975,
1.39subdivision 7; 256.983, subdivision 1; 256B.04, subdivision 16; 256B.055,
1.40subdivisions 7, 12; 256B.056, subdivisions 3, 3b, 3c, by adding a subdivision;
1.41256B.057, subdivisions 3, 9, by adding a subdivision; 256B.0575; 256B.0595,
1.42subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2;
2.1256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions
2.25, 8; 256B.0625, subdivisions 3c, 7, 8, 8a, 9, 13e, 17, 19a, 19c, 26, 41, 42, 47;
2.3256B.0631, subdivision 1; 256B.0641, subdivision 3; 256B.0651; 256B.0652;
2.4256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, subdivisions
2.52, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 256B.0911,
2.6subdivisions 1, 1a, 3, 3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913,
2.7subdivision 4; 256B.0915, subdivisions 3e, 3h, 5, by adding a subdivision;
2.8256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 256B.092,
2.9subdivision 8a, by adding subdivisions; 256B.0943, subdivision 1; 256B.0944,
2.10by adding a subdivision; 256B.0945, subdivision 4; 256B.0947, subdivision
2.111; 256B.15, subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.37,
2.12subdivisions 1, 5; 256B.434, by adding a subdivision; 256B.437, subdivision 6;
2.13256B.441, subdivisions 48, 55, by adding subdivisions; 256B.49, subdivisions
2.1412, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 4a; 256B.5011,
2.15subdivision 2; 256B.5012, by adding a subdivision; 256B.5013, subdivision
2.161; 256B.69, subdivisions 5a, 5c, 5f; 256B.76, subdivisions 1, 4, by adding
2.17a subdivision; 256B.761; 256D.024, by adding a subdivision; 256D.03,
2.18subdivision 4; 256D.051, subdivision 2a; 256D.0515; 256D.06, subdivision
2.192; 256D.09, subdivision 6; 256D.44, subdivision 5; 256D.49, subdivision 3;
2.20256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, subdivisions 1a, 7c;
2.21256J.08, subdivision 73a; 256J.20, subdivision 3; 256J.24, subdivisions 5a,
2.2210; 256J.26, by adding a subdivision; 256J.37, subdivision 3a, by adding a
2.23subdivision; 256J.38, subdivision 1; 256J.45, subdivision 3; 256J.49, subdivision
2.2413; 256J.575, subdivisions 3, 6, 7; 256J.621; 256J.626, subdivision 6; 256J.751,
2.25by adding a subdivision; 256J.95, subdivision 12; 256L.04, subdivision 10a,
2.26by adding a subdivision; 256L.05, subdivision 1, by adding subdivisions;
2.27256L.11, subdivisions 1, 7; 256L.12, subdivision 9; 256L.17, subdivision 3;
2.28259.67, by adding a subdivision; 270A.09, by adding a subdivision; 295.52,
2.29by adding a subdivision; 327.14, by adding a subdivision; 327.15; 327.16;
2.30327.20, subdivision 1, by adding a subdivision; 393.07, subdivision 10; 501B.89,
2.31by adding a subdivision; 518A.53, subdivisions 1, 4, 10; 519.05; 604A.33,
2.32subdivision 1; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572,
2.33subdivisions 6, 13, 21; Laws 2003, First Special Session chapter 14, article
2.3413C, section 2, subdivision 1, as amended; Laws 2007, chapter 147, article
2.3519, section 3, subdivision 4, as amended; proposing coding for new law in
2.36Minnesota Statutes, chapters 62A; 62Q; 156; 246B; 254B; 256; 256B; proposing
2.37coding for new law as Minnesota Statutes, chapter 402A; repealing Minnesota
2.38Statutes 2008, sections 62U.08; 103I.112; 144.9501, subdivision 17b; 148D.180,
2.39subdivision 8; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, subdivision
2.407; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10,
2.4111, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision 5a; 256B.19,
2.42subdivision 1d; 256B.431, subdivision 23; 256D.46; 256I.06, subdivision 9;
2.43256J.626, subdivision 7; 327.14, subdivisions 5, 6; Laws 1988, chapter 689,
2.44section 251; Minnesota Rules, parts 4626.2015, subpart 9; 9100.0400, subparts
2.451, 3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 9500.1261, subparts 3, 4, 5,
2.466; 9555.6125, subpart 4, item B.
2.47May 10, 2009
2.48The Honorable Margaret Anderson Kelliher
2.49Speaker of the House of Representatives
2.50The Honorable James P. Metzen
2.51President of the Senate
2.52We, the undersigned conferees for H. F. No. 1362 report that we have agreed upon
2.53the items in dispute and recommend as follows:
3.1That the Senate recede from its amendment and that H. F. No. 1362 be further
3.2amended as follows:
3.3Delete everything after the enacting clause and insert:

3.4"ARTICLE 1
3.5LICENSING

3.6    Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to
3.7read:
3.8    Subd. 2. County fees for background studies and licensing inspections. (a) For
3.9purposes of family and group family child care licensing under this chapter, a county
3.10agency may charge a fee to an applicant or license holder to recover the actual cost of
3.11background studies, but in any case not to exceed $100 annually. A county agency may
3.12also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
3.13license or $100 for a two-year license.
3.14    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
3.15applicant for authorization to recover the actual cost of background studies completed
3.16under section 119B.125, but in any case not to exceed $100 annually.
3.17    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
3.18    (1) in cases of financial hardship;
3.19    (2) if the county has a shortage of providers in the county's area;
3.20    (3) for new providers; or
3.21    (4) for providers who have attained at least 16 hours of training before seeking
3.22initial licensure.
3.23    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
3.24an installment basis for up to one year. If the provider is receiving child care assistance
3.25payments from the state, the provider may have the fees under paragraph (a) or (b)
3.26deducted from the child care assistance payments for up to one year and the state shall
3.27reimburse the county for the county fees collected in this manner.
3.28    (e) For purposes of adult foster care and child foster care licensing under this
3.29chapter, a county agency may charge a fee to a corporate applicant or corporate license
3.30holder to recover the actual cost of background studies. A county agency may also charge
3.31a fee to a corporate applicant or corporate license holder to recover the actual cost of
3.32licensing inspections, not to exceed $500 annually.
3.33    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
3.34following circumstances:
3.35(1) in cases of financial hardship;
4.1(2) if the county has a shortage of providers in the county's area; or
4.2(3) for new providers.

4.3    Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:
4.4    Subd. 3. Application fee for initial license or certification. (a) For fees required
4.5under subdivision 1, an applicant for an initial license or certification issued by the
4.6commissioner shall submit a $500 application fee with each new application required
4.7under this subdivision. The application fee shall not be prorated, is nonrefundable, and
4.8is in lieu of the annual license or certification fee that expires on December 31. The
4.9commissioner shall not process an application until the application fee is paid.
4.10(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license
4.11to provide services at a specific location.
4.12(1) For a license to provide waivered residential-based habilitation services to
4.13persons with developmental disabilities or related conditions under chapter 245B, an
4.14applicant shall submit an application for each county in which the waivered services will
4.15be provided. Upon licensure, the license holder may provide services to persons in that
4.16county plus no more than three persons at any one time in each of up to ten additional
4.17counties. A license holder in one county may not provide services under the home and
4.18community-based waiver for persons with developmental disabilities to more than three
4.19people in a second county without holding a separate license for that second county.
4.20Applicants or licensees providing services under this clause to not more than three persons
4.21remain subject to the inspection fees established in section 245A.10, subdivision 2, for
4.22each location. The license issued by the commissioner must state the name of each
4.23additional county where services are being provided to persons with developmental
4.24disabilities. A license holder must notify the commissioner before making any changes
4.25that would alter the license information listed under section 245A.04, subdivision 7,
4.26paragraph (a), including any additional counties where persons with developmental
4.27disabilities are being served.
4.28(2) For a license to provide supported employment, crisis respite, or
4.29semi-independent living services to persons with developmental disabilities or related
4.30conditions under chapter 245B, an applicant shall submit a single application to provide
4.31services statewide.
4.32(3) For a license to provide independent living assistance for youth under section
4.33245A.22 , an applicant shall submit a single application to provide services statewide.

4.34    Sec. 3. Minnesota Statutes 2008, section 245A.11, subdivision 2a, is amended to read:
5.1    Subd. 2a. Adult foster care license capacity. The commissioner shall issue adult
5.2foster care licenses with a maximum licensed capacity of four beds, including nonstaff
5.3roomers and boarders, except that the commissioner may issue a license with a capacity of
5.4five beds, including roomers and boarders, according to paragraphs (a) to (e).
5.5(a) An adult foster care license holder may have a maximum license capacity of five
5.6if all persons in care are age 55 or over and do not have a serious and persistent mental
5.7illness or a developmental disability.
5.8(b) The commissioner may grant variances to paragraph (a) to allow a foster care
5.9provider with a licensed capacity of five persons to admit an individual under the age of 55
5.10if the variance complies with section 245A.04, subdivision 9, and approval of the variance
5.11is recommended by the county in which the licensed foster care provider is located.
5.12(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth
5.13bed for emergency crisis services for a person with serious and persistent mental illness
5.14or a developmental disability, regardless of age, if the variance complies with section
5.15245A.04, subdivision 9 , and approval of the variance is recommended by the county in
5.16which the licensed foster care provider is located.
5.17(d) Notwithstanding paragraph (a), If the 2009 legislature adopts a rate reduction
5.18that impacts providers of adult foster care services, the commissioner may issue an adult
5.19foster care license with a capacity of five adults if the fifth bed does not increase the
5.20overall statewide capacity of licensed adult foster care beds in homes that are not the
5.21primary residence of the license holder, over the licensed capacity in such homes on July
5.221, 2009, as identified in a plan submitted to the commissioner by the county, when the
5.23capacity is recommended by the county licensing agency of the county in which the
5.24facility is located and if the recommendation verifies that:
5.25(1) the facility meets the physical environment requirements in the adult foster
5.26care licensing rule;
5.27(2) the five-bed living arrangement is specified for each resident in the resident's:
5.28(i) individualized plan of care;
5.29(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
5.30(iii) individual resident placement agreement under Minnesota Rules, part
5.319555.5105, subpart 19, if required;
5.32(3) the license holder obtains written and signed informed consent from each
5.33resident or resident's legal representative documenting the resident's informed choice to
5.34living in the home and that the resident's refusal to consent would not have resulted in
5.35service termination; and
5.36(4) the facility was licensed for adult foster care before March 1, 2003 2009.
6.1(e) The commissioner shall not issue a new adult foster care license under paragraph
6.2(d) after June 30, 2005 2011. The commissioner shall allow a facility with an adult foster
6.3care license issued under paragraph (d) before June 30, 2005 2011, to continue with a
6.4capacity of five adults if the license holder continues to comply with the requirements in
6.5paragraph (d).
6.6EFFECTIVE DATE.This section is effective July 1, 2009.

6.7    Sec. 4. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
6.8to read:
6.9    Subd. 7a. Alternate overnight supervision technology; adult foster care license.
6.10    (a) The commissioner may grant an applicant or license holder an adult foster care license
6.11for a residence that does not have a caregiver in the residence during normal sleeping
6.12hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
6.13monitoring technology to alert the license holder when an incident occurs that may
6.14jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
6.15holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
6.16to 9555.6265, and the requirements under this subdivision. The license printed by the
6.17commissioner must state in bold and large font:
6.18    (1) that the facility is under electronic monitoring; and
6.19    (2) the telephone number of the county's common entry point for making reports of
6.20suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
6.21(b) Applications for a license under this section must be submitted directly to
6.22the Department of Human Services licensing division. The licensing division must
6.23immediately notify the host county and lead county contract agency and the host county
6.24licensing agency. The licensing division must collaborate with the county licensing
6.25agency in the review of the application and the licensing of the program.
6.26    (c) Before a license is issued by the commissioner, and for the duration of the
6.27license, the applicant or license holder must establish, maintain, and document the
6.28implementation of written policies and procedures addressing the requirements in
6.29paragraphs (d) through (f).
6.30    (d) The applicant or license holder must have policies and procedures that:
6.31    (1) establish characteristics of target populations that will be admitted into the home,
6.32and characteristics of populations that will not be accepted into the home;
6.33    (2) explain the discharge process when a foster care recipient requires overnight
6.34supervision or other services that cannot be provided by the license holder due to the
6.35limited hours that the license holder is on-site;
7.1    (3) describe the types of events to which the program will respond with a physical
7.2presence when those events occur in the home during time when staff are not on-site, and
7.3how the license holder's response plan meets the requirements in paragraph (e), clause
7.4(1) or (2);
7.5    (4) establish a process for documenting a review of the implementation and
7.6effectiveness of the response protocol for the response required under paragraph (e),
7.7clause (1) or (2). The documentation must include:
7.8    (i) a description of the triggering incident;
7.9    (ii) the date and time of the triggering incident;
7.10    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
7.11    (iv) whether the response met the resident's needs;
7.12    (v) whether the existing policies and response protocols were followed; and
7.13    (vi) whether the existing policies and protocols are adequate or need modification.
7.14    When no physical presence response is completed for a three-month period, the
7.15license holder's written policies and procedures must require a physical presence response
7.16drill be to conducted for which the effectiveness of the response protocol under paragraph
7.17(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
7.18    (5) establish that emergency and nonemergency phone numbers are posted in a
7.19prominent location in a common area of the home where they can be easily observed by a
7.20person responding to an incident who is not otherwise affiliated with the home.
7.21    (e) The license holder must document and include in the license application which
7.22response alternative under clause (1) or (2) is in place for responding to situations that
7.23present a serious risk to the health, safety, or rights of people receiving foster care services
7.24in the home:
7.25    (1) response alternative (1) requires only the technology to provide an electronic
7.26notification or alert to the license holder that an event is underway that requires a response.
7.27Under this alternative, no more than ten minutes will pass before the license holder will be
7.28physically present on-site to respond to the situation; or
7.29    (2) response alternative (2) requires the electronic notification and alert system
7.30under alternative (1), but more than ten minutes may pass before the license holder is
7.31present on-site to respond to the situation. Under alternative (2), all of the following
7.32conditions are met:
7.33    (i) the license holder has a written description of the interactive technological
7.34applications that will assist the licenser holder in communicating with and assessing the
7.35needs related to care, health, and safety of the foster care recipients. This interactive
7.36technology must permit the license holder to remotely assess the well being of the foster
8.1care recipient without requiring the initiation of the foster care recipient. Requiring the
8.2foster care recipient to initiate a telephone call does not meet this requirement;
8.3(ii) the license holder documents how the remote license holder is qualified and
8.4capable of meeting the needs of the foster care recipients and assessing foster care
8.5recipients' needs under item (i) during the absence of the license holder on-site;
8.6(iii) the license holder maintains written procedures to dispatch emergency response
8.7personnel to the site in the event of an identified emergency; and
8.8    (iv) each foster care recipient's individualized plan of care, individual service plan
8.9under section 256B.092, subdivision 1b, if required, or individual resident placement
8.10agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
8.11maximum response time, which may be greater than ten minutes, for the license holder
8.12to be on-site for that foster care recipient.
8.13    (f) All placement agreements, individual service agreements, and plans applicable
8.14to the foster care recipient must clearly state that the adult foster care license category is
8.15a program without the presence of a caregiver in the residence during normal sleeping
8.16hours; the protocols in place for responding to situations that present a serious risk to
8.17health, safety, or rights of foster care recipients under paragraph (e), clause (1) or (2); and a
8.18signed informed consent from each foster care recipient or the person's legal representative
8.19documenting the person's or legal representative's agreement with placement in the
8.20program. If electronic monitoring technology is used in the home, the informed consent
8.21form must also explain the following:
8.22    (1) how any electronic monitoring is incorporated into the alternative supervision
8.23system;
8.24    (2) the backup system for any electronic monitoring in times of electrical outages or
8.25other equipment malfunctions;
8.26    (3) how the license holder is trained on the use of the technology;
8.27    (4) the event types and license holder response times established under paragraph (e);
8.28    (5) how the license holder protects the foster care recipient's privacy related to
8.29electronic monitoring and related to any electronically recorded data generated by the
8.30monitoring system. A foster care recipient may not be removed from a program under
8.31this subdivision for failure to consent to electronic monitoring. The consent form must
8.32explain where and how the electronically recorded data is stored, with whom it will be
8.33shared, and how long it is retained; and
8.34    (6) the risks and benefits of the alternative overnight supervision system.
9.1    The written explanations under clauses (1) to (6) may be accomplished through
9.2cross-references to other policies and procedures as long as they are explained to the
9.3person giving consent, and the person giving consent is offered a copy.
9.4(g) Nothing in this section requires the applicant or license holder to develop or
9.5maintain separate or duplicative polices, procedures, documentation, consent forms, or
9.6individual plans that may be required for other licensing standards, if the requirements of
9.7this section are incorporated into those documents.
9.8(h) The commissioner may grant variances to the requirements of this section
9.9according to section 245A.04, subdivision 9.
9.10(i) For the purposes of paragraphs (d) through (h), license holder has the meaning
9.11under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
9.12contractors affiliated with the license holder.
9.13(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
9.14remotely determine what action the license holder needs to take to protect the well-being
9.15of the foster care recipient.

9.16    Sec. 5. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
9.17to read:
9.18    Subd. 8b. Adult foster care data privacy and security. (a) An adult foster
9.19care license holder who creates, collects, records, maintains, stores, or discloses any
9.20individually identifiable recipient data, whether in an electronic or any other format,
9.21must comply with the privacy and security provisions of applicable privacy laws and
9.22regulations, including:
9.23(1) the federal Health Insurance Portability and Accountability Act of 1996
9.24(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
9.25title 45, part 160, and subparts A and E of part 164; and
9.26(2) the Minnesota Government Data Practices Act as codified in chapter 13.
9.27(b) For purposes of licensure, the license holder shall be monitored for compliance
9.28with the following data privacy and security provisions:
9.29(1) the license holder must control access to data on foster care recipients according
9.30to the definitions of public and private data on individuals under section 13.02;
9.31classification of the data on individuals as private under section 13.46, subdivision 2;
9.32and control over the collection, storage, use, access, protection, and contracting related
9.33to data according to section 13.05, in which the license holder is assigned the duties
9.34of a government entity;
10.1(2) the license holder must provide each foster care recipient with a notice that
10.2meets the requirements under section 13.04, in which the license holder is assigned the
10.3duties of the government entity, and that meets the requirements of Code of Federal
10.4Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of
10.5the data, and to whom and why it may be disclosed pursuant to law. The notice must
10.6inform the recipient that the license holder uses electronic monitoring and, if applicable,
10.7that recording technology is used;
10.8(3) the license holder must not install monitoring cameras in bathrooms;
10.9(4) electronic monitoring cameras must not be concealed from the foster care
10.10recipients; and
10.11(5) electronic video and audio recordings of foster care recipients shall not be stored
10.12by the license holder for more than five days.
10.13(c) The commissioner shall develop, and make available to license holders and
10.14county licensing workers, a checklist of the data privacy provisions to be monitored
10.15for purposes of licensure.

10.16    Sec. 6. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:
10.17    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
10.18private agencies that have been designated or licensed by the commissioner to perform
10.19licensing functions and activities under section 245A.04 and background studies for
10.20adult foster care, family adult day services, and family child care, under chapter 245C; to
10.21recommend denial of applicants under section 245A.05; to issue correction orders, to issue
10.22variances, and recommend a conditional license under section 245A.06, or to recommend
10.23suspending or revoking a license or issuing a fine under section 245A.07, shall comply
10.24with rules and directives of the commissioner governing those functions and with this
10.25section. The following variances are excluded from the delegation of variance authority
10.26and may be issued only by the commissioner:
10.27    (1) dual licensure of family child care and child foster care, dual licensure of child
10.28and adult foster care, and adult foster care and family child care;
10.29    (2) adult foster care maximum capacity;
10.30    (3) adult foster care minimum age requirement;
10.31    (4) child foster care maximum age requirement;
10.32    (5) variances regarding disqualified individuals except that county agencies may
10.33issue variances under section 245C.30 regarding disqualified individuals when the county
10.34is responsible for conducting a consolidated reconsideration according to sections 245C.25
11.1and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
11.2and a disqualification based on serious or recurring maltreatment; and
11.3    (6) the required presence of a caregiver in the adult foster care residence during
11.4normal sleeping hours.
11.5    (b) County agencies must report information about disqualification reconsiderations
11.6under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances
11.7granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
11.8prescribed by the commissioner.
11.9    (c) For family day care programs, the commissioner may authorize licensing reviews
11.10every two years after a licensee has had at least one annual review.
11.11    (d) For family adult day services programs, the commissioner may authorize
11.12licensing reviews every two years after a licensee has had at least one annual review.
11.13    (e) A license issued under this section may be issued for up to two years.

11.14    Sec. 7. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:
11.15    Subd. 3. Recommendations to commissioner. The county or private agency
11.16shall not make recommendations to the commissioner regarding licensure without first
11.17conducting an inspection, and for adult foster care, family adult day services, and family
11.18child care, a background study of the applicant under chapter 245C. The county or private
11.19agency must forward its recommendation to the commissioner regarding the appropriate
11.20licensing action within 20 working days of receipt of a completed application.

11.21    Sec. 8. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:
11.22    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
11.23background study of an individual required to be studied under section 245C.03,
11.24subdivision 1
, at least upon application for initial license for all license types.
11.25    (b) The commissioner shall conduct a background study of an individual required to
11.26be studied under section 245C.03, subdivision 1, at reapplication for a license for adult
11.27foster care, family adult day services, and family child care.
11.28    (c) The commissioner is not required to conduct a study of an individual at the time
11.29of reapplication for a license if the individual's background study was completed by the
11.30commissioner of human services for an adult foster care license holder that is also:
11.31    (1) registered under chapter 144D; or
11.32    (2) licensed to provide home and community-based services to people with
11.33disabilities at the foster care location and the license holder does not reside in the foster
11.34care residence; and
12.1    (3) the following conditions are met:
12.2    (i) a study of the individual was conducted either at the time of initial licensure or
12.3when the individual became affiliated with the license holder;
12.4    (ii) the individual has been continuously affiliated with the license holder since
12.5the last study was conducted; and
12.6    (iii) the last study of the individual was conducted on or after October 1, 1995.
12.7    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
12.8conduct a study of an individual required to be studied under section 245C.03, at the
12.9time of reapplication for a child foster care license. The county or private agency shall
12.10collect and forward to the commissioner the information required under section 245C.05,
12.11subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
12.12study conducted by the commissioner of human services under this paragraph must
12.13include a review of the information required under section 245C.08, subdivisions 1,
12.14paragraph (a), clauses (1) to (5), 3, and 4.
12.15    (e) The commissioner of human services shall conduct a background study of an
12.16individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2)
12.17to (6), who is newly affiliated with a child foster care license holder. The county or
12.18private agency shall collect and forward to the commissioner the information required
12.19under section 245C.05, subdivisions 1 and 5. The background study conducted by the
12.20commissioner of human services under this paragraph must include a review of the
12.21information required under section 245C.08, subdivisions 1, 3, and 4.
12.22    (f) From January 1, 2010, to December 31, 2012, unless otherwise specified in
12.23paragraph (c), the commissioner shall conduct a study of an individual required to be
12.24studied under section 245C.03 at the time of reapplication for an adult foster care or family
12.25adult day services license: (1) the county shall collect and forward to the commissioner
12.26the information required under section 245C.05, subdivision 1, paragraphs (a) and (b),
12.27and subdivision 5, paragraphs (a) and (b), for background studies conducted by the
12.28commissioner for adult foster care and family adult day services when the license holder
12.29resides in the adult foster care or family adult day services residence; (2) the license
12.30holder shall collect and forward to the commissioner the information required under
12.31section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs (a) and (b),
12.32for background studies conducted by the commissioner for adult foster care when the
12.33license holder does not reside in the adult foster care residence; and (3) the background
12.34study conducted by the commissioner under this paragraph must include a review of the
12.35information required under section 245C.08, subdivision 1, paragraph (a), clauses (1)
12.36to (5), and subdivisions 3 and 4.
13.1(g) The commissioner shall conduct a background study of an individual specified
13.2under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
13.3affiliated with an adult foster care or family adult day services license holder: (1) the
13.4county shall collect and forward to the commissioner the information required under
13.5section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a)
13.6and (b), for background studies conducted by the commissioner for adult foster care
13.7and family adult day services when the license holder resides in the adult foster care or
13.8family adult day services residence; (2) the license holder shall collect and forward to the
13.9commissioner the information required under section 245C.05, subdivisions 1, paragraphs
13.10(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the
13.11commissioner for adult foster care when the license holder does not reside in the adult
13.12foster care residence; and (3) the background study conducted by the commissioner under
13.13this paragraph must include a review of the information required under section 245C.08,
13.14subdivision 1, paragraph (a), and subdivisions 3 and 4.
13.15 (h) Applicants for licensure, license holders, and other entities as provided in this
13.16chapter must submit completed background study forms to the commissioner before
13.17individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
13.18contact in any licensed program.
13.19    (g) (i) For purposes of this section, a physician licensed under chapter 147 is
13.20considered to be continuously affiliated upon the license holder's receipt from the
13.21commissioner of health or human services of the physician's background study results.

13.22    Sec. 9. Minnesota Statutes 2008, section 245C.05, is amended by adding a subdivision
13.23to read:
13.24    Subd. 2b. County agency to collect and forward information to the
13.25commissioner. For background studies related to adult foster care and family adult
13.26day services when the license holder resides in the adult foster care or family adult
13.27day services residence, the county agency must collect the information required under
13.28subdivision 1 and forward it to the commissioner.

13.29    Sec. 10. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:
13.30    Subd. 4. Electronic transmission. For background studies conducted by the
13.31Department of Human Services, the commissioner shall implement a system for the
13.32electronic transmission of:
13.33    (1) background study information to the commissioner;
13.34    (2) background study results to the license holder; and
14.1    (3) background study results to county and private agencies for background studies
14.2conducted by the commissioner for child foster care; and
14.3(4) background study results to county agencies for background studies conducted
14.4by the commissioner for adult foster care and family adult day services.

14.5    Sec. 11. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:
14.6    Subd. 2. Background studies conducted by a county agency. (a) For a background
14.7study conducted by a county agency for adult foster care, family adult day services, and
14.8family child care services, the commissioner shall review:
14.9    (1) information from the county agency's record of substantiated maltreatment
14.10of adults and the maltreatment of minors;
14.11    (2) information from juvenile courts as required in subdivision 4 for individuals
14.12listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and
14.13    (3) information from the Bureau of Criminal Apprehension.
14.14    (b) If the individual has resided in the county for less than five years, the study shall
14.15include the records specified under paragraph (a) for the previous county or counties of
14.16residence for the past five years.
14.17    (c) Notwithstanding expungement by a court, the county agency may consider
14.18information obtained under paragraph (a), clause (3), unless the commissioner received
14.19notice of the petition for expungement and the court order for expungement is directed
14.20specifically to the commissioner.

14.21    Sec. 12. Minnesota Statutes 2008, section 245C.10, is amended by adding a
14.22subdivision to read:
14.23    Subd. 5. Adult foster care services. The commissioner shall recover the cost of
14.24background studies required under section 245C.03, subdivision 1, for the purposes of
14.25adult foster care and family adult day services licensing, through a fee of no more than
14.26$20 per study charged to the license holder. The fees collected under this subdivision are
14.27appropriated to the commissioner for the purpose of conducting background studies.

14.28    Sec. 13. Minnesota Statutes 2008, section 245C.10, is amended by adding a
14.29subdivision to read:
14.30    Subd. 8. Private agencies. The commissioner shall recover the cost of conducting
14.31background studies under section 245C.33 for studies initiated by private agencies for the
14.32purpose of adoption through a fee of no more than $70 per study charged to the private
15.1agency. The fees collected under this subdivision are appropriated to the commissioner for
15.2the purpose of conducting background studies.

15.3    Sec. 14. Minnesota Statutes 2008, section 245C.17, is amended by adding a
15.4subdivision to read:
15.5    Subd. 6. Notice to county agency. For studies on individuals related to a license
15.6to provide adult foster care and family adult day services, the commissioner shall also
15.7provide a notice of the background study results to the county agency that initiated the
15.8background study.

15.9    Sec. 15. Minnesota Statutes 2008, section 245C.20, is amended to read:
15.10245C.20 LICENSE HOLDER RECORD KEEPING.
15.11A licensed program shall document the date the program initiates a background
15.12study under this chapter in the program's personnel files. When a background study is
15.13completed under this chapter, a licensed program shall maintain a notice that the study
15.14was undertaken and completed in the program's personnel files. Except when background
15.15studies are initiated through the commissioner's online system, if a licensed program
15.16has not received a response from the commissioner under section 245C.17 within 45
15.17days of initiation of the background study request, the licensed program must contact the
15.18commissioner human services licensing division to inquire about the status of the study. If
15.19a license holder initiates a background study under the commissioner's online system, but
15.20the background study subject's name does not appear in the list of active or recent studies
15.21initiated by that license holder, the license holder must either contact the human services
15.22licensing division or resubmit the background study information online for that individual.

15.23    Sec. 16. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:
15.24    Subd. 1a. Submission of reconsideration request to county or private agency. (a)
15.25For disqualifications related to studies conducted by county agencies for family child care,
15.26and for disqualifications related to studies conducted by the commissioner for child foster
15.27care, adult foster care, and family adult day services, the individual shall submit the request
15.28for reconsideration to the county or private agency that initiated the background study.
15.29    (b) For disqualifications related to studies conducted by the commissioner for child
15.30foster care, the individual shall submit the request for reconsideration to the private agency
15.31that initiated the background study.
16.1(c) A reconsideration request shall be submitted within 30 days of the individual's
16.2receipt of the disqualification notice or the time frames specified in subdivision 2,
16.3whichever time frame is shorter.
16.4    (c) (d) The county or private agency shall forward the individual's request for
16.5reconsideration and provide the commissioner with a recommendation whether to set aside
16.6the individual's disqualification.

16.7    Sec. 17. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:
16.8    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The
16.9commissioner shall notify the license holder of the disqualification and order the license
16.10holder to immediately remove the individual from any position allowing direct contact
16.11with persons receiving services from the license holder if:
16.12    (1) the individual studied does not submit a timely request for reconsideration
16.13under section 245C.21;
16.14    (2) the individual submits a timely request for reconsideration, but the commissioner
16.15does not set aside the disqualification for that license holder under section 245C.22;
16.16    (3) an individual who has a right to request a hearing under sections 245C.27 and
16.17256.045 , or 245C.28 and chapter 14 for a disqualification that has not been set aside, does
16.18not request a hearing within the specified time; or
16.19    (4) an individual submitted a timely request for a hearing under sections 245C.27
16.20and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
16.21disqualification under section 245A.08, subdivision 5, or 256.045.
16.22    (b) If the commissioner does not set aside the disqualification under section 245C.22,
16.23and the license holder was previously ordered under section 245C.17 to immediately
16.24remove the disqualified individual from direct contact with persons receiving services or
16.25to ensure that the individual is under continuous, direct supervision when providing direct
16.26contact services, the order remains in effect pending the outcome of a hearing under
16.27sections 245C.27 and 256.045, or 245C.28 and chapter 14.
16.28    (c) For background studies related to child foster care, the commissioner shall
16.29also notify the county or private agency that initiated the study of the results of the
16.30reconsideration.
16.31(d) For background studies related to adult foster care and family adult day services,
16.32the commissioner shall also notify the county that initiated the study of the results of
16.33the reconsideration.

17.1    Sec. 18. Minnesota Statutes 2008, section 256B.092, is amended by adding a
17.2subdivision to read:
17.3    Subd. 5b. Revised per diem based on legislated rate reduction. Notwithstanding
17.4section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction
17.5that impacts payment to providers of adult foster care services, the commissioner may
17.6issue adult foster care licenses that permit a capacity of five adults. The application for a
17.7five-bed license must meet the requirements of section 245A.11, subdivision 2a. Prior to
17.8admission of the fifth recipient of adult foster care services, the county must negotiate a
17.9revised per diem rate for room and board and waiver services that reflects the legislated
17.10rate reduction and results in an overall average per diem reduction for all foster care
17.11recipients in that home. The revised per diem must allow the provider to maintain, as
17.12much as possible, the level of services or enhanced services provided in the residence,
17.13while mitigating the losses of the legislated rate reduction.
17.14EFFECTIVE DATE.This section is effective July 1, 2009.

17.15    Sec. 19. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
17.16    Subd. 17. Cost of services and supports. (a) The commissioner shall ensure
17.17that the average per capita expenditures estimated in any fiscal year for home and
17.18community-based waiver recipients does not exceed the average per capita expenditures
17.19that would have been made to provide institutional services for recipients in the absence
17.20of the waiver.
17.21(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
17.22need-based methods for allocating to local agencies the home and community-based
17.23waivered service resources available to support recipients with disabilities in need of
17.24the level of care provided in a nursing facility or a hospital. The commissioner shall
17.25allocate resources to single counties and county partnerships in a manner that reflects
17.26consideration of:
17.27(1) an incentive-based payment process for achieving outcomes;
17.28(2) the need for a state-level risk pool;
17.29(3) the need for retention of management responsibility at the state agency level; and
17.30(4) a phase-in strategy as appropriate.
17.31(c) Until the allocation methods described in paragraph (b) are implemented, the
17.32annual allowable reimbursement level of home and community-based waiver services
17.33shall be the greater of:
18.1(1) the statewide average payment amount which the recipient is assigned under the
18.2waiver reimbursement system in place on June 30, 2001, modified by the percentage of
18.3any provider rate increase appropriated for home and community-based services; or
18.4(2) an amount approved by the commissioner based on the recipient's extraordinary
18.5needs that cannot be met within the current allowable reimbursement level. The
18.6increased reimbursement level must be necessary to allow the recipient to be discharged
18.7from an institution or to prevent imminent placement in an institution. The additional
18.8reimbursement may be used to secure environmental modifications; assistive technology
18.9and equipment; and increased costs for supervision, training, and support services
18.10necessary to address the recipient's extraordinary needs. The commissioner may approve
18.11an increased reimbursement level for up to one year of the recipient's relocation from an
18.12institution or up to six months of a determination that a current waiver recipient is at
18.13imminent risk of being placed in an institution.
18.14(d) Beginning July 1, 2001, medically necessary private duty nursing services will be
18.15authorized under this section as complex and regular care according to sections 256B.0651
18.16and 256B.0653 to 256B.0656. The rate established by the commissioner for registered
18.17nurse or licensed practical nurse services under any home and community-based waiver as
18.18of January 1, 2001, shall not be reduced.
18.19(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009
18.20legislature adopts a rate reduction that impacts payment to providers of adult foster care
18.21services, the commissioner may issue adult foster care licenses that permit a capacity of
18.22five adults. The application for a five-bed license must meet the requirements of section
18.23245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care
18.24services, the county must negotiate a revised per diem rate for room and board and waiver
18.25services that reflects the legislated rate reduction and results in an overall average per
18.26diem reduction for all foster care recipients in that home. The revised per diem must allow
18.27the provider to maintain, as much as possible, the level of services or enhanced services
18.28provided in the residence, while mitigating the losses of the legislated rate reduction.
18.29EFFECTIVE DATE.This section is effective July 1, 2009.

18.30    Sec. 20. WAIVER.
18.31By December 1, 2009, the commissioner shall request all federal approvals and
18.32waiver amendments to the disability home and community-based waivers to allow properly
18.33licensed adult foster care homes to provide residential services for up to five individuals.
18.34EFFECTIVE DATE.This section is effective July 1, 2009.

19.1    Sec. 21. REPEALER.
19.2(a) Minnesota Statutes 2008, section 245C.11, subdivisions 1 and 2, are repealed.
19.3(b) Minnesota Statutes 2008, section 256B.092, subdivision 5a, is repealed effective
19.4July 1, 2009.
19.5(c) Minnesota Rules, part 9555.6125, subpart 4, item B, is repealed.

19.6ARTICLE 2
19.7MFIP/CHILD CARE/ADULT SUPPORTS/FRAUD PREVENTION

19.8    Section 1. Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read:
19.9    Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child
19.10care assistance under this chapter is the later of the date the application was signed; the
19.11beginning date of employment, education, or training; the date the infant is born for
19.12applicants to the at-home infant care program; or the date a determination has been made
19.13that the applicant is a participant in employment and training services under Minnesota
19.14Rules, part 3400.0080, or chapter 256J.
19.15    (b) Payment ceases for a family under the at-home infant child care program when a
19.16family has used a total of 12 months of assistance as specified under section 119B.035.
19.17Payment of child care assistance for employed persons on MFIP is effective the date of
19.18employment or the date of MFIP eligibility, whichever is later. Payment of child care
19.19assistance for MFIP or DWP participants in employment and training services is effective
19.20the date of commencement of the services or the date of MFIP or DWP eligibility,
19.21whichever is later. Payment of child care assistance for transition year child care must be
19.22made retroactive to the date of eligibility for transition year child care.
19.23(c) Notwithstanding paragraph (b), payment of child care assistance for participants
19.24eligible under section 119B.05 may only be made retroactive for a maximum of six
19.25months from the date of application for child care assistance.
19.26EFFECTIVE DATE.This section is effective October 1, 2009.

19.27    Sec. 2. Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read:
19.28    Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments
19.29to the child care provider or pay the parent directly for eligible child care expenses.
19.30(b) If payments for child care assistance are made to providers, the provider shall
19.31bill the county for services provided within ten days of the end of the service period. If
19.32bills are submitted within ten days of the end of the service period, a county or the state
19.33shall issue payment to the provider of child care under the child care fund within 30 days
20.1of receiving a bill from the provider. Counties or the state may establish policies that
20.2make payments on a more frequent basis.
20.3(c) All bills If a provider has received an authorization of care and been issued a
20.4billing form for an eligible family, the bill must be submitted within 60 days of the last
20.5date of service on the bill. A county may pay a bill submitted more than 60 days after
20.6the last date of service if the provider shows good cause why the bill was not submitted
20.7within 60 days. Good cause must be defined in the county's child care fund plan under
20.8section 119B.08, subdivision 3, and the definition of good cause must include county
20.9error. A county may not pay any bill submitted more than a year after the last date of
20.10service on the bill.
20.11(d) If a provider provided care for a time period without receiving an authorization
20.12of care and a billing form for an eligible family, payment of child care assistance may only
20.13be made retroactively for a maximum of six months from the date the provider is issued
20.14an authorization of care and billing form.
20.15(e) A county may stop payment issued to a provider or may refuse to pay a bill
20.16submitted by a provider if:
20.17(1) the provider admits to intentionally giving the county materially false information
20.18on the provider's billing forms; or
20.19(2) a county finds by a preponderance of the evidence that the provider intentionally
20.20gave the county materially false information on the provider's billing forms.
20.21(e) (f) A county's payment policies must be included in the county's child care plan
20.22under section 119B.08, subdivision 3. If payments are made by the state, in addition to
20.23being in compliance with this subdivision, the payments must be made in compliance
20.24with section 16A.124.
20.25EFFECTIVE DATE.This section is effective October 1, 2009.

20.26    Sec. 3. Minnesota Statutes 2008, section 119B.21, subdivision 5, is amended to read:
20.27    Subd. 5. Child care services grants. (a) A child care resource and referral program
20.28designated under section 119B.19, subdivision 1a, may award child care services grants
20.29for:
20.30    (1) creating new licensed child care facilities and expanding existing facilities,
20.31including, but not limited to, supplies, equipment, facility renovation, and remodeling;
20.32    (2) improving licensed child care facility programs;
20.33    (3) staff training and development services including, but not limited to, in-service
20.34training, curriculum development, accreditation, certification, consulting, resource
21.1centers, program and resource materials, supporting effective teacher-child interactions,
21.2child-focused teaching, and content-driven classroom instruction;
21.3    (4) interim financing;
21.4    (5) capacity building through the purchase of appropriate technology to create,
21.5enhance, and maintain business management systems;
21.6    (6) emergency assistance for child care programs;
21.7    (7) new programs or projects for the creation, expansion, or improvement of
21.8programs that serve ethnic immigrant and refugee communities; and
21.9    (8) targeted recruitment initiatives to expand and build the capacity of the child
21.10care system and to improve the quality of care provided by legal nonlicensed child care
21.11providers.
21.12    (b) A child care resource and referral program designated under section 119B.19,
21.13subdivision 1a
, may award child care services grants to:
21.14    (1) licensed providers;
21.15    (2) providers in the process of being licensed;
21.16    (3) corporations or public agencies that develop or provide child care services;
21.17    (4) school-age care programs;
21.18    (5) legal nonlicensed or family, friend, and neighbor care providers; or
21.19    (6) any combination of clauses (1) to (5).
21.20    (c) A recipient of a child care services grant for facility improvements, interim
21.21financing, or staff training and development must provide a 25 percent local match.
21.22(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly
21.23awarded for activities that improve provider quality, including activities under paragraph
21.24(a), clauses (1) to (3) and (7).

21.25    Sec. 4. Minnesota Statutes 2008, section 119B.21, subdivision 10, is amended to read:
21.26    Subd. 10. Family child care technical assistance grants. (a) A child care resource
21.27and referral organization designated under section 119B.19, subdivision 1a, may award
21.28technical assistance grants of up to $1,000. These grants may be used for:
21.29    (1) facility improvements, including, but not limited to, improvements to meet
21.30licensing requirements;
21.31    (2) improvements to expand a child care facility or program;
21.32    (3) toys, materials, and equipment to improve the learning environment;
21.33    (4) technology and software to create, enhance, and maintain business management
21.34systems;
21.35    (5) start-up costs;
22.1    (6) staff training and development; and
22.2    (7) other uses approved by the commissioner.
22.3    (b) A child care resource and referral program may award family child care technical
22.4assistance grants to:
22.5    (1) licensed family child care providers;
22.6    (2) child care providers in the process of becoming licensed; or
22.7    (3) legal nonlicensed or family, friend, and neighbor care providers.
22.8    (c) A local match is not required for a family child care technical assistance grant.
22.9(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly
22.10awarded for activities that improve provider quality, including activities under paragraph
22.11(a), clauses (1), (3), and (6).

22.12    Sec. 5. Minnesota Statutes 2008, section 119B.231, subdivision 2, is amended to read:
22.13    Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall
22.14apply to the commissioner or have been chosen as an SRSA provider prior to June 30,
22.152009, and have complied with all requirements of the SRSA agreement. Priority for funds
22.16is given to providers who had agreements prior to June 30, 2009. If sufficient funds are
22.17available, the commissioner shall make applications available to additional providers. To
22.18be eligible to apply for an SRSA, a provider shall:
22.19    (1) be eligible for child care assistance payments under chapter 119B;
22.20    (2) have at least 25 percent of the children enrolled with the provider subsidized
22.21through the child care assistance program;
22.22    (3) provide full-time, full-year child care services; and
22.23    (4) serve at least one child who is subsidized through the child care assistance
22.24program and who is expected to enter kindergarten within the following 30 months have
22.25obtained a level 3 or 4 star rating under the voluntary Parent Aware quality rating system.
22.26    (b) The commissioner may waive the 25 percent requirement in paragraph (a),
22.27clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity
22.28of types of care provided by SRSA providers.
22.29    (c) An eligible provider who would like to enter into an SRSA with the commissioner
22.30shall submit an SRSA application. To determine whether to enter into an SRSA with a
22.31provider, the commissioner shall evaluate the following factors:
22.32    (1) the qualifications of the provider and the provider's staff provider's Parent
22.33Aware rating score;
22.34    (2) the provider's staff-child ratios;
22.35    (3) the provider's curriculum;
23.1    (4) the provider's current or planned parent education activities;
23.2    (5) (2) the provider's current or planned social service and employment linkages;
23.3    (6) the provider's child development assessment plan;
23.4    (7) (3) the geographic distribution needed for SRSA providers;
23.5    (8) (4) the inclusion of a variety of child care delivery models; and
23.6    (9) (5) other related factors determined by the commissioner.

23.7    Sec. 6. Minnesota Statutes 2008, section 119B.231, subdivision 3, is amended to read:
23.8    Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA
23.9provider for their children shall:
23.10    (1) be eligible to receive child care assistance under any provision in chapter 119B
23.11except section 119B.035;
23.12    (2) be in an authorized activity for an average of at least 35 hours per week when
23.13initial eligibility is determined; and
23.14    (3) include a child who has not yet entered kindergarten.
23.15    (b) A family who is determined to be eligible to choose an SRSA provider remains
23.16eligible to be paid at a higher rate through the SRSA provider when the following
23.17conditions exist:
23.18    (1) the child attends child care with the SRSA provider a minimum of 25 hours per
23.19week, on average;
23.20    (2) the family has a child who has not yet entered kindergarten; and
23.21    (3) the family maintains eligibility under chapter 119B except section 119B.035.
23.22    (c) For the 12 months After initial eligibility has been determined, a decrease in the
23.23family's authorized activities to an average of less than 35 hours per week does not result
23.24in ineligibility for the SRSA rate. A family must continue to maintain eligibility under this
23.25chapter and be in an authorized activity.
23.26    (d) A family that moves between counties but continues to use the same SRSA
23.27provider shall continue to receive SRSA funding for the increased payments.

23.28    Sec. 7. Minnesota Statutes 2008, section 119B.231, subdivision 4, is amended to read:
23.29    Subd. 4. Requirements of providers. An SRSA must include assessment,
23.30evaluation, and reporting requirements that promote the goals of improved school
23.31readiness and movement toward appropriate child development milestones. A provider
23.32who enters into an SRSA shall comply with all SRSA requirements, including the
23.33assessment, evaluation, and reporting requirements in the SRSA. Providers who have been
23.34selected previously for SRSAs must begin the process to obtain a rating using Parent
24.1Aware according to timelines established by the commissioner. If the initial Parent Aware
24.2rating is less than three stars, the provider must submit a plan to improve the rating. If
24.3a 3 or 4 star rating is not obtained within established timelines, the commissioner may
24.4consider continuation of the agreement, depending upon the progress made and other
24.5factors. Providers who apply and are selected for a new SRSA agreement on or after July
24.61, 2009, must have a level 3 or 4 star rating under the voluntary Parent Aware quality
24.7rating system at the time the SRSA agreement is signed.

24.8    Sec. 8. Minnesota Statutes 2008, section 145A.17, is amended by adding a subdivision
24.9to read:
24.10    Subd. 4a. Home visitors as MFIP employment and training service providers.
24.11The county social service agency and the local public health department may mutually
24.12agree to utilize home visitors under this section as MFIP employment and training service
24.13providers under section 256J.49, subdivision 4, for MFIP participants who are: (1) ill or
24.14incapacitated under section 256J.425, subdivision 2; or (2) minor caregivers under section
24.15256J.54. The county social service agency and the local public health department may
24.16also mutually agree to utilize home visitors to provide outreach to MFIP families who are
24.17being sanctioned or who have been terminated from MFIP due to the 60-month time limit.

24.18    Sec. 9. Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read:
24.19    Subd. 3. State agency hearings. (a) State agency hearings are available for the
24.20following:
24.21    (1) any person applying for, receiving or having received public assistance, medical
24.22care, or a program of social services granted by the state agency or a county agency or
24.23the federal Food Stamp Act whose application for assistance is denied, not acted upon
24.24with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
24.25claimed to have been incorrectly paid;
24.26    (2) any patient or relative aggrieved by an order of the commissioner under section
24.27252.27 ;
24.28    (3) a party aggrieved by a ruling of a prepaid health plan;
24.29    (4) except as provided under chapter 245C, any individual or facility determined by
24.30a lead agency to have maltreated a vulnerable adult under section 626.557 after they have
24.31exercised their right to administrative reconsideration under section 626.557;
24.32    (5) any person whose claim for foster care payment according to a placement of the
24.33child resulting from a child protection assessment under section 626.556 is denied or not
24.34acted upon with reasonable promptness, regardless of funding source;
25.1    (6) any person to whom a right of appeal according to this section is given by other
25.2provision of law;
25.3    (7) an applicant aggrieved by an adverse decision to an application for a hardship
25.4waiver under section 256B.15;
25.5    (8) an applicant aggrieved by an adverse decision to an application or redetermination
25.6for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
25.7    (9) except as provided under chapter 245A, an individual or facility determined
25.8to have maltreated a minor under section 626.556, after the individual or facility has
25.9exercised the right to administrative reconsideration under section 626.556; or
25.10    (10) except as provided under chapter 245C, an individual disqualified under sections
25.11245C.14 and 245C.15, on the basis of serious or recurring maltreatment; a preponderance
25.12of the evidence that the individual has committed an act or acts that meet the definition
25.13of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make
25.14reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings
25.15regarding a maltreatment determination under clause (4) or (9) and a disqualification under
25.16this clause in which the basis for a disqualification is serious or recurring maltreatment,
25.17which has not been set aside under sections 245C.22 and 245C.23, shall be consolidated
25.18into a single fair hearing. In such cases, the scope of review by the human services referee
25.19shall include both the maltreatment determination and the disqualification. The failure to
25.20exercise the right to an administrative reconsideration shall not be a bar to a hearing under
25.21this section if federal law provides an individual the right to a hearing to dispute a finding
25.22of maltreatment. Individuals and organizations specified in this section may contest the
25.23specified action, decision, or final disposition before the state agency by submitting a
25.24written request for a hearing to the state agency within 30 days after receiving written
25.25notice of the action, decision, or final disposition, or within 90 days of such written notice
25.26if the applicant, recipient, patient, or relative shows good cause why the request was not
25.27submitted within the 30-day time limit.; or
25.28    (11) any person with an outstanding debt resulting from receipt of public assistance,
25.29medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
25.30Department of Human Services or a county agency. The scope of the appeal is the validity
25.31of the claimant agency's intention to request a setoff of a refund under chapter 270A
25.32against the debt.
25.33    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
25.34(10), is the only administrative appeal to the final agency determination specifically,
25.35including a challenge to the accuracy and completeness of data under section 13.04.
25.36Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
26.1that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
26.2homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
26.3contested case proceeding under the provisions of chapter 14. Hearings requested under
26.4paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
26.5July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
26.6only available when there is no juvenile court or adult criminal action pending. If such
26.7action is filed in either court while an administrative review is pending, the administrative
26.8review must be suspended until the judicial actions are completed. If the juvenile court
26.9action or criminal charge is dismissed or the criminal action overturned, the matter may be
26.10considered in an administrative hearing.
26.11    (c) For purposes of this section, bargaining unit grievance procedures are not an
26.12administrative appeal.
26.13    (d) The scope of hearings involving claims to foster care payments under paragraph
26.14(a), clause (5), shall be limited to the issue of whether the county is legally responsible
26.15for a child's placement under court order or voluntary placement agreement and, if so,
26.16the correct amount of foster care payment to be made on the child's behalf and shall not
26.17include review of the propriety of the county's child protection determination or child
26.18placement decision.
26.19    (e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a
26.20vendor under contract with a county agency to provide social services is not a party and
26.21may not request a hearing under this section, except if assisting a recipient as provided in
26.22subdivision 4.
26.23    (f) An applicant or recipient is not entitled to receive social services beyond the
26.24services prescribed under chapter 256M or other social services the person is eligible
26.25for under state law.
26.26    (g) The commissioner may summarily affirm the county or state agency's proposed
26.27action without a hearing when the sole issue is an automatic change due to a change in
26.28state or federal law.

26.29    Sec. 10. Minnesota Statutes 2008, section 256.983, subdivision 1, is amended to read:
26.30    Subdivision 1. Programs established. Within the limits of available appropriations,
26.31the commissioner of human services shall require the maintenance of budget neutral
26.32fraud prevention investigation programs in the counties participating in the fraud
26.33prevention investigation project established under this section. If funds are sufficient,
26.34the commissioner may also extend fraud prevention investigation programs to other
26.35counties provided the expansion is budget neutral to the state. Under any expansion, the
27.1commissioner has the final authority in decisions regarding the creation and realignment
27.2of individual county or regional operations.

27.3    Sec. 11. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:
27.4    Subd. 7. Countable income. "Countable income" means all income received by an
27.5applicant or recipient less any applicable exclusions or disregards. For a recipient of any
27.6cash benefit from the SSI program, countable income means the SSI benefit limit in effect
27.7at the time the person is in a GRH setting less $20, less the medical assistance personal
27.8needs allowance. If the SSI limit has been reduced for a person due to events occurring
27.9prior to the persons entering the GRH setting, countable income means actual income less
27.10any applicable exclusions and disregards.
27.11EFFECTIVE DATE.This section is effective April 1, 2010.

27.12    Sec. 12. Minnesota Statutes 2008, section 256I.05, subdivision 7c, is amended to read:
27.13    Subd. 7c. Demonstration project. The commissioner is authorized to pursue the
27.14expansion of a demonstration project under federal food stamp regulation for the purpose
27.15of gaining additional federal reimbursement of food and nutritional costs currently paid by
27.16the state group residential housing program. The commissioner shall seek approval no
27.17later than January 1, 2004 October 1, 2009. Any reimbursement received is nondedicated
27.18revenue to the general fund.

27.19    Sec. 13. Minnesota Statutes 2008, section 256J.24, subdivision 5, is amended to read:
27.20    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
27.21on the number of persons in the assistance unit eligible for both food and cash assistance
27.22unless the restrictions in subdivision 6 on the birth of a child apply. The following table
27.23represents the transitional standards effective October 1, 2007 April 1, 2009.
27.24
Number of Eligible People
Transitional Standard
Cash Portion
Food Portion
27.25
1
$391 $428:
$250
$141 $178
27.26
2
$698 $764:
$437
$261$327
27.27
3
$910$1,005:
$532
$378$473
27.28
4
$1,091 $1,217:
$621
$470 $596
27.29
5
$1,245 $1,393:
$697
$548 $696
27.30
6
$1,425$1,602:
$773
$652 $829
28.1
7
$1,553 $1,748:
$850
$703$898
28.2
8
$1,713 $1,934:
$916
$797$1,018
28.3
9
$1,871 $2,119:
$980
$891$1,139
28.4
10
$2,024 $2,298:
$1,035
$989 $1,263
28.5
over 10
add $151 $178:
$53
$98 $125
28.6
per additional member.
28.7    The commissioner shall annually publish in the State Register the transitional
28.8standard for an assistance unit sizes 1 to 10 including a breakdown of the cash and food
28.9portions.
28.10EFFECTIVE DATE.This section is effective retroactively from April 1, 2009.

28.11    Sec. 14. Minnesota Statutes 2008, section 256J.425, subdivision 2, is amended to read:
28.12    Subd. 2. Ill or incapacitated. (a) An assistance unit subject to the time limit in
28.13section 256J.42, subdivision 1, is eligible to receive months of assistance under a hardship
28.14extension if the participant who reached the time limit belongs to any of the following
28.15groups:
28.16(1) participants who are suffering from an illness, injury, or incapacity which
28.17has been certified by a qualified professional when the illness, injury, or incapacity is
28.18expected to continue for more than 30 days and prevents the person from obtaining or
28.19retaining employment severely limits the person's ability to obtain or maintain suitable
28.20employment. These participants must follow the treatment recommendations of the
28.21qualified professional certifying the illness, injury, or incapacity;
28.22(2) participants whose presence in the home is required as a caregiver because of
28.23the illness, injury, or incapacity of another member in the assistance unit, a relative in the
28.24household, or a foster child in the household when the illness or incapacity and the need
28.25for a person to provide assistance in the home has been certified by a qualified professional
28.26and is expected to continue for more than 30 days; or
28.27(3) caregivers with a child or an adult in the household who meets the disability or
28.28medical criteria for home care services under section 256B.0651, subdivision 1, paragraph
28.29(c), or a home and community-based waiver services program under chapter 256B, or
28.30meets the criteria for severe emotional disturbance under section 245.4871, subdivision
28.316
, or for serious and persistent mental illness under section 245.462, subdivision 20,
28.32paragraph (c). Caregivers in this category are presumed to be prevented from obtaining
28.33or retaining employment.
29.1(b) An assistance unit receiving assistance under a hardship extension under this
29.2subdivision may continue to receive assistance as long as the participant meets the criteria
29.3in paragraph (a), clause (1), (2), or (3).

29.4    Sec. 15. Minnesota Statutes 2008, section 256J.425, subdivision 3, is amended to read:
29.5    Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time
29.6limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under
29.7a hardship extension if the participant who reached the time limit belongs to any of the
29.8following groups:
29.9(1) a person who is diagnosed by a licensed physician, psychological practitioner,
29.10or other qualified professional, as developmentally disabled or mentally ill, and that
29.11condition prevents the person from obtaining or retaining unsubsidized employment the
29.12condition severely limits the person's ability to obtain or maintain suitable employment;
29.13(2) a person who:
29.14(i) has been assessed by a vocational specialist or the county agency to be
29.15unemployable for purposes of this subdivision; or
29.16(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
29.17agency to be employable, but not at a level that makes the participant eligible for an
29.18extension under subdivision 4 the condition severely limits the person's ability to obtain or
29.19maintain suitable employment. The determination of IQ level must be made by a qualified
29.20professional. In the case of a non-English-speaking person: (A) the determination must
29.21be made by a qualified professional with experience conducting culturally appropriate
29.22assessments, whenever possible; (B) the county may accept reports that identify an
29.23IQ range as opposed to a specific score; (C) these reports must include a statement of
29.24confidence in the results;
29.25(3) a person who is determined by a qualified professional to be learning disabled,
29.26and the disability condition severely limits the person's ability to obtain, perform, or
29.27maintain suitable employment. For purposes of the initial approval of a learning disability
29.28extension, the determination must have been made or confirmed within the previous 12
29.29months. In the case of a non-English-speaking person: (i) the determination must be made
29.30by a qualified professional with experience conducting culturally appropriate assessments,
29.31whenever possible; and (ii) these reports must include a statement of confidence in the
29.32results. If a rehabilitation plan for a participant extended as learning disabled is developed
29.33or approved by the county agency, the plan must be incorporated into the employment
29.34plan. However, a rehabilitation plan does not replace the requirement to develop and
29.35comply with an employment plan under section 256J.521; or
30.1(4) a person who has been granted a family violence waiver, and who is complying
30.2with an employment plan under section 256J.521, subdivision 3.
30.3(b) For purposes of this section, "severely limits the person's ability to obtain or
30.4maintain suitable employment" means that a qualified professional has determined that the
30.5person's condition prevents the person from working 20 or more hours per week.

30.6    Sec. 16. Minnesota Statutes 2008, section 256J.49, subdivision 1, is amended to read:
30.7    Subdivision 1. Scope. The terms used in sections 256J.50 256J.425 to 256J.72 have
30.8the meanings given them in this section.

30.9    Sec. 17. Minnesota Statutes 2008, section 256J.49, subdivision 4, is amended to read:
30.10    Subd. 4. Employment and training service provider. "Employment and training
30.11service provider" means:
30.12(1) a public, private, or nonprofit agency with which a county has contracted to
30.13provide employment and training services and which is included in the county's service
30.14agreement submitted under section 256J.626, subdivision 4; or
30.15(2) a county agency, if the county has opted to provide employment and training
30.16services and the county has indicated that fact in the service agreement submitted under
30.17section 256J.626, subdivision 4; or
30.18(3) a local public health department under section 145A.17, subdivision 3a, that a
30.19county has designated to provide employment and training services and is included in the
30.20county's service agreement submitted under section 256J.626, subdivision 4.
30.21Notwithstanding section 116L.871, an employment and training services provider
30.22meeting this definition may deliver employment and training services under this chapter.

30.23    Sec. 18. Minnesota Statutes 2008, section 256J.521, subdivision 2, is amended to read:
30.24    Subd. 2. Employment plan; contents. (a) Based on the assessment under
30.25subdivision 1, the job counselor and the participant must develop an employment plan
30.26that includes participation in activities and hours that meet the requirements of section
30.27256J.55, subdivision 1 . The purpose of the employment plan is to identify for each
30.28participant the most direct path to unsubsidized employment and any subsequent steps that
30.29support long-term economic stability. The employment plan should be developed using
30.30the highest level of activity appropriate for the participant. Activities must be chosen from
30.31clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of
30.32preference for activities, priority must be given for activities related to a family violence
30.33waiver when developing the employment plan. The employment plan must also list the
31.1specific steps the participant will take to obtain employment, including steps necessary
31.2for the participant to progress from one level of activity to another, and a timetable for
31.3completion of each step. Levels of activity include:
31.4    (1) unsubsidized employment;
31.5    (2) job search;
31.6    (3) subsidized employment or unpaid work experience;
31.7    (4) unsubsidized employment and job readiness education or job skills training;
31.8    (5) unsubsidized employment or unpaid work experience and activities related to
31.9a family violence waiver or preemployment needs; and
31.10    (6) activities related to a family violence waiver or preemployment needs.
31.11    (b) Participants who are determined to possess sufficient skills such that the
31.12participant is likely to succeed in obtaining unsubsidized employment must job search at
31.13least 30 hours per week for up to six weeks and accept any offer of suitable employment.
31.14The remaining hours necessary to meet the requirements of section 256J.55, subdivision
31.151
, may be met through participation in other work activities under section 256J.49,
31.16subdivision 13
. The participant's employment plan must specify, at a minimum: (1)
31.17whether the job search is supervised or unsupervised; (2) support services that will
31.18be provided; and (3) how frequently the participant must report to the job counselor.
31.19Participants who are unable to find suitable employment after six weeks must meet
31.20with the job counselor to determine whether other activities in paragraph (a) should be
31.21incorporated into the employment plan. Job search activities which are continued after six
31.22weeks must be structured and supervised.
31.23    (c) Beginning July 1, 2004, activities and hourly requirements in the employment
31.24plan may be adjusted as necessary to accommodate the personal and family circumstances
31.25of participants identified under section 256J.561, subdivision 2, paragraph (d). Participants
31.26who no longer meet the provisions of section 256J.561, subdivision 2, paragraph (d),
31.27must meet with the job counselor within ten days of the determination to revise the
31.28employment plan.
31.29    (d) Participants who are determined to have barriers to obtaining or retaining
31.30employment that will not be overcome during six weeks of job search under paragraph (b)
31.31must work with the job counselor to develop an employment plan that addresses those
31.32barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6).
31.33The employment plan must include enough hours to meet the participation requirements
31.34in section 256J.55, subdivision 1, unless a compelling reason to require fewer hours
31.35is noted in the participant's file.
32.1    (e) (d) The job counselor and the participant must sign the employment plan to
32.2indicate agreement on the contents.
32.3    (f) (e) Except as provided under paragraph (g) (f), failure to develop or comply with
32.4activities in the plan, or voluntarily quitting suitable employment without good cause, will
32.5result in the imposition of a sanction under section 256J.46.
32.6    (g) (f) When a participant fails to meet the agreed upon hours of participation in paid
32.7employment because the participant is not eligible for holiday pay and the participant's
32.8place of employment is closed for a holiday, the job counselor shall not impose a sanction
32.9or increase the hours of participation in any other activity, including paid employment, to
32.10offset the hours that were missed due to the holiday.
32.11    (h) (g) Employment plans must be reviewed at least every three months to determine
32.12whether activities and hourly requirements should be revised. The job counselor is
32.13encouraged to allow participants who are participating in at least 20 hours of work
32.14activities to also participate in education and training activities in order to meet the federal
32.15hourly participation rates.

32.16    Sec. 19. Minnesota Statutes 2008, section 256J.545, is amended to read:
32.17256J.545 FAMILY VIOLENCE WAIVER CRITERIA.
32.18    (a) In order to qualify for a family violence waiver, an individual must provide
32.19documentation of past or current family violence which may prevent the individual from
32.20participating in certain employment activities.
32.21    (b) The following items may be considered acceptable documentation or verification
32.22of family violence:
32.23    (1) police, government agency, or court records;
32.24    (2) a statement from a battered women's shelter staff with knowledge of the
32.25circumstances or credible evidence that supports the sworn statement;
32.26    (3) a statement from a sexual assault or domestic violence advocate with knowledge
32.27of the circumstances or credible evidence that supports the sworn statement; or
32.28    (4) a statement from professionals from whom the applicant or recipient has sought
32.29assistance for the abuse.
32.30    (c) A claim of family violence may also be documented by a sworn statement from
32.31the applicant or participant and a sworn statement from any other person with knowledge
32.32of the circumstances or credible evidence that supports the client's statement.

32.33    Sec. 20. Minnesota Statutes 2008, section 256J.561, subdivision 2, is amended to read:
33.1    Subd. 2. Participation requirements. (a) All MFIP caregivers, except caregivers
33.2who meet the criteria in subdivision 3, must participate in employment services develop an
33.3individualized employment plan that identifies the activities the participant is required to
33.4participate in and the required hours of participation. Except as specified in paragraphs (b)
33.5to (d), the employment plan must meet the requirements of section 256J.521, subdivision
33.62
, contain allowable work activities, as defined in section 256J.49, subdivision 13, and,
33.7include at a minimum, the number of participation hours required under section 256J.55,
33.8subdivision 1
.
33.9(b) Minor caregivers and caregivers who are less than age 20 who have not
33.10completed high school or obtained a GED are required to comply with section 256J.54.
33.11(c) A participant who has a family violence waiver shall develop and comply with
33.12an employment plan under section 256J.521, subdivision 3.
33.13(d) As specified in section 256J.521, subdivision 2, paragraph (c), a participant who
33.14meets any one of the following criteria may work with the job counselor to develop an
33.15employment plan that contains less than the number of participation hours under section
33.16256J.55, subdivision 1. Employment plans for participants covered under this paragraph
33.17must be tailored to recognize the special circumstances of caregivers and families
33.18including limitations due to illness or disability and caregiving needs:
33.19(1) a participant who is age 60 or older;
33.20(2) a participant who has been diagnosed by a qualified professional as suffering
33.21from an illness or incapacity that is expected to last for 30 days or more, including a
33.22pregnant participant who is determined to be unable to obtain or retain employment due
33.23to the pregnancy; or
33.24(3) a participant who is determined by a qualified professional as being needed in
33.25the home to care for an ill or incapacitated family member, including caregivers with a
33.26child or an adult in the household who meets the disability or medical criteria for home
33.27care services under section 256B.0651, subdivision 1, paragraph (c), or a home and
33.28community-based waiver services program under chapter 256B, or meets the criteria for
33.29severe emotional disturbance under section 245.4871, subdivision 6, or for serious and
33.30persistent mental illness under section 245.462, subdivision 20, paragraph (c).
33.31(e) For participants covered under paragraphs (c) and (d), the county shall review
33.32the participant's employment services status every three months to determine whether
33.33conditions have changed. When it is determined that the participant's status is no longer
33.34covered under paragraph (c) or (d), the county shall notify the participant that a new or
33.35revised employment plan is needed. The participant and job counselor shall meet within
33.36ten days of the determination to revise the employment plan.
34.1(b) Participants who meet the eligibility requirements in section 256J.575,
34.2subdivision 3, must develop a family stabilization services plan that meets the
34.3requirements in section 256J.575, subdivision 5.
34.4(c) Minor caregivers and caregivers who are less than age 20 who have not
34.5completed high school or obtained a GED must develop an education plan that meets the
34.6requirements in section 256J.54.
34.7(d) Participants with a family violence waiver must develop an employment plan
34.8that meets the requirements in section 256J.521, which cover the provisions in section
34.9256J.575, subdivision 5.
34.10(e) All other participants must develop an employment plan that meets the
34.11requirements of section 256J.521, subdivision 2, and contains allowable work activities,
34.12as defined in section 256J.49, subdivision 13. The employment plan must include, at a
34.13minimum, the number of participation hours required under section 256J.55, subdivision 1.

34.14    Sec. 21. Minnesota Statutes 2008, section 256J.561, subdivision 3, is amended to read:
34.15    Subd. 3. Child under 12 weeks months of age. (a) A participant who has a
34.16natural born child who is less than 12 weeks months of age who meets the criteria in this
34.17subdivision is not required to participate in employment services until the child reaches
34.1812 weeks months of age. To be eligible for this provision, the assistance unit must not
34.19have already used this provision or the previously allowed child under age one exemption.
34.20However, an assistance unit that has an approved child under age one exemption at the
34.21time this provision becomes effective may continue to use that exemption until the child
34.22reaches one year of age.
34.23(b) The provision in paragraph (a) ends the first full month after the child reaches
34.2412 weeks months of age. This provision is available only once in a caregiver's lifetime.
34.25In a two-parent household, only one parent shall be allowed to use this provision. The
34.26participant and job counselor must meet within ten days after the child reaches 12 weeks
34.27months of age to revise the participant's employment plan.
34.28EFFECTIVE DATE.This section is effective March 1, 2010.

34.29    Sec. 22. Minnesota Statutes 2008, section 256J.57, subdivision 1, is amended to read:
34.30    Subdivision 1. Good cause for failure to comply. The county agency shall not
34.31impose the sanction under section 256J.46 if it determines that the participant has good
34.32cause for failing to comply with the requirements of sections 256J.515 to 256J.57. Good
34.33cause exists when:
34.34(1) appropriate child care is not available;
35.1(2) the job does not meet the definition of suitable employment;
35.2(3) the participant is ill or injured;
35.3(4) a member of the assistance unit, a relative in the household, or a foster child in
35.4the household is ill and needs care by the participant that prevents the participant from
35.5complying with the employment plan;
35.6(5) the participant is unable to secure necessary transportation;
35.7(6) the participant is in an emergency situation that prevents compliance with the
35.8employment plan;
35.9(7) the schedule of compliance with the employment plan conflicts with judicial
35.10proceedings;
35.11(8) a mandatory MFIP meeting is scheduled during a time that conflicts with a
35.12judicial proceeding or a meeting related to a juvenile court matter, or a participant's work
35.13schedule;
35.14(9) the participant is already participating in acceptable work activities;
35.15(10) the employment plan requires an educational program for a caregiver under age
35.1620, but the educational program is not available;
35.17(11) activities identified in the employment plan are not available;
35.18(12) the participant is willing to accept suitable employment, but suitable
35.19employment is not available; or
35.20(13) the participant documents other verifiable impediments to compliance with the
35.21employment plan beyond the participant's control; or
35.22(14) the documentation needed to determine if a participant is eligible for family
35.23stabilization services is not available, but there is information that the participant may
35.24qualify and the participant is cooperating with the county or employment service provider's
35.25efforts to obtain the documentation necessary to determine eligibility.
35.26The job counselor shall work with the participant to reschedule mandatory meetings
35.27for individuals who fall under clauses (1), (3), (4), (5), (6), (7), and (8).

35.28    Sec. 23. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:
35.29    Subd. 3. Eligibility. (a) The following MFIP or diversionary work program (DWP)
35.30participants are eligible for the services under this section:
35.31    (1) a participant who meets the requirements for or has been granted a hardship
35.32extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for
35.33the participant to have reached or be approaching 60 months of eligibility for this section
35.34to apply;
36.1    (2) a participant who is applying for Supplemental Security Income or Social
36.2Security disability insurance; and
36.3    (3) a participant who is a noncitizen who has been in the United States for 12 or
36.4fewer months; and
36.5(4) a participant who is age 60 or older.
36.6    (b) Families must meet all other eligibility requirements for MFIP established in
36.7this chapter. Families are eligible for financial assistance to the same extent as if they
36.8were participating in MFIP.
36.9    (c) A participant under paragraph (a), clause (3), must be provided with English as a
36.10second language opportunities and skills training for up to 12 months. After 12 months,
36.11the case manager and participant must determine whether the participant should continue
36.12with English as a second language classes or skills training, or both, and continue to
36.13receive family stabilization services.
36.14(d) If a county agency or employment services provider has information that
36.15an MFIP participant may meet the eligibility criteria set forth in this subdivision, the
36.16county agency or employment services provider must assist the participant in obtaining
36.17the documentation necessary to determine eligibility. Until necessary documentation is
36.18obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7.
36.19EFFECTIVE DATE.This section is effective July 1, 2009, except the amendment
36.20to paragraph (a) striking "or diversionary work program (DWP)" is effective March 1,
36.212010.

36.22    Sec. 24. Minnesota Statutes 2008, section 256J.575, subdivision 4, is amended to read:
36.23    Subd. 4. Universal participation. All caregivers must participate in family
36.24stabilization services as defined in subdivision 2, except for caregivers exempt under
36.25section 256J.561, subdivision 3.
36.26EFFECTIVE DATE.This section is effective March 1, 2010.

36.27    Sec. 25. Minnesota Statutes 2008, section 256J.575, subdivision 6, is amended to read:
36.28    Subd. 6. Cooperation with services requirements. (a) To be eligible, A participant
36.29who is eligible for family stabilization services under this section shall comply with
36.30paragraphs (b) to (d).
36.31    (b) Participants shall engage in family stabilization plan services for the appropriate
36.32number of hours per week that the activities are scheduled and available, unless good
36.33cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate
36.34number of hours must be based on the participant's plan.
37.1    (c) The case manager shall review the participant's progress toward the goals in the
37.2family stabilization plan every six months to determine whether conditions have changed,
37.3including whether revisions to the plan are needed.
37.4    (d) A participant's requirement to comply with any or all family stabilization plan
37.5requirements under this subdivision is excused when the case management services,
37.6training and educational services, or family support services identified in the participant's
37.7family stabilization plan are unavailable for reasons beyond the control of the participant,
37.8including when money appropriated is not sufficient to provide the services.

37.9    Sec. 26. Minnesota Statutes 2008, section 256J.575, subdivision 7, is amended to read:
37.10    Subd. 7. Sanctions. (a) The county agency or employment services provider must
37.11follow the requirements of this subdivision at the time the county agency or employment
37.12services provider has information that an MFIP recipient may meet the eligibility criteria
37.13in subdivision 3.
37.14(b) The financial assistance grant of a participating family is reduced according to
37.15section 256J.46, if a participating adult fails without good cause to comply or continue
37.16to comply with the family stabilization plan requirements in this subdivision, unless
37.17compliance has been excused under subdivision 6, paragraph (d).
37.18    (b) (c) Given the purpose of the family stabilization services in this section and the
37.19nature of the underlying family circumstances that act as barriers to both employment and
37.20full compliance with program requirements, there must be a review by the county agency
37.21prior to imposing a sanction to determine whether the plan was appropriated to the needs
37.22of the participant and family, and. There must be a current assessment by a behavioral
37.23health or medical professional confirming that the participant in all ways had the ability to
37.24comply with the plan, as confirmed by a behavioral health or medical professional.
37.25    (c) (d) Prior to the imposition of a sanction, the county agency or employment
37.26services provider shall review the participant's case to determine if the family stabilization
37.27plan is still appropriate and meet with the participant face-to-face. The participant may
37.28bring an advocate The county agency or employment services provider must inform the
37.29participant of the right to bring an advocate to the face-to-face meeting.
37.30    During the face-to-face meeting, the county agency shall:
37.31    (1) determine whether the continued noncompliance can be explained and mitigated
37.32by providing a needed family stabilization service, as defined in subdivision 2, paragraph
37.33(d);
37.34    (2) determine whether the participant qualifies for a good cause exception under
37.35section 256J.57, or if the sanction is for noncooperation with child support requirements,
38.1determine if the participant qualifies for a good cause exemption under section 256.741,
38.2subdivision 10;
38.3    (3) determine whether activities in the family stabilization plan are appropriate
38.4based on the family's circumstances;
38.5    (4) explain the consequences of continuing noncompliance;
38.6    (5) identify other resources that may be available to the participant to meet the
38.7needs of the family; and
38.8    (6) inform the participant of the right to appeal under section 256J.40.
38.9    If the lack of an identified activity or service can explain the noncompliance, the
38.10county shall work with the participant to provide the identified activity.
38.11    (d) If the participant fails to come to the face-to-face meeting, the case manager or a
38.12designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
38.13the county agency shall send the participant a written notice that includes the information
38.14under paragraph (c).
38.15    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
38.16of a sanction, the county agency shall provide a notice of intent to sanction under section
38.17256J.57, subdivision 2 , and, when applicable, a notice of adverse action under section
38.18256J.31 .
38.19    (f) Section 256J.57 applies to this section except to the extent that it is modified
38.20by this subdivision.

38.21    Sec. 27. Minnesota Statutes 2008, section 256J.621, is amended to read:
38.22256J.621 WORK PARTICIPATION CASH BENEFITS.
38.23    (a) Effective October 1, 2009, upon exiting the diversionary work program (DWP)
38.24or upon terminating the Minnesota family investment program with earnings, a participant
38.25who is employed may be eligible for work participation cash benefits of $75 $50 per
38.26month to assist in meeting the family's basic needs as the participant continues to move
38.27toward self-sufficiency.
38.28    (b) To be eligible for work participation cash benefits, the participant shall not
38.29receive MFIP or diversionary work program assistance during the month and the
38.30participant or participants must meet the following work requirements:
38.31    (1) if the participant is a single caregiver and has a child under six years of age, the
38.32participant must be employed at least 87 hours per month;
38.33    (2) if the participant is a single caregiver and does not have a child under six years of
38.34age, the participant must be employed at least 130 hours per month; or
39.1    (3) if the household is a two-parent family, at least one of the parents must be
39.2employed an average of at least 130 hours per month.
39.3    Whenever a participant exits the diversionary work program or is terminated from
39.4MFIP and meets the other criteria in this section, work participation cash benefits are
39.5available for up to 24 consecutive months.
39.6    (c) Expenditures on the program are maintenance of effort state funds under
39.7a separate state program for participants under paragraph (b), clauses (1) and (2).
39.8Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
39.9funds. Months in which a participant receives work participation cash benefits under this
39.10section do not count toward the participant's MFIP 60-month time limit.

39.11    Sec. 28. Minnesota Statutes 2008, section 256J.626, subdivision 7, is amended to read:
39.12    Subd. 7. Performance base funds. (a) For the purpose of this section, the following
39.13terms have the meanings given.
39.14(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
39.15TANF and separate state program caseload has fallen relative to federal fiscal year 2005
39.16based on caseload data from October 1 to September 30.
39.17(2) "TANF participation rate target" means a 50 percent participation rate reduced by
39.18the CRC for the previous year.
39.19(b) For calendar year 2009 2010 and yearly thereafter, each county and tribe will be
39.20allocated 95 percent of their initial calendar year allocation. Counties and tribes will be
39.21allocated additional funds based on performance as follows:
39.22    (1) a county or tribe that achieves a 50 percent the TANF participation rate target
39.23or a five percentage point improvement over the previous year's TANF participation rate
39.24under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive
39.25months for the most recent year for which the measurements are available, will receive an
39.26additional allocation equal to 2.5 percent of its initial allocation; and
39.27    (2) a county or tribe that performs within or above its range of expected performance
39.28on the annualized three-year self-support index under section 256J.751, subdivision 2,
39.29clause (6), will receive an additional allocation equal to 2.5 percent of its initial allocation;
39.30and
39.31    (3) a county or tribe that does not achieve a 50 percent the TANF participation rate
39.32target or a five percentage point improvement over the previous year's TANF participation
39.33rate under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive
39.34months for the most recent year for which the measurements are available, will not
40.1receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
40.2improvement plan with the commissioner; or
40.3    (4) a county or tribe that does not perform within or above its range of expected
40.4performance on the annualized three-year self-support index under section 256J.751,
40.5subdivision 2
, clause (6), will not receive an additional allocation equal to 2.5 percent
40.6of its initial allocation until after negotiating a multiyear improvement plan with the
40.7commissioner.
40.8    (b) (c) For calendar year 2009 and yearly thereafter, performance-based funds for
40.9a federally approved tribal TANF program in which the state and tribe have in place
40.10a contract under section 256.01, addressing consolidated funding, will be allocated as
40.11follows:
40.12    (1) a tribe that achieves the participation rate approved in its federal TANF plan
40.13using the average of 12 consecutive months for the most recent year for which the
40.14measurements are available, will receive an additional allocation equal to 2.5 percent of
40.15its initial allocation; and
40.16    (2) a tribe that performs within or above its range of expected performance on the
40.17annualized three-year self-support index under section 256J.751, subdivision 2, clause (6),
40.18will receive an additional allocation equal to 2.5 percent of its initial allocation; or
40.19    (3) a tribe that does not achieve the participation rate approved in its federal TANF
40.20plan using the average of 12 consecutive months for the most recent year for which the
40.21measurements are available, will not receive an additional allocation equal to 2.5 percent
40.22of its initial allocation until after negotiating a multiyear improvement plan with the
40.23commissioner; or
40.24    (4) a tribe that does not perform within or above its range of expected performance
40.25on the annualized three-year self-support index under section 256J.751, subdivision
40.262
, clause (6), will not receive an additional allocation equal to 2.5 percent until after
40.27negotiating a multiyear improvement plan with the commissioner.
40.28    (c) (d) Funds remaining unallocated after the performance-based allocations
40.29in paragraph (a) (b) are available to the commissioner for innovation projects under
40.30subdivision 5.
40.31    (d) (1) If available funds are insufficient to meet county and tribal allocations under
40.32paragraph (a) (b), the commissioner may make available for allocation funds that are
40.33unobligated and available from the innovation projects through the end of the current
40.34biennium.
40.35    (2) If after the application of clause (1) funds remain insufficient to meet county
40.36and tribal allocations under paragraph (a) (b), the commissioner must proportionally
41.1reduce the allocation of each county and tribe with respect to their maximum allocation
41.2available under paragraph (a) (b).

41.3    Sec. 29. Minnesota Statutes 2008, section 256J.95, subdivision 3, is amended to read:
41.4    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories
41.5of family units listed below, all family units who apply for cash benefits and who
41.6meet MFIP eligibility as required in sections 256J.11 to 256J.15 are eligible and must
41.7participate in the diversionary work program. Family units that are not eligible for the
41.8diversionary work program include:
41.9    (1) child only cases;
41.10    (2) a single-parent family unit that includes a child under 12 weeks months of age.
41.11A parent is eligible for this exception once in a parent's lifetime and is not eligible if
41.12the parent has already used the previously allowed child under age one exemption from
41.13MFIP employment services;
41.14    (3) a minor parent without a high school diploma or its equivalent;
41.15    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent
41.16who chooses to have an employment plan with an education option;
41.17    (5) a caregiver age 60 or over;
41.18    (6) family units with a caregiver who received DWP benefits in the 12 months prior
41.19to the month the family applied for DWP, except as provided in paragraph (c);
41.20    (7) family units with a caregiver who received MFIP within the 12 months prior to
41.21the month the family unit applied for DWP;
41.22    (8) a family unit with a caregiver who received 60 or more months of TANF
41.23assistance;
41.24    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to
41.25fraud; and
41.26    (10) refugees and asylees as defined in Code of Federal Regulations, title 45, part
41.27400, subpart d, section 400.43, who arrived in the United States in the 12 months prior to
41.28the date of application for family cash assistance.
41.29    (b) A two-parent family must participate in DWP unless both caregivers meet the
41.30criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit
41.31includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), (9), or (10).
41.32    (c) Once DWP eligibility is determined, the four months run consecutively. If a
41.33participant leaves the program for any reason and reapplies during the four-month period,
41.34the county must redetermine eligibility for DWP.
41.35EFFECTIVE DATE.This section is effective March 1, 2010.

42.1    Sec. 30. Minnesota Statutes 2008, section 256J.95, subdivision 11, is amended to read:
42.2    Subd. 11. Universal participation required. (a) All DWP caregivers, except
42.3caregivers who meet the criteria in paragraph (d), are required to participate in DWP
42.4employment services. Except as specified in paragraphs (b) and (c), employment plans
42.5under DWP must, at a minimum, meet the requirements in section 256J.55, subdivision 1.
42.6(b) A caregiver who is a member of a two-parent family that is required to participate
42.7in DWP who would otherwise be ineligible for DWP under subdivision 3 may be allowed
42.8to develop an employment plan under section 256J.521, subdivision 2, paragraph (c), that
42.9may contain alternate activities and reduced hours.
42.10(c) A participant who is a victim of family violence shall be allowed to develop an
42.11employment plan under section 256J.521, subdivision 3. A claim of family violence must
42.12be documented by the applicant or participant by providing a sworn statement which is
42.13supported by collateral documentation in section 256J.545, paragraph (b).
42.14(d) One parent in a two-parent family unit that has a natural born child under 12
42.15weeks months of age is not required to have an employment plan until the child reaches 12
42.16weeks months of age unless the family unit has already used the exclusion under section
42.17256J.561, subdivision 3 , or the previously allowed child under age one exemption under
42.18section 256J.56, paragraph (a), clause (5).
42.19(e) The provision in paragraph (d) ends the first full month after the child reaches 12
42.20weeks months of age. This provision is allowable only once in a caregiver's lifetime. In a
42.21two-parent household, only one parent shall be allowed to use this category.
42.22(f) The participant and job counselor must meet within ten working days after the
42.23child reaches 12 weeks months of age to revise the participant's employment plan. The
42.24employment plan for a family unit that has a child under 12 weeks months of age that has
42.25already used the exclusion in section 256J.561 or the previously allowed child under
42.26age one exemption under section 256J.56, paragraph (a), clause (5), must be tailored to
42.27recognize the caregiving needs of the parent.
42.28EFFECTIVE DATE.This section is effective March 1, 2010.

42.29    Sec. 31. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:
42.30    Subd. 12. Conversion or referral to MFIP. (a) If at any time during the DWP
42.31application process or during the four-month DWP eligibility period, it is determined that
42.32a participant is unlikely to benefit from the diversionary work program, the county shall
42.33convert or refer the participant to MFIP as specified in paragraph (d). Participants who are
42.34determined to be unlikely to benefit from the diversionary work program must develop
42.35and sign an employment plan. Participants who meet any one of the criteria in paragraph
43.1(b) shall be considered to be unlikely to benefit from DWP, provided the necessary
43.2documentation is available to support the determination.
43.3(b) A participant who: meets the eligibility requirements under section 256J.575,
43.4subdivision 3, must be considered to be unlikely to benefit from DWP, provided the
43.5necessary documentation is available to support the determination.
43.6(1) has been determined by a qualified professional as being unable to obtain or retain
43.7employment due to an illness, injury, or incapacity that is expected to last at least 60 days;
43.8(2) is required in the home as a caregiver because of the illness, injury, or incapacity,
43.9of a family member, or a relative in the household, or a foster child, and the illness, injury,
43.10or incapacity and the need for a person to provide assistance in the home has been certified
43.11by a qualified professional and is expected to continue more than 60 days;
43.12(3) is determined by a qualified professional as being needed in the home to care for
43.13a child or adult meeting the special medical criteria in section 256J.561, subdivision 2,
43.14paragraph (d), clause (3);
43.15(4) is pregnant and is determined by a qualified professional as being unable to
43.16obtain or retain employment due to the pregnancy; or
43.17(5) has applied for SSI or SSDI.
43.18(c) In a two-parent family unit, both parents must be if one parent is determined
43.19to be unlikely to benefit from the diversionary work program before, the family unit
43.20can must be converted or referred to MFIP.
43.21(d) A participant who is determined to be unlikely to benefit from the diversionary
43.22work program shall be converted to MFIP and, if the determination was made within 30
43.23days of the initial application for benefits, no additional application form is required.
43.24A participant who is determined to be unlikely to benefit from the diversionary work
43.25program shall be referred to MFIP and, if the determination is made more than 30
43.26days after the initial application, the participant must submit a program change request
43.27form. The county agency shall process the program change request form by the first of
43.28the following month to ensure that no gap in benefits is due to delayed action by the
43.29county agency. In processing the program change request form, the county must follow
43.30section 256J.32, subdivision 1, except that the county agency shall not require additional
43.31verification of the information in the case file from the DWP application unless the
43.32information in the case file is inaccurate, questionable, or no longer current.
43.33(e) The county shall not request a combined application form for a participant who
43.34has exhausted the four months of the diversionary work program, has continued need for
43.35cash and food assistance, and has completed, signed, and submitted a program change
43.36request form within 30 days of the fourth month of the diversionary work program. The
44.1county must process the program change request according to section 256J.32, subdivision
44.21
, except that the county agency shall not require additional verification of information
44.3in the case file unless the information is inaccurate, questionable, or no longer current.
44.4When a participant does not request MFIP within 30 days of the diversionary work
44.5program benefits being exhausted, a new combined application form must be completed
44.6for any subsequent request for MFIP.
44.7EFFECTIVE DATE.This section is effective March 1, 2010.

44.8    Sec. 32. Minnesota Statutes 2008, section 256J.95, subdivision 13, is amended to read:
44.9    Subd. 13. Immediate referral to employment services. Within one working day of
44.10determination that the applicant is eligible for the diversionary work program, but before
44.11benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to
44.12employment services. The referral to the DWP employment services must be in writing
44.13and must contain the following information:
44.14(1) notification that, as part of the application process, applicants are required to
44.15develop an employment plan or the DWP application will be denied;
44.16(2) the employment services provider name and phone number;
44.17(3) the date, time, and location of the scheduled employment services interview;
44.18(4) the immediate availability of supportive services, including, but not limited to,
44.19child care, transportation, and other work-related aid; and
44.20(5) (4) the rights, responsibilities, and obligations of participants in the program,
44.21including, but not limited to, the grounds for good cause, the consequences of refusing or
44.22failing to participate fully with program requirements, and the appeal process.

44.23    Sec. 33. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
44.24to read:
44.25    Subd. 3b. Extension; adoption finalized after age 16. A child who has attained the
44.26age of 16 prior to finalization of their adoption is eligible for extension of the adoption
44.27assistance agreement to the date the child attains age 21 if the child is:
44.28    (1) completing a secondary education program or a program leading to an equivalent
44.29credential;
44.30    (2) enrolled in an institution which provides postsecondary or vocational education;
44.31    (3) participating in a program or activity designed to promote or remove barriers to
44.32employment;
44.33    (4) employed for at least 80 hours per month; or
45.1    (5) incapable of doing any of the activities described in clauses (1) to (4) due to a
45.2medical condition which incapability is supported by regularly updated information in
45.3the case plan of the child.
45.4EFFECTIVE DATE.This section is effective October 1, 2010.

45.5    Sec. 34. Minnesota Statutes 2008, section 270A.09, is amended by adding a
45.6subdivision to read:
45.7    Subd. 1b. Department of Human Services claims. Notwithstanding subdivision 1,
45.8any debtor contesting a setoff claim by the Department of Human Services or a county
45.9agency whose claim relates to a debt resulting from receipt of public assistance, medical
45.10care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as
45.11an appeal under sections 256.045 and 256.0451.

45.12    Sec. 35. AMERICAN INDIAN CHILD WELFARE PROJECTS.
45.13Notwithstanding Minnesota Statutes, section 16A.28, the commissioner of human
45.14services shall extend payment of state fiscal year 2009 funds in state fiscal year 2010
45.15to tribes participating in the American Indian child welfare projects under Minnesota
45.16Statutes, section 256.01, subdivision 14b. Future extensions of payment for a tribe
45.17participating in the Indian child welfare projects under Minnesota Statutes, section 256.01,
45.18subdivision 14b, must be granted according to the commissioner's authority under
45.19Minnesota Statutes, section 16A.28.

45.20    Sec. 36. REPEALER.
45.21Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.

45.22ARTICLE 3
45.23STATE-OPERATED SERVICES/MINNESOTA SEX OFFENDER PROGRAM

45.24    Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:
45.25    Subd. 5. Cost of care. "Cost of care" means the commissioner's charge for services
45.26provided to any person admitted to a state facility.
45.27For purposes of this subdivision, "charge for services" means the cost of services,
45.28treatment, maintenance, bonds issued for capital improvements, depreciation of buildings
45.29and equipment, and indirect costs related to the operation of state facilities. The
45.30commissioner may determine the charge for services on an anticipated average per diem
45.31basis as an all inclusive charge per facility, per disability group, or per treatment program.
45.32The commissioner may determine a charge per service, using a method that includes direct
46.1and indirect costs usual and customary fee charged for services provided to clients. The
46.2usual and customary fee shall be established in a manner required to appropriately bill
46.3services to all payers and shall include the costs related to the operations of any program
46.4offered by the state.

46.5    Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
46.6to read:
46.7    Subd. 10. State-operated community-based program. "State-operated
46.8community-based program" means any program operated in the community including
46.9community behavioral health hospitals, crisis centers, residential facilities, outpatient
46.10services, and other community-based services developed and operated by the state and
46.11under the commissioner's control.

46.12    Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
46.13to read:
46.14    Subd. 11. Health plan company. "Health plan company" has the meaning given it
46.15in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in
46.16section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating
46.17in county-based purchasing according to section 256B.692, and a children's mental health
46.18collaborative under contract to provide medical assistance for individuals enrolled in
46.19the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to
46.20245.495.

46.21    Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
46.22to read:
46.23    Subd. 1a. Clients in state-operated community-based programs; determination.
46.24The commissioner shall determine available health plan coverage from a health plan
46.25company for services provided to clients admitted to a state-operated community-based
46.26program. If the health plan coverage requires a co-pay or deductible, or if there is no
46.27available health plan coverage, the commissioner shall determine or redetermine, what
46.28part of the noncovered cost of care, if any, the client is able to pay. If the client is unable to
46.29pay the uncovered cost of care, the commissioner shall determine the client's relatives'
46.30ability to pay. The client and relatives shall provide to the commissioner documents and
46.31proof necessary to determine the client and relatives' ability to pay. Failure to provide the
46.32commissioner with sufficient information to determine ability to pay may make the client
46.33or relatives liable for the full cost of care until the time when sufficient information is
47.1provided. If it is determined that the responsible party does not have the ability to pay,
47.2the commissioner shall waive payment of the portion that exceeds ability to pay under
47.3the determination.

47.4    Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
47.5to read:
47.6    Subd. 1b. Clients served by regional treatment centers or nursing homes;
47.7determination. The commissioner shall determine or redetermine, if necessary, what part
47.8of the cost of care, if any, a client served in regional treatment centers or nursing homes
47.9operated by state-operated services, is able to pay. If the client is unable to pay the full cost
47.10of care, the commissioner shall determine if the client's relatives have the ability to pay.
47.11The client and relatives shall provide to the commissioner documents and proof necessary
47.12to determine the client and relatives' ability to pay. Failure to provide the commissioner
47.13with sufficient information to determine ability to pay may make the client or relatives
47.14liable for the full cost of care until the time when sufficient information is provided. No
47.15parent shall be liable for the cost of care given a client at a regional treatment center after
47.16the client has reached the age of 18 years.

47.17    Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read:
47.18246.511 RELATIVE RESPONSIBILITY.
47.19Except for chemical dependency services paid for with funds provided under chapter
47.20254B, a client's relatives shall not, pursuant to the commissioner's authority under section
47.21246.51 , be ordered to pay more than ten percent of the cost of the following: (1) for
47.22services provided in a community-based service, the noncovered cost of care as determined
47.23under the ability to pay determination; and (2) for services provided at a regional treatment
47.24center operated by state-operated services, 20 percent of the cost of care, unless they
47.25reside outside the state. Parents of children in state facilities shall have their responsibility
47.26to pay determined according to section 252.27, subdivision 2, or in rules adopted under
47.27chapter 254B if the cost of care is paid under chapter 254B. The commissioner may
47.28accept voluntary payments in excess of ten 20 percent. The commissioner may require
47.29full payment of the full per capita cost of care in state facilities for clients whose parent,
47.30parents, spouse, guardian, or conservator do not reside in Minnesota.

47.31    Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read:
47.32246.52 PAYMENT FOR CARE; ORDER; ACTION.
48.1The commissioner shall issue an order to the client or the guardian of the estate, if
48.2there be one, and relatives determined able to pay requiring them to pay monthly to the
48.3state of Minnesota the amounts so determined the total of which shall not exceed the full
48.4cost of care. Such order shall specifically state the commissioner's determination and shall
48.5be conclusive unless appealed from as herein provided. When a client or relative fails to
48.6pay the amount due hereunder the attorney general, upon request of the commissioner,
48.7may institute, or direct the appropriate county attorney to institute, civil action to recover
48.8such amount.

48.9    Sec. 8. Minnesota Statutes 2008, section 246.54, subdivision 2, is amended to read:
48.10    Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
48.11Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota
48.12extended treatment options program. For services at these facilities, a county's payment
48.13shall be made from the county's own sources of revenue and payments shall be paid as
48.14follows: payments to the state from the county shall equal ten percent of the cost of care,
48.15as determined by the commissioner, for each day, or the portion thereof, that the client
48.16spends at the facility. If payments received by the state under sections 246.50 to 246.53
48.17exceed 90 percent of the cost of care, the county shall be responsible for paying the state
48.18only the remaining amount. The county shall not be entitled to reimbursement from the
48.19client, the client's estate, or from the client's relatives, except as provided in section 246.53.
48.20    (b) Regardless of the facility to which the client is committed, subdivision 1 does
48.21not apply to the following individuals:
48.22    (1) clients who are committed as mentally ill and dangerous under section 253B.02,
48.23subdivision 17;
48.24    (2) clients who are committed as sexual psychopathic personalities under section
48.25253B.02, subdivision 18b ; and
48.26    (3) clients who are committed as sexually dangerous persons under section 253B.02,
48.27subdivision 18c.
48.28    For each of the individuals in clauses (1) to (3), the payment by the county to the state
48.29shall equal ten percent of the cost of care for each day as determined by the commissioner.

48.30    Sec. 9. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
48.31to read:
48.32    Subd. 1a. Client. "Client" means a person who is admitted to the Minnesota sex
48.33offender program or subject to a court hold order under section 253B.185 for the purpose
49.1of assessment, diagnosis, care, treatment, supervision, or other services provided by the
49.2Minnesota sex offender program.

49.3    Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a
49.4subdivision to read:
49.5    Subd. 1b. Client's county. "Client's county" means the county of the client's
49.6legal settlement for poor relief purposes at the time of commitment. If the client has no
49.7legal settlement for poor relief in this state, it means the county of commitment, except
49.8that when a client with no legal settlement for poor relief is committed while serving a
49.9sentence at a penal institution, it means the county from which the client was sentenced.

49.10    Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
49.11to read:
49.12    Subd. 2a. Cost of care. "Cost of care" means the commissioner's charge for housing
49.13and treatment services provided to any person admitted to the Minnesota sex offender
49.14program.
49.15For purposes of this subdivision, "charge for housing and treatment services" means
49.16the cost of services, treatment, maintenance, bonds issued for capital improvements,
49.17depreciation of buildings and equipment, and indirect costs related to the operation of
49.18state facilities. The commissioner may determine the charge for services on an anticipated
49.19average per diem basis as an all-inclusive charge per facility.

49.20    Sec. 12. Minnesota Statutes 2008, section 246B.01, is amended by adding a
49.21subdivision to read:
49.22    Subd. 2b. Local social services agency. "Local social services agency" means the
49.23local social services agency of the client's county as defined in subdivision 1b and of the
49.24county of commitment, and any other local social services agency possessing information
49.25regarding, or requested by the commissioner to investigate, the financial circumstances
49.26of a client.

49.27    Sec. 13. [246B.07] PAYMENT FOR CARE AND TREATMENT:
49.28DETERMINATION.
49.29    Subdivision 1. Procedures. The commissioner shall determine or redetermine, if
49.30necessary, what amount of the cost of care, if any, the client is able to pay. The client shall
49.31provide to the commissioner documents and proof necessary to determine the ability to
49.32pay. Failure to provide the commissioner with sufficient information to determine ability
50.1to pay may make the client liable for the full cost of care until the time when sufficient
50.2information is provided.
50.3    Subd. 2. Rules. The commissioner shall use the standards in section 246.51,
50.4subdivision 2, to determine the client's liability for the care provided by the Minnesota sex
50.5offender program.
50.6    Subd. 3. Applicability. The commissioner may recover, under sections 246B.07 to
50.7246B.10, the cost of any care provided by the Minnesota sex offender program.

50.8    Sec. 14. [246B.08] PAYMENT FOR CARE; ORDER; ACTION.
50.9The commissioner shall issue an order to the client or the guardian of the estate, if
50.10there is one, requiring the client or guardian to pay to the state the amounts determined, the
50.11total of which must not exceed the full cost of care. The order must specifically state the
50.12commissioner's determination and must be conclusive, unless appealed. If a client fails to
50.13pay the amount due, the attorney general, upon request of the commissioner, may institute,
50.14or direct the appropriate county attorney to institute a civil action to recover the amount.

50.15    Sec. 15. [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.
50.16    Subdivision 1. Client's estate. Upon the death of a client, or a former client, the
50.17total cost of care provided to the client, less the amount actually paid toward the cost of
50.18care by the client, must be filed by the commissioner as a claim against the estate of the
50.19client with the court having jurisdiction to probate the estate, and all proceeds collected
50.20by the state in the case must be divided between the state and county in proportion to
50.21the cost of care each has borne.
50.22    Subd. 2. Preferred status. An estate claim in subdivision 1 must be considered an
50.23expense of the last illness for purposes of section 524.3-805.
50.24If the commissioner determines that the property or estate of a client is not more
50.25than needed to care for and maintain the spouse and minor or dependent children of a
50.26deceased client, the commissioner has the power to compromise the claim of the state in a
50.27manner deemed just and proper.
50.28    Subd. 3. Exception from statute of limitations. Any statute of limitations that
50.29limits the commissioner in recovering the cost of care obligation incurred by a client or
50.30former client must not apply to any claim against an estate made under this section to
50.31recover cost of care.

50.32    Sec. 16. [246B.10] LIABILITY OF COUNTY; REIMBURSEMENT.
51.1The client's county shall pay to the state a portion of the cost of care provided in
51.2the Minnesota sex offender program to a client who has legally settled in that county. A
51.3county's payment must be made from the county's own sources of revenue and payments
51.4must equal ten percent of the cost of care, as determined by the commissioner, for each
51.5day or portion of a day, that the client spends at the facility. If payments received by the
51.6state under this chapter exceed 90 percent of the cost of care, the county is responsible
51.7for paying the state the remaining amount. The county is not entitled to reimbursement
51.8from the client, the client's estate, or from the client's relatives, except as provided in
51.9section 246B.07.

51.10    Sec. 17. Minnesota Statutes 2008, section 252.025, subdivision 7, is amended to read:
51.11    Subd. 7. Minnesota extended treatment options. The commissioner shall develop
51.12by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have
51.13developmental disabilities and exhibit severe behaviors which present a risk to public
51.14safety. This program is statewide and must provide specialized residential services in
51.15Cambridge and an array of community support community-based services statewide with
51.16sufficient levels of care and a sufficient number of specialists to ensure that individuals
51.17referred to the program receive the appropriate care. The individuals working in the
51.18community-based services under this section are state employees supervised by the
51.19commissioner of human services. No layoffs shall occur as a result of restructuring
51.20under this section.

51.21    Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED
51.22MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE
51.23ANOKA-METRO REGIONAL TREATMENT CENTER.
51.24In consultation with community partners, the commissioner of human services
51.25shall develop an array of community-based services to transform the current services
51.26now provided to patients at the Anoka-Metro Regional Treatment Center. The
51.27community-based services may be provided in facilities with 16 or fewer beds, and must
51.28provide the appropriate level of care for the patients being admitted to the facilities. The
51.29planning for this transition must be completed by October 1, 2009, with an initial report
51.30to the committee chairs of health and human services by November 30, 2009, and a
51.31semiannual report on progress until the transition is completed. The commissioner of
51.32human services shall solicit interest from stakeholders and potential community partners.
51.33The individuals working in the community-based services facilities under this section are
52.1state employees supervised by the commissioner of human services. No layoffs shall
52.2occur as a result of restructuring under this section.

52.3    Sec. 19. REPEALER.
52.4Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision
52.53, are repealed.

52.6ARTICLE 4
52.7DEPARTMENT OF HEALTH

52.8    Section 1. Minnesota Statutes 2008, section 62J.495, is amended to read:
52.962J.495 HEALTH INFORMATION TECHNOLOGY AND
52.10INFRASTRUCTURE.
52.11    Subdivision 1. Implementation. By January 1, 2015, all hospitals and health care
52.12providers must have in place an interoperable electronic health records system within their
52.13hospital system or clinical practice setting. The commissioner of health, in consultation
52.14with the e-Health Information Technology and Infrastructure Advisory Committee,
52.15shall develop a statewide plan to meet this goal, including uniform standards to be used
52.16for the interoperable system for sharing and synchronizing patient data across systems.
52.17The standards must be compatible with federal efforts. The uniform standards must be
52.18developed by January 1, 2009, with a status report on the development of these standards
52.19submitted to the legislature by January 15, 2008 and updated on an ongoing basis. The
52.20commissioner shall include an update on standards development as part of an annual
52.21report to the legislature.
52.22    Subd. 1a. Definitions. (a) "Certified electronic health record technology" means an
52.23electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH
52.24Act to meet the standards and implementation specifications adopted under section 3004
52.25as applicable.
52.26(b) "Commissioner" means the commissioner of health.
52.27(c) "Pharmaceutical electronic data intermediary" means any entity that provides
52.28the infrastructure to connect computer systems or other electronic devices utilized
52.29by prescribing practitioners with those used by pharmacies, health plans, third party
52.30administrators, and pharmacy benefit manager in order to facilitate the secure transmission
52.31of electronic prescriptions, refill authorization requests, communications, and other
52.32prescription-related information between such entities.
52.33(d) "HITECH Act" means the Health Information Technology for Economic and
52.34Clinical Health Act in division A, title XIII and division B, title IV of the American
53.1Recovery and Reinvestment Act of 2009, including federal regulations adopted under
53.2that act.
53.3(e) "Interoperable electronic health record" means an electronic health record that
53.4securely exchanges health information with another electronic health record system that
53.5meets national requirements for certification under the HITECH Act.
53.6(f) "Qualified electronic health record" means an electronic record of health-related
53.7information on an individual that includes patient demographic and clinical health
53.8information and has the capacity to:
53.9(1) provide clinical decision support;
53.10(2) support physician order entry;
53.11(3) capture and query information relevant to health care quality; and
53.12(4) exchange electronic health information with, and integrate such information
53.13from, other sources.
53.14    Subd. 2. E-Health Information Technology and Infrastructure Advisory
53.15Committee. (a) The commissioner shall establish a an e-Health Information Technology
53.16and Infrastructure Advisory Committee governed by section 15.059 to advise the
53.17commissioner on the following matters:
53.18    (1) assessment of the adoption and effective use of health information technology by
53.19the state, licensed health care providers and facilities, and local public health agencies;
53.20    (2) recommendations for implementing a statewide interoperable health information
53.21infrastructure, to include estimates of necessary resources, and for determining standards
53.22for administrative clinical data exchange, clinical support programs, patient privacy
53.23requirements, and maintenance of the security and confidentiality of individual patient
53.24data;
53.25    (3) recommendations for encouraging use of innovative health care applications
53.26using information technology and systems to improve patient care and reduce the cost
53.27of care, including applications relating to disease management and personal health
53.28management that enable remote monitoring of patients' conditions, especially those with
53.29chronic conditions; and
53.30    (4) other related issues as requested by the commissioner.
53.31    (b) The members of the e-Health Information Technology and Infrastructure
53.32Advisory Committee shall include the commissioners, or commissioners' designees, of
53.33health, human services, administration, and commerce and additional members to be
53.34appointed by the commissioner to include persons representing Minnesota's local public
53.35health agencies, licensed hospitals and other licensed facilities and providers, private
53.36purchasers, the medical and nursing professions, health insurers and health plans, the
54.1state quality improvement organization, academic and research institutions, consumer
54.2advisory organizations with an interest and expertise in health information technology, and
54.3other stakeholders as identified by the Health Information Technology and Infrastructure
54.4Advisory Committee commissioner to fulfill the requirements of section 3013, paragraph
54.5(g) of the HITECH Act.
54.6    (c) The commissioner shall prepare and issue an annual report not later than January
54.730 of each year outlining progress to date in implementing a statewide health information
54.8infrastructure and recommending future projects action on policy and necessary resources
54.9to continue the promotion of adoption and effective use of health information technology.
54.10(d) Notwithstanding section 15.059, this subdivision expires June 30, 2015.
54.11    Subd. 3. Interoperable electronic health record requirements. (a) To meet the
54.12requirements of subdivision 1, hospitals and health care providers must meet the following
54.13criteria when implementing an interoperable electronic health records system within their
54.14hospital system or clinical practice setting.
54.15(a) The electronic health record must be a qualified electronic health record.
54.16    (b) The electronic health record must be certified by the Certification Commission
54.17for Healthcare Information Technology, or its successor Office of the National Coordinator
54.18pursuant to the HITECH Act. This criterion only applies to hospitals and health care
54.19providers whose practice setting is a practice setting covered by the Certification
54.20Commission for Healthcare Information Technology certifications only if a certified
54.21electronic health record product for the provider's particular practice setting is available.
54.22This criterion shall be considered met if a hospital or health care provider is using an
54.23electronic health records system that has been certified within the last three years, even if a
54.24more current version of the system has been certified within the three-year period.
54.25(c) The electronic health record must meet the standards established according to
54.26section 3004 of the HITECH Act as applicable.
54.27(d) The electronic health record must have the ability to generate information on
54.28clinical quality measures and other measures reported under sections 4101, 4102, and
54.294201 of the HITECH Act.
54.30    (c) (e) A health care provider who is a prescriber or dispenser of controlled
54.31substances legend drugs must have an electronic health record system that meets the
54.32requirements of section 62J.497.
54.33    Subd. 4. Coordination with national HIT activities. (a) The commissioner,
54.34in consultation with the e-Health Advisory Committee, shall update the statewide
54.35implementation plan required under subdivision 2 and released June 2008, to be consistent
54.36with the updated Federal HIT Strategic Plan released by the Office of the National
55.1Coordinator in accordance with section 3001 of the HITECH Act. The statewide plan
55.2shall meet the requirements for a plan required under section 3013 of the HITECH Act.
55.3(b) The commissioner, in consultation with the e-Health Advisory Committee, shall
55.4work to ensure coordination between state, regional, and national efforts to support and
55.5accelerate efforts to effectively use health information technology to improve the quality
55.6and coordination of health care and continuity of patient care among health care providers,
55.7to reduce medical errors, to improve population health, to reduce health disparities, and
55.8to reduce chronic disease. The commissioner's coordination efforts shall include but not
55.9be limited to:
55.10(1) assisting in the development and support of health information technology
55.11regional extension centers established under section 3012(c) of the HITECH Act to
55.12provide technical assistance and disseminate best practices; and
55.13(2) providing supplemental information to the best practices gathered by regional
55.14centers to ensure that the information is relayed in a meaningful way to the Minnesota
55.15health care community.
55.16(c) The commissioner, in consultation with the e-Health Advisory Committee, shall
55.17monitor national activity related to health information technology and shall coordinate
55.18statewide input on policy development. The commissioner shall coordinate statewide
55.19responses to proposed federal health information technology regulations in order to ensure
55.20that the needs of the Minnesota health care community are adequately and efficiently
55.21addressed in the proposed regulations. The commissioner's responses may include, but
55.22are not limited to:
55.23(1) reviewing and evaluating any standard, implementation specification, or
55.24certification criteria proposed by the national HIT standards committee;
55.25(2) reviewing and evaluating policy proposed by the national HIT policy
55.26committee relating to the implementation of a nationwide health information technology
55.27infrastructure;
55.28(3) monitoring and responding to activity related to the development of quality
55.29measures and other measures as required by section 4101 of the HITECH Act. Any
55.30response related to quality measures shall consider and address the quality efforts required
55.31under chapter 62U; and
55.32(4) monitoring and responding to national activity related to privacy, security, and
55.33data stewardship of electronic health information and individually identifiable health
55.34information.
55.35(d) To the extent that the state is either required or allowed to apply, or designate an
55.36entity to apply for or carry out activities and programs under section 3013 of the HITECH
56.1Act, the commissioner of health, in consultation with the e-Health Advisory Committee
56.2and the commissioner of human services, shall be the lead applicant or sole designating
56.3authority. The commissioner shall make such designations consistent with the goals and
56.4objectives of sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61.
56.5(e) The commissioner of human services shall apply for funding necessary to
56.6administer the incentive payments to providers authorized under title IV of the American
56.7Recovery and Reinvestment Act.
56.8(f) The commissioner shall include in the report to the legislature information on the
56.9activities of this subdivision and provide recommendations on any relevant policy changes
56.10that should be considered in Minnesota.
56.11    Subd. 5. Collection of data for assessment and eligibility determination. (a)
56.12The commissioner of health, in consultation with the commissioner of human services,
56.13may require providers, dispensers, group purchasers, and pharmaceutical electronic data
56.14intermediaries to submit data in a form and manner specified by the commissioner to
56.15assess the status of adoption, effective use, and interoperability of electronic health
56.16records for the purpose of:
56.17(1) demonstrating Minnesota's progress on goals established by the Office of the
56.18National Coordinator to accelerate the adoption and effective use of health information
56.19technology established under the HITECH Act;
56.20(2) assisting the Center for Medicare and Medicaid Services and Department of
56.21Human Services in determining eligibility of health care professionals and hospitals
56.22to receive federal incentives for the adoption and effective use of health information
56.23technology under the HITECH Act or other federal incentive programs;
56.24(3) assisting the Office of the National Coordinator in completing required
56.25assessments of the impact of the implementation and effective use of health information
56.26technology in achieving goals identified in the national strategic plan, and completing
56.27studies required by the HITECH Act;
56.28(4) providing the data necessary to assist the Office of the National Coordinator in
56.29conducting evaluations of regional extension centers as required by the HITECH Act; and
56.30(5) other purposes as necessary to support the implementation of the HITECH Act.
56.31(b) The commissioner shall coordinate with the commissioner of human services
56.32and other state agencies in the collection of data required under this section to:
56.33(1) avoid duplicative reporting requirements;
56.34(2) maximize efficiencies in the development of reports on state activities as
56.35required by HITECH; and
57.1(3) determine health professional and hospital eligibility for incentives available
57.2under the HITECH Act.
57.3(c) The commissioner must not collect data or publish analyses that identify, or could
57.4potentially identify, individual patients. The commissioner must not collect individual
57.5data in identified or de-identified form.

57.6    Sec. 2. Minnesota Statutes 2008, section 62J.496, is amended to read:
57.762J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
57.8ACCOUNT AND LOAN PROGRAM.
57.9    Subdivision 1. Account establishment. (a) An account is established to: provide
57.10loans to eligible borrowers to assist in financing the installation or support of an
57.11interoperable health record system. The system must provide for the interoperable
57.12exchange of health care information between the applicant and, at a minimum, a hospital
57.13system, pharmacy, and a health care clinic or other physician group.
57.14(1) finance the purchase of certified electronic health records or qualified electronic
57.15health records as defined in section 62J.495, subdivision 1a;
57.16(2) enhance the utilization of electronic health record technology, which may include
57.17costs associated with upgrading the technology to meet the criteria necessary to be a
57.18certified electronic health record or a qualified electronic health record;
57.19(3) train personnel in the use of electronic health record technology; and
57.20(4) improve the secure electronic exchange of health information.
57.21(b) Amounts deposited in the account, including any grant funds obtained through
57.22federal or other sources, loan repayments, and interest earned on the amounts shall be
57.23used only for awarding loans or loan guarantees, as a source of reserve and security for
57.24leveraged loans, or for the administration of the account.
57.25(c) The commissioner may accept contributions to the account from private sector
57.26entities subject to the following provisions:
57.27(1) the contributing entity may not specify the recipient or recipients of any loan
57.28issued under this subdivision;
57.29(2) the commissioner shall make public the identity of any private contributor to the
57.30loan fund, as well as the amount of the contribution provided; and
57.31(3) the commissioner may issue letters of commendation or make other awards that
57.32have no financial value to any such entity.
57.33A contributing entity may not specify that the recipient or recipients of any loan use
57.34specific products or services, nor may the contributing entity imply that a contribution is
57.35an endorsement of any specific product or service.
58.1(d) The commissioner may use the loan funds to reimburse private sector entities
58.2for any contribution made to the loan fund. Reimbursement to private entities may not
58.3exceed the principle amount contributed to the loan fund.
58.4(e) The commissioner may use funds deposited in the account to guarantee, or
58.5purchase insurance for, a local obligation if the guarantee or purchase would improve
58.6credit market access or reduce the interest rate applicable to the obligation involved.
58.7(f) The commissioner may use funds deposited in the account as a source of revenue
58.8or security for the payment of principal and interest on revenue or bonds issued by the
58.9state if the proceeds of the sale of the bonds will be deposited into the loan fund.
58.10    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
58.11(1) federally qualified health centers;
58.12    (1) (2) community clinics, as defined under section 145.9268;
58.13    (2) (3) nonprofit or local unit of government hospitals eligible for rural hospital
58.14capital improvement grants, as defined in section 144.148 licensed under sections 144.50
58.15to 144.56;
58.16    (3) physician clinics located in a community with a population of less than 50,000
58.17according to United States Census Bureau statistics and outside the seven-county
58.18metropolitan area;
58.19(4) individual or small group physician practices that are focused primarily on
58.20primary care;
58.21    (4) (5) nursing facilities licensed under sections 144A.01 to 144A.27; and
58.22(6) local public health departments as defined in chapter 145A; and
58.23    (5) (7) other providers of health or health care services approved by the
58.24commissioner for which interoperable electronic health record capability would improve
58.25quality of care, patient safety, or community health.
58.26 (b) The commissioner shall administer the loan fund to prioritize support and
58.27assistance to:
58.28(1) critical access hospitals;
58.29(2) federally qualified health centers;
58.30(3) entities that serve uninsured, underinsured, and medically underserved
58.31individuals, regardless of whether such area is urban or rural; and
58.32(4) individual or small group practices that are primarily focused on primary care.
58.33    (b) To be eligible for a loan under this section, the (c) An eligible applicant must
58.34submit a loan application to the commissioner of health on forms prescribed by the
58.35commissioner. The application must include, at a minimum:
59.1    (1) the amount of the loan requested and a description of the purpose or project
59.2for which the loan proceeds will be used;
59.3    (2) a quote from a vendor;
59.4    (3) a description of the health care entities and other groups participating in the
59.5project;
59.6    (4) evidence of financial stability and a demonstrated ability to repay the loan; and
59.7    (5) a description of how the system to be financed interconnects interoperates or
59.8plans in the future to interconnect interoperate with other health care entities and provider
59.9groups located in the same geographical area;
59.10(6) a plan on how the certified electronic health record technology will be maintained
59.11and supported over time; and
59.12(7) any other requirements for applications included or developed pursuant to
59.13section 3014 of the HITECH Act.
59.14    Subd. 3. Loans. (a) The commissioner of health may make a no interest loan or
59.15low interest loan to a provider or provider group who is eligible under subdivision 2
59.16on a first-come, first-served basis provided that the applicant is able to comply with this
59.17section consistent with the priorities established in subdivision 2. The total accumulative
59.18loan principal must not exceed $1,500,000 $3,000,000 per loan. The interest rate for each
59.19loan, if imposed, shall not exceed the current market interest rate. The commissioner of
59.20health has discretion over the size, interest rate, and number of loans made. Nothing in
59.21this section shall require the commissioner to make a loan to an eligible borrower under
59.22subdivision 2.
59.23    (b) The commissioner of health may prescribe forms and establish an application
59.24process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable
59.25application fee to cover the cost of administering the loan program. Any application
59.26fees imposed and collected under the electronic health records system revolving account
59.27and loan program in this section are appropriated to the commissioner of health for the
59.28duration of the loan program. The commissioner may apply for and use all federal funds
59.29available through the HITECH Act to administer the loan program.
59.30    (c) For loans approved prior to July 1, 2009, the borrower must begin repaying the
59.31principal no later than two years from the date of the loan. Loans must be amortized no
59.32later than six years from the date of the loan.
59.33(d) For loans granted on January 1, 2010, or thereafter, the borrower must begin
59.34repaying the principle no later than one year from the date of the loan. Loans must be
59.35amortized no later than six years after the date of the loan.
60.1    (d) Repayments (e) All repayments and interest paid on each loan must be credited
60.2to the account.
60.3(f) The loan agreement shall include the assurances that borrower meets requirements
60.4included or developed pursuant to section 3014 of the HITECH Act. The requirements
60.5shall include, but are not limited to:
60.6(1) submitting reports on quality measures in compliance with regulations adopted
60.7by the federal government;
60.8(2) demonstrating that any certified electronic health record technology purchased,
60.9improved, or otherwise financially supported by this loan program is used to exchange
60.10health information in a manner that, in accordance with law and standards applicable to
60.11the exchange of information, improves the quality of health care;
60.12(3) including a plan on how the borrower intends to maintain and support the
60.13certified electronic health record technology over time and the resources expected to be
60.14used to maintain and support the technology purchased with the loan; and
60.15(4) complying with other requirements the secretary may require to use loans funds
60.16under the HITECH Act.
60.17    Subd. 4. Data classification. Data collected by the commissioner of health on the
60.18application to determine eligibility under subdivision 2 and to monitor borrowers' default
60.19risk or collect payments owed under subdivision 3 are (1) private data on individuals as
60.20defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section
60.2113.02, subdivision 9 . The names of borrowers and the amounts of the loans granted
60.22are public data.

60.23    Sec. 3. Minnesota Statutes 2008, section 62J.497, subdivision 1, is amended to read:
60.24    Subdivision 1. Definitions. For the purposes of this section, the following terms
60.25have the meanings given.
60.26(a) "Backward compatible" means that the newer version of a data transmission
60.27standard would retain, at a minimum, the full functionality of the versions previously
60.28adopted, and would permit the successful completion of the applicable transactions with
60.29entities that continue to use the older versions.
60.30    (a) (b) "Dispense" or "dispensing" has the meaning given in section 151.01,
60.31subdivision
30. Dispensing does not include the direct administering of a controlled
60.32substance to a patient by a licensed health care professional.
60.33    (b) (c) "Dispenser" means a person authorized by law to dispense a controlled
60.34substance, pursuant to a valid prescription.
61.1    (c) (d) "Electronic media" has the meaning given under Code of Federal Regulations,
61.2title 45, part 160.103.
61.3    (d) (e) "E-prescribing" means the transmission using electronic media of prescription
61.4or prescription-related information between a prescriber, dispenser, pharmacy benefit
61.5manager, or group purchaser, either directly or through an intermediary, including
61.6an e-prescribing network. E-prescribing includes, but is not limited to, two-way
61.7transmissions between the point of care and the dispenser and two-way transmissions
61.8related to eligibility, formulary, and medication history information.
61.9    (e) (f) "Electronic prescription drug program" means a program that provides for
61.10e-prescribing.
61.11    (f) (g) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
61.12    (g) (h) "HL7 messages" means a standard approved by the standards development
61.13organization known as Health Level Seven.
61.14    (h) (i) "National Provider Identifier" or "NPI" means the identifier described under
61.15Code of Federal Regulations, title 45, part 162.406.
61.16    (i) (j) "NCPDP" means the National Council for Prescription Drug Programs, Inc.
61.17    (j) (k) "NCPDP Formulary and Benefits Standard" means the National Council for
61.18Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide,
61.19Version 1, Release 0, October 2005.
61.20    (k) (l) "NCPDP SCRIPT Standard" means the National Council for Prescription
61.21Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation
61.22Guide Version 8, Release 1 (Version 8.1), October 2005, or the most recent standard
61.23adopted by the Centers for Medicare and Medicaid Services for e-prescribing under
61.24Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and
61.25regulations adopted under it. The standards shall be implemented according to the Centers
61.26for Medicare and Medicaid Services schedule for compliance. Subsequently released
61.27versions of the NCPDP SCRIPT Standard may be used, provided that the new version
61.28of the standard is backward compatible to the current version adopted by the Centers for
61.29Medicare and Medicaid Services.
61.30    (l) (m) "Pharmacy" has the meaning given in section 151.01, subdivision 2.
61.31    (m) (n) "Prescriber" means a licensed health care professional who is authorized to
61.32prescribe a controlled substance under section 152.12, subdivision 1. practitioner, other
61.33than a veterinarian, as defined in section 151.01, subdivision 23.
61.34    (n) (o) "Prescription-related information" means information regarding eligibility for
61.35drug benefits, medication history, or related health or drug information.
62.1    (o) (p) "Provider" or "health care provider" has the meaning given in section 62J.03,
62.2subdivision 8.

62.3    Sec. 4. Minnesota Statutes 2008, section 62J.497, subdivision 2, is amended to read:
62.4    Subd. 2. Requirements for electronic prescribing. (a) Effective January 1, 2011,
62.5all providers, group purchasers, prescribers, and dispensers must establish and, maintain,
62.6and use an electronic prescription drug program that complies. This program must comply
62.7with the applicable standards in this section for transmitting, directly or through an
62.8intermediary, prescriptions and prescription-related information using electronic media.
62.9    (b) Nothing in this section requires providers, group purchasers, prescribers, or
62.10dispensers to conduct the transactions described in this section. If transactions described in
62.11this section are conducted, they must be done electronically using the standards described
62.12in this section. Nothing in this section requires providers, group purchasers, prescribers,
62.13or dispensers to electronically conduct transactions that are expressly prohibited by other
62.14sections or federal law.
62.15    (c) Providers, group purchasers, prescribers, and dispensers must use either HL7
62.16messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related
62.17information internally when the sender and the recipient are part of the same legal entity. If
62.18an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard
62.19or other applicable standards required by this section. Any pharmacy within an entity
62.20must be able to receive electronic prescription transmittals from outside the entity using
62.21the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health
62.22Insurance Portability and Accountability Act (HIPAA) requirement that may require the
62.23use of a HIPAA transaction standard within an organization.
62.24    (d) Entities transmitting prescriptions or prescription-related information where the
62.25prescriber is required by law to issue a prescription for a patient to a nonprescribing
62.26provider that in turn forwards the prescription to a dispenser are exempt from the
62.27requirement to use the NCPDP SCRIPT Standard when transmitting prescriptions or
62.28prescription-related information.

62.29    Sec. 5. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision
62.30to read:
62.31    Subd. 4. Development and use of uniform formulary exception form. (a) The
62.32commissioner of health, in consultation with the Minnesota Administrative Uniformity
62.33Committee, shall develop by July 1, 2009, or six weeks after enactment of this subdivision,
62.34whichever is later, a uniform formulary exception form that allows health care providers
63.1to request exceptions from group purchaser formularies using a uniform form. Upon
63.2development of the form, all health care providers must submit requests for formulary
63.3exceptions using the uniform form, and all group purchasers must accept this form from
63.4health care providers.
63.5    (b) No later than January 1, 2011, the uniform formulary exception form must be
63.6accessible and submitted by health care providers, and accepted and processed by group
63.7purchasers, through secure electronic transmissions. Facsimile shall not be considered
63.8secure electronic transmissions.

63.9    Sec. 6. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision
63.10to read:
63.11    Subd. 5. Electronic drug prior authorization standardization and transmission.
63.12    (a) The commissioner of health, in consultation with the Minnesota e-Health Advisory
63.13Committee and the Minnesota Administrative Uniformity Committee, shall, by February
63.1415, 2010, identify an outline on how best to standardize drug prior authorization request
63.15transactions between providers and group purchasers with the goal of maximizing
63.16administrative simplification and efficiency in preparation for electronic transmissions.
63.17    (b) No later than January 1, 2011, drug prior authorization requests must be
63.18accessible and submitted by health care providers, and accepted and processed by group
63.19purchasers, electronically through secure electronic transmissions. Facsimile shall not be
63.20considered electronic transmission.

63.21    Sec. 7. [62Q.676] MEDICATION THERAPY MANAGEMENT.
63.22    A pharmacy benefit manager that provides prescription drug services must make
63.23available medication therapy management services for enrollees taking four or more
63.24prescriptions to treat or prevent two or more chronic medical conditions. For purposes
63.25of this section, "medication therapy management" means the provision of the following
63.26pharmaceutical care services by, or under the supervision of, a licensed pharmacist to
63.27optimize the therapeutic outcomes of the patient's medications:
63.28    (1) performing a comprehensive medication review to identify, resolve, and prevent
63.29medication-related problems, including adverse drug events;
63.30    (2) communicating essential information to the patient's other primary care
63.31providers; and
63.32    (3) providing verbal education and training designed to enhance patient
63.33understanding and appropriate use of the patient's medications.
64.1    Nothing in this section shall be construed to expand or modify the scope of practice
64.2of the pharmacist as defined in section 151.01, subdivision 27.

64.3    Sec. 8. Minnesota Statutes 2008, section 144.122, is amended to read:
64.4144.122 LICENSE, PERMIT, AND SURVEY FEES.
64.5    (a) The state commissioner of health, by rule, may prescribe procedures and fees
64.6for filing with the commissioner as prescribed by statute and for the issuance of original
64.7and renewal permits, licenses, registrations, and certifications issued under authority of
64.8the commissioner. The expiration dates of the various licenses, permits, registrations,
64.9and certifications as prescribed by the rules shall be plainly marked thereon. Fees may
64.10include application and examination fees and a penalty fee for renewal applications
64.11submitted after the expiration date of the previously issued permit, license, registration,
64.12and certification. The commissioner may also prescribe, by rule, reduced fees for permits,
64.13licenses, registrations, and certifications when the application therefor is submitted
64.14during the last three months of the permit, license, registration, or certification period.
64.15Fees proposed to be prescribed in the rules shall be first approved by the Department of
64.16Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
64.17in an amount so that the total fees collected by the commissioner will, where practical,
64.18approximate the cost to the commissioner in administering the program. All fees collected
64.19shall be deposited in the state treasury and credited to the state government special revenue
64.20fund unless otherwise specifically appropriated by law for specific purposes.
64.21    (b) The commissioner may charge a fee for voluntary certification of medical
64.22laboratories and environmental laboratories, and for environmental and medical laboratory
64.23services provided by the department, without complying with paragraph (a) or chapter 14.
64.24Fees charged for environment and medical laboratory services provided by the department
64.25must be approximately equal to the costs of providing the services.
64.26    (c) The commissioner may develop a schedule of fees for diagnostic evaluations
64.27conducted at clinics held by the services for children with disabilities program. All
64.28receipts generated by the program are annually appropriated to the commissioner for use
64.29in the maternal and child health program.
64.30    (d) The commissioner shall set license fees for hospitals and nursing homes that are
64.31not boarding care homes at the following levels:
65.1
65.2
65.3
65.4
Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) and
American Osteopathic Association (AOA)
hospitals
$7,555$7,655 plus $13$16 per bed
65.5
Non-JCAHO and non-AOA hospitals
$5,180$5,280 plus $247$250 per bed
65.6
Nursing home
$183 plus $91 per bed
65.7    The commissioner shall set license fees for outpatient surgical centers, boarding care
65.8homes, and supervised living facilities at the following levels:
65.9
Outpatient surgical centers
$3,349$3,712
65.10
Boarding care homes
$183 plus $91 per bed
65.11
Supervised living facilities
$183 plus $91 per bed.
65.12    (e) Unless prohibited by federal law, the commissioner of health shall charge
65.13applicants the following fees to cover the cost of any initial certification surveys required
65.14to determine a provider's eligibility to participate in the Medicare or Medicaid program:
65.15
Prospective payment surveys for hospitals
$
900
65.16
Swing bed surveys for nursing homes
$
1,200
65.17
Psychiatric hospitals
$
1,400
65.18
Rural health facilities
$
1,100
65.19
Portable x-ray providers
$
500
65.20
Home health agencies
$
1,800
65.21
Outpatient therapy agencies
$
800
65.22
End stage renal dialysis providers
$
2,100
65.23
Independent therapists
$
800
65.24
Comprehensive rehabilitation outpatient facilities
$
1,200
65.25
Hospice providers
$
1,700
65.26
Ambulatory surgical providers
$
1,800
65.27
Hospitals
$
4,200
65.28
65.29
65.30
Other provider categories or additional
resurveys required to complete initial
certification
Actual surveyor costs: average
surveyor cost x number of hours
for the survey process.
66.1    These fees shall be submitted at the time of the application for federal certification
66.2and shall not be refunded. All fees collected after the date that the imposition of fees is not
66.3prohibited by federal law shall be deposited in the state treasury and credited to the state
66.4government special revenue fund.

66.5    Sec. 9. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:
66.6    Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
66.7subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified
66.8birth, stillbirth, or death record, and for a certification that the record cannot be found.
66.9The local or state registrar shall forward this amount to the commissioner of finance to
66.10be deposited into the state government special revenue fund. This surcharge shall not be
66.11charged under those circumstances in which no fee for a birth, stillbirth, or death record is
66.12permitted under subdivision 1, paragraph (a).
66.13(b) Effective August 1, 2005, to June 30, 2009, the surcharge in paragraph (a) shall
66.14be is $4.

66.15    Sec. 10. Minnesota Statutes 2008, section 148.6445, is amended by adding a
66.16subdivision to read:
66.17    Subd. 2a. Duplicate license fee. The fee for a duplicate license is $25.

66.18ARTICLE 5
66.19HEALTH CARE

66.20    Section 1. Minnesota Statutes 2008, section 60A.092, subdivision 2, is amended to
66.21read:
66.22    Subd. 2. Licensed assuming insurer. Reinsurance is ceded to an assuming insurer
66.23if the assuming insurer is licensed to transact insurance or reinsurance in this state. For
66.24purposes of reinsuring any health risk, an insurer is defined under section 62A.63.

66.25    Sec. 2. Minnesota Statutes 2008, section 62D.03, subdivision 4, is amended to read:
66.26    Subd. 4. Application requirements. Each application for a certificate of authority
66.27shall be verified by an officer or authorized representative of the applicant, and shall be
66.28in a form prescribed by the commissioner of health. Each application shall include the
66.29following:
66.30(a) a copy of the basic organizational document, if any, of the applicant and of
66.31each major participating entity; such as the articles of incorporation, or other applicable
66.32documents, and all amendments thereto;
67.1(b) a copy of the bylaws, rules and regulations, or similar document, if any, and all
67.2amendments thereto which regulate the conduct of the affairs of the applicant and of
67.3each major participating entity;
67.4(c) a list of the names, addresses, and official positions of the following:
67.5(1) all members of the board of directors, or governing body of the local government
67.6unit, and the principal officers and shareholders of the applicant organization; and
67.7(2) all members of the board of directors, or governing body of the local government
67.8unit, and the principal officers of the major participating entity and each shareholder
67.9beneficially owning more than ten percent of any voting stock of the major participating
67.10entity;
67.11The commissioner may by rule identify persons included in the term "principal
67.12officers";
67.13(d) a full disclosure of the extent and nature of any contract or financial arrangements
67.14between the following:
67.15(1) the health maintenance organization and the persons listed in clause (c)(1);
67.16(2) the health maintenance organization and the persons listed in clause (c)(2);
67.17(3) each major participating entity and the persons listed in clause (c)(1) concerning
67.18any financial relationship with the health maintenance organization; and
67.19(4) each major participating entity and the persons listed in clause (c)(2) concerning
67.20any financial relationship with the health maintenance organization;
67.21(e) the name and address of each participating entity and the agreed upon duration of
67.22each contract or agreement;
67.23(f) a copy of the form of each contract binding the participating entities and the
67.24health maintenance organization. Contractual provisions shall be consistent with the
67.25purposes of sections 62D.01 to 62D.30, in regard to the services to be performed under the
67.26contract, the manner in which payment for services is determined, the nature and extent
67.27of responsibilities to be retained by the health maintenance organization, the nature and
67.28extent of risk sharing permissible, and contractual termination provisions;
67.29(g) a copy of each contract binding major participating entities and the health
67.30maintenance organization. Contract information filed with the commissioner shall be
67.31confidential and subject to the provisions of section 13.37, subdivision 1, clause (b), upon
67.32the request of the health maintenance organization.
67.33Upon initial filing of each contract, the health maintenance organization shall file
67.34a separate document detailing the projected annual expenses to the major participating
67.35entity in performing the contract and the projected annual revenues received by the entity
67.36from the health maintenance organization for such performance. The commissioner
68.1shall disapprove any contract with a major participating entity if the contract will result
68.2in an unreasonable expense under section 62D.19. The commissioner shall approve or
68.3disapprove a contract within 30 days of filing.
68.4Within 120 days of the anniversary of the implementation of each contract, the
68.5health maintenance organization shall file a document detailing the actual expenses
68.6incurred and reported by the major participating entity in performing the contract in the
68.7preceding year and the actual revenues received from the health maintenance organization
68.8by the entity in payment for the performance;
68.9(h) a statement generally describing the health maintenance organization, its health
68.10maintenance contracts and separate health service contracts, facilities, and personnel,
68.11including a statement describing the manner in which the applicant proposes to provide
68.12enrollees with comprehensive health maintenance services and separate health services;
68.13(i) a copy of the form of each evidence of coverage to be issued to the enrollees;
68.14(j) a copy of the form of each individual or group health maintenance contract
68.15and each separate health service contract which is to be issued to enrollees or their
68.16representatives;
68.17(k) financial statements showing the applicant's assets, liabilities, and sources of
68.18financial support. If the applicant's financial affairs are audited by independent certified
68.19public accountants, a copy of the applicant's most recent certified financial statement
68.20may be deemed to satisfy this requirement;
68.21(l) a description of the proposed method of marketing the plan, a schedule of
68.22proposed charges, and a financial plan which includes a three-year projection of the
68.23expenses and income and other sources of future capital;
68.24(m) a statement reasonably describing the geographic area or areas to be served and
68.25the type or types of enrollees to be served;
68.26(n) a description of the complaint procedures to be utilized as required under section
68.2762D.11 ;
68.28(o) a description of the procedures and programs to be implemented to meet the
68.29requirements of section 62D.04, subdivision 1, clauses (b) and (c) and to monitor the
68.30quality of health care provided to enrollees;
68.31(p) a description of the mechanism by which enrollees will be afforded an
68.32opportunity to participate in matters of policy and operation under section 62D.06;
68.33(q) a copy of any agreement between the health maintenance organization and
68.34an insurer or, including any nonprofit health service corporation or another health
68.35maintenance organization, regarding reinsurance, stop-loss coverage, insolvency
69.1coverage, or any other type of coverage for potential costs of health services, as authorized
69.2in sections 62D.04, subdivision 1, clause (f), 62D.05, subdivision 3, and 62D.13;
69.3(r) a copy of the conflict of interest policy which applies to all members of the board
69.4of directors and the principal officers of the health maintenance organization, as described
69.5in section 62D.04, subdivision 1, paragraph (g). All currently licensed health maintenance
69.6organizations shall also file a conflict of interest policy with the commissioner within 60
69.7days after August 1, 1990, or at a later date if approved by the commissioner;
69.8(s) a copy of the statement that describes the health maintenance organization's prior
69.9authorization administrative procedures; and
69.10(t) other information as the commissioner of health may reasonably require to be
69.11provided.

69.12    Sec. 3. Minnesota Statutes 2008, section 62D.05, subdivision 3, is amended to read:
69.13    Subd. 3. Contracts; health services. A health maintenance organization may
69.14contract with providers of health care services to render the services the health maintenance
69.15organization has promised to provide under the terms of its health maintenance contracts,
69.16may, subject to section 62D.12, subdivision 11, enter into separate prepaid dental contracts,
69.17or other separate health service contracts, may, subject to the limitations of section
69.1862D.04, subdivision 1 , clause (f), contract with insurance companies and, including
69.19 nonprofit health service plan corporations or other health maintenance organizations,
69.20for insurance, indemnity or reimbursement of its cost of providing health care services
69.21for enrollees or against the risks incurred by the health maintenance organization, may
69.22contract with insurance companies and nonprofit health service plan corporations for
69.23insolvency insurance coverage, and may contract with insurance companies and nonprofit
69.24health service plan corporations to insure or cover the enrollees' costs and expenses in the
69.25health maintenance organization, including the customary prepayment amount and any
69.26co-payment obligations, and may contract to provide reinsurance or insolvency insurance
69.27coverage to health insurers or nonprofit health service plan corporations.

69.28    Sec. 4. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:
69.29    Subd. 7. Transfers from the commissioner of human services. (a) The amount
69.30transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall
69.31be distributed by the commissioner annually to clinical medical education programs that
69.32meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph
69.33(a) Of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a),
69.34clauses (1) to (4), $21,714,000 shall be distributed as follows:
70.1(1) $2,157,000 shall be distributed by the commissioner to the University of
70.2Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
70.3(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
70.4Medical Center for clinical medical education;
70.5(3) $17,400,000 shall be distributed by the commissioner to the University of
70.6Minnesota Board of Regents for purposes of medial education;
70.7(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
70.8dental innovation grants in accordance with subdivision 7a; and
70.9(5) the remainder of the amount transferred according to section 256B.69,
70.10subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
70.11clinical medical education programs that meet the qualifications of subdivision 3 based on
70.12the formula in subdivision 4, paragraph (a).
70.13(b) Fifty percent of the amount transferred according to section 256B.69, subdivision
70.145c
, paragraph (a), clause (2), shall be distributed by the commissioner to the University of
70.15Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40. Of
70.16the remaining amount transferred according to section 256B.69, subdivision 5c, paragraph
70.17(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to
70.18the Hennepin County Medical Center for clinical medical education. The remaining 26
70.19percent of the amount transferred shall be distributed by the commissioner in accordance
70.20with subdivision 7a. If the federal approval is not obtained for the matching funds under
70.21section 256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount
70.22transferred under this paragraph shall be distributed by the commissioner to the University
70.23of Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40.
70.24(c) The amount transferred according to section 256B.69, subdivision 5c, paragraph
70.25(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the
70.26University of Minnesota Board of Regents for the purposes of clinical graduate medical
70.27education.

70.28    Sec. 5. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:
70.29    Subd. 2b. Performance payments. (a) The commissioner shall develop and
70.30implement a pay-for-performance system to provide performance payments to eligible
70.31medical groups and clinics that demonstrate optimum care in serving individuals
70.32with chronic diseases who are enrolled in health care programs administered by the
70.33commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any
70.34federal matching money that is made available through the medical assistance program
70.35for managed care oversight contracted through vendors, including consumer surveys,
71.1studies, and external quality reviews as required by the federal Balanced Budget Act of
71.21997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external
71.3quality review. Any federal money received for managed care oversight is appropriated
71.4to the commissioner for this purpose. The commissioner may expend the federal money
71.5received in either year of the biennium.
71.6    (b) Effective July 1, 2008, or upon federal approval, whichever is later, the
71.7commissioner shall develop and implement a patient incentive health program to provide
71.8incentives and rewards to patients who are enrolled in health care programs administered
71.9by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and
71.10have met personal health goals established with the patients' primary care providers to
71.11manage a chronic disease or condition, including but not limited to diabetes, high blood
71.12pressure, and coronary artery disease.

71.13    Sec. 6. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
71.14to read:
71.15    Subd. 18a. Public Assistance Reporting Information System. (a) Effective
71.16October 1, 2009, the commissioner shall comply with the federal requirements in Public
71.17Law 110-379 in implementing the Public Assistance Reporting Information System
71.18(PARIS) to determine eligibility for all individuals applying for:
71.19(1) health care benefits under chapters 256B, 256D, and 256L; and
71.20(2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition
71.21assistance program.
71.22(b) The commissioner shall determine eligibility under paragraph (a) by performing
71.23data matches, including matching with medical assistance, cash, child care, and
71.24supplemental assistance programs operated by other states.
71.25EFFECTIVE DATE.This section is effective October 1, 2009.

71.26    Sec. 7. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
71.27to read:
71.28    Subd. 18b. Protections for American Indians. Effective February 18, 2009, the
71.29commissioner shall comply with the federal requirements in the American Recovery and
71.30Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding American Indians.

71.31    Sec. 8. Minnesota Statutes 2008, section 256.962, subdivision 2, is amended to read:
72.1    Subd. 2. Outreach grants. (a) The commissioner shall award grants to public and
72.2private organizations, regional collaboratives, and regional health care outreach centers
72.3for outreach activities, including, but not limited to:
72.4    (1) providing information, applications, and assistance in obtaining coverage
72.5through Minnesota public health care programs;
72.6    (2) collaborating with public and private entities such as hospitals, providers, health
72.7plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to
72.8develop outreach activities and partnerships to ensure the distribution of information
72.9and applications and provide assistance in obtaining coverage through Minnesota health
72.10care programs; and
72.11    (3) providing or collaborating with public and private entities to provide multilingual
72.12and culturally specific information and assistance to applicants in areas of high
72.13uninsurance in the state or populations with high rates of uninsurance; and
72.14(4) targeting geographic areas with high rates of (i) eligible but unenrolled children,
72.15including children who reside in rural areas, or (ii) racial and ethnic minorities and health
72.16disparity populations.
72.17    (b) The commissioner shall ensure that all outreach materials are available in
72.18languages other than English.
72.19    (c) The commissioner shall establish an outreach trainer program to provide
72.20training to designated individuals from the community and public and private entities on
72.21application assistance in order for these individuals to provide training to others in the
72.22community on an as-needed basis.

72.23    Sec. 9. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read:
72.24    Subd. 6. School districts and charter schools. (a) At the beginning of each school
72.25year, a school district or charter school shall provide information to each student on the
72.26availability of health care coverage through the Minnesota health care programs and how
72.27to obtain an application for the Minnesota health care programs.
72.28    (b) For each child who is determined to be eligible for the free and reduced-price
72.29school lunch program, the district shall provide the child's family with information on how
72.30to obtain an application for the Minnesota health care programs and application assistance.
72.31    (c) A school district or charter school shall also ensure that applications and
72.32information on application assistance are available at early childhood education sites and
72.33public schools located within the district's jurisdiction.
72.34    (d) (c) Each district shall designate an enrollment specialist to provide application
72.35assistance and follow-up services with families who have indicated an interest in receiving
73.1information or an application for the Minnesota health care program. A district is eligible
73.2for the application assistance bonus described in subdivision 5.
73.3    (e) Each (d) If a school district or charter school maintains a district Web site, the
73.4school district or charter school shall provide on their its Web site a link to information on
73.5how to obtain an application and application assistance.

73.6    Sec. 10. [256.964] DENTAL CARE PILOT PROJECTS.
73.7The commissioner shall authorize pilot projects to reduce the total cost to the state
73.8for dental services provided to enrollees of the state public health care programs by
73.9reducing hospital emergency room costs for preventable or nonemergency dental services.
73.10As part of the project, a community dental clinic or dental provider, in collaboration with a
73.11hospital emergency room, shall provide urgent care dental services as an alternative to the
73.12hospital emergency room for nonemergency dental care. The project participants shall
73.13establish a process to divert a patient presenting at the emergency room for nonemergency
73.14dental care to the dental community clinic or to an appropriate dental provider. The
73.15commissioner may establish special payment rates for urgent care services provided and
73.16may change or waive existing payment policies in order to adequately reimburse providers
73.17for providing cost-effective alternative services in an outpatient or urgent care setting.
73.18The commissioner may establish a project in conjunction with the initiative authorized
73.19under section 256.963.

73.20    Sec. 11. Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read:
73.21    Subd. 2b. Operating payment rates. In determining operating payment rates for
73.22admissions occurring on or after the rate year beginning January 1, 1991, and every two
73.23years after, or more frequently as determined by the commissioner, the commissioner
73.24shall obtain operating data from an updated base year and establish operating payment
73.25rates per admission for each hospital based on the cost-finding methods and allowable
73.26costs of the Medicare program in effect during the base year. Rates under the general
73.27assistance medical care, medical assistance, and MinnesotaCare programs shall not be
73.28rebased to more current data on January 1, 1997, January 1, 2005, and for the first 24
73.29months of the rebased period beginning January 1, 2009, and for the first three months of
73.30the rebased period beginning January 1, 2011. From April 1, 2011, to March 31, 2012,
73.31rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change.
73.32Effective April 1, 2012, rates shall be rebased at full value. The base year operating
73.33payment rate per admission is standardized by the case mix index and adjusted by the
73.34hospital cost index, relative values, and disproportionate population adjustment. The
74.1cost and charge data used to establish operating rates shall only reflect inpatient services
74.2covered by medical assistance and shall not include property cost information and costs
74.3recognized in outlier payments.

74.4    Sec. 12. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:
74.5    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
74.6assistance program must not be submitted until the recipient is discharged. However,
74.7the commissioner shall establish monthly interim payments for inpatient hospitals that
74.8have individual patient lengths of stay over 30 days regardless of diagnostic category.
74.9Except as provided in section 256.9693, medical assistance reimbursement for treatment
74.10of mental illness shall be reimbursed based on diagnostic classifications. Individual
74.11hospital payments established under this section and sections 256.9685, 256.9686, and
74.12256.9695 , in addition to third party and recipient liability, for discharges occurring during
74.13the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
74.14inpatient services paid for the same period of time to the hospital. This payment limitation
74.15shall be calculated separately for medical assistance and general assistance medical
74.16care services. The limitation on general assistance medical care shall be effective for
74.17admissions occurring on or after July 1, 1991. Services that have rates established under
74.18subdivision 11 or 12, must be limited separately from other services. After consulting with
74.19the affected hospitals, the commissioner may consider related hospitals one entity and
74.20may merge the payment rates while maintaining separate provider numbers. The operating
74.21and property base rates per admission or per day shall be derived from the best Medicare
74.22and claims data available when rates are established. The commissioner shall determine
74.23the best Medicare and claims data, taking into consideration variables of recency of the
74.24data, audit disposition, settlement status, and the ability to set rates in a timely manner.
74.25The commissioner shall notify hospitals of payment rates by December 1 of the year
74.26preceding the rate year. The rate setting data must reflect the admissions data used to
74.27establish relative values. Base year changes from 1981 to the base year established for the
74.28rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
74.29to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
74.301. The commissioner may adjust base year cost, relative value, and case mix index data
74.31to exclude the costs of services that have been discontinued by the October 1 of the year
74.32preceding the rate year or that are paid separately from inpatient services. Inpatient stays
74.33that encompass portions of two or more rate years shall have payments established based
74.34on payment rates in effect at the time of admission unless the date of admission preceded
74.35the rate year in effect by six months or more. In this case, operating payment rates for
75.1services rendered during the rate year in effect and established based on the date of
75.2admission shall be adjusted to the rate year in effect by the hospital cost index.
75.3    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
75.4payment, before third-party liability and spenddown, made to hospitals for inpatient
75.5services is reduced by .5 percent from the current statutory rates.
75.6    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
75.7admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
75.8before third-party liability and spenddown, is reduced five percent from the current
75.9statutory rates. Mental health services within diagnosis related groups 424 to 432, and
75.10facilities defined under subdivision 16 are excluded from this paragraph.
75.11    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
75.12fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for
75.13inpatient services before third-party liability and spenddown, is reduced 6.0 percent
75.14from the current statutory rates. Mental health services within diagnosis related groups
75.15424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
75.16Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
75.17assistance does not include general assistance medical care. Payments made to managed
75.18care plans shall be reduced for services provided on or after January 1, 2006, to reflect
75.19this reduction.
75.20    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
75.21fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
75.22to hospitals for inpatient services before third-party liability and spenddown, is reduced
75.233.46 percent from the current statutory rates. Mental health services with diagnosis related
75.24groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
75.25paragraph. Payments made to managed care plans shall be reduced for services provided
75.26on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
75.27    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
75.28fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
75.29to hospitals for inpatient services before third-party liability and spenddown, is reduced
75.301.9 percent from the current statutory rates. Mental health services with diagnosis related
75.31groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
75.32paragraph. Payments made to managed care plans shall be reduced for services provided
75.33on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
75.34    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
75.35for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
75.36inpatient services before third-party liability and spenddown, is reduced 1.79 percent
76.1from the current statutory rates. Mental health services with diagnosis related groups
76.2424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
76.3Payments made to managed care plans shall be reduced for services provided on or after
76.4July 1, 2010, to reflect this reduction.
76.5(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
76.6payment for fee-for-service admissions occurring on or after July 1, 2009, made to
76.7hospitals for inpatient services before third-party liability and spenddown, is reduced
76.8one percent from the current statutory rates. Facilities defined under subdivision 16 are
76.9excluded from this paragraph. Payments made to managed care plans shall be reduced for
76.10services provided on or after October 1, 2009, to reflect this reduction.

76.11    Sec. 13. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
76.12to read:
76.13    Subd. 3b. Nonpayment for hospital-acquired conditions and for certain
76.14treatments. (a) The commissioner must not make medical assistance payments to a
76.15hospital for any costs of care that result from a condition listed in paragraph (c), if the
76.16condition was hospital acquired.
76.17    (b) For purposes of this subdivision, a condition is hospital acquired if it is not
76.18identified by the hospital as present on admission. For purposes of this subdivision,
76.19medical assistance includes general assistance medical care and MinnesotaCare.
76.20(c) The prohibition in paragraph (a) applies to payment for each hospital-acquired
76.21condition listed in this paragraph that is represented by an ICD-9-CM diagnosis code and
76.22is designated as a complicating condition or a major complicating condition:
76.23(1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7);
76.24(2) air embolism (ICD-9-CM code 999.1);
76.25(3) blood incompatibility (ICD-9-CM code 999.6);
76.26(4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24);
76.27(5) falls and trauma, including fracture, dislocation, intracranial injury, crushing
76.28injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating
76.29condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929;
76.30940-949; and 991-994);
76.31(6) catheter-associated urinary tract infection (ICD-9-CM code 996.64);
76.32(7) vascular catheter-associated infection (ICD-9-CM code 999.31);
76.33(8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11;
76.34249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and
76.35251.0);
77.1(9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain
77.2orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07;
77.381.08; 81.23; 81.24; 81.31; 81.32; 81.33; 81.34; 81.35; 81.36; 81.37; 81.38; 81.83; and
77.481.85);
77.5(10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery
77.6(procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity
77.7(ICD-9-CM code 278.01);
77.8(11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary
77.9artery bypass graft (procedure codes 36.10 to 36.19); and
77.10(12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary
77.11embolism (ICD-9-CM codes 415.11 or 415.91) following total knee replacement
77.12(procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51
77.13to 81.52).
77.14(d) The prohibition in paragraph (a) applies to any additional payments that result
77.15from a hospital-acquired condition listed in paragraph (c), including, but not limited to,
77.16additional treatment or procedures, readmission to the facility after discharge, increased
77.17length of stay, change to a higher diagnostic category, or transfer to another hospital. In
77.18the event of a transfer to another hospital, the hospital where the condition listed under
77.19paragraph (c) was acquired is responsible for any costs incurred at the hospital to which
77.20the patient is transferred.
77.21(e) A hospital shall not bill a recipient of services for any payment disallowed under
77.22this subdivision.

77.23    Sec. 14. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
77.24to read:
77.25    Subd. 28. Temporary rate increase for qualifying hospitals. For the period
77.26from April 1, 2009, to September 30, 2010, for each hospital with a medical assistance
77.27utilization rate equal to or greater than 25 percent during the base year, the commissioner
77.28shall provide an equal percentage rate increase for each medical assistance admission. The
77.29commissioner shall estimate the percentage rate increase using as the state share of the
77.30increase the amount available under section 256B.199, paragraph (d). The commissioner
77.31shall settle up payments to qualifying hospitals based on actual payments under that
77.32section and actual hospital admissions.
77.33EFFECTIVE DATE.This section is effective the day following final enactment.

78.1    Sec. 15. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
78.2to read:
78.3    Subd. 29. Reimbursement for the fee increase for the early hearing detection
78.4and intervention program. For services provided on or after July 1, 2010, in addition to
78.5any other payment under this section, the commissioner shall reimburse hospitals for the
78.6increase in the fee for the early hearing detection and intervention program described in
78.7section 144.125, subdivision 1, paid by the hospital for public program recipients.

78.8    Sec. 16. [256B.032] ELIGIBLE VENDORS OF MEDICAL CARE.
78.9(a) Effective January 1, 2011, the commissioner shall establish performance
78.10thresholds for health care providers included in the provider peer grouping system
78.11developed by the commissioner of health under section 62U.04. The thresholds shall be
78.12set at the 10th percentile of the combined cost and quality measure used for provider peer
78.13grouping, and separate thresholds shall be set for hospital and physician services.
78.14(b) Beginning January 1, 2012, any health care provider with a combined cost and
78.15quality score below the threshold set in paragraph (a) shall be prohibited from enrolling
78.16as a vendor of medical care in the medical assistance, general assistance medical care,
78.17or MinnesotaCare programs, and shall not be eligible for direct payments under those
78.18programs or for payments made by managed care plans under their contracts with the
78.19commissioner under section 256B.69 or 256L.12. A health care provider that is prohibited
78.20from enrolling as a vendor or receiving payments under this paragraph may reenroll
78.21effective January 1 of any subsequent year if the provider's most recent combined cost and
78.22quality score exceeds the threshold established in paragraph (a).
78.23(c) Notwithstanding paragraph (b), a provider may continue to participate as a vendor
78.24or as part of a managed care plan provider network if the commissioner determines that a
78.25contract with the provider is necessary to ensure adequate access to health care services.
78.26(d) By January 15, 2013, the commissioner shall report to the legislature on the
78.27impact of this section. The commissioner's report shall include information on:
78.28(1) the providers falling below the thresholds as of January 1, 2012;
78.29(2) the volume of services and cost of care provided to enrollees in the medical
78.30assistance, general assistance medical care, or MinnesotaCare programs in the 12 months
78.31prior to January 1, 2012, by providers falling below the thresholds;
78.32(3) providers who fell below the thresholds but continued to be eligible vendors
78.33under paragraph (c);
78.34(4) the estimated cost savings achieved by not contracting with providers who do
78.35not meet the performance thresholds; and
79.1(5) recommendations for increasing the threshold levels of performance over time.

79.2    Sec. 17. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to
79.3read:
79.4    Subd. 3c. Asset limitations for families and children. A household of two or more
79.5persons must not own more than $20,000 in total net assets, and a household of one
79.6person must not own more than $10,000 in total net assets. In addition to these maximum
79.7amounts, an eligible individual or family may accrue interest on these amounts, but they
79.8must be reduced to the maximum at the time of an eligibility redetermination. The value of
79.9assets that are not considered in determining eligibility for medical assistance for families
79.10and children is the value of those assets excluded under the AFDC state plan as of July 16,
79.111996, as required by the Personal Responsibility and Work Opportunity Reconciliation
79.12Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:
79.13(1) household goods and personal effects are not considered;
79.14(2) capital and operating assets of a trade or business up to $200,000 are not
79.15considered, except that a bank account that contains personal income or assets, or is used to
79.16pay personal expenses, is not considered a capital or operating asset of a trade or business;
79.17(3) one motor vehicle is excluded for each person of legal driving age who is
79.18employed or seeking employment;
79.19(4) one burial plot and all other burial expenses equal to the supplemental security
79.20income program asset limit are not considered for each individual;
79.21(5) court-ordered settlements up to $10,000 are not considered;
79.22(6) individual retirement accounts and funds are not considered; and
79.23(7) assets owned by children are not considered.
79.24The assets specified in clause (2) must be disclosed to the local agency at the time of
79.25application and at the time of an eligibility redetermination, and must be verified upon
79.26request of the local agency.
79.27EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
79.28approval, whichever is later.

79.29    Sec. 18. Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to
79.30read:
79.31    Subd. 3d. Reduction of excess assets. Assets in excess of the limits in subdivisions
79.323 to 3c may be reduced to allowable limits as follows:
79.33(a) Assets may be reduced in any of the three calendar months before the month
79.34of application in which the applicant seeks coverage by:
80.1(1) designating burial funds up to $1,500 for each applicant, spouse, and MA-eligible
80.2dependent child; and
80.3(2) paying health service bills for health services that are incurred in the retroactive
80.4period for which the applicant seeks eligibility, starting with the oldest bill. After assets
80.5are reduced to allowable limits, eligibility begins with the next dollar of MA-covered
80.6health services incurred in the retroactive period. Applicants reducing assets under this
80.7subdivision who also have excess income shall first spend excess assets to pay health
80.8service bills and may meet the income spenddown on remaining bills.
80.9(b) Assets may be reduced beginning the month of application by:
80.10(1) paying bills for health services that are incurred during the period specified in
80.11Minnesota Rules, part 9505.0090, subpart 2, that would otherwise be paid by medical
80.12assistance; and. After assets are reduced to allowable limits, eligibility begins with the
80.13next dollar of medical assistance covered health services incurred in the period. Applicants
80.14reducing assets under this subdivision who also have excess income shall first spend excess
80.15assets to pay health service bills and may meet the income spenddown on remaining bills.
80.16(2) using any means other than a transfer of assets for less than fair market value as
80.17defined in section 256B.0595, subdivision 1, paragraph (b).
80.18EFFECTIVE DATE.This section is effective January 1, 2011.

80.19    Sec. 19. Minnesota Statutes 2008, section 256B.057, is amended by adding a
80.20subdivision to read:
80.21    Subd. 11. Treatment for colorectal cancer. (a) Medical assistance shall be paid for
80.22an individual who:
80.23(1) has been screened for colorectal cancer by the colorectal cancer prevention
80.24demonstration project;
80.25(2) according to the individual's treating health professional, needs treatment for
80.26colorectal cancer;
80.27(3) meets income eligibility guidelines for the colorectal cancer prevention
80.28demonstration project;
80.29(4) is under the age of 65; and
80.30(5) is not otherwise eligible for medical assistance or covered under creditable
80.31coverage as defined under United States Code, title 42, section 300gg(a).
80.32(b) Medical assistance provided under this subdivision shall be limited to services
80.33provided during the period that the individual receives treatment for colorectal cancer.
81.1(c) An individual meeting the criteria in paragraph (a) is eligible for medical
81.2assistance without meeting the eligibility criteria relating to income and assets in section
81.3256B.056, subdivisions 1a to 5b.
81.4(d) This subdivision expires December 31, 2010.

81.5    Sec. 20. Minnesota Statutes 2008, section 256B.0575, is amended to read:
81.6256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
81.7PERSONS.
81.8    Subdivision 1. Income deductions. When an institutionalized person is determined
81.9eligible for medical assistance, the income that exceeds the deductions in paragraphs (a)
81.10and (b) must be applied to the cost of institutional care.
81.11(a) The following amounts must be deducted from the institutionalized person's
81.12income in the following order:
81.13(1) the personal needs allowance under section 256B.35 or, for a veteran who
81.14does not have a spouse or child, or a surviving spouse of a veteran having no child, the
81.15amount of an improved pension received from the veteran's administration not exceeding
81.16$90 per month;
81.17(2) the personal allowance for disabled individuals under section 256B.36;
81.18(3) if the institutionalized person has a legally appointed guardian or conservator,
81.19five percent of the recipient's gross monthly income up to $100 as reimbursement for
81.20guardianship or conservatorship services;
81.21(4) a monthly income allowance determined under section 256B.058, subdivision
81.222
, but only to the extent income of the institutionalized spouse is made available to the
81.23community spouse;
81.24(5) a monthly allowance for children under age 18 which, together with the net
81.25income of the children, would provide income equal to the medical assistance standard
81.26for families and children according to section 256B.056, subdivision 4, for a family size
81.27that includes only the minor children. This deduction applies only if the children do not
81.28live with the community spouse and only to the extent that the deduction is not included
81.29in the personal needs allowance under section 256B.35, subdivision 1, as child support
81.30garnished under a court order;
81.31(6) a monthly family allowance for other family members, equal to one-third of the
81.32difference between 122 percent of the federal poverty guidelines and the monthly income
81.33for that family member;
82.1(7) reparations payments made by the Federal Republic of Germany and reparations
82.2payments made by the Netherlands for victims of Nazi persecution between 1940 and
82.31945;
82.4(8) all other exclusions from income for institutionalized persons as mandated by
82.5federal law; and
82.6(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for
82.7necessary medical or remedial care for the institutionalized person that are recognized
82.8under state law, not medical assistance covered expenses, and that are not subject to
82.9payment by a third party.
82.10Reasonable expenses are limited to expenses that have not been previously used as a
82.11deduction from income and are incurred during the enrollee's current period of eligibility,
82.12including retroactive months associated with the current period of eligibility, for medical
82.13assistance payment of long-term care services.
82.14For purposes of clause (6), "other family member" means a person who resides
82.15with the community spouse and who is a minor or dependent child, dependent parent, or
82.16dependent sibling of either spouse. "Dependent" means a person who could be claimed as
82.17a dependent for federal income tax purposes under the Internal Revenue Code.
82.18(b) Income shall be allocated to an institutionalized person for a period of up to three
82.19calendar months, in an amount equal to the medical assistance standard for a family
82.20size of one if:
82.21(1) a physician certifies that the person is expected to reside in the long-term care
82.22facility for three calendar months or less;
82.23(2) if the person has expenses of maintaining a residence in the community; and
82.24(3) if one of the following circumstances apply:
82.25(i) the person was not living together with a spouse or a family member as defined in
82.26paragraph (a) when the person entered a long-term care facility; or
82.27(ii) the person and the person's spouse become institutionalized on the same date, in
82.28which case the allocation shall be applied to the income of one of the spouses.
82.29For purposes of this paragraph, a person is determined to be residing in a licensed nursing
82.30home, regional treatment center, or medical institution if the person is expected to remain
82.31for a period of one full calendar month or more.
82.32    Subd. 2. Reasonable expenses. For the purposes of subdivision 1, paragraph (a),
82.33clause (9), reasonable expenses are limited to expenses that have not been previously used
82.34as a deduction from income and were not:
82.35    (1) for long-term care expenses incurred during a period of ineligibility as defined in
82.36section 256B.0595, subdivision 2;
83.1    (2) incurred more than three months before the month of application associated with
83.2the current period of eligibility;
83.3    (3) for expenses incurred by a recipient that are duplicative of services that are
83.4covered under chapter 256B; or
83.5    (4) nursing facility expenses incurred without a timely assessment as required under
83.6section 256B.0911.

83.7    Sec. 21. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to
83.8read:
83.9    Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before
83.10August 10, 1993, if an institutionalized person or the institutionalized person's spouse has
83.11given away, sold, or disposed of, for less than fair market value, any asset or interest
83.12therein, except assets other than the homestead that are excluded under the supplemental
83.13security program, within 30 months before or any time after the date of institutionalization
83.14if the person has been determined eligible for medical assistance, or within 30 months
83.15before or any time after the date of the first approved application for medical assistance
83.16if the person has not yet been determined eligible for medical assistance, the person is
83.17ineligible for long-term care services for the period of time determined under subdivision
83.182.
83.19    (b) Effective for transfers made after August 10, 1993, an institutionalized person, an
83.20institutionalized person's spouse, or any person, court, or administrative body with legal
83.21authority to act in place of, on behalf of, at the direction of, or upon the request of the
83.22institutionalized person or institutionalized person's spouse, may not give away, sell, or
83.23dispose of, for less than fair market value, any asset or interest therein, except assets other
83.24than the homestead that are excluded under the Supplemental Security Income program,
83.25for the purpose of establishing or maintaining medical assistance eligibility. This applies
83.26to all transfers, including those made by a community spouse after the month in which
83.27the institutionalized spouse is determined eligible for medical assistance. For purposes of
83.28determining eligibility for long-term care services, any transfer of such assets within 36
83.29months before or any time after an institutionalized person requests medical assistance
83.30payment of long-term care services, or 36 months before or any time after a medical
83.31assistance recipient becomes an institutionalized person, for less than fair market value
83.32may be considered. Any such transfer is presumed to have been made for the purpose
83.33of establishing or maintaining medical assistance eligibility and the institutionalized
83.34person is ineligible for long-term care services for the period of time determined under
83.35subdivision 2, unless the institutionalized person furnishes convincing evidence to
84.1establish that the transaction was exclusively for another purpose, or unless the transfer is
84.2permitted under subdivision 3 or 4. In the case of payments from a trust or portions of a
84.3trust that are considered transfers of assets under federal law, or in the case of any other
84.4disposal of assets made on or after February 8, 2006, any transfers made within 60 months
84.5before or any time after an institutionalized person requests medical assistance payment of
84.6long-term care services and within 60 months before or any time after a medical assistance
84.7recipient becomes an institutionalized person, may be considered.
84.8    (c) This section applies to transfers, for less than fair market value, of income
84.9or assets, including assets that are considered income in the month received, such as
84.10inheritances, court settlements, and retroactive benefit payments or income to which the
84.11institutionalized person or the institutionalized person's spouse is entitled but does not
84.12receive due to action by the institutionalized person, the institutionalized person's spouse,
84.13or any person, court, or administrative body with legal authority to act in place of, on
84.14behalf of, at the direction of, or upon the request of the institutionalized person or the
84.15institutionalized person's spouse.
84.16    (d) This section applies to payments for care or personal services provided by a
84.17relative, unless the compensation was stipulated in a notarized, written agreement which
84.18was in existence when the service was performed, the care or services directly benefited
84.19the person, and the payments made represented reasonable compensation for the care
84.20or services provided. A notarized written agreement is not required if payment for the
84.21services was made within 60 days after the service was provided.
84.22    (e) This section applies to the portion of any asset or interest that an institutionalized
84.23person, an institutionalized person's spouse, or any person, court, or administrative body
84.24with legal authority to act in place of, on behalf of, at the direction of, or upon the request
84.25of the institutionalized person or the institutionalized person's spouse, transfers to any
84.26annuity that exceeds the value of the benefit likely to be returned to the institutionalized
84.27person or institutionalized person's spouse while alive, based on estimated life expectancy
84.28as determined according to the current actuarial tables published by the Office of the
84.29Chief Actuary of the Social Security Administration. The commissioner may adopt rules
84.30reducing life expectancies based on the need for long-term care. This section applies to an
84.31annuity purchased on or after March 1, 2002, that:
84.32    (1) is not purchased from an insurance company or financial institution that is
84.33subject to licensing or regulation by the Minnesota Department of Commerce or a similar
84.34regulatory agency of another state;
84.35    (2) does not pay out principal and interest in equal monthly installments; or
84.36    (3) does not begin payment at the earliest possible date after annuitization.
85.1    (f) Effective for transactions, including the purchase of an annuity, occurring on or
85.2after February 8, 2006, by or on behalf of an institutionalized person who has applied for
85.3or is receiving long-term care services or the institutionalized person's spouse shall be
85.4treated as the disposal of an asset for less than fair market value unless the department is
85.5named a preferred remainder beneficiary as described in section 256B.056, subdivision
85.611
. Any subsequent change to the designation of the department as a preferred remainder
85.7beneficiary shall result in the annuity being treated as a disposal of assets for less than
85.8fair market value. The amount of such transfer shall be the maximum amount the
85.9institutionalized person or the institutionalized person's spouse could receive from the
85.10annuity or similar financial instrument. Any change in the amount of the income or
85.11principal being withdrawn from the annuity or other similar financial instrument at the
85.12time of the most recent disclosure shall be deemed to be a transfer of assets for less than
85.13fair market value unless the institutionalized person or the institutionalized person's spouse
85.14demonstrates that the transaction was for fair market value. In the event a distribution
85.15of income or principal has been improperly distributed or disbursed from an annuity or
85.16other retirement planning instrument of an institutionalized person or the institutionalized
85.17person's spouse, a cause of action exists against the individual receiving the improper
85.18distribution for the cost of medical assistance services provided or the amount of the
85.19improper distribution, whichever is less.
85.20    (g) Effective for transactions, including the purchase of an annuity, occurring on
85.21or after February 8, 2006, by or on behalf of an institutionalized person applying for or
85.22receiving long-term care services shall be treated as a disposal of assets for less than fair
85.23market value unless it is:
85.24    (i) an annuity described in subsection (b) or (q) of section 408 of the Internal
85.25Revenue Code of 1986; or
85.26    (ii) purchased with proceeds from:
85.27    (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the
85.28Internal Revenue Code;
85.29    (B) a simplified employee pension within the meaning of section 408(k) of the
85.30Internal Revenue Code; or
85.31    (C) a Roth IRA described in section 408A of the Internal Revenue Code; or
85.32    (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as
85.33determined in accordance with actuarial publications of the Office of the Chief Actuary of
85.34the Social Security Administration; and provides for payments in equal amounts during
85.35the term of the annuity, with no deferral and no balloon payments made.
86.1     (h) For purposes of this section, long-term care services include services in a nursing
86.2facility, services that are eligible for payment according to section 256B.0625, subdivision
86.32
, because they are provided in a swing bed, intermediate care facility for persons with
86.4developmental disabilities, and home and community-based services provided pursuant
86.5to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and
86.6subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient
86.7in a nursing facility or in a swing bed, or intermediate care facility for persons with
86.8developmental disabilities or who is receiving home and community-based services under
86.9sections 256B.0915, 256B.092, and 256B.49.
86.10    (i) This section applies to funds used to purchase a promissory note, loan, or
86.11mortgage unless the note, loan, or mortgage:
86.12    (1) has a repayment term that is actuarially sound;
86.13    (2) provides for payments to be made in equal amounts during the term of the loan,
86.14with no deferral and no balloon payments made; and
86.15    (3) prohibits the cancellation of the balance upon the death of the lender.
86.16    In the case of a promissory note, loan, or mortgage that does not meet an exception
86.17in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding
86.18balance due as of the date of the institutionalized person's request for medical assistance
86.19payment of long-term care services.
86.20    (j) This section applies to the purchase of a life estate interest in another person's
86.21home unless the purchaser resides in the home for a period of at least one year after the
86.22date of purchase.
86.23(k) This section applies to transfers into a pooled trust that qualifies under United
86.24States Code, title 42, section 1396p(d)(4)(C), by:
86.25(1) a person age 65 or older or the person's spouse; or
86.26(2) any person, court, or administrative body with legal authority to act in place
86.27of, on behalf of, at the direction of, or upon the request of a person age 65 or older or
86.28the person's spouse.

86.29    Sec. 22. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to
86.30read:
86.31    Subd. 2. Period of ineligibility for long-term care services. (a) For any
86.32uncompensated transfer occurring on or before August 10, 1993, the number of months
86.33of ineligibility for long-term care services shall be the lesser of 30 months, or the
86.34uncompensated transfer amount divided by the average medical assistance rate for nursing
86.35facility services in the state in effect on the date of application. The amount used to
87.1calculate the average medical assistance payment rate shall be adjusted each July 1 to
87.2reflect payment rates for the previous calendar year. The period of ineligibility begins
87.3with the month in which the assets were transferred. If the transfer was not reported to
87.4the local agency at the time of application, and the applicant received long-term care
87.5services during what would have been the period of ineligibility if the transfer had been
87.6reported, a cause of action exists against the transferee for the cost of long-term care
87.7services provided during the period of ineligibility, or for the uncompensated amount of
87.8the transfer, whichever is less. The uncompensated transfer amount is the fair market
87.9value of the asset at the time it was given away, sold, or disposed of, less the amount of
87.10compensation received.
87.11    (b) For uncompensated transfers made after August 10, 1993, the number of months
87.12of ineligibility for long-term care services shall be the total uncompensated value of the
87.13resources transferred divided by the average medical assistance rate for nursing facility
87.14services in the state in effect on the date of application. The amount used to calculate
87.15the average medical assistance payment rate shall be adjusted each July 1 to reflect
87.16payment rates for the previous calendar year. The period of ineligibility begins with the
87.17first day of the month after the month in which the assets were transferred except that
87.18if one or more uncompensated transfers are made during a period of ineligibility, the
87.19total assets transferred during the ineligibility period shall be combined and a penalty
87.20period calculated to begin on the first day of the month after the month in which the first
87.21uncompensated transfer was made. If the transfer was reported to the local agency after
87.22the date that advance notice of a period of ineligibility that affects the next month could
87.23be provided to the recipient and the recipient received medical assistance services or the
87.24transfer was not reported to the local agency, and the applicant or recipient received
87.25medical assistance services during what would have been the period of ineligibility if
87.26the transfer had been reported, a cause of action exists against the transferee for that
87.27portion of long-term care services provided during the period of ineligibility, or for the
87.28uncompensated amount of the transfer, whichever is less. The uncompensated transfer
87.29amount is the fair market value of the asset at the time it was given away, sold, or disposed
87.30of, less the amount of compensation received. Effective for transfers made on or after
87.31March 1, 1996, involving persons who apply for medical assistance on or after April 13,
87.321996, no cause of action exists for a transfer unless:
87.33    (1) the transferee knew or should have known that the transfer was being made by a
87.34person who was a resident of a long-term care facility or was receiving that level of care in
87.35the community at the time of the transfer;
88.1    (2) the transferee knew or should have known that the transfer was being made to
88.2assist the person to qualify for or retain medical assistance eligibility; or
88.3    (3) the transferee actively solicited the transfer with intent to assist the person to
88.4qualify for or retain eligibility for medical assistance.
88.5    (c) For uncompensated transfers made on or after February 8, 2006, the period
88.6of ineligibility:
88.7    (1) for uncompensated transfers by or on behalf of individuals receiving medical
88.8assistance payment of long-term care services, begins the first day of the month following
88.9advance notice of the penalty period of ineligibility, but no later than the first day of the
88.10month that follows three full calendar months from the date of the report or discovery
88.11of the transfer; or
88.12    (2) for uncompensated transfers by individuals requesting medical assistance
88.13payment of long-term care services, begins the date on which the individual is eligible
88.14for medical assistance under the Medicaid state plan and would otherwise be receiving
88.15long-term care services based on an approved application for such care but for the
88.16application of the penalty period of ineligibility resulting from the uncompensated
88.17transfer; and
88.18    (3) cannot begin during any other period of ineligibility.
88.19    (d) If a calculation of a penalty period of ineligibility results in a partial month,
88.20payments for long-term care services shall be reduced in an amount equal to the fraction.
88.21    (e) In the case of multiple fractional transfers of assets in more than one month for
88.22less than fair market value on or after February 8, 2006, the period of ineligibility is
88.23calculated by treating the total, cumulative, uncompensated value of all assets transferred
88.24during all months on or after February 8, 2006, as one transfer.
88.25    (f) A period of ineligibility established under paragraph (c) may be eliminated if
88.26all of the assets transferred for less than fair market value used to calculate the period of
88.27ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned
88.28within 12 months after the date the period of ineligibility began. A period of ineligibility
88.29must not be adjusted if less than the full amount of the transferred assets or the full cash
88.30value of the transferred assets are returned.
88.31EFFECTIVE DATE.This section is effective for periods of ineligibility established
88.32on or after January 1, 2011.

88.33    Sec. 23. Minnesota Statutes 2008, section 256B.06, subdivision 4, is amended to read:
88.34    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
88.35to citizens of the United States, qualified noncitizens as defined in this subdivision, and
89.1other persons residing lawfully in the United States. Citizens or nationals of the United
89.2States must cooperate in obtaining satisfactory documentary evidence of citizenship or
89.3nationality according to the requirements of the federal Deficit Reduction Act of 2005,
89.4Public Law 109-171.
89.5(b) "Qualified noncitizen" means a person who meets one of the following
89.6immigration criteria:
89.7(1) admitted for lawful permanent residence according to United States Code, title 8;
89.8(2) admitted to the United States as a refugee according to United States Code,
89.9title 8, section 1157;
89.10(3) granted asylum according to United States Code, title 8, section 1158;
89.11(4) granted withholding of deportation according to United States Code, title 8,
89.12section 1253(h);
89.13(5) paroled for a period of at least one year according to United States Code, title 8,
89.14section 1182(d)(5);
89.15(6) granted conditional entrant status according to United States Code, title 8,
89.16section 1153(a)(7);
89.17(7) determined to be a battered noncitizen by the United States Attorney General
89.18according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
89.19title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
89.20(8) is a child of a noncitizen determined to be a battered noncitizen by the United
89.21States Attorney General according to the Illegal Immigration Reform and Immigrant
89.22Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
89.23Public Law 104-200; or
89.24(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
89.25Law 96-422, the Refugee Education Assistance Act of 1980.
89.26(c) All qualified noncitizens who were residing in the United States before August
89.2722, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
89.28medical assistance with federal financial participation.
89.29(d) All qualified noncitizens who entered the United States on or after August 22,
89.301996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
89.31medical assistance with federal financial participation through November 30, 1996.
89.32Beginning December 1, 1996, qualified noncitizens who entered the United States
89.33on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
89.34chapter are eligible for medical assistance with federal participation for five years if they
89.35meet one of the following criteria:
90.1(i) refugees admitted to the United States according to United States Code, title 8,
90.2section 1157;
90.3(ii) persons granted asylum according to United States Code, title 8, section 1158;
90.4(iii) persons granted withholding of deportation according to United States Code,
90.5title 8, section 1253(h);
90.6(iv) veterans of the United States armed forces with an honorable discharge for
90.7a reason other than noncitizen status, their spouses and unmarried minor dependent
90.8children; or
90.9(v) persons on active duty in the United States armed forces, other than for training,
90.10their spouses and unmarried minor dependent children.
90.11Beginning December 1, 1996, qualified noncitizens who do not meet one of the
90.12criteria in items (i) to (v) are eligible for medical assistance without federal financial
90.13participation as described in paragraph (j).
90.14Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant
90.15women who are qualified noncitizens, as described in paragraph (b), are eligible for
90.16medical assistance with federal financial participation as provided by the federal Children's
90.17Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.
90.18(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
90.19are lawfully present in the United States, as defined in Code of Federal Regulations, title
90.208, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are
90.21eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
90.22with the United States Citizenship and Immigration Services to pursue any applicable
90.23immigration status, including citizenship, that would qualify them for medical assistance
90.24with federal financial participation.
90.25(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
90.26for medical assistance with federal financial participation through December 31, 1996.
90.27(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
90.28medical assistance without federal financial participation as described in paragraph (j).
90.29(3) Beginning December 1, 1996, persons residing in the United States prior to
90.30August 22, 1996, who were not receiving medical assistance and persons who arrived on
90.31or after August 22, 1996, are eligible for medical assistance without federal financial
90.32participation as described in paragraph (j).
90.33(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
90.34are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this
90.35subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
90.36Code, title 8, section 1101(a)(15).
91.1(g) Payment shall also be made for care and services that are furnished to noncitizens,
91.2regardless of immigration status, who otherwise meet the eligibility requirements of
91.3this chapter, if such care and services are necessary for the treatment of an emergency
91.4medical condition, except for organ transplants and related care and services and routine
91.5prenatal care.
91.6(h) For purposes of this subdivision, the term "emergency medical condition" means
91.7a medical condition that meets the requirements of United States Code, title 42, section
91.81396b(v).
91.9(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
91.10nonimmigrants, or eligible for medical assistance as described in paragraph (j), lawfully
91.11present as designated in paragraph (e) and who are not covered by a group health plan
91.12or health insurance coverage according to Code of Federal Regulations, title 42, section
91.13457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible
91.14for medical assistance through the period of pregnancy, including labor and delivery,
91.15and 60 days postpartum, to the extent federal funds are available under title XXI of the
91.16Social Security Act, and the state children's health insurance program, followed by 60
91.17days postpartum without federal financial participation.
91.18(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
91.19lawfully residing in the United States as described in paragraph (e), who are ineligible
91.20for medical assistance with federal financial participation and who otherwise meet the
91.21eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
91.22assistance without federal financial participation. Qualified noncitizens as described
91.23in paragraph (d) are only eligible for medical assistance without federal financial
91.24participation for five years from their date of entry into the United States.
91.25(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation
91.26services from a nonprofit center established to serve victims of torture and are otherwise
91.27ineligible for medical assistance under this chapter are eligible for medical assistance
91.28without federal financial participation. These individuals are eligible only for the period
91.29during which they are receiving services from the center. Individuals eligible under this
91.30paragraph shall not be required to participate in prepaid medical assistance.
91.31EFFECTIVE DATE.This section is effective July 1, 2009.

91.32    Sec. 24. Minnesota Statutes 2008, section 256B.06, subdivision 5, is amended to read:
91.33    Subd. 5. Deeming of sponsor income and resources. When determining eligibility
91.34for any federal or state funded medical assistance under this section, the income
91.35and resources of all noncitizens shall be deemed to include their sponsors' income
92.1and resources as required under the Personal Responsibility and Work Opportunity
92.2Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
92.3subsequently set out in federal rules. This section is effective May 1, 1997. Beginning
92.4July 1, 2010, sponsor deeming does not apply to pregnant women and children who are
92.5qualified noncitizens, as described in section 256B.06, subdivision 4, paragraph (b).
92.6EFFECTIVE DATE.This section is effective July 1, 2010.

92.7    Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to
92.8read:
92.9    Subd. 3. Physicians' services. (a) Medical assistance covers physicians' services.
92.10(b) Rates paid for anesthesiology services provided by physicians shall be according
92.11to the formula utilized in the Medicare program and shall use a conversion factor "at
92.12percentile of calendar year set by legislature.," except that rates paid to physicians for the
92.13medical direction of a certified registered nurse anesthetist shall be the same as the rate
92.14paid to the certified registered nurse anesthetist under medical direction.

92.15    Sec. 26. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, is amended to
92.16read:
92.17    Subd. 3c. Health Services Policy Committee. (a) The commissioner, after
92.18receiving recommendations from professional physician associations, professional
92.19associations representing licensed nonphysician health care professionals, and consumer
92.20groups, shall establish a 13-member Health Services Policy Committee, which consists of
92.2112 voting members and one nonvoting member. The Health Services Policy Committee
92.22shall advise the commissioner regarding health services pertaining to the administration
92.23of health care benefits covered under the medical assistance, general assistance medical
92.24care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at
92.25least quarterly. The Health Services Policy Committee shall annually elect a physician
92.26chair from among its members, who shall work directly with the commissioner's medical
92.27director, to establish the agenda for each meeting. The Health Services Policy Committee
92.28shall also recommend criteria for verifying centers of excellence for specific aspects of
92.29medical care where a specific set of combined services, a volume of patients necessary to
92.30maintain a high level of competency, or a specific level of technical capacity is associated
92.31with improved health outcomes.
92.32(b) The commissioner shall establish a dental subcommittee to operate under the
92.33Health Services Policy Committee. The dental subcommittee consists of general dentists,
92.34dental specialists, safety net providers, dental hygienists, health plan company and
93.1county and public health representatives, health researchers, consumers, and a designee
93.2of the commissioner of health. The dental subcommittee shall advise the commissioner
93.3regarding:
93.4(1) the critical access dental program under section 256B.76, subdivision 4, including
93.5but not limited to criteria for designating and terminating critical access dental providers;
93.6(2) any changes to the critical access dental provider program necessary to comply
93.7with program expenditure limits;
93.8(3) dental coverage policy based on evidence, quality, continuity of care, and best
93.9practices;
93.10(4) the development of dental delivery models; and
93.11(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
93.12(c) The Health Services Policy Committee shall study approaches to making
93.13provider reimbursement under the medical assistance, MinnesotaCare, and general
93.14assistance medical care programs contingent on patient participation in a patient-centered
93.15decision-making process, and shall evaluate the impact of these approaches on health
93.16care quality, patient satisfaction, and health care costs. The committee shall present
93.17findings and recommendations to the commissioner and the legislative committees with
93.18jurisdiction over health care by January 15, 2010.
93.19(d) The Health Services Policy Committee shall monitor and track the practice
93.20patterns of physicians providing services to medical assistance, MinnesotaCare, and
93.21general assistance medical care enrollees under fee-for-service, managed care, and
93.22county-based purchasing. The committee shall focus on services or specialties for which
93.23there is a high variation in utilization across physicians, or which are associated with
93.24high medical costs. The commissioner, based upon the findings of the committee, shall
93.25regularly notify physicians whose practice patterns indicate higher than average utilization
93.26or costs. Managed care and county-based purchasing plans shall provide the committee
93.27with utilization and cost data necessary to implement this paragraph.
93.28    (e) The Health Services Policy Committee shall review caesarean section rates
93.29for the fee-for-service medical assistance population. The committee may develop best
93.30practices policies related to the minimization of caesarean sections, including but not
93.31limited to standards and guidelines for health care providers and health care facilities.

93.32    Sec. 27. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to
93.33read:
94.1    Subd. 9. Dental services. (a) Medical assistance covers dental services. Dental
94.2services include, with prior authorization, fixed bridges that are cost-effective for persons
94.3who cannot use removable dentures because of their medical condition.
94.4(b) Medical assistance dental coverage for nonpregnant adults is limited to the
94.5following services:
94.6(1) comprehensive exams, limited to once every five years;
94.7(2) periodic exams, limited to one per year;
94.8(3) limited exams;
94.9(4) bitewing x-rays, limited to one per year;
94.10(5) periapical x-rays;
94.11(6) panoramic x-rays, limited to one every five years, and only if provided in
94.12conjunction with a posterior extraction or scheduled outpatient facility procedure, or as
94.13medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology
94.14and trauma. Panoramic x-rays may be taken once every two years for patients who cannot
94.15cooperate for intraoral film due to a developmental disability or medical condition that
94.16does not allow for intraoral film placement;
94.17(7) prophylaxis, limited to one per year;
94.18(8) application of fluoride varnish, limited to one per year;
94.19(9) posterior fillings, all at the amalgam rate;
94.20(10) anterior fillings;
94.21(11) endodontics, limited to root canals on the anterior and premolars only;
94.22(12) removable prostheses, each dental arch limited to one every six years;
94.23(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
94.24abscesses;
94.25(14) palliative treatment and sedative fillings for relief of pain; and
94.26(15) full-mouth debridement, limited to one every five years.
94.27(c) In addition to the services specified in paragraph (b), medical assistance
94.28covers the following services for adults, if provided in an outpatient hospital setting or
94.29freestanding ambulatory surgical center as part of outpatient dental surgery:
94.30(1) periodontics, limited to periodontal scaling and root planing once every two
94.31years;
94.32(2) general anesthesia; and
94.33(3) full-mouth survey once every five years.
94.34(d) Medical assistance covers dental services for children that are medically
94.35necessary. The following guidelines apply:
94.36(1) posterior fillings are paid at the amalgam rate;
95.1(2) application of sealants once every five years per permanent molar; and
95.2(3) application of fluoride varnish once every six months.
95.3EFFECTIVE DATE.This section is effective January 1, 2010.

95.4    Sec. 28. Minnesota Statutes 2008, section 256B.0625, subdivision 11, is amended to
95.5read:
95.6    Subd. 11. Nurse anesthetist services. Medical assistance covers nurse anesthetist
95.7services. Rates paid for anesthesiology services provided by a certified registered nurse
95.8anesthetists anesthetist under the direction of a physician shall be according to the formula
95.9utilized in the Medicare program and shall use the conversion factor that is used by
95.10the Medicare program. Rates paid for anesthesiology services provided by a certified
95.11registered nurse anesthetist who is not directed by a physician shall be the same rate as
95.12paid under subdivision 3, paragraph (b).

95.13    Sec. 29. Minnesota Statutes 2008, section 256B.0625, subdivision 13, is amended to
95.14read:
95.15    Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs
95.16when specifically used to enhance fertility, if prescribed by a licensed practitioner and
95.17dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance
95.18program as a dispensing physician, or by a physician, physician assistant, or a nurse
95.19practitioner employed by or under contract with a community health board as defined in
95.20section 145A.02, subdivision 5, for the purposes of communicable disease control.
95.21(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
95.22unless authorized by the commissioner.
95.23(c) Medical assistance covers the following over-the-counter drugs when prescribed
95.24by a licensed practitioner or by a licensed pharmacist who meets standards established by
95.25the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen,
95.26family planning products, aspirin, insulin, products for the treatment of lice, vitamins for
95.27adults with documented vitamin deficiencies, vitamins for children under the age of seven
95.28and pregnant or nursing women, and any other over-the-counter drug identified by the
95.29commissioner, in consultation with the formulary committee, as necessary, appropriate,
95.30and cost-effective for the treatment of certain specified chronic diseases, conditions,
95.31or disorders, and this determination shall not be subject to the requirements of chapter
95.3214. A pharmacist may prescribe over-the-counter medications as provided under this
95.33paragraph for purposes of receiving reimbursement under Medicaid. When prescribing
95.34over-the-counter drugs under this paragraph, licensed pharmacists must consult with the
96.1recipient to determine necessity, provide drug counseling, review drug therapy for potential
96.2adverse interactions, and make referrals as needed to other health care professionals.
96.3(d) Effective January 1, 2006, medical assistance shall not cover drugs that
96.4are coverable under Medicare Part D as defined in the Medicare Prescription Drug,
96.5Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e),
96.6for individuals eligible for drug coverage as defined in the Medicare Prescription
96.7Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section
96.81860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the
96.9drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this
96.10subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code,
96.11title 42, section 1396r-8(d)(2)(E), shall not be covered.

96.12    Sec. 30. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to
96.13read:
96.14    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
96.15shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
96.16the maximum allowable cost set by the federal government or by the commissioner plus
96.17the fixed dispensing fee; or the usual and customary price charged to the public. The
96.18amount of payment basis must be reduced to reflect all discount amounts applied to the
96.19charge by any provider/insurer agreement or contract for submitted charges to medical
96.20assistance programs. The net submitted charge may not be greater than the patient liability
96.21for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
96.22for intravenous solutions which must be compounded by the pharmacist shall be $8 per
96.23bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
96.24nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
96.25nutritional products dispensed in quantities greater than one liter. Actual acquisition
96.26cost includes quantity and other special discounts except time and cash discounts.
96.27Effective July 1, 2008 2009, the actual acquisition cost of a drug shall be estimated by the
96.28commissioner, at average wholesale price minus 14 15 percent. The actual acquisition
96.29cost of antihemophilic factor drugs shall be estimated at the average wholesale price
96.30minus 30 percent. The maximum allowable cost of a multisource drug may be set by the
96.31commissioner and it shall be comparable to, but no higher than, the maximum amount
96.32paid by other third-party payors in this state who have maximum allowable cost programs.
96.33Establishment of the amount of payment for drugs shall not be subject to the requirements
96.34of the Administrative Procedure Act.
97.1    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
97.2to pharmacists for legend drug prescriptions dispensed to residents of long-term care
97.3facilities when a unit dose blister card system, approved by the department, is used. Under
97.4this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
97.5The National Drug Code (NDC) from the drug container used to fill the blister card must
97.6be identified on the claim to the department. The unit dose blister card containing the
97.7drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
97.8that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
97.9will be required to credit the department for the actual acquisition cost of all unused
97.10drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
97.11manufacturer's unopened package. The commissioner may permit the drug clozapine to be
97.12dispensed in a quantity that is less than a 30-day supply.
97.13    (c) Whenever a generically equivalent product is available, payment shall be on the
97.14basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost
97.15established by the commissioner.
97.16    (d) The basis for determining the amount of payment for drugs administered in an
97.17outpatient setting shall be the lower of the usual and customary cost submitted by the
97.18provider or the amount established for Medicare by the United States Department of
97.19Health and Human Services pursuant to title XVIII, section 1847a of the federal Social
97.20Security Act.
97.21    (e) The commissioner may negotiate lower reimbursement rates for specialty
97.22pharmacy products than the rates specified in paragraph (a). The commissioner may
97.23require individuals enrolled in the health care programs administered by the department
97.24to obtain specialty pharmacy products from providers with whom the commissioner has
97.25negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
97.26used by a small number of recipients or recipients with complex and chronic diseases
97.27that require expensive and challenging drug regimens. Examples of these conditions
97.28include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
97.29C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
97.30of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
97.31biotechnology drugs, high-cost therapies, and therapies that require complex care. The
97.32commissioner shall consult with the formulary committee to develop a list of specialty
97.33pharmacy products subject to this paragraph. In consulting with the formulary committee
97.34in developing this list, the commissioner shall take into consideration the population
97.35served by specialty pharmacy products, the current delivery system and standard of care in
98.1the state, and access to care issues. The commissioner shall have the discretion to adjust
98.2the reimbursement rate to prevent access to care issues.

98.3    Sec. 31. Minnesota Statutes 2008, section 256B.0625, subdivision 13h, is amended to
98.4read:
98.5    Subd. 13h. Medication therapy management services. (a) Medical assistance
98.6and general assistance medical care cover medication therapy management services for
98.7a recipient taking four or more prescriptions to treat or prevent two or more chronic
98.8medical conditions, or a recipient with a drug therapy problem that is identified or prior
98.9authorized by the commissioner that has resulted or is likely to result in significant
98.10nondrug program costs. The commissioner may cover medical therapy management
98.11services under MinnesotaCare if the commissioner determines this is cost-effective. For
98.12purposes of this subdivision, "medication therapy management" means the provision
98.13of the following pharmaceutical care services by a licensed pharmacist to optimize the
98.14therapeutic outcomes of the patient's medications:
98.15    (1) performing or obtaining necessary assessments of the patient's health status;
98.16    (2) formulating a medication treatment plan;
98.17    (3) monitoring and evaluating the patient's response to therapy, including safety
98.18and effectiveness;
98.19    (4) performing a comprehensive medication review to identify, resolve, and prevent
98.20medication-related problems, including adverse drug events;
98.21    (5) documenting the care delivered and communicating essential information to
98.22the patient's other primary care providers;
98.23    (6) providing verbal education and training designed to enhance patient
98.24understanding and appropriate use of the patient's medications;
98.25    (7) providing information, support services, and resources designed to enhance
98.26patient adherence with the patient's therapeutic regimens; and
98.27    (8) coordinating and integrating medication therapy management services within the
98.28broader health care management services being provided to the patient.
98.29Nothing in this subdivision shall be construed to expand or modify the scope of practice of
98.30the pharmacist as defined in section 151.01, subdivision 27.
98.31    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
98.32must meet the following requirements:
98.33    (1) have a valid license issued under chapter 151;
98.34    (2) have graduated from an accredited college of pharmacy on or after May 1996, or
98.35completed a structured and comprehensive education program approved by the Board of
99.1Pharmacy and the American Council of Pharmaceutical Education for the provision and
99.2documentation of pharmaceutical care management services that has both clinical and
99.3didactic elements;
99.4    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
99.5have developed a structured patient care process that is offered in a private or semiprivate
99.6patient care area that is separate from the commercial business that also occurs in the
99.7setting, or in home settings, excluding long-term care and group homes, if the service is
99.8ordered by the provider-directed care coordination team; and
99.9    (4) make use of an electronic patient record system that meets state standards.
99.10    (c) For purposes of reimbursement for medication therapy management services,
99.11the commissioner may enroll individual pharmacists as medical assistance and general
99.12assistance medical care providers. The commissioner may also establish contact
99.13requirements between the pharmacist and recipient, including limiting the number of
99.14reimbursable consultations per recipient.
99.15    (d) The commissioner, after receiving recommendations from professional medical
99.16associations, professional pharmacy associations, and consumer groups, shall convene
99.17an 11-member Medication Therapy Management Advisory Committee to advise
99.18the commissioner on the implementation and administration of medication therapy
99.19management services. The committee shall be comprised of: two licensed physicians;
99.20two licensed pharmacists; two consumer representatives; two health plan company
99.21representatives; and three members with expertise in the area of medication therapy
99.22management, who may be licensed physicians or licensed pharmacists. The committee is
99.23governed by section 15.059, except that committee members do not receive compensation
99.24or reimbursement for expenses. The advisory committee expires on June 30, 2007.
99.25    (e) The commissioner shall evaluate the effect of medication therapy management
99.26on quality of care, patient outcomes, and program costs, and shall include a description
99.27of any savings generated in the medical assistance and general assistance medical care
99.28programs that can be attributable to this coverage. The evaluation shall be submitted to
99.29the legislature by December 15, 2007. The commissioner may contract with a vendor
99.30or an academic institution that has expertise in evaluating health care outcomes for the
99.31purpose of completing the evaluation.
99.32(d) The commissioner shall establish a pilot project for an intensive medication
99.33therapy management program for patients identified by the commissioner with multiple
99.34chronic conditions and a high number of medications who are at high risk of preventable
99.35hospitalizations, emergency room use, medication complications, and suboptimal
99.36treatment outcomes due to medication-related problems. For purposes of the pilot
100.1project, medication therapy management services may be provided in a patient's home
100.2or community setting, in addition to other authorized settings. The commissioner may
100.3waive existing payment policies and establish special payment rates for the pilot project.
100.4The pilot project must be designed to produce a net savings to the state compared to the
100.5estimated costs that would otherwise be incurred for similar patients without the program.

100.6    Sec. 32. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to
100.7read:
100.8    Subd. 17. Transportation costs. (a) Medical assistance covers medical
100.9transportation costs incurred solely for obtaining emergency medical care or transportation
100.10costs incurred by eligible persons in obtaining emergency or nonemergency medical
100.11care when paid directly to an ambulance company, common carrier, or other recognized
100.12providers of transportation services. Medical transportation must be provided by:
100.13(1) an ambulance, as defined in section 144E.001, subdivision 2;
100.14(2) special transportation; or
100.15(3) common carrier including, but not limited to, bus, taxicab, other commercial
100.16carrier, or private automobile.
100.17(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
100.18part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
100.19would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
100.20transportation, or private automobile.
100.21The commissioner may use an order by the recipient's attending physician to certify that
100.22the recipient requires special transportation services. Special transportation includes
100.23providers shall perform driver-assisted service to services for eligible individuals.
100.24Driver-assisted service includes passenger pickup at and return to the individual's
100.25residence or place of business, assistance with admittance of the individual to the medical
100.26facility, and assistance in passenger securement or in securing of wheelchairs or stretchers
100.27in the vehicle. Special transportation providers must obtain written documentation
100.28from the health care service provider who is serving the recipient being transported,
100.29identifying the time that the recipient arrived. Special transportation providers may not
100.30bill for separate base rates for the continuation of a trip beyond the original destination.
100.31Special transportation providers must take recipients to the nearest appropriate health
100.32care provider, using the most direct route available. The maximum minimum medical
100.33assistance reimbursement rates for special transportation services are:
100.34(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
100.35eligible persons who need a wheelchair-accessible van;
101.1(2) (ii) $11.50 for the base rate and $1.30 per mile for special transportation services
101.2to eligible persons who do not need a wheelchair-accessible van; and
101.3(3) (iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip,
101.4for special transportation services to eligible persons who need a stretcher-accessible
101.5vehicle;
101.6(2) the base rates for special transportation services in areas defined under RUCA
101.7to be super rural shall be equal to the reimbursement rate established in clause (1) plus
101.811.3 percent; and
101.9(3) for special transportation services in areas defined under RUCA to be rural
101.10or super rural areas:
101.11(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
101.12percent of the respective mileage rate in clause (1); and
101.13(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
101.14112.5 percent of the respective mileage rate in clause (1).
101.15(c) For purposes of reimbursement rates for special transportation services under
101.16paragraph (b), the zip code of the recipient's place of residence shall determine whether
101.17the urban, rural, or super rural reimbursement rate applies.
101.18(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
101.19means a census-tract based classification system under which a geographical area is
101.20determined to be urban, rural, or super rural.

101.21    Sec. 33. Minnesota Statutes 2008, section 256B.0625, subdivision 17a, is amended to
101.22read:
101.23    Subd. 17a. Payment for ambulance services. Medical assistance covers
101.24ambulance services. Providers shall bill ambulance services according to Medicare
101.25criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
101.26for services rendered on or after July 1, 2001, medical assistance payments for ambulance
101.27services shall be paid at the Medicare reimbursement rate or at the medical assistance
101.28payment rate in effect on July 1, 2000, whichever is greater.

101.29    Sec. 34. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
101.30subdivision to read:
101.31    Subd. 18b. Broker dispatching prohibition. The commissioner shall not use a
101.32broker or coordinator for any purpose related to transportation services under subdivision
101.3318.

102.1    Sec. 35. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
102.2subdivision to read:
102.3    Subd. 25a. Prior authorization of diagnostic imaging services. (a) Effective
102.4January 1, 2010, the commissioner shall require prior authorization or decision support
102.5for the ordering providers at the time the service is ordered for the following outpatient
102.6diagnostic imaging services: computerized tomography (CT), magnetic resonance
102.7imaging (MRI), magnetic resonance angiography (MRA), positive emission tomography
102.8(PET), cardiac imaging and ultrasound diagnostic imaging.
102.9(b) Prior authorization under this subdivision is not required for diagnostic imaging
102.10services performed as part of a hospital emergency room visit, inpatient hospitalization, or
102.11if concurrent with or on the same day as an urgent care facility visit.
102.12(c) This subdivision does not apply to services provided to recipients who are
102.13enrolled in Medicare, the prepaid medical assistance program, the prepaid general
102.14assistance medical care program, or the MinnesotaCare program.
102.15(d) The commissioner may contract with a private entity to provide the prior
102.16authorization or decision support required under this subdivision. The contracting entity
102.17must incorporate clinical guidelines that are based on evidence-based medical literature, if
102.18available. By January 1, 2012, the contracting entity shall report to the commissioner the
102.19results of prior authorization or decision support.

102.20    Sec. 36. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to
102.21read:
102.22    Subd. 26. Special education services. (a) Medical assistance covers medical
102.23services identified in a recipient's individualized education plan and covered under the
102.24medical assistance state plan. Covered services include occupational therapy, physical
102.25therapy, speech-language therapy, clinical psychological services, nursing services,
102.26school psychological services, school social work services, personal care assistants
102.27serving as management aides, assistive technology devices, transportation services,
102.28health assessments, and other services covered under the medical assistance state plan.
102.29Mental health services eligible for medical assistance reimbursement must be provided or
102.30coordinated through a children's mental health collaborative where a collaborative exists if
102.31the child is included in the collaborative operational target population. The provision or
102.32coordination of services does not require that the individual education plan be developed
102.33by the collaborative.
102.34The services may be provided by a Minnesota school district that is enrolled as a
102.35medical assistance provider or its subcontractor, and only if the services meet all the
103.1requirements otherwise applicable if the service had been provided by a provider other
103.2than a school district, in the following areas: medical necessity, physician's orders,
103.3documentation, personnel qualifications, and prior authorization requirements. The
103.4nonfederal share of costs for services provided under this subdivision is the responsibility
103.5of the local school district as provided in section 125A.74. Services listed in a child's
103.6individual education plan are eligible for medical assistance reimbursement only if those
103.7services meet criteria for federal financial participation under the Medicaid program.
103.8(b) Approval of health-related services for inclusion in the individual education plan
103.9does not require prior authorization for purposes of reimbursement under this chapter.
103.10The commissioner may require physician review and approval of the plan not more than
103.11once annually or upon any modification of the individual education plan that reflects a
103.12change in health-related services.
103.13(c) Services of a speech-language pathologist provided under this section are covered
103.14notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:
103.15(1) holds a masters degree in speech-language pathology;
103.16(2) is licensed by the Minnesota Board of Teaching as an educational
103.17speech-language pathologist; and
103.18(3) either has a certificate of clinical competence from the American Speech and
103.19Hearing Association, has completed the equivalent educational requirements and work
103.20experience necessary for the certificate or has completed the academic program and is
103.21acquiring supervised work experience to qualify for the certificate.
103.22(d) Medical assistance coverage for medically necessary services provided under
103.23other subdivisions in this section may not be denied solely on the basis that the same or
103.24similar services are covered under this subdivision.
103.25(e) The commissioner shall develop and implement package rates, bundled rates, or
103.26per diem rates for special education services under which separately covered services are
103.27grouped together and billed as a unit in order to reduce administrative complexity.
103.28(f) The commissioner shall develop a cost-based payment structure for payment
103.29of these services. The commissioner shall reimburse claims submitted based on an
103.30interim rate, and shall settle at a final rate once the department has determined it. The
103.31commissioner shall notify the school district of the final rate. The school district has 60
103.32days to appeal the final rate. To appeal the final rate, the school district shall file a written
103.33appeal request to the commissioner within 60 days of the date the final rate determination
103.34was mailed. The appeal request shall specify (1) the disputed items and (2) the name and
103.35address of the person to contact regarding the appeal.
104.1(g) Effective July 1, 2000, medical assistance services provided under an individual
104.2education plan or an individual family service plan by local school districts shall not count
104.3against medical assistance authorization thresholds for that child.
104.4(h) Nursing services as defined in section 148.171, subdivision 15, and provided
104.5as an individual education plan health-related service, are eligible for medical assistance
104.6payment if they are otherwise a covered service under the medical assistance program.
104.7Medical assistance covers the administration of prescription medications by a licensed
104.8nurse who is employed by or under contract with a school district when the administration
104.9of medications is identified in the child's individualized education plan. The simple
104.10administration of medications alone is not covered under medical assistance when
104.11administered by a provider other than a school district or when it is not identified in the
104.12child's individualized education plan.

104.13    Sec. 37. Minnesota Statutes 2008, section 256B.08, is amended by adding a
104.14subdivision to read:
104.15    Subd. 4. Data from Social Security. The commissioner shall accept data from the
104.16Social Security Administration in accordance with United States Code, title 42, section
104.171396U-5(a).
104.18EFFECTIVE DATE.This section is effective January 1, 2010.

104.19    Sec. 38. Minnesota Statutes 2008, section 256B.15, subdivision 1, is amended to read:
104.20    Subdivision 1. Policy and applicability. (a) It is the policy of this state that
104.21individuals or couples, either or both of whom participate in the medical assistance
104.22program, use their own assets to pay their share of the total cost of their care during or
104.23after their enrollment in the program according to applicable federal law and the laws of
104.24this state. The following provisions apply:
104.25    (1) subdivisions 1c to 1k shall not apply to claims arising under this section which
104.26are presented under section 525.313;
104.27    (2) the provisions of subdivisions 1c to 1k expanding the interests included in an
104.28estate for purposes of recovery under this section give effect to the provisions of United
104.29States Code, title 42, section 1396p, governing recoveries, but do not give rise to any
104.30express or implied liens in favor of any other parties not named in these provisions;
104.31    (3) the continuation of a recipient's life estate or joint tenancy interest in real
104.32property after the recipient's death for the purpose of recovering medical assistance under
104.33this section modifies common law principles holding that these interests terminate on
104.34the death of the holder;
105.1    (4) all laws, rules, and regulations governing or involved with a recovery of medical
105.2assistance shall be liberally construed to accomplish their intended purposes;
105.3    (5) a deceased recipient's life estate and joint tenancy interests continued under this
105.4section shall be owned by the remaindermen or surviving joint tenants as their interests
105.5may appear on the date of the recipient's death. They shall not be merged into the
105.6remainder interest or the interests of the surviving joint tenants by reason of ownership.
105.7They shall be subject to the provisions of this section. Any conveyance, transfer, sale,
105.8assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs,
105.9successors, and assigns shall be deemed to include all of their interest in the deceased
105.10recipient's life estate or joint tenancy interest continued under this section; and
105.11    (6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy
105.12interests in real property after the recipient's death do not apply to a homestead owned
105.13of record, on the date the recipient dies, by the recipient and the recipient's spouse as
105.14joint tenants with a right of survivorship. Homestead means the real property occupied
105.15by the surviving joint tenant spouse as their sole residence on the date the recipient dies
105.16and classified and taxed to the recipient and surviving joint tenant spouse as homestead
105.17property for property tax purposes in the calendar year in which the recipient dies. For
105.18purposes of this exemption, real property the recipient and their surviving joint tenant
105.19spouse purchase solely with the proceeds from the sale of their prior homestead, own
105.20of record as joint tenants, and qualify as homestead property under section 273.124 in
105.21the calendar year in which the recipient dies and prior to the recipient's death shall be
105.22deemed to be real property classified and taxed to the recipient and their surviving joint
105.23tenant spouse as homestead property in the calendar year in which the recipient dies.
105.24The surviving spouse, or any person with personal knowledge of the facts, may provide
105.25an affidavit describing the homestead property affected by this clause and stating facts
105.26showing compliance with this clause. The affidavit shall be prima facie evidence of the
105.27facts it states.
105.28    (b) For purposes of this section, "medical assistance" includes the medical assistance
105.29program under this chapter and the general assistance medical care program under chapter
105.30256D and alternative care for nonmedical assistance recipients under section 256B.0913.
105.31    (c) For purposes of this section, beginning January 1, 2010, "medical assistance"
105.32does not include Medicare cost-sharing benefits in accordance with United States Code,
105.33title 42, section 1396p.
105.34    (d) All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j,
105.35related to the continuation of a recipient's life estate or joint tenancy interests in real
105.36property after the recipient's death for the purpose of recovering medical assistance, are
106.1effective only for life estates and joint tenancy interests established on or after August 1,
106.22003. For purposes of this paragraph, medical assistance does not include alternative care.

106.3    Sec. 39. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:
106.4    Subd. 1a. Estates subject to claims. (a) If a person receives any medical assistance
106.5hereunder, on the person's death, if single, or on the death of the survivor of a married
106.6couple, either or both of whom received medical assistance, or as otherwise provided
106.7for in this section, the total amount paid for medical assistance rendered for the person
106.8and spouse shall be filed as a claim against the estate of the person or the estate of the
106.9surviving spouse in the court having jurisdiction to probate the estate or to issue a decree
106.10of descent according to sections 525.31 to 525.313.
106.11(b) For the purposes of this section, the person's estate must consist of:
106.12(1) the person's probate estate;
106.13(2) all of the person's interests or proceeds of those interests in real property the
106.14person owned as a life tenant or as a joint tenant with a right of survivorship at the time of
106.15the person's death;
106.16(3) all of the person's interests or proceeds of those interests in securities the person
106.17owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time
106.18of the person's death, to the extent the interests or proceeds of those interests become part
106.19of the probate estate under section 524.6-307;
106.20(4) all of the person's interests in joint accounts, multiple-party accounts, and
106.21pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of
106.22those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the
106.23person's death to the extent the interests become part of the probate estate under section
106.24524.6-207; and
106.25(5) assets conveyed to a survivor, heir, or assign of the person through survivorship,
106.26living trust, or other arrangements.
106.27(c) For the purpose of this section and recovery in a surviving spouse's estate for
106.28medical assistance paid for a predeceased spouse, the estate must consist of all of the legal
106.29title and interests the deceased individual's predeceased spouse had in jointly owned or
106.30marital property at the time of the spouse's death, as defined in subdivision 2b, and the
106.31proceeds of those interests, that passed to the deceased individual or another individual, a
106.32survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy
106.33in common, survivorship, life estate, living trust, or other arrangement. A deceased
106.34recipient who, at death, owned the property jointly with the surviving spouse shall have
106.35an interest in the entire property.
107.1(d) For the purpose of recovery in a single person's estate or the estate of a survivor
107.2of a married couple, "other arrangement" includes any other means by which title to all or
107.3any part of the jointly owned or marital property or interest passed from the predeceased
107.4spouse to another including, but not limited to, transfers between spouses which are
107.5permitted, prohibited, or penalized for purposes of medical assistance.
107.6(e) A claim shall be filed if medical assistance was rendered for either or both
107.7persons under one of the following circumstances:
107.8(a) (1) the person was over 55 years of age, and received services under this chapter;
107.9(b) (2) the person resided in a medical institution for six months or longer, received
107.10services under this chapter, and, at the time of institutionalization or application for
107.11medical assistance, whichever is later, the person could not have reasonably been expected
107.12to be discharged and returned home, as certified in writing by the person's treating
107.13physician. For purposes of this section only, a "medical institution" means a skilled
107.14nursing facility, intermediate care facility, intermediate care facility for persons with
107.15developmental disabilities, nursing facility, or inpatient hospital; or
107.16(c) (3) the person received general assistance medical care services under chapter
107.17256D.
107.18(f) The claim shall be considered an expense of the last illness of the decedent for the
107.19purpose of section 524.3-805. Notwithstanding any law or rule to the contrary, a state or
107.20county agency with a claim under this section must be a creditor under section 524.6-307.
107.21Any statute of limitations that purports to limit any county agency or the state agency,
107.22or both, to recover for medical assistance granted hereunder shall not apply to any claim
107.23made hereunder for reimbursement for any medical assistance granted hereunder. Notice
107.24of the claim shall be given to all heirs and devisees of the decedent whose identity can be
107.25ascertained with reasonable diligence. The notice must include procedures and instructions
107.26for making an application for a hardship waiver under subdivision 5; time frames for
107.27submitting an application and determination; and information regarding appeal rights and
107.28procedures. Counties are entitled to one-half of the nonfederal share of medical assistance
107.29collections from estates that are directly attributable to county effort. Counties are entitled
107.30to ten percent of the collections for alternative care directly attributable to county effort.

107.31    Sec. 40. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:
107.32    Subd. 1h. Estates of specific persons receiving medical assistance. (a) For
107.33purposes of this section, paragraphs (b) to (k) (j) apply if a person received medical
107.34assistance for which a claim may be filed under this section and died single, or the
108.1surviving spouse of the couple and was not survived by any of the persons described
108.2in subdivisions 3 and 4.
108.3    (b) For purposes of this section, the person's estate consists of: (1) the person's
108.4probate estate; (2) all of the person's interests or proceeds of those interests in real property
108.5the person owned as a life tenant or as a joint tenant with a right of survivorship at the
108.6time of the person's death; (3) all of the person's interests or proceeds of those interests in
108.7securities the person owned in beneficiary form as provided under sections 524.6-301 to
108.8524.6-311 at the time of the person's death, to the extent they become part of the probate
108.9estate under section 524.6-307; (4) all of the person's interests in joint accounts, multiple
108.10party accounts, and pay on death accounts, or the proceeds of those accounts, as provided
108.11under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent
108.12they become part of the probate estate under section 524.6-207; and (5) the person's
108.13legal title or interest at the time of the person's death in real property transferred under
108.14a transfer on death deed under section 507.071, or in the proceeds from the subsequent
108.15sale of the person's interest in the real property. Notwithstanding any law or rule to the
108.16contrary, a state or county agency with a claim under this section shall be a creditor under
108.17section 524.6-307.
108.18    (c) (b) Notwithstanding any law or rule to the contrary, the person's life estate or joint
108.19tenancy interest in real property not subject to a medical assistance lien under sections
108.20514.980 to 514.985 on the date of the person's death shall not end upon the person's death
108.21and shall continue as provided in this subdivision. The life estate in the person's estate
108.22shall be that portion of the interest in the real property subject to the life estate that is equal
108.23to the life estate percentage factor for the life estate as listed in the Life Estate Mortality
108.24Table of the health care program's manual for a person who was the age of the medical
108.25assistance recipient on the date of the person's death. The joint tenancy interest in real
108.26property in the estate shall be equal to the fractional interest the person would have owned
108.27in the jointly held interest in the property had they and the other owners held title to the
108.28property as tenants in common on the date the person died.
108.29    (d) (c) The court upon its own motion, or upon motion by the personal representative
108.30or any interested party, may enter an order directing the remaindermen or surviving joint
108.31tenants and their spouses, if any, to sign all documents, take all actions, and otherwise
108.32fully cooperate with the personal representative and the court to liquidate the decedent's
108.33life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of
108.34those interests to the personal representative and provide for any legal and equitable
108.35sanctions as the court deems appropriate to enforce and carry out the order, including an
108.36award of reasonable attorney fees.
109.1    (e) (d) The personal representative may make, execute, and deliver any conveyances
109.2or other documents necessary to convey the decedent's life estate or joint tenancy interest
109.3in the estate that are necessary to liquidate and reduce to cash the decedent's interest or
109.4for any other purposes.
109.5    (f) (e) Subject to administration, all costs, including reasonable attorney fees,
109.6directly and immediately related to liquidating the decedent's life estate or joint tenancy
109.7interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation
109.8allocable to the decedent's interest and the net proceeds shall be turned over to the personal
109.9representative and applied to payment of the claim presented under this section.
109.10    (g) (f) The personal representative shall bring a motion in the district court in which
109.11the estate is being probated to compel the remaindermen or surviving joint tenants to
109.12account for and deliver to the personal representative all or any part of the proceeds of any
109.13sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the
109.14decedent's life estate or joint tenancy interest in the decedent's estate, and do everything
109.15necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of
109.16the sale or other disposition over to the personal representative. The court may grant any
109.17legal or equitable relief including, but not limited to, ordering a partition of real estate
109.18under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy
109.19interest available to the estate for payment of a claim under this section.
109.20    (h) (g) Subject to administration, the personal representative shall use all of the cash
109.21or proceeds of interests to pay an allowable claim under this section. The remaindermen
109.22or surviving joint tenants and their spouses, if any, may enter into a written agreement
109.23with the personal representative or the claimant to settle and satisfy obligations imposed at
109.24any time before or after a claim is filed.
109.25    (i) (h) The personal representative may, at their discretion, provide any or all of the
109.26other owners, remaindermen, or surviving joint tenants with an affidavit terminating the
109.27decedent's estate's interest in real property the decedent owned as a life tenant or as a joint
109.28tenant with others, if the personal representative determines in good faith that neither the
109.29decedent nor any of the decedent's predeceased spouses received any medical assistance
109.30for which a claim could be filed under this section, or if the personal representative has
109.31filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as
109.32presented, or if there is a written agreement under paragraph (h) (g), or if the claim, as
109.33allowed, has been paid in full or to the full extent of the assets the estate has available
109.34to pay it. The affidavit may be recorded in the office of the county recorder or filed in
109.35the Office of the Registrar of Titles for the county in which the real property is located.
109.36Except as provided in section 514.981, subdivision 6, when recorded or filed, the affidavit
110.1shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a
110.2joint tenant with others. The affidavit shall:
110.3(1) be signed by the personal representative;
110.4(2) identify the decedent and the interest being terminated;
110.5(3) give recording information sufficient to identify the instrument that created the
110.6interest in real property being terminated;
110.7(4) legally describe the affected real property;
110.8(5) state that the personal representative has determined that neither the decedent
110.9nor any of the decedent's predeceased spouses received any medical assistance for which
110.10a claim could be filed under this section;
110.11(6) state that the decedent's estate has other assets sufficient to pay the claim, as
110.12presented, or that there is a written agreement between the personal representative and
110.13the claimant and the other owners or remaindermen or other joint tenants to satisfy the
110.14obligations imposed under this subdivision; and
110.15(7) state that the affidavit is being given to terminate the estate's interest under this
110.16subdivision, and any other contents as may be appropriate.
110.17The recorder or registrar of titles shall accept the affidavit for recording or filing. The
110.18affidavit shall be effective as provided in this section and shall constitute notice even if it
110.19does not include recording information sufficient to identify the instrument creating the
110.20interest it terminates. The affidavit shall be conclusive evidence of the stated facts.
110.21    (j) (i) The holder of a lien arising under subdivision 1c shall release the lien at
110.22the holder's expense against an interest terminated under paragraph (h) (g) to the extent
110.23of the termination.
110.24    (k) (j) If a lien arising under subdivision 1c is not released under paragraph (j) (i),
110.25prior to closing the estate, the personal representative shall deed the interest subject to the
110.26lien to the remaindermen or surviving joint tenants as their interests may appear. Upon
110.27recording or filing, the deed shall work a merger of the recipient's life estate or joint
110.28tenancy interest, subject to the lien, into the remainder interest or interest the decedent and
110.29others owned jointly. The lien shall attach to and run with the property to the extent of
110.30the decedent's interest at the time of the decedent's death.

110.31    Sec. 41. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:
110.32    Subd. 2. Limitations on claims. The claim shall include only the total amount
110.33of medical assistance rendered after age 55 or during a period of institutionalization
110.34described in subdivision 1a, clause (b) paragraph (e), and the total amount of general
110.35assistance medical care rendered, and shall not include interest. Claims that have been
111.1allowed but not paid shall bear interest according to section 524.3-806, paragraph (d). A
111.2claim against the estate of a surviving spouse who did not receive medical assistance, for
111.3medical assistance rendered for the predeceased spouse, shall be payable from the full
111.4value of all of the predeceased spouse's assets and interests which are part of the surviving
111.5spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in
111.6the nonrecipient surviving spouse's estate is limited to the value of the assets of the estate
111.7that were marital property or jointly owned property at any time during the marriage. The
111.8claim is not payable from the value of assets or proceeds of assets in the estate attributable
111.9to a predeceased spouse whom the individual married after the death of the predeceased
111.10recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the
111.11estate which the nonrecipient decedent spouse acquired with assets which were not marital
111.12property or jointly owned property after the death of the predeceased recipient spouse.
111.13Claims for alternative care shall be net of all premiums paid under section 256B.0913,
111.14subdivision 12
, on or after July 1, 2003, and shall be limited to services provided on or
111.15after July 1, 2003. Claims against marital property shall be limited to claims against
111.16recipients who died on or after July 1, 2009.

111.17    Sec. 42. Minnesota Statutes 2008, section 256B.15, is amended by adding a
111.18subdivision to read:
111.19    Subd. 2b. Controlling provisions. (a) For purposes of this subdivision and
111.20subdivisions 1a and 2, paragraphs (b) to (d) apply.
111.21(b) At the time of death of a recipient spouse and solely for purpose of recovery of
111.22medical assistance benefits received, a predeceased recipient spouse shall have a legal
111.23title or interest in the undivided whole of all of the property which the recipient and the
111.24recipient's surviving spouse owned jointly or which was marital property at any time
111.25during their marriage regardless of the form of ownership and regardless of whether
111.26it was owned or titled in the names of one or both the recipient and the recipient's
111.27spouse. Title and interest in the property of a predeceased recipient spouse shall not end
111.28or extinguish upon the person's death and shall continue for the purpose of allowing
111.29recovery of medical assistance in the estate of the surviving spouse. Upon the death of
111.30the predeceased recipient spouse, title and interest in the predeceased spouse's property
111.31shall vest in the surviving spouse by operation of law and without the necessity for any
111.32probate or decree of descent proceedings and shall continue to exist after the death of the
111.33predeceased spouse and the surviving spouse to permit recovery of medical assistance.
111.34The recipient spouse and the surviving spouse of a deceased recipient spouse shall not
112.1encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of
112.2these interests before or upon death.
112.3(c) For purposes of this section, "marital property" includes any and all real or
112.4personal property of any kind or interests in such property the predeceased recipient
112.5spouse and their spouse, or either of them, owned at the time of their marriage to each
112.6other or acquired during their marriage regardless of whether it was owned or titled in
112.7the names of one or both of them. If either or both spouses of a married couple received
112.8medical assistance, all property owned during the marriage or which either or both spouses
112.9acquired during their marriage shall be presumed to be marital property for purposes of
112.10recovering medical assistance unless there is clear and convincing evidence to the contrary.
112.11(d) The agency responsible for the claim for medical assistance for a recipient spouse
112.12may, at its discretion, release specific real and personal property from the provisions of
112.13this section. The release shall extinguish the interest created under paragraph (b) in the
112.14land it describes upon filing or recording. The release need not be attested, certified, or
112.15acknowledged as a condition of filing or recording and shall be filed or recorded in the
112.16office of the county recorder or registrar of titles, as appropriate, in the county where the
112.17real property is located. The party to whom the release is given shall be responsible for
112.18paying all fees and costs necessary to record and file the release. If the property described
112.19in the release is registered property, the registrar of titles shall accept it for recording and
112.20shall record it on the certificate of title for each parcel of property described in the release.
112.21If the property described in the release is abstract property, the recorder shall accept it
112.22for filing and file it in the county's grantor-grantee indexes and any tract index the county
112.23maintains for each parcel of property described in the release.

112.24    Sec. 43. Minnesota Statutes 2008, section 256B.15, is amended by adding a
112.25subdivision to read:
112.26    Subd. 9. Commissioner's intervention. The commissioner shall be permitted to
112.27intervene as a party in any proceeding involving recovery of medical assistance upon
112.28filing a notice of intervention and serving such notice on the other parties.

112.29    Sec. 44. [256B.196] INTERGOVERNMENTAL TRANSFERS; HOSPITAL
112.30PAYMENTS.
112.31    Subdivision 1. Federal approval required. This section is contingent on federal
112.32approval of the intergovernmental transfers and payments authorized under this section.
112.33This section is also contingent on current payment by the government entities of the
112.34intergovernmental transfers under this section.
113.1    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
113.2subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
113.3services upper payment limit for nonstate government hospitals. The commissioner shall
113.4then determine the amount of a supplemental payment to Hennepin County Medical
113.5Center and Regions Hospital for these services that would increase medical assistance
113.6spending in this category to the aggregate upper payment limit for all nonstate government
113.7hospitals in Minnesota. In making this determination, the commissioner shall allot the
113.8available increases between Hennepin County Medical Center and Regions Hospital
113.9based on the ratio of medical assistance fee-for-service outpatient hospital payments to
113.10the two facilities. The commissioner shall adjust this allotment as necessary based on
113.11federal approvals, the amount of intergovernmental transfers received from Hennepin and
113.12Ramsey Counties, and other factors, in order to maximize the additional total payments.
113.13The commissioner shall inform Hennepin County and Ramsey County of the periodic
113.14intergovernmental transfers necessary to match federal Medicaid payments available
113.15under this subdivision in order to make supplementary medical assistance payments to
113.16Hennepin County Medical Center and Regions Hospital equal to an amount that when
113.17combined with existing medical assistance payments to nonstate governmental hospitals
113.18would increase total payments to hospitals in this category for outpatient services to
113.19the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
113.20receipt of these periodic transfers, the commissioner shall make supplementary payments
113.21to Hennepin County Medical Center and Regions Hospital.
113.22(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
113.23determine an upper payment limit for physicians affiliated with Hennepin County Medical
113.24Center and with Regions Hospital. The upper payment limit shall be based on the average
113.25commercial rate or be determined using another method acceptable to the Centers for
113.26Medicare and Medicaid Services. The commissioner shall inform Hennepin County and
113.27Ramsey County of the periodic intergovernmental transfers necessary to match the federal
113.28Medicaid payments available under this subdivision in order to make supplementary
113.29payments to physicians affiliated with Hennepin County Medical Center and Regions
113.30Hospital equal to the difference between the established medical assistance payment for
113.31physician services and the upper payment limit. Upon receipt of these periodic transfers,
113.32the commissioner shall make supplementary payments to physicians of Hennepin Faculty
113.33Associates and HealthPartners.
113.34(c) Beginning January 1, 2010, Hennepin County and Ramsey County shall make
113.35monthly intergovernmental transfers to the commissioner in the following amounts:
113.36$133,333 by Hennepin County and $100,000 by Ramsey County. The commissioner shall
114.1increase the medical assistance capitation payments to Metropolitan Health Plan and
114.2HealthPartners by an amount equal to the annual value of the monthly transfers plus
114.3federal financial participation.
114.4(d) The commissioner shall inform Hennepin County and Ramsey County on an
114.5ongoing basis of the need for any changes needed in the intergovernmental transfers
114.6in order to continue the payments under paragraphs (a) to (c), at their maximum level,
114.7including increases in upper payment limits, changes in the federal Medicaid match, and
114.8other factors.
114.9(e) The payments in paragraphs (a) to (c) shall be implemented independently of
114.10each other, subject to federal approval and to the receipt of transfers under subdivision 3.
114.11    Subd. 3. Intergovernmental transfers. Based on the determination by the
114.12commissioner under subdivision 2, Hennepin County and Ramsey County shall make
114.13periodic intergovernmental transfers to the commissioner for the purposes of subdivision
114.142, paragraphs (a) to (c). All of the intergovernmental transfers made by Hennepin County
114.15shall be used to match federal payments to Hennepin County Medical Center under
114.16subdivision 2, paragraph (a); to physicians affiliated with Hennepin Faculty Associates
114.17under subdivision 2, paragraph (b); and to Metropolitan Health Plan under subdivision
114.182, paragraph (c). All of the intergovernmental transfers made by Ramsey County shall
114.19be used to match federal payments to Regions Hospital under subdivision 2, paragraph
114.20(a); to physicians affiliated with HealthPartners under subdivision 2, paragraph (b); and to
114.21HealthPartners under subdivision 2, paragraph (c).
114.22    Subd. 4. Adjustments permitted. (a) The commissioner may adjust the
114.23intergovernmental transfers under subdivision 3 and the payments under subdivision
114.242, based on the commissioner's determination of Medicare upper payment limits,
114.25hospital-specific charge limits, hospital-specific limitations on disproportionate share
114.26payments, medical inflation, actuarial certification, and cost-effectiveness for purposes
114.27of federal waivers. Any adjustments must be made on a proportional basis. The
114.28commissioner may make adjustments under this subdivision only after consultation
114.29with the affected counties and hospitals. All payments under subdivision 2 and all
114.30intergovernmental transfers under subdivision 3 are limited to amounts available after all
114.31other base rates, adjustments, and supplemental payments in chapter 256B are calculated.
114.32(b) The ratio of medical assistance payments specified in subdivision 2 to the
114.33voluntary intergovernmental transfers specified in subdivision 3 shall not be reduced
114.34except as provided under paragraph (a).
115.1    Subd. 5. Recession period. Each type of intergovernmental transfer in subdivision
115.22, paragraphs (a) to (d), for payment periods from October 1, 2008, through December
115.331, 2010, is voluntary on the part of Hennepin and Ramsey Counties, meaning that the
115.4transfer must be agreed to, in writing, by the counties prior to any payments being issued.
115.5One agreement on each type of transfer shall cover the entire recession period.

115.6    Sec. 45. Minnesota Statutes 2008, section 256B.199, is amended to read:
115.7256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
115.8    (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds
115.9for the expenditures in paragraphs (b) and (c).
115.10    (b) The commissioner shall apply for federal matching funds for certified public
115.11expenditures as follows:
115.12    (1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions
115.13Hospital, the University of Minnesota, and Fairview-University Medical Center shall
115.14report quarterly to the commissioner beginning June 1, 2007, payments made during the
115.15second previous quarter that may qualify for reimbursement under federal law;
115.16     (2) based on these reports, the commissioner shall apply for federal matching
115.17funds. These funds are appropriated to the commissioner for the payments under section
115.18256.969, subdivision 27 ; and
115.19     (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
115.20the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
115.21hospital payment money expected to be available in the current federal fiscal year.
115.22    (c) The commissioner shall apply for federal matching funds for general assistance
115.23medical care expenditures as follows:
115.24    (1) for hospital services occurring on or after July 1, 2007, general assistance medical
115.25care expenditures for fee-for-service inpatient and outpatient hospital payments made by
115.26the department shall be used to apply for federal matching funds, except as limited below:
115.27    (i) only those general assistance medical care expenditures made to an individual
115.28hospital that would not cause the hospital to exceed its individual hospital limits under
115.29section 1923 of the Social Security Act may be considered; and
115.30    (ii) general assistance medical care expenditures may be considered only to the extent
115.31of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
115.32    (2) all hospitals must provide any necessary expenditure, cost, and revenue
115.33information required by the commissioner as necessary for purposes of obtaining federal
115.34Medicaid matching funds for general assistance medical care expenditures.
116.1(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall
116.2apply for additional federal matching funds available as disproportionate share hospital
116.3payments under the American Recovery and Reinvestment Act of 2009. These funds shall
116.4be made available as the state share of payments under section 256.969, subdivision 28.
116.5The entities required to report certified public expenditures under paragraph (b), clause
116.6(1), shall report additional certified public expenditures as necessary under this paragraph.
116.7EFFECTIVE DATE.This section is effective the day following final enactment.

116.8    Sec. 46. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
116.9    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
116.10and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
116.11basis beginning January 1, 1996. Managed care contracts which were in effect on June
116.1230, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
116.13through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
116.14commissioner may issue separate contracts with requirements specific to services to
116.15medical assistance recipients age 65 and older.
116.16    (b) A prepaid health plan providing covered health services for eligible persons
116.17pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
116.18of its contract with the commissioner. Requirements applicable to managed care programs
116.19under chapters 256B, 256D, and 256L, established after the effective date of a contract
116.20with the commissioner take effect when the contract is next issued or renewed.
116.21    (c) Effective for services rendered on or after January 1, 2003, the commissioner shall
116.22withhold five percent of managed care plan payments under this section and county-based
116.23purchasing plan's payment rate under section 256B.692 for the prepaid medical assistance
116.24and general assistance medical care programs pending completion of performance targets.
116.25Each performance target must be quantifiable, objective, measurable, and reasonably
116.26attainable, except in the case of a performance target based on a federal or state law or rule.
116.27Criteria for assessment of each performance target must be outlined in writing prior to the
116.28contract effective date. The managed care plan must demonstrate, to the commissioner's
116.29satisfaction, that the data submitted regarding attainment of the performance target is
116.30accurate. The commissioner shall periodically change the administrative measures used
116.31as performance targets in order to improve plan performance across a broader range of
116.32administrative services. The performance targets must include measurement of plan
116.33efforts to contain spending on health care services and administrative activities. The
116.34commissioner may adopt plan-specific performance targets that take into account factors
116.35affecting only one plan, including characteristics of the plan's enrollee population. The
117.1withheld funds must be returned no sooner than July of the following year if performance
117.2targets in the contract are achieved. The commissioner may exclude special demonstration
117.3projects under subdivision 23. A managed care plan or a county-based purchasing plan
117.4under section 256B.692 may include as admitted assets under section 62D.044 any amount
117.5withheld under this paragraph that is reasonably expected to be returned.
117.6    (d)(1) Effective for services rendered on or after January 1, 2009, through December
117.731, 2009, the commissioner shall withhold three percent of managed care plan payments
117.8under this section and county-based purchasing plan payments under section 256B.692 for
117.9the prepaid medical assistance and general assistance medical care programs. The withheld
117.10funds must be returned no sooner than July 1 and no later than July 31 of the following
117.11year. The commissioner may exclude special demonstration projects under subdivision 23.
117.12    (2) A managed care plan or a county-based purchasing plan under section 256B.692
117.13
may include as admitted assets under section 62D.044 any amount withheld under
117.14this paragraph. The return of the withhold under this paragraph is not subject to the
117.15requirements of paragraph (c).
117.16(e) Effective for services rendered on or after January 1, 2010, through December
117.1731, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments
117.18under this section and county-based purchasing plan payments under section 256B.692
117.19for the prepaid medical assistance program. The withheld funds must be returned no
117.20sooner than July 1 and no later than July 31 of the following year. The commissioner may
117.21exclude special demonstration projects under subdivision 23.
117.22(f) Effective for services rendered on or after January 1, 2011, through December 31,
117.232011, the commissioner shall withhold four percent of managed care plan payments under
117.24this section and county-based purchasing plan payments under section 256B.692 for the
117.25prepaid medical assistance program. The withheld funds must be returned no sooner than
117.26July 1 and no later than July 31 of the following year. The commissioner may exclude
117.27special demonstration projects under subdivision 23.
117.28(g) Effective for services rendered on or after January 1, 2012, through December
117.2931, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
117.30under this section and county-based purchasing plan payments under section 256B.692
117.31for the prepaid medical assistance program. The withheld funds must be returned no
117.32sooner than July 1 and no later than July 31 of the following year. The commissioner may
117.33exclude special demonstration projects under subdivision 23.
117.34(h) Effective for services rendered on or after January 1, 2013, through December
117.3531, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
117.36under this section and county-based purchasing plan payments under section 256B.692
118.1for the prepaid medical assistance program. The withheld funds must be returned no
118.2sooner than July 1 and no later than July 31 of the following year. The commissioner may
118.3exclude special demonstration projects under subdivision 23.
118.4(i) Effective for services rendered on or after January 1, 2014, the commissioner
118.5shall withhold three percent of managed care plan payments under this section and
118.6county-based purchasing plan payments under section 256B.692 for the prepaid medical
118.7assistance and prepaid general assistance medical care programs. The withheld funds must
118.8be returned no sooner than July 1 and no later than July 31 of the following year. The
118.9commissioner may exclude special demonstration projects under subdivision 23.
118.10(j) A managed care plan or a county-based purchasing plan under section 256B.692
118.11may include as admitted assets under section 62D.044 any amount withheld under this
118.12section that is reasonably expected to be returned.

118.13    Sec. 47. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:
118.14    Subd. 5c. Medical education and research fund. (a) Except as provided in
118.15paragraph (c), the commissioner of human services shall transfer each year to the medical
118.16education and research fund established under section 62J.692, the following:
118.17(1) an amount equal to the reduction in the prepaid medical assistance and prepaid
118.18general assistance medical care payments as specified in this clause. Until January 1,
118.192002, the county medical assistance and general assistance medical care capitation base
118.20rate prior to plan specific adjustments and after the regional rate adjustments under section
118.21256B.69, subdivision 5b , is reduced 6.3 percent for Hennepin County, two percent for
118.22the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota
118.23counties; and after January 1, 2002, the county medical assistance and general assistance
118.24medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent
118.25for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent
118.26for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments
118.27and demonstration project payments operating under subdivision 23 are excluded from
118.28this reduction. The amount calculated under this clause shall not be adjusted for periods
118.29already paid due to subsequent changes to the capitation payments;
118.30(2) beginning July 1, 2003, $2,157,000 $4,314,000 from the capitation rates paid
118.31under this section plus any federal matching funds on this amount;
118.32(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
118.33paid under this section; and
118.34(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
118.35under this section.
119.1(b) This subdivision shall be effective upon approval of a federal waiver which
119.2allows federal financial participation in the medical education and research fund. Effective
119.3July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4),
119.4shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first
119.5reduce the amounts otherwise required to be transferred under paragraph (a), clauses
119.6(2) to (4). Any excess following this reduction shall proportionally reduce the transfers
119.7under paragraph (a), clause (1).
119.8(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance
119.9medical care payments under paragraph (a), clause (1), shall be transferred to the general
119.10fund.
119.11(d) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall
119.12transfer $21,714,000 each fiscal year to the medical education and research fund. The
119.13balance of the transfers under paragraph (a) shall be transferred to the medical education
119.14and research fund no earlier than July 1 of the following fiscal year.

119.15    Sec. 48. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:
119.16    Subd. 5f. Capitation rates. (a) Beginning July 1, 2002, the capitation rates paid
119.17under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the
119.18capitation rates paid under this section are increased by $4,700,000 per year.
119.19(b) Beginning July 1, 2009, the capitation rates paid under this section are increased
119.20each year by the lesser of $21,714,000 or an amount equal to the difference between the
119.21estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1),
119.22and the amount of the limit described in subdivision 5c, paragraph (b).

119.23    Sec. 49. Minnesota Statutes 2008, section 256B.69, subdivision 23, is amended to read:
119.24    Subd. 23. Alternative services; elderly and disabled persons. (a) The
119.25commissioner may implement demonstration projects to create alternative integrated
119.26delivery systems for acute and long-term care services to elderly persons and persons
119.27with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
119.28coordination, improve access to quality services, and mitigate future cost increases.
119.29The commissioner may seek federal authority to combine Medicare and Medicaid
119.30capitation payments for the purpose of such demonstrations and may contract with
119.31Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
119.32services shall be administered according to the terms and conditions of the federal contract
119.33and demonstration provisions. For the purpose of administering medical assistance funds,
119.34demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
120.1of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
120.2with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
120.3items B and C, which do not apply to persons enrolling in demonstrations under this
120.4section. An initial open enrollment period may be provided. Persons who disenroll from
120.5demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
120.6to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
120.7the health plan's participation is subsequently terminated for any reason, the person shall
120.8be provided an opportunity to select a new health plan and shall have the right to change
120.9health plans within the first 60 days of enrollment in the second health plan. Persons
120.10required to participate in health plans under this section who fail to make a choice of
120.11health plan shall not be randomly assigned to health plans under these demonstrations.
120.12Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
120.13subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
120.14the commissioner may contract with managed care organizations, including counties, to
120.15serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
120.16disabled persons only. For persons with a primary diagnosis of developmental disability,
120.17serious and persistent mental illness, or serious emotional disturbance, the commissioner
120.18must ensure that the county authority has approved the demonstration and contracting
120.19design. Enrollment in these projects for persons with disabilities shall be voluntary. The
120.20commissioner shall not implement any demonstration project under this subdivision for
120.21persons with a primary diagnosis of developmental disabilities, serious and persistent
120.22mental illness, or serious emotional disturbance, without approval of the county board of
120.23the county in which the demonstration is being implemented.
120.24    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
120.25to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
120.269525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
120.27under this section projects for persons with developmental disabilities. The commissioner
120.28may capitate payments for ICF/MR services, waivered services for developmental
120.29disabilities, including case management services, day training and habilitation and
120.30alternative active treatment services, and other services as approved by the state and by the
120.31federal government. Case management and active treatment must be individualized and
120.32developed in accordance with a person-centered plan. Costs under these projects may not
120.33exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
120.34and until four years after the pilot project implementation date, subcontractor participation
120.35in the long-term care developmental disability pilot is limited to a nonprofit long-term
120.36care system providing ICF/MR services, home and community-based waiver services,
121.1and in-home services to no more than 120 consumers with developmental disabilities in
121.2Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
121.3prior to expansion of the developmental disability pilot project. This paragraph expires
121.4four years after the implementation date of the pilot project.
121.5    (c) Before implementation of a demonstration project for disabled persons, the
121.6commissioner must provide information to appropriate committees of the house of
121.7representatives and senate and must involve representatives of affected disability groups
121.8in the design of the demonstration projects.
121.9    (d) A nursing facility reimbursed under the alternative reimbursement methodology
121.10in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
121.11provide services under paragraph (a). The commissioner shall amend the state plan and
121.12seek any federal waivers necessary to implement this paragraph.
121.13    (e) The commissioner, in consultation with the commissioners of commerce and
121.14health, may approve and implement programs for all-inclusive care for the elderly (PACE)
121.15according to federal laws and regulations governing that program and state laws or rules
121.16applicable to participating providers. The process for approval of these programs shall
121.17begin only after the commissioner receives grant money in an amount sufficient to cover
121.18the state share of the administrative and actuarial costs to implement the programs during
121.19state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
121.20account in the special revenue fund and are appropriated to the commissioner to be used
121.21solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
121.22not required to be licensed or certified as a health plan company as defined in section
121.2362Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county
121.24and found to be eligible for services under the elderly waiver or community alternatives
121.25for disabled individuals or who are already eligible for Medicaid but meet level of
121.26care criteria for receipt of waiver services may choose to enroll in the PACE program.
121.27Medicare and Medicaid services will be provided according to this subdivision and
121.28federal Medicare and Medicaid requirements governing PACE providers and programs.
121.29PACE enrollees will receive Medicaid home and community-based services through the
121.30PACE provider as an alternative to services for which they would otherwise be eligible
121.31through home and community-based waiver programs and Medicaid State Plan Services.
121.32The commissioner shall establish Medicaid rates for PACE providers that do not exceed
121.33costs that would have been incurred under fee-for-service or other relevant managed care
121.34programs operated by the state.
121.35    (f) The commissioner shall seek federal approval to expand the Minnesota disability
121.36health options (MnDHO) program established under this subdivision in stages, first to
122.1regional population centers outside the seven-county metro area and then to all areas of
122.2the state. Until July 1, 2009, expansion for MnDHO projects that include home and
122.3community-based services is limited to the two projects and service areas in effect on
122.4March 1, 2006. Enrollment in integrated MnDHO programs that include home and
122.5community-based services shall remain voluntary. Costs for home and community-based
122.6services included under MnDHO must not exceed costs that would have been incurred
122.7under the fee-for-service program. Notwithstanding whether expansion occurs under
122.8this paragraph, in determining MnDHO payment rates and risk adjustment methods for
122.9contract years starting in 2012, the commissioner must consider the methods used to
122.10determine county allocations for home and community-based program participants. If
122.11necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs
122.12for home and community-based services, the commissioner shall achieve the reduction by
122.13maintaining the base rate for contract years 2010 and 2011 for services provided under the
122.14community alternatives for disabled individuals waiver at the same level as for contract
122.15year 2009. The commissioner may apply other reductions to MnDHO rates to implement
122.16decreases in provider payment rates required by state law. In developing program
122.17specifications for expansion of integrated programs, the commissioner shall involve and
122.18consult the state-level stakeholder group established in subdivision 28, paragraph (d),
122.19including consultation on whether and how to include home and community-based waiver
122.20programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
122.21of the house of representatives and senate committees with jurisdiction over health and
122.22human services policy and finance by February 1, 2007.
122.23    (g) Notwithstanding section 256B.0261, health plans providing services under this
122.24section are responsible for home care targeted case management and relocation targeted
122.25case management. Services must be provided according to the terms of the waivers and
122.26contracts approved by the federal government.

122.27    Sec. 50. [256B.756] REIMBURSEMENT RATES FOR BIRTHS.
122.28    Subdivision 1. Facility rate. (a) Notwithstanding section 256.969, effective for
122.29services provided on or after October 1, 2009, the facility payment rate for the following
122.30diagnosis-related groups, as they fall within the diagnostic categories: (1) 371 cesarean
122.31section without complicating diagnosis; (2) 372 vaginal delivery with complicating
122.32diagnosis; and (3) 373 vaginal delivery without complicating diagnosis, shall be calculated
122.33as provided in paragraph (b).
122.34(b) The commissioner shall calculate a single rate for all of the diagnostic related
122.35groups specified in paragraph (a) consistent with an increase in the proportion of births
123.1by vaginal delivery and a reduction in the percentage of births by cesarean section. The
123.2calculated single rate must be based on an expected increase in the number of vaginal
123.3births and expected reduction in the number of cesarean section such that the reduction
123.4in cesarean sections is less than or equal to one standard deviation below the average in
123.5the frequency of cesarean births for Minnesota health care program clients at hospitals
123.6performing greater than 50 deliveries per year.
123.7(c) The rates described in this subdivision do not include newborn care.
123.8    Subd. 2. Provider rate. Notwithstanding section 256B.76, effective for services
123.9provided on or after October 1, 2009, the payment rate for professional services related
123.10to labor, delivery, and antepartum and postpartum care when provided for any of the
123.11diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using
123.12the methodology specified in subdivision 1, paragraph (b).
123.13    Subd. 3. Health plans. Payments to managed care and county-based purchasing
123.14plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services
123.15provided on or after October 1, 2009, to reflect the adjustments in subdivisions 1 and 2.
123.16    Subd. 4. Prior authorization. Prior authorization shall not be required before
123.17reimbursement is paid for a cesarean section delivery.

123.18    Sec. 51. Minnesota Statutes 2008, section 256B.76, subdivision 1, is amended to read:
123.19    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
123.20or after October 1, 1992, the commissioner shall make payments for physician services
123.21as follows:
123.22    (1) payment for level one Centers for Medicare and Medicaid Services' common
123.23procedural coding system codes titled "office and other outpatient services," "preventive
123.24medicine new and established patient," "delivery, antepartum, and postpartum care,"
123.25"critical care," cesarean delivery and pharmacologic management provided to psychiatric
123.26patients, and level three codes for enhanced services for prenatal high risk, shall be paid
123.27at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
123.2830, 1992. If the rate on any procedure code within these categories is different than the
123.29rate that would have been paid under the methodology in section 256B.74, subdivision 2,
123.30then the larger rate shall be paid;
123.31    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
123.32or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
123.33    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
123.34percentile of 1989, less the percent in aggregate necessary to equal the above increases
124.1except that payment rates for home health agency services shall be the rates in effect
124.2on September 30, 1992.
124.3    (b) Effective for services rendered on or after January 1, 2000, payment rates for
124.4physician and professional services shall be increased by three percent over the rates
124.5in effect on December 31, 1999, except for home health agency and family planning
124.6agency services. The increases in this paragraph shall be implemented January 1, 2000,
124.7for managed care.
124.8(c) Effective for services rendered on or after July 1, 2009, payment rates for
124.9physician and professional services shall be reduced by five percent over the rates in effect
124.10on June 30, 2009. This reduction does not apply to office or other outpatient services
124.11(procedure codes 99201 to 99215), preventive medicine services (procedure codes 99381
124.12to 99412) and family planning services billed by the following primary care specialties:
124.13general practice, internal medicine, pediatrics, geriatrics, family practice, or by an
124.14advanced practice registered nurse or physician assistant practicing in pediatrics, geriatrics,
124.15or family practice. This reduction does not apply to federally qualified health centers,
124.16rural health centers, and Indian health services. Effective October 1, 2009, payments
124.17made to managed care plans and county-based purchasing plans under sections 256B.69,
124.18256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.

124.19    Sec. 52. [256B.766] REIMBURSEMENT FOR BASIC CARE SERVICES.
124.20(a) Effective for services provided on or after July 1, 2009, total payments for basic
124.21care services, shall be reduced by three percent, prior to third-party liability and spenddown
124.22calculation. Payments made to managed care plans and county-based purchasing plans
124.23shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.
124.24(b) This section does not apply to physician and professional services, inpatient
124.25hospital services, family planning services, mental health services, dental services,
124.26prescription drugs, and medical transportation.

124.27    Sec. 53. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:
124.28    Subd. 4. General assistance medical care; services. (a)(i) For a person who is
124.29eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
124.30care covers, except as provided in paragraph (c):
124.31    (1) inpatient hospital services;
124.32    (2) outpatient hospital services;
124.33    (3) services provided by Medicare certified rehabilitation agencies;
125.1    (4) prescription drugs and other products recommended through the process
125.2established in section 256B.0625, subdivision 13;
125.3    (5) equipment necessary to administer insulin and diagnostic supplies and equipment
125.4for diabetics to monitor blood sugar level;
125.5    (6) eyeglasses and eye examinations provided by a physician or optometrist;
125.6    (7) hearing aids;
125.7    (8) prosthetic devices;
125.8    (9) laboratory and X-ray services;
125.9    (10) physician's services;
125.10    (11) medical transportation except special transportation;
125.11    (12) chiropractic services as covered under the medical assistance program;
125.12    (13) podiatric services;
125.13    (14) dental services as covered under the medical assistance program;
125.14    (15) mental health services covered under chapter 256B;
125.15    (16) prescribed medications for persons who have been diagnosed as mentally ill as
125.16necessary to prevent more restrictive institutionalization;
125.17    (17) medical supplies and equipment, and Medicare premiums, coinsurance and
125.18deductible payments;
125.19    (18) medical equipment not specifically listed in this paragraph when the use of
125.20the equipment will prevent the need for costlier services that are reimbursable under
125.21this subdivision;
125.22    (19) services performed by a certified pediatric nurse practitioner, a certified family
125.23nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
125.24nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
125.25practitioner in independent practice, if (1) the service is otherwise covered under this
125.26chapter as a physician service, (2) the service provided on an inpatient basis is not included
125.27as part of the cost for inpatient services included in the operating payment rate, and (3) the
125.28service is within the scope of practice of the nurse practitioner's license as a registered
125.29nurse, as defined in section 148.171;
125.30    (20) services of a certified public health nurse or a registered nurse practicing in
125.31a public health nursing clinic that is a department of, or that operates under the direct
125.32authority of, a unit of government, if the service is within the scope of practice of the
125.33public health nurse's license as a registered nurse, as defined in section 148.171;
125.34    (21) telemedicine consultations, to the extent they are covered under section
125.35256B.0625, subdivision 3b ;
126.1    (22) care coordination and patient education services provided by a community
126.2health worker according to section 256B.0625, subdivision 49; and
126.3    (23) regardless of the number of employees that an enrolled health care provider
126.4may have, sign language interpreter services when provided by an enrolled health care
126.5provider during the course of providing a direct, person-to-person covered health care
126.6service to an enrolled recipient who has a hearing loss and uses interpreting services.
126.7    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
126.8paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
126.9to inpatient hospital services, including physician services provided during the inpatient
126.10hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
126.11    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
126.12subdivision.
126.13    (c) In order to contain costs, the commissioner of human services shall select
126.14vendors of medical care who can provide the most economical care consistent with high
126.15medical standards and shall where possible contract with organizations on a prepaid
126.16capitation basis to provide these services. The commissioner shall consider proposals by
126.17counties and vendors for prepaid health plans, competitive bidding programs, block grants,
126.18or other vendor payment mechanisms designed to provide services in an economical
126.19manner or to control utilization, with safeguards to ensure that necessary services are
126.20provided. Before implementing prepaid programs in counties with a county operated or
126.21affiliated public teaching hospital or a hospital or clinic operated by the University of
126.22Minnesota, the commissioner shall consider the risks the prepaid program creates for the
126.23hospital and allow the county or hospital the opportunity to participate in the program in a
126.24manner that reflects the risk of adverse selection and the nature of the patients served by
126.25the hospital, provided the terms of participation in the program are competitive with the
126.26terms of other participants considering the nature of the population served. Payment for
126.27services provided pursuant to this subdivision shall be as provided to medical assistance
126.28vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
126.29payments made during fiscal year 1990 and later years, the commissioner shall consult
126.30with an independent actuary in establishing prepayment rates, but shall retain final control
126.31over the rate methodology.
126.32    (d) Effective January 1, 2008, drug coverage under general assistance medical
126.33care is limited to prescription drugs that:
126.34    (i) are covered under the medical assistance program as described in section
126.35256B.0625, subdivisions 13 and 13d; and
127.1    (ii) are provided by manufacturers that have fully executed general assistance
127.2medical care rebate agreements with the commissioner and comply with the agreements.
127.3Prescription drug coverage under general assistance medical care must conform to
127.4coverage under the medical assistance program according to section 256B.0625,
127.5subdivisions 13 to 13g.
127.6     (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
127.7co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
127.8    (1) $25 for eyeglasses;
127.9    (2) $25 for nonemergency visits to a hospital-based emergency room;
127.10    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
127.11subject to a $12 per month maximum for prescription drug co-payments. No co-payments
127.12shall apply to antipsychotic drugs when used for the treatment of mental illness; and
127.13    (4) 50 percent coinsurance on restorative dental services.
127.14    (f) Recipients eligible under subdivision 3, paragraph (a), shall include the following
127.15co-payments for services provided on or after January 1, 2009:
127.16    (1) $25 for nonemergency visits to a hospital-based emergency room; and
127.17    (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
127.18subject to a $7 per month maximum for prescription drug co-payments. No co-payments
127.19shall apply to antipsychotic drugs when used for the treatment of mental illness.
127.20    (g) MS 2007 Supp [Expired]
127.21    (h) Effective January 1, 2009, co-payments shall be limited to one per day per
127.22provider for nonemergency visits to a hospital-based emergency room. Recipients of
127.23general assistance medical care are responsible for all co-payments in this subdivision.
127.24The general assistance medical care reimbursement to the provider shall be reduced by the
127.25amount of the co-payment, except that reimbursement for prescription drugs shall not be
127.26reduced once a recipient has reached the $7 per month maximum for prescription drug
127.27co-payments. The provider collects the co-payment from the recipient. Providers may not
127.28deny services to recipients who are unable to pay the co-payment.
127.29    (i) General assistance medical care reimbursement to fee-for-service providers
127.30and payments to managed care plans shall not be increased as a result of the removal of
127.31the co-payments effective January 1, 2009.
127.32    (j) Any county may, from its own resources, provide medical payments for which
127.33state payments are not made.
127.34    (k) Chemical dependency services that are reimbursed under chapter 254B must not
127.35be reimbursed under general assistance medical care.
128.1    (l) The maximum payment for new vendors enrolled in the general assistance
128.2medical care program after the base year shall be determined from the average usual and
128.3customary charge of the same vendor type enrolled in the base year.
128.4    (m) The conditions of payment for services under this subdivision are the same
128.5as the conditions specified in rules adopted under chapter 256B governing the medical
128.6assistance program, unless otherwise provided by statute or rule.
128.7     (n) Inpatient and outpatient payments shall be reduced by five percent, effective July
128.81, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
128.9and incorporated by reference in paragraph (l).
128.10    (o) Payments for all other health services except inpatient, outpatient, and pharmacy
128.11services shall be reduced by five percent, effective July 1, 2003.
128.12    (p) Payments to managed care plans shall be reduced by five percent for services
128.13provided on or after October 1, 2003.
128.14    (q) A hospital receiving a reduced payment as a result of this section may apply the
128.15unpaid balance toward satisfaction of the hospital's bad debts.
128.16    (r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for
128.17services provided on or after January 1, 2006. For purposes of this subdivision, a visit
128.18means an episode of service which is required because of a recipient's symptoms,
128.19diagnosis, or established illness, and which is delivered in an ambulatory setting by
128.20a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
128.21audiologist, optician, or optometrist.
128.22    (s) Payments to managed care plans shall not be increased as a result of the removal
128.23of the $3 nonpreventive visit co-payment effective January 1, 2006.
128.24    (t) Payments for mental health services added as covered benefits after December
128.2531, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).
128.26(u) Effective for services provided on or after July 1, 2009, total payment rates for
128.27basic care services shall be reduced by three percent, in accordance with section 256B.766.
128.28Payments made to managed care plans shall be reduced for services provided on or after
128.29October 1, 2009, to reflect this reduction.
128.30(v) Effective for services provided on or after July 1, 2009, payment rates for
128.31physician and professional services shall be reduced as described under section 256B.76,
128.32subdivision 1, paragraph (c). Payments made to managed care plans shall be reduced for
128.33services provided on or after October 1, 2009, to reflect this reduction.

128.34    Sec. 54. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision
128.35to read:
129.1    Subd. 3b. Chiropractic services. MinnesotaCare covers the following chiropractic
129.2services: medically necessary exams, manual manipulation of the spine, and x-rays.
129.3EFFECTIVE DATE.This section is effective January 1, 2010.

129.4    Sec. 55. Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read:
129.5    Subdivision 1. Families with children. (a) Families with children with family
129.6income equal to or less than 275 percent of the federal poverty guidelines for the
129.7applicable family size shall be eligible for MinnesotaCare according to this section. All
129.8other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
129.9to enrollment under section 256L.07, shall apply unless otherwise specified.
129.10    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
129.11if the children are eligible. Children may be enrolled separately without enrollment by
129.12parents. However, if one parent in the household enrolls, both parents must enroll, unless
129.13other insurance is available. If one child from a family is enrolled, all children must
129.14be enrolled, unless other insurance is available. If one spouse in a household enrolls,
129.15the other spouse in the household must also enroll, unless other insurance is available.
129.16Families cannot choose to enroll only certain uninsured members.
129.17    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
129.18to the MinnesotaCare program. These persons are no longer counted in the parental
129.19household and may apply as a separate household.
129.20    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are
129.21not eligible for MinnesotaCare if their gross income exceeds $57,500.
129.22    (e) Children formerly enrolled in medical assistance and automatically deemed
129.23eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
129.24from the requirements of this section until renewal.
129.25(f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
129.268, are exempt from the eligibility requirements of this subdivision.

129.27    Sec. 56. Minnesota Statutes 2008, section 256L.04, is amended by adding a subdivision
129.28to read:
129.29    Subd. 1b. Children with family income greater than 275 percent of federal
129.30poverty guidelines. Children with family income greater than 275 percent of federal
129.31poverty guidelines for the applicable family size shall be eligible for MinnesotaCare. All
129.32other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
129.33to enrollment under section 256L.07, shall apply unless otherwise specified.
130.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
130.2approval, whichever is later.

130.3    Sec. 57. Minnesota Statutes 2008, section 256L.04, subdivision 7a, is amended to read:
130.4    Subd. 7a. Ineligibility. Applicants Adults whose income is greater than the limits
130.5established under this section may not enroll in the MinnesotaCare program.
130.6EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
130.7approval, whichever is later.

130.8    Sec. 58. Minnesota Statutes 2008, section 256L.04, subdivision 10a, is amended to
130.9read:
130.10    Subd. 10a. Sponsor's income and resources deemed available; documentation.
130.11When determining eligibility for any federal or state benefits under sections 256L.01 to
130.12256L.18 , the income and resources of all noncitizens whose sponsor signed an affidavit of
130.13support as defined under United States Code, title 8, section 1183a, shall be deemed to
130.14include their sponsors' income and resources as defined in the Personal Responsibility
130.15and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections
130.16421 and 422, and subsequently set out in federal rules. To be eligible for the program,
130.17noncitizens must provide documentation of their immigration status. Beginning July
130.181, 2010, or upon federal approval, whichever is later, sponsor deeming does not apply
130.19to pregnant women and children who are qualified noncitizens, as described in section
130.20256B.06, subdivision 4, paragraph (b).
130.21EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
130.22approval, whichever is later. The commissioner shall notify the revisor of statutes when
130.23federal approval has been obtained.

130.24    Sec. 59. Minnesota Statutes 2008, section 256L.05, subdivision 1, is amended to read:
130.25    Subdivision 1. Application assistance and information availability. (a)
130.26Applications and application assistance must be made available at provider offices, local
130.27human services agencies, school districts, public and private elementary schools in which
130.2825 percent or more of the students receive free or reduced price lunches, community health
130.29offices, Women, Infants and Children (WIC) program sites, Head Start program sites,
130.30public housing councils, crisis nurseries, child care centers, early childhood education
130.31and preschool program sites, legal aid offices, and libraries. These sites may accept
130.32applications and forward the forms to the commissioner or local county human services
131.1agencies that choose to participate as an enrollment site. Otherwise, applicants may apply
131.2directly to the commissioner or to participating local county human services agencies.
131.3(b) Application assistance must be available for applicants choosing to file an
131.4online application.

131.5    Sec. 60. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision
131.6to read:
131.7    Subd. 1c. Open enrollment and streamlined application and enrollment
131.8process. (a) The commissioner and local agencies working in partnership must develop a
131.9streamlined and efficient application and enrollment process for medical assistance and
131.10MinnesotaCare enrollees that meets the criteria specified in this subdivision.
131.11(b) The commissioners of human services and education shall provide
131.12recommendations to the legislature by January 15, 2010, on the creation of an open
131.13enrollment process for medical assistance and MinnesotaCare that is coordinated with
131.14the public education system. The recommendations must:
131.15(1) be developed in consultation with medical assistance and MinnesotaCare
131.16enrollees and representatives from organizations that advocate on behalf of children and
131.17families, low-income persons and minority populations, counties, school administrators
131.18and nurses, health plans, and health care providers;
131.19 (2) be based on enrollment and renewal procedures best practices, including express
131.20lane eligibility as required under subdivision 1d;
131.21(3) simplify the enrollment and renewal processes wherever possible; and
131.22(4) establish a process:
131.23(i) to disseminate information on medical assistance and MinnesotaCare to all
131.24children in the public education system, including prekindergarten programs; and
131.25(ii) for the commissioner of human services to enroll children and other household
131.26members who are eligible.
131.27The commissioner of human services in coordination with the commissioner of
131.28education shall implement an open enrollment process by August 1, 2010, to be effective
131.29beginning with the 2010-2011 school year.
131.30(c) The commissioner and local agencies shall develop an online application process
131.31for medical assistance and MinnesotaCare.
131.32(d) The commissioner shall develop an application that is easily understandable
131.33and does not exceed four pages in length.
132.1(e) The commissioner of human services shall present to the legislature, by January
132.215, 2010, an implementation plan for the open enrollment period and online application
132.3process.
132.4EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
132.5approval, which must be requested by the commissioner, whichever is later.

132.6    Sec. 61. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
132.7    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
132.8first day of the month following the month in which eligibility is approved and the first
132.9premium payment has been received. As provided in section 256B.057, coverage for
132.10newborns is automatic from the date of birth and must be coordinated with other health
132.11coverage. The effective date of coverage for eligible newly adoptive children added to a
132.12family receiving covered health services is the month of placement. The effective date
132.13of coverage for other new members added to the family is the first day of the month
132.14following the month in which the change is reported. All eligibility criteria must be met
132.15by the family at the time the new family member is added. The income of the new family
132.16member is included with the family's gross income and the adjusted premium begins in
132.17the month the new family member is added.
132.18(b) The initial premium must be received by the last working day of the month for
132.19coverage to begin the first day of the following month.
132.20(c) Benefits are not available until the day following discharge if an enrollee is
132.21hospitalized on the first day of coverage.
132.22(d) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to
132.23256L.18 are secondary to a plan of insurance or benefit program under which an eligible
132.24person may have coverage and the commissioner shall use cost avoidance techniques to
132.25ensure coordination of any other health coverage for eligible persons. The commissioner
132.26shall identify eligible persons who may have coverage or benefits under other plans of
132.27insurance or who become eligible for medical assistance.
132.28(e) The effective date of coverage for single adults and households with no children
132.29formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
132.30according to section 256D.03, subdivision 3, is the first day of the month following the
132.31last day of general assistance medical care coverage.
132.32(f) The effective date of coverage for children eligible under section 256L.07,
132.33subdivision 8, is the first day of the month following the date of termination from foster
132.34care or release from a juvenile residential correctional facility.
133.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
133.2approval, whichever is later.

133.3    Sec. 62. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:
133.4    Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility
133.5must be renewed every 12 months. The 12-month period begins in the month after the
133.6month the application is approved.
133.7    (b) Each new period of eligibility must take into account any changes in
133.8circumstances that impact eligibility and premium amount. An enrollee must provide all
133.9the information needed to redetermine eligibility by the first day of the month that ends
133.10the eligibility period. If there is no change in circumstances, the enrollee may renew
133.11eligibility at designated locations that include community clinics and health care providers'
133.12offices. The designated sites shall forward the renewal forms to the commissioner. The
133.13commissioner may establish criteria and timelines for sites to forward applications to the
133.14commissioner or county agencies. The premium for the new period of eligibility must be
133.15received as provided in section 256L.06 in order for eligibility to continue.
133.16    (c) For single adults and households with no children formerly enrolled in general
133.17assistance medical care and enrolled in MinnesotaCare according to section 256D.03,
133.18subdivision 3
, the first period of eligibility begins the month the enrollee submitted the
133.19application or renewal for general assistance medical care.
133.20    (d) An enrollee Notwithstanding paragraph (e), an enrollee who fails to submit
133.21renewal forms and related documentation necessary for verification of continued eligibility
133.22in a timely manner shall remain eligible for one additional month beyond the end of the
133.23current eligibility period before being disenrolled. The enrollee remains responsible for
133.24MinnesotaCare premiums for the additional month.
133.25(e) Children in families with family income equal to or below 275 percent of federal
133.26poverty guidelines who fail to submit renewal forms and related documentation necessary
133.27for verification of continued eligibility in a timely manner shall remain eligible for the
133.28program. The commissioner shall use the means described in subdivision 2 or any other
133.29means available to verify family income. If the commissioner determines that there has
133.30been a change in income in which premium payment is required to remain enrolled, the
133.31commissioner shall notify the family of the premium payment, and that the children
133.32will be disenrolled if the premium payment is not received effective the first day of the
133.33calendar month following the calendar month for which the premium is due.
133.34(f) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, the
133.35first period of renewal begins the month the enrollee turns 21 years of age.
134.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
134.2approval, whichever is later.

134.3    Sec. 63. Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:
134.4    Subdivision 1. General requirements. (a) Children enrolled in the original
134.5children's health plan as of September 30, 1992, children who enrolled in the
134.6MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
134.7article 4, section 17, and children who have family gross incomes that are equal to or
134.8less than 150 200 percent of the federal poverty guidelines are eligible without meeting
134.9the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
134.10long as they maintain continuous coverage in the MinnesotaCare program or medical
134.11assistance. Children who apply for MinnesotaCare on or after the implementation date
134.12of the employer-subsidized health coverage program as described in Laws 1998, chapter
134.13407, article 5, section 45, who have family gross incomes that are equal to or less than 150
134.14percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
134.15be eligible for MinnesotaCare.
134.16    Families Parents enrolled in MinnesotaCare under section 256L.04, subdivision 1,
134.17whose income increases above 275 percent of the federal poverty guidelines, are no longer
134.18eligible for the program and shall be disenrolled by the commissioner. Beginning January
134.191, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision
134.207
, whose income increases above 200 percent of the federal poverty guidelines or 250
134.21percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
134.22the program and shall be disenrolled by the commissioner. For persons disenrolled under
134.23this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
134.24following the month in which the commissioner determines that the income of a family or
134.25individual exceeds program income limits.
134.26    (b) Notwithstanding paragraph (a), Children may remain enrolled in MinnesotaCare
134.27if ten percent of their gross individual or gross family income as defined in section
134.28256L.01, subdivision 4 , is less than the annual premium for a policy with a $500
134.29deductible available through the Minnesota Comprehensive Health Association. Children
134.30who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month
134.31notice period from the date that ineligibility is determined before disenrollment greater
134.32than 275 percent of federal poverty guidelines. The premium for children remaining
134.33eligible under this clause paragraph shall be the maximum premium determined under
134.34section 256L.15, subdivision 2, paragraph (b).
135.1    (c) Notwithstanding paragraphs paragraph (a) and (b), parents are not eligible for
135.2MinnesotaCare if gross household income exceeds $57,500 for the 12-month period
135.3of eligibility.
135.4EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
135.5approval, whichever is later.

135.6    Sec. 64. Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read:
135.7    Subd. 2. Must not have access to employer-subsidized coverage. (a) To be
135.8eligible, a family or individual must not have access to subsidized health coverage through
135.9an employer and must not have had access to employer-subsidized coverage through
135.10a current employer for 18 months prior to application or reapplication. A family or
135.11individual whose employer-subsidized coverage is lost due to an employer terminating
135.12health care coverage as an employee benefit during the previous 18 months is not eligible.
135.13(b) This subdivision does not apply to a family or individual who was enrolled
135.14in MinnesotaCare within six months or less of reapplication and who no longer has
135.15employer-subsidized coverage due to the employer terminating health care coverage as an
135.16employee benefit. This subdivision does not apply to children with family gross incomes
135.17that are equal to or less than 200 percent of federal poverty guidelines.
135.18(c) For purposes of this requirement, subsidized health coverage means health
135.19coverage for which the employer pays at least 50 percent of the cost of coverage for
135.20the employee or dependent, or a higher percentage as specified by the commissioner.
135.21Children are eligible for employer-subsidized coverage through either parent, including
135.22the noncustodial parent. The commissioner must treat employer contributions to Internal
135.23Revenue Code Section 125 plans and any other employer benefits intended to pay
135.24health care costs as qualified employer subsidies toward the cost of health coverage for
135.25employees for purposes of this subdivision.
135.26EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
135.27approval, whichever is later.

135.28    Sec. 65. Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read:
135.29    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
135.30MinnesotaCare program must have no health coverage while enrolled or for at least four
135.31months prior to application and renewal. Children with family gross incomes equal to or
135.32greater than 200 percent of federal poverty guidelines, and adults, must have had no health
135.33coverage for at least four months prior to application and renewal. Children enrolled in the
135.34original children's health plan and children in families with income equal to or less than
136.1150 200 percent of the federal poverty guidelines, who have other health insurance, are
136.2eligible if the coverage:
136.3(1) lacks two or more of the following:
136.4(i) basic hospital insurance;
136.5(ii) medical-surgical insurance;
136.6(iii) prescription drug coverage;
136.7(iv) dental coverage; or
136.8(v) vision coverage;
136.9(2) requires a deductible of $100 or more per person per year; or
136.10(3) lacks coverage because the child has exceeded the maximum coverage for a
136.11particular diagnosis or the policy excludes a particular diagnosis.
136.12The commissioner may change this eligibility criterion for sliding scale premiums
136.13in order to remain within the limits of available appropriations. The requirement of no
136.14health coverage does not apply to newborns.
136.15(b) Medical assistance, general assistance medical care, and the Civilian Health and
136.16Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under
136.17United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or
136.18health coverage for purposes of the four-month requirement described in this subdivision.
136.19(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
136.20Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
136.21Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
136.22have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
136.23Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
136.24for MinnesotaCare.
136.25(d) Applicants who were recipients of medical assistance or general assistance
136.26medical care within one month of application must meet the provisions of this subdivision
136.27and subdivision 2.
136.28(e) Cost-effective health insurance that was paid for by medical assistance is not
136.29considered health coverage for purposes of the four-month requirement under this
136.30section, except if the insurance continued after medical assistance no longer considered it
136.31cost-effective or after medical assistance closed.
136.32EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
136.33approval, whichever is later.

136.34    Sec. 66. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
136.35to read:
137.1    Subd. 8. Automatic eligibility for certain children. Any child who was residing
137.2in foster care or a juvenile residential correctional facility on the child's 18th birthday is
137.3automatically deemed eligible for MinnesotaCare upon termination or release until the
137.4child reaches the age of 21, and is exempt from the requirements of this section and
137.5section 256L.15. To be enrolled under this section, a child must complete an initial
137.6application for MinnesotaCare. The commissioner shall contact individuals enrolled
137.7under this section annually to ensure the individual continues to reside in the state and is
137.8interested in continuing MinnesotaCare coverage.
137.9EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
137.10approval, whichever is later.

137.11    Sec. 67. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:
137.12    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers under
137.13sections 256L.01 to 256L.11 shall be at the same rates and conditions established for
137.14medical assistance, except as provided in subdivisions 2 to 6.
137.15(b) Effective for services provided on or after July 1, 2009, total payments for basic
137.16care services shall be reduced by three percent, in accordance with section 256B.766.
137.17Payments made to managed care plans shall be reduced for services provided on or after
137.18October 1, 2009, to reflect this reduction.

137.19    Sec. 68. Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:
137.20    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
137.21commissioner shall establish a sliding fee scale to determine the percentage of monthly
137.22gross individual or family income that households at different income levels must pay to
137.23obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
137.24on the enrollee's monthly gross individual or family income. The sliding fee scale must
137.25contain separate tables based on enrollment of one, two, or three or more persons. Until
137.26June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
137.27individual or family income for individuals or families with incomes below the limits for
137.28the medical assistance program for families and children in effect on January 1, 1999, and
137.29proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
137.308.8 percent. These percentages are matched to evenly spaced income steps ranging from
137.31the medical assistance income limit for families and children in effect on January 1, 1999,
137.32to 275 percent of the federal poverty guidelines for the applicable family size, up to a
137.33family size of five. The sliding fee scale for a family of five must be used for families of
137.34more than five. The sliding fee scale and percentages are not subject to the provisions of
138.1chapter 14. If a family or individual reports increased income after enrollment, premiums
138.2shall be adjusted at the time the change in income is reported.
138.3    (b) Children in families whose gross income is above 275 percent of the federal
138.4poverty guidelines shall pay the maximum premium. The maximum premium is defined
138.5as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
138.6cases paid the maximum premium, the total revenue would equal the total cost of
138.7MinnesotaCare medical coverage and administration. In this calculation, administrative
138.8costs shall be assumed to equal ten percent of the total. The costs of medical coverage
138.9for pregnant women and children under age two and the enrollees in these groups shall
138.10be excluded from the total. The maximum premium for two enrollees shall be twice the
138.11maximum premium for one, and the maximum premium for three or more enrollees shall
138.12be three times the maximum premium for one.
138.13    (c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according
138.14to the premium scale specified in paragraph (d) with the exception that children in families
138.15with income at or below 150 200 percent of the federal poverty guidelines shall pay
138.16a monthly premium of $4 no premiums. For purposes of paragraph (d), "minimum"
138.17means a monthly premium of $4.
138.18    (d) The following premium scale is established for individuals and families with
138.19gross family incomes of 300 percent of the federal poverty guidelines or less:
138.20
138.21
Federal Poverty Guideline Range
Percent of Average Gross Monthly
Income
138.22
0-45%
minimum
138.23
46-54%
1.1%
138.24
55-81%
1.6%
138.25
82-109%
2.2%
138.26
110-136%
2.9%
138.27
137-164%
3.6%
138.28
165-191%
4.6%
138.29
192-219%
5.6%
138.30
220-248%
6.5%
138.31
249-274%
7.2%
138.32
275-300%
8.0%
139.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
139.2approval, whichever is later.

139.3    Sec. 69. Minnesota Statutes 2008, section 256L.15, subdivision 3, is amended to read:
139.4    Subd. 3. Exceptions to sliding scale. Children in families with income at or below
139.5150 200 percent of the federal poverty guidelines shall pay a no monthly premium of
139.6$4 premiums.
139.7EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
139.8approval, whichever is later.

139.9    Sec. 70. Minnesota Statutes 2008, section 256L.17, subdivision 3, is amended to read:
139.10    Subd. 3. Documentation. (a) The commissioner of human services shall require
139.11individuals and families, at the time of application or renewal, to indicate on a checkoff
139.12form developed by the commissioner whether they satisfy the MinnesotaCare asset
139.13requirement.
139.14    (b) The commissioner may require individuals and families to provide any
139.15information the commissioner determines necessary to verify compliance with the asset
139.16requirement, if the commissioner determines that there is reason to believe that an
139.17individual or family has assets that exceed the program limit.

139.18    Sec. 71. Minnesota Statutes 2008, section 256L.17, subdivision 5, is amended to read:
139.19    Subd. 5. Exemption. This section does not apply to pregnant women or children.
139.20For purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.

139.21    Sec. 72. Minnesota Statutes 2008, section 501B.89, is amended by adding a
139.22subdivision to read:
139.23    Subd. 4. Annual filing requirement for supplemental needs trusts. (a) A trustee
139.24of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or
139.25(C), shall submit to the commissioner of human services, at the time of a beneficiary's
139.26request for medical assistance, the following information about the trust:
139.27(1) a copy of the trust instrument; and
139.28(2) an inventory of the beneficiary's trust account assets and the value of those assets.
139.29(b) A trustee of a trust under subdivision 3 and United States Code, title 42, section
139.301396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the
139.31commissioner of human services at least annually until the trust, or the beneficiary's
139.32interest in the trust, terminates. Accountings are due on the anniversary of the execution
140.1date of the trust unless another annual date is established by the terms of the trust. The
140.2accounting must include the following information for the accounting period:
140.3(1) an inventory of trust assets and the value of those assets at the beginning of the
140.4accounting period;
140.5(2) additions to the trust during the accounting period and the source of those
140.6additions;
140.7(3) itemized distributions from the trust during the accounting period, including the
140.8purpose of the distributions and to whom the distributions were made;
140.9(4) an inventory of trust assets and the value of those assets at the end of the
140.10accounting period; and
140.11(5) changes to the trust instrument during the accounting period.
140.12(c) For the purpose of paragraph (b), an accounting period is 12 months unless an
140.13accounting period of a different length is permitted by the commissioner.
140.14EFFECTIVE DATE.This section is effective for applications for medical
140.15assistance and renewals of medical assistance submitted on or after July 1, 2009.

140.16    Sec. 73. Minnesota Statutes 2008, section 519.05, is amended to read:
140.17519.05 LIABILITY OF HUSBAND AND WIFE.
140.18(a) A spouse is not liable to a creditor for any debts of the other spouse. Where
140.19husband and wife are living together, they shall be jointly and severally liable for
140.20necessary medical services that have been furnished to either spouse, including any claims
140.21arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household
140.22articles and supplies furnished to and used by the family. Notwithstanding this paragraph,
140.23in a proceeding under chapter 518 the court may apportion such debt between the spouses.
140.24(b) Either spouse may close a credit card account or other unsecured consumer line
140.25of credit on which both spouses are contractually liable, by giving written notice to the
140.26creditor.

140.27    Sec. 74. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision
140.281, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:
140.29
Subdivision 1.Total Appropriation
$
3,848,049,000
$
4,135,780,000
140.30
Summary by Fund
140.31
General
3,301,811,000
3,561,055,000
141.1
141.2
State Government
Special Revenue
534,000
534,000
141.3
Health Care Access
273,723,000
302,272,000
141.4
Federal TANF
270,425,000
270,363,000
141.5
Lottery Cash Flow
1,556,000
1,556,000
141.6Federal Contingency Appropriation. (a)
141.7Federal Medicaid funds made available
141.8under title IV of the federal Jobs and Growth
141.9Tax Relief Reconciliation Act of 2003
141.10are appropriated to the commissioner of
141.11human services for use in the state's medical
141.12assistance and MinnesotaCare programs.
141.13The commissioners of human services and
141.14finance shall report to the legislative advisory
141.15committee on the additional federal Medicaid
141.16matching funds that will be available to the
141.17state.
141.18(b) Because of the availability of these funds,
141.19the following policies shall become effective:
141.20(1) medical assistance and MinnesotaCare
141.21eligibility and local financial participation
141.22changes provided for in this act may be
141.23implemented prior to September 2, 2003, or
141.24may be delayed as necessary to maximize
141.25the use of federal funds received under
141.26title IV of the Jobs and Growth Tax Relief
141.27Reconciliation Act of 2003;
141.28(2) the aggregate cap on the services
141.29identified in Minnesota Statutes, section
141.30256L.035 , paragraph (a), clause (3), shall
141.31be increased from $2,000 to $5,000. This
141.32increase shall expire at the end of fiscal year
141.332007. Funds may be transferred from the
142.1general fund to the health care access fund as
142.2necessary to implement this provision; and
142.3(3) the following payment shifts shall not be
142.4implemented:
142.5(i) MFIP payment shift found in subdivision
142.611;
142.7(ii) the county payment shift found in
142.8subdivision 1; and
142.9(iii) the delay in medical assistance
142.10and general assistance medical care
142.11fee-for-service payments found in
142.12subdivision 6.
142.13(c) Notwithstanding section 14, paragraphs
142.14(a) and (b) shall expire June 30, 2007.
142.15Receipts for Systems Projects.
142.16Appropriations and federal receipts for
142.17information system projects for MAXIS,
142.18PRISM, MMIS, and SSIS must be deposited
142.19in the state system account authorized in
142.20Minnesota Statutes, section 256.014. Money
142.21appropriated for computer projects approved
142.22by the Minnesota office of technology,
142.23funded by the legislature, and approved
142.24by the commissioner of finance may be
142.25transferred from one project to another
142.26and from development to operations as the
142.27commissioner of human services considers
142.28necessary. Any unexpended balance in
142.29the appropriation for these projects does
142.30not cancel but is available for ongoing
142.31development and operations.
142.32Gifts. Notwithstanding Minnesota Statutes,
142.33chapter 7, the commissioner may accept
142.34on behalf of the state additional funding
143.1from sources other than state funds for the
143.2purpose of financing the cost of assistance
143.3program grants or nongrant administration.
143.4All additional funding is appropriated to the
143.5commissioner for use as designated by the
143.6grantor of funding.
143.7Systems Continuity. In the event of
143.8disruption of technical systems or computer
143.9operations, the commissioner may use
143.10available grant appropriations to ensure
143.11continuity of payments for maintaining the
143.12health, safety, and well-being of clients
143.13served by programs administered by the
143.14department of human services. Grant funds
143.15must be used in a manner consistent with the
143.16original intent of the appropriation.
143.17Nonfederal Share Transfers. The
143.18nonfederal share of activities for which
143.19federal administrative reimbursement is
143.20appropriated to the commissioner may be
143.21transferred to the special revenue fund.
143.22TANF Funds Appropriated to Other
143.23Entities. Any expenditures from the TANF
143.24block grant shall be expended in accordance
143.25with the requirements and limitations of part
143.26A of title IV of the Social Security Act, as
143.27amended, and any other applicable federal
143.28requirement or limitation. Prior to any
143.29expenditure of these funds, the commissioner
143.30shall assure that funds are expended in
143.31compliance with the requirements and
143.32limitations of federal law and that any
143.33reporting requirements of federal law are
143.34met. It shall be the responsibility of any entity
143.35to which these funds are appropriated to
144.1implement a memorandum of understanding
144.2with the commissioner that provides the
144.3necessary assurance of compliance prior to
144.4any expenditure of funds. The commissioner
144.5shall receipt TANF funds appropriated
144.6to other state agencies and coordinate all
144.7related interagency accounting transactions
144.8necessary to implement these appropriations.
144.9Unexpended TANF funds appropriated to
144.10any state, local, or nonprofit entity cancel
144.11at the end of the state fiscal year unless
144.12appropriating language permits otherwise.
144.13TANF Funds Transferred to Other Federal
144.14Grants. The commissioner must authorize
144.15transfers from TANF to other federal block
144.16grants so that funds are available to meet the
144.17annual expenditure needs as appropriated.
144.18Transfers may be authorized prior to the
144.19expenditure year with the agreement of the
144.20receiving entity. Transferred funds must be
144.21expended in the year for which the funds
144.22were appropriated unless appropriation
144.23language permits otherwise. In accelerating
144.24transfer authorizations, the commissioner
144.25must aim to preserve the future potential
144.26transfer capacity from TANF to other block
144.27grants.
144.28TANF Maintenance of Effort. (a) In
144.29order to meet the basic maintenance of
144.30effort (MOE) requirements of the TANF
144.31block grant specified under Code of Federal
144.32Regulations, title 45, section 263.1, the
144.33commissioner may only report nonfederal
144.34money expended for allowable activities
144.35listed in the following clauses as TANF/MOE
144.36expenditures:
145.1(1) MFIP cash, diversionary work program,
145.2and food assistance benefits under Minnesota
145.3Statutes, chapter 256J;
145.4(2) the child care assistance programs
145.5under Minnesota Statutes, sections 119B.03
145.6and 119B.05, and county child care
145.7administrative costs under Minnesota
145.8Statutes, section 119B.15;
145.9(3) state and county MFIP administrative
145.10costs under Minnesota Statutes, chapters
145.11256J and 256K;
145.12(4) state, county, and tribal MFIP
145.13employment services under Minnesota
145.14Statutes, chapters 256J and 256K;
145.15(5) expenditures made on behalf of
145.16noncitizen MFIP recipients who qualify
145.17for the medical assistance without federal
145.18financial participation program under
145.19Minnesota Statutes, section 256B.06,
145.20subdivision 4
, paragraphs (d), (e), and (j);
145.21and
145.22(6) qualifying working family credit
145.23expenditures under Minnesota Statutes,
145.24section 290.0671.
145.25(b) The commissioner shall ensure that
145.26sufficient qualified nonfederal expenditures
145.27are made each year to meet the state's
145.28TANF/MOE requirements. For the activities
145.29listed in paragraph (a), clauses (2) to
145.30(6), the commissioner may only report
145.31expenditures that are excluded from the
145.32definition of assistance under Code of
145.33Federal Regulations, title 45, section 260.31.
146.1(c) By August 31 of each year, the
146.2commissioner shall make a preliminary
146.3calculation to determine the likelihood
146.4that the state will meet its annual federal
146.5work participation requirement under Code
146.6of Federal Regulations, title 45, sections
146.7261.21 and 261.23, after adjustment for any
146.8caseload reduction credit under Code of
146.9Federal Regulations, title 45, section 261.41.
146.10If the commissioner determines that the
146.11state will meet its federal work participation
146.12rate for the federal fiscal year ending that
146.13September, the commissioner may reduce the
146.14expenditure under paragraph (a), clause (1),
146.15to the extent allowed under Code of Federal
146.16Regulations, title 45, section 263.1(a)(2).
146.17(d) For fiscal years beginning with state
146.18fiscal year 2003, the commissioner shall
146.19assure that the maintenance of effort used
146.20by the commissioner of finance for the
146.21February and November forecasts required
146.22under Minnesota Statutes, section 16A.103,
146.23contains expenditures under paragraph (a),
146.24clause (1), equal to at least 25 percent of
146.25the total required under Code of Federal
146.26Regulations, title 45, section 263.1.
146.27(e) If nonfederal expenditures for the
146.28programs and purposes listed in paragraph
146.29(a) are insufficient to meet the state's
146.30TANF/MOE requirements, the commissioner
146.31shall recommend additional allowable
146.32sources of nonfederal expenditures to the
146.33legislature, if the legislature is or will be in
146.34session to take action to specify additional
146.35sources of nonfederal expenditures for
146.36TANF/MOE before a federal penalty is
147.1imposed. The commissioner shall otherwise
147.2provide notice to the legislative commission
147.3on planning and fiscal policy under paragraph
147.4(g).
147.5(f) If the commissioner uses authority
147.6granted under section 11, or similar authority
147.7granted by a subsequent legislature, to
147.8meet the state's TANF/MOE requirement
147.9in a reporting period, the commissioner
147.10shall inform the chairs of the appropriate
147.11legislative committees about all transfers
147.12made under that authority for this purpose.
147.13(g) If the commissioner determines that
147.14nonfederal expenditures under paragraph
147.15(a) are insufficient to meet TANF/MOE
147.16expenditure requirements, and if the
147.17legislature is not or will not be in
147.18session to take timely action to avoid a
147.19federal penalty, the commissioner may
147.20report nonfederal expenditures from
147.21other allowable sources as TANF/MOE
147.22expenditures after the requirements of this
147.23paragraph are met. The commissioner
147.24may report nonfederal expenditures
147.25in addition to those specified under
147.26paragraph (a) as nonfederal TANF/MOE
147.27expenditures, but only ten days after the
147.28commissioner of finance has first submitted
147.29the commissioner's recommendations for
147.30additional allowable sources of nonfederal
147.31TANF/MOE expenditures to the members of
147.32the legislative commission on planning and
147.33fiscal policy for their review.
147.34(h) The commissioner of finance shall not
147.35incorporate any changes in federal TANF
148.1expenditures or nonfederal expenditures for
148.2TANF/MOE that may result from reporting
148.3additional allowable sources of nonfederal
148.4TANF/MOE expenditures under the interim
148.5procedures in paragraph (g) into the February
148.6or November forecasts required under
148.7Minnesota Statutes, section 16A.103, unless
148.8the commissioner of finance has approved
148.9the additional sources of expenditures under
148.10paragraph (g).
148.11(i) Minnesota Statutes, section 256.011,
148.12subdivision 3
, which requires that federal
148.13grants or aids secured or obtained under that
148.14subdivision be used to reduce any direct
148.15appropriations provided by law, do not apply
148.16if the grants or aids are federal TANF funds.
148.17(j) Notwithstanding section 14, paragraph
148.18(a), clauses (1) to (6), and paragraphs (b) to
148.19(j) expire June 30, 2007.
148.20Working Family Credit Expenditures as
148.21TANF MOE. The commissioner may claim
148.22as TANF maintenance of effort up to the
148.23following amounts of working family credit
148.24expenditures for the following fiscal years:
148.25(1) fiscal year 2004, $7,013,000;
148.26(2) fiscal year 2005, $25,133,000;
148.27(3) fiscal year 2006, $6,942,000; and
148.28(4) fiscal year 2007, $6,707,000.
148.29Fiscal Year 2003 Appropriations
148.30Carryforward. Effective the day following
148.31final enactment, notwithstanding Minnesota
148.32Statutes, section 16A.28, or any other law to
148.33the contrary, state agencies and constitutional
148.34offices may carry forward unexpended
149.1and unencumbered nongrant operating
149.2balances from fiscal year 2003 general fund
149.3appropriations into fiscal year 2004 to offset
149.4general budget reductions.
149.5Transfer of Grant Balances. Effective
149.6the day following final enactment, the
149.7commissioner of human services, with
149.8the approval of the commissioner of
149.9finance and after notification of the chair
149.10of the senate health, human services and
149.11corrections budget division and the chair
149.12of the house of representatives health
149.13and human services finance committee,
149.14may transfer unencumbered appropriation
149.15balances for the biennium ending June 30,
149.162003, in fiscal year 2003 among the MFIP,
149.17MFIP child care assistance under Minnesota
149.18Statutes, section 119B.05, general assistance,
149.19general assistance medical care, medical
149.20assistance, Minnesota supplemental aid,
149.21and group residential housing programs,
149.22and the entitlement portion of the chemical
149.23dependency consolidated treatment fund, and
149.24between fiscal years of the biennium.
149.25TANF Appropriation Cancellation.
149.26Notwithstanding the provisions of Laws
149.272000, chapter 488, article 1, section 16,
149.28any prior appropriations of TANF funds
149.29to the department of trade and economic
149.30development or to the job skills partnership
149.31board or any transfers of TANF funds from
149.32another agency to the department of trade
149.33and economic development or to the job
149.34skills partnership board are not available
149.35until expended, and if unobligated as of June
150.130, 2003, these appropriations or transfers
150.2shall cancel to the TANF fund.
150.3Shift County Payment. The commissioner
150.4shall make up to 100 percent of the
150.5calendar year 2005 payments to counties for
150.6developmental disabilities semi-independent
150.7living services grants, developmental
150.8disabilities family support grants, and
150.9adult mental health grants from fiscal year
150.102006 appropriations. This is a onetime
150.11payment shift. Calendar year 2006 and future
150.12payments for these grants are not affected by
150.13this shift. This provision expires June 30,
150.142006.
150.15Capitation Rate Increase. Of the health care
150.16access fund appropriations to the University
150.17of Minnesota in the higher education
150.18omnibus appropriation bill, $2,157,000 in
150.19fiscal year 2004 and $2,157,000 in fiscal year
150.202005 are to be used to increase the capitation
150.21payments under for fiscal years beginning
150.22July 1, 2003, and thereafter, $2,157,000 each
150.23year shall be transferred to the commissioner
150.24for purposes of Minnesota Statutes, section
150.25256B.69 . Notwithstanding the provisions of
150.26section 14, this provision shall not expire.

150.27    Sec. 75. ASTHMA COVERAGE DEMONSTRATION PROJECT.
150.28    Subdivision 1. Medical assistance coverage. The commissioner of human services
150.29shall establish a demonstration project to provide additional medical assistance coverage
150.30for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth
150.31who are burdened by health disparities associated with the cumulative health impact of
150.32toxic environmental exposures. Under this demonstration project, the additional medical
150.33assistance coverage for this population must include, but is not limited to, the following
150.34durable medical equipment: high efficiency particulate air (HEPA) cleaners, HEPA
150.35vacuum cleaners, allergy bed and pillow encasements, high filtration filters for forced air
151.1gas furnaces, and dehumidifiers with medical tubing to connect the appliance to a floor
151.2drain, if the listed item is medically necessary to reduce asthma symptoms. Provision
151.3of these items must be preceded by a home environmental assessment for triggers of
151.4asthma and in-home asthma education on the proper medical management of asthma by a
151.5Certified Asthma Educator or public health nurse with asthma management training.
151.6    Subd. 2. Report. (a) Two years following implementation of the medical assistance
151.7coverage demonstration project established under this section, the commissioner of health,
151.8in collaboration with the Department of Human Services, must report to the legislature
151.9on the number of asthma-related hospital admittances that occurred in the population of
151.10children described in subdivision 1, before and after implementation of the demonstration
151.11project, and whether the demonstration project had an impact on asthma-related school
151.12absenteeism for this population of children.
151.13(b) The commissioner of health must seek nonstate funding to conduct this report.
151.14The reporting requirement is contingent upon the availability of nonstate funds.

151.15    Sec. 76. CLAIMS AND UTILIZATION DATA.
151.16The commissioner of human services, in consultation with the Health Services
151.17Policy Committee, shall develop and provide to the legislature by December 15, 2009, a
151.18methodology and any draft legislation necessary to allow for the release, upon request, of
151.19summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, on claims
151.20and utilization for medical assistance, general assistance medical care, and MinnesotaCare
151.21enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical
151.22School, Northwestern Health Sciences University, the Institute for Clinical Systems
151.23Improvement, and other research institutions, to conduct analyses of health care outcomes
151.24and treatment effectiveness, provided the research institutions do not release private or
151.25nonpublic data, or data for which dissemination is prohibited by law.

151.26    Sec. 77. ADMINISTRATION OF PUBLICLY FUNDED HEALTH CARE
151.27PROGRAMS.
151.28(a) The commissioner of human services, in cooperation with the representatives
151.29of county human services agencies and with input from organizations that advocate on
151.30behalf of families and children, shall develop a plan that, to the extent feasible, seeks to
151.31align standards, income and asset methodologies, and procedures for families and children
151.32under medical assistance and MinnesotaCare. The commissioner shall evaluate the impact
151.33of different approaches toward alignment on the number of potential medical assistance
151.34and MinnesotaCare enrollees who are families and children, and on administrative, health
152.1care, and other costs to the state. The commissioner shall present recommendations to the
152.2legislative committees with jurisdiction over health care by September 15, 2010.
152.3(b) The commissioner shall report in detail to the chair of the Health Care and
152.4Human Services Finance Committee of the house of representatives and to the chair of
152.5the Health and Human Services Division of the Finance Committee of the senate, prior
152.6to entering into any contracts involving counties for streamlined electronic enrollment
152.7and eligibility determinations for publicly funded health care programs, if such contracts
152.8would require payment from either the general fund, or the health care access fund, as
152.9described in Minnesota Statutes, sections 295.58 and 297I.05.

152.10    Sec. 78. COBRA PREMIUM STATE SUBSIDY.
152.11    Subdivision 1. Eligibility. (a) An individual and the individual's qualified
152.12beneficiaries shall be eligible for a state premium subsidy equal to 35 percent of the
152.13premiums the individual is required to pay for the continuation of health care coverage
152.14under COBRA, if the individual and the individual's qualified beneficiaries:
152.15(1) are eligible for the 65 percent COBRA continuation premium subsidy for health
152.16care coverage under the American Recovery and Reinvestment Act of 2009;
152.17(2) elect COBRA continuation health care coverage; and
152.18(3) are eligible for medical assistance under Minnesota Statutes, chapter 256B;
152.19general assistance medical care under Minnesota Statutes, section 256D.03; or
152.20MinnesotaCare under Minnesota Statutes, chapter 256L, except for the four-month barrier
152.21requirement under Minnesota Statutes, section 256L.07, subdivision 3.
152.22(b) Eligibility for the state subsidy shall continue for as long as the individual
152.23remains eligible for the COBRA premium subsidies provided under the American
152.24Recovery and Reinvestment Act of 2009.
152.25    Subd. 2. Subsidy. (a) The commissioner of human services shall pay 35 percent of
152.26the COBRA premiums that the individual must pay for continuation health care coverage
152.27for the individual and the individual's qualified beneficiaries, if the individual and the
152.28individual's qualified beneficiaries meet the requirements in subdivision 1.
152.29(b) The state subsidy payment required under this section shall be made directly to
152.30the entity to which the individual is required to make COBRA premium payments.
152.31(c) If any eligible individual has paid either the full amount of the COBRA premiums
152.32or 35 percent of the COBRA premiums before the date of enactment of this section, the
152.33individual is not entitled to a reimbursement of any premium paid.
152.34    Subd. 3. Notification. (a) All employers and plan administrators who are required to
152.35provide notice to all qualified individuals under the American Recovery and Reinvestment
153.1Act of 2009 must include information to qualified individuals residing in Minnesota of
153.2the availability of the state subsidy available under this section. The notice shall include
153.3the eligibility requirements for the state subsidy and that the individual must apply to the
153.4commissioner of human services to receive the state subsidy.
153.5(b) The commissioner of employment and economic development must inform an
153.6applicant for unemployment benefits of the availability of a state subsidy if the applicant
153.7elects COBRA continuation coverage and the applicant meets the eligibility requirements
153.8of this section.
153.9    Subd. 4. Exemption. Any individual who receives a state subsidy under this
153.10section is exempt from the four-month requirement under Minnesota Statutes, section
153.11256L.07, subdivision 3, if the individual or the individual's qualified beneficiaries apply
153.12for MinnesotaCare after the individual no longer receives COBRA continuation coverage.
153.13    Subd. 5. Expiration. This section expires December 31, 2010.

153.14    Sec. 79. FEDERAL APPROVAL.
153.15The commissioner of human services shall resubmit for federal approval the
153.16elimination of depreciation for self-employed farmers in determining income eligibility
153.17for MinnesotaCare passed in Laws 2007, chapter 147, article 5, section 19.

153.18    Sec. 80. REPEALER.
153.19Minnesota Statutes 2008, sections 256.962, subdivision 7; and 256L.17, subdivision
153.206, are repealed.

153.21ARTICLE 6
153.22TECHNICAL

153.23    Section 1. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to
153.24read:
153.25    Subdivision 1. License required. (a) A home care provider may not operate in the
153.26state without a current license issued by the commissioner of health. A home care provider
153.27may hold a separate license for each class of home care licensure.
153.28    (b) Within ten days after receiving an application for a license, the commissioner
153.29shall acknowledge receipt of the application in writing. The acknowledgment must
153.30indicate whether the application appears to be complete or whether additional information
153.31is required before the application will be considered complete. Within 90 days after
153.32receiving a complete application, the commissioner shall either grant or deny the license.
153.33If an applicant is not granted or denied a license within 90 days after submitting a
154.1complete application, the license must be deemed granted. An applicant whose license has
154.2been deemed granted must provide written notice to the commissioner before providing a
154.3home care service.
154.4    (c) Each application for a home care provider license, or for a renewal of a license,
154.5shall be accompanied by a fee to be set by the commissioner under section 144.122.
154.6    (d) The commissioner of health, in consultation with the commissioner of human
154.7services, shall provide recommendations to the legislature by February 15, 2009, for
154.8provider standards for personal care assistant services as described in section 256B.0655
154.9256B.0659.

154.10    Sec. 2. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:
154.11    Subd. 9. Employee. "Employee" means any person who performs services for
154.12another for hire including the following:
154.13(1) an alien;
154.14(2) a minor;
154.15(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and
154.16peace officer while engaged in the enforcement of peace or in the pursuit or capture of a
154.17person charged with or suspected of crime;
154.18(4) a person requested or commanded to aid an officer in arresting or retaking a
154.19person who has escaped from lawful custody, or in executing legal process, in which
154.20cases, for purposes of calculating compensation under this chapter, the daily wage of the
154.21person shall be the prevailing wage for similar services performed by paid employees;
154.22(5) a county assessor;
154.23(6) an elected or appointed official of the state, or of a county, city, town, school
154.24district, or governmental subdivision in the state. An officer of a political subdivision
154.25elected or appointed for a regular term of office, or to complete the unexpired portion of a
154.26regular term, shall be included only after the governing body of the political subdivision
154.27has adopted an ordinance or resolution to that effect;
154.28(7) an executive officer of a corporation, except those executive officers excluded
154.29by section 176.041;
154.30(8) a voluntary uncompensated worker, other than an inmate, rendering services in
154.31state institutions under the commissioners of human services and corrections similar to
154.32those of officers and employees of the institutions, and whose services have been accepted
154.33or contracted for by the commissioner of human services or corrections as authorized by
154.34law. In the event of injury or death of the worker, the daily wage of the worker, for the
154.35purpose of calculating compensation under this chapter, shall be the usual wage paid at
155.1the time of the injury or death for similar services in institutions where the services are
155.2performed by paid employees;
155.3(9) a voluntary uncompensated worker engaged in emergency management as
155.4defined in section 12.03, subdivision 4, who is:
155.5(i) registered with the state or any political subdivision of it, according to the
155.6procedures set forth in the state or political subdivision emergency operations plan; and
155.7(ii) acting under the direction and control of, and within the scope of duties approved
155.8by, the state or political subdivision.
155.9The daily wage of the worker, for the purpose of calculating compensation under this
155.10chapter, shall be the usual wage paid at the time of the injury or death for similar services
155.11performed by paid employees;
155.12(10) a voluntary uncompensated worker participating in a program established by a
155.13local social services agency. For purposes of this clause, "local social services agency"
155.14means any agency established under section 393.01. In the event of injury or death of the
155.15worker, the wage of the worker, for the purpose of calculating compensation under this
155.16chapter, shall be the usual wage paid in the county at the time of the injury or death for
155.17similar services performed by paid employees working a normal day and week;
155.18(11) a voluntary uncompensated worker accepted by the commissioner of natural
155.19resources who is rendering services as a volunteer pursuant to section 84.089. The daily
155.20wage of the worker for the purpose of calculating compensation under this chapter, shall
155.21be the usual wage paid at the time of injury or death for similar services performed by
155.22paid employees;
155.23(12) a voluntary uncompensated worker in the building and construction industry
155.24who renders services for joint labor-management nonprofit community service projects.
155.25The daily wage of the worker for the purpose of calculating compensation under this
155.26chapter shall be the usual wage paid at the time of injury or death for similar services
155.27performed by paid employees;
155.28(13) a member of the military forces, as defined in section 190.05, while in state
155.29active service, as defined in section 190.05, subdivision 5a. The daily wage of the member
155.30for the purpose of calculating compensation under this chapter shall be based on the
155.31member's usual earnings in civil life. If there is no evidence of previous occupation or
155.32earning, the trier of fact shall consider the member's earnings as a member of the military
155.33forces;
155.34(14) a voluntary uncompensated worker, accepted by the director of the Minnesota
155.35Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily
155.36wage of the worker, for the purposes of calculating compensation under this chapter,
156.1shall be the usual wage paid at the time of injury or death for similar services performed
156.2by paid employees;
156.3(15) a voluntary uncompensated worker, other than a student, who renders services
156.4at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the
156.5Blind, and whose services have been accepted or contracted for by the commissioner of
156.6education, as authorized by law. In the event of injury or death of the worker, the daily
156.7wage of the worker, for the purpose of calculating compensation under this chapter, shall
156.8be the usual wage paid at the time of the injury or death for similar services performed in
156.9institutions by paid employees;
156.10(16) a voluntary uncompensated worker, other than a resident of the veterans home,
156.11who renders services at a Minnesota veterans home, and whose services have been
156.12accepted or contracted for by the commissioner of veterans affairs, as authorized by law.
156.13In the event of injury or death of the worker, the daily wage of the worker, for the purpose
156.14of calculating compensation under this chapter, shall be the usual wage paid at the time of
156.15the injury or death for similar services performed in institutions by paid employees;
156.16(17) a worker performing services under section 256B.0655 256B.0659 for a
156.17recipient in the home of the recipient or in the community under section 256B.0625,
156.18subdivision 19a
, who is paid from government funds through a fiscal intermediary under
156.19section 256B.0655, subdivision 7 256B.0659, subdivision 33. For purposes of maintaining
156.20workers' compensation insurance, the employer of the worker is as designated in law
156.21by the commissioner of the Department of Human Services, notwithstanding any other
156.22law to the contrary;
156.23(18) students enrolled in and regularly attending the Medical School of the
156.24University of Minnesota in the graduate school program or the postgraduate program. The
156.25students shall not be considered employees for any other purpose. In the event of the
156.26student's injury or death, the weekly wage of the student for the purpose of calculating
156.27compensation under this chapter, shall be the annualized educational stipend awarded to
156.28the student, divided by 52 weeks. The institution in which the student is enrolled shall
156.29be considered the "employer" for the limited purpose of determining responsibility for
156.30paying benefits under this chapter;
156.31(19) a faculty member of the University of Minnesota employed for an academic
156.32year is also an employee for the period between that academic year and the succeeding
156.33academic year if:
156.34(a) the member has a contract or reasonable assurance of a contract from the
156.35University of Minnesota for the succeeding academic year; and
157.1(b) the personal injury for which compensation is sought arises out of and in the
157.2course of activities related to the faculty member's employment by the University of
157.3Minnesota;
157.4(20) a worker who performs volunteer ambulance driver or attendant services is an
157.5employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other
157.6entity for which the worker performs the services. The daily wage of the worker for the
157.7purpose of calculating compensation under this chapter shall be the usual wage paid at the
157.8time of injury or death for similar services performed by paid employees;
157.9(21) a voluntary uncompensated worker, accepted by the commissioner of
157.10administration, rendering services as a volunteer at the Department of Administration. In
157.11the event of injury or death of the worker, the daily wage of the worker, for the purpose of
157.12calculating compensation under this chapter, shall be the usual wage paid at the time of the
157.13injury or death for similar services performed in institutions by paid employees;
157.14(22) a voluntary uncompensated worker rendering service directly to the Pollution
157.15Control Agency. The daily wage of the worker for the purpose of calculating compensation
157.16payable under this chapter is the usual going wage paid at the time of injury or death for
157.17similar services if the services are performed by paid employees;
157.18(23) a voluntary uncompensated worker while volunteering services as a first
157.19responder or as a member of a law enforcement assistance organization while acting
157.20under the supervision and authority of a political subdivision. The daily wage of the
157.21worker for the purpose of calculating compensation payable under this chapter is the
157.22usual going wage paid at the time of injury or death for similar services if the services
157.23are performed by paid employees;
157.24(24) a voluntary uncompensated member of the civil air patrol rendering service on
157.25the request and under the authority of the state or any of its political subdivisions. The
157.26daily wage of the member for the purposes of calculating compensation payable under this
157.27chapter is the usual going wage paid at the time of injury or death for similar services if
157.28the services are performed by paid employees; and
157.29(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in
157.30sections 145A.04 and 145A.06, responding at the request of or engaged in training
157.31conducted by the commissioner of health. The daily wage of the volunteer for the purposes
157.32of calculating compensation payable under this chapter is established in section 145A.06.
157.33A person who qualifies under this clause and who may also qualify under another clause
157.34of this subdivision shall receive benefits in accordance with this clause.
157.35If it is difficult to determine the daily wage as provided in this subdivision, the trier
157.36of fact may determine the wage upon which the compensation is payable.

158.1    Sec. 3. Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read:
158.2    Subd. 2. Personal care provider organizations. The commissioner shall conduct
158.3background studies on any individual required under sections 256B.0651 and 256B.0653
158.4to 256B.0656 and 256B.0659 to have a background study completed under this chapter.

158.5    Sec. 4. Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read:
158.6    Subd. 3. Personal care provider organizations. (a) The commissioner shall
158.7conduct a background study of an individual required to be studied under section 245C.03,
158.8subdivision 2
, at least upon application for initial enrollment under sections 256B.0651
158.9and 256B.0653 to 256B.0656 and 256B.0659.
158.10(b) Organizations required to initiate background studies under sections 256B.0651
158.11and 256B.0653 to 256B.0656 and 256B.0659 for individuals described in section 245C.03,
158.12subdivision 2
, must submit a completed background study form to the commissioner
158.13before those individuals begin a position allowing direct contact with persons served
158.14by the organization.

158.15    Sec. 5. Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read:
158.16    Subd. 3. Personal care provider organizations. The commissioner shall recover
158.17the cost of background studies initiated by a personal care provider organization under
158.18sections 256B.0651 and 256B.0653 to 256B.0656 and 256B.0659 through a fee of no
158.19more than $20 per study charged to the organization responsible for submitting the
158.20background study form. The fees collected under this subdivision are appropriated to the
158.21commissioner for the purpose of conducting background studies.

158.22    Sec. 6. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:
158.23    Subd. 16. Personal care services. (a) Notwithstanding any contrary language in
158.24this paragraph, the commissioner of human services and the commissioner of health shall
158.25jointly promulgate rules to be applied to the licensure of personal care services provided
158.26under the medical assistance program. The rules shall consider standards for personal care
158.27services that are based on the World Institute on Disability's recommendations regarding
158.28personal care services. These rules shall at a minimum consider the standards and
158.29requirements adopted by the commissioner of health under section 144A.45, which the
158.30commissioner of human services determines are applicable to the provision of personal
158.31care services, in addition to other standards or modifications which the commissioner of
158.32human services determines are appropriate.
159.1The commissioner of human services shall establish an advisory group including
159.2personal care consumers and providers to provide advice regarding which standards or
159.3modifications should be adopted. The advisory group membership must include not less
159.4than 15 members, of which at least 60 percent must be consumers of personal care services
159.5and representatives of recipients with various disabilities and diagnoses and ages. At least
159.651 percent of the members of the advisory group must be recipients of personal care.
159.7The commissioner of human services may contract with the commissioner of health
159.8to enforce the jointly promulgated licensure rules for personal care service providers.
159.9Prior to final promulgation of the joint rule the commissioner of human services
159.10shall report preliminary findings along with any comments of the advisory group and a
159.11plan for monitoring and enforcement by the Department of Health to the legislature by
159.12February 15, 1992.
159.13Limits on the extent of personal care services that may be provided to an individual
159.14must be based on the cost-effectiveness of the services in relation to the costs of inpatient
159.15hospital care, nursing home care, and other available types of care. The rules must
159.16provide, at a minimum:
159.17(1) that agencies be selected to contract with or employ and train staff to provide and
159.18supervise the provision of personal care services;
159.19(2) that agencies employ or contract with a qualified applicant that a qualified
159.20recipient proposes to the agency as the recipient's choice of assistant;
159.21(3) that agencies bill the medical assistance program for a personal care service
159.22by a personal care assistant and supervision by a qualified professional supervising the
159.23personal care assistant unless the recipient selects the fiscal agent option under section
159.24256B.0655, subdivision 7 256B.0659, subdivision 33;
159.25(4) that agencies establish a grievance mechanism; and
159.26(5) that agencies have a quality assurance program.
159.27(b) The commissioner may waive the requirement for the provision of personal care
159.28services through an agency in a particular county, when there are less than two agencies
159.29providing services in that county and shall waive the requirement for personal care
159.30assistants required to join an agency for the first time during 1993 when personal care
159.31services are provided under a relative hardship waiver under Minnesota Statutes 1992,
159.32section 256B.0627, subdivision 4, paragraph (b), clause (7), and at least two agencies
159.33providing personal care services have refused to employ or contract with the independent
159.34personal care assistant.

159.35    Sec. 7. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:
160.1    Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the
160.2person is under age 19 and qualifies as a disabled individual under United States Code,
160.3title 42, section 1382c(a), and would be eligible for medical assistance under the state
160.4plan if residing in a medical institution, and the child requires a level of care provided in
160.5a hospital, nursing facility, or intermediate care facility for persons with developmental
160.6disabilities, for whom home care is appropriate, provided that the cost to medical
160.7assistance under this section is not more than the amount that medical assistance would pay
160.8for if the child resides in an institution. After the child is determined to be eligible under
160.9this section, the commissioner shall review the child's disability under United States Code,
160.10title 42, section 1382c(a) and level of care defined under this section no more often than
160.11annually and may elect, based on the recommendation of health care professionals under
160.12contract with the state medical review team, to extend the review of disability and level of
160.13care up to a maximum of four years. The commissioner's decision on the frequency of
160.14continuing review of disability and level of care is not subject to administrative appeal
160.15under section 256.045. The county agency shall send a notice of disability review to the
160.16enrollee six months prior to the date the recertification of disability is due. Nothing in this
160.17subdivision shall be construed as affecting other redeterminations of medical assistance
160.18eligibility under this chapter and annual cost-effective reviews under this section.
160.19    (b) For purposes of this subdivision, "hospital" means an institution as defined
160.20in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part
160.214640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this
160.22subdivision, a child requires a level of care provided in a hospital if the child is determined
160.23by the commissioner to need an extensive array of health services, including mental health
160.24services, for an undetermined period of time, whose health condition requires frequent
160.25monitoring and treatment by a health care professional or by a person supervised by a
160.26health care professional, who would reside in a hospital or require frequent hospitalization
160.27if these services were not provided, and the daily care needs are more complex than
160.28a nursing facility level of care.
160.29    A child with serious emotional disturbance requires a level of care provided in a
160.30hospital if the commissioner determines that the individual requires 24-hour supervision
160.31because the person exhibits recurrent or frequent suicidal or homicidal ideation or
160.32behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that
160.33may become life threatening, recurrent or frequent severe socially unacceptable behavior
160.34associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing
160.35and chronic developmental problems requiring continuous skilled observation, or severe
161.1disabling symptoms for which office-centered outpatient treatment is not adequate, and
161.2which overall severely impact the individual's ability to function.
161.3    (c) For purposes of this subdivision, "nursing facility" means a facility which
161.4provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to
161.5sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative
161.6treatment; is in need of special treatments provided or supervised by a licensed nurse; or
161.7has unpredictable episodes of active disease processes requiring immediate judgment
161.8by a licensed nurse. For purposes of this subdivision, a child requires the level of care
161.9provided in a nursing facility if the child is determined by the commissioner to meet
161.10the requirements of the preadmission screening assessment document under section
161.11256B.0911 and the home care independent rating document under section 256B.0655,
161.12subdivision 4
, clause (3), adjusted to address age-appropriate standards for children age 18
161.13and under, pursuant to section 256B.0655, subdivision 3.
161.14    (d) For purposes of this subdivision, "intermediate care facility for persons with
161.15developmental disabilities" or "ICF/MR" means a program licensed to provide services to
161.16persons with developmental disabilities under section 252.28, and chapter 245A, and a
161.17physical plant licensed as a supervised living facility under chapter 144, which together
161.18are certified by the Minnesota Department of Health as meeting the standards in Code of
161.19Federal Regulations, title 42, part 483, for an intermediate care facility which provides
161.20services for persons with developmental disabilities who require 24-hour supervision
161.21and active treatment for medical, behavioral, or habilitation needs. For purposes of this
161.22subdivision, a child requires a level of care provided in an ICF/MR if the commissioner
161.23finds that the child has a developmental disability in accordance with section 256B.092,
161.24is in need of a 24-hour plan of care and active treatment similar to persons with
161.25developmental disabilities, and there is a reasonable indication that the child will need
161.26ICF/MR services.
161.27    (e) For purposes of this subdivision, a person requires the level of care provided
161.28in a nursing facility if the person requires 24-hour monitoring or supervision and a plan
161.29of mental health treatment because of specific symptoms or functional impairments
161.30associated with a serious mental illness or disorder diagnosis, which meet severity criteria
161.31for mental health established by the commissioner and published in March 1997 as
161.32the Minnesota Mental Health Level of Care for Children and Adolescents with Severe
161.33Emotional Disorders.
161.34    (f) The determination of the level of care needed by the child shall be made by
161.35the commissioner based on information supplied to the commissioner by the parent or
161.36guardian, the child's physician or physicians, and other professionals as requested by the
162.1commissioner. The commissioner shall establish a screening team to conduct the level of
162.2care determinations according to this subdivision.
162.3    (g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
162.4must assess the case to determine whether:
162.5    (1) the child qualifies as a disabled individual under United States Code, title 42,
162.6section 1382c(a), and would be eligible for medical assistance if residing in a medical
162.7institution; and
162.8    (2) the cost of medical assistance services for the child, if eligible under this
162.9subdivision, would not be more than the cost to medical assistance if the child resides in a
162.10medical institution to be determined as follows:
162.11    (i) for a child who requires a level of care provided in an ICF/MR, the cost of
162.12care for the child in an institution shall be determined using the average payment rate
162.13established for the regional treatment centers that are certified as ICF's/MR;
162.14    (ii) for a child who requires a level of care provided in an inpatient hospital setting
162.15according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
162.16Rules, part 9505.3520, items F and G; and
162.17    (iii) for a child who requires a level of care provided in a nursing facility according
162.18to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota
162.19Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to
162.20reflect rates which would be paid for children under age 16. The commissioner may
162.21authorize an amount up to the amount medical assistance would pay for a child referred to
162.22the commissioner by the preadmission screening team under section 256B.0911.
162.23    (h) Children eligible for medical assistance services under section 256B.055,
162.24subdivision 12
, as of June 30, 1995, must be screened according to the criteria in this
162.25subdivision prior to January 1, 1996. Children found to be ineligible may not be removed
162.26from the program until January 1, 1996.

162.27    Sec. 8. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:
162.28    Subd. 2. Targeted case management; definitions. For purposes of subdivisions 3
162.29to 10, the following terms have the meanings given them:
162.30    (1) "home care service recipients" means those individuals receiving the following
162.31services under sections 256B.0651 to 256B.0656 and 256B.0659: skilled nursing visits,
162.32home health aide visits, private duty nursing, personal care assistants, or therapies
162.33provided through a home health agency;
163.1    (2) "home care targeted case management" means the provision of targeted case
163.2management services for the purpose of assisting home care service recipients to gain
163.3access to needed services and supports so that they may remain in the community;
163.4    (3) "institutions" means hospitals, consistent with Code of Federal Regulations, title
163.542, section 440.10; regional treatment center inpatient services, consistent with section
163.6245.474 ; nursing facilities; and intermediate care facilities for persons with developmental
163.7disabilities;
163.8    (4) "relocation targeted case management" includes the provision of both county
163.9targeted case management and public or private vendor service coordination services
163.10for the purpose of assisting recipients to gain access to needed services and supports if
163.11they choose to move from an institution to the community. Relocation targeted case
163.12management may be provided during the lesser of:
163.13    (i) the last 180 consecutive days of an eligible recipient's institutional stay; or
163.14    (ii) the limits and conditions which apply to federal Medicaid funding for this
163.15service; and
163.16    (5) "targeted case management" means case management services provided to help
163.17recipients gain access to needed medical, social, educational, and other services and
163.18supports.

163.19    Sec. 9. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to read:
163.20    Subd. 3. Assessment and prior authorization process. Effective January 1, 1996,
163.21for purposes of providing informed choice, coordinating of local planning decisions, and
163.22streamlining administrative requirements, the assessment and prior authorization process
163.23for persons receiving both home care and home and community-based waivered services
163.24for persons with developmental disabilities shall meet the requirements of sections
163.25256B.0651 and 256B.0653 to 256B.0656 and 256B.0659 with the following exceptions:
163.26(a) Upon request for home care services and subsequent assessment by the public
163.27health nurse under sections 256B.0651 and 256B.0653 to 256B.0656 and 256B.0659,
163.28the public health nurse shall participate in the screening process, as appropriate, and,
163.29if home care services are determined to be necessary, participate in the development
163.30of a service plan coordinating the need for home care and home and community-based
163.31waivered services with the assigned county case manager, the recipient of services, and
163.32the recipient's legal representative, if any.
163.33(b) The public health nurse shall give prior authorization for home care services
163.34to the extent that home care services are:
163.35(1) medically necessary;
164.1(2) chosen by the recipient and their legal representative, if any, from the array of
164.2home care and home and community-based waivered services available;
164.3(3) coordinated with other services to be received by the recipient as described
164.4in the service plan; and
164.5(4) provided within the county's reimbursement limits for home care and home and
164.6community-based waivered services for persons with developmental disabilities.
164.7(c) If the public health agency is or may be the provider of home care services to the
164.8recipient, the public health agency shall provide the commissioner of human services with
164.9a written plan that specifies how the assessment and prior authorization process will be
164.10held separate and distinct from the provision of services.

164.11    Sec. 10. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to
164.12read:
164.13    Subd. 2. Eligibility. (a) The self-directed supports option is available to a person
164.14who:
164.15    (1) is a recipient of medical assistance as determined under sections 256B.055,
164.16256B.056 , and 256B.057, subdivision 9;
164.17    (2) is eligible for personal care assistant services under section 256B.0655
164.18256B.0659;
164.19    (3) lives in the person's own apartment or home, which is not owned, operated, or
164.20controlled by a provider of services not related by blood or marriage;
164.21    (4) has the ability to hire, fire, supervise, establish staff compensation for, and
164.22manage the individuals providing services, and to choose and obtain items, related
164.23services, and supports as described in the participant's plan. If the recipient is not able to
164.24carry out these functions but has a legal guardian or parent to carry them out, the guardian
164.25or parent may fulfill these functions on behalf of the recipient; and
164.26    (5) has not been excluded or disenrolled by the commissioner.
164.27    (b) The commissioner may disenroll or exclude recipients, including guardians and
164.28parents, under the following circumstances:
164.29    (1) recipients who have been restricted by the Primary Care Utilization Review
164.30Committee may be excluded for a specified time period;
164.31    (2) recipients who exit the self-directed supports option during the recipient's
164.32service plan year shall not access the self-directed supports option for the remainder of
164.33that service plan year; and
164.34    (3) when the department determines that the recipient cannot manage recipient
164.35responsibilities under the program.

165.1    Sec. 11. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to
165.2read:
165.3    Subd. 6. Services covered. (a) Services covered under the self-directed supports
165.4option include:
165.5    (1) personal care assistant services under section 256B.0655 256B.0659; and
165.6    (2) items, related services, and supports, including assistive technology, that increase
165.7independence or substitute for human assistance to the extent expenditures would
165.8otherwise be used for human assistance.
165.9    (b) Items, supports, and related services purchased under this option shall not be
165.10considered home care services for the purposes of section 144A.43.

165.11    Sec. 12. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to
165.12read:
165.13    Subd. 8. Self-directed budget requirements. The budget for the provision of the
165.14self-directed service option shall be equal to the greater of either:
165.15    (1) the annual amount of personal care assistant services under section 256B.0655
165.16256B.0659 that the recipient has used in the most recent 12-month period; or
165.17    (2) the amount determined using the consumer support grant methodology under
165.18section 256.476, subdivision 11, except that the budget amount shall include the federal
165.19and nonfederal share of the average service costs.

165.20    Sec. 13. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
165.21    Subd. 17. Cost of services and supports. (a) The commissioner shall ensure
165.22that the average per capita expenditures estimated in any fiscal year for home and
165.23community-based waiver recipients does not exceed the average per capita expenditures
165.24that would have been made to provide institutional services for recipients in the absence
165.25of the waiver.
165.26(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
165.27need-based methods for allocating to local agencies the home and community-based
165.28waivered service resources available to support recipients with disabilities in need of
165.29the level of care provided in a nursing facility or a hospital. The commissioner shall
165.30allocate resources to single counties and county partnerships in a manner that reflects
165.31consideration of:
165.32(1) an incentive-based payment process for achieving outcomes;
165.33(2) the need for a state-level risk pool;
165.34(3) the need for retention of management responsibility at the state agency level; and
166.1(4) a phase-in strategy as appropriate.
166.2(c) Until the allocation methods described in paragraph (b) are implemented, the
166.3annual allowable reimbursement level of home and community-based waiver services
166.4shall be the greater of:
166.5(1) the statewide average payment amount which the recipient is assigned under the
166.6waiver reimbursement system in place on June 30, 2001, modified by the percentage of
166.7any provider rate increase appropriated for home and community-based services; or
166.8(2) an amount approved by the commissioner based on the recipient's extraordinary
166.9needs that cannot be met within the current allowable reimbursement level. The
166.10increased reimbursement level must be necessary to allow the recipient to be discharged
166.11from an institution or to prevent imminent placement in an institution. The additional
166.12reimbursement may be used to secure environmental modifications; assistive technology
166.13and equipment; and increased costs for supervision, training, and support services
166.14necessary to address the recipient's extraordinary needs. The commissioner may approve
166.15an increased reimbursement level for up to one year of the recipient's relocation from an
166.16institution or up to six months of a determination that a current waiver recipient is at
166.17imminent risk of being placed in an institution.
166.18(d) Beginning July 1, 2001, medically necessary private duty nursing services
166.19will be authorized under this section as complex and regular care according to sections
166.20256B.0651 and 256B.0653 to 256B.0656 and 256B.0659. The rate established by the
166.21commissioner for registered nurse or licensed practical nurse services under any home and
166.22community-based waiver as of January 1, 2001, shall not be reduced.

166.23    Sec. 14. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to
166.24read:
166.25    Subd. 4a. Inclusion of home care costs in waiver rates. The commissioner
166.26shall adjust the limits of the established average daily reimbursement rates for waivered
166.27services to include the cost of home care services that may be provided to waivered
166.28services recipients. This adjustment must be used to maintain or increase services and
166.29shall not be used by county agencies for inflation increases for waivered services vendors.
166.30Home care services referenced in this section are those listed in section 256B.0651,
166.31subdivision 2
. The average daily reimbursement rates established in accordance with
166.32the provisions of this subdivision apply only to the combined average, daily costs of
166.33waivered and home care services and do not change home care limitations under sections
166.34256B.0651 and 256B.0653 to 256B.0656 and 256B.0659. Waivered services recipients
167.1receiving home care as of June 30, 1992, shall not have the amount of their services
167.2reduced as a result of this section.

167.3    Sec. 15. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:
167.4    Subd. 6. Excluded time. "Excluded time" means:
167.5(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter
167.6other than an emergency shelter, halfway house, foster home, semi-independent living
167.7domicile or services program, residential facility offering care, board and lodging facility
167.8or other institution for the hospitalization or care of human beings, as defined in section
167.9144.50 , 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter,
167.10or correctional facility; or any facility based on an emergency hold under sections
167.11253B.05, subdivisions 1 and 2 , and 253B.07, subdivision 6;
167.12(b) any period an applicant spends on a placement basis in a training and habilitation
167.13program, including a rehabilitation facility or work or employment program as defined
167.14in section 268A.01; or receiving personal care assistant services pursuant to section
167.15256B.0655, subdivision 2 256B.0659; semi-independent living services provided under
167.16section 252.275, and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and
167.17habilitation programs and assisted living services; and
167.18(c) any placement for a person with an indeterminate commitment, including
167.19independent living.

167.20    Sec. 16. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:
167.21    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
167.22256I.04, subdivision 3 , the county agency may negotiate a payment not to exceed $426.37
167.23for other services necessary to provide room and board provided by the group residence
167.24if the residence is licensed by or registered by the Department of Health, or licensed by
167.25the Department of Human Services to provide services in addition to room and board,
167.26and if the provider of services is not also concurrently receiving funding for services for
167.27a recipient under a home and community-based waiver under title XIX of the Social
167.28Security Act; or funding from the medical assistance program under section 256B.0655,
167.29subdivision 2
256B.0659, for personal care services for residents in the setting; or residing
167.30in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000.
167.31If funding is available for other necessary services through a home and community-based
167.32waiver, or personal care services under section 256B.0655, subdivision 2 256B.0659,
167.33then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided
167.34in law, in no case may the supplementary service rate exceed $426.37. The registration
168.1and licensure requirement does not apply to establishments which are exempt from state
168.2licensure because they are located on Indian reservations and for which the tribe has
168.3prescribed health and safety requirements. Service payments under this section may be
168.4prohibited under rules to prevent the supplanting of federal funds with state funds. The
168.5commissioner shall pursue the feasibility of obtaining the approval of the Secretary of
168.6Health and Human Services to provide home and community-based waiver services under
168.7title XIX of the Social Security Act for residents who are not eligible for an existing home
168.8and community-based waiver due to a primary diagnosis of mental illness or chemical
168.9dependency and shall apply for a waiver if it is determined to be cost-effective.
168.10(b) The commissioner is authorized to make cost-neutral transfers from the GRH
168.11fund for beds under this section to other funding programs administered by the department
168.12after consultation with the county or counties in which the affected beds are located.
168.13The commissioner may also make cost-neutral transfers from the GRH fund to county
168.14human service agencies for beds permanently removed from the GRH census under a plan
168.15submitted by the county agency and approved by the commissioner. The commissioner
168.16shall report the amount of any transfers under this provision annually to the legislature.
168.17(c) The provisions of paragraph (b) do not apply to a facility that has its
168.18reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

168.19    Sec. 17. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:
168.20    Subd. 3. Good cause exemptions for not attending orientation. (a) The county
168.21agency shall not impose the sanction under section 256J.46 if it determines that the
168.22participant has good cause for failing to attend orientation. Good cause exists when:
168.23(1) appropriate child care is not available;
168.24(2) the participant is ill or injured;
168.25(3) a family member is ill and needs care by the participant that prevents the
168.26participant from attending orientation. For a caregiver with a child or adult in the
168.27household who meets the disability or medical criteria for home care services under
168.28section 256B.0655, subdivision 1c 256B.0659, or a home and community-based waiver
168.29services program under chapter 256B, or meets the criteria for severe emotional
168.30disturbance under section 245.4871, subdivision 6, or for serious and persistent mental
168.31illness under section 245.462, subdivision 20, paragraph (c), good cause also exists when
168.32an interruption in the provision of those services occurs which prevents the participant
168.33from attending orientation;
168.34(4) the caregiver is unable to secure necessary transportation;
168.35(5) the caregiver is in an emergency situation that prevents orientation attendance;
169.1(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
169.2(7) the caregiver documents other verifiable impediments to orientation attendance
169.3beyond the caregiver's control.
169.4(b) Counties must work with clients to provide child care and transportation
169.5necessary to ensure a caregiver has every opportunity to attend orientation.

169.6    Sec. 18. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:
169.7    Subdivision 1. Application. This section applies to residential treatment programs
169.8for children or group homes for children licensed under chapter 245A, residential
169.9services and programs for juveniles licensed under section 241.021, providers licensed
169.10pursuant to sections 144A.01 to 144A.33 or sections 144A.43 to 144A.47, personal care
169.11provider organizations under section 256B.0655, subdivision 1g 256B.0659, providers
169.12of day training and habilitation services under sections 252.40 to 252.46, board and
169.13lodging facilities licensed under chapter 157, intermediate care facilities for persons with
169.14developmental disabilities, and other facilities licensed to provide residential services to
169.15persons with developmental disabilities.

169.16    Sec. 19. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:
169.17    Subd. 11. Vulnerable adult. "Vulnerable adult" means any person 18 years of
169.18age or older who:
169.19(1) is a resident inpatient of a facility;
169.20(2) receives services at or from a facility required to be licensed to serve adults
169.21under sections 245A.01 to 245A.15, except that a person receiving outpatient services for
169.22treatment of chemical dependency or mental illness, or one who is committed as a sexual
169.23psychopathic personality or as a sexually dangerous person under chapter 253B, is not
169.24considered a vulnerable adult unless the person meets the requirements of clause (4);
169.25(3) receives services from a home care provider required to be licensed under section
169.26144A.46 ; or from a person or organization that exclusively offers, provides, or arranges
169.27for personal care assistant services under the medical assistance program as authorized
169.28under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and
169.29256B.0653 to 256B.0656 and 256B.0659; or
169.30(4) regardless of residence or whether any type of service is received, possesses a
169.31physical or mental infirmity or other physical, mental, or emotional dysfunction:
169.32(i) that impairs the individual's ability to provide adequately for the individual's
169.33own care without assistance, including the provision of food, shelter, clothing, health
169.34care, or supervision; and
170.1(ii) because of the dysfunction or infirmity and the need for assistance, the individual
170.2has an impaired ability to protect the individual from maltreatment.

170.3    Sec. 20. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:
170.4    Subd. 6. Facility. (a) "Facility" means a hospital or other entity required to be
170.5licensed under sections 144.50 to 144.58; a nursing home required to be licensed to
170.6serve adults under section 144A.02; a residential or nonresidential facility required to
170.7be licensed to serve adults under sections 245A.01 to 245A.16; a home care provider
170.8licensed or required to be licensed under section 144A.46; a hospice provider licensed
170.9under sections 144A.75 to 144A.755; or a person or organization that exclusively offers,
170.10provides, or arranges for personal care assistant services under the medical assistance
170.11program as authorized under sections 256B.04, subdivision 16, 256B.0625, subdivision
170.1219a
, 256B.0651, and 256B.0653 to 256B.0656, and 256B.0659.
170.13(b) For home care providers and personal care attendants, the term "facility" refers
170.14to the provider or person or organization that exclusively offers, provides, or arranges for
170.15personal care services, and does not refer to the client's home or other location at which
170.16services are rendered.

170.17    Sec. 21. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to
170.18read:
170.19    Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of
170.20age or older who:
170.21    (1) is a resident or inpatient of a facility;
170.22    (2) receives services at or from a facility required to be licensed to serve adults
170.23under sections 245A.01 to 245A.15, except that a person receiving outpatient services for
170.24treatment of chemical dependency or mental illness, or one who is served in the Minnesota
170.25sex offender program on a court-hold order for commitment, or is committed as a sexual
170.26psychopathic personality or as a sexually dangerous person under chapter 253B, is not
170.27considered a vulnerable adult unless the person meets the requirements of clause (4);
170.28    (3) receives services from a home care provider required to be licensed under section
170.29144A.46 ; or from a person or organization that exclusively offers, provides, or arranges
170.30for personal care assistant services under the medical assistance program as authorized
170.31under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and
170.32256B.0653 to 256B.0656, and 256B.0659; or
170.33    (4) regardless of residence or whether any type of service is received, possesses a
170.34physical or mental infirmity or other physical, mental, or emotional dysfunction:
171.1    (i) that impairs the individual's ability to provide adequately for the individual's
171.2own care without assistance, including the provision of food, shelter, clothing, health
171.3care, or supervision; and
171.4    (ii) because of the dysfunction or infirmity and the need for assistance, the individual
171.5has an impaired ability to protect the individual from maltreatment.

171.6ARTICLE 7
171.7CHEMICAL AND MENTAL HEALTH

171.8    Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to
171.9read:
171.10    Subd. 18. Mental health professional. "Mental health professional" means a
171.11person providing clinical services in the treatment of mental illness who is qualified in at
171.12least one of the following ways:
171.13    (1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171
171.14to 148.285; and:
171.15    (i) who is certified as a clinical specialist or as a nurse practitioner in adult or family
171.16psychiatric and mental health nursing by a national nurse certification organization; or
171.17    (ii) who has a master's degree in nursing or one of the behavioral sciences or related
171.18fields from an accredited college or university or its equivalent, with at least 4,000 hours
171.19of post-master's supervised experience in the delivery of clinical services in the treatment
171.20of mental illness;
171.21    (2) in clinical social work: a person licensed as an independent clinical social worker
171.22under chapter 148D, or a person with a master's degree in social work from an accredited
171.23college or university, with at least 4,000 hours of post-master's supervised experience in
171.24the delivery of clinical services in the treatment of mental illness;
171.25    (3) in psychology: an individual licensed by the Board of Psychology under sections
171.26148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis
171.27and treatment of mental illness;
171.28    (4) in psychiatry: a physician licensed under chapter 147 and certified by the
171.29American Board of Psychiatry and Neurology or eligible for board certification in
171.30psychiatry;
171.31    (5) in marriage and family therapy: the mental health professional must be a
171.32marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least
171.33two years of post-master's supervised experience in the delivery of clinical services in
171.34the treatment of mental illness; or
172.1    (6) in licensed professional clinical counseling, the mental health professional
172.2shall be a licensed professional clinical counselor under section 148B.5301 with at least
172.34,000 hours of postmaster's supervised experience in the delivery of clinical services in
172.4the treatment of mental illness; or
172.5    (7) in allied fields: a person with a master's degree from an accredited college or
172.6university in one of the behavioral sciences or related fields, with at least 4,000 hours of
172.7post-master's supervised experience in the delivery of clinical services in the treatment of
172.8mental illness.

172.9    Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read:
172.10    Subdivision 1. Availability of outpatient services. (a) County boards must provide
172.11or contract for enough outpatient services within the county to meet the needs of adults
172.12with mental illness residing in the county. Services may be provided directly by the
172.13county through county-operated mental health centers or mental health clinics approved
172.14by the commissioner under section 245.69, subdivision 2; by contract with privately
172.15operated mental health centers or mental health clinics approved by the commissioner
172.16under section 245.69, subdivision 2; by contract with hospital mental health outpatient
172.17programs certified by the Joint Commission on Accreditation of Hospital Organizations;
172.18or by contract with a licensed mental health professional as defined in section 245.462,
172.19subdivision 18
, clauses (1) to (4) (6). Clients may be required to pay a fee according to
172.20section 245.481. Outpatient services include:
172.21    (1) conducting diagnostic assessments;
172.22    (2) conducting psychological testing;
172.23    (3) developing or modifying individual treatment plans;
172.24    (4) making referrals and recommending placements as appropriate;
172.25    (5) treating an adult's mental health needs through therapy;
172.26    (6) prescribing and managing medication and evaluating the effectiveness of
172.27prescribed medication; and
172.28    (7) preventing placement in settings that are more intensive, costly, or restrictive
172.29than necessary and appropriate to meet client needs.
172.30    (b) County boards may request a waiver allowing outpatient services to be provided
172.31in a nearby trade area if it is determined that the client can best be served outside the
172.32county.

172.33    Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read:
173.1    Subd. 27. Mental health professional. "Mental health professional" means a
173.2person providing clinical services in the diagnosis and treatment of children's emotional
173.3disorders. A mental health professional must have training and experience in working with
173.4children consistent with the age group to which the mental health professional is assigned.
173.5A mental health professional must be qualified in at least one of the following ways:
173.6    (1) in psychiatric nursing, the mental health professional must be a registered nurse
173.7who is licensed under sections 148.171 to 148.285 and who is certified as a clinical
173.8specialist in child and adolescent psychiatric or mental health nursing by a national nurse
173.9certification organization or who has a master's degree in nursing or one of the behavioral
173.10sciences or related fields from an accredited college or university or its equivalent, with
173.11at least 4,000 hours of post-master's supervised experience in the delivery of clinical
173.12services in the treatment of mental illness;
173.13    (2) in clinical social work, the mental health professional must be a person licensed
173.14as an independent clinical social worker under chapter 148D, or a person with a master's
173.15degree in social work from an accredited college or university, with at least 4,000 hours of
173.16post-master's supervised experience in the delivery of clinical services in the treatment
173.17of mental disorders;
173.18    (3) in psychology, the mental health professional must be an individual licensed by
173.19the board of psychology under sections 148.88 to 148.98 who has stated to the board of
173.20psychology competencies in the diagnosis and treatment of mental disorders;
173.21    (4) in psychiatry, the mental health professional must be a physician licensed under
173.22chapter 147 and certified by the American board of psychiatry and neurology or eligible
173.23for board certification in psychiatry;
173.24    (5) in marriage and family therapy, the mental health professional must be a
173.25marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least
173.26two years of post-master's supervised experience in the delivery of clinical services in the
173.27treatment of mental disorders or emotional disturbances; or
173.28    (6) in licensed professional clinical counseling, the mental health professional shall
173.29be a licensed professional clinical counselor under section 148B.5301 with at least 4,000
173.30hours of postmaster's supervised experience in the delivery of clinical services in the
173.31treatment of mental disorders or emotional disturbances; or
173.32    (7) in allied fields, the mental health professional must be a person with a master's
173.33degree from an accredited college or university in one of the behavioral sciences or related
173.34fields, with at least 4,000 hours of post-master's supervised experience in the delivery of
173.35clinical services in the treatment of emotional disturbances.

174.1    Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read:
174.2    Subdivision 1. Availability of outpatient services. (a) County boards must provide
174.3or contract for enough outpatient services within the county to meet the needs of each
174.4child with emotional disturbance residing in the county and the child's family. Services
174.5may be provided directly by the county through county-operated mental health centers or
174.6mental health clinics approved by the commissioner under section 245.69, subdivision 2;
174.7by contract with privately operated mental health centers or mental health clinics approved
174.8by the commissioner under section 245.69, subdivision 2; by contract with hospital
174.9mental health outpatient programs certified by the Joint Commission on Accreditation
174.10of Hospital Organizations; or by contract with a licensed mental health professional as
174.11defined in section 245.4871, subdivision 27, clauses (1) to (4) (6). A child or a child's
174.12parent may be required to pay a fee based in accordance with section 245.481. Outpatient
174.13services include:
174.14    (1) conducting diagnostic assessments;
174.15    (2) conducting psychological testing;
174.16    (3) developing or modifying individual treatment plans;
174.17    (4) making referrals and recommending placements as appropriate;
174.18    (5) treating the child's mental health needs through therapy; and
174.19    (6) prescribing and managing medication and evaluating the effectiveness of
174.20prescribed medication.
174.21    (b) County boards may request a waiver allowing outpatient services to be provided
174.22in a nearby trade area if it is determined that the child requires necessary and appropriate
174.23services that are only available outside the county.
174.24    (c) Outpatient services offered by the county board to prevent placement must be at
174.25the level of treatment appropriate to the child's diagnostic assessment.

174.26    Sec. 5. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision
174.27to read:
174.28    Subd. 8a. Placing authority. "Placing authority" means a county, prepaid health
174.29plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to
174.309530.6655.

174.31    Sec. 6. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision
174.32to read:
174.33    Subd. 6. Monitoring. The commissioner shall gather and placing authorities shall
174.34provide information to measure compliance with Minnesota Rules, parts 9530.6600 to
175.19530.6655. The commissioner shall specify the format for data collection to facilitate
175.2tracking, aggregating, and using the information.

175.3    Sec. 7. Minnesota Statutes 2008, section 254B.03, subdivision 1, is amended to read:
175.4    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical
175.5dependency services to persons residing within its jurisdiction who meet criteria
175.6established by the commissioner for placement in a chemical dependency residential or
175.7nonresidential treatment service. Chemical dependency money must be administered
175.8by the local agencies according to law and rules adopted by the commissioner under
175.9sections 14.001 to 14.69.
175.10    (b) In order to contain costs, the county board shall, with the approval of the
175.11commissioner of human services, shall select eligible vendors of chemical dependency
175.12services who can provide economical and appropriate treatment. Unless the local agency
175.13is a social services department directly administered by a county or human services board,
175.14the local agency shall not be an eligible vendor under section 254B.05. The commissioner
175.15may approve proposals from county boards to provide services in an economical manner
175.16or to control utilization, with safeguards to ensure that necessary services are provided.
175.17If a county implements a demonstration or experimental medical services funding plan,
175.18the commissioner shall transfer the money as appropriate. If a county selects a vendor
175.19located in another state, the county shall ensure that the vendor is in compliance with the
175.20rules governing licensure of programs located in the state.
175.21    (c) A culturally specific vendor that provides assessments under a variance under
175.22Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
175.23persons not covered by the variance.
175.24EFFECTIVE DATE.This section is effective July 1, 2011.

175.25    Sec. 8. Minnesota Statutes 2008, section 254B.03, subdivision 3, is amended to read:
175.26    Subd. 3. Local agencies to pay state for county share. Local agencies shall pay
175.27the state for the county share of the services authorized by the local agency, except when
175.28the payment is made according to section 254B.09, subdivision 8.

175.29    Sec. 9. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision
175.30to read:
175.31    Subd. 9. Commissioner to select vendors and set rates. (a) Effective July 1, 2011,
175.32the commissioner shall:
175.33(1) enter into agreements with eligible vendors that:
176.1(i) meet the standards in section 254B.05, subdivision 1;
176.2(ii) have good standing in all applicable licensure; and
176.3(iii) have a current approved provider agreement as a Minnesota health care program
176.4provider; and
176.5(2) set rates for services reimbursed under this chapter.
176.6(b) When setting rates, the commissioner shall consider the complexity and the
176.7acuity of the problems presented by the client.
176.8(c) When rates set under this section and rates set under section 254B.09, subdivision
176.98, apply to the same treatment placement, section 254B.09, subdivision 8, supersedes.

176.10    Sec. 10. Minnesota Statutes 2008, section 254B.05, subdivision 1, is amended to read:
176.11    Subdivision 1. Licensure required. Programs licensed by the commissioner are
176.12eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
176.13notwithstanding the provisions of section 245A.03. American Indian programs located on
176.14federally recognized tribal lands that provide chemical dependency primary treatment,
176.15extended care, transitional residence, or outpatient treatment services, and are licensed by
176.16tribal government are eligible vendors. Detoxification programs are not eligible vendors.
176.17Programs that are not licensed as a chemical dependency residential or nonresidential
176.18treatment program by the commissioner or by tribal government are not eligible vendors.
176.19To be eligible for payment under the Consolidated Chemical Dependency Treatment Fund,
176.20a vendor of a chemical dependency service must participate in the Drug and Alcohol
176.21Abuse Normative Evaluation System and the treatment accountability plan.
176.22Effective January 1, 2000, vendors of room and board are eligible for chemical
176.23dependency fund payment if the vendor:
176.24(1) is certified by the county or tribal governing body as having has rules prohibiting
176.25residents bringing chemicals into the facility or using chemicals while residing in the
176.26facility and provide consequences for infractions of those rules;
176.27(2) has a current contract with a county or tribal governing body;
176.28(3) is determined to meet applicable health and safety requirements;
176.29(4) is not a jail or prison; and
176.30(5) is not concurrently receiving funds under chapter 256I for the recipient.
176.31EFFECTIVE DATE.This section is effective July 1, 2011.

176.32    Sec. 11. Minnesota Statutes 2008, section 254B.09, subdivision 2, is amended to read:
176.33    Subd. 2. American Indian agreements. The commissioner may enter into
176.34agreements with federally recognized tribal units to pay for chemical dependency
177.1treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The
177.2agreements must clarify how the governing body of the tribal unit fulfills local agency
177.3responsibilities regarding:
177.4(1) selection of eligible vendors under section 254B.03, subdivision 1;
177.5(2) negotiation of agreements that establish vendor services and rates for programs
177.6located on the tribal governing body's reservation;
177.7(3) (1) the form and manner of invoicing; and
177.8(4) (2) provide that only invoices for eligible vendors according to section 254B.05
177.9will be included in invoices sent to the commissioner for payment, to the extent that
177.10money allocated under subdivisions 4 and 5 is used.
177.11EFFECTIVE DATE.This section is effective July 1, 2011.

177.12    Sec. 12. [254B.11] MAXIMUM RATES.
177.13The commissioner shall publish maximum rates for vendors of the consolidated
177.14chemical dependency treatment fund by July 1 of each year for implementation the
177.15following January 1. Rates for calendar year 2010 must not exceed 185 percent of the
177.16average rate on January 1, 2009, for each group of vendors with similar attributes. Unless
177.17a new rate methodology is developed under section 254B.12, rates for services provided on
177.18and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009,
177.19for each group of vendors with similar attributes. Payment for services provided by Indian
177.20Health Services or by agencies operated by Indian tribes for medical assistance-eligible
177.21individuals must be governed by the applicable federal rate methodology.

177.22    Sec. 13. [254B.12] RATE METHODOLOGY.
177.23The commissioner shall, with broad-based stakeholder input, develop a
177.24recommendation and present a report to the 2011 legislature, including proposed
177.25legislation for a new rate methodology for the consolidated chemical dependency
177.26treatment fund. The new methodology must replace county-negotiated rates with a
177.27uniform statewide methodology that must include a graduated reimbursement scale based
177.28on the patients' level of acuity and complexity.

177.29    Sec. 14. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to
177.30read:
177.31    Subd. 2. Definitions. For purposes of this section, the following terms have the
177.32meanings given them.
178.1    (a) "Intensive nonresidential rehabilitative mental health services" means adult
178.2rehabilitative mental health services as defined in section 256B.0623, subdivision 2,
178.3paragraph (a), except that these services are provided by a multidisciplinary staff using
178.4a total team approach consistent with assertive community treatment, the Fairweather
178.5Lodge treatment model, as defined by the standards established by the National Coalition
178.6for Community Living, and other evidence-based practices, and directed to recipients with
178.7a serious mental illness who require intensive services.
178.8    (b) "Intensive residential rehabilitative mental health services" means short-term,
178.9time-limited services provided in a residential setting to recipients who are in need of
178.10more restrictive settings and are at risk of significant functional deterioration if they do
178.11not receive these services. Services are designed to develop and enhance psychiatric
178.12stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more
178.13independent setting. Services must be directed toward a targeted discharge date with
178.14specified client outcomes and must be consistent with the Fairweather Lodge treatment
178.15model as defined in paragraph (a), and other evidence-based practices.
178.16    (c) "Evidence-based practices" are nationally recognized mental health services that
178.17are proven by substantial research to be effective in helping individuals with serious
178.18mental illness obtain specific treatment goals.
178.19    (d) "Overnight staff" means a member of the intensive residential rehabilitative
178.20mental health treatment team who is responsible during hours when recipients are
178.21typically asleep.
178.22    (e) "Treatment team" means all staff who provide services under this section to
178.23recipients. At a minimum, this includes the clinical supervisor, mental health professionals
178.24as defined in section 245.462, subdivision 18, clauses (1) to (5) (6); mental health
178.25practitioners as defined in section 245.462, subdivision 17; mental health rehabilitation
178.26workers under section 256B.0623, subdivision 5, clause (3); and certified peer specialists
178.27under section 256B.0615.

178.28    Sec. 15. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to
178.29read:
178.30    Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health
178.31services must be provided by qualified individual provider staff of a certified provider
178.32entity. Individual provider staff must be qualified under one of the following criteria:
178.33    (1) a mental health professional as defined in section 245.462, subdivision 18,
178.34clauses (1) to (5) (6). If the recipient has a current diagnostic assessment by a licensed
178.35mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5)
179.1(6), recommending receipt of adult mental health rehabilitative services, the definition of
179.2mental health professional for purposes of this section includes a person who is qualified
179.3under section 245.462, subdivision 18, clause (6) (7), and who holds a current and valid
179.4national certification as a certified rehabilitation counselor or certified psychosocial
179.5rehabilitation practitioner;
179.6    (2) a mental health practitioner as defined in section 245.462, subdivision 17. The
179.7mental health practitioner must work under the clinical supervision of a mental health
179.8professional;
179.9    (3) a certified peer specialist under section 256B.0615. The certified peer specialist
179.10must work under the clinical supervision of a mental health professional; or
179.11    (4) a mental health rehabilitation worker. A mental health rehabilitation worker
179.12means a staff person working under the direction of a mental health practitioner or mental
179.13health professional and under the clinical supervision of a mental health professional in
179.14the implementation of rehabilitative mental health services as identified in the recipient's
179.15individual treatment plan who:
179.16    (i) is at least 21 years of age;
179.17    (ii) has a high school diploma or equivalent;
179.18    (iii) has successfully completed 30 hours of training during the past two years in all
179.19of the following areas: recipient rights, recipient-centered individual treatment planning,
179.20behavioral terminology, mental illness, co-occurring mental illness and substance abuse,
179.21psychotropic medications and side effects, functional assessment, local community
179.22resources, adult vulnerability, recipient confidentiality; and
179.23    (iv) meets the qualifications in subitem (A) or (B):
179.24    (A) has an associate of arts degree in one of the behavioral sciences or human
179.25services, or is a registered nurse without a bachelor's degree, or who within the previous
179.26ten years has:
179.27    (1) three years of personal life experience with serious and persistent mental illness;
179.28    (2) three years of life experience as a primary caregiver to an adult with a serious
179.29mental illness or traumatic brain injury; or
179.30    (3) 4,000 hours of supervised paid work experience in the delivery of mental health
179.31services to adults with a serious mental illness or traumatic brain injury; or
179.32    (B)(1) is fluent in the non-English language or competent in the culture of the
179.33ethnic group to which at least 20 percent of the mental health rehabilitation worker's
179.34clients belong;
179.35    (2) receives during the first 2,000 hours of work, monthly documented individual
179.36clinical supervision by a mental health professional;
180.1    (3) has 18 hours of documented field supervision by a mental health professional
180.2or practitioner during the first 160 hours of contact work with recipients, and at least six
180.3hours of field supervision quarterly during the following year;
180.4    (4) has review and cosignature of charting of recipient contacts during field
180.5supervision by a mental health professional or practitioner; and
180.6    (5) has 40 hours of additional continuing education on mental health topics during
180.7the first year of employment.

180.8    Sec. 16. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to
180.9read:
180.10    Subd. 5. Mobile crisis intervention staff qualifications. For provision of adult
180.11mental health mobile crisis intervention services, a mobile crisis intervention team is
180.12comprised of at least two mental health professionals as defined in section 245.462,
180.13subdivision 18
, clauses (1) to (5) (6), or a combination of at least one mental health
180.14professional and one mental health practitioner as defined in section 245.462, subdivision
180.1517
, with the required mental health crisis training and under the clinical supervision of
180.16a mental health professional on the team. The team must have at least two people with
180.17at least one member providing on-site crisis intervention services when needed. Team
180.18members must be experienced in mental health assessment, crisis intervention techniques,
180.19and clinical decision-making under emergency conditions and have knowledge of local
180.20services and resources. The team must recommend and coordinate the team's services
180.21with appropriate local resources such as the county social services agency, mental health
180.22services, and local law enforcement when necessary.

180.23    Sec. 17. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to
180.24read:
180.25    Subd. 8. Adult crisis stabilization staff qualifications. (a) Adult mental health
180.26crisis stabilization services must be provided by qualified individual staff of a qualified
180.27provider entity. Individual provider staff must have the following qualifications:
180.28    (1) be a mental health professional as defined in section 245.462, subdivision 18,
180.29clauses (1) to (5) (6);
180.30    (2) be a mental health practitioner as defined in section 245.462, subdivision 17.
180.31The mental health practitioner must work under the clinical supervision of a mental health
180.32professional; or
180.33    (3) be a mental health rehabilitation worker who meets the criteria in section
180.34256B.0623, subdivision 5 , clause (3); works under the direction of a mental health
181.1practitioner as defined in section 245.462, subdivision 17, or under direction of a
181.2mental health professional; and works under the clinical supervision of a mental health
181.3professional.
181.4    (b) Mental health practitioners and mental health rehabilitation workers must have
181.5completed at least 30 hours of training in crisis intervention and stabilization during
181.6the past two years.

181.7    Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to
181.8read:
181.9    Subd. 42. Mental health professional. Notwithstanding Minnesota Rules, part
181.109505.0175, subpart 28, the definition of a mental health professional shall include a person
181.11who is qualified as specified in section 245.462, subdivision 18, clause clauses (5) and (6);
181.12or 245.4871, subdivision 27, clause clauses (5) and (6), for the purpose of this section and
181.13Minnesota Rules, parts 9505.0170 to 9505.0475.

181.14    Sec. 19. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to
181.15read:
181.16    Subdivision 1. Definitions. For purposes of this section, the following terms have
181.17the meanings given them.
181.18    (a) "Children's therapeutic services and supports" means the flexible package of
181.19mental health services for children who require varying therapeutic and rehabilitative
181.20levels of intervention. The services are time-limited interventions that are delivered using
181.21various treatment modalities and combinations of services designed to reach treatment
181.22outcomes identified in the individual treatment plan.
181.23    (b) "Clinical supervision" means the overall responsibility of the mental health
181.24professional for the control and direction of individualized treatment planning, service
181.25delivery, and treatment review for each client. A mental health professional who is an
181.26enrolled Minnesota health care program provider accepts full professional responsibility
181.27for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
181.28and oversees or directs the supervisee's work.
181.29    (c) "County board" means the county board of commissioners or board established
181.30under sections 402.01 to 402.10 or 471.59.
181.31    (d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
181.32    (e) "Culturally competent provider" means a provider who understands and can
181.33utilize to a client's benefit the client's culture when providing services to the client. A
181.34provider may be culturally competent because the provider is of the same cultural or
182.1ethnic group as the client or the provider has developed the knowledge and skills through
182.2training and experience to provide services to culturally diverse clients.
182.3    (f) "Day treatment program" for children means a site-based structured program
182.4consisting of group psychotherapy for more than three individuals and other intensive
182.5therapeutic services provided by a multidisciplinary team, under the clinical supervision
182.6of a mental health professional.
182.7    (g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
182.811
.
182.9    (h) "Direct service time" means the time that a mental health professional, mental
182.10health practitioner, or mental health behavioral aide spends face-to-face with a client
182.11and the client's family. Direct service time includes time in which the provider obtains
182.12a client's history or provides service components of children's therapeutic services and
182.13supports. Direct service time does not include time doing work before and after providing
182.14direct services, including scheduling, maintaining clinical records, consulting with others
182.15about the client's mental health status, preparing reports, receiving clinical supervision
182.16directly related to the client's psychotherapy session, and revising the client's individual
182.17treatment plan.
182.18    (i) "Direction of mental health behavioral aide" means the activities of a mental
182.19health professional or mental health practitioner in guiding the mental health behavioral
182.20aide in providing services to a client. The direction of a mental health behavioral aide
182.21must be based on the client's individualized treatment plan and meet the requirements in
182.22subdivision 6, paragraph (b), clause (5).
182.23    (j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
182.2415
. For persons at least age 18 but under age 21, mental illness has the meaning given in
182.25section 245.462, subdivision 20, paragraph (a).
182.26    (k) "Individual behavioral plan" means a plan of intervention, treatment, and
182.27services for a child written by a mental health professional or mental health practitioner,
182.28under the clinical supervision of a mental health professional, to guide the work of the
182.29mental health behavioral aide.
182.30    (l) "Individual treatment plan" has the meaning given in section 245.4871,
182.31subdivision 21
.
182.32    (m) "Mental health professional" means an individual as defined in section 245.4871,
182.33subdivision 27
, clauses (1) to (5) (6), or tribal vendor as defined in section 256B.02,
182.34subdivision 7
, paragraph (b).
182.35    (n) "Preschool program" means a day program licensed under Minnesota Rules,
182.36parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
183.1supports provider to provide a structured treatment program to a child who is at least 33
183.2months old but who has not yet attended the first day of kindergarten.
183.3    (o) "Skills training" means individual, family, or group training designed to improve
183.4the basic functioning of the child with emotional disturbance and the child's family in the
183.5activities of daily living and community living, and to improve the social functioning of the
183.6child and the child's family in areas important to the child's maintaining or reestablishing
183.7residency in the community. Individual, family, and group skills training must:
183.8    (1) consist of activities designed to promote skill development of the child and the
183.9child's family in the use of age-appropriate daily living skills, interpersonal and family
183.10relationships, and leisure and recreational services;
183.11    (2) consist of activities that will assist the family's understanding of normal child
183.12development and to use parenting skills that will help the child with emotional disturbance
183.13achieve the goals outlined in the child's individual treatment plan; and
183.14    (3) promote family preservation and unification, promote the family's integration
183.15with the community, and reduce the use of unnecessary out-of-home placement or
183.16institutionalization of children with emotional disturbance.

183.17    Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to
183.18read:
183.19    Subd. 47. Treatment foster care services. Effective July 1, 2007 2011, and subject
183.20to federal approval, medical assistance covers treatment foster care services according to
183.21section 256B.0946.

183.22    Sec. 21. Minnesota Statutes 2008, section 256B.0943, subdivision 12, is amended to
183.23read:
183.24    Subd. 12. Excluded services. The following services are not eligible for medical
183.25assistance payment as children's therapeutic services and supports:
183.26    (1) service components of children's therapeutic services and supports
183.27simultaneously provided by more than one provider entity unless prior authorization is
183.28obtained;
183.29    (2) treatment by multiple providers within the same agency at the same clock time;
183.30(3) children's therapeutic services and supports provided in violation of medical
183.31assistance policy in Minnesota Rules, part 9505.0220;
183.32    (3) (4) mental health behavioral aide services provided by a personal care assistant
183.33who is not qualified as a mental health behavioral aide and employed by a certified
183.34children's therapeutic services and supports provider entity;
184.1    (4) (5) service components of CTSS that are the responsibility of a residential or
184.2program license holder, including foster care providers under the terms of a service
184.3agreement or administrative rules governing licensure;
184.4    (5) (6) adjunctive activities that may be offered by a provider entity but are not
184.5otherwise covered by medical assistance, including:
184.6    (i) a service that is primarily recreation oriented or that is provided in a setting that
184.7is not medically supervised. This includes sports activities, exercise groups, activities
184.8such as craft hours, leisure time, social hours, meal or snack time, trips to community
184.9activities, and tours;
184.10    (ii) a social or educational service that does not have or cannot reasonably be
184.11expected to have a therapeutic outcome related to the client's emotional disturbance;
184.12    (iii) consultation with other providers or service agency staff about the care or
184.13progress of a client;
184.14    (iv) prevention or education programs provided to the community; and
184.15    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse; and
184.16    (6) (7) activities that are not direct service time.

184.17    Sec. 22. Minnesota Statutes 2008, section 256B.0944, is amended by adding a
184.18subdivision to read:
184.19    Subd. 4a. Alternative provider standards. If a provider entity demonstrates that,
184.20due to geographic or other barriers, it is not feasible to provide mobile crisis intervention
184.21services 24 hours a day, seven days a week, according to the standards in subdivision 4,
184.22paragraph (b), clause (1), the commissioner may approve a crisis response provider based
184.23on an alternative plan proposed by a provider entity. The alternative plan must:
184.24(1) result in increased access and a reduction in disparities in the availability of
184.25crisis services; and
184.26(2) provide mobile services outside of the usual nine-to-five office hours and on
184.27weekends and holidays.

184.28    Sec. 23. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to
184.29read:
184.30    Subdivision 1. Scope. Subject to federal approval Effective November 1, 2010, and
184.31subject to federal approval, medical assistance covers medically necessary, intensive
184.32nonresidential rehabilitative mental health services as defined in subdivision 2, for
184.33recipients as defined in subdivision 3, when the services are provided by an entity meeting
184.34the standards in this section.

185.1    Sec. 24. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to read:
185.2    Subd. 73a. Qualified professional. (a) For physical illness, injury, or incapacity,
185.3a "qualified professional" means a licensed physician, a physician's assistant, a nurse
185.4practitioner, or a licensed chiropractor.
185.5    (b) For developmental disability and intelligence testing, a "qualified professional"
185.6means an individual qualified by training and experience to administer the tests necessary
185.7to make determinations, such as tests of intellectual functioning, assessments of adaptive
185.8behavior, adaptive skills, and developmental functioning. These professionals include
185.9licensed psychologists, certified school psychologists, or certified psychometrists working
185.10under the supervision of a licensed psychologist.
185.11    (c) For learning disabilities, a "qualified professional" means a licensed psychologist
185.12or school psychologist with experience determining learning disabilities.
185.13    (d) For mental health, a "qualified professional" means a licensed physician or a
185.14qualified mental health professional. A "qualified mental health professional" means:
185.15    (1) for children, in psychiatric nursing, a registered nurse who is licensed under
185.16sections 148.171 to 148.285, and who is certified as a clinical specialist in child
185.17and adolescent psychiatric or mental health nursing by a national nurse certification
185.18organization or who has a master's degree in nursing or one of the behavioral sciences
185.19or related fields from an accredited college or university or its equivalent, with at least
185.204,000 hours of post-master's supervised experience in the delivery of clinical services in
185.21the treatment of mental illness;
185.22    (2) for adults, in psychiatric nursing, a registered nurse who is licensed under
185.23sections 148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric
185.24and mental health nursing by a national nurse certification organization or who has a
185.25master's degree in nursing or one of the behavioral sciences or related fields from an
185.26accredited college or university or its equivalent, with at least 4,000 hours of post-master's
185.27supervised experience in the delivery of clinical services in the treatment of mental illness;
185.28    (3) in clinical social work, a person licensed as an independent clinical social worker
185.29under chapter 148D, or a person with a master's degree in social work from an accredited
185.30college or university, with at least 4,000 hours of post-master's supervised experience in
185.31the delivery of clinical services in the treatment of mental illness;
185.32    (4) in psychology, an individual licensed by the Board of Psychology under sections
185.33148.88 to 148.98, who has stated to the Board of Psychology competencies in the
185.34diagnosis and treatment of mental illness;
186.1    (5) in psychiatry, a physician licensed under chapter 147 and certified by the
186.2American Board of Psychiatry and Neurology or eligible for board certification in
186.3psychiatry; and
186.4    (6) in marriage and family therapy, the mental health professional must be a
186.5marriage and family therapist licensed under sections 148B.29 to 148B.39, with at least
186.6two years of post-master's supervised experience in the delivery of clinical services in the
186.7treatment of mental illness; and
186.8    (7) in licensed professional clinical counseling, the mental health professional
186.9shall be a licensed professional clinical counselor under section 148B.5301 with at least
186.104,000 hours of postmaster's supervised experience in the delivery of clinical services in
186.11the treatment of mental illness.

186.12    Sec. 25. AUTISM SPECTRUM DISORDER TASK FORCE.
186.13(a) The Autism Spectrum Disorder Task Force is composed of 15 members,
186.14appointed as follows:
186.15(1) two members of the senate appointed by the Subcommittee on Committees of the
186.16Committee on Rules and Administration, one of whom must be a member of the minority;
186.17(2) two members of the house of representatives, one from the majority party,
186.18appointed by the speaker of the house, and one from the minority party, appointed by
186.19the minority leader;
186.20    (3) two members appointed by the legislature, with regard to geographic diversity in
186.21the state, who are parents of children with autism spectrum disorder (ASD); one member
186.22shall be appointed by the senate Subcommittee on Committees of the Committee on
186.23Rules and Administration making appointments for the senate; and one member shall be
186.24appointed by the speaker of the house making the appointments for the house;
186.25(4) one member appointed by the Minnesota chapter of the American Academy of
186.26Pediatrics who is a general primary care pediatrician;
186.27(5) one member appointed by the Minnesota Academy of Family Physicians who is
186.28a family practice physician;
186.29(6) one member appointed by the Minnesota Psychological Association who is a
186.30neuropsychologist;
186.31(7) one member appointed by the directors of public school student support services;
186.32(8) one member appointed by the Somali American Autism Foundation;
186.33(9) one member appointed by the ARC of Minnesota;
186.34(10) one member appointed by the Autism Society of Minnesota;
187.1(11) one member appointed by the Parent Advocacy Coalition for Educational
187.2Rights; and
187.3(12) one member appointed by the Minnesota Council of Health Plans.
187.4Appointments must be made by September 1, 2009. The Legislative Coordinating
187.5Commission shall provide meeting space for the task force. The senate member appointed
187.6by the minority leader of the senate shall convene the first meeting of the task force no
187.7later than October 1, 2009. The task force shall elect a chair at the first meeting.
187.8(b) If federal or state funding is available, the commissioners of education,
187.9employment and economic development, health, and human services shall provide
187.10assistance to the task force.
187.11(c) The task force shall develop recommendations and report on the following topics:
187.12(1) ways to improve services provided by all state and political subdivisions;
187.13(2) sources of public and private funding available for treatment and ways to
187.14improve efficiency in the use of these funds;
187.15(3) methods to improve coordination in the delivery of service between public
187.16and private agencies, health providers, and schools, and to address any geographic
187.17discrepancies in the delivery of services;
187.18(4) increasing the availability of and the training for medical providers and educators
187.19who identify and provide services to individuals with ASD; and
187.20(5) treatment options supported by peer-reviewed, established scientific research
187.21for individuals with ASD.
187.22(d) The task force shall coordinate with existing efforts at the Departments of
187.23Education, Health, Human Services, and Employment and Economic Development
187.24related to ASD.
187.25(e) By January 15 of each year, the task force shall provide a report regarding its
187.26findings and consideration of the topics listed under paragraph (c), and the action taken
187.27under paragraph (d), including draft legislation if necessary, to the chairs and ranking
187.28minority members of the legislative committees with jurisdiction over health and human
187.29services.
187.30(f) This section expires June 30, 2011.

187.31    Sec. 26. STATE-COUNTY CHEMICAL HEALTH CARE HOME PILOT
187.32PROJECT.
187.33    Subdivision 1. Establishment; purpose. There is established a state-county
187.34chemical health care home pilot project. The purpose of the pilot project is for the
187.35Department of Human Services and counties to authentically and creatively work in
188.1partnership to redesign the current chemical health service delivery system in a way
188.2that promotes greater accountability, productivity, and results in the delivery of state
188.3chemical dependency services. The pilot project or projects must look to provide
188.4appropriate flexibility in a way that ensures timely access to needed services as well
188.5as better aligning systems and services to offer the most appropriate level of chemical
188.6health care services to the client. This may include, but is not limited to, looking into new
188.7governance agreements, performance agreements, or service level agreements. Pilot
188.8projects must maintain eligibility requirements for the consolidated chemical dependency
188.9treatment fund, continue to meet the requirements of Minnesota Rules, parts 9530.6600 to
188.109530.6655 (also known as Rule 25) and Minnesota Rules, parts 9530.6405 to 9530.6505
188.11(also known as Rule 31), and must not put at risk current and future federal funding toward
188.12chemical health-related services in the state of Minnesota.
188.13    Subd. 2. Workgroup; report. A workgroup must be convened on or before July
188.1415, 2009, consisting of representatives from the Department of Human Services and
188.15potential participating counties to develop draft proposals for pilot projects meeting the
188.16requirements of this section. The workgroup shall report back to the legislative committees
188.17with jurisdiction over chemical health by January 15, 2010, for potential approval of one
188.18metro and one nonmetro county pilot project to be implemented beginning July 10, 2010.
188.19    Subd. 3. Report. The Department of Human Services shall evaluate the efficacy and
188.20feasibility of the pilot projects and report the results of that evaluation to the legislative
188.21committees having jurisdiction over chemical health by June 30, 2011. Expansion of pilot
188.22projects may occur only if the department's report finds the pilot projects effective.
188.23    Subd. 4. Expiration. This section expires June 30, 2012.
188.24EFFECTIVE DATE.This section is effective the day following final enactment.

188.25ARTICLE 8
188.26CONTINUING CARE

188.27    Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to
188.28read:
188.29    Subd. 2. Definitions. For purposes of this section, the following terms have the
188.30meanings given.
188.31(a) "Assessment reference date" means the last day of the minimum data set
188.32observation period. The date sets the designated endpoint of the common observation
188.33period, and all minimum data set items refer back in time from that point.
189.1(b) "Case mix index" means the weighting factors assigned to the RUG-III
189.2classifications.
189.3(c) "Index maximization" means classifying a resident who could be assigned to
189.4more than one category, to the category with the highest case mix index.
189.5(d) "Minimum data set" means the assessment instrument specified by the Centers for
189.6Medicare and Medicaid Services and designated by the Minnesota Department of Health.
189.7(e) "Representative" means a person who is the resident's guardian or conservator,
189.8the person authorized to pay the nursing home expenses of the resident, a representative
189.9of the nursing home ombudsman's office whose assistance has been requested, or any
189.10other individual designated by the resident.
189.11(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
189.12facility's residents according to their clinical and functional status identified in data
189.13supplied by the facility's minimum data set.
189.14(g) "Activities of daily living" means grooming, dressing, bathing, transferring,
189.15mobility, positioning, eating, and toileting.
189.16(h) "Nursing facility level of care determination" means the assessment process
189.17that results in a determination of a resident's or prospective resident's need for nursing
189.18facility level of care as established in subdivision 11 for purposes of medical assistance
189.19payment of long-term care services for:
189.20(1) nursing facility services under section 256B.434 or 256B.441;
189.21(2) elderly waiver services under section 256B.0915;
189.22(3) CADI and TBI waiver services under section 256B.49; and
189.23(4) state payment of alternative care services under section 256B.0913.
189.24EFFECTIVE DATE.The section is effective January 1, 2011.

189.25    Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:
189.26    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
189.27electronically submit to the commissioner of health case mix assessments that conform
189.28with the assessment schedule defined by Code of Federal Regulations, title 42, section
189.29483.20 , and published by the United States Department of Health and Human Services,
189.30Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
189.31Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made
189.32in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0,
189.33August 1996. The commissioner of health may substitute successor manuals or question
189.34and answer documents published by the United States Department of Health and Human
190.1Services, Centers for Medicare and Medicaid Services, to replace or supplement the
190.2current version of the manual or document.
190.3(b) The assessments used to determine a case mix classification for reimbursement
190.4include the following:
190.5(1) a new admission assessment must be completed by day 14 following admission;
190.6(2) an annual assessment must be completed within 366 days of the last
190.7comprehensive assessment;
190.8(3) a significant change assessment must be completed within 14 days of the
190.9identification of a significant change; and
190.10(4) the second quarterly assessment following either a new admission assessment,
190.11an annual assessment, or a significant change assessment, and all quarterly assessments
190.12beginning October 1, 2006. Each quarterly assessment must be completed within 92
190.13days of the previous assessment.
190.14(c) In addition to the assessments listed in paragraph (b), the assessments used to
190.15determine nursing facility level of care include the following:
190.16(1) preadmission screening completed under section 256B.0911, subdivision 4a,
190.17by a county, tribe, or managed care organization under contract with the Department
190.18of Human Services; and
190.19(2) a face-to-face long-term care consultation assessment completed under section
190.20256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization
190.21under contract with the Department of Human Services.
190.22EFFECTIVE DATE.The section is effective January 1, 2011.

190.23    Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:
190.24    Subd. 8. Request for reconsideration of resident classifications. (a) The resident,
190.25or resident's representative, or the nursing facility or boarding care home may request that
190.26the commissioner of health reconsider the assigned reimbursement classification. The
190.27request for reconsideration must be submitted in writing to the commissioner within
190.2830 days of the day the resident or the resident's representative receives the resident
190.29classification notice. The request for reconsideration must include the name of the
190.30resident, the name and address of the facility in which the resident resides, the reasons for
190.31the reconsideration, the requested classification changes, and documentation supporting
190.32the requested classification. The documentation accompanying the reconsideration request
190.33is limited to documentation which establishes that the needs of the resident at the time of
190.34the assessment justify a classification which is different than the classification established
190.35by the commissioner of health.
191.1(b) Upon request, the nursing facility must give the resident or the resident's
191.2representative a copy of the assessment form and the other documentation that was given
191.3to the commissioner of health to support the assessment findings. The nursing facility
191.4shall also provide access to and a copy of other information from the resident's record that
191.5has been requested by or on behalf of the resident to support a resident's reconsideration
191.6request. A copy of any requested material must be provided within three working days of
191.7receipt of a written request for the information. If a facility fails to provide the material
191.8within this time, it is subject to the issuance of a correction order and penalty assessment
191.9under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order
191.10issued under this subdivision must require that the nursing facility immediately comply
191.11with the request for information and that as of the date of the issuance of the correction
191.12order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and
191.13an increase in the $100 fine by $50 increments for each day the noncompliance continues.
191.14(c) In addition to the information required under paragraphs (a) and (b), a
191.15reconsideration request from a nursing facility must contain the following information: (i)
191.16the date the reimbursement classification notices were received by the facility; (ii) the date
191.17the classification notices were distributed to the resident or the resident's representative;
191.18and (iii) a copy of a notice sent to the resident or to the resident's representative. This
191.19notice must inform the resident or the resident's representative that a reconsideration of the
191.20resident's classification is being requested, the reason for the request, that the resident's
191.21rate will change if the request is approved by the commissioner, the extent of the change,
191.22that copies of the facility's request and supporting documentation are available for review,
191.23and that the resident also has the right to request a reconsideration. If the facility fails to
191.24provide the required information with the reconsideration request, the request must be
191.25denied, and the facility may not make further reconsideration requests on that specific
191.26reimbursement classification.
191.27(d) Reconsideration by the commissioner must be made by individuals not involved
191.28in reviewing the assessment, audit, or reconsideration that established the disputed
191.29classification. The reconsideration must be based upon the initial assessment and upon the
191.30information provided to the commissioner under paragraphs (a) and (b). If necessary for
191.31evaluating the reconsideration request, the commissioner may conduct on-site reviews.
191.32Within 15 working days of receiving the request for reconsideration, the commissioner
191.33shall affirm or modify the original resident classification. The original classification
191.34must be modified if the commissioner determines that the assessment resulting in the
191.35classification did not accurately reflect the needs or assessment characteristics of the
191.36resident at the time of the assessment. The resident and the nursing facility or boarding
192.1care home shall be notified within five working days after the decision is made. A decision
192.2by the commissioner under this subdivision is the final administrative decision of the
192.3agency for the party requesting reconsideration.
192.4(e) The resident classification established by the commissioner shall be the
192.5classification that applies to the resident while the request for reconsideration is pending.
192.6If a request for reconsideration applies to an assessment used to determine nursing facility
192.7level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible
192.8for nursing facility level of care while the request for reconsideration is pending.
192.9(f) The commissioner may request additional documentation regarding a
192.10reconsideration necessary to make an accurate reconsideration determination.
192.11EFFECTIVE DATE.The section is effective January 1, 2011.

192.12    Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
192.13to read:
192.14    Subd. 11. Nursing facility level of care. (a) For purposes of medical assistance
192.15payment of long-term care services, a recipient must be determined, using assessments
192.16defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
192.17(1) the person needs the assistance of another person or constant supervision to begin
192.18and complete at least four of the following activities of living: bathing, bed mobility,
192.19dressing, eating, grooming, toileting, transferring, and walking;
192.20(2) the person needs the assistance of another person or constant supervision to begin
192.21and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
192.22(3) the person has significant difficulty with memory, using information, daily
192.23decision making, or behavioral needs that require intervention;
192.24(4) the person has had a qualifying nursing facility stay of at least 90 days; or
192.25(5) the person is determined to be at risk for nursing facility admission or
192.26readmission through a face-to-face long-term care consultation assessment as specified
192.27in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care
192.28organization under contract with the Department of Human Services. The person is
192.29considered at risk under this clause if the person currently lives alone or will live alone
192.30upon discharge and also meets one of the following criteria:
192.31(i) the person has experienced a fall resulting in a fracture;
192.32(ii) the person has been determined to be at risk of maltreatment or neglect,
192.33including self-neglect; or
192.34(iii) the person has a sensory impairment that substantially impacts functional ability
192.35and maintenance of a community residence.
193.1(b) The assessment used to establish medical assistance payment for nursing facility
193.2services must be the most recent assessment performed under subdivision 4, paragraph
193.3(b), that occurred no more than 90 calendar days before the effective date of medical
193.4assistance eligibility for payment of long-term care services. In no case shall medical
193.5assistance payment for long-term care services occur prior to the date of the determination
193.6of nursing facility level of care.
193.7(c) The assessment used to establish medical assistance payment for long-term care
193.8services provided under sections 256B.0915 and 256B.49 and alternative care payment
193.9for services provided under section 256B.0913 must be the most recent face-to-face
193.10assessment performed under section 256B.0911, subdivision 3a, that occurred no more
193.11than 60 calendar days before the effective date of medical assistance eligibility for
193.12payment of long-term care services.
193.13EFFECTIVE DATE.The section is effective January 1, 2011.

193.14    Sec. 5. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
193.15to read:
193.16    Subd. 12. Appeal of nursing facility level of care determination. A resident or
193.17prospective resident whose level of care determination results in a denial of long-term care
193.18services can appeal the determination as outlined in section 256B.0911, subdivision 3a,
193.19paragraph (h), clause (7).
193.20EFFECTIVE DATE.The section is effective January 1, 2011.

193.21    Sec. 6. Minnesota Statutes 2008, section 144A.073, is amended by adding a
193.22subdivision to read:
193.23    Subd. 12. Extension of approval of moratorium exception projects.
193.24Notwithstanding subdivision 3, the commissioner of health shall extend project approval
193.25by an additional 18 months for an approved proposal for an exception to the nursing home
193.26licensure and certification moratorium if the proposal was approved under this section
193.27between July 1, 2007, and June 30, 2009.

193.28    Sec. 7. Minnesota Statutes 2008, section 144A.44, subdivision 2, is amended to read:
193.29    Subd. 2. Interpretation and enforcement of rights. These rights are established
193.30for the benefit of persons who receive home care services. "Home care services" means
193.31home care services as defined in section 144A.43, subdivision 3, and unlicensed personal
193.32care assistance services, including services covered by medical assistance under section
193.33256B.0625, subdivision 19a. A home care provider may not require a person to surrender
194.1these rights as a condition of receiving services. A guardian or conservator or, when there
194.2is no guardian or conservator, a designated person, may seek to enforce these rights. This
194.3statement of rights does not replace or diminish other rights and liberties that may exist
194.4relative to persons receiving home care services, persons providing home care services, or
194.5providers licensed under Laws 1987, chapter 378. A copy of these rights must be provided
194.6to an individual at the time home care services, including personal care assistance
194.7services, are initiated. The copy shall also contain the address and phone number of the
194.8Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care
194.9and a brief statement describing how to file a complaint with these offices. Information
194.10about how to contact the Office of Ombudsman for Long-Term Care shall be included in
194.11notices of change in client fees and in notices where home care providers initiate transfer
194.12or discontinuation of services.

194.13    Sec. 8. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision
194.14to read:
194.15    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
194.16initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
194.172960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
194.189555.6265, under this chapter for a physical location that will not be the primary residence
194.19of the license holder for the entire period of licensure. If a license is issued during this
194.20moratorium, and the license holder changes the license holder's primary residence away
194.21from the physical location of the foster care license, the commissioner shall revoke the
194.22license according to section 245A.07. Exceptions to the moratorium include:
194.23(1) foster care settings that are required to be registered under chapter 144D;
194.24(2) foster care licenses replacing foster care licenses in existence on the effective
194.25date of this section and determined to be needed by the commissioner under paragraph (b);
194.26(3) new foster care licenses determined to be needed by the commissioner under
194.27paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
194.28(4) new foster care licenses determined to be needed by the commissioner under
194.29paragraph (b) for persons requiring hospital level care; or
194.30(5) new foster care licenses determined to be needed by the commissioner for the
194.31transition of people from personal care assistance to the home and community-based
194.32services.
194.33(b) The commissioner shall determine the need for newly licensed foster care homes
194.34as defined under this subdivision. As part of the determination, the commissioner shall
194.35consider the availability of foster care capacity in the area which the licensee seeks to
195.1operate, and the recommendation of the local county board. The determination by the
195.2commissioner must be final. A determination of need is not required for a change in
195.3ownership at the same address.
195.4    (c) Residential settings that would otherwise be subject to the moratorium established
195.5in paragraph (a), that are in the process of receiving an adult or child foster care license as
195.6of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
195.7or child foster care license. For this paragraph, all of the following conditions must be met
195.8to be considered in process of receiving an adult or child foster care license:
195.9    (1) participants have made decisions to move into the residential setting, including
195.10documentation in each participant's care plan;
195.11    (2) the provider has purchased housing or has made a financial investment in the
195.12property;
195.13    (3) the lead agency has approved the plans, including costs for the residential setting
195.14for each individual;
195.15    (4) the completion of the licensing process, including all necessary inspections, is
195.16the only remaining component prior to being able to provide services; and
195.17    (5) the needs of the individuals cannot be met within the existing capacity in that
195.18county.
195.19To qualify for the process under this paragraph, the lead agency must submit
195.20documentation to the commissioner by August 1, 2009, that all of the above criteria are
195.21met.
195.22(d) The commissioner shall study the effects of the license moratorium under this
195.23subdivision and shall report back to the legislature by January 15, 2011.
195.24EFFECTIVE DATE.This section is effective the day following final enactment.

195.25    Sec. 9. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
195.26to read:
195.27    Subd. 8. Community residential setting license. (a) The commissioner shall
195.28establish provider standards for residential support services that integrate service standards
195.29and the residential setting under one license. The commissioner shall propose statutory
195.30language and an implementation plan for licensing requirements for residential support
195.31services to the legislature by January 15, 2011.
195.32(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
195.33for services in settings licensed as adult foster care under Minnesota Rules, parts
195.349555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to
196.12960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph
196.2(b), must be required to obtain a community residential setting license.

196.3    Sec. 10. Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision
196.4to read:
196.5    Subd. 1a. Day training and habilitation rates. The commissioner shall establish
196.6a statewide rate-setting methodology for all day training and habilitation services. The
196.7rate-setting methodology must abide by the principles of transparency and equitability
196.8across the state. The methodology must involve a uniform process of structuring rates for
196.9each service and must promote quality and participant choice.

196.10    Sec. 11. Minnesota Statutes 2008, section 252.50, subdivision 1, is amended to read:
196.11    Subdivision 1. Community-based programs established. The commissioner
196.12shall establish a system of state-operated, community-based programs for persons with
196.13developmental disabilities. For purposes of this section, "state-operated, community-based
196.14program" means a program administered by the state to provide treatment and habilitation
196.15in noninstitutional community settings to persons with developmental disabilities.
196.16Employees of the programs, except clients who work within and benefit from these
196.17treatment and habilitation programs, must be state employees under chapters 43A and
196.18179A. Although any clients who work within and benefit from these treatment and
196.19habilitation programs are not employees under chapters 43A and 179A, the Department
196.20of Human Services may consider clients who work within and benefit from these
196.21programs employees for federal tax purposes. The establishment of state-operated,
196.22community-based programs must be within the context of a comprehensive definition of
196.23the role of state-operated services in the state. The role of state-operated services must
196.24be defined within the context of a comprehensive system of services for persons with
196.25developmental disabilities. State-operated, community-based programs may include, but
196.26are not limited to, community group homes, foster care, supportive living services, day
196.27training and habilitation programs, and respite care arrangements. The commissioner
196.28may operate the pilot projects established under Laws 1985, First Special Session
196.29chapter 9, article 1, section 2, subdivision 6, and shall, within the limits of available
196.30appropriations, establish additional state-operated, community-based programs for
196.31persons with developmental disabilities. State-operated, community-based programs may
196.32accept admissions from regional treatment centers, from the person's own home, or from
196.33community programs. State-operated, community-based programs offering day program
196.34services may be provided for persons with developmental disabilities who are living in
197.1state-operated, community-based residential programs until July 1, 2000. No later than
197.21994, the commissioner, together with family members, counties, advocates, employee
197.3representatives, and other interested parties, shall begin planning so that by July 1, 2000,
197.4state-operated, community-based residential facilities will be in compliance with section
197.5252.41, subdivision 9 .

197.6    Sec. 12. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
197.7to read:
197.8    Subd. 29. State medical review team. (a) To ensure the timely processing of
197.9determinations of disability by the commissioner's state medical review team under
197.10sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
197.11(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence
197.12submitted by county agencies with a referral and seek additional information from
197.13providers, applicants, and enrollees to support the determination of disability where
197.14necessary. Disability shall be determined according to the rules of title XVI and title
197.15XIX of the Social Security Act and pertinent rules and policies of the Social Security
197.16Administration.
197.17    (b) Prior to a denial or withdrawal of a requested determination of disability due
197.18to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
197.19necessary and appropriate to a determination of disability, and (2) assist applicants and
197.20enrollees to obtain the evidence, including, but not limited to, medical examinations
197.21and electronic medical records.
197.22(c) The commissioner shall provide the chairs of the legislative committees with
197.23jurisdiction over health and human services finance and budget the following information
197.24on the activities of the state medical review team by February 1, 2010, and annually
197.25thereafter:
197.26(1) the number of applications to the state medical review team that were denied,
197.27approved, or withdrawn;
197.28(2) the average length of time from receipt of the application to a decision;
197.29(3) the number of appeals and appeal results;
197.30(4) for applicants, their age, health coverage at the time of application, hospitalization
197.31history within three months of application, and whether an application for Social Security
197.32or Supplemental Security Income benefits is pending; and
197.33(5) specific information on the medical certification, licensure, or other credentials
197.34of the person or persons performing the medical review determinations and length of
197.35time in that position.

198.1    Sec. 13. [256.0281] INTERAGENCY DATA EXCHANGE.
198.2The Department of Human Services, the Department of Health, and the Office of the
198.3Ombudsman for Mental Health and Developmental Disabilities may establish interagency
198.4agreements governing the electronic exchange of data on providers and individuals
198.5collected, maintained, or used by each agency when such exchange is outlined by each
198.6agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
198.7(1) to improve provider enrollment processes for home and community-based
198.8services and state plan home care services;
198.9(2) to improve quality management of providers between state agencies;
198.10(3) to establish and maintain provider eligibility to participate as providers under
198.11Minnesota health care programs; or
198.12(4) to meet the quality assurance reporting requirements under federal law under
198.13section 1915(c) of the Social Security Act related to home and community-based waiver
198.14programs.
198.15Each interagency agreement must include provisions to ensure anonymity of individuals,
198.16including mandated reporters, and must outline the specific uses of and access to shared
198.17data within each agency. Electronic interfaces between source data systems developed
198.18under these interagency agreements must incorporate these provisions as well as other
198.19HIPPA provisions related to individual data.

198.20    Sec. 14. Minnesota Statutes 2008, section 256.476, subdivision 5, is amended to read:
198.21    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of
198.22transferring persons to the consumer support grant program from the family support
198.23program and personal care assistant services, home health aide services, or private duty
198.24nursing services, the amount of funds transferred by the commissioner between the
198.25family support program account, the medical assistance account, or the consumer support
198.26grant account shall be based on each county's participation in transferring persons to the
198.27consumer support grant program from those programs and services.
198.28    (b) At the beginning of each fiscal year, county allocations for consumer support
198.29grants shall be based on:
198.30    (1) the number of persons to whom the county board expects to provide consumer
198.31supports grants;
198.32    (2) their eligibility for current program and services;
198.33    (3) the amount of nonfederal dollars monthly grant levels allowed under subdivision
198.3411; and
199.1    (4) projected dates when persons will start receiving grants. County allocations shall
199.2be adjusted periodically by the commissioner based on the actual transfer of persons or
199.3service openings, and the nonfederal dollars monthly grant levels associated with those
199.4persons or service openings, to the consumer support grant program.
199.5    (c) The amount of funds transferred by the commissioner from the medical
199.6assistance account for an individual may be changed if it is determined by the county or its
199.7agent that the individual's need for support has changed.
199.8    (d) The authority to utilize funds transferred to the consumer support grant account
199.9for the purposes of implementing and administering the consumer support grant program
199.10will not be limited or constrained by the spending authority provided to the program
199.11of origination.
199.12    (e) The commissioner may use up to five percent of each county's allocation, as
199.13adjusted, for payments for administrative expenses, to be paid as a proportionate addition
199.14to reported direct service expenditures.
199.15    (f) The county allocation for each person or the person's legal representative or other
199.16authorized representative cannot exceed the amount allowed under subdivision 11.
199.17    (g) The commissioner may recover, suspend, or withhold payments if the county
199.18board, local agency, or grantee does not comply with the requirements of this section.
199.19    (h) Grant funds unexpended by consumers shall return to the state once a year. The
199.20annual return of unexpended grant funds shall occur in the quarter following the end of
199.21the state fiscal year.

199.22    Sec. 15. Minnesota Statutes 2008, section 256.476, subdivision 11, is amended to read:
199.23    Subd. 11. Consumer support grant program after July 1, 2001. (a) Effective
199.24July 1, 2001, the commissioner shall allocate consumer support grant resources to
199.25serve additional individuals based on a review of Medicaid authorization and payment
199.26information of persons eligible for a consumer support grant from the most recent fiscal
199.27year. The commissioner shall use the following methodology to calculate maximum
199.28allowable monthly consumer support grant levels:
199.29    (1) For individuals whose program of origination is medical assistance home care
199.30under sections 256B.0651 and 256B.0653 to 256B.0656, the maximum allowable monthly
199.31grant levels are calculated by:
199.32    (i) determining the nonfederal share 50 percent of the average service authorization
199.33for each home care rating;
199.34    (ii) calculating the overall ratio of actual payments to service authorizations by
199.35program;
200.1    (iii) applying the overall ratio to the average service authorization level of each
200.2home care rating;
200.3    (iv) adjusting the result for any authorized rate increases provided by the legislature;
200.4and
200.5    (v) adjusting the result for the average monthly utilization per recipient.
200.6    (2) The commissioner may review and evaluate the methodology to reflect changes
200.7in the home care program's overall ratio of actual payments to service authorizations
200.8programs.
200.9    (b) Effective January 1, 2004, persons previously receiving exception grants will
200.10have their grants calculated using the methodology in paragraph (a), clause (1). If a person
200.11currently receiving an exception grant wishes to have their home care rating reevaluated,
200.12they may request an assessment as defined in section 256B.0651, subdivision 1, paragraph
200.13(b).

200.14    Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:
200.15    Subd. 7. Consumer information and assistance and long-term care options
200.16counseling; senior linkage Senior LinkAge Line. (a) The Minnesota Board on Aging
200.17shall operate a statewide information and assistance service to aid older Minnesotans and
200.18their families in making informed choices about long-term care options and health care
200.19benefits. Language services to persons with limited English language skills may be made
200.20available. The service, known as Senior LinkAge Line, must be available during business
200.21hours through a statewide toll-free number and must also be available through the Internet.
200.22    (b) The service must assist provide long-term care options counseling by assisting
200.23older adults, caregivers, and providers in accessing information and options counseling
200.24about choices in long-term care services that are purchased through private providers or
200.25available through public options. The service must:
200.26    (1) develop a comprehensive database that includes detailed listings in both
200.27consumer- and provider-oriented formats;
200.28    (2) make the database accessible on the Internet and through other telecommunication
200.29and media-related tools;
200.30    (3) link callers to interactive long-term care screening tools and make these tools
200.31available through the Internet by integrating the tools with the database;
200.32    (4) develop community education materials with a focus on planning for long-term
200.33care and evaluating independent living, housing, and service options;
200.34    (5) conduct an outreach campaign to assist older adults and their caregivers in
200.35finding information on the Internet and through other means of communication;
201.1    (6) implement a messaging system for overflow callers and respond to these callers
201.2by the next business day;
201.3    (7) link callers with county human services and other providers to receive more
201.4in-depth assistance and consultation related to long-term care options;
201.5    (8) link callers with quality profiles for nursing facilities and other providers
201.6developed by the commissioner of health; and
201.7    (9) incorporate information about housing with services and consumer rights
201.8within the MinnesotaHelp.info network long-term care database to facilitate consumer
201.9comparison of services and costs among housing with services establishments and with
201.10other in-home services and to support financial self-sufficiency as long as possible.
201.11Housing with services establishments and their arranged home care providers shall provide
201.12information to the commissioner of human services that is consistent with information
201.13required by the commissioner of health under section 144G.06, the Uniform Consumer
201.14Information Guide. The commissioner of human services shall provide the data to the
201.15Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term
201.16care database.;
201.17(10) provide long-term care options counseling. Long-term care options counselors
201.18shall:
201.19(i) for individuals not eligible for case management under a public program or public
201.20funding source, provide interactive decision support under which consumers, family
201.21members, or other helpers are supported in their deliberations to determine appropriate
201.22long-term care choices in the context of the consumer's needs, preferences, values, and
201.23individual circumstances, including implementing a community support plan;
201.24(ii) provide Web-based educational information and collateral written materials to
201.25familiarize consumers, family members, or other helpers with the long-term care basics,
201.26issues to be considered, and the range of options available in the community;
201.27(iii) provide long-term care futures planning, which means providing assistance to
201.28individuals who anticipate having long-term care needs to develop a plan for the more
201.29distant future; and
201.30(iv) provide expertise in benefits and financing options for long-term care, including
201.31Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
201.32private pay options, and ways to access low or no-cost services or benefits through
201.33volunteer-based or charitable programs; and
201.34(11) using risk management and support planning protocols, provide long-term care
201.35options counseling to current residents of nursing homes deemed appropriate for discharge
201.36by the commissioner. In order to meet this requirement, the commissioner shall provide
202.1designated Senior LinkAge Line contact centers with a list of nursing home residents
202.2appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
202.3provide these residents, if they indicate a preference to receive long-term care options
202.4counseling, with initial assessment, review of risk factors, independent living support
202.5consultation, or referral to:
202.6(i) services under section 256B.0911, subdivision 3;
202.7(ii) designated care coordinators of contracted entities under section 256B.035 for
202.8persons who are enrolled in a managed care plan; or
202.9(iii) the long-term care consultation team for those who are appropriate for relocation
202.10service coordination due to high-risk factors or psychological or physical disability.
202.11    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness
202.12of the statewide information and assistance, and submit this evaluation to the legislature
202.13by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps
202.14in service delivery, continuity in information between the service and identified linkages,
202.15and potential use of private funding to enhance the service.

202.16    Sec. 17. Minnesota Statutes 2008, section 256B.055, subdivision 7, is amended to read:
202.17    Subd. 7. Aged, blind, or disabled persons. (a) Medical assistance may be paid for
202.18a person who meets the categorical eligibility requirements of the supplemental security
202.19income program or, who would meet those requirements except for excess income or
202.20assets, and who meets the other eligibility requirements of this section.
202.21(b) Following a determination that the applicant is not aged or blind and does not
202.22meet any other category of eligibility for medical assistance and has not been determined
202.23disabled by the Social Security Administration, applicants under this subdivision shall be
202.24referred to the commissioner's state medical review team for a determination of disability.

202.25    Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to
202.26read:
202.27    Subd. 6a. Home health services. Home health services are those services specified
202.28in Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical
202.29assistance covers home health services at a recipient's home residence. Medical assistance
202.30does not cover home health services for residents of a hospital, nursing facility, or
202.31intermediate care facility, unless the commissioner of human services has prior authorized
202.32skilled nurse visits for less than 90 days for a resident at an intermediate care facility for
202.33persons with developmental disabilities, to prevent an admission to a hospital or nursing
202.34facility or unless a resident who is otherwise eligible is on leave from the facility and the
203.1facility either pays for the home health services or forgoes the facility per diem for the
203.2leave days that home health services are used. Home health services must be provided by
203.3a Medicare certified home health agency. All nursing and home health aide services must
203.4be provided according to sections 256B.0651 to 256B.0656 256B.0653.

203.5    Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to
203.6read:
203.7    Subd. 7. Private duty nursing. Medical assistance covers private duty nursing
203.8services in a recipient's home. Recipients who are authorized to receive private duty
203.9nursing services in their home may use approved hours outside of the home during hours
203.10when normal life activities take them outside of their home. To use private duty nursing
203.11services at school, the recipient or responsible party must provide written authorization in
203.12the care plan identifying the chosen provider and the daily amount of services to be used at
203.13school. Medical assistance does not cover private duty nursing services for residents of a
203.14hospital, nursing facility, intermediate care facility, or a health care facility licensed by the
203.15commissioner of health, except as authorized in section 256B.64 for ventilator-dependent
203.16recipients in hospitals or unless a resident who is otherwise eligible is on leave from the
203.17facility and the facility either pays for the private duty nursing services or forgoes the
203.18facility per diem for the leave days that private duty nursing services are used. Total hours
203.19of service and payment allowed for services outside the home cannot exceed that which is
203.20otherwise allowed in an in-home setting according to sections 256B.0651 and 256B.0653
203.21256B.0654 to 256B.0656. All private duty nursing services must be provided according to
203.22the limits established under sections 256B.0651 and 256B.0653 to 256B.0656. Private
203.23duty nursing services may not be reimbursed if the nurse is the family foster care provider
203.24of a recipient who is under age 18, unless allowed under section 256B.0654, subdivision 4.

203.25    Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to
203.26read:
203.27    Subd. 19a. Personal care assistant assistance services. Medical assistance covers
203.28personal care assistant assistance se