HF 2294

1st Unofficial Engrossment - 87th Legislature (2011 - 2012) Posted on 04/10/2012 12:34pm

1.1A bill for an act

1.2relating to state government; making adjustments to health and human services
1.3appropriations; making changes to provisions related to health care, the
1.4Department of Health, children and family services, continuing care; providing
1.5for data sharing; requiring eligibility determinations; encouraging the University
1.6of Minnesota to request funding for rural primary care training; providing grants;
1.7requiring studies and reports; appropriating money;amending Minnesota Statutes
1.82010, sections 43A.316, subdivision 5; 62A.047; 62A.21, subdivision 2a;
1.962D.02, subdivision 3; 62D.05, subdivision 6; 62D.101, subdivision 2a; 62D.12,
1.10subdivision 1; 62J.26, subdivisions 3, 5, by adding a subdivision; 62J.496,
1.11subdivision 2; 62Q.80; 62U.04, subdivisions 1, 2, 4, 5; 144.5509; 144A.073, by
1.12adding a subdivision; 144A.351; 145.906; 245A.03, by adding a subdivision;
1.13245A.11, subdivisions 2a, 7, 7a; 245B.07, subdivision 1; 245C.04, subdivision 6;
1.14245C.05, subdivision 7; 256.01, by adding subdivisions; 256.975, subdivision 7;
1.15256B.056, subdivision 1a; 256B.0625, subdivision 9, by adding a subdivision;
1.16256B.0754, subdivision 2; 256B.0911, by adding a subdivision; 256B.092,
1.17subdivision 1b; 256B.0943, subdivision 9; 256B.431, subdivision 17e, by adding
1.18a subdivision; 256B.434, subdivision 10; 256B.441, by adding a subdivision;
1.19256B.48, by adding a subdivision; 256B.76, by adding a subdivision; 256D.06,
1.20subdivision 1b; 256D.44, subdivision 5; 626.556, by adding a subdivision;
1.21Minnesota Statutes 2011 Supplement, sections 62U.04, subdivisions 3, 9;
1.22119B.13, subdivision 7; 144.1222, subdivision 5; 245A.03, subdivision 7;
1.23256.987, subdivision 1; 256B.056, subdivision 3; 256B.057, subdivision
1.249; 256B.0625, subdivision 17; 256B.0631, subdivisions 1, 2; 256B.0659,
1.25subdivision 11; 256B.0911, subdivisions 3a, 3c; 256B.0915, subdivisions 3e, 3h;
1.26256B.097, subdivision 3; 256B.49, subdivisions 15, 23; 256B.69, subdivisions
1.275a, 9c; 256B.76, subdivisions 1, 2, 4; 256B.766; 256L.12, subdivision 9; Laws
1.282011, First Special Session chapter 9, article 7, section 52; article 10, sections
1.293, subdivisions 1, 3, 4; 4, subdivision 2; 8, subdivision 8; proposing coding
1.30for new law in Minnesota Statutes, chapters 62Q; 144; 148; 256B; repealing
1.31Minnesota Statutes 2010, sections 62D.04, subdivision 5; 144A.073, subdivision
1.329; 256B.0644; 256B.48, subdivision 6; Minnesota Statutes 2011 Supplement,
1.33section 256B.5012, subdivision 13; Laws 2011, First Special Session chapter
1.349, article 7, section 54.
1.35BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.1ARTICLE 1

2.2HEALTH CARE

2.3    Section 1. Minnesota Statutes 2010, section 256B.0625, subdivision 9, is amended to
2.4read:
2.5    Subd. 9. Dental services. (a) Medical assistance covers dental services.
2.6(b) Medical assistance dental coverage for nonpregnant adults is limited to the
2.7following services:
2.8(1) comprehensive exams, limited to once every five years;
2.9(2) periodic exams, limited to one per year;
2.10(3) limited exams;
2.11(4) bitewing x-rays, limited to one per year;
2.12(5) periapical x-rays;
2.13(6) panoramic x-rays, limited to one every five years except (1) when medically
2.14necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma
2.15or (2) once every two years for patients who cannot cooperate for intraoral film due to
2.16a developmental disability or medical condition that does not allow for intraoral film
2.17placement;
2.18(7) prophylaxis, limited to one per year;
2.19(8) application of fluoride varnish, limited to one per year;
2.20(9) posterior fillings, all at the amalgam rate;
2.21(10) anterior fillings;
2.22(11) endodontics, limited to root canals on the anterior and premolars only;
2.23(12) removable prostheses, each dental arch limited to one every six years including
2.24repairs and the replacement of each dental arch limited to one every six years;
2.25(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
2.26abscesses;
2.27(14) palliative treatment and sedative fillings for relief of pain; and
2.28(15) full-mouth debridement, limited to one every five years.
2.29(c) In addition to the services specified in paragraph (b), medical assistance
2.30covers the following services for adults, if provided in an outpatient hospital setting or
2.31freestanding ambulatory surgical center as part of outpatient dental surgery:
2.32(1) periodontics, limited to periodontal scaling and root planing once every two
2.33years;
2.34(2) general anesthesia; and
2.35(3) full-mouth survey once every five years.
3.1(d) Medical assistance covers medically necessary dental services for children and
3.2pregnant women. The following guidelines apply:
3.3(1) posterior fillings are paid at the amalgam rate;
3.4(2) application of sealants are covered once every five years per permanent molar for
3.5children only;
3.6(3) application of fluoride varnish is covered once every six months; and
3.7(4) orthodontia is eligible for coverage for children only.
3.8(e) In addition to the services specified in paragraphs (b) and (c), medical assistance
3.9covers the following services for developmentally disabled adults:
3.10(1) house calls or extended care facility calls for on-site delivery of covered services;
3.11(2) behavioral management when additional staff time is required to accommodate
3.12behavioral challenges and sedation is not used;
3.13(3) oral or IV conscious sedation, if the covered dental service cannot be performed
3.14safely without it or would otherwise require the service to be performed under general
3.15anesthesia in a hospital or surgical center; and
3.16(4) prophylaxis, in accordance with an appropriate individualized treatment plan
3.17formulated by a licensed dentist, but no more than four times per year.
3.18EFFECTIVE DATE.The amendment to paragraph (b) is effective January 1, 2013.

3.19    Sec. 2. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
3.20subdivision to read:
3.21    Subd. 60. Community paramedic services. (a) Medical assistance covers services
3.22provided by community paramedics who are certified under section 144E.28, subdivision
3.239, when the services are provided in accordance with this subdivision to an eligible
3.24recipient as defined in paragraph (b).
3.25(b) For purposes of this subdivision, an eligible recipient is defined as an individual
3.26who has received hospital emergency department services three or more times in a period
3.27of four consecutive months in the past 12 months or an individual who has been identified
3.28by the individual's primary health care provider for whom community paramedic services
3.29identified in paragraph (c) would likely prevent admission to or would allow discharge
3.30from a nursing facility; or would likely prevent readmission to a hospital or nursing facility.
3.31(c) Payment for services provided by a community paramedic under this subdivision
3.32must be a part of a care plan ordered by a primary health care provider in consultation with
3.33the medical director of an ambulance service and must be billed by an eligible provider
3.34enrolled in medical assistance that employs or contracts with the community paramedic.
3.35The care plan must ensure that the services provided by a community paramedic are
4.1coordinated with other community health providers and local public health agencies and
4.2that community paramedic services do not duplicate services already provided to the
4.3patient, including home health and waiver services. Community paramedic services
4.4shall include health assessment, chronic disease monitoring and education, medication
4.5compliance, immunizations and vaccinations, laboratory specimen collection, hospital
4.6discharge follow-up care, and minor medical procedures approved by the ambulance
4.7medical director.
4.8(d) Services provided by a community paramedic to an eligible recipient who is
4.9also receiving care coordination services must be in consultation with the providers of
4.10the recipient's care coordination services.
4.11(e) The commissioner shall seek the necessary federal approval to implement this
4.12subdivision.
4.13EFFECTIVE DATE.This section is effective July 1, 2012, or upon federal
4.14approval, whichever is later.

4.15    Sec. 3. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 1,
4.16is amended to read:
4.17    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
4.18assistance benefit plan shall include the following cost-sharing for all recipients, effective
4.19for services provided on or after September 1, 2011:
4.20    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
4.21of this subdivision, a visit means an episode of service which is required because of
4.22a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
4.23ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
4.24midwife, advanced practice nurse, audiologist, optician, or optometrist;
4.25    (2) $3 for eyeglasses;
4.26    (3) $3.50 for nonemergency visits to a hospital-based emergency room, except that
4.27this co-payment shall be increased to $20 upon federal approval;
4.28    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
4.29subject to a $12 per month maximum for prescription drug co-payments. No co-payments
4.30shall apply to antipsychotic drugs when used for the treatment of mental illness;
4.31(5) effective January 1, 2012, a family deductible equal to the maximum amount
4.32allowed under Code of Federal Regulations, title 42, part 447.54; and
4.33    (6) for individuals identified by the commissioner with income at or below 100
4.34percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
4.35percent of family income. For purposes of this paragraph, family income is the total
5.1earned and unearned income of the individual and the individual's spouse, if the spouse is
5.2enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
5.3    (b) Recipients of medical assistance are responsible for all co-payments and
5.4deductibles in this subdivision.
5.5(c) Notwithstanding paragraph (b), a prepaid health plan may waive the family
5.6deductible described under paragraph (a), clause (5), within the existing capitation rates
5.7on an ongoing basis.
5.8EFFECTIVE DATE.This section is effective January 1, 2012.

5.9    Sec. 4. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a, is
5.10amended to read:
5.11    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
5.12and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
5.13January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
5.14renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
5.1531, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
5.16issue separate contracts with requirements specific to services to medical assistance
5.17recipients age 65 and older.
5.18    (b) A prepaid health plan providing covered health services for eligible persons
5.19pursuant to chapters 256B and 256L is responsible for complying with the terms of its
5.20contract with the commissioner. Requirements applicable to managed care programs
5.21under chapters 256B and 256L established after the effective date of a contract with the
5.22commissioner take effect when the contract is next issued or renewed.
5.23    (c) Effective for services rendered on or after January 1, 2003, the commissioner
5.24shall withhold five percent of managed care plan payments under this section and
5.25county-based purchasing plan payments under section 256B.692 for the prepaid medical
5.26assistance program pending completion of performance targets. Each performance target
5.27must be quantifiable, objective, measurable, and reasonably attainable, except in the case
5.28of a performance target based on a federal or state law or rule. Criteria for assessment
5.29of each performance target must be outlined in writing prior to the contract effective
5.30date. Clinical or utilization performance targets and their related criteria must consider
5.31evidence-based research and reasonable interventions when available or applicable to the
5.32populations served, and must be developed with input from external clinical experts
5.33and stakeholders, including managed care plans, county-based purchasing plans, and
5.34providers. The managed care or county-based purchasing plan must demonstrate,
5.35to the commissioner's satisfaction, that the data submitted regarding attainment of
6.1the performance target is accurate. The commissioner shall periodically change the
6.2administrative measures used as performance targets in order to improve plan performance
6.3across a broader range of administrative services. The performance targets must include
6.4measurement of plan efforts to contain spending on health care services and administrative
6.5activities. The commissioner may adopt plan-specific performance targets that take into
6.6account factors affecting only one plan, including characteristics of the plan's enrollee
6.7population. The withheld funds must be returned no sooner than July of the following
6.8year if performance targets in the contract are achieved. The commissioner may exclude
6.9special demonstration projects under subdivision 23.
6.10    (d) Effective for services rendered on or after January 1, 2009, through December
6.1131, 2009, the commissioner shall withhold three percent of managed care plan payments
6.12under this section and county-based purchasing plan payments under section 256B.692
6.13for the prepaid medical assistance program. The withheld funds must be returned no
6.14sooner than July 1 and no later than July 31 of the following year. The commissioner may
6.15exclude special demonstration projects under subdivision 23.
6.16(e) Effective for services provided on or after January 1, 2010, the commissioner
6.17shall require that managed care plans use the assessment and authorization processes,
6.18forms, timelines, standards, documentation, and data reporting requirements, protocols,
6.19billing processes, and policies consistent with medical assistance fee-for-service or the
6.20Department of Human Services contract requirements consistent with medical assistance
6.21fee-for-service or the Department of Human Services contract requirements for all
6.22personal care assistance services under section 256B.0659.
6.23(f) Effective for services rendered on or after January 1, 2010, through December
6.2431, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
6.25under this section and county-based purchasing plan payments under section 256B.692
6.26for the prepaid medical assistance program. The withheld funds must be returned no
6.27sooner than July 1 and no later than July 31 of the following year. The commissioner may
6.28exclude special demonstration projects under subdivision 23.
6.29(g) Effective for services rendered on or after January 1, 2011, through December
6.3031, 2011, the commissioner shall include as part of the performance targets described
6.31in paragraph (c) a reduction in the health plan's emergency room utilization rate for
6.32state health care program enrollees by a measurable rate of five percent from the plan's
6.33utilization rate for state health care program enrollees for the previous calendar year.
6.34Effective for services rendered on or after January 1, 2012, the commissioner shall include
6.35as part of the performance targets described in paragraph (c) a reduction in the health
6.36plan's emergency department utilization rate for medical assistance and MinnesotaCare
7.1enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
7.2the health plan's utilization in 2009. To earn the return of the withhold each subsequent
7.3year, the managed care plan or county-based purchasing plan must achieve a qualifying
7.4reduction of no less than ten percent of the plan's emergency department utilization
7.5rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees
7.6in programs described in subdivisions 23 and 28, compared to the previous calendar
7.7measurement year until the final performance target is reached. When measuring
7.8performance, the commissioner must consider the difference in health risk in a managed
7.9care or county-based purchasing plan's membership in the baseline year compared to the
7.10measurement year, and work with the managed care or county-based purchasing plan to
7.11account for differences that they agree are significant.
7.12The withheld funds must be returned no sooner than July 1 and no later than July 31
7.13of the following calendar year if the managed care plan or county-based purchasing plan
7.14demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
7.15was achieved. The commissioner shall structure the withhold so that the commissioner
7.16returns a portion of the withheld funds in amounts commensurate with achieved reductions
7.17in utilization less than the target amount.
7.18The withhold described in this paragraph shall continue for each consecutive
7.19contract period until the plan's emergency room utilization rate for state health care
7.20program enrollees is reduced by 25 percent of the plan's emergency room utilization
7.21rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009.
7.22Hospitals shall cooperate with the health plans in meeting this performance target and
7.23shall accept payment withholds that may be returned to the hospitals if the performance
7.24target is achieved.
7.25(h) Effective for services rendered on or after January 1, 2012, the commissioner
7.26shall include as part of the performance targets described in paragraph (c) a reduction in the
7.27plan's hospitalization admission rate for medical assistance and MinnesotaCare enrollees,
7.28as determined by the commissioner. To earn the return of the withhold each year, the
7.29managed care plan or county-based purchasing plan must achieve a qualifying reduction
7.30of no less than five percent of the plan's hospital admission rate for medical assistance
7.31and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
7.32subdivisions 23 and 28, compared to the previous calendar year until the final performance
7.33target is reached. When measuring performance, the commissioner must consider the
7.34difference in health risk in a managed care or county-based purchasing plan's membership
7.35in the baseline year compared to the measurement year, and work with the managed care
7.36or county-based purchasing plan to account for differences that they agree are significant.
8.1The withheld funds must be returned no sooner than July 1 and no later than July
8.231 of the following calendar year if the managed care plan or county-based purchasing
8.3plan demonstrates to the satisfaction of the commissioner that this reduction in the
8.4hospitalization rate was achieved. The commissioner shall structure the withhold so that
8.5the commissioner returns a portion of the withheld funds in amounts commensurate with
8.6achieved reductions in utilization less than the targeted amount.
8.7The withhold described in this paragraph shall continue until there is a 25 percent
8.8reduction in the hospital admission rate compared to the hospital admission rates in
8.9calendar year 2011, as determined by the commissioner. The hospital admissions in this
8.10performance target do not include the admissions applicable to the subsequent hospital
8.11admission performance target under paragraph (i). Hospitals shall cooperate with the
8.12plans in meeting this performance target and shall accept payment withholds that may be
8.13returned to the hospitals if the performance target is achieved.
8.14(i) Effective for services rendered on or after January 1, 2012, the commissioner
8.15shall include as part of the performance targets described in paragraph (c) a reduction in
8.16the plan's hospitalization admission rates for subsequent hospitalizations within 30 days
8.17of a previous hospitalization of a patient regardless of the reason, for medical assistance
8.18and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
8.19the withhold each year, the managed care plan or county-based purchasing plan must
8.20achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance
8.21and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
8.22subdivisions 23 and 28, of no less than five percent compared to the previous calendar
8.23year until the final performance target is reached.
8.24The withheld funds must be returned no sooner than July 1 and no later than July
8.2531 of the following calendar year if the managed care plan or county-based purchasing
8.26plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
8.27the subsequent hospitalization rate was achieved. The commissioner shall structure the
8.28withhold so that the commissioner returns a portion of the withheld funds in amounts
8.29commensurate with achieved reductions in utilization less that the targeted amount.
8.30The withhold described in this paragraph must continue for each consecutive
8.31contract period until the plan's subsequent hospitalization rate for medical assistance
8.32and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
8.33subdivisions 23 and 28, is reduced by 25 percent of the plan's subsequent hospitalization
8.34rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
8.35performance target and shall accept payment withholds that must be returned to the
8.36hospitals if the performance target is achieved.
9.1(j) Effective for services rendered on or after January 1, 2011, through December 31,
9.22011, the commissioner shall withhold 4.5 percent of managed care plan payments under
9.3this section and county-based purchasing plan payments under section 256B.692 for the
9.4prepaid medical assistance program. The withheld funds must be returned no sooner than
9.5July 1 and no later than July 31 of the following year. The commissioner may exclude
9.6special demonstration projects under subdivision 23.
9.7(k) Effective for services rendered on or after January 1, 2012, through December
9.831, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
9.9under this section and county-based purchasing plan payments under section 256B.692
9.10for the prepaid medical assistance program. The withheld funds must be returned no
9.11sooner than July 1 and no later than July 31 of the following year. The commissioner may
9.12exclude special demonstration projects under subdivision 23.
9.13(l) Effective for services rendered on or after January 1, 2013, through December 31,
9.142013, the commissioner shall withhold 4.5 percent of managed care plan payments under
9.15this section and county-based purchasing plan payments under section 256B.692 for the
9.16prepaid medical assistance program. The withheld funds must be returned no sooner than
9.17July 1 and no later than July 31 of the following year. The commissioner may exclude
9.18special demonstration projects under subdivision 23.
9.19(m) Effective for services rendered on or after January 1, 2014, the commissioner
9.20shall withhold three percent of managed care plan payments under this section and
9.21county-based purchasing plan payments under section 256B.692 for the prepaid medical
9.22assistance program. The withheld funds must be returned no sooner than July 1 and
9.23no later than July 31 of the following year. The commissioner may exclude special
9.24demonstration projects under subdivision 23.
9.25(n) A managed care plan or a county-based purchasing plan under section 256B.692
9.26may include as admitted assets under section 62D.044 any amount withheld under this
9.27section that is reasonably expected to be returned.
9.28(o) Contracts between the commissioner and a prepaid health plan are exempt from
9.29the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
9.30(a), and 7.
9.31(p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject
9.32to the requirements of paragraph (c).

9.33    Sec. 5. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 9c, is
9.34amended to read:
10.1    Subd. 9c. Managed care financial reporting. (a) The commissioner shall collect
10.2detailed data regarding financials, provider payments, provider rate methodologies, and
10.3other data as determined by the commissioner and managed care and county-based
10.4purchasing plans that are required to be submitted under this section. The commissioner,
10.5in consultation with the commissioners of health and commerce, and in consultation
10.6with managed care plans and county-based purchasing plans, shall set uniform criteria,
10.7definitions, and standards for the data to be submitted, and shall require managed care and
10.8county-based purchasing plans to comply with these criteria, definitions, and standards
10.9when submitting data under this section. In carrying out the responsibilities of this
10.10subdivision, the commissioner shall ensure that the data collection is implemented in an
10.11integrated and coordinated manner that avoids unnecessary duplication of effort. To the
10.12extent possible, the commissioner shall use existing data sources and streamline data
10.13collection in order to reduce public and private sector administrative costs. Nothing in
10.14this subdivision shall allow release of information that is nonpublic data pursuant to
10.15section 13.02.
10.16(b) Each managed care and county-based purchasing plan must annually provide
10.17to the commissioner the following information on state public programs, in the form
10.18and manner specified by the commissioner, according to guidelines developed by the
10.19commissioner in consultation with managed care plans and county-based purchasing
10.20plans under contract:
10.21(1) administrative expenses by category and subcategory consistent with
10.22administrative expense reporting to other state and federal regulatory agencies, by
10.23program;
10.24(2) revenues by program, including investment income;
10.25(3) nonadministrative service payments, provider payments, and reimbursement
10.26rates by provider type or service category, by program, paid by the managed care plan
10.27under this section or the county-based purchasing plan under section 256B.692 to
10.28providers and vendors for administrative services under contract with the plan, including
10.29but not limited to:
10.30(i) individual-level provider payment and reimbursement rate data;
10.31(ii) provider reimbursement rate methodologies by provider type, by program,
10.32including a description of alternative payment arrangements and payments outside the
10.33claims process;
10.34(iii) data on implementation of legislatively mandated provider rate changes; and
10.35(iv) individual-level provider payment and reimbursement rate data and plan-specific
10.36provider reimbursement rate methodologies by provider type, by program, including
11.1alternative payment arrangements and payments outside the claims process, provided to
11.2the commissioner under this subdivision are nonpublic data as defined in section 13.02;
11.3(4) data on the amount of reinsurance or transfer of risk by program; and
11.4(5) contribution to reserve, by program.
11.5(c) In the event a report is published or released based on data provided under
11.6this subdivision, the commissioner shall provide the report to managed care plans and
11.7county-based purchasing plans 30 days prior to the publication or release of the report.
11.8Managed care plans and county-based purchasing plans shall have 30 days to review the
11.9report and provide comment to the commissioner.
11.10(d) The legislative auditor shall contract for the audit required under this paragraph.
11.11The commissioner shall require, in the request for bids and the resulting contracts for
11.12coverage to be provided under this section, that each managed care and county-based
11.13purchasing plan submit to and fully cooperate with an annual independent third-party
11.14financial audit of the information required under paragraph (b). For purposes of
11.15this paragraph, "independent third party" means an audit firm that is independent in
11.16accordance with Government Auditing Standards issued by the United States Government
11.17Accountability Office and licensed in accordance with chapter 326A. In no case shall
11.18the audit firm conducting the audit provide services to a managed care or county-based
11.19purchasing plan at the same time as the audit is being conducted or have provided services
11.20to a managed care or county-based purchasing plan during the prior three years.
11.21(e) The audit of the information required under paragraph (b) shall be conducted
11.22by an independent third-party firm in accordance with generally accepted government
11.23auditing standards issued by the United States Government Accountability Office.
11.24(f) A managed care or county-based purchasing plan that provides services under
11.25this section shall provide to the commissioner biweekly encounter and claims data at
11.26a detailed level and shall participate in a quality assurance program that verifies the
11.27timeliness, completeness, accuracy, and consistency of data provided. The commissioner
11.28shall have written protocols for the quality assurance program that are publicly available.
11.29The commissioner shall contract with an independent third-party auditing firm to evaluate
11.30the quality assurance protocols, the capacity of those protocols to assure complete and
11.31accurate data, and the commissioner's implementation of the protocols.
11.32(g) Contracts awarded under this section to a managed care or county-based
11.33purchasing plan must provide that the commissioner and the contracted auditor shall have
11.34unlimited access to any and all data required to complete the audit and that this access
11.35shall be enforceable in a court of competent jurisdiction through the process of injunctive
11.36or other appropriate relief.
12.1(h) Any actuary or actuarial firm must meet the independence requirements under
12.2the professional code for fellows in the Society of Actuaries when providing actuarial
12.3services to the commissioner in connection with this subdivision and providing services to
12.4any managed care or county-based purchasing plan participating in this subdivision during
12.5the term of the actuary's work for the commissioner under this subdivision.
12.6(i) The actuary or actuarial firm referenced in paragraph (h) shall certify and attest
12.7to the rates paid to managed care plans and county-based purchasing plans under this
12.8section, and the certification and attestation must be auditable.
12.9(j) The independent third-party audit shall include a determination of compliance
12.10with the federal Medicaid rate certification process.
12.11(k) The legislative auditor's contract with the independent third-party auditing firm
12.12shall be designed and administered so as to render the independent third-party audit
12.13eligible for a federal subsidy if available for that purpose. The independent third-party
12.14auditing firm shall have the same powers as the legislative auditor under section 3.978,
12.15subdivision 2.
12.16(l) Upon completion of the audit, and its receipt by the legislative auditor, the
12.17legislative auditor shall provide copies of the audit report to the commissioner, the state
12.18auditor, the attorney general, and the chairs and ranking minority members of the health
12.19finance committees of the legislature.
12.20EFFECTIVE DATE.This section is effective the day following final enactment
12.21and applies to contracts, and the contracting process, for contracts that are effective
12.22January 1, 2013, and thereafter.

12.23    Sec. 6. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 4, is
12.24amended to read:
12.25    Subd. 4. Critical access dental providers. (a) Effective for dental services
12.26rendered on or after January 1, 2002, the commissioner shall increase reimbursements
12.27to dentists and dental clinics deemed by the commissioner to be critical access dental
12.28providers. For dental services rendered on or after July 1, 2007, the commissioner shall
12.29increase reimbursement by 30 percent above the reimbursement rate that would otherwise
12.30be paid to the critical access dental provider. The commissioner shall pay the managed
12.31care plans and county-based purchasing plans in amounts sufficient to reflect increased
12.32reimbursements to critical access dental providers as approved by the commissioner.
12.33(b) The commissioner shall designate the following dentists and dental clinics as
12.34critical access dental providers:
12.35    (1) nonprofit community clinics that:
13.1(i) have nonprofit status in accordance with chapter 317A;
13.2(ii) have tax exempt status in accordance with the Internal Revenue Code, section
13.3501(c)(3);
13.4(iii) are established to provide oral health services to patients who are low income,
13.5uninsured, have special needs, and are underserved;
13.6(iv) have professional staff familiar with the cultural background of the clinic's
13.7patients;
13.8(v) charge for services on a sliding fee scale designed to provide assistance to
13.9low-income patients based on current poverty income guidelines and family size;
13.10(vi) do not restrict access or services because of a patient's financial limitations
13.11or public assistance status; and
13.12(vii) have free care available as needed;
13.13    (2) federally qualified health centers, rural health clinics, and public health clinics;
13.14    (3) county owned and operated hospital-based dental clinics;
13.15(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
13.16accordance with chapter 317A with more than 10,000 patient encounters per year with
13.17patients who are uninsured or covered by medical assistance, general assistance medical
13.18care, or MinnesotaCare; and
13.19(5) a dental clinic owned and operated by the University of Minnesota or the
13.20Minnesota State Colleges and Universities system.
13.21     (c) The commissioner may designate a dentist or dental clinic as a critical access
13.22dental provider if the dentist or dental clinic is willing to provide care to patients covered
13.23by medical assistance, general assistance medical care, or MinnesotaCare at a level which
13.24significantly increases access to dental care in the service area.
13.25(d) Notwithstanding paragraph (a), critical access payments must not be made for
13.26dental services provided from April 1, 2010, through June 30, 2010. A designated critical
13.27access clinic shall receive the reimbursement rate specified in paragraph (a) for dental
13.28services provided off-site at a private dental office if the following requirements are met:
13.29(1) the designated critical access dental clinic is located within a health professional
13.30shortage area as defined under the Code of Federal Regulations, title 42, part 5, and
13.31the United States Code, title 42, section 254E, and is located outside the seven-county
13.32metropolitan area;
13.33(2) the designated critical access dental clinic is not able to provide the service
13.34and refers the patient to the off-site dentist;
13.35(3) the service, if provided at the critical access dental clinic, would be reimbursed
13.36at the critical access reimbursement rate;
14.1(4) the dentist and allied dental professionals providing the services off-site are
14.2licensed and in good standing under chapter 150A;
14.3(5) the dentist providing the services is enrolled as a medical assistance provider;
14.4(6) the critical access dental clinic submits the claim for services provided off-site
14.5and receives the payment for the services; and
14.6(7) the critical access dental clinic maintains dental records for each claim submitted
14.7under this paragraph, including the name of the dentist, the off-site location, and the
14.8license number of the dentist and allied dental professionals providing the services.
14.9EFFECTIVE DATE.This section is effective July 1, 2012, or upon federal
14.10approval, whichever is later.

14.11    Sec. 7. Minnesota Statutes 2010, section 256B.76, is amended by adding a subdivision
14.12to read:
14.13    Subd. 7a. Volunteer dental providers. (a) A volunteer dentist who is not enrolled
14.14as a medical assistance provider; is providing volunteer services for a nonprofit or
14.15government-owned dental provider enrolled as a medical assistance dental provider; and
14.16is not receiving payment for services provided, shall complete and submit a volunteer
14.17agreement form as prescribed by the commissioner. The volunteer agreement shall be
14.18used to enroll the dentist in medical assistance only for the purpose of providing volunteer
14.19services. The volunteer agreement shall specify that a volunteer dentist:
14.20(1) will not appear in the Minnesota health care programs provider directory;
14.21(2) will not receive payment for the services they provide to Minnesota health care
14.22program patients; and
14.23(3) is not required to serve Minnesota health care program patients when providing
14.24nonvolunteer services in a private practice.
14.25(b) A volunteer dentist enrolled under this subdivision shall not otherwise be enrolled
14.26in or receive payments from Minnesota health care programs as a fee-for-service provider.
14.27(c) The volunteer dentist shall be notified by the dental provider for which they
14.28are providing services that medical assistance is being billed for the volunteer services
14.29provided.

14.30    Sec. 8. Minnesota Statutes 2011 Supplement, section 256L.12, subdivision 9, is
14.31amended to read:
14.32    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
14.33per capita, where possible. The commissioner may allow health plans to arrange for
15.1inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
15.2an independent actuary to determine appropriate rates.
15.3    (b) For services rendered on or after January 1, 2004, the commissioner shall
15.4withhold five percent of managed care plan payments and county-based purchasing
15.5plan payments under this section pending completion of performance targets. Each
15.6performance target must be quantifiable, objective, measurable, and reasonably attainable,
15.7except in the case of a performance target based on a federal or state law or rule. Criteria
15.8for assessment of each performance target must be outlined in writing prior to the contract
15.9effective date. Clinical or utilization performance targets and their related criteria must
15.10consider evidence-based research and reasonable interventions, when available or
15.11applicable to the populations served, and must be developed with input from external
15.12clinical experts and stakeholders, including managed care plans, county-based purchasing
15.13plans, and providers. The managed care plan must demonstrate, to the commissioner's
15.14satisfaction, that the data submitted regarding attainment of the performance target is
15.15accurate. The commissioner shall periodically change the administrative measures used
15.16as performance targets in order to improve plan performance across a broader range of
15.17administrative services. The performance targets must include measurement of plan
15.18efforts to contain spending on health care services and administrative activities. The
15.19commissioner may adopt plan-specific performance targets that take into account factors
15.20affecting only one plan, such as characteristics of the plan's enrollee population. The
15.21withheld funds must be returned no sooner than July 1 and no later than July 31 of the
15.22following calendar year if performance targets in the contract are achieved.
15.23(c) For services rendered on or after January 1, 2011, the commissioner shall
15.24withhold an additional three percent of managed care plan or county-based purchasing
15.25plan payments under this section. The withheld funds must be returned no sooner than
15.26July 1 and no later than July 31 of the following calendar year. The return of the withhold
15.27under this paragraph is not subject to the requirements of paragraph (b).
15.28(d) Effective for services rendered on or after January 1, 2011, through December
15.2931, 2011, the commissioner shall include as part of the performance targets described in
15.30paragraph (b) a reduction in the plan's emergency room utilization rate for state health care
15.31program enrollees by a measurable rate of five percent from the plan's utilization rate for
15.32the previous calendar year. Effective for services rendered on or after January 1, 2012,
15.33the commissioner shall include as part of the performance targets described in paragraph
15.34(b) a reduction in the health plan's emergency department utilization rate for medical
15.35assistance and MinnesotaCare enrollees, as determined by the commissioner. For 2012,
15.36the reductions shall be based on the health plan's utilization in 2009. To earn the return of
16.1the withhold each subsequent year, the managed care plan or county-based purchasing
16.2plan must achieve a qualifying reduction of no less than ten percent of the plan's utilization
16.3rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees in
16.4programs described in section 256B.69, subdivisions 23 and 28, compared to the previous
16.5calendar measurement year, until the final performance target is reached. When measuring
16.6performance, the commissioner must consider the difference in health risk in a managed
16.7care or county-based purchasing plan's membership in the baseline year compared to the
16.8measurement year, and work with the managed care or county-based purchasing plan to
16.9account for differences that they agree are significant.
16.10The withheld funds must be returned no sooner than July 1 and no later than July 31
16.11of the following calendar year if the managed care plan or county-based purchasing plan
16.12demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
16.13was achieved. The commissioner shall structure the withhold so that the commissioner
16.14returns a portion of the withheld funds in amounts commensurate with achieved reductions
16.15in utilization less than the targeted amount.
16.16The withhold described in this paragraph shall continue for each consecutive
16.17contract period until the plan's emergency room utilization rate for state health care
16.18program enrollees is reduced by 25 percent of the plan's emergency room utilization
16.19rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009.
16.20Hospitals shall cooperate with the health plans in meeting this performance target and
16.21shall accept payment withholds that may be returned to the hospitals if the performance
16.22target is achieved.
16.23(e) Effective for services rendered on or after January 1, 2012, the commissioner
16.24shall include as part of the performance targets described in paragraph (b) a reduction
16.25in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
16.26enrollees, as determined by the commissioner. To earn the return of the withhold
16.27each year, the managed care plan or county-based purchasing plan must achieve a
16.28qualifying reduction of no less than five percent of the plan's hospital admission rate
16.29for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees
16.30in programs described in section 256B.69, subdivisions 23 and 28, compared to the
16.31previous calendar year, until the final performance target is reached. When measuring
16.32performance, the commissioner must consider the difference in health risk in a managed
16.33care or county-based purchasing plan's membership in the baseline year compared to the
16.34measurement year, and work with the managed care or county-based purchasing plan to
16.35account for differences that they agree are significant.
17.1The withheld funds must be returned no sooner than July 1 and no later than July
17.231 of the following calendar year if the managed care plan or county-based purchasing
17.3plan demonstrates to the satisfaction of the commissioner that this reduction in the
17.4hospitalization rate was achieved. The commissioner shall structure the withhold so that
17.5the commissioner returns a portion of the withheld funds in amounts commensurate with
17.6achieved reductions in utilization less than the targeted amount.
17.7The withhold described in this paragraph shall continue until there is a 25 percent
17.8reduction in the hospitals admission rate compared to the hospital admission rate for
17.9calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the
17.10plans in meeting this performance target and shall accept payment withholds that may be
17.11returned to the hospitals if the performance target is achieved. The hospital admissions
17.12in this performance target do not include the admissions applicable to the subsequent
17.13hospital admission performance target under paragraph (f).
17.14(f) Effective for services provided on or after January 1, 2012, the commissioner
17.15shall include as part of the performance targets described in paragraph (b) a reduction
17.16in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a
17.17previous hospitalization of a patient regardless of the reason, for medical assistance and
17.18MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
17.19withhold each year, the managed care plan or county-based purchasing plan must achieve
17.20a qualifying reduction of the subsequent hospital admissions rate for medical assistance
17.21and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
17.22section 256B.69, subdivisions 23 and 28, of no less than five percent compared to the
17.23previous calendar year until the final performance target is reached.
17.24The withheld funds must be returned no sooner than July 1 and no later than July 31
17.25of the following calendar year if the managed care plan or county-based purchasing plan
17.26demonstrates to the satisfaction of the commissioner that a reduction in the subsequent
17.27hospitalization rate was achieved. The commissioner shall structure the withhold so that
17.28the commissioner returns a portion of the withheld funds in amounts commensurate with
17.29achieved reductions in utilization less than the targeted amount.
17.30The withhold described in this paragraph must continue for each consecutive
17.31contract period until the plan's subsequent hospitalization rate for medical assistance and
17.32MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization
17.33rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
17.34performance target and shall accept payment withholds that must be returned to the
17.35hospitals if the performance target is achieved.
18.1(g) A managed care plan or a county-based purchasing plan under section 256B.692
18.2may include as admitted assets under section 62D.044 any amount withheld under this
18.3section that is reasonably expected to be returned.

18.4    Sec. 9. EMERGENCY MEDICAL CONDITION DIALYSIS COVERAGE
18.5EXCEPTION.
18.6(a) Notwithstanding Minnesota Statutes, section 256B.06, subdivision 4, paragraph
18.7(h), clause (2), dialysis services provided in a hospital or freestanding dialysis facility
18.8shall be covered as an emergency medical condition under Minnesota Statutes, section
18.9256B.06, subdivision 4, paragraph (f).
18.10(b) Coverage under paragraph (a) is effective May 1, 2012, until June 30, 2013.
18.11EFFECTIVE DATE.This section is effective the day following final enactment.

18.12    Sec. 10. COST-SHARING REQUIREMENTS STUDY.
18.13The commissioner of human services, in consultation with managed care plans,
18.14county-based purchasing plans, and other stakeholders, shall develop recommendations
18.15to implement a revised cost-sharing structure for state public health care programs that
18.16ensures application of meaningful cost-sharing requirements within the limits of title
18.1742, Code of Federal Regulations, section 447.54, for enrollees in these programs. The
18.18commissioner shall report to the chairs and ranking minority members of the legislative
18.19committees with jurisdiction over these issues by January 15, 2013, with draft legislation
18.20to implement these recommendations effective January 1, 2014.

18.21    Sec. 11. STUDY OF MANAGED CARE.
18.22The commissioner of human services must contract with an independent vendor
18.23with demonstrated expertise in evaluating Medicaid managed care programs to evaluate
18.24the value of managed care for state public health care programs provided under
18.25Minnesota Statutes, sections 256B.69, 256B.692, and 256L.12. The evaluation must be
18.26completed and reported to the legislature by January 15, 2013. Determination of the
18.27value of managed care must include consideration of the following, as compared to a
18.28fee-for-service program:
18.29(1) the satisfaction of state public health care program recipients and providers;
18.30(2) the ability to measure and improve health outcomes of recipients;
18.31(3) the access to health services for recipients;
18.32(4) the availability of additional services such as care coordination, case
18.33management, disease management, transportation, and after-hours nurse lines;
19.1(5) actual and potential cost savings to the state;
19.2(6) the level of alignment with state and federal health reform policies, including a
19.3health benefit exchange for individuals not enrolled in state public health care programs;
19.4and
19.5(7) the ability to use different provider payment models that provide incentives for
19.6cost-effective health care.

19.7    Sec. 12. STUDY OF FOR-PROFIT HEALTH MAINTENANCE
19.8ORGANIZATIONS.
19.9The commissioner of health shall contract with an entity with expertise in health
19.10economics and health care delivery and quality to study the efficiency, costs, service
19.11quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to
19.12not-for-profit health maintenance organizations operating in Minnesota and other states.
19.13The study findings must address whether the state could: (1) reduce medical assistance
19.14and MinnesotaCare costs and costs of providing coverage to state employees; and (2)
19.15maintain or improve the quality of care provided to state health care program enrollees
19.16and state employees if for-profit health maintenance organizations were allowed to operate
19.17in the state. In comparing for-profit health maintenance organizations operating in other
19.18states with not-for-profit health maintenance organizations operating in Minnesota, the
19.19entity must consider differences in regulatory oversight, benefit requirements, network
19.20standards, human resource costs, and assessments, fees, and taxes that may impact the
19.21cost and quality comparisons. The commissioner shall require the entity under contract to
19.22report study findings to the commissioner and the legislature by January 15, 2013.

19.23    Sec. 13. REPEALER.
19.24Minnesota Statutes 2010, sections 62D.04, subdivision 5; and 256B.0644, are
19.25repealed effective January 1, 2013.

19.26ARTICLE 2

19.27DEPARTMENT OF HEALTH

19.28    Section 1. Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:
19.29    Subd. 3. Commissioner of health commerce or commissioner. "Commissioner of
19.30health commerce" or "commissioner" means the state commissioner of health commerce
19.31or a designee.

19.32    Sec. 2. Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:
20.1    Subd. 6. Supplemental benefits. (a) A health maintenance organization may, as
20.2a supplemental benefit, provide coverage to its enrollees for health care services and
20.3supplies received from providers who are not employed by, under contract with, or
20.4otherwise affiliated with the health maintenance organization. Supplemental benefits may
20.5be provided if the following conditions are met:
20.6(1) a health maintenance organization desiring to offer supplemental benefits must at
20.7all times comply with the requirements of sections 62D.041 and 62D.042;
20.8(2) a health maintenance organization offering supplemental benefits must maintain
20.9an additional surplus in the first year supplemental benefits are offered equal to the
20.10lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of
20.11the second year supplemental benefits are offered, the health maintenance organization
20.12must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the
20.13supplemental benefit expenses. At the end of the third year benefits are offered and every
20.14year after that, the health maintenance organization must maintain an additional surplus
20.15equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses.
20.16When in the judgment of the commissioner the health maintenance organization's surplus
20.17is inadequate, the commissioner may require the health maintenance organization to
20.18maintain additional surplus;
20.19(3) claims relating to supplemental benefits must be processed in accordance with
20.20the requirements of section 72A.201; and
20.21(4) in marketing supplemental benefits, the health maintenance organization shall
20.22fully disclose and describe to enrollees and potential enrollees the nature and extent of the
20.23supplemental coverage, and any claims filing and other administrative responsibilities in
20.24regard to supplemental benefits.
20.25(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer
20.26rules relating to this subdivision, including: rules insuring that these benefits are
20.27supplementary and not substitutes for comprehensive health maintenance services by
20.28addressing percentage of out-of-plan coverage; rules relating to the establishment of
20.29necessary financial reserves; rules relating to marketing practices; and other rules necessary
20.30for the effective and efficient administration of this subdivision. The commissioner, in
20.31adopting rules, shall give consideration to existing laws and rules administered and
20.32enforced by the Department of Commerce relating to health insurance plans.

20.33    Sec. 3. Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:
20.34    Subdivision 1. False representations. No health maintenance organization or
20.35representative thereof may cause or knowingly permit the use of advertising or solicitation
21.1which is untrue or misleading, or any form of evidence of coverage which is deceptive.
21.2Each health maintenance organization shall be subject to sections 72A.17 to 72A.32,
21.3relating to the regulation of trade practices, except (a) to the extent that the nature of a
21.4health maintenance organization renders such sections clearly inappropriate and (b) that
21.5enforcement shall be by the commissioner of health and not by the commissioner of
21.6commerce. Every health maintenance organization shall be subject to sections 8.31 and
21.7325F.69 .

21.8    Sec. 4. Minnesota Statutes 2010, section 62Q.80, is amended to read:
21.962Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM.
21.10    Subdivision 1. Scope. (a) Any community-based health care initiative may develop
21.11and operate community-based health care coverage programs that offer to eligible
21.12individuals and their dependents the option of purchasing through their employer health
21.13care coverage on a fixed prepaid basis without meeting the requirements of chapter 60A,
21.1462A, 62C, 62D, 62M, 62N, 62Q, 62T, or 62U, or any other law or rule that applies to
21.15entities licensed under these chapters.
21.16(b) Each initiative shall establish health outcomes to be achieved through the
21.17programs and performance measurements in order to determine whether these outcomes
21.18have been met. The outcomes must include, but are not limited to:
21.19(1) a reduction in uncompensated care provided by providers participating in the
21.20community-based health network;
21.21(2) an increase in the delivery of preventive health care services; and
21.22(3) health improvement for enrollees with chronic health conditions through the
21.23management of these conditions.
21.24In establishing performance measurements, the initiative shall use measures that are
21.25consistent with measures published by nonprofit Minnesota or national organizations that
21.26produce and disseminate health care quality measures.
21.27(c) Any program established under this section shall not constitute a financial
21.28liability for the state, in that any financial risk involved in the operation or termination
21.29of the program shall be borne by the community-based initiative and the participating
21.30health care providers.
21.31    Subd. 1a. Demonstration project. The commissioner of health and the
21.32commissioner of human services shall award demonstration project grants to
21.33community-based health care initiatives to develop and operate community-based health
21.34care coverage programs in Minnesota. The demonstration projects shall extend for five
21.35years and must comply with the requirements of this section.
22.1    Subd. 2. Definitions. For purposes of this section, the following definitions apply:
22.2(a) "Community-based" means located in or primarily relating to the community,
22.3as determined by the board of a community-based health initiative that is served by the
22.4community-based health care coverage program.
22.5(b) "Community-based health care coverage program" or "program" means a
22.6program administered by a community-based health initiative that provides health care
22.7services through provider members of a community-based health network or combination
22.8of networks to eligible individuals and their dependents who are enrolled in the program.
22.9(c) "Community-based health initiative" or "initiative" means a nonprofit corporation
22.10that is governed by a board that has at least 80 percent of its members residing in the
22.11community and includes representatives of the participating network providers and
22.12employers, or a county-based purchasing organization as defined in section 256B.692.
22.13(d) "Community-based health network" means a contract-based network of health
22.14care providers organized by the community-based health initiative to provide or support
22.15the delivery of health care services to enrollees of the community-based health care
22.16coverage program on a risk-sharing or nonrisk-sharing basis.
22.17(e) "Dependent" means an eligible employee's spouse or unmarried child who is
22.18under the age of 19 years.
22.19    Subd. 3. Approval. (a) Prior to the operation of a community-based health
22.20care coverage program, a community-based health initiative, defined in subdivision
22.212, paragraph (c), and receiving funds from the Department of Health, shall submit to
22.22the commissioner of health for approval the community-based health care coverage
22.23program developed by the initiative. Each community-based health initiative as defined
22.24in subdivision 2, paragraph (c), and receiving State Health Access Program (SHAP)
22.25grant funding shall submit to the commissioner of human services for approval prior
22.26to its operation the community-based health care coverage programs developed by the
22.27initiatives. The commissioners commissioner shall ensure that each program meets
22.28the federal grant requirements and any requirements described in this section and is
22.29actuarially sound based on a review of appropriate records and methods utilized by the
22.30community-based health initiative in establishing premium rates for the community-based
22.31health care coverage programs.
22.32    (b) Prior to approval, the commissioner shall also ensure that:
22.33    (1) the benefits offered comply with subdivision 8 and that there are adequate
22.34numbers of health care providers participating in the community-based health network to
22.35deliver the benefits offered under the program;
23.1    (2) the activities of the program are limited to activities that are exempt under this
23.2section or otherwise from regulation by the commissioner of commerce;
23.3    (3) the complaint resolution process meets the requirements of subdivision 10; and
23.4    (4) the data privacy policies and procedures comply with state and federal law.
23.5    Subd. 4. Establishment. The initiative shall establish and operate upon approval
23.6by the commissioners commissioner of health and human services community-based
23.7health care coverage programs. The operational structure established by the initiative
23.8shall include, but is not limited to:
23.9    (1) establishing a process for enrolling eligible individuals and their dependents;
23.10    (2) collecting and coordinating premiums from enrollees and employers of enrollees;
23.11    (3) providing payment to participating providers;
23.12    (4) establishing a benefit set according to subdivision 8 and establishing premium
23.13rates and cost-sharing requirements;
23.14    (5) creating incentives to encourage primary care and wellness services; and
23.15    (6) initiating disease management services, as appropriate.
23.16    Subd. 5. Qualifying employees. To be eligible for the community-based health
23.17care coverage program, an individual must:
23.18(1) reside in or work within the designated community-based geographic area
23.19served by the program;
23.20(2) be employed by a qualifying employer, be an employee's dependent, or be
23.21self-employed on a full-time basis;
23.22(3) not be enrolled in or have currently available health coverage, except for
23.23catastrophic health care coverage; and
23.24(4) not be eligible for or enrolled in medical assistance or general assistance medical
23.25care, and not be enrolled in MinnesotaCare or Medicare.
23.26    Subd. 6. Qualifying employers. (a) To qualify for participation in the
23.27community-based health care coverage program, an employer must:
23.28(1) employ at least one but no more than 50 employees at the time of initial
23.29enrollment in the program;
23.30(2) pay its employees a median wage that equals 350 percent of the federal poverty
23.31guidelines or less for an individual; and
23.32(3) not have offered employer-subsidized health coverage to its employees for
23.33at least 12 months prior to the initial enrollment in the program. For purposes of this
23.34section, "employer-subsidized health coverage" means health care coverage for which the
23.35employer pays at least 50 percent of the cost of coverage for the employee.
23.36(b) To participate in the program, a qualifying employer agrees to:
24.1(1) offer health care coverage through the program to all eligible employees and
24.2their dependents regardless of health status;
24.3(2) participate in the program for an initial term of at least one year;
24.4(3) pay a percentage of the premium established by the initiative for the employee;
24.5and
24.6(4) provide the initiative with any employee information deemed necessary by the
24.7initiative to determine eligibility and premium payments.
24.8    Subd. 7. Participating providers. Any health care provider participating in the
24.9community-based health network must accept as payment in full the payment rate
24.10established by the initiatives and may not charge to or collect from an enrollee any amount
24.11in access of this amount for any service covered under the program.
24.12    Subd. 8. Coverage. (a) The initiatives shall establish the health care benefits offered
24.13through the community-based health care coverage programs. The benefits established
24.14shall include, at a minimum:
24.15(1) child health supervision services up to age 18, as defined under section 62A.047;
24.16and
24.17(2) preventive services, including:
24.18(i) health education and wellness services;
24.19(ii) health supervision, evaluation, and follow-up;
24.20(iii) immunizations; and
24.21(iv) early disease detection.
24.22(b) Coverage of health care services offered by the program may be limited to
24.23participating health care providers or health networks. All services covered under the
24.24programs must be services that are offered within the scope of practice of the participating
24.25health care providers.
24.26(c) The initiatives may establish cost-sharing requirements. Any co-payment or
24.27deductible provisions established may not discriminate on the basis of age, sex, race,
24.28disability, economic status, or length of enrollment in the programs.
24.29(d) If any of the initiatives amends or alters the benefits offered through the program
24.30from the initial offering, that initiative must notify the commissioners commissioner of
24.31health and human services and all enrollees of the benefit change.
24.32    Subd. 9. Enrollee information. (a) The initiatives must provide an individual or
24.33family who enrolls in the program a clear and concise written statement that includes
24.34the following information:
24.35(1) health care services that are covered under the program;
25.1(2) any exclusions or limitations on the health care services covered, including any
25.2cost-sharing arrangements or prior authorization requirements;
25.3(3) a list of where the health care services can be obtained and that all health
25.4care services must be provided by or through a participating health care provider or
25.5community-based health network;
25.6(4) a description of the program's complaint resolution process, including how to
25.7submit a complaint; how to file a complaint with the commissioner of health; and how to
25.8obtain an external review of any adverse decisions as provided under subdivision 10;
25.9(5) the conditions under which the program or coverage under the program may
25.10be canceled or terminated; and
25.11(6) a precise statement specifying that this program is not an insurance product and,
25.12as such, is exempt from state regulation of insurance products.
25.13(b) The commissioners commissioner of health and human services must approve a
25.14copy of the written statement prior to the operation of the program.
25.15    Subd. 10. Complaint resolution process. (a) The initiatives must establish
25.16a complaint resolution process. The process must make reasonable efforts to resolve
25.17complaints and to inform complainants in writing of the initiative's decision within 60
25.18days of receiving the complaint. Any decision that is adverse to the enrollee shall include
25.19a description of the right to an external review as provided in paragraph (c) and how to
25.20exercise this right.
25.21(b) The initiatives must report any complaint that is not resolved within 60 days to
25.22the commissioner of health.
25.23(c) The initiatives must include in the complaint resolution process the ability of an
25.24enrollee to pursue the external review process provided under section 62Q.73 with any
25.25decision rendered under this external review process binding on the initiatives.
25.26    Subd. 11. Data privacy. The initiatives shall establish data privacy policies and
25.27procedures for the program that comply with state and federal data privacy laws.
25.28    Subd. 12. Limitations on enrollment. (a) The initiatives may limit enrollment in
25.29the program. If enrollment is limited, a waiting list must be established.
25.30(b) The initiatives shall not restrict or deny enrollment in the program except for
25.31nonpayment of premiums, fraud or misrepresentation, or as otherwise permitted under
25.32this section.
25.33(c) The initiatives may require a certain percentage of participation from eligible
25.34employees of a qualifying employer before coverage can be offered through the program.
25.35    Subd. 13. Report. Each initiative shall submit quarterly an annual status reports
25.36to the commissioner of health on January 15, April 15, July 15, and October 15 of each
26.1year, with the first report due January 15, 2008. Each initiative receiving funding from the
26.2Department of Human Services shall submit status reports to the commissioner of human
26.3services as defined in the terms of the contract with the Department of Human Services.
26.4Each status report shall include:
26.5    (1) the financial status of the program, including the premium rates, cost per member
26.6per month, claims paid out, premiums received, and administrative expenses;
26.7    (2) a description of the health care benefits offered and the services utilized;
26.8    (3) the number of employers participating, the number of employees and dependents
26.9covered under the program, and the number of health care providers participating;
26.10    (4) a description of the health outcomes to be achieved by the program and a status
26.11report on the performance measurements to be used and collected; and
26.12    (5) any other information requested by the commissioners of health, human services,
26.13or commerce or the legislature.
26.14    Subd. 14. Sunset. This section expires August 31, 2014.

26.15    Sec. 5. Minnesota Statutes 2010, section 62U.04, subdivision 1, is amended to read:
26.16    Subdivision 1. Development of tools to improve costs and quality outcomes.
26.17    The commissioner of health shall develop a plan to create transparent prices, encourage
26.18greater provider innovation and collaboration across points on the health continuum
26.19in cost-effective, high-quality care delivery, reduce the administrative burden on
26.20providers and health plans associated with submitting and processing claims, and provide
26.21comparative information to consumers on variation in health care cost and quality across
26.22providers. The development must be complete by January 1, 2010.

26.23    Sec. 6. Minnesota Statutes 2010, section 62U.04, subdivision 2, is amended to read:
26.24    Subd. 2. Calculation of health care costs and quality. The commissioner of health
26.25shall develop a uniform method of calculating providers' relative cost of care, defined as a
26.26measure of health care spending including resource use and unit prices, and relative quality
26.27of care. In developing this method, the commissioner must address the following issues:
26.28    (1) provider attribution of costs and quality;
26.29    (2) appropriate adjustment for outlier or catastrophic cases;
26.30    (3) appropriate risk adjustment to reflect differences in the demographics and health
26.31status across provider patient populations, using generally accepted and transparent risk
26.32adjustment methodologies and case mix adjustment;
26.33    (4) specific types of providers that should be included in the calculation;
26.34    (5) specific types of services that should be included in the calculation;
27.1    (6) appropriate adjustment for variation in payment rates;
27.2    (7) the appropriate provider level for analysis;
27.3    (8) payer mix adjustments, including variation across providers in the percentage of
27.4revenue received from government programs; and
27.5    (9) other factors that the commissioner determines and the advisory committee,
27.6established under subdivision 3, determine are needed to ensure validity and comparability
27.7of the analysis.

27.8    Sec. 7. Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 3, is
27.9amended to read:
27.10    Subd. 3. Provider peer grouping; system development; advisory committee.
27.11    (a) The commissioner shall develop a peer grouping system for providers based on a
27.12combined measure that incorporates both provider risk-adjusted cost of care and quality of
27.13care, and for specific conditions as determined by the commissioner. In developing this
27.14system, the commissioner shall consult and coordinate with health care providers, health
27.15plan companies, state agencies, and organizations that work to improve health care quality
27.16in Minnesota. For purposes of the final establishment of the peer grouping system, the
27.17commissioner shall not contract with any private entity, organization, or consortium of
27.18entities that has or will have a direct financial interest in the outcome of the system.
27.19(b) The commissioner shall establish an advisory committee comprised of
27.20representatives of health care providers, health plan companies, consumers, state agencies,
27.21employers, academic researchers, and organizations that work to improve health care
27.22quality in Minnesota. The advisory committee shall meet no fewer than three times
27.23per year. The commissioner shall consult with the advisory committee in developing
27.24and administering the peer grouping system, including but not limited to the following
27.25activities:
27.26(1) establishing peer groups;
27.27(2) selecting quality measures;
27.28(3) recommending thresholds for completeness of data and statistical significance
27.29for the purposes of public release of provider peer grouping results;
27.30(4) considering whether adjustments are necessary for facilities that provide medical
27.31education, level 1 trauma services, neonatal intensive care, or inpatient psychiatric care;
27.32(5) recommending inclusion or exclusion of other costs; and
27.33(6) adopting patient attribution and quality and cost-scoring methodologies.
27.34    Subd. 3a. Provider peer grouping; dissemination of data to providers. (b) By
27.35no later than October 15, 2010, (a) The commissioner shall disseminate information
28.1to providers on their total cost of care, total resource use, total quality of care, and the
28.2total care results of the grouping developed under this subdivision 3 in comparison to an
28.3appropriate peer group. Data used for this analysis must be the most recent data available.
28.4Any analyses or reports that identify providers may only be published after the provider
28.5has been provided the opportunity by the commissioner to review the underlying data in
28.6order to verify, consistent with the recommendations developed pursuant to subdivision
28.73c, paragraph (d), and adopted by the commissioner the accuracy and representativeness
28.8of any analyses or reports and submit comments to the commissioner or initiate an appeal
28.9under subdivision 3b. Providers may Upon request, providers shall be given any data for
28.10which they are the subject of the data. The provider shall have 30 60 days to review the
28.11data for accuracy and initiate an appeal as specified in paragraph (d) subdivision 3b.
28.12    (c) By no later than January 1, 2011, (b) The commissioner shall disseminate
28.13information to providers on their condition-specific cost of care, condition-specific
28.14resource use, condition-specific quality of care, and the condition-specific results of the
28.15grouping developed under this subdivision 3 in comparison to an appropriate peer group.
28.16Data used for this analysis must be the most recent data available. Any analyses or
28.17reports that identify providers may only be published after the provider has been provided
28.18the opportunity by the commissioner to review the underlying data in order to verify,
28.19consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d),
28.20and adopted by the commissioner the accuracy and representativeness of any analyses or
28.21reports and submit comments to the commissioner or initiate an appeal under subdivision
28.223b. Providers may Upon request, providers shall be given any data for which they are the
28.23subject of the data. The provider shall have 30 60 days to review the data for accuracy and
28.24initiate an appeal as specified in paragraph (d) subdivision 3b.
28.25    Subd. 3b. Provider peer grouping; appeals process. (d) The commissioner shall
28.26establish an appeals a process to resolve disputes from providers regarding the accuracy
28.27of the data used to develop analyses or reports or errors in the application of standards
28.28or methodology established by the commissioner in consultation with the advisory
28.29committee. When a provider appeals the accuracy of the data used to calculate the peer
28.30grouping system results submits an appeal, the provider shall:
28.31(1) clearly indicate the reason they believe the data used to calculate the peer group
28.32system results are not accurate or reasons for the appeal;
28.33(2) provide any evidence and, calculations, or documentation to support the reason
28.34that data was not accurate for the appeal; and
28.35(3) cooperate with the commissioner, including allowing the commissioner access to
28.36data necessary and relevant to resolving the dispute.
29.1The commissioner shall cooperate with the provider during the data review period
29.2specified in subdivisions 3a and 3c by giving the provider information necessary for the
29.3preparation of an appeal.
29.4If a provider does not meet the requirements of this paragraph subdivision, a provider's
29.5appeal shall be considered withdrawn. The commissioner shall not publish peer grouping
29.6results for a specific provider under paragraph (e) or (f) while that provider has an
29.7unresolved appeal until the appeal has been resolved.
29.8    Subd. 3c. Provider peer grouping; publication of information for the public.
29.9    (e) Beginning January 1, 2011, the commissioner shall, no less than annually, publish
29.10information on providers' total cost, total resource use, total quality, and the results of
29.11the total care portion of the peer grouping process. The results that are published must
29.12be on a risk-adjusted basis. (a) The commissioner may publicly release summary data
29.13related to the peer grouping system as long as the data do not contain information or
29.14descriptions from which the identity of individual hospitals, clinics, or other providers
29.15may be discerned.
29.16(f) Beginning March 30, 2011, the commissioner shall no less than annually publish
29.17information on providers' condition-specific cost, condition-specific resource use, and
29.18condition-specific quality, and the results of the condition-specific portion of the peer
29.19grouping process. The results that are published must be on a risk-adjusted basis. (b) The
29.20commissioner may publicly release analyses or results related to the peer grouping system
29.21that identify hospitals, clinics, or other providers only if the following criteria are met:
29.22(1) the results, data, and summaries, including any graphical depictions of provider
29.23performance, have been distributed to providers at least 120 days prior to publication;
29.24(2) the commissioner has provided an opportunity for providers to verify and review
29.25data for which the provider is the subject consistent with the recommendations developed
29.26pursuant to paragraph (d) and adopted by the commissioner;
29.27(3) the results meet thresholds of validity, reliability, statistical significance,
29.28representativeness, and other standards that reflect the recommendations of the advisory
29.29committee, established under subdivision 3; and
29.30(4) any public report or other usage of the analyses, report, or data used by the
29.31state clearly notifies consumers about how to use and interpret the results, including
29.32any limitations of the data and analysis.
29.33(g) (c) After publishing the first public report, the commissioner shall, no less
29.34frequently than annually, publish information on providers' total cost, total resource use,
29.35total quality, and the results of the total care portion of the peer grouping process, as well
29.36as information on providers' condition-specific cost, condition-specific resource use,
30.1and condition-specific quality, and the results of the condition-specific portion of the
30.2peer grouping process. The results that are published must be on a risk-adjusted basis,
30.3including case mix adjustments.
30.4(d) The commissioner shall convene a work group comprised of representatives
30.5of physician clinics, hospitals, their respective statewide associations, and other
30.6relevant stakeholder organizations to make recommendations on data to be made
30.7available to hospitals and physician clinics to allow for verification of the accuracy and
30.8representativeness of the provider peer grouping results.
30.9    Subd. 3d. Provider peer grouping; standards for dissemination and publication.
30.10(a) Prior to disseminating data to providers under paragraph (b) or (c) subdivision 3a or
30.11publishing information under paragraph (e) or (f) subdivision 3c, the commissioner, in
30.12consultation with the advisory committee, shall ensure the scientific and statistical validity
30.13and reliability of the results according to the standards described in paragraph (h) (b).
30.14If additional time is needed to establish the scientific validity, statistical significance,
30.15and reliability of the results, the commissioner may delay the dissemination of data to
30.16providers under paragraph (b) or (c) subdivision 3a, or the publication of information under
30.17paragraph (e) or (f) subdivision 3c. If the delay is more than 60 days, the commissioner
30.18shall report in writing to the chairs and ranking minority members of the legislative
30.19committees with jurisdiction over health care policy and finance the following information:
30.20(1) the reason for the delay;
30.21(2) the actions being taken to resolve the delay and establish the scientific validity
30.22and reliability of the results; and
30.23(3) the new dates by which the results shall be disseminated.
30.24If there is a delay under this paragraph, The commissioner must disseminate the
30.25information to providers under paragraph (b) or (c) subdivision 3a at least 90 120 days
30.26before publishing results under paragraph (e) or (f) subdivision 3c.
30.27(h) (b) The commissioner's assurance of valid, timely, and reliable clinic and hospital
30.28peer grouping performance results shall include, at a minimum, the following:
30.29(1) use of the best available evidence, research, and methodologies; and
30.30(2) establishment of an explicit minimum reliability threshold thresholds for both
30.31quality and costs developed in collaboration with the subjects of the data and the users of
30.32the data, at a level not below nationally accepted standards where such standards exist.
30.33In achieving these thresholds, the commissioner shall not aggregate clinics that are not
30.34part of the same system or practice group. The commissioner shall consult with and
30.35solicit feedback from the advisory committee and representatives of physician clinics
30.36and hospitals during the peer grouping data analysis process to obtain input on the
31.1methodological options prior to final analysis and on the design, development, and testing
31.2of provider reports.

31.3    Sec. 8. Minnesota Statutes 2010, section 62U.04, subdivision 4, is amended to read:
31.4    Subd. 4. Encounter data. (a) Beginning July 1, 2009, and every six months
31.5thereafter, all health plan companies and third-party administrators shall submit encounter
31.6data to a private entity designated by the commissioner of health. The data shall be
31.7submitted in a form and manner specified by the commissioner subject to the following
31.8requirements:
31.9    (1) the data must be de-identified data as described under the Code of Federal
31.10Regulations, title 45, section 164.514;
31.11    (2) the data for each encounter must include an identifier for the patient's health care
31.12home if the patient has selected a health care home; and
31.13    (3) except for the identifier described in clause (2), the data must not include
31.14information that is not included in a health care claim or equivalent encounter information
31.15transaction that is required under section 62J.536.
31.16    (b) The commissioner or the commissioner's designee shall only use the data
31.17submitted under paragraph (a) for the purpose of carrying out its responsibilities in this
31.18section, and must maintain the data that it receives according to the provisions of this
31.19section. to carry out its responsibilities in this section, including supplying the data to
31.20providers so they can verify their results of the peer grouping process consistent with the
31.21recommendations developed pursuant to subdivision 3c, paragraph (d), and adopted by
31.22the commissioner and, if necessary, submit comments to the commissioner or initiate
31.23an appeal.
31.24    (c) Data on providers collected under this subdivision are private data on individuals
31.25or nonpublic data, as defined in section 13.02. Notwithstanding the definition of summary
31.26data in section 13.02, subdivision 19, summary data prepared under this subdivision
31.27may be derived from nonpublic data. The commissioner or the commissioner's designee
31.28shall establish procedures and safeguards to protect the integrity and confidentiality of
31.29any data that it maintains.
31.30    (d) The commissioner or the commissioner's designee shall not publish analyses or
31.31reports that identify, or could potentially identify, individual patients.

31.32    Sec. 9. Minnesota Statutes 2010, section 62U.04, subdivision 5, is amended to read:
31.33    Subd. 5. Pricing data. (a) Beginning July 1, 2009, and annually on January 1
31.34thereafter, all health plan companies and third-party administrators shall submit data
32.1on their contracted prices with health care providers to a private entity designated by
32.2the commissioner of health for the purposes of performing the analyses required under
32.3this subdivision. The data shall be submitted in the form and manner specified by the
32.4commissioner of health.
32.5    (b) The commissioner or the commissioner's designee shall only use the data
32.6submitted under this subdivision for the purpose of carrying out its responsibilities under
32.7this section to carry out its responsibilities under this section, including supplying the
32.8data to providers so they can verify their results of the peer grouping process consistent
32.9with the recommendations developed pursuant to subdivision 3c, paragraph (d), and
32.10adopted by the commissioner and, if necessary, submit comments to the commissioner or
32.11initiate an appeal.
32.12    (c) Data collected under this subdivision are nonpublic data as defined in section
32.1313.02 . Notwithstanding the definition of summary data in section 13.02, subdivision 19,
32.14summary data prepared under this section may be derived from nonpublic data. The
32.15commissioner shall establish procedures and safeguards to protect the integrity and
32.16confidentiality of any data that it maintains.

32.17    Sec. 10. Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 9, is
32.18amended to read:
32.19    Subd. 9. Uses of information. (a) For product renewals or for new products that
32.20are offered, after 12 months have elapsed from publication by the commissioner of the
32.21information in subdivision 3, paragraph (e):
32.22    (1) the commissioner of management and budget shall may use the information and
32.23methods developed under subdivision 3 subdivisions 3 to 3d to strengthen incentives for
32.24members of the state employee group insurance program to use high-quality, low-cost
32.25providers;
32.26    (2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer
32.27health benefits to their employees must may offer plans that differentiate providers on their
32.28cost and quality performance and create incentives for members to use better-performing
32.29providers;
32.30    (3) all health plan companies shall may use the information and methods developed
32.31under subdivision 3 subdivisions 3 to 3d to develop products that encourage consumers to
32.32use high-quality, low-cost providers; and
32.33    (4) health plan companies that issue health plans in the individual market or the
32.34small employer market must may offer at least one health plan that uses the information
32.35developed under subdivision 3 subdivisions 3 to 3d to establish financial incentives for
33.1consumers to choose higher-quality, lower-cost providers through enrollee cost-sharing
33.2or selective provider networks.
33.3    (b) By January 1, 2011, the commissioner of health shall report to the governor
33.4and the legislature on recommendations to encourage health plan companies to promote
33.5widespread adoption of products that encourage the use of high-quality, low-cost providers.
33.6The commissioner's recommendations may include tax incentives, public reporting of
33.7health plan performance, regulatory incentives or changes, and other strategies.

33.8    Sec. 11. Minnesota Statutes 2011 Supplement, section 144.1222, subdivision 5,
33.9is amended to read:
33.10    Subd. 5. Swimming pond exemption Exemptions. (a) A public swimming pond
33.11in existence before January 1, 2008, is not a public pool for purposes of this section and
33.12section 157.16, and is exempt from the requirements for public swimming pools under
33.13Minnesota Rules, chapter 4717.
33.14(b) A naturally treated swimming pool located in the city of Minneapolis is not
33.15a public pool for purposes of this section and section 157.16, and is exempt from the
33.16requirements for public swimming pools under Minnesota Rules, chapter 4717.
33.17    (b) (c) Notwithstanding paragraph paragraphs (a) and (b), a public swimming pond
33.18and a naturally treated swimming pool must meet the requirements for public pools
33.19described in subdivisions 1c and 1d.
33.20    (c) (d) For purposes of this subdivision, a "public swimming pond" means an
33.21artificial body of water contained within a lined, sand-bottom basin, intended for public
33.22swimming, relaxation, or recreational use that includes a water circulation system for
33.23maintaining water quality and does not include any portion of a naturally occurring lake
33.24or stream.
33.25(e) For purposes of this subdivision, a "naturally treated swimming pool" means an
33.26artificial body of water contained in a basin, intended for public swimming, relaxation, or
33.27recreational use that uses a chemical free filtration system for maintaining water quality
33.28through natural processes, including the use of plants, beneficial bacteria, and microbes.
33.29EFFECTIVE DATE.This section is effective the day following final enactment.

33.30    Sec. 12. Minnesota Statutes 2010, section 144.5509, is amended to read:
33.31144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.
34.1    (a) A radiation therapy facility may be constructed only by an entity owned,
34.2operated, or controlled by a hospital licensed according to sections 144.50 to 144.56 either
34.3alone or in cooperation with another entity. This paragraph expires August 1, 2014.
34.4    (b) Notwithstanding paragraph (a), there shall be a moratorium on the construction
34.5of any radiation therapy facility located in the following counties: Hennepin, Ramsey,
34.6Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns,
34.7Chisago, Isanti, and Wright. This paragraph does not apply to the relocation or
34.8reconstruction of an existing facility owned by a hospital if the relocation or reconstruction
34.9is within one mile of the existing facility. This paragraph does not apply to a radiation
34.10therapy facility that is being built attached to a community hospital in Wright County and
34.11meets the following conditions prior to August 1, 2007: the capital expenditure report
34.12required under Minnesota Statutes, section 62J.17, has been filed with the commissioner
34.13of health; a timely construction schedule is developed, stipulating dates for beginning,
34.14achieving various stages, and completing construction; and all zoning and building permits
34.15applied for. Beginning January 1, 2013, this paragraph does not apply to any construction
34.16necessary to relocate a radiation therapy machine from a community hospital-owned
34.17radiation therapy facility located in the city of Maplewood to a community hospital
34.18campus in the city of Woodbury within the same health system. This paragraph expires
34.19August 1, 2014.
34.20(c) After August 1, 2014, a radiation therapy facility may be constructed only if the
34.21following requirements are met:
34.22(1) the entity constructing the radiation therapy facility is controlled by or is under
34.23common control with a hospital licensed under sections 144.50 to 144.56; and
34.24(2) the new radiation therapy facility is located at least seven miles from an existing
34.25radiation therapy facility.
34.26(d) Any referring physician must provide each patient who is in need of radiation
34.27therapy services with a list of all radiation therapy facilities located within the following
34.28counties: Hennepin, Ramsey, Dakota, Washington, Anoka, Carver, Scott, St. Louis,
34.29Sherburne, Benton, Stearns, Chisago, Isanti, and Wright. Physicians with a financial
34.30interest in any radiation therapy facility must disclose to the patient the existence of the
34.31interest.
34.32(e) For purposes of this section, "controlled by" or "under common control with"
34.33means the possession, direct or indirect, of the power to direct or cause the direction of the
34.34policies, operations, or activities of an entity, through the ownership of, or right to vote
34.35or to direct the disposition of shares, membership interests, or ownership interests of
34.36the entity.
35.1(f) For purposes of this section, "financial interest in any radiation therapy facility"
35.2means a direct or indirect ownership or investment interest in a radiation therapy facility
35.3or a compensation arrangement with a radiation therapy facility.
35.4(g) This section does not apply to the relocation or reconstruction of an existing
35.5radiation therapy facility if:
35.6(1) the relocation or reconstruction of the facility remains owned by the same entity;
35.7(2) the relocation or reconstruction is located within one mile of the existing facility;
35.8and
35.9(3) the period in which the existing facility is closed and the relocated or
35.10reconstructed facility begins providing services does not exceed 12 months.

35.11    Sec. 13. Minnesota Statutes 2010, section 145.906, is amended to read:
35.12145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
35.13(a) The commissioner of health shall work with health care facilities, licensed health
35.14and mental health care professionals, the women, infants, and children (WIC) program,
35.15mental health advocates, consumers, and families in the state to develop materials and
35.16information about postpartum depression, including treatment resources, and develop
35.17policies and procedures to comply with this section.
35.18(b) Physicians, traditional midwives, and other licensed health care professionals
35.19providing prenatal care to women must have available to women and their families
35.20information about postpartum depression.
35.21(c) Hospitals and other health care facilities in the state must provide departing new
35.22mothers and fathers and other family members, as appropriate, with written information
35.23about postpartum depression, including its symptoms, methods of coping with the illness,
35.24and treatment resources.
35.25(d) Information about postpartum depression, including its symptoms, potential
35.26impact on families, and treatment resources must be available at WIC sites.

35.27    Sec. 14. Minnesota Statutes 2010, section 256B.0754, subdivision 2, is amended to
35.28read:
35.29    Subd. 2. Payment reform. By no later than 12 months after the commissioner of
35.30health publishes the information in section 62U.04, subdivision 3, paragraph (e) 62U.04,
35.31subdivision 3c, paragraph (b), the commissioner of human services shall may use the
35.32information and methods developed under section 62U.04 to establish a payment system
35.33that:
35.34    (1) rewards high-quality, low-cost providers;
36.1    (2) creates enrollee incentives to receive care from high-quality, low-cost providers;
36.2and
36.3    (3) fosters collaboration among providers to reduce cost shifting from one part of
36.4the health continuum to another.

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

36.7 36.8

Subd. 2.Community and Family Health Promotion

36.9	Appropriations by Fund
36.10	General	45,577,000	46,030,000
36.11 36.12	State Government Special Revenue	1,033,000	1,033,000
36.13	Health Care Access	16,719,000	1,719,000
36.14	Federal TANF	11,713,000	11,713,000

36.15TANF Appropriations. (1) $1,156,000 of
36.16the TANF funds is appropriated each year of
36.17the biennium to the commissioner for family
36.18planning grants under Minnesota Statutes,
36.19section 145.925.
36.20(2) $3,579,000 of the TANF funds is
36.21appropriated each year of the biennium to
36.22the commissioner for home visiting and
36.23nutritional services listed under Minnesota
36.24Statutes, section 145.882, subdivision 7,
36.25clauses (6) and (7). Funds must be distributed
36.26to community health boards according to
36.27Minnesota Statutes, section 145A.131,
36.28subdivision 1 .
36.29(3) $2,000,000 of the TANF funds is
36.30appropriated each year of the biennium to
36.31the commissioner for decreasing racial and
36.32ethnic disparities in infant mortality rates
36.33under Minnesota Statutes, section 145.928,
36.34subdivision 7 .
37.1(4) $4,978,000 of the TANF funds is
37.2appropriated each year of the biennium to the
37.3commissioner for the family home visiting
37.4grant program according to Minnesota
37.5Statutes, section 145A.17. $4,000,000 of the
37.6funding must be distributed to community
37.7health boards according to Minnesota
37.8Statutes, section 145A.131, subdivision 1.
37.9$978,000 of the funding must be distributed
37.10to tribal governments based on Minnesota
37.11Statutes, section 145A.14, subdivision 2a.
37.12(5) The commissioner may use up to 6.23
37.13percent of the funds appropriated each fiscal
37.14year to conduct the ongoing evaluations
37.15required under Minnesota Statutes, section
37.16145A.17, subdivision 7 , and training and
37.17technical assistance as required under
37.18Minnesota Statutes, section 145A.17,
37.19subdivisions 4 and 5.
37.20TANF Carryforward. Any unexpended
37.21balance of the TANF appropriation in the
37.22first year of the biennium does not cancel but
37.23is available for the second year.
37.24Statewide Health Improvement Program.
37.25(a) $15,000,000 in the biennium ending June
37.2630, 2013, is appropriated from the health
37.27care access fund for the statewide health
37.28improvement program and is available until
37.29expended. Notwithstanding Minnesota
37.30Statutes, sections 144.396, and 145.928, the
37.31commissioner may use tobacco prevention
37.32grant funding and grant funding under
37.33Minnesota Statutes, section 145.928, to
37.34support the statewide health improvement
37.35program. The commissioner may focus the
38.1program geographically or on a specific
38.2goal of tobacco use reduction or on
38.3reducing obesity. By February 15, 2013, the
38.4commissioner shall report to the chairs of
38.5the health and human services committee
38.6on progress toward meeting the goals of the
38.7program as outlined in Minnesota Statutes,
38.8section 145.986, and estimate the dollar
38.9value of the reduced health care costs for
38.10both public and private payers.
38.11(b) By February 15, 2012, the commissioner
38.12shall develop a plan to implement
38.13evidence-based strategies from the statewide
38.14health improvement program as part of
38.15hospital community benefit programs
38.16and health maintenance organizations
38.17collaboration plans. The implementation
38.18plan shall include an advisory board
38.19to determine priority needs for health
38.20improvement in reducing obesity and
38.21tobacco use in Minnesota and to review
38.22and approve hospital community benefit
38.23activities reported under Minnesota Statutes,
38.24section 144.699, and health maintenance
38.25organizations collaboration plans in
38.26Minnesota Statutes, section 62Q.075. The
38.27commissioner shall consult with hospital
38.28and health maintenance organizations in
38.29creating and implementing the plan. The
38.30plan described in this paragraph shall be
38.31implemented by July 1, 2012.
38.32(c) The commissioners of Minnesota
38.33management and budget, human services,
38.34and health shall include in each forecast
38.35beginning February of 2013 a report that
38.36identifies an estimated dollar value of the
39.1health care savings in the state health care
39.2programs that are directly attributable to the
39.3strategies funded from the statewide health
39.4improvement program. The report shall
39.5include a description of methodologies and
39.6assumptions used to calculate the estimate.
39.7Funding Usage. Up to 75 percent of the
39.8fiscal year 2012 appropriation for local public
39.9health grants may be used to fund calendar
39.10year 2011 allocations for this program and
39.11up to 75 percent of the fiscal year 2013
39.12appropriation may be used for calendar year
39.132012 allocations. The fiscal year 2014 base
39.14shall be increased by $5,193,000.
39.15Base Level Adjustment. The general fund
39.16base is increased by $5,188,000 in fiscal year
39.172014 and decreased by $5,000 in 2015.

39.18    Sec. 16. STUDY OF RADIATION THERAPY FACILITIES CAPACITY.
39.19(a) To the extent of available appropriations, the commissioner of health shall
39.20conduct a study of the following: (1) current treatment capacity of the existing radiation
39.21therapy facilities within the state; (2) the present need for radiation therapy services based
39.22on population demographics and new cancer cases; and (3) the projected need in the next
39.23ten years for radiation therapy services and whether the current facilities can sustain
39.24this projected need.
39.25(b) The commissioner may contract with a qualified entity to conduct the study. The
39.26study shall be completed by March 15, 2013, and the results shall be submitted to the
39.27chairs and ranking minority members of the health and human services committees of
39.28the legislature.

39.29    Sec. 17. REVISOR'S INSTRUCTION.
39.30The revisor of statutes shall change the terms "commissioner of health" or similar
39.31term to "commissioner of commerce" or similar term and "department of health" or similar
39.32term to "department of commerce" or similar term wherever necessary in Minnesota
39.33Statutes, chapters 62A to 62U, and other relevant statutes as needed to signify the transfer
40.1of regulatory jurisdiction of health maintenance organizations from the commissioner of
40.2health to the commissioner of commerce.

40.3    Sec. 18. EFFECTIVE DATE.
40.4Sections 5 to 10 and 14 are effective July 1, 2012, and apply to all information
40.5provided or released to the public or to health care providers, pursuant to Minnesota
40.6Statutes, section 62U.04, on or after that date. Section 7 shall be implemented by the
40.7commissioner of health within available resources.

40.8ARTICLE 3

40.9CHILDREN AND FAMILY SERVICES

40.10    Section 1. Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is
40.11amended to read:
40.12    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
40.13must not be reimbursed for more than ten full-day absent days per child, excluding
40.14holidays, in a fiscal year. Legal nonlicensed family child care providers must not be
40.15reimbursed for absent days. If a child attends for part of the time authorized to be in care in
40.16a day, but is absent for part of the time authorized to be in care in that same day, the absent
40.17time must be reimbursed but the time must not count toward the ten absent day limit.
40.18Child care providers must only be reimbursed for absent days if the provider has a written
40.19policy for child absences and charges all other families in care for similar absences.
40.20(b) Notwithstanding paragraph (a), children in families may exceed the ten absent
40.21days limit if at least one parent is: (1) under the age of 21; (2) does not have a high school
40.22or general equivalency diploma; and (3) is a student in a school district or another similar
40.23program that provides or arranges for child care, parenting support, social services, career
40.24and employment supports, and academic support to achieve high school graduation, upon
40.25request of the program and approval of the county. If a child attends part of an authorized
40.26day, payment to the provider must be for the full amount of care authorized for that day.
40.27    (b) (c) Child care providers must be reimbursed for up to ten federal or state
40.28holidays or designated holidays per year when the provider charges all families for these
40.29days and the holiday or designated holiday falls on a day when the child is authorized to
40.30be in attendance. Parents may substitute other cultural or religious holidays for the ten
40.31recognized state and federal holidays. Holidays do not count toward the ten absent day
40.32limit.
40.33    (c) (d) A family or child care provider must not be assessed an overpayment for an
40.34absent day payment unless (1) there was an error in the amount of care authorized for the
41.1family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
41.2the family or provider did not timely report a change as required under law.
41.3    (d) (e) The provider and family shall receive notification of the number of absent
41.4days used upon initial provider authorization for a family and ongoing notification of the
41.5number of absent days used as of the date of the notification.
41.6EFFECTIVE DATE.This section is effective January 1, 2013.

41.7    Sec. 2. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
41.8to read:
41.9    Subd. 18c. Drug convictions. (a) The state court administrator shall provide a
41.10report every six months by electronic means to the commissioner of human services,
41.11including the name, address, date of birth, and, if available, driver's license or state
41.12identification card number, date of sentence, effective date of the sentence, and county in
41.13which the conviction occurred of each person convicted of a felony under chapter 152
41.14during the previous six months.
41.15(b) The commissioner shall determine whether the individuals who are the subject of
41.16the data reported under paragraph (a) are receiving public assistance under chapter 256D
41.17or 256J, and if the individual is receiving assistance under chapter 256D or 256J, the
41.18commissioner shall instruct the county to proceed under section 256D.024 or 256J.26,
41.19whichever is applicable, for this individual.
41.20(c) The commissioner shall not retain any data received under paragraph (a) or (d)
41.21that does not relate to an individual receiving publicly funded assistance under chapter
41.22256D or 256J.
41.23(d) In addition to the routine data transfer under paragraph (a), the state court
41.24administrator shall provide a onetime report of the data fields under paragraph (a) for
41.25individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until
41.26the date of the data transfer. The commissioner shall perform the tasks identified under
41.27paragraph (b) related to this data and shall retain the data according to paragraph (c).
41.28EFFECTIVE DATE.This section is effective January 1, 2013.

41.29    Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
41.30to read:
41.31    Subd. 18d. Data sharing with the Department of Human Services; multiple
41.32identification cards. (a) The commissioner of public safety shall, on a monthly basis,
41.33provide the commissioner of human services with the first, middle, and last name,
42.1the address, date of birth, and driver's license or state identification card number of all
42.2applicants and holders whose drivers' licenses and state identification cards have been
42.3canceled under section 171.14, paragraph (a), clauses (2) or (3), by the commissioner of
42.4public safety. After the initial data report has been provided by the commissioner of
42.5public safety to the commissioner of human services under this paragraph, subsequent
42.6reports shall only include cancellations that occurred after the end date of the cancellations
42.7represented in the previous data report.
42.8(b) The commissioner of human services shall compare the information provided
42.9under paragraph (a) with the commissioner's data regarding recipients of all public
42.10assistance programs managed by the Department of Human Services to determine whether
42.11any person with multiple identification cards issued by the Department of Public Safety
42.12has illegally or improperly enrolled in any public assistance program managed by the
42.13Department of Human Services.
42.14(c) If the commissioner of human services determines that an applicant or recipient
42.15has illegally or improperly enrolled in any public assistance program, the commissioner
42.16shall provide all due process protections to the individual before terminating the individual
42.17from the program according to applicable statute and notifying the county attorney.
42.18EFFECTIVE DATE.This section is effective January 1, 2013.

42.19    Sec. 4. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
42.20to read:
42.21    Subd. 18e. Data sharing with the Department of Human Services; legal
42.22presence date. (a) The commissioner of public safety shall, on a monthly basis, provide
42.23the commissioner of human services with the first, middle, and last name, address, date of
42.24birth, and driver's license or state identification number of all applicants and holders of
42.25drivers' licenses and state identification cards whose temporary legal presence date has
42.26expired and whose driver's license or identification card has been canceled under section
42.27171.14 by the commissioner of public safety.
42.28(b) The commissioner of human services shall use the information provided under
42.29paragraph (a) to determine whether the eligibility of any recipients of public assistance
42.30programs managed by the Department of Human Services has changed as a result of the
42.31status change in the Department of Public Safety data.
42.32(c) If the commissioner of human services determines that a recipient has illegally or
42.33improperly received benefits from any public assistance program, the commissioner shall
42.34provide all due process protections to the individual before terminating the individual from
42.35the program according to applicable statute and notifying the county attorney.
43.1EFFECTIVE DATE.This section is effective January 1, 2013.

43.2    Sec. 5. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is
43.3amended to read:
43.4    Subdivision 1. Electronic benefit transfer (EBT) card. Cash benefits for the
43.5general assistance and Minnesota supplemental aid programs under chapter 256D and
43.6programs under chapter 256J must be issued on a separate an EBT card with the name of
43.7the head of household printed on the card. The card must include the following statement:
43.8"It is unlawful to use this card to purchase tobacco products or alcoholic beverages." This
43.9card must be issued within 30 calendar days of an eligibility determination. During the
43.10initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT
43.11card without a name printed on the card. This card may be the same card on which food
43.12support benefits are issued and does not need to meet the requirements of this section.

43.13    Sec. 6. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:
43.14    Subd. 1b. Earned income savings account. In addition to the $50 disregard
43.15required under subdivision 1, the county agency shall disregard an additional earned
43.16income up to a maximum of $150 $500 per month for: (1) persons residing in facilities
43.17licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to
43.189530.4000, and for whom discharge and work are part of a treatment plan; (2) persons
43.19living in supervised apartments with services funded under Minnesota Rules, parts
43.209535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan;
43.21and (3) persons residing in group residential housing, as that term is defined in section
43.22256I.03, subdivision 3 , for whom the county agency has approved a discharge plan
43.23which includes work. The additional amount disregarded must be placed in a separate
43.24savings account by the eligible individual, to be used upon discharge from the residential
43.25facility into the community. For individuals residing in a chemical dependency program
43.26licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from
43.27the savings account require the signature of the individual and for those individuals with
43.28an authorized representative payee, the signature of the payee. A maximum of $1,000
43.29$2,000, including interest, of the money in the savings account must be excluded from
43.30the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in
43.31that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If
43.32excluded money is removed from the savings account by the eligible individual at any
43.33time before the individual is discharged from the facility into the community, the money is
43.34income to the individual in the month of receipt and a resource in subsequent months. If
44.1an eligible individual moves from a community facility to an inpatient hospital setting,
44.2the separate savings account is an excluded asset for up to 18 months. During that time,
44.3amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to
44.4the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the
44.518-month period, the entire account must be applied to the patient's cost of care.
44.6EFFECTIVE DATE.This section is effective October 1, 2012.

44.7    Sec. 7. Minnesota Statutes 2010, section 626.556, is amended by adding a subdivision
44.8to read:
44.9    Subd. 10n. Required referral to early intervention services. A child under
44.10age three who is involved in a substantiated case of maltreatment shall be referred for
44.11screening under the Individuals with Disabilities Education Act, part C. Parents must be
44.12informed that the evaluation and acceptance of services are voluntary. The commissioner
44.13of human services shall monitor referral rates by county and annually report the
44.14information to the legislature beginning March 15, 2014. Refusal to have a child screened
44.15is not a basis for a child in need of protection or services petition under chapter 260C.

44.16    Sec. 8. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 1,
44.17is amended to read:

44.18

Subdivision 1.Total Appropriation

$

6,259,280,000

$

6,212,085,000

44.19	Appropriations by Fund
44.20		2012	2013
44.21	General	5,657,737,000	5,584,471,000
44.22 44.23	State Government Special Revenue	3,565,000	3,565,000
44.24	Health Care Access	330,435,000	353,283,000
44.25	Federal TANF	265,378,000	268,101,000
44.26	Lottery Prize	1,665,000	1,665,000
44.27	Special Revenue	500,000	1,000,000

44.28Receipts for Systems Projects.
44.29Appropriations and federal receipts for
44.30information systems projects for MAXIS,
44.31PRISM, MMIS, and SSIS must be deposited
44.32in the state systems account authorized in
44.33Minnesota Statutes, section 256.014. Money
44.34appropriated for computer projects approved
45.1by the Minnesota Office of Enterprise
45.2Technology, funded by the legislature,
45.3and approved by the commissioner
45.4of management and budget, may be
45.5transferred from one project to another
45.6and from development to operations as the
45.7commissioner of human services considers
45.8necessary. Any unexpended balance in
45.9the appropriation for these projects does
45.10not cancel but is available for ongoing
45.11development and operations.
45.12Nonfederal Share Transfers. The
45.13nonfederal share of activities for which
45.14federal administrative reimbursement is
45.15appropriated to the commissioner may be
45.16transferred to the special revenue fund.
45.17TANF Maintenance of Effort.
45.18(a) In order to meet the basic maintenance
45.19of effort (MOE) requirements of the TANF
45.20block grant specified under Code of Federal
45.21Regulations, title 45, section 263.1, the
45.22commissioner may only report nonfederal
45.23money expended for allowable activities
45.24listed in the following clauses as TANF/MOE
45.25expenditures:
45.26(1) MFIP cash, diversionary work program,
45.27and food assistance benefits under Minnesota
45.28Statutes, chapter 256J;
45.29(2) the child care assistance programs
45.30under Minnesota Statutes, sections 119B.03
45.31and 119B.05, and county child care
45.32administrative costs under Minnesota
45.33Statutes, section 119B.15;
46.1(3) state and county MFIP administrative
46.2costs under Minnesota Statutes, chapters
46.3256J and 256K;
46.4(4) state, county, and tribal MFIP
46.5employment services under Minnesota
46.6Statutes, chapters 256J and 256K;
46.7(5) expenditures made on behalf of legal
46.8noncitizen MFIP recipients who qualify for
46.9the MinnesotaCare program under Minnesota
46.10Statutes, chapter 256L;
46.11(6) qualifying working family credit
46.12expenditures under Minnesota Statutes,
46.13section 290.0671; and
46.14(7) qualifying Minnesota education credit
46.15expenditures under Minnesota Statutes,
46.16section 290.0674.
46.17(b) The commissioner shall ensure that
46.18sufficient qualified nonfederal expenditures
46.19are made each year to meet the state's
46.20TANF/MOE requirements. For the activities
46.21listed in paragraph (a), clauses (2) to
46.22(7), the commissioner may only report
46.23expenditures that are excluded from the
46.24definition of assistance under Code of
46.25Federal Regulations, title 45, section 260.31.
46.26(c) For fiscal years beginning with state fiscal
46.27year 2003, the commissioner shall assure
46.28that the maintenance of effort used by the
46.29commissioner of management and budget
46.30for the February and November forecasts
46.31required under Minnesota Statutes, section
46.3216A.103 , contains expenditures under
46.33paragraph (a), clause (1), equal to at least 16
46.34percent of the total required under Code of
46.35Federal Regulations, title 45, section 263.1.
47.1(d) Minnesota Statutes, section 256.011,
47.2subdivision 3 , which requires that federal
47.3grants or aids secured or obtained under that
47.4subdivision be used to reduce any direct
47.5appropriations provided by law, do not apply
47.6if the grants or aids are federal TANF funds.
47.7(e) For the federal fiscal years beginning on
47.8or after October 1, 2007, the commissioner
47.9may not claim an amount of TANF/MOE in
47.10excess of the 75 percent standard in Code
47.11of Federal Regulations, title 45, section
47.12263.1(a)(2), except:
47.13(1) to the extent necessary to meet the 80
47.14percent standard under Code of Federal
47.15Regulations, title 45, section 263.1(a)(1),
47.16if it is determined by the commissioner
47.17that the state will not meet the TANF work
47.18participation target rate for the current year;
47.19(2) to provide any additional amounts
47.20under Code of Federal Regulations, title 45,
47.21section 264.5, that relate to replacement of
47.22TANF funds due to the operation of TANF
47.23penalties; and
47.24(3) to provide any additional amounts that
47.25may contribute to avoiding or reducing
47.26TANF work participation penalties through
47.27the operation of the excess MOE provisions
47.28of Code of Federal Regulations, title 45,
47.29section 261.43 (a)(2).
47.30For the purposes of clauses (1) to (3),
47.31the commissioner may supplement the
47.32MOE claim with working family credit
47.33expenditures or other qualified expenditures
47.34to the extent such expenditures are otherwise
48.1available after considering the expenditures
48.2allowed in this subdivision.
48.3(f) Notwithstanding any contrary provision
48.4in this article, paragraphs (a) to (e) expire
48.5June 30, 2015.
48.6Working Family Credit Expenditures
48.7as TANF/MOE. The commissioner may
48.8claim as TANF maintenance of effort up to
48.9$6,707,000 per year of working family credit
48.10expenditures for fiscal years 2012 and 2013.
48.11Working Family Credit Expenditures
48.12to be Claimed for TANF/MOE. The
48.13commissioner may count the following
48.14amounts of working family credit
48.15expenditures as TANF/MOE:
48.16(1) fiscal year 2012, $23,692,000
48.17$23,761,000;
48.18(2) fiscal year 2013, $44,969,000
48.19$48,738,000;
48.20(3) fiscal year 2014, $32,579,000
48.21$32,665,000; and
48.22(4) fiscal year 2015, $32,476,000
48.23$32,590,000.
48.24Notwithstanding any contrary provision in
48.25this article, this rider expires June 30, 2015.
48.26TANF Transfer to Federal Child Care
48.27and Development Fund. (a) The following
48.28TANF fund amounts are appropriated
48.29to the commissioner for purposes of
48.30MFIP/Transition Year Child Care Assistance
48.31under Minnesota Statutes, section 119B.05:
48.32(1) fiscal year 2012, $10,020,000;
48.33(2) fiscal year 2013, $28,020,000;
49.1(3) fiscal year 2014, $14,020,000; and
49.2(4) fiscal year 2015, $14,020,000.
49.3(b) The commissioner shall authorize the
49.4transfer of sufficient TANF funds to the
49.5federal child care and development fund to
49.6meet this appropriation and shall ensure that
49.7all transferred funds are expended according
49.8to federal child care and development fund
49.9regulations.
49.10Food Stamps Employment and Training
49.11Funds. (a) Notwithstanding Minnesota
49.12Statutes, sections 256D.051, subdivisions 1a,
49.136b, and 6c, and 256J.626, federal food stamps
49.14employment and training funds received
49.15as reimbursement for child care assistance
49.16program expenditures must be deposited in
49.17the general fund. The amount of funds must
49.18be limited to $500,000 per year in fiscal
49.19years 2012 through 2015, contingent upon
49.20approval by the federal Food and Nutrition
49.21Service.
49.22(b) Consistent with the receipt of these
49.23federal funds, the commissioner may
49.24adjust the level of working family credit
49.25expenditures claimed as TANF maintenance
49.26of effort. Notwithstanding any contrary
49.27provision in this article, this rider expires
49.28June 30, 2015.
49.29ARRA Food Support Benefit Increases.
49.30The funds provided for food support benefit
49.31increases under the Supplemental Nutrition
49.32Assistance Program provisions of the
49.33American Recovery and Reinvestment Act
49.34(ARRA) of 2009 must be used for benefit
49.35increases beginning July 1, 2009.
50.1Supplemental Security Interim Assistance
50.2Reimbursement Funds. $2,800,000 of
50.3uncommitted revenue available to the
50.4commissioner of human services for SSI
50.5advocacy and outreach services must be
50.6transferred to and deposited into the general
50.7fund by October 1, 2011.

50.8    Sec. 9. DIRECTIONS TO THE COMMISSIONER.
50.9The commissioner of human services, in consultation with the commissioner of
50.10public safety, shall report to the chairs and ranking minority members of the legislative
50.11committees with jurisdiction over health and human services policy and finance regarding
50.12the implementation of Minnesota Statutes, section 256.01, subdivisions 18d, 18e, and 18f,
50.13the number of persons affected, and fiscal impact by program by April 1, 2013.
50.14EFFECTIVE DATE.This section is effective January 1, 2013.

50.15ARTICLE 4

50.16CONTINUING CARE

50.17    Section 1. Minnesota Statutes 2010, section 62J.496, subdivision 2, is amended to read:
50.18    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
50.19(1) federally qualified health centers;
50.20    (2) community clinics, as defined under section 145.9268;
50.21    (3) nonprofit or local unit of government hospitals licensed under sections 144.50
50.22to 144.56;
50.23(4) individual or small group physician practices that are focused primarily on
50.24primary care;
50.25    (5) nursing facilities licensed under sections 144A.01 to 144A.27;
50.26(6) local public health departments as defined in chapter 145A; and
50.27    (7) other providers of health or health care services approved by the commissioner
50.28for which interoperable electronic health record capability would improve quality of
50.29care, patient safety, or community health.
50.30(b) The commissioner shall administer the loan fund to prioritize support and
50.31assistance to:
50.32(1) critical access hospitals;
50.33(2) federally qualified health centers;
51.1(3) entities that serve uninsured, underinsured, and medically underserved
51.2individuals, regardless of whether such area is urban or rural; and
51.3(4) individual or small group practices that are primarily focused on primary care;
51.4(5) nursing facilities certified to participate in the medical assistance program; and
51.5(6) providers enrolled in the elderly waiver program of customized living or 24-hour
51.6customized living of the medical assistance program, if at least half of their annual
51.7operating revenue is paid under that medical assistance program.
51.8    (c) An eligible applicant must submit a loan application to the commissioner of
51.9health on forms prescribed by the commissioner. The application must include, at a
51.10minimum:
51.11    (1) the amount of the loan requested and a description of the purpose or project
51.12for which the loan proceeds will be used;
51.13    (2) a quote from a vendor;
51.14    (3) a description of the health care entities and other groups participating in the
51.15project;
51.16    (4) evidence of financial stability and a demonstrated ability to repay the loan; and
51.17    (5) a description of how the system to be financed interoperates or plans in the
51.18future to interoperate with other health care entities and provider groups located in the
51.19same geographical area;
51.20(6) a plan on how the certified electronic health record technology will be maintained
51.21and supported over time; and
51.22(7) any other requirements for applications included or developed pursuant to
51.23section 3014 of the HITECH Act.

51.24    Sec. 2. [144.595] HOSPITAL FUTILITY POLICY.
51.25(a) A hospital licensed under sections 144.50 to 144.56 that adopts or implements a
51.26futility policy that applies to treatment of any child, from birth to 18 years of age, must
51.27disclose the futility policy to the parents of children treated at the hospital when the
51.28hospital identifies the need for a formal process to address concerns over the proposed
51.29treatment of a child. The hospital must, upon request of a parent of a patient or prospective
51.30patient, provide a copy of the current policy, if any.
51.31(b) For purposes of this section, a "futility policy" is any written policy that
51.32encourages or allows hospital employees, or other medical professionals who provide
51.33care to patients at the hospital, to withhold or discontinue treatment for a patient on the
51.34grounds of medical futility.

52.1    Sec. 3. Minnesota Statutes 2010, section 144A.073, is amended by adding a
52.2subdivision to read:
52.3    Subd. 13. Moratorium exception funding. In fiscal year 2013, the commissioner
52.4of health may approve moratorium exception projects under this section for which the full
52.5annualized state share of medical assistance costs does not exceed $1,000,000.

52.6    Sec. 4. Minnesota Statutes 2010, section 144A.351, is amended to read:
52.7144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
52.8REPORT REQUIRED.
52.9    The commissioners of health and human services, with the cooperation of counties
52.10and stakeholders, including persons who need or are using long-term care services and
52.11supports; lead agencies; regional entities,; senior, mental health, and disability organization
52.12representatives; services providers; and community members, including representatives of
52.13local business and faith communities shall prepare a report to the legislature by August 15,
52.142004 2013, and biennially thereafter, regarding the status of the full range of long-term
52.15care services and supports for the elderly and children and adults with disabilities and
52.16mental illnesses in Minnesota. The report shall address:
52.17    (1) demographics and need for long-term care services and supports in Minnesota;
52.18    (2) summary of county and regional reports on long-term care gaps, surpluses,
52.19imbalances, and corrective action plans;
52.20    (3) status of long-term care services by county and region including:
52.21    (i) changes in availability of the range of long-term care services and housing
52.22options;
52.23    (ii) access problems regarding long-term care services; and
52.24    (iii) comparative measures of long-term care services availability and progress
52.25changes over time; and
52.26    (4) recommendations regarding goals for the future of long-term care services,
52.27policy and fiscal changes, and resource needs.

52.28    Sec. 5. Minnesota Statutes 2010, section 245A.03, is amended by adding a subdivision
52.29to read:
52.30    Subd. 6a. Adult foster care homes serving people with mental illness;
52.31certification. (a) The commissioner of human services shall issue a mental health
52.32certification for adult foster care homes licensed under this chapter and Minnesota Rules,
52.33parts 9555.5105 to 9555.6265, that serve people with mental illness where the home is not
52.34the primary residence of the license holder when a provider is determined to have met
53.1the requirements under paragraph (b). This certification is voluntary for license holders.
53.2The certification shall be printed on the license, and identified on the commissioner's
53.3public Web site.
53.4(b) The requirements for certification are:
53.5(1) all staff working in the adult foster care home have received at least seven hours
53.6of annual training covering all of the following topics:
53.7(i) mental health diagnoses;
53.8(ii) mental health crisis response and de-escalation techniques;
53.9(iii) recovery from mental illness;
53.10(iv) treatment options including evidence-based practices;
53.11(v) medications and their side effects;
53.12(vi) co-occurring substance abuse and health conditions; and
53.13(vii) community resources;
53.14(2) a mental health professional, as defined in section 245.462, subdivision 18, or
53.15a mental health practitioner as defined in section 245.462, subdivision 17, are available
53.16for consultation and assistance;
53.17(3) there is a plan and protocol in place to address a mental health crisis; and
53.18(4) each individual's Individual Placement Agreement identifies who is providing
53.19clinical services and their contact information, and includes an individual crisis prevention
53.20and management plan developed with the individual.
53.21(c) License holders seeking certification under this subdivision must request this
53.22certification on forms provided by the commissioner and must submit the request to the
53.23county licensing agency in which the home is located. The county licensing agency must
53.24forward the request to the commissioner with a county recommendation regarding whether
53.25the commissioner should issue the certification.
53.26(d) Ongoing compliance with the certification requirements under paragraph (b)
53.27shall be reviewed by the county licensing agency at each licensing review. When a county
53.28licensing agency determines that the requirements of paragraph (b) are not met, the county
53.29shall inform the commissioner, and the commissioner will remove the certification.
53.30(e) A denial of the certification or the removal of the certification based on a
53.31determination that the requirements under paragraph (b) have not been met by the adult
53.32foster care license holder are not subject to appeal. A license holder that has been denied a
53.33certification or that has had a certification removed may again request certification when
53.34the license holder is in compliance with the requirements of paragraph (b).

54.1    Sec. 6. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is
54.2amended to read:
54.3    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
54.4initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
54.52960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
54.69555.6265, under this chapter for a physical location that will not be the primary residence
54.7of the license holder for the entire period of licensure. If a license is issued during this
54.8moratorium, and the license holder changes the license holder's primary residence away
54.9from the physical location of the foster care license, the commissioner shall revoke the
54.10license according to section 245A.07. Exceptions to the moratorium include:
54.11(1) foster care settings that are required to be registered under chapter 144D;
54.12(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
54.13and determined to be needed by the commissioner under paragraph (b);
54.14(3) new foster care licenses determined to be needed by the commissioner under
54.15paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
54.16restructuring of state-operated services that limits the capacity of state-operated facilities;
54.17(4) new foster care licenses determined to be needed by the commissioner under
54.18paragraph (b) for persons requiring hospital level care; or
54.19(5) new foster care licenses determined to be needed by the commissioner for the
54.20transition of people from personal care assistance to the home and community-based
54.21services.
54.22(b) The commissioner shall determine the need for newly licensed foster care homes
54.23as defined under this subdivision. As part of the determination, the commissioner shall
54.24consider the availability of foster care capacity in the area in which the licensee seeks to
54.25operate, and the recommendation of the local county board. The determination by the
54.26commissioner must be final. A determination of need is not required for a change in
54.27ownership at the same address.
54.28    (c) Residential settings that would otherwise be subject to the moratorium established
54.29in paragraph (a), that are in the process of receiving an adult or child foster care license as
54.30of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
54.31or child foster care license. For this paragraph, all of the following conditions must be met
54.32to be considered in the process of receiving an adult or child foster care license:
54.33    (1) participants have made decisions to move into the residential setting, including
54.34documentation in each participant's care plan;
54.35    (2) the provider has purchased housing or has made a financial investment in the
54.36property;
55.1    (3) the lead agency has approved the plans, including costs for the residential setting
55.2for each individual;
55.3    (4) the completion of the licensing process, including all necessary inspections, is
55.4the only remaining component prior to being able to provide services; and
55.5    (5) the needs of the individuals cannot be met within the existing capacity in that
55.6county.
55.7To qualify for the process under this paragraph, the lead agency must submit
55.8documentation to the commissioner by August 1, 2009, that all of the above criteria are
55.9met.
55.10(d) The commissioner shall study the effects of the license moratorium under this
55.11subdivision and shall report back to the legislature by January 15, 2011. This study shall
55.12include, but is not limited to the following:
55.13(1) the overall capacity and utilization of foster care beds where the physical location
55.14is not the primary residence of the license holder prior to and after implementation
55.15of the moratorium;
55.16(2) the overall capacity and utilization of foster care beds where the physical
55.17location is the primary residence of the license holder prior to and after implementation
55.18of the moratorium; and
55.19(3) the number of licensed and occupied ICF/MR beds prior to and after
55.20implementation of the moratorium.
55.21(e) When a foster care recipient moves out of a foster home that is not the primary
55.22residence of the license holder according to section 256B.49, subdivision 15, paragraph
55.23(f), the county shall immediately inform the Department of Human Services Licensing
55.24Division, and. The department shall immediately decrease the licensed capacity for the
55.25home, if the voluntary changes described in paragraph (g) are not sufficient to meet the
55.26savings required by 2011 reductions in licensed bed capacity and maintain statewide
55.27long-term care residential services capacity within budgetary limits. The commissioner
55.28shall delicense up to 128 beds by June 30, 2013, using the needs determination process.
55.29Under this paragraph, the commissioner has the authority to reduce unused licensed
55.30capacity of a current foster care program to accomplish the consolidation or closure of
55.31settings. A decreased licensed capacity according to this paragraph is not subject to appeal
55.32under this chapter.
55.33(f) Residential settings that would otherwise be subject to the decreased license
55.34capacity established in paragraph (e) shall be exempt under the following circumstances:
55.35(1) until August 1, 2013, the license holder's beds occupied by residents whose
55.36primary diagnosis is mental illness and the license holder is:
56.1(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
56.2health services (ARMHS) as defined in section 256B.0623;
56.3(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
56.49520.0870;
56.5(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
56.69520.0870; or
56.7(iv) a provider of intensive residential treatment services (IRTS) licensed under
56.8Minnesota Rules, parts 9520.0500 to 9520.0670; or
56.9(2) the license holder is certified under the requirements in subdivision 6a.
56.10(g) A resource need determination process, managed at the state level, using the
56.11available reports required by section 144A.351, and other data and information shall
56.12be used to determine where the reduced capacity required under paragraph (e) will be
56.13implemented. The commissioner shall consult with the stakeholders described in section
56.14144A.351, and employ a variety of methods to improve the state's capacity to meet
56.15long-term care service needs within budgetary limits, including seeking proposals from
56.16service providers or lead agencies to change service type, capacity, or location to improve
56.17services, increase the independence of residents, and better meet needs identified by the
56.18long-term care services reports and statewide data and information. By February 1 of each
56.19year, the commissioner shall provide information and data on the overall capacity of
56.20licensed long-term care services, actions taken under this subdivision to manage statewide
56.21long-term care services and supports resources, and any recommendations for change to
56.22the legislative committees with jurisdiction over health and human services budget.

56.23    Sec. 7. Minnesota Statutes 2010, section 245A.11, subdivision 2a, is amended to read:
56.24    Subd. 2a. Adult foster care license capacity. (a) The commissioner shall issue
56.25adult foster care licenses with a maximum licensed capacity of four beds, including
56.26nonstaff roomers and boarders, except that the commissioner may issue a license with a
56.27capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).
56.28(b) An adult foster care license holder may have a maximum license capacity of five
56.29if all persons in care are age 55 or over and do not have a serious and persistent mental
56.30illness or a developmental disability.
56.31(c) The commissioner may grant variances to paragraph (b) to allow a foster care
56.32provider with a licensed capacity of five persons to admit an individual under the age of 55
56.33if the variance complies with section 245A.04, subdivision 9, and approval of the variance
56.34is recommended by the county in which the licensed foster care provider is located.
57.1(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
57.2bed for emergency crisis services for a person with serious and persistent mental illness
57.3or a developmental disability, regardless of age, if the variance complies with section
57.4245A.04, subdivision 9 , and approval of the variance is recommended by the county in
57.5which the licensed foster care provider is located.
57.6(e) The commissioner may grant a variance to paragraph (b) to allow for the
57.7use of a fifth bed for respite services, as defined in section 245A.02, for persons with
57.8disabilities, regardless of age, if the variance complies with section 245A.03, subdivision
57.97, and section 245A.04, subdivision 9, and approval of the variance is recommended by
57.10the county in which the licensed foster care provider is licensed. Respite care may be
57.11provided under the following conditions:
57.12(1) staffing ratios cannot be reduced below the approved level for the individuals
57.13being served in the home on a permanent basis;
57.14(2) no more than two different individuals can be accepted for respite services in
57.15any calendar month and the total respite days may not exceed 120 days per program in
57.16any calendar year;
57.17(3) the person receiving respite services must have his or her own bedroom, which
57.18could be used for alternative purposes when not used as a respite bedroom, and cannot be
57.19the room of another person who lives in the foster care home; and
57.20(4) individuals living in the foster care home must be notified when the variance
57.21is approved. The provider must give 60 days' notice in writing to the residents and their
57.22legal representatives prior to accepting the first respite placement. Notice must be given to
57.23residents at least two days prior to service initiation, or as soon as the license holder is
57.24able if they receive notice of the need for respite less than two days prior to initiation,
57.25each time a respite client will be served, unless the requirement for this notice is waived
57.26by the resident or legal guardian.
57.27(e) If the 2009 legislature adopts a rate reduction that impacts providers of adult
57.28foster care services, (f) The commissioner may issue an adult foster care license with a
57.29capacity of five adults if the fifth bed does not increase the overall statewide capacity of
57.30licensed adult foster care beds in homes that are not the primary residence of the license
57.31holder, over the licensed capacity in such homes on July 1, 2009, as identified in a plan
57.32submitted to the commissioner by the county, when the capacity is recommended by
57.33the county licensing agency of the county in which the facility is located and if the
57.34recommendation verifies that:
57.35(1) the facility meets the physical environment requirements in the adult foster
57.36care licensing rule;
58.1(2) the five-bed living arrangement is specified for each resident in the resident's:
58.2(i) individualized plan of care;
58.3(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
58.4(iii) individual resident placement agreement under Minnesota Rules, part
58.59555.5105, subpart 19, if required;
58.6(3) the license holder obtains written and signed informed consent from each
58.7resident or resident's legal representative documenting the resident's informed choice
58.8to remain living in the home and that the resident's refusal to consent would not have
58.9resulted in service termination; and
58.10(4) the facility was licensed for adult foster care before March 1, 2009 2011.
58.11(f) (g) The commissioner shall not issue a new adult foster care license under
58.12paragraph (e) (f) after June 30, 2011 2016. The commissioner shall allow a facility with
58.13an adult foster care license issued under paragraph (e) (f) before June 30, 2011 2016, to
58.14continue with a capacity of five adults if the license holder continues to comply with the
58.15requirements in paragraph (e) (f).

58.16    Sec. 8. Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:
58.17    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The
58.18commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
58.19requiring a caregiver to be present in an adult foster care home during normal sleeping
58.20hours to allow for alternative methods of overnight supervision. The commissioner may
58.21grant the variance if the local county licensing agency recommends the variance and the
58.22county recommendation includes documentation verifying that:
58.23    (1) the county has approved the license holder's plan for alternative methods of
58.24providing overnight supervision and determined the plan protects the residents' health,
58.25safety, and rights;
58.26    (2) the license holder has obtained written and signed informed consent from
58.27each resident or each resident's legal representative documenting the resident's or legal
58.28representative's agreement with the alternative method of overnight supervision; and
58.29    (3) the alternative method of providing overnight supervision, which may include
58.30the use of technology, is specified for each resident in the resident's: (i) individualized
58.31plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
58.32required; or (iii) individual resident placement agreement under Minnesota Rules, part
58.339555.5105, subpart 19, if required.
58.34    (b) To be eligible for a variance under paragraph (a), the adult foster care license
58.35holder must not have had a licensing action conditional license issued under section
59.1245A.06 , or any other licensing sanction issued under section 245A.07 during the prior 24
59.2months based on failure to provide adequate supervision, health care services, or resident
59.3safety in the adult foster care home.
59.4    (c) A license holder requesting a variance under this subdivision to utilize
59.5technology as a component of a plan for alternative overnight supervision may request
59.6the commissioner's review in the absence of a county recommendation. Upon receipt of
59.7such a request from a license holder, the commissioner shall review the variance request
59.8with the county.

59.9    Sec. 9. Minnesota Statutes 2010, section 245A.11, subdivision 7a, is amended to read:
59.10    Subd. 7a. Alternate overnight supervision technology; adult foster care license.
59.11    (a) The commissioner may grant an applicant or license holder an adult foster care license
59.12for a residence that does not have a caregiver in the residence during normal sleeping
59.13hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
59.14monitoring technology to alert the license holder when an incident occurs that may
59.15jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
59.16holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
59.17to 9555.6265, and the requirements under this subdivision. The license printed by the
59.18commissioner must state in bold and large font:
59.19    (1) that the facility is under electronic monitoring; and
59.20    (2) the telephone number of the county's common entry point for making reports of
59.21suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
59.22(b) Applications for a license under this section must be submitted directly to
59.23the Department of Human Services licensing division. The licensing division must
59.24immediately notify the host county and lead county contract agency and the host county
59.25licensing agency. The licensing division must collaborate with the county licensing
59.26agency in the review of the application and the licensing of the program.
59.27    (c) Before a license is issued by the commissioner, and for the duration of the
59.28license, the applicant or license holder must establish, maintain, and document the
59.29implementation of written policies and procedures addressing the requirements in
59.30paragraphs (d) through (f).
59.31    (d) The applicant or license holder must have policies and procedures that:
59.32    (1) establish characteristics of target populations that will be admitted into the home,
59.33and characteristics of populations that will not be accepted into the home;
60.1    (2) explain the discharge process when a foster care recipient requires overnight
60.2supervision or other services that cannot be provided by the license holder due to the
60.3limited hours that the license holder is on site;
60.4    (3) describe the types of events to which the program will respond with a physical
60.5presence when those events occur in the home during time when staff are not on site, and
60.6how the license holder's response plan meets the requirements in paragraph (e), clause
60.7(1) or (2);
60.8    (4) establish a process for documenting a review of the implementation and
60.9effectiveness of the response protocol for the response required under paragraph (e),
60.10clause (1) or (2). The documentation must include:
60.11    (i) a description of the triggering incident;
60.12    (ii) the date and time of the triggering incident;
60.13    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
60.14    (iv) whether the response met the resident's needs;
60.15    (v) whether the existing policies and response protocols were followed; and
60.16    (vi) whether the existing policies and protocols are adequate or need modification.
60.17    When no physical presence response is completed for a three-month period, the
60.18license holder's written policies and procedures must require a physical presence response
60.19drill to be conducted for which the effectiveness of the response protocol under paragraph
60.20(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
60.21    (5) establish that emergency and nonemergency phone numbers are posted in a
60.22prominent location in a common area of the home where they can be easily observed by a
60.23person responding to an incident who is not otherwise affiliated with the home.
60.24    (e) The license holder must document and include in the license application which
60.25response alternative under clause (1) or (2) is in place for responding to situations that
60.26present a serious risk to the health, safety, or rights of people receiving foster care services
60.27in the home:
60.28    (1) response alternative (1) requires only the technology to provide an electronic
60.29notification or alert to the license holder that an event is underway that requires a response.
60.30Under this alternative, no more than ten minutes will pass before the license holder will be
60.31physically present on site to respond to the situation; or
60.32    (2) response alternative (2) requires the electronic notification and alert system
60.33under alternative (1), but more than ten minutes may pass before the license holder is
60.34present on site to respond to the situation. Under alternative (2), all of the following
60.35conditions are met:
61.1    (i) the license holder has a written description of the interactive technological
61.2applications that will assist the license holder in communicating with and assessing the
61.3needs related to the care, health, and safety of the foster care recipients. This interactive
61.4technology must permit the license holder to remotely assess the well being of the foster
61.5care recipient without requiring the initiation of the foster care recipient. Requiring the
61.6foster care recipient to initiate a telephone call does not meet this requirement;
61.7(ii) the license holder documents how the remote license holder is qualified and
61.8capable of meeting the needs of the foster care recipients and assessing foster care
61.9recipients' needs under item (i) during the absence of the license holder on site;
61.10(iii) the license holder maintains written procedures to dispatch emergency response
61.11personnel to the site in the event of an identified emergency; and
61.12    (iv) each foster care recipient's individualized plan of care, individual service plan
61.13under section 256B.092, subdivision 1b, if required, or individual resident placement
61.14agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
61.15maximum response time, which may be greater than ten minutes, for the license holder
61.16to be on site for that foster care recipient.
61.17    (f) All Each foster care recipient's placement agreements agreement, individual
61.18service agreements, and plans applicable to the foster care recipient agreement, and plan
61.19must clearly state that the adult foster care license category is a program without the
61.20presence of a caregiver in the residence during normal sleeping hours; the protocols in
61.21place for responding to situations that present a serious risk to the health, safety, or rights
61.22of foster care recipients under paragraph (e), clause (1) or (2); and a signed informed
61.23consent from each foster care recipient or the person's legal representative documenting
61.24the person's or legal representative's agreement with placement in the program. If
61.25electronic monitoring technology is used in the home, the informed consent form must
61.26also explain the following:
61.27    (1) how any electronic monitoring is incorporated into the alternative supervision
61.28system;
61.29    (2) the backup system for any electronic monitoring in times of electrical outages or
61.30other equipment malfunctions;
61.31    (3) how the license holder is caregivers are trained on the use of the technology;
61.32    (4) the event types and license holder response times established under paragraph (e);
61.33    (5) how the license holder protects the foster care recipient's privacy related to
61.34electronic monitoring and related to any electronically recorded data generated by the
61.35monitoring system. A foster care recipient may not be removed from a program under
61.36this subdivision for failure to consent to electronic monitoring. The consent form must
62.1explain where and how the electronically recorded data is stored, with whom it will be
62.2shared, and how long it is retained; and
62.3    (6) the risks and benefits of the alternative overnight supervision system.
62.4    The written explanations under clauses (1) to (6) may be accomplished through
62.5cross-references to other policies and procedures as long as they are explained to the
62.6person giving consent, and the person giving consent is offered a copy.
62.7(g) Nothing in this section requires the applicant or license holder to develop or
62.8maintain separate or duplicative policies, procedures, documentation, consent forms, or
62.9individual plans that may be required for other licensing standards, if the requirements of
62.10this section are incorporated into those documents.
62.11(h) The commissioner may grant variances to the requirements of this section
62.12according to section 245A.04, subdivision 9.
62.13(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
62.14under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
62.15contractors affiliated with the license holder.
62.16(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
62.17remotely determine what action the license holder needs to take to protect the well-being
62.18of the foster care recipient.
62.19(k) The commissioner shall evaluate license applications using the requirements
62.20in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
62.21including a checklist of criteria needed for approval.
62.22(l) To be eligible for a license under paragraph (a), the adult foster care license holder
62.23must not have had a conditional license issued under section 245A.06 or any licensing
62.24sanction under section 245A.07 during the prior 24 months based on failure to provide
62.25adequate supervision, health care services, or resident safety in the adult foster care home.
62.26(m) The commissioner shall review an application for an alternative overnight
62.27supervision license within 60 days of receipt of the application. When the commissioner
62.28receives an application that is incomplete because the applicant failed to submit required
62.29documents or that is substantially deficient because the documents submitted do not meet
62.30licensing requirements, the commissioner shall provide the applicant written notice
62.31that the application is incomplete or substantially deficient. In the written notice to the
62.32applicant, the commissioner shall identify documents that are missing or deficient and
62.33give the applicant 45 days to resubmit a second application that is substantially complete.
62.34An applicant's failure to submit a substantially complete application after receiving
62.35notice from the commissioner is a basis for license denial under section 245A.05. The
62.36commissioner shall complete subsequent review within 30 days.
63.1(n) Once the application is considered complete under paragraph (m), the
63.2commissioner will approve or deny an application for an alternative overnight supervision
63.3license within 60 days.
63.4(o) For the purposes of this subdivision, "supervision" means:
63.5(1) oversight by a caregiver as specified in the individual resident's place agreement
63.6and awareness of the resident's needs and activities; and
63.7(2) the presence of a caregiver in a residence during normal sleeping hours, unless a
63.8determination has been made and documented in the individual's support plan that the
63.9individual does not require the presence of a caregiver during normal sleeping hours.

63.10    Sec. 10. Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:
63.11    Subdivision 1. Consumer data file. The license holder must maintain the following
63.12information for each consumer:
63.13(1) identifying information that includes date of birth, medications, legal
63.14representative, history, medical, and other individual-specific information, and names and
63.15telephone numbers of contacts;
63.16(2) consumer health information, including individual medication administration
63.17and monitoring information;
63.18(3) the consumer's individual service plan. When a consumer's case manager does
63.19not provide a current individual service plan, the license holder shall make a written
63.20request to the case manager to provide a copy of the individual service plan and inform
63.21the consumer or the consumer's legal representative of the right to an individual service
63.22plan and the right to appeal under section 256.045;. In the event the case manager fails
63.23to provide an individual service plan after a written request from the license holder, the
63.24license holder shall not be sanctioned or penalized financially for not having a current
63.25individual service plan in the consumer's data file;
63.26(4) copies of assessments, analyses, summaries, and recommendations;
63.27(5) progress review reports;
63.28(6) incidents involving the consumer;
63.29(7) reports required under section 245B.05, subdivision 7;
63.30(8) discharge summary, when applicable;
63.31(9) record of other license holders serving the consumer that includes a contact
63.32person and telephone numbers, services being provided, services that require coordination
63.33between two license holders, and name of staff responsible for coordination;
63.34(10) information about verbal aggression directed at the consumer by another
63.35consumer; and
64.1(11) information about self-abuse.

64.2    Sec. 11. Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:
64.3    Subd. 6. Unlicensed home and community-based waiver providers of service to
64.4seniors and individuals with disabilities. (a) Providers required to initiate background
64.5studies under section 256B.4912 must initiate a study before the individual begins in a
64.6position allowing direct contact with persons served by the provider.
64.7(b) The commissioner shall conduct Except as provided in paragraph (c), the
64.8providers must initiate a background study annually of an individual required to be studied
64.9under section 245C.03, subdivision 6.
64.10(c) After an initial background study under this subdivision is initiated on an
64.11individual by a provider of both services licensed by the commissioner and the unlicensed
64.12services under this subdivision, a repeat annual background study is not required if:
64.13(1) the provider maintains compliance with the requirements of section 245C.07,
64.14paragraph (a), regarding one individual with one address and telephone number as the
64.15person to receive sensitive background study information for the multiple programs that
64.16depend on the same background study, and that the individual who is designated to receive
64.17the sensitive background information is capable of determining, upon the request of the
64.18commissioner, whether a background study subject is providing direct contact services
64.19in one or more of the provider's programs or services and, if so, at which location or
64.20locations; and
64.21(2) the individual who is the subject of the background study provides direct
64.22contact services under the provider's licensed program for at least 40 hours per year so
64.23the individual will be recognized by a probation officer or corrections agent to prompt
64.24a report to the commissioner regarding criminal convictions as required under section
64.25245C.05, subdivision 7.

64.26    Sec. 12. Minnesota Statutes 2010, section 245C.05, subdivision 7, is amended to read:
64.27    Subd. 7. Probation officer and corrections agent. (a) A probation officer or
64.28corrections agent shall notify the commissioner of an individual's conviction if the
64.29individual is:
64.30    (1) has been affiliated with a program or facility regulated by the Department of
64.31Human Services or Department of Health, a facility serving children or youth licensed by
64.32the Department of Corrections, or any type of home care agency or provider of personal
64.33care assistance services within the preceding year; and
65.1    (2) has been convicted of a crime constituting a disqualification under section
65.2245C.14 .
65.3    (b) For the purpose of this subdivision, "conviction" has the meaning given it
65.4in section 609.02, subdivision 5.
65.5    (c) The commissioner, in consultation with the commissioner of corrections, shall
65.6develop forms and information necessary to implement this subdivision and shall provide
65.7the forms and information to the commissioner of corrections for distribution to local
65.8probation officers and corrections agents.
65.9    (d) The commissioner shall inform individuals subject to a background study that
65.10criminal convictions for disqualifying crimes will be reported to the commissioner by the
65.11corrections system.
65.12    (e) A probation officer, corrections agent, or corrections agency is not civilly or
65.13criminally liable for disclosing or failing to disclose the information required by this
65.14subdivision.
65.15    (f) Upon receipt of disqualifying information, the commissioner shall provide the
65.16notice required under section 245C.17, as appropriate, to agencies on record as having
65.17initiated a background study or making a request for documentation of the background
65.18study status of the individual.
65.19    (g) This subdivision does not apply to family child care programs.

65.20    Sec. 13. Minnesota Statutes 2010, section 256.975, subdivision 7, is amended to read:
65.21    Subd. 7. Consumer information and assistance and long-term care options
65.22counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
65.23statewide service to aid older Minnesotans and their families in making informed choices
65.24about long-term care options and health care benefits. Language services to persons with
65.25limited English language skills may be made available. The service, known as Senior
65.26LinkAge Line, must be available during business hours through a statewide toll-free
65.27number and must also be available through the Internet.
65.28    (b) The service must provide long-term care options counseling by assisting older
65.29adults, caregivers, and providers in accessing information and options counseling about
65.30choices in long-term care services that are purchased through private providers or available
65.31through public options. The service must:
65.32    (1) develop a comprehensive database that includes detailed listings in both
65.33consumer- and provider-oriented formats;
65.34    (2) make the database accessible on the Internet and through other telecommunication
65.35and media-related tools;
66.1    (3) link callers to interactive long-term care screening tools and make these tools
66.2available through the Internet by integrating the tools with the database;
66.3    (4) develop community education materials with a focus on planning for long-term
66.4care and evaluating independent living, housing, and service options;
66.5    (5) conduct an outreach campaign to assist older adults and their caregivers in
66.6finding information on the Internet and through other means of communication;
66.7    (6) implement a messaging system for overflow callers and respond to these callers
66.8by the next business day;
66.9    (7) link callers with county human services and other providers to receive more
66.10in-depth assistance and consultation related to long-term care options;
66.11    (8) link callers with quality profiles for nursing facilities and other providers
66.12developed by the commissioner of health;
66.13    (9) incorporate information about the availability of housing options, as well as
66.14registered housing with services and consumer rights within the MinnesotaHelp.info
66.15network long-term care database to facilitate consumer comparison of services and costs
66.16among housing with services establishments and with other in-home services and to
66.17support financial self-sufficiency as long as possible. Housing with services establishments
66.18and their arranged home care providers shall provide information that will facilitate price
66.19comparisons, including delineation of charges for rent and for services available. The
66.20commissioners of health and human services shall align the data elements required by
66.21section 144G.06, the Uniform Consumer Information Guide, and this section to provide
66.22consumers standardized information and ease of comparison of long-term care options.
66.23The commissioner of human services shall provide the data to the Minnesota Board on
66.24Aging for inclusion in the MinnesotaHelp.info network long-term care database;
66.25(10) provide long-term care options counseling. Long-term care options counselors
66.26shall:
66.27(i) for individuals not eligible for case management under a public program or public
66.28funding source, provide interactive decision support under which consumers, family
66.29members, or other helpers are supported in their deliberations to determine appropriate
66.30long-term care choices in the context of the consumer's needs, preferences, values, and
66.31individual circumstances, including implementing a community support plan;
66.32(ii) provide Web-based educational information and collateral written materials to
66.33familiarize consumers, family members, or other helpers with the long-term care basics,
66.34issues to be considered, and the range of options available in the community;
67.1(iii) provide long-term care futures planning, which means providing assistance to
67.2individuals who anticipate having long-term care needs to develop a plan for the more
67.3distant future; and
67.4(iv) provide expertise in benefits and financing options for long-term care, including
67.5Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
67.6private pay options, and ways to access low or no-cost services or benefits through
67.7volunteer-based or charitable programs; and
67.8(11) using risk management and support planning protocols, provide long-term care
67.9options counseling to current residents of nursing homes deemed appropriate for discharge
67.10by the commissioner. In order to meet this requirement, the commissioner shall provide
67.11designated Senior LinkAge Line contact centers with a list of nursing home residents
67.12appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
67.13provide these residents, if they indicate a preference to receive long-term care options
67.14counseling, with initial assessment, review of risk factors, independent living support
67.15consultation, or referral to:
67.16(i) long-term care consultation services under section 256B.0911;
67.17(ii) designated care coordinators of contracted entities under section 256B.035 for
67.18persons who are enrolled in a managed care plan; or
67.19(iii) the long-term care consultation team for those who are appropriate for relocation
67.20service coordination due to high-risk factors or psychological or physical disability; and
67.21(12) develop referral protocols and processes that will assist certified health care
67.22homes and hospitals to identify at-risk older adults and determine when to refer these
67.23individuals to the Senior LinkAge Line for long-term care options counseling under this
67.24section. The commissioner is directed to work with the commissioner of health to develop
67.25protocols that would comply with the health care home designation criteria and protocols
67.26available at the time of hospital discharge.
67.27EFFECTIVE DATE.This section is effective is effective July 1, 2013.

67.28    Sec. 14. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to
67.29read:
67.30    Subd. 1a. Income and assets generally. Unless specifically required by state
67.31law or rule or federal law or regulation, the methodologies used in counting income
67.32and assets to determine eligibility for medical assistance for persons whose eligibility
67.33category is based on blindness, disability, or age of 65 or more years, the methodologies
67.34for the supplemental security income program shall be used, except as provided under
67.35subdivision 3, paragraph (a), clause (6). Increases in benefits under title II of the Social
68.1Security Act shall not be counted as income for purposes of this subdivision until July 1 of
68.2each year. Effective upon federal approval, for children eligible under section 256B.055,
68.3subdivision 12 , or for home and community-based waiver services whose eligibility
68.4for medical assistance is determined without regard to parental income, child support
68.5payments, including any payments made by an obligor in satisfaction of or in addition
68.6to a temporary or permanent order for child support, and Social Security payments are
68.7not counted as income. For families and children, which includes all other eligibility
68.8categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as
68.9required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
68.10(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the
68.11earned income disregards and deductions are limited to those in subdivision 1c. For these
68.12purposes, a "methodology" does not include an asset or income standard, or accounting
68.13method, or method of determining effective dates.
68.14EFFECTIVE DATE.This section is effective April 1, 2012.

68.15    Sec. 15. Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3,
68.16is amended to read:
68.17    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
68.18medical assistance, a person must not individually own more than $3,000 in assets, or if a
68.19member of a household with two family members, husband and wife, or parent and child,
68.20the household must not own more than $6,000 in assets, plus $200 for each additional
68.21legal dependent. In addition to these maximum amounts, an eligible individual or family
68.22may accrue interest on these amounts, but they must be reduced to the maximum at the
68.23time of an eligibility redetermination. The accumulation of the clothing and personal
68.24needs allowance according to section 256B.35 must also be reduced to the maximum at
68.25the time of the eligibility redetermination. The value of assets that are not considered in
68.26determining eligibility for medical assistance is the value of those assets excluded under
68.27the supplemental security income program for aged, blind, and disabled persons, with
68.28the following exceptions:
68.29(1) household goods and personal effects are not considered;
68.30(2) capital and operating assets of a trade or business that the local agency determines
68.31are necessary to the person's ability to earn an income are not considered;
68.32(3) motor vehicles are excluded to the same extent excluded by the supplemental
68.33security income program;
68.34(4) assets designated as burial expenses are excluded to the same extent excluded by
68.35the supplemental security income program. Burial expenses funded by annuity contracts
69.1or life insurance policies must irrevocably designate the individual's estate as contingent
69.2beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
69.3(5) for a person who no longer qualifies as an employed person with a disability due
69.4to loss of earnings, assets allowed while eligible for medical assistance under section
69.5256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
69.6of ineligibility as an employed person with a disability, to the extent that the person's total
69.7assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph
69.8(d).; and
69.9    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
69.109, is age 65 or older and has been enrolled during each of the 24 consecutive months
69.11before the person's 65th birthday, the assets owned by the person and the person's spouse
69.12must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
69.13when determining eligibility for medical assistance under section 256B.055, subdivision
69.147. The income of a spouse of a person enrolled in medical assistance under section
69.15256B.057, subdivision 9, during each of the 24 consecutive months before the person's
69.1665th birthday must be disregarded when determining eligibility for medical assistance
69.17under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
69.18the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
69.19is required to have qualified for medical assistance under section 256B.057, subdivision 9,
69.20prior to age 65 for at least 20 months in the 24 months prior to reaching age 65.
69.21(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
69.2215.

69.23    Sec. 16. Minnesota Statutes 2011 Supplement, section 256B.057, subdivision 9,
69.24is amended to read:
69.25    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
69.26for a person who is employed and who:
69.27    (1) but for excess earnings or assets, meets the definition of disabled under the
69.28Supplemental Security Income program;
69.29    (2) is at least 16 but less than 65 years of age;
69.30    (3) meets the asset limits in paragraph (d); and
69.31    (4) (3) pays a premium and other obligations under paragraph (e).
69.32    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
69.33for medical assistance under this subdivision, a person must have more than $65 of earned
69.34income. Earned income must have Medicare, Social Security, and applicable state and
69.35federal taxes withheld. The person must document earned income tax withholding. Any
70.1spousal income or assets shall be disregarded for purposes of eligibility and premium
70.2determinations.
70.3    (c) After the month of enrollment, a person enrolled in medical assistance under
70.4this subdivision who:
70.5    (1) is temporarily unable to work and without receipt of earned income due to a
70.6medical condition, as verified by a physician; or
70.7    (2) loses employment for reasons not attributable to the enrollee, and is without
70.8receipt of earned income may retain eligibility for up to four consecutive months after the
70.9month of job loss. To receive a four-month extension, enrollees must verify the medical
70.10condition or provide notification of job loss. All other eligibility requirements must be met
70.11and the enrollee must pay all calculated premium costs for continued eligibility.
70.12    (d) For purposes of determining eligibility under this subdivision, a person's assets
70.13must not exceed $20,000, excluding:
70.14    (1) all assets excluded under section 256B.056;
70.15    (2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
70.16Keogh plans, and pension plans;
70.17    (3) medical expense accounts set up through the person's employer; and
70.18    (4) spousal assets, including spouse's share of jointly held assets.
70.19    (e) All enrollees must pay a premium to be eligible for medical assistance under this
70.20subdivision, except as provided under section 256.01, subdivision 18b.
70.21    (1) An enrollee must pay the greater of a $65 premium or the premium calculated
70.22based on the person's gross earned and unearned income and the applicable family size
70.23using a sliding fee scale established by the commissioner, which begins at one percent of
70.24income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of
70.25income for those with incomes at or above 300 percent of the federal poverty guidelines.
70.26    (2) Annual adjustments in the premium schedule based upon changes in the federal
70.27poverty guidelines shall be effective for premiums due in July of each year.
70.28    (3) All enrollees who receive unearned income must pay five percent of unearned
70.29income in addition to the premium amount, except as provided under section 256.01,
70.30subdivision 18b .
70.31    (4) Increases in benefits under title II of the Social Security Act shall not be counted
70.32as income for purposes of this subdivision until July 1 of each year.
70.33    (f) A person's eligibility and premium shall be determined by the local county
70.34agency. Premiums must be paid to the commissioner. All premiums are dedicated to
70.35the commissioner.
71.1    (g) Any required premium shall be determined at application and redetermined at
71.2the enrollee's six-month income review or when a change in income or household size is
71.3reported. Enrollees must report any change in income or household size within ten days
71.4of when the change occurs. A decreased premium resulting from a reported change in
71.5income or household size shall be effective the first day of the next available billing month
71.6after the change is reported. Except for changes occurring from annual cost-of-living
71.7increases, a change resulting in an increased premium shall not affect the premium amount
71.8until the next six-month review.
71.9    (h) Premium payment is due upon notification from the commissioner of the
71.10premium amount required. Premiums may be paid in installments at the discretion of
71.11the commissioner.
71.12    (i) Nonpayment of the premium shall result in denial or termination of medical
71.13assistance unless the person demonstrates good cause for nonpayment. Good cause exists
71.14if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
71.15D, are met. Except when an installment agreement is accepted by the commissioner,
71.16all persons disenrolled for nonpayment of a premium must pay any past due premiums
71.17as well as current premiums due prior to being reenrolled. Nonpayment shall include
71.18payment with a returned, refused, or dishonored instrument. The commissioner may
71.19require a guaranteed form of payment as the only means to replace a returned, refused,
71.20or dishonored instrument.
71.21    (j) The commissioner shall notify enrollees annually beginning at least 24 months
71.22before the person's 65th birthday of the medical assistance eligibility rules affecting
71.23income, assets, and treatment of a spouse's income and assets that will be applied upon
71.24reaching age 65.
71.25    (k) For enrollees whose income does not exceed 200 percent of the federal poverty
71.26guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
71.27the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
71.28paragraph (a).
71.29EFFECTIVE DATE.This section is effective April 1, 2012.

71.30    Sec. 17. Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 17,
71.31is amended to read:
71.32    Subd. 17. Transportation costs. (a) Medical assistance covers medical
71.33transportation costs incurred solely for obtaining emergency medical care or transportation
71.34costs incurred by eligible persons in obtaining emergency or nonemergency medical
72.1care when paid directly to an ambulance company, common carrier, or other recognized
72.2providers of transportation services. Medical transportation must be provided by:
72.3(1) an ambulance, as defined in section 144E.001, subdivision 2;
72.4(2) special transportation; or
72.5(3) common carrier including, but not limited to, bus, taxicab, other commercial
72.6carrier, or private automobile.
72.7(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
72.8part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
72.9would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
72.10transportation, or private automobile.
72.11The commissioner may use an order by the recipient's attending physician to certify that
72.12the recipient requires special transportation services. Special transportation providers shall
72.13perform driver-assisted services for eligible individuals. Driver-assisted service includes
72.14passenger pickup at and return to the individual's residence or place of business, assistance
72.15with admittance of the individual to the medical facility, and assistance in passenger
72.16securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation
72.17providers must obtain written documentation from the health care service provider who
72.18is serving the recipient being transported, identifying the time that the recipient arrived.
72.19Special transportation providers may not bill for separate base rates for the continuation of
72.20a trip beyond the original destination. Special transportation providers must take recipients
72.21to the nearest appropriate health care provider, using the most direct route. The minimum
72.22medical assistance reimbursement rates for special transportation services are:
72.23(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to
72.24eligible persons who need a wheelchair-accessible van;
72.25(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
72.26eligible persons who do not need a wheelchair-accessible van; and
72.27(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
72.28special transportation services to eligible persons who need a stretcher-accessible vehicle;
72.29(2) the base rates for special transportation services in areas defined under RUCA
72.30to be super rural shall be equal to the reimbursement rate established in clause (1) plus
72.3111.3 percent; and
72.32(3) for special transportation services in areas defined under RUCA to be rural
72.33or super rural areas:
72.34(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
72.35percent of the respective mileage rate in clause (1); and
73.1(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
73.2112.5 percent of the respective mileage rate in clause (1).
73.3(c) For purposes of reimbursement rates for special transportation services under
73.4paragraph (b), the zip code of the recipient's place of residence shall determine whether
73.5the urban, rural, or super rural reimbursement rate applies.
73.6(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
73.7means a census-tract based classification system under which a geographical area is
73.8determined to be urban, rural, or super rural.
73.9(e) Effective for services provided on or after September 1, 2011, nonemergency
73.10transportation rates, including special transportation, taxi, and other commercial carriers,
73.11are reduced 4.5 percent. Payments made to managed care plans and county-based
73.12purchasing plans must be reduced for services provided on or after January 1, 2012,
73.13to reflect this reduction.
73.14(f) Outside of a metropolitan county as defined in section 473.121, subdivision 4,
73.15reimbursement rates under this subdivision may be adjusted monthly by the commissioner
73.16when the statewide average price of regular grade gasoline is over $3 per gallon, as
73.17calculated by Oil Price Information Service. The rate adjustment shall be a one-percent
73.18increase or decrease for each corresponding $0.10 increase or decrease in the statewide
73.19average price of regular grade gasoline.

73.20    Sec. 18. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 2,
73.21is amended to read:
73.22    Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following
73.23exceptions:
73.24(1) children under the age of 21;
73.25(2) pregnant women for services that relate to the pregnancy or any other medical
73.26condition that may complicate the pregnancy;
73.27(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
73.28intermediate care facility for the developmentally disabled;
73.29(4) recipients receiving hospice care;
73.30(5) 100 percent federally funded services provided by an Indian health service;
73.31(6) emergency services;
73.32(7) family planning services;
73.33(8) services that are paid by Medicare, resulting in the medical assistance program
73.34paying for the coinsurance and deductible; and
74.1(9) co-payments that exceed one per day per provider for nonpreventive visits,
74.2eyeglasses, and nonemergency visits to a hospital-based emergency room; and
74.3(10) home and community-based waiver services for persons with developmental
74.4disabilities under section 256B.501; home and community-based waiver services for the
74.5elderly under section 256B.0915; waivered services under community alternatives for
74.6disabled individuals under section 256B.49; community alternative care waivered services
74.7under section 256B.49; traumatic brain injury waivered services under section 256B.49;
74.8nursing services and home health services under section 256B.0625, subdivision 6a;
74.9personal care services and nursing supervision of personal care services under section
74.10256B.0625, subdivision 19a; private duty nursing services under section 256B.0625,
74.11subdivision 7; personal care assistance services under section 256B.0659; and day training
74.12and habilitation services for adults with developmental disabilities under sections 252.40
74.13to 252.46.
74.14EFFECTIVE DATE.This section is effective July 1, 2013.

74.15    Sec. 19. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3a,
74.16is amended to read:
74.17    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
74.18services planning, or other assistance intended to support community-based living,
74.19including persons who need assessment in order to determine waiver or alternative care
74.20program eligibility, must be visited by a long-term care consultation team within 15
74.21calendar days after the date on which an assessment was requested or recommended. After
74.22January 1, 2011, these requirements also apply to personal care assistance services, private
74.23duty nursing, and home health agency services, on timelines established in subdivision 5.
74.24Face-to-face assessments must be conducted according to paragraphs (b) to (i).
74.25    (b) The county may utilize a team of either the social worker or public health nurse,
74.26or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
74.27assessment in a face-to-face interview. The consultation team members must confer
74.28regarding the most appropriate care for each individual screened or assessed.
74.29    (c) The assessment must be comprehensive and include a person-centered
74.30assessment of the health, psychological, functional, environmental, and social needs of
74.31referred individuals and provide information necessary to develop a support plan that
74.32meets the consumers needs, using an assessment form provided by the commissioner.
74.33    (d) The assessment must be conducted in a face-to-face interview with the person
74.34being assessed and the person's legal representative, as required by legally executed
74.35documents, and other individuals as requested by the person, who can provide information
75.1on the needs, strengths, and preferences of the person necessary to develop a support plan
75.2that ensures the person's health and safety, but who is not a provider of service or has any
75.3financial interest in the provision of services. For persons who are to be assessed for
75.4elderly waiver customized living services under section 256B.0915, with the permission
75.5of the person being assessed or the person's designated or legal representative, the client's
75.6current or proposed provider of services may submit a copy of the provider's nursing
75.7assessment or written report outlining their recommendations regarding the client's care
75.8needs. The person conducting the assessment will notify the provider of the date by which
75.9this information is to be submitted. This information shall be provided to the person
75.10conducting the assessment prior to the assessment.
75.11    (e) The person, or the person's legal representative, must be provided with written
75.12recommendations for community-based services, including consumer-directed options,
75.13or institutional care that include documentation that the most cost-effective alternatives
75.14available were offered to the individual, and alternatives to residential settings, including,
75.15but not limited to, foster care settings that are not the primary residence of the license
75.16holder. For purposes of this requirement, "cost-effective alternatives" means community
75.17services and living arrangements that cost the same as or less than institutional care.
75.18    (f) If the person chooses to use community-based services, the person or the person's
75.19legal representative must be provided with a written community support plan, regardless
75.20of whether the individual is eligible for Minnesota health care programs. A person may
75.21request assistance in identifying community supports without participating in a complete
75.22assessment. Upon a request for assistance identifying community support, the person must
75.23be transferred or referred to the services available under sections 256.975, subdivision 7,
75.24and 256.01, subdivision 24, for telephone assistance and follow up.
75.25    (g) The person has the right to make the final decision between institutional
75.26placement and community placement after the recommendations have been provided,
75.27except as provided in subdivision 4a, paragraph (c).
75.28    (h) The team must give the person receiving assessment or support planning, or
75.29the person's legal representative, materials, and forms supplied by the commissioner
75.30containing the following information:
75.31    (1) the need for and purpose of preadmission screening if the person selects nursing
75.32facility placement;
75.33    (2) the role of the long-term care consultation assessment and support planning in
75.34waiver and alternative care program eligibility determination;
75.35    (3) information about Minnesota health care programs;
75.36    (4) the person's freedom to accept or reject the recommendations of the team;
76.1    (5) the person's right to confidentiality under the Minnesota Government Data
76.2Practices Act, chapter 13;
76.3    (6) the long-term care consultant's decision regarding the person's need for
76.4institutional level of care as determined under criteria established in section 144.0724,
76.5subdivision 11 , or 256B.092; and
76.6    (7) the person's right to appeal the decision regarding the need for nursing facility
76.7level of care or the county's final decisions regarding public programs eligibility according
76.8to section 256.045, subdivision 3.
76.9    (i) Face-to-face assessment completed as part of eligibility determination for
76.10the alternative care, elderly waiver, community alternatives for disabled individuals,
76.11community alternative care, and traumatic brain injury waiver programs under sections
76.12256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more
76.13than 60 calendar days after the date of assessment. The effective eligibility start date
76.14for these programs can never be prior to the date of assessment. If an assessment was
76.15completed more than 60 days before the effective waiver or alternative care program
76.16eligibility start date, assessment and support plan information must be updated in a
76.17face-to-face visit and documented in the department's Medicaid Management Information
76.18System (MMIS). The effective date of program eligibility in this case cannot be prior to
76.19the date the updated assessment is completed.

76.20    Sec. 20. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c,
76.21is amended to read:
76.22    Subd. 3c. Consultation for housing with services. (a) The purpose of long-term
76.23care consultation for registered housing with services is to support persons with current or
76.24anticipated long-term care needs in making informed choices among options that include
76.25the most cost-effective and least restrictive settings. Prospective residents maintain the
76.26right to choose housing with services or assisted living if that option is their preference.
76.27    (b) Registered housing with services establishments shall inform all prospective
76.28residents or the prospective resident's designated or legal representative of the availability
76.29of long-term care consultation and the need to receive and verify the consultation prior
76.30to signing a lease or contract requirement for long-term care options counseling and the
76.31opportunity to decline long-term care options counseling. Prospective residents declining
76.32long-term care options counseling are required to sign a waiver form designated by the
76.33commissioner and supplied by the provider. The housing with services establishment shall
76.34maintain copies of signed waiver forms or verification that the consultation was conducted
76.35for audit for a period of three years. Long-term care consultation for registered housing
77.1with services is provided as determined by the commissioner of human services. The
77.2service is delivered under a partnership between lead agencies as defined in subdivision 1a,
77.3paragraph (d), and the Area Agencies on Aging, and is a point of entry to a combination
77.4of telephone-based long-term care options counseling provided by Senior LinkAge Line
77.5and in-person long-term care consultation provided by lead agencies. The point of entry
77.6service must be provided within five working days of the request of the prospective
77.7resident as follows:
77.8    (1) the consultation shall be conducted with the prospective resident, or in the
77.9alternative, the resident's designated or legal representative, if:
77.10(i) the resident verbally requests; or
77.11(ii) the registered housing with services provider has documentation of the
77.12designated or legal representative's authority to enter into a lease or contract on behalf of
77.13the prospective resident and accepts the documentation in good faith;
77.14(2) the consultation shall be performed in a manner that provides objective and
77.15complete information;
77.16    (2) (3) the consultation must include a review of the prospective resident's reasons
77.17for considering housing with services, the prospective resident's personal goals, a
77.18discussion of the prospective resident's immediate and projected long-term care needs,
77.19and alternative community services or housing with services settings that may meet the
77.20prospective resident's needs;
77.21    (3) (4) the prospective resident shall be informed of the availability of a face-to-face
77.22visit at no charge to the prospective resident to assist the prospective resident in assessment
77.23and planning to meet the prospective resident's long-term care needs; and
77.24(4) (5) verification of counseling shall be generated and provided to the prospective
77.25resident by Senior LinkAge Line upon completion of the telephone-based counseling.
77.26(c) Housing with services establishments registered under chapter 144D shall:
77.27(1) inform all prospective residents or the prospective resident's designated or legal
77.28representative of the availability of and contact information for consultation services
77.29under this subdivision;
77.30(2) except for individuals seeking lease-only arrangements in subsidized housing
77.31settings, receive a copy of the verification of counseling prior to executing a lease or
77.32service contract with the prospective resident, and prior to executing a service contract
77.33with individuals who have previously entered into lease-only arrangements; and
77.34(3) retain a copy of the verification of counseling as part of the resident's file.
77.35EFFECTIVE DATE.This section is effective July 1, 2013.

78.1    Sec. 21. Minnesota Statutes 2010, section 256B.0911, is amended by adding a
78.2subdivision to read:
78.3    Subd. 3d. Exemptions. Individuals shall be exempt from the requirements outlined
78.4in subdivision 3c in the following circumstances:
78.5(1) the individual is seeking a lease-only arrangement in a subsidized housing
78.6setting; or
78.7(2) the individual has previously received a long-term care consultation assessment
78.8under this section. In this instance, the assessor who completes the long-term care
78.9consultation will issue a verification code and provide it to the individual.
78.10EFFECTIVE DATE.This section is effective July 1, 2013.

78.11    Sec. 22. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3e,
78.12is amended to read:
78.13    Subd. 3e. Customized living service rate. (a) Payment for customized living
78.14services shall be a monthly rate authorized by the lead agency within the parameters
78.15established by the commissioner. The payment agreement must delineate the amount of
78.16each component service included in the recipient's customized living service plan. The
78.17lead agency, with input from the provider of customized living services, shall ensure that
78.18there is a documented need within the parameters established by the commissioner for all
78.19component customized living services authorized.
78.20(b) The payment rate must be based on the amount of component services to be
78.21provided utilizing component rates established by the commissioner. Counties and tribes
78.22shall use tools issued by the commissioner to develop and document customized living
78.23service plans and rates.
78.24(c) Component service rates must not exceed payment rates for comparable elderly
78.25waiver or medical assistance services and must reflect economies of scale. Customized
78.26living services must not include rent or raw food costs.
78.27    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
78.28individualized monthly authorized payment for the customized living service plan shall
78.29not exceed 50 percent of the greater of either the statewide or any of the geographic
78.30groups' weighted average monthly nursing facility rate of the case mix resident class
78.31to which the elderly waiver eligible client would be assigned under Minnesota Rules,
78.32parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
78.33in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
78.34resident assessment system as described in section 256B.438 for nursing home rate
78.35determination is implemented. Effective on July 1 of the state fiscal year in which
79.1the resident assessment system as described in section 256B.438 for nursing home
79.2rate determination is implemented and July 1 of each subsequent state fiscal year, the
79.3individualized monthly authorized payment for the services described in this clause shall
79.4not exceed the limit which was in effect on June 30 of the previous state fiscal year
79.5updated annually based on legislatively adopted changes to all service rate maximums for
79.6home and community-based service providers.
79.7(e) Effective July 1, 2011, the individualized monthly payment for the customized
79.8living service plan for individuals described in subdivision 3a, paragraph (b), must be the
79.9monthly authorized payment limit for customized living for individuals classified as case
79.10mix A, reduced by 25 percent. This rate limit must be applied to all new participants
79.11enrolled in the program on or after July 1, 2011, who meet the criteria described in
79.12subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
79.13meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
79.14    (f) Customized living services are delivered by a provider licensed by the
79.15Department of Health as a class A or class F home care provider and provided in a
79.16building that is registered as a housing with services establishment under chapter 144D.
79.17Licensed home care providers are subject to section 256B.0651, subdivision 14.
79.18(g) A provider may not bill or otherwise charge an elderly waiver participant or their
79.19family for additional units of any allowable component service beyond those available
79.20under the service rate limits described in paragraph (d), nor for additional units of any
79.21allowable component service beyond those approved in the service plan by the lead agency.

79.22    Sec. 23. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3h,
79.23is amended to read:
79.24    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
79.25payment rate for 24-hour customized living services is a monthly rate authorized by the
79.26lead agency within the parameters established by the commissioner of human services.
79.27The payment agreement must delineate the amount of each component service included
79.28in each recipient's customized living service plan. The lead agency, with input from
79.29the provider of customized living services, shall ensure that there is a documented need
79.30within the parameters established by the commissioner for all component customized
79.31living services authorized. The lead agency shall not authorize 24-hour customized living
79.32services unless there is a documented need for 24-hour supervision.
79.33(b) For purposes of this section, "24-hour supervision" means that the recipient
79.34requires assistance due to needs related to one or more of the following:
79.35    (1) intermittent assistance with toileting, positioning, or transferring;
80.1    (2) cognitive or behavioral issues;
80.2    (3) a medical condition that requires clinical monitoring; or
80.3    (4) for all new participants enrolled in the program on or after July 1, 2011, and
80.4all other participants at their first reassessment after July 1, 2011, dependency in at
80.5least three of the following activities of daily living as determined by assessment under
80.6section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency
80.7score in eating is three or greater; and needs medication management and at least 50
80.8hours of service per month. The lead agency shall ensure that the frequency and mode
80.9of supervision of the recipient and the qualifications of staff providing supervision are
80.10described and meet the needs of the recipient.
80.11(c) The payment rate for 24-hour customized living services must be based on the
80.12amount of component services to be provided utilizing component rates established by the
80.13commissioner. Counties and tribes will use tools issued by the commissioner to develop
80.14and document customized living plans and authorize rates.
80.15(d) Component service rates must not exceed payment rates for comparable elderly
80.16waiver or medical assistance services and must reflect economies of scale.
80.17(e) The individually authorized 24-hour customized living payments, in combination
80.18with the payment for other elderly waiver services, including case management, must not
80.19exceed the recipient's community budget cap specified in subdivision 3a. Customized
80.20living services must not include rent or raw food costs.
80.21(f) The individually authorized 24-hour customized living payment rates shall not
80.22exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
80.23living services in effect and in the Medicaid management information systems on March
80.2431, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
80.25to 9549.0059, to which elderly waiver service clients are assigned. When there are
80.26fewer than 50 authorizations in effect in the case mix resident class, the commissioner
80.27shall multiply the calculated service payment rate maximum for the A classification by
80.28the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
80.299549.0059, to determine the applicable payment rate maximum. Service payment rate
80.30maximums shall be updated annually based on legislatively adopted changes to all service
80.31rates for home and community-based service providers.
80.32    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
80.33may establish alternative payment rate systems for 24-hour customized living services in
80.34housing with services establishments which are freestanding buildings with a capacity of
80.3516 or fewer, by applying a single hourly rate for covered component services provided
80.36in either:
81.1    (1) licensed corporate adult foster homes; or
81.2    (2) specialized dementia care units which meet the requirements of section 144D.065
81.3and in which:
81.4    (i) each resident is offered the option of having their own apartment; or
81.5    (ii) the units are licensed as board and lodge establishments with maximum capacity
81.6of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
81.7subparts 1, 2, 3, and 4, item A.
81.8(h) A provider may not bill or otherwise charge an elderly waiver participant or their
81.9family for additional units of any allowable component service beyond those available
81.10under the service rate limits described in paragraph (e), nor for additional units of any
81.11allowable component service beyond those approved in the service plan by the lead agency.

81.12    Sec. 24. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to
81.13read:
81.14    Subd. 1b. Individual service plan. (a) The individual service plan must:
81.15(1) include the results of the assessment information on the person's need for service,
81.16including identification of service needs that will be or that are met by the person's
81.17relatives, friends, and others, as well as community services used by the general public;
81.18(2) identify the person's preferences for services as stated by the person, the person's
81.19legal guardian or conservator, or the parent if the person is a minor;
81.20(3) identify long- and short-range goals for the person;
81.21(4) identify specific services and the amount and frequency of the services to be
81.22provided to the person based on assessed needs, preferences, and available resources.
81.23The individual service plan shall also specify other services the person needs that are
81.24not available;
81.25(5) identify the need for an individual program plan to be developed by the provider
81.26according to the respective state and federal licensing and certification standards, and
81.27additional assessments to be completed or arranged by the provider after service initiation;
81.28(6) identify provider responsibilities to implement and make recommendations for
81.29modification to the individual service plan;
81.30(7) include notice of the right to request a conciliation conference or a hearing
81.31under section 256.045;
81.32(8) be agreed upon and signed by the person, the person's legal guardian
81.33or conservator, or the parent if the person is a minor, and the authorized county
81.34representative; and
82.1(9) be reviewed by a health professional if the person has overriding medical needs
82.2that impact the delivery of services.
82.3(b) Service planning formats developed for interagency planning such as transition,
82.4vocational, and individual family service plans may be substituted for service planning
82.5formats developed by county agencies.
82.6(c) Approved, written, and signed changes to a consumer's services that meet the
82.7criteria in this subdivision shall be an addendum to that consumer's individual service plan.

82.8    Sec. 25. Minnesota Statutes 2011 Supplement, section 256B.097, subdivision 3,
82.9is amended to read:
82.10    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
82.11Council which must define regional quality councils, and carry out a community-based,
82.12person-directed quality review component, and a comprehensive system for effective
82.13incident reporting, investigation, analysis, and follow-up.
82.14    (b) By August 1, 2011, the commissioner of human services shall appoint the
82.15members of the initial State Quality Council. Members shall include representatives
82.16from the following groups:
82.17    (1) disability service recipients and their family members;
82.18    (2) during the first two years of the State Quality Council, there must be at least three
82.19members from the Region 10 stakeholders. As regional quality councils are formed under
82.20subdivision 4, each regional quality council shall appoint one member;
82.21    (3) disability service providers;
82.22    (4) disability advocacy groups; and
82.23    (5) county human services agencies and staff from the Department of Human
82.24Services and Ombudsman for Mental Health and Developmental Disabilities.
82.25    (c) Members of the council who do not receive a salary or wages from an employer
82.26for time spent on council duties may receive a per diem payment when performing council
82.27duties and functions.
82.28    (d) The State Quality Council shall:
82.29    (1) assist the Department of Human Services in fulfilling federally mandated
82.30obligations by monitoring disability service quality and quality assurance and
82.31improvement practices in Minnesota; and
82.32    (2) establish state quality improvement priorities with methods for achieving results
82.33and provide an annual report to the legislative committees with jurisdiction over policy
82.34and funding of disability services on the outcomes, improvement priorities, and activities
82.35undertaken by the commission during the previous state fiscal year;
83.1(3) identify issues pertaining to financial and personal risk that impede Minnesotans
83.2with disabilities from optimizing choice of community-based services; and
83.3(4) recommend to the chairs and ranking minority members of the legislative
83.4committees with jurisdiction over human services and civil law by January 15, 2013,
83.5statutory and rule changes related to the findings under clause (3) that promote
83.6individualized service and housing choices balanced with appropriate individualized
83.7protection.
83.8    (e) The State Quality Council, in partnership with the commissioner, shall:
83.9    (1) approve and direct implementation of the community-based, person-directed
83.10system established in this section;
83.11    (2) recommend an appropriate method of funding this system, and determine the
83.12feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
83.13    (3) approve measurable outcomes in the areas of health and safety, consumer
83.14evaluation, education and training, providers, and systems;
83.15    (4) establish variable licensure periods not to exceed three years based on outcomes
83.16achieved; and
83.17    (5) in cooperation with the Quality Assurance Commission, design a transition plan
83.18for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
83.19    (f) The State Quality Council shall notify the commissioner of human services that a
83.20facility, program, or service has been reviewed by quality assurance team members under
83.21subdivision 4, paragraph (b), clause (13), and qualifies for a license.
83.22    (g) The State Quality Council, in partnership with the commissioner, shall establish
83.23an ongoing review process for the system. The review shall take into account the
83.24comprehensive nature of the system which is designed to evaluate the broad spectrum of
83.25licensed and unlicensed entities that provide services to persons with disabilities. The
83.26review shall address efficiencies and effectiveness of the system.
83.27    (h) The State Quality Council may recommend to the commissioner certain
83.28variances from the standards governing licensure of programs for persons with disabilities
83.29in order to improve the quality of services so long as the recommended variances do
83.30not adversely affect the health or safety of persons being served or compromise the
83.31qualifications of staff to provide services.
83.32    (i) The safety standards, rights, or procedural protections referenced under
83.33subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
83.34recommendations to the commissioner or to the legislature in the report required under
83.35paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
83.36procedural protections referenced under subdivision 2, paragraph (c).
84.1    (j) The State Quality Council may hire staff to perform the duties assigned in this
84.2subdivision.

84.3    Sec. 26. Minnesota Statutes 2010, section 256B.431, subdivision 17e, is amended to
84.4read:
84.5    Subd. 17e. Replacement-costs-new per bed limit effective October 1, 2007.
84.6    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2),
84.7for a total replacement, as defined in subdivision 17d, authorized under section
84.8144A.071 or 144A.073 after July 1, 1999, any building project that is a relocation,
84.9renovation, upgrading, or conversion completed on or after July 1, 2001, or any
84.10building project eligible for reimbursement under section 256B.434, subdivision 4f, the
84.11replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
84.12rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
84.13the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
84.149549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
84.15adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1,
84.162000. These amounts must be increased annually as specified in subdivision 3f, paragraph
84.17(a), beginning October 1, 2012.

84.18    Sec. 27. Minnesota Statutes 2010, section 256B.431, is amended by adding a
84.19subdivision to read:
84.20    Subd. 45. Rate adjustments for some moratorium exception projects.
84.21Notwithstanding any other law to the contrary, money available for moratorium exception
84.22projects under section 144A.073, subdivisions 2 and 11, shall be used to fund the
84.23incremental rate increases resulting from this section for any nursing facility with a
84.24moratorium exception project approved under section 144A.073, and completed after
84.25August 30, 2010, where the replacement-costs-new limits under subdivision 17e were
84.26higher at any time after project approval than at the time of project completion. The
84.27commissioner shall calculate the property rate increase for these facilities using the highest
84.28set of limits; however, any rate increase under this section shall not be effective until on
84.29or after the effective date of this section, contingent upon federal approval. No property
84.30rate decrease shall result from this section.
84.31EFFECTIVE DATE.This section is effective upon federal approval.

84.32    Sec. 28. Minnesota Statutes 2010, section 256B.434, subdivision 10, is amended to
84.33read:
85.1    Subd. 10. Exemptions. (a) To the extent permitted by federal law, (1) a facility that
85.2has entered into a contract under this section is not required to file a cost report, as defined
85.3in Minnesota Rules, part 9549.0020, subpart 13, for any year after the base year that is the
85.4basis for the calculation of the contract payment rate for the first rate year of the alternative
85.5payment demonstration project contract; and (2) a facility under contract is not subject
85.6to audits of historical costs or revenues, or paybacks or retroactive adjustments based on
85.7these costs or revenues, except audits, paybacks, or adjustments relating to the cost report
85.8that is the basis for calculation of the first rate year under the contract.
85.9(b) A facility that is under contract with the commissioner under this section is
85.10not subject to the moratorium on licensure or certification of new nursing home beds in
85.11section 144A.071, unless the project results in a net increase in bed capacity or involves
85.12relocation of beds from one site to another. Contract payment rates must not be adjusted
85.13to reflect any additional costs that a nursing facility incurs as a result of a construction
85.14project undertaken under this paragraph. In addition, as a condition of entering into a
85.15contract under this section, a nursing facility must agree that any future medical assistance
85.16payments for nursing facility services will not reflect any additional costs attributable to
85.17the sale of a nursing facility under this section and to construction undertaken under
85.18this paragraph that otherwise would not be authorized under the moratorium in section
85.19144A.073 . Nothing in this section prevents a nursing facility participating in the
85.20alternative payment demonstration project under this section from seeking approval of
85.21an exception to the moratorium through the process established in section 144A.073,
85.22and if approved the facility's rates shall be adjusted to reflect the cost of the project.
85.23Nothing in this section prevents a nursing facility participating in the alternative payment
85.24demonstration project from seeking legislative approval of an exception to the moratorium
85.25under section 144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the
85.26cost of the project.
85.27(c) Notwithstanding section 256B.48, subdivision 6, paragraphs (c), (d), and (e),
85.28and pursuant to any terms and conditions contained in the facility's contract, a nursing
85.29facility that is under contract with the commissioner under this section is in compliance
85.30with section 256B.48, subdivision 6, paragraph (b), if the facility is Medicare certified.
85.31(d) (c) Notwithstanding paragraph (a), if by April 1, 1996, the health care financing
85.32administration has not approved a required waiver, or the Centers for Medicare and
85.33Medicaid Services otherwise requires cost reports to be filed prior to the waiver's approval,
85.34the commissioner shall require a cost report for the rate year.
85.35(e) (d) A facility that is under contract with the commissioner under this section
85.36shall be allowed to change therapy arrangements from an unrelated vendor to a related
86.1vendor during the term of the contract. The commissioner may develop reasonable
86.2requirements designed to prevent an increase in therapy utilization for residents enrolled
86.3in the medical assistance program.
86.4(f) (e) Nursing facilities participating in the alternative payment system
86.5demonstration project must either participate in the alternative payment system quality
86.6improvement program established by the commissioner or submit information on their
86.7own quality improvement process to the commissioner for approval. Nursing facilities
86.8that have had their own quality improvement process approved by the commissioner
86.9must report results for at least one key area of quality improvement annually to the
86.10commissioner.

86.11    Sec. 29. Minnesota Statutes 2010, section 256B.441, is amended by adding a
86.12subdivision to read:
86.13    Subd. 63. Critical access nursing facilities. (a) The commissioner, in consultation
86.14with the commissioner of health, may designate certain nursing facilities as critical access
86.15nursing facilities. The designation shall be granted on a competitive basis, within the
86.16limits of funds appropriated for this purpose.
86.17(b) The commissioner shall request proposals from nursing facilities every two years.
86.18Proposals must be submitted in the form and according to the timelines established by
86.19the commissioner. In selecting applicants to designate, the commissioner, in consultation
86.20with the commissioner of health, and with input from stakeholders, shall develop criteria
86.21designed to preserve access to nursing facility services in isolated areas, rebalance
86.22long-term care, and improve quality.
86.23(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing
86.24facilities designated as critical access nursing facilities:
86.25(1) partial rebasing, with operating payment rates being the sum of 60 percent of the
86.26operating payment rate determined in accordance with subdivision 54 and 40 percent of the
86.27operating payment rate that would have been allowed had the facility not been designated;
86.28(2) enhanced payments for leave days. Notwithstanding section 256B.431,
86.29subdivision 2r, upon designation as a critical access nursing facility, the commissioner
86.30shall limit payment for leave days to 60 percent of that nursing facility's total payment rate
86.31for the involved resident, and shall allow this payment only when the occupancy of the
86.32nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;
86.33(3) two designated critical access nursing facilities, with up to 100 beds in active
86.34service, may jointly apply to the commissioner of health for a waiver of Minnesota
86.35Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The
87.1commissioner of health will consider each waiver request independently based on the
87.2criteria under Minnesota Rules, part 4658.0040;
87.3(4) the minimum threshold under section 256B.431, subdivisions 3f, paragraph (a),
87.4and 17e, shall be 40 percent of the amount that would otherwise apply; and
87.5(5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based
87.6rate limits under subdivision 50 shall apply to designated critical access nursing facilities.
87.7(d) Designation of a critical access nursing facility shall be for a period of two
87.8years, after which the benefits allowed under paragraph (c) shall be removed. Designated
87.9facilities may apply for continued designation.
87.10EFFECTIVE DATE.This section is effective the day following final enactment.

87.11    Sec. 30. Minnesota Statutes 2010, section 256B.48, is amended by adding a
87.12subdivision to read:
87.13    Subd. 6a. Referrals to Medicare providers required. Notwithstanding subdivision
87.141, nursing facility providers that do not participate in or accept Medicare assignment
87.15must refer and document the referral of dual eligible recipients for whom placement is
87.16requested and for whom the resident would be qualified for a Medicare-covered stay to
87.17Medicare providers. The commissioner shall audit nursing facilities that do not accept
87.18Medicare and determine if dual eligible individuals with Medicare qualifying stays have
87.19been admitted. If such a determination is made, the commissioner shall deny Medicaid
87.20payment for the first 20 days of that resident's stay.

87.21    Sec. 31. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15,
87.22is amended to read:
87.23    Subd. 15. Individualized service plan; comprehensive transitional service plan;
87.24maintenance service plan. (a) Each recipient of home and community-based waivered
87.25services shall be provided a copy of the written service plan which:
87.26(1) is developed and signed by the recipient within ten working days of the
87.27completion of the assessment;
87.28(2) meets the assessed needs of the recipient;
87.29(3) reasonably ensures the health and safety of the recipient;
87.30(4) promotes independence;
87.31(5) allows for services to be provided in the most integrated settings; and
87.32(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
87.33paragraph (p), of service and support providers.
88.1(b) In developing the comprehensive transitional service plan, the individual
88.2receiving services, the case manager, and the guardian, if applicable, will identify
88.3the transitional service plan fundamental service outcome and anticipated timeline to
88.4achieve this outcome. Within the first 20 days following a recipient's request for an
88.5assessment or reassessment, the transitional service planning team must be identified. A
88.6team leader must be identified who will be responsible for assigning responsibility and
88.7communicating with team members to ensure implementation of the transition plan and
88.8ongoing assessment and communication process. The team leader should be an individual,
88.9such as the case manager or guardian, who has the opportunity to follow the recipient to
88.10the next level of service.
88.11Within ten days following an assessment, a comprehensive transitional service plan
88.12must be developed incorporating elements of a comprehensive functional assessment and
88.13including short-term measurable outcomes and timelines for achievement of and reporting
88.14on these outcomes. Functional milestones must also be identified and reported according
88.15to the timelines agreed upon by the transitional service planning team. In addition, the
88.16comprehensive transitional service plan must identify additional supports that may assist
88.17in the achievement of the fundamental service outcome such as the development of greater
88.18natural community support, increased collaboration among agencies, and technological
88.19supports.
88.20The timelines for reporting on functional milestones will prompt a reassessment of
88.21services provided, the units of services, rates, and appropriate service providers. It is
88.22the responsibility of the transitional service planning team leader to review functional
88.23milestone reporting to determine if the milestones are consistent with observable skills
88.24and that milestone achievement prompts any needed changes to the comprehensive
88.25transitional service plan.
88.26For those whose fundamental transitional service outcome involves the need to
88.27procure housing, a plan for the recipient to seek the resources necessary to secure the least
88.28restrictive housing possible should be incorporated into the plan, including employment
88.29and public supports such as housing access and shelter needy funding.
88.30(c) Counties and other agencies responsible for funding community placement and
88.31ongoing community supportive services are responsible for the implementation of the
88.32comprehensive transitional service plans. Oversight responsibilities include both ensuring
88.33effective transitional service delivery and efficient utilization of funding resources.
88.34(d) Following one year of transitional services, the transitional services planning
88.35team will make a determination as to whether or not the individual receiving services
88.36requires the current level of continuous and consistent support in order to maintain the
89.1recipient's current level of functioning. Recipients who are determined to have not had
89.2a significant change in functioning for 12 months must move from a transitional to a
89.3maintenance service plan. Recipients on a maintenance service plan must be reassessed
89.4to determine if the recipient would benefit from a transitional service plan at least every
89.512 months and at other times when there has been a significant change in the recipient's
89.6functioning. This assessment should consider any changes to technological or natural
89.7community supports.
89.8(e) When a county is evaluating denials, reductions, or terminations of home and
89.9community-based services under section 256B.49 for an individual, the case manager
89.10shall offer to meet with the individual or the individual's guardian in order to discuss the
89.11prioritization of service needs within the individualized service plan, comprehensive
89.12transitional service plan, or maintenance service plan. The reduction in the authorized
89.13services for an individual due to changes in funding for waivered services may not exceed
89.14the amount needed to ensure medically necessary services to meet the individual's health,
89.15safety, and welfare.
89.16(f) At the time of reassessment, local agency case managers shall assess each
89.17recipient of community alternatives for disabled individuals or traumatic brain injury
89.18waivered services currently residing in a licensed adult foster home that is not the primary
89.19residence of the license holder, or in which the license holder is not the primary caregiver,
89.20to determine if that recipient could appropriately be served in a community-living setting.
89.21If appropriate for the recipient, the case manager shall offer the recipient, through a
89.22person-centered planning process, the option to receive alternative housing and service
89.23options. In the event that the recipient chooses to transfer from the adult foster home,
89.24the vacated bed shall not be filled with another recipient of waiver services and group
89.25residential housing, unless and the licensed capacity shall be reduced accordingly, unless
89.26the savings required by the 2011 licensed bed closure reductions for foster care settings
89.27where the physical location is not the primary residence of the license holder are met
89.28through voluntary changes described in section 245A.03, subdivision 7, paragraph (g),
89.29or as provided under section 245A.03, subdivision 7, paragraph (a), clauses (3) and (4),
89.30and the licensed capacity shall be reduced accordingly. If the adult foster home becomes
89.31no longer viable due to these transfers, the county agency, with the assistance of the
89.32department, shall facilitate a consolidation of settings or closure. This reassessment
89.33process shall be completed by June 30, 2012 July 1, 2013.

89.34    Sec. 32. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 23,
89.35is amended to read:
90.1    Subd. 23. Community-living settings. "Community-living settings" means a
90.2single-family home or apartment where the service recipient or their family owns or rents,
90.3as demonstrated by a lease agreement, and maintains control over the individual unit as
90.4demonstrated by the lease agreement, or has a plan for transition of a lease from a service
90.5provider to the individual. Within two years of signing the initial lease, the service provider
90.6shall transfer the lease to the individual. In the event the landlord denies the transfer, the
90.7commissioner may approve an exception within sufficient time to ensure the continued
90.8occupancy by the individual. Community-living settings are subject to the following:
90.9(1) individuals are not required to receive services;
90.10(2) individuals are not required to have a disability or specific diagnosis to live in the
90.11community-living setting, unless state or federal funding requires it;
90.12(3) individuals may hire service providers of their choice;
90.13(4) individuals may choose whether to share their household and with whom;
90.14(5) the home or apartment must include living, sleeping, bathing, and cooking areas;
90.15(6) individuals must have lockable access and egress;
90.16(7) individuals must be free to receive visitors and leave the settings at times and for
90.17durations of their own choosing;
90.18(8) leases must not reserve the right to assign units or change unit assignments; and
90.19(9) access to the greater community must be easily facilitated based on the
90.20individual's needs and preferences.

90.21    Sec. 33. [256B.492] ADULT FOSTER CARE VOLUNTARY CLOSURE.
90.22    Subdivision 1. Commissioner's duties; report. The commissioner of human
90.23services shall ask providers of adult foster care services to present proposals for the
90.24conversion of services provided for persons with developmental disabilities in settings
90.25licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, to services to other
90.26community settings in conjunction with the cessation of operations and closure of
90.27identified facilities.
90.28    Subd. 2. Inventory of foster care capacity. The commissioner of human services
90.29shall submit to the legislature by February 15, 2013, a report that includes:
90.30(1) an inventory of the assessed needs of all individuals with disabilities receiving
90.31foster care services under section 256B.092;
90.32(2) an inventory of total licensed foster care capacity for adults and children
90.33available in Minnesota as of January 1, 2013; and
90.34(3) a comparison of the needs of individuals receiving services in foster care settings
90.35and nonfoster care settings.
91.1The report will also contain recommendations on developing a profile of individuals
91.2requiring foster care services and the projected level of foster care capacity needed
91.3to serve that population.
91.4    Subd. 3. Voluntary closure process need determination. If the report required in
91.5subdivision 2 determines the existing supply of foster care capacity is higher than needed
91.6to meet the needs of individuals requiring that level of care, the commissioner shall,
91.7within the limits of available appropriations, announce and implement a program for
91.8closure of adult foster care homes.
91.9    Subd. 4. Application process. (a) The commissioner shall establish a process of
91.10application, review, and approval for licensees to submit proposals for the closure of
91.11facilities.
91.12(b) A licensee shall notify the following parties in writing when an application for a
91.13planned closure adjustment is submitted:
91.14(1) the county social services agency; and
91.15(2) current and prospective residents and their families.
91.16(c) After providing written notice, and prior to admission, the licensee must fully
91.17inform prospective residents and their families of the intent to close operations and of
91.18the relocation plan.
91.19    Subd. 5. Review and approval process. (a) To be considered for approval, an
91.20application must include:
91.21(1) a description of the proposed closure plan, which must include identification of
91.22the home or homes to receive a planned closure rate adjustment;
91.23(2) the proposed timetable for any proposed closure, including the proposed dates for
91.24announcement to residents and the affected county social service agency, commencement
91.25of closure, and completion of closure;
91.26(3) the proposed relocation plan jointly developed by the county of financial
91.27responsibility and the providers for current residents of any facility designated for closure;
91.28and
91.29(4) documentation in a format approved by the commissioner that all the adult foster
91.30care homes receiving a planned closure rate adjustment under the plan have accepted joint
91.31and several liability for recovery of overpayments under section 256B.0641, subdivision
91.322, for the facilities designated for closure under the plan.
91.33(c) In reviewing and approving closure proposals, the commissioner shall give first
91.34priority to proposals that:
91.35(1) result in the closing of a facility;
91.36(2) demonstrate savings of medical assistance expenditures; and
92.1(3) demonstrate that alternative placements will be developed based on individual
92.2resident needs and applicable federal and state rules.
92.3The commissioner shall also consider any information provided by residents, their
92.4family, or the county social services agency on the impact of the planned closure on
92.5the services they receive.
92.6(d) The commissioner shall select proposals that best meet the criteria established
92.7in this subdivision within the appropriation made available for planned closure of adult
92.8foster care facilities. The commissioner shall notify licensees of the selections made and
92.9approved by the commissioner.
92.10(e) For each proposal approved by the commissioner, a contract must be established
92.11between the commissioner, the county of financial responsibility, and the participating
92.12licensee.
92.13    Subd. 6. Adjustment to rates. (a) For purposes of this section, the commissioner
92.14shall establish an enhanced payment rate under section 256B.0913 to facilitate an orderly
92.15transition for persons with developmental disabilities from adult foster care to other
92.16community-based settings.
92.17(b) The maximum length the commissioner may establish an enhanced rate is six
92.18months.
92.19(c) The commissioner shall allocate funds, up to a total of $450 in state and federal
92.20funds per adult foster care home bed that is closing, to be used for relocation costs incurred
92.21by counties under this process
92.22(d) The commissioner shall analyze the fiscal impact of the closure of each facility
92.23on medical assistance expenditures. Any savings is allocated to the medical assistance
92.24program.

92.25    Sec. 34. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
92.26    Subd. 5. Special needs. In addition to the state standards of assistance established in
92.27subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
92.28Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
92.29center, or a group residential housing facility.
92.30    (a) The county agency shall pay a monthly allowance for medically prescribed
92.31diets if the cost of those additional dietary needs cannot be met through some other
92.32maintenance benefit. The need for special diets or dietary items must be prescribed by
92.33a licensed physician. Costs for special diets shall be determined as percentages of the
92.34allotment for a one-person household under the thrifty food plan as defined by the United
93.1States Department of Agriculture. The types of diets and the percentages of the thrifty
93.2food plan that are covered are as follows:
93.3    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
93.4    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
93.5of thrifty food plan;
93.6    (3) controlled protein diet, less than 40 grams and requires special products, 125
93.7percent of thrifty food plan;
93.8    (4) low cholesterol diet, 25 percent of thrifty food plan;
93.9    (5) high residue diet, 20 percent of thrifty food plan;
93.10    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
93.11    (7) gluten-free diet, 25 percent of thrifty food plan;
93.12    (8) lactose-free diet, 25 percent of thrifty food plan;
93.13    (9) antidumping diet, 15 percent of thrifty food plan;
93.14    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
93.15    (11) ketogenic diet, 25 percent of thrifty food plan.
93.16    (b) Payment for nonrecurring special needs must be allowed for necessary home
93.17repairs or necessary repairs or replacement of household furniture and appliances using
93.18the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
93.19as long as other funding sources are not available.
93.20    (c) A fee for guardian or conservator service is allowed at a reasonable rate
93.21negotiated by the county or approved by the court. This rate shall not exceed five percent
93.22of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
93.23guardian or conservator is a member of the county agency staff, no fee is allowed.
93.24    (d) The county agency shall continue to pay a monthly allowance of $68 for
93.25restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
93.261990, and who eats two or more meals in a restaurant daily. The allowance must continue
93.27until the person has not received Minnesota supplemental aid for one full calendar month
93.28or until the person's living arrangement changes and the person no longer meets the criteria
93.29for the restaurant meal allowance, whichever occurs first.
93.30    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
93.31is allowed for representative payee services provided by an agency that meets the
93.32requirements under SSI regulations to charge a fee for representative payee services. This
93.33special need is available to all recipients of Minnesota supplemental aid regardless of
93.34their living arrangement.
93.35    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
93.36maximum allotment authorized by the federal Food Stamp Program for a single individual
94.1which is in effect on the first day of July of each year will be added to the standards of
94.2assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
94.3as shelter needy and are: (i) relocating from an institution, or an adult mental health
94.4residential treatment program under section 256B.0622; (ii) eligible for the self-directed
94.5supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
94.6community-based waiver recipients living in their own home or rented or leased apartment
94.7which is not owned, operated, or controlled by a provider of service not related by blood
94.8or marriage, unless allowed under paragraph (g).
94.9    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
94.10shelter needy benefit under this paragraph is considered a household of one. An eligible
94.11individual who receives this benefit prior to age 65 may continue to receive the benefit
94.12after the age of 65.
94.13    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
94.14exceed 40 percent of the assistance unit's gross income before the application of this
94.15special needs standard. "Gross income" for the purposes of this section is the applicant's or
94.16recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
94.17in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
94.18state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
94.19considered shelter needy for purposes of this paragraph.
94.20(g) Notwithstanding this subdivision, to access housing and services as provided
94.21in paragraph (f), the recipient may choose housing that may be owned, operated, or
94.22controlled by the recipient's service provider. In a multifamily building of four or more
94.23units, the maximum number of apartments that may be used by recipients of this program
94.24shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. of
94.25more than four units, the maximum number of units that may be used by recipients of this
94.26program shall be the greater of four units of 25 percent of the units in the building. In
94.27multifamily buildings of four or fewer units, all of the units may be used by recipients
94.28of this program. When housing is controlled by the service provider, the individual may
94.29choose their own service provider as provided in section 256B.49, subdivision 23, clause
94.30(3). When the housing is controlled by the service provider, the service provider shall
94.31implement a plan with the recipient to transition the lease to the recipient's name. Within
94.32two years of signing the initial lease, the service provider shall transfer the lease entered
94.33into under this subdivision to the recipient. In the event the landlord denies this transfer,
94.34the commissioner may approve an exception within sufficient time to ensure the continued
94.35occupancy by the recipient. This paragraph expires June 30, 2016.

95.1    Sec. 35. Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to
95.2read:
95.3    Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.
95.4The commissioner shall seek any necessary federal approval in order to implement
95.5the changes to the level of care criteria in Minnesota Statutes, section 144.0724,
95.6subdivision 11 , on or after July 1, 2012, for adults and children.
95.7EFFECTIVE DATE.This section is effective the day following final enactment.

95.8    Sec. 36. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
95.93, is amended to read:

95.10

Subd. 3.Forecasted Programs

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

95.13

(a) MFIP/DWP Grants

95.14	Appropriations by Fund
95.15	General	84,680,000	91,978,000
95.16	Federal TANF	84,425,000	75,417,000

95.17

(b) MFIP Child Care Assistance Grants

55,456,000

30,923,000

95.18

(c) General Assistance Grants

49,192,000

46,938,000

95.19General Assistance Standard. The
95.20commissioner shall set the monthly standard
95.21of assistance for general assistance units
95.22consisting of an adult recipient who is
95.23childless and unmarried or living apart
95.24from parents or a legal guardian at $203.
95.25The commissioner may reduce this amount
95.26according to Laws 1997, chapter 85, article
95.273, section 54.
95.28Emergency General Assistance. The
95.29amount appropriated for emergency general
95.30assistance funds is limited to no more
95.31than $6,689,812 in fiscal year 2012 and
95.32$6,729,812 in fiscal year 2013. Funds
95.33to counties shall be allocated by the
96.1commissioner using the allocation method
96.2specified in Minnesota Statutes, section
96.3256D.06 .

96.4

(d) Minnesota Supplemental Aid Grants

38,095,000

39,120,000

96.5

(e) Group Residential Housing Grants

121,080,000

129,238,000

96.6

(f) MinnesotaCare Grants

295,046,000

317,272,000

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

96.9

(g) Medical Assistance Grants

4,501,582,000

4,437,282,000

96.10Managed Care Incentive Payments. The
96.11commissioner shall not make managed care
96.12incentive payments for expanding preventive
96.13services during fiscal years beginning July 1,
96.142011, and July 1, 2012.
96.15Reduction of Rates for Congregate
96.16Living for Individuals with Lower Needs.
96.17Beginning October 1, 2011, lead agencies
96.18must reduce rates in effect on January 1,
96.192011, by ten percent for individuals with
96.20lower needs living in foster care settings
96.21where the license holder does not share the
96.22residence with recipients on the CADI and
96.23DD waivers and customized living settings
96.24for CADI. Lead agencies shall consult
96.25with providers to review individual service
96.26plans and identify changes or modifications
96.27to reduce the utilization of services while
96.28maintaining the health and safety of the
96.29individual receiving services. Lead agencies
96.30must adjust contracts within 60 days of the
96.31effective date.
96.32Reduction of Lead Agency Waiver
96.33Allocations to Implement Rate Reductions
96.34for Congregate Living for Individuals
97.1with Lower Needs. Beginning October 1,
97.22011, the commissioner shall reduce lead
97.3agency waiver allocations to implement the
97.4reduction of rates for individuals with lower
97.5needs living in foster care settings where the
97.6license holder does not share the residence
97.7with recipients on the CADI and DD waivers
97.8and customized living settings for CADI.
97.9Reduce customized living and 24-hour
97.10customized living component rates.
97.11Effective July 1, 2011, the commissioner
97.12shall reduce elderly waiver customized living
97.13and 24-hour customized living component
97.14service spending by five percent through
97.15reductions in component rates and service
97.16rate limits. The commissioner shall adjust
97.17the elderly waiver capitation payment
97.18rates for managed care organizations paid
97.19under Minnesota Statutes, section 256B.69,
97.20subdivisions 6a and 23, to reflect reductions
97.21in component spending for customized living
97.22services and 24-hour customized living
97.23services under Minnesota Statutes, section
97.24256B.0915, subdivisions 3e and 3h, for the
97.25contract period beginning January 1, 2012.
97.26To implement the reduction specified in
97.27this provision, capitation rates paid by the
97.28commissioner to managed care organizations
97.29under Minnesota Statutes, section 256B.69,
97.30shall reflect a ten percent reduction for the
97.31specified services for the period January 1,
97.322012, to June 30, 2012, and a five percent
97.33reduction for those services on or after July
97.341, 2012.
97.35Limit Growth in the Developmental
97.36Disability Waiver. The commissioner
98.1shall limit growth in the developmental
98.2disability waiver to six diversion allocations
98.3per month beginning July 1, 2011, through
98.4June 30, 2013, and 15 diversion allocations
98.5per month beginning July 1, 2013, through
98.6June 30, 2015. Waiver allocations shall
98.7be targeted to individuals who meet the
98.8priorities for accessing waiver services
98.9identified in Minnesota Statutes, 256B.092,
98.10subdivision 12 . The limits do not include
98.11conversions from intermediate care facilities
98.12for persons with developmental disabilities.
98.13Notwithstanding any contrary provisions in
98.14this article, this paragraph expires June 30,
98.152015.
98.16Limit Growth in the Community
98.17Alternatives for Disabled Individuals
98.18Waiver. The commissioner shall limit
98.19growth in the community alternatives for
98.20disabled individuals waiver to 60 allocations
98.21per month beginning July 1, 2011, through
98.22June 30, 2013, and 85 allocations per
98.23month beginning July 1, 2013, through
98.24June 30, 2015. Waiver allocations must
98.25be targeted to individuals who meet the
98.26priorities for accessing waiver services
98.27identified in Minnesota Statutes, section
98.28256B.49, subdivision 11a . The limits include
98.29conversions and diversions, unless the
98.30commissioner has approved a plan to convert
98.31funding due to the closure or downsizing
98.32of a residential facility or nursing facility
98.33to serve directly affected individuals on
98.34the community alternatives for disabled
98.35individuals waiver. Notwithstanding any
99.1contrary provisions in this article, this
99.2paragraph expires June 30, 2015.
99.3Personal Care Assistance Relative
99.4Care. The commissioner shall adjust the
99.5capitation payment rates for managed care
99.6organizations paid under Minnesota Statutes,
99.7section 256B.69, to reflect the rate reductions
99.8for personal care assistance provided by
99.9a relative pursuant to Minnesota Statutes,
99.10section 256B.0659, subdivision 11.

99.11

(h) Alternative Care Grants

46,421,000

46,035,000

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

99.17

(i) Chemical Dependency Entitlement Grants

94,675,000

93,298,000

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

99.20

Subd. 4.Grant Programs

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

99.23

(a) Support Services Grants

99.24	Appropriations by Fund
99.25	General	8,715,000	8,715,000
99.26	Federal TANF	100,525,000	94,611,000

99.27MFIP Consolidated Fund Grants. The
99.28TANF fund base is reduced by $10,000,000
99.29each year beginning in fiscal year 2012.
99.30Subsidized Employment Funding Through
99.31ARRA. The commissioner is authorized to
99.32apply for TANF emergency fund grants for
99.33subsidized employment activities. Growth
100.1in expenditures for subsidized employment
100.2within the supported work program and the
100.3MFIP consolidated fund over the amount
100.4expended in the calendar year quarters in
100.5the TANF emergency fund base year shall
100.6be used to leverage the TANF emergency
100.7fund grants for subsidized employment and
100.8to fund supported work. The commissioner
100.9shall develop procedures to maximize
100.10reimbursement of these expenditures over the
100.11TANF emergency fund base year quarters,
100.12and may contract directly with employers
100.13and providers to maximize these TANF
100.14emergency fund grants.

100.15 100.16

(b) Basic Sliding Fee Child Care Assistance Grants

37,144,000

38,678,000

100.17Base Adjustment. The general fund base is
100.18decreased by $990,000 in fiscal year 2014
100.19and $979,000 in fiscal year 2015.
100.20Child Care and Development Fund
100.21Unexpended Balance. In addition to
100.22the amount provided in this section, the
100.23commissioner shall expend $5,000,000
100.24in fiscal year 2012 from the federal child
100.25care and development fund unexpended
100.26balance for basic sliding fee child care under
100.27Minnesota Statutes, section 119B.03. The
100.28commissioner shall ensure that all child
100.29care and development funds are expended
100.30according to the federal child care and
100.31development fund regulations.

100.32

(c) Child Care Development Grants

774,000

774,000

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

101.1

(d) Child Support Enforcement Grants

50,000

50,000

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

101.9

(e) Children's Services Grants

101.10	Appropriations by Fund
101.11	General	47,949,000	48,507,000
101.12	Federal TANF	140,000	140,000

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

101.30

(f) Children and Community Services Grants

53,301,000

53,301,000

101.31

(g) Children and Economic Support Grants

101.32	Appropriations by Fund
101.33	General	16,103,000	16,180,000
101.34	Federal TANF	700,000	0

102.1Long-Term Homeless Services. $700,000
102.2is appropriated from the federal TANF
102.3fund for the biennium beginning July
102.41, 2011, to the commissioner of human
102.5services for long-term homeless services
102.6for low-income homeless families under
102.7Minnesota Statutes, section 256K.26. This
102.8is a onetime appropriation and is not added
102.9to the base.
102.10Base Adjustment. The general fund base is
102.11increased by $42,000 in fiscal year 2014 and
102.12$43,000 in fiscal year 2015.
102.13Minnesota Food Assistance Program.
102.14$333,000 in fiscal year 2012 and $408,000 in
102.15fiscal year 2013 are to increase the general
102.16fund base for the Minnesota food assistance
102.17program. Unexpended funds for fiscal year
102.182012 do not cancel but are available to the
102.19commissioner for this purpose in fiscal year
102.202013.

102.21

(h) Health Care Grants

102.22	Appropriations by Fund
102.23	General	26,000	66,000
102.24	Health Care Access	190,000	190,000

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

102.28

(i) Aging and Adult Services Grants

12,154,000

11,456,000

102.29Aging Grants Reduction. Effective July
102.301, 2011, funding for grants made under
102.31Minnesota Statutes, sections 256.9754 and
102.32256B.0917, subdivision 13 , is reduced by
102.33$3,600,000 for each year of the biennium.
102.34These reductions are onetime and do
102.35not affect base funding for the 2014-2015
103.1biennium. Grants made during the 2012-2013
103.2biennium under Minnesota Statutes, section
103.3256B.9754 , must not be used for new
103.4construction or building renovation.
103.5Essential Community Support Grant
103.6Delay. Upon federal approval to implement
103.7the nursing facility level of care on July
103.81, 2013, essential community supports
103.9grants under Minnesota Statutes, section
103.10256B.0917, subdivision 14 , are reduced by
103.11$6,410,000 in fiscal year 2013. Base level
103.12funding is increased by $5,541,000 in fiscal
103.13year 2014 and $6,410,000 in fiscal year 2015.
103.14Base Level Adjustment. The general fund
103.15base is increased by $10,035,000 in fiscal
103.16year 2014 and increased by $10,901,000 in
103.17fiscal year 2015.

103.18

(j) Deaf and Hard-of-Hearing Grants

1,936,000

1,767,000

103.19

(k) Disabilities Grants

15,945,000

18,284,000

103.20Grants for Housing Access Services. In
103.21fiscal year 2012, the commissioner shall
103.22make available a total of $161,000 in housing
103.23access services grants to individuals who
103.24relocate from an adult foster care home to
103.25a community living setting for assistance
103.26with completion of rental applications or
103.27lease agreements; assistance with publicly
103.28financed housing options; development of
103.29household budgets; and assistance with
103.30funding affordable furnishings and related
103.31household matters.
103.32HIV Grants. The general fund appropriation
103.33for the HIV drug and insurance grant
103.34program shall be reduced by $2,425,000 in
103.35fiscal year 2012 and increased by $2,425,000
104.1in fiscal year 2014. These adjustments are
104.2onetime and shall not be applied to the base.
104.3Notwithstanding any contrary provision, this
104.4provision expires June 30, 2014.
104.5Region 10. Of this appropriation, $100,000
104.6each year is for a grant provided under
104.7Minnesota Statutes, section 256B.097.
104.8Base Level Adjustment. The general fund
104.9base is increased by $2,944,000 in fiscal year
104.102014 and $653,000 in fiscal year 2015.
104.11Local Planning Grants for Creating
104.12Alternatives to Congregate Living for
104.13Individuals with Lower Needs. (1) The
104.14commissioner shall make available a total
104.15of $250,000 per year in local planning
104.16grants, beginning July 1, 2011, to assist
104.17lead agencies and provider organizations in
104.18developing alternatives to congregate living
104.19within the available level of resources for the
104.20home and community-based services waivers
104.21for persons with disabilities.
104.22(2) Notwithstanding clause (1), for fiscal
104.23years 2012 and 2013 only, the appropriation
104.24of $250,000 for fiscal year 2012 carries
104.25forward to fiscal year 2013, effective the day
104.26following final enactment.
104.27Of the appropriations available for fiscal
104.28year 2013, $100,000 is for administrative
104.29functions related to the planning process
104.30required under Minnesota Statutes, sections
104.31144A.351 and 245A.03, subdivision 7,
104.32paragraphs (e) and (g), and $400,000 is for
104.33grants required to accomplish that planning
104.34process.
105.1(3) Base funding for the grants under clause
105.2(1) is not affected by the appropriations
105.3under clause (2).
105.4Disability Linkage Line. Of this
105.5appropriation, $125,000 in fiscal year 2012
105.6and $300,000 in fiscal year 2013 are for
105.7assistance to people with disabilities who are
105.8considering enrolling in managed care.

105.9

(l) Adult Mental Health Grants

105.10	Appropriations by Fund
105.11	General	70,570,000	70,570,000
105.12	Health Care Access	750,000	750,000
105.13	Lottery Prize	1,508,000	1,508,000

105.14Funding Usage. Up to 75 percent of a fiscal
105.15year's appropriation for adult mental health
105.16grants may be used to fund allocations in that
105.17portion of the fiscal year ending December
105.1831.
105.19Base Adjustment. The general fund base is
105.20increased by $200,000 in fiscal years 2014
105.21and 2015.

105.22

(m) Children's Mental Health Grants

16,457,000

16,457,000

105.23Funding Usage. Up to 75 percent of a fiscal
105.24year's appropriation for children's mental
105.25health grants may be used to fund allocations
105.26in that portion of the fiscal year ending
105.27December 31.
105.28Base Adjustment. The general fund base is
105.29increased by $225,000 in fiscal years 2014
105.30and 2015.

105.31 105.32

(n) Chemical Dependency Nonentitlement Grants

1,336,000

1,336,000

105.33    Sec. 38. COMMISSIONER AUTHORITY TO REDUCE 2011 CONGREGATE
105.34CARE LOW NEED RATE CUT.
106.1During fiscal years 2013 and 2014, the commissioner shall reduce the 2011 reduction
106.2of rates for congregate living for individuals with lower needs to the extent the actions
106.3taken under Minnesota Statutes, section 245A.03, subdivision 7, paragraph (g), produce
106.4savings beyond the amount needed to meet the licensed bed closure savings requirements
106.5of Minnesota Statutes, section 245A.03, subdivision 7, paragraph (e). Each February 1,
106.6the commissioner shall report to the chairs and ranking minority members of the health
106.7and human services finance committees on any reductions provided under this section.
106.8EFFECTIVE DATE.This section is effective July 1, 2012, and expires June 30,
106.92014.

106.10    Sec. 39. HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH
106.11DISABILITIES.
106.12(a) Individuals receiving services under a home and community-based waiver under
106.13Minnesota Statutes, section 256B.092 or 256B.49, may receive services in the following
106.14settings:
106.15(1) an individual's own home or family home;
106.16(2) a licensed adult foster care setting of up to five people; and
106.17(3) community living settings as defined in Minnesota Statutes, section 256B.49,
106.18subdivision 23, where individuals with disabilities may reside in all of the units in a
106.19building of four or fewer units no more than the greater of four or 25 percent of the units
106.20in a multifamily building of more than four units.
106.21The above settings must not:
106.22(1) be located in a building that is a publicly or privately operated facility that
106.23provides institutional treatment or custodial care;
106.24(2) be located in a building on the grounds of or adjacent to a public institution;
106.25(3) be a housing complex designed expressly around an individual's diagnosis or
106.26disability unless state or federal funding for housing requires it;
106.27(4) be segregated based on a disability, either physically or because of setting
106.28characteristics, from the larger community; and
106.29(5) have the qualities of an institution, unless specifically required in the individual's
106.30plan developed with the lead agency case manager and legal guardian. The qualities of an
106.31institution include, but are not limited to:
106.32(i) regimented meal and sleep times;
106.33(ii) limitations on visitors; and
106.34(iii) lack of privacy.
107.1(b) The provisions of paragraph (a) do not apply to any setting in which residents
107.2receive services under a home and community-based waiver as of June 30, 2013, and
107.3which has been delivering those services for at least one year.
107.4(c) Notwithstanding paragraph (b), a program in Hennepin County established as
107.5part of a Hennepin County demonstration project is qualified for the exception allowed
107.6under paragraph (b).
107.7(d) The commissioner shall submit an amendment to the waiver plan no later than
107.8December 31, 2012.

107.9    Sec. 40. INDEPENDENT LIVING SERVICES BILLING.
107.10The commissioner shall allow for daily rate and 15-minute increment billing for
107.11independent living services under the brain injury (BI) and CADI waivers. If necessary to
107.12comply with this requirement, the commissioner shall submit a waiver amendment to the
107.13state plan no later than December 31, 2012.

107.14    Sec. 41. REPEALER.
107.15(a) Minnesota Statutes 2010, sections 144A.073, subdivision 9; and 256B.48,
107.16subdivision 6, and Laws 2011, First Special Session chapter 9, article 7, section 54, are
107.17repealed.
107.18(b) Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13, is
107.19repealed.

107.20ARTICLE 5

107.21MISCELLANEOUS

107.22    Section 1. Minnesota Statutes 2010, section 43A.316, subdivision 5, is amended to
107.23read:
107.24    Subd. 5. Public employee participation. (a) Participation in the program is subject
107.25to the conditions in this subdivision.
107.26(b) Each exclusive representative for an eligible employer determines whether the
107.27employees it represents will participate in the program. The exclusive representative shall
107.28give the employer notice of intent to participate at least 30 days before the expiration date
107.29of the collective bargaining agreement preceding the collective bargaining agreement that
107.30covers the date of entry into the program. The exclusive representative and the eligible
107.31employer shall give notice to the commissioner of the determination to participate in the
107.32program at least 30 days before entry into the program. Entry into the program is governed
107.33by a schedule established by the commissioner. Employees of an eligible employer that is
108.1not participating in the program as of the date of enactment shall not be allowed to enter
108.2the program until January 1, 2015, except that a city that has received a formal written bid
108.3from the program as of the date of enactment shall be allowed to enter the program based
108.4on the bid if the city so chooses.
108.5(c) Employees not represented by exclusive representatives may become members of
108.6the program upon a determination of an eligible employer to include these employees in the
108.7program. Either all or none of the employer's unrepresented employees must participate.
108.8The eligible employer shall give at least 30 days' notice to the commissioner before
108.9entering the program. Entry into the program is governed by a schedule established by the
108.10commissioner. Employees of an eligible employer that is not participating in the program
108.11as of the date of enactment shall not be allowed to enter the program until January 1, 2015,
108.12except that a city that has received a formal written bid from the program as of the date of
108.13enactment shall be allowed to enter the program based on the bid if the city so chooses.
108.14(d) Participation in the program is for a two-year term. Participation is automatically
108.15renewed for an additional two-year term unless the exclusive representative, or the
108.16employer for unrepresented employees, gives the commissioner notice of withdrawal
108.17at least 30 days before expiration of the participation period. A group that withdraws
108.18must wait two years before rejoining. An exclusive representative, or employer for
108.19unrepresented employees, may also withdraw if premiums increase 50 percent or more
108.20from one insurance year to the next.
108.21(e) The exclusive representative shall give the employer notice of intent to withdraw
108.22to the commissioner at least 30 days before the expiration date of a collective bargaining
108.23agreement that includes the date on which the term of participation expires.
108.24(f) Each participating eligible employer shall notify the commissioner of names of
108.25individuals who will be participating within two weeks of the commissioner receiving
108.26notice of the parties' intent to participate. The employer shall also submit other information
108.27as required by the commissioner for administration of the program.
108.28EFFECTIVE DATE.This section is effective the day following final enactment.

108.29    Sec. 2. Minnesota Statutes 2010, section 62A.047, is amended to read:
108.3062A.047 CHILDREN'S HEALTH SUPERVISION SERVICES AND
108.31PRENATAL CARE SERVICES.
108.32A policy of individual or group health and accident insurance regulated under this
108.33chapter, or individual or group subscriber contract regulated under chapter 62C, health
108.34maintenance contract regulated under chapter 62D, or health benefit certificate regulated
109.1under chapter 64B, issued, renewed, or continued to provide coverage to a Minnesota
109.2resident, must provide coverage for child health supervision services and prenatal care
109.3services. The policy, contract, or certificate must specifically exempt reasonable and
109.4customary charges for child health supervision services and prenatal care services from a
109.5deductible, co-payment, or other coinsurance or dollar limitation requirement. Nothing
109.6in this section prohibits a health plan company that has a network of providers from
109.7imposing a deductible, co-payment, or other coinsurance or dollar limitation requirement
109.8for child health supervision services and prenatal care services that are delivered by an
109.9out-of-network provider. This section does not prohibit the use of policy waiting periods
109.10or preexisting condition limitations for these services. Minimum benefits may be limited
109.11to one visit payable to one provider for all of the services provided at each visit cited in
109.12this section subject to the schedule set forth in this section. Nothing in this section applies
109.13to a commercial health insurance policy issued as a companion to a health maintenance
109.14organization contract, a policy designed primarily to provide coverage payable on a per
109.15diem, fixed indemnity, or nonexpense incurred basis, or a policy that provides only
109.16accident coverage Nothing in this section applies to a policy designed primarily to provide
109.17coverage payable on a per diem, fixed indemnity, or non-expense-incurred basis, or a
109.18policy that provides only accident coverage. Nothing in this section prevents a health
109.19plan company from using reasonable medical management techniques to determine the
109.20frequency, method, treatment, or setting for child health supervision services and prenatal
109.21care services.
109.22"Child health supervision services" means pediatric preventive services, appropriate
109.23immunizations, developmental assessments, and laboratory services appropriate to the age
109.24of a child from birth to age six, and appropriate immunizations from ages six to 18, as
109.25defined by Standards of Child Health Care issued by the American Academy of Pediatrics.
109.26Reimbursement must be made for at least five child health supervision visits from birth
109.27to 12 months, three child health supervision visits from 12 months to 24 months, once a
109.28year from 24 months to 72 months.
109.29"Prenatal care services" means the comprehensive package of medical and
109.30psychosocial support provided throughout the pregnancy, including risk assessment,
109.31serial surveillance, prenatal education, and use of specialized skills and technology,
109.32when needed, as defined by Standards for Obstetric-Gynecologic Services issued by the
109.33American College of Obstetricians and Gynecologists.
109.34EFFECTIVE DATE.This section is effective August 1, 2012.

109.35    Sec. 3. Minnesota Statutes 2010, section 62A.21, subdivision 2a, is amended to read:
110.1    Subd. 2a. Continuation privilege. Every policy described in subdivision 1 shall
110.2contain a provision which permits continuation of coverage under the policy for the
110.3insured's former spouse and dependent children upon entry of a valid decree of dissolution
110.4of marriage. The coverage shall be continued until the earlier of the following dates:
110.5    (a) the date the insured's former spouse becomes covered under any other group
110.6health plan; or
110.7    (b) the date coverage would otherwise terminate under the policy.
110.8    If the coverage is provided under a group policy, any required premium contributions
110.9for the coverage shall be paid by the insured on a monthly basis to the group policyholder
110.10for remittance to the insurer. The policy must require the group policyholder to, upon
110.11request, provide the insured with written verification from the insurer of the cost of this
110.12coverage promptly at the time of eligibility for this coverage and at any time during
110.13the continuation period. In no event shall the amount of premium charged exceed 102
110.14percent of the cost to the plan for such period of coverage for other similarly situated
110.15spouses and dependent children with respect to whom the marital relationship has not
110.16dissolved, without regard to whether such cost is paid by the employer or employee The
110.17required premium amount for continuation of the coverage shall be calculated in the same
110.18manner as provided under section 4980B of the Internal Revenue Code, its implementing
110.19regulations and Internal Revenue Service rulings on section 4980B.
110.20    Upon request by the insured's former spouse or dependent child, a health carrier
110.21must provide the instructions necessary to enable the child or former spouse to elect
110.22continuation of coverage.
110.23EFFECTIVE DATE.This section is effective August 1, 2012.

110.24    Sec. 4. Minnesota Statutes 2010, section 62D.101, subdivision 2a, is amended to read:
110.25    Subd. 2a. Continuation privilege. Every health maintenance contract as described
110.26in subdivision 1 shall contain a provision which permits continuation of coverage under
110.27the contract for the enrollee's former spouse and children upon entry of a valid decree of
110.28dissolution of marriage. The coverage shall be continued until the earlier of the following
110.29dates:
110.30    (a) the date the enrollee's former spouse becomes covered under another group
110.31plan or Medicare; or
110.32    (b) the date coverage would otherwise terminate under the health maintenance
110.33contract.
110.34    If coverage is provided under a group policy, any required premium contributions
110.35for the coverage shall be paid by the enrollee on a monthly basis to the group contract
111.1holder to be paid to the health maintenance organization. The contract must require the
111.2group contract holder to, upon request, provide the enrollee with written verification from
111.3the insurer of the cost of this coverage promptly at the time of eligibility for this coverage
111.4and at any time during the continuation period. In no event shall the fee charged exceed
111.5102 percent of the cost to the plan for the period of coverage for other similarly situated
111.6spouses and dependent children when the marital relationship has not dissolved, regardless
111.7of whether the cost is paid by the employer or employee The required premium amount
111.8for continuation of the coverage shall be calculated in the same manner as provided under
111.9section 4980B in the Internal Revenue Code, its implementing regulations and Internal
111.10Revenue Service rulings on section 4980B.
111.11EFFECTIVE DATE.This section is effective August 1, 2012.

111.12    Sec. 5. Minnesota Statutes 2010, section 62J.26, subdivision 3, is amended to read:
111.13    Subd. 3. Requests for evaluation. (a) Whenever a legislative measure containing
111.14a mandated health benefit proposal is introduced as a bill or offered as an amendment
111.15to a bill, or is likely to be introduced as a bill or offered as an amendment, a the chair
111.16of any standing the legislative committee that has jurisdiction over the subject matter
111.17of the proposal may must request that the commissioner complete an evaluation of the
111.18proposal under this section, to inform any committee of floor action by either house of
111.19the legislature.
111.20(b) The commissioner must conduct an evaluation described in subdivision 2 of each
111.21mandated health benefit proposal for which an evaluation is requested under paragraph (a),
111.22unless the commissioner determines under paragraph (c) or subdivision 4 that priorities
111.23and resources do not permit its evaluation introduced as a bill or offered as an amendment
111.24to a bill as requested under paragraph (a).
111.25(c) If requests for evaluation of multiple proposals are received, the commissioner
111.26must consult with the chairs of the standing legislative committees having jurisdiction
111.27over the subject matter of the mandated health benefit proposals to prioritize the requests
111.28and establish a reporting date for each proposal to be evaluated. The commissioner
111.29is not required to direct an unreasonable quantity of the commissioner's resources to
111.30these evaluations.

111.31    Sec. 6. Minnesota Statutes 2010, section 62J.26, subdivision 5, is amended to read:
111.32    Subd. 5. Report to legislature. The commissioner must submit a written report on
111.33the evaluation to the legislature no later than 180 30 days after the request. The report
111.34must be submitted in compliance with sections 3.195 and 3.197.

112.1    Sec. 7. Minnesota Statutes 2010, section 62J.26, is amended by adding a subdivision to
112.2read:
112.3    Subd. 6. Evaluation of mandated health benefits. (a) The commissioner of
112.4commerce, in consultation with the commissioners of health and management and budget,
112.5shall evaluate each mandated health benefit currently required in Minnesota Statutes or
112.6Rules in accordance with the evaluation process described in subdivision 2.
112.7(b) For purposes of this subdivision, a "mandated health benefit" means a statutory
112.8or administrative requirement that a health plan do the following:
112.9(1) provide coverage or increase the amount of coverage for the treatment of a
112.10particular disease, condition, or other health care need;
112.11(2) provide coverage or increase the amount of coverage of a particular type of
112.12health care treatment or service, or of equipment, supplies, or drugs used in connection
112.13with a health care treatment or service; or
112.14(3) provide coverage for care delivered by a specific type of provider.
112.15(c) The commissioner must submit a written report on the evaluation of existing state
112.16mandated health benefits to the legislature by December 31, 2015.
112.17EFFECTIVE DATE.This section is effective July 1, 2013.

112.18    Sec. 8. [62Q.026] CERTAIN FEDERALLY NONQUALIFIED HEALTH PLANS;
112.19SALE PERMITTED.
112.20    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined
112.21in this section have the meanings given.
112.22(b) "Commissioner" means the commissioner of commerce.
112.23(c) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
112.24(d) "Health plan company" has the meaning given in section 62Q.01, subdivision 4.
112.25(e) "Nonqualified health plan" means any health plan not certified by the federal
112.26Secretary of Health and Human Services in accordance with the Patient Protection and
112.27Affordable Care Act of 2010, as amended.
112.28(f) "Qualified health plan" means a health plan certified by the federal Secretary of
112.29Health and Human Services for eligibility to be sold inside health benefit exchanges in
112.30accordance with the Patient Protection and Affordable Care Act of 2010, as amended.
112.31    Subd. 2. Sale of nonqualified health plan permitted. A health plan company
112.32authorized under Minnesota law to offer, issue, sell, or renew a health plan in Minnesota
112.33may do so regardless of whether the health plan is a qualified or nonqualified health plan
112.34under the federal Patient Protection and Affordable Care Act of 2010, as amended. No
112.35statute or rule of this state shall be interpreted as providing to the contrary.
113.1EFFECTIVE DATE.This section is effective the day following final enactment.

113.2    Sec. 9. [148.2855] NURSE LICENSURE COMPACT.
113.3The Nurse Licensure Compact is enacted into law and entered into with all other
113.4jurisdictions legally joining in it, in the form substantially as follows:

113.5ARTICLE 1

113.6DEFINITIONS

113.7As used in this compact:
113.8(a) "Adverse action" means a home or remote state action.
113.9(b) "Alternative program" means a voluntary, nondisciplinary monitoring program
113.10approved by a nurse licensing board.
113.11(c) "Coordinated licensure information system" means an integrated process for
113.12collecting, storing, and sharing information on nurse licensure and enforcement activities
113.13related to nurse licensure laws, which is administered by a nonprofit organization
113.14composed of and controlled by state nurse licensing boards.
113.15(d) "Current significant investigative information" means:
113.16(1) investigative information that a licensing board, after a preliminary inquiry that
113.17includes notification and an opportunity for the nurse to respond if required by state law,
113.18has reason to believe is not groundless and, if proved true, would indicate more than a
113.19minor infraction; or
113.20(2) investigative information that indicates that the nurse represents an immediate
113.21threat to public health and safety regardless of whether the nurse has been notified and
113.22had an opportunity to respond.
113.23(e) "Home state" means the party state which is the nurse's primary state of residence.
113.24(f) "Home state action" means any administrative, civil, equitable, or criminal
113.25action permitted by the home state's laws which are imposed on a nurse by the home
113.26state's licensing board or other authority including actions against an individual's license
113.27such as revocation, suspension, probation, or any other action which affects a nurse's
113.28authorization to practice.
113.29(g) "Licensing board" means a party state's regulatory body responsible for issuing
113.30nurse licenses.
113.31(h) "Multistate licensure privilege" means current, official authority from a
113.32remote state permitting the practice of nursing as either a registered nurse or a licensed
113.33practical/vocational nurse in the party state. All party states have the authority, according
113.34to existing state due process law, to take actions against the nurse's privilege such as
114.1revocation, suspension, probation, or any other action which affects a nurse's authorization
114.2to practice.
114.3(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those
114.4terms are defined by each party state's practice laws.
114.5(j) "Party state" means any state that has adopted this compact.
114.6(k) "Remote state" means a party state other than the home state:
114.7(1) where the patient is located at the time nursing care is provided; or
114.8(2) in the case of the practice of nursing not involving a patient, in the party state
114.9where the recipient of nursing practice is located.
114.10(l) "Remote state action" means:
114.11(1) any administrative, civil, equitable, or criminal action permitted by a remote
114.12state's laws which are imposed on a nurse by the remote state's licensing board or other
114.13authority including actions against an individual's multistate licensure privilege to practice
114.14in the remote state; and
114.15(2) cease and desist and other injunctive or equitable orders issued by remote states
114.16or the licensing boards of those states.
114.17(m) "State" means a state, territory, or possession of the United States, the District of
114.18Columbia, or the Commonwealth of Puerto Rico.
114.19(n) "State practice laws" means individual party state laws and regulations that
114.20govern the practice of nursing, define the scope of nursing practice, and create the
114.21methods and grounds for imposing discipline. State practice laws does not include the
114.22initial qualifications for licensure or requirements necessary to obtain and retain a license,
114.23except for qualifications or requirements of the home state.

114.24ARTICLE 2

114.25GENERAL PROVISIONS AND JURISDICTION

114.26(a) A license to practice registered nursing issued by a home state to a resident in
114.27that state will be recognized by each party state as authorizing a multistate licensure
114.28privilege to practice as a registered nurse in the party state. A license to practice licensed
114.29practical/vocational nursing issued by a home state to a resident in that state will be
114.30recognized by each party state as authorizing a multistate licensure privilege to practice
114.31as a licensed practical/vocational nurse in the party state. In order to obtain or retain a
114.32license, an applicant must meet the home state's qualifications for licensure and license
114.33renewal as well as all other applicable state laws.
114.34(b) Party states may, according to state due process laws, limit or revoke the
114.35multistate licensure privilege of any nurse to practice in their state and may take any other
114.36actions under their applicable state laws necessary to protect the health and safety of
115.1their citizens. If a party state takes such action, it shall promptly notify the administrator
115.2of the coordinated licensure information system. The administrator of the coordinated
115.3licensure information system shall promptly notify the home state of any such actions by
115.4remote states.
115.5(c) Every nurse practicing in a party state must comply with the state practice laws of
115.6the state in which the patient is located at the time care is rendered. In addition, the practice
115.7of nursing is not limited to patient care, but shall include all nursing practice as defined by
115.8the state practice laws of the party state. The practice of nursing will subject a nurse to the
115.9jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
115.10(d) This compact does not affect additional requirements imposed by states for
115.11advanced practice registered nursing. However, a multistate licensure privilege to practice
115.12registered nursing granted by a party state shall be recognized by other party states as a
115.13license to practice registered nursing if one is required by state law as a precondition for
115.14qualifying for advanced practice registered nurse authorization.
115.15(e) Individuals not residing in a party state shall continue to be able to apply for
115.16nurse licensure as provided for under the laws of each party state. However, the license
115.17granted to these individuals will not be recognized as granting the privilege to practice
115.18nursing in any other party state unless explicitly agreed to by that party state.

115.19ARTICLE 3

115.20APPLICATIONS FOR LICENSURE IN A PARTY STATE

115.21(a) Upon application for a license, the licensing board in a party state shall ascertain,
115.22through the coordinated licensure information system, whether the applicant has ever held
115.23or is the holder of a license issued by any other state, whether there are any restrictions
115.24on the multistate licensure privilege, and whether any other adverse action by a state
115.25has been taken against the license.
115.26(b) A nurse in a party state shall hold licensure in only one party state at a time,
115.27issued by the home state.
115.28(c) A nurse who intends to change primary state of residence may apply for licensure
115.29in the new home state in advance of the change. However, new licenses will not be
115.30issued by a party state until after a nurse provides evidence of change in primary state of
115.31residence satisfactory to the new home state's licensing board.
115.32(d) When a nurse changes primary state of residence by:
115.33(1) moving between two party states, and obtains a license from the new home state,
115.34the license from the former home state is no longer valid;
116.1(2) moving from a nonparty state to a party state, and obtains a license from the new
116.2home state, the individual state license issued by the nonparty state is not affected and will
116.3remain in full force if so provided by the laws of the nonparty state; or
116.4(3) moving from a party state to a nonparty state, the license issued by the prior
116.5home state converts to an individual state license, valid only in the former home state,
116.6without the multistate licensure privilege to practice in other party states.

116.7ARTICLE 4

116.8ADVERSE ACTIONS

116.9In addition to the general provisions described in article 2, the provisions in this
116.10article apply.
116.11(a) The licensing board of a remote state shall promptly report to the administrator
116.12of the coordinated licensure information system any remote state actions including the
116.13factual and legal basis for the action, if known. The licensing board of a remote state shall
116.14also promptly report any significant current investigative information yet to result in a
116.15remote state action. The administrator of the coordinated licensure information system
116.16shall promptly notify the home state of any reports.
116.17(b) The licensing board of a party state shall have the authority to complete any
116.18pending investigation for a nurse who changes primary state of residence during the
116.19course of the investigation. The board shall also have the authority to take appropriate
116.20action, and shall promptly report the conclusion of the investigation to the administrator
116.21of the coordinated licensure information system. The administrator of the coordinated
116.22licensure information system shall promptly notify the new home state of any action.
116.23(c) A remote state may take adverse action affecting the multistate licensure
116.24privilege to practice within that party state. However, only the home state shall have the
116.25power to impose adverse action against the license issued by the home state.
116.26(d) For purposes of imposing adverse actions, the licensing board of the home state
116.27shall give the same priority and effect to reported conduct received from a remote state as
116.28it would if the conduct had occurred within the home state. In so doing, it shall apply its
116.29own state laws to determine appropriate action.
116.30(e) The home state may take adverse action based on the factual findings of the
116.31remote state, provided each state follows its own procedures for imposing the adverse
116.32action.
116.33(f) Nothing in this compact shall override a party state's decision that participation
116.34in an alternative program may be used in lieu of licensure action and that participation
116.35shall remain nonpublic if required by the party state's laws.
117.1Party states must require nurses who enter any alternative programs to agree not to
117.2practice in any other party state during the term of the alternative program without prior
117.3authorization from the other party state.

117.4ARTICLE 5

117.5ADDITIONAL AUTHORITIES INVESTED IN

117.6PARTY STATE NURSE LICENSING BOARDS

117.7Notwithstanding any other laws, party state nurse licensing boards shall have the
117.8authority to:
117.9(1) if otherwise permitted by state law, recover from the affected nurse the costs of
117.10investigation and disposition of cases resulting from any adverse action taken against
117.11that nurse;
117.12(2) issue subpoenas for both hearings and investigations which require the attendance
117.13and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse
117.14licensing board in a party state for the attendance and testimony of witnesses, and the
117.15production of evidence from another party state, shall be enforced in the latter state by
117.16any court of competent jurisdiction according to the practice and procedure of that court
117.17applicable to subpoenas issued in proceedings pending before it. The issuing authority
117.18shall pay any witness fees, travel expenses, mileage, and other fees required by the service
117.19statutes of the state where the witnesses and evidence are located;
117.20(3) issue cease and desist orders to limit or revoke a nurse's authority to practice
117.21in the nurse's state; and
117.22(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).

117.23ARTICLE 6

117.24COORDINATED LICENSURE INFORMATION SYSTEM

117.25(a) All party states shall participate in a cooperative effort to create a coordinated
117.26database of all licensed registered nurses and licensed practical/vocational nurses. This
117.27system shall include information on the licensure and disciplinary history of each
117.28nurse, as contributed by party states, to assist in the coordination of nurse licensure and
117.29enforcement efforts.
117.30(b) Notwithstanding any other provision of law, all party states' licensing boards shall
117.31promptly report adverse actions, actions against multistate licensure privileges, any current
117.32significant investigative information yet to result in adverse action, denials of applications,
117.33and the reasons for the denials to the coordinated licensure information system.
117.34(c) Current significant investigative information shall be transmitted through the
117.35coordinated licensure information system only to party state licensing boards.
118.1(d) Notwithstanding any other provision of law, all party states' licensing boards
118.2contributing information to the coordinated licensure information system may designate
118.3information that may not be shared with nonparty states or disclosed to other entities or
118.4individuals without the express permission of the contributing state.
118.5(e) Any personally identifiable information obtained by a party state's licensing
118.6board from the coordinated licensure information system may not be shared with nonparty
118.7states or disclosed to other entities or individuals except to the extent permitted by the
118.8laws of the party state contributing the information.
118.9(f) Any information contributed to the coordinated licensure information system that
118.10is subsequently required to be expunged by the laws of the party state contributing that
118.11information shall also be expunged from the coordinated licensure information system.
118.12(g) The compact administrators, acting jointly with each other and in consultation
118.13with the administrator of the coordinated licensure information system, shall formulate
118.14necessary and proper procedures for the identification, collection, and exchange of
118.15information under this compact.

118.16ARTICLE 7

118.17COMPACT ADMINISTRATION AND

118.18INTERCHANGE OF INFORMATION

118.19(a) The head or designee of the nurse licensing board of each party state shall be the
118.20administrator of this compact for that state.
118.21(b) The compact administrator of each party state shall furnish to the compact
118.22administrator of each other party state any information and documents including, but not
118.23limited to, a uniform data set of investigations, identifying information, licensure data, and
118.24disclosable alternative program participation information to facilitate the administration of
118.25this compact.
118.26(c) Compact administrators shall have the authority to develop uniform rules to
118.27facilitate and coordinate implementation of this compact. These uniform rules shall be
118.28adopted by party states under the authority in article 5, clause (4).

118.29ARTICLE 8

118.30IMMUNITY

118.31A party state or the officers, employees, or agents of a party state's nurse licensing
118.32board who acts in good faith according to the provisions of this compact shall not be
118.33liable for any act or omission while engaged in the performance of their duties under
118.34this compact. Good faith shall not include willful misconduct, gross negligence, or
118.35recklessness.

118.36ARTICLE 9

119.1ENACTMENT, WITHDRAWAL, AND AMENDMENT

119.2(a) This compact shall become effective for each state when it has been enacted by
119.3that state. Any party state may withdraw from this compact by repealing the nurse licensure
119.4compact, but no withdrawal shall take effect until six months after the withdrawing state
119.5has given notice of the withdrawal to the executive heads of all other party states.
119.6(b) No withdrawal shall affect the validity or applicability by the licensing boards
119.7of states remaining party to the compact of any report of adverse action occurring prior
119.8to the withdrawal.
119.9(c) Nothing contained in this compact shall be construed to invalidate or prevent any
119.10nurse licensure agreement or other cooperative arrangement between a party state and a
119.11nonparty state that is made according to the other provisions of this compact.
119.12(d) This compact may be amended by the party states. No amendment to this
119.13compact shall become effective and binding upon the party states until it is enacted into
119.14the laws of all party states.

119.15ARTICLE 10

119.16CONSTRUCTION AND SEVERABILITY

119.17(a) This compact shall be liberally construed to effectuate the purposes of the
119.18compact. The provisions of this compact shall be severable and if any phrase, clause,
119.19sentence, or provision of this compact is declared to be contrary to the constitution of any
119.20party state or of the United States or the applicability thereof to any government, agency,
119.21person, or circumstance is held invalid, the validity of the remainder of this compact and
119.22the applicability of it to any government, agency, person, or circumstance shall not be
119.23affected by it. If this compact is held contrary to the constitution of any party state, the
119.24compact shall remain in full force and effect for the remaining party states and in full force
119.25and effect for the party state affected as to all severable matters.
119.26(b) In the event party states find a need for settling disputes arising under this
119.27compact:
119.28(1) the party states may submit the issues in dispute to an arbitration panel which
119.29shall be comprised of an individual appointed by the compact administrator in the home
119.30state, an individual appointed by the compact administrator in the remote states involved,
119.31and an individual mutually agreed upon by the compact administrators of the party states
119.32involved in the dispute; and
119.33(2) the decision of a majority of the arbitrators shall be final and binding.
119.34EFFECTIVE DATE.This section is effective upon implementation of the
119.35coordinated licensure information system defined in section 148.2855, but no sooner
119.36than July 1, 2013.

120.1    Sec. 10. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
120.2EXISTING LAWS.
120.3(a) A nurse practicing professional or practical nursing in Minnesota under the
120.4authority of section 148.2855 shall have the same obligations, privileges, and rights as if
120.5the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section
120.6148.2855, the Board of Nursing shall comply with and follow all laws and rules with
120.7respect to registered and licensed practical nurses practicing professional or practical
120.8nursing in Minnesota under the authority of section 148.2855, and all such individuals
120.9shall be governed and regulated as if they were licensed by the board.
120.10(b) Section 148.2855 does not relieve employers of nurses from complying with
120.11statutorily imposed obligations.
120.12(c) Section 148.2855 does not supersede existing state labor laws.
120.13(d) For purposes of the Minnesota Government Data Practices Act, chapter 13,
120.14an individual not licensed as a nurse under sections 148.171 to 148.285 who practices
120.15professional or practical nursing in Minnesota under the authority of section 148.2855 is
120.16considered to be a licensee of the board.
120.17(e) Uniform rules developed by the compact administrators shall not be subject
120.18to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101,
120.1914.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
120.20(f) Proceedings brought against an individual's multistate privilege shall be
120.21adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject
120.22to judicial review as provided for in sections 14.63 to 14.69.
120.23(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4;
120.24144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917,
120.25subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40,
120.26subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are
120.27licensed as registered or licensed practical nurses in the home state shall be considered
120.28to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to
120.29registered nurses or the practice of professional nursing, then only holders of a multistate
120.30privilege who are licensed as registered nurses in the home state shall be considered
120.31licensees.
120.32(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557
120.33apply to individuals not licensed as registered or licensed practical nurses under sections
120.34148.171 to 148.285 who practice professional or practical nursing in Minnesota under
120.35the authority of section 148.2855.
121.1(i) The board may take action against an individual's multistate privilege based on
121.2the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or
121.3requiring the board to take corrective or disciplinary action.
121.4(j) The board may take all forms of disciplinary action provided for in section
121.5148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision
121.66, against an individual's multistate privilege.
121.7(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals
121.8who practice professional or practical nursing in Minnesota under the authority of section
121.9148.2855.
121.10(l) The cooperation requirements of section 148.265 apply to individuals who
121.11practice professional or practical nursing in Minnesota under the authority of section
121.12148.2855.
121.13(m) The provisions of section 148.283 shall not apply to individuals who practice
121.14professional or practical nursing in Minnesota under the authority of section 148.2855.
121.15(n) Complaints against individuals who practice professional or practical nursing
121.16in Minnesota under the authority of section 148.2855 shall be handled as provided in
121.17sections 214.10 and 214.103.
121.18(o) All provisions of section 148.2855 authorizing or requiring the board to provide
121.19data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
121.20(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a
121.21remote state any active investigative data regarding a complaint investigation against a
121.22nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable
121.23assurances from the remote state that the data will be maintained with the same protections
121.24as provided in Minnesota law.
121.25(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice
121.26professional or practical nursing in Minnesota under the authority of section 148.2855
121.27when the practice involves direct physical contact between the nurse and a patient.
121.28(r) A nurse practicing professional or practical nursing in Minnesota under the
121.29authority of section 148.2855 must comply with any criminal background check required
121.30under Minnesota law.
121.31EFFECTIVE DATE.This section is effective upon implementation of the
121.32coordinated licensure information system defined in section 148.2855, but no sooner
121.33than July 1, 2013.

121.34    Sec. 11. [148.2857] WITHDRAWAL FROM COMPACT.
122.1The governor may withdraw the state from the compact in section 148.2855 if
122.2the Board of Nursing notifies the governor that a party state to the compact changed
122.3the party state's requirements for nurse licensure after July 1, 2012, and that the party
122.4state's requirements, as changed, are substantially lower than the requirements for nurse
122.5licensure in this state.
122.6EFFECTIVE DATE.This section is effective upon implementation of the
122.7coordinated licensure information system defined in section 148.2855, but no sooner
122.8than July 1, 2013.

122.9    Sec. 12. [148.2858] MISCELLANEOUS PROVISIONS.
122.10(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board"
122.11means the executive director of the board.
122.12(b) The Board of Nursing shall have the authority to recover from a nurse practicing
122.13professional or practical nursing in Minnesota under the authority of section 148.2855
122.14the costs of investigation and disposition of cases resulting from any adverse action
122.15taken against the nurse.
122.16(c) The board may implement a system of identifying individuals who practice
122.17professional or practical nursing in Minnesota under the authority of section 148.2855.
122.18EFFECTIVE DATE.This section is effective upon implementation of the
122.19coordinated licensure information system defined in section 148.2855, but no sooner
122.20than July 1, 2013.

122.21    Sec. 13. [148.2859] NURSE LICENSURE COMPACT ADVISORY
122.22COMMITTEE.
122.23    Subdivision 1. Establishment; membership. A Nurse Licensure Compact Advisory
122.24Committee is established to advise the compact administrator in the implementation of
122.25section 148.2855. Members of the advisory committee shall be appointed by the board
122.26and shall be composed of representatives of Minnesota nursing organizations, Minnesota
122.27licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses
122.28who provide home care, Minnesota licensed advanced practice registered nurses, and
122.29public members as defined in section 214.02.
122.30    Subd. 2. Duties. The advisory committee shall advise the compact administrator in
122.31the implementation of section 148.2855.
122.32    Subd. 3. Organization. The advisory committee shall be organized and
122.33administered under section 15.059.
123.1EFFECTIVE DATE.This section is effective upon implementation of the
123.2coordinated licensure information system defined in section 148.2855, but no sooner
123.3than July 1, 2013.

123.4    Sec. 14. Minnesota Statutes 2010, section 256B.0943, subdivision 9, is amended to
123.5read:
123.6    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a
123.7certified provider entity must ensure that:
123.8    (1) each individual provider's caseload size permits the provider to deliver services
123.9to both clients with severe, complex needs and clients with less intensive needs. The
123.10provider's caseload size should reasonably enable the provider to play an active role in
123.11service planning, monitoring, and delivering services to meet the client's and client's
123.12family's needs, as specified in each client's individual treatment plan;
123.13    (2) site-based programs, including day treatment and preschool programs, provide
123.14staffing and facilities to ensure the client's health, safety, and protection of rights, and that
123.15the programs are able to implement each client's individual treatment plan;
123.16    (3) a day treatment program is provided to a group of clients by a multidisciplinary
123.17team under the clinical supervision of a mental health professional. The day treatment
123.18program must be provided in and by: (i) an outpatient hospital accredited by the Joint
123.19Commission on Accreditation of Health Organizations and licensed under sections 144.50
123.20to 144.55; (ii) a community mental health center under section 245.62; or (iii) an entity
123.21that is under contract with the county board certified under subdivision 4 to operate a
123.22program that meets the requirements of section 245.4712, subdivision 2, or 245.4884,
123.23subdivision 2 , and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment
123.24program must stabilize the client's mental health status while developing and improving
123.25the client's independent living and socialization skills. The goal of the day treatment
123.26program must be to reduce or relieve the effects of mental illness and provide training to
123.27enable the client to live in the community. The program must be available at least one day
123.28a week for a two-hour time block. The two-hour time block must include at least one hour
123.29of individual or group psychotherapy. The remainder of the structured treatment program
123.30may include individual or group psychotherapy, and individual or group skills training, if
123.31included in the client's individual treatment plan. Day treatment programs are not part of
123.32inpatient or residential treatment services. A day treatment program may provide fewer
123.33than the minimally required hours for a particular child during a billing period in which
123.34the child is transitioning into, or out of, the program; and
124.1    (4) a therapeutic preschool program is a structured treatment program offered
124.2to a child who is at least 33 months old, but who has not yet reached the first day of
124.3kindergarten, by a preschool multidisciplinary team in a day program licensed under
124.4Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available two
124.5hours per day, five days per week, and 12 months of each calendar year. The structured
124.6treatment program may include individual or group psychotherapy and individual or
124.7group skills training, if included in the client's individual treatment plan. A therapeutic
124.8preschool program may provide fewer than the minimally required hours for a particular
124.9child during a billing period in which the child is transitioning into, or out of, the program.
124.10    (b) A provider entity must deliver the service components of children's therapeutic
124.11services and supports in compliance with the following requirements:
124.12    (1) individual, family, and group psychotherapy must be delivered as specified in
124.13Minnesota Rules, part 9505.0323;
124.14    (2) individual, family, or group skills training must be provided by a mental health
124.15professional or a mental health practitioner who has a consulting relationship with a
124.16mental health professional who accepts full professional responsibility for the training;
124.17    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
124.18through arrangements for direct intervention and support services to the child and the
124.19child's family. Crisis assistance must utilize resources designed to address abrupt or
124.20substantial changes in the functioning of the child or the child's family as evidenced by
124.21a sudden change in behavior with negative consequences for well being, a loss of usual
124.22coping mechanisms, or the presentation of danger to self or others;
124.23    (4) mental health behavioral aide services must be medically necessary treatment
124.24services, identified in the child's individual treatment plan and individual behavior plan,
124.25which are performed minimally by a paraprofessional qualified according to subdivision
124.267, paragraph (b), clause (3), and which are designed to improve the functioning of the
124.27child in the progressive use of developmentally appropriate psychosocial skills. Activities
124.28involve working directly with the child, child-peer groupings, or child-family groupings
124.29to practice, repeat, reintroduce, and master the skills defined in subdivision 1, paragraph
124.30(p), as previously taught by a mental health professional or mental health practitioner
124.31including:
124.32(i) providing cues or prompts in skill-building peer-to-peer or parent-child
124.33interactions so that the child progressively recognizes and responds to the cues
124.34independently;
124.35(ii) performing as a practice partner or role-play partner;
124.36(iii) reinforcing the child's accomplishments;
125.1(iv) generalizing skill-building activities in the child's multiple natural settings;
125.2(v) assigning further practice activities; and
125.3(vi) intervening as necessary to redirect the child's target behavior and to de-escalate
125.4behavior that puts the child or other person at risk of injury.
125.5A mental health behavioral aide must document the delivery of services in written
125.6progress notes. The mental health behavioral aide must implement treatment strategies
125.7in the individual treatment plan and the individual behavior plan. The mental health
125.8behavioral aide must document the delivery of services in written progress notes. Progress
125.9notes must reflect implementation of the treatment strategies, as performed by the mental
125.10health behavioral aide and the child's responses to the treatment strategies; and
125.11    (5) direction of a mental health behavioral aide must include the following:
125.12    (i) a clinical supervision plan approved by the responsible mental health professional;
125.13    (ii) ongoing on-site observation by a mental health professional or mental health
125.14practitioner for at least a total of one hour during every 40 hours of service provided
125.15to a child; and
125.16    (iii) immediate accessibility of the mental health professional or mental health
125.17practitioner to the mental health behavioral aide during service provision.

125.18    Sec. 15. Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision
125.198, is amended to read:

125.20 125.21

Subd. 8.Board of Nursing Home Administrators

2,153,000

2,145,000

125.22Rulemaking. Of this appropriation, $44,000
125.23in fiscal year 2012 is for rulemaking. This is
125.24a onetime appropriation.
125.25Electronic Licensing System Adaptors.
125.26Of this appropriation, $761,000 in fiscal
125.27year 2013 from the state government special
125.28revenue fund is to the administrative services
125.29unit to cover the costs to connect to the
125.30e-licensing system. Minnesota Statutes,
125.31section 16E.22. Base level funding for this
125.32activity in fiscal year 2014 shall be $100,000.
125.33Base level funding for this activity in fiscal
125.34year 2015 shall be $50,000.
126.1Development and Implementation of a
126.2Disciplinary, Regulatory, Licensing and
126.3Information Management System. Of this
126.4appropriation, $800,000 in fiscal year 2012
126.5and $300,000 in fiscal year 2013 are for the
126.6development of a shared system. Base level
126.7funding for this activity in fiscal year 2014
126.8shall be $50,000.
126.9Administrative Services Unit - Operating
126.10Costs. Of this appropriation, $526,000
126.11in fiscal year 2012 and $526,000 in
126.12fiscal year 2013 are for operating costs
126.13of the administrative services unit. The
126.14administrative services unit may receive
126.15and expend reimbursements for services
126.16performed by other agencies.
126.17Administrative Services Unit - Retirement
126.18Costs. Of this appropriation in fiscal year
126.192012, $225,000 is for onetime retirement
126.20costs in the health-related boards. This
126.21funding may be transferred to the health
126.22boards incurring those costs for their
126.23payment. These funds are available either
126.24year of the biennium.
126.25Administrative Services Unit - Volunteer
126.26Health Care Provider Program. Of this
126.27appropriation, $150,000 in fiscal year 2012
126.28and $150,000 in fiscal year 2013 are to pay
126.29for medical professional liability coverage
126.30required under Minnesota Statutes, section
126.31214.40 .
126.32Administrative Services Unit - Contested
126.33Cases and Other Legal Proceedings. Of
126.34this appropriation, $200,000 in fiscal year
126.352012 and $200,000 in fiscal year 2013 are
127.1for costs of contested case hearings and other
127.2unanticipated costs of legal proceedings
127.3involving health-related boards funded
127.4under this section. Upon certification of a
127.5health-related board to the administrative
127.6services unit that the costs will be incurred
127.7and that there is insufficient money available
127.8to pay for the costs out of money currently
127.9available to that board, the administrative
127.10services unit is authorized to transfer money
127.11from this appropriation to the board for
127.12payment of those costs with the approval
127.13of the commissioner of management and
127.14budget. This appropriation does not cancel.
127.15Any unencumbered and unspent balances
127.16remain available for these expenditures in
127.17subsequent fiscal years.
127.18Base Adjustment. The State Government
127.19Special Revenue Fund base is decreased by
127.20$911,000 in fiscal year 2014 and $1,011,000
127.21$961,000 in fiscal year 2015.

127.22    Sec. 16. BIENNIAL BUDGET REQUEST; UNIVERSITY OF MINNESOTA.
127.23Beginning in 2013, as part of the biennial budget request submitted to the
127.24Department of Management and Budget, and the legislature, the Board of Regents of the
127.25University of Minnesota is encouraged to include a request for funding for rural primary
127.26care training by family practice residence programs to prepare doctors for the practice
127.27of primary care medicine in rural areas of the state. The funding request should provide
127.28for ongoing support of rural primary care training through the University of Minnesota's
127.29general operation and maintenance funding or through dedicated health science funding.

127.30ARTICLE 6

127.31HEALTH AND HUMAN SERVICES APPROPRIATIONS

127.32

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

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

128.9				APPROPRIATIONS
128.10				Available for the Year
128.11				Ending June 30
128.12					2012		2013

128.13 128.14

Sec. 2. COMMISSIONER OF HUMAN SERVICES

128.15

Subdivision 1.Total Appropriation

$

69,000

$

5,163,000

128.16	Appropriations by Fund
128.17		2012	2013
128.18	General	-0-	(668,000)
128.19	Health Care Access	-0-	1,176,000
128.20	Federal TANF	82,000	4,655,000

128.21

Subd. 2.Central Office Operations

128.22

(a) Operations

-0-

502,000

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

128.26

(b) Health Care

-0-

473,000

128.27	Appropriations by Fund
128.28		2012	2013
128.29	General	-0-	473,000
128.30	Health Care Access	-0-	1,153,000

128.31The general fund appropriation is a onetime
128.32appropriation.
128.33In fiscal year 2013, the commissioner
128.34shall transfer from the health care access
128.35fund $870,000 to the legislative auditor
129.1for managed care audit activities under
129.2Minnesota Statutes, section 256B.69,
129.3subdivision 9c. This is an ongoing transfer.
129.4Beginning in fiscal year 2014, the base
129.5amount for this transfer is $1,740,000.
129.6Base Adjustment. The health care access
129.7fund base is increased by $689,000 in fiscal
129.8years 2014 and 2015.

129.9

(c) Continuing Care

-0-

375,000

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

129.13

Subd. 3.Forecasted Programs

129.14

(a) MFIP/DWP Grants

129.15	Appropriations by Fund
129.16		2012	2013
129.17	General	(82,000)	(4,660,000)
129.18	Federal TANF	82,000	4,655,000

129.19

(b) MFIP Child Care Assistance Grants

-0-

2,000

129.20

(c) General Assistance Grants

-0-

(41,000)

129.21

(d) Minnesota Supplemental Aid Grants

-0-

154,000

129.22

(e) Group Residential Housing Grants

-0-

(199,000)

129.23

(f) MinnesotaCare Grants

-0-

23,000

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

129.26

(g) Medical Assistance Grants

82,000

2,725,000

129.27Continuing Care Provider Fiscal Year
129.282013 Payment Delay. The commissioner
129.29of human services shall delay the last
129.30payment or payments in fiscal year 2013 by
129.31up to $22,854,000 to the following service
129.32providers:
130.1(1) home and community-based waivered
130.2services for persons with developmental
130.3disabilities or related conditions, including
130.4consumer-directed community supports,
130.5under Minnesota Statutes, section 256B.501;
130.6(2) home and community-based waivered
130.7services for the elderly, including
130.8consumer-directed community supports,
130.9under Minnesota Statutes, section
130.10256B.0915;
130.11(3) waivered services under community
130.12alternatives for disabled individuals,
130.13including consumer-directed community
130.14supports, under Minnesota Statutes, section
130.15256B.49;
130.16(4) community alternative care waivered
130.17services, including consumer-directed
130.18community supports, under Minnesota
130.19Statutes, section 256B.49;
130.20(5) traumatic brain injury waivered services,
130.21including consumer-directed community
130.22supports, under Minnesota Statutes, section
130.23256B.49;
130.24(6) nursing services and home health
130.25services under Minnesota Statutes, section
130.26256B.0625, subdivision 6a;
130.27(7) personal care services and qualified
130.28professional supervision of personal care
130.29services under Minnesota Statutes, section
130.30256B.0625, subdivisions 6a and 19a;
130.31(8) private duty nursing services under
130.32Minnesota Statutes, section 256B.0625,
130.33subdivision 7;
131.1(9) day training and habilitation services for
131.2adults with developmental disabilities or
131.3related conditions under Minnesota Statutes,
131.4sections 252.40 to 252.46, including the
131.5additional cost of rate adjustments on day
131.6training and habilitation services, provided
131.7as a social service under Minnesota Statutes,
131.8section 256M.60;
131.9(10) alternative care services under
131.10Minnesota Statutes, section 256B.0913;
131.11(11) managed care organizations under
131.12Minnesota Statutes, section 256B.69,
131.13receiving state payments for services in
131.14clauses (1) to (10); and
131.15(12) intermediate care facilities for persons
131.16with developmental disabilities under
131.17Minnesota Statutes, section 256B.5012,
131.18subdivision 13.
131.19In calculating the actual payment amounts to
131.20be delayed, the commissioner must reduce
131.21the $22,854,000 amount by any cash basis
131.22state share savings to be realized in fiscal
131.23year 2013 from implementing the long-term
131.24care realignment waiver before July 1, 2013.
131.25The commissioner shall make the delayed
131.26payments in July 2013. Notwithstanding
131.27any contrary provisions in this article, this
131.28provision expires on August 1, 2013.
131.29Critical Access Nursing Facilities
131.30Designation. $1,000,000 is appropriated in
131.31fiscal year 2013 from the general fund to
131.32the commissioner of human services for the
131.33purposes of critical access nursing facilities
131.34under Minnesota Statutes, section 256B.441,
132.1subdivision 63. This appropriation is
132.2ongoing and is added to the base.

132.3

Subd. 4.Grant Programs

132.4

(a) Basic Sliding Fee Child Care Grants

-0-

1,000

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

132.8

(b) Disabilities Grants

-0-

-0-

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

132.19

Sec. 3. COMMISSIONER OF HEALTH

132.20

Policy Quality and Compliance

-0-

(1,185,000)

132.21	Appropriations by Fund
132.22		2012	2013
132.23	General	-0-	127,000
132.24 132.25	State Government Special Revenue	-0-	(1,449,000)
132.26	Health Care Access	-0-	137,000

132.27In fiscal year 2013, $137,000 from the health
132.28care access fund is for a study of radiation
132.29therapy facilities capacity. This is a onetime
132.30appropriation.
132.31In fiscal year 2015, the commissioner shall
132.32transfer from the general fund $59,000,
132.33including $40,000 for SEGIP activities to the
132.34commissioner of management and budget for
133.1actuarial and consulting services to support
133.2the Department of Commerce evaluation of
133.3mandated health benefits under Minnesota
133.4Statutes, section 62J.26, subdivision 6.
133.5This is a onetime transfer. Notwithstanding
133.6section 7, this paragraph expires on June 30,
133.72015.
133.8The general fund base is decreased by
133.9$105,000 in fiscal year 2014 and $46,000 in
133.10fiscal year 2015.

133.11

Sec. 4. BOARD OF NURSING

$

-0-

$

149,000

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

133.19

Sec. 5. COMMISSIONER OF COMMERCE

133.20

Subdivision 1.Total Appropriation

$

-0-

$

1,727,000

133.21	Appropriations by Fund
133.22		2012	2013
133.23	General	-0-	60,000
133.24 133.25	State Government Special Revenue	-0-	1,449,000
133.26	Special Revenue	-0-	218,000

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

134.24 134.25

Sec. 6. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

-0-

$

10,000

134.26This appropriation is to provide a grant to
134.27the Minnesota Ambulance Association to
134.28coordinate and prepare an assessment of
134.29the extent and costs of uncompensated care
134.30as a direct result of emergency responses
134.31on interstate highways in Minnesota.
134.32The study will collect appropriate
134.33information from medical response units
134.34and ambulance services regulated under
134.35Minnesota Statutes, chapter 144E, and to
135.1the extent possible, firefighting agencies.
135.2In preparing the assessment, the Minnesota
135.3Ambulance Association shall consult with
135.4its membership, the Minnesota Fire Chiefs
135.5Association, the Office of the State Fire
135.6Marshal, and the Emergency Medical
135.7Services Regulatory Board. The findings
135.8of the assessment will be reported to the
135.9chairs and ranking minority members of the
135.10legislative committees with jurisdiction over
135.11health and public safety by January 1, 2013.

135.12    Sec. 7. EXPIRATION OF UNCODIFIED LANGUAGE.
135.13All uncodified language contained in this article expires on June 30, 2013, unless a
135.14different expiration date is explicit.

135.15    Sec. 8. EFFECTIVE DATE.
135.16The provisions in this article are effective July 1, 2012, unless a different effective
135.17date is explicit.

135.18ARTICLE 7

135.19CONTINGENT APPROPRIATIONS

135.20

Section 1. APPROPRIATIONS.

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

135.31				APPROPRIATIONS
135.32				Available for the Year
136.1				Ending June 30
136.2					2012		2013

136.3 136.4

Sec. 2. COMMISSIONER OF HUMAN SERVICES

$

721,000

$

21,153,000

136.5

(a) Operations

118,000

11,000

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

136.14

(b) Health Care

24,000

(110,000)

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

136.18

(c) Continuing Care

19,000

-0-

136.19This is a onetime appropriation.

136.20

(d) Chemical and Mental Health

19,000

68,000

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

136.24

(e) Medical Assistance Grants

541,000

19,935,000

136.25

(f) Aging and Adult Services Grants

-0-

999,000

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

136.32

(g) Disabilities Grants

-0-

250,000

137.1This is a onetime appropriation.

137.2    Sec. 3. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is
137.3amended to read:
137.4    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
137.5initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
137.62960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
137.79555.6265, under this chapter for a physical location that will not be the primary residence
137.8of the license holder for the entire period of licensure. If a license is issued during this
137.9moratorium, and the license holder changes the license holder's primary residence away
137.10from the physical location of the foster care license, the commissioner shall revoke the
137.11license according to section 245A.07. Exceptions to the moratorium include:
137.12(1) foster care settings that are required to be registered under chapter 144D;
137.13(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
137.14and determined to be needed by the commissioner under paragraph (b);
137.15(3) new foster care licenses determined to be needed by the commissioner under
137.16paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
137.17restructuring of state-operated services that limits the capacity of state-operated facilities;
137.18(4) new foster care licenses determined to be needed by the commissioner under
137.19paragraph (b) for persons requiring hospital level care; or
137.20(5) new foster care licenses determined to be needed by the commissioner for the
137.21transition of people from personal care assistance to the home and community-based
137.22services.
137.23(b) The commissioner shall determine the need for newly licensed foster care homes
137.24as defined under this subdivision. As part of the determination, the commissioner shall
137.25consider the availability of foster care capacity in the area in which the licensee seeks to
137.26operate, and the recommendation of the local county board. The determination by the
137.27commissioner must be final. A determination of need is not required for a change in
137.28ownership at the same address.
137.29    (c) Residential settings that would otherwise be subject to the moratorium established
137.30in paragraph (a), that are in the process of receiving an adult or child foster care license as
137.31of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
137.32or child foster care license. For this paragraph, all of the following conditions must be met
137.33to be considered in the process of receiving an adult or child foster care license:
137.34    (1) participants have made decisions to move into the residential setting, including
137.35documentation in each participant's care plan;
138.1    (2) the provider has purchased housing or has made a financial investment in the
138.2property;
138.3    (3) the lead agency has approved the plans, including costs for the residential setting
138.4for each individual;
138.5    (4) the completion of the licensing process, including all necessary inspections, is
138.6the only remaining component prior to being able to provide services; and
138.7    (5) the needs of the individuals cannot be met within the existing capacity in that
138.8county.
138.9To qualify for the process under this paragraph, the lead agency must submit
138.10documentation to the commissioner by August 1, 2009, that all of the above criteria are
138.11met.
138.12(d) The commissioner shall study the effects of the license moratorium under this
138.13subdivision and shall report back to the legislature by January 15, 2011. This study shall
138.14include, but is not limited to the following:
138.15(1) the overall capacity and utilization of foster care beds where the physical location
138.16is not the primary residence of the license holder prior to and after implementation
138.17of the moratorium;
138.18(2) the overall capacity and utilization of foster care beds where the physical
138.19location is the primary residence of the license holder prior to and after implementation
138.20of the moratorium; and
138.21(3) the number of licensed and occupied ICF/MR beds prior to and after
138.22implementation of the moratorium.
138.23(e) When a foster care recipient moves out of a foster home that is not the primary
138.24residence of the license holder according to section 256B.49, subdivision 15, paragraph
138.25(f), the county shall immediately inform the Department of Human Services Licensing
138.26Division, and the department shall immediately decrease the statewide licensed capacity
138.27for the home foster care settings where the physical location is not the primary residence
138.28of the license holder. A decreased licensed capacity according to this paragraph is not
138.29subject to appeal under this chapter. A needs determination process, managed at the state
138.30level, with county input, will determine where the reduced capacity will occur.

138.31    Sec. 4. Minnesota Statutes 2011 Supplement, section 256B.0659, subdivision 11,
138.32is amended to read:
138.33    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
138.34must meet the following requirements:
139.1    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years
139.2of age with these additional requirements:
139.3    (i) supervision by a qualified professional every 60 days; and
139.4    (ii) employment by only one personal care assistance provider agency responsible
139.5for compliance with current labor laws;
139.6    (2) be employed by a personal care assistance provider agency;
139.7    (3) enroll with the department as a personal care assistant after clearing a background
139.8study. Except as provided in subdivision 11a, before a personal care assistant provides
139.9services, the personal care assistance provider agency must initiate a background study on
139.10the personal care assistant under chapter 245C, and the personal care assistance provider
139.11agency must have received a notice from the commissioner that the personal care assistant
139.12is:
139.13    (i) not disqualified under section 245C.14; or
139.14    (ii) is disqualified, but the personal care assistant has received a set aside of the
139.15disqualification under section 245C.22;
139.16    (4) be able to effectively communicate with the recipient and personal care
139.17assistance provider agency;
139.18    (5) be able to provide covered personal care assistance services according to the
139.19recipient's personal care assistance care plan, respond appropriately to recipient needs,
139.20and report changes in the recipient's condition to the supervising qualified professional
139.21or physician;
139.22    (6) not be a consumer of personal care assistance services;
139.23    (7) maintain daily written records including, but not limited to, time sheets under
139.24subdivision 12;
139.25    (8) effective January 1, 2010, complete standardized training as determined
139.26by the commissioner before completing enrollment. The training must be available
139.27in languages other than English and to those who need accommodations due to
139.28disabilities. Personal care assistant training must include successful completion of the
139.29following training components: basic first aid, vulnerable adult, child maltreatment,
139.30OSHA universal precautions, basic roles and responsibilities of personal care assistants
139.31including information about assistance with lifting and transfers for recipients, emergency
139.32preparedness, orientation to positive behavioral practices, fraud issues, and completion of
139.33time sheets. Upon completion of the training components, the personal care assistant must
139.34demonstrate the competency to provide assistance to recipients;
139.35    (9) complete training and orientation on the needs of the recipient within the first
139.36seven days after the services begin; and
140.1    (10) be limited to providing and being paid for up to 275 hours per month, except
140.2that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
140.32011, of personal care assistance services regardless of the number of recipients being
140.4served or the number of personal care assistance provider agencies enrolled with. The
140.5number of hours worked per day shall not be disallowed by the department unless in
140.6violation of the law.
140.7    (b) A legal guardian may be a personal care assistant if the guardian is not being paid
140.8for the guardian services and meets the criteria for personal care assistants in paragraph (a).
140.9    (c) Persons who do not qualify as a personal care assistant include parents and
140.10stepparents of minors, spouses, paid legal guardians, family foster care providers, except
140.11as otherwise allowed in section 256B.0625, subdivision 19a, or staff of a residential
140.12setting. When the personal care assistant is a relative of the recipient, the commissioner
140.13shall pay 80 percent of the provider rate. This rate reduction is effective July 1, 2013. For
140.14purposes of this section, relative means the parent or adoptive parent of an adult child, a
140.15sibling aged 16 years or older, an adult child, a grandparent, or a grandchild.

140.16    Sec. 5. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15, is
140.17amended to read:
140.18    Subd. 15. Individualized service plan; comprehensive transitional service plan;
140.19maintenance service plan. (a) Each recipient of home and community-based waivered
140.20services shall be provided a copy of the written service plan which:
140.21(1) is developed and signed by the recipient within ten working days of the
140.22completion of the assessment;
140.23(2) meets the assessed needs of the recipient;
140.24(3) reasonably ensures the health and safety of the recipient;
140.25(4) promotes independence;
140.26(5) allows for services to be provided in the most integrated settings; and
140.27(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
140.28paragraph (p), of service and support providers.
140.29(b) In developing the comprehensive transitional service plan, the individual
140.30receiving services, the case manager, and the guardian, if applicable, will identify
140.31the transitional service plan fundamental service outcome and anticipated timeline to
140.32achieve this outcome. Within the first 20 days following a recipient's request for an
140.33assessment or reassessment, the transitional service planning team must be identified. A
140.34team leader must be identified who will be responsible for assigning responsibility and
140.35communicating with team members to ensure implementation of the transition plan and
141.1ongoing assessment and communication process. The team leader should be an individual,
141.2such as the case manager or guardian, who has the opportunity to follow the recipient to
141.3the next level of service.
141.4Within ten days following an assessment, a comprehensive transitional service plan
141.5must be developed incorporating elements of a comprehensive functional assessment and
141.6including short-term measurable outcomes and timelines for achievement of and reporting
141.7on these outcomes. Functional milestones must also be identified and reported according
141.8to the timelines agreed upon by the transitional service planning team. In addition, the
141.9comprehensive transitional service plan must identify additional supports that may assist
141.10in the achievement of the fundamental service outcome such as the development of greater
141.11natural community support, increased collaboration among agencies, and technological
141.12supports.
141.13The timelines for reporting on functional milestones will prompt a reassessment of
141.14services provided, the units of services, rates, and appropriate service providers. It is
141.15the responsibility of the transitional service planning team leader to review functional
141.16milestone reporting to determine if the milestones are consistent with observable skills
141.17and that milestone achievement prompts any needed changes to the comprehensive
141.18transitional service plan.
141.19For those whose fundamental transitional service outcome involves the need to
141.20procure housing, a plan for the recipient to seek the resources necessary to secure the least
141.21restrictive housing possible should be incorporated into the plan, including employment
141.22and public supports such as housing access and shelter needy funding.
141.23(c) Counties and other agencies responsible for funding community placement and
141.24ongoing community supportive services are responsible for the implementation of the
141.25comprehensive transitional service plans. Oversight responsibilities include both ensuring
141.26effective transitional service delivery and efficient utilization of funding resources.
141.27(d) Following one year of transitional services, the transitional services planning
141.28team will make a determination as to whether or not the individual receiving services
141.29requires the current level of continuous and consistent support in order to maintain the
141.30recipient's current level of functioning. Recipients who are determined to have not had
141.31a significant change in functioning for 12 months must move from a transitional to a
141.32maintenance service plan. Recipients on a maintenance service plan must be reassessed
141.33to determine if the recipient would benefit from a transitional service plan at least every
141.3412 months and at other times when there has been a significant change in the recipient's
141.35functioning. This assessment should consider any changes to technological or natural
141.36community supports.
142.1(e) When a county is evaluating denials, reductions, or terminations of home and
142.2community-based services under section 256B.49 for an individual, the case manager
142.3shall offer to meet with the individual or the individual's guardian in order to discuss the
142.4prioritization of service needs within the individualized service plan, comprehensive
142.5transitional service plan, or maintenance service plan. The reduction in the authorized
142.6services for an individual due to changes in funding for waivered services may not exceed
142.7the amount needed to ensure medically necessary services to meet the individual's health,
142.8safety, and welfare.
142.9(f) At the time of reassessment, local agency case managers shall assess each
142.10recipient of community alternatives for disabled individuals or traumatic brain injury
142.11waivered services currently residing in a licensed adult foster home that is not the primary
142.12residence of the license holder, or in which the license holder is not the primary caregiver,
142.13to determine if that recipient could appropriately be served in a community-living setting.
142.14If appropriate for the recipient, the case manager shall offer the recipient, through a
142.15person-centered planning process, the option to receive alternative housing and service
142.16options. In the event that the recipient chooses to transfer from the adult foster home,
142.17the vacated bed shall not be filled with another recipient of waiver services and group
142.18residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a),
142.19clauses (3) and (4), and the statewide licensed capacity shall be reduced accordingly. If
142.20the adult foster home becomes no longer viable due to these transfers, the county agency,
142.21with the assistance of the department, shall facilitate a consolidation of settings or closure.
142.22This reassessment process shall be completed by June 30, 2012 2013. The results of the
142.23assessments shall be used in the statewide needs determination process. Implementation
142.24of the statewide licensed capacity reduction shall begin on July 1, 2013.

142.25    Sec. 6. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 1, is
142.26amended to read:
142.27    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
142.28or after October 1, 1992, the commissioner shall make payments for physician services
142.29as follows:
142.30    (1) payment for level one Centers for Medicare and Medicaid Services' common
142.31procedural coding system codes titled "office and other outpatient services," "preventive
142.32medicine new and established patient," "delivery, antepartum, and postpartum care,"
142.33"critical care," cesarean delivery and pharmacologic management provided to psychiatric
142.34patients, and level three codes for enhanced services for prenatal high risk, shall be paid
142.35at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
143.130, 1992. If the rate on any procedure code within these categories is different than the
143.2rate that would have been paid under the methodology in section 256B.74, subdivision 2,
143.3then the larger rate shall be paid;
143.4    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
143.5or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
143.6    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
143.7percentile of 1989, less the percent in aggregate necessary to equal the above increases
143.8except that payment rates for home health agency services shall be the rates in effect
143.9on September 30, 1992.
143.10    (b) Effective for services rendered on or after January 1, 2000, payment rates for
143.11physician and professional services shall be increased by three percent over the rates
143.12in effect on December 31, 1999, except for home health agency and family planning
143.13agency services. The increases in this paragraph shall be implemented January 1, 2000,
143.14for managed care.
143.15(c) Effective for services rendered on or after July 1, 2009, payment rates for
143.16physician and professional services shall be reduced by five percent, except that for the
143.17period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
143.18for the medical assistance and general assistance medical care programs, over the rates in
143.19effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
143.20to office or other outpatient visits, preventive medicine visits and family planning visits
143.21billed by physicians, advanced practice nurses, or physician assistants in a family planning
143.22agency or in one of the following primary care practices: general practice, general internal
143.23medicine, general pediatrics, general geriatrics, and family medicine. This reduction
143.24and the reductions in paragraph (d) do not apply to federally qualified health centers,
143.25rural health centers, and Indian health services. Effective October 1, 2009, payments
143.26made to managed care plans and county-based purchasing plans under sections 256B.69,
143.27256B.692 , and 256L.12 shall reflect the payment reduction described in this paragraph.
143.28(d) Effective for services rendered on or after July 1, 2010, payment rates for
143.29physician and professional services shall be reduced an additional seven percent over
143.30the five percent reduction in rates described in paragraph (c). This additional reduction
143.31does not apply to physical therapy services, occupational therapy services, and speech
143.32pathology and related services provided on or after July 1, 2010. This additional reduction
143.33does not apply to physician services billed by a psychiatrist or an advanced practice nurse
143.34with a specialty in mental health. Effective October 1, 2010, payments made to managed
143.35care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
143.36256L.12 shall reflect the payment reduction described in this paragraph.
144.1(e) Effective for services rendered on or after September 1, 2011, through June
144.230, 2013 2012, payment rates for physician and professional services shall be reduced
144.3three percent from the rates in effect on August 31, 2011. This reduction does not apply
144.4to physical therapy services, occupational therapy services, and speech pathology and
144.5related services.

144.6    Sec. 7. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 2, is
144.7amended to read:
144.8    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
144.9October 1, 1992, the commissioner shall make payments for dental services as follows:
144.10    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
144.11percent above the rate in effect on June 30, 1992; and
144.12    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
144.13percentile of 1989, less the percent in aggregate necessary to equal the above increases.
144.14    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
144.15shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
144.16    (c) Effective for services rendered on or after January 1, 2000, payment rates for
144.17dental services shall be increased by three percent over the rates in effect on December
144.1831, 1999.
144.19    (d) Effective for services provided on or after January 1, 2002, payment for
144.20diagnostic examinations and dental x-rays provided to children under age 21 shall be the
144.21lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
144.22    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
144.232000, for managed care.
144.24(f) Effective for dental services rendered on or after October 1, 2010, by a
144.25state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
144.26on the Medicare principles of reimbursement. This payment shall be effective for services
144.27rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
144.28county-based purchasing plans.
144.29(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
144.30in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
144.31year, a supplemental state payment equal to the difference between the total payments
144.32in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
144.33services for the operation of the dental clinics.
144.34(h) If the cost-based payment system for state-operated dental clinics described in
144.35paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
145.1designated as critical access dental providers under subdivision 4, paragraph (b), and shall
145.2receive the critical access dental reimbursement rate as described under subdivision 4,
145.3paragraph (a).
145.4(i) Effective for services rendered on or after September 1, 2011, through June 30,
145.52013 2012, payment rates for dental services shall be reduced by three percent. This
145.6reduction does not apply to state-operated dental clinics in paragraph (f).

145.7    Sec. 8. Minnesota Statutes 2011 Supplement, section 256B.766, is amended to read:
145.8256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
145.9(a) Effective for services provided on or after July 1, 2009, total payments for basic
145.10care services, shall be reduced by three percent, except that for the period July 1, 2009,
145.11through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
145.12assistance and general assistance medical care programs, prior to third-party liability and
145.13spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
145.14therapy services, occupational therapy services, and speech-language pathology and
145.15related services as basic care services. The reduction in this paragraph shall apply to
145.16physical therapy services, occupational therapy services, and speech-language pathology
145.17and related services provided on or after July 1, 2010.
145.18(b) Payments made to managed care plans and county-based purchasing plans shall
145.19be reduced for services provided on or after October 1, 2009, to reflect the reduction
145.20effective July 1, 2009, and payments made to the plans shall be reduced effective October
145.211, 2010, to reflect the reduction effective July 1, 2010.
145.22(c) Effective for services provided on or after September 1, 2011, through June 30,
145.232013 2012, total payments for outpatient hospital facility fees shall be reduced by five
145.24percent from the rates in effect on August 31, 2011.
145.25(d) Effective for services provided on or after September 1, 2011, through June 30,
145.262013 2012, total payments for ambulatory surgery centers facility fees, medical supplies
145.27and durable medical equipment not subject to a volume purchase contract, prosthetics
145.28and orthotics, renal dialysis services, laboratory services, public health nursing services,
145.29physical therapy services, occupational therapy services, speech therapy services,
145.30eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
145.31purchase contract, anesthesia services, and hospice services shall be reduced by three
145.32percent from the rates in effect on August 31, 2011.
145.33(e) This section does not apply to physician and professional services, inpatient
145.34hospital services, family planning services, mental health services, dental services,
146.1prescription drugs, medical transportation, federally qualified health centers, rural health
146.2centers, Indian health services, and Medicare cost-sharing.

146.3    Sec. 9. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 3,
146.4is amended to read:

146.5

Subd. 3.Forecasted Programs

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

146.8

(a) MFIP/DWP Grants

146.9	Appropriations by Fund
146.10	General	84,680,000	91,978,000
146.11	Federal TANF	84,425,000	75,417,000

146.12

(b) MFIP Child Care Assistance Grants

55,456,000

30,923,000

146.13

(c) General Assistance Grants

49,192,000

46,938,000

146.14General Assistance Standard. The
146.15commissioner shall set the monthly standard
146.16of assistance for general assistance units
146.17consisting of an adult recipient who is
146.18childless and unmarried or living apart
146.19from parents or a legal guardian at $203.
146.20The commissioner may reduce this amount
146.21according to Laws 1997, chapter 85, article
146.223, section 54.
146.23Emergency General Assistance. The
146.24amount appropriated for emergency general
146.25assistance funds is limited to no more
146.26than $6,689,812 in fiscal year 2012 and
146.27$6,729,812 in fiscal year 2013. Funds
146.28to counties shall be allocated by the
146.29commissioner using the allocation method
146.30specified in Minnesota Statutes, section
146.31256D.06 .

146.32

(d) Minnesota Supplemental Aid Grants

38,095,000

39,120,000

146.33

(e) Group Residential Housing Grants

121,080,000

129,238,000

147.1

(f) MinnesotaCare Grants

295,046,000

317,272,000

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

147.4

(g) Medical Assistance Grants

4,501,582,000

4,437,282,000

147.5Managed Care Incentive Payments. The
147.6commissioner shall not make managed care
147.7incentive payments for expanding preventive
147.8services during fiscal years beginning July 1,
147.92011, and July 1, 2012.
147.10Reduction of Rates for Congregate
147.11Living for Individuals with Lower Needs.
147.12Beginning October 1, 2011, lead agencies
147.13must reduce rates in effect on January 1,
147.142011, by ten up to five percent for individuals
147.15with lower needs living in foster care settings
147.16where the license holder does not share
147.17the residence with recipients on the CADI
147.18and DD waivers and customized living
147.19settings for CADI. Lead agencies must adjust
147.20contracts within 60 days of the effective date.
147.21Reduction of Lead Agency Waiver
147.22Allocations to Implement Rate Reductions
147.23for Congregate Living for Individuals
147.24with Lower Needs. Beginning October 1,
147.252011, the commissioner shall reduce lead
147.26agency waiver allocations to implement the
147.27reduction of rates for individuals with lower
147.28needs living in foster care settings where the
147.29license holder does not share the residence
147.30with recipients on the CADI and DD waivers
147.31and customized living settings for CADI.
147.32Reduce customized living and 24-hour
147.33customized living component rates.
147.34Effective July 1, 2011, the commissioner
148.1shall reduce elderly waiver customized living
148.2and 24-hour customized living component
148.3service spending by five percent through
148.4reductions in component rates and service
148.5rate limits. The commissioner shall adjust
148.6the elderly waiver capitation payment
148.7rates for managed care organizations paid
148.8under Minnesota Statutes, section 256B.69,
148.9subdivisions 6a and 23, to reflect reductions
148.10in component spending for customized living
148.11services and 24-hour customized living
148.12services under Minnesota Statutes, section
148.13256B.0915, subdivisions 3e and 3h, for the
148.14contract period beginning January 1, 2012.
148.15To implement the reduction specified in
148.16this provision, capitation rates paid by the
148.17commissioner to managed care organizations
148.18under Minnesota Statutes, section 256B.69,
148.19shall reflect a ten percent reduction for the
148.20specified services for the period January 1,
148.212012, to June 30, 2012, and a five percent
148.22reduction for those services on or after July
148.231, 2012.
148.24Limit Growth in the Developmental
148.25Disability Waiver. The commissioner
148.26shall limit growth in the developmental
148.27disability waiver to six diversion allocations
148.28per month beginning July 1, 2011, through
148.29June 30, 2013, and 15 diversion allocations
148.30per month beginning July 1, 2013, through
148.31June 30, 2015. Waiver allocations shall
148.32be targeted to individuals who meet the
148.33priorities for accessing waiver services
148.34identified in Minnesota Statutes, 256B.092,
148.35subdivision 12 . The limits do not include
148.36conversions from intermediate care facilities
149.1for persons with developmental disabilities.
149.2Notwithstanding any contrary provisions in
149.3this article, this paragraph expires June 30,
149.42015.
149.5Limit Growth in the Community
149.6Alternatives for Disabled Individuals
149.7Waiver. The commissioner shall limit
149.8growth in the community alternatives for
149.9disabled individuals waiver to 60 allocations
149.10per month beginning July 1, 2011, through
149.11June 30, 2013, and 85 allocations per
149.12month beginning July 1, 2013, through
149.13June 30, 2015. Waiver allocations must
149.14be targeted to individuals who meet the
149.15priorities for accessing waiver services
149.16identified in Minnesota Statutes, section
149.17256B.49, subdivision 11a . The limits include
149.18conversions and diversions, unless the
149.19commissioner has approved a plan to convert
149.20funding due to the closure or downsizing
149.21of a residential facility or nursing facility
149.22to serve directly affected individuals on
149.23the community alternatives for disabled
149.24individuals waiver. Notwithstanding any
149.25contrary provisions in this article, this
149.26paragraph expires June 30, 2015.
149.27Personal Care Assistance Relative
149.28Care. The commissioner shall adjust the
149.29capitation payment rates for managed care
149.30organizations paid under Minnesota Statutes,
149.31section 256B.69, to reflect the rate reductions
149.32for personal care assistance provided by
149.33a relative pursuant to Minnesota Statutes,
149.34section 256B.0659, subdivision 11. This rate
149.35reduction is effective July 1, 2013.

150.1

(h) Alternative Care Grants

46,421,000

46,035,000

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

150.7

(i) Chemical Dependency Entitlement Grants

94,675,000

93,298,000

150.8    Sec. 10. EMERGENCY MEDICAL ASSISTANCE STUDY.
150.9(a) The commissioner of human services shall develop a plan to provide coordinated
150.10and cost-effective health care and coverage for individuals who meet eligibility standards
150.11for emergency medical assistance and who are ineligible for other state public programs.
150.12The commissioner shall consult with relevant stakeholders in the development of the plan.
150.13The commissioner shall consider the following elements:
150.14(1) strategies to provide individuals with the most appropriate care in the appropriate
150.15setting, utilizing higher quality and lower cost providers;
150.16(2) payment mechanisms to encourage providers to manage the care of these
150.17populations, and to produce lower cost of care and better patient outcomes;
150.18(3) ensure coverage and payment options that address the unique needs of those
150.19needing episodic care, chronic care, and long-term care services;
150.20(4) strategies for coordinating health care and nonhealth care services, and
150.21integrating with existing coverage; and
150.22(5) other issues and strategies to ensure cost-effective and coordinated delivery
150.23of coverage and services.
150.24(b) The commissioner shall submit the plan to the chairs and ranking minority
150.25members of the legislative committees with jurisdiction over health and human services
150.26policy and financing by January 15, 2013.

150.27    Sec. 11. EMERGENCY MEDICAL CONDITION CANCER TREATMENT
150.28COVERAGE EXCEPTION.
150.29(a) Notwithstanding Minnesota Statutes, section 256B.06, subdivision 4, paragraph
150.30(h), clause (2), surgery and the administration of chemotherapy, radiation, and related
150.31services necessary to treat cancer shall be covered as an emergency medical condition
150.32under Minnesota Statutes, section 256B.06, paragraph (f), if the recipient has a cancer
151.1diagnosis that is not in remission and requires surgery, chemotherapy, or radiation
151.2treatment.
151.3(b) Coverage under paragraph (a) is effective May 1, 2012, until June 30, 2013.

151.4    Sec. 12. INSTRUCTIONS TO THE COMMISSIONERS TO DEVELOP A PLAN
151.5FOR AN AUTISM RESIDENTIAL CAMPUS.
151.6(a) The commissioner of human services, in consultation with the commissioners
151.7of education and employment and economic development, shall develop a plan to create
151.8a residential campus providing 24-hour supervision for individuals with a diagnosis of
151.9autistic disorder as defined by diagnostic code 299.0 in the Diagnostic and Statistical
151.10Manual of Mental Disorders (DSM-IV). This plan must identify how the costs and
151.11programming will be shared between the agencies so that the social, educational, sensory,
151.12and vocational needs of the individuals served by the program will be met.
151.13(b) The plan must be developed no later than August 31, 2012.

151.14    Sec. 13. INSTRUCTIONS TO THE COMMISSIONER TO REQUEST A
151.15WAIVER AND CREATE AND FUND AN AUTISM RESIDENTIAL CAMPUS.
151.16(a) The commissioner of human services shall develop a proposal to the United
151.17States Department of Health and Human Services which shall include any necessary
151.18waivers, state plan amendments, and any other federal authority that may be necessary to
151.19create and fund the program in paragraph (b).
151.20(b) The commissioner shall request authority to create and fund a residential campus
151.21program to serve individuals to age 21 who are diagnosed with autistic disorder as defined
151.22by diagnostic code 299.0 in the Diagnostic and Statistical Manual of Mental Disorders
151.23(DSM-IV), and who are able to live in a supported housing environment that provides
151.2424-hour supervision. The program must:
151.25(1) provide continuous on-site supervision;
151.26(2) provide sensory or other therapeutic programming as appropriate for each
151.27resident; and
151.28(3) incorporate independent living skills, socialization skills, and vocational skills,
151.29as appropriate for each resident.
151.30(c) The commissioner shall submit the proposal no later than January 1, 2013.

151.31    Sec. 14. STUDY OF PERSONAL CARE ASSISTANCE AND OTHER
151.32UNLICENSED ATTENDANT SERVICES PROCEDURES.
152.1The commissioner of human services shall assign the department's office of
152.2inspector general to evaluate and make recommendations regarding state policies and
152.3statutory directives to control improper billing and fraud in personal care attendant and
152.4other unlicensed attendant services reimbursed through the department. The evaluation
152.5must review:
152.6(1) the care provided by personal care attendants, behavioral aides, and other
152.7unlicensed attendant care services reimbursed through the department;
152.8(2) investigations completed in recent years by the department's surveillance and
152.9integrity review division and the attorney general's office Medicaid fraud control unit to
152.10determine patterns of improper billing and fraud;
152.11(3) whether there are appropriate standards for an objective assessment or for
152.12determining a medical basis for client service eligibility; and
152.13(4) current policies and other requirements related to supervision and verification of
152.14services to clients.
152.15The study may involve unannounced site visits to enrolled providers and recipients
152.16of services in this study. The commissioner shall report to the chairs and ranking minority
152.17members of the legislative committees with jurisdiction over these issues with draft
152.18legislation to implement these recommendations by February 15, 2013.

152.19    Sec. 15. STUDY OF PERSONAL CARE ASSISTANCE SERVICE MODEL.
152.20The commissioner of human services shall study the current service model of
152.21personal care assistance services and any current gaps that exist in the program. The
152.22report shall include an analysis of the utilization of additional services by personal care
152.23assistance recipients, the effects of access to care coordination services, eligibility criteria,
152.24and the results of reductions in personal care assistance services. The results of this study
152.25will become part of medical assistance reform work under Minnesota Statutes, section
152.26256B.021. The commissioner shall report the findings of this study to the chairs and
152.27ranking minority members of the legislative committees with jurisdiction over these
152.28issues by February 15, 2013.

152.29    Sec. 16. EFFECTIVE DATE.
152.30This article is effective upon receipt by the commissioner of money from managed
152.31care organizations pursuant to contract agreements to return any surplus in excess of one
152.32percent. If the money is received after June 30, 2012, amounts appropriated in fiscal
152.33year 2012 are available in fiscal year 2013.