HF 2614

1st Committee Engrossment - 86th Legislature (2009 - 2010) Posted on 03/19/2013 07:29pm

1.1A bill for an act

1.2relating to human services; licensing; state health care programs; continuing
1.3care; children and family services; health reform; public health; assessing
1.4administrative penalties; requiring reports; making supplemental appropriations
1.5and reductions; amending Minnesota Statutes 2008, sections 3.971, subdivision
1.62; 3.98, by adding a subdivision; 62D.08, by adding a subdivision; 62J.07,
1.7subdivision 2, by adding a subdivision; 62J.38; 62Q.19, subdivision 1;
1.862Q.76, subdivision 1; 62U.05; 144.226, subdivision 3; 144.291, subdivision
1.92; 144.651, subdivision 2; 144.9504, by adding a subdivision; 144A.51,
1.10subdivision 5; 144E.37; 245C.27, subdivision 2; 245C.28, subdivision 3;
1.11254B.01, subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivision 4,
1.12by adding a subdivision; 254B.05, subdivision 4; 254B.06, subdivision 2;
1.13254B.09, subdivision 8; 256.01, by adding a subdivision; 256.9657, subdivision
1.143; 256B.04, subdivision 14; 256B.055, by adding a subdivision; 256B.056,
1.15subdivision 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b,
1.1618a, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644, as
1.17amended; 256B.0754, by adding a subdivision; 256B.0915, subdivision 3b;
1.18256B.19, subdivision 1c; 256B.69, subdivisions 20, as amended, 27, by adding
1.19subdivisions; 256B.692, subdivision 1; 256B.75; 256B.76, subdivisions 2, 4, by
1.20adding a subdivision; 256D.0515; 256J.20, subdivision 3; 256J.24, subdivision
1.2110; 256J.37, subdivision 3a; 256L.02, subdivision 3; 256L.03, subdivision
1.223, by adding a subdivision; 256L.05, by adding a subdivision; 256L.07, by
1.23adding a subdivision; 256L.12, subdivisions 5, 6, 9; 626.556, subdivision
1.2410i; 626.557, subdivision 9d; Minnesota Statutes 2009 Supplement, sections
1.2562J.495, subdivisions 1a, 3, by adding a subdivision; 245C.27, subdivision 1;
1.26252.025, subdivision 7; 252.27, subdivision 2a; 256.045, subdivision 3; 256.969,
1.27subdivision 3a; 256B.0625, subdivisions 9, 13e; 256B.0653, subdivision 5;
1.28256B.0915, subdivision 3a; 256B.69, subdivision 23; 256B.76, subdivision
1.291; 256B.766; 256D.03, subdivision 3, as amended; 256J.425, subdivision 3;
1.30256L.03, subdivision 5; 256L.11, subdivision 1; Laws 2009, chapter 79, article 3,
1.31section 18; article 5, section 78, subdivision 5; article 13, section 3, subdivisions
1.321, as amended, 3, as amended, 4, as amended, 8, as amended; Laws 2010, chapter
1.33200, article 1, sections 12, subdivisions 6, 7, 8; 16; 21; article 2, section 2,
1.34subdivisions 1, 8; proposing coding for new law in Minnesota Statutes, chapters
1.3562A; 62D; 62E; 62J; 62Q; 144; 245; 254B; 256; 256B; repealing Minnesota
1.36Statutes 2008, sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5,
1.377; 256D.03, subdivisions 3a, 3b, 5, 6, 7, 8; Minnesota Statutes 2009 Supplement,
1.38section 256D.03, subdivision 3; Laws 2009, chapter 79, article 7, section 26,
2.1subdivision 3; Laws 2010, chapter 200, article 1, sections 12, subdivisions 1,
2.22, 3, 4, 5, 6, 7, 8, 9; 18; 19.
2.3BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.4ARTICLE 1

2.5DHS LICENSING

2.6    Section 1. Minnesota Statutes 2009 Supplement, section 245C.27, subdivision 1, is
2.7amended to read:
2.8    Subdivision 1. Fair hearing when disqualification is not set aside rescinded. (a)
2.9If the commissioner does not set aside rescind a disqualification of an individual under
2.10section 245C.22 who is disqualified on the basis of a preponderance of evidence that the
2.11individual committed an act or acts that meet the definition of any of the crimes listed in
2.12section 245C.15; for a determination under section 626.556 or 626.557 of substantiated
2.13maltreatment that was serious or recurring under section 245C.15; or for failure to make
2.14required reports under section 626.556, subdivision 3; or 626.557, subdivision 3, pursuant
2.15to section 245C.15, subdivision 4, paragraph (b), clause (1), the individual may request
2.16a fair hearing under section 256.045, unless the disqualification is deemed conclusive
2.17under section 245C.29.
2.18    (b) The fair hearing is the only administrative appeal of the final agency
2.19determination for purposes of appeal by the disqualified individual. The disqualified
2.20individual does not have the right to challenge the accuracy and completeness of data
2.21under section 13.04.
2.22    (c) Except as provided under paragraph (e), if the individual was disqualified based
2.23on a conviction of, admission to, or Alford Plea to any crimes listed in section 245C.15,
2.24subdivisions 1 to 4 , or for a disqualification under section 256.98, subdivision 8, the
2.25reconsideration decision under section 245C.22 is the final agency determination for
2.26purposes of appeal by the disqualified individual and is not subject to a hearing under
2.27section 256.045. If the individual was disqualified based on a judicial determination, that
2.28determination is treated the same as a conviction for purposes of appeal.
2.29    (d) This subdivision does not apply to a public employee's appeal of a disqualification
2.30under section 245C.28, subdivision 3.
2.31    (e) Notwithstanding paragraph (c), if the commissioner does not set aside a
2.32disqualification of an individual who was disqualified based on both a preponderance
2.33of evidence and a conviction or admission, the individual may request a fair hearing
2.34under section 256.045, unless the disqualifications are deemed conclusive under section
2.35245C.29 . The scope of the hearing conducted under section 256.045 with regard to the
3.1disqualification based on a conviction or admission shall be limited solely to whether the
3.2individual poses a risk of harm, according to section 256.045, subdivision 3b. In this case,
3.3the reconsideration decision under section 245C.22 is not the final agency decision for
3.4purposes of appeal by the disqualified individual.

3.5    Sec. 2. Minnesota Statutes 2008, section 245C.27, subdivision 2, is amended to read:
3.6    Subd. 2. Consolidated fair hearing. (a) If an individual who is disqualified on the
3.7bases of serious or recurring maltreatment requests a fair hearing on the maltreatment
3.8determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, and
3.9requests a fair hearing under this section on the disqualification, which has not been
3.10set aside rescinded, the scope of the fair hearing under section 256.045 shall include the
3.11maltreatment determination and the disqualification.
3.12(b) A fair hearing is the only administrative appeal of the final agency determination.
3.13The disqualified individual does not have the right to challenge the accuracy and
3.14completeness of data under section 13.04.
3.15(c) This subdivision does not apply to a public employee's appeal of a disqualification
3.16under section 245C.28, subdivision 3.

3.17    Sec. 3. Minnesota Statutes 2008, section 245C.28, subdivision 3, is amended to read:
3.18    Subd. 3. Employees of public employer. (a) If the commissioner does not set
3.19aside rescind the disqualification of an individual who is an employee of an employer, as
3.20defined in section 179A.03, subdivision 15, the individual may request a contested case
3.21hearing under chapter 14, unless the disqualification is deemed conclusive under section
3.22245C.29. The request for a contested case hearing must be made in writing and must be
3.23postmarked and sent within 30 calendar days after the employee receives notice that the
3.24disqualification has not been set aside rescinded. If the individual was disqualified based
3.25on a conviction or admission to any crimes listed in section 245C.15, the scope of the
3.26contested case hearing shall be limited solely to whether the individual poses a risk of
3.27harm pursuant to section 245C.22.
3.28(b) If the commissioner does not set aside rescind a disqualification that is based on
3.29a maltreatment determination, the scope of the contested case hearing must include the
3.30maltreatment determination and the disqualification. In such cases, a fair hearing must
3.31not be conducted under section 256.045.
3.32(c) If the commissioner does not rescind a disqualification that is based on a
3.33preponderance of evidence that the individual committed an act or acts that meet the
3.34definition of any of the crimes listed in section 245C.15, the scope of the contested case
4.1hearing must include the disqualification decision. In such cases, a fair hearing must
4.2not be conducted under section 256.045.
4.3(c) (d) Rules adopted under this chapter may not preclude an employee in a contested
4.4case hearing for a disqualification from submitting evidence concerning information
4.5gathered under this chapter.
4.6(d) (e) When an individual has been disqualified from multiple licensed programs
4.7and the disqualifications have not been set aside rescinded under section 245C.22, if at
4.8least one of the disqualifications entitles the person to a contested case hearing under this
4.9subdivision, the scope of the contested case hearing shall include all disqualifications from
4.10licensed programs which were not set aside rescinded.
4.11(e) (f) In determining whether the disqualification should be set aside, the
4.12administrative law judge shall consider all of the characteristics that cause the individual
4.13to be disqualified in order to determine whether the individual poses a risk of harm. The
4.14administrative law judge's recommendation and the commissioner's order to set aside
4.15a disqualification that is the subject of the hearing constitutes a determination that the
4.16individual does not pose a risk of harm and that the individual may provide direct contact
4.17services in the individual program specified in the set aside.

4.18    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.045, subdivision 3, is
4.19amended to read:
4.20    Subd. 3. State agency hearings. (a) State agency hearings are available for the
4.21following:
4.22    (1) any person applying for, receiving or having received public assistance, medical
4.23care, or a program of social services granted by the state agency or a county agency or
4.24the federal Food Stamp Act whose application for assistance is denied, not acted upon
4.25with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
4.26claimed to have been incorrectly paid;
4.27    (2) any patient or relative aggrieved by an order of the commissioner under section
4.28252.27 ;
4.29    (3) a party aggrieved by a ruling of a prepaid health plan;
4.30    (4) except as provided under chapter 245C, any individual or facility determined by
4.31a lead agency to have maltreated a vulnerable adult under section 626.557 after they have
4.32exercised their right to administrative reconsideration under section 626.557;
4.33    (5) any person whose claim for foster care payment according to a placement of the
4.34child resulting from a child protection assessment under section 626.556 is denied or not
4.35acted upon with reasonable promptness, regardless of funding source;
5.1    (6) any person to whom a right of appeal according to this section is given by other
5.2provision of law;
5.3    (7) an applicant aggrieved by an adverse decision to an application for a hardship
5.4waiver under section 256B.15;
5.5    (8) an applicant aggrieved by an adverse decision to an application or redetermination
5.6for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
5.7    (9) except as provided under chapter 245A, an individual or facility determined
5.8to have maltreated a minor under section 626.556, after the individual or facility has
5.9exercised the right to administrative reconsideration under section 626.556;
5.10    (10) except as provided under chapter 245C, an individual disqualified under
5.11sections 245C.14 and 245C.15, which has not been set aside rescinded under sections
5.12245C.22 and 245C.23, on the basis of serious or recurring maltreatment; a preponderance
5.13of the evidence that the individual has committed an act or acts that meet the definition
5.14of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make
5.15reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings
5.16regarding a maltreatment determination under clause (4) or (9) and a disqualification under
5.17this clause in which the basis for a disqualification is serious or recurring maltreatment,
5.18which has not been set aside rescinded under sections 245C.22 and 245C.23, shall be
5.19consolidated into a single fair hearing. In such cases, the scope of review by the human
5.20services referee shall include both the maltreatment determination and the disqualification.
5.21The failure to exercise the right to an administrative reconsideration shall not be a bar to a
5.22hearing under this section if federal law provides an individual the right to a hearing to
5.23dispute a finding of maltreatment. Individuals and organizations specified in this section
5.24may contest the specified action, decision, or final disposition before the state agency by
5.25submitting a written request for a hearing to the state agency within 30 days after receiving
5.26written notice of the action, decision, or final disposition, or within 90 days of such written
5.27notice if the applicant, recipient, patient, or relative shows good cause why the request
5.28was not submitted within the 30-day time limit; or
5.29    (11) any person with an outstanding debt resulting from receipt of public assistance,
5.30medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
5.31Department of Human Services or a county agency. The scope of the appeal is the validity
5.32of the claimant agency's intention to request a setoff of a refund under chapter 270A
5.33against the debt.
5.34    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
5.35(10), is the only administrative appeal to the final agency determination specifically,
5.36including a challenge to the accuracy and completeness of data under section 13.04.
6.1Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
6.2that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
6.3homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
6.4contested case proceeding under the provisions of chapter 14. Hearings requested under
6.5paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
6.6July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
6.7only available when there is no juvenile court or adult criminal action pending. If such
6.8action is filed in either court while an administrative review is pending, the administrative
6.9review must be suspended until the judicial actions are completed. If the juvenile court
6.10action or criminal charge is dismissed or the criminal action overturned, the matter may be
6.11considered in an administrative hearing.
6.12    (c) For purposes of this section, bargaining unit grievance procedures are not an
6.13administrative appeal.
6.14    (d) The scope of hearings involving claims to foster care payments under paragraph
6.15(a), clause (5), shall be limited to the issue of whether the county is legally responsible
6.16for a child's placement under court order or voluntary placement agreement and, if so,
6.17the correct amount of foster care payment to be made on the child's behalf and shall not
6.18include review of the propriety of the county's child protection determination or child
6.19placement decision.
6.20    (e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a
6.21vendor under contract with a county agency to provide social services is not a party and
6.22may not request a hearing under this section, except if assisting a recipient as provided in
6.23subdivision 4.
6.24    (f) An applicant or recipient is not entitled to receive social services beyond the
6.25services prescribed under chapter 256M or other social services the person is eligible
6.26for under state law.
6.27    (g) The commissioner may summarily affirm the county or state agency's proposed
6.28action without a hearing when the sole issue is an automatic change due to a change in
6.29state or federal law.

6.30    Sec. 5. Minnesota Statutes 2008, section 626.556, subdivision 10i, is amended to read:
6.31    Subd. 10i. Administrative reconsideration; review panel. (a) Administrative
6.32reconsideration is not applicable in family assessments since no determination concerning
6.33maltreatment is made. For investigations, except as provided under paragraph (e), an
6.34individual or facility that the commissioner of human services, a local social service
6.35agency, or the commissioner of education determines has maltreated a child, an interested
7.1person acting on behalf of the child, regardless of the determination, who contests
7.2the investigating agency's final determination regarding maltreatment, may request the
7.3investigating agency to reconsider its final determination regarding maltreatment. The
7.4request for reconsideration must be submitted in writing to the investigating agency within
7.515 calendar days after receipt of notice of the final determination regarding maltreatment
7.6or, if the request is made by an interested person who is not entitled to notice, within
7.715 days after receipt of the notice by the parent or guardian of the child. If mailed, the
7.8request for reconsideration must be postmarked and sent to the investigating agency
7.9within 15 calendar days of the individual's or facility's receipt of the final determination. If
7.10the request for reconsideration is made by personal service, it must be received by the
7.11investigating agency within 15 calendar days after the individual's or facility's receipt of the
7.12final determination. Effective January 1, 2002, an individual who was determined to have
7.13maltreated a child under this section and who was disqualified on the basis of serious or
7.14recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration
7.15of the maltreatment determination and the disqualification. The request for reconsideration
7.16of the maltreatment determination and the disqualification must be submitted within 30
7.17calendar days of the individual's receipt of the notice of disqualification under sections
7.18245C.16 and 245C.17. If mailed, the request for reconsideration of the maltreatment
7.19determination and the disqualification must be postmarked and sent to the investigating
7.20agency within 30 calendar days of the individual's receipt of the maltreatment
7.21determination and notice of disqualification. If the request for reconsideration is made by
7.22personal service, it must be received by the investigating agency within 30 calendar days
7.23after the individual's receipt of the notice of disqualification.
7.24    (b) Except as provided under paragraphs (e) and (f), if the investigating agency
7.25denies the request or fails to act upon the request within 15 working days after receiving
7.26the request for reconsideration, the person or facility entitled to a fair hearing under section
7.27256.045 may submit to the commissioner of human services or the commissioner of
7.28education a written request for a hearing under that section. Section 256.045 also governs
7.29hearings requested to contest a final determination of the commissioner of education. For
7.30reports involving maltreatment of a child in a facility, an interested person acting on behalf
7.31of the child may request a review by the Child Maltreatment Review Panel under section
7.32256.022 if the investigating agency denies the request or fails to act upon the request or
7.33if the interested person contests a reconsidered determination. The investigating agency
7.34shall notify persons who request reconsideration of their rights under this paragraph.
7.35The request must be submitted in writing to the review panel and a copy sent to the
7.36investigating agency within 30 calendar days of receipt of notice of a denial of a request
8.1for reconsideration or of a reconsidered determination. The request must specifically
8.2identify the aspects of the agency determination with which the person is dissatisfied.
8.3    (c) If, as a result of a reconsideration or review, the investigating agency changes
8.4the final determination of maltreatment, that agency shall notify the parties specified in
8.5subdivisions 10b, 10d, and 10f.
8.6    (d) Except as provided under paragraph (f), if an individual or facility contests the
8.7investigating agency's final determination regarding maltreatment by requesting a fair
8.8hearing under section 256.045, the commissioner of human services shall assure that the
8.9hearing is conducted and a decision is reached within 90 days of receipt of the request for
8.10a hearing. The time for action on the decision may be extended for as many days as the
8.11hearing is postponed or the record is held open for the benefit of either party.
8.12    (e) Effective January 1, 2002, If an individual was disqualified under sections
8.13245C.14 and 245C.15, on the basis of a determination of maltreatment, which was
8.14serious or recurring, and the individual has requested reconsideration of the maltreatment
8.15determination under paragraph (a) and requested reconsideration of the disqualification
8.16under sections 245C.21 to 245C.27, reconsideration of the maltreatment determination and
8.17reconsideration of the disqualification shall be consolidated into a single reconsideration.
8.18If reconsideration of the maltreatment determination is denied or the disqualification is not
8.19set aside rescinded under sections 245C.21 to 245C.27, the individual may request a fair
8.20hearing under section 256.045. If an individual requests a fair hearing on the maltreatment
8.21determination and the disqualification, the scope of the fair hearing shall include both the
8.22maltreatment determination and the disqualification.
8.23    (f) Effective January 1, 2002, If a maltreatment determination or a disqualification
8.24based on serious or recurring maltreatment is the basis for a denial of a license under
8.25section 245A.05 or a licensing sanction under section 245A.07, the license holder has the
8.26right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505
8.27to 1400.8612. As provided for under section 245A.08, subdivision 2a, the scope of the
8.28contested case hearing shall include the maltreatment determination, disqualification,
8.29and licensing sanction or denial of a license. In such cases, a fair hearing regarding
8.30the maltreatment determination and disqualification shall not be conducted under
8.31section 256.045. Except for family child care and child foster care, reconsideration of a
8.32maltreatment determination as provided under this subdivision, and reconsideration of a
8.33disqualification as provided under section 245C.22, shall also not be conducted when:
8.34    (1) a denial of a license under section 245A.05 or a licensing sanction under section
8.35245A.07 , is based on a determination that the license holder is responsible for maltreatment
8.36or the disqualification of a license holder based on serious or recurring maltreatment;
9.1    (2) the denial of a license or licensing sanction is issued at the same time as the
9.2maltreatment determination or disqualification; and
9.3    (3) the license holder appeals the maltreatment determination or disqualification, and
9.4denial of a license or licensing sanction.
9.5    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
9.6determination or disqualification, but does not appeal the denial of a license or a licensing
9.7sanction, reconsideration of the maltreatment determination shall be conducted under
9.8sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
9.9disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
9.10shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
9.11626.557, subdivision 9d .
9.12    If the disqualified subject is an individual other than the license holder and upon
9.13whom a background study must be conducted under chapter 245C, the hearings of all
9.14parties may be consolidated into a single contested case hearing upon consent of all parties
9.15and the administrative law judge.
9.16    (g) For purposes of this subdivision, "interested person acting on behalf of the
9.17child" means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult
9.18stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been
9.19determined to be the perpetrator of the maltreatment.

9.20    Sec. 6. Minnesota Statutes 2008, section 626.557, subdivision 9d, is amended to read:
9.21    Subd. 9d. Administrative reconsideration; review panel. (a) Except as provided
9.22under paragraph (e), any individual or facility which a lead agency determines has
9.23maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on
9.24behalf of the vulnerable adult, regardless of the lead agency's determination, who contests
9.25the lead agency's final disposition of an allegation of maltreatment, may request the
9.26lead agency to reconsider its final disposition. The request for reconsideration must be
9.27submitted in writing to the lead agency within 15 calendar days after receipt of notice of
9.28final disposition or, if the request is made by an interested person who is not entitled to
9.29notice, within 15 days after receipt of the notice by the vulnerable adult or the vulnerable
9.30adult's legal guardian. If mailed, the request for reconsideration must be postmarked and
9.31sent to the lead agency within 15 calendar days of the individual's or facility's receipt of
9.32the final disposition. If the request for reconsideration is made by personal service, it must
9.33be received by the lead agency within 15 calendar days of the individual's or facility's
9.34receipt of the final disposition. An individual who was determined to have maltreated a
9.35vulnerable adult under this section and who was disqualified on the basis of serious or
10.1recurring maltreatment under sections 245C.14 and 245C.15, may request reconsideration
10.2of the maltreatment determination and the disqualification. The request for reconsideration
10.3of the maltreatment determination and the disqualification must be submitted in writing
10.4within 30 calendar days of the individual's receipt of the notice of disqualification
10.5under sections 245C.16 and 245C.17. If mailed, the request for reconsideration of
10.6the maltreatment determination and the disqualification must be postmarked and sent
10.7to the lead agency within 30 calendar days of the individual's receipt of the notice of
10.8disqualification. If the request for reconsideration is made by personal service, it must be
10.9received by the lead agency within 30 calendar days after the individual's receipt of the
10.10notice of disqualification.
10.11    (b) Except as provided under paragraphs (e) and (f), if the lead agency denies the
10.12request or fails to act upon the request within 15 working days after receiving the request
10.13for reconsideration, the person or facility entitled to a fair hearing under section 256.045,
10.14may submit to the commissioner of human services a written request for a hearing
10.15under that statute. The vulnerable adult, or an interested person acting on behalf of the
10.16vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review
10.17Panel under section 256.021 if the lead agency denies the request or fails to act upon the
10.18request, or if the vulnerable adult or interested person contests a reconsidered disposition.
10.19The lead agency shall notify persons who request reconsideration of their rights under this
10.20paragraph. The request must be submitted in writing to the review panel and a copy sent
10.21to the lead agency within 30 calendar days of receipt of notice of a denial of a request for
10.22reconsideration or of a reconsidered disposition. The request must specifically identify the
10.23aspects of the agency determination with which the person is dissatisfied.
10.24    (c) If, as a result of a reconsideration or review, the lead agency changes the final
10.25disposition, it shall notify the parties specified in subdivision 9c, paragraph (d).
10.26    (d) For purposes of this subdivision, "interested person acting on behalf of the
10.27vulnerable adult" means a person designated in writing by the vulnerable adult to act
10.28on behalf of the vulnerable adult, or a legal guardian or conservator or other legal
10.29representative, a proxy or health care agent appointed under chapter 145B or 145C,
10.30or an individual who is related to the vulnerable adult, as defined in section 245A.02,
10.31subdivision 13 .
10.32    (e) If an individual was disqualified under sections 245C.14 and 245C.15, on
10.33the basis of a determination of maltreatment, which was serious or recurring, and
10.34the individual has requested reconsideration of the maltreatment determination under
10.35paragraph (a) and reconsideration of the disqualification under sections 245C.21 to
10.36245C.27 , reconsideration of the maltreatment determination and requested reconsideration
11.1of the disqualification shall be consolidated into a single reconsideration. If reconsideration
11.2of the maltreatment determination is denied or if the disqualification is not set aside
11.3rescinded under sections 245C.21 to 245C.27, the individual may request a fair hearing
11.4under section 256.045. If an individual requests a fair hearing on the maltreatment
11.5determination and the disqualification, the scope of the fair hearing shall include both the
11.6maltreatment determination and the disqualification.
11.7    (f) If a maltreatment determination or a disqualification based on serious or recurring
11.8maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
11.9sanction under section 245A.07, the license holder has the right to a contested case hearing
11.10under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided
11.11for under section 245A.08, the scope of the contested case hearing must include the
11.12maltreatment determination, disqualification, and licensing sanction or denial of a license.
11.13In such cases, a fair hearing must not be conducted under section 256.045. Except for
11.14family child care and child foster care, reconsideration of a maltreatment determination
11.15under this subdivision, and reconsideration of a disqualification under section 245C.22,
11.16must not be conducted when:
11.17    (1) a denial of a license under section 245A.05, or a licensing sanction under section
11.18245A.07 , is based on a determination that the license holder is responsible for maltreatment
11.19or the disqualification of a license holder based on serious or recurring maltreatment;
11.20    (2) the denial of a license or licensing sanction is issued at the same time as the
11.21maltreatment determination or disqualification; and
11.22    (3) the license holder appeals the maltreatment determination or disqualification, and
11.23denial of a license or licensing sanction.
11.24    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
11.25determination or disqualification, but does not appeal the denial of a license or a licensing
11.26sanction, reconsideration of the maltreatment determination shall be conducted under
11.27sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
11.28disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
11.29shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
11.30626.557, subdivision 9d .
11.31    If the disqualified subject is an individual other than the license holder and upon
11.32whom a background study must be conducted under chapter 245C, the hearings of all
11.33parties may be consolidated into a single contested case hearing upon consent of all parties
11.34and the administrative law judge.
11.35    (g) Until August 1, 2002, an individual or facility that was determined by the
11.36commissioner of human services or the commissioner of health to be responsible for
12.1neglect under section 626.5572, subdivision 17, after October 1, 1995, and before August
12.21, 2001, that believes that the finding of neglect does not meet an amended definition of
12.3neglect may request a reconsideration of the determination of neglect. The commissioner
12.4of human services or the commissioner of health shall mail a notice to the last known
12.5address of individuals who are eligible to seek this reconsideration. The request for
12.6reconsideration must state how the established findings no longer meet the elements of
12.7the definition of neglect. The commissioner shall review the request for reconsideration
12.8and make a determination within 15 calendar days. The commissioner's decision on this
12.9reconsideration is the final agency action.
12.10    (1) For purposes of compliance with the data destruction schedule under subdivision
12.1112b, paragraph (d), when a finding of substantiated maltreatment has been changed as
12.12a result of a reconsideration under this paragraph, the date of the original finding of a
12.13substantiated maltreatment must be used to calculate the destruction date.
12.14    (2) For purposes of any background studies under chapter 245C, when a
12.15determination of substantiated maltreatment has been changed as a result of a
12.16reconsideration under this paragraph, any prior disqualification of the individual under
12.17chapter 245C that was based on this determination of maltreatment shall be rescinded,
12.18and for future background studies under chapter 245C the commissioner must not use the
12.19previous determination of substantiated maltreatment as a basis for disqualification or as a
12.20basis for referring the individual's maltreatment history to a health-related licensing board
12.21under section 245C.31.

12.22ARTICLE 2

12.23HEALTH CARE

12.24    Section 1. Minnesota Statutes 2008, section 144.291, subdivision 2, is amended to read:
12.25    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following
12.26terms have the meanings given.
12.27    (a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
12.28    (b) "Health information exchange" means a legal arrangement between health care
12.29providers and group purchasers to enable and oversee the business and legal issues
12.30involved in the electronic exchange of health records between the entities for the delivery
12.31of patient care.
12.32    (c) "Health record" means any information, whether oral or recorded in any form or
12.33medium, that relates to the past, present, or future physical or mental health or condition of
12.34a patient; the provision of health care to a patient; or the past, present, or future payment
12.35for the provision of health care to a patient.
13.1    (d) "Identifying information" means the patient's name, address, date of birth,
13.2gender, parent's or guardian's name regardless of the age of the patient, and other
13.3nonclinical data which can be used to uniquely identify a patient.
13.4    (e) "Individually identifiable form" means a form in which the patient is or can be
13.5identified as the subject of the health records.
13.6    (f) "Medical emergency" means medically necessary care which is immediately
13.7needed to preserve life, prevent serious impairment to bodily functions, organs, or parts,
13.8or prevent placing the physical or mental health of the patient in serious jeopardy.
13.9    (g) "Patient" means a natural person who has received health care services from a
13.10provider for treatment or examination of a medical, psychiatric, or mental condition, the
13.11surviving spouse and parents of a deceased patient, or a person the patient appoints in
13.12writing as a representative, including a health care agent acting according to chapter 145C,
13.13unless the authority of the agent has been limited by the principal in the principal's health
13.14care directive. Except for minors who have received health care services under sections
13.15144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a
13.16person acting as a parent or guardian in the absence of a parent or guardian.
13.17    (h) "Provider" means:
13.18    (1) any person who furnishes health care services and is regulated to furnish the
13.19services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
13.20151, 153, or 153A;
13.21    (2) a home care provider licensed under section 144A.46;
13.22    (3) a health care facility licensed under this chapter or chapter 144A;
13.23    (4) a physician assistant registered under chapter 147A; and
13.24    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to
13.25148B.71 .
13.26    (i) "Record locator service" means an electronic index of patient identifying
13.27information that directs providers in a health information exchange to the location of
13.28patient health records held by providers and group purchasers.
13.29    (j) "Related health care entity" means an affiliate, as defined in section 144.6521,
13.30subdivision 3 , paragraph (b), of the provider releasing the health records, including, but
13.31not limited to, affiliates of providers participating in a coordinated care delivery system
13.32established under section 256D.031, subdivision 6.

13.33    Sec. 2. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
13.34to read:
14.1    Subd. 30. Review and evaluation of studies. The commissioner shall review
14.2all published studies, reports, and program evaluations completed by the Department
14.3of Human Services, and those requested by the legislature but not completed, for state
14.4fiscal years 2000 through 2010. For each item, the commissioner shall report the
14.5legislature's original appropriation for that work, if any, and the actual reported cost of the
14.6completed work by the Department of Human Services. The commissioner shall make
14.7recommendations to the legislature about which studies, reports, and program evaluations
14.8required by law are duplicative, unnecessary, or obsolete. The commissioner shall repeat
14.9this review every five fiscal years.

14.10    Sec. 3. Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:
14.11    Subd. 3. Surcharge on HMOs and community integrated service networks. (a)
14.12Effective October 1, 1992, each health maintenance organization with a certificate of
14.13authority issued by the commissioner of health under chapter 62D and each community
14.14integrated service network licensed by the commissioner under chapter 62N shall pay to
14.15the commissioner of human services a surcharge equal to six-tenths of one percent of the
14.16total premium revenues of the health maintenance organization or community integrated
14.17service network as reported to the commissioner of health according to the schedule in
14.18subdivision 4.
14.19(b) Effective June 1, 2010: (1) the surcharge under paragraph (a) is increased to 3.0
14.20percent; and (2) each county-based purchasing plan authorized under section 256B.692
14.21shall pay to the commissioner a surcharge equal to 3.0 percent of the total premium
14.22revenues of the plan, as reported to the commissioner of health, according to the payment
14.23schedule in subdivision 4.
14.24(c) For purposes of this subdivision, total premium revenue means:
14.25(1) premium revenue recognized on a prepaid basis from individuals and groups
14.26for provision of a specified range of health services over a defined period of time which
14.27is normally one month, excluding premiums paid to a health maintenance organization
14.28or community integrated service network from the Federal Employees Health Benefit
14.29Program;
14.30(2) premiums from Medicare wrap-around subscribers for health benefits which
14.31supplement Medicare coverage;
14.32(3) Medicare revenue, as a result of an arrangement between a health maintenance
14.33organization or a community integrated service network and the Centers for Medicare
14.34and Medicaid Services of the federal Department of Health and Human Services, for
14.35services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
15.1from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
15.2Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
15.31395w-24, respectively, as they may be amended from time to time; and
15.4(4) medical assistance revenue, as a result of an arrangement between a health
15.5maintenance organization or community integrated service network and a Medicaid state
15.6agency, for services to a medical assistance beneficiary.
15.7If advance payments are made under clause (1) or (2) to the health maintenance
15.8organization or community integrated service network for more than one reporting period,
15.9the portion of the payment that has not yet been earned must be treated as a liability.
15.10(c) (d) When a health maintenance organization or community integrated service
15.11network merges or consolidates with or is acquired by another health maintenance
15.12organization or community integrated service network, the surviving corporation or the
15.13new corporation shall be responsible for the annual surcharge originally imposed on
15.14each of the entities or corporations subject to the merger, consolidation, or acquisition,
15.15regardless of whether one of the entities or corporations does not retain a certificate of
15.16authority under chapter 62D or a license under chapter 62N.
15.17(d) (e) Effective July 1 of each year, the surviving corporation's or the new
15.18corporation's surcharge shall be based on the revenues earned in the second previous
15.19calendar year by all of the entities or corporations subject to the merger, consolidation,
15.20or acquisition regardless of whether one of the entities or corporations does not retain a
15.21certificate of authority under chapter 62D or a license under chapter 62N until the total
15.22premium revenues of the surviving corporation include the total premium revenues of all
15.23the merged entities as reported to the commissioner of health.
15.24(e) (f) When a health maintenance organization or community integrated service
15.25network, which is subject to liability for the surcharge under this chapter, transfers,
15.26assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
15.27for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
15.28of the health maintenance organization or community integrated service network.
15.29(f) (g) In the event a health maintenance organization or community integrated
15.30service network converts its licensure to a different type of entity subject to liability
15.31for the surcharge under this chapter, but survives in the same or substantially similar
15.32form, the surviving entity remains liable for the surcharge regardless of whether one of
15.33the entities or corporations does not retain a certificate of authority under chapter 62D
15.34or a license under chapter 62N.
16.1(g) (h) The surcharge assessed to a health maintenance organization or community
16.2integrated service network ends when the entity ceases providing services for premiums
16.3and the cessation is not connected with a merger, consolidation, acquisition, or conversion.
16.4EFFECTIVE DATE.This section is effective June 1, 2010.

16.5    Sec. 4. Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is
16.6amended to read:
16.7    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
16.8assistance program must not be submitted until the recipient is discharged. However,
16.9the commissioner shall establish monthly interim payments for inpatient hospitals that
16.10have individual patient lengths of stay over 30 days regardless of diagnostic category.
16.11Except as provided in section 256.9693, medical assistance reimbursement for treatment
16.12of mental illness shall be reimbursed based on diagnostic classifications. Individual
16.13hospital payments established under this section and sections 256.9685, 256.9686, and
16.14256.9695 , in addition to third party and recipient liability, for discharges occurring during
16.15the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
16.16inpatient services paid for the same period of time to the hospital. This payment limitation
16.17shall be calculated separately for medical assistance and general assistance medical
16.18care services. The limitation on general assistance medical care shall be effective for
16.19admissions occurring on or after July 1, 1991. Services that have rates established under
16.20subdivision 11 or 12, must be limited separately from other services. After consulting with
16.21the affected hospitals, the commissioner may consider related hospitals one entity and
16.22may merge the payment rates while maintaining separate provider numbers. The operating
16.23and property base rates per admission or per day shall be derived from the best Medicare
16.24and claims data available when rates are established. The commissioner shall determine
16.25the best Medicare and claims data, taking into consideration variables of recency of the
16.26data, audit disposition, settlement status, and the ability to set rates in a timely manner.
16.27The commissioner shall notify hospitals of payment rates by December 1 of the year
16.28preceding the rate year. The rate setting data must reflect the admissions data used to
16.29establish relative values. Base year changes from 1981 to the base year established for the
16.30rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
16.31to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
16.321. The commissioner may adjust base year cost, relative value, and case mix index data
16.33to exclude the costs of services that have been discontinued by the October 1 of the year
16.34preceding the rate year or that are paid separately from inpatient services. Inpatient stays
16.35that encompass portions of two or more rate years shall have payments established based
17.1on payment rates in effect at the time of admission unless the date of admission preceded
17.2the rate year in effect by six months or more. In this case, operating payment rates for
17.3services rendered during the rate year in effect and established based on the date of
17.4admission shall be adjusted to the rate year in effect by the hospital cost index.
17.5    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
17.6payment, before third-party liability and spenddown, made to hospitals for inpatient
17.7services is reduced by .5 percent from the current statutory rates.
17.8    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
17.9admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
17.10before third-party liability and spenddown, is reduced five percent from the current
17.11statutory rates. Mental health services within diagnosis related groups 424 to 432, and
17.12facilities defined under subdivision 16 are excluded from this paragraph.
17.13    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
17.14fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
17.15inpatient services before third-party liability and spenddown, is reduced 6.0 percent
17.16from the current statutory rates. Mental health services within diagnosis related groups
17.17424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
17.18Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
17.19assistance does not include general assistance medical care. Payments made to managed
17.20care plans shall be reduced for services provided on or after January 1, 2006, to reflect
17.21this reduction.
17.22    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
17.23fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
17.24to hospitals for inpatient services before third-party liability and spenddown, is reduced
17.253.46 percent from the current statutory rates. Mental health services with diagnosis related
17.26groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
17.27paragraph. Payments made to managed care plans shall be reduced for services provided
17.28on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
17.29    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
17.30fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
17.31to hospitals for inpatient services before third-party liability and spenddown, is reduced
17.321.9 percent from the current statutory rates. Mental health services with diagnosis related
17.33groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
17.34paragraph. Payments made to managed care plans shall be reduced for services provided
17.35on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
18.1    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
18.2for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
18.3inpatient services before third-party liability and spenddown, is reduced 1.79 percent
18.4from the current statutory rates. Mental health services with diagnosis related groups
18.5424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
18.6Payments made to managed care plans shall be reduced for services provided on or after
18.7July 1, 2010, to reflect this reduction.
18.8(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
18.9payment for fee-for-service admissions occurring on or after July 1, 2009, made to
18.10hospitals for inpatient services before third-party liability and spenddown, is reduced
18.11one percent from the current statutory rates. Facilities defined under subdivision 16 are
18.12excluded from this paragraph. Payments made to managed care plans shall be reduced for
18.13services provided on or after October 1, 2009, to reflect this reduction.
18.14(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
18.15payment for fee-for-service admissions occurring on or after July 1, 2011, made to
18.16hospitals for inpatient services before third-party liability and spenddown, is reduced
18.17seven percent from the current statutory rates. Facilities defined under subdivision 16 are
18.18excluded from this paragraph. Payments made to managed care plans shall be reduced
18.19for services provided on or after January 1, 2012, to reflect this reduction. Hospitals that,
18.20prior to December 31, 2007, received payment to support the training of residents from an
18.21approved graduate medical residency training program pursuant to United States Code,
18.22title 42, section 256e, are not subject to the provisions of this paragraph.

18.23    Sec. 5. Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to read:
18.24    Subd. 14. Competitive bidding. (a) When determined to be effective, economical,
18.25and feasible, the commissioner may utilize volume purchase through competitive bidding
18.26and negotiation under the provisions of chapter 16C, to provide items under the medical
18.27assistance program including but not limited to the following:
18.28    (1) eyeglasses;
18.29    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency
18.30situation on a short-term basis, until the vendor can obtain the necessary supply from
18.31the contract dealer;
18.32    (3) hearing aids and supplies; and
18.33    (4) durable medical equipment, including but not limited to:
18.34    (i) hospital beds;
18.35    (ii) commodes;
19.1    (iii) glide-about chairs;
19.2    (iv) patient lift apparatus;
19.3    (v) wheelchairs and accessories;
19.4    (vi) oxygen administration equipment;
19.5    (vii) respiratory therapy equipment;
19.6    (viii) electronic diagnostic, therapeutic and life-support systems;
19.7    (5) nonemergency medical transportation level of need determinations, disbursement
19.8of public transportation passes and tokens, and volunteer and recipient mileage and
19.9parking reimbursements; and
19.10    (6) drugs; and
19.11(7) medical supplies.
19.12    (b) Rate changes under this chapter and chapters 256D and 256L do not affect
19.13contract payments under this subdivision unless specifically identified.
19.14    (c) The commissioner may not utilize volume purchase through competitive bidding
19.15and negotiation for special transportation services under the provisions of chapter 16C.

19.16    Sec. 6. Minnesota Statutes 2008, section 256B.055, is amended by adding a
19.17subdivision to read:
19.18    Subd. 15. Adults without children. Medical assistance may be paid for a person
19.19who is over age 21 and under age 65, who is not pregnant, and who is not described in
19.20subdivision 4, 7, or another subdivision of this section.
19.21EFFECTIVE DATE.This section is effective upon federal approval and is
19.22retroactive from April 1, 2010.

19.23    Sec. 7. Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:
19.24    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
19.25section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
19.26the federal poverty guidelines. Effective January 1, 2000, and each successive January,
19.27recipients of supplemental security income may have an income up to the supplemental
19.28security income standard in effect on that date.
19.29(b) To be eligible for medical assistance, families and children may have an income
19.30up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
19.31AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
19.321996, shall be increased by three percent.
19.33(c) Effective July 1, 2002, to be eligible for medical assistance, families and children
19.34may have an income up to 100 percent of the federal poverty guidelines for the family size.
20.1(d) In computing income to determine eligibility of persons under paragraphs (a)
20.2to (c) and (e) who are not residents of long-term care facilities, the commissioner shall
20.3disregard increases in income as required by Public Law Numbers 94-566, section 503;
20.499-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration
20.5unusual medical expense payments are considered income to the recipient.
20.6(e) To be eligible for medical assistance, a person eligible under section 256B.055,
20.7subdivision 15, may have income up to 75 percent of the federal poverty guidelines for
20.8family size.
20.9EFFECTIVE DATE.This section is effective upon federal approval and is
20.10retroactive from April 1, 2010.

20.11    Sec. 8. Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to read:
20.12    Subd. 8. Physical therapy. Medical assistance covers physical therapy and related
20.13services, including specialized maintenance therapy. Authorization by the commissioner
20.14is required to provide services to a recipient beyond any of the following onetime service
20.15thresholds: (1) 80 units of any approved CPT code other than modalities; (2) 20 modality
20.16sessions; and (3) three evaluations or reevaluations. Services provided by a physical
20.17therapy assistant shall be reimbursed at the same rate as services performed by a physical
20.18therapist when the services of the physical therapy assistant are provided under the
20.19direction of a physical therapist who is on the premises. Services provided by a physical
20.20therapy assistant that are provided under the direction of a physical therapist who is not on
20.21the premises shall be reimbursed at 65 percent of the physical therapist rate.

20.22    Sec. 9. Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to
20.23read:
20.24    Subd. 8a. Occupational therapy. Medical assistance covers occupational therapy
20.25and related services, including specialized maintenance therapy. Authorization by the
20.26commissioner is required to provide services to a recipient beyond any of the following
20.27onetime service thresholds: (1) 120 units of any combination of approved CPT codes;
20.28and (2) two evaluations or reevaluations. Services provided by an occupational therapy
20.29assistant shall be reimbursed at the same rate as services performed by an occupational
20.30therapist when the services of the occupational therapy assistant are provided under the
20.31direction of the occupational therapist who is on the premises. Services provided by an
20.32occupational therapy assistant that are provided under the direction of an occupational
20.33therapist who is not on the premises shall be reimbursed at 65 percent of the occupational
20.34therapist rate.

21.1    Sec. 10. Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to
21.2read:
21.3    Subd. 8b. Speech language pathology and audiology services. Medical assistance
21.4covers speech language pathology and related services, including specialized maintenance
21.5therapy. Authorization by the commissioner is required to provide services to a recipient
21.6beyond any of the following onetime service thresholds: (1) 50 treatment sessions with
21.7any combination of approved CPT codes; and (2) one evaluation. Medical assistance
21.8covers audiology services and related services. Services provided by a person who has
21.9been issued a temporary registration under section 148.5161 shall be reimbursed at the
21.10same rate as services performed by a speech language pathologist or audiologist as long as
21.11the requirements of section 148.5161, subdivision 3, are met.

21.12    Sec. 11. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
21.13subdivision to read:
21.14    Subd. 8d. Chiropractic services. Payment for chiropractic services is limited to
21.15one annual evaluation and 12 visits per year unless prior authorization of a greater number
21.16of visits is obtained.

21.17    Sec. 12. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 9,
21.18is amended to read:
21.19    Subd. 9. Dental services. (a) Medical assistance covers dental services.
21.20(b) Medical assistance dental coverage for nonpregnant adults is limited to the
21.21following services:
21.22(1) comprehensive exams, limited to once every five years;
21.23(2) periodic exams, limited to one per year;
21.24(3) limited exams;
21.25(4) bitewing x-rays, limited to one set per year;
21.26(5) periapical x-rays;
21.27(6) panoramic x-rays or full-mouth radiographs, limited to one every five years,
21.28and only if provided in conjunction with a posterior extraction or scheduled outpatient
21.29facility procedure, or as medically necessary for the diagnosis and follow-up of oral and
21.30maxillofacial pathology and trauma. Panoramic x-rays may be taken once every two years
21.31for patients who cannot cooperate for intraoral film due to a developmental disability or
21.32medical condition that does not allow for intraoral film placement;
21.33(7) prophylaxis, limited to one per year;
21.34(8) application of fluoride varnish, limited to one per year;
22.1(9) posterior fillings, all at the amalgam rate;
22.2(10) anterior fillings;
22.3(11) endodontics, limited to root canals on the anterior and premolars only, and
22.4molar root canal therapy as deemed medically necessary for patients that are at high risk
22.5of osteonecrosis from molar extractions;
22.6(12) removable prostheses, each dental arch limited to one every six years; including:
22.7(i) relines of full dentures once every six years per dental arch;
22.8(ii) repair of acrylic bases of full dentures and acrylic partial dentures, limited to one
22.9per year; and
22.10(iii) adding a maximum of two denture teeth and two wrought wire clasps per year to
22.11partial dentures per dental arch;
22.12(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
22.13abscesses;
22.14(14) palliative treatment and sedative fillings for relief of pain; and
22.15(15) full-mouth debridement periodontal scaling and root planing, limited to one
22.16every five years; and
22.17(16) moderate sedation, deep sedation, and general anesthesia, limited to when
22.18provided by an oral maxillofacial surgeon who is board-certified, or actively participating
22.19in the American Board of Oral and Maxillofacial Surgery certification process, when
22.20medically necessary to allow the surgical management of acute oral and maxillofacial
22.21pathology which cannot be accomplished safely with local anesthesia alone and would
22.22otherwise require operating room services.
22.23(c) In addition to the services specified in paragraph (b), medical assistance
22.24covers the following services for adults, if provided in an outpatient hospital setting or
22.25freestanding ambulatory surgical center as part of outpatient dental surgery:
22.26(1) periodontics, limited to periodontal scaling and root planing once every two
22.27years;
22.28(2) general anesthesia; and
22.29(3) full-mouth survey once every five two years.
22.30(d) Medical assistance covers dental services for children that are medically
22.31necessary. The following guidelines apply:
22.32(1) posterior fillings are paid at the amalgam rate;
22.33(2) application of sealants once every five years per permanent molar; and
22.34(3) application of fluoride varnish once every six months.

23.1    Sec. 13. Minnesota Statutes 2009 Supplement, section 256B.0625, subdivision 13e,
23.2is amended to read:
23.3    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
23.4shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
23.5the maximum allowable cost set by the federal government or by the commissioner plus
23.6the fixed dispensing fee; or the usual and customary price charged to the public. The
23.7amount of payment basis must be reduced to reflect all discount amounts applied to the
23.8charge by any provider/insurer agreement or contract for submitted charges to medical
23.9assistance programs. The net submitted charge may not be greater than the patient liability
23.10for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
23.11for intravenous solutions which must be compounded by the pharmacist shall be $8 per
23.12bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
23.13nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
23.14nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
23.15includes quantity and other special discounts except time and cash discounts. Effective
23.16July 1, 2009 July 1, 2010, the actual acquisition cost of a drug shall be estimated by the
23.17commissioner, at average wholesale price minus 15 12.5 percent or wholesale acquisition
23.18cost plus 5.0 percent, whichever is lower. The actual acquisition cost of antihemophilic
23.19factor drugs shall be estimated at the average wholesale price minus 30 28.12 percent or
23.20wholesale acquisition cost minus 13.76 percent, whichever is lower. Average wholesale
23.21price is defined as the price for a drug product listed as the average wholesale price in the
23.22commissioner's primary reference source. Wholesale acquisition cost is defined as the
23.23manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the
23.24United States, not including prompt pay or other discounts, rebates, or reductions in price,
23.25for the most recent month for which information is available, as reported in wholesale price
23.26guides or other publications of drug or biological pricing data. The maximum allowable
23.27cost of a multisource drug may be set by the commissioner and it shall be comparable to,
23.28but no higher than, the maximum amount paid by other third-party payors in this state who
23.29have maximum allowable cost programs. Establishment of the amount of payment for
23.30drugs shall not be subject to the requirements of the Administrative Procedure Act.
23.31    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
23.32to pharmacists for legend drug prescriptions dispensed to residents of long-term care
23.33facilities when a unit dose blister card system, approved by the department, is used. Under
23.34this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
23.35The National Drug Code (NDC) from the drug container used to fill the blister card must
23.36be identified on the claim to the department. The unit dose blister card containing the
24.1drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
24.2that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
24.3will be required to credit the department for the actual acquisition cost of all unused
24.4drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
24.5manufacturer's unopened package. The commissioner may permit the drug clozapine to be
24.6dispensed in a quantity that is less than a 30-day supply.
24.7    (c) Whenever a generically equivalent product is available, payment shall be on the
24.8basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost
24.9established by the commissioner.
24.10    (d) The basis for determining the amount of payment for drugs administered in an
24.11outpatient setting shall be the lower of the usual and customary cost submitted by the
24.12provider or the amount established for Medicare by the United States Department of
24.13Health and Human Services pursuant to title XVIII, section 1847a of the federal Social
24.14Security Act.
24.15    (e) The commissioner may negotiate lower reimbursement rates for specialty
24.16pharmacy products than the rates specified in paragraph (a). The commissioner may
24.17require individuals enrolled in the health care programs administered by the department
24.18to obtain specialty pharmacy products from providers with whom the commissioner has
24.19negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
24.20used by a small number of recipients or recipients with complex and chronic diseases
24.21that require expensive and challenging drug regimens. Examples of these conditions
24.22include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
24.23C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
24.24of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
24.25biotechnology drugs, high-cost therapies, and therapies that require complex care. The
24.26commissioner shall consult with the formulary committee to develop a list of specialty
24.27pharmacy products subject to this paragraph. In consulting with the formulary committee
24.28in developing this list, the commissioner shall take into consideration the population
24.29served by specialty pharmacy products, the current delivery system and standard of care in
24.30the state, and access to care issues. The commissioner shall have the discretion to adjust
24.31the reimbursement rate to prevent access to care issues.
24.32EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
24.33approval, whichever is later.

24.34    Sec. 14. Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to
24.35read:
25.1    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
25.2meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
25.3$6.50 for lunch, or $8 for dinner.
25.4    (b) Medical assistance reimbursement for lodging for persons traveling to receive
25.5medical care may not exceed $50 per day unless prior authorized by the local agency.
25.6    (c) Medical assistance direct mileage reimbursement to the eligible person or the
25.7eligible person's driver may not exceed 20 cents per mile.
25.8    (d) Regardless of the number of employees that an enrolled health care provider
25.9may have, medical assistance covers sign and oral language interpreter services when
25.10provided by an enrolled health care provider during the course of providing a direct,
25.11person-to-person covered health care service to an enrolled recipient with limited English
25.12proficiency or who has a hearing loss and uses interpreting services. Coverage for oral
25.13language interpreter services shall be provided only if the oral language interpreter used
25.14by the enrolled health care provider is listed in the registry or roster established under
25.15section 144.058.
25.16EFFECTIVE DATE.This section is effective July 1, 2010.

25.17    Sec. 15. Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to
25.18read:
25.19    Subd. 31. Medical supplies and equipment. Medical assistance covers medical
25.20supplies and equipment. Separate payment outside of the facility's payment rate shall
25.21be made for wheelchairs and wheelchair accessories for recipients who are residents
25.22of intermediate care facilities for the developmentally disabled. Reimbursement for
25.23wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
25.24conditions and limitations as coverage for recipients who do not reside in institutions. A
25.25wheelchair purchased outside of the facility's payment rate is the property of the recipient.
25.26The commissioner may set reimbursement rates for specified categories of medical
25.27supplies at levels below the Medicare payment rate.

25.28    Sec. 16. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
25.29subdivision to read:
25.30    Subd. 54. Services provided in birth centers. (a) Medical assistance covers
25.31services provided in a birth center licensed under section 144.615 by a licensed health
25.32professional if the service would otherwise be covered if provided in a hospital.
25.33(b) Facility services provided by a birth center shall be paid at the lower of billed
25.34charges or 70 percent of the statewide average for a facility payment rate made to a
26.1hospital for an uncomplicated vaginal birth as determined using the most recent calendar
26.2year for which complete claims data is available. If a recipient is transported from a birth
26.3center to a hospital prior to the delivery, the payment for facility services to the birth center
26.4shall be the lower of billed charges or 15 percent of the average facility payment made to a
26.5hospital for the services provided for an uncomplicated vaginal delivery as determined
26.6using the most recent calendar year for which complete claims data is available.
26.7(c) Professional services provided by traditional midwives licensed under chapter
26.8147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a
26.9physician performing the same services. If a recipient is transported from a birth center to
26.10a hospital prior to the delivery, a licensed traditional midwife who does not perform the
26.11delivery may not bill for any delivery services. Services are not covered if provided by an
26.12unlicensed traditional midwife.
26.13(d) The commissioner shall apply for any necessary waivers from the Centers for
26.14Medicare and Medicaid Services to allow birth centers and birth center providers to be
26.15reimbursed.
26.16EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
26.17approval, whichever is later.

26.18    Sec. 17. Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to
26.19read:
26.20    Subdivision 1. Co-payments. (a) Except as provided in subdivision 2, the medical
26.21assistance benefit plan shall include the following co-payments for all recipients, effective
26.22for services provided on or after October 1, 2003, and before January 1, 2009:
26.23    (1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an
26.24episode of service which is required because of a recipient's symptoms, diagnosis, or
26.25established illness, and which is delivered in an ambulatory setting by a physician or
26.26physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
26.27audiologist, optician, or optometrist;
26.28    (2) $3 for eyeglasses;
26.29    (3) $6 for nonemergency visits to a hospital-based emergency room; and
26.30    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
26.31subject to a $12 per month maximum for prescription drug co-payments. No co-payments
26.32shall apply to antipsychotic drugs when used for the treatment of mental illness.
26.33    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall
26.34include the following co-payments for all recipients, effective for services provided on
26.35or after January 1, 2009:
27.1    (1) $6 $3.50 for nonemergency visits to a hospital-based emergency room;
27.2    (2) $3 per brand-name drug prescription and $1 per generic drug prescription, subject
27.3to a $7 $12 per month maximum for prescription drug co-payments. No co-payments shall
27.4apply to antipsychotic drugs when used for the treatment of mental illness; and
27.5    (3) for individuals identified by the commissioner with income at or below 100
27.6percent of the federal poverty guidelines, total monthly co-payments must not exceed five
27.7percent of family income. For purposes of this paragraph, family income is the total
27.8earned and unearned income of the individual and the individual's spouse, if the spouse is
27.9enrolled in medical assistance and also subject to the five percent limit on co-payments.
27.10    (c) Recipients of medical assistance are responsible for all co-payments in this
27.11subdivision.
27.12EFFECTIVE DATE.The amendment to paragraph (b), clause (1), related to the
27.13co-payment for nonemergency visits is effective January 1, 2011, and the amendment
27.14to paragraph (b), clause (2), related to the per month maximum for prescription drug
27.15co-payments is effective July 1, 2010.

27.16    Sec. 18. Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to
27.17read:
27.18    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider
27.19shall be reduced by the amount of the co-payment, except that reimbursements shall
27.20not be reduced:
27.21    (1) once a recipient has reached the $12 per month maximum or the $7 per month
27.22maximum effective January 1, 2009, for prescription drug co-payments; or
27.23    (2) for a recipient identified by the commissioner under 100 percent of the federal
27.24poverty guidelines who has met their monthly five percent co-payment limit.
27.25    (b) The provider collects the co-payment from the recipient. Providers may not deny
27.26services to recipients who are unable to pay the co-payment.
27.27    (c) Medical assistance reimbursement to fee-for-service providers and payments to
27.28managed care plans shall not be increased as a result of the removal of the co-payments
27.29effective on or after January 1, 2009.

27.30    Sec. 19. Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010,
27.31chapter 200, article 1, section 6, is amended to read:
27.32256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
27.33PROGRAMS.
28.1    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
28.2health maintenance organization, as defined in chapter 62D, must participate as a provider
28.3or contractor in the medical assistance program, general assistance medical care program,
28.4and MinnesotaCare as a condition of participating as a provider in health insurance plans
28.5and programs or contractor for state employees established under section 43A.18, the
28.6public employees insurance program under section 43A.316, for health insurance plans
28.7offered to local statutory or home rule charter city, county, and school district employees,
28.8the workers' compensation system under section 176.135, and insurance plans provided
28.9through the Minnesota Comprehensive Health Association under sections 62E.01 to
28.1062E.19 . The limitations on insurance plans offered to local government employees shall
28.11not be applicable in geographic areas where provider participation is limited by managed
28.12care contracts with the Department of Human Services.
28.13    (b) For providers other than health maintenance organizations, participation in the
28.14medical assistance program means that:
28.15     (1) the provider accepts new medical assistance, general assistance medical care,
28.16and MinnesotaCare patients;
28.17    (2) for providers other than dental service providers, at least 20 percent of the
28.18provider's patients are covered by medical assistance, general assistance medical care,
28.19and MinnesotaCare as their primary source of coverage; or
28.20    (3) for dental service providers, at least ten percent of the provider's patients are
28.21covered by medical assistance, general assistance medical care, and MinnesotaCare as
28.22their primary source of coverage, or the provider accepts new medical assistance and
28.23MinnesotaCare patients who are children with special health care needs. For purposes
28.24of this section, "children with special health care needs" means children up to age 18
28.25who: (i) require health and related services beyond that required by children generally;
28.26and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
28.27condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
28.28cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
28.29neurological diseases; visual impairment or deafness; Down syndrome and other genetic
28.30disorders; autism; fetal alcohol syndrome; and other conditions designated by the
28.31commissioner after consultation with representatives of pediatric dental providers and
28.32consumers.
28.33    (c) Patients seen on a volunteer basis by the provider at a location other than
28.34the provider's usual place of practice may be considered in meeting the participation
28.35requirement in this section. The commissioner shall establish participation requirements
28.36for health maintenance organizations. The commissioner shall provide lists of participating
29.1medical assistance providers on a quarterly basis to the commissioner of management and
29.2budget, the commissioner of labor and industry, and the commissioner of commerce. Each
29.3of the commissioners shall develop and implement procedures to exclude as participating
29.4providers in the program or programs under their jurisdiction those providers who do
29.5not participate in the medical assistance program. The commissioner of management
29.6and budget shall implement this section through contracts with participating health and
29.7dental carriers.
29.8    (d) Any hospital or other provider that is participating in a coordinated care
29.9delivery system under section 256D.031, subdivision 6, or receives payments from the
29.10uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to
29.11provide services to any patient enrolled in general assistance medical care regardless of
29.12the availability or the amount of payment.
29.13    (e) (d) For purposes of paragraphs (a) and (b), participation in the general assistance
29.14medical care program applies only to pharmacy providers dispensing prescription drugs
29.15according to section 256D.03, subdivision 3.
29.16EFFECTIVE DATE.The amendment striking the existing paragraph (d) is effective
29.1730 days after federal approval of the amendments in this article to Minnesota Statutes,
29.18sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011,
29.19whichever is later. The amendment to the new paragraph (d) is effective June 1, 2010.

29.20    Sec. 20. Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5,
29.21is amended to read:
29.22    Subd. 5. Home care therapies. (a) Home care therapies include the following:
29.23physical therapy, occupational therapy, respiratory therapy, and speech and language
29.24pathology therapy services.
29.25(b) Home care therapies must be:
29.26(1) provided in the recipient's residence after it has been determined the recipient is
29.27unable to access outpatient therapy;
29.28(2) prescribed, ordered, or referred by a physician and documented in a plan of care
29.29and reviewed, according to Minnesota Rules, part 9505.0390;
29.30(3) assessed by an appropriate therapist; and
29.31(4) provided by a Medicare-certified home health agency enrolled as a Medicaid
29.32provider agency.
29.33(c) Restorative and specialized maintenance therapies must be provided according to
29.34Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be
29.35used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
30.1(d) For both physical and occupational therapies, the therapist and the therapist's
30.2assistant may not both bill for services provided to a recipient on the same day.

30.3    Sec. 21. [256B.0755] PAYMENT REFORM DEMONSTRATION PROJECT FOR
30.4SPECIAL PATIENT POPULATIONS.
30.5    Subdivision 1. Demonstration project. (a) The commissioner of human services,
30.6in consultation with the commissioner of health, shall establish a payment reform
30.7demonstration project implementing an alternative payment system for health care
30.8providers serving an identified group of patients who are enrolled in a state health
30.9care program, and are either high utilizers of high-cost health care services or have
30.10characteristics that put them at high risk of becoming high utilizers. The purpose of the
30.11demonstration project is to implement and evaluate methods of reducing hospitalizations,
30.12emergency room use, high-cost medications and specialty services, admissions to nursing
30.13facilities, or use of long-term home and community-based services, in order to reduce the
30.14total cost of care and services for the patients.
30.15(b) The commissioner shall give the highest priority to projects that will serve
30.16patients who have chronic medical conditions or complex medical needs that are
30.17complicated by a physical disability, serious mental illness, or serious socioeconomic
30.18factors such as poverty, homelessness, or language or cultural barriers. The commissioner
30.19shall also give the highest priority to providers or groups of providers who have the
30.20highest concentrations of patients with these characteristics.
30.21(c) The commissioner must implement this payment reform demonstration project
30.22in a manner consistent with the payment reform initiative provided in sections 62U.02
30.23to 62U.04.
30.24(d) For purposes of this section, "state health care program" means the medical
30.25assistance, MinnesotaCare, and general assistance medical care programs.
30.26    Subd. 2. Participation. (a) The commissioner shall request eligible providers or
30.27groups of providers to submit a proposal to participate in the demonstration project by
30.28September 1, 2010. The providers who are interested in participating shall negotiate with
30.29the commissioner to determine:
30.30(1) the identified group of patients who are to be enrolled in the program;
30.31(2) the services that are to be included in the total cost of care calculation;
30.32(3) the methodology for calculating the total cost of care, which may take into
30.33consideration the impact on costs to other state or local government programs including,
30.34but not limited to, social services and income maintenance programs;
30.35(4) the time period to be covered under the bid;
31.1(5) the implementation of a risk adjustment mechanism to adjust for factors that are
31.2beyond the control of the provider including nonclinical factors that will affect the cost
31.3or outcomes of treatment;
31.4(6) the payment reforms and payment methods to be used under the project, which
31.5may include but are not limited to adjustments in fee-for-service payments, payment of
31.6care coordination fees, payments for start-up and implementation costs to be recovered or
31.7repaid later in the project, payments adjusted based on a provider's proportion of patients
31.8who are enrolled in state health care programs; payments adjusted for the clinical or
31.9socioeconomic complexity of the patients served, payment incentives tied to use of
31.10inpatient and emergency room services, and periodic settle-up adjustments;
31.11(7) methods of sharing financial risk and benefit between the commissioner and
31.12the provider or groups of providers, which may include but are not limited to stop-loss
31.13arrangements to cover high-cost outlier cases or costs that are beyond the control of the
31.14provider, and risk-sharing and benefit-sharing corridors; and
31.15(8) performance and outcome benchmarks to be used to measure performance,
31.16achievement of cost-savings targets, and quality of care provided.
31.17(b) A provider or group of providers may submit a proposal for a demonstration
31.18project in partnership with a health maintenance organization or county-based purchasing
31.19plan for the purposes of sharing risk, claims processing, or administration of the project,
31.20or to extend participation in the project to persons who are enrolled in prepaid health
31.21care programs.
31.22    Subd. 3. Total cost of care agreement. Based on negotiations, the commissioner
31.23must enter into an agreement with interested and eligible providers or groups of providers
31.24to implement projects that are designed to reduce the total cost of care for the identified
31.25patients. To the extent possible, the projects shall begin implementation on January 1,
31.262011, or upon federal approval, whichever is later.
31.27    Subd. 4. Eligibility. To be eligible to participate, providers or groups of providers
31.28must meet certification standards for health care homes established by the Department of
31.29Health and the Department of Human Services under section 256B.0751.
31.30    Subd. 5. Alternative payments. The commissioner shall seek all federal waivers
31.31and approvals necessary to implement this section and to obtain federal matching funds. To
31.32the extent authorized by federal law, the commissioner may waive existing fee-for-service
31.33payment rates, provider contract or performance requirements, consumer incentive
31.34policies, or other requirements in statute or rule in order to allow the providers or groups
31.35of providers to utilize alternative payment and financing methods that will appropriately
31.36fund necessary and cost-effective primary care and care coordination services; establish
32.1appropriate incentives for prevention, health promotion, and care coordination; and
32.2mitigate financial harm to participating providers caused by the successful reduction in
32.3preventable hospitalization, emergency room use, and other costly services.
32.4    Subd. 6. Cost neutrality. The total cost, including administrative costs, of this
32.5demonstration project must not exceed the costs that would otherwise be incurred by
32.6the state had services to the state health care program enrollees participating in the
32.7demonstration project been provided, as applicable for the enrollee, under fee-for-service
32.8or through managed care or county-based purchasing plans.

32.9    Sec. 22. [256B.0757] INTENSIVE CARE MANAGEMENT PROGRAM.
32.10    Subdivision 1. Report. The commissioner shall review medical assistance
32.11enrollment and by July 1, 2011, present a report to the legislature that describes the
32.12common characteristics and costs of those enrollees age 18 and over whose annual medical
32.13costs are greater than 95 percent of all other enrollees, using deidentified data.
32.14    Subd. 2. Intensive care management system established. The commissioner shall
32.15implement, by January 1, 2012, or upon federal approval, whichever is later, a program
32.16to provide intensive care management to medical assistance enrollees age 18 and over
32.17currently served under fee-for-service, managed care, or county-based purchasing, whose
32.18annual medical care costs are in the top five percent of all medical assistance enrollees.
32.19The intensive care management program must reduce these enrollees' medical assistance
32.20costs by at least 20 percent on average, improve quality of care through care coordination,
32.21and provide financial incentives for providers to deliver care efficiently. The commissioner
32.22may require medical assistance enrollees meeting the criteria specified in this subdivision
32.23to participate in the intensive care management program, and may reassign enrollees
32.24from existing managed care and county-based purchasing plans to those plans that are
32.25participating in the demonstration program. The commissioner shall seek all federal
32.26approvals and waivers necessary to implement the intensive care management program.
32.27    Subd. 3. Request for proposals. The commissioner of human services shall
32.28request proposals by September 1, 2011, or upon federal approval, whichever is later,
32.29from health care providers, managed care plans, and county-based purchasing plans to
32.30provide intensive care management services under the requirements of subdivision 1.
32.31Proposals submitted must:
32.32(1) designate the medical assistance population and geographic area of the state
32.33to be served;
32.34(2) describe in detail the proposed intensive care management program;
33.1(3) provide estimates of cost savings to the state and the evidence supporting these
33.2estimates;
33.3(4) describe the extent to which the intensive care management program is consistent
33.4with and builds upon current state health care home, care coordination, and payment
33.5reform initiatives; and
33.6(5) meet quality assurance, data reporting, and other criteria specified by the
33.7commissioner in the request for proposals.
33.8EFFECTIVE DATE.This section is effective the day following final enactment.

33.9    Sec. 23. Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:
33.10    Subd. 1c. Additional portion of nonfederal share. (a) Hennepin County shall
33.11be responsible for a monthly transfer payment of $1,500,000, due before noon on the
33.1215th of each month and the University of Minnesota shall be responsible for a monthly
33.13transfer payment of $500,000 due before noon on the 15th of each month, beginning July
33.1415, 1995. These sums shall be part of the designated governmental unit's portion of the
33.15nonfederal share of medical assistance costs.
33.16(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall
33.17be $2,066,000 each month.
33.18(c) Beginning July 1, 2001, the commissioner shall increase annual capitation
33.19payments to the metropolitan health plan under section 256B.69 for the prepaid medical
33.20assistance program by approximately $3,400,000, plus any available federal matching
33.21funds, $6,800,000 to recognize higher than average medical education costs.
33.22(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a)
33.23and (b) shall be reduced to $566,000, and the University of Minnesota's payment under
33.24paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 30, 2010,
33.25Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective
33.26January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be
33.27$566,000.
33.28(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June
33.2930, 2011, of the enhanced federal medical assistance percentage (FMAP) originally
33.30provided under Public Law 111-5, for the six-month period from January 1, 2011, to June
33.3130, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.

33.32    Sec. 24. Minnesota Statutes 2008, section 256B.69, is amended by adding a
33.33subdivision to read:
34.1    Subd. 5k. Payment rate modification. For services rendered on or after August
34.21, 2010, the total payment made to managed care and county-based purchasing plans
34.3under the medical assistance program and under MinnesotaCare for families with children
34.4shall be increased by 1.4 percent.
34.5EFFECTIVE DATE.This section is effective August 1, 2010.

34.6    Sec. 25. Minnesota Statutes 2008, section 256B.69, is amended by adding a
34.7subdivision to read:
34.8    Subd. 5l. Payment reduction. For services rendered on or after January 1, 2011,
34.9the total payment made to managed care plans for providing covered services under
34.10the medical assistance, general assistance medical care, and MinnesotaCare programs
34.11is reduced by one percent from their current statutory rates. This provision excludes
34.12payments for nursing home services, home and community-based waivers, home care
34.13services covered under section 256B.0651, subdivision 2, payments to demonstration
34.14projects for persons with disabilities, and mental health services added as covered benefits
34.15after December 31, 2007.

34.16    Sec. 26. Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by
34.17Laws 2010, chapter 200, article 1, section 10, is amended to read:
34.18    Subd. 20. Ombudsperson. (a) The commissioner shall designate an ombudsperson
34.19to advocate for persons required to enroll in prepaid health plans under this section. The
34.20ombudsperson shall advocate for recipients enrolled in prepaid health plans through
34.21complaint and appeal procedures and ensure that necessary medical services are provided
34.22either by the prepaid health plan directly or by referral to appropriate social services. At
34.23the time of enrollment in a prepaid health plan, the local agency shall inform recipients
34.24about the ombudsperson program and their right to a resolution of a complaint by the
34.25prepaid health plan if they experience a problem with the plan or its providers.
34.26    (b) The commissioner shall designate an ombudsperson to advocate for persons
34.27enrolled in a care coordination delivery system under section 256D.031. The
34.28ombudsperson shall advocate for recipients enrolled in a care coordination delivery
34.29system through the state appeal process and assist enrollees in accessing necessary
34.30medical services through the care coordination delivery systems directly or by referral to
34.31appropriate services. At the time of enrollment in a care coordination delivery system, the
34.32local agency shall inform recipients about the ombudsperson program.
35.1EFFECTIVE DATE.This section is effective 30 days after federal approval of the
35.2amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and
35.3256B.056, subdivision 4, or January 1, 2011, whichever is later.

35.4    Sec. 27. Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:
35.5    Subd. 27. Information for persons with limited English-language proficiency.
35.6    Managed care contracts entered into under this section and sections 256D.03, subdivision
35.74 , paragraph (c), and section 256L.12 must require demonstration providers to provide
35.8language assistance to enrollees that ensures meaningful access to its programs and
35.9services according to Title VI of the Civil Rights Act and federal regulations adopted
35.10under that law or any guidance from the United States Department of Health and Human
35.11Services.
35.12EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

35.13    Sec. 28. Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:
35.14    Subdivision 1. In general. County boards or groups of county boards may elect
35.15to purchase or provide health care services on behalf of persons eligible for medical
35.16assistance and general assistance medical care who would otherwise be required to or may
35.17elect to participate in the prepaid medical assistance or prepaid general assistance medical
35.18care programs according to sections section 256B.69 and 256D.03. Counties that elect to
35.19purchase or provide health care under this section must provide all services included in
35.20prepaid managed care programs according to sections section 256B.69, subdivisions 1
35.21to 22 , and 256D.03. County-based purchasing under this section is governed by section
35.22256B.69 , unless otherwise provided for under this section.
35.23EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

35.24    Sec. 29. Minnesota Statutes 2008, section 256B.75, is amended to read:
35.25256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
35.26    (a) For outpatient hospital facility fee payments for services rendered on or after
35.27October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
35.28charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
35.29services for which there is a federal maximum allowable payment. Effective for services
35.30rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
35.31facility fees and emergency room facility fees shall be increased by eight percent over the
35.32rates in effect on December 31, 1999, except for those services for which there is a federal
36.1maximum allowable payment. Services for which there is a federal maximum allowable
36.2payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
36.3allowable payment. Total aggregate payment for outpatient hospital facility fee services
36.4shall not exceed the Medicare upper limit. If it is determined that a provision of this
36.5section conflicts with existing or future requirements of the United States government with
36.6respect to federal financial participation in medical assistance, the federal requirements
36.7prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
36.8avoid reduced federal financial participation resulting from rates that are in excess of
36.9the Medicare upper limitations.
36.10    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
36.11ambulatory surgery hospital facility fee services for critical access hospitals designated
36.12under section 144.1483, clause (10), shall be paid on a cost-based payment system that is
36.13based on the cost-finding methods and allowable costs of the Medicare program.
36.14    (c) Effective for services provided on or after July 1, 2003, rates that are based
36.15on the Medicare outpatient prospective payment system shall be replaced by a budget
36.16neutral prospective payment system that is derived using medical assistance data. The
36.17commissioner shall provide a proposal to the 2003 legislature to define and implement
36.18this provision.
36.19    (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
36.20before third-party liability and spenddown, made to hospitals for outpatient hospital
36.21facility services is reduced by .5 percent from the current statutory rate.
36.22    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
36.23services provided on or after July 1, 2003, made to hospitals for outpatient hospital
36.24facility services before third-party liability and spenddown, is reduced five percent from
36.25the current statutory rates. Facilities defined under section 256.969, subdivision 16, are
36.26excluded from this paragraph.
36.27    (f) In addition to the reductions in paragraphs (d) and (e), the total payment for
36.28fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
36.29hospital facility services before third-party liability and spenddown, is reduced three
36.30percent from the current statutory rates. Mental health services and facilities defined under
36.31section 256.969, subdivision 16, are excluded from this paragraph.
36.32    (g) Notwithstanding any contrary provision in this section, payment for all outpatient
36.33and emergency services provided by any hospital that, prior to December 31, 2007, has
36.34received payment to support the training of residents from an approved graduate medical
36.35residency training program under United States Code, title 42, section 256e, must be paid
37.1for fiscal years 2012 and 2013 an additional $7,000,000. Payment rates for subsequent
37.2fiscal years are as follows:
37.3    (1) 2014: 50 percent of costs;
37.4    (2) 2015: 60 percent of costs;
37.5    (3) 2016: 70 percent of costs;
37.6    (4) 2017: 80 percent of costs;
37.7    (5) 2018: 90 percent of costs; and
37.8    (6) 2019 and thereafter: 100 percent of costs.

37.9    Sec. 30. Minnesota Statutes 2009 Supplement, section 256B.76, subdivision 1, is
37.10amended to read:
37.11    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
37.12or after October 1, 1992, the commissioner shall make payments for physician services
37.13as follows:
37.14    (1) payment for level one Centers for Medicare and Medicaid Services' common
37.15procedural coding system codes titled "office and other outpatient services," "preventive
37.16medicine new and established patient," "delivery, antepartum, and postpartum care,"
37.17"critical care," cesarean delivery and pharmacologic management provided to psychiatric
37.18patients, and level three codes for enhanced services for prenatal high risk, shall be paid
37.19at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
37.2030, 1992. If the rate on any procedure code within these categories is different than the
37.21rate that would have been paid under the methodology in section 256B.74, subdivision 2,
37.22then the larger rate shall be paid;
37.23    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
37.24or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
37.25    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
37.26percentile of 1989, less the percent in aggregate necessary to equal the above increases
37.27except that payment rates for home health agency services shall be the rates in effect
37.28on September 30, 1992.
37.29    (b) Effective for services rendered on or after January 1, 2000, payment rates for
37.30physician and professional services shall be increased by three percent over the rates
37.31in effect on December 31, 1999, except for home health agency and family planning
37.32agency services. The increases in this paragraph shall be implemented January 1, 2000,
37.33for managed care.
37.34(c) Effective for services rendered on or after July 1, 2009, payment rates for
37.35physician and professional services shall be reduced by five percent over the rates in
38.1effect on June 30, 2009. This reduction does not apply to office or other outpatient visits,
38.2preventive medicine visits and family planning visits billed by physicians, advanced
38.3practice nurses, or physician assistants in a family planning agency or in one of the
38.4following primary care practices: general practice, general internal medicine, general
38.5pediatrics, general geriatrics, and family medicine. This reduction does not apply to
38.6federally qualified health centers, rural health centers, and Indian health services. This
38.7reduction does not apply to physical therapy services, occupational therapy services,
38.8and speech pathology and related services provided on or after July 1, 2010. Effective
38.9October 1, 2009, payments made to managed care plans and county-based purchasing
38.10plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction
38.11described in this paragraph.
38.12(d) Effective for services rendered on or after July 1, 2010, payment rates for
38.13physician and professional services shall be reduced by three percent over the rates in
38.14effect on June 30, 2010. This reduction does not apply to those providers and entities
38.15exempt from the reduction in paragraph (c). Effective October 1, 2010, payments made
38.16to managed care plans and county-based purchasing plans under sections 256B.69,
38.17256B.692, and 256L.12 shall reflect the payment reductions in this paragraph.
38.18(e) Effective for services rendered on or after June 1, 2010, payment rates for
38.19physician and professional services billed by physicians employed by and clinics that are
38.20owned by a nonprofit health maintenance organization shall be increased by 15 percent.
38.21Effective October 1, 2010, payments to managed care and county-based purchasing
38.22plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase
38.23described in this paragraph.

38.24    Sec. 31. Minnesota Statutes 2008, section 256B.76, subdivision 2, is amended to read:
38.25    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
38.26October 1, 1992, the commissioner shall make payments for dental services as follows:
38.27    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
38.28percent above the rate in effect on June 30, 1992; and
38.29    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
38.30percentile of 1989, less the percent in aggregate necessary to equal the above increases.
38.31    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
38.32shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
38.33    (c) Effective for services rendered on or after January 1, 2000, payment rates for
38.34dental services shall be increased by three percent over the rates in effect on December
38.3531, 1999.
39.1    (d) Effective for services provided on or after January 1, 2002, payment for
39.2diagnostic examinations and dental x-rays provided to children under age 21 shall be the
39.3lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
39.4    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
39.52000, for managed care.
39.6(f) Effective for dental services rendered on or after October 1, 2010, by a
39.7state-operated dental clinic, payment shall be paid on a cost-based payment system that
39.8is based on the cost-finding methods and allowable costs of the Medicare program. For
39.9services performed by a state-operated dental clinic pursuant to a contract between the
39.10clinic and a managed care plan or a county-based purchasing plan, a supplemental payment
39.11shall be made to the clinic by the commissioner that is equal to the amount by which the
39.12amount determined under this paragraph exceeds the amount of the payments provided
39.13under the contract. Managed care plans and county-based purchasing plans participating
39.14in medical assistance must provide to the commissioner any expenditure, cost, and
39.15revenue information deemed necessary by the commissioner for purposes of obtaining
39.16federal Medicaid matching funds for cost-based reimbursement for state-operated dental
39.17clinics. Cost-based reimbursement shall be implemented in managed care contracts
39.18beginning January 1, 2011.
39.19(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
39.20in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
39.21year, a supplemental state payment equal to the difference between the total payments
39.22in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
39.23services for the operation of the dental clinics.

39.24    Sec. 32. Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:
39.25    Subd. 4. Critical access dental providers. Effective for dental services rendered
39.26on or after January 1, 2002, the commissioner shall increase reimbursements to dentists
39.27and dental clinics deemed by the commissioner to be critical access dental providers.
39.28For dental services rendered on or after July 1, 2007, the commissioner shall increase
39.29reimbursement by 30 percent above the reimbursement rate that would otherwise be paid to
39.30the critical access dental provider. The commissioner shall pay the health plan companies
39.31in amounts sufficient to reflect increased reimbursements to critical access dental providers
39.32as approved by the commissioner. In determining which dentists and dental clinics shall
39.33be deemed critical access dental providers, the commissioner shall review:
40.1    (1) the utilization rate in the service area in which the dentist or dental clinic operates
40.2for dental services to patients covered by medical assistance, general assistance medical
40.3care, or MinnesotaCare as their primary source of coverage;
40.4    (2) the level of services provided by the dentist or dental clinic to patients covered
40.5by medical assistance, general assistance medical care, or MinnesotaCare as their primary
40.6source of coverage; and. The commissioner shall pay critical access dental provider
40.7payments to a dentist or dental clinic that meets any one of the following criteria:
40.8    (i) at least 40 percent of patient encounters are with patients who are uninsured or
40.9covered by medical assistance, general assistance medical care, or MinnesotaCare;
40.10    (ii) the dental clinic or dental group is owned and operated by a nonprofit operation
40.11under chapter 317A with more than 10,000 patient encounters per year with patients
40.12who are uninsured or covered by medical assistance, general assistance medical care,
40.13or MinnesotaCare;
40.14    (iii) the dental clinic is associated with an oral health or dental education program
40.15operated by the University of Minnesota or an institution within the Minnesota State
40.16Colleges and Universities system; or
40.17(iv) the dental clinic is a state-operated dental clinic;
40.18    (3) whether the level of services provided by the dentist or dental clinic is critical to
40.19maintaining adequate levels of patient access within the a geographic service area, and
40.20to ensure that the maximum travel distance or travel time is the lesser of 60 miles or 60
40.21minutes;
40.22    (4) whether the provider has completed the application for critical access dental
40.23provider designation by the due date, and has provided correct information;
40.24    (5) whether the dentist or dental clinic meets the quality and continuity of care
40.25criteria recommended by the dental services advisory committee and adopted by the
40.26department; and
40.27(6) whether the dentist or dental clinic serves people in all Minnesota health care
40.28programs.
40.29In the absence of a critical access dental provider in a service area, the commissioner may
40.30designate a dentist or dental clinic as a critical access dental provider if the dentist or
40.31dental clinic is willing to provide care to patients covered by medical assistance, general
40.32assistance medical care, or MinnesotaCare at a level which significantly increases access
40.33to dental care in the service area.
40.34EFFECTIVE DATE.This section is effective January 1, 2011.

41.1    Sec. 33. Minnesota Statutes 2008, section 256B.76, is amended by adding a
41.2subdivision to read:
41.3    Subd. 4a. Designation and termination of critical access dental providers. (a)
41.4Notwithstanding the provisions in subdivision 4, the commissioner may review and not
41.5designate an individual dentist or dental clinic as a critical access dental provider under
41.6subdivision 4 or section 256L.11, subdivision 7, when the dentist or clinic:
41.7(1) has been subject to a corrective or disciplinary action by the Board of Dentistry
41.8related to fraud or direct patient care. Designation shall not be made until the provider is no
41.9longer subject to a corrective or disciplinary action related to fraud or direct patient care; or
41.10(2) has been subject, within the past three years, to a postinvestigation action by the
41.11commissioner of human services or issuance of a warning as specified in Minnesota Rules,
41.12parts 9505.2160 to 9505.2245. The provider shall not be considered for critical access
41.13dental designation until the January following the year in which the action has ended.
41.14(b) The commissioner may terminate a critical access designation of an individual
41.15dentist or clinic if the dentist or clinic:
41.16(1) becomes subject to a disciplinary or corrective action by the Board of Dentistry
41.17related to fraud or direct patient care. The provider shall not be considered for critical
41.18access designation until the January following the year in which the action has ended;
41.19(2) becomes subject to a postinvestigation action by the commissioner of human
41.20services or issuance of a warning as specified in Minnesota Rules, parts 9505.2160
41.21to 9505.2245;
41.22(3) does not meet the quality and continuity of care criteria that have been
41.23recommended by the Dental Services Advisory Committee and adopted by the department;
41.24or
41.25(4) does not serve people in all Minnesota public health care programs.
41.26(c) Any termination is effective on the date of notification of the:
41.27(1) postinvestigative action;
41.28(2) disciplinary or corrective action by the Minnesota Board of Dentistry; or
41.29(3) determination of not meeting quality and continuity of care criteria.
41.30The commissioner may review postinvestigative actions taken by a health plan
41.31under contract to provide dental services to Minnesota health care program enrollees.
41.32After an investigation conducted by the Department of Human Services surveillance unit,
41.33the findings of the health plan may be incorporated to determine if a provider will be
41.34designated or terminated from the program.
41.35(d) A provider who has been terminated or not designated under this section may
41.36appeal only through the contested hearing process as defined in section 14.02, subdivision
42.13, by filing with the commissioner a written request of appeal. The appeal request must
42.2be received by the commissioner no later than 30 days after notification of termination
42.3or nondesignation.
42.4(e) The commissioner may make an exception to paragraphs (a) and (b) if an action
42.5taken by the Board of Dentistry or the commissioner is the result of events not directly
42.6related to patient care or that will not affect direct patient care to Minnesota health care
42.7program enrollees.
42.8EFFECTIVE DATE.This section is effective the day following final enactment.

42.9    Sec. 34. Minnesota Statutes 2009 Supplement, section 256B.766, is amended to read:
42.10256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
42.11(a) Effective for services provided on or after July 1, 2009, total payments for
42.12basic care services, shall be reduced by three percent, prior to third-party liability and
42.13spenddown calculation. This reduction applies to physical therapy services, occupational
42.14therapy services, and speech language pathology and related services provided on or after
42.15July 1, 2010. Effective July 1, 2010, the commissioner shall classify physical therapy
42.16services, occupational therapy services, and speech language pathology and related
42.17services as basic care services. Payments made to managed care plans and county-based
42.18purchasing plans shall be reduced for services provided on or after October 1, 2009,
42.19to reflect this reduction.
42.20(b) This section does not apply to physician and professional services, inpatient
42.21hospital services, family planning services, mental health services, dental services,
42.22prescription drugs, medical transportation, federally qualified health centers, rural health
42.23centers, Indian health services, and Medicare cost-sharing.

42.24    Sec. 35. [256B.767] MEDICARE PAYMENT LIMIT.
42.25Effective for services rendered on or after July 1, 2010, fee-for-service payment
42.26rates for physician and professional services under section 256B.76, subdivision 1, and
42.27basic care services subject to the rate reduction specified in section 256B.766, shall not
42.28exceed the Medicare payment rate for the applicable service.

42.29    Sec. 36. [256B.768] FEE-FOR-SERVICE PAYMENT INCREASE.
42.30Effective for services rendered on or after January 1, 2011, the commissioner shall
42.31increase fee-for-service payment rates by seven percent for physician and professional
43.1services under section 256B.76, subdivision 1, and basic care services subject to the rate
43.2reduction specified in section 256B.766.

43.3    Sec. 37. Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as
43.4amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:
43.5    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1, 2010,
43.6the general assistance medical care program shall be administered according to section
43.7256D.031 , unless otherwise stated, except for outpatient prescription drug coverage,
43.8which shall continue to be administered under this section and funded under section
43.9256D.031, subdivision 9 , beginning June 1, 2010.
43.10(b) Outpatient prescription drug coverage under general assistance medical care is
43.11limited to prescription drugs that:
43.12(1) are covered under the medical assistance program as described in section
43.13256B.0625, subdivisions 13 and 13d; and
43.14(2) are provided by manufacturers that have fully executed general assistance
43.15medical care rebate agreements with the commissioner and comply with the agreements.
43.16Outpatient prescription drug coverage under general assistance medical care must conform
43.17to coverage under the medical assistance program according to section 256B.0625,
43.18subdivisions 13 to 13g 13h.
43.19    (c) Outpatient prescription drug coverage does not include drugs administered in a
43.20clinic or other outpatient setting.
43.21(d) For the period beginning April 1, 2010, to May 31, 2010, general assistance
43.22medical care covers the services listed in subdivision 4.
43.23EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

43.24    Sec. 38. Minnesota Statutes 2008, section 256L.02, subdivision 3, is amended to read:
43.25    Subd. 3. Financial management. (a) The commissioner shall manage spending for
43.26the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
43.27each state revenue and expenditure forecast, the commissioner must make an assessment
43.28of the expected expenditures for the covered services for the remainder of the current
43.29biennium and for the following biennium. The estimated expenditure, including the
43.30reserve, shall be compared to an estimate of the revenues that will be available in the health
43.31care access fund. Based on this comparison, and after consulting with the chairs of the
43.32house of representatives Ways and Means Committee and the senate Finance Committee,
43.33and the Legislative Commission on Health Care Access, the commissioner shall, as
43.34necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
44.1remain within the limits of available revenues for the remainder of the current biennium
44.2and for the following biennium. The commissioner shall not hire additional staff using
44.3appropriations from the health care access fund until the commissioner of management
44.4and budget makes a determination that the adjustments implemented under paragraph (b)
44.5are sufficient to allow MinnesotaCare expenditures to remain within the limits of available
44.6revenues for the remainder of the current biennium and for the following biennium.
44.7(b) The adjustments the commissioner shall use must be implemented in this order,
44.8but shall not be implemented before July 1, 2014: first, stop enrollment of single adults
44.9and households without children; and second, upon 45 days' notice, stop coverage of
44.10single adults and households without children already enrolled in the MinnesotaCare
44.11program; third, upon 90 days' notice, decrease the premium subsidy amounts by ten
44.12percent for families with gross annual income above 200 percent of the federal poverty
44.13guidelines; fourth, upon 90 days' notice, decrease the premium subsidy amounts by ten
44.14percent for families with gross annual income at or below 200 percent; and fifth, require
44.15applicants to be uninsured for at least six months prior to eligibility in the MinnesotaCare
44.16program. If these measures are insufficient to limit the expenditures to the estimated
44.17amount of revenue, the commissioner shall further limit enrollment or decrease premium
44.18subsidies notify the chairs of the house of representatives Ways and Means Committee and
44.19the senate Finance Committee, and the Legislative Commission on Health Care Access,
44.20and present recommendations to the chairs and commission for limiting expenditures to
44.21the estimated amount of revenue.
44.22EFFECTIVE DATE.This section is effective upon federal approval of the
44.23amendments in this article to Minnesota Statutes, sections 256B.055, subdivision 15, and
44.24256B.056, subdivision 4.

44.25    Sec. 39. Minnesota Statutes 2008, section 256L.03, subdivision 3, is amended to read:
44.26    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
44.27inpatient hospital services, including inpatient hospital mental health services and inpatient
44.28hospital and residential chemical dependency treatment, subject to those limitations
44.29necessary to coordinate the provision of these services with eligibility under the medical
44.30assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
44.31section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
44.322 , with family gross income that exceeds 200 percent of the federal poverty guidelines or
44.33215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
44.34pregnant, is subject to an annual limit of $10,000, unless supplemental hospital coverage
44.35has been purchased under subdivision 3c.
45.1    (b) Admissions for inpatient hospital services paid for under section 256L.11,
45.2subdivision 3 , must be certified as medically necessary in accordance with Minnesota
45.3Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
45.4    (1) all admissions must be certified, except those authorized under rules established
45.5under section 254A.03, subdivision 3, or approved under Medicare; and
45.6    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
45.7for admissions for which certification is requested more than 30 days after the day of
45.8admission. The hospital may not seek payment from the enrollee for the amount of the
45.9payment reduction under this clause.
45.10EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
45.11approval, whichever is later.

45.12    Sec. 40. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision
45.13to read:
45.14    Subd. 3c. Supplemental hospital coverage. (a) Effective January 1, 2011, or upon
45.15federal approval, whichever is later, the commissioner shall offer all MinnesotaCare
45.16applicants, and all enrollees during the open enrollment periods specified in paragraph
45.17(b), the opportunity to purchase at full cost, supplemental hospital coverage to cover
45.18inpatient hospital expenses in excess of the inpatient hospital annual limit established
45.19under subdivision 3. Premiums for this coverage may vary only for age and shall be
45.20collected by the commissioner using the procedures established for the sliding scale
45.21premium determined under section 256L.15.
45.22(b) The commissioner shall notify all persons submitting applications of the option to
45.23purchase this coverage at the time of application. The commissioner shall provide persons
45.24enrolled in MinnesotaCare on the effective date of this subdivision with the opportunity to
45.25purchase this supplemental coverage during an initial open enrollment period. Following
45.26this initial open enrollment period, the commissioner shall provide all enrollees with the
45.27opportunity to purchase this supplemental coverage during an annual open enrollment
45.28period during the month of November with coverage to take effect the following January 1.

45.29    Sec. 41. Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is
45.30amended to read:
45.31    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
45.32and (c), the MinnesotaCare benefit plan shall include the following co-payments and
45.33coinsurance requirements for all enrollees:
46.1    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
46.2subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
46.3    (2) $3 per prescription for adult enrollees;
46.4    (3) $25 for eyeglasses for adult enrollees;
46.5    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
46.6episode of service which is required because of a recipient's symptoms, diagnosis, or
46.7established illness, and which is delivered in an ambulatory setting by a physician or
46.8physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
46.9audiologist, optician, or optometrist; and
46.10    (5) $6 for nonemergency visits to a hospital-based emergency room for services
46.11provided through December 31, 2010, and $3.50 effective January 1, 2011.
46.12    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
46.13children under the age of 21.
46.14    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
46.15    (d) Paragraph (a), clause (4), does not apply to mental health services.
46.16    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
46.17poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
46.18and who are not pregnant shall be financially responsible for the coinsurance amount, if
46.19applicable, and if supplemental coverage has not been purchased under subdivision 3c,
46.20amounts which exceed the $10,000 inpatient hospital benefit limit.
46.21    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
46.22or changes from one prepaid health plan to another during a calendar year, any charges
46.23submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
46.24expenses incurred by the enrollee for inpatient services, that were submitted or incurred
46.25prior to enrollment, or prior to the change in health plans, shall be disregarded.
46.26(g) MinnesotaCare reimbursement to fee-for-service providers and payments to
46.27managed care plans shall not be increased as a result of the reduction of the co-payments
46.28in paragraph (a), clause (5), effective January 1, 2011.
46.29EFFECTIVE DATE.The amendment to paragraph (e) is effective January 1, 2011,
46.30or upon federal approval, whichever is later.

46.31    Sec. 42. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision
46.32to read:
46.33    Subd. 6. Disclosure statement for inpatient hospital limit. The commissioner
46.34shall develop, and include with MinnesotaCare application and renewal materials, a
46.35disclosure statement that contains the following or similar language: "For adults without
47.1children, and for parents and relative caretakers with family gross income that exceeds
47.2215 percent of the federal poverty guidelines, who are not pregnant, coverage of inpatient
47.3hospital services under MinnesotaCare is subject to an annual limit of $10,000. Enrollees
47.4subject to the limit may be responsible for inpatient hospital costs that exceed the $10,000
47.5annual limit."

47.6    Sec. 43. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
47.7to read:
47.8    Subd. 9. Firefighters; volunteer ambulance attendants. (a) For purposes of this
47.9subdivision, "qualified individual" means:
47.10(1) a volunteer firefighter with a department as defined in section 299N.01,
47.11subdivision 2, who has passed the probationary period; and
47.12(2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15.
47.13(b) A qualified individual who documents to the satisfaction of the commissioner
47.14status as a qualified individual by completing and submitting a one-page form developed
47.15by the commissioner is eligible for MinnesotaCare without meeting other eligibility
47.16requirements of this chapter, but must pay premiums equal to the average expected
47.17capitation rate for adults with no children paid under section 256L.12. Individuals eligible
47.18under this subdivision shall receive coverage for the benefit set provided to adults with no
47.19children.

47.20    Sec. 44. Minnesota Statutes 2009 Supplement, section 256L.11, subdivision 1, is
47.21amended to read:
47.22    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers under
47.23sections 256L.01 to 256L.11 shall be at the same rates and conditions established for
47.24medical assistance, except as provided in subdivisions 2 to 6.
47.25(b) Effective for services provided on or after July 1, 2009, total payments for basic
47.26care services shall be reduced by three percent, in accordance with section 256B.766.
47.27Payments made to managed care and county-based purchasing plans shall be reduced for
47.28services provided on or after October 1, 2009, to reflect this reduction.
47.29(c) Effective for services provided on or after July 1, 2009, payment rates for
47.30physician and professional services shall be reduced as described under section 256B.76,
47.31subdivision 1, paragraph (c). Payments made to managed care and county-based
47.32purchasing plans shall be reduced for services provided on or after October 1, 2009,
47.33to reflect this reduction.
48.1(d) Effective for services provided on or after July 1, 2010, payment rates for
48.2physician and professional services shall be reduced as described under section 256B.76,
48.3subdivision 1, paragraph (d). Payments made to managed care plans and county-based
48.4purchasing plans shall be reduced for services provided on or after October 1, 2010,
48.5to reflect this reduction.

48.6    Sec. 45. Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:
48.7    Subd. 5. Eligibility for other state programs. MinnesotaCare enrollees who
48.8become eligible for medical assistance or general assistance medical care will remain in
48.9the same managed care plan if the managed care plan has a contract for that population.
48.10Effective January 1, 1998, MinnesotaCare enrollees who were formerly eligible for
48.11general assistance medical care pursuant to section 256D.03, subdivision 3, within six
48.12months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant
48.13to section 256D.03, subdivision 4, paragraph (c), must remain in the same managed care
48.14plan if the managed care plan has a contract for that population. Managed care plans must
48.15participate in the MinnesotaCare and general assistance medical care programs program
48.16under a contract with the Department of Human Services in service areas where they
48.17participate in the medical assistance program.
48.18EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

48.19    Sec. 46. Minnesota Statutes 2008, section 256L.12, subdivision 6, is amended to read:
48.20    Subd. 6. Co-payments and benefit limits. Enrollees are responsible for all
48.21co-payments in sections 256L.03, subdivision 5, and 256L.035, and shall pay co-payments
48.22to the managed care plan or to its participating providers. The enrollee is also responsible
48.23for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit,
48.24unless supplemental hospital coverage has been purchased under subdivision 3c.
48.25EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
48.26approval, whichever is later.

48.27    Sec. 47. Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:
48.28    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
48.29per capita, where possible. The commissioner may allow health plans to arrange for
48.30inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
48.31an independent actuary to determine appropriate rates.
49.1    (b) For services rendered on or after January 1, 2003, to December 31, 2003, the
49.2commissioner shall withhold .5 percent of managed care plan payments under this section
49.3pending completion of performance targets. The withheld funds must be returned no
49.4sooner than July 1 and no later than July 31 of the following year if performance targets
49.5in the contract are achieved. A managed care plan may include as admitted assets under
49.6section 62D.044 any amount withheld under this paragraph that is reasonably expected
49.7to be returned.
49.8    (c) For services rendered on or after January 1, 2004, the commissioner shall
49.9withhold five percent of managed care plan payments under this section pending
49.10completion of performance targets. Each performance target must be quantifiable,
49.11objective, measurable, and reasonably attainable, except in the case of a performance target
49.12based on a federal or state law or rule. Criteria for assessment of each performance target
49.13must be outlined in writing prior to the contract effective date. The managed care plan
49.14must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
49.15attainment of the performance target is accurate. The commissioner shall periodically
49.16change the administrative measures used as performance targets in order to improve plan
49.17performance across a broader range of administrative services. The performance targets
49.18must include measurement of plan efforts to contain spending on health care services and
49.19administrative activities. The commissioner may adopt plan-specific performance targets
49.20that take into account factors affecting only one plan, such as characteristics of the plan's
49.21enrollee population. The withheld funds must be returned no sooner than July 1 and no
49.22later than July 31 of the following calendar year if performance targets in the contract are
49.23achieved. A managed care plan or a county-based purchasing plan under section 256B.692
49.24may include as admitted assets under section 62D.044 any amount withheld under this
49.25paragraph that is reasonably expected to be returned.
49.26(d) For services rendered on or after January 1, 2011, the commissioner shall
49.27withhold an additional three percent of managed care plan payments under this section.
49.28The withheld funds must be returned no sooner than July 1, and no later than July 31 of
49.29the following calendar year. The return of the withhold under this paragraph is not subject
49.30to the requirements of paragraph (b) or (c).
49.31(e) A managed care plan or a county-based purchasing plan under section 256B.692
49.32may include as admitted assets under section 62D.044 any amount withheld under this
49.33section.

49.34    Sec. 48. Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:
50.1    Subd. 5. Expiration. This section, with the exception of subdivision 4, expires
50.2December 31, 2010 June 30, 2011. Subdivision 4 expires December 31, 2011.

50.3    Sec. 49. Laws 2010, chapter 200, article 1, section 12, subdivision 6, is amended to
50.4read:
50.5    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010, the
50.6commissioner shall contract with hospitals or groups of hospitals that qualify under
50.7paragraph (b) and agree to deliver services according to this subdivision. Contracting
50.8hospitals shall develop and implement a coordinated care delivery system to provide health
50.9care services to individuals who are eligible for general assistance medical care under this
50.10section and who either choose to receive services through the coordinated care delivery
50.11system or who are enrolled by the commissioner under paragraph (c). A contracting
50.12hospital may negotiate a limit to the number of general assistance medical care enrollees it
50.13serves, but must comply with the emergency care requirements of United States Code, title
50.1442, 1395dd (EMTALA). The health care services provided by the system must include:
50.15(1) the services described in subdivision 4 with the exception of outpatient prescription
50.16drug coverage but shall include drugs administered in a clinic or other outpatient setting;
50.17or (2) a set of comprehensive and medically necessary health services that the recipients
50.18might reasonably require to be maintained in good health and that has been approved by
50.19the commissioner, including at a minimum, but not limited to, emergency care, medical
50.20transportation services, inpatient hospital and physician care, outpatient health services,
50.21preventive health services, mental health services, and prescription drugs administered
50.22in a clinic or other outpatient setting. Outpatient prescription drug coverage is covered
50.23on a fee-for-service basis in accordance with section 256D.03, subdivision 3, and funded
50.24under subdivision 9. A hospital establishing a coordinated care delivery system under this
50.25subdivision must ensure that the requirements of this subdivision are met.
50.26(b) A hospital or group of hospitals may contract with the commissioner to develop
50.27and implement a coordinated care delivery system as follows:
50.28(1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
50.29calendar year 2008, it received fee-for-service payments for services to general assistance
50.30medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
50.31than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
50.32provide geographic access or to ensure that at least 80 percent of enrollees have access to
50.33a coordinated care delivery system; and
51.1(2) effective December 1, 2010, a Minnesota hospital not qualified under clause
51.2(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
51.3requirements of this subdivision.
51.4Participation by hospitals shall become effective quarterly on June 1, September 1,
51.5December 1, or March 1. Hospital participation is effective for a period of 12 months and
51.6may be renewed for successive 12-month periods.
51.7Coordinated care delivery system contracts are in effect from June 1, 2010, to
51.8December 31, 2010, or upon the effective date of the expansion of medical assistance
51.9coverage to include adults without children, whichever is later.
51.10(c) Applicants and recipients may enroll in any available coordinated care delivery
51.11system statewide. If more than one coordinated care delivery system is available, the
51.12applicant or recipient shall be allowed to choose among the systems that provide services
51.13within 25 miles of the individual's community of residence. The commissioner may assign
51.14an applicant or recipient to a coordinated care delivery system that provides services
51.15within 25 miles of the individual's community of residence, if no choice is made by the
51.16applicant or recipient. The commissioner shall consider a recipient's zip code, city of
51.17residence, county of residence, or distance from a participating coordinated care delivery
51.18system when determining default assignment. An applicant or recipient may decline
51.19enrollment in a coordinated care delivery system. Upon enrollment into a coordinated care
51.20delivery system, the recipient must agree to receive all nonemergency services through the
51.21coordinated care delivery system. Enrollment in a coordinated care delivery system is
51.22for six months and may be renewed for additional six-month periods, except that initial
51.23enrollment is for six months or until the end of a recipient's period of general assistance
51.24medical care eligibility, whichever occurs first. A recipient who continues to meet the
51.25eligibility requirements of this section is not eligible to enroll in MinnesotaCare during
51.26a period of enrollment in a coordinated care delivery system. From June 1, 2010, to
51.27November 30, 2010, applicants and recipients not enrolled in a coordinated care delivery
51.28system may seek services from a hospital eligible for reimbursement under the temporary
51.29uncompensated care pool established under subdivision 8. After November 30, 2010,
51.30services are available only through a coordinated care delivery system.
51.31(d) A hospital must provide access to cost-effective outpatient services available
51.32in its service area. The hospital may contract and coordinate with providers and clinics
51.33for the delivery of services and shall contract with federally qualified health centers and
51.34essential community providers as defined under section 62Q.19, subdivision 1, paragraph
51.35(a), clauses (1) and (2), to the extent practicable. If a provider or clinic contracts with a
51.36hospital to provide services through the coordinated care delivery system, the provider
52.1may not refuse to provide services to any recipient enrolled in the system, and payment for
52.2services shall be negotiated with the hospital and paid by the hospital from the system's
52.3allocation under subdivision 7.
52.4(e) A coordinated care delivery system must:
52.5(1) provide the covered services required under paragraph (a) to recipients enrolled
52.6in the coordinated care delivery system, and comply with the requirements of subdivision
52.74, paragraphs (b) to (g);
52.8(2) establish a process to monitor enrollment and ensure the quality of care provided;
52.9and
52.10(3) in cooperation with counties, coordinate the delivery of health care services with
52.11existing homeless prevention, supportive housing, and rent subsidy programs and funding
52.12administered by the Minnesota Housing Finance Agency under chapter 462A; and
52.13(4) adopt innovative and cost-effective methods of care delivery and coordination,
52.14which may include the use of allied health professionals, telemedicine, patient educators,
52.15care coordinators, and community health workers.
52.16(f) The hospital may require a recipient to designate a primary care provider or
52.17a primary care clinic. The hospital may limit the delivery of services to a network of
52.18providers who have contracted with the hospital to deliver services in accordance with
52.19this subdivision, and require a recipient to seek services only within this network. The
52.20hospital may also require a referral to a provider before the service is eligible for payment.
52.21A coordinated care delivery system is not required to provide payment to a provider who
52.22is not employed by or under contract with the system for services provided to a recipient
52.23enrolled in the system, except in cases of an emergency. For purposes of this section,
52.24emergency services are defined in accordance with Code of Federal Regulations, title
52.2542, section 438.114 (a).
52.26(g) A recipient enrolled in a coordinated care delivery system has the right to appeal
52.27to the commissioner according to section 256.045.
52.28(h) The state shall not be liable for the payment of any cost or obligation incurred
52.29by the coordinated care delivery system.
52.30(i) The hospital must provide the commissioner with data necessary for assessing
52.31enrollment, quality of care, cost, and utilization of services. Each hospital must provide,
52.32on a quarterly basis on a form prescribed by the commissioner for each recipient served by
52.33the coordinated care delivery system, the services provided, the cost of services provided,
52.34and the actual payment amount for the services provided and any other information the
52.35commissioner deems necessary to claim federal Medicaid match. The commissioner must
52.36provide this data to the legislature on a quarterly basis.
53.1(j) Effective June 1, 2010, the provisions of section 256.9695, subdivision 2,
53.2paragraph (b), do not apply to general assistance medical care provided under this section.
53.3(k) If a recipient is transferred from a hospital that is not participating in a
53.4coordinated care delivery system to a hospital participating in a coordinated care delivery
53.5system, in order to receive a higher level of care, the transferring hospital remains eligible
53.6to receive any available funding through the temporary uncompensated care pool for the
53.7care initially provided at that hospital. The hospital participating in the coordinated care
53.8delivery system shall be responsible only for care provided at that hospital, and is not
53.9financially liable for the initial care provided by the transferring hospital.

53.10    Sec. 50. Laws 2010, chapter 200, article 1, section 12, subdivision 7, is amended to
53.11read:
53.12    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
53.13system. (a) Effective for general assistance medical care services, with the exception
53.14of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
53.15coordinated care delivery system, the commissioner shall allocate the annual appropriation
53.16for the coordinated care delivery system to hospitals participating under subdivision
53.176 in quarterly payments, beginning on the first scheduled warrant on or after June 1,
53.182010. The payment shall be allocated among all hospitals qualified to participate on the
53.19allocation date. Each hospital or group of hospitals shall receive a pro rata share of the
53.20allocation based on the hospital's or group of hospitals' calendar year 2008 payments for
53.21general assistance medical care services, adjusted for any limits on the number of general
53.22assistance medical care enrollees accepted by a hospital, provided that, for the purposes of
53.23this allocation, payments to Hennepin County Medical Center, Regions Hospital, Saint
53.24Mary's Medical Center, and University of Minnesota Medical Center, Fairview, shall be
53.25weighted at 110 percent of the actual amount. The commissioner may prospectively
53.26reallocate payments to participating hospitals on a biannual basis to ensure that final
53.27allocations reflect actual coordinated care delivery system enrollment. The 2008 base year
53.28shall be updated by one calendar year each June 1, beginning June 1, 2011.
53.29(b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the
53.30commissioner shall make one-third of the quarterly payment in June and the remaining
53.31two-thirds of the quarterly payment in July to each participating hospital or group of
53.32hospitals.
53.33(b) (c) In order to be reimbursed under this section, nonhospital providers of health
53.34care services shall contract with one or more hospitals described in paragraph (a) to
53.35provide services to general assistance medical care recipients through the coordinated care
54.1delivery system established by the hospital. The hospital shall reimburse bills submitted
54.2by nonhospital providers participating under this paragraph at a rate negotiated between
54.3the hospital and the nonhospital provider.
54.4(c) (d) The commissioner shall apply for federal matching funds under section
54.5256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
54.6(d) (e) Outpatient prescription drug coverage is provided in accordance with section
54.7256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9.

54.8    Sec. 51. Laws 2010, chapter 200, article 1, section 12, subdivision 8, is amended to
54.9read:
54.10    Subd. 8. Temporary uncompensated care pool. (a) The commissioner shall
54.11establish a temporary uncompensated care pool, effective June 1, 2010. Payments from
54.12the pool must be distributed, within the limits of the available appropriation, to hospitals
54.13that are not part of a coordinated care delivery system established under subdivision
54.146. Payments from the pool must also be distributed, within the limits of the available
54.15appropriation, to ambulance services licensed under chapter 144E that respond to a request
54.16for an emergency ambulance call or interfacility transfer for a general assistance medical
54.17care enrollee, if the call or transfer originates from a location more than 25 miles from the
54.18health care facility that receives the enrollee.
54.19(b) Hospitals seeking reimbursement from this pool must submit an invoice to
54.20the commissioner in a form prescribed by the commissioner for payment for services
54.21provided to an applicant or recipient not enrolled in a coordinated care delivery system. A
54.22payment amount, as calculated under current law, must be determined, but not paid, for
54.23each admission of or service provided to a general assistance medical care recipient on
54.24or after June 1, 2010, to November 30 December 31, 2010, or until medical assistance
54.25coverage is expanded to include adults without children, whichever is later.
54.26(c) The aggregated payment amounts for each hospital must be calculated as a
54.27percentage of the total calculated amount for all hospitals.
54.28(d) Distributions from the uncompensated care pool for each hospital must be
54.29determined by multiplying the factor in paragraph (c) by the amount of money in the
54.30uncompensated care pool that is available for the six-month period.
54.31(e) The commissioner shall apply for federal matching funds under section
54.32256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
54.33(f) Outpatient prescription drugs are not eligible for payment under this subdivision.

55.1    Sec. 52. Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to
55.2read:
55.3EFFECTIVE DATE.This section is effective for services rendered on or after
55.4April 1, 2010, except that subdivision 4 is effective June 1, 2010.
55.5EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

55.6    Sec. 53. Laws 2010, chapter 200, article 1, section 16, is amended to read:
55.7    Sec. 16. Minnesota Statutes 2008, section 256L.05, subdivision 3c, is amended to
55.8read:
55.9    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective
55.10date of coverage shall be the first day of the month following termination from medical
55.11assistance for families and individuals who are eligible for MinnesotaCare and who
55.12submitted a written request for retroactive MinnesotaCare coverage with a completed
55.13application within 30 days of the mailing of notification of termination from medical
55.14assistance. The applicant must provide all required verifications within 30 days of the
55.15written request for verification. For retroactive coverage, premiums must be paid in full
55.16for any retroactive month, current month, and next month within 30 days of the premium
55.17billing. General assistance medical care recipients may qualify for retroactive coverage
55.18under this subdivision at six-month renewal.
55.19EFFECTIVE DATE.This section is effective June 1, 2010.

55.20    Sec. 54. Laws 2010, chapter 200, article 1, section 21, is amended to read:
55.21    Sec. 21. REPEALER.
55.22(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03,
55.23subdivision 9, are repealed effective April 1, 2010.
55.24(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed
55.25effective April June 1, 2010.
55.26(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed
55.27effective for federal fiscal year 2010.
55.28(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and
55.293, are repealed effective for federal fiscal year 2010.
55.30(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision
55.314; and 256L.17, subdivision 7, are repealed January 1, 2011.
55.32EFFECTIVE DATE.This section is effective retroactively from April 1, 2010.

56.1    Sec. 55. Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:

56.2

Subdivision 1.Total Appropriation

$

(7,985,000)

$

(93,128,000)

56.3	Appropriations by Fund
56.4		2010	2011
56.5	General	34,807,000	118,493,000
56.6	Health Care Access	(42,792,000)	(211,621,000)

56.7The amounts that may be spent for each
56.8purpose are specified in the following
56.9subdivisions.
56.10Special Revenue Fund Transfers.
56.11(1) The commissioner shall transfer the
56.12following amounts from special revenue
56.13fund balances to the general fund by June
56.1430 of each respective fiscal year: $410,000
56.15for fiscal year 2010, and $412,000 for fiscal
56.16year 2011.
56.17(2) Actual transfers made under clause (1)
56.18must be separately identified and reported as
56.19part of the quarterly reporting of transfers
56.20to the chairs of the relevant senate budget
56.21division and house of representatives finance
56.22division.
56.23EFFECTIVE DATE.This section is effective the day following final enactment.

56.24    Sec. 56. Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:

56.25

Subd. 8.Transfers

56.26The commissioner must transfer $29,538,000
56.27in fiscal year 2010 and $18,462,000 in fiscal
56.28year 2011 from the health care access fund to
56.29the general fund. This is a onetime transfer.
56.30The commissioner must transfer $4,800,000
56.31from the consolidated chemical dependency
56.32treatment fund to the general fund by June
56.3330, 2010.
57.1Compulsive Gambling Special Revenue
57.2Administration. The lottery prize fund
57.3appropriation for compulsive gambling
57.4administration is reduced by $6,000 for fiscal
57.5year 2010 and $4,000 for fiscal year 2011
57.6must be transferred from the lottery prize
57.7fund appropriation for compulsive gambling
57.8administration to the general fund by June
57.930 of each respective fiscal year. These are
57.10onetime reductions.
57.11EFFECTIVE DATE.This section is effective the day following final enactment.

57.12    Sec. 57. EARLY EXPANSION.
57.13All costs related to implementation of Minnesota Statutes, sections 256B.055,
57.14subdivision 15, and 256B.056, subdivision 4, paragraph (e), shall be paid from the health
57.15care access fund.
57.16EFFECTIVE DATE.This section is effective upon federal approval and is
57.17retroactive to April 1, 2010.

57.18    Sec. 58. FISCAL AND ACTUARIAL ANALYSIS.
57.19The commissioner of human services shall offer a request for proposal and accept
57.20bids for the completion of a complete fiscal and actuarial analysis of 2010 House File 135
57.21and 2010 Senate File 118. The commissioner shall report this analysis to the chairs of the
57.22health and human services finance and policy divisions in the house of representatives and
57.23senate no later than December 15, 2010.

57.24    Sec. 59. REPEALER; TRANSFER.
57.25(a) Laws 2010, chapter 200, article 1, section 12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8,
57.26and 9, are repealed.
57.27(b) Laws 2010, chapter 200, article 1, sections 18; and 19, are repealed.
57.28(c) Minnesota Statutes 2008, section 256D.03, subdivisions 3a, 3b, 5, 6, 7, and 8,
57.29and Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, are repealed.
57.30EFFECTIVE DATE.Paragraphs (a) and (b) are effective 30 days after federal
57.31approval of the amendments in this article to Minnesota Statutes, sections 256B.055,
57.32subdivision 15, and 256B.056, subdivision 4, or January 1, 2011, whichever is later,
58.1and all remaining unspent appropriations for the program established by Laws 2010,
58.2chapter 200, are transferred to the health care access fund. Paragraph (c) is effective
58.330 days after federal approval of the amendments in this article to Minnesota Statutes,
58.4sections 256B.055, subdivision 15, and 256B.056, subdivision 4, or January 1, 2011,
58.5whichever is later.

58.6ARTICLE 3

58.7CONTINUING CARE

58.8    Section 1. Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a,
58.9is amended to read:
58.10    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
58.11child, including a child determined eligible for medical assistance without consideration of
58.12parental income, must contribute to the cost of services used by making monthly payments
58.13on a sliding scale based on income, unless the child is married or has been married,
58.14parental rights have been terminated, or the child's adoption is subsidized according to
58.15section 259.67 or through title IV-E of the Social Security Act. The parental contribution
58.16is a partial or full payment for medical services provided for diagnostic, therapeutic,
58.17curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
58.18defined in United States Code, title 26, section 213, needed by the child with a chronic
58.19illness or disability.
58.20    (b) For households with adjusted gross income equal to or greater than 100 percent
58.21of federal poverty guidelines, the parental contribution shall be computed by applying the
58.22following schedule of rates to the adjusted gross income of the natural or adoptive parents:
58.23    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
58.24poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
58.25contribution is $4 per month;
58.26    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
58.27poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
58.28the parental contribution shall be determined using a sliding fee scale established by the
58.29commissioner of human services which begins at one percent of adjusted gross income
58.30at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
58.31gross income for those with adjusted gross income up to 545 percent of federal poverty
58.32guidelines; and
58.33    (3) if the adjusted gross income is greater than 545 percent of federal poverty
58.34guidelines and less than 675 percent of federal poverty guidelines, the parental
58.35contribution shall be 7.5 12.5 percent of adjusted gross income;.
59.1    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
59.2poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
59.3contribution shall be determined using a sliding fee scale established by the commissioner
59.4of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
59.5federal poverty guidelines and increases to ten percent of adjusted gross income for those
59.6with adjusted gross income up to 975 percent of federal poverty guidelines; and
59.7    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
59.8poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
59.9income.
59.10    If the child lives with the parent, the annual adjusted gross income is reduced by
59.11$2,400 prior to calculating the parental contribution. If the child resides in an institution
59.12specified in section 256B.35, the parent is responsible for the personal needs allowance
59.13specified under that section in addition to the parental contribution determined under this
59.14section. The parental contribution is reduced by any amount required to be paid directly to
59.15the child pursuant to a court order, but only if actually paid.
59.16    (c) The household size to be used in determining the amount of contribution under
59.17paragraph (b) includes natural and adoptive parents and their dependents, including the
59.18child receiving services. Adjustments in the contribution amount due to annual changes
59.19in the federal poverty guidelines shall be implemented on the first day of July following
59.20publication of the changes.
59.21    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
59.22natural or adoptive parents determined according to the previous year's federal tax form,
59.23except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
59.24have been used to purchase a home shall not be counted as income.
59.25    (e) The contribution shall be explained in writing to the parents at the time eligibility
59.26for services is being determined. The contribution shall be made on a monthly basis
59.27effective with the first month in which the child receives services. Annually upon
59.28redetermination or at termination of eligibility, if the contribution exceeded the cost of
59.29services provided, the local agency or the state shall reimburse that excess amount to
59.30the parents, either by direct reimbursement if the parent is no longer required to pay a
59.31contribution, or by a reduction in or waiver of parental fees until the excess amount is
59.32exhausted. All reimbursements must include a notice that the amount reimbursed may be
59.33taxable income if the parent paid for the parent's fees through an employer's health care
59.34flexible spending account under the Internal Revenue Code, section 125, and that the
59.35parent is responsible for paying the taxes owed on the amount reimbursed.
60.1    (f) The monthly contribution amount must be reviewed at least every 12 months;
60.2when there is a change in household size; and when there is a loss of or gain in income
60.3from one month to another in excess of ten percent. The local agency shall mail a written
60.4notice 30 days in advance of the effective date of a change in the contribution amount.
60.5A decrease in the contribution amount is effective in the month that the parent verifies a
60.6reduction in income or change in household size.
60.7    (g) Parents of a minor child who do not live with each other shall each pay the
60.8contribution required under paragraph (a). An amount equal to the annual court-ordered
60.9child support payment actually paid on behalf of the child receiving services shall be
60.10deducted from the adjusted gross income of the parent making the payment prior to
60.11calculating the parental contribution under paragraph (b).
60.12    (h) The contribution under paragraph (b) shall be increased by an additional five
60.13percent if the local agency determines that insurance coverage is available but not
60.14obtained for the child. For purposes of this section, "available" means the insurance is a
60.15benefit of employment for a family member at an annual cost of no more than five percent
60.16of the family's annual income. For purposes of this section, "insurance" means health
60.17and accident insurance coverage, enrollment in a nonprofit health service plan, health
60.18maintenance organization, self-insured plan, or preferred provider organization.
60.19    Parents who have more than one child receiving services shall not be required
60.20to pay more than the amount for the child with the highest expenditures. There shall
60.21be no resource contribution from the parents. The parent shall not be required to pay
60.22a contribution in excess of the cost of the services provided to the child, not counting
60.23payments made to school districts for education-related services. Notice of an increase in
60.24fee payment must be given at least 30 days before the increased fee is due.
60.25    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
60.26in the 12 months prior to July 1:
60.27    (1) the parent applied for insurance for the child;
60.28    (2) the insurer denied insurance;
60.29    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
60.30a complaint or appeal, in writing, to the commissioner of health or the commissioner of
60.31commerce, or litigated the complaint or appeal; and
60.32    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
60.33    For purposes of this section, "insurance" has the meaning given in paragraph (h).
60.34    A parent who has requested a reduction in the contribution amount under this
60.35paragraph shall submit proof in the form and manner prescribed by the commissioner or
60.36county agency, including, but not limited to, the insurer's denial of insurance, the written
61.1letter or complaint of the parents, court documents, and the written response of the insurer
61.2approving insurance. The determinations of the commissioner or county agency under this
61.3paragraph are not rules subject to chapter 14.

61.4    Sec. 2. Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:
61.5    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
61.6for a person who is employed and who:
61.7(1) but for excess earnings or assets, meets the definition of disabled under the
61.8supplemental security income program;
61.9(2) is at least 16 but less than 65 years of age;
61.10(3) meets the asset limits in paragraph (c); and
61.11(4) effective November 1, 2003, pays a premium and other obligations under
61.12paragraph (e).
61.13Any spousal income or assets shall be disregarded for purposes of eligibility and premium
61.14determinations.
61.15(b) After the month of enrollment, a person enrolled in medical assistance under
61.16this subdivision who:
61.17(1) is temporarily unable to work and without receipt of earned income due to a
61.18medical condition, as verified by a physician, may retain eligibility for up to four calendar
61.19months; or
61.20(2) effective January 1, 2004, loses employment for reasons not attributable to the
61.21enrollee, may retain eligibility for up to four consecutive months after the month of job
61.22loss. To receive a four-month extension, enrollees must verify the medical condition or
61.23provide notification of job loss. All other eligibility requirements must be met and the
61.24enrollee must pay all calculated premium costs for continued eligibility.
61.25(c) For purposes of determining eligibility under this subdivision, a person's assets
61.26must not exceed $20,000, excluding:
61.27(1) all assets excluded under section 256B.056;
61.28(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
61.29Keogh plans, and pension plans; and
61.30(3) medical expense accounts set up through the person's employer.
61.31(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
61.32earned income disregard. To be eligible, a person applying for medical assistance under
61.33this subdivision must have earned income above the disregard level.
62.1(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
62.2Security, and applicable state and federal income taxes must be withheld. To be eligible,
62.3a person must document earned income tax withholding.
62.4(e)(1) A person whose earned and unearned income is equal to or greater than 100
62.5percent of federal poverty guidelines for the applicable family size must pay a premium
62.6to be eligible for medical assistance under this subdivision. The premium shall be based
62.7on the person's gross earned and unearned income and the applicable family size using a
62.8sliding fee scale established by the commissioner, which begins at one percent of income
62.9at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income
62.10for those with incomes at or above 300 percent of the federal poverty guidelines. Annual
62.11adjustments in the premium schedule based upon changes in the federal poverty guidelines
62.12shall be effective for premiums due in July of each year.
62.13(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
62.14medical assistance under this subdivision. An enrollee shall pay the greater of a $35 $50
62.15premium or the premium calculated in clause (1).
62.16(3) Effective November 1, 2003, all enrollees who receive unearned income must
62.17pay one-half of one 2.5 percent of unearned income in addition to the premium amount.
62.18(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
62.19percent of the federal poverty guidelines and who are also enrolled in Medicare, the
62.20commissioner must reimburse the enrollee for Medicare Part B premiums under section
62.21256B.0625, subdivision 15 , paragraph (a).
62.22(5) Increases in benefits under title II of the Social Security Act shall not be counted
62.23as income for purposes of this subdivision until July 1 of each year.
62.24(f) A person's eligibility and premium shall be determined by the local county
62.25agency. Premiums must be paid to the commissioner. All premiums are dedicated to
62.26the commissioner.
62.27(g) Any required premium shall be determined at application and redetermined at
62.28the enrollee's six-month income review or when a change in income or household size is
62.29reported. Enrollees must report any change in income or household size within ten days
62.30of when the change occurs. A decreased premium resulting from a reported change in
62.31income or household size shall be effective the first day of the next available billing month
62.32after the change is reported. Except for changes occurring from annual cost-of-living
62.33increases, a change resulting in an increased premium shall not affect the premium amount
62.34until the next six-month review.
63.1(h) Premium payment is due upon notification from the commissioner of the
63.2premium amount required. Premiums may be paid in installments at the discretion of
63.3the commissioner.
63.4(i) Nonpayment of the premium shall result in denial or termination of medical
63.5assistance unless the person demonstrates good cause for nonpayment. Good cause exists
63.6if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
63.7D, are met. Except when an installment agreement is accepted by the commissioner,
63.8all persons disenrolled for nonpayment of a premium must pay any past due premiums
63.9as well as current premiums due prior to being reenrolled. Nonpayment shall include
63.10payment with a returned, refused, or dishonored instrument. The commissioner may
63.11require a guaranteed form of payment as the only means to replace a returned, refused,
63.12or dishonored instrument.
63.13(j) The commissioner shall notify enrollees annually beginning at least 24 months
63.14before the person's 65th birthday of the medical assistance eligibility rules affecting
63.15income, assets, and treatment of a spouse's income and assets that will be applied upon
63.16reaching age 65.
63.17EFFECTIVE DATE.This section is effective January 1, 2011.

63.18    Sec. 3. Minnesota Statutes 2009 Supplement, section 256B.0915, subdivision 3a,
63.19is amended to read:
63.20    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
63.21waivered services to an individual elderly waiver client except for individuals described
63.22in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
63.23mix resident class to which the elderly waiver client would be assigned under Minnesota
63.24Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
63.25as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
63.26which the resident assessment system as described in section 256B.438 for nursing home
63.27rate determination is implemented. Effective on the first day of the state fiscal year in
63.28which the resident assessment system as described in section 256B.438 for nursing home
63.29rate determination is implemented and the first day of each subsequent state fiscal year, the
63.30monthly limit for the cost of waivered services to an individual elderly waiver client shall
63.31be the rate of the case mix resident class to which the waiver client would be assigned
63.32under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
63.33previous state fiscal year, adjusted by the greater of any legislatively adopted home and
63.34community-based services percentage rate increase or the average statewide percentage
63.35increase in nursing facility payment rates adjustment.
64.1    (b) The monthly limit for the cost of waivered services to an individual elderly
64.2waiver client assigned to a case mix classification A under paragraph (a) with (1) no
64.3dependencies in activities of daily living, (2) only one dependency in bathing, dressing,
64.4grooming, or walking, or (3) a dependency score of less than three if eating is the only
64.5dependency, shall be the lower of the case mix classification amount for case mix A as
64.6determined under paragraph (a) or the case mix classification amount for case mix A
64.7effective on October 1, 2008, per month for all new participants enrolled in the program
64.8on or after July 1, 2009. This monthly limit shall be applied to all other participants who
64.9meet this criteria at reassessment.
64.10(c) If extended medical supplies and equipment or environmental modifications are
64.11or will be purchased for an elderly waiver client, the costs may be prorated for up to
64.1212 consecutive months beginning with the month of purchase. If the monthly cost of a
64.13recipient's waivered services exceeds the monthly limit established in paragraph (a) or
64.14(b), the annual cost of all waivered services shall be determined. In this event, the annual
64.15cost of all waivered services shall not exceed 12 times the monthly limit of waivered
64.16services as described in paragraph (a) or (b).

64.17    Sec. 4. Minnesota Statutes 2008, section 256B.0915, subdivision 3b, is amended to
64.18read:
64.19    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
64.20facility. (a) For a person who is a nursing facility resident at the time of requesting a
64.21determination of eligibility for elderly waivered services, a monthly conversion limit for
64.22the cost of elderly waivered services may be requested. The monthly conversion limit for
64.23the cost of elderly waiver services shall be the resident class assigned under Minnesota
64.24Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where
64.25the resident currently resides until July 1 of the state fiscal year in which the resident
64.26assessment system as described in section 256B.438 for nursing home rate determination
64.27is implemented. Effective on July 1 of the state fiscal year in which the resident
64.28assessment system as described in section 256B.438 for nursing home rate determination
64.29is implemented, the monthly conversion limit for the cost of elderly waiver services shall
64.30be the per diem nursing facility rate as determined by the resident assessment system as
64.31described in section 256B.438 for that resident residents in the nursing facility where the
64.32resident currently resides, but in effect on June 30, 2010, and adjusted annually by any
64.33legislatively adopted percentage change in the elderly waiver services rates. That per
64.34diem shall be multiplied by 365 and, divided by 12, less and reduced by the recipient's
64.35maintenance needs allowance as described in subdivision 1d. The initially approved
65.1conversion rate may must be adjusted by the greater of any subsequent legislatively
65.2adopted home and community-based services percentage rate increase or the average
65.3statewide percentage increase in nursing facility payment rates adjustment. The limit
65.4under this subdivision only applies to persons discharged from a nursing facility after a
65.5minimum 30-day stay and found eligible for waivered services on or after July 1, 1997.
65.6For conversions from the nursing home to the elderly waiver with consumer directed
65.7community support services, the conversion rate limit is equal to the nursing facility rate
65.8reduced by a percentage equal to the percentage difference between the consumer directed
65.9services budget limit that would be assigned according to the federally approved waiver
65.10plan and the corresponding community case mix cap, but not to exceed 50 percent.
65.11    (b) The following costs must be included in determining the total monthly costs
65.12for the waiver client:
65.13    (1) cost of all waivered services, including extended medical specialized supplies
65.14and equipment and environmental modifications and accessibility adaptations; and
65.15    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
65.16by medical assistance.

65.17    Sec. 5. Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23, is
65.18amended to read:
65.19    Subd. 23. Alternative services; elderly and disabled persons. (a) The
65.20commissioner may implement demonstration projects to create alternative integrated
65.21delivery systems for acute and long-term care services to elderly persons and persons
65.22with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
65.23coordination, improve access to quality services, and mitigate future cost increases.
65.24The commissioner may seek federal authority to combine Medicare and Medicaid
65.25capitation payments for the purpose of such demonstrations and may contract with
65.26Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
65.27services shall be administered according to the terms and conditions of the federal contract
65.28and demonstration provisions. For the purpose of administering medical assistance funds,
65.29demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
65.30of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
65.31with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
65.32items B and C, which do not apply to persons enrolling in demonstrations under this
65.33section. An initial open enrollment period may be provided. Persons who disenroll from
65.34demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
65.35to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
66.1the health plan's participation is subsequently terminated for any reason, the person shall
66.2be provided an opportunity to select a new health plan and shall have the right to change
66.3health plans within the first 60 days of enrollment in the second health plan. Persons
66.4required to participate in health plans under this section who fail to make a choice of
66.5health plan shall not be randomly assigned to health plans under these demonstrations.
66.6Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
66.7subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
66.8the commissioner may contract with managed care organizations, including counties, to
66.9serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
66.10disabled persons only. For persons with a primary diagnosis of developmental disability,
66.11serious and persistent mental illness, or serious emotional disturbance, the commissioner
66.12must ensure that the county authority has approved the demonstration and contracting
66.13design. Enrollment in these projects for persons with disabilities shall be voluntary. The
66.14commissioner shall not implement any demonstration project under this subdivision for
66.15persons with a primary diagnosis of developmental disabilities, serious and persistent
66.16mental illness, or serious emotional disturbance, without approval of the county board of
66.17the county in which the demonstration is being implemented.
66.18    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
66.19to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
66.209525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
66.21under this section projects for persons with developmental disabilities. The commissioner
66.22may capitate payments for ICF/MR services, waivered services for developmental
66.23disabilities, including case management services, day training and habilitation and
66.24alternative active treatment services, and other services as approved by the state and by the
66.25federal government. Case management and active treatment must be individualized and
66.26developed in accordance with a person-centered plan. Costs under these projects may not
66.27exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
66.28and until four years after the pilot project implementation date, subcontractor participation
66.29in the long-term care developmental disability pilot is limited to a nonprofit long-term
66.30care system providing ICF/MR services, home and community-based waiver services,
66.31and in-home services to no more than 120 consumers with developmental disabilities in
66.32Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
66.33prior to expansion of the developmental disability pilot project. This paragraph expires
66.34four years after the implementation date of the pilot project.
66.35    (c) Before implementation of a demonstration project for disabled persons, the
66.36commissioner must provide information to appropriate committees of the house of
67.1representatives and senate and must involve representatives of affected disability groups
67.2in the design of the demonstration projects.
67.3    (d) A nursing facility reimbursed under the alternative reimbursement methodology
67.4in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
67.5provide services under paragraph (a). The commissioner shall amend the state plan and
67.6seek any federal waivers necessary to implement this paragraph.
67.7    (e) The commissioner, in consultation with the commissioners of commerce and
67.8health, may approve and implement programs for all-inclusive care for the elderly (PACE)
67.9according to federal laws and regulations governing that program and state laws or rules
67.10applicable to participating providers. The process for approval of these programs shall
67.11begin only after the commissioner receives grant money in an amount sufficient to cover
67.12the state share of the administrative and actuarial costs to implement the programs during
67.13state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
67.14account in the special revenue fund and are appropriated to the commissioner to be used
67.15solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
67.16not required to be licensed or certified as a health plan company as defined in section
67.1762Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county
67.18and found to be eligible for services under the elderly waiver or community alternatives
67.19for disabled individuals or who are already eligible for Medicaid but meet level of
67.20care criteria for receipt of waiver services may choose to enroll in the PACE program.
67.21Medicare and Medicaid services will be provided according to this subdivision and
67.22federal Medicare and Medicaid requirements governing PACE providers and programs.
67.23PACE enrollees will receive Medicaid home and community-based services through the
67.24PACE provider as an alternative to services for which they would otherwise be eligible
67.25through home and community-based waiver programs and Medicaid State Plan Services.
67.26The commissioner shall establish Medicaid rates for PACE providers that do not exceed
67.27costs that would have been incurred under fee-for-service or other relevant managed care
67.28programs operated by the state.
67.29    (f) The commissioner shall seek federal approval to expand the Minnesota disability
67.30health options (MnDHO) program established under this subdivision in stages, first to
67.31regional population centers outside the seven-county metro area and then to all areas of
67.32the state. Until July 1, 2009, expansion for MnDHO projects that include home and
67.33community-based services is limited to the two projects and service areas in effect on
67.34March 1, 2006. Enrollment in integrated MnDHO programs that include home and
67.35community-based services shall remain voluntary. Costs for home and community-based
67.36services included under MnDHO must not exceed costs that would have been incurred
68.1under the fee-for-service program. Notwithstanding whether expansion occurs under
68.2this paragraph, in determining MnDHO payment rates and risk adjustment methods for
68.3contract years starting in 2012, the commissioner must consider the methods used to
68.4determine county allocations for home and community-based program participants. If
68.5necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs
68.6for home and community-based services, the commissioner shall achieve the reduction by
68.7maintaining the base rate for contract years 2010 and 2011 for services provided under the
68.8community alternatives for disabled individuals waiver at the same level as for contract
68.9year 2009. The commissioner may apply other reductions to MnDHO rates to implement
68.10decreases in provider payment rates required by state law. In developing program
68.11specifications for expansion of integrated programs, the commissioner shall involve and
68.12consult the state-level stakeholder group established in subdivision 28, paragraph (d),
68.13including consultation on whether and how to include home and community-based waiver
68.14programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
68.15of the house of representatives and senate committees with jurisdiction over health and
68.16human services policy and finance by February 1, 2007.
68.17    (g) Notwithstanding section 256B.0261, health plans providing services under this
68.18section are responsible for home care targeted case management and relocation targeted
68.19case management. Services must be provided according to the terms of the waivers and
68.20contracts approved by the federal government.

68.21    Sec. 6. CASE MANAGEMENT REFORM.
68.22(a) By February 1, 2011, the commissioner of human services shall provide specific
68.23recommendations and language for proposed legislation to:
68.24(1) define the administrative and the service functions of case management and make
68.25changes to improve the funding for administrative functions;
68.26(2) standardize and simplify processes, standards, and timelines for administrative
68.27functions of case management within the Department of Human Services, Disability
68.28Services Division, including eligibility determinations, resource allocation, management
68.29of dollars, provision for assignment of one case manager at a time per person, waiting lists,
68.30quality assurance, host county concurrence requirements, county of financial responsibility
68.31provisions, and waiver compliance; and
68.32(3) increase opportunities for consumer choice of case management functions
68.33involving service coordination.
68.34(b) In developing these recommendations, the commissioner shall consider the
68.35recommendations of the 2007 Redesigning Case Management Services for Persons
69.1with Disabilities report and consult with existing stakeholder groups, which include
69.2representatives of counties, disability and senior advocacy groups, service providers, and
69.3representatives of agencies which provide contracted case management.
69.4EFFECTIVE DATE.This section is effective the day following final enactment.

69.5    Sec. 7. [256.4825] REPORT REGARDING PROGRAMS AND SERVICES FOR
69.6PEOPLE WITH DISABILITIES.
69.7The Minnesota State Council on Disability, the Minnesota Consortium for Citizens
69.8with Disabilities, and the Arc of Minnesota may submit an annual report by January 15 of
69.9each year, beginning in 2012, to the chairs and ranking minority members of the legislative
69.10committees with jurisdiction over programs serving people with disabilities as provided in
69.11this section. The report must describe the existing state policies and goals for programs
69.12serving people with disabilities including, but not limited to, programs for employment,
69.13transportation, housing, education, quality assurance, consumer direction, physical and
69.14programmatic access, and health. The report must provide data and measurements to
69.15assess the extent to which the policies and goals are being met. The commissioner of
69.16human services and the commissioners of other state agencies administering programs for
69.17people with disabilities shall cooperate with the Minnesota State Council on Disability,
69.18the Minnesota Consortium for Citizens with Disabilities, and the Arc of Minnesota and
69.19provide those organizations with existing published information and reports that will assist
69.20in the preparation of the report.

69.21    Sec. 8. COMMISSIONER TO SEEK FEDERAL MATCH.
69.22(a) The commissioner of human services shall seek federal financial participation
69.23for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change
69.24Together to establish a statewide self-advocacy network for persons with developmental
69.25disabilities and for eligible activities under any future grants to the organization.
69.26(b) The commissioner shall report to the chairs of the senate Health and Human
69.27Services Budget Division and the house of representatives Health Care and Human
69.28Services Finance Division by December 15, 2010, with the results of the application for
69.29federal matching funds.

70.1ARTICLE 4

70.2CHILDREN AND FAMILY SERVICES

70.3    Section 1. Minnesota Statutes 2008, section 256D.0515, is amended to read:
70.4256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.
70.5All food stamp households must be determined eligible for the benefit discussed
70.6under section 256.029. Food stamp households must demonstrate that:
70.7(1) their gross income meets the federal Food Stamp requirements under United
70.8States Code, title 7, section 2014(c); and is equal to or less than 165 percent of the federal
70.9poverty guidelines for the same family size.
70.10(2) they have financial resources, excluding vehicles, of less than $7,000.

70.11    Sec. 2. Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:
70.12    Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of
70.13all nonexcluded real and personal property of the assistance unit must not exceed $2,000
70.14for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
70.15(19) must be excluded when determining the equity value of real and personal property:
70.16    (1) a licensed vehicle up to a loan value of less than or equal to $15,000 $7,500. If the
70.17assistance unit owns more than one licensed vehicle, the county agency shall determine the
70.18loan value of all additional vehicles and exclude the combined loan value of less than or
70.19equal to $7,500. The county agency shall apply any excess loan value as if it were equity
70.20value to the asset limit described in this section,. If the assistance unit owns more than
70.21one licensed vehicle, the county agency shall determine the vehicle with the highest loan
70.22value and count only the loan value over $7,500, excluding: (i) the value of one vehicle
70.23per physically disabled person when the vehicle is needed to transport the disabled unit
70.24member; this exclusion does not apply to mentally disabled people; (ii) the value of special
70.25equipment for a disabled member of the assistance unit; and (iii) any vehicle used for
70.26long-distance travel, other than daily commuting, for the employment of a unit member.
70.27    The county agency shall count the loan value of all other vehicles and apply this
70.28amount as if it were equity value to the asset limit described in this section. To establish the
70.29loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide,
70.30Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook,
70.31or when the applicant or participant disputes the loan value listed in the guidebook as
70.32unreasonable given the condition of the particular vehicle, the county agency may require
70.33the applicant or participant document the loan value by securing a written statement from
70.34a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer
71.1would pay to purchase the vehicle. The county agency shall reimburse the applicant or
71.2participant for the cost of a written statement that documents a lower loan value;
71.3    (2) the value of life insurance policies for members of the assistance unit;
71.4    (3) one burial plot per member of an assistance unit;
71.5    (4) the value of personal property needed to produce earned income, including
71.6tools, implements, farm animals, inventory, business loans, business checking and
71.7savings accounts used at least annually and used exclusively for the operation of a
71.8self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
71.9is to produce income and if the vehicles are essential for the self-employment business;
71.10    (5) the value of personal property not otherwise specified which is commonly
71.11used by household members in day-to-day living such as clothing, necessary household
71.12furniture, equipment, and other basic maintenance items essential for daily living;
71.13    (6) the value of real and personal property owned by a recipient of Supplemental
71.14Security Income or Minnesota supplemental aid;
71.15    (7) the value of corrective payments, but only for the month in which the payment
71.16is received and for the following month;
71.17    (8) a mobile home or other vehicle used by an applicant or participant as the
71.18applicant's or participant's home;
71.19    (9) money in a separate escrow account that is needed to pay real estate taxes or
71.20insurance and that is used for this purpose;
71.21    (10) money held in escrow to cover employee FICA, employee tax withholding,
71.22sales tax withholding, employee worker compensation, business insurance, property rental,
71.23property taxes, and other costs that are paid at least annually, but less often than monthly;
71.24    (11) monthly assistance payments for the current month's or short-term emergency
71.25needs under section 256J.626, subdivision 2;
71.26    (12) the value of school loans, grants, or scholarships for the period they are
71.27intended to cover;
71.28    (13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
71.29in escrow for a period not to exceed three months to replace or repair personal or real
71.30property;
71.31    (14) income received in a budget month through the end of the payment month;
71.32    (15) savings from earned income of a minor child or a minor parent that are set aside
71.33in a separate account designated specifically for future education or employment costs;
71.34    (16) the federal earned income credit, Minnesota working family credit, state and
71.35federal income tax refunds, state homeowners and renters credits under chapter 290A,
72.1property tax rebates and other federal or state tax rebates in the month received and the
72.2following month;
72.3    (17) payments excluded under federal law as long as those payments are held in a
72.4separate account from any nonexcluded funds;
72.5    (18) the assets of children ineligible to receive MFIP benefits because foster care or
72.6adoption assistance payments are made on their behalf; and
72.7    (19) the assets of persons whose income is excluded under section 256J.21,
72.8subdivision 2 , clause (43).
72.9EFFECTIVE DATE.This section is effective October 1, 2010.

72.10    Sec. 3. Minnesota Statutes 2008, section 256J.24, subdivision 10, is amended to read:
72.11    Subd. 10. MFIP exit level. The commissioner shall adjust the MFIP earned income
72.12disregard to ensure that most participants do not lose eligibility for MFIP until their
72.13income reaches at least 115 110 percent of the federal poverty guidelines in effect in
72.14October of each fiscal year at the time of the adjustment. The adjustment to the disregard
72.15shall be based on a household size of three, and the resulting earned income disregard
72.16percentage must be applied to all household sizes. The adjustment under this subdivision
72.17must be implemented at the same time as the October food stamp or whenever there is a
72.18food support cost-of-living adjustment is reflected in the food portion of MFIP transitional
72.19standard as required under subdivision 5a.
72.20EFFECTIVE DATE.This section is effective October 1, 2010.

72.21    Sec. 4. Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:
72.22    Subd. 3a. Rental subsidies; unearned income. (a) Effective July 1, 2003, The
72.23county agency shall count $50 $100 of the value of public and assisted rental subsidies
72.24provided through the Department of Housing and Urban Development (HUD) as unearned
72.25income to the cash portion of the MFIP grant. The full amount of the subsidy must be
72.26counted as unearned income when the subsidy is less than $50 $100. The income from
72.27this subsidy shall be budgeted according to section 256J.34.
72.28(b) The provisions of this subdivision shall not apply to an MFIP assistance unit
72.29which includes a participant who is:
72.30(1) age 60 or older;
72.31(2) a caregiver who is suffering from an illness, injury, or incapacity that has been
72.32certified by a qualified professional when the illness, injury, or incapacity is expected
73.1to continue for more than 30 days and prevents the person from obtaining or retaining
73.2employment; or
73.3(3) a caregiver whose presence in the home is required due to the illness or
73.4incapacity of another member in the assistance unit, a relative in the household, or a foster
73.5child in the household when the illness or incapacity and the need for the participant's
73.6presence in the home has been certified by a qualified professional and is expected to
73.7continue for more than 30 days.
73.8(c) The provisions of this subdivision shall not apply to an MFIP assistance unit
73.9where the parental caregiver is an SSI recipient.
73.10(d) Prior to implementing this provision, the commissioner must identify the MFIP
73.11participants subject to this provision and provide written notice to these participants at
73.12least 30 days before the first grant reduction. The notice must inform the participant of the
73.13basis for the potential grant reduction, the exceptions to the provision, if any, and inform
73.14the participant of the steps necessary to claim an exception. A person who is found not to
73.15meet one of the exceptions to the provision must be notified and informed of the right to a
73.16fair hearing under section 256J.40. The notice must also inform the participant that the
73.17participant may be eligible for a rent reduction resulting from a reduction in the MFIP
73.18grant and encourage the participant to contact the local housing authority.
73.19EFFECTIVE DATE.This section is effective October 1, 2010.

73.20    Sec. 5. Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is
73.21amended to read:
73.22    Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time
73.23limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under
73.24a hardship extension if the participant who reached the time limit belongs to any of the
73.25following groups:
73.26    (1) a person who is diagnosed by a licensed physician, psychological practitioner, or
73.27other qualified professional, as developmentally disabled or mentally ill, and the condition
73.28severely limits the person's ability to obtain or maintain suitable employment;
73.29    (2) a person who:
73.30    (i) has been assessed by a vocational specialist or the county agency to be
73.31unemployable for purposes of this subdivision; or
73.32    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
73.33agency to be employable, but the condition severely limits the person's ability to obtain or
73.34maintain suitable employment. The determination of IQ level must be made by a qualified
73.35professional. In the case of a non-English-speaking person: (A) the determination must
74.1be made by a qualified professional with experience conducting culturally appropriate
74.2assessments, whenever possible; (B) the county may accept reports that identify an
74.3IQ range as opposed to a specific score; (C) these reports must include a statement of
74.4confidence in the results;
74.5    (3) a person who is determined by a qualified professional to be learning disabled,
74.6and the condition severely limits the person's ability to obtain or maintain suitable
74.7employment. For purposes of the initial approval of a learning disability extension, the
74.8determination must have been made or confirmed within the previous 12 months. In the
74.9case of a non-English-speaking person: (i) the determination must be made by a qualified
74.10professional with experience conducting culturally appropriate assessments, whenever
74.11possible; and (ii) these reports must include a statement of confidence in the results. If a
74.12rehabilitation plan for a participant extended as learning disabled is developed or approved
74.13by the county agency, the plan must be incorporated into the employment plan. However,
74.14a rehabilitation plan does not replace the requirement to develop and comply with an
74.15employment plan under section 256J.521; or
74.16    (4) a person who has been granted a family violence waiver, and who is complying
74.17with an employment plan under section 256J.521, subdivision 3.
74.18    (b) For purposes of this section chapter, "severely limits the person's ability to obtain
74.19or maintain suitable employment" means:
74.20    (1) that a qualified professional has determined that the person's condition prevents
74.21the person from working 20 or more hours per week; or
74.22    (2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or
74.23clause (3), a qualified professional has determined the person's condition:
74.24    (i) significantly restricts the range of employment that the person is able to perform;
74.25or
74.26    (ii) significantly interferes with the person's ability to obtain or maintain suitable
74.27employment for 20 or more hours per week.

74.28ARTICLE 5

74.29MISCELLANEOUS

74.30    Section 1. Minnesota Statutes 2008, section 3.971, subdivision 2, is amended to read:
74.31    Subd. 2. Staff; compensation. The legislative auditor shall establish a Financial
74.32Audits Division and a Program Evaluation Division to fulfill the duties prescribed in
74.33this section. The legislative auditor shall establish a Legislative Budget Office Division
74.34to fulfill the duties in section 3.98, subdivision 5. Each division may be supervised by a
74.35deputy auditor, appointed by the legislative auditor, with the approval of the commission,
75.1for a term coterminous with the legislative auditor's term. The deputy auditors may be
75.2removed before the expiration of their terms only for cause. The legislative auditor
75.3and deputy auditors may each appoint a confidential secretary to serve at pleasure.
75.4The salaries and benefits of the legislative auditor, deputy auditors and confidential
75.5secretaries shall be determined by the compensation plan approved by the Legislative
75.6Coordinating Commission. The deputy auditors may perform and exercise the powers,
75.7duties and responsibilities imposed by law on the legislative auditor when authorized by
75.8the legislative auditor. The deputy auditors and the confidential secretaries serve in the
75.9unclassified civil service, but all other employees of the legislative auditor are in the
75.10classified civil service. Compensation for employees of the legislative auditor in the
75.11classified service shall be governed by a plan prepared by the legislative auditor and
75.12approved by the Legislative Coordinating Commission and the legislature under section
75.133.855, subdivision 3 . While in office, a person appointed deputy for the Financial Audit
75.14Division must hold an active license as a certified public accountant.
75.15EFFECTIVE DATE.This section is effective July 1, 2011.

75.16    Sec. 2. Minnesota Statutes 2008, section 3.98, is amended by adding a subdivision to
75.17read:
75.18    Subd. 5. Fiscal notes; Department of Human Services. (a) The responsibilities of
75.19the Department of Human Services for the preparation of fiscal notes under this chapter
75.20are transferred to the Legislative Budget Office Division under section 3.971.
75.21(b) The Legislative Budget Office Division shall prepare a fiscal note for any bill that
75.22increases or decreases expenditures at the Department of Human Services at the request of
75.23the chair of the budget or finance division to which a bill relating to the department has
75.24been referred, or at the request of either the chair of the house of representatives Ways and
75.25Means Committee, or the chair of the senate Finance Committee. At the request of the
75.26commissioner of human services, the Legislative Budget Office Division shall include a
75.27statement from the commissioner:
75.28(1) concurring with the information provided;
75.29(2) suggesting alternative dollar amounts for a specific program or function; or
75.30(3) indicating any other information which the commissioner deems relevant.

75.31    Sec. 3. [62A.3075] CANCER CHEMOTHERAPY TREATMENT COVERAGE.
75.32(a) A health plan company that provides coverage under a health plan for cancer
75.33chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance
75.34amount for a prescribed, orally administered anticancer medication that is used to kill or
76.1slow the growth of cancerous cells than what the health plan requires for an intravenously
76.2administered or injected cancer medication that is provided, regardless of formulation or
76.3benefit category determination by the health plan company.
76.4(b) A health plan company must not achieve compliance with this section
76.5by imposing an increase in co-payment, deductible, or coinsurance amount for an
76.6intravenously administered or injected cancer chemotherapy agent covered under the
76.7health plan.
76.8(c) Nothing in this section shall be interpreted to prohibit a health plan company
76.9from requiring prior authorization or imposing other appropriate utilization controls in
76.10approving coverage for any chemotherapy.
76.11(d) A plan offered by the commissioner of management and budget under section
76.1243A.23 is deemed to be at parity and in compliance with this section.
76.13EFFECTIVE DATE.Paragraphs (a) and (c) are effective August 1, 2010, and apply
76.14to health plans providing coverage to a Minnesota resident offered, issued, sold, renewed,
76.15or continued as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after
76.16that date. Paragraph (b) is effective the day following final enactment.

76.17    Sec. 4. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
76.18    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
76.19paragraphs (b) to (e) have the meanings given.
76.20(b) "Autism spectrum disorder" means the following conditions as determined by
76.21criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of
76.22Mental Disorders of the American Psychiatric Association:
76.23(1) autism or autistic disorder;
76.24(2) Asperger's syndrome; or
76.25(3) pervasive developmental disorder - not otherwise specified.
76.26(c) "Board-certified behavior analyst" means an individual certified by the Behavior
76.27Analyst Certification Board as a board-certified behavior analyst.
76.28(d) "Evidence-based," for purposes of this section only, is as described in subdivision
76.292, paragraph (c), clause (2).
76.30(e) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
76.31(f) "Manualized approach" means a self-contained volume, text, or set of
76.32instructional media, which may include videos or compact discs, that codifies in
76.33reasonable detail the procedures for implementing treatment.
76.34(g) "Medical necessity" or "medically necessary care" has the meaning given in
76.35section 62Q.53, subdivision 2.
77.1(h) "Mental health professional" has the meaning given in section 245.4871,
77.2subdivision 27, clauses (1) to (6).
77.3(i) "Qualified mental health behavioral aide" means a mental health behavioral aide
77.4as defined in section 256B.0943, subdivision 7.
77.5(j) "Qualified mental health practitioner" means a mental health practitioner as
77.6defined in section 245.4871, subdivision 26.
77.7(k) "Statistically superior outcomes" means a research study in which the probability
77.8that the results would be obtained under the null hypothesis is less than five percent.
77.9    Subd. 2. Coverage required. (a) For coverage requirements to apply, an individual
77.10must have a diagnosis of autism spectrum disorder made through an evaluation of the
77.11patient, completed within the six months prior to the start of treatment, which includes
77.12all of the following:
77.13(1) a complete medical and psychological evaluation performed by a licensed
77.14physician and psychologist using empirically validated tools or tests that incorporate
77.15measures for intellectual functioning, language development, adaptive skills, and
77.16behavioral problems, which must include:
77.17(i) a developmental history of the child, focusing on developmental milestones
77.18and delays;
77.19(ii) a family history, including whether there are other family members with an
77.20autism spectrum disorder, developmental disability, fragile X syndrome, or tuberous
77.21sclerosis;
77.22(iii) a medical history, including signs of deterioration, seizure activity, brain injury,
77.23and head circumference;
77.24(iv) a physical examination completed within the past 12 months;
77.25(v) an evaluation for intellectual functioning;
77.26(vi) a lead screening for those children with a developmental disability; and
77.27(vii) other evaluations and testing as indicated by the medical evaluation, which
77.28may include neuropsychological testing, occupational therapy, physical therapy, family
77.29functioning, genetic testing, imaging laboratory tests, and electrophysiological testing;
77.30(2) a communication assessment conducted by a speech pathologist; and
77.31(3) a comprehensive hearing test conducted by an audiologist with experience in
77.32testing very young children.
77.33(b) A health plan must provide coverage for the diagnosis, evaluation, assessment,
77.34and medically necessary care of autism spectrum disorders that is evidence-based,
77.35including but not limited to:
78.1(1) neurodevelopmental and behavioral health treatments, instruction, and
78.2management;
78.3(2) applied behavior analysis and intensive early intervention services, including
78.4service package models such as intensive early intervention behavior therapy services
78.5and Lovaas therapy;
78.6(3) speech therapy;
78.7(4) occupational therapy;
78.8(5) physical therapy; and
78.9(6) prescription medications.
78.10(c) Coverage required under this section shall include treatment that is in accordance
78.11with:
78.12(1) an individualized treatment plan prescribed by the insured's treating physician or
78.13mental health professional as defined in this section; and
78.14(2) medically and scientifically accepted evidence that meets the criteria of a
78.15peer-reviewed, published study that is one of the following:
78.16(i) a randomized study with adequate statistical power, including a sample size of
78.1730 or more for each group, that shows statistically superior outcomes to a pill placebo
78.18group, psychological placebo group, another treatment group, or a wait list control group,
78.19or that is equivalent to another evidence-based treatment that meets the above standard
78.20for the specified problem area; or
78.21(ii) a series of at least three single-case design experiments with clear specification
78.22of the subjects and with clear specification of the treatment approach that:
78.23(A) use robust experimental designs;
78.24(B) show statistically superior outcomes to pill placebo, psychological placebo,
78.25or another treatment group; and
78.26(C) either use a manualized approach or are conducted by at least two independent
78.27investigators or teams; or
78.28(3) where evidence meeting the standards of this subdivision does not exist for
78.29the treatment of a diagnosed condition or for an individual matching the demographic
78.30characteristics for which the evidence is valid, practice guidelines based on consensus
78.31of Minnesota health care professionals knowledgeable in the treatment of individuals
78.32with autism spectrum disorders.
78.33(d) Early intensive behavior therapies that meet the criteria set forth in paragraphs
78.34(b) and (c) must also meet the following best practices standards:
78.35(1) the services must be prescribed by a mental health professional as an appropriate
78.36treatment option for the individual child;
79.1(2) regular reporting of services provided and the child's progress must be submitted
79.2to the prescribing mental health professional;
79.3(3) care must include appropriate parent or legal guardian education and
79.4involvement;
79.5(4) the medically prescribed treatment and frequency of services should be
79.6coordinated between the school and provider for all children up to age 21; and
79.7(5) services must be provided by a mental health professional or, as appropriate, a
79.8board-certified behavior analyst, a qualified mental health practitioner, or a qualified
79.9mental health behavioral aide.
79.10(e) Providers under this section must work with the commissioner in implementing
79.11evidence-based practices and, specifically for children under age 21, the Minnesota
79.12Evidence-Based Practice Database of research-informed practice elements and specific
79.13constituent practices.
79.14(f) A health plan company may not refuse to renew or reissue, or otherwise terminate
79.15or restrict coverage of an individual solely because the individual is diagnosed with an
79.16autism spectrum disorder.
79.17(g) A health plan company may request an updated treatment plan only once every
79.18six months, unless the health plan company and the treating physician or mental health
79.19professional agree that a more frequent review is necessary due to emerging circumstances.
79.20    Subd. 3. Supervision, delegation of duties, and observation of qualified mental
79.21health practitioner, board-certified behavior analyst, or mental health behavioral
79.22aide. A mental health professional who uses the services of a qualified mental health
79.23practitioner, board-certified behavior analyst, or qualified mental health behavioral aide for
79.24the purpose of assisting in the provision of services to patients who have autism spectrum
79.25disorder is responsible for functions performed by these service providers. The qualified
79.26mental health professional must maintain clinical supervision of services they provide
79.27and accept full responsibility for their actions. The services provided must be medically
79.28necessary and identified in the child's individual treatment plan. Service providers must
79.29document their activities in written progress notes that reflect implementation of the
79.30individual treatment plan.
79.31    Subd. 4. State health care programs. This section does not affect benefits
79.32available under the medical assistance, MinnesotaCare, and general assistance medical
79.33care programs, and the state employee group insurance plan offered under sections
79.3443A.22 to 43A.30. These programs and the state employee group insurance plan must
79.35maintain current levels of coverage, and section 256B.0644 shall continue to apply.
79.36The commissioner shall monitor these services and report to the chairs of the house
80.1of representatives and senate standing committees that have jurisdiction over health
80.2and human services by February 1, 2011, whether there are gaps in the level of service
80.3provided by these programs and the state employee group insurance plan, and the level of
80.4service provided by private health plans following enactment of this section.
80.5    Subd. 5. No effect on other law. Nothing in this section limits in any way the
80.6coverage required under sections 62Q.47 and 62Q.53.
80.7EFFECTIVE DATE.This section is effective August 1, 2010, and applies to
80.8coverage offered, issued, sold, renewed, or continued as defined in Minnesota Statutes,
80.9section 60A.02, subdivision 2a, on or after that date.

80.10    Sec. 5. Minnesota Statutes 2008, section 62J.38, is amended to read:
80.1162J.38 COST CONTAINMENT DATA FROM GROUP PURCHASERS.
80.12(a) The commissioner shall require group purchasers to submit detailed data on total
80.13health care spending for each calendar year. Group purchasers shall submit data for the
80.141993 calendar year by April 1, 1994, and each April 1 thereafter shall submit data for the
80.15preceding calendar year.
80.16(b) The commissioner shall require each group purchaser to submit data on revenue,
80.17expenses, and member months, as applicable. Revenue data must distinguish between
80.18premium revenue and revenue from other sources and must also include information
80.19on the amount of revenue in reserves and changes in reserves. Expenditure data must
80.20distinguish between costs incurred for patient care and administrative costs, including
80.21amounts paid to contractors, subcontractors, and other entities for the purpose of managing
80.22provider utilization or distributing provider payments. Patient care and administrative
80.23costs must include only expenses incurred on behalf of health plan members and must
80.24not include the cost of providing health care services for nonmembers at facilities owned
80.25by the group purchaser or affiliate. Expenditure data must be provided separately
80.26for the following categories and for other categories required by the commissioner:
80.27physician services, dental services, other professional services, inpatient hospital services,
80.28outpatient hospital services, emergency, pharmacy services and other nondurable medical
80.29goods, mental health, and chemical dependency services, other expenditures, subscriber
80.30liability, and administrative costs. Administrative costs must include costs for marketing;
80.31advertising; overhead; salaries and benefits of central office staff who do not provide
80.32direct patient care; underwriting; lobbying; claims processing; provider contracting and
80.33credentialing; detection and prevention of payment for fraudulent or unjustified requests
80.34for reimbursement or services; clinical quality assurance and other types of medical care
81.1quality improvement efforts; concurrent or prospective utilization review as defined in
81.2section 62M.02; costs incurred to acquire a hospital, clinic, or health care facility, or the
81.3assets thereof; capital costs incurred on behalf of a hospital or clinic; lease payments; or
81.4any other costs incurred pursuant to a partnership, joint venture, integration, or affiliation
81.5agreement with a hospital, clinic, or other health care provider. Capital costs and costs
81.6incurred must be recorded according to standard accounting principles. The reports of
81.7this data must also separately identify expenses for local, state, and federal taxes, fees,
81.8and assessments. The commissioner may require each group purchaser to submit any
81.9other data, including data in unaggregated form, for the purposes of developing spending
81.10estimates, setting spending limits, and monitoring actual spending and costs. In addition to
81.11reporting administrative costs incurred to acquire a hospital, clinic, or health care facility,
81.12or the assets thereof; or any other costs incurred pursuant to a partnership, joint venture,
81.13integration, or affiliation agreement with a hospital, clinic, or other health care provider;
81.14reports submitted under this section also must include the payments made during the
81.15calendar year for these purposes. The commissioner shall make public, by group purchaser
81.16data collected under this paragraph in accordance with section 62J.321, subdivision 5.
81.17Workers' compensation insurance plans and automobile insurance plans are exempt from
81.18complying with this paragraph as it relates to the submission of administrative costs.
81.19(c) The commissioner may collect information on:
81.20(1) premiums, benefit levels, managed care procedures, and other features of health
81.21plan companies;
81.22(2) prices, provider experience, and other information for services less commonly
81.23covered by insurance or for which patients commonly face significant out-of-pocket
81.24expenses; and
81.25(3) information on health care services not provided through health plan companies,
81.26including information on prices, costs, expenditures, and utilization.
81.27(d) All group purchasers shall provide the required data using a uniform format and
81.28uniform definitions, as prescribed by the commissioner.

81.29    Sec. 6. [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.
81.30(a) A health plan must cover private duty nursing services as provided under section
81.31256B.0625, subdivision 7, for persons who are covered under the health plan and require
81.32private duty nursing services.
81.33(b) For purposes of this section, a period of private duty nursing services may
81.34be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing
81.35requirements that apply under the health plan. Cost-sharing requirements for private duty
82.1nursing services must not place a greater financial burden on the insured or enrollee than
82.2those requirements applied by the health plan to other similar services or benefits.
82.3EFFECTIVE DATE.This section is effective July 1, 2010, and applies to health
82.4plans offered, sold, issued, or renewed on or after that date.

82.5    Sec. 7. Minnesota Statutes 2008, section 62Q.76, subdivision 1, is amended to read:
82.6    Subdivision 1. Applicability. For purposes of sections 62Q.76 to 62Q.79 62Q.791,
82.7the terms defined in this section contract, health care provider, dental plan, dental
82.8organization, dentist, and enrollee have the meanings given them in sections 62Q.733
82.9and 62Q.76.

82.10    Sec. 8. [62Q.791] CONTRACTS WITH DENTAL CARE PROVIDERS.
82.11    (a) Notwithstanding any other provision of law, no contract of any dental
82.12organization licensed under chapter 62C for provision of dental care services may:
82.13    (1) require, directly or indirectly, that a dentist or health care provider provide dental
82.14care services to its enrollees at a fee set by the dental organization, unless the services
82.15provided are covered dental care services for enrollees under the dental plan or contract; or
82.16    (2) prohibit, directly or indirectly, the dentist or health care provider from offering or
82.17providing dental care services that are not covered dental care services under the dental
82.18plan or contract, on terms and conditions acceptable to the enrollee and the dentist or
82.19health care provider. For purposes of this section, "covered dental care services" means
82.20dental care services that are expressly covered under the dental plan or contract, including
82.21dental care services that are subject to contractual limitations such as deductibles,
82.22co-payments, annual maximums, and waiting periods.
82.23    (b) When making payment or otherwise adjudicating any claim for dental care
82.24services provided to an enrollee, a dental organization or dental plan must clearly identify
82.25on an explanation of benefits form or other form of claim resolution the amount, if any,
82.26that is the enrollee's responsibility to pay to the enrollee's dentist or health care provider.
82.27    (c) This section does not apply to any contract for the provision of dental care
82.28services under any public program sponsored or funded by the state or federal government.
82.29EFFECTIVE DATE.This section is effective August 1, 2010.

82.30    Sec. 9. [245.6971] ADVISORY GROUP ON STATE-OPERATED SERVICES
82.31REDESIGN.
83.1    Subdivision 1. Establishment. The Advisory Group on State-Operated Services
83.2Redesign is established to make recommendations to the commissioner of human services
83.3and the legislature on the continuum of services needed to provide individuals with
83.4complex conditions including mental illness and developmental disabilities access to
83.5quality care and the appropriate level of care across the state to promote wellness, reduce
83.6cost, and improve efficiency.
83.7    Subd. 2. Duties. The Advisory Group on State-Operated Services Redesign shall
83.8make recommendations to the commissioner and the legislature no later than December
83.915, 2010, on the following:
83.10(1) transformation needed to improve service delivery and provide a continuum of
83.11care, such as transition of current facilities, closure of current facilities, or the development
83.12of new models of care;
83.13(2) gaps and barriers to accessing quality care, system inefficiencies, and cost
83.14pressures;
83.15(3) services that are best provided by the state and those that are best provided
83.16in the community;
83.17(4) an implementation plan to achieve integrated service delivery across the public,
83.18private, and nonprofit sectors;
83.19(5) an implementation plan to ensure that individuals with complex chemical and
83.20mental health needs receive the appropriate level of care to achieve recovery and wellness;
83.21and
83.22(6) financing mechanisms that include all possible revenue sources to maximize
83.23federal funding and promote cost efficiencies and sustainability.
83.24    Subd. 3. Membership. The advisory group shall be composed of the following,
83.25who will serve at the pleasure of their appointing authority:
83.26(1) the commissioner of human services or the commissioner's designee, and two
83.27additional representatives from the department;
83.28(2) two legislators appointed by the speaker of the house, one from the minority
83.29and one from the majority;
83.30(3) two legislators appointed by the senate rules committee, one from the minority
83.31and one from the majority;
83.32(4) one representative appointed by AFSCME Council 5;
83.33(5) one representative appointed by the ombudsman for mental health and
83.34developmental disabilities;
83.35(6) one representative appointed by the Minnesota Association of Professional
83.36Employees;
84.1(7) one representative appointed by the Minnesota Hospital Association;
84.2(8) one representative appointed by the Minnesota Nurses Association;
84.3(9) one representative appointed by NAMI-MN;
84.4(10) one representative appointed by the Mental Health Association of Minnesota;
84.5(11) one representative appointed by the Minnesota Association Of Community
84.6Mental Health Programs;
84.7(12) one representative appointed by the Minnesota Dental Association;
84.8(13) three clients or client family members representing different populations
84.9receiving services from state-operated services, who are appointed by the commissioner;
84.10(14) one representative appointed by the chair of the state-operated services
84.11governing board; and
84.12(15) one representative appointed by the Minnesota Disability Law Center.
84.13    Subd. 4. Administration. The commissioner shall convene the first meeting of the
84.14advisory group and shall provide administrative support and staff.
84.15    Subd. 5. Recommendations. The advisory group must report its recommendations
84.16to the commissioner and to the legislature no later than December 15, 2010.
84.17    Subd. 6. Expiration. This section expires January 31, 2011.

84.18    Sec. 10. [245.6972] LEGISLATIVE APPROVAL REQUIRED.
84.19The commissioner of human services shall not redesign or move state-operated
84.20services programs without specific legislative approval. The commissioner may proceed
84.21with redesign at the Mankato Crisis Center and the closure of the Community Behavioral
84.22Health Hospital in Cold Spring.

84.23    Sec. 11. Minnesota Statutes 2009 Supplement, section 252.025, subdivision 7, is
84.24amended to read:
84.25    Subd. 7. Minnesota extended treatment options. The commissioner shall develop
84.26by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have
84.27developmental disabilities and exhibit severe behaviors which present a risk to public
84.28safety. This program is statewide and must provide specialized residential services in
84.29Cambridge and an array of community-based services with sufficient levels of care and a
84.30sufficient number of specialists to ensure that individuals referred to the program receive
84.31the appropriate care. The number of beds at the Cambridge facility may be reorganized
84.32into two 16-bed facilities, one for individuals with developmental disabilities and one
84.33for individuals with developmental disabilities and a co-occurring mental illness, with
84.34the remaining beds converted into transitional intensive treatment foster homes.The
85.1individuals working in the community-based services under this section are state
85.2employees supervised by the commissioner of human services. No layoffs shall occur as a
85.3result of restructuring under this section.
85.4EFFECTIVE DATE.This section is effective the day following final enactment.

85.5    Sec. 12. Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read:
85.6    Subd. 2. American Indian. For purposes of services provided under section
85.7254B.09, subdivision 7 254B.09, subdivision 8, "American Indian" means a person who is
85.8a member of an Indian tribe, and the commissioner shall use the definitions of "Indian"
85.9and "Indian tribe" and "Indian organization" provided in Public Law 93-638. For purposes
85.10of services provided under section 254B.09, subdivision 4 254B.09, subdivision 6,
85.11"American Indian" means a resident of federally recognized tribal lands who is recognized
85.12as an Indian person by the federally recognized tribal governing body.

85.13    Sec. 13. Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read:
85.14    Subdivision 1. Chemical dependency treatment allocation. The chemical
85.15dependency funds appropriated for allocation treatment appropriation shall be placed in
85.16a special revenue account. The commissioner shall annually transfer funds from the
85.17chemical dependency fund to pay for operation of the drug and alcohol abuse normative
85.18evaluation system and to pay for all costs incurred by adding two positions for licensing
85.19of chemical dependency treatment and rehabilitation programs located in hospitals for
85.20which funds are not otherwise appropriated. Six percent of the remaining money must
85.21be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The
85.22commissioner shall annually divide the money available in the chemical dependency
85.23fund that is not held in reserve by counties from a previous allocation, or allocated to
85.24the American Indian chemical dependency tribal account. Six percent of the remaining
85.25money must be reserved for the nonreservation American Indian chemical dependency
85.26allocation for treatment of American Indians by eligible vendors under section 254B.05,
85.27subdivision 1 . The remainder of the money must be allocated among the counties
85.28according to the following formula, using state demographer data and other data sources
85.29determined by the commissioner: in the special revenue account must be used according
85.30to the requirements in this chapter.
85.31    (a) For purposes of this formula, American Indians and children under age 14 are
85.32subtracted from the population of each county to determine the restricted population.
85.33    (b) The amount of chemical dependency fund expenditures for entitled persons for
85.34services not covered by prepaid plans governed by section 256B.69 in the previous year is
86.1divided by the amount of chemical dependency fund expenditures for entitled persons for
86.2all services to determine the proportion of exempt service expenditures for each county.
86.3    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt
86.4service expenditures to determine the adjusted prepaid plan months of eligibility for
86.5each county.
86.6    (d) The adjusted prepaid plan months of eligibility is added to the number of
86.7restricted population fee for service months of eligibility for the Minnesota family
86.8investment program, general assistance, and medical assistance and divided by the county
86.9restricted population to determine county per capita months of covered service eligibility.
86.10    (e) The number of adjusted prepaid plan months of eligibility for the state is added
86.11to the number of fee for service months of eligibility for the Minnesota family investment
86.12program, general assistance, and medical assistance for the state restricted population and
86.13divided by the state restricted population to determine state per capita months of covered
86.14service eligibility.
86.15    (f) The county per capita months of covered service eligibility is divided by the
86.16state per capita months of covered service eligibility to determine the county welfare
86.17caseload factor.
86.18    (g) The median married couple income for the most recent three-year period
86.19available for the state is divided by the median married couple income for the same period
86.20for each county to determine the income factor for each county.
86.21    (h) The county restricted population is multiplied by the sum of the county welfare
86.22caseload factor and the county income factor to determine the adjusted population.
86.23    (i) $15,000 shall be allocated to each county.
86.24    (j) The remaining funds shall be allocated proportional to the county adjusted
86.25population.

86.26    Sec. 14. Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read:
86.27    Subd. 5. Administrative adjustment. The commissioner may make payments to
86.28local agencies from money allocated under this section to support administrative activities
86.29under sections 254B.03 and 254B.04. The administrative payment must not exceed
86.30the lesser of (1) five percent of the first $50,000, four percent of the next $50,000, and
86.31three percent of the remaining payments for services from the allocation special revenue
86.32account according to subdivision 1; or (2) the local agency administrative payment for
86.33the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in
86.34the appropriation for this chapter.

87.1    Sec. 15. Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read:
87.2    Subd. 4. Division of costs. Except for services provided by a county under
87.3section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03,
87.4subdivision 4 , paragraph (b), the county shall, out of local money, pay the state for
87.515 16.14 percent of the cost of chemical dependency services, including those services
87.6provided to persons eligible for medical assistance under chapter 256B and general
87.7assistance medical care under chapter 256D. Counties may use the indigent hospitalization
87.8levy for treatment and hospital payments made under this section. Fifteen 16.14 percent
87.9of any state collections from private or third-party pay, less 15 percent of for the cost
87.10of payment and collections, must be distributed to the county that paid for a portion of
87.11the treatment under this section. If all funds allocated according to section 254B.02 are
87.12exhausted by a county and the county has met or exceeded the base level of expenditures
87.13under section 254B.02, subdivision 3, the county shall pay the state for 15 percent of the
87.14costs paid by the state under this section. The commissioner may refuse to pay state funds
87.15for services to persons not eligible under section 254B.04, subdivision 1, if the county
87.16financially responsible for the persons has exhausted its allocation.

87.17    Sec. 16. Minnesota Statutes 2008, section 254B.03, is amended by adding a
87.18subdivision to read:
87.19    Subd. 4a. Division of costs for medical assistance services. Notwithstanding
87.20subdivision 4, for chemical dependency services provided on or after October 1, 2008, and
87.21reimbursed by medical assistance, the county share is 30 percent of the nonfederal share.

87.22    Sec. 17. Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read:
87.23    Subd. 4. Regional treatment centers. Regional treatment center chemical
87.24dependency treatment units are eligible vendors. The commissioner may expand the
87.25capacity of chemical dependency treatment units beyond the capacity funded by direct
87.26legislative appropriation to serve individuals who are referred for treatment by counties
87.27and whose treatment will be paid for with a county's allocation under section 254B.02 by
87.28funding under this chapter or other funding sources. Notwithstanding the provisions of
87.29sections 254B.03 to 254B.041, payment for any person committed at county request to
87.30a regional treatment center under chapter 253B for chemical dependency treatment and
87.31determined to be ineligible under the chemical dependency consolidated treatment fund,
87.32shall become the responsibility of the county.

87.33    Sec. 18. Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read:
88.1    Subd. 2. Allocation of collections. The commissioner shall allocate all federal
88.2financial participation collections to the reserve fund under section 254B.02, subdivision 3
88.3a special revenue account. The commissioner shall retain 85 allocate 83.86 percent of
88.4patient payments and third-party payments to the special revenue account and allocate
88.5the collections to the treatment allocation for the county that is financially responsible
88.6for the person. Fifteen 16.14 percent of patient and third-party payments must be paid
88.7to the county financially responsible for the patient. Collections for patient payment and
88.8third-party payment for services provided under section 254B.09 shall be allocated to the
88.9allocation of the tribal unit which placed the person. Collections of federal financial
88.10participation for services provided under section 254B.09 shall be allocated to the tribal
88.11reserve account under section 254B.09, subdivision 5.

88.12    Sec. 19. Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read:
88.13    Subd. 8. Payments to improve services to American Indians. The commissioner
88.14may set rates for chemical dependency services to American Indians according to the
88.15American Indian Health Improvement Act, Public Law 94-437, for eligible vendors.
88.16These rates shall supersede rates set in county purchase of service agreements when
88.17payments are made on behalf of clients eligible according to Public Law 94-437.

88.18    Sec. 20. [254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE.
88.19    Subdivision 1. Authorization for pilot projects. The commissioner of human
88.20services may approve and implement pilot projects developed under the planning process
88.21required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
88.22enhance coordination of the delivery of chemical health services required under section
88.23254B.03.
88.24    Subd. 2. Program design and implementation. (a) The commissioner of
88.25human services and counties participating in the pilot projects shall continue to work in
88.26partnership to refine and implement the pilot projects initiated under Laws 2009, chapter
88.2779, article 7, section 26.
88.28    (b) The commissioner and counties participating in the pilot projects shall
88.29complete the planning phase by June 30, 2010, and, if approved by the commissioner for
88.30implementation, enter into agreements governing the operation of the pilot projects with
88.31implementation scheduled no earlier than July 1, 2010.
88.32    Subd. 3. Program evaluation. The commissioner of human services shall evaluate
88.33pilot projects under this section and report the results of the evaluation to the legislative
88.34committees with jurisdiction over chemical health by June 30, 2013. Evaluation of the
89.1pilot projects must be based on outcome evaluation criteria negotiated with the projects
89.2prior to implementation.
89.3    Subd. 4. Notice of project discontinuation. Each county's participation in the
89.4pilot project may be discontinued for any reason by the county or the commissioner of
89.5human services after 30 days' written notice to the other party. Any unspent funds held
89.6for the exiting county's pro rata share in the special revenue fund under the authority
89.7in subdivision 5, paragraph (c), shall be transferred to the general fund following
89.8discontinuation of the pilot project.
89.9    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
89.10this chapter, the commissioner may authorize pilot projects to use chemical dependency
89.11treatment funds to pay for services:
89.12    (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
89.13(a); and
89.14    (2) by vendors in addition to those authorized under section 254B.05 when not
89.15providing chemical dependency treatment services.
89.16    (b) State expenditures for chemical dependency services and any other services
89.17provided by or through the pilot projects must not be greater than chemical dependency
89.18treatment fund expenditures expected in the absence of the pilot projects. The
89.19commissioner may restructure the schedule of payments between the state and participating
89.20counties under the local agency share and division of cost provisions under section
89.21254B.03, subdivisions 3 and 4, as necessary to facilitate the operation of the pilot projects.
89.22    (c) To the extent that state fiscal year expenditures within a pilot project region are
89.23less than expected in the absence of the pilot projects, the commissioner may deposit
89.24these unexpended funds in the special revenue fund and make these funds available for
89.25expenditure by the pilot counties the following year. To the extent that treatment and pilot
89.26project ancillary services expenditures within the pilot project exceed the amount expected
89.27in the absence of the pilot projects, the pilot counties are responsible for the portion of
89.28nontreatment expenditures in excess of otherwise expected expenditures.
89.29    (d) The commissioner may waive administrative rule requirements which are
89.30incompatible with the implementation of the pilot project.
89.31    (e) The commissioner shall not approve or enter into any agreement related to pilot
89.32projects authorized under this section which puts current or future federal funding at risk.
89.33    Subd. 6. Duties of county board. The county board, or other county entity that is
89.34approved to administer a pilot project, shall:
89.35    (1) administer the pilot project in a manner consistent with the objectives described
89.36in subdivision 2 and the planning process in subdivision 5;
90.1    (2) ensure that no one is denied chemical dependency treatment services for which
90.2they would otherwise be eligible under section 254A.03, subdivision 3; and
90.3    (3) provide the commissioner of human services with timely and pertinent
90.4information as negotiated in agreements governing operation of the pilot projects.

90.5    Sec. 21. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
90.6to read:
90.7    Subd. 30. Office of Health Care Inspector General. (a) The commissioner shall
90.8create within the Department of Human Services an Office of Health Care Inspector
90.9General to enhance antifraud activities and to protect the integrity of the state health care
90.10programs, as well as the health and welfare of the beneficiaries of those programs. The
90.11Office of Health Care Inspector General must periodically report to the commissioner and
90.12to the legislature program and management problems and recommendations to correct
90.13them.
90.14(b) The duties of the Office of Health Care Inspector General include, but are not
90.15limited to:
90.16(1) promoting economy, efficiency, and effectiveness through the elimination of
90.17waste, fraud, and abuse;
90.18(2) conducting and supervising audits, investigations, inspections, and evaluations
90.19relating to the state health care programs under chapters 256B, 256D, and 256L;
90.20(3) identifying weaknesses giving rise to opportunities for fraud and abuse in the
90.21state health care programs and operations and making recommendations to prevent their
90.22recurrence;
90.23(4) leading and coordinating activities to prevent and detect fraud and abuse in the
90.24state health care programs and operations;
90.25(5) detecting wrongdoers and abusers of the state health care programs and
90.26beneficiaries so appropriate remedies may be brought;
90.27(6) keeping the commissioner and the legislature fully and currently informed about
90.28problems and deficiencies in the administration of the state health care programs and
90.29operations and about the need for and progress of corrective action;
90.30(7) operating a toll-free hotline to permit individuals to call in suspected fraud,
90.31waste, or abuse, referring the calls for appropriate action by the agency, and analyzing the
90.32calls to identify trends and patterns of fraud and abuse needing attention;
90.33(8) developing and reviewing legislative, regulatory, and program proposals to
90.34reduce vulnerabilities to fraud, waste, and mismanagement; and
91.1(9) recommending changes in program policies, regulations, and laws to improve
91.2efficiency and effectiveness, and to prevent fraud, waste, abuse, and mismanagement.
91.3(c) Beginning July 1, 2011, the commissioner, in consultation with the Office of
91.4Health Care Inspector General, shall annually report to the legislature and the governor
91.5new results from the two ongoing federal Medicaid audits. The commissioner shall report
91.6(1) the most recent Medicaid Integrity Program (MIP) audit results, with any corrective
91.7actions needed, and (2) certify the rate of errors determined for the state health care
91.8programs under chapters 256B, 256D, and 256L, as determined from the most recent
91.9Payment Error Rate Measurement (PERM) audit results for Minnesota. When the PERM
91.10audit rate for Minnesota is greater than the national rate for the year or the MIP audit
91.11determines the need for corrective action, the commissioner shall present a plan to the
91.12legislature and the governor for the corrective actions and reduction of the error rate
91.13in the next calendar year.

91.14    Sec. 22. Laws 2009, chapter 79, article 3, section 18, is amended to read:
91.15    Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED
91.16MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE
91.17ANOKA-METRO REGIONAL TREATMENT CENTER.
91.18In consultation with community partners, the commissioner of human services The
91.19Advisory Group on State-Operated Services Redesign shall develop recommend an array
91.20of community-based services to transform the current services now provided to patients
91.21at the Anoka-Metro Regional Treatment Center. The community-based services may
91.22be provided in facilities with 16 or fewer beds, and must provide the appropriate level
91.23of care for the patients being admitted to the facilities. The planning for this transition
91.24must be completed by October 1, 2009 2010, with an initial report to the committee chairs
91.25of health and human services by November 30, 2009 2010, and a semiannual report on
91.26progress until the transition is completed. The commissioner of human services shall
91.27solicit interest from stakeholders and potential community partners. The individuals
91.28working in the community-based services facilities under this section are state employees
91.29supervised by the commissioner of human services. No layoffs shall occur as a result of
91.30restructuring under this section.
91.31EFFECTIVE DATE.This section is effective the day following final enactment.

91.32    Sec. 23. NONSUBMISSION OF HEALTH CARE CLAIM BY
91.33CLEARINGHOUSE; SIGNIFICANT DISRUPTION.
92.1(a) A situation shall be considered a significant disruption to normal operations that
92.2materially affects the provider's or facility's ability to conduct business in a normal manner
92.3and to submit claims on a timely basis under Minnesota Statutes, section 62Q.75, if:
92.4(1) a clearinghouse loses, or otherwise does not submit, a health care claim as
92.5required by Minnesota Statutes, section 62J.536; and
92.6(2) the provider or facility can substantiate that it submitted a complete claim to the
92.7clearinghouse within provisions stated in contract or six months of the date of service,
92.8whichever is less.
92.9(b) This section expires January 1, 2012.

92.10    Sec. 24. REPEALER.
92.11Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09,
92.12subdivisions 4, 5, and 7, and Laws 2009, chapter 79, article 7, section 26, subdivision
92.133, are repealed.

92.14    Sec. 25. EFFECTIVE DATE.
92.15Sections 12 to 17 and 24 are effective for claims paid on or after July 1, 2010.

92.16ARTICLE 6

92.17DEPARTMENT OF HEALTH

92.18    Section 1. Minnesota Statutes 2008, section 62D.08, is amended by adding a
92.19subdivision to read:
92.20    Subd. 7. Consistent administrative expenses and investment income reporting.
92.21(a) Every health maintenance organization must directly allocate administrative expenses
92.22to specific lines of business or products when such information is available. Remaining
92.23expenses that cannot be directly allocated must be allocated based on other methods, as
92.24recommended by the Advisory Group on Administrative Expenses. Health maintenance
92.25organizations must submit this information, including administrative expenses for dental
92.26services, using the reporting template provided by the commissioner of health.
92.27(b) Every health maintenance organization must allocate investment income based
92.28on cumulative net income over time by business line or product and must submit this
92.29information, including investment income for dental services, using the reporting template
92.30provided by the commissioner of health.
92.31EFFECTIVE DATE.This section is effective January 1, 2012.

93.1    Sec. 2. [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
93.2    Subdivision 1. Establishment. The Advisory Group on Administrative Expenses
93.3is established to make recommendations on the development of consistent guidelines
93.4and reporting requirements, including development of a reporting template, for health
93.5maintenance organizations and county-based purchasers that participate in publicly
93.6funded programs.
93.7    Subd. 2. Membership. The membership of the advisory group shall be comprised
93.8of the following, who serve at the pleasure of their appointing authority:
93.9(1) the commissioner of health or the commissioner's designee;
93.10(2) the commissioner of human services or the commissioner's designee;
93.11(3) the commissioner of commerce or the commissioner's designee; and
93.12(4) representatives of health maintenance organizations and county-based purchasers
93.13appointed by the commissioner of health.
93.14    Subd. 3. Administration. The commissioner of health shall convene the first
93.15meeting of the advisory group by September 1, 2010, and shall provide administrative
93.16support and staff. The commissioner of health may contract with a consultant to provide
93.17professional assistance and expertise to the advisory group.
93.18    Subd. 4. Recommendations. The Advisory Group on Administrative Expenses
93.19must report its recommendations, including any proposed legislation necessary to
93.20implement the recommendations, to the commissioner of health and to the chairs and
93.21ranking minority members of the legislative committees and divisions with jurisdiction
93.22over health policy and finance by July 1, 2011.
93.23    Subd. 5. Expiration. This section expires after submission of the report required
93.24under subdivision 4 or June 30, 2012, whichever is sooner.

93.25    Sec. 3. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 1a, is
93.26amended to read:
93.27    Subd. 1a. Definitions. (a) "Certified electronic health record technology" means an
93.28electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH
93.29Act to meet the standards and implementation specifications adopted under section 3004
93.30as applicable.
93.31(b) "Commissioner" means the commissioner of health.
93.32(c) "Pharmaceutical electronic data intermediary" means any entity that provides
93.33the infrastructure to connect computer systems or other electronic devices utilized
93.34by prescribing practitioners with those used by pharmacies, health plans, third-party
93.35administrators, and pharmacy benefit managers in order to facilitate the secure
94.1transmission of electronic prescriptions, refill authorization requests, communications,
94.2and other prescription-related information between such entities.
94.3(d) "HITECH Act" means the Health Information Technology for Economic and
94.4Clinical Health Act in division A, title XIII and division B, title IV of the American
94.5Recovery and Reinvestment Act of 2009, including federal regulations adopted under
94.6that act.
94.7(e) "Interoperable electronic health record" means an electronic health record that
94.8securely exchanges health information with another electronic health record system that
94.9meets requirements specified in subdivision 3, and national requirements for certification
94.10under the HITECH Act.
94.11(f) "Qualified electronic health record" means an electronic record of health-related
94.12information on an individual that includes patient demographic and clinical health
94.13information and has the capacity to:
94.14(1) provide clinical decision support;
94.15(2) support physician order entry;
94.16(3) capture and query information relevant to health care quality; and
94.17(4) exchange electronic health information with, and integrate such information
94.18from, other sources.

94.19    Sec. 4. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 3, is
94.20amended to read:
94.21    Subd. 3. Interoperable electronic health record requirements. To meet the
94.22requirements of subdivision 1, hospitals and health care providers must meet the following
94.23criteria when implementing an interoperable electronic health records system within their
94.24hospital system or clinical practice setting.
94.25(a) The electronic health record must be a qualified electronic health record.
94.26    (b) The electronic health record must be certified by the Office of the National
94.27Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and
94.28health care providers only if a certified electronic health record product for the provider's
94.29particular practice setting is available. This criterion shall be considered met if a hospital
94.30or health care provider is using an electronic health records system that has been certified
94.31within the last three years, even if a more current version of the system has been certified
94.32within the three-year period.
94.33(c) The electronic health record must meet the standards established according to
94.34section 3004 of the HITECH Act as applicable.
95.1(d) The electronic health record must have the ability to generate information on
95.2clinical quality measures and other measures reported under sections 4101, 4102, and
95.34201 of the HITECH Act.
95.4(e) The electronic health record system must be connected to a state-certified
95.5health information organization either directly or through a connection facilitated by a
95.6state-certified health data intermediary as defined in section 62J.498.
95.7    (e) (f) A health care provider who is a prescriber or dispenser of legend drugs must
95.8have an electronic health record system that meets the requirements of section 62J.497.

95.9    Sec. 5. Minnesota Statutes 2009 Supplement, section 62J.495, is amended by adding a
95.10subdivision to read:
95.11    Subd. 6. State agency information system. Development of a state agency
95.12information system necessary to implement this section is subject to the authority of the
95.13Office of Enterprise Technology in chapter 16E, including, but not limited to:
95.14(1) evaluation and approval of the system as specified in section 16E.03, subdivisions
95.153 and 4;
95.16(2) review of the system to ensure compliance with security policies, guidelines, and
95.17standards as specified in section 16E.03, subdivision 7; and
95.18(3) assurance that the system complies with accessibility standards developed under
95.19section 16E.03, subdivision 9.

95.20    Sec. 6. [62J.498] HEALTH INFORMATION EXCHANGE.
95.21    Subdivision 1. Definitions. The following definitions apply to sections 62J.498 to
95.2262J.4982:
95.23(a) "Clinical transaction" means any meaningful use transaction that is not covered
95.24by section 62J.536.
95.25(b) "Commissioner" means the commissioner of health.
95.26(c) "Direct health information exchange" means the electronic transmission of
95.27health-related information through a direct connection between the electronic health
95.28record systems of health care providers without the use of a health data intermediary.
95.29(d) "Health care provider" or "provider" means a health care provider or provider as
95.30defined in section 62J.03, subdivision 8.
95.31(e) "Health data intermediary" means an entity that provides the infrastructure to
95.32connect computer systems or other electronic devices used by health care providers,
95.33laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit
95.34managers to facilitate the secure transmission of health information, including
96.1pharmaceutical electronic data intermediaries as defined in section 62J.495. This does not
96.2include health care providers engaged in a direct health information exchange.
96.3(f) "Health information exchange" means the electronic transmission of
96.4health-related information between organizations according to nationally recognized
96.5standards.
96.6(g) "Health information exchange service provider" means a health data intermediary
96.7or health information organization that has been issued a certificate of authority by the
96.8commissioner under section 62J.4981.
96.9(h) "Health information organization" means an organization that oversees, governs,
96.10and facilitates the exchange of health-related information among organizations according
96.11to nationally recognized standards.
96.12(i) "HITECH Act" means the Health Information Technology for Economic and
96.13Clinical Health Act as defined in section 62J.495.
96.14(j) "Major participating entity" means:
96.15(1) a participating entity that receives compensation for services that is greater
96.16than 30 percent of the health information organization's gross annual revenues from the
96.17health information exchange service provider;
96.18(2) a participating entity providing administrative, financial, or management services
96.19to the health information organization, if the total payment for all services provided by the
96.20participating entity exceeds three percent of the gross revenue of the health information
96.21organization; and
96.22(3) a participating entity that nominates or appoints 30 percent or more of the board
96.23of directors of the health information organization.
96.24(k) "Meaningful use" means use of certified electronic health record technology that
96.25includes e-prescribing, and is connected in a manner that provides for the electronic
96.26exchange of health information and used for the submission of clinical quality measures
96.27as established by the Center for Medicare and Medicaid Services and the Minnesota
96.28Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH
96.29Act.
96.30(l) "Meaningful use transaction" means an electronic transaction that a health care
96.31provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare
96.32penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
96.33(m) "Participating entity" means any of the following persons, health care providers,
96.34companies, or other organizations with which a health information organization or health
96.35data intermediary has contracts or other agreements for the provision of health information
96.36exchange service providers:
97.1(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
97.2licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
97.3licensed under the laws of this state or registered with the commissioner;
97.4(2) a health care provider, and any other health care professional otherwise licensed
97.5under the laws of this state or registered with the commissioner;
97.6(3) a group, professional corporation, or other organization that provides the
97.7services of individuals or entities identified in clause (2), including but not limited to a
97.8medical clinic, a medical group, a home health care agency, an urgent care center, and
97.9an emergent care center;
97.10(4) a health plan as defined in section 62A.011, subdivision 3; and
97.11(5) a state agency as defined in section 13.02, subdivision 17.
97.12(n) "Reciprocal agreement" means an arrangement in which two or more health
97.13information exchange service providers agree to share in-kind services and resources to
97.14allow for the pass-through of meaningful use transactions.
97.15(o) "State-certified health data intermediary" means a health data intermediary that:
97.16(1) provides a subset of the meaningful use transaction capabilities necessary for
97.17hospitals and providers to achieve meaningful use of electronic health records;
97.18(2) is not exclusively engaged in the exchange of meaningful use transactions
97.19covered by section 62J.536; and
97.20(3) has been issued a certificate of authority to operate in Minnesota.
97.21(p) "State-certified health information organization" means a nonprofit health
97.22information organization that provides transaction capabilities necessary to fully support
97.23clinical transactions required for meaningful use of electronic health records that has been
97.24issued a certificate of authority to operate in Minnesota.
97.25    Subd. 2. Health information exchange oversight. (a) The commissioner shall
97.26protect the public interest on matters pertaining to health information exchange. The
97.27commissioner shall:
97.28(1) review and act on applications from health data intermediaries and health
97.29information organizations for certificates of authority to operate in Minnesota;
97.30(2) provide ongoing monitoring to ensure compliance with criteria established under
97.31sections 62J.498 to 62J.4982;
97.32(3) respond to public complaints related to health information exchange services;
97.33(4) take enforcement actions as necessary, including the imposition of fines,
97.34suspension, or revocation of certificates of authority as outlined in section 62J.4982;
97.35(5) provide a biannual report on the status of health information exchange services
97.36that includes but is not limited to:
98.1(i) recommendations on actions necessary to ensure that health information exchange
98.2services are adequate to meet the needs of Minnesota citizens and providers statewide;
98.3(ii) recommendations on enforcement actions to ensure that health information
98.4exchange service providers act in the public interest without causing disruption in health
98.5information exchange services;
98.6(iii) recommendations on updates to criteria for obtaining certificates of authority
98.7under this section; and
98.8(iv) recommendations on standard operating procedures for health information
98.9exchange, including but not limited to the management of consumer preferences; and
98.10(6) other duties necessary to protect the public interest.
98.11(b) As part of the application review process for certification under paragraph (a),
98.12prior to issuing a certificate of authority, the commissioner shall:
98.13(1) hold public hearings that provide an adequate opportunity for participating
98.14entities and consumers to provide feedback and recommendations on the application under
98.15consideration. The commissioner shall make all portions of the application classified
98.16as public data available to the public at least ten days in advance of the hearing. The
98.17applicant shall participate in the hearing by presenting an application overview and
98.18responding to questions from interested parties;
98.19(2) make available all feedback and recommendations from the hearing available to
98.20the public prior to issuing a certificate of authority; and
98.21(3) consult with hospitals, physicians, and other professionals eligible to receive
98.22meaningful use incentive payments or are subject to penalties as established in the
98.23HITECH Act, and their respective statewide associations, prior to issuing a certificate of
98.24authority.
98.25(c)(1) When the commissioner is actively considering a suspension or revocation of
98.26a certificate of authority as described in section 62J.4982, subdivision 3, all investigatory
98.27data that are collected, created, or maintained related to the suspension or revocation
98.28are classified as confidential data on individuals and as protected nonpublic data in the
98.29case of data not on individuals.
98.30(2) The commissioner may disclose data classified as protected nonpublic or
98.31confidential under this paragraph if disclosing the data will protect the health or safety of
98.32patients.
98.33(d) After the commissioner makes a final determination regarding a suspension or
98.34revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
98.35conclusions of law, and the specification of the final disciplinary action, are classified
98.36as public data.

99.1    Sec. 7. [62J.4981] CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
99.2INFORMATION EXCHANGE SERVICES.
99.3    Subdivision 1. Authority to require organizations to apply. The commissioner
99.4shall require an entity providing health information exchange services to apply for a
99.5certificate of authority under this section. An applicant may continue to operate until
99.6the commissioner acts on the application. If the application is denied, the applicant is
99.7considered a health information organization whose certificate of authority has been
99.8revoked under section 62J.4982, subdivision 2, paragraph (d).
99.9    Subd. 2. Certificate of authority for health data intermediaries. (a) A health
99.10data intermediary that provides health information exchange services for the transmission
99.11of one or more clinical transactions necessary for hospitals, providers, or eligible
99.12professionals to achieve meaningful use must be registered with the state and comply with
99.13requirements established in this section.
99.14(b) Notwithstanding any law to the contrary, any corporation organized to do so
99.15may apply to the commissioner for a certificate of authority to establish and operate as
99.16a health data intermediary in compliance with this section. No person shall establish or
99.17operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers
99.18to purchase or receive advance or periodic consideration in conjunction with a health
99.19data intermediary contract unless the organization has a certificate of authority or has an
99.20application under active consideration under this section.
99.21(c) In issuing the certificate of authority, the commissioner shall determine whether
99.22the applicant for the certificate of authority has demonstrated that the applicant meets
99.23the following minimum criteria:
99.24(1) can interoperate with at least one state-certified health information organization;
99.25(2) can provide an option for Minnesota entities to connect to their services through
99.26at least one state-certified health information organization;
99.27(3) has a record locator service as defined in section 144.291, subdivision 2,
99.28paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8,
99.29when conducting meaningful use transactions; and
99.30(4) holds reciprocal agreements with at least one state-certified health information
99.31organization to enable access to record locator services to find patient data, and for the
99.32transmission and receipt of meaningful use transactions consistent with the format and
99.33content required by national standards established by Centers for Medicare and Medicaid
99.34Services. Reciprocal agreements must meet the requirements established in subdivision 5.
99.35    Subd. 3. Certificate of authority for health information organizations.
99.36(a) A health information organization that provides all electronic capabilities for the
100.1transmission of clinical transactions necessary for meaningful use of electronic health
100.2records must obtain a certificate of authority from the commissioner and demonstrate
100.3compliance with the criteria in paragraph (c).
100.4(b) Notwithstanding any law to the contrary, a nonprofit corporation organized to do
100.5so may apply for a certificate of authority to establish and operate a health information
100.6organization under this section. No person shall establish or operate a health information
100.7organization in this state, or sell or offer to sell, or solicit offers to purchase or receive
100.8advance or periodic consideration in conjunction with a health information organization
100.9or health information contract unless the organization has a certificate of authority under
100.10this section.
100.11(c) In issuing the certificate of authority, the commissioner shall determine whether
100.12the applicant for the certificate of authority has demonstrated that the applicant meets
100.13the following minimum criteria:
100.14(1) the entity is a legally established, nonprofit organization;
100.15(2) has appropriate insurance, including liability insurance, for the operation of the
100.16health information organization is in place and sufficient to protect the interest of the
100.17public and participating entities;
100.18(3) has strategic and operational plans that clearly address how the organization will
100.19expand technical capacity of the health information organization to support providers in
100.20achieving meaningful use of electronic health records over time;
100.21(4) the entity addresses the parameters to be used with participating entities and
100.22other health information organizations for meaningful use transactions, compliance with
100.23Minnesota law, and interstate health information exchange in trust agreements;
100.24(5) the entity's board of directors is comprised of members that broadly represent the
100.25health information organization's participating entities and consumers;
100.26(6) the entity maintains a professional staff responsible to the board of directors with
100.27the capacity to ensure accountability to the organization's mission;
100.28(7) the entity is compliant with criteria established under the Health Information
100.29Exchange Accreditation Program of the Electronic Healthcare Network Accreditation
100.30Commission (EHNAC) or equivalent criteria established by the commissioner;
100.31(8) the entity maintains a record locator service as defined in section 144.291,
100.32subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293,
100.33subdivision 8, when conducting meaningful use transactions;
100.34(9) the organization demonstrates interoperability with all other state-certified health
100.35information organizations using nationally recognized standards;
101.1(10) the organization demonstrates compliance with all privacy and security
101.2requirements required by state and federal law; and
101.3(11) the organization uses financial policies and procedures consistent with generally
101.4accepted accounting principles and has an independent audit of the organization's
101.5financials on an annual basis.
101.6(d) Health information organizations that have obtained a certificate of authority
101.7must:
101.8(1) meet the requirements established for connecting to the Nationwide Health
101.9Information Network (NHIN) within the federally mandated timeline or within a time
101.10frame established by the commissioner and published in the State Register. If the state
101.11timeline for implementation varies from the federal timeline, the State Register notice
101.12shall include an explanation for the variation;
101.13(2) annually submit strategic and operational plans for review by the commissioner
101.14that address:
101.15(i) increasing adoption rates to include a sufficient number of participating entities to
101.16achieve financial sustainability; and
101.17(ii) progress in achieving objectives included in previously submitted strategic
101.18and operational plans across the following domains: business and technical operations,
101.19technical infrastructure, legal and policy issues, finance, and organizational governance;
101.20(3) develop and maintain a business plan that addresses:
101.21(i) plans for ensuring the necessary capacity to support meaningful use transactions;
101.22(ii) approach for attaining financial sustainability, including public and private
101.23financing strategies, and rate structures;
101.24(iii) rates of adoption, utilization, and transaction volume, and mechanisms to
101.25support health information exchange; and
101.26(iv) an explanation of methods employed to address the needs of community clinics,
101.27critical access hospitals, and free clinics in accessing health information exchange services;
101.28(4) annually submit a rate plan outlining fee structures for health information
101.29exchange services for approval by the commissioner. The commissioner shall approve the
101.30rate plan if it:
101.31(i) distributes costs equitably among users of health information services;
101.32(ii) provides predictable costs for participating entities;
101.33(iii) covers all costs associated with conducting the full range of meaningful use
101.34clinical transactions, including access to health information retrieved through other
101.35state-certified health information exchange service providers; and
102.1(iv) provides for a predictable revenue stream for the health information organization
102.2and generates sufficient resources to maintain operating costs and develop technical
102.3infrastructure necessary to serve the public interest;
102.4(5) enter into reciprocal agreements with all other state-certified health information
102.5organizations to enable access to record locator services to find patient data, and
102.6transmission and receipt of meaningful use transactions consistent with the format and
102.7content required by national standards established by Centers for Medicare and Medicaid
102.8Services. Reciprocal agreements must meet the requirements in subdivision 5; and
102.9(6) comply with additional requirements for the certification or recertification of
102.10health information organizations that may be established by the commissioner.
102.11    Subd. 4. Application for certificate of authority for health information exchange
102.12service providers. (a) Each application for a certificate of authority shall be in a form
102.13prescribed by the commissioner and verified by an officer or authorized representative of
102.14the applicant. Each application shall include the following:
102.15(1) a copy of the basic organizational document, if any, of the applicant and of
102.16each major participating entity, such as the articles of incorporation, or other applicable
102.17documents, and all amendments to it;
102.18(2) a list of the names, addresses, and official positions of the following:
102.19(i) all members of the board of directors and the principal officers and, if applicable,
102.20shareholders of the applicant organization; and
102.21(ii) all members of the board of directors and the principal officers of each major
102.22participating entity and, if applicable, each shareholder beneficially owning more than ten
102.23percent of any voting stock of the major participating entity;
102.24(3) the name and address of each participating entity and the agreed-upon duration
102.25of each contract or agreement if applicable;
102.26(4) a copy of each standard agreement or contract intended to bind the participating
102.27entities and the health information organization. Contractual provisions shall be consistent
102.28with the purposes of this section in regard to the services to be performed under the
102.29standard agreement or contract, the manner in which payment for services is determined,
102.30the nature and extent of responsibilities to be retained by the health information
102.31organization, and contractual termination provisions;
102.32(5) a copy of each contract intended to bind major participating entities and the
102.33health information organization. Contract information filed with the commissioner under
102.34this section shall be nonpublic as defined in section 13.02, subdivision 9;
102.35(6) a statement generally describing the health information organization, its health
102.36information exchange contracts, facilities, and personnel, including a statement describing
103.1the manner in which the applicant proposes to provide participants with comprehensive
103.2health information exchange services;
103.3(7) financial statements showing the applicant's assets, liabilities, and sources
103.4of financial support, including a copy of the applicant's most recent certified financial
103.5statement;
103.6(8) strategic and operational plans that specifically address how the organization
103.7will expand technical capacity of the health information organization to support providers
103.8in achieving meaningful use of electronic health records over time, a description of
103.9the proposed method of marketing the services, a schedule of proposed charges, and a
103.10financial plan that includes a three-year projection of the expenses and income and other
103.11sources of future capital;
103.12(9) a statement reasonably describing the geographic area or areas to be served and
103.13the type or types of participants to be served;
103.14(10) a description of the complaint procedures to be used as required under this
103.15section;
103.16(11) a description of the mechanism by which participating entities will have an
103.17opportunity to participate in matters of policy and operation;
103.18(12) a copy of any pertinent agreements between the health information organization
103.19and insurers, including liability insurers, demonstrating coverage is in place;
103.20(13) a copy of the conflict of interest policy that applies to all members of the board
103.21of directors and the principal officers of the health information organization; and
103.22(14) other information as the commissioner may reasonably require to be provided.
103.23(b) Thirty days after the receipt of the application for a certificate of authority,
103.24the commissioner shall determine whether or not the application submitted meets the
103.25requirements for completion in paragraph (a), and notify the applicant of any further
103.26information required for the application to be processed.
103.27(c) Ninety days after the receipt of a complete application for a certificate of
103.28authority, the commissioner shall issue a certificate of authority to the applicant if the
103.29commissioner determines that the applicant meets the minimum criteria requirements
103.30of subdivision 2 for health data intermediaries or subdivision 3 for health information
103.31organizations. If the commissioner determines that the applicant is not qualified, the
103.32commissioner shall notify the applicant and specify the reasons for disqualification.
103.33(d) Upon being granted a certificate of authority to operate as a health information
103.34organization, the organization must operate in compliance with the provisions of this
103.35section. Noncompliance may result in the imposition of a fine or the suspension or
103.36revocation of the certificate of authority according to section 62J.4982.
104.1    Subd. 5. Reciprocal agreements between health information exchange entities.
104.2(a) Reciprocal agreements between two health information organizations or between a
104.3health information organization and a health data intermediary must include a fair and
104.4equitable model for charges between the entities that:
104.5(1) does not impede the secure transmission of transactions necessary to achieve
104.6meaningful use;
104.7(2) does not charge a fee for the exchange of meaningful use transactions transmitted
104.8according to nationally recognized standards where no additional value-added service
104.9is rendered to the sending or receiving health information organization or health data
104.10intermediary either directly or on behalf of the client;
104.11(3) is consistent with fair market value and proportionately reflects the value-added
104.12services accessed as a result of the agreement; and
104.13(4) prevents health care stakeholders from being charged multiple times for the
104.14same service.
104.15(b) Reciprocal agreements must include comparable quality of service standards that
104.16ensure equitable levels of services.
104.17(c) Reciprocal agreements are subject to review and approval by the commissioner.
104.18(d) Nothing in this section precludes a state-certified health information organization
104.19or state-certified health data intermediary from entering into contractual agreements for
104.20the provision of value-added services beyond meaningful use.
104.21(e) The commissioner of human services or health, when providing access to data or
104.22services through a certified health information organization, must offer the same data or
104.23services directly through any certified health information organization at the same pricing,
104.24if the health information organization pays for all connection costs to the state data or
104.25service. For all external connectivity to the respective agencies through existing or future
104.26information exchange implementations, the respective agency shall establish the required
104.27connectivity methods as well as protocol standards to be utilized.
104.28    Subd. 6. State participation in health information exchange. A state agency
104.29that connects to a health information exchange service provider for the purpose of
104.30exchanging meaningful use transactions must ensure that the contracted health information
104.31exchange service provider has reciprocal agreements in place as required by this section.
104.32The reciprocal agreements must provide equal access to information supplied by the
104.33agency and necessary for meaningful use by the participating entities of the other health
104.34information service providers.

104.35    Sec. 8. [62J.4982] ENFORCEMENT AUTHORITY; COMPLIANCE.
105.1    Subdivision 1. Penalties and enforcement. (a) The commissioner may, for any
105.2violation of statute or rule applicable to a health information exchange service provider,
105.3levy an administrative penalty in an amount up to $25,000 for each violation. In
105.4determining the level of an administrative penalty, the commissioner shall consider the
105.5following factors:
105.6(1) the number of participating entities affected by the violation;
105.7(2) the effect of the violation on participating entities' access to health information
105.8exchange services;
105.9(3) if only one participating entity is affected, the effect of the violation on the
105.10patients of that entity;
105.11(4) whether the violation is an isolated incident or part of a pattern of violations;
105.12(5) the economic benefits derived by the health information organization or a health
105.13data intermediary by virtue of the violation;
105.14(6) whether the violation hindered or facilitated an individual's ability to obtain
105.15health care;
105.16(7) whether the violation was intentional;
105.17(8) whether the violation was beyond the direct control of the health information
105.18exchange service provider;
105.19(9) any history of prior compliance with the provisions of this section, including
105.20violations;
105.21(10) whether and to what extent the health information exchange service provider
105.22attempted to correct previous violations;
105.23(11) how the health information exchange service provider responded to technical
105.24assistance from the commissioner provided in the context of a compliance effort; and
105.25(12) the financial condition of the health information exchange service provider
105.26including, but not limited to, whether the health information exchange service provider
105.27had financial difficulties that affected its ability to comply or whether the imposition of an
105.28administrative monetary penalty would jeopardize the ability of the health information
105.29exchange service provider to continue to deliver health information exchange services.
105.30Reasonable notice in writing shall be given to the health information exchange
105.31service provider of the intent to levy the penalty and the reasons for them. A health
105.32information exchange service provider may have 15 days within which to contest whether
105.33the finding of facts constitute a violation of this section and section 62J.4981, according to
105.34the contested case and judicial review provisions of sections 14.57 to 14.69.
105.35(b) If the commissioner has reason to believe that a violation of this section or
105.36section 62J.4981 has occurred or is likely, the commissioner may confer with the persons
106.1involved before commencing action under subdivision 2. The commissioner may notify
106.2the health information exchange service provider and the representatives, or other persons
106.3who appear to be involved in the suspected violation, to arrange a voluntary conference
106.4with the alleged violators or their authorized representatives. The purpose of the
106.5conference is to attempt to learn the facts about the suspected violation and if it appears
106.6that a violation has occurred or is threatened, to find a way to correct or prevent it. The
106.7conference is not governed by any formal procedural requirements and may be conducted
106.8as the commissioner considers appropriate.
106.9(c) The commissioner may issue an order directing a health information exchange
106.10service provider or a representative of a health information exchange service provider to
106.11cease and desist from engaging in any act or practice in violation of this section and
106.12section 62J.4981.
106.13(d) Within 20 days after service of the order to cease and desist, a health information
106.14exchange service provider may contest whether the finding of facts constitutes a violation
106.15of this section and section 62J.4981 according to the contested case and judicial review
106.16provisions of sections 14.57 to 14.69.
106.17(e) In the event of noncompliance with a cease and desist order issued under this
106.18subdivision, the commissioner may institute a proceeding to obtain injunctive relief or
106.19other appropriate relief in Ramsey County District Court.
106.20    Subd. 2. Suspension or revocation of certificates of authority. (a) The
106.21commissioner may suspend or revoke a certificate of authority issued to a health
106.22data intermediary or health information organization under section 62J.4981 if the
106.23commissioner finds that:
106.24(1) the health information exchange service provider is operating significantly
106.25in contravention of its basic organizational document, or in a manner contrary to that
106.26described in and reasonably inferred from any other information submitted under section
106.2762J.4981, unless amendments to the submissions have been filed with and approved by
106.28the commissioner;
106.29(2) the health information exchange service provider is unable to fulfill its
106.30obligations to furnish comprehensive health information exchange services as required
106.31under its health information exchange contract;
106.32(3) the health information exchange service provider is no longer financially solvent
106.33or may not reasonably be expected to meet its obligations to participating entities;
106.34(4) the health information exchange service provider has failed to implement the
106.35complaint system in a manner designed to reasonably resolve valid complaints;
107.1(5) the health information exchange service provider, or any person acting with its
107.2sanction, has advertised or merchandised its services in an untrue, misleading, deceptive,
107.3or unfair manner;
107.4(6) the continued operation of the health information exchange service provider
107.5would be hazardous to its participating entities or the patients served by the participating
107.6entities; or
107.7(7) the health information exchange service provider has otherwise failed to
107.8substantially comply with section 62J.4981 or with any other statute or administrative
107.9rule applicable to health information exchange service providers, or has submitted false
107.10information in any report required under sections 62J.498 to 62J.4982.
107.11(b) A certificate of authority shall be suspended or revoked only after meeting the
107.12requirements of subdivision 3.
107.13(c) If the certificate of authority of a health information exchange service provider is
107.14suspended, the health information exchange service provider shall not, during the period
107.15of suspension, enroll any additional participating entities, and shall not engage in any
107.16advertising or solicitation.
107.17(d) If the certificate of authority of a health information exchange service provider is
107.18revoked, the organization shall proceed, immediately following the effective date of the
107.19order of revocation, to wind up its affairs and shall conduct no further business except as
107.20necessary to the orderly conclusion of the affairs of the organization. The organization
107.21shall engage in no further advertising or solicitation. The commissioner may, by written
107.22order, permit further operation of the organization as the commissioner finds to be in the
107.23best interest of participating entities, to the end that participating entities will be given the
107.24greatest practical opportunity to access continuing health information exchange services.
107.25    Subd. 3. Denial, suspension, and revocation; administrative procedures. (a)
107.26When the commissioner has cause to believe that grounds for the denial, suspension,
107.27or revocation of a certificate of authority exists, the commissioner shall notify the
107.28health information exchange service provider in writing stating the grounds for denial,
107.29suspension, or revocation and setting a time within 20 days for a hearing on the matter.
107.30(b) After a hearing before the commissioner at which the health information
107.31exchange service provider may respond to the grounds for denial, suspension, or
107.32revocation, or upon the failure of the health information exchange service provider to
107.33appear at the hearing, the commissioner shall take action as deemed necessary and shall
107.34issue written findings that shall be mailed to the health information exchange service
107.35provider.
108.1(c) If suspension, revocation, or an administrative penalty is proposed according
108.2to this section, the commissioner must deliver, or send by certified mail with return
108.3receipt requested, to the health information exchange service provider written notice of
108.4the commissioner's intent to impose a penalty. This notice of proposed determination
108.5must include:
108.6(1) a reference to the statutory basis for the penalty;
108.7(2) a description of the findings of fact regarding the violations with respect to
108.8which the penalty is proposed;
108.9(3) the nature and amount of the proposed penalty;
108.10(4) any circumstances described in subdivision 1, paragraph (a), that were considered
108.11in determining the amount of the proposed penalty;
108.12(5) instructions for responding to the notice, including a statement of the health
108.13information exchange service provider's right to a contested case proceeding and a
108.14statement that failure to request a contested case proceeding within 30 calendar days
108.15permits the imposition of the proposed penalty; and
108.16(6) the address to which the contested case proceeding request must be sent.
108.17    Subd. 4. Coordination. (a) To the extent possible when implementing sections
108.1862J.498 to 62J.4982, the commissioner shall seek the advice of the Minnesota e-Health
108.19Advisory Committee, in the review and update of criteria for the certification and
108.20recertification of health information exchange service providers.
108.21(b) By January 1, 2011, the commissioner shall report to the governor and the
108.22chairs of the senate and house of representatives committees having jurisdiction over
108.23health information policy issues on the status of the health information exchange in
108.24Minnesota and provide recommendations on further action necessary to facilitate the
108.25secure electronic movement of health information among health providers that will enable
108.26Minnesota providers and hospitals to meet meaningful use exchange requirements.
108.27    Subd. 5. Fees and monetary penalties. (a) Every health information exchange
108.28service provider subject to this section and section 62J.4981 shall be assessed fees as
108.29follows:
108.30(1) filing an application for certificate of authority to operate as a health information
108.31organization, $10,500;
108.32(2) filing an application for certificate of authority to operate as a health data
108.33intermediary, $7,000;
108.34(3) annual health information organization certificate fee, $14,000;
108.35(4) annual health data intermediary certificate fee, $7,000; and
108.36(5) fees for other filings, as specified by rule.
109.1(b) Administrative monetary penalties imposed under this subdivision shall be
109.2deposited into a revolving fund and are appropriated to the commissioner for the purposes
109.3of sections 62J.498 to 62J.4982.

109.4    Sec. 9. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:
109.5    Subdivision 1. Designation. (a) The commissioner shall designate essential
109.6community providers. The criteria for essential community provider designation shall be
109.7the following:
109.8(1) a demonstrated ability to integrate applicable supportive and stabilizing services
109.9with medical care for uninsured persons and high-risk and special needs populations,
109.10underserved, and other special needs populations; and
109.11(2) a commitment to serve low-income and underserved populations by meeting the
109.12following requirements:
109.13(i) has nonprofit status in accordance with chapter 317A;
109.14(ii) has tax exempt status in accordance with the Internal Revenue Service Code,
109.15section 501(c)(3);
109.16(iii) charges for services on a sliding fee schedule based on current poverty income
109.17guidelines; and
109.18(iv) does not restrict access or services because of a client's financial limitation;
109.19(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
109.20hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
109.21government, an Indian health service unit, or a community health board as defined in
109.22chapter 145A;
109.23(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
109.24bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
109.25conditions; or
109.26(5) a sole community hospital. For these rural hospitals, the essential community
109.27provider designation applies to all health services provided, including both inpatient and
109.28outpatient services. For purposes of this section, "sole community hospital" means a
109.29rural hospital that:
109.30(i) is eligible to be classified as a sole community hospital according to Code
109.31of Federal Regulations, title 42, section 412.92, or is located in a community with a
109.32population of less than 5,000 and located more than 25 miles from a like hospital currently
109.33providing acute short-term services;
110.1(ii) has experienced net operating income losses in two of the previous three
110.2most recent consecutive hospital fiscal years for which audited financial information is
110.3available; and
110.4(iii) consists of 40 or fewer licensed beds; or
110.5(6) a birth center licensed under section 144.615.
110.6(b) Prior to designation, the commissioner shall publish the names of all applicants
110.7in the State Register. The public shall have 30 days from the date of publication to submit
110.8written comments to the commissioner on the application. No designation shall be made
110.9by the commissioner until the 30-day period has expired.
110.10(c) The commissioner may designate an eligible provider as an essential community
110.11provider for all the services offered by that provider or for specific services designated by
110.12the commissioner.
110.13(d) For the purpose of this subdivision, supportive and stabilizing services include at
110.14a minimum, transportation, child care, cultural, and linguistic services where appropriate.

110.15    Sec. 10. Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:
110.16    Subd. 3. Birth record surcharge. (a) In addition to any fee prescribed under
110.17subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
110.18stillbirth record and for a certification that the vital record cannot be found. The local or
110.19state registrar shall forward this amount to the commissioner of management and budget
110.20for deposit into the account for the children's trust fund for the prevention of child abuse
110.21established under section 256E.22. This surcharge shall not be charged under those
110.22circumstances in which no fee for a certified birth or stillbirth record is permitted under
110.23subdivision 1, paragraph (a). Upon certification by the commissioner of management and
110.24budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.
110.25(b) In addition to any fee prescribed under subdivision 1, there shall be a
110.26nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
110.27shall forward this amount to the commissioner of finance for deposit in the general fund
110.28for the Minnesota Birth Defects Information System established under section 144.2215.
110.29This surcharge shall not be charged under those circumstances in which no fee for a
110.30certified birth record is permitted under subdivision 1, paragraph (a).
110.31EFFECTIVE DATE.This section is effective July 1, 2010.

110.32    Sec. 11. [144.615] BIRTH CENTERS.
110.33    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
110.34have the meanings given them.
111.1(b) "Birth center" means a facility licensed for the primary purpose of performing
111.2low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are
111.3planned to occur away from the mother's usual residence following a low-risk pregnancy.
111.4(c) "CABC" means the Commission for the Accreditation of Birth Centers.
111.5(d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as
111.6determined by documentation of adequate prenatal care and the anticipation of a normal
111.7uncomplicated labor and birth, as defined by reasonable and generally accepted criteria
111.8adopted by professional groups for maternal, fetal, and neonatal health care.
111.9    Subd. 2. License required. (a) Beginning January 1, 2011, no birth center shall be
111.10established, operated, or maintained in the state without first obtaining a license from the
111.11commissioner of health according to this section.
111.12(b) A license issued under this section is not transferable or assignable and is subject
111.13to suspension or revocation at any time for failure to comply with this section.
111.14(c) A birth center licensed under this section shall not assert, represent, offer,
111.15provide, or imply that the center is or may render care or services other than the services it
111.16is permitted to render within the scope of the license or the accreditation issued.
111.17(d) The license must be conspicuously posted in an area where patients are admitted.
111.18    Subd. 3. Temporary license. For new birth centers planning to begin operations
111.19after January 1, 2011, the commissioner may issue a temporary license to the birth center
111.20that is valid for a period of six months from the date of issuance. The birth center must
111.21submit to the commissioner an application and applicable fee for licensure as required
111.22under subdivision 4. The application must include the information required in subdivision
111.234, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted
111.24an application for accreditation to the CABC. Upon receipt of accreditation from the
111.25CABC, the birth center must submit to the commissioner the information required in
111.26subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner
111.27shall issue a new license.
111.28    Subd. 4. Application. An application for a license to operate a birth center and the
111.29applicable fee under subdivision 8 must be submitted to the commissioner on a form
111.30provided by the commissioner and must contain:
111.31(1) the name of the applicant;
111.32(2) the site location of the birth center;
111.33(3) the name of the person in charge of the center;
111.34(4) documentation that the accreditation described under subdivision 6 has been
111.35issued, including the effective date and the expiration date of the accreditation, and the
111.36date of the last site visit by the CABC;
112.1(5) the number of patients the birth center is capable of serving at a given time;
112.2(6) the names and license numbers, if applicable, of the health care professionals
112.3on staff at the birth center; and
112.4(7) any other information the commissioner deems necessary.
112.5    Subd. 5. Suspension, revocation, and refusal to renew. The commissioner may
112.6refuse to grant or renew, or may suspend or revoke, a license on any of the grounds
112.7described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or
112.8upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice
112.9and a hearing as described under section 144.55, subdivision 7, and a new license may be
112.10issued after proper inspection of the birth center has been conducted.
112.11    Subd. 6. Standards for licensure. (a) To be eligible for licensure under this
112.12section, a birth center must be accredited by the CABC or must obtain accreditation
112.13within six months of the date of the application for licensure. If the birth center loses its
112.14accreditation, the birth center must immediately notify the commissioner.
112.15(b) The center must have procedures in place specifying criteria by which risk status
112.16will be established and applied to each woman at admission and during labor.
112.17(c) Upon request, the birth center shall provide the commissioner of health with any
112.18material submitted by the birth center to the CABC as part of the accreditation process,
112.19including the accreditation application, the self-evaluation report, the accreditation
112.20decision letter from the CABC, and any reports from the CABC following a site visit.
112.21    Subd. 7. Limitations of services. (a) The following limitations apply to the services
112.22performed at a birth center:
112.23(1) surgical procedures must be limited to those normally accomplished during an
112.24uncomplicated birth, including episiotomy and repair;
112.25(2) no abortions may be administered; and
112.26(3) no general or regional anesthesia may be administered.
112.27(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth
112.28center if the administration of the anesthetic is performed within the scope of practice of a
112.29health care professional.
112.30    Subd. 8. Fees. (a) The biennial license fee for a birth center is $365.
112.31(b) The temporary license fee is $365.
112.32(c) Fees shall be collected and deposited according to section 144.122.
112.33    Subd. 9. Renewal. (a) Except as provided in paragraph (b), a license issued under
112.34this section expires two years from the date of issue.
112.35(b) A temporary license issued under subdivision 3 expires six months from the date
112.36of issue, and may be renewed for one additional six-month period.
113.1(c) An application for renewal shall be submitted at least 60 days prior to expiration
113.2of the license on forms prescribed by the commissioner of health.
113.3    Subd. 10. Records. All health records maintained on each client by a birth center
113.4are subject to sections 144.292 to 144.298.
113.5    Subd. 11. Report. (a) The commissioner of health, in consultation with the
113.6commissioner of human services and representatives of the licensed birth centers,
113.7the American College of Obstetricians and Gynecologists, the American Academy
113.8of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance
113.9Association, shall evaluate the quality of care and outcomes for services provided in
113.10licensed birth centers, including, but not limited to, the utilization of services provided at a
113.11birth center, the outcomes of care provided to both mothers and newborns, and the numbers
113.12of transfers to other health care facilities that are required and the reasons for the transfers.
113.13The commissioner shall work with the birth centers to establish a process to gather and
113.14analyze the data within protocols that protect the confidentiality of patient identification.
113.15(b) The commissioner of health shall report the findings of the evaluation to the
113.16legislature by January 15, 2014.

113.17    Sec. 12. Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read:
113.18    Subd. 2. Definitions. For the purposes of this section, "patient" means a person
113.19who is admitted to an acute care inpatient facility for a continuous period longer than
113.2024 hours, for the purpose of diagnosis or treatment bearing on the physical or mental
113.21health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20,
113.22"patient" also means a person who receives health care services at an outpatient surgical
113.23center or at a birth center licensed under section 144.615. "Patient" also means a minor
113.24who is admitted to a residential program as defined in section 253C.01. For purposes of
113.25subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving
113.26mental health treatment on an outpatient basis or in a community support program or other
113.27community-based program. "Resident" means a person who is admitted to a nonacute care
113.28facility including extended care facilities, nursing homes, and boarding care homes for
113.29care required because of prolonged mental or physical illness or disability, recovery from
113.30injury or disease, or advancing age. For purposes of all subdivisions except subdivisions
113.3128 and 29, "resident" also means a person who is admitted to a facility licensed as a board
113.32and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised
113.33living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates
113.34a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450.

114.1    Sec. 13. Minnesota Statutes 2008, section 144.9504, is amended by adding a
114.2subdivision to read:
114.3    Subd. 12. Blood lead level guidelines. (a) By January 1, 2011, the commissioner
114.4must revise clinical and case management guidelines to include recommendations
114.5for protective health actions and follow-up services when a child's blood lead level
114.6exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be
114.7implemented to the extent possible using available resources.
114.8(b) In revising the clinical and case management guidelines for blood lead levels
114.9greater than five micrograms of lead per deciliter of blood under this subdivision,
114.10the commissioner of health must consult with a statewide organization representing
114.11physicians, the public health department of Minneapolis and other public health
114.12departments, and a nonprofit organization with expertise in lead abatement.

114.13    Sec. 14. Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read:
114.14    Subd. 5. Health facility. "Health facility" means a facility or that part of a facility
114.15which is required to be licensed pursuant to sections 144.50 to 144.58, 144.615, and a
114.16facility or that part of a facility which is required to be licensed under any law of this state
114.17which provides for the licensure of nursing homes.

114.18    Sec. 15. Minnesota Statutes 2008, section 144E.37, is amended to read:
114.19144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.
114.20The board commissioner of health shall establish a comprehensive advanced
114.21life-support educational program to train rural medical personnel, including physicians,
114.22physician assistants, nurses, and allied health care providers, in a team approach to
114.23anticipate, recognize, and treat life-threatening emergencies before serious injury or
114.24cardiac arrest occurs.
114.25EFFECTIVE DATE.This section is effective July 1, 2010.

114.26    Sec. 16. HEALTH PLAN AND COUNTY ADMINISTRATIVE COST
114.27REDUCTION; REPORTING REQUIREMENTS.
114.28(a) Minnesota health plans and county-based purchasing plans may complete an
114.29inventory of existing data collection and reporting requirements for health plans and
114.30county-based purchasing plans and submit to the commissioners of health and human
114.31services a list of data, documentation, and reports that:
115.1(1) are collected from the same health plan or county-based purchasing plan more
115.2than once;
115.3(2) are collected directly from the health plan or county-based purchasing plan but
115.4are available to the state agencies from other sources;
115.5(3) are not currently being used by state agencies; or
115.6(4) collect similar information more than once in different formats, at different
115.7times, or by more than one state agency.
115.8(b) The report to the commissioners may also identify the percentage of health
115.9plan and county-based purchasing plan administrative time and expense attributed to
115.10fulfilling reporting requirements and include recommendations regarding ways to reduce
115.11duplicative reporting requirements.
115.12(c) Upon receipt, the commissioners shall submit the inventory and recommendations
115.13to the chairs of the appropriate legislative committees, along with their comments
115.14and recommendations as to whether any action should be taken by the legislature to
115.15establish a consolidated and streamlined reporting system under which data, reports, and
115.16documentation are collected only once and only when needed for the state agencies to
115.17fulfill their duties under law and applicable regulations.

115.18    Sec. 17. APPLICATION PROCESS FOR HEALTH INFORMATION
115.19EXCHANGE.
115.20To the extent that the commissioner of health applies for additional federal funding
115.21to support the commissioner's responsibilities of developing and maintaining state level
115.22health information exchange under section 3013 of the HITECH Act, the commissioner of
115.23health shall ensure that applications are made through an open process that provides health
115.24information exchange service providers equal opportunity to receive funding.

115.25    Sec. 18. TRANSFER.
115.26The powers and duties of the Emergency Medical Services Regulatory Board with
115.27respect to the comprehensive advanced life-support educational program under Minnesota
115.28Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota
115.29Statutes, section 15.039.
115.30EFFECTIVE DATE.This section is effective July 1, 2010.

115.31    Sec. 19. REVISOR'S INSTRUCTION.
116.1The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as
116.2Minnesota Statutes, section 144.6062, and make all necessary changes in statutory
116.3cross-references in Minnesota Statutes and Minnesota Rules.
116.4EFFECTIVE DATE.This section is effective July 1, 2010.

116.5ARTICLE 7

116.6HEALTH CARE REFORM

116.7    Section 1. [62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK
116.8POOL.
116.9    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
116.10this subdivision have the meanings given.
116.11(b) "Association" means the Minnesota Comprehensive Health Association.
116.12(c) "Federal law" means Title I, subtitle B, section 1101, of the federal Patient
116.13Protection and Affordable Care Act, Public Law 111-148, including any federal
116.14regulations adopted under it.
116.15(d) "Federal qualified high-risk pool" means an arrangement established by the
116.16federal secretary of health and human services that meets the requirements of the federal
116.17law.
116.18    Subd. 2. Timing of this section. This section applies beginning as of the date the
116.19temporary federal qualified high risk health pool created under the federal law begins
116.20to provide coverage in this state.
116.21    Subd. 3. Maintenance of effort. The assessments made by the comprehensive
116.22health association on its member insurers must comply with the maintenance of effort
116.23requirement contained in paragraph (b), clause (3), of the federal law, to the extent that
116.24requirement applies to assessments made by the association.
116.25    Subd. 4. Coordination with federal law. Upon the date a federal qualified high-risk
116.26pool begins to provide coverage in this state, the comprehensive health association must
116.27not enroll new enrollees, notwithstanding section 62E.14 or other law to the contrary. If
116.28the lack of new enrollees would otherwise lead to noncompliance with subdivision 3, the
116.29association shall reduce the premiums to levels below those otherwise required under
116.30section 62E.08, to the extent necessary to comply with subdivision 3.
116.31    Subd. 5. Coordination with state health care programs. The commissioner of
116.32human services, in consultation with the commissioner of commerce and the Minnesota
116.33Comprehensive Health Association, shall coordinate enrollment between medical
117.1assistance, MinnesotaCare, the federal qualified high-risk pool, and the Minnesota
117.2Comprehensive Health Association, to ensure that:
117.3(1) applicants for coverage through the federal qualified high-risk pool, or through
117.4the Minnesota Comprehensive Health Association to the extent the association is enrolling
117.5new members, are referred to the medical assistance or MinnesotaCare programs if they
117.6are determined to be potentially eligible for coverage through those programs; and
117.7(2) applicants for coverage under medical assistance or MinnesotaCare who are
117.8determined not to be eligible for those programs are provided information about coverage
117.9through the federal qualified high-risk pool and the Minnesota Comprehensive Health
117.10Association.

117.11    Sec. 2. Minnesota Statutes 2008, section 62J.07, subdivision 2, is amended to read:
117.12    Subd. 2. Membership. The Legislative Commission on Health Care Access
117.13consists of five seven members of the senate appointed under the rules of the senate and
117.14five seven members of the house of representatives appointed under the rules of the house
117.15of representatives. The Legislative Commission on Health Care Access must include three
117.16five members of the majority party and two members of the minority party in each house.

117.17    Sec. 3. Minnesota Statutes 2008, section 62J.07, is amended by adding a subdivision to
117.18read:
117.19    Subd. 5. Federal health care reform. (a) The Legislative Commission on
117.20Health Care Access shall analyze options and make recommendations regarding the
117.21implementation of provisions of the Patient Protection and Affordable Health Care Act,
117.22Public Law 111-148, and the health care reform provisions in the Health Care and
117.23Education Reconciliation Act of 2010, Public Law 111-152, including:
117.24(1) development of accountable care organizations;
117.25(2) health insurance reform, including options related to coverage, purchasing,
117.26exchange development, and coverage for high-risk individuals; and
117.27(3) other provisions that will require changes in state law.
117.28(b) Before finalizing and submitting federal applications for pilot projects authorized
117.29under federal health care reform, the governor and state agencies shall seek review and
117.30advice from the commission.
117.31(c) The commission may create and make appointments to work groups to assist the
117.32commission in its work. Work group members may include legislators, representatives
117.33of businesses and nonprofit agencies impacted by federal health care reform, academic
117.34experts, and consumer representatives.

118.1    Sec. 4. Minnesota Statutes 2008, section 62U.05, is amended to read:
118.262U.05 PROVIDER PRICING FOR BASKETS OF CARE; ACCOUNTABLE
118.3CARE ORGANIZATIONS.
118.4    Subdivision 1. Establishment of definitions. (a) By July 1, 2009, the commissioner
118.5of health shall establish uniform definitions for baskets of care beginning with a minimum
118.6of seven baskets of care. In selecting health conditions for which baskets of care should
118.7be defined, the commissioner shall consider coronary artery and heart disease, diabetes,
118.8asthma, and depression. In selecting health conditions, the commissioner shall also
118.9consider the prevalence of the health conditions, the cost of treating the health conditions,
118.10and the potential for innovations to reduce cost and improve quality.
118.11    (b) The commissioner shall convene one or more work groups to assist in
118.12establishing these definitions. Each work group shall include members appointed by
118.13statewide associations representing relevant health care providers and health plan
118.14companies, and organizations that work to improve health care quality in Minnesota.
118.15    (c) To the extent possible, the baskets of care must incorporate a patient-directed,
118.16decision-making support model.
118.17(d) By January 1, 2012, the commissioner shall establish uniform definitions for the
118.18total cost of providing all necessary services to a patient through an accountable care
118.19organization meeting the standards specified in section 3022 of the Patient Protection
118.20and Affordable Care Act, Public Law 111-148, and shall develop a standard method
118.21and format for accountable care organizations to use for submitting package prices for
118.22the total cost of care. This method must be published in the State Register and must be
118.23made available to all providers.
118.24    Subd. 2. Package prices. (a) Beginning January 1, 2010, health care providers may
118.25establish package prices for the baskets of care defined under subdivision 1. Beginning
118.26July 1, 2012, accountable care organizations may establish package prices for the total
118.27cost of care defined under subdivision 1.
118.28    (b) Beginning January 1, 2010, no health care provider or group of providers that
118.29has established a package price for a basket of care under this section, and beginning
118.30July 1, 2012, no accountable care organization that has established a package price for
118.31the total cost of care under this section, shall vary the payment amount that the provider
118.32or organization accepts as full payment for a health care service based upon the identity of
118.33the payer, upon a contractual relationship with a payer, upon the identity of the patient,
118.34or upon whether the patient has coverage through a group purchaser. This paragraph
118.35applies only to health care services provided to Minnesota residents or to non-Minnesota
118.36residents who obtain health insurance through a Minnesota employer. This paragraph does
119.1not apply to services paid for by Medicare, state public health care programs through
119.2fee-for-service or prepaid arrangements, workers' compensation, or no-fault automobile
119.3insurance. This paragraph does not affect the right of a provider to provide charity care
119.4or care for a reduced price due to financial hardship of the patient or due to the patient
119.5being a relative or friend of the provider.
119.6    Subd. 3. Quality measurements for baskets of care. (a) The commissioner shall
119.7establish quality measurements for the defined baskets of care by December 31, 2009.
119.8The commissioner shall establish quality measures for the total cost of care for services
119.9delivered through an accountable care organization by June 30, 2012. The commissioner
119.10may contract with an organization that works to improve health care quality to make
119.11recommendations about the use of existing measures or establishing new measures where
119.12no measures currently exist.
119.13    (b) Beginning July 1, 2010, the commissioner or the commissioner's designee shall
119.14publish comparative price and quality information on the baskets of care in a manner
119.15that is easily accessible and understandable to the public, as this information becomes
119.16available. Beginning January 1, 2013, the commissioner or the commissioner's designee
119.17shall publish comparative price and quality information on the total cost of care for
119.18services delivered through an accountable care organization in a manner that is easily
119.19accessible and understandable to the public, as this information becomes available.

119.20    Sec. 5. Minnesota Statutes 2008, section 256B.0754, is amended by adding a
119.21subdivision to read:
119.22    Subd. 3. Accountable care organizations. By July 1, 2012, the commissioner of
119.23human services shall deliver services to enrollees in state health care programs through
119.24accountable care organizations, and shall provide incentive payments to accountable care
119.25organizations that meet or exceed annual quality and performance targets. Accountable
119.26care organizations and incentive payments must meet the standards specified in the Patient
119.27Protection and Affordable Care Act, Public Law 111-148.

119.28    Sec. 6. [256B.0756] COORDINATED CARE THROUGH A HEALTH HOME.
119.29    Subdivision 1. Provision of coverage. (a) The commissioner shall provide
119.30medical assistance coverage of health home services for eligible individuals with chronic
119.31conditions who select a designated provider, a team of health care professionals, or a
119.32health team as the individual's health home.
119.33(b) The commissioner shall implement this section in compliance with the
119.34requirements of the state option to provide health homes for enrollees with chronic
120.1conditions, as provided under the Patient Protection and Affordable Care Act, Public
120.2Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning
120.3provided in that act.
120.4    Subd. 2. Eligible individual. An individual is eligible for health home services
120.5under this section if the individual is eligible for medical assistance under this chapter
120.6and has at least:
120.7(1) two chronic conditions;
120.8(2) one chronic condition and is at risk of having a second chronic condition; or
120.9(3) one serious and persistent mental health condition.
120.10    Subd. 3. Health home services. (a) Health home services means comprehensive and
120.11timely high-quality services that are provided by a health home. These services include:
120.12(1) comprehensive care management;
120.13(2) care coordination and health promotion;
120.14(3) comprehensive transitional care, including appropriate follow-up, from inpatient
120.15to other settings;
120.16(4) patient and family support, including authorized representatives;
120.17(5) referral to community and social support services, if relevant; and
120.18(6) use of health information technology to link services, as feasible and appropriate.
120.19(b) The commissioner shall maximize the number and type of services
120.20included in this subdivision to the extent permissible under federal law, including
120.21physician, outpatient, mental health treatment, and rehabilitation services necessary for
120.22comprehensive transitional care following hospitalization.
120.23    Subd. 4. Health teams. The commissioner shall establish health teams to support
120.24the patient-centered health home and provide the services described in subdivision 3 to
120.25individuals eligible under subdivision 2. The commissioner shall apply for grants or
120.26contracts as provided under section 3502 of the Patient Protection and Affordable Care
120.27Act to establish health teams and provide capitated payments to primary care providers.
120.28For purposes of this section, "health teams" means community-based, interdisciplinary,
120.29inter-professional teams of health care providers that support primary care practices.
120.30These providers may include medical specialists, nurses, advanced practice registered
120.31nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers,
120.32doctors of chiropractic, licensed complementary and alternative medicine practitioners,
120.33and physician's assistants.
120.34    Subd. 5. Payments. The commissioner shall make payments to each health home
120.35and each health team for the provision of health home services to each eligible individual
120.36with chronic conditions that selects the health home as a provider.
121.1    Subd. 6. Coordination. The commissioner, to the extent feasible, shall ensure that
121.2the requirements and payment methods for health homes and health teams developed
121.3under this section are consistent with the requirements and payment methods for health
121.4care homes established under sections 256B.0751 and 256B.0753. The commissioner may
121.5modify requirements and payment methods under sections 256B.0751 and 256B.0753 in
121.6order to be consistent with federal health home requirements and payment methods.
121.7    Subd. 7. State plan amendment. The commissioner shall submit a state plan
121.8amendment to implement this section to the federal Centers for Medicare and Medicaid
121.9Services by January 1, 2011.
121.10EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
121.11approval, whichever is later.

121.12    Sec. 7. FEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS
121.13AND GRANTS.
121.14(a) The commissioner of human services shall seek to participate in the following
121.15demonstration projects, or apply for the following grants, as described in the federal
121.16Patient Protection and Affordable Care Act, Public Law 111-148:
121.17(1) the demonstration project to evaluate integrated care around a hospitalization,
121.18Public Law 111-148, section 2704;
121.19(2) the Medicaid global payment system demonstration project, Public Law 111-148,
121.20section 2705;
121.21(3) the pediatric accountable care organization demonstration project, Public Law
121.22111-148, section 2706;
121.23(4) the Medicaid emergency psychiatric demonstration project, Public Law 111-148,
121.24section 2707; and
121.25(5) grants to provide incentives for prevention of chronic diseases in Medicaid,
121.26Public Law 111-148, section 4108.
121.27(b) The commissioner of human services shall report to the chairs and ranking
121.28minority members of the house of representatives and senate committees or divisions with
121.29jurisdiction over health care policy and finance on the status of the demonstration project
121.30and grant applications. If the state is accepted as a demonstration project participant, or is
121.31awarded a grant, the commissioner shall notify the chairs and ranking minority members
121.32of those committees or divisions of any legislative changes necessary to implement the
121.33demonstration projects or grants.

121.34    Sec. 8. HEALTH CARE REFORM TASK FORCE.
122.1    Subdivision 1. Task force. (a) The governor shall convene a Health Care
122.2Reform Task Force to advise and assist the governor and the legislature regarding state
122.3implementation of federal health care reform legislation. For purposes of this section,
122.4"federal health care reform legislation" means the Patient Protection and Affordable Care
122.5Act, Public Law 111-148, and the health care reform provisions in the Health Care and
122.6Education Reconciliation Act of 2010, Public Law 111-152. The task force shall consist of:
122.7(1) two legislators from the house of representatives appointed by the speaker and
122.8two legislators from the senate appointed by the Subcommittee on Committees of the
122.9Committee on Rules and Administration;
122.10    (2) two representatives appointed by the governor to represent the governor and
122.11state agencies;
122.12    (3) three persons appointed by the governor who have demonstrated leadership in
122.13health care organizations, health plan companies, or health care trade or professional
122.14associations;
122.15    (4) three persons appointed by the governor who have demonstrated leadership in
122.16employer and group purchaser activities related to health system improvement of whom at
122.17least two must be from a labor organization; and
122.18    (5) five persons appointed by the governor who have demonstrated expertise in the
122.19areas of health care financing, access, and quality.
122.20    The governor is exempt from the requirements of the open appointments process
122.21for purposes of appointing task force members. Members shall be appointed for one-year
122.22terms and may be reappointed.
122.23    (b) The Department of Health, Department of Human Services, and Department of
122.24Commerce shall provide staff support to the task force. The task force may accept outside
122.25resources to help support its efforts.
122.26    (c) Task force members must be appointed by July 1, 2010. The task force must hold
122.27its first meeting by July 15, 2010.
122.28    Subd. 2. Duties. (a) By December 15, 2010, the task force shall develop and
122.29present to the legislature and the governor a preliminary report and recommendations on
122.30state implementation of federal health care reform legislation. The report must include
122.31recommendations for state law and program changes necessary to comply with the federal
122.32health care reform legislation, and also recommendations for implementing provisions of
122.33the federal legislation that are optional for states. In developing recommendations, the task
122.34force shall consider the extent to which an approach maximizes federal funding to the state.
123.1(b) The task force, in consultation with the governor and the legislature, shall also
123.2establish timelines and criteria for future reports on state implementation of the federal
123.3health care reform legislation.

123.4    Sec. 9. AMERICAN HEALTH BENEFIT EXCHANGE; PLANNING
123.5PROVISIONS.
123.6    Subdivision 1. Federal planning grants. The commissioners of commerce, health,
123.7and human services shall jointly or separately apply to the federal secretary of health and
123.8human services for one or more planning and establishment grants, including renewal
123.9grants, authorized under section 1311 of the Patient Protection and Affordable Care Act,
123.10Public Law 111-148, including any future amendments of that provision, relating to state
123.11creation of American Health Benefit Exchanges.
123.12    Subd. 2. Consideration of early creation and operation of exchange. (a) The
123.13commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages
123.14to the state of planning to have a state health insurance exchange, similar to an American
123.15Health Benefit Exchange referenced in subdivision 1, begin prior to the federal deadline
123.16of January 1, 2014.
123.17(b) The commissioners shall provide a written report to the legislature on the results
123.18of the analysis required under paragraph (a) no later than December 15, 2010. The written
123.19report must comply with Minnesota Statutes, sections 3.195 and 3.197.

123.20ARTICLE 8

123.21HUMAN SERVICES FORECAST ADJUSTMENTS

123.22 123.23

Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

123.24The dollar amounts shown are added to or if shown in parentheses, are subtracted
123.25from the appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009,
123.26chapter 173, article 2, from the general fund or any fund named to the Department of
123.27Human Services for the purposes specified in this article, to be available for the fiscal
123.28year indicated for each purpose. The figure "2010" used in this article means that the
123.29appropriation or appropriations listed are available for the fiscal year ending June 30,
123.302010. The figure "2011" used in this article means that the appropriation or appropriations
123.31listed are available for the fiscal year ending June 30, 2011.

123.32					2010		2011
123.33	General			$	(109,876,000)	$	(28,344,000)
123.34	Health Care Access				99,654,000		276,500,000
124.1	Federal TANF				(9,830,000)		15,133,000
124.2	Total			$	(20,052,000)	$	263,289,000

124.3 124.4

Sec. 2. COMMISSIONER OF HUMAN SERVICES

124.5

Subdivision 1.Total Appropriation

$

(20,052,000)

$

263,289,000

124.6	Appropriations by Fund
124.7		2010	2011
124.8	General	(109,876,000)	(28,344,000)
124.9	Health Care Access	99,654,000	276,500,000
124.10	Federal TANF	(9,830,000)	15,133,000

124.11

Subd. 2. Revenue and Pass-Through

124.12

Federal TANF

390,000

(251,000)

124.13 124.14

Subd. 3.Children and Economic Assistance Grants

124.15	General Fund	4,489,000	(4,140,000)
124.16	Federal TANF	(10,220,000)	15,384,000

124.17The amounts that may be spent from this
124.18appropriation are as follows:

124.19

(a) MFIP Grants

124.20	General Fund	7,916,000	(14,481,000)
124.21	TANF Fund	(10,220,000)	15,384,000

124.22

(b) MFIP Child Care Assistance Grants

(7,832,000)

2,579,000

124.23

(c) General Assistance Grants

875,000

1,339,000

124.24

(d) Minnesota Supplemental Aid Grants

2,454,000

3,843,000

124.25

(e) Group Residential Housing Grants

1,076,000

2,580,000

124.26

Subd. 4.Basic Health Care Grants

124.27	General Fund	(62,770,000)	29,192,000
124.28	TANF Fund	99,654,000	276,500,000

124.29The amounts that may be spent from this
124.30appropriation are as follows:

124.31

(a) MinnesotaCare Grants

125.1 125.2

Health Care Access Fund

99,654,000

276,500,000

125.3 125.4

(b) Medical Assistance Basic Health Care – Families and Children

1,165,000

24,146,000

125.5 125.6

(c) Medical Assistance Basic Health Care – Elderly and Disabled

(63,935,000)

5,046,000

125.7

Subd. 5.Continuing Care Grants

(51,595,000)

(53,396,000)

125.8The amounts that may be spent from this
125.9appropriation are as follows:

125.10 125.11

(a) Medical Assistance Long-Term Care Facilities

(3,774,000)

(8,275,000)

125.12 125.13

(b) Medical Assistance Long-Term Care Waivers

(27,710,000)

(22,452,000)

125.14

(c) Chemical Dependency Entitlement Grants

(20,111,000)

(22,669,000)

125.15    Sec. 3. EFFECTIVE DATE.
125.16Sections 1 and 2 are effective the date following final enactment.

125.17ARTICLE 9

125.18HEALTH AND HUMAN SERVICES APPROPRIATIONS

125.19

Section 1. SUMMARY OF APPROPRIATIONS.

125.20The amounts shown in this section summarize direct appropriations, by fund, made
125.21in this article.

125.22			2010		2011		Total
125.23	General	$	(10,162,000)	$	(99,234,000)	$	(109,396,000)
125.24 125.25	State Government Special Revenue		(608,000)		(275,000)		(883,000)
125.26	Health Care Access		(1,094,000)		72,459,000		71,365,000
125.27	Federal TANF		-0-		27,918,000		27,918,000
125.28	Total	$	(11,864,000)	$	(867,000)	$	(10,997,000)

125.29

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

125.30The sums shown in the columns marked "Appropriations" are added to or, if shown
125.31in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13,
125.32as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes
125.33specified in this article. The appropriations are from the general fund and are available
126.1for the fiscal years indicated for each purpose. The figures "2010" and "2011" used in
126.2this article mean that the addition to or subtraction from the appropriation listed under
126.3them is available for the fiscal year ending June 30, 2010, or June 30, 2011, respectively.
126.4Supplemental appropriations and reductions to appropriations for the fiscal year ending
126.5June 30, 2010, are effective the day following final enactment unless a different effective
126.6date is explicit.

126.7				APPROPRIATIONS
126.8				Available for the Year
126.9				Ending June 30
126.10					2010		2011

126.11 126.12

Sec. 3. COMMISSIONER OF HUMAN SERVICES

126.13

Subdivision 1.Total Appropriation

$

(9,467,000)

$

(5,084,000)

126.14	Appropriations by Fund
126.15		2010	2011
126.16	General	(8,365,000)	(105,244,000)
126.17 126.18	State Government Special Revenue	(8,000)	(16,000)
126.19	Health Care Access	(1,094,000)	72,259,000
126.20	Federal TANF	-0-	27,918,000

126.21Working Family Credit Expenditures to
126.22be Claimed for TANF/MOE. For fiscal year
126.232011, the commissioner may count $38,000
126.24of working family credit expenditures as
126.25TANF/MOE. Notwithstanding any provision
126.26to the contrary, this rider expires June 30,
126.272013.
126.28TANF Financing and Maintenance of
126.29Effort. The commissioner of human
126.30services, with the approval of the
126.31commissioner of management and budget,
126.32and after notification of the chairs of the
126.33relevant senate budget division and house of
126.34representatives finance division, may adjust
126.35the amount of TANF transfers between the
126.36MFIP transition year child care assistance
126.37program and MFIP grant programs within the
127.1fiscal year, and within the current biennium
127.2and the biennium ending June 30, 2013,
127.3to ensure that state and federal match and
127.4maintenance of effort requirements are
127.5met. These transfers and amounts must be
127.6reported to the chairs of the senate and house
127.7of representatives Finance Committees, the
127.8senate Health and Human Services Budget
127.9Division, the house of representatives Health
127.10Care and Human Services Finance Division,
127.11and Early Childhood Finance and Policy
127.12Division by December 1 of each fiscal
127.13year. Notwithstanding any provision to the
127.14contrary, this rider expires June 30, 2013.
127.15The appropriation reductions for each
127.16purpose are shown in the following
127.17subdivisions.

127.18 127.19

Subd. 2.Agency Management; Financial Operations

(8,000)

(16,000)

127.20This appropriation reduction is from the state
127.21government special revenue fund.

127.22 127.23

Subd. 3.Revenue and Pass-Through Revenue Expenditures

-0-

28,000,000

127.24TANF Funding for the Working Family
127.25Tax Credit. In addition to the amounts
127.26specified in Minnesota Statutes, section
127.27290.0671, subdivision 6, $18,722,000
127.28of TANF funds in fiscal year 2010 and
127.29$18,689,000 of TANF funds in fiscal year
127.302011 are appropriated to the commissioner
127.31of human services to reimburse the cost of
127.32the working family tax credit for eligible
127.33families. Beginning January 1, 2011, the
127.34commissioner shall reimburse the general
127.35fund on a monthly basis according to a
127.36schedule based on the pattern of working
128.1family credit expenditures through June 20,
128.22011. This rider is effective upon enactment.

128.3 128.4

Subd. 4.Children and Economic Assistance Grants

128.5 128.6

(a) MFIP and Diversionary Work Program Grants

-0-

(2,033,000)

128.7This appropriation reduces the general
128.8fund appropriation by $5,691,000 and
128.9increases the federal TANF appropriation by
128.10$3,658,000.

128.11

(b) Support Services Grants

-0-

(7,646,000)

128.12Supported Work. The fiscal year 2011
128.13TANF appropriation to the commissioner of
128.14human services for supported work for MFIP
128.15recipients is reduced by $4,000,000. This
128.16reduction is onetime.
128.17Base Adjustment. The general fund base
128.18shall be increased by $2,642,000 for fiscal
128.19years 2012 and 2013.

128.20

(c) MFIP Child Care Assistance Grants

-0-

(38,000)

128.21This appropriation reduces the general
128.22fund appropriation by $4,000,000 and
128.23increases the federal TANF appropriation by
128.24$3,962,000.

128.25

(d) Children and Community Services Grants

-0-

(9,900,000)

128.26Children and Community Services Grant
128.27Reduction. The fiscal year 2011 general
128.28fund appropriation to the commissioner
128.29of human services for the children and
128.30community services grants under Minnesota
128.31Statutes, section 256M.40, is reduced by
128.32$9,900,000. This reduction is ongoing and is
128.33subtracted from the base.

128.34

(e) Children's Mental Health Grants

-0-

(8,028,000)

129.1(1) The general fund appropriation for
129.2respite care services for children with
129.3severe emotional disturbance who are at
129.4risk of out-of-home placement is reduced
129.5by $1,024,000 for fiscal year 2011. This
129.6reduction is onetime.
129.7(2) The general fund appropriation for
129.8children's early intervention services is
129.9reduced by $1,024,000 for fiscal year 2011.
129.10This reduction is onetime.
129.11(3) The general fund appropriation for
129.12children's capacity school-based services is
129.13reduced by $4,777,000 for fiscal year 2011.
129.14(4) The general fund appropriation for
129.15children's mental health targeted case
129.16management grants is reduced by $1,210,000
129.17for fiscal year 2011.

129.18 129.19

Subd. 5.Children and Economic Assistance Management

129.20 129.21

(a) Children and Economic Assistance Administration

-0-

-0-

129.22The general fund appropriation is reduced by
129.23$172,000 in fiscal year 2010 and by $176,000
129.24in fiscal year 2011.
129.25The federal TANF appropriation is increased
129.26by $172,000 in fiscal year 2010 and by
129.27$176,000 in fiscal year 2011. The TANF
129.28fund base shall be reduced by $700,000 in
129.29fiscal years 2012 and 2013.

129.30 129.31

(b) Children and Economic Assistance Operations

(1,580,000)

(1,692,000)

129.32The general fund appropriation is reduced
129.33by $1,408,000 in fiscal year 2010 and by
129.34$1,534,000 in fiscal year 2011. The general
130.1fund base is reduced by $26,000 in each of
130.2fiscal years 2012 and 2013.
130.3$74,000 in fiscal year 2011 is appropriated
130.4from the health care access fund. This
130.5appropriation is onetime.
130.6The federal TANF appropriation is reduced
130.7by $172,000 in fiscal year 2010 and by
130.8$232,000 in fiscal year 2011.

130.9

Subd. 6.Basic Health Care Grants

130.10

(a) MinnesotaCare Grants

-0-

(67,549,000)

130.11This appropriation reduction is from the
130.12health care access fund.

130.13 130.14

(b) Medical Assistance Basic Health Care Grants - Families and Children

-0-

(1,108,000)

130.15 130.16

(c) Medical Assistance Basic Health Care Grants - Elderly and Disabled

-0-

(2,817,000)

130.17

(d) General Assistance Medical Care Grants

-0-

(52,614,000)

130.18Funding Reduction; Coordinated Care
130.19Delivery Systems. The appropriation for
130.20payments to coordinated care delivery
130.21systems in Laws 2010, chapter 200, article
130.222, section 2, subdivision 4, paragraph (d), is
130.23reduced by $20,000,000 in fiscal year 2011.

130.24 130.25

(e) Medical Assistance; Adults Without Children

-0-

144,114,000

130.26Of this appropriation, $142,768,000 is from
130.27the health care access fund.

130.28

(f) Other Health Care Grants

-0-

(1,831,000)

130.29Of this appropriation, the general fund is
130.30increased by $19,000 and the health care
130.31access fund appropriation is reduced by
130.32$1,850,000. This appropriation is onetime.
131.1COBRA Carryforward. Unexpended
131.2funds appropriated in fiscal year 2010 for
131.3COBRA grants under Laws 2009, chapter
131.479, article 5, section 78, do not cancel and
131.5are available to the commissioner of human
131.6services for fiscal year 2011 COBRA grant
131.7expenditures. Up to $110,000 of the fiscal
131.8year 2011 appropriation for COBRA grants
131.9provided in Laws 2009, chapter 79, article
131.1013, section 3, subdivision 6, may be used
131.11by the commissioner of human services for
131.12costs related to administration of the COBRA
131.13grants.
131.14Transfer. The commissioner shall transfer
131.15$19,000 to the commissioner of commerce
131.16for regulation of Minnesota Statutes, section
131.1762A.3075.

131.18

Subd. 7.Health Care Management

131.19

(a) Health Care Administration

(2,853,000)

(4,783,000)

131.20For fiscal year 2011 the health care access
131.21fund appropriation is increased by $250,000
131.22and the general fund appropriation is reduced
131.23by $4,633,000.
131.24Reduction in Appropriation. The base
131.25funding under the current law forecast used
131.26to calculate the state appropriation for the
131.27medical assistance program is reduced by
131.28one percent for the 2012-2013 biennium.
131.29This reduction is subject to federal approval
131.30of the intensive care management program
131.31authorized under Minnesota Statutes, section
131.32256B.0755, and is ongoing and shall apply
131.33to future bienniums, or for as long as the
131.34intensive care management program is
132.1determined to be cost-effective by the
132.2commissioner of human services.
132.3PACE Implementation Funding. For fiscal
132.4year 2011, $145,000 is appropriated from
132.5the general fund to the commissioner of
132.6human services to complete the actuarial and
132.7administrative work necessary to begin the
132.8operation of PACE under Minnesota Statutes,
132.9section 256B.69, subdivision 23, paragraph
132.10(e). Base level funding for this activity shall
132.11be $130,000 in fiscal year 2012 and $0 in
132.12fiscal year 2013.
132.13Minnesota Senior Health Options
132.14Reimbursement. Effective July 1, 2011,
132.15federal administrative reimbursement
132.16resulting from the Minnesota senior
132.17health options project is appropriated
132.18to the commissioner for this activity.
132.19Notwithstanding any contrary provision, this
132.20provision expires June 30, 2013.
132.21Health Care Inspector General. $120,000
132.22from the general fund in fiscal year 2011
132.23is for the Office of Health Care Inspector
132.24General, established under Minnesota
132.25Statutes, section 256.01, subdivision 30.
132.26Fiscal and Actuarial Analysis. $250,000
132.27from the general fund is for the fiscal and
132.28actuarial analysis of 2010 House File No.
132.29135 and 2010 Senate File No. 118. This
132.30appropriation is onetime.
132.31Utilization Review. Effective July 1,
132.322011, federal administrative reimbursement
132.33resulting from prior authorization and
132.34inpatient admission certification by a
132.35professional review organization shall be
133.1dedicated to, and is appropriated to, the
133.2commissioner for these activities. A portion
133.3of these funds must be used for activities to
133.4decrease unnecessary pharmaceutical costs
133.5in medical assistance. Notwithstanding any
133.6contrary provision, this provision expires
133.7June 30, 2013.
133.8Base Adjustment. The health care access
133.9fund base is reduced by $50,000 in each of
133.10fiscal years 2012 and 2013.
133.11The general fund base is reduced by $416,000
133.12in each of fiscal years 2012 and 2013.

133.13

(b) Health Care Operations

133.14	Appropriations by Fund
133.15	General	-0-	64,000
133.16	Health Care Access	(1,094,000)	(1,234,000)

133.17Base Adjustment. The health care access
133.18fund base for health care operations is
133.19reduced by $1,272,000 in fiscal year 2012
133.20and $1,337,000 in fiscal year 2013. The
133.21general fund appropriation is onetime.

133.22

Subd. 8.Continuing Care Grants

133.23

(a) Aging and Adult Services Grants

(154,000)

(139,000)

133.24This reduction is onetime and must not be
133.25applied to the base.
133.26Community Service Development
133.27Reduction. The appropriation in Laws
133.282009, chapter 79, article 13, section 3,
133.29subdivision 8, paragraph (a), for community
133.30service development grants, as amended by
133.31Laws 2009, chapter 173, article 2, section
133.321, subdivision 8, paragraph (a), is reduced
133.33by $154,000 in fiscal year 2011. The
133.34appropriation base is reduced by $139,000
134.1for fiscal year 2012 and $0 for fiscal year
134.22013. Notwithstanding any law or rule to
134.3the contrary, this provision expires June 30,
134.42012.

134.5 134.6

(b) Medical Assistance Long-Term Care Facilities Grants

-0-

551,000

134.7 134.8

(c) Medical Assistance Long-Term Care Waivers and Home Care Grants

-0-

(2,747,000)

134.9Manage Growth in Traumatic Brain
134.10Injury and Community Alternatives for
134.11Disabled Individuals' Waivers. During
134.12the fiscal year beginning July 1, 2010, the
134.13commissioner shall allocate money for home
134.14and community-based waiver programs
134.15under Minnesota Statutes, section 256B.49,
134.16to ensure a reduction in state spending that is
134.17equivalent to limiting the caseload growth
134.18of the traumatic brain injury waiver to six
134.19allocations per month and the community
134.20alternatives for disabled individuals waiver
134.21to 60 allocations per month. The limits do not
134.22apply: (1) when there is an approved plan for
134.23nursing facility bed closures for individuals
134.24under age 65 who require relocation due to
134.25the bed closure; (2) to fiscal year 2009 waiver
134.26allocations delayed due to unallotment; or (3)
134.27to transfers authorized by the commissioner
134.28from the personal care assistance program
134.29of individuals having a home care rating of
134.30CS, MT, or HL. Priorities for the allocation
134.31of funds must be for individuals anticipated
134.32to be discharged from institutional settings or
134.33who are at imminent risk of a placement in
134.34an institutional setting.
134.35Manage Growth in the Developmental
134.36Disability (DD) Waiver. The commissioner
135.1shall manage the growth in the developmental
135.2disability waiver by limiting the allocations
135.3included in the November 2010 forecast to
135.4six additional diversion allocations each
135.5month for the calendar year that begins on
135.6January 1, 2011. Additional allocations must
135.7be made available for transfers authorized
135.8by the commissioner from the personal care
135.9assistance program of individuals having a
135.10home care rating of CS, MT, or HL. This
135.11provision is effective through December 31,
135.122011.

135.13

(d) Adult Mental Health Grants

(3,500,000)

(9,903,000)

135.14Compulsive Gambling Special Revenue
135.15Account. $149,000 for fiscal year 2010
135.16and $27,000 for fiscal year 2011 from
135.17the compulsive gambling special revenue
135.18account established under Minnesota
135.19Statutes, section 245.982, must be transferred
135.20and deposited into the general fund by June
135.2130 of each respective fiscal year.
135.22Compulsive Gambling Lottery Prize Fund
135.23Appropriation. The lottery prize fund
135.24appropriation for compulsive gambling, is
135.25reduced by $80,000 in fiscal year 2010 and
135.26$79,000 in fiscal year 2011. This is a onetime
135.27reduction.
135.28Adult Mental Health. (1) The general
135.29fund appropriation for adult mental health
135.30evidence-based practices, including but not
135.31limited to, assertive community treatment
135.32and integrated dual diagnosis treatment
135.33services, is reduced by $750,000 for fiscal
135.34year 2011. This reduction is onetime.
136.1(2) The general fund appropriation for
136.2mental health grants to increase availability
136.3of culturally specific adult mental health
136.4services is reduced by $300,000 for fiscal
136.5year 2011. This reduction is onetime.
136.6(3) The general fund appropriation for
136.7grants to community hospitals to provide
136.8alternatives to residential treatment center
136.9mental health programs is reduced by
136.10$2,653,000 for fiscal year 2011. This
136.11reduction is onetime.
136.12(4) The general fund appropriation for grants
136.13to counties for adult mental health services is
136.14reduced by $6,200,000 for fiscal year 2011,
136.15and $6,000,000 in each of fiscal years 2012
136.16and 2013.
136.17(5) Of the fiscal year 2010 general fund
136.18appropriation for grants to counties for
136.19housing with support services for adults
136.20with serious and persistent mental illness,
136.21$3,300,000 is canceled and returned to the
136.22general fund.
136.23(6) Of the fiscal year 2010 general
136.24fund appropriation for additional crisis
136.25intervention team training for law
136.26enforcement, $200,000 is canceled and
136.27returned to the general fund.

136.28

(e) Chemical Dependency Entitlement Grants

-0-

(3,986,000)

136.29 136.30

(f) Chemical Dependency Nonentitlement Grants

(389,000)

-0-

136.31Chemical Health. Of the fiscal year 2010
136.32general fund appropriation to Mother's First
136.33and the Native American Program, $389,000
136.34is canceled and returned to the general fund.

137.1

(g) Other Continuing Care Grants

-0-

100,000

137.2Intermediate Care Facilities for the
137.3Developmentally Disabled Payment Rates.
137.4$36,000 is appropriated from the general
137.5fund in fiscal year 2011 and $4,000 in fiscal
137.6year 2012 to increase payment rates for an
137.7ICF/MR licensed for six beds and located in
137.8Kandiyohi County to serve persons with high
137.9behavioral needs. The payment rate increase
137.10shall be effective for services provided from
137.11July 1, 2010, through June 30, 2011. These
137.12appropriations are onetime.
137.13Region 10 Quality Assurance Commission.
137.14$100,000 is appropriated from the general
137.15fund in fiscal year 2011 to the commissioner
137.16of human services for the purposes
137.17of the Region 10 Quality Assurance
137.18Commission under Minnesota Statutes,
137.19section 256B.0951. This appropriation is
137.20onetime.

137.21

Subd. 9.Continuing Care Management

111,000

101,000

137.22PACE Implementation Funding. For fiscal
137.23year 2011, $111,000 is appropriated from
137.24the general fund to the commissioner of
137.25human services to complete the actuarial
137.26and administrative work necessary to begin
137.27the operation of PACE under Minnesota
137.28Statutes, section 256B.69, subdivision 23,
137.29paragraph (e). Base level funding for this
137.30activity shall be $101,000 in fiscal year 2012
137.31and $0 in fiscal year 2013. For fiscal year
137.322013 and beyond, the commissioner must
137.33work with stakeholders to develop financing
137.34mechanisms to complete the actuarial
137.35and administrative costs of PACE. The
138.1commissioner shall inform the chairs and
138.2ranking minority members of the legislative
138.3committee with jurisdiction over health care
138.4funding by January 15, 2011, on progress to
138.5develop financing mechanisms.

138.6

Subd. 10.State-Operated Services

138.7Obsolete Laundry Depreciation Account.
138.8$669,000, or the balance, whichever is
138.9greater, must be transferred from the
138.10state-operated services laundry depreciation
138.11account in the special revenue fund and
138.12deposited into the general fund by June 30,
138.132010.
138.14State-operated Services Programs. Of
138.15the fiscal year 2011 appropriation for
138.16the Minnesota sex offender program,
138.17$12,600,000 is transferred to state-operated
138.18services to maintain the METO program and
138.19other residential adult mental health services.

138.20

Subd. 11.Adult Mental Health Services

-0-

12,600,000

138.21

Subd. 12.Minnesota Sex Offender Services

-0-

(12,600,000)

138.22 138.23

Subd. 13.Contingent Appropriations Reductions

138.24Upon enactment of the extension of
138.25the enhanced federal medical assistance
138.26percentage (FMAP) under Public Law 111-5
138.27to June 30, 2011, that is contained in the
138.28president's budget for federal fiscal year 2011
138.29or contained in House Resolution 2847, the
138.30federal "Jobs for Main Street Act of 2010," or
138.31subsequent federal legislation, the reductions
138.32identified in each clause shall be made to
138.33the specified general fund appropriations
138.34for fiscal year 2011. These contingent
138.35reductions, if implemented, are in addition
139.1to the reductions specified in subdivision 6,
139.2paragraphs (a), (b), and (c), and subdivision
139.38, paragraphs (c) and (d), respectively.

139.4

(1) MinnesotaCare Grants

-0-

(9,200,000)

139.5 139.6

(2) Medical Assistance Basic Health Care Grants - Families and Children

-0-

(109,662,500)

139.7 139.8

(3) Medical Assistance Basic Health Care Grants - Elderly and Disabled

-0-

(110,437,500)

139.9 139.10

(4) Medical Assistance Long-Term Care Facilities Grants

-0-

(51,925,000)

139.11 139.12

(5) Medical Assistance Long-Term Care Waivers and Home Care Grants

-0-

(115,475,000)

139.13

Sec. 4. COMMISSIONER OF HEALTH

139.14				APPROPRIATIONS
139.15				Available for the Year
139.16				Ending June 30
139.17					2010		2011

139.18

Subdivision 1.Total Appropriation

$

(2,397,000)

$

5,751,000

139.19	Appropriations by Fund
139.20		2010	2011
139.21	General	(1,797,000)	5,810,000
139.22 139.23	State Government Special Revenue	(600,000)	(259,000)
139.24 139.25	Health Care Access Fund	-0-	200,000

139.26

Subd. 2.Community and Family Health

-0-

100,000

139.27Grant for Memory Care Clinic. $100,000
139.28from the general fund in fiscal year 2011
139.29is for a grant to a nonprofit, multispecialty
139.30clinic located in the city of St. Cloud that
139.31provides early identification, diagnosis, and
139.32treatment of memory loss, and information
139.33and support for family members who care for
139.34persons with memory impairment. In order
139.35to receive the grant, the clinic must certify to
139.36the commissioner that it has a commitment
140.1from a private foundation to provide a 50
140.2percent match of the grant amount. This
140.3appropriation is onetime.
140.4Statewide Health Improvement Program.
140.5$8,500,000 from the health care access
140.6fund in fiscal year 2012 and $8,500,000 in
140.7fiscal year 2013 is for the statewide health
140.8improvement program under Minnesota
140.9Statutes, section 145.986. These additions
140.10are onetime.

140.11

Subd. 3.Policy, Quality, and Compliance

140.12	Appropriations by Fund
140.13		2010	2011
140.14	General	(1,797,000)	5,210,000
140.15 140.16	State Government Special Revenue	(600,000)	(268,000)
140.17 140.18	Health Care Access Fund	-0-	200,000

140.19Of this appropriation, $74,000 in fiscal
140.20year 2011 is to restore unallotments for the
140.21Office of Unlicensed Complementary and
140.22Alternative Health Care Practice.
140.23Health Care Reform. Funds appropriated
140.24in Laws 2008, chapter 358, article 5, section
140.254, subdivision 3, for health reform activities
140.26to implement Laws 2008, chapter 358,
140.27article 4, are available until expended.
140.28Notwithstanding any contrary provision in
140.29this article, this provision shall not expire.
140.30Health Care Reform Task Force. $200,000
140.31from the general fund is for expenses related
140.32to the Health Care Reform Task Force
140.33established under article 7, section 8.
140.34Autism Coverage Study. $50,000 in
140.35fiscal year 2011 is appropriated to the
140.36commissioner of health to monitor the gaps
141.1in the level of service provided by state
141.2health programs, the state employee group
141.3insurance plan, and private health plans for
141.4autism spectrum disorder. This appropriation
141.5is onetime.
141.6Rural Hospital Capital Improvement
141.7Grants. Of the general fund reductions in
141.8fiscal year 2010, $1,755,000 is for the rural
141.9hospital capital improvement grant program.
141.10Health Information Exchange Oversight.
141.11Of the state government special revenue fund
141.12appropriations, $104,000 in fiscal year 2011
141.13is for the duties required under Minnesota
141.14Statutes, sections 62J.498 to 62J.4982.
141.15Birth Centers. Of the state government
141.16special revenue fund appropriations, $9,000
141.17is for licensing birth centers under Minnesota
141.18Statutes, section 144.651. Base funding shall
141.19be $7,000 in fiscal year 2012 and $7,000 in
141.20fiscal year 2013.
141.21Advisory Group on Administrative
141.22Expenses. Of the general fund appropriation,
141.23$40,000 in fiscal year 2011 is for the advisory
141.24group established under Minnesota Statutes,
141.25section 62D.31.
141.26Community Clinic Grants. Of this
141.27appropriation, $2,500,000 in fiscal
141.28year 2011 is for the commissioner to
141.29provide community clinic grants under
141.30Minnesota Statutes, section 145.9268. This
141.31appropriation is onetime. In awarding grants
141.32using this funding, the commissioner shall
141.33give priority to proposals that seek to serve
141.34medically underserved areas of the state that
141.35are not served by a coordinated care delivery
142.1system established under Minnesota Statutes,
142.2section 256D.031, subdivision 6.
142.3Federally Qualified Health Center
142.4Subsidies. Of this appropriation, $2,500,000
142.5in fiscal year 2011 is for the commissioner to
142.6increase subsidies to federally qualified health
142.7centers provided under Minnesota Statutes,
142.8section 145.9269. This appropriation is
142.9onetime. In awarding subsidies using this
142.10funding, the commissioner shall give priority
142.11to federally qualified health centers that serve
142.12medically underserved areas of the state that
142.13are not served by a coordinated care delivery
142.14system established under Minnesota Statutes,
142.15section 256D.031, subdivision 6.
142.16Base Level Adjustment. The general fund
142.17base is increased by $76,000 in each of fiscal
142.18years 2012 and 2013. The state government
142.19special revenue fund base is increased by
142.20$97,000 in each of fiscal years 2012 and
142.212013.

142.22

Subd. 4.Health Protection

-0-

500,000

142.23Birth Defects Information System. Of
142.24the general fund appropriation, $500,000 in
142.25fiscal year 2011 is for the Minnesota Birth
142.26Defects Information System established
142.27under Minnesota Statutes, section 144.2215.

142.28

Sec. 5. Office of the Legislative Auditor

$

-0-

$

200,000

142.29$200,000 or an amount equal to 90 percent
142.30of the nonfederal administrative staff funds
142.31expended by the commissioner of human
142.32services related to the preparation and
142.33drafting of fiscal notes during fiscal year
142.342009, is transferred from the Department
143.1of Human Services to the Office of the
143.2Legislative Auditor, and appropriated for
143.3the fiscal year beginning July 1, 2011,
143.4for completion of the duties described in
143.5Minnesota Statutes, section 3.98.

143.6    Sec. 6. Laws 2009, chapter 79, article 13, section 3, subdivision 1, as amended by
143.7Laws 2009, chapter 173, article 2, section 1, subdivision 1, is amended to read:

143.8

Subdivision 1.Total Appropriation

$

5,225,451,000

$

6,002,864,000

143.9	Appropriations by Fund
143.10		2010	2011
143.11	General	4,375,689,000	5,209,765,000
143.12 143.13	State Government Special Revenue	565,000	565,000
143.14	Health Care Access	450,662,000	527,411,000
143.15	Federal TANF	286,770,000	263,458,000
143.16	Lottery Prize	1,665,000	1,665,000
143.17	Federal Fund	110,000,000	0

143.18Receipts for Systems Projects.
143.19Appropriations and federal receipts for
143.20information systems projects for MAXIS,
143.21PRISM, MMIS, and SSIS must be deposited
143.22in the state system account authorized in
143.23Minnesota Statutes, section 256.014. Money
143.24appropriated for computer projects approved
143.25by the Minnesota Office of Enterprise
143.26Technology, funded by the legislature, and
143.27approved by the commissioner of finance,
143.28may be transferred from one project to
143.29another and from development to operations
143.30as the commissioner of human services
143.31considers necessary, except that any transfers
143.32to one project that exceed $1,000,000 or
143.33multiple transfers to one project that exceed
143.34$1,000,000 in total require the express
143.35approval of the legislature. The preceding
143.36requirement for legislative approval does not
144.1apply to transfers made to establish a project's
144.2initial operating budget each year; instead,
144.3the requirements of section 11, subdivision
144.42, of this article apply to those transfers. Any
144.5unexpended balance in the appropriation
144.6for these projects does not cancel but is
144.7available for ongoing development and
144.8operations. Any computer project with a
144.9total cost exceeding $1,000,000, including,
144.10but not limited to, a replacement for the
144.11proposed HealthMatch system, shall not be
144.12commenced without the express approval of
144.13the legislature.
144.14HealthMatch Systems Project. In fiscal
144.15year 2010, $3,054,000 shall be transferred
144.16from the HealthMatch account in the state
144.17systems account in the special revenue fund
144.18to the general fund.
144.19Nonfederal Share Transfers. The
144.20nonfederal share of activities for which
144.21federal administrative reimbursement is
144.22appropriated to the commissioner may be
144.23transferred to the special revenue fund.
144.24TANF Maintenance of Effort.
144.25(a) In order to meet the basic maintenance
144.26of effort (MOE) requirements of the TANF
144.27block grant specified under Code of Federal
144.28Regulations, title 45, section 263.1, the
144.29commissioner may only report nonfederal
144.30money expended for allowable activities
144.31listed in the following clauses as TANF/MOE
144.32expenditures:
144.33(1) MFIP cash, diversionary work program,
144.34and food assistance benefits under Minnesota
144.35Statutes, chapter 256J;
145.1(2) the child care assistance programs
145.2under Minnesota Statutes, sections 119B.03
145.3and 119B.05, and county child care
145.4administrative costs under Minnesota
145.5Statutes, section 119B.15;
145.6(3) state and county MFIP administrative
145.7costs under Minnesota Statutes, chapters
145.8256J and 256K;
145.9(4) state, county, and tribal MFIP
145.10employment services under Minnesota
145.11Statutes, chapters 256J and 256K;
145.12(5) expenditures made on behalf of
145.13noncitizen MFIP recipients who qualify
145.14for the medical assistance without federal
145.15financial participation program under
145.16Minnesota Statutes, section 256B.06,
145.17subdivision 4 , paragraphs (d), (e), and (j);
145.18and
145.19(6) qualifying working family credit
145.20expenditures under Minnesota Statutes,
145.21section 290.0671.; and
145.22(7) qualifying Minnesota education credit
145.23expenditures under Minnesota Statutes,
145.24section 290.0674.
145.25(b) The commissioner shall ensure that
145.26sufficient qualified nonfederal expenditures
145.27are made each year to meet the state's
145.28TANF/MOE requirements. For the activities
145.29listed in paragraph (a), clauses (2) to
145.30(6), the commissioner may only report
145.31expenditures that are excluded from the
145.32definition of assistance under Code of
145.33Federal Regulations, title 45, section 260.31.
146.1(c) For fiscal years beginning with state
146.2fiscal year 2003, the commissioner shall
146.3ensure that the maintenance of effort used
146.4by the commissioner of finance for the
146.5February and November forecasts required
146.6under Minnesota Statutes, section 16A.103,
146.7contains expenditures under paragraph (a),
146.8clause (1), equal to at least 16 percent of
146.9the total required under Code of Federal
146.10Regulations, title 45, section 263.1.
146.11(d) For the federal fiscal years beginning on
146.12or after October 1, 2007, the commissioner
146.13may not claim an amount of TANF/MOE in
146.14excess of the 75 percent standard in Code
146.15of Federal Regulations, title 45, section
146.16263.1(a)(2), except:
146.17(1) to the extent necessary to meet the 80
146.18percent standard under Code of Federal
146.19Regulations, title 45, section 263.1(a)(1),
146.20if it is determined by the commissioner
146.21that the state will not meet the TANF work
146.22participation target rate for the current year;
146.23(2) to provide any additional amounts
146.24under Code of Federal Regulations, title 45,
146.25section 264.5, that relate to replacement of
146.26TANF funds due to the operation of TANF
146.27penalties; and
146.28(3) to provide any additional amounts that
146.29may contribute to avoiding or reducing
146.30TANF work participation penalties through
146.31the operation of the excess MOE provisions
146.32of Code of Federal Regulations, title 45,
146.33section 261.43 (a)(2).
146.34For the purposes of clauses (1) to (3),
146.35the commissioner may supplement the
147.1MOE claim with working family credit
147.2expenditures to the extent such expenditures
147.3or other qualified expenditures are otherwise
147.4available after considering the expenditures
147.5allowed in this section.
147.6(e) Minnesota Statutes, section 256.011,
147.7subdivision 3 , which requires that federal
147.8grants or aids secured or obtained under that
147.9subdivision be used to reduce any direct
147.10appropriations provided by law, do not apply
147.11if the grants or aids are federal TANF funds.
147.12(f) Notwithstanding any contrary provision
147.13in this article, this provision expires June 30,
147.142013.
147.15Working Family Credit Expenditures as
147.16TANF/MOE. The commissioner may claim
147.17as TANF/MOE up to $6,707,000 per year of
147.18working family credit expenditures for fiscal
147.19year 2010 through fiscal year 2011.
147.20Working Family Credit Expenditures
147.21to be Claimed for TANF/MOE. The
147.22commissioner may count the following
147.23amounts of working family credit expenditure
147.24as TANF/MOE:
147.25(1) fiscal year 2010, $50,973,000
147.26$50,897,000;
147.27(2) fiscal year 2011, $53,793,000
147.28$54,243,000;
147.29(3) fiscal year 2012, $23,516,000
147.30$23,345,000; and
147.31(4) fiscal year 2013, $16,808,000
147.32$16,585,000.
147.33Notwithstanding any contrary provision in
147.34this article, this rider expires June 30, 2013.
148.1Food Stamps Employment and Training.
148.2(a) The commissioner shall apply for and
148.3claim the maximum allowable federal
148.4matching funds under United States Code,
148.5title 7, section 2025, paragraph (h), for
148.6state expenditures made on behalf of family
148.7stabilization services participants voluntarily
148.8engaged in food stamp employment and
148.9training activities, where appropriate.
148.10(b) Notwithstanding Minnesota Statutes,
148.11sections 256D.051, subdivisions 1a, 6b,
148.12and 6c, and 256J.626, federal food stamps
148.13employment and training funds received
148.14as reimbursement of MFIP consolidated
148.15fund grant expenditures for diversionary
148.16work program participants and child
148.17care assistance program expenditures for
148.18two-parent families must be deposited in the
148.19general fund. The amount of funds must be
148.20limited to $3,350,000 in fiscal year 2010
148.21and $4,440,000 in fiscal years 2011 through
148.222013, contingent on approval by the federal
148.23Food and Nutrition Service.
148.24(c) Consistent with the receipt of these federal
148.25funds, the commissioner may adjust the
148.26level of working family credit expenditures
148.27claimed as TANF maintenance of effort.
148.28Notwithstanding any contrary provision in
148.29this article, this rider expires June 30, 2013.
148.30ARRA Food Support Administration.
148.31The funds available for food support
148.32administration under the American Recovery
148.33and Reinvestment Act (ARRA) of 2009
148.34are appropriated to the commissioner
148.35to pay actual costs of implementing the
149.1food support benefit increases, increased
149.2eligibility determinations, and outreach. Of
149.3these funds, 20 percent shall be allocated
149.4to the commissioner and 80 percent shall
149.5be allocated to counties. The commissioner
149.6shall allocate the county portion based on
149.7caseload. Reimbursement shall be based on
149.8actual costs reported by counties through
149.9existing processes. Tribal reimbursement
149.10must be made from the state portion based
149.11on a caseload factor equivalent to that of a
149.12county.
149.13ARRA Food Support Benefit Increases.
149.14The funds provided for food support benefit
149.15increases under the Supplemental Nutrition
149.16Assistance Program provisions of the
149.17American Recovery and Reinvestment Act
149.18(ARRA) of 2009 must be used for benefit
149.19increases beginning July 1, 2009.
149.20Emergency Fund for the TANF Program.
149.21TANF Emergency Contingency funds
149.22available under the American Recovery
149.23and Reinvestment Act of 2009 (Public Law
149.24111-5) are appropriated to the commissioner.
149.25The commissioner must request TANF
149.26Emergency Contingency funds from the
149.27Secretary of the Department of Health
149.28and Human Services to the extent the
149.29commissioner meets or expects to meet the
149.30requirements of section 403(c) of the Social
149.31Security Act. The commissioner must seek
149.32to maximize such grants. The funds received
149.33must be used as appropriated. Each county
149.34must maintain the county's current level of
149.35emergency assistance funding under the
149.36MFIP consolidated fund and use the funds
150.1under this paragraph to supplement existing
150.2emergency assistance funding levels.

150.3    Sec. 7. Laws 2009, chapter 79, article 13, section 3, subdivision 3, as amended by
150.4Laws 2009, chapter 173, article 2, section 1, subdivision 3, is amended to read:

150.5 150.6

Subd. 3.Revenue and Pass-Through Revenue Expenditures

68,337,000

70,505,000

150.7This appropriation is from the federal TANF
150.8fund.
150.9TANF Transfer to Federal Child Care
150.10and Development Fund. The following
150.11TANF fund amounts are appropriated to the
150.12commissioner for the purposes of MFIP and
150.13transition year child care under Minnesota
150.14Statutes, section 119B.05:
150.15(1) fiscal year 2010, $6,531,000 $862,000;
150.16(2) fiscal year 2011, $10,241,000 $978,000;
150.17(3) fiscal year 2012, $10,826,000 $0; and
150.18(4) fiscal year 2013, $4,046,000 $0.
150.19The commissioner shall authorize the
150.20transfer of sufficient TANF funds to the
150.21federal child care and development fund to
150.22meet this appropriation and shall ensure that
150.23all transferred funds are expended according
150.24to federal child care and development fund
150.25regulations.

150.26    Sec. 8. Laws 2009, chapter 79, article 13, section 3, subdivision 4, as amended by
150.27Laws 2009, chapter 173, article 2, section 1, subdivision 4, is amended to read:

150.28 150.29

Subd. 4.Children and Economic Assistance Grants

150.30The amounts that may be spent from this
150.31appropriation for each purpose are as follows:

150.32

(a) MFIP/DWP Grants

151.1	Appropriations by Fund
151.2	General	63,205,000	89,033,000
151.3	Federal TANF	100,818,000	84,538,000

151.4

(b) Support Services Grants

151.5	Appropriations by Fund
151.6	General	8,715,000	12,498,000
151.7	Federal TANF	116,557,000	107,457,000

151.8MFIP Consolidated Fund. The MFIP
151.9consolidated fund TANF appropriation is
151.10reduced by $1,854,000 in fiscal year 2010
151.11and fiscal year 2011.
151.12Notwithstanding Minnesota Statutes, section
151.13256J.626, subdivision 8 , paragraph (b), the
151.14commissioner shall reduce proportionately
151.15the reimbursement to counties for
151.16administrative expenses.
151.17Subsidized Employment Funding Through
151.18ARRA. The commissioner is authorized to
151.19apply for TANF emergency fund grants for
151.20subsidized employment activities. Growth
151.21in expenditures for subsidized employment
151.22within the supported work program and the
151.23MFIP consolidated fund over the amount
151.24expended in the calendar quarters in the
151.25TANF emergency fund base year shall be
151.26used to leverage the TANF emergency fund
151.27grants for subsidized employment and to
151.28fund supported work. The commissioner
151.29shall develop procedures to maximize
151.30reimbursement of these expenditures over the
151.31TANF emergency fund base year quarters,
151.32and may contract directly with employers
151.33and providers to maximize these TANF
151.34emergency fund grants.
152.1Supported Work. Of the TANF
152.2appropriation, $4,700,000 in fiscal year 2010
152.3and $4,700,000 in fiscal year 2011 are to the
152.4commissioner for supported work for MFIP
152.5recipients and is available until expended.
152.6Supported work includes paid transitional
152.7work experience and a continuum of
152.8employment assistance, including outreach
152.9and recruitment, program orientation
152.10and intake, testing and assessment, job
152.11development and marketing, preworksite
152.12training, supported worksite experience,
152.13job coaching, and postplacement follow-up,
152.14in addition to extensive case management
152.15and referral services. This is a onetime
152.16appropriation.
152.17Base Adjustment. The general fund base
152.18is reduced by $3,783,000 in each of fiscal
152.19years 2012 and 2013. The TANF fund base
152.20is increased by $5,004,000 in each of fiscal
152.21years 2012 and 2013.
152.22Integrated Services Program Funding.
152.23The TANF appropriation for integrated
152.24services program funding is $1,250,000 in
152.25fiscal year 2010 and $0 in fiscal year 2011
152.26and the base for fiscal years 2012 and 2013
152.27is $0.
152.28TANF Emergency Fund; Nonrecurrent
152.29Short-Term Benefits. (1) TANF emergency
152.30contingency fund grants received due to
152.31increases in expenditures for nonrecurrent
152.32short-term benefits must be used to offset the
152.33increase in these expenditures for counties
152.34under the MFIP consolidated fund, under
152.35Minnesota Statutes, section 256J.626,
153.1and the diversionary work program. The
153.2commissioner shall develop procedures
153.3to maximize reimbursement of these
153.4expenditures over the TANF emergency fund
153.5base year quarters. Growth in expenditures
153.6for the diversionary work program over the
153.7amount expended in the calendar quarters in
153.8the TANF emergency fund base year shall be
153.9used to leverage these funds.
153.10(2) To the extent that the commissioner
153.11can claim eligible tax credit growth as
153.12nonrecurrent short-term benefits, the
153.13commissioner shall use those funds to
153.14leverage the increased expenditures in clause
153.15(1).
153.16(3) TANF emergency funds for nonrecurrent
153.17short-term benefits received in excess of the
153.18amounts necessary for clauses (1) and (2)
153.19shall be used to reimburse the general fund
153.20for the costs of eligible tax credits in fiscal
153.21year 2011. The amount of such funds shall
153.22not exceed $28,000,000.

153.23

(c) MFIP Child Care Assistance Grants

61,171,000

65,214,000

153.24Acceleration of ARRA Child Care and
153.25Development Fund Expenditure. The
153.26commissioner must liquidate all child care
153.27and development money available under
153.28the American Recovery and Reinvestment
153.29Act (ARRA) of 2009, Public Law 111-5,
153.30by September 30, 2010. In order to expend
153.31those funds by September 30, 2010, the
153.32commissioner may redesignate and expend
153.33the ARRA child care and development funds
153.34appropriated in fiscal year 2011 for purposes
153.35under this section for related purposes that
154.1will allow liquidation by September 30,
154.22010. Child care and development funds
154.3otherwise available to the commissioner
154.4for those related purposes shall be used to
154.5fund the purposes from which the ARRA
154.6child care and development funds had been
154.7redesignated.
154.8School Readiness Service Agreements.
154.9$400,000 in fiscal year 2010 and $400,000
154.10in fiscal year 2011 are from the federal
154.11TANF fund to the commissioner of human
154.12services consistent with federal regulations
154.13for the purpose of school readiness service
154.14agreements under Minnesota Statutes,
154.15section 119B.231. This is a onetime
154.16appropriation. Any unexpended balance the
154.17first year is available in the second year.

154.18 154.19

(d) Basic Sliding Fee Child Care Assistance Grants

40,100,000

45,092,000

154.20School Readiness Service Agreements.
154.21$257,000 in fiscal year 2010 and $257,000
154.22in fiscal year 2011 are from the general
154.23fund for the purpose of school readiness
154.24service agreements under Minnesota
154.25Statutes, section 119B.231. This is a onetime
154.26appropriation. Any unexpended balance the
154.27first year is available in the second year.
154.28Child Care Development Fund
154.29Unexpended Balance. In addition to
154.30the amount provided in this section, the
154.31commissioner shall expend $5,244,000 in
154.32fiscal year 2010 from the federal child care
154.33development fund unexpended balance
154.34for basic sliding fee child care under
154.35Minnesota Statutes, section 119B.03. The
154.36commissioner shall ensure that all child
155.1care and development funds are expended
155.2according to the federal child care and
155.3development fund regulations.
155.4Basic Sliding Fee. $4,000,000 in fiscal year
155.52010 and $4,000,000 in fiscal year 2011 are
155.6from the federal child care development
155.7funds received from the American Recovery
155.8and Reinvestment Act of 2009, Public
155.9Law 111-5, to the commissioner of human
155.10services consistent with federal regulations
155.11for the purpose of basic sliding fee child care
155.12assistance under Minnesota Statutes, section
155.13119B.03 . This is a onetime appropriation.
155.14Any unexpended balance the first year is
155.15available in the second year.
155.16Basic Sliding Fee Allocation for Calendar
155.17Year 2010. Notwithstanding Minnesota
155.18Statutes, section 119B.03, subdivision 6,
155.19in calendar year 2010, basic sliding fee
155.20funds shall be distributed according to
155.21this provision. Funds shall be allocated
155.22first in amounts equal to each county's
155.23guaranteed floor, according to Minnesota
155.24Statutes, section 119B.03, subdivision 8,
155.25with any remaining available funds allocated
155.26according to the following formula:
155.27(a) Up to one-fourth of the funds shall be
155.28allocated in proportion to the number of
155.29families participating in the transition year
155.30child care program as reported during and
155.31averaged over the most recent six months
155.32completed at the time of the notice of
155.33allocation. Funds in excess of the amount
155.34necessary to serve all families in this category
155.35shall be allocated according to paragraph (d).
156.1(b) Up to three-fourths of the funds shall
156.2be allocated in proportion to the average
156.3of each county's most recent six months of
156.4reported waiting list as defined in Minnesota
156.5Statutes, section 119B.03, subdivision 2, and
156.6the reinstatement list of those families whose
156.7assistance was terminated with the approval
156.8of the commissioner under Minnesota Rules,
156.9part 3400.0183, subpart 1. Funds in excess
156.10of the amount necessary to serve all families
156.11in this category shall be allocated according
156.12to paragraph (d).
156.13(c) The amount necessary to serve all families
156.14in paragraphs (a) and (b) shall be calculated
156.15based on the basic sliding fee average cost of
156.16care per family in the county with the highest
156.17cost in the most recently completed calendar
156.18year.
156.19(d) Funds in excess of the amount necessary
156.20to serve all families in paragraphs (a) and
156.21(b) shall be allocated in proportion to each
156.22county's total expenditures for the basic
156.23sliding fee child care program reported
156.24during the most recent fiscal year completed
156.25at the time of the notice of allocation. To
156.26the extent that funds are available, and
156.27notwithstanding Minnesota Statutes, section
156.28119B.03, subdivision 8 , for the period
156.29January 1, 2011, to December 31, 2011, each
156.30county's guaranteed floor must be equal to its
156.31original calendar year 2010 allocation.
156.32Base Adjustment. The general fund base is
156.33decreased by $257,000 in each of fiscal years
156.342012 and 2013.

156.35

(e) Child Care Development Grants

1,487,000

1,487,000

157.1Family, friends, and neighbor grants.
157.2$375,000 in fiscal year 2010 and $375,000
157.3in fiscal year 2011 are from the child
157.4care development fund required targeted
157.5quality funds for quality expansion and
157.6infant/toddler from the American Recovery
157.7and Reinvestment Act of 2009, Public
157.8Law 111-5, to the commissioner of human
157.9services for family, friends, and neighbor
157.10grants under Minnesota Statutes, section
157.11119B.232 . This appropriation may be used
157.12on programs receiving family, friends, and
157.13neighbor grant funds as of June 30, 2009,
157.14or on new programs or projects. This is a
157.15onetime appropriation. Any unexpended
157.16balance the first year is available in the
157.17second year.
157.18Voluntary quality rating system training,
157.19coaching, consultation, and supports.
157.20$633,000 in fiscal year 2010 and $633,000
157.21in fiscal year 2011 are from the federal child
157.22care development fund required targeted
157.23quality funds for quality expansion and
157.24infant/toddler from the American Recovery
157.25and Reinvestment Act of 2009, Public
157.26Law 111-5, to the commissioner of human
157.27services consistent with federal regulations
157.28for the purpose of providing grants to provide
157.29statewide child-care provider training,
157.30coaching, consultation, and supports to
157.31prepare for the voluntary Minnesota quality
157.32rating system rating tool. This is a onetime
157.33appropriation. Any unexpended balance the
157.34first year is available in the second year.
157.35Voluntary quality rating system. $184,000
157.36in fiscal year 2010 and $1,200,000 in fiscal
158.1year 2011 are from the federal child care
158.2development fund required targeted funds for
158.3quality expansion and infant/toddler from the
158.4American Recovery and Reinvestment Act of
158.52009, Public Law 111-5, to the commissioner
158.6of human services consistent with federal
158.7regulations for the purpose of implementing
158.8the voluntary Parent Aware quality star
158.9rating system pilot in coordination with the
158.10Minnesota Early Learning Foundation. The
158.11appropriation for the first year is to complete
158.12and promote the voluntary Parent Aware
158.13quality rating system pilot program through
158.14June 30, 2010, and the appropriation for
158.15the second year is to continue the voluntary
158.16Minnesota quality rating system pilot
158.17through June 30, 2011. This is a onetime
158.18appropriation. Any unexpended balance the
158.19first year is available in the second year.

158.20

(f) Child Support Enforcement Grants

3,705,000

3,705,000

158.21

(g) Children's Services Grants

158.22	Appropriations by Fund
158.23	General	48,333,000	50,498,000
158.24	Federal TANF	340,000	240,000

158.25Base Adjustment. The general fund base is
158.26decreased by $5,371,000 in fiscal year 2012
158.27and decreased $5,371,000 in fiscal year 2013.
158.28Privatized Adoption Grants. Federal
158.29reimbursement for privatized adoption grant
158.30and foster care recruitment grant expenditures
158.31is appropriated to the commissioner for
158.32adoption grants and foster care and adoption
158.33administrative purposes.
158.34Adoption Assistance Incentive Grants.
158.35Federal funds available during fiscal year
159.12010 and fiscal year 2011 for the adoption
159.2incentive grants are appropriated to the
159.3commissioner for postadoption services
159.4including parent support groups.
159.5Adoption Assistance and Relative Custody
159.6Assistance. The commissioner may transfer
159.7unencumbered appropriation balances for
159.8adoption assistance and relative custody
159.9assistance between fiscal years and between
159.10programs.

159.11

(h) Children and Community Services Grants

67,663,000

67,542,000

159.12Targeted Case Management Temporary
159.13Funding Adjustment. The commissioner
159.14shall recover from each county and tribe
159.15receiving a targeted case management
159.16temporary funding payment in fiscal year
159.172008 an amount equal to that payment. The
159.18commissioner shall recover one-half of the
159.19funds by February 1, 2010, and the remainder
159.20by February 1, 2011. At the commissioner's
159.21discretion and at the request of a county
159.22or tribe, the commissioner may revise
159.23the payment schedule, but full payment
159.24must not be delayed beyond May 1, 2011.
159.25The commissioner may use the recovery
159.26procedure under Minnesota Statutes, section
159.27256.017 , to recover the funds. Recovered
159.28funds must be deposited into the general
159.29fund.

159.30

(i) General Assistance Grants

48,215,000

48,608,000

159.31General Assistance Standard. The
159.32commissioner shall set the monthly standard
159.33of assistance for general assistance units
159.34consisting of an adult recipient who is
159.35childless and unmarried or living apart
160.1from parents or a legal guardian at $203.
160.2The commissioner may reduce this amount
160.3according to Laws 1997, chapter 85, article
160.43, section 54.
160.5Emergency General Assistance. The
160.6amount appropriated for emergency general
160.7assistance funds is limited to no more
160.8than $7,889,812 in fiscal year 2010 and
160.9$7,889,812 in fiscal year 2011. Funds
160.10to counties must be allocated by the
160.11commissioner using the allocation method
160.12specified in Minnesota Statutes, section
160.13256D.06 .

160.14

(j) Minnesota Supplemental Aid Grants

33,930,000

35,191,000

160.15Emergency Minnesota Supplemental
160.16Aid Funds. The amount appropriated for
160.17emergency Minnesota supplemental aid
160.18funds is limited to no more than $1,100,000
160.19in fiscal year 2010 and $1,100,000 in fiscal
160.20year 2011. Funds to counties must be
160.21allocated by the commissioner using the
160.22allocation method specified in Minnesota
160.23Statutes, section 256D.46.

160.24

(k) Group Residential Housing Grants

111,778,000

114,034,000

160.25Group Residential Housing Costs
160.26Refinanced. (a) Effective July 1, 2011, the
160.27commissioner shall increase the home and
160.28community-based service rates and county
160.29allocations provided to programs for persons
160.30with disabilities established under section
160.311915(c) of the Social Security Act to the
160.32extent that these programs will be paying
160.33for the costs above the rate established
160.34in Minnesota Statutes, section 256I.05,
160.35subdivision 1 .
161.1(b) For persons receiving services under
161.2Minnesota Statutes, section 245A.02, who
161.3reside in licensed adult foster care beds
161.4for which a difficulty of care payment
161.5was being made under Minnesota Statutes,
161.6section 256I.05, subdivision 1c, paragraph
161.7(b), counties may request an exception to
161.8the individual's service authorization not to
161.9exceed the difference between the client's
161.10monthly service expenditures plus the
161.11amount of the difficulty of care payment.

161.12

(l) Children's Mental Health Grants

16,885,000

16,882,000

161.13Funding Usage. Up to 75 percent of a fiscal
161.14year's appropriation for children's mental
161.15health grants may be used to fund allocations
161.16in that portion of the fiscal year ending
161.17December 31.

161.18 161.19

(m) Other Children and Economic Assistance Grants

16,047,000

15,339,000

161.20Fraud Prevention Grants. Of this
161.21appropriation, $228,000 in fiscal year 2010
161.22and $228,000 in fiscal year 2011 is to the
161.23commissioner for fraud prevention grants to
161.24counties.
161.25Homeless and Runaway Youth. $218,000
161.26in fiscal year 2010 is for the Runaway
161.27and Homeless Youth Act under Minnesota
161.28Statutes, section 256K.45. Funds shall be
161.29spent in each area of the continuum of care
161.30to ensure that programs are meeting the
161.31greatest need. Any unexpended balance in
161.32the first year is available in the second year.
161.33Beginning July 1, 2011, the base is increased
161.34by $119,000 each year.
162.1ARRA Homeless Youth Funds. To the
162.2extent permitted under federal law, the
162.3commissioner shall designate $2,500,000
162.4of the Homeless Prevention and Rapid
162.5Re-Housing Program funds provided under
162.6the American Recovery and Reinvestment
162.7Act of 2009, Public Law 111-5, for agencies
162.8providing homelessness prevention and rapid
162.9rehousing services to youth.
162.10Supportive Housing Services. $1,500,000
162.11each year is for supportive services under
162.12Minnesota Statutes, section 256K.26. This is
162.13a onetime appropriation.
162.14Community Action Grants. Community
162.15action grants are reduced one time by
162.16$1,794,000 each year. This reduction is due
162.17to the availability of federal funds under the
162.18American Recovery and Reinvestment Act.
162.19Base Adjustment. The general fund base
162.20is increased by $773,000 in fiscal year 2012
162.21and $773,000 in fiscal year 2013.
162.22Federal ARRA Funds for Existing
162.23Programs. (a) (1) Federal funds received by
162.24the commissioner for the emergency food
162.25and shelter program from the American
162.26Recovery and Reinvestment Act of 2009,
162.27Public Law 111-5, but not previously
162.28approved by the legislature are appropriated
162.29to the commissioner for the purposes of the
162.30grant program.
162.31(b) (2) Federal funds received by the
162.32commissioner for the emergency shelter
162.33grant program including the Homelessness
162.34Prevention and Rapid Re-Housing
162.35Program from the American Recovery and
163.1Reinvestment Act of 2009, Public Law
163.2111-5, are appropriated to the commissioner
163.3for the purposes of the grant programs.
163.4(c) (3) Federal funds received by the
163.5commissioner for the emergency food
163.6assistance program from the American
163.7Recovery and Reinvestment Act of 2009,
163.8Public Law 111-5, are appropriated to the
163.9commissioner for the purposes of the grant
163.10program.
163.11(d) (4) Federal funds received by the
163.12commissioner for senior congregate meals
163.13and senior home-delivered meals from the
163.14American Recovery and Reinvestment Act
163.15of 2009, Public Law 111-5, are appropriated
163.16to the commissioner for the Minnesota Board
163.17on Aging, for purposes of the grant programs.
163.18(e) (5) Federal funds received by the
163.19commissioner for the community services
163.20block grant program from the American
163.21Recovery and Reinvestment Act of 2009,
163.22Public Law 111-5, are appropriated to the
163.23commissioner for the purposes of the grant
163.24program.
163.25Long-Term Homeless Supportive
163.26Service Fund Appropriation. To the
163.27extent permitted under federal law, the
163.28commissioner shall designate $3,000,000
163.29of the Homelessness Prevention and Rapid
163.30Re-Housing Program funds provided under
163.31the American Recovery and Reinvestment
163.32Act of 2009, Public Law, 111-5, to the
163.33long-term homeless service fund under
163.34Minnesota Statutes, section 256K.26. This
163.35appropriation shall become available by July
164.11, 2009. This paragraph is effective the day
164.2following final enactment.

164.3    Sec. 9. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by
164.4Laws 2009, chapter 173, article 2, section 1, subdivision 8, is amended to read:

164.5

Subd. 8.Continuing Care Grants

164.6The amounts that may be spent from the
164.7appropriation for each purpose are as follows:

164.8

(a) Aging and Adult Services Grants

13,499,000

15,805,000

164.9Base Adjustment. The general fund base is
164.10increased by $5,751,000 in fiscal year 2012
164.11and $6,705,000 in fiscal year 2013.
164.12Information and Assistance
164.13Reimbursement. Federal administrative
164.14reimbursement obtained from information
164.15and assistance services provided by the
164.16Senior LinkAge or Disability Linkage lines
164.17to people who are identified as eligible for
164.18medical assistance shall be appropriated to
164.19the commissioner for this activity.
164.20Community Service Development Grant
164.21Reduction. Funding for community service
164.22development grants must be reduced by
164.23$260,000 for fiscal year 2010; $284,000 in
164.24fiscal year 2011; $43,000 in fiscal year 2012;
164.25and $43,000 in fiscal year 2013. Base level
164.26funding shall be restored in fiscal year 2014.
164.27Community Service Development Grant
164.28Community Initiative. Funding for
164.29community service development grants shall
164.30be used to offset the cost of aging support
164.31grants. Base level funding shall be restored
164.32in fiscal year 2014.
165.1Senior Nutrition Use of Federal Funds.
165.2For fiscal year 2010, general fund grants
165.3for home-delivered meals and congregate
165.4dining shall be reduced by $500,000. The
165.5commissioner must replace these general
165.6fund reductions with equal amounts from
165.7federal funding for senior nutrition from the
165.8American Recovery and Reinvestment Act
165.9of 2009.

165.10

(b) Alternative Care Grants

50,234,000

48,576,000

165.11Base Adjustment. The general fund base is
165.12decreased by $3,598,000 in fiscal year 2012
165.13and $3,470,000 in fiscal year 2013.
165.14Alternative Care Transfer. Any money
165.15allocated to the alternative care program that
165.16is not spent for the purposes indicated does
165.17not cancel but must be transferred to the
165.18medical assistance account.

165.19 165.20

(c) Medical Assistance Grants; Long-Term Care Facilities.

367,444,000

419,749,000

165.21 165.22

(d) Medical Assistance Long-Term Care Waivers and Home Care Grants

853,567,000

1,039,517,000

165.23Manage Growth in TBI and CADI
165.24Waivers. During the fiscal years beginning
165.25on July 1, 2009, and July 1, 2010, the
165.26commissioner shall allocate money for home
165.27and community-based waiver programs
165.28under Minnesota Statutes, section 256B.49,
165.29to ensure a reduction in state spending that is
165.30equivalent to limiting the caseload growth of
165.31the TBI waiver to 12.5 allocations per month
165.32each year of the biennium and the CADI
165.33waiver to 95 allocations per month each year
165.34of the biennium. Limits do not apply: (1)
165.35when there is an approved plan for nursing
166.1facility bed closures for individuals under
166.2age 65 who require relocation due to the
166.3bed closure; (2) to fiscal year 2009 waiver
166.4allocations delayed due to unallotment; or (3)
166.5to transfers authorized by the commissioner
166.6from the personal care assistance program
166.7of individuals having a home care rating
166.8of "CS," "MT," or "HL." Priorities for the
166.9allocation of funds must be for individuals
166.10anticipated to be discharged from institutional
166.11settings or who are at imminent risk of a
166.12placement in an institutional setting.
166.13Manage Growth in DD Developmental
166.14Disability Waiver. The commissioner
166.15shall manage the growth in the DD waiver
166.16by limiting the allocations included in the
166.17February 2009 forecast to 15 additional
166.18diversion allocations each month for the
166.19calendar years that begin on January 1, 2010,
166.20and January 1, 2011. Additional allocations
166.21must be made available for transfers
166.22authorized by the commissioner from the
166.23personal care program of individuals having
166.24a home care rating of "CS," "MT," or "HL."
166.25Adjustment to Lead Agency Waiver
166.26Allocations. Prior to the availability of the
166.27alternative license defined in Minnesota
166.28Statutes, section 245A.11, subdivision 8,
166.29the commissioner shall reduce lead agency
166.30waiver allocations for the purposes of
166.31implementing a moratorium on corporate
166.32foster care.
166.33Alternatives to Personal Care Assistance
166.34Services. Base level funding of $3,237,000
166.35in fiscal year 2012 and $4,856,000 in
167.1fiscal year 2013 is to implement alternative
167.2services to personal care assistance services
167.3for persons with mental health and other
167.4behavioral challenges who can benefit
167.5from other services that more appropriately
167.6meet their needs and assist them in living
167.7independently in the community. These
167.8services may include, but not be limited to, a
167.91915(i) state plan option.

167.10

(e) Mental Health Grants

167.11	Appropriations by Fund
167.12	General	77,739,000	77,739,000
167.13	Health Care Access	750,000	750,000
167.14	Lottery Prize	1,508,000	1,508,000

167.15Funding Usage. Up to 75 percent of a fiscal
167.16year's appropriation for adult mental health
167.17grants may be used to fund allocations in that
167.18portion of the fiscal year ending December
167.1931.

167.20

(f) Deaf and Hard-of-Hearing Grants

1,930,000

1,917,000

167.21

(g) Chemical Dependency Entitlement Grants

111,303,000

122,822,000

167.22Payments for Substance Abuse Treatment.
167.23For services provided during fiscal years
167.242010 and 2011, county-negotiated rates
167.25and provider claims to the consolidated
167.26chemical dependency fund must not exceed
167.27the lesser of: (1) rates charged for these
167.28services on January 1, 2009; or (2) 160
167.29percent of the average rate on January 1,
167.302009, for each group of vendors with similar
167.31attributes. For services provided in fiscal
167.32years 2012 and 2013, the statewide average
167.33rates aggregate payment under the new
167.34rate methodology to be developed under
167.35Minnesota Statutes, section 254B.12, must
168.1not exceed the average rates charged for
168.2these services on January 1, 2009, plus a
168.3state share increase of $3,787,000 for fiscal
168.4year 2012 and $5,023,000 for fiscal year
168.52013 projected aggregate payment under
168.6the rates in effect for fiscal year 2010 minus
168.71.25 percent. Notwithstanding any provision
168.8to the contrary in this article, this provision
168.9expires on June 30, 2013.
168.10Chemical Dependency Special Revenue
168.11Account. For fiscal year 2010, $750,000
168.12must be transferred from the consolidated
168.13chemical dependency treatment fund
168.14administrative account and deposited into the
168.15general fund.
168.16County CD Share of MA Costs for
168.17ARRA Compliance. Notwithstanding the
168.18provisions of Minnesota Statutes, chapter
168.19254B, for chemical dependency services
168.20provided during the period October 1, 2008,
168.21to December 31, 2010, and reimbursed by
168.22medical assistance at the enhanced federal
168.23matching rate provided under the American
168.24Recovery and Reinvestment Act of 2009, the
168.25county share is 30 percent of the nonfederal
168.26share. This provision is effective the day
168.27following final enactment.

168.28 168.29

(h) Chemical Dependency Nonentitlement Grants

1,729,000

1,729,000

168.30

(i) Other Continuing Care Grants

19,201,000

17,528,000

168.31Base Adjustment. The general fund base is
168.32increased by $2,639,000 in fiscal year 2012
168.33and increased by $3,854,000 in fiscal year
168.342013.
169.1Technology Grants. $650,000 in fiscal
169.2year 2010 and $1,000,000 in fiscal year
169.32011 are for technology grants, case
169.4consultation, evaluation, and consumer
169.5information grants related to developing and
169.6supporting alternatives to shift-staff foster
169.7care residential service models.
169.8Other Continuing Care Grants; HIV
169.9Grants. Money appropriated for the HIV
169.10drug and insurance grant program in fiscal
169.11year 2010 may be used in either year of the
169.12biennium.
169.13Quality Assurance Commission. Effective
169.14July 1, 2009, state funding for the quality
169.15assurance commission under Minnesota
169.16Statutes, section 256B.0951, is canceled.

169.17    Sec. 10. CANCELLATIONS.
169.18The remaining balance from Laws 2008, chapter 358, article 5, section 4, subdivision
169.193, appropriation for Section 125 employer incentives, is canceled.

169.20    Sec. 11. TRANSFERS.
169.21The commissioner of management and budget shall transfer from the general fund to
169.22the health care access fund $38,475,000 in fiscal year 2011, $14,758,000 in fiscal year
169.232012, and $35,058,000 in fiscal year 2013.
169.24EFFECTIVE DATE.This section is effective upon federal approval of the
169.25amendments to Minnesota Statutes, sections 256B.055, subdivision 15, and 256B.056,
169.26subdivision 4.

169.27    Sec. 12. EXPIRATION OF UNCODIFIED LANGUAGE.
169.28All uncodified language contained in this article expires on June 30, 2011, unless a
169.29different expiration date is explicit.

169.30    Sec. 13. EFFECTIVE DATE.
170.1The provisions in this article are effective July 1, 2010, unless a different effective
170.2date is explicit.