HF 3976

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to state government; making changes to health and human services
programs; amending continuing care, agency management, children and family
services, and health care; awarding housing access grants; requiring studies and
reports; making supplemental appropriations; reducing certain appropriations;
making forecast adjustments; clarifying appropriations and transfers; amending
Minnesota Statutes 2006, sections 13.461, by adding a subdivision; 256.01, by
adding a subdivision; 256.741, subdivisions 2, 2a, 3; 256.969, subdivisions 2b,
20; 256B.0571, subdivisions 8, 9; 256B.0621, subdivisions 2, 6, 10; 256B.0924,
subdivisions 4, 6; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256B.69,
subdivisions 5a, 6, by adding subdivisions; 256B.692, subdivision 2, by adding
a subdivision; 256D.44, subdivisions 2, 5; 256L.12, subdivision 9; 518A.50;
518A.53, subdivision 5; Minnesota Statutes 2007 Supplement, sections 256.741,
subdivision 1; 256B.0625, subdivision 20; 256B.0631, subdivisions 1, 3;
256B.199; 256B.434, subdivision 19; 256J.621; Laws 2007, chapter 147, article
2, section 21; article 19, section 3, subdivision 1; proposing coding for new
law in Minnesota Statutes, chapter 256B; repealing Minnesota Statutes 2006,
sections 256.741, subdivision 15; 256J.24, subdivision 6; Minnesota Statutes
2007 Supplement, section 256.969, subdivision 27.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

CONTINUING CARE

Section 1.

Minnesota Statutes 2006, section 256B.0621, subdivision 2, is amended to
read:

Subd. 2.

Targeted case management; definitions.

For purposes of subdivisions 3
to 10, the following terms have the meanings given them:

(1) "home care service recipients" means those individuals receiving the following
services under sections 256B.0651 to 256B.0656: skilled nursing visits, home health aide
visits, private duty nursing, personal care assistants, or therapies provided through a
home health agency;

(2) "home care targeted case management" means the provision of targeted case
management services for the purpose of assisting home care service recipients to gain
access to needed services and supports so that they may remain in the community;

(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title
42, section 440.10; regional treatment center inpatient services, consistent with section
245.474; nursing facilities; and intermediate care facilities for persons with developmental
disabilities;

(4) "relocation targeted case management" includes the provision of both county
targeted case management and public or private vendor service coordination services
for the purpose of assisting recipients to gain access to needed services and supports if
they choose to move from an institution to the community. Relocation targeted case
management may be provided during new text begin the lesser of:
new text end

new text begin (i) new text end the last 180 consecutive days of an eligible recipient's institutional stay new text begin ; or
new text end

new text begin (ii) the limits and conditions which apply to federal Medicaid funding for this
service new text end ; and

(5) "targeted case management" means case management services provided to help
recipients gain access to needed medical, social, educational, and other services and
supports.

Sec. 2.

Minnesota Statutes 2006, section 256B.0621, subdivision 6, is amended to read:

Subd. 6.

Eligible services.

(a) Services eligible for medical assistance
reimbursement as targeted case management include:

(1) assessment of the recipient's need for targeted case management services and
for persons choosing to relocate, the county must provide service coordination provider
options at the first contact and upon request;

(2) development, completion, and regular review of a written individual service
plan, which is based upon the assessment of the recipient's needs and choices, and which
will ensure access to medical, social, educational, and other related services and supports;

(3) routine contact or communication with the recipient, recipient's family, primary
caregiver, legal representative, substitute care provider, service providers, or other relevant
persons identified as necessary to the development or implementation of the goals of the
individual service plan;

(4) coordinating referrals for, and the provision of, case management services for
the recipient with appropriate service providers, consistent with section 1902(a)(23) of
the Social Security Act;

(5) coordinating and monitoring the overall service delivery and engaging in
advocacy as needed to ensure quality of services, appropriateness, and continued need;

(6) completing and maintaining necessary documentation that supports and verifies
the activities in this subdivision;

(7) assisting individuals in order to access needed services, including travel to
conduct a visit with the recipient or other relevant person necessary to develop or
implement the goals of the individual service plan; and

(8) coordinating with the institution discharge planner deleted text begin in the 180-day period deleted text end before
the recipient's discharge.

(b) Relocation targeted county case management includes services under paragraph
(a), clauses (1), (2), and (4). Relocation service coordination includes services under
paragraph (a), clauses (3) and (5) to (8). Home care targeted case management includes
services under paragraph (a), clauses (1) to (8).

Sec. 3.

Minnesota Statutes 2006, section 256B.0621, subdivision 10, is amended to
read:

Subd. 10.

Payment rates.

The commissioner shall set payment rates for targeted
case management under this subdivision. Case managers may bill according to the
following criteria:

(1) for relocation targeted case management, case managers may bill for direct case
management activities, including face-to-face and telephone contacts, in the new text begin lesser of:
new text end

new text begin (i) new text end 180 days preceding an eligible recipient's discharge from an institution new text begin ; or
new text end

new text begin (ii) the limits and conditions which apply to federal Medicaid funding for this
service new text end ;

(2) for home care targeted case management, case managers may bill for direct case
management activities, including face-to-face and telephone contacts; and

(3) billings for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

Sec. 4.

Minnesota Statutes 2007 Supplement, section 256B.0625, subdivision 20,
is amended to read:

Subd. 20.

Mental health case management.

(a) To the extent authorized by rule
of the state agency, medical assistance covers case management services to persons with
serious and persistent mental illness and children with severe emotional disturbance.
Services provided under this section must meet the relevant standards in sections 245.461
to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe
emotional disturbance when these services meet the program standards in Minnesota
Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case
management shall be made on a monthly basis. In order to receive payment for an eligible
child, the provider must document at least a face-to-face contact with the child, the child's
parents, or the child's legal representative. To receive payment for an eligible adult, the
provider must document:

(1) at least a face-to-face contact with the adult or the adult's legal representative; or

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact with the adult or the adult's legal representative within
the preceding two months.

(d) Payment for mental health case management provided by county or state staff
shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
paragraph (b), with separate rates calculated for child welfare and mental health, and
within mental health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services
or by agencies operated by Indian tribes may be made according to this section or other
relevant federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract
with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the
county or tribe may negotiate a team rate with a vendor who is a member of the team. The
team shall determine how to distribute the rate among its members. No reimbursement
received by contracted vendors shall be returned to the county or tribe, except to reimburse
the county or tribe for advance funding provided by the county or tribe to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal
staff, and county or state staff, the costs for county or state staff participation in the team
shall be included in the rate for county-provided services. In this case, the contracted
vendor, the tribal agency, and the county may each receive separate payment for services
provided by each entity in the same month. In order to prevent duplication of services,
each entity must document, in the recipient's file, the need for team case management and
a description of the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs
for mental health case management shall be provided by the recipient's county of
responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
funds or funds used to match other federal funds. If the service is provided by a tribal
agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this
service is paid by the state without a federal share through fee-for-service, 50 percent of
the cost shall be provided by the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical
assistance, general assistance medical care, and MinnesotaCare include mental health case
management. When the service is provided through prepaid capitation, the nonfederal
share is paid by the state and the county pays no share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a
provider that does not meet the reporting or other requirements of this section. The county
of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal
agency, is responsible for any federal disallowances. The county or tribe may share this
responsibility with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, clause (15). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures
under this section shall only be made from federal earnings from services provided
under this section. When this service is paid by the state without a federal share through
fee-for-service, 50 percent of the cost shall be provided by the state. Payments to
county-contracted vendors shall include the federal earnings, the state share, and the
county share.

(m) Case management services under this subdivision do not include therapy,
treatment, legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or
hospital, and the recipient's institutional care is paid by medical assistance, payment for
case management services under this subdivision is limited to the new text begin lesser of:
new text end

new text begin (1) the new text end last 180 days of the recipient's residency in that facility and may not exceed
more than six months in a calendar year new text begin ; or
new text end

new text begin (2) the limits and conditions which apply to federal Medicaid funding for this service new text end .

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

Sec. 5.

new text begin [256B.0658] HOUSING ACCESS GRANTS.
new text end

new text begin The commissioner of human services shall award through a competitive process
contracts for grants to public and private agencies to support and assist individuals eligible
for publicly funded home and community-based services, including state plan home care,
to access housing. Grants may be awarded to agencies that may include, but are not limited
to, the following supports: assessment to assure suitability of housing, accompanying an
individual to look at housing, filling out applications and rental agreements, meeting
with landlords, helping with Section 8 or other program applications, helping to develop
a budget, obtaining furniture and household goods, if necessary, and assisting with any
problems that may arise with housing.
new text end

Sec. 6.

Minnesota Statutes 2006, section 256B.0924, subdivision 4, is amended to read:

Subd. 4.

Targeted case management service activities.

(a) For persons with
developmental disabilities, targeted case management services must meet the provisions
of section 256B.092.

(b) For persons not eligible as a person with a developmental disability, targeted
case management service activities include:

(1) an assessment of the person's need for targeted case management services;

(2) the development of a written personal service plan;

(3) a regular review and revision of the written personal service plan with the
recipient and the recipient's legal representative, and others as identified by the recipient,
to ensure access to necessary services and supports identified in the plan;

(4) effective communication with the recipient and the recipient's legal representative
and others identified by the recipient;

(5) coordination of referrals for needed services with qualified providers;

(6) coordination and monitoring of the overall service delivery to ensure the quality
and effectiveness of services;

(7) assistance to the recipient and the recipient's legal representative to help make
an informed choice of services;

(8) advocating on behalf of the recipient when service barriers are encountered or
referring the recipient and the recipient's legal representative to an independent advocate;

(9) monitoring and evaluating services identified in the personal service plan to
ensure personal outcomes are met and to ensure satisfaction with services and service
delivery;

(10) conducting face-to-face monitoring with the recipient at least twice a year;

(11) completing and maintaining necessary documentation that supports and verifies
the activities in this section;

(12) coordinating with the medical assistance facility discharge planner deleted text begin in the
180-day period deleted text end prior to the recipient's discharge into the community; and

(13) a personal service plan developed and reviewed at least annually with the
recipient and the recipient's legal representative. The personal service plan must be revised
when there is a change in the recipient's status. The personal service plan must identify:

(i) the desired personal short and long-term outcomes;

(ii) the recipient's preferences for services and supports, including development of
a person-centered plan if requested; and

(iii) formal and informal services and supports based on areas of assessment, such
as: social, health, mental health, residence, family, educational and vocational, safety,
legal, self-determination, financial, and chemical health as determined by the recipient and
the recipient's legal representative and the recipient's support network.

Sec. 7.

Minnesota Statutes 2006, section 256B.0924, subdivision 6, is amended to read:

Subd. 6.

Payment for targeted case management.

(a) Medical assistance and
MinnesotaCare payment for targeted case management shall be made on a monthly basis.
In order to receive payment for an eligible adult, the provider must document at least one
contact per month and not more than two consecutive months without a face-to-face
contact with the adult or the adult's legal representative, family, primary caregiver, or
other relevant persons identified as necessary to the development or implementation
of the goals of the personal service plan.

(b) Payment for targeted case management provided by county staff under this
subdivision shall be based on the monthly rate methodology under section 256B.094,
subdivision 6, paragraph (b), calculated as one combined average rate together with
adult mental health case management under section 256B.0625, subdivision 20, except
for calendar year 2002. In calendar year 2002, the rate for case management under this
section shall be the same as the rate for adult mental health case management in effect
as of December 31, 2001. Billing and payment must identify the recipient's primary
population group to allow tracking of revenues.

(c) Payment for targeted case management provided by county-contracted vendors
shall be based on a monthly rate negotiated by the host county. The negotiated rate must
not exceed the rate charged by the vendor for the same service to other payers. If the
service is provided by a team of contracted vendors, the county may negotiate a team rate
with a vendor who is a member of the team. The team shall determine how to distribute
the rate among its members. No reimbursement received by contracted vendors shall be
returned to the county, except to reimburse the county for advance funding provided by
the county to the vendor.

(d) If the service is provided by a team that includes contracted vendors and county
staff, the costs for county staff participation on the team shall be included in the rate for
county-provided services. In this case, the contracted vendor and the county may each
receive separate payment for services provided by each entity in the same month. In
order to prevent duplication of services, the county must document, in the recipient's file,
the need for team targeted case management and a description of the different roles of
the team members.

(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs
for targeted case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or
funds used to match other federal funds.

(f) The commissioner may suspend, reduce, or terminate reimbursement to a
provider that does not meet the reporting or other requirements of this section. The county
of responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted vendors.

(g) The commissioner shall set aside five percent of the federal funds received under
this section for use in reimbursing the state for costs of developing and implementing
this section.

(h) Payments to counties for targeted case management expenditures under this
section shall only be made from federal earnings from services provided under this
section. Payments to contracted vendors shall include both the federal earnings and the
county share.

(i) Notwithstanding section 256B.041, county payments for the cost of case
management services provided by county staff shall not be made to the commissioner of
finance. For the purposes of targeted case management services provided by county staff
under this section, the centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services provided under this section.

(j) If the recipient is a resident of a nursing facility, intermediate care facility, or
hospital, and the recipient's institutional care is paid by medical assistance, payment for
targeted case management services under this subdivision is limited to new text begin the lesser of:
new text end

new text begin (1) new text end the last 180 days of the recipient's residency in that facility deleted text begin and may not exceed
more than six months in a calendar year deleted text end new text begin ; or
new text end

new text begin (2) the limits and conditions which apply to federal Medicaid funding for this service new text end .

(k) Payment for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.

(l) Any growth in targeted case management services and cost increases under this
section shall be the responsibility of the counties.

Sec. 8.

Minnesota Statutes 2006, section 256B.19, subdivision 1d, is amended to read:

Subd. 1d.

Portion of nonfederal share to be paid by certain counties.

(a)
In addition to the percentage contribution paid by a county under subdivision 1, the
governmental units designated in this subdivision shall be responsible for an additional
portion of the nonfederal share of medical assistance cost. For purposes of this
subdivision, "designated governmental unit" means the counties of Becker, Beltrami,
Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, Pennington, Pipestone, Ramsey, St.
Louis, Steele, Todd, Traverse, and Wadena.

(b) Beginning in 1994, each of the governmental units designated in this subdivision
shall transfer before noon on May 31 to the state Medicaid agency an amount equal to the
number of licensed beds in any nursing home owned and operated by the county on that
date, with the county named as licensee, multiplied by $5,723. If two or more counties own
and operate a nursing home, the payment shall be prorated. These sums shall be part of the
designated governmental unit's portion of the nonfederal share of medical assistance costs.

(c) Beginning in 2002, in addition to any transfer under paragraph (b), each of the
governmental units designated in this subdivision shall transfer before noon on May 31
to the state Medicaid agency an amount equal to the number of licensed beds in any
nursing home owned and operated by the county on that date, with the county named as
licensee, multiplied by $10,784. The provisions of paragraph (b) apply to transfers under
this paragraph.

deleted text begin (d) Beginning in 2003, in addition to any transfer under paragraphs (b) and (c), each
of the governmental units designated in this subdivision shall transfer before noon on May
31 to the state Medicaid agency an amount equal to the number of licensed beds in any
nursing home owned and operated by the county on that date, with the county named as
licensee, multiplied by $2,230. The provisions of paragraph (b) apply to transfers under
this paragraph.
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end The commissioner may reduce the intergovernmental transfers under
deleted text begin paragraphs deleted text end new text begin paragraph new text end (c) deleted text begin and (d) deleted text end based on the commissioner's determination of the
payment rate in section 256B.431, subdivision 23, paragraphs (c) deleted text begin , deleted text end new text begin and new text end (d) deleted text begin , and (e) deleted text end . Any
adjustments must be made on a per-bed basis and must result in an amount equivalent to
the total amount resulting from the rate adjustment in section 256B.431, subdivision 23,
paragraphs (c) deleted text begin , deleted text end new text begin and new text end (d) deleted text begin , and (e) deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 9.

Minnesota Statutes 2006, section 256B.431, subdivision 23, is amended to read:

Subd. 23.

County nursing home payment adjustments.

(a) Beginning in 1994,
the commissioner shall pay a nursing home payment adjustment on May 31 after noon
to a county in which is located a nursing home that, on that date, was county-owned and
operated, with the county named as licensee by the commissioner of health, and had over
40 beds and medical assistance occupancy in excess of 50 percent during the reporting
year ending September 30, 1991. The adjustment shall be an amount equal to $16 per
calendar day multiplied by the number of beds licensed in the facility on that date.

(b) Payments under paragraph (a) are excluded from medical assistance per diem
rate calculations. These payments are required notwithstanding any rule prohibiting
medical assistance payments from exceeding payments from private pay residents. A
facility receiving a payment under paragraph (a) may not increase charges to private pay
residents by an amount equivalent to the per diem amount payments under paragraph (a)
would equal if converted to a per diem.

(c) Beginning in 2002, in addition to any payment under paragraph (a), the
commissioner shall pay to a nursing facility described in paragraph (a) an adjustment in
an amount equal to $29.55 per calendar day multiplied by the number of beds licensed
in the facility on that date. The provisions of paragraphs (a) and (b) apply to payments
under this paragraph.

deleted text begin (d) Beginning in 2003, in addition to any payment under paragraphs (a) and (c), the
commissioner shall pay to a nursing facility described in paragraph (a) an adjustment in
an amount equal to $6.11 per calendar day multiplied by the number of beds licensed in
the facility on that date. The provisions of paragraphs (a) and (b) apply to payments
under this paragraph.
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end The commissioner may reduce payments under deleted text begin paragraphs deleted text end new text begin paragraph new text end (c) deleted text begin and
(d) deleted text end based on the commissioner's determination of Medicare upper payment limits. Any
adjustments must be proportional to adjustments made under section 256B.19, subdivision
1d, paragraph deleted text begin (e) deleted text end new text begin (d) new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 10.

Minnesota Statutes 2007 Supplement, section 256B.434, subdivision 19,
is amended to read:

Subd. 19.

Nursing facility rate increases beginning October 1, 2007 new text begin , and
October 1, 2008 new text end .

(a) For the rate year beginning October 1, 2007, the commissioner
shall make available to each nursing facility reimbursed under this section operating
payment rate adjustments equal to 1.87 percent of the operating payment rates in effect
on September 30, 2007. new text begin For the rate year beginning October 1, 2008, the commissioner
shall make available to each nursing facility reimbursed under this section, operating
payment rate adjustments equal to 2.0 percent of the operating payment rates in effect
on September 30, 2008.
new text end

(b) Seventy-five percent of the money resulting from the rate adjustment under
paragraph (a) must be used for increases in compensation-related costs for employees
directly employed by the nursing facility on or after the effective date of the rate
adjustment, except:

(1) the administrator;

(2) persons employed in the central office of a corporation that has an ownership
interest in the nursing facility or exercises control over the nursing facility; and

(3) persons paid by the nursing facility under a management contract.

(c) Two-thirds of the money available under paragraph (b) must be used for wage
increases for all employees directly employed by the nursing facility on or after the
effective date of the rate adjustment, except those listed in paragraph (b), clauses (1) to
(3). The wage adjustment that employees receive under this paragraph must be paid as
an equal hourly percentage wage increase for all eligible employees. All wage increases
under this paragraph must be effective on the same date. Only costs associated with the
portion of the equal hourly percentage wage increase that goes to all employees shall
qualify under this paragraph. Costs associated with wage increases in excess of the
amount of the equal hourly percentage wage increase provided to all employees shall be
allowed only for meeting the requirements in paragraph (b). This paragraph shall not
apply to employees covered by a collective bargaining agreement.

(d) The commissioner shall allow as compensation-related costs all costs for:

(1) wages and salaries;

(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
compensation;

(3) the employer's share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, and pensions; and

(4) other benefits provided, subject to the approval of the commissioner.

(e) The portion of the rate adjustment under paragraph (a) that is not subject to the
requirements in paragraphs (b) and (c) shall be provided to nursing facilities effective
October 1, 2007 new text begin , or October 1, 2008, as applicable new text end .

(f) Nursing facilities may apply for the portion of the rate adjustment under
paragraph (a) that is subject to the requirements in paragraphs (b) and (c). The application
must be submitted to the commissioner within six months of the effective date of the
rate adjustment, and the nursing facility must provide additional information required
by the commissioner within nine months of the effective date of the rate adjustment.
The commissioner must respond to all applications within three weeks of receipt.
The commissioner may waive the deadlines in this paragraph under extraordinary
circumstances, to be determined at the sole discretion of the commissioner. The
application must contain:

(1) an estimate of the amounts of money that must be used as specified in paragraphs
(b) and (c);

(2) a detailed distribution plan specifying the allowable compensation-related and
wage increases the nursing facility will implement to use the funds available in clause (1);

(3) a description of how the nursing facility will notify eligible employees of
the contents of the approved application, which must provide for giving each eligible
employee a copy of the approved application, excluding the information required in clause
(1), or posting a copy of the approved application, excluding the information required in
clause (1), for a period of at least six weeks in an area of the nursing facility to which all
eligible employees have access; and

(4) instructions for employees who believe they have not received the
compensation-related or wage increases specified in clause (2), as approved by the
commissioner, and which must include a mailing address, e-mail address, and the
telephone number that may be used by the employee to contact the commissioner or the
commissioner's representative.

(g) The commissioner shall ensure that cost increases in distribution plans under
paragraph (f), clause (2), that may be included in approved applications, comply with the
following requirements:

(1) costs to be incurred during the applicable rate year resulting from wage and
salary increases effective after October 1, 2006, and prior to the first day of the nursing
facility's payroll period that includes October 1 deleted text begin , 2007 deleted text end new text begin of each year new text end , shall be allowed if they
were not used in the prior year's application;

(2) a portion of the costs resulting from tenure-related wage or salary increases
may be considered to be allowable wage increases, according to formulas that the
commissioner shall provide, where employee retention is above the average statewide
rate of retention of direct care employees;

(3) the annualized amount of increases in costs for the employer's share of health
and dental insurance, life insurance, disability insurance, and workers' compensation
shall be allowable compensation-related increases if they are effective on or after April
1 deleted text begin , 2007, deleted text end new text begin of the year in which the rate adjustments are effective new text end and prior to April 1 deleted text begin , 2008 deleted text end new text begin
of the following year new text end ; and

(4) for nursing facilities in which employees are represented by an exclusive
bargaining representative, the commissioner shall approve the application only upon
receipt of a letter of acceptance of the distribution plan, in regard to members of the
bargaining unit, signed by the exclusive bargaining agent and dated after May 25, 2007.
Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of
this section as having been met in regard to the members of the bargaining unit.

(h) The commissioner shall review applications received under paragraph (f) and
shall provide the portion of the rate adjustment under paragraphs (b) and (c) if the
requirements of this subdivision have been met. The rate adjustment shall be effective
October 1. Notwithstanding paragraph (a), if the approved application distributes less
money than is available, the amount of the rate adjustment shall be reduced so that the
amount of money made available is equal to the amount to be distributed.

Sec. 11.

Minnesota Statutes 2006, section 256B.69, subdivision 6, is amended to read:

Subd. 6.

Service delivery.

(a) Each demonstration provider shall be responsible for
the health care coordination for eligible individuals. Demonstration providers:

(1) shall authorize and arrange for the provision of all needed health services
including but not limited to the full range of services listed in sections 256B.02,
subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered to
enrollees new text begin . Notwithstanding section 256B.0621, demonstration providers that provide
nursing home and community-based services under this section shall provide relocation
service coordination to enrolled persons age 65 and over new text end ;

(2) shall accept the prospective, per capita payment from the commissioner in return
for the provision of comprehensive and coordinated health care services for eligible
individuals enrolled in the program;

(3) may contract with other health care and social service practitioners to provide
services to enrollees; and

(4) shall institute recipient grievance procedures according to the method established
by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved
through this process shall be appealable to the commissioner as provided in subdivision 11.

(b) Demonstration providers must comply with the standards for claims settlement
under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health
care and social service practitioners to provide services to enrollees. A demonstration
provider must pay a clean claim, as defined in Code of Federal Regulations, title 42,
section 447.45(b), within 30 business days of the date of acceptance of the claim.

Sec. 12.

Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:

Subd. 2.

Standard of assistance for persons eligible for medical assistance
waivers or at risk of placement in a group residential housing facility.

The state
standard of assistance for a person who new text begin : (1) new text end is eligible for a medical assistance home and
community-based services waiver deleted text begin or a person who deleted text end new text begin ; (2) new text end has been determined by the local
agency to meet the plan requirements for placement in a group residential housing facility
under section 256I.04, subdivision 1a deleted text begin , deleted text end new text begin ; or (3) is eligible for a shelter needy payment
under subdivision 5, paragraph (f); new text end is the standard established in subdivision 3, paragraph
(a) or (b).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

Sec. 13.

Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:

Subd. 5.

Special needs.

In addition to the state standards of assistance established in
subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a group residential housing facility.

(a) The county agency shall pay a monthly allowance for medically prescribed
diets if the cost of those additional dietary needs cannot be met through some other
maintenance benefit. The need for special diets or dietary items must be prescribed by
a licensed physician. Costs for special diets shall be determined as percentages of the
allotment for a one-person household under the thrifty food plan as defined by the United
States Department of Agriculture. The types of diets and the percentages of the thrifty
food plan that are covered are as follows:

(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;

(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
of thrifty food plan;

(3) controlled protein diet, less than 40 grams and requires special products, 125
percent of thrifty food plan;

(4) low cholesterol diet, 25 percent of thrifty food plan;

(5) high residue diet, 20 percent of thrifty food plan;

(6) pregnancy and lactation diet, 35 percent of thrifty food plan;

(7) gluten-free diet, 25 percent of thrifty food plan;

(8) lactose-free diet, 25 percent of thrifty food plan;

(9) antidumping diet, 15 percent of thrifty food plan;

(10) hypoglycemic diet, 15 percent of thrifty food plan; or

(11) ketogenic diet, 25 percent of thrifty food plan.

(b) Payment for nonrecurring special needs must be allowed for necessary home
repairs or necessary repairs or replacement of household furniture and appliances using
the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
as long as other funding sources are not available.

(c) A fee for guardian or conservator service is allowed at a reasonable rate
negotiated by the county or approved by the court. This rate shall not exceed five percent
of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
guardian or conservator is a member of the county agency staff, no fee is allowed.

(d) The county agency shall continue to pay a monthly allowance of $68 for
restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
1990, and who eats two or more meals in a restaurant daily. The allowance must continue
until the person has not received Minnesota supplemental aid for one full calendar month
or until the person's living arrangement changes and the person no longer meets the criteria
for the restaurant meal allowance, whichever occurs first.

(e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
is allowed for representative payee services provided by an agency that meets the
requirements under SSI regulations to charge a fee for representative payee services. This
special need is available to all recipients of Minnesota supplemental aid regardless of
their living arrangement.

(f) new text begin (1) new text end Notwithstanding the language in this subdivision, an amount equal to the
maximum allotment authorized by the federal Food Stamp Program for a single individual
which is in effect on the first day of deleted text begin January deleted text end new text begin July new text end of deleted text begin the previous deleted text end new text begin each new text end year will be added to
the standards of assistance established in subdivisions 1 to 4 for deleted text begin individuals deleted text end new text begin adults new text end under
the age of 65 who new text begin qualify as shelter needy and new text end are new text begin : (i) new text end relocating from an institution, or an
adult mental health residential treatment program under section 256B.0622 deleted text begin , and who are
shelter needy deleted text end new text begin ; (ii) eligible for the self-directed supports option as defined under section
256B.0657, subdivision 2; or (iii) home and community-based waiver recipients living in
their own home or rented or leased apartment which is not owned, operated, or controlled
by a provider of service not related by blood or marriage new text end .

new text begin (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
shelter needy benefit under this paragraph is considered a household of one. new text end An eligible
individual who receives this benefit prior to age 65 may continue to receive the benefit
after the age of 65.

new text begin (3) new text end "Shelter needy" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this
special needs standard. "Gross income" for the purposes of this section is the applicant's or
recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
in subdivision 3, new text begin paragraph (a) or (b), new text end whichever is greater. A recipient of a federal or
state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
considered shelter needy for purposes of this paragraph.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2009.
new text end

ARTICLE 2

AGENCY MANAGEMENT

Section 1.

Minnesota Statutes 2006, section 13.461, is amended by adding a
subdivision to read:

new text begin Subd. 24a. new text end

new text begin Managed care plans. new text end

new text begin Data provided to the commissioner of human
services by managed care plans relating to contracts and provider payment rates are
classified under section 256B.69, subdivision 9b.
new text end

Sec. 2.

Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
to read:

new text begin Subd. 27. new text end

new text begin Automation and coordination for state health care programs. new text end

new text begin (a) For
purposes of this subdivision, "state health care program" means the medical assistance,
MinnesotaCare, or general assistance medical care programs.
new text end

new text begin (b) By July 1, 2010, the commissioner shall improve coordination between state
health care programs and social service programs including but not limited to WIC,
free and reduced-price school lunch programs, and food stamps, and shall develop and
use automated systems to identify persons served by social service programs who may
be eligible for, but are not enrolled in, a state health care program. The system must
also permit enrollees to renew state health care program enrollment through these social
services programs. By January 15, 2010, the commissioner shall, as necessary, identify
and recommend to the legislature statutory changes to state health care and social service
programs necessary to improve coordination and automation of outreach and enrollment
efforts, and report estimated local and state costs of implementation and evaluate funding
alternatives, including possible federal reimbursement.
new text end

new text begin (c) By January 15, 2010, the commissioner shall establish and implement an
automated process to send out state health care program renewal forms in the most
common foreign languages to those state health care program enrollees who request
renewal forms in those foreign languages. The commissioner, as part of the initial
enrollment process, shall inform applicants of the availability of this option.
new text end

new text begin (d) Beginning July 1, 2010, the commissioner, county social service agencies, and
health care providers shall update state health care program enrollee addresses and related
contact information at the time of each enrollee contact. The commissioner shall report
the costs of automatically updating contact information across programs to health care
providers and county agencies.
new text end

Sec. 3.

Minnesota Statutes 2006, section 256B.69, subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section
and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
basis beginning January 1, 1996. Managed care contracts which were in effect on June
30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
commissioner may issue separate contracts with requirements specific to services to
medical assistance recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
of its contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B, 256D, and 256L, established after the effective date of a contract
with the commissioner take effect when the contract is next issued or renewed.

(c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance
target based on a federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. new text begin The managed
care plan must demonstrate, to the commissioner's satisfaction, that the data submitted
regarding attainment of the performance target is accurate. The commissioner shall
periodically change the administrative measures used as performance targets in order
to improve plan performance across a broader range of administrative services. The
performance targets must include measurement of plan efforts to contain spending
on health care services and administrative activities. The commissioner may adopt
plan-specific performance targets that take into account factors affecting only one plan,
including characteristics of the plan's enrollee population. new text end The withheld funds must be
returned no sooner than July of the following year if performance targets in the contract
are achieved. The commissioner may exclude special demonstration projects under
subdivision 23. A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this paragraph that is reasonably expected to be returned.

Sec. 4.

Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 5i. new text end

new text begin Administrative expenses. new text end

new text begin (a) Managed care plan and county-based
purchasing plan administrative costs for a prepaid health plan provided under this section
or section 256B.692 must not exceed by more than five percent that prepaid health plan's
or county-based purchasing plan's actual calculated administrative spending for the
previous calendar year as a percentage of total revenue. The penalty for exceeding this
limit must be the amount of administrative spending in excess of 105 percent of the actual
calculated amount. The commissioner may waive this penalty if the excess administrative
spending is the result of unexpected shifts in enrollment or member needs or new program
requirements.
new text end

new text begin (b) Capitated rate payments for administrative costs must be reduced to exclude
onetime or sporadic expenditures in the prior year unless the managed care plan certifies
that the expenditure will recur during the contract year. The commissioner shall verify
these certifications on an annual basis and recoup any payments made for onetime or
sporadic expenditures that did not occur in the prior year.
new text end

new text begin (c) Expenses under section 62D.12, subdivision 9a, clause (4), are not allowable
administrative expenses for rate-setting purposes under this section, unless approved by
the commissioner.
new text end

Sec. 5.

Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 5j. new text end

new text begin Treatment of investment earnings. new text end

new text begin Capitation rates shall treat investment
income and interest earnings as income to the same extent that investment-related
expenses are treated as administrative expenditures.
new text end

Sec. 6.

Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 9a. new text end

new text begin Administrative expense reporting. new text end

new text begin Each managed care plan and
county-based purchasing plan must provide to the commissioner detailed information on
administrative spending, including:
new text end

new text begin (1) itemized lists of costs for claims processing and provider network management;
new text end

new text begin (2) detailed reports of costs for contracts with providers and third-party
administrators;
new text end

new text begin (3) a detailed analysis of administrative spending for each Minnesota health care
program;
new text end

new text begin (4) a detailed analysis of the provider's allocation of administrative expenses among
its public and commercial lines of business;
new text end

new text begin (5) a detailed analysis of administrative costs by service category; and
new text end

new text begin (6) a detailed analysis of onetime and sporadic expenditures included in the
administrative spending category.
new text end

Sec. 7.

Minnesota Statutes 2006, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 9b. new text end

new text begin Reporting of subcontracts and provider payment rates. new text end

new text begin (a) Each
managed care plan and county-based purchasing plan must provide to the commissioner:
new text end

new text begin (1) detailed information on contracts with health care providers; and
new text end

new text begin (2) detailed information on reimbursement rates paid by the managed care plan
to providers under contract with the plan.
new text end

new text begin (b) Data provided to the commissioner under this subdivision are nonpublic data as
defined in section 13.02.
new text end

Sec. 8.

Minnesota Statutes 2006, section 256B.692, subdivision 2, is amended to read:

Subd. 2.

Duties of commissioner of health.

(a) Notwithstanding chapters 62D
and 62N, a county that elects to purchase medical assistance and general assistance
medical care in return for a fixed sum without regard to the frequency or extent of services
furnished to any particular enrollee is not required to obtain a certificate of authority
under chapter 62D or 62N. The county board of commissioners is the governing body of
a county-based purchasing program. In a multicounty arrangement, the governing body
is a joint powers board established under section 471.59.

(b) A county that elects to purchase medical assistance and general assistance
medical care services under this section must satisfy the commissioner of health that the
requirements for assurance of consumer protection, provider protection, and new text begin , effective
January 1, 2010, new text end fiscal solvency of chapter 62D, applicable to health maintenance
organizations deleted text begin , or chapter 62N, applicable to community integrated service networks, deleted text end will
be met deleted text begin . deleted text end new text begin according to the following schedule:
new text end

new text begin (1) for a county-based purchasing plan approved on or before June 30, 2008, the
plan must have in reserve:
new text end

new text begin (i) at least 50 percent of the minimum amount required under chapter 62D as
of January 1, 2010;
new text end

new text begin (ii) at least 75 percent of the minimum amount required under chapter 62D as of
January 1, 2011;
new text end

new text begin (iii) at least 87.5 percent of the minimum amount required under chapter 62D as
of January 1, 2012; and
new text end

new text begin (iv) at least 100 percent of the minimum amount required under chapter 62D as
of January 1, 2013; and
new text end

new text begin (2) for a county-based purchasing plan first approved after June 30, 2008, the plan
must have in reserve:
new text end

new text begin (i) at least 50 percent of the minimum amount required under chapter 62D at the
time the plan begins enrolling enrollees;
new text end

new text begin (ii) at least 75 percent of the minimum amount required under chapter 62D after
the first full calendar year;
new text end

new text begin (iii) at least 87.5 percent of the minimum amount required under chapter 62D after
the second full calendar year; and
new text end

new text begin (iv) at least 100 percent of the minimum amount required under chapter 62D after
the third full calendar year.
new text end

(c) new text begin Until a plan is required to have reserves equaling at least 100 percent of the
minimum amount required under chapter 62D, the plan may demonstrate its ability to
cover any losses by satisfying the requirements of chapter 62N. new text end A deleted text begin county deleted text end new text begin county-based
purchasing plan new text end must also assure the commissioner of health that the requirements of
sections 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all applicable provisions
of chapter 62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 62Q.12; 62Q.135;
62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47; 62Q.50; 62Q.52 to
62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.

(d) All enforcement and rulemaking powers available under chapters 62D, 62J,
62M, 62N, and 62Q are hereby granted to the commissioner of health with respect to
counties that purchase medical assistance and general assistance medical care services
under this section.

(e) The commissioner, in consultation with county government, shall develop
administrative and financial reporting requirements for county-based purchasing programs
relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31,
and other sections as necessary, that are specific to county administrative, accounting, and
reporting systems and consistent with other statutory requirements of counties.

Sec. 9.

Minnesota Statutes 2006, section 256B.692, is amended by adding a
subdivision to read:

new text begin Subd. 4a. new text end

new text begin Expenditure of revenues. new text end

new text begin (a) A county that has elected to participate
in a county-based purchasing plan under this section shall use any excess revenues over
expenses that are received by the county and are not needed for capital reserves under
subdivision 2, to increase payments to providers, or to repay county investments or
contributions to the county-based purchasing plan, for prevention, early intervention, and
health care programs, services, or activities.
new text end

new text begin (b) A county-based purchasing plan under this section is subject to the unreasonable
expense provisions of section 62D.19.
new text end

Sec. 10.

Minnesota Statutes 2006, section 256L.12, subdivision 9, is amended to read:

Subd. 9.

Rate setting; performance withholds.

(a) Rates will be prospective,
per capita, where possible. The commissioner may allow health plans to arrange for
inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
an independent actuary to determine appropriate rates.

(b) For services rendered on or after January 1, 2003, to December 31, 2003, the
commissioner shall withhold .5 percent of managed care plan payments under this section
pending completion of performance targets. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year if performance targets
in the contract are achieved. A managed care plan may include as admitted assets under
section 62D.044 any amount withheld under this paragraph that is reasonably expected
to be returned.

(c) For services rendered on or after January 1, 2004, the commissioner shall
withhold five percent of managed care plan payments under this section pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance target
based on a federal or state law or rule. Criteria for assessment of each performance target
must be outlined in writing prior to the contract effective date. new text begin The managed care plan
must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
attainment of the performance target is accurate. The commissioner shall periodically
change the administrative measures used as performance targets in order to improve plan
performance across a broader range of administrative services. The performance targets
must include measurement of plan efforts to contain spending on health care services and
administrative activities. The commissioner may adopt plan-specific performance targets
that take into account factors affecting only one plan, such as characteristics of the plan's
enrollee population. new text end The withheld funds must be returned no sooner than July 1 and no
later than July 31 of the following calendar year if performance targets in the contract are
achieved. A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
paragraph that is reasonably expected to be returned.

Sec. 11. new text begin REPORT ON FINANCIAL MANAGEMENT OF HEALTH CARE
PROGRAMS.
new text end

new text begin The commissioner of human services shall report to the legislature under Minnesota
Statutes, section 3.195, by January 15, 2009, with the following information regarding
financial management of health care programs:
new text end

new text begin (1) a status report on implementation of the cost containment strategies identified in
the 2005 "Strategies for Savings" report. The report must include:
new text end

new text begin (i) information on progress made towards implementation of cost-saving strategies;
new text end

new text begin (ii) an explanation of why certain strategies were not implemented; and
new text end

new text begin (iii) where appropriate, alternative strategies to those recommended in 2005 for
containing public health care program costs;
new text end

new text begin (2) a description of and, to the extent possible, an explanation of recent differences
between the health plan net revenue targets established by the commissioner for health
plans participating in public health care programs and the actual net revenue realized by
the plans from public programs;
new text end

new text begin (3) the adequacy of public health care programs for fee-for-service rates, including
an identification of service areas or geographical regions where enrollees have difficulty
accessing providers as the result of inadequate provider payments. This report must
include recommendations to increase rates as needed to eliminate identified access
problems; and
new text end

new text begin (4) a progress report on implementation of Minnesota Statutes, section 256B.76,
paragraph (e), requiring payments for physician and professional services to be based
on Medicare relative value units, and an estimated completion date for implementation
of this payment system.
new text end

Sec. 12. new text begin HEALTH PLAN AND COUNTY-BASED PURCHASING PLAN
REQUIREMENTS.
new text end

new text begin (a) The commissioner of health shall develop and report to the legislature under
Minnesota Statutes, section 3.195, by January 15, 2009, guidelines to ensure that health
plans, and county-based purchasing plans where applicable, have consistent procedures
for allocating administrative expenses and investment income across their commercial and
public lines of business and across individual public programs. The guidelines shall be
consistent with generally accepted accounting principles and principles from the National
Association of Insurance Commissioners. The guidelines shall not have the effect of
changing allocation for Medicare-related programs as permitted by federal law and the
Centers for Medicare and Medicaid Services.
new text end

new text begin (b) The commissioner of health, in cooperation with the commissioners of commerce
and human services, shall develop and report to the legislature under Minnesota Statutes,
section 3.195, by January 15, 2009, detailed standards and procedures for examining
the reasonableness of health plan and county-based purchasing plan administrative
expenditures for publicly funded programs. These standards and procedures must include
a process for detailed examinations of individual programs and functional areas.
new text end

new text begin (c) The commissioner of health shall develop and report to the legislature under
Minnesota Statutes, section 3.195, by January 15, 2009, a more efficient method for a
health plan, and a county-based purchasing plan where appropriate, to demonstrate to the
commissioner that providers in the plan's network have appropriate credentials. The
commissioner shall review issues regarding:
new text end

new text begin (1) the duplicate review of credentials at a health care provider by multiple health
plans;
new text end

new text begin (2) the review of the credentials of all staff of a health care provider when only
limited staff will be in the plan network; and
new text end

new text begin (3) other duplicative credentialing issues.
new text end

Sec. 13. new text begin OMBUDSMAN FOR MANAGED CARE STUDY.
new text end

new text begin The commissioner of human services, in cooperation with the ombudsman for
managed care, shall study and report to the legislature under Minnesota Statutes,
section 3.195, by January 15, 2009, with recommendations on whether the duties of the
ombudsman should be expanded to include advocating on behalf of public health care
programs fee-for-service enrollees. The report must include:
new text end

new text begin (1) a comparison of recourses available to managed care clients versus
fee-for-service clients when service problems occur; and
new text end

new text begin (2) an estimate of any net cost increase from this change in the ombudsman's duties,
taking into account any reduction in the commissioner's duties.
new text end

Sec. 14. new text begin REPORTING MANAGED CARE PERFORMANCE DATA.
new text end

new text begin The commissioner of human services, in cooperation with the commissioner of
health, shall report to the legislature under Minnesota Statutes, section 3.195, by January
15, 2009, with recommendations on the adoption of a single method to compute and
publicly report managed health care performance measures in order to avoid confusion
about the plans' performance levels. The study must include recommendations regarding
coordinated use by the two agencies of the following data sources:
new text end

new text begin (1) Healthcare Effectiveness Data and Information Set (HEDIS) from managed
care organizations;
new text end

new text begin (2) data that health plans submit to claim reimbursement for health care procedures;
and
new text end

new text begin (3) data collected from medical record reviews of randomly selected individuals.
new text end

Sec. 15. new text begin PUBLIC DENTAL COVERAGE PROGRAM STUDY.
new text end

new text begin (a) The commissioner of human services shall undertake a study to determine
whether alternative approaches to offering dental coverage to public programs enrollees
would result in:
new text end

new text begin (1) improved access to dental care;
new text end

new text begin (2) cost savings to providers and the department; and
new text end

new text begin (3) improved quality and outcomes of care.
new text end

new text begin Alternatives considered must include moving to a single dental plan administrator,
retaining the current model, and other innovative approaches. Issues relating to chronic
disease management, medical and dental interface, plan payment approaches, and provider
payment should also be addressed. The report must make a recommendation on whether
to alter the current approach to contracting for dental services, and include a detailed
plan on how to implement any changes. The commissioner shall consult with dentists,
safety net dental providers, dental plans, health plans and county-based purchasing
organizations, patients and advocates, and other interested parties in developing their
findings and recommendations.
new text end

new text begin (b) By December 15, 2008, the commissioner of human services shall report findings
and recommendations to the chairs of the house of representatives and senate committees
having jurisdiction over health and human services policy and finance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 16. new text begin WORK GROUP; TARGETED CASE MANAGEMENT.
new text end

new text begin (a) The commissioner of human services shall convene a work group and seek
information from counties, juvenile court staff, guardians ad litem, and mental health and
child welfare advocates on the impact of federal regulations that cut funding for targeted
case management services and the child support administrative collection system. The
work group shall consider the impact these cuts will have on child protection, mental
health, and housing relocation services.
new text end

new text begin (b) The commissioner shall issue a report from the work group summarizing the
impact of the federal budget cuts on persons eligible for targeted case management
services and the impact on county budgets. This report shall include budget and policy
strategies to restore service levels to that of the year prior to the effective date of the
federal regulations. A preliminary report shall be issued on December 15, 2008.
new text end

ARTICLE 3

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2007 Supplement, section 256.741, subdivision 1,
is amended to read:

Subdivision 1.

deleted text begin Public assistance deleted text end new text begin Definitions new text end .

(a) The term "direct support" as used
in this chapter and chapters 257, 518, 518A, and 518C refers to an assigned support
payment from an obligor which is paid directly to a recipient of deleted text begin TANF or MFIP deleted text end new text begin public
assistance new text end .

(b) The term "public assistance" as used in this chapter and chapters 257, 518, 518A,
and 518C, includes any form of assistance provided under the AFDC program formerly
codified in sections 256.72 to 256.87, MFIP and MFIP-R formerly codified under chapter
256, MFIP under chapter 256J, work first program new text begin formerly codified new text end under chapter 256K;
child care assistance provided through the child care fund under chapter 119B; any form
of medical assistance under chapter 256B; MinnesotaCare under chapter 256L; and foster
care as provided under title IV-E of the Social Security Act.

(c) The term "child support agency" as used in this section refers to the public
authority responsible for child support enforcement.

(d) The term "public assistance agency" as used in this section refers to a public
authority providing public assistance to an individual.

new text begin (e) The terms "child support" and "arrears" as used in this section have the meanings
provided in section 518A.26.
new text end

new text begin (f) The term "maintenance" as used in this section has the meaning provided in
section 518.003.
new text end

Sec. 2.

Minnesota Statutes 2006, section 256.741, subdivision 2, is amended to read:

Subd. 2.

Assignment of support and maintenance rights.

(a) An individual
receiving public assistance in the form of assistance under any of the following programs:
the AFDC program formerly codified in sections 256.72 to 256.87, MFIP under chapter
256J, MFIP-R and MFIP formerly codified under chapter 256, or work first new text begin program
formerly codified under chapter 256K new text end is considered to have assigned to the state at the
time of application all rights to child support and maintenance from any other person the
applicant or recipient may have in the individual's own behalf or in the behalf of any other
family member for whom application for public assistance is made. An assistance unit is
ineligible for the Minnesota family investment program unless the caregiver assigns all
rights to child support and deleted text begin spousal deleted text end maintenance benefits according to this section.

(1) deleted text begin An deleted text end new text begin The new text end assignment deleted text begin made according to this section deleted text end is effective as to deleted text begin :
deleted text end

deleted text begin (i) deleted text end any current child support and current deleted text begin spousal deleted text end maintenance deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (ii) any accrued child support and spousal maintenance arrears.
deleted text end

deleted text begin (2) An assignment made after September 30, 1997, is effective as to:
deleted text end

deleted text begin (i) any current child support and current spousal maintenance;
deleted text end

deleted text begin (ii) any accrued child support and spousal maintenance arrears collected before
October 1, 2000, or the date the individual terminates assistance, whichever is later; and
deleted text end

deleted text begin (iii) any accrued child support and spousal maintenance arrears collected under
federal tax intercept.
deleted text end

new text begin (2) Any child support or maintenance arrears that accrue while an individual is
receiving public assistance in the form of assistance under any of the programs listed in
this paragraph are permanently assigned to the state.
new text end

new text begin (3) The assignment of current child support and current maintenance ends on the
date the individual ceases to receive or is no longer eligible to receive public assistance
under any of the programs listed in this paragraph.
new text end

(b) An individual receiving public assistance in the form of medical assistance,
including MinnesotaCare, is considered to have assigned to the state at the time of
application all rights to medical support from any other person the individual may have
in the individual's own behalf or in the behalf of any other family member for whom
medical assistance is provided.

new text begin (1) new text end An assignment made after September 30, 1997, is effective as to any medical
support accruing after the date of medical assistance or MinnesotaCare eligibility.

new text begin (2) Any medical support arrears that accrue while an individual is receiving public
assistance in the form of medical assistance, including MinnesotaCare, are permanently
assigned to the state.
new text end

new text begin (3) The assignment of current medical support ends on the date the individual ceases
to receive or is no longer eligible to receive public assistance in the form of medical
assistance or MinnesotaCare.
new text end

(c) An individual receiving public assistance in the form of child care assistance
under the child care fund pursuant to chapter 119B is considered to have assigned to the
state at the time of application all rights to child care support from any other person the
individual may have in the individual's own behalf or in the behalf of any other family
member for whom child care assistance is provided.

deleted text begin An deleted text end new text begin (1) The new text end assignment deleted text begin made according to this paragraph deleted text end is effective as to deleted text begin :
deleted text end

deleted text begin (1) deleted text end any current child care support deleted text begin and any child care support arrears assigned and
accruing after July 1, 1997, that are collected before October 1, 2000; and deleted text end new text begin .
new text end

(2) deleted text begin any accrued child care support arrears collected under federal tax intercept. deleted text end new text begin Any
child care support arrears that accrue while an individual is receiving public assistance in
the form of child care assistance under the child care fund in chapter 119B are permanently
assigned to the state.
new text end

new text begin (3) The assignment of current child care support ends on the date the individual
ceases to receive or is no longer eligible to receive public assistance in the form of child
care assistance under the child care fund under chapter 119B.
new text end

Sec. 3.

Minnesota Statutes 2006, section 256.741, subdivision 2a, is amended to read:

Subd. 2a.

deleted text begin Families-first deleted text end Distribution of child support deleted text begin arrearages deleted text end .

new text begin (a) The
state shall distribute current child support and maintenance received by the state to an
individual who assigns the right to that support under subdivision 2, paragraph (a).
new text end

new text begin (b) new text end When the public authority collects new text begin child new text end support arrearages on behalf of an
individual who is receiving new text begin public new text end assistance deleted text begin provided under MFIP or MFIP-R under
this chapter, MFIP under chapter 256J, or work first under chapter 256K, and the public
authority has the option of applying the collection to arrears permanently assigned to the
state or to arrears temporarily assigned to the state deleted text end , the public authority shall first apply the
collection to satisfy those arrears that are permanently assigned to the state.

new text begin (c) When the public authority collects child support arrearages on behalf of an
individual who is not receiving public assistance, the public authority shall first apply the
collection to satisfy those arrears that are not permanently assigned to the state.
new text end

new text begin (d) When the public authority collects child support arrearages certified under the
federal tax offset, the public authority shall first apply the collection to satisfy those arrears
that are permanently assigned to the state.
new text end

Sec. 4.

Minnesota Statutes 2006, section 256.741, subdivision 3, is amended to read:

Subd. 3.

Existing assignments.

Assignments based on the receipt of public
assistance in existence prior to July 1, 1997, are permanently assigned to the state. new text begin Arrears
that accrued prior to the receipt of assistance that were assigned to the state between July
1, 1997, and October 1, 2009, must no longer be assigned as of October 1, 2009.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2009.
new text end

Sec. 5.

Minnesota Statutes 2007 Supplement, section 256J.621, is amended to read:

256J.621 WORK PARTICIPATION deleted text begin BONUS deleted text end new text begin FOOD BENEFITS new text end .

(a) new text begin Effective March 1, 2010, new text end upon exiting the diversionary work program (DWP) or
upon terminating new text begin the Minnesota family investment program ( new text end MFIP new text begin ) new text end deleted text begin cash assistance deleted text end with
earnings, a participant who is employed may be eligible for deleted text begin transitional assistance deleted text end new text begin work
participation food benefits new text end of $75 per month to assist in meeting the family's basic needs
as the participant continues to move toward self-sufficiency.

(b) To be eligible for deleted text begin a transitional assistance payment deleted text end new text begin work participation food
benefits new text end , the participant shall not receive MFIP deleted text begin cash assistance deleted text end or diversionary work
program assistance during the month and the participant or participants must meet the
following work requirements:

(1) if the participant is a single caregiver and has a child under six years of age, the
participant must be employed at least 87 hours per month;

(2) if the participant is a single caregiver and does not have a child under six years of
age, the participant must be employed at least 130 hours per month; or

(3) if the household is a two-parent family, at least one of the parents must be
employed an average of at least 130 hours per month.

Whenever a participant exits the diversionary work program or is terminated from
MFIP deleted text begin cash assistance deleted text end and meets the other criteria in this section, deleted text begin transitional assistance is deleted text end
new text begin work participation food benefits are new text end available for up to 24 consecutive months.

(c) Expenditures on the program are maintenance of effort state funds for participants
under paragraph (b), clauses (1) and (2). Expenditures for participants under paragraph
(b), clause (3), are nonmaintenance of effort funds. Months in which a participant receives
deleted text begin transitional assistance deleted text end new text begin work participation food benefits new text end under this section do not count
toward the participant's MFIP 60-month time limit.

Sec. 6.

Minnesota Statutes 2006, section 518A.50, is amended to read:

518A.50 PAYMENT TO PUBLIC AGENCY.

(a) This section applies to all proceedings involving a support order, including, but
not limited to, a support order establishing an order for past support or reimbursement
of public assistance.

(b) The court shall direct that all payments ordered for maintenance or support
be made to the public authority responsible for child support enforcement so long as
the obligee is receiving or has applied for public assistance, or has applied for child
support or maintenance collection services. Public authorities responsible for child
support enforcement may act on behalf of other public authorities responsible for child
support enforcement, including the authority to represent the legal interests of or execute
documents on behalf of the other public authority in connection with the establishment,
enforcement, and collection of child support, maintenance, or medical support, and
collection on judgments.

(c) Payments made to the public authority deleted text begin other than payments under section
518A.53 deleted text end must be credited as of the date the payment is received by the central collections
unit deleted text begin . deleted text end new text begin , except that payments made under section 518A.53 may be considered to have been
paid as of the date the obligor received the remainder of the income.
new text end

(d) Monthly amounts received by the public agency responsible for child support
enforcement from the obligor that are greater than the monthly amount of public assistance
granted to the obligee must be remitted to the obligee.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2009.
new text end

Sec. 7.

Minnesota Statutes 2006, section 518A.53, subdivision 5, is amended to read:

Subd. 5.

Payor of funds responsibilities.

(a) An order for or notice of withholding
is binding on a payor of funds upon receipt. Withholding must begin no later than the first
pay period that occurs after 14 days following the date of receipt of the order for or notice
of withholding. In the case of a financial institution, preauthorized transfers must occur in
accordance with a court-ordered payment schedule.

(b) A payor of funds shall withhold from the income payable to the obligor the
amount specified in the order or notice of withholding and amounts specified under
subdivisions 6 and 9 and shall remit the amounts withheld to the public authority within
seven business days of the date the obligor is paid the remainder of the income. The payor
of funds shall include with the remittance the Social Security number of the obligor, the
case type indicator as provided by the public authority and the date the obligor is paid
the remainder of the income. deleted text begin The obligor is considered to have paid the amount withheld
as of the date the obligor received the remainder of the income. deleted text end A payor of funds may
combine all amounts withheld from one pay period into one payment to each public
authority, but shall separately identify each obligor making payment.

(c) A payor of funds shall not discharge, or refuse to hire, or otherwise discipline an
employee as a result of wage or salary withholding authorized by this section. A payor of
funds shall be liable to the obligee for any amounts required to be withheld. A payor of
funds that fails to withhold or transfer funds in accordance with this section is also liable
to the obligee for interest on the funds at the rate applicable to judgments under section
549.09, computed from the date the funds were required to be withheld or transferred.
A payor of funds is liable for reasonable attorney fees of the obligee or public authority
incurred in enforcing the liability under this paragraph. A payor of funds that has failed
to comply with the requirements of this section is subject to contempt sanctions under
section 518A.73. If the payor of funds is an employer or independent contractor and
violates this subdivision, a court may award the obligor twice the wages lost as a result
of this violation. If a court finds a payor of funds violated this subdivision, the court
shall impose a civil fine of not less than $500. The liabilities in this paragraph apply to
intentional noncompliance with this section.

(d) If a single employee is subject to multiple withholding orders or multiple notices
of withholding for the support of more than one child, the payor of funds shall comply
with all of the orders or notices to the extent that the total amount withheld from the
obligor's income does not exceed the limits imposed under the Consumer Credit Protection
Act, United States Code, title 15, section 1673(b), giving priority to amounts designated in
each order or notice as current support as follows:

(1) if the total of the amounts designated in the orders for or notices of withholding
as current support exceeds the amount available for income withholding, the payor of
funds shall allocate to each order or notice an amount for current support equal to the
amount designated in that order or notice as current support, divided by the total of the
amounts designated in the orders or notices as current support, multiplied by the amount
of the income available for income withholding; and

(2) if the total of the amounts designated in the orders for or notices of withholding
as current support does not exceed the amount available for income withholding, the
payor of funds shall pay the amounts designated as current support, and shall allocate to
each order or notice an amount for past due support, equal to the amount designated in
that order or notice as past due support, divided by the total of the amounts designated in
the orders or notices as past due support, multiplied by the amount of income remaining
available for income withholding after the payment of current support.

(e) When an order for or notice of withholding is in effect and the obligor's
employment is terminated, the obligor and the payor of funds shall notify the public
authority of the termination within ten days of the termination date. The termination
notice shall include the obligor's home address and the name and address of the obligor's
new payor of funds, if known.

(f) A payor of funds may deduct one dollar from the obligor's remaining salary for
each payment made pursuant to an order for or notice of withholding under this section to
cover the expenses of withholding.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2009.
new text end

Sec. 8.

Laws 2007, chapter 147, article 2, section 21, the effective date, is amended to
read:

EFFECTIVE DATE.

Subdivision 1 is effective February 1, 2008, and subdivision
2 is effective deleted text begin May 1, 2008 deleted text end new text begin March 1, 2009 new text end .

Sec. 9.

Laws 2007, chapter 147, article 19, section 3, subdivision 1, is amended to read:

Subdivision 1. Total Appropriation

$

5,294,627,000

$

5,695,458,000

Appropriations by Fund
	2008	2009
General	4,614,727,000	4,940,293,000
State Government Special Revenue	549,000	565,000
Health Care Access	426,628,000	492,759,000
Federal TANF	250,537,000	260,051,000
Lottery Prize Fund	2,185,000	1,790,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Receipts for Systems Projects.
Appropriations and federal receipts for
information system projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state system account authorized in
Minnesota Statutes, section 256.014. Money
appropriated for computer projects approved
by the Minnesota Office of Enterprise
Technology, funded by the legislature, and
approved by the commissioner of finance,
may be transferred from one project to
another and from development to operations
as the commissioner of human services
considers necessary. Any unexpended
balance in the appropriation for these
projects does not cancel but is available for
ongoing development and operations.

Pay for Performance. (a) Of the general
fund appropriation, $272,000 each year
is available to the commissioner of
human services only under the following
circumstances:

(1) $272,000 shall be made available by the
commissioner of finance on January 1, 2009,
only after notification by the commissioner
of human services to the commissioner of
finance and to the chairs of the relevant house
of representatives and senate finance and
policy committees that the average number
of days from the receipt of a MinnesotaCare
application at the state processing unit until
the initial eligibility determination of the
application was 30 days or less during the
period October 1, 2007, to September 30,
2008. Applications transferred from counties
to the state processing unit are excluded from
this calculation; and

(2) $272,000 shall be made available by the
commissioner of finance on January 1, 2009,
only after notification by the commissioner
of human services to the commissioner of
finance and to the chairs of the relevant
house of representatives and senate finance
and policy committees that the commissioner
initiated a separate treatment program for
persons in the Minnesota sex offenders
program who are between the ages of 18 and
25 by January 1, 2008.

(b) Regardless of whether these
appropriations are made available to
the commissioner of human services, they
shall be part of base level funding for the
biennium beginning July 1, 2009.

Purchasing Alliance Fund Transfer.
On September 1, 2007, any remaining
balance in the purchasing alliance stop-loss
fund account established under Minnesota
Statutes, section 256.956, shall transfer to
the general fund.

Nonfederal Share Transfers. The
nonfederal share of activities for which
federal administrative reimbursement is
appropriated to the commissioner may be
transferred to the special revenue fund.

TANF Maintenance of Effort. (a) In order
to meet the basic MOE requirements of the
TANF block grant specified under Code
of Federal Regulations, title 45, section
263.1, the commissioner may only report
nonfederal money expended for allowable
activities listed in the following clauses as
TANF/MOE expenditures:

(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;

(2) the child care assistance programs
under Minnesota Statutes, sections 119B.03
and 119B.05, and county child care
administrative costs under Minnesota
Statutes, section 119B.15;

(3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;

(4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;

(5) expenditures made on behalf of
noncitizen MFIP recipients who qualify
for the medical assistance without federal
financial participation program under
Minnesota Statutes, section 256B.06,
subdivision 4, paragraphs (d), (e), and (j);
and

(6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671.

(b) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
TANF/MOE requirements. For the activities
listed in paragraph (a), clauses (2) to
(6), the commissioner may only report
expenditures that are excluded from the
definition of assistance under Code of
Federal Regulations, title 45, section 260.31.

(c) The commissioner shall ensure that the
MOE used by the commissioner of finance
for the February and November forecasts
required under Minnesota Statutes, section
16A.103, contains expenditures under
paragraph (a), clause (1), equal to at least 16
percent of the total required under Code of
Federal Regulations, title 45, section 263.1.

(d) new text begin For the federal fiscal year beginning
October 1, 2007, the commissioner may not
claim an amount of TANF/MOE in excess of
the 75 percent standard in Code of Federal
Regulations, title 45, section 263.1(a)(2),
except:
new text end

new text begin (1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1),
if it is determined by the commissioner
that the state will not meet the TANF work
participation target rate for the current year;
new text end

new text begin (2) to provide any additional amounts under
Code of Federal Regulations, title 45, section
264.5, that relate to replacement of TANF
funds due to the operation of TANF penalties;
new text end

new text begin (3) to provide any additional amounts that
may contribute to avoiding or reducing
TANF work participation penalties through
the operation of the excess MOE provisions
of Code of Federal Regulations, title 45,
section 261.43(a)(2); and
new text end

new text begin (4) for the purposes of clauses (1) to (3),
the commissioner may supplement the
MOE claim with working family credit
expenditures to the extent such expenditures
or other qualified expenditures are otherwise
available after considering the expenditures
allowed in this section.
new text end

new text begin (e) If allowable by the federal Office of
Family Assistance, the commissioner may
claim excess MOE with respect to federal
fiscal years 2006 and 2007 to the extent
that working family credit expenditures are
otherwise available to supplement the state's
MOE claim for those years after considering
the expenditures allowed in this subdivision.
new text end

new text begin If other qualified expenditures are available,
the commissioner may use those expenditures
as excess MOE and by April 15, 2009,
shall report those expenditures to the chairs
of the senate and house of representatives
Finance Committees, the senate Health and
Human Services Budget Division, and house
of representatives Health Care and Human
Services Finance Division.
new text end

deleted text begin (d) deleted text end new text begin (f) new text end Minnesota Statutes, section 256.011,
subdivision 3, which requires that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, does not
apply if the grants or aids are federal TANF
funds.

deleted text begin (e) deleted text end new text begin (g) new text end Notwithstanding any contrary
provision in this article, this rider expires
June 30, 2011.

Working Family Credit Expenditures as
TANF/MOE. The commissioner may claim
as TANF/MOE up to $6,707,000 per year
for fiscal year 2008 through fiscal year 2011.
Notwithstanding any contrary provision in
this article, this rider expires June 30, 2011.

Additional Working Family Credit
Expenditures to be Claimed for
TANF/MOE. In addition to the amounts
provided in this section, the commissioner
may count the following amounts of working
family credit expenditure as TANF/MOE:

(1) fiscal year 2008, deleted text begin $11,097,000 deleted text end new text begin
$28,222,000 new text end ;

(2) fiscal year 2009, deleted text begin $25,401,000 deleted text end new text begin
$42,905,000 new text end ;

(3) fiscal year 2010, deleted text begin $20,398,000 deleted text end
new text begin $29,026,000 new text end ; and

(4) fiscal year 2011, deleted text begin $19,841,000 deleted text end
new text begin $28,361,000 new text end .

Notwithstanding any contrary provision in
this article, this rider expires June 30, 2011.

Capitation Rate Increase. Of the health care
access fund appropriations to the University
of Minnesota in the higher education
omnibus appropriation bill, $2,157,000 in
fiscal year 2008 and $2,157,000 in fiscal year
2009 are to be used to increase the capitation
payments under Minnesota Statutes, section
256B.69.

Sec. 10. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, sections 256.741, subdivision 15; and 256J.24, subdivision
6, new text end new text begin are repealed.
new text end

ARTICLE 4

HEALTH CARE

Section 1.

Minnesota Statutes 2006, section 256.969, subdivision 2b, is amended to
read:

Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner
shall obtain operating data from an updated base year and establish operating payment
rates per admission for each hospital based on the cost-finding methods and allowable
costs of the Medicare program in effect during the base year. Rates under the general
assistance medical care, medical assistance, and MinnesotaCare programs shall not be
rebased to more current data on January 1, 1997, deleted text begin and deleted text end January 1, 2005 new text begin , and for the first
year of the rebased period beginning January 1, 2009 new text end . The base year operating payment
rate per admission is standardized by the case mix index and adjusted by the hospital
cost index, relative values, and disproportionate population adjustment. The cost and
charge data used to establish operating rates shall only reflect inpatient services covered
by medical assistance and shall not include property cost information and costs recognized
in outlier payments.

Sec. 2.

Minnesota Statutes 2006, section 256.969, subdivision 20, is amended to read:

Subd. 20.

Increases in medical assistance inpatient payments; conditions.

(a)
Medical assistance inpatient payments shall increase 20 percent for inpatient hospital
originally paid admissions, excluding Medicare crossovers, that occurred between July 1,
1988 and December 31, 1990, if: (i) the hospital had 100 or fewer Minnesota medical
assistance annualized paid admissions, excluding Medicare crossovers, that were paid by
March 1, 1988, for the period January 1, 1987 to June 30, 1987; (ii) the hospital had 100
or fewer licensed beds on March 1, 1988; (iii) the hospital is located in Minnesota; and
(iv) the hospital is not located in a city of the first class as defined in section 410.01.
For purposes of this paragraph, medical assistance does not include general assistance
medical care.

(b) Medical assistance inpatient payments shall increase 15 percent for inpatient
hospital originally paid admissions, excluding Medicare crossovers, that occurred between
July 1, 1988 and December 31, 1990, if: (i) the hospital had more than 100 but fewer
than 250 Minnesota medical assistance annualized paid admissions, excluding Medicare
crossovers, that were paid by March 1, 1988, for the period January 1, 1987 to June 30,
1987; (ii) the hospital had 100 or fewer licensed beds on March 1, 1988; (iii) the hospital
is located in Minnesota; and (iv) the hospital is not located in a city of the first class as
defined in section 410.01. For purposes of this paragraph, medical assistance does not
include general assistance medical care.

(c) Medical assistance inpatient payment rates shall increase 20 percent for inpatient
hospital originally paid admissions, excluding Medicare crossovers, that occur on or
after October 1, 1992, if: (i) the hospital had 100 or fewer Minnesota medical assistance
annualized paid admissions, excluding Medicare crossovers, that were paid by March
1, 1988, for the period January 1, 1987 to June 30, 1987; (ii) the hospital had 100 or
fewer licensed beds on March 1, 1988; (iii) the hospital is located in Minnesota; and (iv)
the hospital is not located in a city of the first class as defined in section 410.01. For a
hospital that qualifies for an adjustment under this paragraph and under subdivision 9 or
23, the hospital must be paid the adjustment under subdivisions 9 and 23, as applicable,
plus any amount by which the adjustment under this paragraph exceeds the adjustment
under those subdivisions. For this paragraph, medical assistance does not include general
assistance medical care.

(d) Medical assistance inpatient payment rates shall increase 15 percent for inpatient
hospital originally paid admissions, excluding Medicare crossovers, that occur after
September 30, 1992, if: (i) the hospital had more than 100 but fewer than 250 Minnesota
medical assistance annualized paid admissions, excluding Medicare crossovers, that
were paid by March 1, 1988, for the period January 1, 1987 to June 30, 1987; (ii) the
hospital had 100 or fewer licensed beds on March 1, 1988; (iii) the hospital is located in
Minnesota; and (iv) the hospital is not located in a city of the first class as defined in
section 410.01. For a hospital that qualifies for an adjustment under this paragraph and
under subdivision 9 or 23, the hospital must be paid the adjustment under subdivisions
9 and 23, as applicable, plus any amount by which the adjustment under this paragraph
exceeds the adjustment under those subdivisions. For purposes of this paragraph, medical
assistance does not include general assistance medical care.

new text begin (e) For admissions occurring on or after July 1, 2008, fee-for-service inpatient
payments must increase eight percent for a hospital with a medical assistance inpatient
utilization rate of 17.95 percent of total patient days as of the base year in effect on July 1,
2005, and nine percent for a hospital with a medical assistance inpatient utilization rate of
59.60 percent of total patient days as of the base year in effect on July 1, 2005. Payments
made to managed care plans must not be increased to reflect this increase. For purposes of
this paragraph, medical assistance does not include general assistance medical care.
new text end

Sec. 3.

Minnesota Statutes 2006, section 256B.0571, subdivision 8, is amended to read:

Subd. 8.

Program established.

(a) The commissioner, in cooperation with the
commissioner of commerce, shall establish the Minnesota partnership for long-term care
program to provide for the financing of long-term care through a combination of private
insurance and medical assistance.

(b) An individual who meets the requirements in this paragraph is eligible to
participate in the partnership program. The individual must:

(1) be a Minnesota resident at the time coverage first became effective under the
partnership policy; new text begin and
new text end

(2) be a beneficiary of a partnership policy that (i) is issued on or after the effective
date of the state plan amendment implementing the partnership program in Minnesota, or
(ii) qualifies as a partnership policy under the provisions of subdivision 8a deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (3) have exhausted all of the benefits under the partnership policy as described in this
section. Benefits received under a long-term care insurance policy before July 1, 2006, do
not count toward the exhaustion of benefits required in this subdivision.
deleted text end

Sec. 4.

Minnesota Statutes 2006, section 256B.0571, subdivision 9, is amended to read:

Subd. 9.

Medical assistance eligibility.

(a) Upon application for medical assistance
program payment of long-term care services by an individual who meets the requirements
described in subdivision 8, the commissioner shall determine the individual's eligibility
for medical assistance according to paragraphs (b) to (i).

(b) After determining assets subject to the asset limit under section 256B.056,
subdivision 3 or 3c, or 256B.057, subdivision 9 or 10, the commissioner shall allow the
individual to designate assets to be protected from recovery under subdivisions 13 and
15 up to the dollar amount of the benefits utilized under the partnership policy new text begin as of the
effective date of eligibility for medical assistance program payment of long-term care
services. Benefits utilized under a long-term care insurance policy before July 1, 2006,
do not count for the purpose of determining the amount of assets that can be designated new text end .
Designated assets shall be disregarded for purposes of determining eligibility for payment
of long-term care services. new text begin The dollar amount of benefits utilized must be equal to the
amount of claims paid by the issuer under the policy as verified by the issuer.
new text end

(c) The individual shall identify the designated assets and the full fair market value
of those assets and designate them as assets to be protected at the time of deleted text begin initial deleted text end application
for medical assistance new text begin payment of long-term care services new text end . The full fair market value of
real property or interests in real property shall be based on the most recent full assessed
value for property tax purposes for the real property, unless the individual provides a
complete professional appraisal by a licensed appraiser to establish the full fair market
value. The extent of a life estate in real property shall be determined using the life estate
table in the health care program's manual. Ownership of any asset in joint tenancy shall be
treated as ownership as tenants in common for purposes of its designation as a disregarded
asset. The unprotected value of any protected asset is subject to estate recovery according
to subdivisions 13 and 15.

(d) The right to designate assets to be protected is personal to the individual and
ends when the individual dies, except as otherwise provided in subdivisions 13 and
15. It does not include the increase in the value of the protected asset and the income,
dividends, or profits from the asset. It may be exercised by the individual or by anyone
with the legal authority to do so on the individual's behalf. It shall not be sold, assigned,
transferred, or given away.

(e) deleted text begin If the dollar amount of the benefits utilized under a partnership policy is greater
than the full fair market value of all assets protected at the time of the application for
medical assistance long-term care services, deleted text end new text begin As the individual continues to utilize benefits
under a partnership policy after eligibility for medical assistance payment of long-term
care services begins, new text end the individual may designate new text begin , for additional protection, an increase
in the value of protected assets and new text end additional assets that become available during the
individual's lifetime deleted text begin for protection under this section deleted text end new text begin up to the amount of additional
benefits utilized new text end . The individual must make the designation in writing to the county agency
no later than the last date on which the individual must report a change in circumstances to
the county agency, as provided for under the medical assistance program. deleted text begin Any excess used
for this purpose shall not be available to the individual's estate to protect assets in the estate
from recovery under section 256B.15 or 524.3-1202, or otherwise. deleted text end new text begin The amount used for
this purpose must reduce the unused amount of asset protection available to protect assets
in the individual's estate from recovery under section 256B.15 or 524.3-1202, or otherwise.
new text end

(f) This section applies only to estate recovery under United States Code, title 42,
section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other
provisions of federal law, including, but not limited to, recovery from trusts under United
States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from
annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of
the Deficit Reduction Act of 2005, Public Law 109-171.

(g) An individual's protected assets owned by the individual's spouse who applies
for payment of medical assistance long-term care services shall not be protected assets or
disregarded for purposes of eligibility of the individual's spouse solely because they were
protected assets of the individual.

(h) Assets designated under this subdivision shall not be subject to penalty under
section 256B.0595.

(i) The commissioner shall otherwise determine the individual's eligibility
for payment of long-term care services according to medical assistance eligibility
requirements.

Sec. 5.

Minnesota Statutes 2007 Supplement, section 256B.0631, subdivision 1,
is amended to read:

Subdivision 1.

Co-payments.

(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following co-payments for all recipients, effective
for services provided on or after October 1, 2003, and before January 1, 2009:

(1) $3 per nonpreventive visit. For purposes of this subdivision, a visit means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist;

(2) $3 for eyeglasses;

(3) $6 for nonemergency visits to a hospital-based emergency room; and

(4) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness.

(b) Except as provided in subdivision 2, the medical assistance benefit plan shall
include the following co-payments for all recipients, effective for services provided on
or after January 1, 2009:

(1) $6 for nonemergency visits to a hospital-based emergency room; deleted text begin and
deleted text end

(2) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $7 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness deleted text begin . deleted text end new text begin ; and
new text end

new text begin (3) for individuals identified by the commissioner with income at or below 100
percent of the federal poverty guidelines, total monthly co-payments must not exceed five
percent of family income. For purposes of this paragraph, family income is the total
earned and unearned income of the individual and the individual's spouse, if the spouse is
enrolled in medical assistance and also subject to the five percent limit on co-payments.
new text end

(c) Recipients of medical assistance are responsible for all co-payments in this
subdivision.

Sec. 6.

Minnesota Statutes 2007 Supplement, section 256B.0631, subdivision 3,
is amended to read:

Subd. 3.

Collection.

(a) The medical assistance reimbursement to the provider shall
be reduced by the amount of the co-payment, except that deleted text begin reimbursement for prescription
drugs deleted text end new text begin reimbursements new text end shall not be reduced new text begin :
new text end

new text begin (1) new text end once a recipient has reached the $12 per month maximum or the $7 per month
maximum effective January 1, 2009, for prescription drug co-payments new text begin ; or
new text end

new text begin (2) for a recipient identified by the commissioner under 100 percent of the federal
poverty guidelines who has met their monthly five percent co-payment limit new text end .

(b) The provider collects the co-payment from the recipient. Providers may not deny
services to recipients who are unable to pay the co-payment.

(c) Medical assistance reimbursement to fee-for-service providers and payments to
managed care plans shall not be increased as a result of the removal of the co-payments
effective January 1, 2009.

Sec. 7.

new text begin [256B.194] FEDERAL PAYMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Payments at actual cost. new text end

new text begin Notwithstanding any other statute or rule
to the contrary, for providers that are units of government, the commissioner may limit
medical assistance and MinnesotaCare payments to a provider's actual cost of providing
services, according to the Centers for Medicare and Medicaid Services (CAMS) final rule
referenced in this subdivision. The commissioner may also require medical assistance
and MinnesotaCare providers to provide any information necessary to determine
Medicaid-related costs, and require the cooperation of providers in any audit or review
necessary to ensure payments are limited to cost. This section does not apply to providers
who are exempt from the provisions of the CAMS final rule. This subdivision becomes
effective when the CAMS final rule, published May 29, 2007, at Federal Register, Vow.
72, No. 100, governing payments to providers that are units of government goes into
effect at the end of the moratorium imposed by Congress.
new text end

new text begin Subd. 2. new text end

new text begin Loss of federal financial participation. new text end

new text begin For all transfers, certified
expenditures, and medical assistance payments listed in this subdivision, if the
commissioner determines that federal financial participation is no longer available for the
medical assistance payments listed, then related obligations for the nonfederal share of
payments and the medical assistance payments must terminate. The commissioner shall
notify all affected parties of the loss of federal financial participation, and the resulting
payments and obligations that are terminated. If the commissioner determines that federal
financial participation is no longer available for any medical assistance payments or
contributions to the nonfederal share of medical assistance payments that have already
been made, the commissioner may collect the medical assistance payments from providers
and return contributions of the nonfederal share to its source. The transfers, certified
expenditures, and medical assistance payments subject to this section are those specified in
section 62J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d;
256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses
(2) to (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws 2005,
First Special Session chapter 4, article 9, section 2, subdivision 1.
new text end

Sec. 8.

Minnesota Statutes 2007 Supplement, section 256B.199, is amended to read:

256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.

(a) Effective July 1, 2007, the commissioner shall apply for federal matching funds
for the expenditures in paragraphs (b) and (c).

(b) The commissioner shall apply for federal matching funds for certified public
expenditures as follows:

(1) Hennepin County deleted text begin , deleted text end new text begin and new text end Hennepin County Medical Center deleted text begin , Ramsey County,
Regions Hospital, the University of Minnesota, and Fairview-University Medical Center deleted text end
shall report quarterly to the commissioner beginning June 1, 2007, payments made during
the second previous quarter that may qualify for reimbursement under federal law;

(2) based on these reports, the commissioner shall apply for federal matching funds.
These funds are appropriated to the commissioner deleted text begin for the payments under section 256.969,
subdivision 27 deleted text end new text begin to offset medical assistance expenditures new text end ; and

(3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
the nonstate entities listed in new text begin this new text end paragraph deleted text begin (a) deleted text end of the amount of federal disproportionate
share hospital payment money expected to be available in the current federal fiscal year.

(c) The commissioner shall apply for federal matching funds for general assistance
medical care expenditures as follows:

(1) for hospital services occurring on or after July 1, 2007, general assistance medical
care expenditures for fee-for-service inpatient and outpatient hospital payments made by
the department shall be used to apply for federal matching funds, except as limited below:

(i) only those general assistance medical care expenditures made to an individual
hospital that would not cause the hospital to exceed its individual hospital limits under
section 1923 of the Social Security Act may be considered; and

(ii) general assistance medical care expenditures may be considered only to the extent
of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and

(2) all hospitals must provide any necessary expenditure, cost, and revenue
information required by the commissioner as necessary for purposes of obtaining federal
Medicaid matching funds for general assistance medical care expenditures.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from July 1, 2007.
new text end

Sec. 9.

Minnesota Statutes 2006, section 256B.69, subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section
and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
basis beginning January 1, 1996. Managed care contracts which were in effect on June
30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
commissioner may issue separate contracts with requirements specific to services to
medical assistance recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
of its contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B, 256D, and 256L, established after the effective date of a contract
with the commissioner take effect when the contract is next issued or renewed.

(c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance
target based on a federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. The withheld funds
must be returned no sooner than July of the following year if performance targets in the
contract are achieved. The commissioner may exclude special demonstration projects
under subdivision 23. A managed care plan or a county-based purchasing plan under
section 256B.692 may include as admitted assets under section 62D.044 any amount
withheld under this paragraph that is reasonably expected to be returned.

new text begin (d)(1) Effective for services rendered on or after January 1, 2009, the commissioner
shall withhold two percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs. The withheld
funds must be returned no sooner than July 1 and no later than July 31 of the following
year. The commissioner may exclude special demonstration projects under subdivision 23.
new text end

new text begin (2) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under
this paragraph. The return of the withhold under this paragraph is not subject to the
requirements of paragraph (c).
new text end

Sec. 10.

Minnesota Statutes 2006, section 256L.12, subdivision 9, is amended to read:

Subd. 9.

Rate setting; performance withholds.

(a) Rates will be prospective,
per capita, where possible. The commissioner may allow health plans to arrange for
inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
an independent actuary to determine appropriate rates.

(b) For services rendered on or after January 1, 2003, to December 31, 2003, the
commissioner shall withhold .5 percent of managed care plan payments under this section
pending completion of performance targets. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year if performance targets
in the contract are achieved. A managed care plan may include as admitted assets under
section 62D.044 any amount withheld under this paragraph that is reasonably expected
to be returned.

(c) For services rendered on or after January 1, 2004, the commissioner shall
withhold five percent of managed care plan payments under this section pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance
target based on a federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. The withheld
funds must be returned no sooner than July 1 and no later than July 31 of the following
calendar year if performance targets in the contract are achieved. A managed care plan or
a county-based purchasing plan under section 256B.692 may include as admitted assets
under section 62D.044 any amount withheld under this paragraph that is reasonably
expected to be returned.

new text begin (d) For services rendered on or after January 1, 2009, the commissioner shall
withhold two percent of managed care plan payments under this section. The withheld
funds must be returned no sooner than July 1 and no later than July 31 of the following
calendar year. A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this paragraph.
new text end

Sec. 11. new text begin FEDERAL APPROVAL FOR INCREASED DISPROPORTIONATE
SHARE HOSPITAL PAYMENTS.
new text end

new text begin By January 1, 2009, the commissioner of human services, in cooperation with
hospitals with high rates of utilization by medical assistance enrollees, shall develop
and submit for federal approval a proposal to increase disproportionate share hospital
payments to Minnesota hospitals. In developing the proposal, the commissioner shall
consider, but is not required to adopt, disproportionate share hospital payment proposals
from other states that have received federal approval.
new text end

Sec. 12. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2007 Supplement, section 256.969, subdivision 27, new text end new text begin is repealed
retroactively from July 1, 2007.
new text end

ARTICLE 5

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATION. new text end

new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown
in parentheses, subtracted from the appropriations in Laws 2007, chapter 147, or other
law to the agencies and for the purposes specified in this article. The appropriations
are from the general fund, or another named fund, and are available for the fiscal years
indicated for each purpose. The figures "2008" and "2009" used in this article mean
that the addition or subtraction from appropriations listed under them are available for
the fiscal year ending June 30, 2008, or June 30, 2009, respectively. "The first year" is
fiscal year 2008. "The second year" is fiscal year 2009. "The biennium" is fiscal years
2008 and 2009. Supplemental appropriations and reductions for the fiscal year ending
June 30, 2008, are effective the day following final enactment.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2008 new text end		new text begin 2009 new text end

Sec. 2. new text begin HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin (34,855,000) new text end

new text begin $ new text end

new text begin (56,265,000) new text end

new text begin Appropriations by Fund new text end
	new text begin 2008 new text end	new text begin 2009 new text end
new text begin General new text end	new text begin (51,980,000) new text end	new text begin (80,296,000) new text end
new text begin Health Care Access new text end	new text begin 0 new text end	new text begin (3,292,000) new text end
new text begin Federal TANF new text end	new text begin 17,125,000 new text end	new text begin 27,323,000 new text end

new text begin Subd. 2. new text end new text begin Agency Management new text end

new text begin Financial Operations new text end

new text begin 0 new text end

new text begin (5,867,000) new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin Base Adjustment. new text end new text begin The general fund base
is increased $23,000 in fiscal year 2010 and
$26,000 in fiscal year 2011.
new text end

new text begin Subd. 3. new text end new text begin Revenue and Pass-Through Revenue Expenditures new text end

new text begin Federal TANF new text end

new text begin 25,000,000 new text end

new text begin 27,039,000 new text end

new text begin Additional TANF Transfer to Social
Services Block Grant. In addition to
transfers allowed under prior law, $5,754,000
in fiscal year 2009 is appropriated to the
commissioner for the purposes of providing
services for families with children whose
incomes are at or below 200 percent
of the federal poverty guidelines. The
commissioner shall authorize a sufficient
transfer of funds from the state's federal
social services block grant to meet this
appropriation. The funds must be distributed
to counties for the children and community
services grant according to the formula for
state appropriations in Minnesota Statutes,
chapter 256M.
new text end

new text begin Subd. 4. new text end new text begin Children and Economic Assistance Grants new text end

new text begin The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end

new text begin (a) new text end new text begin MFIP/DWP Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin (17,125,000) new text end	new text begin (25,947,000) new text end
new text begin Federal TANF new text end	new text begin 17,125,000 new text end	new text begin 27,311,000 new text end

new text begin (b) new text end new text begin MFIP Child Care Assistance Grants new text end

new text begin 0 new text end

new text begin 0 new text end

new text begin (c) new text end new text begin Children's Services Grants new text end

new text begin (311,000) new text end

new text begin (1,663,000) new text end

new text begin Base Adjustment. The general fund base
is increased $1,726,000 in fiscal year 2010
and $1,742,000 in fiscal year 2011 due to
the onetime increase in adoption assistance
grants and the onetime decreases in relative
custody assistance grants, and county shift
for children's mental health grants.
new text end

new text begin Funding Usage. Up to 75 percent of the
fiscal year 2010 appropriation for children's
mental health screening grants may be used
to fund calendar year 2009 allocations for
these programs, with the resulting calendar
year funding pattern continuing into the
future.
new text end

new text begin Subd. 4a. new text end new text begin Children and Economic Assistance Management new text end

new text begin General new text end

new text begin 0 new text end

new text begin 12,000 new text end

new text begin Children and Economic Assistance Operations new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 0 new text end	new text begin 12,000 new text end

new text begin new text begin MAXIS costs. new text end $12,000 is appropriated in
fiscal year 2009 for MAXIS systems costs.
This appropriation is onetime only.
new text end

new text begin Subd. 5. new text end new text begin Basic Health Care Grants new text end

new text begin The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end

new text begin (a) new text end new text begin MinnesotaCare Grants new text end

new text begin Health Care Access new text end

new text begin 0 new text end

new text begin (3,292,000) new text end

new text begin Incentive Program and Outreach Grants.
Of the appropriation for the Minnesota health
care outreach program in Laws 2007, chapter
147, article 19, section 3, subdivision 7,
paragraph (b):
new text end

new text begin (1) $400,000 in fiscal year 2009 from the
general fund and $200,000 in fiscal year 2009
from the health care access fund are for the
incentive program under Minnesota Statutes,
section 256.962, subdivision 5. For the
biennium beginning July 1, 2009, base level
funding for this activity shall be $360,000
from the general fund and $160,000 from the
health care access fund; and
new text end

new text begin (2) $100,000 in fiscal year 2009 from the
general fund and $50,000 in fiscal year 2009
from the health care access fund are for the
outreach grants under Minnesota Statutes,
section 256.962, subdivision 2. For the
biennium beginning July 1, 2009, base level
funding for this activity shall be $90,000
from the general fund and $40,000 from the
health care access fund.
new text end

new text begin (b) new text end new text begin MA Basic Health Care Grants - Families and Children new text end

new text begin (17,985,000) new text end

new text begin (24,848,000) new text end

new text begin Hospital Payment Delay. Notwithstanding
Laws 2005, First Special Session chapter 4,
article 9, section 2, subdivision 6, payments
from the Medicaid Management Information
System that would otherwise have been made
for inpatient hospital services for medical
assistance enrollees are delayed as follows:
(1) for fiscal year 2008, the last payments for
the month of June must be included in the
first payments in fiscal year 2009; and (2)
for fiscal year 2009, the last payments in the
month of June must be included in the first
payment of fiscal year 2010. The provisions
of Minnesota Statutes, section 16A.124, shall
not apply to these delayed payments.
new text end

new text begin (c) new text end new text begin MA Basic Health Care Grants - Elderly and Disabled new text end

new text begin (14,028,000) new text end

new text begin (2,254,000) new text end

new text begin Minnesota Disability Health Options Rate
Setting Methodology. The commissioner
shall develop and implement a methodology
for risk adjusting payments for community
alternatives for disabled individuals (CADI)
and traumatic brain injury (TBI) home
and community-based waiver services
delivered under the Minnesota disability
health options program (MnDHO) effective
January 1, 2009. The commissioner shall
take into account the weighting system used
to determine county waiver allocations in
developing the new payment methodology.
Growth in the number of enrollees receiving
CADI or TBI waiver payments through
MnDHO is limited to an increase of 200
enrollees in each calendar year from January
2009 through December 2011. If those limits
are reached, additional members may be
enrolled in MnDHO for basic care services
only as defined under Minnesota Statutes,
section 256B.69, subdivision 28, and the
commissioner may establish a waiting list for
future access of MnDHO members to those
waiver services.
new text end

new text begin new text begin Critical Access Dental Reimbursement. new text end
Effective for fiscal years beginning on or after
July 1, 2009, funding for medical assistance
critical access dental reimbursement rates
must be paid from the health care access
fund.
new text end

new text begin (d) new text end new text begin General Assistance Medical Care Grants new text end

new text begin 0 new text end

new text begin (3,729,000) new text end

new text begin MinnesotaCare Outreach Grants Special
Revenue Account. The balance in the
MinnesotaCare outreach grants special
revenue account at the close of fiscal year
2008 must be transferred to the general fund.
new text end

new text begin Subd. 6. new text end new text begin Health Care Management new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin Health Care Administration new text end

new text begin 0 new text end

new text begin 100,000 new text end

new text begin Subd. 7. new text end new text begin Continuing Care Grants new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin (a) new text end new text begin MA Long-Term Care Facilities Grants new text end

new text begin (2,306,000) new text end

new text begin (2,291,000) new text end

new text begin (b) new text end new text begin MA Long-Term Care Waivers and Home Care Grants new text end

new text begin 0 new text end

new text begin (5,397,000) new text end

new text begin Manage Growth in TBI and CADI Waiver.
During the fiscal years beginning on July
1, 2008, July 1, 2009, and July 1, 2010,
the commissioner shall allocate money
for home and community-based programs
covered under Minnesota Statutes, section
256B.49, to ensure a reduction in state
spending that is equivalent to limiting the
caseload growth of the traumatic brain injury
(TBI) waiver to 200 allocations in each
year of the biennium and the community
alternatives for disabled individuals (CADI)
waiver to 1,500 allocations each year of the
biennium. Priorities for the allocation of
funds must be for individuals anticipated to
be discharged from institutional settings or
who are at imminent risk of a placement in
an institutional setting. Notwithstanding any
contrary section in this article, this provision
expires June 30, 2011.
new text end

new text begin (c) new text end new text begin Mental Health Grants new text end

new text begin 0 new text end

new text begin (4,555,000) new text end

new text begin Base Adjustment. The general fund base
is increased $5,270,000 in fiscal year 2010
and $5,450,000 in fiscal year 2011 due to the
county payment shift for adult mental health
grants.
new text end

new text begin Targeted Case Management Work Group.
$15,000 is appropriated from the general
fund for fiscal year 2009 to the commissioner
of human services for administrative costs
directly related to the operation of the
targeted case management work group.
new text end

new text begin (d) new text end new text begin Chemical Dependency Entitlement Grants new text end

new text begin 0 new text end

new text begin (1,503,000) new text end

new text begin Payments for Substance Abuse Treatment.
For services provided in fiscal year 2009,
county-negotiated rates and provider claims
to the consolidated chemical dependency
fund must not exceed rates charged for
services in excess of those in effect on
May 31, 2008. If statutes authorize a
cost-of-living adjustment during fiscal year
2009, then notwithstanding any law to the
contrary, fiscal year 2009 rates may not
exceed those in effect on May 31, 2008, plus
any authorized cost-of-living adjustments.
new text end

new text begin Chemical Dependency Treatment Fund
Special Revenue Account. The lesser of
the balance of the consolidated chemical
dependency treatment fund at the close
of fiscal year 2008 or $2,650,000 must be
transferred and deposited into the general
fund.
new text end

new text begin (e) new text end new text begin Chemical Dependency Nonentitlement Grants new text end

new text begin 0 new text end

new text begin 2,150,000 new text end

new text begin Base Level Adjustment. The general
fund base for chemical dependency
nonentitlement treatment grants shall be
increased by $150,000 for fiscal years
2010 and 2011 for increased grants for
methamphetamine treatment.
new text end

new text begin American Indian Youth Program. Of the
general fund appropriation, $2,000,000 in
fiscal year 2009 is for grants to be awarded
competitively to American Indian tribes to
purchase or develop one or more culturally
specific treatment programs designed to
serve youth from native cultures. This
appropriation is onetime and available until
spent.
new text end

new text begin (f) new text end new text begin Other Continuing Care Grants new text end

new text begin 0 new text end

new text begin (4,381,000) new text end

new text begin Base Level Adjustment. The general fund
base is increased $7,633,000 in fiscal year
2010 and $5,332,000 in fiscal year 2011, due
to the onetime reduction of HIV grants in
fiscal year 2009, an increase each year for
housing grants under Minnesota Statutes,
section 256B.0658, and the adjustment
for the county grant payment shift for
developmental disability semi-independent
services grants and developmental disability
family support grants.
new text end

new text begin Housing Access Grants. Of the general
fund appropriation, $250,000 is appropriated
in fiscal year 2009 for housing access
grants under Minnesota Statutes, section
256B.0658.
new text end

new text begin Funding Usage. Up to 75 percent of
the fiscal year 2010 appropriation for
developmental disability semi-independent
living services grants and developmental
disability family support grants may be used
to fund calendar year 2009 allocations for
these programs, with the resulting calendar
year funding pattern continuing into the
future.
new text end

new text begin Subd. 8. new text end new text begin State-Operated Services new text end

new text begin County Past Due Receivables. new text end new text begin The
commissioner is authorized to withhold
county federal administrative reimbursement
when the county of financial responsibility
for cost-of-care payments due to the state
under Minnesota Statutes, section 246.54
or 253B.045, is 180 days past due. The
commissioner shall deposit the federal
administrative withholding into the general
fund to settle the claims with the county of
financial responsibility.
new text end

new text begin Mental Health Services new text end

new text begin (225,000) new text end

new text begin (300,000) new text end

Sec. 3. new text begin Health Department new text end

new text begin new text begin Federally Qualified Health Centers. new text end
Effective for fiscal years beginning on
or after July 1, 2009, the general fund
appropriation of $1,500,000 each fiscal year
for federally qualified health centers under
Minnesota Statutes, section 145.9269, is
eliminated and is replaced by a $1,500,000
appropriation each fiscal year from the health
care access fund.
new text end

new text begin new text begin MERC Federal Compliance. new text end Effective
for fiscal years beginning on or after July
1, 2009, the general fund appropriation of
$2,000,000 each fiscal year to the Mayo
Clinic for the purpose of providing transition
funding while federal compliance changes
are made to the medical education and
research cost funding distribution formula is
eliminated and is replaced by a $2,000,000
appropriation each fiscal year from the health
care access fund.
new text end

ARTICLE 6

HEALTH AND HUMAN SERVICES FORECAST CHANGES

Section 1. new text begin SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT. new text end

new text begin The dollar amounts shown are added to or, if shown in parentheses, are subtracted
from the appropriations in Laws 2007, chapter 147, from the general fund, or any other
fund named, to the Department of Human Services for the purposes specified in this
article, to be available for the fiscal year indicated for each purpose. The figure "2008"
used in this article means that the appropriation or appropriations listed are available for
the fiscal year ending June 30, 2008. The figure "2009" used in this article means that the
appropriation or appropriations listed are available for the fiscal year ending June 30, 2009.
new text end

				new text begin 2008 new text end		new text begin 2009 new text end
new text begin General new text end			new text begin $ new text end	new text begin 6,739,000 new text end	new text begin $ new text end	new text begin 52,350,000 new text end
new text begin Health Care Access new text end				new text begin (84,156,000) new text end		new text begin (96,019,000) new text end
new text begin TANF new text end				new text begin (28,427,000) new text end		new text begin (7,441,000) new text end
new text begin Total new text end			new text begin $ new text end	new text begin (105,844,000) new text end	new text begin $ new text end	new text begin (51,110,000) new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin (105,844,000) new text end

new text begin $ new text end

new text begin (51,110,000) new text end

new text begin Appropriations by Fund new text end
	new text begin 2008 new text end	new text begin 2009 new text end
new text begin General new text end	new text begin 6,739,000 new text end	new text begin 52,350,000 new text end
new text begin Health Care Access new text end	new text begin (84,156,000) new text end	new text begin (96,019,000) new text end
new text begin TANF new text end	new text begin (28,427,000) new text end	new text begin (7,441,000) new text end

new text begin Subd. 2. new text end new text begin Revenue and Pass-Through new text end

new text begin TANF new text end

new text begin 1,187,000 new text end

new text begin 1,507,000 new text end

new text begin Subd. 3. new text end new text begin Children and Economic Assistance Grants new text end

new text begin General new text end	new text begin (4,960,000) new text end	new text begin 5,925,000 new text end
new text begin TANF new text end	new text begin (29,614,000) new text end	new text begin (8,948,000) new text end

new text begin The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end

new text begin (a) new text end new text begin MFIP/DWP Grants new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 25,139,000 new text end	new text begin 11,665,000 new text end
new text begin TANF new text end	new text begin (29,614,000) new text end	new text begin (8,948,000) new text end

new text begin (b) new text end new text begin MFIP Child Care Assistance Grants new text end

new text begin (26,141,000) new text end

new text begin (10,710,000) new text end

new text begin (c) new text end new text begin General Assistance Grants new text end

new text begin 2,529,000 new text end

new text begin 6,033,000 new text end

new text begin (d) new text end new text begin Minnesota Supplemental Aid Grants new text end

new text begin 299,000 new text end

new text begin 500,000 new text end

new text begin (e) new text end new text begin Group Residential Housing Grants new text end

new text begin (6,786,000) new text end

new text begin (1,563,000) new text end

new text begin Subd. 4. new text end new text begin Basic Health Care Grants new text end

new text begin General new text end	new text begin 30,075,000 new text end	new text begin 48,389,000 new text end
new text begin Health Care Access new text end	new text begin (84,156,000) new text end	new text begin (96,019,000) new text end

new text begin The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end

new text begin (a) new text end new text begin MinnesotaCare new text end

new text begin Health Care Access new text end

new text begin (84,156,000) new text end

new text begin (96,019,000) new text end

new text begin (b) new text end new text begin MA Basic Health Care - Families and Children new text end

new text begin 13,525,000 new text end

new text begin 7,005,000 new text end

new text begin (c) new text end new text begin MA Basic Health Care - Elderly and Disabled new text end

new text begin (2,292,000) new text end

new text begin 5,479,000 new text end

new text begin (d) new text end new text begin General Assistance Medical Care new text end

new text begin 18,842,000 new text end

new text begin 35,905,000 new text end

new text begin Subd. 5. new text end new text begin Continuing Care Grants new text end

new text begin (18,376,000) new text end

new text begin (1,964,000) new text end

new text begin The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end

new text begin (a) new text end new text begin MA Long-Term Care Facilities new text end

new text begin (10,986,000) new text end

new text begin (2,148,000) new text end

new text begin (b) new text end new text begin MA Long-Term Care Waivers new text end

new text begin (18,484,000) new text end

new text begin (13,598,000) new text end

new text begin (c) new text end new text begin Chemical Dependency Entitlement Grants new text end

new text begin 11,094,000 new text end

new text begin 13,782,000 new text end

ARTICLE 7

APPROPRIATIONS AND TRANSFERS

Section 1. new text begin DUPLICATE APPROPRIATIONS.
new text end

new text begin Unless another act explicitly provides otherwise, appropriations and transfers made
in this act and other acts must be implemented only once, even if the provision or a similar
provision with the same fiscal effect in the same fiscal year is included in another act. This
section applies to laws enacted in the 2008 regular session.
new text end