Skip to main content Skip to office menu Skip to footer
Capital IconMinnesota Legislature

SF 2093

3rd Engrossment - 87th Legislature (2011 - 2012) Posted on 04/26/2012 04:19pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 3rd Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34
2.1 2.2
2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 3.1 3.2 3.3 3.4
3.5
3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 3.34 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 4.36 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 5.36 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15
6.16
6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 6.34 6.35 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30
7.31
7.32 7.33 7.34 7.35 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25
8.26 8.27
8.28 8.29 8.30 8.31 8.32 8.33 8.34 8.35 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20
9.21
9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 10.35 11.1 11.2
11.3
11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 11.34 11.35 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 12.34 12.35 12.36 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 13.34 13.35 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 14.34 14.35 14.36 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28
15.29 15.30 15.31 15.32 15.33 15.34 15.35 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 16.35 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22
18.23 18.24 18.25
18.26 18.27 18.28 18.29 18.30 18.31
18.32
19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 19.35 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22
20.23 20.24
20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 20.34 20.35 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 21.36 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 22.35 22.36 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30
23.31 23.32 23.33 23.34 23.35 24.1 24.2 24.3 24.4
24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23
24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 24.34 25.1 25.2 25.3 25.4 25.5
25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21
25.22
25.23 25.24 25.25 25.26 25.27 25.28 25.29
25.30 25.31 25.32 26.1 26.2 26.3 26.4 26.5 26.6 26.7
26.8 26.9
26.10 26.11 26.12 26.13
26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 26.34 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12
27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22
27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 28.35 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33 29.34 29.35 29.36 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 30.34 30.35 30.36 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 31.34 31.35 31.36 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30
32.31 32.32 32.33 32.34 32.35 33.1 33.2 33.3
33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22
33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 34.34 34.35 34.36 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 35.33 35.34 35.35 35.36 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 36.34 36.35 36.36 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19
37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32 37.33 37.34 37.35 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13
38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32
38.33 38.34 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24
39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12
40.13
40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 40.33 40.34 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27
41.28 41.29 41.30 41.31 41.32 41.33 41.34 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9
42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21
42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 42.33 42.34 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 44.34 44.35 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 46.1 46.2 46.3
46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14
46.15 46.16 46.17 46.18 46.19 46.20 46.21
46.22 46.23 46.24 46.25 46.26
46.27 46.28
46.29 46.30 46.31 46.32 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26
47.27
47.28 47.29 47.30 47.31 47.32 47.33 47.34 47.35 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13
48.14
48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 48.34 49.1 49.2
49.3
49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20
49.21
49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32
50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27
50.28
50.29 50.30 50.31 50.32 50.33 50.34 50.35 51.1 51.2
51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 51.34 51.35 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 53.34 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 54.35 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29
56.30 56.31 56.32 56.33 57.1 57.2
57.3
57.4 57.5
57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 57.33 57.34 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11
58.12 58.13 58.14 58.15 58.16
58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 58.33 58.34 59.1 59.2 59.3 59.4
59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 59.33 59.34 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11
60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 60.35 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 61.34 61.35 61.36 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 62.34
62.35 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 63.34 63.35 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27
64.28 64.29 64.30 64.31 64.32 64.33 64.34 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21
65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 65.33 65.34 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 66.34 66.35 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 67.35 67.36 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 68.35 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22
69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 69.35 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14
70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 70.34 70.35 71.1 71.2 71.3
71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30
71.31 71.32 71.33 71.34 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 72.34 72.35 72.36 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33 73.34 73.35 73.36
74.1
74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22
74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 74.34 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32
75.33 75.34 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 76.34 76.35 76.36 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21
77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 77.33 77.34 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15
78.16
78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33 78.34 78.35 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31
79.32
79.33 79.34 80.1 80.2 80.3 80.4 80.5 80.6 80.7
80.8
80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 81.1 81.2 81.3 81.4 81.5
81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 81.33 81.34 81.35 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33 82.34 82.35 82.36
83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15
83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28
83.29
83.30 83.31 83.32 83.33 83.34 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 84.33 84.34 84.35 84.36 85.1 85.2 85.3 85.4 85.5 85.6 85.7
85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 85.33 85.34 86.1 86.2 86.3 86.4 86.5 86.6 86.7
86.8
86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18
86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 86.34 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 87.34 87.35 87.36 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30
88.31 88.32 88.33 88.34 88.35 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17
89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 89.34 89.35 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 90.33 90.34 90.35 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22
91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 91.34 91.35 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 92.33 92.34 92.35 92.36 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32
93.33 93.34 93.35 94.1 94.2 94.3
94.4
94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 94.32 94.33 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 95.34 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 96.33 96.34 96.35 96.36 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 97.33 97.34 97.35 97.36 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13
98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 99.33 99.34 99.35 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 100.33 100.34 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 101.33 101.34 101.35 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 102.34 102.35 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 103.34 103.35 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27
104.28 104.29 104.30 104.31 104.32 104.33 104.34 105.1 105.2
105.3 105.4
105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28
105.29 105.30 105.31 105.32 105.33 105.34 106.1 106.2
106.3 106.4 106.5 106.6 106.7 106.8
106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8
107.9 107.10 107.11 107.12 107.13
107.14 107.15 107.16 107.17 107.18 107.19
107.20 107.21
107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27
108.28
108.29 108.30 108.31 108.32 108.33 108.34 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30
109.31 109.32 109.33 109.34 109.35 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18
110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 110.34 110.35 111.1 111.2 111.3 111.4 111.5
111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24
111.25 111.26 111.27 111.28
111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12
112.13
112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 112.34 112.35 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 113.33 113.34 113.35 113.36 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 114.34 114.35 114.36 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 115.33 115.34 115.35 115.36 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 116.33 116.34 116.35 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 117.33 117.34 117.35 117.36 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 118.33 118.34 118.35 119.1 119.2 119.3 119.4 119.5 119.6
119.7 119.8 119.9
119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 119.35 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 120.34 120.35 120.36 121.1 121.2 121.3
121.4 121.5 121.6
121.7 121.8 121.9 121.10 121.11 121.12
121.13 121.14 121.15
121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24
121.25 121.26 121.27
121.28 121.29 121.30 121.31 121.32 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8
122.9 122.10 122.11
122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 122.34 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 123.34 123.35 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15
124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23
124.24 124.25
124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 124.34 125.1 125.2 125.3 125.4 125.5 125.6
125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 127.33 127.34 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30
128.31 128.32 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22
129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30
129.31 129.32 129.33 129.34 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 130.34
131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23
131.24 131.25 131.26
131.27 131.28 131.29
131.30 131.31
131.32 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14
132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13
133.14 133.15 133.16 133.17
133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 134.33 134.34 134.35 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13
135.14
135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 135.34 135.35 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 136.34
136.35
137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 137.34 137.35 137.36 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 138.34 138.35 138.36 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8
139.9
139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 139.34 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27
140.28 140.29 140.30 140.31 140.32 140.33 140.34 140.35 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28
141.29 141.30 141.31 141.32 141.33 141.34 141.35 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23
142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33 142.34 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 143.33 143.34 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 144.34 144.35 144.36 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 145.34 145.35 145.36 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26
146.27
146.28 146.29 146.30 146.31 146.32 146.33 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13
147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22
147.23
147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33
148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17
148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 148.33 148.34 148.35 149.1 149.2
149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12

A bill for an act
relating to state government; making adjustments to health and human services
appropriations; making changes to provisions related to health care, the
Department of Health, children and family services, continuing care; providing
for data sharing; requiring eligibility determinations; providing grants; requiring
studies and reports; appropriating money; amending Minnesota Statutes 2010,
sections 43A.316, subdivision 5; 62A.047; 62A.21, subdivision 2a; 62D.02,
subdivision 3; 62D.05, subdivision 6; 62D.101, subdivision 2a; 62D.12,
subdivision 1; 62J.26, subdivisions 3, 5, by adding a subdivision; 62J.496,
subdivision 2; 62Q.80; 62U.04, subdivisions 1, 2, 4, 5; 72A.201, subdivision 8;
144.5509; 144A.073, by adding a subdivision; 144A.351; 145.906; 245A.03, by
adding a subdivision; 245A.11, subdivisions 2a, 7, 7a; 245B.07, subdivision 1;
245C.04, subdivision 6; 245C.05, subdivision 7; 256.01, by adding subdivisions;
256.975, subdivision 7; 256B.056, subdivision 1a; 256B.0625, subdivision 9,
by adding a subdivision; 256B.0644; 256B.0754, subdivision 2; 256B.0911,
by adding a subdivision; 256B.092, subdivision 1b; 256B.431, subdivision
17e, by adding a subdivision; 256B.434, subdivision 10; 256B.441, by adding
a subdivision; 256B.48, by adding a subdivision; 256B.69, by adding a
subdivision; 256D.06, subdivision 1b; 256D.44, subdivision 5; 626.556, by
adding a subdivision; Minnesota Statutes 2011 Supplement, sections 62U.04,
subdivisions 3, 9; 119B.13, subdivision 7; 144.1222, subdivision 5; 245A.03,
subdivision 7; 256.987, subdivision 1; 256B.056, subdivision 3; 256B.06,
subdivision 4; 256B.0625, subdivision 17; 256B.0631, subdivisions 1, 2;
256B.0659, subdivision 11; 256B.0911, subdivision 3c; 256B.097, subdivision
3; 256B.49, subdivisions 15, 23; 256B.69, subdivisions 5a, 9c; 256B.76,
subdivisions 1, 2, 4; 256B.766; 256L.12, subdivision 9; Laws 2011, First Special
Session chapter 9, article 7, section 52; article 10, sections 3, subdivisions
1, 3, 4; 4, subdivision 2; 8, subdivision 8; proposing coding for new law in
Minnesota Statutes, chapters 148; 256B; repealing Minnesota Statutes 2010,
sections 62D.04, subdivision 5; 62M.09, subdivision 9; 62Q.64; 144A.073,
subdivision 9; 256B.48, subdivision 6; Minnesota Statutes 2011 Supplement,
section 256B.5012, subdivision 13; Laws 2011, First Special Session chapter 9,
article 7, section 54; Minnesota Rules, part 4685.2000.

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

ARTICLE 1

HEALTH CARE

Section 1.

Minnesota Statutes 2010, section 72A.201, subdivision 8, is amended to
read:


Subd. 8.

Standards for claim denial.

The following acts by an insurer, adjuster, or
self-insured, or self-insurance administrator constitute unfair settlement practices:

(1) denying a claim or any element of a claim on the grounds of a specific policy
provision, condition, or exclusion, without informing the insured of the policy provision,
condition, or exclusion on which the denial is based;

(2) denying a claim without having made a reasonable investigation of the claim;

(3) denying a liability claim because the insured has requested that the claim be
denied;

(4) denying a liability claim because the insured has failed or refused to report the
claim, unless an independent evaluation of available information indicates there is no
liability;

(5) denying a claim without including the following information:

(i) the basis for the denial;

(ii) the name, address, and telephone number of the insurer's claim service office
or the claim representative of the insurer to whom the insured or claimant may take any
questions or complaints about the denial;

(iii) the claim number and the policy number of the insured; and

(iv) if the denied claim is a fire claim, the insured's right to file with the Department
of Commerce a complaint regarding the denial, and the address and telephone number
of the Department of Commerce;

(6) denying a claim because the insured or claimant failed to exhibit the damaged
property unless:

(i) the insurer, within a reasonable time period, made a written demand upon the
insured or claimant to exhibit the property; and

(ii) the demand was reasonable under the circumstances in which it was made;

(7) denying a claim by an insured or claimant based on the evaluation of a chemical
dependency claim reviewer selected by the insurer unless the reviewer meets the
qualifications specified under subdivision 8a. An insurer that selects chemical dependency
reviewers to conduct claim evaluations must annually file with the commissioner of
commerce a report containing the specific evaluation standards and criteria used in these
evaluations. The report must be filed at the same time its annual statement is submitted
under section 60A.13. deleted text beginThe report must also include the number of evaluations performed
on behalf of the insurer during the reporting period, the types of evaluations performed,
the results, the number of appeals of denials based on these evaluations, the results of
these appeals, and the number of complaints filed in a court of competent jurisdiction.
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. 2.

Minnesota Statutes 2011 Supplement, section 256B.06, subdivision 4, is
amended to read:


Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited
to citizens of the United States, qualified noncitizens as defined in this subdivision, and
other persons residing lawfully in the United States. Citizens or nationals of the United
States must cooperate in obtaining satisfactory documentary evidence of citizenship or
nationality according to the requirements of the federal Deficit Reduction Act of 2005,
Public Law 109-171.

(b) "Qualified noncitizen" means a person who meets one of the following
immigration criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code,
title 8, section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8,
section 1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8,
section 1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration Reform and Immigrant
Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
Public Law 104-200; or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August
22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation.

(d) Beginning December 1, 1996, qualified noncitizens who entered the United
States on or after August 22, 1996, and who otherwise meet the eligibility requirements
of this chapter are eligible for medical assistance with federal participation for five years
if they meet one of the following criteria:

(1) refugees admitted to the United States according to United States Code, title 8,
section 1157;

(2) persons granted asylum according to United States Code, title 8, section 1158;

(3) persons granted withholding of deportation according to United States Code,
title 8, section 1253(h);

(4) veterans of the United States armed forces with an honorable discharge for
a reason other than noncitizen status, their spouses and unmarried minor dependent
children; or

(5) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.

Beginning July 1, 2010, children and pregnant women who are noncitizens
described in paragraph (b) or who are lawfully present in the United States as defined
in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
eligibility requirements of this chapter, are eligible for medical assistance with federal
financial participation as provided by the federal Children's Health Insurance Program
Reauthorization Act of 2009, Public Law 111-3.

(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
Code, title 8, section 1101(a)(15).

(f) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of
this chapter, if such care and services are necessary for the treatment of an emergency
medical condition.

(g) For purposes of this subdivision, the term "emergency medical condition" means
a medical condition that meets the requirements of United States Code, title 42, section
1396b(v).

(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
of an emergency medical condition are limited to the following:

(i) services delivered in an emergency room or by an ambulance service licensed
under chapter 144E that are directly related to the treatment of an emergency medical
condition;

(ii) services delivered in an inpatient hospital setting following admission from an
emergency room or clinic for an acute emergency condition; deleted text beginand
deleted text end

(iii) follow-up services that are directly related to the original service provided to
treat the emergency medical condition and are covered by the global payment made to
the providerdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (iv) dialysis services provided in a hospital or freestanding dialysis facility.
new text end

(2) Services for the treatment of emergency medical conditions do not include:

(i) services delivered in an emergency room or inpatient setting to treat a
nonemergency condition;

(ii) organ transplants, stem cell transplants, and related care;

(iii) services for routine prenatal care;

(iv) continuing care, including long-term care, nursing facility services, home health
care, adult day care, day training, or supportive living services;

(v) elective surgery;

(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
part of an emergency room visit;

(vii) preventative health care and family planning services;

(viii) deleted text begindialysis;
deleted text end

deleted text begin (ix)deleted text end chemotherapy or therapeutic radiation services;

deleted text begin (x)deleted text end new text begin(ix) new text endrehabilitation services;

deleted text begin (xi)deleted text end new text begin(x) new text endphysical, occupational, or speech therapy;

deleted text begin (xii)deleted text end new text begin(xi) new text endtransportation services;

deleted text begin (xiii)deleted text end new text begin(xii) new text endcase management;

deleted text begin (xiv)deleted text end new text begin(xiii) new text endprosthetics, orthotics, durable medical equipment, or medical supplies;

deleted text begin (xv)deleted text end new text begin(xiv) new text enddental services;

deleted text begin (xvi)deleted text end new text begin(xv) new text endhospice care;

deleted text begin (xvii)deleted text end new text begin(xvi) new text endaudiology services and hearing aids;

deleted text begin (xviii)deleted text end new text begin(xvii) new text endpodiatry services;

deleted text begin (xix)deleted text end new text begin(xviii) new text endchiropractic services;

deleted text begin (xx)deleted text end new text begin(xix) new text endimmunizations;

deleted text begin (xxi)deleted text end new text begin(xx) new text endvision services and eyeglasses;

deleted text begin (xxii)deleted text end new text begin(xxi) new text endwaiver services;

deleted text begin (xxiii)deleted text end new text begin(xxii) new text endindividualized education programs; or

deleted text begin (xxiv)deleted text endnew text begin (xxiii) new text end chemical dependency treatment.

(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
nonimmigrants, or lawfully present in the United States as defined in Code of Federal
Regulations, title 8, section 103.12, are not covered by a group health plan or health
insurance coverage according to Code of Federal Regulations, title 42, section 457.310,
and who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance through the period of pregnancy, including labor and delivery, and 60
days postpartum, to the extent federal funds are available under title XXI of the Social
Security Act, and the state children's health insurance program.

(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
services from a nonprofit center established to serve victims of torture and are otherwise
ineligible for medical assistance under this chapter are eligible for medical assistance
without federal financial participation. These individuals are eligible only for the period
during which they are receiving services from the center. Individuals eligible under this
paragraph shall not be required to participate in prepaid medical assistance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective May 1, 2012.
new text end

Sec. 3.

Minnesota Statutes 2010, section 256B.0625, subdivision 9, is amended to read:


Subd. 9.

Dental services.

(a) Medical assistance covers dental services.

(b) Medical assistance dental coverage for nonpregnant adults is limited to the
following services:

(1) comprehensive exams, limited to once every five years;

(2) periodic exams, limited to one per year;

(3) limited exams;

(4) bitewing x-rays, limited to one per year;

(5) periapical x-rays;

(6) panoramic x-rays, limited to one every five years except (1) when medically
necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma
or (2) once every two years for patients who cannot cooperate for intraoral film due to
a developmental disability or medical condition that does not allow for intraoral film
placement;

(7) prophylaxis, limited to one per year;

(8) application of fluoride varnish, limited to one per year;

(9) posterior fillings, all at the amalgam rate;

(10) anterior fillings;

(11) endodontics, limited to root canals on the anterior and premolars only;

(12) removable prostheses, deleted text begineach dental arch limited to one every six yearsdeleted text endnew text begin including
repairs and the replacement of each dental arch limited to one every six years
new text end;

(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
abscesses;

(14) palliative treatment and sedative fillings for relief of pain; and

(15) full-mouth debridement, limited to one every five years.

(c) In addition to the services specified in paragraph (b), medical assistance
covers the following services for adults, if provided in an outpatient hospital setting or
freestanding ambulatory surgical center as part of outpatient dental surgery:

(1) periodontics, limited to periodontal scaling and root planing once every two
years;

(2) general anesthesia; and

(3) full-mouth survey once every five years.

(d) Medical assistance covers medically necessary dental services for children and
pregnant women. The following guidelines apply:

(1) posterior fillings are paid at the amalgam rate;

(2) application of sealants are covered once every five years per permanent molar for
children only;

(3) application of fluoride varnish is covered once every six months; and

(4) orthodontia is eligible for coverage for children only.

new text begin (e) In addition to the services specified in paragraphs (b) and (c), medical assistance
covers the following services for developmentally disabled adults:
new text end

new text begin (1) house calls or extended care facility calls for on-site delivery of covered services;
new text end

new text begin (2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used;
new text end

new text begin (3) oral or IV conscious sedation, if the covered dental service cannot be performed
safely without it or would otherwise require the service to be performed under general
anesthesia in a hospital or surgical center; and
new text end

new text begin (4) prophylaxis, in accordance with an appropriate individualized treatment plan
formulated by a licensed dentist, but no more than four times per year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendment to paragraph (b) is effective January 1, 2013.
new text end

Sec. 4.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 60. new text end

new text begin Community paramedic services. new text end

new text begin (a) Medical assistance covers services
provided by community paramedics who are certified under section 144E.28, subdivision
9, when the services are provided in accordance with this subdivision to an eligible
recipient as defined in paragraph (b).
new text end

new text begin (b) For purposes of this subdivision, an eligible recipient is defined as an individual
who has received hospital emergency department services three or more times in a period
of four consecutive months in the past 12 months or an individual who has been identified
by the individual's primary health care provider for whom community paramedic services
identified in paragraph (c) would likely prevent admission to or would allow discharge
from a nursing facility; or would likely prevent readmission to a hospital or nursing facility.
new text end

new text begin (c) Payment for services provided by a community paramedic under this subdivision
must be a part of a care plan ordered by a primary health care provider in consultation with
the medical director of an ambulance service and must be billed by an eligible provider
enrolled in medical assistance that employs or contracts with the community paramedic.
The care plan must ensure that the services provided by a community paramedic are
coordinated with other community health providers and local public health agencies and
that community paramedic services do not duplicate services already provided to the
patient, including home health and waiver services. Community paramedic services
shall include health assessment, chronic disease monitoring and education, medication
compliance, immunizations and vaccinations, laboratory specimen collection, hospital
discharge follow-up care, and minor medical procedures approved by the ambulance
medical director.
new text end

new text begin (d) Services provided by a community paramedic to an eligible recipient who is
also receiving care coordination services must be in consultation with the providers of
the recipient's care coordination services.
new text end

new text begin (e) The commissioner shall seek the necessary federal approval to implement this
subdivision.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, or upon federal
approval, whichever is later.
new text end

Sec. 5.

Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 1,
is amended to read:


Subdivision 1.

Cost-sharing.

(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following cost-sharing for all recipients, effective
for services provided on or after September 1, 2011:

(1) $3 per nonpreventive visit, except as provided in paragraph (b). 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) $3.50 for nonemergency visits to a hospital-based emergency room, except that
this co-payment shall be increased to $20 upon federal approval;

(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;

(5) effective January 1, 2012, a family deductible equal to the maximum amount
allowed under Code of Federal Regulations, title 42, part 447.54; and

(6) for individuals identified by the commissioner with income at or below 100
percent of the federal poverty guidelines, total monthly cost-sharing 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 cost-sharing.

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

new text begin (c) Notwithstanding paragraph (b), a prepaid health plan may waive the family
deductible described under paragraph (a), clause (5), within the existing capitation rates
on an ongoing basis.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2012.
new text end

Sec. 6.

Minnesota Statutes 2010, section 256B.0644, is amended to read:


256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
PROGRAMS.

(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, deleted text beginand a
health maintenance organization, as defined in chapter 62D,
deleted text end must participate as a provider
or contractor in the medical assistance programdeleted text begin, general assistance medical care program,deleted text end
and MinnesotaCare as a condition of participating as a provider in health insurance plans
and programs or contractor for state employees established under section 43A.18, the
public employees insurance program under section 43A.316, for health insurance plans
offered to local statutory or home rule charter city, county, and school district employees,
the workers' compensation system under section 176.135, and insurance plans provided
through the Minnesota Comprehensive Health Association under sections 62E.01 to
62E.19. The limitations on insurance plans offered to local government employees shall
not be applicable in geographic areas where provider participation is limited by managed
care contracts with the Department of Human Services.new text begin For purposes of this section, a
health maintenance organization, as defined in chapter 62D, is not a vendor of medical
care.
new text end

(b) deleted text beginFor providers other than health maintenance organizations,deleted text end Participation in the
medical assistance program means that:

(1) the provider accepts new medical assistancedeleted text begin, general assistance medical care,deleted text end
and MinnesotaCare patients;

(2) for providers other than dental service providers, at least 20 percent of the
provider's patients are covered by medical assistancedeleted text begin, general assistance medical care,deleted text end
and MinnesotaCare as their primary source of coverage; or

(3) for dental service providers, at least ten percent of the provider's patients are
covered by medical assistancedeleted text begin, general assistance medical care,deleted text end and MinnesotaCare as
their primary source of coverage, or the provider accepts new medical assistance and
MinnesotaCare patients who are children with special health care needs. For purposes
of this section, "children with special health care needs" means children up to age 18
who: (i) require health and related services beyond that required by children generally;
and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
neurological diseases; visual impairment or deafness; Down syndrome and other genetic
disorders; autism; fetal alcohol syndrome; and other conditions designated by the
commissioner after consultation with representatives of pediatric dental providers and
consumers.

(c) Patients seen on a volunteer basis by the provider at a location other than
the provider's usual place of practice may be considered in meeting the participation
requirement in this section. deleted text beginThe commissioner shall establish participation requirements
for health maintenance organizations.
deleted text end The commissioner shall provide lists of participating
medical assistance providers on a quarterly basis to the commissioner of management and
budget, the commissioner of labor and industry, and the commissioner of commerce. Each
of the commissioners shall develop and implement procedures to exclude as participating
providers in the program or programs under their jurisdiction those providers who do
not participate in the medical assistance program. The commissioner of management
and budget shall implement this section through contracts with participating health and
dental carriers.

deleted text begin (d) For purposes of paragraphs (a) and (b), participation in the general assistance
medical care program applies only to pharmacy providers.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2013.
new text end

Sec. 7.

Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a, is
amended to read:


Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section
and section 256L.12 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 and 256L is responsible for complying with the terms of its
contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B 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 and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program 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 beginClinical or utilization performance targets and their related criteria must consider
evidence-based research and reasonable interventions when available or applicable to the
populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers.
new text endThe managed care new text beginor county-based purchasingnew text end 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. 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.

(d) Effective for services rendered on or after January 1, 2009, through December
31, 2009, the commissioner shall withhold three percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

(e) Effective for services provided on or after January 1, 2010, the commissioner
shall require that managed care plans use the assessment and authorization processes,
forms, timelines, standards, documentation, and data reporting requirements, protocols,
billing processes, and policies consistent with medical assistance fee-for-service or the
Department of Human Services contract requirements consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all
personal care assistance services under section 256B.0659.

(f) Effective for services rendered on or after January 1, 2010, through December
31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

(g) Effective for services rendered on or after January 1, 2011, through December
31, 2011, the commissioner shall include as part of the performance targets described
in paragraph (c) a reduction in the health plan's emergency room utilization rate for
state health care program enrollees by a measurable rate of five percent from the plan's
utilization rate for state health care program enrollees for the previous calendar year.
Effective for services rendered on or after January 1, 2012, the commissioner shall include
as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. new text beginFor 2012, the reduction shall be based on
the health plan's utilization in 2009.
new text endTo earn the return of the withhold each new text beginsubsequent
new text endyear, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization
rate for medical assistance and MinnesotaCare enrollees, excluding deleted text beginMedicaredeleted text end enrolleesnew text begin
in programs described in subdivisions 23 and 28
new text end, compared to the previous deleted text begincalendardeleted text endnew text begin
measurement
new text end year until the final performance target is reached.new text begin When measuring
performance, the commissioner must consider the difference in health risk in a managed
care or county-based purchasing plan's membership in the baseline year compared to the
measurement year, and work with the managed care or county-based purchasing plan to
account for differences that they agree are significant.
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 the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved.new text begin The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the target amount.
new text end

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization
rate for medical assistance and MinnesotaCare enrollees for calendar year deleted text begin2011deleted text endnew text begin 2009new text end.
Hospitals shall cooperate with the health plans in meeting this performance target and
shall accept payment withholds that may be returned to the hospitals if the performance
target is achieved.

(h) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in the
plan's hospitalization admission rate for medical assistance and MinnesotaCare enrollees,
as determined by the commissioner. To earn the return of the withhold each year, the
managed care plan or county-based purchasing plan must achieve a qualifying reduction
of no less than five percent of the plan's hospital admission rate for medical assistance
and MinnesotaCare enrollees, excluding deleted text beginMedicaredeleted text end enrolleesnew text begin in programs described in
subdivisions 23 and 28
new text end, compared to the previous calendar year until the final performance
target is reached.new text begin When measuring performance, the commissioner must consider the
difference in health risk in a managed care or county-based purchasing plan's membership
in the baseline year compared to the measurement year, and work with the managed care
or county-based purchasing plan to account for differences that they agree are significant.
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 the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved.new text begin The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
new text end

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in
calendar year 2011, as determined by the commissioner. The hospital admissions in this
performance target do not include the admissions applicable to the subsequent hospital
admission performance target under paragraph (i). Hospitals shall cooperate with the
plans in meeting this performance target and shall accept payment withholds that may be
returned to the hospitals if the performance target is achieved.

(i) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the plan's hospitalization admission rates for subsequent hospitalizations within 30 days
of a previous hospitalization of a patient regardless of the reason, for medical assistance
and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
the withhold each year, the managed care plan or county-based purchasing plan must
achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance
and MinnesotaCare enrollees, excluding deleted text beginMedicaredeleted text end enrolleesnew text begin in programs described in
subdivisions 23 and 28
new text end, of no less than five percent compared to the previous calendar
year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
the subsequent hospitalization rate was achieved.new text begin The commissioner shall structure the
withhold so that the commissioner returns a portion of the withheld funds in amounts
commensurate with achieved reductions in utilization less that the targeted amount.
new text end

The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for medical assistance
and MinnesotaCare enrollees, excluding deleted text beginMedicaredeleted text end enrolleesnew text begin in programs described in
subdivisions 23 and 28
new text end, is reduced by 25 percent of the plan's subsequent hospitalization
rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
performance target and shall accept payment withholds that must be returned to the
hospitals if the performance target is achieved.

(j) Effective for services rendered on or after January 1, 2011, through December 31,
2011, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. 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.

(k) Effective for services rendered on or after January 1, 2012, through December
31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. 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.

(l) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. 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.

(m) Effective for services rendered on or after January 1, 2014, the commissioner
shall withhold three percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. 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.

(n) 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
section that is reasonably expected to be returned.

(o) Contracts between the commissioner and a prepaid health plan are exempt from
the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
(a), and 7.

(p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject
to the requirements of paragraph (c).

Sec. 8.

Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 9c, is
amended to read:


Subd. 9c.

Managed care financial reporting.

(a) The commissioner shall collect
detailed data regarding financials, provider payments, provider rate methodologies, and
other data as determined by the commissioner and managed care and county-based
purchasing plans that are required to be submitted under this section. The commissioner,
in consultation with the commissioners of health and commerce, and in consultation
with managed care plans and county-based purchasing plans, shall set uniform criteria,
definitions, and standards for the data to be submitted, and shall require managed care and
county-based purchasing plans to comply with these criteria, definitions, and standards
when submitting data under this section. In carrying out the responsibilities of this
subdivision, the commissioner shall ensure that the data collection is implemented in an
integrated and coordinated manner that avoids unnecessary duplication of effort. To the
extent possible, the commissioner shall use existing data sources and streamline data
collection in order to reduce public and private sector administrative costs. Nothing in
this subdivision shall allow release of information that is nonpublic data pursuant to
section 13.02.

(b) Each managed care and county-based purchasing plan must annually provide
to the commissioner the following information on state public programs, in the form
and manner specified by the commissioner, according to guidelines developed by the
commissioner in consultation with managed care plans and county-based purchasing
plans under contract:

(1) administrative expenses by category and subcategory consistent with
administrative expense reporting to other state and federal regulatory agencies, by
program;

(2) revenues by program, including investment income;

(3) nonadministrative service payments, provider payments, and reimbursement
rates by provider type or service category, by program, paid by the managed care plan
under this section or the county-based purchasing plan under section 256B.692 to
providers and vendors for administrative services under contract with the plan, including
but not limited to:

(i) individual-level provider payment and reimbursement rate data;

(ii) provider reimbursement rate methodologies by provider type, by program,
including a description of alternative payment arrangements and payments outside the
claims process;

(iii) data on implementation of legislatively mandated provider rate changes; and

(iv) individual-level provider payment and reimbursement rate data and plan-specific
provider reimbursement rate methodologies by provider type, by program, including
alternative payment arrangements and payments outside the claims process, provided to
the commissioner under this subdivision are nonpublic data as defined in section 13.02;

(4) data on the amount of reinsurance or transfer of risk by program; and

(5) contribution to reserve, by program.

(c) In the event a report is published or released based on data provided under
this subdivision, the commissioner shall provide the report to managed care plans and
county-based purchasing plans 30 days prior to the publication or release of the report.
Managed care plans and county-based purchasing plans shall have 30 days to review the
report and provide comment to the commissioner.

new text begin (d) The legislative auditor shall contract for the audit required under this paragraph.
The commissioner shall require, in the request for bids and the resulting contracts for
coverage to be provided under this section, that each managed care and county-based
purchasing plan submit to and fully cooperate with an annual independent third-party
financial audit of the information required under paragraph (b). For purposes of
this paragraph, "independent third party" means an audit firm that is independent in
accordance with Government Auditing Standards issued by the United States Government
Accountability Office and licensed in accordance with chapter 326A. In no case shall
the audit firm conducting the audit provide services to a managed care or county-based
purchasing plan at the same time as the audit is being conducted or have provided services
to a managed care or county-based purchasing plan during the prior three years.
new text end

new text begin (e) The audit of the information required under paragraph (b) shall be conducted
by an independent third-party firm in accordance with generally accepted government
auditing standards issued by the United States Government Accountability Office.
new text end

new text begin (f) A managed care or county-based purchasing plan that provides services under
this section shall provide to the commissioner biweekly encounter and claims data at
a detailed level and shall participate in a quality assurance program that verifies the
timeliness, completeness, accuracy, and consistency of data provided. The commissioner
shall have written protocols for the quality assurance program that are publicly available.
The commissioner shall contract with an independent third-party auditing firm to evaluate
the quality assurance protocols, the capacity of those protocols to assure complete and
accurate data, and the commissioner's implementation of the protocols.
new text end

new text begin (g) Contracts awarded under this section to a managed care or county-based
purchasing plan must provide that the commissioner and the contracted auditor shall have
unlimited access to any and all data required to complete the audit and that this access
shall be enforceable in a court of competent jurisdiction through the process of injunctive
or other appropriate relief.
new text end

new text begin (h) Any actuary or actuarial firm must meet the independence requirements under
the professional code for fellows in the Society of Actuaries when providing actuarial
services to the commissioner in connection with this subdivision and providing services to
any managed care or county-based purchasing plan participating in this subdivision during
the term of the actuary's work for the commissioner under this subdivision.
new text end

new text begin (i) The actuary or actuarial firm referenced in paragraph (h) shall certify and attest
to the rates paid to managed care plans and county-based purchasing plans under this
section, and the certification and attestation must be auditable.
new text end

new text begin (j) The independent third-party audit shall include a determination of compliance
with the federal Medicaid rate certification process.
new text end

new text begin (k) The legislative auditor's contract with the independent third-party auditing firm
shall be designed and administered so as to render the independent third-party audit
eligible for a federal subsidy if available for that purpose. The independent third-party
auditing firm shall have the same powers as the legislative auditor under section 3.978,
subdivision 2.
new text end

new text begin (l) Upon completion of the audit, and its receipt by the legislative auditor, the
legislative auditor shall provide copies of the audit report to the commissioner, the state
auditor, the attorney general, and the chairs and ranking minority members of the health
finance committees of the legislature.
new text end

new text begin (m) The commissioner shall annually assess managed care and county-based
purchasing plans for agency costs related to implementing paragraphs (d) to (l), which
have been approved as reasonable by the commissioner of management and budget.
The assessment for each plan shall be in proportion to that plan's share of total medical
assistance and MinnesotaCare enrollment under this section, section 256B.692, and
section 256L.12.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment
and applies to contracts, and the contracting process, for contracts that are effective
January 1, 2013, and thereafter.
new text end

Sec. 9.

Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision
to read:


new text begin Subd. 9d. new text end

new text begin Savings from report elimination. new text end

new text begin Managed care and county-based
purchasing plans shall use the savings resulting from the elimination or modification
of specified reporting requirements to pay the assessment required by subdivision 9c,
paragraph (m).
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 2011 Supplement, section 256B.76, subdivision 4, is
amended to read:


Subd. 4.

Critical access dental providers.

(a) Effective for dental services
rendered on or after January 1, 2002, the commissioner shall increase reimbursements
to dentists and dental clinics deemed by the commissioner to be critical access dental
providers. For dental services rendered on or after July 1, 2007, the commissioner shall
increase reimbursement by 30 percent above the reimbursement rate that would otherwise
be paid to the critical access dental provider. The commissioner shall pay the managed
care plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.

(b) The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:

(1) nonprofit community clinics that:

(i) have nonprofit status in accordance with chapter 317A;

(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);

(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;

(iv) have professional staff familiar with the cultural background of the clinic's
patients;

(v) charge for services on a sliding fee scale designed to provide assistance to
low-income patients based on current poverty income guidelines and family size;

(vi) do not restrict access or services because of a patient's financial limitations
or public assistance status; and

(vii) have free care available as needed;

(2) federally qualified health centers, rural health clinics, and public health clinics;

(3) county owned and operated hospital-based dental clinics;

(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance, general assistance medical
care, or MinnesotaCare; and

(5) a dental clinic owned and operated by the University of Minnesota or the
Minnesota State Colleges and Universities system.

(c) The commissioner may designate a dentist or dental clinic as a critical access
dental provider if the dentist or dental clinic is willing to provide care to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare at a level which
significantly increases access to dental care in the service area.

(d) deleted text beginNotwithstanding paragraph (a), critical access payments must not be made for
dental services provided from April 1, 2010, through June 30, 2010.
deleted text endnew text begin A designated critical
access clinic shall receive the reimbursement rate specified in paragraph (a) for dental
services provided off-site at a private dental office if the following requirements are met:
new text end

new text begin (1) the designated critical access dental clinic is located within a health professional
shortage area as defined under the Code of Federal Regulations, title 42, part 5, and
the United States Code, title 42, section 254E, and is located outside the seven-county
metropolitan area;
new text end

new text begin (2) the designated critical access dental clinic is not able to provide the service
and refers the patient to the off-site dentist;
new text end

new text begin (3) the service, if provided at the critical access dental clinic, would be reimbursed
at the critical access reimbursement rate;
new text end

new text begin (4) the dentist and allied dental professionals providing the services off-site are
licensed and in good standing under chapter 150A;
new text end

new text begin (5) the dentist providing the services is enrolled as a medical assistance provider;
new text end

new text begin (6) the critical access dental clinic submits the claim for services provided off-site
and receives the payment for the services; and
new text end

new text begin (7) the critical access dental clinic maintains dental records for each claim submitted
under this paragraph, including the name of the dentist, the off-site location, and the
license number of the dentist and allied dental professionals providing the services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, or upon federal
approval, whichever is later.
new text end

Sec. 11.

Minnesota Statutes 2011 Supplement, 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, 2004, the commissioner shall
withhold five percent of managed care plan payments and county-based purchasing
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 beginClinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions, when available or
applicable to the populations served, and must be developed with input from external
clinical experts and stakeholders, including managed care plans, county-based purchasing
plans, and providers.
new text endThe 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. 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.

(c) For services rendered on or after January 1, 2011, the commissioner shall
withhold an additional three percent of managed care plan or county-based purchasing
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. The return of the withhold
under this paragraph is not subject to the requirements of paragraph (b).

(d) Effective for services rendered on or after January 1, 2011, through December
31, 2011, the commissioner shall include as part of the performance targets described in
paragraph (b) a reduction in the plan's emergency room utilization rate for state health care
program enrollees by a measurable rate of five percent from the plan's utilization rate for
the previous calendar year. Effective for services rendered on or after January 1, 2012,
the commissioner shall include as part of the performance targets described in paragraph
(b) a reduction in the health plan's emergency department utilization rate for medical
assistance and MinnesotaCare enrollees, as determined by the commissioner. new text beginFor 2012,
the reductions shall be based on the health plan's utilization in 2009.
new text endTo earn the return of
the withhold each new text beginsubsequent new text endyear, the managed care plan or county-based purchasing
plan must achieve a qualifying reduction of no less than ten percent of the plan's utilization
rate for medical assistance and MinnesotaCare enrollees, excluding deleted text beginMedicaredeleted text end enrolleesnew text begin in
programs described in section 256B.69, subdivisions 23 and 28
new text end, compared to the previous
deleted text begin calendardeleted text endnew text begin measurementnew text end year, until the final performance target is reached.new text begin When measuring
performance, the commissioner must consider the difference in health risk in a managed
care or county-based purchasing plan's membership in the baseline year compared to the
measurement year, and work with the managed care or county-based purchasing plan to
account for differences that they agree are significant.
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 the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved.new text begin The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
new text end

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization
rate for medical assistance and MinnesotaCare enrollees for calendar year deleted text begin2011deleted text endnew text begin 2009new text end.
Hospitals shall cooperate with the health plans in meeting this performance target and
shall accept payment withholds that may be returned to the hospitals if the performance
target is achieved.

(e) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction
in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold
each year, the managed care plan or county-based purchasing plan must achieve a
qualifying reduction of no less than five percent of the plan's hospital admission rate
for medical assistance and MinnesotaCare enrollees, excluding deleted text beginMedicaredeleted text end enrolleesnew text begin
in programs described in section 256B.69, subdivisions 23 and 28
new text end, compared to the
previous calendar year, until the final performance target is reached.new text begin When measuring
performance, the commissioner must consider the difference in health risk in a managed
care or county-based purchasing plan's membership in the baseline year compared to the
measurement year, and work with the managed care or county-based purchasing plan to
account for differences that they agree are significant.
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 the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved.new text begin The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
new text end

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospitals admission rate compared to the hospital admission rate for
calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the
plans in meeting this performance target and shall accept payment withholds that may be
returned to the hospitals if the performance target is achieved. The hospital admissions
in this performance target do not include the admissions applicable to the subsequent
hospital admission performance target under paragraph (f).

(f) Effective for services provided on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction
in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a
previous hospitalization of a patient regardless of the reason, for medical assistance and
MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
withhold each year, the managed care plan or county-based purchasing plan must achieve
a qualifying reduction of the subsequent hospital admissions rate for medical assistance
and MinnesotaCare enrollees, excluding deleted text beginMedicaredeleted text end enrolleesnew text begin in programs described in
section 256B.69, subdivisions 23 and 28
new text end, of no less than five percent compared to the
previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the subsequent
hospitalization rate was achieved.new text begin The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
new text end

The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization
rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
performance target and shall accept payment withholds that must be returned to the
hospitals if the performance target is achieved.

(g) 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
section that is reasonably expected to be returned.

Sec. 12. new text beginCOST-SHARING REQUIREMENTS STUDY.
new text end

new text begin The commissioner of human services, in consultation with managed care plans,
county-based purchasing plans, and other stakeholders, shall develop recommendations
to implement a revised cost-sharing structure for state public health care programs that
ensures application of meaningful cost-sharing requirements within the limits of title
42, Code of Federal Regulations, section 447.54, for enrollees in these programs. The
commissioner shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over these issues by January 15, 2013, with draft legislation
to implement these recommendations effective January 1, 2014.
new text end

Sec. 13. new text beginSTUDY OF MANAGED CARE.
new text end

new text begin The commissioner of human services must contract with an independent vendor
with demonstrated expertise in evaluating Medicaid managed care programs to evaluate
the value of managed care for state public health care programs provided under
Minnesota Statutes, sections 256B.69, 256B.692, and 256L.12. The evaluation must be
completed and reported to the legislature by January 15, 2013. Determination of the
value of managed care must include consideration of the following, as compared to a
fee-for-service program:
new text end

new text begin (1) the satisfaction of state public health care program recipients and providers;
new text end

new text begin (2) the ability to measure and improve health outcomes of recipients;
new text end

new text begin (3) the access to health services for recipients;
new text end

new text begin (4) the availability of additional services such as care coordination, case
management, disease management, transportation, and after-hours nurse lines;
new text end

new text begin (5) actual and potential cost savings to the state;
new text end

new text begin (6) the level of alignment with state and federal health reform policies, including a
health benefit exchange for individuals not enrolled in state public health care programs;
and
new text end

new text begin (7) the ability to use different provider payment models that provide incentives for
cost-effective health care.
new text end

Sec. 14. new text beginSTUDY OF FOR-PROFIT HEALTH MAINTENANCE
ORGANIZATIONS.
new text end

new text begin The commissioner of health shall contract with an entity with expertise in health
economics and health care delivery and quality to study the efficiency, costs, service
quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to
not-for-profit health maintenance organizations operating in Minnesota and other states.
The study findings must address whether the state could: (1) reduce medical assistance
and MinnesotaCare costs and costs of providing coverage to state employees; and (2)
maintain or improve the quality of care provided to state health care program enrollees
and state employees if for-profit health maintenance organizations were allowed to operate
in the state. In comparing for-profit health maintenance organizations operating in other
states with not-for-profit health maintenance organizations operating in Minnesota, the
entity must consider differences in regulatory oversight, benefit requirements, network
standards, human resource costs, and assessments, fees, and taxes that may impact the
cost and quality comparisons. The commissioner shall require the entity under contract to
report study findings to the commissioner and the legislature by January 15, 2013.
new text end

Sec. 15. new text beginREPORTING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Evidence-based childbirth program. new text end

new text begin The commissioner of human
services may discontinue the evidence-based childbirth program and shall discontinue all
affiliated reporting requirements established under Minnesota Statutes, section 256B.0625,
subdivision 3g, once the commissioner determines that hospitals representing at least 90
percent of births covered by Medical Assistance or MinnesotaCare have approved policies
and processes in place that prohibit elective inductions prior to 39 weeks' gestation.
new text end

new text begin Subd. 2. new text end

new text begin Provider networks. new text end

new text begin The commissioner of health, the commissioner of
commerce, and the commissioner of human services shall merge reporting requirements
for health maintenance organizations and county-based purchasing plans related to
Minnesota Department of Health oversight of network adequacy under Minnesota
Statutes, section 62D.124, and the provider network list reported to the Department of
Human Services under Minnesota Rules, part 4685.2100. The commissioners shall work
with health maintenance organizations and county-based purchasing plans to ensure that
the report merger is done in a manner that simplifies health maintenance organization and
county-based purchasing plan reporting processes.
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 beginREPORT ELIMINATION SAVINGS.
new text end

new text begin Managed care plans and county-based purchasing plans shall use the savings
resulting from the elimination or modification of reporting requirements under Minnesota
Statutes, sections 62D.124; 62M.09, subdivision 9; 62Q.64; 72A.201, subdivision 8;
256B.0625, subdivision 3g; and Minnesota Rules, parts 4685.2000; and 4685.2100, to
pay the assessment required in Minnesota Statutes, section 256B.69, subdivision 9c,
paragraph (m).
new text end

Sec. 17. new text begin REPEALER.
new text end

new text begin Subdivision 1. new text end

new text begin Summary of complaints and grievances. new text end

new text begin Minnesota Rules, part
4685.2000,
new text end new text begin is repealed effective the day following final enactment.
new text end

new text begin Subd. 2. new text end

new text begin Medical necessity denials and appeals. new text end

new text begin Minnesota Statutes 2010, section
62M.09, subdivision 9,
new text end new text begin is repealed effective the day following final enactment.
new text end

new text begin Subd. 3. new text end

new text begin Salary reports. new text end

new text begin Minnesota Statutes 2010, section 62Q.64, new text end new text begin is repealed
effective the day following final enactment.
new text end

new text begin Subd. 4. new text end

new text begin Mandatory HMO participation as provider in public programs.
new text end

new text begin Minnesota Statutes 2010, section 62D.04, subdivision 5, new text end new text begin is repealed effective January
1, 2013.
new text end

ARTICLE 2

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:


Subd. 3.

Commissioner of deleted text beginhealthdeleted text endnew text begin commercenew text end or commissioner.

"Commissioner of
deleted text begin healthdeleted text endnew text begin commercenew text end" or "commissioner" means the state commissioner of deleted text beginhealthdeleted text endnew text begin commercenew text end
or a designee.

Sec. 2.

Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:


Subd. 6.

Supplemental benefits.

(a) A health maintenance organization may, as
a supplemental benefit, provide coverage to its enrollees for health care services and
supplies received from providers who are not employed by, under contract with, or
otherwise affiliated with the health maintenance organization. Supplemental benefits may
be provided if the following conditions are met:

(1) a health maintenance organization desiring to offer supplemental benefits must at
all times comply with the requirements of sections 62D.041 and 62D.042;

(2) a health maintenance organization offering supplemental benefits must maintain
an additional surplus in the first year supplemental benefits are offered equal to the
lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of
the second year supplemental benefits are offered, the health maintenance organization
must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the
supplemental benefit expenses. At the end of the third year benefits are offered and every
year after that, the health maintenance organization must maintain an additional surplus
equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses.
When in the judgment of the commissioner the health maintenance organization's surplus
is inadequate, the commissioner may require the health maintenance organization to
maintain additional surplus;

(3) claims relating to supplemental benefits must be processed in accordance with
the requirements of section 72A.201; and

(4) in marketing supplemental benefits, the health maintenance organization shall
fully disclose and describe to enrollees and potential enrollees the nature and extent of the
supplemental coverage, and any claims filing and other administrative responsibilities in
regard to supplemental benefits.

(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer
rules relating to this subdivision, including: rules insuring that these benefits are
supplementary and not substitutes for comprehensive health maintenance services by
addressing percentage of out-of-plan coverage; rules relating to the establishment of
necessary financial reserves; rules relating to marketing practices; and other rules necessary
for the effective and efficient administration of this subdivision. deleted text beginThe commissioner, in
adopting rules, shall give consideration to existing laws and rules administered and
enforced by the Department of Commerce relating to health insurance plans.
deleted text end

Sec. 3.

Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:


Subdivision 1.

False representations.

No health maintenance organization or
representative thereof may cause or knowingly permit the use of advertising or solicitation
which is untrue or misleading, or any form of evidence of coverage which is deceptive.
Each health maintenance organization shall be subject to sections 72A.17 to 72A.32,
relating to the regulation of trade practices, except deleted text begin(a)deleted text end to the extent that the nature of a
health maintenance organization renders such sections clearly inappropriate deleted text beginand (b) that
enforcement shall be by the commissioner of health and not by the commissioner of
commerce
deleted text end. Every health maintenance organization shall be subject to sections 8.31 and
325F.69.

Sec. 4.

Minnesota Statutes 2010, section 62Q.80, is amended to read:


62Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM.

Subdivision 1.

Scope.

(a) Any community-based health care initiative may develop
and operate community-based health care coverage programs that offer to eligible
individuals and their dependents the option of purchasing through their employer health
care coverage on a fixed prepaid basis without meeting the requirements of chapter 60A,
62A, 62C, 62D, 62M, 62N, 62Q, 62T, or 62U, or any other law or rule that applies to
entities licensed under these chapters.

(b) Each initiative shall establish health outcomes to be achieved through the
programs and performance measurements in order to determine whether these outcomes
have been met. The outcomes must include, but are not limited to:

(1) a reduction in uncompensated care provided by providers participating in the
community-based health network;

(2) an increase in the delivery of preventive health care services; and

(3) health improvement for enrollees with chronic health conditions through the
management of these conditions.

In establishing performance measurements, the initiative shall use measures that are
consistent with measures published by nonprofit Minnesota or national organizations that
produce and disseminate health care quality measures.

(c) Any program established under this section shall not constitute a financial
liability for the state, in that any financial risk involved in the operation or termination
of the program shall be borne by the community-based initiative and the participating
health care providers.

deleted text begin Subd. 1a. deleted text end

deleted text begin Demonstration project. deleted text end

deleted text begin The commissioner of health and the
commissioner of human services shall award demonstration project grants to
community-based health care initiatives to develop and operate community-based health
care coverage programs in Minnesota. The demonstration projects shall extend for five
years and must comply with the requirements of this section.
deleted text end

Subd. 2.

Definitions.

For purposes of this section, the following definitions apply:

(a) "Community-based" means located in or primarily relating to the community,
as determined by the board of a community-based health initiative that is served by the
community-based health care coverage program.

(b) "Community-based health care coverage program" or "program" means a
program administered by a community-based health initiative that provides health care
services through provider members of a community-based health network or combination
of networks to eligible individuals and their dependents who are enrolled in the program.

(c) "Community-based health initiative" or "initiative" means a nonprofit corporation
that is governed by a board that has at least 80 percent of its members residing in the
community and includes representatives of the participating network providers and
employers, or a county-based purchasing organization as defined in section 256B.692.

(d) "Community-based health network" means a contract-based network of health
care providers organized by the community-based health initiative to provide or support
the delivery of health care services to enrollees of the community-based health care
coverage program on a risk-sharing or nonrisk-sharing basis.

(e) "Dependent" means an eligible employee's spouse or unmarried child who is
under the age of 19 years.

Subd. 3.

Approval.

(a) Prior to the operation of a community-based health
care coverage program, a community-based health initiative, defined in subdivision
2, paragraph (c), deleted text beginand receiving funds from the Department of Health,deleted text end shall submit to
the commissioner of health for approval the community-based health care coverage
program developed by the initiative. deleted text beginEach community-based health initiative as defined
in subdivision 2, paragraph (c), and receiving State Health Access Program (SHAP)
grant funding shall submit to the commissioner of human services for approval prior
to its operation the community-based health care coverage programs developed by the
initiatives.
deleted text end The deleted text begincommissionersdeleted text endnew text begin commissionernew text end shall ensure that each program meets
deleted text begin the federal grant requirements and anydeleted text end requirements described in this section and is
actuarially sound based on a review of appropriate records and methods utilized by the
community-based health initiative in establishing premium rates for the community-based
health care coverage programs.

(b) Prior to approval, the commissioner shall also ensure that:

(1) the benefits offered comply with subdivision 8 and that there are adequate
numbers of health care providers participating in the community-based health network to
deliver the benefits offered under the program;

(2) the activities of the program are limited to activities that are exempt under this
section or otherwise from regulation by the commissioner of commerce;

(3) the complaint resolution process meets the requirements of subdivision 10; and

(4) the data privacy policies and procedures comply with state and federal law.

Subd. 4.

Establishment.

The initiative shall establish and operate upon approval
by the deleted text begincommissionersdeleted text endnew text begin commissionernew text end of health deleted text beginand human servicesdeleted text end community-based
health care coverage programs. The operational structure established by the initiative
shall include, but is not limited to:

(1) establishing a process for enrolling eligible individuals and their dependents;

(2) collecting and coordinating premiums from enrollees and employers of enrollees;

(3) providing payment to participating providers;

(4) establishing a benefit set according to subdivision 8 and establishing premium
rates and cost-sharing requirements;

(5) creating incentives to encourage primary care and wellness services; and

(6) initiating disease management services, as appropriate.

Subd. 5.

Qualifying employees.

To be eligible for the community-based health
care coverage program, an individual must:

(1) reside in or work within the designated community-based geographic area
served by the program;

(2) be employed by a qualifying employer, be an employee's dependent, or be
self-employed on a full-time basis;

(3) not be enrolled in or have currently available health coverage, except for
catastrophic health care coverage; and

(4) not be eligible for or enrolled in medical assistance or general assistance medical
care, and not be enrolled in MinnesotaCare or Medicare.

Subd. 6.

Qualifying employers.

(a) To qualify for participation in the
community-based health care coverage program, an employer must:

(1) employ at least one but no more than 50 employees at the time of initial
enrollment in the program;

(2) pay its employees a median wage that equals 350 percent of the federal poverty
guidelines or less for an individual; and

(3) not have offered employer-subsidized health coverage to its employees for
at least 12 months prior to the initial enrollment in the program. For purposes of this
section, "employer-subsidized health coverage" means health care coverage for which the
employer pays at least 50 percent of the cost of coverage for the employee.

(b) To participate in the program, a qualifying employer agrees to:

(1) offer health care coverage through the program to all eligible employees and
their dependents regardless of health status;

(2) participate in the program for an initial term of at least one year;

(3) pay a percentage of the premium established by the initiative for the employee;
and

(4) provide the initiative with any employee information deemed necessary by the
initiative to determine eligibility and premium payments.

Subd. 7.

Participating providers.

Any health care provider participating in the
community-based health network must accept as payment in full the payment rate
established by the initiatives and may not charge to or collect from an enrollee any amount
in access of this amount for any service covered under the program.

Subd. 8.

Coverage.

(a) The initiatives shall establish the health care benefits offered
through the community-based health care coverage programs. The benefits established
shall include, at a minimum:

(1) child health supervision services up to age 18, as defined under section 62A.047;
and

(2) preventive services, including:

(i) health education and wellness services;

(ii) health supervision, evaluation, and follow-up;

(iii) immunizations; and

(iv) early disease detection.

(b) Coverage of health care services offered by the program may be limited to
participating health care providers or health networks. All services covered under the
programs must be services that are offered within the scope of practice of the participating
health care providers.

(c) The initiatives may establish cost-sharing requirements. Any co-payment or
deductible provisions established may not discriminate on the basis of age, sex, race,
disability, economic status, or length of enrollment in the programs.

(d) If any of the initiatives amends or alters the benefits offered through the program
from the initial offering, that initiative must notify the deleted text begincommissionersdeleted text endnew text begin commissionernew text end of
health deleted text beginand human servicesdeleted text end and all enrollees of the benefit change.

Subd. 9.

Enrollee information.

(a) The initiatives must provide an individual or
family who enrolls in the program a clear and concise written statement that includes
the following information:

(1) health care services that are covered under the program;

(2) any exclusions or limitations on the health care services covered, including any
cost-sharing arrangements or prior authorization requirements;

(3) a list of where the health care services can be obtained and that all health
care services must be provided by or through a participating health care provider or
community-based health network;

(4) a description of the program's complaint resolution process, including how to
submit a complaint; how to file a complaint with the commissioner of health; and how to
obtain an external review of any adverse decisions as provided under subdivision 10;

(5) the conditions under which the program or coverage under the program may
be canceled or terminated; and

(6) a precise statement specifying that this program is not an insurance product and,
as such, is exempt from state regulation of insurance products.

(b) The deleted text begincommissionersdeleted text endnew text begin commissionernew text end of health deleted text beginand human servicesdeleted text end must approve a
copy of the written statement prior to the operation of the program.

Subd. 10.

Complaint resolution process.

(a) The initiatives must establish
a complaint resolution process. The process must make reasonable efforts to resolve
complaints and to inform complainants in writing of the initiative's decision within 60
days of receiving the complaint. Any decision that is adverse to the enrollee shall include
a description of the right to an external review as provided in paragraph (c) and how to
exercise this right.

(b) The initiatives must report any complaint that is not resolved within 60 days to
the commissioner of health.

(c) The initiatives must include in the complaint resolution process the ability of an
enrollee to pursue the external review process provided under section 62Q.73 with any
decision rendered under this external review process binding on the initiatives.

Subd. 11.

Data privacy.

The initiatives shall establish data privacy policies and
procedures for the program that comply with state and federal data privacy laws.

Subd. 12.

Limitations on enrollment.

(a) The initiatives may limit enrollment in
the program. If enrollment is limited, a waiting list must be established.

(b) The initiatives shall not restrict or deny enrollment in the program except for
nonpayment of premiums, fraud or misrepresentation, or as otherwise permitted under
this section.

(c) The initiatives may require a certain percentage of participation from eligible
employees of a qualifying employer before coverage can be offered through the program.

Subd. 13.

Report.

Each initiative shall submit deleted text beginquarterlydeleted text end new text begin an annual new text endstatus reportdeleted text beginsdeleted text end
to the commissioner of health on January 15deleted text begin, April 15, July 15, and October 15deleted text end of each
year, with the first report due January 15, 2008. deleted text beginEach initiative receiving funding from the
Department of Human Services shall submit status reports to the commissioner of human
services as defined in the terms of the contract with the Department of Human Services.
deleted text end
Each status report shall include:

(1) the financial status of the program, including the premium rates, cost per member
per month, claims paid out, premiums received, and administrative expenses;

(2) a description of the health care benefits offered and the services utilized;

(3) the number of employers participating, the number of employees and dependents
covered under the program, and the number of health care providers participating;

(4) a description of the health outcomes to be achieved by the program and a status
report on the performance measurements to be used and collected; and

(5) any other information requested by the commissioners of healthdeleted text begin, human services,deleted text end
or commerce or the legislature.

deleted text begin Subd. 14. deleted text end

deleted text begin Sunset. deleted text end

deleted text begin This section expires August 31, 2014.
deleted text end

Sec. 5.

Minnesota Statutes 2010, section 62U.04, subdivision 1, is amended to read:


Subdivision 1.

Development of tools to improve costs and quality outcomes.

The commissioner of health shall develop a plan to create transparent prices, encourage
greater provider innovation and collaboration across points on the health continuum
in cost-effective, high-quality care delivery, reduce the administrative burden on
providers and health plans associated with submitting and processing claims, and provide
comparative information to consumers on variation in health care cost and quality across
providers. deleted text beginThe development must be complete by January 1, 2010.
deleted text end

Sec. 6.

Minnesota Statutes 2010, section 62U.04, subdivision 2, is amended to read:


Subd. 2.

Calculation of health care costs and quality.

The commissioner of health
shall develop a uniform method of calculating providers' relative cost of care, defined as a
measure of health care spending including resource use and unit prices, and relative quality
of care. In developing this method, the commissioner must address the following issues:

(1) provider attribution of costs and quality;

(2) appropriate adjustment for outlier or catastrophic cases;

(3) appropriate risk adjustment to reflect differences in the demographics and health
status across provider patient populations, using generally accepted and transparent risk
adjustment methodologiesnew text begin and case mix adjustmentnew text end;

(4) specific types of providers that should be included in the calculation;

(5) specific types of services that should be included in the calculation;

(6) appropriate adjustment for variation in payment rates;

(7) the appropriate provider level for analysis;

(8) payer mix adjustments, including variation across providers in the percentage of
revenue received from government programs; and

(9) other factors that the commissioner deleted text begindeterminesdeleted text endnew text begin and the advisory committee,
established under subdivision 3, determine
new text end are needed to ensure validity and comparability
of the analysis.

Sec. 7.

Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 3, is
amended to read:


Subd. 3.

Provider peer groupingnew text begin; system development; advisory committeenew text end.

(a) The commissioner shall develop a peer grouping system for providers deleted text beginbased on a
combined measure
deleted text end that incorporates both provider risk-adjusted cost of care and quality of
care, and for specific conditions as determined by the commissioner. deleted text beginIn developing this
system, the commissioner shall consult and coordinate with health care providers, health
plan companies, state agencies, and organizations that work to improve health care quality
in Minnesota.
deleted text end For purposes of the final establishment of the peer grouping system, the
commissioner shall not contract with any private entity, organization, or consortium of
entities that has or will have a direct financial interest in the outcome of the system.

new text begin (b) The commissioner shall establish an advisory committee comprised of
representatives of health care providers, health plan companies, consumers, state agencies,
employers, academic researchers, and organizations that work to improve health care
quality in Minnesota. The advisory committee shall meet no fewer than three times
per year. The commissioner shall consult with the advisory committee in developing
and administering the peer grouping system, including but not limited to the following
activities:
new text end

new text begin (1) establishing peer groups;
new text end

new text begin (2) selecting quality measures;
new text end

new text begin (3) recommending thresholds for completeness of data and statistical significance
for the purposes of public release of provider peer grouping results;
new text end

new text begin (4) considering whether adjustments are necessary for facilities that provide medical
education, level 1 trauma services, neonatal intensive care, or inpatient psychiatric care;
new text end

new text begin (5) recommending inclusion or exclusion of other costs; and
new text end

new text begin (6) adopting patient attribution and quality and cost-scoring methodologies.
new text end

new text begin Subd. 3a. new text end

new text begin Provider peer grouping; dissemination of data to providers. new text end

deleted text begin(b) By
no later than October 15, 2010,
deleted text endnew text begin (a)new text end The commissioner shall disseminate information
to providers on their total cost of care, total resource use, total quality of care, and the
total care results of the grouping developed under deleted text beginthisdeleted text end subdivisionnew text begin 3new text end in comparison to an
appropriate peer group. new text beginData used for this analysis must be the most recent data available.
new text endAny analyses or reports that identify providers may only be published after the provider
has been provided the opportunity by the commissioner to review the underlying datanew text begin in
order to verify, consistent with the recommendations developed pursuant to subdivision
3c, paragraph (d), and adopted by the commissioner the accuracy and representativeness
of any analyses or reports
new text end and submit commentsnew text begin to the commissioner or initiate an appeal
under subdivision 3b
new text end. deleted text beginProviders maydeleted text endnew text begin Upon request, providers shallnew text end be given any data for
which they are the subject of the data. The provider shall have deleted text begin30deleted text endnew text begin 60new text end days to review the
data for accuracy and initiate an appeal as specified in deleted text beginparagraph (d)deleted text endnew text begin subdivision 3bnew text end.

deleted text begin (c) By no later than January 1, 2011,deleted text endnew text begin (b)new text end The commissioner shall disseminate
information to providers on their condition-specific cost of care, condition-specific
resource use, condition-specific quality of care, and the condition-specific results of the
grouping developed under deleted text beginthisdeleted text end subdivisionnew text begin 3new text end in comparison to an appropriate peer group.new text begin
Data used for this analysis must be the most recent data available.
new text end Any analyses or
reports that identify providers may only be published after the provider has been provided
the opportunity by the commissioner to review the underlying datanew text begin in order to verify,
consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d),
and adopted by the commissioner the accuracy and representativeness of any analyses or
reports
new text end and submit commentsnew text begin to the commissioner or initiate an appeal under subdivision
3b
new text end. deleted text beginProviders maydeleted text endnew text begin Upon request, providers shallnew text end be given any data for which they are the
subject of the data. The provider shall have deleted text begin30deleted text endnew text begin 60new text end days to review the data for accuracy and
initiate an appeal as specified in deleted text beginparagraph (d)deleted text endnew text begin subdivision 3bnew text end.

new text begin Subd. 3b. new text end

new text begin Provider peer grouping; appeals process. new text end

deleted text begin(d)deleted text end The commissioner shall
establish deleted text beginan appealsdeleted text endnew text begin anew text end process to resolve disputes from providers regarding the accuracy
of the data used to develop analyses or reportsnew text begin or errors in the application of standards
or methodology established by the commissioner in consultation with the advisory
committee
new text end. When a provider deleted text beginappeals the accuracy of the data used to calculate the peer
grouping system results
deleted text endnew text begin submits an appealnew text end, the provider shall:

(1) clearly indicate the reason deleted text beginthey believe the data used to calculate the peer group
system results are not accurate
deleted text endnew text begin or reasons for the appealnew text end;

(2) providenew text begin anynew text end evidence deleted text beginanddeleted text endnew text begin, calculations, ornew text end documentation to support the reason
deleted text begin that data was not accuratedeleted text endnew text begin for the appealnew text end; and

(3) cooperate with the commissioner, including allowing the commissioner access to
data necessary and relevant to resolving the dispute.

new text begin The commissioner shall cooperate with the provider during the data review period
specified in subdivisions 3a and 3c by giving the provider information necessary for the
preparation of an appeal.
new text end

If a provider does not meet the requirements of this deleted text beginparagraphdeleted text endnew text begin subdivisionnew text end, a provider's
appeal shall be considered withdrawn. The commissioner shall not publishnew text begin peer groupingnew text end
results for a deleted text beginspecificdeleted text end provider deleted text beginunder paragraph (e) or (f) while that provider has an
unresolved appeal
deleted text endnew text begin until the appeal has been resolvednew text end.

new text begin Subd. 3c. new text end

new text begin Provider peer grouping; publication of information for the public.
new text end

deleted text begin (e) Beginning January 1, 2011, the commissioner shall, no less than annually, publish
information on providers' total cost, total resource use, total quality, and the results of
the total care portion of the peer grouping process. The results that are published must
be on a risk-adjusted basis.
deleted text end new text begin (a) The commissioner may publicly release summary data
related to the peer grouping system as long as the data do not contain information or
descriptions from which the identity of individual hospitals, clinics, or other providers
may be discerned.
new text end

deleted text begin (f) Beginning March 30, 2011, the commissioner shall no less than annually publish
information on providers' condition-specific cost, condition-specific resource use, and
condition-specific quality, and the results of the condition-specific portion of the peer
grouping process. The results that are published must be on a risk-adjusted basis.
deleted text end new text begin (b) The
commissioner may publicly release analyses or results related to the peer grouping system
that identify hospitals, clinics, or other providers only if the following criteria are met:
new text end

new text begin (1) the results, data, and summaries, including any graphical depictions of provider
performance, have been distributed to providers at least 120 days prior to publication;
new text end

new text begin (2) the commissioner has provided an opportunity for providers to verify and review
data for which the provider is the subject consistent with the recommendations developed
pursuant to paragraph (d) and adopted by the commissioner;
new text end

new text begin (3) the results meet thresholds of validity, reliability, statistical significance,
representativeness, and other standards that reflect the recommendations of the advisory
committee, established under subdivision 3; and
new text end

new text begin (4) any public report or other usage of the analyses, report, or data used by the
state clearly notifies consumers about how to use and interpret the results, including
any limitations of the data and analysis.
new text end

deleted text begin (g)deleted text endnew text begin (c) After publishing the first public report, the commissioner shall, no less
frequently than annually, publish information on providers' total cost, total resource use,
total quality, and the results of the total care portion of the peer grouping process, as well
as information on providers' condition-specific cost, condition-specific resource use,
and condition-specific quality, and the results of the condition-specific portion of the
peer grouping process. The results that are published must be on a risk-adjusted basis,
including case mix adjustments.
new text end

new text begin (d) The commissioner shall convene a work group comprised of representatives
of physician clinics, hospitals, their respective statewide associations, and other
relevant stakeholder organizations to make recommendations on data to be made
available to hospitals and physician clinics to allow for verification of the accuracy and
representativeness of the provider peer grouping results.
new text end

new text begin Subd. 3d. new text end

new text begin Provider peer grouping; standards for dissemination and publication.
new text end

new text begin (a) new text endPrior to disseminating data to providers under deleted text beginparagraph (b) or (c)deleted text endnew text begin subdivision 3anew text end or
publishing information under deleted text beginparagraph (e) or (f)deleted text endnew text begin subdivision 3cnew text end, the commissionernew text begin, in
consultation with the advisory committee,
new text end shall ensure the scientific new text beginand statistical new text endvalidity
and reliability of the results according to the standards described in paragraph deleted text begin(h)deleted text endnew text begin (b)new text end.
If additional time is needed to establish the scientific validitynew text begin, statistical significance,new text end
and reliability of the results, the commissioner may delay the dissemination of data to
providers under deleted text beginparagraph (b) or (c)deleted text endnew text begin subdivision 3anew text end, or the publication of information under
deleted text begin paragraph (e) or (f)deleted text endnew text begin subdivision 3cnew text end. deleted text beginIf the delay is more than 60 days, the commissioner
shall report in writing to the chairs and ranking minority members of the legislative
committees with jurisdiction over health care policy and finance the following information:
deleted text end

deleted text begin (1) the reason for the delay;
deleted text end

deleted text begin (2) the actions being taken to resolve the delay and establish the scientific validity
and reliability of the results; and
deleted text end

deleted text begin (3) the new dates by which the results shall be disseminated.
deleted text end

deleted text begin If there is a delay under this paragraph,deleted text end The commissioner must disseminate the
information to providers under deleted text beginparagraph (b) or (c)deleted text endnew text begin subdivision 3anew text end at least deleted text begin90deleted text endnew text begin 120new text end days
before publishing results under deleted text beginparagraph (e) or (f)deleted text endnew text begin subdivision 3cnew text end.

deleted text begin (h)deleted text endnew text begin (b)new text end The commissioner's assurance of validnew text begin, timely,new text end and reliable clinic and hospital
peer grouping performance results shall include, at a minimum, the following:

(1) use of the best available evidence, research, and methodologies; and

(2) establishment of deleted text beginandeleted text end explicit minimum reliability deleted text beginthresholddeleted text end new text begin thresholds for both
quality and costs
new text enddeveloped in collaboration with the subjects of the data and the users of
the data, at a level not below nationally accepted standards where such standards exist.

In achieving these thresholds, the commissioner shall not aggregate clinics that are not
part of the same system or practice group. The commissioner shall consult with and
solicit feedback fromnew text begin the advisory committee andnew text end representatives of physician clinics
and hospitals during the peer grouping data analysis process to obtain input on the
methodological options prior to final analysis and on the design, development, and testing
of provider reports.

Sec. 8.

Minnesota Statutes 2010, section 62U.04, subdivision 4, is amended to read:


Subd. 4.

Encounter data.

(a) Beginning July 1, 2009, and every six months
thereafter, all health plan companies and third-party administrators shall submit encounter
data to a private entity designated by the commissioner of health. The data shall be
submitted in a form and manner specified by the commissioner subject to the following
requirements:

(1) the data must be de-identified data as described under the Code of Federal
Regulations, title 45, section 164.514;

(2) the data for each encounter must include an identifier for the patient's health care
home if the patient has selected a health care home; and

(3) except for the identifier described in clause (2), the data must not include
information that is not included in a health care claim or equivalent encounter information
transaction that is required under section 62J.536.

(b) The commissioner or the commissioner's designee shall only use the data
submitted under paragraph (a) deleted text beginfor thedeleted text end deleted text beginpurpose of carrying out its responsibilities in this
section, and must maintain the data that it receives according to the provisions of this
section.
deleted text endnew text begin to carry out its responsibilities in this section, including supplying the data to
providers so they can verify their results of the peer grouping process consistent with the
recommendations developed pursuant to subdivision 3c, paragraph (d), and adopted by
the commissioner and, if necessary, submit comments to the commissioner or initiate
an appeal.
new text end

(c) Data on providers collected under this subdivision are private data on individuals
or nonpublic data, as defined in section 13.02. Notwithstanding the definition of summary
data in section 13.02, subdivision 19, summary data prepared under this subdivision
may be derived from nonpublic data. The commissioner or the commissioner's designee
shall establish procedures and safeguards to protect the integrity and confidentiality of
any data that it maintains.

(d) The commissioner or the commissioner's designee shall not publish analyses or
reports that identify, or could potentially identify, individual patients.

Sec. 9.

Minnesota Statutes 2010, section 62U.04, subdivision 5, is amended to read:


Subd. 5.

Pricing data.

(a) Beginning July 1, 2009, and annually on January 1
thereafter, all health plan companies and third-party administrators shall submit data
on their contracted prices with health care providers to a private entity designated by
the commissioner of health for the purposes of performing the analyses required under
this subdivision. The data shall be submitted in the form and manner specified by the
commissioner of health.

(b) The commissioner or the commissioner's designee shall only use the data
submitted under this subdivision deleted text beginfor the purpose of carrying out its responsibilities under
this section
deleted text endnew text begin to carry out its responsibilities under this section, including supplying the
data to providers so they can verify their results of the peer grouping process consistent
with the recommendations developed pursuant to subdivision 3c, paragraph (d), and
adopted by the commissioner and, if necessary, submit comments to the commissioner or
initiate an appeal
new text end.

(c) Data collected under this subdivision are nonpublic data as defined in section
13.02. Notwithstanding the definition of summary data in section 13.02, subdivision 19,
summary data prepared under this section may be derived from nonpublic data. The
commissioner shall establish procedures and safeguards to protect the integrity and
confidentiality of any data that it maintains.

Sec. 10.

Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 9, is
amended to read:


Subd. 9.

Uses of information.

deleted text begin(a)deleted text end For product renewals or for new products that
are offereddeleted text begin, after 12 months have elapsed from publication by the commissioner of the
information in subdivision 3, paragraph (e)
deleted text end:

(1) the commissioner of management and budget deleted text beginshalldeleted text endnew text begin maynew text end use the information and
methods developed under deleted text beginsubdivision 3deleted text endnew text begin subdivisions 3 to 3dnew text end to strengthen incentives for
members of the state employee group insurance program to use high-quality, low-cost
providers;

(2) deleted text beginalldeleted text end political subdivisions, as defined in section 13.02, subdivision 11, that offer
health benefits to their employees deleted text beginmustdeleted text endnew text begin maynew text end offer plans that differentiate providers on their
cost and quality performance and create incentives for members to use better-performing
providers;

(3) deleted text beginalldeleted text end health plan companies deleted text beginshalldeleted text endnew text begin maynew text end use the information and methods developed
under deleted text beginsubdivision 3deleted text endnew text begin subdivisions 3 to 3dnew text end to develop products that encourage consumers to
use high-quality, low-cost providers; and

(4) health plan companies that issue health plans in the individual market or the
small employer market deleted text beginmustdeleted text endnew text begin maynew text end offer at least one health plan that uses the information
developed under deleted text beginsubdivision 3deleted text endnew text begin subdivisions 3 to 3dnew text end to establish financial incentives for
consumers to choose higher-quality, lower-cost providers through enrollee cost-sharing
or selective provider networks.

deleted text begin (b) By January 1, 2011, the commissioner of health shall report to the governor
and the legislature on recommendations to encourage health plan companies to promote
widespread adoption of products that encourage the use of high-quality, low-cost providers.
The commissioner's recommendations may include tax incentives, public reporting of
health plan performance, regulatory incentives or changes, and other strategies.
deleted text end

Sec. 11.

Minnesota Statutes 2011 Supplement, section 144.1222, subdivision 5,
is amended to read:


Subd. 5.

deleted text beginSwimming pond exemptiondeleted text endnew text begin Exemptionsnew text end.

(a) A public swimming pond
in existence before January 1, 2008, is not a public pool for purposes of this section and
section 157.16, and is exempt from the requirements for public swimming pools under
Minnesota Rules, chapter 4717.

new text begin (b) A naturally treated swimming pool located in the city of Minneapolis is not
a public pool for purposes of this section and section 157.16, and is exempt from the
requirements for public swimming pools under Minnesota Rules, chapter 4717.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end Notwithstanding deleted text beginparagraphdeleted text endnew text begin paragraphsnew text end (a)new text begin and (b)new text end, a public swimming pond
new text begin and a naturally treated swimming pool new text endmust meet the requirements for public pools
described in subdivisions 1c and 1d.

deleted text begin (c)deleted text endnew text begin (d)new text end For purposes of this subdivision, a "public swimming pond" means an
artificial body of water contained within a lined, sand-bottom basin, intended for public
swimming, relaxation, or recreational use that includes a water circulation system for
maintaining water quality and does not include any portion of a naturally occurring lake
or stream.

new text begin (e) For purposes of this subdivision, a "naturally treated swimming pool" means an
artificial body of water contained in a basin, intended for public swimming, relaxation, or
recreational use that uses a chemical free filtration system for maintaining water quality
through natural processes, including the use of plants, beneficial bacteria, and microbes.
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. 12.

Minnesota Statutes 2010, section 144.5509, is amended to read:


144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.

(a) A radiation therapy facility may be constructed only by an entity owned,
operated, or controlled by a hospital licensed according to sections 144.50 to 144.56 either
alone or in cooperation with another entity.new text begin This paragraph expires August 1, 2014.
new text end

(b) Notwithstanding paragraph (a), there shall be a moratorium on the construction
of any radiation therapy facility located in the following counties: Hennepin, Ramsey,
Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns,
Chisago, Isanti, and Wright. This paragraph does not apply to the relocation or
reconstruction of an existing facility owned by a hospital if the relocation or reconstruction
is within one mile of the existing facility. This paragraph does not apply to a radiation
therapy facility that is being built attached to a community hospital in Wright County and
meets the following conditions prior to August 1, 2007: the capital expenditure report
required under Minnesota Statutes, section 62J.17, has been filed with the commissioner
of health; a timely construction schedule is developed, stipulating dates for beginning,
achieving various stages, and completing construction; and all zoning and building permits
applied for. new text beginBeginning January 1, 2013, this paragraph does not apply to any construction
necessary to relocate a radiation therapy machine from a community hospital-owned
radiation therapy facility located in the city of Maplewood to a community hospital
campus in the city of Woodbury within the same health system.
new text endThis paragraph expires
August 1, 2014.

new text begin (c) After August 1, 2014, a radiation therapy facility may be constructed only if the
following requirements are met:
new text end

new text begin (1) the entity constructing the radiation therapy facility is controlled by or is under
common control with a hospital licensed under sections 144.50 to 144.56; and
new text end

new text begin (2) the new radiation therapy facility is located at least seven miles from an existing
radiation therapy facility.
new text end

new text begin (d) Any referring physician must provide each patient who is in need of radiation
therapy services with a list of all radiation therapy facilities located within the following
counties: Hennepin, Ramsey, Dakota, Washington, Anoka, Carver, Scott, St. Louis,
Sherburne, Benton, Stearns, Chisago, Isanti, and Wright. Physicians with a financial
interest in any radiation therapy facility must disclose to the patient the existence of the
interest.
new text end

new text begin (e) For purposes of this section, "controlled by" or "under common control with"
means the possession, direct or indirect, of the power to direct or cause the direction of the
policies, operations, or activities of an entity, through the ownership of, or right to vote
or to direct the disposition of shares, membership interests, or ownership interests of
the entity.
new text end

new text begin (f) For purposes of this section, "financial interest in any radiation therapy facility"
means a direct or indirect ownership or investment interest in a radiation therapy facility
or a compensation arrangement with a radiation therapy facility.
new text end

new text begin (g) This section does not apply to the relocation or reconstruction of an existing
radiation therapy facility if:
new text end

new text begin (1) the relocation or reconstruction of the facility remains owned by the same entity;
new text end

new text begin (2) the relocation or reconstruction is located within one mile of the existing facility;
and
new text end

new text begin (3) the period in which the existing facility is closed and the relocated or
reconstructed facility begins providing services does not exceed 12 months.
new text end

Sec. 13.

Minnesota Statutes 2010, section 145.906, is amended to read:


145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.

(a) The commissioner of health shall work with health care facilities, licensed health
and mental health care professionals, new text beginthe women, infants, and children (WIC) program,
new text endmental health advocates, consumers, and families in the state to develop materials and
information about postpartum depression, including treatment resources, and develop
policies and procedures to comply with this section.

(b) Physicians, traditional midwives, and other licensed health care professionals
providing prenatal care to women must have available to women and their families
information about postpartum depression.

(c) Hospitals and other health care facilities in the state must provide departing new
mothers and fathers and other family members, as appropriate, with written information
about postpartum depression, including its symptoms, methods of coping with the illness,
and treatment resources.

new text begin (d) Information about postpartum depression, including its symptoms, potential
impact on families, and treatment resources must be available at WIC sites.
new text end

Sec. 14.

Minnesota Statutes 2010, section 256B.0754, subdivision 2, is amended to
read:


Subd. 2.

Payment reform.

By no later than 12 months after the commissioner of
health publishes the information in section deleted text begin62U.04, subdivision 3, paragraph (e)deleted text endnew text begin 62U.04,
subdivision 3c, paragraph (b)
new text end, the commissioner of human services deleted text beginshalldeleted text endnew text begin maynew text end use the
information and methods developed under section 62U.04 to establish a payment system
that:

(1) rewards high-quality, low-cost providers;

(2) creates enrollee incentives to receive care from high-quality, low-cost providers;
and

(3) fosters collaboration among providers to reduce cost shifting from one part of
the health continuum to another.

Sec. 15.

Laws 2011, First Special Session chapter 9, article 10, section 4, subdivision
2, is amended to read:


Subd. 2.

Community and Family Health
Promotion

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

TANF Appropriations. (1) $1,156,000 of
the TANF funds is appropriated each year of
the biennium to the commissioner for family
planning grants under Minnesota Statutes,
section 145.925.

(2) $3,579,000 of the TANF funds is
appropriated each year of the biennium to
the commissioner for home visiting and
nutritional services listed under Minnesota
Statutes, section 145.882, subdivision 7,
clauses (6) and (7). Funds must be distributed
to community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1
.

(3) $2,000,000 of the TANF funds is
appropriated each year of the biennium to
the commissioner for decreasing racial and
ethnic disparities in infant mortality rates
under Minnesota Statutes, section 145.928,
subdivision 7
.

(4) $4,978,000 of the TANF funds is
appropriated each year of the biennium to the
commissioner for the family home visiting
grant program according to Minnesota
Statutes, section 145A.17. $4,000,000 of the
funding must be distributed to community
health boards according to Minnesota
Statutes, section 145A.131, subdivision 1.
$978,000 of the funding must be distributed
to tribal governments based on Minnesota
Statutes, section 145A.14, subdivision 2a.

(5) The commissioner may use up to 6.23
percent of the funds appropriated each fiscal
year to conduct the ongoing evaluations
required under Minnesota Statutes, section
145A.17, subdivision 7, and training and
technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4
and 5.

TANF Carryforward. Any unexpended
balance of the TANF appropriation in the
first year of the biennium does not cancel but
is available for the second year.

Statewide Health Improvement Program.
deleted text begin (a)deleted text end $15,000,000 in the biennium ending June
30, 2013, is appropriated from the health
care access fund for the statewide health
improvement program and is available until
expended. Notwithstanding Minnesota
Statutes, sections 144.396, and 145.928, the
commissioner may use tobacco prevention
grant funding and grant funding under
Minnesota Statutes, section 145.928, to
support the statewide health improvement
program. The commissioner may focus the
program geographically or on a specific
goal of tobacco use reduction or on
reducing obesity. deleted text beginBy February 15, 2013, the
commissioner shall report to the chairs of
the health and human services committee
on progress toward meeting the goals of the
program as outlined in Minnesota Statutes,
section 145.986, and estimate the dollar
value of the reduced health care costs for
both public and private payers.
deleted text end

deleted text begin (b) By February 15, 2012, the commissioner
shall develop a plan to implement
evidence-based strategies from the statewide
health improvement program as part of
hospital community benefit programs
and health maintenance organizations
collaboration plans. The implementation
plan shall include an advisory board
to determine priority needs for health
improvement in reducing obesity and
tobacco use in Minnesota and to review
and approve hospital community benefit
activities reported under Minnesota Statutes,
section 144.699, and health maintenance
organizations collaboration plans in
Minnesota Statutes, section 62Q.075. The
commissioner shall consult with hospital
and health maintenance organizations in
creating and implementing the plan. The
plan described in this paragraph shall be
implemented by July 1, 2012.
deleted text end

deleted text begin (c) The commissioners of Minnesota
management and budget, human services,
and health shall include in each forecast
beginning February of 2013 a report that
identifies an estimated dollar value of the
health care savings in the state health care
programs that are directly attributable to the
strategies funded from the statewide health
improvement program. The report shall
include a description of methodologies and
assumptions used to calculate the estimate.
deleted text end

Funding Usage. Up to 75 percent of the
fiscal year 2012 appropriation for local public
health grants may be used to fund calendar
year 2011 allocations for this program and
up to 75 percent of the fiscal year 2013
appropriation may be used for calendar year
2012 allocations. The fiscal year 2014 base
shall be increased by $5,193,000.

Base Level Adjustment. The general fund
base is increased by $5,188,000 in fiscal year
2014 and decreased by $5,000 in 2015.

Sec. 16. new text beginSTUDY OF RADIATION THERAPY FACILITIES CAPACITY.
new text end

new text begin (a) To the extent of available appropriations, the commissioner of health shall
conduct a study of the following: (1) current treatment capacity of the existing radiation
therapy facilities within the state; (2) the present need for radiation therapy services based
on population demographics and new cancer cases; and (3) the projected need in the next
ten years for radiation therapy services and whether the current facilities can sustain
this projected need.
new text end

new text begin (b) The commissioner may contract with a qualified entity to conduct the study. The
study shall be completed by March 15, 2013, and the results shall be submitted to the
chairs and ranking minority members of the health and human services committees of
the legislature.
new text end

Sec. 17. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the terms "commissioner of health" or similar
term to "commissioner of commerce" or similar term and "department of health" or similar
term to "department of commerce" or similar term wherever necessary in Minnesota
Statutes, chapters 62A to 62U, and other relevant statutes as needed to signify the transfer
of regulatory jurisdiction of health maintenance organizations from the commissioner of
health to the commissioner of commerce.
new text end

Sec. 18. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 5 to 10 and 14 are effective July 1, 2012, and apply to all information
provided or released to the public or to health care providers, pursuant to Minnesota
Statutes, section 62U.04, on or after that date. Section 7 shall be implemented by the
commissioner of health within available resources.
new text end

ARTICLE 3

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is
amended to read:


Subd. 7.

Absent days.

(a) Licensed child care providers and license-exempt centers
must not be reimbursed for more than ten full-day absent days per child, excluding
holidays, in a fiscal year. Legal nonlicensed family child care providers must not be
reimbursed for absent days. If a child attends for part of the time authorized to be in care in
a day, but is absent for part of the time authorized to be in care in that same day, the absent
time must be reimbursed but the time must not count toward the ten absent day limit.
Child care providers must only be reimbursed for absent days if the provider has a written
policy for child absences and charges all other families in care for similar absences.

new text begin (b) Notwithstanding paragraph (a), children in families may exceed the ten absent
days limit if at least one parent is: (1) under the age of 21; (2) does not have a high school
or general equivalency diploma; and (3) is a student in a school district or another similar
program that provides or arranges for child care, parenting support, social services, career
and employment supports, and academic support to achieve high school graduation, upon
request of the program and approval of the county. If a child attends part of an authorized
day, payment to the provider must be for the full amount of care authorized for that day.
new text end

deleted text begin (b)deleted text end new text begin(c) new text endChild care providers must be reimbursed for up to ten federal or state
holidays or designated holidays per year when the provider charges all families for these
days and the holiday or designated holiday falls on a day when the child is authorized to
be in attendance. Parents may substitute other cultural or religious holidays for the ten
recognized state and federal holidays. Holidays do not count toward the ten absent day
limit.

deleted text begin (c)deleted text end new text begin(d) new text endA family or child care provider must not be assessed an overpayment for an
absent day payment unless (1) there was an error in the amount of care authorized for the
family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
the family or provider did not timely report a change as required under law.

deleted text begin (d)deleted text end new text begin(e) new text endThe provider and family shall receive notification of the number of absent
days used upon initial provider authorization for a family and ongoing notification of the
number of absent days used as of the date of the notification.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2013.
new text end

Sec. 2.

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:


new text begin Subd. 18d. new text end

new text begin Drug convictions. new text end

new text begin (a) The state court administrator shall provide a
report every six months by electronic means to the commissioner of human services,
including the name, address, date of birth, and, if available, driver's license or state
identification card number, date of sentence, effective date of the sentence, and county in
which the conviction occurred of each person convicted of a felony under chapter 152
during the previous six months.
new text end

new text begin (b) The commissioner shall determine whether the individuals who are the subject of
the data reported under paragraph (a) are receiving public assistance under chapter 256D
or 256J, and if the individual is receiving assistance under chapter 256D or 256J, the
commissioner shall instruct the county to proceed under section 256D.024 or 256J.26,
whichever is applicable, for this individual.
new text end

new text begin (c) The commissioner shall not retain any data received under paragraph (a) or (d)
that does not relate to an individual receiving publicly funded assistance under chapter
256D or 256J.
new text end

new text begin (d) In addition to the routine data transfer under paragraph (a), the state court
administrator shall provide a onetime report of the data fields under paragraph (a) for
individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until
the date of the data transfer. The commissioner shall perform the tasks identified under
paragraph (b) related to this data and shall retain the data according to paragraph (c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2013.
new text end

Sec. 3.

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:


new text begin Subd. 18e. new text end

new text begin Data sharing with the Department of Human Services; multiple
identification cards.
new text end

new text begin (a) The commissioner of public safety shall, on a monthly basis,
provide the commissioner of human services with the first, middle, and last name,
the address, date of birth, and driver's license or state identification card number of all
applicants and holders whose drivers' licenses and state identification cards have been
canceled under section 171.14, paragraph (a), clauses (2) or (3), by the commissioner of
public safety. After the initial data report has been provided by the commissioner of
public safety to the commissioner of human services under this paragraph, subsequent
reports shall only include cancellations that occurred after the end date of the cancellations
represented in the previous data report.
new text end

new text begin (b) The commissioner of human services shall compare the information provided
under paragraph (a) with the commissioner's data regarding recipients of all public
assistance programs managed by the Department of Human Services to determine whether
any person with multiple identification cards issued by the Department of Public Safety
has illegally or improperly enrolled in any public assistance program managed by the
Department of Human Services.
new text end

new text begin (c) If the commissioner of human services determines that an applicant or recipient
has illegally or improperly enrolled in any public assistance program, the commissioner
shall provide all due process protections to the individual before terminating the individual
from the program according to applicable statute and notifying the county attorney.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2013.
new text end

Sec. 4.

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:


new text begin Subd. 18f. new text end

new text begin Data sharing with the Department of Human Services; legal presence
status.
new text end

new text begin (a) The commissioner of public safety shall, on a monthly basis, provide the
commissioner of human services with the first, middle, and last name, address, date of
birth, and driver's license or state identification number of all applicants and holders of
drivers' licenses and state identification cards whose temporary legal presence status has
expired and whose driver's license or identification card has been canceled under section
171.14 by the commissioner of public safety.
new text end

new text begin (b) The commissioner of human services shall use the information provided under
paragraph (a) to determine whether the eligibility of any recipients of public assistance
programs managed by the Department of Human Services has changed as a result of the
status change in the Department of Public Safety data.
new text end

new text begin (c) If the commissioner of human services determines that a recipient has illegally or
improperly received benefits from any public assistance program, the commissioner shall
provide all due process protections to the individual before terminating the individual from
the program according to applicable statute and notifying the county attorney.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2013.
new text end

Sec. 5.

Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is
amended to read:


Subdivision 1.

Electronic benefit transfer (EBT) card.

Cash benefits for the
general assistance and Minnesota supplemental aid programs under chapter 256D and
programs under chapter 256J must be issued on deleted text begina separatedeleted text endnew text begin annew text end EBT card with the name of
the head of household printed on the card. The card must include the following statement:
"It is unlawful to use this card to purchase tobacco products or alcoholic beverages." This
card must be issued within 30 calendar days of an eligibility determination. During the
initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT
card without a name printed on the card. This card may be the same card on which food
support benefits are issued and does not need to meet the requirements of this section.

Sec. 6.

Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:


Subd. 1b.

Earned income savings account.

In addition to the $50 disregard
required under subdivision 1, the county agency shall disregard an additional earned
income up to a maximum of deleted text begin$150deleted text endnew text begin $500new text end per month for: (1) persons residing in facilities
licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to
9530.4000, and for whom discharge and work are part of a treatment plan; (2) persons
living in supervised apartments with services funded under Minnesota Rules, parts
9535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan;
and (3) persons residing in group residential housing, as that term is defined in section
256I.03, subdivision 3, for whom the county agency has approved a discharge plan
which includes work. The additional amount disregarded must be placed in a separate
savings account by the eligible individual, to be used upon discharge from the residential
facility into the community. For individuals residing in a chemical dependency program
licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from
the savings account require the signature of the individual and for those individuals with
an authorized representative payee, the signature of the payee. A maximum of deleted text begin$1,000deleted text endnew text begin
$2,000
new text end, including interest, of the money in the savings account must be excluded from
the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in
that account in excess of deleted text begin$1,000deleted text endnew text begin $2,000new text end must be applied to the resident's cost of care. If
excluded money is removed from the savings account by the eligible individual at any
time before the individual is discharged from the facility into the community, the money is
income to the individual in the month of receipt and a resource in subsequent months. If
an eligible individual moves from a community facility to an inpatient hospital setting,
the separate savings account is an excluded asset for up to 18 months. During that time,
amounts that accumulate in excess of the deleted text begin$1,000deleted text endnew text begin $2,000new text end savings limit must be applied to
the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the
18-month period, the entire account must be applied to the patient's cost of care.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2012.
new text end

Sec. 7.

Minnesota Statutes 2010, section 626.556, is amended by adding a subdivision
to read:


new text begin Subd. 10n. new text end

new text begin Required referral to early intervention services. new text end

new text begin A child under
age three who is involved in a substantiated case of maltreatment shall be referred for
screening under the Individuals with Disabilities Education Act, part C. Parents must be
informed that the evaluation and acceptance of services are voluntary. The commissioner
of human services shall monitor referral rates by county and annually report the
information to the legislature beginning March 15, 2014. Refusal to have a child screened
is not a basis for a child in need of protection or services petition under chapter 260C.
new text end

Sec. 8.

Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 1,
is amended to read:


Subdivision 1.

Total Appropriation

$
6,259,280,000
$
6,212,085,000
Appropriations by Fund
2012
2013
General
5,657,737,000
5,584,471,000
State Government
Special Revenue
3,565,000
3,565,000
Health Care Access
330,435,000
353,283,000
Federal TANF
265,378,000
268,101,000
Lottery Prize
1,665,000
1,665,000
Special Revenue
500,000
1,000,000

Receipts for Systems Projects.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state systems 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 management and budget, 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.

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 maintenance
of effort (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 legal
noncitizen MFIP recipients who qualify for
the MinnesotaCare program under Minnesota
Statutes, chapter 256L;

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

(7) qualifying Minnesota education credit
expenditures under Minnesota Statutes,
section 290.0674.

(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
(7), 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) For fiscal years beginning with state fiscal
year 2003, the commissioner shall assure
that the maintenance of effort used by the
commissioner of management and budget
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) 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, do not apply
if the grants or aids are federal TANF funds.

(e) For the federal fiscal years beginning on
or after 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:

(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;

(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; and

(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).

For the purposes of clauses (1) to (3),
the commissioner may supplement the
MOE claim with working family credit
expenditures or other qualified expenditures
to the extent such expenditures are otherwise
available after considering the expenditures
allowed in this subdivision.

(f) Notwithstanding any contrary provision
in this article, paragraphs (a) to (e) expire
June 30, 2015.

Working Family Credit Expenditures
as TANF/MOE.
The commissioner may
claim as TANF maintenance of effort up to
$6,707,000 per year of working family credit
expenditures for fiscal years 2012 and 2013.

Working Family Credit Expenditures
to be Claimed for TANF/MOE.
The
commissioner may count the following
amounts of working family credit
expenditures as TANF/MOE:

(1) fiscal year 2012, deleted text begin$23,692,000deleted text endnew text begin
$23,761,000
new text end;

(2) fiscal year 2013, deleted text begin$44,969,000deleted text endnew text begin
$48,738,000
new text end;

(3) fiscal year 2014, deleted text begin$32,579,000deleted text endnew text begin
$32,665,000
new text end; and

(4) fiscal year 2015, deleted text begin$32,476,000deleted text endnew text begin
$32,590,000
new text end.

Notwithstanding any contrary provision in
this article, this rider expires June 30, 2015.

TANF Transfer to Federal Child Care
and Development Fund.
(a) The following
TANF fund amounts are appropriated
to the commissioner for purposes of
MFIP/Transition Year Child Care Assistance
under Minnesota Statutes, section 119B.05:

(1) fiscal year 2012, $10,020,000;

(2) fiscal year 2013, $28,020,000;

(3) fiscal year 2014, $14,020,000; and

(4) fiscal year 2015, $14,020,000.

(b) The commissioner shall authorize the
transfer of sufficient TANF funds to the
federal child care and development fund to
meet this appropriation and shall ensure that
all transferred funds are expended according
to federal child care and development fund
regulations.

Food Stamps Employment and Training
Funds.
(a) Notwithstanding Minnesota
Statutes, sections 256D.051, subdivisions 1a,
6b, and 6c, and 256J.626, federal food stamps
employment and training funds received
as reimbursement for child care assistance
program expenditures must be deposited in
the general fund. The amount of funds must
be limited to $500,000 per year in fiscal
years 2012 through 2015, contingent upon
approval by the federal Food and Nutrition
Service.

(b) Consistent with the receipt of these
federal funds, the commissioner may
adjust the level of working family credit
expenditures claimed as TANF maintenance
of effort. Notwithstanding any contrary
provision in this article, this rider expires
June 30, 2015.

ARRA Food Support Benefit Increases.
The funds provided for food support benefit
increases under the Supplemental Nutrition
Assistance Program provisions of the
American Recovery and Reinvestment Act
(ARRA) of 2009 must be used for benefit
increases beginning July 1, 2009.

Supplemental Security Interim Assistance
Reimbursement Funds.
$2,800,000 of
uncommitted revenue available to the
commissioner of human services for SSI
advocacy and outreach services must be
transferred to and deposited into the general
fund by October 1, 2011.

Sec. 9. new text beginDIRECTIONS TO THE COMMISSIONER.
new text end

new text begin The commissioner of human services, in consultation with the commissioner of
public safety, shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services policy and finance regarding
the implementation of Minnesota Statutes, section 256.01, subdivisions 18d, 18e, and 18f,
the number of persons affected, and fiscal impact by program by April 1, 2013.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2013.
new text end

ARTICLE 4

CONTINUING CARE

Section 1.

Minnesota Statutes 2010, section 62J.496, subdivision 2, is amended to read:


Subd. 2.

Eligibility.

(a) "Eligible borrower" means one of the following:

(1) federally qualified health centers;

(2) community clinics, as defined under section 145.9268;

(3) nonprofit or local unit of government hospitals licensed under sections 144.50
to 144.56;

(4) individual or small group physician practices that are focused primarily on
primary care;

(5) nursing facilities licensed under sections 144A.01 to 144A.27;

(6) local public health departments as defined in chapter 145A; and

(7) other providers of health or health care services approved by the commissioner
for which interoperable electronic health record capability would improve quality of
care, patient safety, or community health.

(b) The commissioner shall administer the loan fund to prioritize support and
assistance to:

(1) critical access hospitals;

(2) federally qualified health centers;

(3) entities that serve uninsured, underinsured, and medically underserved
individuals, regardless of whether such area is urban or rural; deleted text beginand
deleted text end

(4) individual or small group practices that are primarily focused on primary carenew text begin;
new text end

new text begin (5) nursing facilities certified to participate in the medical assistance program; and
new text end

new text begin (6) providers enrolled in the elderly waiver program of customized living or 24-hour
customized living of the medical assistance program, if at least half of their annual
operating revenue is paid under that medical assistance program
new text end.

(c) An eligible applicant must submit a loan application to the commissioner of
health on forms prescribed by the commissioner. The application must include, at a
minimum:

(1) the amount of the loan requested and a description of the purpose or project
for which the loan proceeds will be used;

(2) a quote from a vendor;

(3) a description of the health care entities and other groups participating in the
project;

(4) evidence of financial stability and a demonstrated ability to repay the loan; and

(5) a description of how the system to be financed interoperates or plans in the
future to interoperate with other health care entities and provider groups located in the
same geographical area;

(6) a plan on how the certified electronic health record technology will be maintained
and supported over time; and

(7) any other requirements for applications included or developed pursuant to
section 3014 of the HITECH Act.

Sec. 2.

Minnesota Statutes 2010, section 144A.073, is amended by adding a
subdivision to read:


new text begin Subd. 13. new text end

new text begin Moratorium exception funding. new text end

new text begin In fiscal year 2013, the commissioner
of health may approve moratorium exception projects under this section for which the full
annualized state share of medical assistance costs does not exceed $1,000,000.
new text end

Sec. 3.

Minnesota Statutes 2010, section 144A.351, is amended to read:


144A.351 BALANCING LONG-TERM CAREnew text begin SERVICES AND SUPPORTSnew text end:
REPORT REQUIRED.

The commissioners of health and human services, with deleted text beginthe cooperation of counties
and
deleted text end new text beginstakeholders, including persons who need or are using long-term care services and
supports; lead agencies;
new text endregional entitiesdeleted text begin,deleted text endnew text begin;new text end new text beginsenior, mental health, and disability organization
representatives; services providers; and community members, including representatives of
local business and faith communities
new text endshall prepare a report to the legislature by August 15,
deleted text begin 2004deleted text endnew text begin 2013new text end, and biennially thereafter, regarding the status of the full range of long-term
care services new text beginand supports new text endfor the elderly new text beginand children and adults with disabilities and
mental illnesses
new text endin Minnesota. The report shall address:

(1) demographics and need for long-term care new text beginservices and supports new text endin Minnesota;

(2) summary of county and regional reports on long-term care gaps, surpluses,
imbalances, and corrective action plans;

(3) status of long-term care services by county and region including:

(i) changes in availability of the range of long-term care services and housing
options;

(ii) access problems regarding long-term carenew text begin servicesnew text end; and

(iii) comparative measures of long-term care new text beginservices new text endavailability and deleted text beginprogressdeleted text end
new text begin changes new text endover time; and

(4) recommendations regarding goals for the future of long-term care services,
policy new text begin and fiscal new text endchanges, and resource needs.

Sec. 4.

Minnesota Statutes 2010, section 245A.03, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Adult foster care homes serving people with mental illness;
certification.
new text end

new text begin (a) The commissioner of human services shall issue a mental health
certification for adult foster care homes licensed under this chapter and Minnesota Rules,
parts 9555.5105 to 9555.6265, that serve people with mental illness where the home is not
the primary residence of the license holder when a provider is determined to have met
the requirements under paragraph (b). This certification is voluntary for license holders.
The certification shall be printed on the license, and identified on the commissioner's
public Web site.
new text end

new text begin (b) The requirements for certification are:
new text end

new text begin (1) all staff working in the adult foster care home have received at least seven hours
of annual training covering all of the following topics:
new text end

new text begin (i) mental health diagnoses;
new text end

new text begin (ii) mental health crisis response and de-escalation techniques;
new text end

new text begin (iii) recovery from mental illness;
new text end

new text begin (iv) treatment options including evidence-based practices;
new text end

new text begin (v) medications and their side effects;
new text end

new text begin (vi) co-occurring substance abuse and health conditions; and
new text end

new text begin (vii) community resources;
new text end

new text begin (2) a mental health professional, as defined in section 245.462, subdivision 18, or
a mental health practitioner as defined in section 245.462, subdivision 17, are available
for consultation and assistance;
new text end

new text begin (3) there is a plan and protocol in place to address a mental health crisis; and
new text end

new text begin (4) each individual's Individual Placement Agreement identifies who is providing
clinical services and their contact information, and includes an individual crisis prevention
and management plan developed with the individual.
new text end

new text begin (c) License holders seeking certification under this subdivision must request this
certification on forms provided by the commissioner and must submit the request to the
county licensing agency in which the home is located. The county licensing agency must
forward the request to the commissioner with a county recommendation regarding whether
the commissioner should issue the certification.
new text end

new text begin (d) Ongoing compliance with the certification requirements under paragraph (b)
shall be reviewed by the county licensing agency at each licensing review. When a county
licensing agency determines that the requirements of paragraph (b) are not met, the county
shall inform the commissioner, and the commissioner will remove the certification.
new text end

new text begin (e) A denial of the certification or the removal of the certification based on a
determination that the requirements under paragraph (b) have not been met by the adult
foster care license holder are not subject to appeal. A license holder that has been denied a
certification or that has had a certification removed may again request certification when
the license holder is in compliance with the requirements of paragraph (b).
new text end

Sec. 5.

Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is
amended to read:


Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an
initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
9555.6265, under this chapter for a physical location that will not be the primary residence
of the license holder for the entire period of licensure. If a license is issued during this
moratorium, and the license holder changes the license holder's primary residence away
from the physical location of the foster care license, the commissioner shall revoke the
license according to section 245A.07. Exceptions to the moratorium include:

(1) foster care settings that are required to be registered under chapter 144D;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
and determined to be needed by the commissioner under paragraph (b);

(3) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
restructuring of state-operated services that limits the capacity of state-operated facilities;

(4) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for persons requiring hospital level care; or

(5) new foster care licenses determined to be needed by the commissioner for the
transition of people from personal care assistance to the home and community-based
services.

(b) The commissioner shall determine the need for newly licensed foster care homes
as defined under this subdivision. As part of the determination, the commissioner shall
consider the availability of foster care capacity in the area in which the licensee seeks to
operate, and the recommendation of the local county board. The determination by the
commissioner must be final. A determination of need is not required for a change in
ownership at the same address.

(c) Residential settings that would otherwise be subject to the moratorium established
in paragraph (a), that are in the process of receiving an adult or child foster care license as
of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
or child foster care license. For this paragraph, all of the following conditions must be met
to be considered in the process of receiving an adult or child foster care license:

(1) participants have made decisions to move into the residential setting, including
documentation in each participant's care plan;

(2) the provider has purchased housing or has made a financial investment in the
property;

(3) the lead agency has approved the plans, including costs for the residential setting
for each individual;

(4) the completion of the licensing process, including all necessary inspections, is
the only remaining component prior to being able to provide services; and

(5) the needs of the individuals cannot be met within the existing capacity in that
county.

To qualify for the process under this paragraph, the lead agency must submit
documentation to the commissioner by August 1, 2009, that all of the above criteria are
met.

(d) The commissioner shall study the effects of the license moratorium under this
subdivision and shall report back to the legislature by January 15, 2011. This study shall
include, but is not limited to the following:

(1) the overall capacity and utilization of foster care beds where the physical location
is not the primary residence of the license holder prior to and after implementation
of the moratorium;

(2) the overall capacity and utilization of foster care beds where the physical
location is the primary residence of the license holder prior to and after implementation
of the moratorium; and

(3) the number of licensed and occupied ICF/MR beds prior to and after
implementation of the moratorium.

(e) When a foster care recipient moves out of a foster home that is not the primary
residence of the license holder according to section 256B.49, subdivision 15, paragraph
(f), the county shall immediately inform the Department of Human Services Licensing
Divisiondeleted text begin, anddeleted text endnew text begin.new text end The department shall deleted text beginimmediatelydeleted text end decrease the licensed capacity for the
homenew text begin, if the voluntary changes described in paragraph (g) are not sufficient to meet the
savings required by 2011 reductions in licensed bed capacity and maintain statewide
long-term care residential services capacity within budgetary limits. The commissioner
shall delicense up to 128 beds by June 30, 2013, using the needs determination process.
Under this paragraph, the commissioner has the authority to reduce unused licensed
capacity of a current foster care program to accomplish the consolidation or closure of
settings
new text end. A decreased licensed capacity according to this paragraph is not subject to appeal
under this chapter.

new text begin (f) Residential settings that would otherwise be subject to the decreased license
capacity established in paragraph (e) shall be exempt under the following circumstances:
new text end

new text begin (1) until August 1, 2013, the beds of a license holder whose primary diagnosis is
mental illness and the license holder is:
new text end

new text begin (i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
health services (ARMHS) as defined in section 256B.0623;
new text end

new text begin (ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
9520.0870;
new text end

new text begin (iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
9520.0870; or
new text end

new text begin (iv) a provider of intensive residential treatment services (IRTS) licensed under
Minnesota Rules, parts 9520.0500 to 9520.0670; or
new text end

new text begin (2) the license holder is certified under the requirements in subdivision 6a.
new text end

new text begin (g) A resource need determination process, managed at the state level, using the
available reports required by section 144A.351, and other data and information shall
be used to determine where the reduced capacity required under paragraph (e) will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet
long-term care service needs within budgetary limits, including seeking proposals from
service providers or lead agencies to change service type, capacity, or location to improve
services, increase the independence of residents, and better meet needs identified by the
long-term care services reports and statewide data and information. By February 1 of each
year, the commissioner shall provide information and data on the overall capacity of
licensed long-term care services, actions taken under this subdivision to manage statewide
long-term care services and supports resources, and any recommendations for change to
the legislative committees with jurisdiction over health and human services budget.
new text end

Sec. 6.

Minnesota Statutes 2010, section 245A.11, subdivision 2a, is amended to read:


Subd. 2a.

Adult foster care license capacity.

(a) The commissioner shall issue
adult foster care licenses with a maximum licensed capacity of four beds, including
nonstaff roomers and boarders, except that the commissioner may issue a license with a
capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).

(b) An adult foster care license holder may have a maximum license capacity of five
if all persons in care are age 55 or over and do not have a serious and persistent mental
illness or a developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a foster care
provider with a licensed capacity of five persons to admit an individual under the age of 55
if the variance complies with section 245A.04, subdivision 9, and approval of the variance
is recommended by the county in which the licensed foster care provider is located.

(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
bed for emergency crisis services for a person with serious and persistent mental illness
or a developmental disability, regardless of age, if the variance complies with section
245A.04, subdivision 9, and approval of the variance is recommended by the county in
which the licensed foster care provider is located.

new text begin (e) The commissioner may grant a variance to paragraph (b) to allow for the
use of a fifth bed for respite services, as defined in section 245A.02, for persons with
disabilities, regardless of age, if the variance complies with section 245A.03, subdivision
7, and section 245A.04, subdivision 9, and approval of the variance is recommended by
the county in which the licensed foster care provider is licensed. Respite care may be
provided under the following conditions:
new text end

new text begin (1) staffing ratios cannot be reduced below the approved level for the individuals
being served in the home on a permanent basis;
new text end

new text begin (2) no more than two different individuals can be accepted for respite services in
any calendar month and the total respite days may not exceed 120 days per program in
any calendar year;
new text end

new text begin (3) the person receiving respite services must have his or her own bedroom, which
could be used for alternative purposes when not used as a respite bedroom, and cannot be
the room of another person who lives in the foster care home; and
new text end

new text begin (4) individuals living in the foster care home must be notified when the variance
is approved. The provider must give 60 days' notice in writing to the residents and their
legal representatives prior to accepting the first respite placement. Notice must be given to
residents at least two days prior to service initiation, or as soon as the license holder is
able if they receive notice of the need for respite less than two days prior to initiation,
each time a respite client will be served, unless the requirement for this notice is waived
by the resident or legal guardian.
new text end

deleted text begin (e) If the 2009 legislature adopts a rate reduction that impacts providers of adult
foster care services,
deleted text endnew text begin (f) new text end The commissioner may issue an adult foster care license with a
capacity of five adults if the fifth bed does not increase the overall statewide capacity of
licensed adult foster care beds in homes that are not the primary residence of the license
holder, deleted text beginover the licensed capacity in such homes on July 1, 2009,deleted text end as identified in a plan
submitted to the commissioner by the county, when the capacity is recommended by
the county licensing agency of the county in which the facility is located and if the
recommendation verifies that:

(1) the facility meets the physical environment requirements in the adult foster
care licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part
9555.5105, subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each
resident or resident's legal representative documenting the resident's informed choice
tonew text begin remainnew text end living in the home and that the resident's refusal to consent would not have
resulted in service termination; and

(4) the facility was licensed for adult foster care before March 1, deleted text begin2009deleted text endnew text begin 2011new text end.

deleted text begin (f)deleted text endnew text begin (g)new text end The commissioner shall not issue a new adult foster care license under
paragraph deleted text begin(e)deleted text endnew text begin (f)new text end after June 30, deleted text begin2011deleted text endnew text begin 2016new text end. The commissioner shall allow a facility with
an adult foster care license issued under paragraph deleted text begin(e)deleted text endnew text begin (f)new text end before June 30, deleted text begin2011deleted text endnew text begin 2016new text end, to
continue with a capacity of five adults if the license holder continues to comply with the
requirements in paragraph deleted text begin(e)deleted text endnew text begin (f)new text end.

Sec. 7.

Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:


Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home during normal sleeping
hours to allow for alternative methods of overnight supervision. The commissioner may
grant the variance if the local county licensing agency recommends the variance and the
county recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of
providing overnight supervision and determined the plan protects the residents' health,
safety, and rights;

(2) the license holder has obtained written and signed informed consent from
each resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include
the use of technology, is specified for each resident in the resident's: (i) individualized
plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
required; or (iii) individual resident placement agreement under Minnesota Rules, part
9555.5105, subpart 19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster care license
holder must not have had a deleted text beginlicensing actiondeleted text endnew text begin conditional license issuednew text end under section
245A.06new text begin,new text end ornew text begin any other licensing sanction issued under sectionnew text end 245A.07 during the prior 24
months based on failure to provide adequate supervision, health care services, or resident
safety in the adult foster care home.

(c) A license holder requesting a variance under this subdivision to utilize
technology as a component of a plan for alternative overnight supervision may request
the commissioner's review in the absence of a county recommendation. Upon receipt of
such a request from a license holder, the commissioner shall review the variance request
with the county.

Sec. 8.

Minnesota Statutes 2010, section 245A.11, subdivision 7a, is amended to read:


Subd. 7a.

Alternate overnight supervision technology; adult foster care license.

(a) The commissioner may grant an applicant or license holder an adult foster care license
for a residence that does not have a caregiver in the residence during normal sleeping
hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
monitoring technology to alert the license holder when an incident occurs that may
jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, and the requirements under this subdivision. The license printed by the
commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to
the Department of Human Services licensing division. The licensing division must
immediately notify the host county and lead county contract agency and the host county
licensing agency. The licensing division must collaborate with the county licensing
agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the
license, the applicant or license holder must establish, maintain, and document the
implementation of written policies and procedures addressing the requirements in
paragraphs (d) through (f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home,
and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a foster care recipient requires overnight
supervision or other services that cannot be provided by the license holder due to the
limited hours that the license holder is on site;

(3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on site, and
how the license holder's response plan meets the requirements in paragraph (e), clause
(1) or (2);

(4) establish a process for documenting a review of the implementation and
effectiveness of the response protocol for the response required under paragraph (e),
clause (1) or (2). The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the
license holder's written policies and procedures must require a physical presence response
drill to be conducted for which the effectiveness of the response protocol under paragraph
(e), clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a
prominent location in a common area of the home where they can be easily observed by a
person responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of people receiving foster care services
in the home:

(1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system
under alternative (1), but more than ten minutes may pass before the license holder is
present on site to respond to the situation. Under alternative (2), all of the following
conditions are met:

(i) the license holder has a written description of the interactive technological
applications that will assist the license holder in communicating with and assessing the
needs related to the care, health, and safety of the foster care recipients. This interactive
technology must permit the license holder to remotely assess the well being of the foster
care recipient without requiring the initiation of the foster care recipient. Requiring the
foster care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and
capable of meeting the needs of the foster care recipients and assessing foster care
recipients' needs under item (i) during the absence of the license holder on site;

(iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and

(iv) each foster care recipient's individualized plan of care, individual service plan
under section 256B.092, subdivision 1b, if required, or individual resident placement
agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
maximum response time, which may be greater than ten minutes, for the license holder
to be on site for that foster care recipient.

(f) deleted text beginAlldeleted text endnew text begin Each foster care recipient'snew text end placement deleted text beginagreementsdeleted text endnew text begin agreementnew text end, individual
service deleted text beginagreements, and plans applicable to the foster care recipientdeleted text end new text begin agreement, and plan
new text endmust clearly state that the adult foster care license category is a program without the
presence of a caregiver in the residence during normal sleeping hours; the protocols in
place for responding to situations that present a serious risk to the health, safety, or rights
of foster care recipients under paragraph (e), clause (1) or (2); and a signed informed
consent from each foster care recipient or the person's legal representative documenting
the person's or legal representative's agreement with placement in the program. If
electronic monitoring technology is used in the home, the informed consent form must
also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision
system;

(2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;

(3) how the deleted text beginlicense holder isdeleted text endnew text begin caregivers arenew text end trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects the foster care recipient's privacy related to
electronic monitoring and related to any electronically recorded data generated by the
monitoring system. A foster care recipient may not be removed from a program under
this subdivision for failure to consent to electronic monitoring. The consent form must
explain where and how the electronically recorded data is stored, with whom it will be
shared, and how long it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the
person giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or
maintain separate or duplicative policies, procedures, documentation, consent forms, or
individual plans that may be required for other licensing standards, if the requirements of
this section are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section
according to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
remotely determine what action the license holder needs to take to protect the well-being
of the foster care recipient.

new text begin (k) The commissioner shall evaluate license applications using the requirements
in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
including a checklist of criteria needed for approval.
new text end

new text begin (l) To be eligible for a license under paragraph (a), the adult foster care license holder
must not have had a conditional license issued under section 245A.06 or any licensing
sanction under section 245A.07 during the prior 24 months based on failure to provide
adequate supervision, health care services, or resident safety in the adult foster care home.
new text end

new text begin (m) The commissioner shall review an application for an alternative overnight
supervision license within 60 days of receipt of the application. When the commissioner
receives an application that is incomplete because the applicant failed to submit required
documents or that is substantially deficient because the documents submitted do not meet
licensing requirements, the commissioner shall provide the applicant written notice
that the application is incomplete or substantially deficient. In the written notice to the
applicant, the commissioner shall identify documents that are missing or deficient and
give the applicant 45 days to resubmit a second application that is substantially complete.
An applicant's failure to submit a substantially complete application after receiving
notice from the commissioner is a basis for license denial under section 245A.05. The
commissioner shall complete subsequent review within 30 days.
new text end

new text begin (n) Once the application is considered complete under paragraph (m), the
commissioner will approve or deny an application for an alternative overnight supervision
license within 60 days.
new text end

new text begin (o) For the purposes of this subdivision, "supervision" means:
new text end

new text begin (1) oversight by a caregiver as specified in the individual resident's place agreement
and awareness of the resident's needs and activities; and
new text end

new text begin (2) the presence of a caregiver in a residence during normal sleeping hours, unless a
determination has been made and documented in the individual's support plan that the
individual does not require the presence of a caregiver during normal sleeping hours.
new text end

Sec. 9.

Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:


Subdivision 1.

Consumer data file.

The license holder must maintain the following
information for each consumer:

(1) identifying information that includes date of birth, medications, legal
representative, history, medical, and other individual-specific information, and names and
telephone numbers of contacts;

(2) consumer health information, including individual medication administration
and monitoring information;

(3) the consumer's individual service plan. When a consumer's case manager does
not provide a current individual service plan, the license holder shall make a written
request to the case manager to provide a copy of the individual service plan and inform
the consumer or the consumer's legal representative of the right to an individual service
plan and the right to appeal under section 256.045deleted text begin;deleted text endnew text begin. In the event the case manager fails
to provide an individual service plan after a written request from the license holder, the
license holder shall not be sanctioned or penalized financially for not having a current
individual service plan in the consumer's data file;
new text end

(4) copies of assessments, analyses, summaries, and recommendations;

(5) progress review reports;

(6) incidents involving the consumer;

(7) reports required under section 245B.05, subdivision 7;

(8) discharge summary, when applicable;

(9) record of other license holders serving the consumer that includes a contact
person and telephone numbers, services being provided, services that require coordination
between two license holders, and name of staff responsible for coordination;

(10) information about verbal aggression directed at the consumer by another
consumer; and

(11) information about self-abuse.

Sec. 10.

Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:


Subd. 6.

Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.

(a) Providers required to initiate background
studies under section 256B.4912 must initiate a study before the individual begins in a
position allowing direct contact with persons served by the provider.

(b) deleted text beginThe commissioner shall conductdeleted text endnew text begin Except as provided in paragraph (c), the
providers must initiate
new text end a background study annually of an individual required to be studied
under section 245C.03, subdivision 6.

new text begin (c) After an initial background study under this subdivision is initiated on an
individual by a provider of both services licensed by the commissioner and the unlicensed
services under this subdivision, a repeat annual background study is not required if:
new text end

new text begin (1) the provider maintains compliance with the requirements of section 245C.07,
paragraph (a), regarding one individual with one address and telephone number as the
person to receive sensitive background study information for the multiple programs that
depend on the same background study, and that the individual who is designated to receive
the sensitive background information is capable of determining, upon the request of the
commissioner, whether a background study subject is providing direct contact services
in one or more of the provider's programs or services and, if so, at which location or
locations; and
new text end

new text begin (2) the individual who is the subject of the background study provides direct
contact services under the provider's licensed program for at least 40 hours per year so
the individual will be recognized by a probation officer or corrections agent to prompt
a report to the commissioner regarding criminal convictions as required under section
245C.05, subdivision 7.
new text end

Sec. 11.

Minnesota Statutes 2010, section 245C.05, subdivision 7, is amended to read:


Subd. 7.

Probation officer and corrections agent.

(a) A probation officer or
corrections agent shall notify the commissioner of an individual's conviction if the
individual deleted text beginisdeleted text end:

(1) new text beginhas been new text endaffiliated with a program or facility regulated by the Department of
Human Services or Department of Health, a facility serving children or youth licensed by
the Department of Corrections, or any type of home care agency or provider of personal
care assistance servicesnew text begin within the preceding yearnew text end; and

(2) new text beginhas been new text endconvicted of a crime constituting a disqualification under section
245C.14.

(b) For the purpose of this subdivision, "conviction" has the meaning given it
in section 609.02, subdivision 5.

(c) The commissioner, in consultation with the commissioner of corrections, shall
develop forms and information necessary to implement this subdivision and shall provide
the forms and information to the commissioner of corrections for distribution to local
probation officers and corrections agents.

(d) The commissioner shall inform individuals subject to a background study that
criminal convictions for disqualifying crimes will be reported to the commissioner by the
corrections system.

(e) A probation officer, corrections agent, or corrections agency is not civilly or
criminally liable for disclosing or failing to disclose the information required by this
subdivision.

(f) Upon receipt of disqualifying information, the commissioner shall provide the
notice required under section 245C.17, as appropriate, to agencies on record as having
initiated a background study or making a request for documentation of the background
study status of the individual.

(g) This subdivision does not apply to family child care programs.

Sec. 12.

Minnesota Statutes 2010, section 256.975, subdivision 7, is amended to read:


Subd. 7.

Consumer information and assistance and long-term care options
counseling; Senior LinkAge Line.

(a) The Minnesota Board on Aging shall operate a
statewide service to aid older Minnesotans and their families in making informed choices
about long-term care options and health care benefits. Language services to persons with
limited English language skills may be made available. The service, known as Senior
LinkAge Line, must be available during business hours through a statewide toll-free
number and must also be available through the Internet.

(b) The service must provide long-term care options counseling by assisting older
adults, caregivers, and providers in accessing information and options counseling about
choices in long-term care services that are purchased through private providers or available
through public options. The service must:

(1) develop a comprehensive database that includes detailed listings in both
consumer- and provider-oriented formats;

(2) make the database accessible on the Internet and through other telecommunication
and media-related tools;

(3) link callers to interactive long-term care screening tools and make these tools
available through the Internet by integrating the tools with the database;

(4) develop community education materials with a focus on planning for long-term
care and evaluating independent living, housing, and service options;

(5) conduct an outreach campaign to assist older adults and their caregivers in
finding information on the Internet and through other means of communication;

(6) implement a messaging system for overflow callers and respond to these callers
by the next business day;

(7) link callers with county human services and other providers to receive more
in-depth assistance and consultation related to long-term care options;

(8) link callers with quality profiles for nursing facilities and other providers
developed by the commissioner of health;

(9) incorporate information about the availability of housing options, as well as
registered housing with services and consumer rights within the MinnesotaHelp.info
network long-term care database to facilitate consumer comparison of services and costs
among housing with services establishments and with other in-home services and to
support financial self-sufficiency as long as possible. Housing with services establishments
and their arranged home care providers shall provide information that will facilitate price
comparisons, including delineation of charges for rent and for services available. The
commissioners of health and human services shall align the data elements required by
section 144G.06, the Uniform Consumer Information Guide, and this section to provide
consumers standardized information and ease of comparison of long-term care options.
The commissioner of human services shall provide the data to the Minnesota Board on
Aging for inclusion in the MinnesotaHelp.info network long-term care database;

(10) provide long-term care options counseling. Long-term care options counselors
shall:

(i) for individuals not eligible for case management under a public program or public
funding source, provide interactive decision support under which consumers, family
members, or other helpers are supported in their deliberations to determine appropriate
long-term care choices in the context of the consumer's needs, preferences, values, and
individual circumstances, including implementing a community support plan;

(ii) provide Web-based educational information and collateral written materials to
familiarize consumers, family members, or other helpers with the long-term care basics,
issues to be considered, and the range of options available in the community;

(iii) provide long-term care futures planning, which means providing assistance to
individuals who anticipate having long-term care needs to develop a plan for the more
distant future; and

(iv) provide expertise in benefits and financing options for long-term care, including
Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
private pay options, and ways to access low or no-cost services or benefits through
volunteer-based or charitable programs; deleted text beginand
deleted text end

(11) using risk management and support planning protocols, provide long-term care
options counseling to current residents of nursing homes deemed appropriate for discharge
by the commissioner. In order to meet this requirement, the commissioner shall provide
designated Senior LinkAge Line contact centers with a list of nursing home residents
appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
provide these residents, if they indicate a preference to receive long-term care options
counseling, with initial assessment, review of risk factors, independent living support
consultation, or referral to:

(i) long-term care consultation services under section 256B.0911;

(ii) designated care coordinators of contracted entities under section 256B.035 for
persons who are enrolled in a managed care plan; or

(iii) the long-term care consultation team for those who are appropriate for relocation
service coordination due to high-risk factors or psychological or physical disabilitynew text begin; and
new text end

new text begin (12) develop referral protocols and processes that will assist certified health care
homes and hospitals to identify at-risk older adults and determine when to refer these
individuals to the Senior LinkAge Line for long-term care options counseling under this
section. The commissioner is directed to work with the commissioner of health to develop
protocols that would comply with the health care home designation criteria and protocols
available at the time of hospital discharge
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective is effective July 1, 2013.
new text end

Sec. 13.

Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to
read:


Subd. 1a.

Income and assets generally.

Unless specifically required by state
law or rule or federal law or regulation, the methodologies used in counting income
and assets to determine eligibility for medical assistance for persons whose eligibility
category is based on blindness, disability, or age of 65 or more years, the methodologies
for the supplemental security income program shall be usednew text begin, except as provided under
subdivision 3, paragraph (a), clause (6)
new text end. Increases in benefits under title II of the Social
Security Act shall not be counted as income for purposes of this subdivision until July 1 of
each year. Effective upon federal approval, for children eligible under section 256B.055,
subdivision 12
, or for home and community-based waiver services whose eligibility
for medical assistance is determined without regard to parental income, child support
payments, including any payments made by an obligor in satisfaction of or in addition
to a temporary or permanent order for child support, and Social Security payments are
not counted as income. For families and children, which includes all other eligibility
categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as
required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the
earned income disregards and deductions are limited to those in subdivision 1c. For these
purposes, a "methodology" does not include an asset or income standard, or accounting
method, or method of determining effective dates.

Sec. 14.

Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3,
is amended to read:


Subd. 3.

Asset limitations for individuals and families.

(a) To be eligible for
medical assistance, a person must not individually own more than $3,000 in assets, or if a
member of a household with two family members, husband and wife, or parent and child,
the household must not own more than $6,000 in assets, plus $200 for each additional
legal dependent. In addition to these maximum amounts, an eligible individual or family
may accrue interest on these amounts, but they must be reduced to the maximum at the
time of an eligibility redetermination. The accumulation of the clothing and personal
needs allowance according to section 256B.35 must also be reduced to the maximum at
the time of the eligibility redetermination. The value of assets that are not considered in
determining eligibility for medical assistance is the value of those assets excluded under
the supplemental security income program for aged, blind, and disabled persons, with
the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the supplemental
security income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by
the supplemental security income program. Burial expenses funded by annuity contracts
or life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses; deleted text beginand
deleted text end

(5) for a person who no longer qualifies as an employed person with a disability due
to loss of earnings, assets allowed while eligible for medical assistance under section
256B.057, subdivision 9, are not considered for 12 months, beginning with the first month
of ineligibility as an employed person with a disability, to the extent that the person's total
assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d)deleted text begin.deleted text endnew text begin;
new text end

new text begin (6) when a person enrolled in medical assistance under section 256B.057, subdivision
9, reaches age 65 and has been enrolled during each of the 24 consecutive months before
the person's 65th birthday, the assets owned by the person and the person's spouse must
be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when
determining eligibility for medical assistance under section 256B.055, subdivision 7. The
income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7, when the person reaches age 65. Persons eligible under this
clause are not subject to the provisions in section 256B.059; and
new text end

new text begin (7) notwithstanding the requirements of clause (6), persons whose 65th birthday
occurs in 2012 or 2013 are required to have qualified for medical assistance under section
256B.057, subdivision 9, prior to age 65 for at least 20 months in the 24 months prior
to reaching age 65.
new text end

(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.

Sec. 15.

Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 17,
is amended to read:


Subd. 17.

Transportation costs.

(a) Medical assistance covers medical
transportation costs incurred solely for obtaining emergency medical care or transportation
costs incurred by eligible persons in obtaining emergency or nonemergency medical
care when paid directly to an ambulance company, common carrier, or other recognized
providers of transportation services. Medical transportation must be provided by:

(1) an ambulance, as defined in section 144E.001, subdivision 2;

(2) special transportation; or

(3) common carrier including, but not limited to, bus, taxicab, other commercial
carrier, or private automobile.

(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
transportation, or private automobile.

The commissioner may use an order by the recipient's attending physician to certify that
the recipient requires special transportation services. Special transportation providers shall
perform driver-assisted services for eligible individuals. Driver-assisted service includes
passenger pickup at and return to the individual's residence or place of business, assistance
with admittance of the individual to the medical facility, and assistance in passenger
securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation
providers must obtain written documentation from the health care service provider who
is serving the recipient being transported, identifying the time that the recipient arrived.
Special transportation providers may not bill for separate base rates for the continuation of
a trip beyond the original destination. Special transportation providers must take recipients
to the nearest appropriate health care provider, using the most direct route. The minimum
medical assistance reimbursement rates for special transportation services are:

(1)(i) $17 for the base rate and $1.35 per mile for special transportation services to
eligible persons who need a wheelchair-accessible van;

(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
eligible persons who do not need a wheelchair-accessible van; and

(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
special transportation services to eligible persons who need a stretcher-accessible vehicle;

(2) the base rates for special transportation services in areas defined under RUCA
to be super rural shall be equal to the reimbursement rate established in clause (1) plus
11.3 percent; and

(3) for special transportation services in areas defined under RUCA to be rural
or super rural areas:

(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
percent of the respective mileage rate in clause (1); and

(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
112.5 percent of the respective mileage rate in clause (1).

(c) For purposes of reimbursement rates for special transportation services under
paragraph (b), the zip code of the recipient's place of residence shall determine whether
the urban, rural, or super rural reimbursement rate applies.

(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
means a census-tract based classification system under which a geographical area is
determined to be urban, rural, or super rural.

(e) Effective for services provided on or after September 1, 2011, nonemergency
transportation rates, including special transportation, taxi, and other commercial carriers,
are reduced 4.5 percent. Payments made to managed care plans and county-based
purchasing plans must be reduced for services provided on or after January 1, 2012,
to reflect this reduction.

new text begin (f) Outside of a metropolitan county as defined in section 473.121, subdivision 4,
reimbursement rates under this subdivision may be adjusted monthly by the commissioner
when the statewide average price of regular grade gasoline is over $3 per gallon, as
calculated by Oil Price Information Service. The rate adjustment shall be a one-percent
increase or decrease for each corresponding $0.10 increase or decrease in the statewide
average price of regular grade gasoline.
new text end

Sec. 16.

Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 2,
is amended to read:


Subd. 2.

Exceptions.

Co-payments and deductibles shall be subject to the following
exceptions:

(1) children under the age of 21;

(2) pregnant women for services that relate to the pregnancy or any other medical
condition that may complicate the pregnancy;

(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
intermediate care facility for the developmentally disabled;

(4) recipients receiving hospice care;

(5) 100 percent federally funded services provided by an Indian health service;

(6) emergency services;

(7) family planning services;

(8) services that are paid by Medicare, resulting in the medical assistance program
paying for the coinsurance and deductible; deleted text beginand
deleted text end

(9) co-payments that exceed one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency roomnew text begin; and
new text end

new text begin (10) home and community-based waiver services for persons with developmental
disabilities under section 256B.501; home and community-based waiver services for the
elderly under section 256B.0915; waivered services under community alternatives for
disabled individuals under section 256B.49; community alternative care waivered services
under section 256B.49; traumatic brain injury waivered services under section 256B.49;
nursing services and home health services under section 256B.0625, subdivision 6a;
personal care services and nursing supervision of personal care services under section
256B.0625, subdivision 19a; private duty nursing services under section 256B.0625,
subdivision 7; personal care assistance services under section 256B.0659; and day training
and habilitation services for adults with developmental disabilities under sections 252.40
to 252.46
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 17.

Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c,
is amended to read:


Subd. 3c.

Consultation for housing with services.

(a) The purpose of long-term
care consultation for registered housing with services is to support persons with current or
anticipated long-term care needs in making informed choices among options that include
the most cost-effective and least restrictive settings. Prospective residents maintain the
right to choose housing with services or assisted living if that option is their preference.

(b) Registered housing with services establishments shall inform all prospective
residents new text beginor the prospective resident's designated or legal representative new text endof the deleted text beginavailability
of long-term care consultation and the need to receive and verify the consultation prior
to signing a lease or contract
deleted text endnew text begin requirement for long-term care options counseling and the
opportunity to decline long-term care options counseling. Prospective residents declining
long-term care options counseling are required to sign a waiver form designated by the
commissioner and supplied by the provider. The housing with services establishment shall
maintain copies of signed waiver forms or verification that the consultation was conducted
for audit for a period of three years
new text end. Long-term care consultation for registered housing
with services is provided as determined by the commissioner of human services. The
service is delivered under a partnership between lead agencies as defined in subdivision 1a,
paragraph (d), and the Area Agencies on Aging, and is a point of entry to a combination
of telephone-based long-term care options counseling provided by Senior LinkAge Line
and in-person long-term care consultation provided by lead agencies. The point of entry
service must be provided within five working days of the request of the prospective
resident as follows:

(1) new text beginthe consultation shall be conducted with the prospective resident, or in the
alternative, the resident's designated or legal representative, if:
new text end

new text begin (i) the resident verbally requests; or
new text end

new text begin (ii) the registered housing with services provider has documentation of the
designated or legal representative's authority to enter into a lease or contract on behalf of
the prospective resident and accepts the documentation in good faith;
new text end

new text begin (2) new text endthe consultation shall be performed in a manner that provides objective and
complete information;

deleted text begin (2)deleted text endnew text begin (3) new text end the consultation must include a review of the prospective resident's reasons
for considering housing with services, the prospective resident's personal goals, a
discussion of the prospective resident's immediate and projected long-term care needs,
and alternative community services or housing with services settings that may meet the
prospective resident's needs;

deleted text begin (3)deleted text endnew text begin (4) new text end the prospective resident shall be informed of the availability of a face-to-face
visit at no charge to the prospective resident to assist the prospective resident in assessment
and planning to meet the prospective resident's long-term care needs; and

deleted text begin (4)deleted text endnew text begin (5) new text end verification of counseling shall be generated and provided to the prospective
resident by Senior LinkAge Line upon completion of the telephone-based counseling.

(c) Housing with services establishments registered under chapter 144D shall:

(1) inform all prospective residents new text beginor the prospective resident's designated or legal
representative
new text endof the availability of and contact information for consultation services
under this subdivision;

(2) deleted text beginexcept for individuals seeking lease-only arrangements in subsidized housing
settings,
deleted text end receive a copy of the verification of counseling prior to executing a lease or
service contract with the prospective resident, and prior to executing a service contract
with individuals who have previously entered into lease-only arrangements; and

(3) retain a copy of the verification of counseling as part of the resident's file.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 18.

Minnesota Statutes 2010, section 256B.0911, is amended by adding a
subdivision to read:


new text begin Subd. 3d. new text end

new text begin Exemptions. new text end

new text begin Individuals shall be exempt from the requirements outlined
in subdivision 3c in the following circumstances:
new text end

new text begin (1) the individual is seeking a lease-only arrangement in a subsidized housing
setting; or
new text end

new text begin (2) the individual has previously received a long-term care consultation assessment
under this section. In this instance, the assessor who completes the long-term care
consultation will issue a verification code and provide it to the individual.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 19.

Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to
read:


Subd. 1b.

Individual service plan.

new text begin(a) new text endThe individual service plan must:

(1) include the results of the assessment information on the person's need for service,
including identification of service needs that will be or that are met by the person's
relatives, friends, and others, as well as community services used by the general public;

(2) identify the person's preferences for services as stated by the person, the person's
legal guardian or conservator, or the parent if the person is a minor;

(3) identify long- and short-range goals for the person;

(4) identify specific services and the amount and frequency of the services to be
provided to the person based on assessed needs, preferences, and available resources.
The individual service plan shall also specify other services the person needs that are
not available;

(5) identify the need for an individual program plan to be developed by the provider
according to the respective state and federal licensing and certification standards, and
additional assessments to be completed or arranged by the provider after service initiation;

(6) identify provider responsibilities to implement and make recommendations for
modification to the individual service plan;

(7) include notice of the right to request a conciliation conference or a hearing
under section 256.045;

(8) be agreed upon and signed by the person, the person's legal guardian
or conservator, or the parent if the person is a minor, and the authorized county
representative; and

(9) be reviewed by a health professional if the person has overriding medical needs
that impact the delivery of services.

new text begin (b) new text endService planning formats developed for interagency planning such as transition,
vocational, and individual family service plans may be substituted for service planning
formats developed by county agencies.

new text begin (c) Approved, written, and signed changes to a consumer's services that meet the
criteria in this subdivision shall be an addendum to that consumer's individual service plan.
new text end

Sec. 20.

Minnesota Statutes 2011 Supplement, section 256B.097, subdivision 3,
is amended to read:


Subd. 3.

State Quality Council.

(a) There is hereby created a State Quality
Council which must define regional quality councils, and carry out a community-based,
person-directed quality review component, and a comprehensive system for effective
incident reporting, investigation, analysis, and follow-up.

(b) By August 1, 2011, the commissioner of human services shall appoint the
members of the initial State Quality Council. Members shall include representatives
from the following groups:

(1) disability service recipients and their family members;

(2) during the first two years of the State Quality Council, there must be at least three
members from the Region 10 stakeholders. As regional quality councils are formed under
subdivision 4, each regional quality council shall appoint one member;

(3) disability service providers;

(4) disability advocacy groups; and

(5) county human services agencies and staff from the Department of Human
Services and Ombudsman for Mental Health and Developmental Disabilities.

(c) Members of the council who do not receive a salary or wages from an employer
for time spent on council duties may receive a per diem payment when performing council
duties and functions.

(d) The State Quality Council shall:

(1) assist the Department of Human Services in fulfilling federally mandated
obligations by monitoring disability service quality and quality assurance and
improvement practices in Minnesota; deleted text beginand
deleted text end

(2) establish state quality improvement priorities with methods for achieving results
and provide an annual report to the legislative committees with jurisdiction over policy
and funding of disability services on the outcomes, improvement priorities, and activities
undertaken by the commission during the previous state fiscal yearnew text begin;
new text end

new text begin (3) identify issues pertaining to financial and personal risk that impede Minnesotans
with disabilities from optimizing choice of community-based services; and
new text end

new text begin (4) recommend to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services and civil law by January 15, 2013,
statutory and rule changes related to the findings under clause (3) that promote
individualized service and housing choices balanced with appropriate individualized
protection
new text end.

(e) The State Quality Council, in partnership with the commissioner, shall:

(1) approve and direct implementation of the community-based, person-directed
system established in this section;

(2) recommend an appropriate method of funding this system, and determine the
feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;

(3) approve measurable outcomes in the areas of health and safety, consumer
evaluation, education and training, providers, and systems;

(4) establish variable licensure periods not to exceed three years based on outcomes
achieved; and

(5) in cooperation with the Quality Assurance Commission, design a transition plan
for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.

(f) The State Quality Council shall notify the commissioner of human services that a
facility, program, or service has been reviewed by quality assurance team members under
subdivision 4, paragraph (b), clause (13), and qualifies for a license.

(g) The State Quality Council, in partnership with the commissioner, shall establish
an ongoing review process for the system. The review shall take into account the
comprehensive nature of the system which is designed to evaluate the broad spectrum of
licensed and unlicensed entities that provide services to persons with disabilities. The
review shall address efficiencies and effectiveness of the system.

(h) The State Quality Council may recommend to the commissioner certain
variances from the standards governing licensure of programs for persons with disabilities
in order to improve the quality of services so long as the recommended variances do
not adversely affect the health or safety of persons being served or compromise the
qualifications of staff to provide services.

(i) The safety standards, rights, or procedural protections referenced under
subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
recommendations to the commissioner or to the legislature in the report required under
paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
procedural protections referenced under subdivision 2, paragraph (c).

(j) The State Quality Council may hire staff to perform the duties assigned in this
subdivision.

Sec. 21.

Minnesota Statutes 2010, section 256B.431, subdivision 17e, is amended to
read:


Subd. 17e.

Replacement-costs-new per bed limit effective October 1, 2007.

Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2),
for a total replacement, as defined in subdivision 17d, authorized under section
144A.071 or 144A.073 after July 1, 1999, any building project that is a relocation,
renovation, upgrading, or conversion completed on or after July 1, 2001, or any
building project eligible for reimbursement under section 256B.434, subdivision 4f, the
replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
9549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1,
2000.new text begin These amounts must be increased annually as specified in subdivision 3f, paragraph
(a), beginning October 1, 2012.
new text end

Sec. 22.

Minnesota Statutes 2010, section 256B.431, is amended by adding a
subdivision to read:


new text begin Subd. 45. new text end

new text begin Rate adjustments for some moratorium exception projects.
new text end

new text begin Notwithstanding any other law to the contrary, money available for moratorium exception
projects under section 144A.073, subdivisions 2 and 11, shall be used to fund the
incremental rate increases resulting from this section for any nursing facility with a
moratorium exception project approved under section 144A.073, and completed after
August 30, 2010, where the replacement-costs-new limits under subdivision 17e were
higher at any time after project approval than at the time of project completion. The
commissioner shall calculate the property rate increase for these facilities using the highest
set of limits; however, any rate increase under this section shall not be effective until on
or after the effective date of this section, contingent upon federal approval. No property
rate decrease shall result from this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval.
new text end

Sec. 23.

Minnesota Statutes 2010, section 256B.434, subdivision 10, is amended to
read:


Subd. 10.

Exemptions.

(a) To the extent permitted by federal law, (1) a facility that
has entered into a contract under this section is not required to file a cost report, as defined
in Minnesota Rules, part 9549.0020, subpart 13, for any year after the base year that is the
basis for the calculation of the contract payment rate for the first rate year of the alternative
payment demonstration project contract; and (2) a facility under contract is not subject
to audits of historical costs or revenues, or paybacks or retroactive adjustments based on
these costs or revenues, except audits, paybacks, or adjustments relating to the cost report
that is the basis for calculation of the first rate year under the contract.

(b) A facility that is under contract with the commissioner under this section is
not subject to the moratorium on licensure or certification of new nursing home beds in
section 144A.071, unless the project results in a net increase in bed capacity or involves
relocation of beds from one site to another. Contract payment rates must not be adjusted
to reflect any additional costs that a nursing facility incurs as a result of a construction
project undertaken under this paragraph. In addition, as a condition of entering into a
contract under this section, a nursing facility must agree that any future medical assistance
payments for nursing facility services will not reflect any additional costs attributable to
the sale of a nursing facility under this section and to construction undertaken under
this paragraph that otherwise would not be authorized under the moratorium in section
144A.073. Nothing in this section prevents a nursing facility participating in the
alternative payment demonstration project under this section from seeking approval of
an exception to the moratorium through the process established in section 144A.073,
and if approved the facility's rates shall be adjusted to reflect the cost of the project.
Nothing in this section prevents a nursing facility participating in the alternative payment
demonstration project from seeking legislative approval of an exception to the moratorium
under section 144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the
cost of the project.

deleted text begin (c) Notwithstanding section 256B.48, subdivision 6, paragraphs (c), (d), and (e),
and pursuant to any terms and conditions contained in the facility's contract, a nursing
facility that is under contract with the commissioner under this section is in compliance
with section 256B.48, subdivision 6, paragraph (b), if the facility is Medicare certified.
deleted text end

deleted text begin (d)deleted text end new text begin (c) new text endNotwithstanding paragraph (a), if by April 1, 1996, the health care financing
administration has not approved a required waiver, or the Centers for Medicare and
Medicaid Services otherwise requires cost reports to be filed prior to the waiver's approval,
the commissioner shall require a cost report for the rate year.

deleted text begin (e)deleted text endnew text begin (d)new text end A facility that is under contract with the commissioner under this section
shall be allowed to change therapy arrangements from an unrelated vendor to a related
vendor during the term of the contract. The commissioner may develop reasonable
requirements designed to prevent an increase in therapy utilization for residents enrolled
in the medical assistance program.

deleted text begin (f)deleted text endnew text begin (e)new text end Nursing facilities participating in the alternative payment system
demonstration project must either participate in the alternative payment system quality
improvement program established by the commissioner or submit information on their
own quality improvement process to the commissioner for approval. Nursing facilities
that have had their own quality improvement process approved by the commissioner
must report results for at least one key area of quality improvement annually to the
commissioner.

Sec. 24.

Minnesota Statutes 2010, section 256B.441, is amended by adding a
subdivision to read:


new text begin Subd. 63. new text end

new text begin Critical access nursing facilities. new text end

new text begin (a) The commissioner, in consultation
with the commissioner of health, may designate certain nursing facilities as critical access
nursing facilities. The designation shall be granted on a competitive basis, within the
limits of funds appropriated for this purpose.
new text end

new text begin (b) The commissioner shall request proposals from nursing facilities every two years.
Proposals must be submitted in the form and according to the timelines established by
the commissioner. In selecting applicants to designate, the commissioner, in consultation
with the commissioner of health, and with input from stakeholders, shall develop criteria
designed to preserve access to nursing facility services in isolated areas, rebalance
long-term care, and improve quality.
new text end

new text begin (c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing
facilities designated as critical access nursing facilities:
new text end

new text begin (1) partial rebasing, with operating payment rates being the sum of 60 percent of the
operating payment rate determined in accordance with subdivision 54 and 40 percent of the
operating payment rate that would have been allowed had the facility not been designated;
new text end

new text begin (2) enhanced payments for leave days. Notwithstanding section 256B.431,
subdivision 2r, upon designation as a critical access nursing facility, the commissioner
shall limit payment for leave days to 60 percent of that nursing facility's total payment rate
for the involved resident, and shall allow this payment only when the occupancy of the
nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;
new text end

new text begin (3) two designated critical access nursing facilities, with up to 100 beds in active
service, may jointly apply to the commissioner of health for a waiver of Minnesota
Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The
commissioner of health will consider each waiver request independently based on the
criteria under Minnesota Rules, part 4658.0040;
new text end

new text begin (4) the minimum threshold under section 256B.431, subdivisions 3f, paragraph (a),
and 17e, shall be 40 percent of the amount that would otherwise apply; and
new text end

new text begin (5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based
rate limits under subdivision 50 shall apply to designated critical access nursing facilities.
new text end

new text begin (d) Designation of a critical access nursing facility shall be for a period of two
years, after which the benefits allowed under paragraph (c) shall be removed. Designated
facilities may apply for continued designation.
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. 25.

Minnesota Statutes 2010, section 256B.48, is amended by adding a
subdivision to read:


new text begin Subd. 6a. new text end

new text begin Referrals to Medicare providers required. new text end

new text begin Notwithstanding subdivision
1, nursing facility providers that do not participate in or accept Medicare assignment
must refer and document the referral of dual eligible recipients for whom placement is
requested and for whom the resident would be qualified for a Medicare-covered stay to
Medicare providers. The commissioner shall audit nursing facilities that do not accept
Medicare and determine if dual eligible individuals with Medicare qualifying stays have
been admitted. If such a determination is made, the commissioner shall deny Medicaid
payment for the first 20 days of that resident's stay.
new text end

Sec. 26.

Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15,
is amended to read:


Subd. 15.

Individualized service plan; comprehensive transitional service plan;
maintenance service plan.

(a) Each recipient of home and community-based waivered
services shall be provided a copy of the written service plan which:

(1) is developed and signed by the recipient within ten working days of the
completion of the assessment;

(2) meets the assessed needs of the recipient;

(3) reasonably ensures the health and safety of the recipient;

(4) promotes independence;

(5) allows for services to be provided in the most integrated settings; and

(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (p), of service and support providers.

(b) In developing the comprehensive transitional service plan, the individual
receiving services, the case manager, and the guardian, if applicable, will identify
the transitional service plan fundamental service outcome and anticipated timeline to
achieve this outcome. Within the first 20 days following a recipient's request for an
assessment or reassessment, the transitional service planning team must be identified. A
team leader must be identified who will be responsible for assigning responsibility and
communicating with team members to ensure implementation of the transition plan and
ongoing assessment and communication process. The team leader should be an individual,
such as the case manager or guardian, who has the opportunity to follow the recipient to
the next level of service.

Within ten days following an assessment, a comprehensive transitional service plan
must be developed incorporating elements of a comprehensive functional assessment and
including short-term measurable outcomes and timelines for achievement of and reporting
on these outcomes. Functional milestones must also be identified and reported according
to the timelines agreed upon by the transitional service planning team. In addition, the
comprehensive transitional service plan must identify additional supports that may assist
in the achievement of the fundamental service outcome such as the development of greater
natural community support, increased collaboration among agencies, and technological
supports.

The timelines for reporting on functional milestones will prompt a reassessment of
services provided, the units of services, rates, and appropriate service providers. It is
the responsibility of the transitional service planning team leader to review functional
milestone reporting to determine if the milestones are consistent with observable skills
and that milestone achievement prompts any needed changes to the comprehensive
transitional service plan.

For those whose fundamental transitional service outcome involves the need to
procure housing, a plan for the recipient to seek the resources necessary to secure the least
restrictive housing possible should be incorporated into the plan, including employment
and public supports such as housing access and shelter needy funding.

(c) Counties and other agencies responsible for funding community placement and
ongoing community supportive services are responsible for the implementation of the
comprehensive transitional service plans. Oversight responsibilities include both ensuring
effective transitional service delivery and efficient utilization of funding resources.

(d) Following one year of transitional services, the transitional services planning
team will make a determination as to whether or not the individual receiving services
requires the current level of continuous and consistent support in order to maintain the
recipient's current level of functioning. Recipients who are determined to have not had
a significant change in functioning for 12 months must move from a transitional to a
maintenance service plan. Recipients on a maintenance service plan must be reassessed
to determine if the recipient would benefit from a transitional service plan at least every
12 months and at other times when there has been a significant change in the recipient's
functioning. This assessment should consider any changes to technological or natural
community supports.

(e) When a county is evaluating denials, reductions, or terminations of home and
community-based services under section 256B.49 for an individual, the case manager
shall offer to meet with the individual or the individual's guardian in order to discuss the
prioritization of service needs within the individualized service plan, comprehensive
transitional service plan, or maintenance service plan. The reduction in the authorized
services for an individual due to changes in funding for waivered services may not exceed
the amount needed to ensure medically necessary services to meet the individual's health,
safety, and welfare.

(f) At the time of reassessment, local agency case managers shall assess each
recipient of community alternatives for disabled individuals or traumatic brain injury
waivered services currently residing in a licensed adult foster home that is not the primary
residence of the license holder, or in which the license holder is not the primary caregiver,
to determine if that recipient could appropriately be served in a community-living setting.
If appropriate for the recipient, the case manager shall offer the recipient, through a
person-centered planning process, the option to receive alternative housing and service
options. In the event that the recipient chooses to transfer from the adult foster home,
the vacated bed shall not be filled with another recipient of waiver services and group
residential housingdeleted text begin, unlessdeleted text end new text begin and the licensed capacity shall be reduced accordingly, unless
the savings required by the 2011 licensed bed closure reductions for foster care settings
where the physical location is not the primary residence of the license holder are met
through voluntary changes described in section 245A.03, subdivision 7, paragraph (g),
or as
new text endprovided under deleted text beginsection 245A.03, subdivision 7deleted text end, paragraph (a), clauses (3) and (4)deleted text begin,
and the licensed capacity shall be reduced accordingly
deleted text end. If the adult foster home becomes
no longer viable due to these transfers, the county agency, with the assistance of the
department, shall facilitate a consolidation of settings or closure. This reassessment
process shall be completed by deleted text beginJune 30, 2012deleted text endnew text begin July 1, 2013new text end.

Sec. 27.

Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 23,
is amended to read:


Subd. 23.

Community-living settings.

"Community-living settings" means a
single-family home or apartment where the service recipient or their family owns or rents,
deleted text begin as demonstrated by a lease agreement,deleted text end and maintains control over the individual unitnew text begin as
demonstrated by the lease agreement, or has a plan for transition of a lease from a service
provider to the individual. Within two years of signing the initial lease, the service provider
shall transfer the lease to the individual. In the event the landlord denies the transfer, the
commissioner may approve an exception within sufficient time to ensure the continued
occupancy by the individual
new text end. Community-living settings are subject to the following:

(1) individuals are not required to receive services;

(2) individuals are not required to have a disability or specific diagnosis to live in the
community-living settingnew text begin, unless state or federal funding requires itnew text end;

(3) individuals may hire service providers of their choice;

(4) individuals may choose whether to share their household and with whom;

(5) the home or apartment must include living, sleeping, bathing, and cooking areas;

(6) individuals must have lockable access and egress;

(7) individuals must be free to receive visitors and leave the settings at times and for
durations of their own choosing;

(8) leases must not reserve the right to assign units or change unit assignments; and

(9) access to the greater community must be easily facilitated based on the
individual's needs and preferences.

Sec. 28.

new text begin [256B.492] ADULT FOSTER CARE VOLUNTARY CLOSURE.
new text end

new text begin Subdivision 1. new text end

new text begin Commissioner's duties; report. new text end

new text begin The commissioner of human
services shall ask providers of adult foster care services to present proposals for the
conversion of services provided for persons with developmental disabilities in settings
licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, to services to other
community settings in conjunction with the cessation of operations and closure of
identified facilities.
new text end

new text begin Subd. 2. new text end

new text begin Inventory of foster care capacity. new text end

new text begin The commissioner of human services
shall submit to the legislature by February 15, 2013, a report that includes:
new text end

new text begin (1) an inventory of the assessed needs of all individuals with disabilities receiving
foster care services under section 256B.092;
new text end

new text begin (2) an inventory of total licensed foster care capacity for adults and children
available in Minnesota as of January 1, 2013; and
new text end

new text begin (3) a comparison of the needs of individuals receiving services in foster care settings
and nonfoster care settings.
new text end

new text begin The report will also contain recommendations on developing a profile of individuals
requiring foster care services and the projected level of foster care capacity needed
to serve that population.
new text end

new text begin Subd. 3. new text end

new text begin Voluntary closure process need determination. new text end

new text begin If the report required in
subdivision 2 determines the existing supply of foster care capacity is higher than needed
to meet the needs of individuals requiring that level of care, the commissioner shall,
within the limits of available appropriations, announce and implement a program for
closure of adult foster care homes.
new text end

new text begin Subd. 4. new text end

new text begin Application process. new text end

new text begin (a) The commissioner shall establish a process of
application, review, and approval for licensees to submit proposals for the closure of
facilities.
new text end

new text begin (b) A licensee shall notify the following parties in writing when an application for a
planned closure adjustment is submitted:
new text end

new text begin (1) the county social services agency; and
new text end

new text begin (2) current and prospective residents and their families.
new text end

new text begin (c) After providing written notice, and prior to admission, the licensee must fully
inform prospective residents and their families of the intent to close operations and of
the relocation plan.
new text end

new text begin Subd. 5. new text end

new text begin Review and approval process. new text end

new text begin (a) To be considered for approval, an
application must include:
new text end

new text begin (1) a description of the proposed closure plan, which must include identification of
the home or homes to receive a planned closure rate adjustment;
new text end

new text begin (2) the proposed timetable for any proposed closure, including the proposed dates for
announcement to residents and the affected county social service agency, commencement
of closure, and completion of closure;
new text end

new text begin (3) the proposed relocation plan jointly developed by the county of financial
responsibility and the providers for current residents of any facility designated for closure;
and
new text end

new text begin (4) documentation in a format approved by the commissioner that all the adult foster
care homes receiving a planned closure rate adjustment under the plan have accepted joint
and several liability for recovery of overpayments under section 256B.0641, subdivision
2, for the facilities designated for closure under the plan.
new text end

new text begin (c) In reviewing and approving closure proposals, the commissioner shall give first
priority to proposals that:
new text end

new text begin (1) result in the closing of a facility;
new text end

new text begin (2) demonstrate savings of medical assistance expenditures; and
new text end

new text begin (3) demonstrate that alternative placements will be developed based on individual
resident needs and applicable federal and state rules.
new text end

new text begin The commissioner shall also consider any information provided by residents, their
family, or the county social services agency on the impact of the planned closure on
the services they receive.
new text end

new text begin (d) The commissioner shall select proposals that best meet the criteria established
in this subdivision within the appropriation made available for planned closure of adult
foster care facilities. The commissioner shall notify licensees of the selections made and
approved by the commissioner.
new text end

new text begin (e) For each proposal approved by the commissioner, a contract must be established
between the commissioner, the county of financial responsibility, and the participating
licensee.
new text end

new text begin Subd. 6. new text end

new text begin Adjustment to rates. new text end

new text begin (a) For purposes of this section, the commissioner
shall establish an enhanced payment rate under section 256B.0913 to facilitate an orderly
transition for persons with developmental disabilities from adult foster care to other
community-based settings.
new text end

new text begin (b) The maximum length the commissioner may establish an enhanced rate is six
months.
new text end

new text begin (c) The commissioner shall allocate funds, up to a total of $450 in state and federal
funds per adult foster care home bed that is closing, to be used for relocation costs incurred
by counties under this process
new text end

new text begin (d) The commissioner shall analyze the fiscal impact of the closure of each facility
on medical assistance expenditures. Any savings is allocated to the medical assistance
program.
new text end

Sec. 29.

Minnesota Statutes 2010, 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)(1) 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 July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
as shelter needy and are: (i) relocating from an institution, or an adult mental health
residential treatment program under section 256B.0622; (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, unless allowed under paragraph (g).

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

(3) "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, paragraph (a) or (b), 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.

(g) Notwithstanding this subdivision, to access housing and services as provided
in paragraph (f), the recipient may choose housing that may be owned, operated, or
controlled by the recipient's service provider. In a multifamily building deleted text beginof four or more
units, the maximum number of apartments that may be used by recipients of this program
shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.
deleted text endnew text begin of
more than four units, the maximum number of units that may be used by recipients of this
program shall be the greater of four units of 25 percent of the units in the building. In
multifamily buildings of four or fewer units, all of the units may be used by recipients
of this program. When housing is controlled by the service provider, the individual may
choose their own service provider as provided in section 256B.49, subdivision 23, clause
(3). When the housing is controlled by the service provider, the service provider shall
implement a plan with the recipient to transition the lease to the recipient's name. Within
two years of signing the initial lease, the service provider shall transfer the lease entered
into under this subdivision to the recipient. In the event the landlord denies this transfer,
the commissioner may approve an exception within sufficient time to ensure the continued
occupancy by the recipient. This paragraph expires June 30, 2016.
new text end

Sec. 30.

Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to
read:


Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.

The commissioner shall seek any necessary federal approval in order to implement
the changes to the level of care criteria in Minnesota Statutes, section 144.0724,
subdivision 11
, on new text beginor after new text endJuly 1, 2012new text begin, for adults and childrennew 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. 31.

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


Subd. 3.

Forecasted Programs

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

(a) MFIP/DWP Grants
Appropriations by Fund
General
84,680,000
91,978,000
Federal TANF
84,425,000
75,417,000
(b) MFIP Child Care Assistance Grants
55,456,000
30,923,000
(c) General Assistance Grants
49,192,000
46,938,000

General Assistance Standard. The
commissioner shall set the monthly standard
of assistance for general assistance units
consisting of an adult recipient who is
childless and unmarried or living apart
from parents or a legal guardian at $203.
The commissioner may reduce this amount
according to Laws 1997, chapter 85, article
3, section 54.

Emergency General Assistance. The
amount appropriated for emergency general
assistance funds is limited to no more
than $6,689,812 in fiscal year 2012 and
$6,729,812 in fiscal year 2013. Funds
to counties shall be allocated by the
commissioner using the allocation method
specified in Minnesota Statutes, section
256D.06.

(d) Minnesota Supplemental Aid Grants
38,095,000
39,120,000
(e) Group Residential Housing Grants
121,080,000
129,238,000
(f) MinnesotaCare Grants
295,046,000
317,272,000

This appropriation is from the health care
access fund.

(g) Medical Assistance Grants
4,501,582,000
4,437,282,000

Managed Care Incentive Payments. The
commissioner shall not make managed care
incentive payments for expanding preventive
services during fiscal years beginning July 1,
2011, and July 1, 2012.

Reduction of Rates for Congregate
Living for Individuals with Lower Needs.
Beginning October 1, 2011, lead agencies
must reduce rates in effect on January 1,
2011, by ten percent for individuals with
lower needs living in foster care settings
where the license holder does not share the
residence with recipients on the CADI and
DD waivers and customized living settings
for CADI. new text begin Lead agencies shall consult
with providers to review individual service
plans and identify changes or modifications
to reduce the utilization of services while
maintaining the health and safety of the
individual receiving services.
new text endLead agencies
must adjust contracts within 60 days of the
effective date.

Reduction of Lead Agency Waiver
Allocations to Implement Rate Reductions
for Congregate Living for Individuals
with Lower Needs.
Beginning October 1,
2011, the commissioner shall reduce lead
agency waiver allocations to implement the
reduction of rates for individuals with lower
needs living in foster care settings where the
license holder does not share the residence
with recipients on the CADI and DD waivers
and customized living settings for CADI.

Reduce customized living and 24-hour
customized living component rates.

Effective July 1, 2011, the commissioner
shall reduce elderly waiver customized living
and 24-hour customized living component
service spending by five percent through
reductions in component rates and service
rate limits. The commissioner shall adjust
the elderly waiver capitation payment
rates for managed care organizations paid
under Minnesota Statutes, section 256B.69,
subdivisions 6a
and 23, to reflect reductions
in component spending for customized living
services and 24-hour customized living
services under Minnesota Statutes, section
256B.0915, subdivisions 3e and 3h, for the
contract period beginning January 1, 2012.
To implement the reduction specified in
this provision, capitation rates paid by the
commissioner to managed care organizations
under Minnesota Statutes, section 256B.69,
shall reflect a ten percent reduction for the
specified services for the period January 1,
2012, to June 30, 2012, and a five percent
reduction for those services on or after July
1, 2012.

Limit Growth in the Developmental
Disability Waiver.
The commissioner
shall limit growth in the developmental
disability waiver to six diversion allocations
per month beginning July 1, 2011, through
June 30, 2013, and 15 diversion allocations
per month beginning July 1, 2013, through
June 30, 2015. Waiver allocations shall
be targeted to individuals who meet the
priorities for accessing waiver services
identified in Minnesota Statutes, 256B.092,
subdivision 12
. The limits do not include
conversions from intermediate care facilities
for persons with developmental disabilities.
Notwithstanding any contrary provisions in
this article, this paragraph expires June 30,
2015.

Limit Growth in the Community
Alternatives for Disabled Individuals
Waiver.
The commissioner shall limit
growth in the community alternatives for
disabled individuals waiver to 60 allocations
per month beginning July 1, 2011, through
June 30, 2013, and 85 allocations per
month beginning July 1, 2013, through
June 30, 2015. Waiver allocations must
be targeted to individuals who meet the
priorities for accessing waiver services
identified in Minnesota Statutes, section
256B.49, subdivision 11a. The limits include
conversions and diversions, unless the
commissioner has approved a plan to convert
funding due to the closure or downsizing
of a residential facility or nursing facility
to serve directly affected individuals on
the community alternatives for disabled
individuals waiver. Notwithstanding any
contrary provisions in this article, this
paragraph expires June 30, 2015.

Personal Care Assistance Relative
Care.
The commissioner shall adjust the
capitation payment rates for managed care
organizations paid under Minnesota Statutes,
section 256B.69, to reflect the rate reductions
for personal care assistance provided by
a relative pursuant to Minnesota Statutes,
section 256B.0659, subdivision 11.

(h) Alternative Care Grants
46,421,000
46,035,000

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

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

Sec. 32.

Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
4, is amended to read:


Subd. 4.

Grant Programs

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

(a) Support Services Grants
Appropriations by Fund
General
8,715,000
8,715,000
Federal TANF
100,525,000
94,611,000

MFIP Consolidated Fund Grants. The
TANF fund base is reduced by $10,000,000
each year beginning in fiscal year 2012.

Subsidized Employment Funding Through
ARRA.
The commissioner is authorized to
apply for TANF emergency fund grants for
subsidized employment activities. Growth
in expenditures for subsidized employment
within the supported work program and the
MFIP consolidated fund over the amount
expended in the calendar year quarters in
the TANF emergency fund base year shall
be used to leverage the TANF emergency
fund grants for subsidized employment and
to fund supported work. The commissioner
shall develop procedures to maximize
reimbursement of these expenditures over the
TANF emergency fund base year quarters,
and may contract directly with employers
and providers to maximize these TANF
emergency fund grants.

(b) Basic Sliding Fee Child Care Assistance
Grants
37,144,000
38,678,000

Base Adjustment. The general fund base is
decreased by $990,000 in fiscal year 2014
and $979,000 in fiscal year 2015.

Child Care and Development Fund
Unexpended Balance.
In addition to
the amount provided in this section, the
commissioner shall expend $5,000,000
in fiscal year 2012 from the federal child
care and development fund unexpended
balance for basic sliding fee child care under
Minnesota Statutes, section 119B.03. The
commissioner shall ensure that all child
care and development funds are expended
according to the federal child care and
development fund regulations.

(c) Child Care Development Grants
774,000
774,000

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

(d) Child Support Enforcement Grants
50,000
50,000

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

(e) Children's Services Grants
Appropriations by Fund
General
47,949,000
48,507,000
Federal TANF
140,000
140,000

Adoption Assistance and Relative Custody
Assistance Transfer.
The commissioner
may transfer unencumbered appropriation
balances for adoption assistance and relative
custody assistance between fiscal years and
between programs.

Privatized Adoption Grants. Federal
reimbursement for privatized adoption grant
and foster care recruitment grant expenditures
is appropriated to the commissioner for
adoption grants and foster care and adoption
administrative purposes.

Adoption Assistance Incentive Grants.
Federal funds available during fiscal year
2012 and fiscal year 2013 for adoption
incentive grants are appropriated to the
commissioner for these purposes.

(f) Children and Community Services Grants
53,301,000
53,301,000
(g) Children and Economic Support Grants
Appropriations by Fund
General
16,103,000
16,180,000
Federal TANF
700,000
0

Long-Term Homeless Services. $700,000
is appropriated from the federal TANF
fund for the biennium beginning July
1, 2011, to the commissioner of human
services for long-term homeless services
for low-income homeless families under
Minnesota Statutes, section 256K.26. This
is a onetime appropriation and is not added
to the base.

Base Adjustment. The general fund base is
increased by $42,000 in fiscal year 2014 and
$43,000 in fiscal year 2015.

Minnesota Food Assistance Program.
$333,000 in fiscal year 2012 and $408,000 in
fiscal year 2013 are to increase the general
fund base for the Minnesota food assistance
program. Unexpended funds for fiscal year
2012 do not cancel but are available to the
commissioner for this purpose in fiscal year
2013.

(h) Health Care Grants

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

Base Adjustment. The general fund base is
increased by $24,000 in each of fiscal years
2014 and 2015.

(i) Aging and Adult Services Grants
12,154,000
11,456,000

Aging Grants Reduction. Effective July
1, 2011, funding for grants made under
Minnesota Statutes, sections 256.9754 and
256B.0917, subdivision 13, is reduced by
$3,600,000 for each year of the biennium.
These reductions are onetime and do
not affect base funding for the 2014-2015
biennium. Grants made during the 2012-2013
biennium under Minnesota Statutes, section
256B.9754, must not be used for new
construction or building renovation.

Essential Community Support Grant
Delay.
Upon federal approval to implement
the nursing facility level of care on July
1, 2013, essential community supports
grants under Minnesota Statutes, section
256B.0917, subdivision 14, are reduced by
$6,410,000 in fiscal year 2013. Base level
funding is increased by $5,541,000 in fiscal
year 2014 and $6,410,000 in fiscal year 2015.

Base Level Adjustment. The general fund
base is increased by $10,035,000 in fiscal
year 2014 and increased by $10,901,000 in
fiscal year 2015.

(j) Deaf and Hard-of-Hearing Grants
1,936,000
1,767,000
(k) Disabilities Grants
15,945,000
18,284,000

Grants for Housing Access Services. In
fiscal year 2012, the commissioner shall
make available a total of $161,000 in housing
access services grants to individuals who
relocate from an adult foster care home to
a community living setting for assistance
with completion of rental applications or
lease agreements; assistance with publicly
financed housing options; development of
household budgets; and assistance with
funding affordable furnishings and related
household matters.

HIV Grants. The general fund appropriation
for the HIV drug and insurance grant
program shall be reduced by $2,425,000 in
fiscal year 2012 and increased by $2,425,000
in fiscal year 2014. These adjustments are
onetime and shall not be applied to the base.
Notwithstanding any contrary provision, this
provision expires June 30, 2014.

Region 10. Of this appropriation, $100,000
each year is for a grant provided under
Minnesota Statutes, section 256B.097.

Base Level Adjustment. The general fund
base is increased by $2,944,000 in fiscal year
2014 and $653,000 in fiscal year 2015.

Local Planning Grants for Creating
Alternatives to Congregate Living for
Individuals with Lower Needs.
new text begin (1) new text endThe
commissioner shall make available a total
of $250,000 per year in local planning
grants, beginning July 1, 2011, to assist
lead agencies and provider organizations in
developing alternatives to congregate living
within the available level of resources for the
home and community-based services waivers
for persons with disabilities.

new text begin (2) Notwithstanding clause (1), for fiscal
years 2012 and 2013 only, the appropriation
of $250,000 for fiscal year 2012 carries
forward to fiscal year 2013, effective the day
following final enactment.
new text end

new text begin Of the total appropriations available for fiscal
year 2013, $100,000 is for administrative
functions related to the planning process
required under Minnesota Statutes, sections
144A.351 and 245A.03, subdivision 7,
paragraphs (e) and (g), and $400,000 is for
grants required to accomplish that planning
process.
new text end

new text begin (3) Base funding for the grants under clause
(1) is not affected by the appropriations
under clause (2).
new text end

Disability Linkage Line. Of this
appropriation, $125,000 in fiscal year 2012
and $300,000 in fiscal year 2013 are for
assistance to people with disabilities who are
considering enrolling in managed care.

(l) Adult Mental Health Grants
Appropriations by Fund
General
70,570,000
70,570,000
Health Care Access
750,000
750,000
Lottery Prize
1,508,000
1,508,000

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

Base Adjustment. The general fund base is
increased by $200,000 in fiscal years 2014
and 2015.

(m) Children's Mental Health Grants
16,457,000
16,457,000

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

Base Adjustment. The general fund base is
increased by $225,000 in fiscal years 2014
and 2015.

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

Sec. 33. new text beginCOMMISSIONER AUTHORITY TO REDUCE 2011 CONGREGATE
CARE LOW NEED RATE CUT.
new text end

new text begin During fiscal years 2013 and 2014, the commissioner shall reduce the 2011 reduction
of rates for congregate living for individuals with lower needs to the extent the actions
taken under Minnesota Statutes, section 245A.03, subdivision 7, paragraph (g), produce
savings beyond the amount needed to meet the licensed bed closure savings requirements
of Minnesota Statutes, section 245A.03, subdivision 7, paragraph (e). Each February 1,
the commissioner shall report to the chairs and ranking minority members of the health
and human services finance committees on any reductions provided under this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, and expires June 30,
2014.
new text end

Sec. 34. new text beginCOMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.
new text end

new text begin (a) By June 1, 2012, the commissioner of human services shall seek federal approval
as part of the MA reform waiver request required under Minnesota Statutes, section
256B.021 to:
new text end

new text begin (1) authorize persons who have been eligible for medical assistance under Minnesota
Statutes, section 256B.057, subdivision 9, for each of the 24 consecutive months prior
to reaching age 65, to continue to qualify for medical assistance under Minnesota
Statutes, section 256B.057, subdivision 9, beyond their 65th birthday as long as the other
requirements of Minnesota Statutes, section 256B.057, subdivision 9, are met;
new text end

new text begin (2) authorize federal funding under the waiver from April 1, 2012, until federal
approval is obtained for persons who turn age 65 in 2012 and who have been enrolled in
medical assistance under Minnesota Statutes, section 256B.057, subdivision 9, for at least
20 months within the 24 months prior to reaching age 65 to continue to qualify for medical
assistance under Minnesota Statutes, section 256B.057, subdivision 9. If federal approval
of clause (1) is not granted, then for temporary federal funding until 30 days after any
federal denial is made public through the disability stakeholders electronic notice list; and
new text end

new text begin (3) notwithstanding the requirements of clause (1), persons whose 65th birthday
occurs in 2012 or 2013 are required to have qualified for medical assistance under
Minnesota Statutes, section 256B.057, subdivision 9, prior to age 65 for at least 20 months
in the 24 months prior to reaching age 65.
new text end

new text begin (b) Money shall be appropriated from the state general fund until federal approval is
granted for individuals eligible for medical assistance under paragraph (a), clause (2).
new text end

new text begin This section shall expire when federal approval is granted or 30 days after a federal
denial.
new text end

Sec. 35. new text beginCONTINUATION OF MEDICAL ASSISTANCE FOR EMPLOYED
PERSONS WITH DISABILITIES WHILE WAIVER REQUEST IS PENDING.
new text end

new text begin Persons eligible for medical assistance under Minnesota Statutes, section 245A.07,
subdivision 7, paragraph (a), clause (2), shall be allowed to continue to qualify for
Minnesota Statutes, section 256B.057, subdivision 9, until the federal approval requested
under Minnesota Statutes, section 245A.07, subdivision 7, is granted, or until 30 days after
any federal denial is made public through the disability stakeholders electronic notice list.
This section shall expire June 30, 2013.
new text end

Sec. 36. new text beginSCOPE OF FISCAL ANALYSIS.
new text end

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

Sec. 37. new text beginHOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH
DISABILITIES.
new text end

new text begin (a) Individuals receiving services under a home and community-based waiver under
Minnesota Statutes, section 256B.092 or 256B.49, may receive services in the following
settings:
new text end

new text begin (1) an individual's own home or family home;
new text end

new text begin (2) a licensed adult foster care setting of up to five people; and
new text end

new text begin (3) community living settings as defined in Minnesota Statutes, section 256B.49,
subdivision 23, where individuals with disabilities may reside in all of the units in a
building of four or fewer units no more than the greater of four or 25 percent of the units
in a multifamily building of more than four units.
new text end

new text begin The above settings must not:
new text end

new text begin (1) be located in a building that is a publicly or privately operated facility that
provides institutional treatment or custodial care;
new text end

new text begin (2) be located in a building on the grounds of or adjacent to a public institution;
new text end

new text begin (3) be a housing complex designed expressly around an individual's diagnosis or
disability unless state or federal funding for housing requires it;
new text end

new text begin (4) be segregated based on a disability, either physically or because of setting
characteristics, from the larger community; and
new text end

new text begin (5) have the qualities of an institution, unless specifically required in the individual's
plan developed with the lead agency case manager and legal guardian. The qualities of an
institution include, but are not limited to:
new text end

new text begin (i) regimented meal and sleep times;
new text end

new text begin (ii) limitations on visitors; and
new text end

new text begin (iii) lack of privacy.
new text end

new text begin (b) The provisions of paragraph (a) do not apply to any setting in which residents
receive services under a home and community-based waiver as of June 30, 2013, and
which has been delivering those services for at least one year.
new text end

new text begin (c) Notwithstanding paragraph (b), a program in Hennepin County established as
part of a Hennepin County demonstration project is qualified for the exception allowed
under paragraph (b).
new text end

new text begin (d) The commissioner shall submit an amendment to the waiver plan no later than
December 31, 2012.
new text end

Sec. 38. new text beginINDEPENDENT LIVING SERVICES BILLING.
new text end

new text begin The commissioner shall allow for daily rate and 15-minute increment billing for
independent living services under the brain injury (BI) and CADI waivers. If necessary to
comply with this requirement, the commissioner shall submit a waiver amendment to the
state plan no later than December 31, 2012.
new text end

Sec. 39. new text begin REPEALER.
new text end

new text begin (a) Minnesota Statutes 2010, sections 144A.073, subdivision 9; and 256B.48,
subdivision 6,
new text end new text begin and new text end new text begin Laws 2011, First Special Session chapter 9, article 7, section 54, new text end new text begin are
repealed.
new text end

new text begin (b) Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13, new text end new text begin is
repealed.
new text end

ARTICLE 5

MISCELLANEOUS

Section 1.

Minnesota Statutes 2010, section 43A.316, subdivision 5, is amended to
read:


Subd. 5.

Public employee participation.

(a) Participation in the program is subject
to the conditions in this subdivision.

(b) Each exclusive representative for an eligible employer determines whether the
employees it represents will participate in the program. The exclusive representative shall
give the employer notice of intent to participate at least 30 days before the expiration date
of the collective bargaining agreement preceding the collective bargaining agreement that
covers the date of entry into the program. The exclusive representative and the eligible
employer shall give notice to the commissioner of the determination to participate in the
program at least 30 days before entry into the program. Entry into the program is governed
by a schedule established by the commissioner.new text begin Employees of an eligible employer that is
not participating in the program as of the date of enactment shall not be allowed to enter
the program until January 1, 2015, except that a city that has received a formal written bid
from the program as of the date of enactment shall be allowed to enter the program based
on the bid if the city so chooses.
new text end

(c) Employees not represented by exclusive representatives may become members of
the program upon a determination of an eligible employer to include these employees in the
program. Either all or none of the employer's unrepresented employees must participate.
The eligible employer shall give at least 30 days' notice to the commissioner before
entering the program. Entry into the program is governed by a schedule established by the
commissioner.new text begin Employees of an eligible employer that is not participating in the program
as of the date of enactment shall not be allowed to enter the program until January 1, 2015,
except that a city that has received a formal written bid from the program as of the date of
enactment shall be allowed to enter the program based on the bid if the city so chooses.
new text end

(d) Participation in the program is for a two-year term. Participation is automatically
renewed for an additional two-year term unless the exclusive representative, or the
employer for unrepresented employees, gives the commissioner notice of withdrawal
at least 30 days before expiration of the participation period. A group that withdraws
must wait two years before rejoining. An exclusive representative, or employer for
unrepresented employees, may also withdraw if premiums increase 50 percent or more
from one insurance year to the next.

(e) The exclusive representative shall give the employer notice of intent to withdraw
to the commissioner at least 30 days before the expiration date of a collective bargaining
agreement that includes the date on which the term of participation expires.

(f) Each participating eligible employer shall notify the commissioner of names of
individuals who will be participating within two weeks of the commissioner receiving
notice of the parties' intent to participate. The employer shall also submit other information
as required by the commissioner for administration of the program.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2010, section 62A.047, is amended to read:


62A.047 CHILDREN'S HEALTH SUPERVISION SERVICES AND
PRENATAL CARE SERVICES.

A policy of individual or group health and accident insurance regulated under this
chapter, or individual or group subscriber contract regulated under chapter 62C, health
maintenance contract regulated under chapter 62D, or health benefit certificate regulated
under chapter 64B, issued, renewed, or continued to provide coverage to a Minnesota
resident, must provide coverage for child health supervision services and prenatal care
services. The policy, contract, or certificate must specifically exempt reasonable and
customary charges for child health supervision services and prenatal care services from a
deductible, co-payment, or other coinsurance or dollar limitation requirement. new text beginNothing
in this section prohibits a health plan company that has a network of providers from
imposing a deductible, co-payment, or other coinsurance or dollar limitation requirement
for child health supervision services and prenatal care services that are delivered by an
out-of-network provider.
new text endThis section does not prohibit the use of policy waiting periods
or preexisting condition limitations for these services. Minimum benefits may be limited
to one visit payable to one provider for all of the services provided at each visit cited in
this section subject to the schedule set forth in this section. deleted text beginNothing in this section applies
to a commercial health insurance policy issued as a companion to a health maintenance
organization contract, a policy designed primarily to provide coverage payable on a
per diem, fixed indemnity, or nonexpense incurred basis, or a policy that provides
only accident coverage
deleted text endnew text begin Nothing in this section prevents a health plan company from
using reasonable medical management techniques to determine the frequency, method,
treatment, or setting for child health supervision services and prenatal care services
new text end.

"Child health supervision services" means pediatric preventive services, appropriate
immunizations, developmental assessments, and laboratory services appropriate to the age
of a child from birth to age six, and appropriate immunizations from ages six to 18, as
defined by Standards of Child Health Care issued by the American Academy of Pediatrics.
Reimbursement must be made for at least five child health supervision visits from birth
to 12 months, three child health supervision visits from 12 months to 24 months, once a
year from 24 months to 72 months.

"Prenatal care services" means the comprehensive package of medical and
psychosocial support provided throughout the pregnancy, including risk assessment,
serial surveillance, prenatal education, and use of specialized skills and technology,
when needed, as defined by Standards for Obstetric-Gynecologic Services issued by the
American College of Obstetricians and Gynecologists.

Sec. 3.

Minnesota Statutes 2010, section 62A.21, subdivision 2a, is amended to read:


Subd. 2a.

Continuation privilege.

Every policy described in subdivision 1 shall
contain a provision which permits continuation of coverage under the policy for the
insured's former spouse and dependent children upon entry of a valid decree of dissolution
of marriage. The coverage shall be continued until the earlier of the following dates:

(a) the date the insured's former spouse becomes covered under any other group
health plan; or

(b) the date coverage would otherwise terminate under the policy.

If the coverage is provided under a group policy, any required premium contributions
for the coverage shall be paid by the insured on a monthly basis to the group policyholder
for remittance to the insurer. The policy must require the group policyholder to, upon
request, provide the insured with written verification from the insurer of the cost of this
coverage promptly at the time of eligibility for this coverage and at any time during
the continuation period. deleted text beginIn no event shall the amount of premium charged exceed 102
percent of the cost to the plan for such period of coverage for other similarly situated
spouses and dependent children with respect to whom the marital relationship has not
dissolved, without regard to whether such cost is paid by the employer or employee
deleted text endnew text begin The
required premium amount for continuation of the coverage shall be calculated in the same
manner as provided under section 4980B of the Internal Revenue Code, its implementing
regulations and Internal Revenue Service rulings on section 4980B
new text end.

Upon request by the insured's former spouse or dependent child, a health carrier
must provide the instructions necessary to enable the child or former spouse to elect
continuation of coverage.

Sec. 4.

Minnesota Statutes 2010, section 62D.101, subdivision 2a, is amended to read:


Subd. 2a.

Continuation privilege.

Every health maintenance contract as described
in subdivision 1 shall contain a provision which permits continuation of coverage under
the contract for the enrollee's former spouse and children upon entry of a valid decree of
dissolution of marriage. The coverage shall be continued until the earlier of the following
dates:

(a) the date the enrollee's former spouse becomes covered under another group
plan or Medicare; or

(b) the date coverage would otherwise terminate under the health maintenance
contract.

If coverage is provided under a group policy, any required premium contributions
for the coverage shall be paid by the enrollee on a monthly basis to the group contract
holder to be paid to the health maintenance organization. The contract must require the
group contract holder to, upon request, provide the enrollee with written verification from
the insurer of the cost of this coverage promptly at the time of eligibility for this coverage
and at any time during the continuation period. deleted text beginIn no event shall the fee charged exceed
102 percent of the cost to the plan for the period of coverage for other similarly situated
spouses and dependent children when the marital relationship has not dissolved, regardless
of whether the cost is paid by the employer or employee
deleted text endnew text begin The required premium amount
for continuation of the coverage shall be calculated in the same manner as provided under
section 4980B in the Internal Revenue Code, its implementing regulations and Internal
Revenue Service rulings on section 4980B
new text end.

Sec. 5.

Minnesota Statutes 2010, section 62J.26, subdivision 3, is amended to read:


Subd. 3.

Requests for evaluation.

(a) Whenever a legislative measure containing
a mandated health benefit proposal is introduced as a bill or offered as an amendment
to a bill, deleted text beginor is likely to be introduced as a bill or offered as an amendment, adeleted text endnew text begin thenew text end chair
of deleted text beginany standingdeleted text endnew text begin thenew text end legislative committee that has jurisdiction over the subject matter
of the proposal deleted text beginmaydeleted text endnew text begin mustnew text end request that the commissioner complete an evaluation of the
proposal under this sectiondeleted text begin, to inform any committee of floor action by either house of
the legislature
deleted text end.

(b) The commissioner must conduct an evaluation described in subdivision 2 of each
mandated health benefit proposal deleted text beginfor which an evaluation is requested under paragraph (a),
unless the commissioner determines under paragraph (c) or subdivision 4 that priorities
and resources do not permit its evaluation
deleted text endnew text begin introduced as a bill or offered as an amendment
to a bill as requested under paragraph (a)
new text end.

deleted text begin (c) If requests for evaluation of multiple proposals are received, the commissioner
must consult with the chairs of the standing legislative committees having jurisdiction
over the subject matter of the mandated health benefit proposals to prioritize the requests
and establish a reporting date for each proposal to be evaluated. The commissioner
is not required to direct an unreasonable quantity of the commissioner's resources to
these evaluations.
deleted text end

Sec. 6.

Minnesota Statutes 2010, section 62J.26, subdivision 5, is amended to read:


Subd. 5.

Report to legislature.

The commissioner must submit a written report on
the evaluation to the legislature no later than deleted text begin180deleted text endnew text begin 30new text end days after the request. The report
must be submitted in compliance with sections 3.195 and 3.197.

Sec. 7.

Minnesota Statutes 2010, section 62J.26, is amended by adding a subdivision to
read:


new text begin Subd. 6. new text end

new text begin Evaluation of mandated health benefits. new text end

new text begin (a) The commissioner of
commerce, in consultation with the commissioners of health and management and budget,
shall evaluate each mandated health benefit currently required in Minnesota Statutes or
Rules in accordance with the evaluation process described in subdivision 2.
new text end

new text begin (b) For purposes of this subdivision, a "mandated health benefit" means a statutory
or administrative requirement that a health plan do the following:
new text end

new text begin (1) provide coverage or increase the amount of coverage for the treatment of a
particular disease, condition, or other health care need;
new text end

new text begin (2) provide coverage or increase the amount of coverage of a particular type of
health care treatment or service, or of equipment, supplies, or drugs used in connection
with a health care treatment or service; or
new text end

new text begin (3) provide coverage for care delivered by a specific type of provider.
new text end

new text begin (c) The commissioner must submit a written report on the evaluation of existing state
mandated health benefits to the legislature by December 31, 2015.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013.
new text end

Sec. 8.

new text begin [148.2855] NURSE LICENSURE COMPACT.
new text end

new text begin The Nurse Licensure Compact is enacted into law and entered into with all other
jurisdictions legally joining in it, in the form substantially as follows:
new text end

new text begin ARTICLE 1
new text end

new text begin DEFINITIONS
new text end

new text begin As used in this compact:
new text end

new text begin (a) "Adverse action" means a home or remote state action.
new text end

new text begin (b) "Alternative program" means a voluntary, nondisciplinary monitoring program
approved by a nurse licensing board.
new text end

new text begin (c) "Coordinated licensure information system" means an integrated process for
collecting, storing, and sharing information on nurse licensure and enforcement activities
related to nurse licensure laws, which is administered by a nonprofit organization
composed of and controlled by state nurse licensing boards.
new text end

new text begin (d) "Current significant investigative information" means:
new text end

new text begin (1) investigative information that a licensing board, after a preliminary inquiry that
includes notification and an opportunity for the nurse to respond if required by state law,
has reason to believe is not groundless and, if proved true, would indicate more than a
minor infraction; or
new text end

new text begin (2) investigative information that indicates that the nurse represents an immediate
threat to public health and safety regardless of whether the nurse has been notified and
had an opportunity to respond.
new text end

new text begin (e) "Home state" means the party state which is the nurse's primary state of residence.
new text end

new text begin (f) "Home state action" means any administrative, civil, equitable, or criminal
action permitted by the home state's laws which are imposed on a nurse by the home
state's licensing board or other authority including actions against an individual's license
such as revocation, suspension, probation, or any other action which affects a nurse's
authorization to practice.
new text end

new text begin (g) "Licensing board" means a party state's regulatory body responsible for issuing
nurse licenses.
new text end

new text begin (h) "Multistate licensure privilege" means current, official authority from a
remote state permitting the practice of nursing as either a registered nurse or a licensed
practical/vocational nurse in the party state. All party states have the authority, according
to existing state due process law, to take actions against the nurse's privilege such as
revocation, suspension, probation, or any other action which affects a nurse's authorization
to practice.
new text end

new text begin (i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those
terms are defined by each party state's practice laws.
new text end

new text begin (j) "Party state" means any state that has adopted this compact.
new text end

new text begin (k) "Remote state" means a party state other than the home state:
new text end

new text begin (1) where the patient is located at the time nursing care is provided; or
new text end

new text begin (2) in the case of the practice of nursing not involving a patient, in the party state
where the recipient of nursing practice is located.
new text end

new text begin (l) "Remote state action" means:
new text end

new text begin (1) any administrative, civil, equitable, or criminal action permitted by a remote
state's laws which are imposed on a nurse by the remote state's licensing board or other
authority including actions against an individual's multistate licensure privilege to practice
in the remote state; and
new text end

new text begin (2) cease and desist and other injunctive or equitable orders issued by remote states
or the licensing boards of those states.
new text end

new text begin (m) "State" means a state, territory, or possession of the United States, the District of
Columbia, or the Commonwealth of Puerto Rico.
new text end

new text begin (n) "State practice laws" means individual party state laws and regulations that
govern the practice of nursing, define the scope of nursing practice, and create the
methods and grounds for imposing discipline. State practice laws does not include the
initial qualifications for licensure or requirements necessary to obtain and retain a license,
except for qualifications or requirements of the home state.
new text end

new text begin ARTICLE 2
new text end

new text begin GENERAL PROVISIONS AND JURISDICTION
new text end

new text begin (a) A license to practice registered nursing issued by a home state to a resident in
that state will be recognized by each party state as authorizing a multistate licensure
privilege to practice as a registered nurse in the party state. A license to practice licensed
practical/vocational nursing issued by a home state to a resident in that state will be
recognized by each party state as authorizing a multistate licensure privilege to practice
as a licensed practical/vocational nurse in the party state. In order to obtain or retain a
license, an applicant must meet the home state's qualifications for licensure and license
renewal as well as all other applicable state laws.
new text end

new text begin (b) Party states may, according to state due process laws, limit or revoke the
multistate licensure privilege of any nurse to practice in their state and may take any other
actions under their applicable state laws necessary to protect the health and safety of
their citizens. If a party state takes such action, it shall promptly notify the administrator
of the coordinated licensure information system. The administrator of the coordinated
licensure information system shall promptly notify the home state of any such actions by
remote states.
new text end

new text begin (c) Every nurse practicing in a party state must comply with the state practice laws of
the state in which the patient is located at the time care is rendered. In addition, the practice
of nursing is not limited to patient care, but shall include all nursing practice as defined by
the state practice laws of the party state. The practice of nursing will subject a nurse to the
jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
new text end

new text begin (d) This compact does not affect additional requirements imposed by states for
advanced practice registered nursing. However, a multistate licensure privilege to practice
registered nursing granted by a party state shall be recognized by other party states as a
license to practice registered nursing if one is required by state law as a precondition for
qualifying for advanced practice registered nurse authorization.
new text end

new text begin (e) Individuals not residing in a party state shall continue to be able to apply for
nurse licensure as provided for under the laws of each party state. However, the license
granted to these individuals will not be recognized as granting the privilege to practice
nursing in any other party state unless explicitly agreed to by that party state.
new text end

new text begin ARTICLE 3
new text end

new text begin APPLICATIONS FOR LICENSURE IN A PARTY STATE
new text end

new text begin (a) Upon application for a license, the licensing board in a party state shall ascertain,
through the coordinated licensure information system, whether the applicant has ever held
or is the holder of a license issued by any other state, whether there are any restrictions
on the multistate licensure privilege, and whether any other adverse action by a state
has been taken against the license.
new text end

new text begin (b) A nurse in a party state shall hold licensure in only one party state at a time,
issued by the home state.
new text end

new text begin (c) A nurse who intends to change primary state of residence may apply for licensure
in the new home state in advance of the change. However, new licenses will not be
issued by a party state until after a nurse provides evidence of change in primary state of
residence satisfactory to the new home state's licensing board.
new text end

new text begin (d) When a nurse changes primary state of residence by:
new text end

new text begin (1) moving between two party states, and obtains a license from the new home state,
the license from the former home state is no longer valid;
new text end

new text begin (2) moving from a nonparty state to a party state, and obtains a license from the new
home state, the individual state license issued by the nonparty state is not affected and will
remain in full force if so provided by the laws of the nonparty state; or
new text end

new text begin (3) moving from a party state to a nonparty state, the license issued by the prior
home state converts to an individual state license, valid only in the former home state,
without the multistate licensure privilege to practice in other party states.
new text end

new text begin ARTICLE 4
new text end

new text begin ADVERSE ACTIONS
new text end

new text begin In addition to the general provisions described in article 2, the provisions in this
article apply.
new text end

new text begin (a) The licensing board of a remote state shall promptly report to the administrator
of the coordinated licensure information system any remote state actions including the
factual and legal basis for the action, if known. The licensing board of a remote state shall
also promptly report any significant current investigative information yet to result in a
remote state action. The administrator of the coordinated licensure information system
shall promptly notify the home state of any reports.
new text end

new text begin (b) The licensing board of a party state shall have the authority to complete any
pending investigation for a nurse who changes primary state of residence during the
course of the investigation. The board shall also have the authority to take appropriate
action, and shall promptly report the conclusion of the investigation to the administrator
of the coordinated licensure information system. The administrator of the coordinated
licensure information system shall promptly notify the new home state of any action.
new text end

new text begin (c) A remote state may take adverse action affecting the multistate licensure
privilege to practice within that party state. However, only the home state shall have the
power to impose adverse action against the license issued by the home state.
new text end

new text begin (d) For purposes of imposing adverse actions, the licensing board of the home state
shall give the same priority and effect to reported conduct received from a remote state as
it would if the conduct had occurred within the home state. In so doing, it shall apply its
own state laws to determine appropriate action.
new text end

new text begin (e) The home state may take adverse action based on the factual findings of the
remote state, provided each state follows its own procedures for imposing the adverse
action.
new text end

new text begin (f) Nothing in this compact shall override a party state's decision that participation
in an alternative program may be used in lieu of licensure action and that participation
shall remain nonpublic if required by the party state's laws.
new text end

new text begin Party states must require nurses who enter any alternative programs to agree not to
practice in any other party state during the term of the alternative program without prior
authorization from the other party state.
new text end

new text begin ARTICLE 5
new text end

new text begin ADDITIONAL AUTHORITIES INVESTED IN
new text end

new text begin PARTY STATE NURSE LICENSING BOARDS
new text end

new text begin Notwithstanding any other laws, party state nurse licensing boards shall have the
authority to:
new text end

new text begin (1) if otherwise permitted by state law, recover from the affected nurse the costs of
investigation and disposition of cases resulting from any adverse action taken against
that nurse;
new text end

new text begin (2) issue subpoenas for both hearings and investigations which require the attendance
and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse
licensing board in a party state for the attendance and testimony of witnesses, and the
production of evidence from another party state, shall be enforced in the latter state by
any court of competent jurisdiction according to the practice and procedure of that court
applicable to subpoenas issued in proceedings pending before it. The issuing authority
shall pay any witness fees, travel expenses, mileage, and other fees required by the service
statutes of the state where the witnesses and evidence are located;
new text end

new text begin (3) issue cease and desist orders to limit or revoke a nurse's authority to practice
in the nurse's state; and
new text end

new text begin (4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).
new text end

new text begin ARTICLE 6
new text end

new text begin COORDINATED LICENSURE INFORMATION SYSTEM
new text end

new text begin (a) All party states shall participate in a cooperative effort to create a coordinated
database of all licensed registered nurses and licensed practical/vocational nurses. This
system shall include information on the licensure and disciplinary history of each
nurse, as contributed by party states, to assist in the coordination of nurse licensure and
enforcement efforts.
new text end

new text begin (b) Notwithstanding any other provision of law, all party states' licensing boards shall
promptly report adverse actions, actions against multistate licensure privileges, any current
significant investigative information yet to result in adverse action, denials of applications,
and the reasons for the denials to the coordinated licensure information system.
new text end

new text begin (c) Current significant investigative information shall be transmitted through the
coordinated licensure information system only to party state licensing boards.
new text end

new text begin (d) Notwithstanding any other provision of law, all party states' licensing boards
contributing information to the coordinated licensure information system may designate
information that may not be shared with nonparty states or disclosed to other entities or
individuals without the express permission of the contributing state.
new text end

new text begin (e) Any personally identifiable information obtained by a party state's licensing
board from the coordinated licensure information system may not be shared with nonparty
states or disclosed to other entities or individuals except to the extent permitted by the
laws of the party state contributing the information.
new text end

new text begin (f) Any information contributed to the coordinated licensure information system that
is subsequently required to be expunged by the laws of the party state contributing that
information shall also be expunged from the coordinated licensure information system.
new text end

new text begin (g) The compact administrators, acting jointly with each other and in consultation
with the administrator of the coordinated licensure information system, shall formulate
necessary and proper procedures for the identification, collection, and exchange of
information under this compact.
new text end

new text begin ARTICLE 7
new text end

new text begin COMPACT ADMINISTRATION AND
new text end

new text begin INTERCHANGE OF INFORMATION
new text end

new text begin (a) The head or designee of the nurse licensing board of each party state shall be the
administrator of this compact for that state.
new text end

new text begin (b) The compact administrator of each party state shall furnish to the compact
administrator of each other party state any information and documents including, but not
limited to, a uniform data set of investigations, identifying information, licensure data, and
disclosable alternative program participation information to facilitate the administration of
this compact.
new text end

new text begin (c) Compact administrators shall have the authority to develop uniform rules to
facilitate and coordinate implementation of this compact. These uniform rules shall be
adopted by party states under the authority in article 5, clause (4).
new text end

new text begin ARTICLE 8
new text end

new text begin IMMUNITY
new text end

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

new text begin ARTICLE 9
new text end

new text begin ENACTMENT, WITHDRAWAL, AND AMENDMENT
new text end

new text begin (a) This compact shall become effective for each state when it has been enacted by
that state. Any party state may withdraw from this compact by repealing the nurse licensure
compact, but no withdrawal shall take effect until six months after the withdrawing state
has given notice of the withdrawal to the executive heads of all other party states.
new text end

new text begin (b) No withdrawal shall affect the validity or applicability by the licensing boards
of states remaining party to the compact of any report of adverse action occurring prior
to the withdrawal.
new text end

new text begin (c) Nothing contained in this compact shall be construed to invalidate or prevent any
nurse licensure agreement or other cooperative arrangement between a party state and a
nonparty state that is made according to the other provisions of this compact.
new text end

new text begin (d) This compact may be amended by the party states. No amendment to this
compact shall become effective and binding upon the party states until it is enacted into
the laws of all party states.
new text end

new text begin ARTICLE 10
new text end

new text begin CONSTRUCTION AND SEVERABILITY
new text end

new text begin (a) This compact shall be liberally construed to effectuate the purposes of the
compact. The provisions of this compact shall be severable and if any phrase, clause,
sentence, or provision of this compact is declared to be contrary to the constitution of any
party state or of the United States or the applicability thereof to any government, agency,
person, or circumstance is held invalid, the validity of the remainder of this compact and
the applicability of it to any government, agency, person, or circumstance shall not be
affected by it. If this compact is held contrary to the constitution of any party state, the
compact shall remain in full force and effect for the remaining party states and in full force
and effect for the party state affected as to all severable matters.
new text end

new text begin (b) In the event party states find a need for settling disputes arising under this
compact:
new text end

new text begin (1) the party states may submit the issues in dispute to an arbitration panel which
shall be comprised of an individual appointed by the compact administrator in the home
state, an individual appointed by the compact administrator in the remote states involved,
and an individual mutually agreed upon by the compact administrators of the party states
involved in the dispute; and
new text end

new text begin (2) the decision of a majority of the arbitrators shall be final and binding.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon implementation of the
coordinated licensure information system defined in section 148.2855, but no sooner
than July 1, 2013.
new text end

Sec. 9.

new text begin [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
EXISTING LAWS.
new text end

new text begin (a) A nurse practicing professional or practical nursing in Minnesota under the
authority of section 148.2855 shall have the same obligations, privileges, and rights as if
the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section
148.2855, the Board of Nursing shall comply with and follow all laws and rules with
respect to registered and licensed practical nurses practicing professional or practical
nursing in Minnesota under the authority of section 148.2855, and all such individuals
shall be governed and regulated as if they were licensed by the board.
new text end

new text begin (b) Section 148.2855 does not relieve employers of nurses from complying with
statutorily imposed obligations.
new text end

new text begin (c) Section 148.2855 does not supersede existing state labor laws.
new text end

new text begin (d) For purposes of the Minnesota Government Data Practices Act, chapter 13,
an individual not licensed as a nurse under sections 148.171 to 148.285 who practices
professional or practical nursing in Minnesota under the authority of section 148.2855 is
considered to be a licensee of the board.
new text end

new text begin (e) Uniform rules developed by the compact administrators shall not be subject
to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101,
14.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
new text end

new text begin (f) Proceedings brought against an individual's multistate privilege shall be
adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject
to judicial review as provided for in sections 14.63 to 14.69.
new text end

new text begin (g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4;
144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917,
subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40,
subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are
licensed as registered or licensed practical nurses in the home state shall be considered
to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to
registered nurses or the practice of professional nursing, then only holders of a multistate
privilege who are licensed as registered nurses in the home state shall be considered
licensees.
new text end

new text begin (h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557
apply to individuals not licensed as registered or licensed practical nurses under sections
148.171 to 148.285 who practice professional or practical nursing in Minnesota under
the authority of section 148.2855.
new text end

new text begin (i) The board may take action against an individual's multistate privilege based on
the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or
requiring the board to take corrective or disciplinary action.
new text end

new text begin (j) The board may take all forms of disciplinary action provided for in section
148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision
6, against an individual's multistate privilege.
new text end

new text begin (k) The immunity provisions of section 148.264, subdivision 1, apply to individuals
who practice professional or practical nursing in Minnesota under the authority of section
148.2855.
new text end

new text begin (l) The cooperation requirements of section 148.265 apply to individuals who
practice professional or practical nursing in Minnesota under the authority of section
148.2855.
new text end

new text begin (m) The provisions of section 148.283 shall not apply to individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855.
new text end

new text begin (n) Complaints against individuals who practice professional or practical nursing
in Minnesota under the authority of section 148.2855 shall be handled as provided in
sections 214.10 and 214.103.
new text end

new text begin (o) All provisions of section 148.2855 authorizing or requiring the board to provide
data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
new text end

new text begin (p) Except as provided in section 13.41, subdivision 6, the board shall not report to a
remote state any active investigative data regarding a complaint investigation against a
nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable
assurances from the remote state that the data will be maintained with the same protections
as provided in Minnesota law.
new text end

new text begin (q) The provisions of sections 214.17 to 214.25 apply to individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855
when the practice involves direct physical contact between the nurse and a patient.
new text end

new text begin (r) A nurse practicing professional or practical nursing in Minnesota under the
authority of section 148.2855 must comply with any criminal background check required
under Minnesota law.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon implementation of the
coordinated licensure information system defined in section 148.2855, but no sooner
than July 1, 2013.
new text end

Sec. 10.

new text begin [148.2857] WITHDRAWAL FROM COMPACT.
new text end

new text begin The governor may withdraw the state from the compact in section 148.2855 if
the Board of Nursing notifies the governor that a party state to the compact changed
the party state's requirements for nurse licensure after July 1, 2012, and that the party
state's requirements, as changed, are substantially lower than the requirements for nurse
licensure in this state.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon implementation of the
coordinated licensure information system defined in section 148.2855, but no sooner
than July 1, 2013.
new text end

Sec. 11.

new text begin [148.2858] MISCELLANEOUS PROVISIONS.
new text end

new text begin (a) For the purposes of section 148.2855, "head of the Nurse Licensing Board"
means the executive director of the board.
new text end

new text begin (b) The Board of Nursing shall have the authority to recover from a nurse practicing
professional or practical nursing in Minnesota under the authority of section 148.2855
the costs of investigation and disposition of cases resulting from any adverse action
taken against the nurse.
new text end

new text begin (c) The board may implement a system of identifying individuals who practice
professional or practical nursing in Minnesota under the authority of section 148.2855.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon implementation of the
coordinated licensure information system defined in section 148.2855, but no sooner
than July 1, 2013.
new text end

Sec. 12.

new text begin [148.2859] NURSE LICENSURE COMPACT ADVISORY
COMMITTEE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; membership. new text end

new text begin A Nurse Licensure Compact Advisory
Committee is established to advise the compact administrator in the implementation of
section 148.2855. Members of the advisory committee shall be appointed by the board
and shall be composed of representatives of Minnesota nursing organizations, Minnesota
licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses
who provide home care, Minnesota licensed advanced practice registered nurses, and
public members as defined in section 214.02.
new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin The advisory committee shall advise the compact administrator in
the implementation of section 148.2855.
new text end

new text begin Subd. 3. new text end

new text begin Organization. new text end

new text begin The advisory committee shall be organized and
administered under section 15.059.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon implementation of the
coordinated licensure information system defined in section 148.2855, but no sooner
than July 1, 2013.
new text end

Sec. 13.

Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision
8, is amended to read:


Subd. 8.

Board of Nursing Home
Administrators

2,153,000
2,145,000

Rulemaking. Of this appropriation, $44,000
in fiscal year 2012 is for rulemaking. This is
a onetime appropriation.

Electronic Licensing System Adaptors.
Of this appropriation, $761,000 in fiscal
year 2013 from the state government special
revenue fund is to the administrative services
unit to cover the costs to connect to the
e-licensing system. Minnesota Statutes,
section 16E.22. Base level funding for this
activity in fiscal year 2014 shall be $100,000.
Base level funding for this activity in fiscal
year 2015 shall be $50,000.

Development and Implementation of a
Disciplinary, Regulatory, Licensing and
Information Management System.
Of this
appropriation, $800,000 in fiscal year 2012
and $300,000 in fiscal year 2013 are for the
development of a shared system. Base level
funding for this activity in fiscal year 2014
shall be $50,000.

Administrative Services Unit - Operating
Costs.
Of this appropriation, $526,000
in fiscal year 2012 and $526,000 in
fiscal year 2013 are for operating costs
of the administrative services unit. The
administrative services unit may receive
and expend reimbursements for services
performed by other agencies.

Administrative Services Unit - Retirement
Costs.
Of this appropriation in fiscal year
2012, $225,000 is for onetime retirement
costs in the health-related boards. This
funding may be transferred to the health
boards incurring those costs for their
payment. These funds are available either
year of the biennium.

Administrative Services Unit - Volunteer
Health Care Provider Program.
Of this
appropriation, $150,000 in fiscal year 2012
and $150,000 in fiscal year 2013 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.

Administrative Services Unit - Contested
Cases and Other Legal Proceedings.
Of
this appropriation, $200,000 in fiscal year
2012 and $200,000 in fiscal year 2013 are
for costs of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded
under this section. Upon certification of a
health-related board to the administrative
services unit that the costs will be incurred
and that there is insufficient money available
to pay for the costs out of money currently
available to that board, the administrative
services unit is authorized to transfer money
from this appropriation to the board for
payment of those costs with the approval
of the commissioner of management and
budget. This appropriation does not cancel.
Any unencumbered and unspent balances
remain available for these expenditures in
subsequent fiscal years.

Base Adjustment. The State Government
Special Revenue Fund base is decreased by
$911,000 in fiscal year 2014 and deleted text begin$1,011,000deleted text endnew text begin
$961,000
new text end in fiscal year 2015.

Sec. 14. new text beginBIENNIAL BUDGET REQUEST; UNIVERSITY OF MINNESOTA.
new text end

new text begin Beginning in 2013, as part of the biennial budget request submitted to the
Department of Management and Budget, and the legislature, the Board of Regents of the
University of Minnesota is encouraged to include a request for funding for rural primary
care training by family practice residence programs to prepare doctors for the practice
of primary care medicine in rural areas of the state. The funding request should provide
for ongoing support of rural primary care training through the University of Minnesota's
general operation and maintenance funding or through dedicated health science funding.
new text end

ARTICLE 6

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1. new text beginHEALTH AND HUMAN SERVICES APPROPRIATIONS.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 2011, First Special Session
chapter 9, article 10, to the agencies and for the purposes specified in this article. The
appropriations are from the general fund or other named fund and are available for the
fiscal years indicated for each purpose. The figures "2012" and "2013" used in this
article mean that the addition to or subtraction from the appropriation listed under them
is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively.
Supplemental appropriations and reductions to appropriations for the fiscal year ending
June 30, 2012, are effective the day following final enactment unless a different effective
date is explicit.
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 2012
new text end
new text begin 2013
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 69,000
new text end
new text begin $
new text end
new text begin 3,833,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2012
new text end
new text begin 2013
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin 46,000
new text end
new text begin Health Care Access
new text end
new text begin -0-
new text end
new text begin 23,000
new text end
new text begin Federal TANF
new text end
new text begin 69,000
new text end
new text begin 3,764,000
new text end

new text begin Subd. 2. new text end

new text begin Central Office Operations
new text end

new text begin (a) Operations
new text end
new text begin -0-
new text end
new text begin 502,000
new text end

new text begin Base Level Adjustment. The general fund
base is decreased by $104,000 in fiscal year
2014 and $107,000 in fiscal year 2015.
new text end

new text begin (b) Health Care
new text end
new text begin -0-
new text end
new text begin 473,000
new text end

new text begin This is a onetime appropriation.
new text end

new text begin (c) Continuing Care
new text end
new text begin -0-
new text end
new text begin 275,000
new text end

new text begin new text begin Base Level Adjustment.new text end The general fund
base is decreased by $149,000 in fiscal year
2014 and $169,000 in fiscal year 2015.
new text end

new text begin Subd. 3. new text end

new text begin Forecasted Programs
new text end

new text begin (a) MFIP/DWP Grants
new text end
new text begin Appropriations by Fund
new text end
new text begin 2012
new text end
new text begin 2013
new text end
new text begin General
new text end
new text begin (69,000)
new text end
new text begin (3,769,000)
new text end
new text begin Federal TANF
new text end
new text begin 69,000
new text end
new text begin 3,764,000
new text end
new text begin (b) MFIP Child Care Assistance Grants
new text end
new text begin -0-
new text end
new text begin 2,000
new text end
new text begin (c) General Assistance Grants
new text end
new text begin -0-
new text end
new text begin (41,000)
new text end
new text begin (d) Minnesota Supplemental Aid Grants
new text end
new text begin -0-
new text end
new text begin 154,000
new text end
new text begin (e) Group Residential Housing Grants
new text end
new text begin -0-
new text end
new text begin (199,000)
new text end
new text begin (f) MinnesotaCare Grants
new text end
new text begin -0-
new text end
new text begin 23,000
new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin (g) Medical Assistance Grants
new text end
new text begin 69,000
new text end
new text begin 2,583,000
new text end

new text begin new text begin Continuing Care Provider Fiscal Year
2013 Payment Delay.
new text end
The commissioner
of human services shall delay the last
payment or payments in fiscal year 2013 by
up to $22,854,000 to the following service
providers:
new text end

new text begin (1) home and community-based waivered
services for persons with developmental
disabilities or related conditions, including
consumer-directed community supports,
under Minnesota Statutes, section 256B.501;
new text end

new text begin (2) home and community-based waivered
services for the elderly, including
consumer-directed community supports,
under Minnesota Statutes, section
256B.0915;
new text end

new text begin (3) waivered services under community
alternatives for disabled individuals,
including consumer-directed community
supports, under Minnesota Statutes, section
256B.49;
new text end

new text begin (4) community alternative care waivered
services, including consumer-directed
community supports, under Minnesota
Statutes, section 256B.49;
new text end

new text begin (5) traumatic brain injury waivered services,
including consumer-directed community
supports, under Minnesota Statutes, section
256B.49;
new text end

new text begin (6) nursing services and home health
services under Minnesota Statutes, section
256B.0625, subdivision 6a;
new text end

new text begin (7) personal care services and qualified
professional supervision of personal care
services under Minnesota Statutes, section
256B.0625, subdivisions 6a and 19a;
new text end

new text begin (8) private duty nursing services under
Minnesota Statutes, section 256B.0625,
subdivision 7;
new text end

new text begin (9) day training and habilitation services for
adults with developmental disabilities or
related conditions under Minnesota Statutes,
sections 252.40 to 252.46, including the
additional cost of rate adjustments on day
training and habilitation services, provided
as a social service under Minnesota Statutes,
section 256M.60;
new text end

new text begin (10) alternative care services under
Minnesota Statutes, section 256B.0913;
new text end

new text begin (11) managed care organizations under
Minnesota Statutes, section 256B.69,
receiving state payments for services in
clauses (1) to (10); and
new text end

new text begin (12) intermediate care facilities for persons
with developmental disabilities under
Minnesota Statutes, section 256B.5012,
subdivision 13.
new text end

new text begin In calculating the actual payment amounts to
be delayed, the commissioner must reduce
the $22,854,000 amount by any cash basis
state share savings to be realized in fiscal
year 2013 from implementing the long-term
care realignment waiver before July 1, 2013.
The commissioner shall make the delayed
payments in July 2013. Notwithstanding
any contrary provisions in this article, this
provision expires on August 1, 2013.
new text end

new text begin new text begin Critical Access Nursing Facilities
Designation.
new text end
$1,000,000 is appropriated in
fiscal year 2013 from the general fund to
the commissioner of human services for the
purposes of critical access nursing facilities
under Minnesota Statutes, section 256B.441,
subdivision 63. This appropriation is
ongoing and is added to the base.
new text end

new text begin Subd. 4. new text end

new text begin Grant Programs
new text end

new text begin (a) Basic Sliding Fee Child Care Grants
new text end
new text begin -0-
new text end
new text begin 1,000
new text end

new text begin Base Level Adjustment. The general fund
base is increased by $5,000 in fiscal years
2014 and 2015.
new text end

new text begin (b) Disabilities Grants
new text end
new text begin -0-
new text end
new text begin 65,000
new text end

new text begin This appropriation is for living skills training
programs for persons with intractable
epilepsy who need assistance in the transition
to independent living under Laws 1988,
chapter 689, article 2, section 251. This
appropriation is ongoing and added to the
general fund base.
new text end

new text begin Base Level Adjustment. The general fund
base is increased by $411,000 in fiscal year
2014.
new text end

Sec. 3. new text beginCOMMISSIONER OF HEALTH
new text end

new text begin Policy Quality and Compliance
new text end
new text begin -0-
new text end
new text begin (1,185,000)
new text end
new text begin Appropriations by Fund
new text end
new text begin 2012
new text end
new text begin 2013
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin 127,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin -0-
new text end
new text begin (1,449,000)
new text end
new text begin Health Care Access
new text end
new text begin -0-
new text end
new text begin 137,000
new text end

new text begin In fiscal year 2013, $137,000 from the health
care access fund is for a study of radiation
therapy facilities capacity. This is a onetime
appropriation.
new text end

new text begin In fiscal year 2015, the commissioner shall
transfer from the general fund $59,000,
including $40,000 for SEGIP activities to the
commissioner of management and budget for
actuarial and consulting services to support
the Department of Commerce evaluation of
mandated health benefits under Minnesota
Statutes, section 62J.26, subdivision 6. This
is a onetime transfer.
new text end

new text begin The general fund base is decreased by
$105,000 in fiscal year 2014 and $46,000 in
fiscal year 2015.
new text end

Sec. 4. new text beginBOARD OF NURSING
new text end

new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 149,000
new text end

new text begin This appropriation is from the state
government special revenue fund for the
nurse licensure compact.
new text end

new text begin Base Level Adjustment. The state
government special revenue fund base is
decreased by $143,000 in fiscal years 2014
and 2015.
new text end

Sec. 5.

new text begin COMMISSIONER OF COMMERCE
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 -0-
new text end
new text begin $
new text end
new text begin 1,727,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2012
new text end
new text begin 2013
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin 60,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin -0-
new text end
new text begin 1,449,000
new text end
new text begin Special Revenue
new text end
new text begin -0-
new text end
new text begin 218,000
new text end

new text begin In fiscal year 2013, $8,000 from the general
fund is for additional form review filings
under Minnesota Statutes, section 62A.047.
This is a onetime appropriation.
new text end

new text begin In fiscal year 2013, $22,000 from the general
fund is for relocation costs related to the
transfer of health maintenance organization
regulatory activities. This is a onetime
appropriation.
new text end

new text begin In fiscal year 2013, $30,000 from the
general fund is for ongoing information
technology expenses related to the transfer of
health maintenance organization regulatory
activities.
new text end

new text begin $1,449,000 from the state government special
revenue fund is for health maintenance
organization regulatory activities transferred
from the Department of Health. This is an
ongoing appropriation.
new text end

new text begin $218,000 from the special revenue fund is
for expenses related to health maintenance
organization regulatory activities for the
interagency agreement with the Department
of Human Services.
new text end

new text begin The general fund base is increased by
$960,000 in fiscal years 2014 and 2015 for
the evaluation of mandated health benefits
under Minnesota Statutes, section 62J.26,
subdivision 6. The base for this purpose
beginning in fiscal year 2016 is $330,000.
new text end

Sec. 6. new text beginEMERGENCY MEDICAL SERVICES
REGULATORY BOARD
new text end

new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 10,000
new text end

new text begin This appropriation is to provide a grant to
the Minnesota Ambulance Association to
coordinate and prepare an assessment of
the extent and costs of uncompensated care
as a direct result of emergency responses
on interstate highways in Minnesota.
The study will collect appropriate
information from medical response units
and ambulance services regulated under
Minnesota Statutes, chapter 144E, and to
the extent possible, firefighting agencies.
In preparing the assessment, the Minnesota
Ambulance Association shall consult with
its membership, the Minnesota Fire Chiefs
Association, the Office of the State Fire
Marshal, and the Emergency Medical
Services Regulatory Board. The findings
of the assessment will be reported to the
chairs and ranking minority members of the
legislative committees with jurisdiction over
health and public safety by January 1, 2013.
new text end

Sec. 7. new text beginEXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2013, unless a
different expiration date is explicit.
new text end

Sec. 8. new text beginEFFECTIVE DATE.
new text end

new text begin The provisions in this article are effective July 1, 2012, unless a different effective
date is explicit.
new text end

ARTICLE 7

CONTINGENT APPROPRIATIONS

Section 1. new text beginAPPROPRIATIONS.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 2011, First Special Session
chapter 9, article 10, to the agencies and for the purposes specified in this article. The
appropriations are from the general fund or other named fund and are available for the
fiscal years indicated for each purpose. The figures "2012" and "2013" used in this
article mean that the addition to or subtraction from the appropriation listed under them
is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively.
Supplemental appropriations and reductions to appropriations for the fiscal year ending
June 30, 2012, are effective the day following final enactment unless a different effective
date is explicit.
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 2012
new text end
new text begin 2013
new text end

Sec. 2. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin $
new text end
new text begin 721,000
new text end
new text begin $
new text end
new text begin 21,153,000
new text end
new text begin (a) Operations
new text end
new text begin 118,000
new text end
new text begin 11,000
new text end

new text begin In fiscal years 2012 and 2013 only, the
commissioner shall transfer $11,000 to the
commissioner of education for activities
related to developing a plan for a residential
campus for individuals with autism.
new text end

new text begin Base Adjustment. The general fund base
is reduced by $11,000 in fiscal years 2014
and 2015.
new text end

new text begin (b) Health Care
new text end
new text begin 24,000
new text end
new text begin (110,000)
new text end

new text begin Base Adjustment. The general fund base is
increased by $110,000 in fiscal years 2014
and 2015.
new text end

new text begin (c) Continuing Care
new text end
new text begin 19,000
new text end
new text begin -0-
new text end

new text begin This is a onetime appropriation.
new text end

new text begin (d) Chemical and Mental Health
new text end
new text begin 19,000
new text end
new text begin 68,000
new text end

new text begin Base Adjustment. The general fund base
is decreased by $68,000 in fiscal years 2014
and 2015.
new text end

new text begin (e) Medical Assistance Grants
new text end
new text begin 541,000
new text end
new text begin 19,935,000
new text end
new text begin (f) Aging and Adult Services Grants
new text end
new text begin -0-
new text end
new text begin 999,000
new text end

new text begin In fiscal year 2013, upon federal approval
to implement the nursing facility level
of care under Minnesota Statutes, section
144.0724, subdivision 11, $999,000 is for
essential community supports grants. This is
a onetime appropriation.
new text end

new text begin (g) Disabilities Grants
new text end
new text begin -0-
new text end
new text begin 250,000
new text end

new text begin This is a onetime appropriation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon receipt by the commissioner of
money from managed care organizations pursuant to contract agreements to return any
surplus in excess of one percent. If the money is received after June 30, 2012, amounts
appropriated in fiscal year 2012 are available in fiscal year 2013.
new text end

Sec. 3.

Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is
amended to read:


Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an
initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
9555.6265, under this chapter for a physical location that will not be the primary residence
of the license holder for the entire period of licensure. If a license is issued during this
moratorium, and the license holder changes the license holder's primary residence away
from the physical location of the foster care license, the commissioner shall revoke the
license according to section 245A.07. Exceptions to the moratorium include:

(1) foster care settings that are required to be registered under chapter 144D;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
and determined to be needed by the commissioner under paragraph (b);

(3) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
restructuring of state-operated services that limits the capacity of state-operated facilities;

(4) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for persons requiring hospital level care; or

(5) new foster care licenses determined to be needed by the commissioner for the
transition of people from personal care assistance to the home and community-based
services.

(b) The commissioner shall determine the need for newly licensed foster care homes
as defined under this subdivision. As part of the determination, the commissioner shall
consider the availability of foster care capacity in the area in which the licensee seeks to
operate, and the recommendation of the local county board. The determination by the
commissioner must be final. A determination of need is not required for a change in
ownership at the same address.

(c) Residential settings that would otherwise be subject to the moratorium established
in paragraph (a), that are in the process of receiving an adult or child foster care license as
of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
or child foster care license. For this paragraph, all of the following conditions must be met
to be considered in the process of receiving an adult or child foster care license:

(1) participants have made decisions to move into the residential setting, including
documentation in each participant's care plan;

(2) the provider has purchased housing or has made a financial investment in the
property;

(3) the lead agency has approved the plans, including costs for the residential setting
for each individual;

(4) the completion of the licensing process, including all necessary inspections, is
the only remaining component prior to being able to provide services; and

(5) the needs of the individuals cannot be met within the existing capacity in that
county.

To qualify for the process under this paragraph, the lead agency must submit
documentation to the commissioner by August 1, 2009, that all of the above criteria are
met.

(d) The commissioner shall study the effects of the license moratorium under this
subdivision and shall report back to the legislature by January 15, 2011. This study shall
include, but is not limited to the following:

(1) the overall capacity and utilization of foster care beds where the physical location
is not the primary residence of the license holder prior to and after implementation
of the moratorium;

(2) the overall capacity and utilization of foster care beds where the physical
location is the primary residence of the license holder prior to and after implementation
of the moratorium; and

(3) the number of licensed and occupied ICF/MR beds prior to and after
implementation of the moratorium.

(e) When a foster care recipient moves out of a foster home that is not the primary
residence of the license holder according to section 256B.49, subdivision 15, paragraph
(f), the county shall immediately inform the Department of Human Services Licensing
Division, and the department shall immediately decrease the new text beginstatewide new text endlicensed capacity
for deleted text beginthe homedeleted text endnew text begin foster care settings where the physical location is not the primary residence
of the license holder
new text end. A decreased licensed capacity according to this paragraph is not
subject to appeal under this chapter.new text begin A needs determination process, managed at the state
level, with county input, will determine where the reduced capacity will occur.
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. 4.

Minnesota Statutes 2011 Supplement, section 256B.0659, subdivision 11,
is amended to read:


Subd. 11.

Personal care assistant; requirements.

(a) A personal care assistant
must meet the following requirements:

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years
of age with these additional requirements:

(i) supervision by a qualified professional every 60 days; and

(ii) employment by only one personal care assistance provider agency responsible
for compliance with current labor laws;

(2) be employed by a personal care assistance provider agency;

(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:

(i) not disqualified under section 245C.14; or

(ii) is disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;

(4) be able to effectively communicate with the recipient and personal care
assistance provider agency;

(5) be able to provide covered personal care assistance services according to the
recipient's personal care assistance care plan, respond appropriately to recipient needs,
and report changes in the recipient's condition to the supervising qualified professional
or physician;

(6) not be a consumer of personal care assistance services;

(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;

(8) effective January 1, 2010, complete standardized training as determined
by the commissioner before completing enrollment. The training must be available
in languages other than English and to those who need accommodations due to
disabilities. Personal care assistant training must include successful completion of the
following training components: basic first aid, vulnerable adult, child maltreatment,
OSHA universal precautions, basic roles and responsibilities of personal care assistants
including information about assistance with lifting and transfers for recipients, emergency
preparedness, orientation to positive behavioral practices, fraud issues, and completion of
time sheets. Upon completion of the training components, the personal care assistant must
demonstrate the competency to provide assistance to recipients;

(9) complete training and orientation on the needs of the recipient within the first
seven days after the services begin; and

(10) be limited to providing and being paid for up to 275 hours per month, except
that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
2011, of personal care assistance services regardless of the number of recipients being
served or the number of personal care assistance provider agencies enrolled with. The
number of hours worked per day shall not be disallowed by the department unless in
violation of the law.

(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).

(c) Persons who do not qualify as a personal care assistant include parents and
stepparents of minors, spouses, paid legal guardians, family foster care providers, except
as otherwise allowed in section 256B.0625, subdivision 19a, or staff of a residential
setting. When the personal care assistant is a relative of the recipient, the commissioner
shall pay 80 percent of the provider rate. new text beginThis rate reduction is delayed until July 1, 2013.
new text endFor purposes of this section, relative means the parent or adoptive parent of an adult child,
a sibling aged 16 years or older, an adult child, a grandpare