SF 3280

as introduced - 86th Legislature (2009 - 2010) Posted on 03/16/2010 11:30am

A bill for an act
relating to state government finance; appropriating and transferring money and
supplementing or reducing appropriations for the Departments of Health and
Human Services, health-related boards, Emergency Medical Services Board,
Council on Disabilities, omsbudsman for mental health and developmental
disabilities, and omsbudsperson for families; establishing, regulating, or
modifying health care services programs, continuing care services, children
and family services, and Department of Health provisions; establishing a
health information exchange; imposing fees and civil penalties; authorizing
rulemaking; requiring reports; amending Minnesota Statutes 2008, sections
62J.04, subdivision 3; 62J.17, subdivision 4a; 62J.692, subdivision 4; 119B.011,
subdivision 15; 119B.13, subdivision 1; 150A.22; 214.40, subdivision 7;
256.969, subdivision 27; 256B.0625, subdivision 39; 256B.0915, subdivision
3b; 256B.434, by adding a subdivision; 256B.48, subdivision 1; 256B.5012,
by adding a subdivision; 256B.76, subdivision 4; 256D.045; 256D.05,
subdivision 1; 256D.07; 256D.10; 256D.47; 256I.04, subdivision 1; 256J.13,
subdivision 1; 256J.20, subdivision 3; 256J.21, subdivision 2; 256J.24,
subdivisions 3, 4; 256J.28, by adding a subdivision; 256J.37, subdivisions
3a, 9; 256L.04, subdivision 7; 256L.05, subdivision 5; 256L.07, subdivision
1; 256L.12, subdivision 9; 256L.15, subdivision 2; 257.75, subdivision 7;
297F.10, subdivision 1; 517.08, subdivision 1c; Minnesota Statutes 2009
Supplement, sections 62J.495, subdivisions 1a, 3; 157.16, subdivision 3;
252.025, subdivision 7; 256.969, subdivisions 2b, 3a; 256B.0651, subdivision
1; 256B.0653, subdivisions 2, 6; 256B.0915, subdivision 3a; 256B.0947,
subdivision 1; 256B.199; 256D.01, subdivision 1b; 256D.03, subdivision 4;
256D.44, subdivision 5; 256J.575, subdivision 3; 327.15, subdivision 3; Laws
2009, chapter 79, article 3, section 18; article 13, sections 3, subdivisions 1, as
amended, 3, as amended, 4, as amended, 8, as amended; 5, subdivision 8, as
amended; proposing coding for new law in Minnesota Statutes, chapters 62J;
256D; repealing Minnesota Statutes 2008, sections 62J.17, subdivisions 1, 3, 5a,
6a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 256.742;
256.969, subdivision 26; 256.979, subdivision 8; 256D.06, subdivision 2;
256D.46; Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision
5; Minnesota Rules, parts 9500.1200; 9500.1202; 9500.1206, subparts 1, 1a, 2, 3,
4a, 4b, 5, 5a, 6, 6a, 6b, 7a, 7b, 8, 8a, 9, 9a, 9b, 11, 11a, 12, 12a, 12b, 12c, 12d,
12e, 12f, 12g, 12h, 12k, 13a, 14, 14a, 15, 15a, 15b, 15c, 15d, 16a, 17, 18, 18a,
18b, 18c, 18d, 19a, 19b, 21, 22a, 22b, 23, 23a, 24, 24a, 24b, 25, 25a, 25b, 25c,
25d, 25e, 25f, 26, 26b, 26c, 28a, 28b, 28c, 28d, 28e, 29, 29a, 29b, 30, 32, 32b,
32c, 32d, 32e, 32f, 33; 9500.1211; 9500.1213; 9500.1215; 9500.1219, subparts
1, 2, 3, 4; 9500.1221; 9500.1223, subparts 1, 2, 3, 5; 9500.1225; 9500.1226,
subparts 1, 5, 6, 7, 8, 9; 9500.1231; 9500.1232, subpart 4; 9500.1233, subparts
1, 2, 3, 5; 9500.1237, subparts 1, 2, 4, 6; 9500.1239; 9500.1243; 9500.1245,
subparts 1, 2, 3, 4, 5, 6, 7; 9500.1248, subpart 3; 9500.1250; 9500.1254, subparts
1, 2, 4, 5, 6, 7; 9500.1259, subparts 2, 3, 4; 9500.1261; 9500.1272.

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

ARTICLE 1

HEALTH CARE SERVICES

Section 1.

Minnesota Statutes 2009 Supplement, section 256.969, subdivision 2b,
is amended to read:

Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner shall
obtain operating data from an updated base year and establish operating payment rates
per admission for each hospital based on the cost-finding methods and allowable costs of
the Medicare program in effect during the base year. Rates under the general assistance
medical care, medical assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, January 1, 2005, for the first 24 months of the
rebased period beginning January 1, 2009. For the first three months of the rebased period
beginning January 1, 2011, rates shall new text begin not new text end be rebased deleted text begin at 74.25 percent of the full value
of the rebasing percentage change deleted text end . From April 1, 2011, to March 31, 2012, rates shall
be rebased at 39.2 percent of the full value of the rebasing percentage change. Effective
April 1, 2012, rates shall be rebased at full value. The base year operating payment rate
per admission is standardized by the case mix index and adjusted by the hospital cost
index, relative values, and disproportionate population adjustment. The cost and charge
data used to establish operating rates shall only reflect inpatient services covered by
medical assistance and shall not include property cost information and costs recognized
in outlier payments.

Sec. 2.

Minnesota Statutes 2009 Supplement, section 256.969, subdivision 3a, is
amended to read:

Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical
assistance program must not be submitted until the recipient is discharged. However,
the commissioner shall establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless of diagnostic category.
Except as provided in section 256.9693, medical assistance reimbursement for treatment
of mental illness shall be reimbursed based on diagnostic classifications. Individual
hospital payments established under this section and sections 256.9685, 256.9686, and
256.9695, in addition to third party and recipient liability, for discharges occurring during
the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
inpatient services paid for the same period of time to the hospital. This payment limitation
shall be calculated separately for medical assistance and general assistance medical
care services. The limitation on general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. Services that have rates established under
subdivision 11 or 12, must be limited separately from other services. After consulting with
the affected hospitals, the commissioner may consider related hospitals one entity and
may merge the payment rates while maintaining separate provider numbers. The operating
and property base rates per admission or per day shall be derived from the best Medicare
and claims data available when rates are established. The commissioner shall determine
the best Medicare and claims data, taking into consideration variables of recency of the
data, audit disposition, settlement status, and the ability to set rates in a timely manner.
The commissioner shall notify hospitals of payment rates by December 1 of the year
preceding the rate year. The rate setting data must reflect the admissions data used to
establish relative values. Base year changes from 1981 to the base year established for the
rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
1. The commissioner may adjust base year cost, relative value, and case mix index data
to exclude the costs of services that have been discontinued by the October 1 of the year
preceding the rate year or that are paid separately from inpatient services. Inpatient stays
that encompass portions of two or more rate years shall have payments established based
on payment rates in effect at the time of admission unless the date of admission preceded
the rate year in effect by six months or more. In this case, operating payment rates for
services rendered during the rate year in effect and established based on the date of
admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Mental health services within diagnosis related groups 424 to 432, and
facilities defined under subdivision 16 are excluded from this paragraph.

(d) In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 6.0 percent
from the current statutory rates. Mental health services within diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
assistance does not include general assistance medical care. Payments made to managed
care plans shall be reduced for services provided on or after January 1, 2006, to reflect
this reduction.

(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
3.46 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2009, through June 30, 2009, to reflect this reduction.

(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
1.9 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after July 1, 2009, through June 30, 2010, to reflect this reduction.

(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 1.79 percent
from the current statutory rates. Mental health services with diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Payments made to managed care plans shall be reduced for services provided on or after
July 1, 2010, to reflect this reduction.

(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
payment for fee-for-service admissions occurring on or after July 1, 2009, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
one percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after October 1, 2009, to reflect this reduction.

new text begin (i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
payment for fee-for-service admissions occurring on or after July 1, 2010, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
three percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after January 1, 2011, to reflect this reduction.
new text end

Sec. 3.

Minnesota Statutes 2008, section 256.969, subdivision 27, is amended to read:

Subd. 27.

Quarterly payment adjustment.

(a) In addition to any other payment
under this section, the commissioner shall make the following payments effective July
1, 2007:

(1) for a hospital located in Minnesota and not eligible for payments under
subdivision 20, with a medical assistance inpatient utilization rate greater than 17.8
percent of total patient days as of the base year in effect on July 1, 2005, a payment equal
to 13 percent of the total of the operating and property payment rates;

(2) for a hospital located in Minnesota in a specified urban area outside of the
seven-county metropolitan area and not eligible for payments under subdivision 20, with
a medical assistance inpatient utilization rate less than or equal to 17.8 percent of total
patient days as of the base year in effect on July 1, 2005, a payment equal to ten percent
of the total of the operating and property payment rates. For purposes of this clause, the
following cities are specified urban areas: Detroit Lakes, Rochester, Willmar, Alexandria,
Austin, Cambridge, Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls, and Wadena;

(3) for a hospital located in Minnesota but not located in a specified urban area
under clause (2), with a medical assistance inpatient utilization rate less than or equal to
17.8 percent of total patient days as of the base year in effect on July 1, 2005, a payment
equal to four percent of the total of the operating and property payment rates. A hospital
located in Woodbury and not in existence during the base year shall be reimbursed under
this clause; and

(4) in addition to any payments under clauses (1) to (3), for a hospital located in
Minnesota and not eligible for payments under subdivision 20 with a medical assistance
inpatient utilization rate of 17.9 percent of total patient days as of the base year in effect
on July 1, 2005, a payment equal to eight percent of the total of the operating and property
payment rates, and for a hospital located in Minnesota and not eligible for payments
under subdivision 20 with a medical assistance inpatient utilization rate of 59.6 percent
of total patient days as of the base year in effect on July 1, 2005, a payment equal to
nine percent of the total of the operating and property payment rates. After making any
ratable adjustments required under paragraph (b), the commissioner shall proportionately
reduce payments under clauses (2) and (3) by an amount needed to make payments under
this clause.

(b) The state share of payments under paragraph (a) shall be equal to federal
reimbursements to the commissioner to reimburse expenditures reported under section
256B.199 new text begin , subdivision 1 new text end . The commissioner shall ratably reduce or increase payments
under this subdivision in order to ensure that these payments equal the amount of
reimbursement received by the commissioner under section 256B.199, new text begin subdivision 1,
new text end except that payments shall be ratably reduced by an amount equivalent to the state share of
a four percent reduction in MinnesotaCare and medical assistance payments for inpatient
hospital services. Effective July 1, 2009, the ratable reduction shall be equivalent to the
state share of a three percent reduction in these payments.

(c) The payments under paragraph (a) shall be paid quarterly based on each hospital's
operating and property payments from the second previous quarter, beginning on July
15, 2007, or upon federal approval of federal reimbursements under section 256B.199,
new text begin subdivision 1, new text end whichever occurs later.

(d) The commissioner shall not adjust rates paid to a prepaid health plan under
contract with the commissioner to reflect payments provided in paragraph (a).

(e) The commissioner shall maximize the use of available federal money for
disproportionate share hospital payments and shall maximize payments to qualifying
hospitals. In order to accomplish these purposes, the commissioner may, in consultation
with the nonstate entities identified in section 256B.199, new text begin subdivision 1, new text end adjust, on a pro
rata basis if feasible, the amounts reported by nonstate entities under section 256B.199 new text begin ,
subdivision 1, new text end when application for reimbursement is made to the federal government,
and otherwise adjust the provisions of this subdivision. The commissioner shall utilize a
settlement process based on finalized data to maximize revenue under section 256B.199 new text begin ,
subdivision 1, new text end and payments under this section.

(f) For purposes of this subdivision, medical assistance does not include general
assistance medical care.

Sec. 4.

Minnesota Statutes 2008, section 256B.0625, subdivision 39, is amended to
read:

Subd. 39.

Childhood immunizations.

Providers who administer pediatric vaccines
within the scope of their licensure, and who are enrolled as a medical assistance provider,
must enroll in the pediatric vaccine administration program established by section 13631
of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an $8.50
fee per dose for administration of the vaccine new text begin and for all other vaccines supplied at no
cost by the federal government, including vaccines delivered in a pandemic situation new text end to
children eligible for medical assistance. Medical assistance does not pay for vaccines that
are available at no cost from the pediatric vaccine administration program.

Sec. 5.

Minnesota Statutes 2009 Supplement, section 256B.0651, subdivision 1,
is amended to read:

Subdivision 1.

Definitions.

(a) For the purposes of sections 256B.0651 to
256B.0656 and 256B.0659, the terms in paragraphs (b) to (g) have the meanings given.

(b) "Activities of daily living" has the meaning given in section 256B.0659,
subdivision 1, paragraph (b).

(c) "Assessment" means a review and evaluation of a recipient's need for home
care services conducted in person.

(d) "Home care services" means medical assistance covered services that are home
health agency services, including skilled nurse visits; home health aide visits; deleted text begin physical
therapy, occupational therapy, respiratory therapy, and language-speech pathology
therapy; deleted text end private duty nursing; and personal care assistance.

(e) "Home residence," effective January 1, 2010, means a residence owned or
rented by the recipient either alone, with roommates of the recipient's choosing, or with
an unpaid responsible party or legal representative; or a family foster home where the
license holder lives with the recipient and is not paid to provide home care services for the
recipient except as allowed under sections 256B.0652, subdivision 10, and 256B.0654,
subdivision 4.

(f) "Medically necessary" has the meaning given in Minnesota Rules, parts
9505.0170 to 9505.0475.

(g) "Ventilator-dependent" means an individual who receives mechanical ventilation
for life support at least six hours per day and is expected to be or has been dependent on a
ventilator for at least 30 consecutive days.

Sec. 6.

Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 2,
is amended to read:

Subd. 2.

Definitions.

For the purposes of this section, the following terms have
the meanings given.

(a) "Assessment" means an evaluation of the recipient's medical need for home
health agency services by a registered nurse or appropriate therapist that is conducted
within 30 days of a request.

deleted text begin (b) "Home care therapies" means occupational, physical, and respiratory therapy
and speech-language pathology services provided in the home by a Medicare certified
home health agency.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end "Home health agency services" means services delivered in the recipient's
home residence, except as specified in section 256B.0625, by a home health agency to a
recipient with medical needs due to illness, disability, or physical conditions.

deleted text begin (d) deleted text end new text begin (c) new text end "Home health aide" means an employee of a home health agency who
completes medically oriented tasks written in the plan of care for a recipient.

deleted text begin (e) deleted text end new text begin (d) new text end "Home health agency" means a home care provider agency that is
Medicare-certified.

deleted text begin (f) "Occupational therapy services" mean the services defined in Minnesota Rules,
part 9505.0390.
deleted text end

deleted text begin (g) "Physical therapy services" mean the services defined in Minnesota Rules, part
9505.0390.
deleted text end

deleted text begin (h) "Respiratory therapy services" mean the services defined in chapter 147C and
Minnesota Rules, part 4668.0003, subpart 37.
deleted text end

deleted text begin (i) "Speech-language pathology services" mean the services defined in Minnesota
Rules, part 9505.0390.
deleted text end

deleted text begin (j) deleted text end new text begin (e) new text end "Skilled nurse visit" means a professional nursing visit to complete nursing
tasks required due to a recipient's medical condition that can only be safely provided by a
professional nurse to restore and maintain optimal health.

deleted text begin (k) deleted text end new text begin (f) new text end "Store-and-forward technology" means telehomecare services that do not
occur in real time via synchronous transmissions such as diabetic and vital sign monitoring.

deleted text begin (l) deleted text end new text begin (g) new text end "Telehomecare" means the use of telecommunications technology
via live, two-way interactive audiovisual technology which may be augmented by
store-and-forward technology.

deleted text begin (m) deleted text end new text begin (h) new text end "Telehomecare skilled nurse visit" means a visit by a professional nurse
to deliver a skilled nurse visit to a recipient located at a site other than the site where
the nurse is located and is used in combination with face-to-face skilled nurse visits to
adequately meet the recipient's needs.

Sec. 7.

Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 6,
is amended to read:

Subd. 6.

Noncovered home health agency services.

The following are not eligible
for payment under medical assistance as a home health agency service:

(1) telehomecare skilled nurses services that is communication between the home
care nurse and recipient that consists solely of a telephone conversation, facsimile,
electronic mail, or a consultation between two health care practitioners;

(2) the following skilled nurse visits:

(i) for the purpose of monitoring medication compliance with an established
medication program for a recipient;

(ii) administering or assisting with medication administration, including injections,
prefilling syringes for injections, or oral medication setup of an adult recipient, when,
as determined and documented by the registered nurse, the need can be met by an
available pharmacy or the recipient or a family member is physically and mentally able
to self-administer or prefill a medication;

(iii) services done for the sole purpose of supervision of the home health aide or
personal care assistant;

(iv) services done for the sole purpose to train other home health agency workers;

(v) services done for the sole purpose of blood samples or lab draw when the
recipient is able to access these services outside the home; and

(vi) Medicare evaluation or administrative nursing visits required by Medicare;

(3) home health aide visits when the following activities are the sole purpose for the
visit: companionship, socialization, household tasks, transportation, and education; and

(4) home care therapies deleted text begin provided in other settings such as a clinic, day program, or as
an inpatient or when the recipient can access therapy outside of the recipient's residence deleted text end .

Sec. 8.

Minnesota Statutes 2009 Supplement, section 256B.0947, subdivision 1,
is amended to read:

Subdivision 1.

Scope.

Effective November 1, deleted text begin 2010 deleted text end new text begin 2011 new text end , and subject to federal
approval, medical assistance covers medically necessary, intensive nonresidential
rehabilitative mental health services as defined in subdivision 2, for recipients as defined
in subdivision 3, when the services are provided by an entity meeting the standards
in this section.

Sec. 9.

Minnesota Statutes 2009 Supplement, section 256B.199, is amended to read:

256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.

new text begin Subdivision 1. new text end

new text begin Federal matching funds effective July 1, 2007. new text end

(a) Effective July
1, 2007, the commissioner shall apply for federal matching funds for the expenditures
in paragraphs (b) and (c). new text begin These funds are appropriated to the commissioner for the
payments under section 256.969, subdivision 27.
new text end

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

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

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

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

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

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

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

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

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

(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall
apply for additional federal matching funds available as disproportionate share hospital
payments under the American Recovery and Reinvestment Act of 2009. These funds shall
be made available as the state share of payments under section 256.969, subdivision 28.
The entities required to report certified public expenditures under paragraph (b), clause
(1), shall report additional certified public expenditures as necessary under this paragraph.

new text begin Subd. 2. new text end

new text begin Federal matching funds; certain MinnesotaCare expenditures. new text end

new text begin (a)
Effective July 1, 2010, the commissioner shall apply for federal matching funds for
MinnesotaCare expenditures for single adults and households with no children defined in
section 256L.04, subdivision 7, occurring on or after April 1, 2010. These funds shall be
deposited as provided under section 16A.724, subdivision 3.
new text end

new text begin (b) The commissioner shall apply for federal matching funds under section 1923 of
the Social Security Act for the expenditures in this section in the following sequence:
new text end

new text begin (1) general assistance medical care expenditures under subdivision 1, paragraph (c);
new text end

new text begin (2) MinnesotaCare expenditures for childless adults under paragraph (a); and
new text end

new text begin (3) certified public expenditures under subdivision 1, paragraph (b).
new text end

new text begin Subd. 3. new text end

new text begin Extent of federal match. new text end

new text begin The commissioner shall apply for federal
matching funds under section 1923 of the Social Security Act for the expenditures in this
section only to the extent that Minnesota's disproportionate share hospital allotment has
not been exhausted by the payments for the medical assistance disproportionate population
adjustments defined in section 256.969, subdivision 9, paragraph (b).
new text end

Sec. 10.

Minnesota Statutes 2008, section 256B.76, subdivision 4, is amended to read:

Subd. 4.

Critical access dental providers.

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 health plan
companies in amounts sufficient to reflect increased reimbursements to critical access
dental providers as approved by the commissioner. deleted text begin In determining which dentists and
dental clinics shall be deemed critical access dental providers, the commissioner shall
review deleted text end new text begin Dentists and dental clinics that operate with a mission to serve disproportionately
large numbers of uninsured and underinsured individuals regardless of their ability to pay,
may be designated as critical access dental providers. These providers are limited to new text end :

(1) deleted text begin the utilization rate in the service area in which the dentist or dental clinic operates
for dental services to patients covered by medical assistance, general assistance medical
care, or MinnesotaCare as their primary source of coverage; deleted text end new text begin nonprofit community clinics
that:
new text end

new text begin (i) have nonprofit status as specified in chapter 317A;
new text end

new text begin (ii) have tax B exempt status as provided in Internal Revenue Code, section
501(c)(3);
new text end

new text begin (iii) are established to provide oral health services to low-income, uninsured, high
risk, underserved, or other special needs populations;
new text end

new text begin (iv) have professional staff familiar with cultural background of clients;
new text end

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

new text begin (vi) do not restrict access or services because of a client's financial limitations or
public assistance status; and
new text end

new text begin (vii) have free care available as needed;
new text end

(2) deleted text begin the level of services provided by the dentist or dental clinic to patients covered
by medical assistance, general assistance medical care, or MinnesotaCare as their primary
source of coverage; and deleted text end new text begin federally qualified health centers, rural health centers, or public
health clinics;
new text end

(3) deleted text begin whether the level of services provided by the dentist or dental clinic is critical
to maintaining adequate levels of patient access within the service area. deleted text end new text begin state-operated
dental clinics; and
new text end

new text begin (4) county-owned and operated hospital based dental clinics.
new text end

deleted text begin In the absence of a critical access dental provider in a service area, 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.
deleted text end

Sec. 11.

Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is
amended to read:

Subd. 4.

General assistance medical care; services.

(a)(i) For a person who is
eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
care covers, except as provided in paragraph (c):

(1) inpatient hospital services;

(2) outpatient hospital services;

deleted text begin (3) services provided by Medicare certified rehabilitation agencies;
deleted text end

deleted text begin (4) deleted text end new text begin (3) new text end prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;

deleted text begin (5) deleted text end new text begin (4) new text end equipment necessary to administer insulin and diagnostic supplies and
equipment for diabetics to monitor blood sugar level;

deleted text begin (6) deleted text end new text begin (5) new text end eyeglasses and eye examinations provided by a physician or optometrist;

deleted text begin (7) deleted text end new text begin (6) new text end hearing aids;

deleted text begin (8) deleted text end new text begin (7) new text end prosthetic devices;

deleted text begin (9) deleted text end new text begin (8) new text end laboratory and X-ray services;

deleted text begin (10) deleted text end new text begin (9) new text end physician's services;

deleted text begin (11) deleted text end new text begin (10) new text end medical transportation except special transportation;

deleted text begin (12) deleted text end new text begin (11) new text end chiropractic services as covered under the medical assistance program;

deleted text begin (13) deleted text end new text begin (12) new text end podiatric services;

deleted text begin (14) deleted text end new text begin (13) new text end dental services as covered under the medical assistance program;

deleted text begin (15) deleted text end new text begin (14) new text end mental health services covered under chapter 256B;

deleted text begin (16) deleted text end new text begin (15) new text end prescribed medications for persons who have been diagnosed as mentally
ill as necessary to prevent more restrictive institutionalization;

deleted text begin (17) deleted text end new text begin (16) new text end medical supplies and equipment, and Medicare premiums, coinsurance
and deductible payments;

deleted text begin (18) deleted text end new text begin (17) new text end medical equipment not specifically listed in this paragraph when the use
of the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;

deleted text begin (19) deleted text end new text begin (18) new text end services performed by a certified pediatric nurse practitioner, a
certified family nurse practitioner, a certified adult nurse practitioner, a certified
obstetric/gynecological nurse practitioner, a certified neonatal nurse practitioner, or a
certified geriatric nurse practitioner in independent practice, if (1) the service is otherwise
covered under this chapter as a physician service, (2) the service provided on an inpatient
basis is not included as part of the cost for inpatient services included in the operating
payment rate, and (3) the service is within the scope of practice of the nurse practitioner's
license as a registered nurse, as defined in section 148.171;

deleted text begin (20) deleted text end new text begin (19) new text end services of a certified public health nurse or a registered nurse practicing
in a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;

deleted text begin (21) deleted text end new text begin (20) new text end telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3b;

deleted text begin (22) deleted text end new text begin (21) new text end care coordination and patient education services provided by a community
health worker according to section 256B.0625, subdivision 49; and

deleted text begin (23) deleted text end new text begin (22) new text end regardless of the number of employees that an enrolled health care provider
may have, sign language interpreter services when provided by an enrolled health care
provider during the course of providing a direct, person-to-person covered health care
service to an enrolled recipient who has a hearing loss and uses interpreting services.

(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
to inpatient hospital services, including physician services provided during the inpatient
hospital stay. A $1,000 deductible is required for each inpatient hospitalization.

(b) Effective August 1, 2005, sex reassignment surgery is not covered under this
subdivision.

(c) In order to contain costs, the commissioner of human services shall select
vendors of medical care who can provide the most economical care consistent with high
medical standards and shall where possible contract with organizations on a prepaid
capitation basis to provide these services. The commissioner shall consider proposals by
counties and vendors for prepaid health plans, competitive bidding programs, block grants,
or other vendor payment mechanisms designed to provide services in an economical
manner or to control utilization, with safeguards to ensure that necessary services are
provided. Before implementing prepaid programs in counties with a county operated or
affiliated public teaching hospital or a hospital or clinic operated by the University of
Minnesota, the commissioner shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to participate in the program in a
manner that reflects the risk of adverse selection and the nature of the patients served by
the hospital, provided the terms of participation in the program are competitive with the
terms of other participants considering the nature of the population served. Payment for
services provided pursuant to this subdivision shall be as provided to medical assistance
vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
payments made during fiscal year 1990 and later years, the commissioner shall consult
with an independent actuary in establishing prepayment rates, but shall retain final control
over the rate methodology.

(d) Effective January 1, 2008, drug coverage under general assistance medical
care is limited to prescription drugs that:

(i) are covered under the medical assistance program as described in section
256B.0625, subdivisions 13 and 13d; and

(ii) are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with the agreements.
Prescription drug coverage under general assistance medical care must conform to
coverage under the medical assistance program according to section 256B.0625,
subdivisions 13 to 13g.

(e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
co-payments for services provided on or after October 1, 2003, and before January 1, 2009:

(1) $25 for eyeglasses;

(2) $25 for nonemergency visits to a hospital-based emergency room;

(3) $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; and

(4) 50 percent coinsurance on restorative dental services.

(f) Recipients eligible under subdivision 3, paragraph (a), shall include the following
co-payments for services provided on or after January 1, 2009:

(1) $25 for nonemergency visits to a hospital-based emergency room; and

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

(g) MS 2007 Supp [Expired]

(h) Effective January 1, 2009, co-payments shall be limited to one per day per
provider for nonemergency visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all co-payments in this subdivision.
The general assistance medical care reimbursement to the provider shall be reduced by the
amount of the co-payment, except that reimbursement for prescription drugs shall not be
reduced once a recipient has reached the $7 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the recipient. Providers may not
deny services to recipients who are unable to pay the co-payment.

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

(j) Any county may, from its own resources, provide medical payments for which
state payments are not made.

(k) Chemical dependency services that are reimbursed under chapter 254B must not
be reimbursed under general assistance medical care.

(l) The maximum payment for new vendors enrolled in the general assistance
medical care program after the base year shall be determined from the average usual and
customary charge of the same vendor type enrolled in the base year.

(m) The conditions of payment for services under this subdivision are the same
as the conditions specified in rules adopted under chapter 256B governing the medical
assistance program, unless otherwise provided by statute or rule.

(n) Inpatient and outpatient payments shall be reduced by five percent, effective July
1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
and incorporated by reference in paragraph (l).

(o) Payments for all other health services except inpatient, outpatient, and pharmacy
services shall be reduced by five percent, effective July 1, 2003.

(p) Payments to managed care plans shall be reduced by five percent for services
provided on or after October 1, 2003.

(q) A hospital receiving a reduced payment as a result of this section may apply the
unpaid balance toward satisfaction of the hospital's bad debts.

(r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for
services provided on or after January 1, 2006. 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, advance practice nurse,
audiologist, optician, or optometrist.

(s) Payments to managed care plans shall not be increased as a result of the removal
of the $3 nonpreventive visit co-payment effective January 1, 2006.

(t) Payments for mental health services added as covered benefits after December
31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).

(u) Effective for services provided on or after July 1, 2009, total payment rates for
basic care services shall be reduced by three percent, in accordance with section 256B.766.
Payments made to managed care plans shall be reduced for services provided on or after
October 1, 2009, to reflect this reduction.

(v) Effective for services provided on or after July 1, 2009, payment rates for
physician and professional services shall be reduced as described under section 256B.76,
subdivision 1, paragraph (c). Payments made to managed care and county-based
purchasing plans shall be reduced for services provided on or after October 1, 2009,
to reflect this reduction.

new text begin (w) Effective January 1, 2011, rehabilitative and therapeutic services described in
section 256B.0625, subdivisions 8, 8a, and 8b, provided in any outpatient setting are not
covered under this subdivision.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256L.04, subdivision 7, is amended to read:

Subd. 7.

Single adults and households with no children.

(a) The definition of
eligible persons includes all individuals and households with no children who have
gross family incomes that are equal to or less than deleted text begin 200 deleted text end new text begin 75 new text end percent of the federal poverty
guidelines.

deleted text begin (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
and households with no children who have gross family incomes that are equal to or less
than 250 percent of the federal poverty guidelines.
deleted text end

new text begin (b) Effective October 1, 2010, the definition of eligible persons includes all
individuals and households with no children who have gross family incomes that are equal
to or less than 75 percent of the federal poverty guidelines.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2010.
new text end

Sec. 13.

Minnesota Statutes 2008, section 256L.05, subdivision 5, is amended to read:

Subd. 5.

Availability of private insurance.

The commissioner, in consultation with
the commissioners of health and commerce, shall provide information regarding the
availability of private health insurance coverage and the possibility of disenrollment
under section 256L.07, subdivision 1, paragraphs (b) and (c), to all deleted text begin : (1) deleted text end families deleted text begin enrolled
in the MinnesotaCare program whose gross family income is equal to or more than 225
percent of the federal poverty guidelines; deleted text end and deleted text begin (2) deleted text end single adults and households without
children enrolled in the MinnesotaCare program deleted text begin whose gross family income is equal to
or more than 165 percent of the federal poverty guidelines. This information must be
provided deleted text end upon initial enrollment and annually thereafter. The commissioner shall also
include information regarding the availability of private health insurance coverage in the
notice of ineligibility provided to persons subject to disenrollment under section 256L.07,
subdivision 1, paragraphs (b) and (c).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2010.
new text end

Sec. 14.

Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:

Subdivision 1.

General requirements.

(a) Children enrolled in the original
children's health plan as of September 30, 1992, children who enrolled in the
MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
article 4, section 17, and children who have family gross incomes that are equal to or
less than 150 percent of the federal poverty guidelines are eligible without meeting
the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
long as they maintain continuous coverage in the MinnesotaCare program or medical
assistance. Children who apply for MinnesotaCare on or after the implementation date
of the employer-subsidized health coverage program as described in Laws 1998, chapter
407, article 5, section 45, who have family gross incomes that are equal to or less than 150
percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
be eligible for MinnesotaCare.

Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
income increases above 275 percent of the federal poverty guidelines, are no longer
eligible for the program and shall be disenrolled by the commissioner. Beginning January
1, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7,
whose income increases above deleted text begin 200 deleted text end new text begin 75 new text end percent of the federal poverty guidelines deleted text begin or 250
percent of the federal poverty guidelines on or after July 1, 2009 deleted text end , are no longer eligible for
the program and shall be disenrolled by the commissioner. For persons disenrolled under
this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
following the month in which the commissioner determines that the income of a family or
individual exceeds program income limits.

(b) Notwithstanding paragraph (a), children may remain enrolled in MinnesotaCare
if ten percent of their gross individual or gross family income as defined in section
256L.01, subdivision 4, is less than the annual premium for a policy with a $500
deductible available through the Minnesota Comprehensive Health Association. Children
who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month
notice period from the date that ineligibility is determined before disenrollment. The
premium for children remaining eligible under this clause shall be the maximum premium
determined under section 256L.15, subdivision 2, paragraph (b).

(c) Notwithstanding paragraphs (a) and (b), parents are not eligible for
MinnesotaCare if gross household income exceeds $57,500 for the 12-month period
of eligibility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2010.
new text end

Sec. 15.

Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:

Subd. 9.

Rate setting; performance withholds.

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

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

(c) For services rendered on or after January 1, 2004, the commissioner shall
withhold five percent of managed care plan payments under this section pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance target
based on a federal or state law or rule. Criteria for assessment of each performance target
must be outlined in writing prior to the contract effective date. The 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. deleted text begin A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
paragraph that is reasonably expected to be returned. deleted text end

new text begin (d) For services rendered on or after January 1, 2011, the commissioner shall
withhold an additional three percent of managed care plan payments under this section.
The withheld funds must be returned no sooner than July 1, and no later than July 31 of
the following calendar year. The return of the withhold under this paragraph is not subject
to the requirements of paragraph (b) or (c).
new text end

new text begin (e) 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.
new text end

Sec. 16.

Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:

Subd. 2.

Sliding fee scale; monthly gross individual or family income.

(a) The
commissioner shall establish a sliding fee scale to determine the percentage of monthly
gross individual or family income that households at different income levels must pay
to obtain coverage through the MinnesotaCare program. The sliding fee scale must be
based on the enrollee's monthly gross individual or family income. The sliding fee scale
must contain separate tables based on enrollment of one, two, or three or more persons.
deleted text begin Until June 30, 2009, deleted text end The sliding fee scale begins with a premium of 1.5 percent of
monthly gross individual or family income for individuals or families with incomes below
the limits for the medical assistance program for families and children in effect on January
1, 1999, and proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8,
5.9, 7.4, and 8.8 percent. These percentages are matched to evenly spaced income steps
ranging from the medical assistance income limit for families and children in effect on
January 1, 1999, to 275 percent of the federal poverty guidelines for the applicable family
size, up to a family size of five. The sliding fee scale for a family of five must be used
for families of more than five. The sliding fee scale and percentages are not subject to
the provisions of chapter 14. If a family or individual reports increased income after
enrollment, premiums shall be adjusted at the time the change in income is reported.

(b) Children in families whose gross income is above 275 percent of the federal
poverty guidelines shall pay the maximum premium. The maximum premium is defined
as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
cases paid the maximum premium, the total revenue would equal the total cost of
MinnesotaCare medical coverage and administration. In this calculation, administrative
costs shall be assumed to equal ten percent of the total. The costs of medical coverage
for pregnant women and children under age two and the enrollees in these groups shall
be excluded from the total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or more enrollees shall
be three times the maximum premium for one.

(c) Beginning July 1, deleted text begin 2009 deleted text end new text begin 2011 new text end , MinnesotaCare enrollees shall pay premiums
according to the premium scale specified in paragraph deleted text begin (d) deleted text end new text begin (a) new text end with the exception that
children in families with income at or below 150 percent of the federal poverty guidelines
shall pay a monthly premium of $4. deleted text begin For purposes of paragraph (d), "minimum" means a
monthly premium of $4.
deleted text end

deleted text begin (d) The following premium scale is established for individuals and families with
gross family incomes of 300 percent of the federal poverty guidelines or less:
deleted text end

deleted text begin Federal Poverty Guideline Range deleted text end	deleted text begin Percent of Average Gross Monthly Income deleted text end
deleted text begin 0-45% deleted text end	deleted text begin minimum deleted text end
deleted text begin 46-54% deleted text end	deleted text begin 1.1% deleted text end
deleted text begin 55-81% deleted text end	deleted text begin 1.6% deleted text end
deleted text begin 82-109% deleted text end	deleted text begin 2.2% deleted text end
deleted text begin 110-136% deleted text end	deleted text begin 2.9% deleted text end
deleted text begin 137-164% deleted text end	deleted text begin 3.6% deleted text end
deleted text begin 165-191% deleted text end	deleted text begin 4.6% deleted text end
deleted text begin 192-219% deleted text end	deleted text begin 5.6% deleted text end
deleted text begin 220-248% deleted text end	deleted text begin 6.5% deleted text end
deleted text begin 249-274% deleted text end	deleted text begin 7.2% deleted text end
deleted text begin 275-300% deleted text end	deleted text begin 8.0% deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2011.
new text end

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

new text begin Minnesota Statutes 2008, section 256.969, subdivision 26, new text end new text begin is repealed.
new text end

new text begin Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5, new text end new text begin is repealed.
new text end

ARTICLE 2

CONTINUING CARE

Section 1.

Minnesota Statutes 2009 Supplement, section 256B.0915, subdivision 3a,
is amended to read:

Subd. 3a.

Elderly waiver cost limits.

(a) The monthly limit for the cost of
waivered services to an individual elderly waiver client except for individuals described
in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
mix resident class to which the elderly waiver client would be assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
which the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented. Effective on the first day of the state fiscal year in
which the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and the first day of each subsequent state fiscal year, the
monthly limit for the cost of waivered services to an individual elderly waiver client shall
be the rate of the case mix resident class to which the waiver client would be assigned
under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
previous state fiscal year, adjusted by deleted text begin the greater of deleted text end any legislatively adopted home and
community-based services percentage rate deleted text begin increase or the average statewide percentage
increase in nursing facility payment rates deleted text end new text begin adjustment new text end .

(b) The monthly limit for the cost of waivered services to an individual elderly
waiver client assigned to a case mix classification A under paragraph (a) with (1) no
dependencies in activities of daily living, (2) only one dependency in bathing, dressing,
grooming, or walking, or (3) a dependency score of less than three if eating is the only
dependency, shall be the lower of the case mix classification amount for case mix A as
determined under paragraph (a) or the case mix classification amount for case mix A
effective on October 1, 2008, per month for all new participants enrolled in the program
on or after July 1, 2009. This monthly limit shall be applied to all other participants who
meet this criteria at reassessment.

(c) If extended medical supplies and equipment or environmental modifications are
or will be purchased for an elderly waiver client, the costs may be prorated for up to
12 consecutive months beginning with the month of purchase. If the monthly cost of a
recipient's waivered services exceeds the monthly limit established in paragraph (a) or
(b), the annual cost of all waivered services shall be determined. In this event, the annual
cost of all waivered services shall not exceed 12 times the monthly limit of waivered
services as described in paragraph (a) or (b).

Sec. 2.

Minnesota Statutes 2008, section 256B.0915, subdivision 3b, is amended to
read:

Subd. 3b.

Cost limits for elderly waiver applicants who reside in a nursing
facility.

(a) For a person who is a nursing facility resident at the time of requesting a
determination of eligibility for elderly waivered services, a monthly conversion limit for
the cost of elderly waivered services may be requested. The monthly conversion limit for
the cost of elderly waiver services shall be the resident class assigned under Minnesota
Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where
the resident currently resides until July 1 of the state fiscal year in which the resident
assessment system as described in section 256B.438 for nursing home rate determination
is implemented. Effective on July 1 of the state fiscal year in which the resident
assessment system as described in section 256B.438 for nursing home rate determination
is implemented, the monthly conversion limit for the cost of elderly waiver services shall
be the per diem nursing facility rate as determined by the resident assessment system as
described in section 256B.438 for deleted text begin that resident deleted text end new text begin residents new text end in the nursing facility where the
resident currently resides new text begin , but in effect on June 30, 2010, and adjusted annually by any
legislatively adopted percentage change in the elderly waiver services rates. That per
diem shall be new text end multiplied by 365 new text begin , new text end deleted text begin and deleted text end divided by 12, deleted text begin less deleted text end new text begin and reduced by new text end the recipient's
maintenance needs allowance as described in subdivision 1d. The initially approved
conversion rate deleted text begin may deleted text end new text begin must new text end be adjusted by deleted text begin the greater of deleted text end any subsequent legislatively
adopted home and community-based services percentage rate deleted text begin increase or the average
statewide percentage increase in nursing facility payment rates deleted text end new text begin adjustment new text end . The limit
under this subdivision only applies to persons discharged from a nursing facility after a
minimum 30-day stay and found eligible for waivered services on or after July 1, 1997.
For conversions from the nursing home to the elderly waiver with consumer directed
community support services, the conversion rate limit is equal to the nursing facility rate
reduced by a percentage equal to the percentage difference between the consumer directed
services budget limit that would be assigned according to the federally approved waiver
plan and the corresponding community case mix cap, but not to exceed 50 percent.

(b) The following costs must be included in determining the total monthly costs
for the waiver client:

(1) cost of all waivered services, including deleted text begin extended medical deleted text end new text begin specialized new text end supplies
and equipment and environmental deleted text begin modifications and deleted text end new text begin accessibility new text end adaptations; and

(2) cost of skilled nursing, home health aide, and personal care services reimbursable
by medical assistance.

Sec. 3.

Minnesota Statutes 2008, section 256B.434, is amended by adding a
subdivision to read:

new text begin Subd. 22. new text end

new text begin Nursing facility rate reductions effective July 1, 2010. new text end

new text begin Effective July
1, 2010, the commissioner shall decrease the operating payment rates of each nursing
facility reimbursed under this section by 2.5 percent of the operating payment rate in
effect on June 30, 2010.
new text end

Sec. 4.

Minnesota Statutes 2008, section 256B.48, subdivision 1, is amended to read:

Subdivision 1.

Prohibited practices.

A nursing facility is not eligible to receive
medical assistance payments unless it refrains from all of the following:

(a) Charging private paying residents rates for similar services which exceed those
which are approved by the state agency for medical assistance recipients as determined by
the prospective desk audit rate, except under the following circumstances:

new text begin (1) new text end the nursing facility may new text begin :
new text end

deleted text begin (1) deleted text end new text begin (i) new text end charge private paying residents a higher rate for a private room deleted text begin , deleted text end new text begin ; new text end and

deleted text begin (2) deleted text end new text begin (ii) new text end charge for special services which are not included in the daily rate if medical
assistance residents are charged separately at the same rate for the same services in
addition to the daily rate paid by the commissioner deleted text begin . deleted text end new text begin ; new text end

new text begin (2) effective July 1, 2010, through September 30, 2011, nursing facilities may charge
private paying residents rates up to two percent higher than the allowable payment rate
determined by the commissioner for the RUG's group currently assigned to the resident;
new text end

new text begin (3) effective October 1, 2011, through September 30, 2012, nursing facilities
may charge private paying residents rates up to four percent higher than the allowable
payment rate determined by the commissioner for the RUG's group currently assigned
to the resident; and
new text end

new text begin (4) effective October 1, 2012, through September 30, 2013, nursing facilities may
charge private paying residents rates up to six percent higher than the allowable payment
rate determined by the commissioner for the RUG's group currently assigned to the
resident.
new text end

new text begin Nothing in this section precludes a nursing facility from charging a rate allowable
under the facility's single room election option under Minnesota Rules, part 9549.0060,
subpart 11. new text end Services covered by the payment rate must be the same regardless of payment
source. Special services, if offered, must be available to all residents in all areas of the
nursing facility and charged separately at the same rate. Residents are free to select
or decline special services. Special services must not include services which must be
provided by the nursing facility in order to comply with licensure or certification standards
and that if not provided would result in a deficiency or violation by the nursing facility.
Services beyond those required to comply with licensure or certification standards must
not be charged separately as a special service if they were included in the payment rate for
the previous reporting year. A nursing facility that charges a private paying resident a rate
in violation of this clause is subject to an action by the state of Minnesota or any of its
subdivisions or agencies for civil damages. A private paying resident or the resident's legal
representative has a cause of action for civil damages against a nursing facility that charges
the resident rates in violation of this clause. The damages awarded shall include three
times the payments that result from the violation, together with costs and disbursements,
including reasonable attorneys' fees or their equivalent. A private paying resident or the
resident's legal representative, the state, subdivision or agency, or a nursing facility may
request a hearing to determine the allowed rate or rates at issue in the cause of action.
Within 15 calendar days after receiving a request for such a hearing, the commissioner
shall request assignment of an administrative law judge under sections 14.48 to 14.56 to
conduct the hearing as soon as possible or according to agreement by the parties. The
administrative law judge shall issue a report within 15 calendar days following the close
of the hearing. The prohibition set forth in this clause shall not apply to facilities licensed
as boarding care facilities which are not certified as skilled or intermediate care facilities
level I or II for reimbursement through medical assistance.

(b) new text begin Effective October 1, 2013, paragraph (a) no longer applies, except that special
services, if offered, must be available to all residents of the nursing facility and charged
separately at the same rate. Residents are free to select or decline special services. Special
services must not include services which must be provided by the nursing facility in order
to comply with licensure or certification standards and that if not provided would result in
a deficiency or violation by the nursing facility.
new text end

new text begin (c) new text end (1) Charging, soliciting, accepting, or receiving from an applicant for admission
to the facility, or from anyone acting in behalf of the applicant, as a condition of
admission, expediting the admission, or as a requirement for the individual's continued
stay, any fee, deposit, gift, money, donation, or other consideration not otherwise required
as payment under the state plan new text begin . For residents on medical assistance, medical assistance
payment according to the state plan must be accepted as payment in full for continued
stay, except where otherwise provided for under statute new text end ;

(2) requiring an individual, or anyone acting in behalf of the individual, to loan
any money to the nursing facility;

(3) requiring an individual, or anyone acting in behalf of the individual, to promise
to leave all or part of the individual's estate to the facility; or

(4) requiring a third-party guarantee of payment to the facility as a condition of
admission, expedited admission, or continued stay in the facility.

Nothing in this paragraph would prohibit discharge for nonpayment of services in
accordance with state and federal regulations.

deleted text begin (c) deleted text end new text begin (d) new text end Requiring any resident of the nursing facility to utilize a vendor of health
care services chosen by the nursing facility. A nursing facility may require a resident
to use pharmacies that utilize unit dose packing systems approved by the Minnesota
Board of Pharmacy, and may require a resident to use pharmacies that are able to meet
the federal regulations for safe and timely administration of medications such as systems
with specific number of doses, prompt delivery of medications, or access to medications
on a 24-hour basis. Notwithstanding the provisions of this paragraph, nursing facilities
shall not restrict a resident's choice of pharmacy because the pharmacy utilizes a specific
system of unit dose drug packing.

deleted text begin (d) deleted text end new text begin (e) new text end Providing differential treatment on the basis of status with regard to public
assistance.

deleted text begin (e) deleted text end new text begin (f) new text end Discriminating in admissions, services offered, or room assignment on the
basis of status with regard to public assistance deleted text begin or refusal to purchase special services deleted text end .
new text begin Discrimination in new text end admissions deleted text begin discrimination deleted text end new text begin , services offered, or room assignment new text end shall
include, but is not limited to:

(1) basing admissions decisions upon deleted text begin assurance by the applicant to the nursing
facility, or the applicant's guardian or conservator, that the applicant is neither eligible for
nor will seek deleted text end new text begin information or assurances regarding current or future eligibility for new text end public
assistance for payment of nursing facility care deleted text begin costs deleted text end ; and

(2) engaging in preferential selection from waiting lists based on an applicant's
ability to pay privately or an applicant's refusal to pay for a special service.

The collection and use by a nursing facility of financial information of any applicant
pursuant to a preadmission screening program established by law shall not raise an
inference that the nursing facility is utilizing that information for any purpose prohibited
by this paragraph.

deleted text begin (f) deleted text end new text begin (g) new text end Requiring any vendor of medical care as defined by section 256B.02,
subdivision 7, who is reimbursed by medical assistance under a separate fee schedule,
to pay any amount based on utilization or service levels or any portion of the vendor's
fee to the nursing facility except as payment for renting or leasing space or equipment
or purchasing support services from the nursing facility as limited by section 256B.433.
All agreements must be disclosed to the commissioner upon request of the commissioner.
Nursing facilities and vendors of ancillary services that are found to be in violation of
this provision shall each be subject to an action by the state of Minnesota or any of its
subdivisions or agencies for treble civil damages on the portion of the fee in excess of that
allowed by this provision and section 256B.433. Damages awarded must include three
times the excess payments together with costs and disbursements including reasonable
attorney's fees or their equivalent.

deleted text begin (g) deleted text end new text begin (h) new text end Refusing, for more than 24 hours, to accept a resident returning to the same
bed or a bed certified for the same level of care, in accordance with a physician's order
authorizing transfer, after receiving inpatient hospital services.

new text begin (i) new text end For a period not to exceed 180 days, the commissioner may continue to make
medical assistance payments to a nursing facility or boarding care home which is in
violation of this section if extreme hardship to the residents would result. In these cases
the commissioner shall issue an order requiring the nursing facility to correct the violation.
The nursing facility shall have 20 days from its receipt of the order to correct the violation.
If the violation is not corrected within the 20-day period the commissioner may reduce
the payment rate to the nursing facility by up to 20 percent. The amount of the payment
rate reduction shall be related to the severity of the violation and shall remain in effect
until the violation is corrected. The nursing facility or boarding care home may appeal the
commissioner's action pursuant to the provisions of chapter 14 pertaining to contested
cases. An appeal shall be considered timely if written notice of appeal is received by the
commissioner within 20 days of notice of the commissioner's proposed action.

In the event that the commissioner determines that a nursing facility is not eligible
for reimbursement for a resident who is eligible for medical assistance, the commissioner
may authorize the nursing facility to receive reimbursement on a temporary basis until the
resident can be relocated to a participating nursing facility.

Certified beds in facilities which do not allow medical assistance intake on July 1,
1984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

Sec. 5.

Minnesota Statutes 2008, section 256B.5012, is amended by adding a
subdivision to read:

new text begin Subd. 9. new text end

new text begin ICF/MR rate decreases effective July 1, 2010. new text end

new text begin Effective July 1, 2010,
the commissioner shall decrease the operating payment rate of each facility reimbursed
under this section by 2.5 percent of the operating payment rates in effect on June 30, 2010.
For each facility, the commissioner shall implement the rate reduction, based on occupied
beds, using the percentage specified in this subdivision multiplied by the total payment
rate, including the variable rate but excluding the property-related payment rate, in effect
on the preceding date. The total rate reduction shall include the adjustment provided in
section 256B.5012, subdivision 7.
new text end

Sec. 6. new text begin COLA COMPENSATION REQUIREMENTS.
new text end

new text begin Effective July 1, 2010, providers who received rate increases under Minnesota
Statutes, sections 256B.431, subdivision 41; 256B.434, subdivision 19; and 256B.5012,
subdivision 7; Laws 2007, chapter 147, article 7, section 71, as amended by Laws 2008,
chapter 363, article 15, section 17; and Laws 2008, chapter 363, article 18, section 3,
subdivision 6, paragraph (c), for state fiscal years 2008 and 2009 are no longer required
to continue or retain employee compensation or wage-related increases required by
those sections or by other laws or statutes enacted earlier in which compensation-related
increases were required as a condition of receiving a rate increase.
new text end

Sec. 7. new text begin PROVIDER RATE AND GRANT REDUCTIONS.
new text end

new text begin (a) The commissioner of human services shall decrease grants, allocations,
reimbursement rates, or rate limits, as applicable, by 2.5 percent effective July 1, 2010, for
services rendered on or after that date. County or tribal contracts for services specified
in this section must be amended to pass through these rate reductions within 60 days of
the effective date of the decrease and must be retroactive from the effective date of the
rate decrease.
new text end

new text begin (b) The rate changes described in this section must be provided to:
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) semi-independent living services (SILS) under Minnesota Statutes, section
252.275, including SILS funding under county social services grants formerly funded
under Minnesota Statutes, chapter 256I;
new text end

new text begin (12) community support services for deaf and hard-of-hearing adults with mental
illness who use or wish to use sign language as their primary means of communication
under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
grants under Minnesota Statutes, sections 256C.233, 256C.25, and 256C.261; Laws 1985,
First Special Session chapter 9, article 1; Laws 1997, chapter 203, article 1, section 2,
subdivision 8, as amended by Laws 1997, First Special Session chapter 5, section 20;
and Laws 2007, chapter 147, article 19, section 3, subdivision 8, as amended by Laws
2008, chapter 317, section 3;
new text end

new text begin (13) consumer support grants under Minnesota Statutes, section 256.476;
new text end

new text begin (14) family support grants under Minnesota Statutes, section 252.32;
new text end

new text begin (15) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
and 256B.0928;
new text end

new text begin (16) disability linkage line grants under Minnesota Statutes, section 256.01,
subdivision 24; and
new text end

new text begin (17) housing access grants under Minnesota Statutes, section 256B.0658.
new text end

new text begin (c) To implement the rate reductions in this section and in Minnesota Statutes,
section 256B.434, subdivision 22, capitation rates paid by the commissioner to managed
care organizations under Minnesota Statutes, section 256B.69, must reflect a 5.0 percent
reduction for the specified services for the period January 1, 2011, through June 30, 2011,
and a 2.5 percent reduction for those services on and after July 1, 2011.
new text end

ARTICLE 3

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2008, section 119B.011, subdivision 15, is amended to
read:

Subd. 15.

Income.

"Income" means earned or unearned income received by all
family members, including public assistance cash benefits and at-home infant child
care subsidy payments, unless specifically excluded and child support and maintenance
distributed to the family under section 256.741, subdivision 15. The following are
excluded from income: funds used to pay for health insurance premiums for family
members, deleted text begin Supplemental Security Income, deleted text end scholarships, work-study income, and grants
that cover costs or reimbursement for tuition, fees, books, and educational supplies;
student loans for tuition, fees, books, supplies, and living expenses; state and federal
earned income tax credits; assistance specifically excluded as income by law; in-kind
income such as food support, energy assistance, foster care assistance, medical assistance,
child care assistance, and housing subsidies; earned income of full-time or part-time
students up to the age of 19, who have not earned a high school diploma or GED high
school equivalency diploma including earnings from summer employment; grant awards
under the family subsidy program; nonrecurring lump-sum income only to the extent that
it is earmarked and used for the purpose for which it is paid; and any income assigned to
the public authority according to section 256.741.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2011.
new text end

Sec. 2.

Minnesota Statutes 2008, section 119B.13, subdivision 1, is amended to read:

Subdivision 1.

Subsidy restrictions.

(a) Beginning deleted text begin July 1, 2006 deleted text end new text begin March 1, 2011 new text end , the
maximum rate paid for child care assistance in any county or multicounty region under the
child care fund shall be the rate for like-care arrangements in the county effective January
1, deleted text begin 2006 deleted text end new text begin 2010 new text end , deleted text begin increased deleted text end new text begin decreased new text end by deleted text begin six deleted text end new text begin five new text end percent.

deleted text begin (b) Rate changes shall be implemented for services provided in September 2006
unless a participant eligibility redetermination or a new provider agreement is completed
between July 1, 2006, and August 31, 2006.
deleted text end

deleted text begin As necessary, appropriate notice of adverse action must be made according to
Minnesota Rules, part 3400.0185, subparts 3 and 4.
deleted text end

deleted text begin New cases approved on or after July 1, 2006, shall have the maximum rates under
paragraph (a), implemented immediately.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end Every year, the commissioner shall survey rates charged by child care
providers in Minnesota to determine the 75th percentile for like-care arrangements in
counties. When the commissioner determines that, using the commissioner's established
protocol, the number of providers responding to the survey is too small to determine
the 75th percentile rate for like-care arrangements in a county or multicounty region,
the commissioner may establish the 75th percentile maximum rate based on like-care
arrangements in a county, region, or category that the commissioner deems to be similar.

deleted text begin (d) deleted text end new text begin (c) new text end A rate which includes a special needs rate paid under subdivision 3 or under a
school readiness service agreement paid under section 119B.231, may be in excess of the
maximum rate allowed under this subdivision.

deleted text begin (e) deleted text end new text begin (d) new text end The department shall monitor the effect of this paragraph on provider rates.
The county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care on
an hourly, full-day, and weekly basis, including special needs and disability care.

deleted text begin (f) deleted text end new text begin (e) new text end When the provider charge is greater than the maximum provider rate allowed,
the parent is responsible for payment of the difference in the rates in addition to any
family co-payment fee.

deleted text begin (g) deleted text end new text begin (f) new text end All maximum provider rates changes shall be implemented on the Monday
following the effective date of the maximum provider rate.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2011.
new text end

Sec. 3.

Minnesota Statutes 2009 Supplement, section 256D.01, subdivision 1b, is
amended to read:

Subd. 1b.

deleted text begin Rules deleted text end new text begin Personal needs allowance new text end .

deleted text begin The commissioner shall adopt rules
to set standards of assistance and methods of calculating payment to conform with
subdivision 1a. When a recipient is a resident of a licensed residential facility, except
shelters for the homeless or shelters under section 611A.31, the recipient is not eligible for
a full general assistance standard. deleted text end The state standard of assistance for those recipients who
have personal needs not otherwise provided for is the personal needs allowance authorized
for medical assistance recipients under section 256B.35.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2010.
new text end

Sec. 4.

Minnesota Statutes 2008, section 256D.045, is amended to read:

256D.045 SOCIAL SECURITY NUMBER REQUIRED.

To be eligible for general assistance under sections 256D.01 to 256D.21, an
individual must provide the individual's Social Security number to the county agency or
submit proof that an application has been made. An individual who refuses to provide
a Social Security number because of a well-established religious objection as described
in Code of Federal Regulations, title 42, section 435.910, may be eligible for general
assistance medical care under section 256D.03. deleted text begin The provisions of this section do not
apply to the determination of eligibility for emergency general assistance under section
256D.06, subdivision 2. deleted text end This provision applies to eligible children under the age of 18
effective July 1, 1997.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2010.
new text end

Sec. 5.

Minnesota Statutes 2008, section 256D.05, subdivision 1, is amended to read:

Subdivision 1.

Eligibility.

(a) Each assistance unit with income and resources
less than the standard of assistance established by the commissioner and with a member
who is a resident of the state shall be eligible for and entitled to general assistance if
the assistance unit is:

deleted text begin (1) a person who is suffering from a professionally certified permanent or temporary
illness, injury, or incapacity which is expected to continue for more than 30 days and
which prevents the person from obtaining or retaining employment;
deleted text end

deleted text begin (2) a person whose presence in the home on a substantially continuous basis is
required because of the professionally certified illness, injury, incapacity, or the age of
another member of the household;
deleted text end

deleted text begin (3) deleted text end new text begin (1) new text end a person who has been placed in, and is residing in, a licensed or certified
facility for purposes of physical or mental health or rehabilitation, or in an approved
chemical dependency domiciliary facility, if the placement is based on illness or incapacity
and is according to a plan developed or approved by the county agency through its director
or designated representative; new text begin or
new text end

deleted text begin (4) deleted text end new text begin (2) new text end a person who resides in a shelter facility described in deleted text begin subdivision 3; deleted text end new text begin section
611A.31.
new text end

deleted text begin (5) a person not described in clause (1) or (3) who is diagnosed by a licensed
physician, psychological practitioner, or other qualified professional, as developmentally
disabled or mentally ill, and that condition prevents the person from obtaining or retaining
employment;
deleted text end

deleted text begin (6) a person who has an application pending for, or is appealing termination of
benefits from, the Social Security disability program or the program of supplemental
security income for the aged, blind, and disabled, provided the person has a professionally
certified permanent or temporary illness, injury, or incapacity which is expected to
continue for more than 30 days and which prevents the person from obtaining or retaining
employment;
deleted text end

deleted text begin (7) a person who is unable to obtain or retain employment because advanced age
significantly affects the person's ability to seek or engage in substantial work;
deleted text end

deleted text begin (8) a person who has been assessed by a vocational specialist and, in consultation
with the county agency, has been determined to be unemployable for purposes of this
clause; a person is considered employable if there exist positions of employment in the
local labor market, regardless of the current availability of openings for those positions,
that the person is capable of performing. The person's eligibility under this category must
be reassessed at least annually. The county agency must provide notice to the person not
later than 30 days before annual eligibility under this item ends, informing the person of the
date annual eligibility will end and the need for vocational assessment if the person wishes
to continue eligibility under this clause. For purposes of establishing eligibility under this
clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
deleted text end

deleted text begin (9) a person who is determined by the county agency, according to permanent rules
adopted by the commissioner, to be learning disabled, provided that if a rehabilitation plan
for the person is developed or approved by the county agency, the person is following
the plan;
deleted text end

deleted text begin (10) a child under the age of 18 who is not living with a parent, stepparent, or legal
custodian, and only if: the child is legally emancipated or living with an adult with the
consent of an agency acting as a legal custodian; the child is at least 16 years of age
and the general assistance grant is approved by the director of the county agency or a
designated representative as a component of a social services case plan for the child; or the
child is living with an adult with the consent of the child's legal custodian and the county
agency. For purposes of this clause, "legally emancipated" means a person under the age
of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of
the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv)
is otherwise considered emancipated under Minnesota law, and for whom county social
services has not determined that a social services case plan is necessary, for reasons other
than the child has failed or refuses to cooperate with the county agency in developing
the plan;
deleted text end

deleted text begin (11) a person who is eligible for displaced homemaker services, programs, or
assistance under section 116L.96, but only if that person is enrolled as a full-time student;
deleted text end

deleted text begin (12) a person who lives more than four hours round-trip traveling time from any
potential suitable employment;
deleted text end

deleted text begin (13) a person who is involved with protective or court-ordered services that prevent
the applicant or recipient from working at least four hours per day;
deleted text end

deleted text begin (14) a person over age 18 whose primary language is not English and who is
attending high school at least half time; or
deleted text end

deleted text begin (15) a person whose alcohol and drug addiction is a material factor that contributes
to the person's disability; applicants who assert this clause as a basis for eligibility must
be assessed by the county agency to determine if they are amenable to treatment; if the
applicant is determined to be not amenable to treatment, but is otherwise eligible for
benefits, then general assistance must be paid in vendor form, for the individual's shelter
costs up to the limit of the grant amount, with the residual, if any, paid according to section
256D.09, subdivision 2a; if the applicant is determined to be amenable to treatment, then
in order to receive benefits, the applicant must be in a treatment program or on a waiting
list and the benefits must be paid in vendor form, for the individual's shelter costs, up to
the limit of the grant amount, with the residual, if any, paid according to section 256D.09,
subdivision 2a.
deleted text end

(b) As a condition of eligibility under paragraph (a), deleted text begin clauses deleted text end new text begin clause new text end (1), deleted text begin (3), (5), (8),
and (9), deleted text end the recipient must complete an interim assistance agreement and must apply
for other maintenance benefits as specified in section 256D.06, subdivision 5, and must
comply with efforts to determine the recipient's eligibility for those other maintenance
benefits.

(c) The burden of providing documentation for a county agency to use to verify
eligibility for general assistance or for exemption from the food stamp employment
and training program is upon the applicant or recipient. The county agency shall use
documents already in its possession to verify eligibility, and shall help the applicant or
recipient obtain other existing verification necessary to determine eligibility which the
applicant or recipient does not have and is unable to obtain.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2010.
new text end

Sec. 6.

Minnesota Statutes 2008, section 256D.07, is amended to read:

256D.07 TIME OF PAYMENT OF ASSISTANCE.

An applicant for general assistance or general assistance medical care authorized
by section 256D.03, subdivision 3, shall be deemed eligible if the application and the
verification of the statement on that application demonstrate that the applicant is within
the eligibility criteria established by sections 256D.01 to 256D.21 and any applicable rules
of the commissioner. Any person requesting general assistance or general assistance
medical care shall be permitted by the county agency to make an application for assistance
as soon as administratively possible and in no event later than the fourth day following
the date on which assistance is first requested, and no county agency shall require that a
person requesting assistance appear at the offices of the county agency more than once
prior to the date on which the person is permitted to make the application. The application
shall be in writing in the manner and upon the form prescribed by the commissioner
and attested to by the oath of the applicant or in lieu thereof shall contain the following
declaration which shall be signed by the applicant: "I declare that this application has
been examined by me and to the best of my knowledge and belief is a true and correct
statement of every material point." On the date that general assistance is first requested,
the county agency shall inquire and determine whether the person requesting assistance
is in immediate need of food, shelter, clothing, assistance for necessary transportation,
or other emergency assistance pursuant to section 256D.06, subdivision 2. deleted text begin A person in
need of emergency assistance shall be granted emergency assistance immediately, and
necessary emergency assistance shall continue for up to 30 days following the date of
application. deleted text end A determination of an applicant's eligibility for general assistance shall be
made by the county agency as soon as the required verifications are received by the county
agency and in no event later than 30 days following the date that the application is made.
Any verifications required of the applicant shall be reasonable, and the commissioner
shall by rule establish reasonable verifications. General assistance shall be granted to an
eligible applicant without the necessity of first securing action by the board of the county
agency. The first month's grant must be computed to cover the time period starting with
the date a signed application form is received by the county agency or from the date that
the applicant meets all eligibility factors, whichever occurs later.

If upon verification and due investigation it appears that the applicant provided
false information and the false information materially affected the applicant's eligibility
for general assistance or general assistance medical care provided pursuant to section
256D.03, subdivision 3, or the amount of the applicant's general assistance grant, the
county agency may refer the matter to the county attorney. The county attorney may
commence a criminal prosecution or a civil action for the recovery of any general
assistance wrongfully received, or both.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2010.
new text end

Sec. 7.

Minnesota Statutes 2008, section 256D.10, is amended to read:

256D.10 ADMINISTRATIVE HEARING PRIOR TO ADVERSE ACTION.

No grant of general assistance except one made pursuant to section deleted text begin 256D.06,
subdivision 2; or deleted text end 256D.08, subdivision 2, shall be reduced, terminated, or suspended
unless the recipient receives notice and is afforded an opportunity to be heard prior to
any action by the county agency.

Nothing herein shall deprive a recipient of the right to full administrative and judicial
review of an order or determination of a county agency as provided for in section 256.045
subsequent to any action taken by a county agency after a prior hearing.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2010.
new text end new text begin new text end

Sec. 8.

Minnesota Statutes 2009 Supplement, 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 deleted text begin nursing home, a regional treatment
center, or a group deleted text end new text begin licensed new text end 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.

deleted text begin (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.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (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.
deleted text end

deleted text begin (f)(1) Notwithstanding the language in this subdivision, deleted text end new text begin (b) new text end 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.

(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.

deleted text begin (g) deleted text end new text begin (c) new text end Notwithstanding this subdivision, to access housing and services as provided
in paragraph deleted text begin (f) deleted text end new text begin (b) new text end , the recipient may choose housing that may or may not be owned,
operated, or controlled by the recipient's service provider if the housing is located in a
multifamily building of six or more units. The maximum number of units that may be used
by recipients of this program shall be 50 percent of the units in a building. The department
shall develop an exception process to the 50 percent maximum. This paragraph expires
on June 30, 2011.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2010.
new text end

Sec. 9.

new text begin [256D.441] SHORT-TERM AID PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Short-term aid program. new text end

new text begin A grant of short-term aid shall, to the
extent funds are available, be made to an eligible single adult, married couple, or family
where the recipient requests temporary assistance not exceeding 30 days if (1) a crisis
situation appears to exist under written criteria adopted by the county agency, (2) the
individual or family is ineligible for MFIP or DWP and has not received a consolidated
fund emergency grant within 12 months of application, and (3) the individual or family's
annual net income is no greater than 200 percent of the federal poverty guidelines for the
previous calendar year.
new text end

new text begin Subd. 2. new text end

new text begin County to advise. new text end

new text begin If an applicant or recipient relates facts to the county
agency which may be sufficient to constitute a crisis situation, the county agency shall,
to the extent funds are available, advise the person of the procedure for applying for aid
according to this subdivision. A short-term aid grant is available to a recipient not more
than once in a 12-month period.
new text end

new text begin Subd. 3. new text end

new text begin Limited funding. new text end

new text begin (a) Funding for the short-term aid program is limited
to the appropriation. Each fiscal year the commissioner shall allocate to counties the
money appropriated for short-term aid grants based on each county agency's average
share of state's former emergency general assistance expenditures and any subsequent
short-term aid expenditures for the immediate past three fiscal years as determined by the
commissioner. The commissioner may reallocate any unspent amounts to other counties.
No county shall be allocated less than $1,000 for the fiscal year.
new text end

new text begin (b) Any short-term aid expenditures by a county above the amount of the
commissioner's allocation to the county must be made from county funds.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2010.
new text end

Sec. 10.

Minnesota Statutes 2008, section 256D.47, is amended to read:

256D.47 PAYMENT METHODS.

Minnesota supplemental aid payments must be issued to the recipient, a protective
payee, or a conservator or guardian of the recipient's estate in the form of county warrants
immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the
recipient's account in a financial institution. Minnesota supplemental aid payments must
be issued regularly on the first day of the month. The supplemental aid warrants must be
mailed only to the address at which the recipient resides, unless another address has been
approved in advance by the county agency. Vendor payments must not be issued by the
county agency except for nonrecurring emergency need payments; at the request of the
recipient; deleted text begin for special needs, other than special diets; deleted text end or when the agency determines the
need for protective payments exist.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2010.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256I.04, subdivision 1, is amended to read:

Subdivision 1.

Individual eligibility requirements.

new text begin (a) new text end An individual is eligible for
and entitled to a group residential housing payment to be made on the individual's behalf
if the county agency has approved the individual's residence in a group residential housing
setting and the individual meets the requirements in deleted text begin paragraph (a) or (b) deleted text end new text begin this subdivision new text end .

deleted text begin (a) deleted text end new text begin (b) new text end The individual is aged, blind, or is over 18 years of age and disabled as
determined under the criteria used by the title II program of the Social Security Act,
and meets the resource restrictions and standards of the supplemental security income
program, and the individual's countable income after deducting the (1) exclusions and
disregards of the SSI program, (2) the medical assistance personal needs allowance
under section 256B.35, and (3) an amount equal to the income actually made available
to a community spouse by an elderly waiver recipient under the provisions of sections
256B.0575, paragraph (a), clause (4), and 256B.058, subdivision 2, is less than the
monthly rate specified in the county agency's agreement with the provider of group
residential housing in which the individual resides.

deleted text begin (b) The individual meets a category of eligibility under section 256D.05, subdivision
1, paragraph (a), and the individual's resources are less than the standards specified by
section 256D.08, and the individual's countable income as determined under sections
256D.01 to 256D.21, less the medical assistance personal needs allowance under section
256B.35 is less than the monthly rate specified in the county agency's agreement with the
provider of group residential housing in which the individual resides. deleted text end

new text begin (c) Each assistance unit with income and resources less than the standard of
assistance for group residential housing established by the commissioner who is a resident
of the state shall be eligible for and entitled to group residential housing if the assistance
unit is a person who has been placed in, and is residing in, a licensed or certified facility
for purposes of physical or mental health or rehabilitation, or in an approved chemical
dependency domiciliary facility, if the placement is based on illness or incapacity and is
according to a plan developed or approved by the county agency through its director or
designated representative.
new text end

new text begin (d) As a condition of eligibility under paragraph (c), the recipient shall complete an
interim assistance agreement and must apply for other maintenance benefits for which
the individual may be eligible.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective December 1, 2010.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256J.13, subdivision 1, is amended to read:

Subdivision 1.

Minor child or pregnant woman.

The assistance unit must
include at least one minor child or a pregnant woman. deleted text begin If a minor child is a recipient
of Supplemental Security Income or Minnesota supplemental aid, the assistance unit
is eligible for MFIP, but the needs of the minor child receiving Supplemental Security
Income or Minnesota supplemental aid must not be taken into account when the county
agency determines the amount of the assistance payment to be paid to the assistance unit.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 13.

Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:

Subd. 3.

Other property limitations.

To be eligible for MFIP, the equity value of all
nonexcluded real and personal property of the assistance unit must not exceed $2,000 for
applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to deleted text begin (19) deleted text end new text begin
(18) new text end must be excluded when determining the equity value of real and personal property:

(1) a licensed vehicle up to a loan value of less than or equal to $15,000. If the
assistance unit owns more than one licensed vehicle, the county agency shall determine the
loan value of all additional vehicles and exclude the combined loan value of less than or
equal to $7,500. The county agency shall apply any excess loan value as if it were equity
value to the asset limit described in this section, excluding: (i) the value of one vehicle
per physically disabled person when the vehicle is needed to transport the disabled unit
member; this exclusion does not apply to mentally disabled people; (ii) the value of special
equipment for a disabled member of the assistance unit; and (iii) any vehicle used for
long-distance travel, other than daily commuting, for the employment of a unit member.

To establish the loan value of vehicles, a county agency must use the N.A.D.A.
Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not
listed in the guidebook, or when the applicant or participant disputes the loan value listed
in the guidebook as unreasonable given the condition of the particular vehicle, the county
agency may require the applicant or participant document the loan value by securing a
written statement from a motor vehicle dealer licensed under section 168.27, stating
the amount that the dealer would pay to purchase the vehicle. The county agency shall
reimburse the applicant or participant for the cost of a written statement that documents
a lower loan value;

(2) the value of life insurance policies for members of the assistance unit;

(3) one burial plot per member of an assistance unit;

(4) the value of personal property needed to produce earned income, including
tools, implements, farm animals, inventory, business loans, business checking and
savings accounts used at least annually and used exclusively for the operation of a
self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
is to produce income and if the vehicles are essential for the self-employment business;

(5) the value of personal property not otherwise specified which is commonly
used by household members in day-to-day living such as clothing, necessary household
furniture, equipment, and other basic maintenance items essential for daily living;

deleted text begin (6) the value of real and personal property owned by a recipient of Supplemental
Security Income or Minnesota supplemental aid;
deleted text end

deleted text begin (7) deleted text end new text begin (6) new text end the value of corrective payments, but only for the month in which the
payment is received and for the following month;

deleted text begin (8) deleted text end new text begin (7) new text end a mobile home or other vehicle used by an applicant or participant as the
applicant's or participant's home;

deleted text begin (9) deleted text end new text begin (8) new text end money in a separate escrow account that is needed to pay real estate taxes or
insurance and that is used for this purpose;

deleted text begin (10) deleted text end new text begin (9) new text end money held in escrow to cover employee FICA, employee tax withholding,
sales tax withholding, employee worker compensation, business insurance, property rental,
property taxes, and other costs that are paid at least annually, but less often than monthly;

deleted text begin (11) deleted text end new text begin (10) new text end monthly assistance payments for the current month's or short-term
emergency needs under section 256J.626, subdivision 2;

deleted text begin (12) deleted text end new text begin (11) new text end the value of school loans, grants, or scholarships for the period they are
intended to cover;

deleted text begin (13) deleted text end new text begin (12) new text end payments listed in section 256J.21, subdivision 2, clause (9), which are
held in escrow for a period not to exceed three months to replace or repair personal or
real property;

deleted text begin (14) deleted text end new text begin (13) new text end income received in a budget month through the end of the payment month;

deleted text begin (15) deleted text end new text begin (14) new text end savings from earned income of a minor child or a minor parent that are set
aside in a separate account designated specifically for future education or employment
costs;

deleted text begin (16) deleted text end new text begin (15) new text end the federal earned income credit, Minnesota working family credit, state
and federal income tax refunds, state homeowners and renters credits under chapter
290A, property tax rebates and other federal or state tax rebates in the month received
and the following month;

deleted text begin (17) deleted text end new text begin (16) new text end payments excluded under federal law as long as those payments are held in
a separate account from any nonexcluded funds;

deleted text begin (18) deleted text end new text begin (17) new text end the assets of children ineligible to receive MFIP benefits because foster
care or adoption assistance payments are made on their behalf; and

deleted text begin (19) deleted text end new text begin (18) new text end the assets of persons whose income is excluded under section 256J.21,
subdivision 2, clause (43).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 14.

Minnesota Statutes 2008, section 256J.21, subdivision 2, is amended to read:

Subd. 2.

Income exclusions.

The following must be excluded in determining a
family's available income:

(1) payments for basic care, difficulty of care, and clothing allowances received for
providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used
for care and maintenance of a third-party beneficiary who is not a household member;

(2) reimbursements for employment training received through the Workforce
Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;

(3) reimbursement for out-of-pocket expenses incurred while performing volunteer
services, jury duty, employment, or informal carpooling arrangements directly related to
employment;

(4) all educational assistance, except the county agency must count graduate student
teaching assistantships, fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary educational expenses, shall
count scholarships or grants awarded to graduate students that do not require teaching
or research as unearned income;

(5) loans, regardless of purpose, from public or private lending institutions,
governmental lending institutions, or governmental agencies;

(6) loans from private individuals, regardless of purpose, provided an applicant or
participant documents that the lender expects repayment;

(7)(i) state income tax refunds; and

(ii) federal income tax refunds;

(8)(i) federal earned income credits;

(ii) Minnesota working family credits;

(iii) state homeowners and renters credits under chapter 290A; and

(iv) federal or state tax rebates;

(9) funds received for reimbursement, replacement, or rebate of personal or real
property when these payments are made by public agencies, awarded by a court, solicited
through public appeal, or made as a grant by a federal agency, state or local government,
or disaster assistance organizations, subsequent to a presidential declaration of disaster;

(10) the portion of an insurance settlement that is used to pay medical, funeral, and
burial expenses, or to repair or replace insured property;

(11) reimbursements for medical expenses that cannot be paid by medical assistance;

(12) payments by a vocational rehabilitation program administered by the state
under chapter 268A, except those payments that are for current living expenses;

(13) in-kind income, including any payments directly made by a third party to a
provider of goods and services;

(14) assistance payments to correct underpayments, but only for the month in which
the payment is received;

(15) payments for short-term emergency needs under section 256J.626, subdivision
2;

(16) funeral and cemetery payments as provided by section 256.935;

(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
a calendar month;

(18) any form of energy assistance payment made through Public Law 97-35,
Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
providers by other public and private agencies, and any form of credit or rebate payment
issued by energy providers;

deleted text begin (19) Supplemental Security Income (SSI), including retroactive SSI payments and
other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
deleted text end

deleted text begin (20) Minnesota supplemental aid, including retroactive payments;
deleted text end

deleted text begin (21) deleted text end new text begin (19) new text end proceeds from the sale of real or personal property;

deleted text begin (22) deleted text end new text begin (20) new text end state adoption assistance payments under section 259.67, and up to an
equal amount of county adoption assistance payments;

deleted text begin (23) deleted text end new text begin (21) new text end state-funded family subsidy program payments made under section 252.32
to help families care for children with developmental disabilities, consumer support
grant funds under section 256.476, and resources and services for a disabled household
member under one of the home and community-based waiver services programs under
chapter 256B;

deleted text begin (24) deleted text end new text begin (22) new text end interest payments and dividends from property that is not excluded from
and that does not exceed the asset limit;

deleted text begin (25) deleted text end new text begin (23) new text end rent rebates;

deleted text begin (26) deleted text end new text begin (24) new text end income earned by a minor caregiver, minor child through age 6, or a
minor child who is at least a half-time student in an approved elementary or secondary
education program;

deleted text begin (27) deleted text end new text begin (25) new text end income earned by a caregiver under age 20 who is at least a half-time
student in an approved elementary or secondary education program;

deleted text begin (28) deleted text end new text begin (26) new text end MFIP child care payments under section 119B.05;

deleted text begin (29) deleted text end new text begin (27) new text end all other payments made through MFIP to support a caregiver's pursuit of
greater economic stability;

deleted text begin (30) deleted text end new text begin (28) new text end income a participant receives related to shared living expenses;

deleted text begin (31) deleted text end new text begin (29) new text end reverse mortgages;

deleted text begin (32) deleted text end new text begin (30) new text end benefits provided by the Child Nutrition Act of 1966, United States Code,
title 42, chapter 13A, sections 1771 to 1790;

deleted text begin (33) deleted text end new text begin (31) new text end benefits provided by the women, infants, and children (WIC) nutrition
program, United States Code, title 42, chapter 13A, section 1786;

deleted text begin (34) deleted text end new text begin (32) new text end benefits from the National School Lunch Act, United States Code, title 42,
chapter 13, sections 1751 to 1769e;

deleted text begin (35) deleted text end new text begin (33) new text end relocation assistance for displaced persons under the Uniform Relocation
Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
Code, title 12, chapter 13, sections 1701 to 1750jj;

deleted text begin (36) deleted text end new text begin (34) new text end benefits from the Trade Act of 1974, United States Code, title 19, chapter
12, part 2, sections 2271 to 2322;

deleted text begin (37) deleted text end new text begin (35) new text end war reparations payments to Japanese Americans and Aleuts under United
States Code, title 50, sections 1989 to 1989d;

deleted text begin (38) deleted text end new text begin (36) new text end payments to veterans or their dependents as a result of legal settlements
regarding Agent Orange or other chemical exposure under Public Law 101-239, section
10405, paragraph (a)(2)(E);

deleted text begin (39) deleted text end new text begin (37) new text end income that is otherwise specifically excluded from MFIP consideration in
federal law, state law, or federal regulation;

deleted text begin (40) deleted text end new text begin (38) new text end security and utility deposit refunds;

deleted text begin (41) deleted text end new text begin (39) new text end American Indian tribal land settlements excluded under Public Laws
98-123, 98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth,
Leech Lake, and Mille Lacs reservations and payments to members of the White Earth
Band, under United States Code, title 25, chapter 9, section 331, and chapter 16, section
1407;

deleted text begin (42) deleted text end new text begin (40) new text end all income of the minor parent's parents and stepparents when determining
the grant for the minor parent in households that include a minor parent living with parents
or stepparents on MFIP with other children;

deleted text begin (43) deleted text end new text begin (41) new text end income of the minor parent's parents and stepparents equal to 200 percent
of the federal poverty guideline for a family size not including the minor parent and the
minor parent's child in households that include a minor parent living with parents or
stepparents not on MFIP when determining the grant for the minor parent. The remainder
of income is deemed as specified in section 256J.37, subdivision 1b;

deleted text begin (44) deleted text end new text begin (42) new text end payments made to children eligible for relative custody assistance under
section 257.85;

deleted text begin (45) deleted text end new text begin (43) new text end vendor payments for goods and services made on behalf of a client unless
the client has the option of receiving the payment in cash;

deleted text begin (46) deleted text end new text begin (44) new text end the principal portion of a contract for deed payment; and

deleted text begin (47) deleted text end new text begin (45) new text end cash payments to individuals enrolled for full-time service as a volunteer
under AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State,
AmeriCorps National, and AmeriCorps NCCC.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 15.

Minnesota Statutes 2008, section 256J.24, subdivision 3, is amended to read:

Subd. 3.

Individuals who must be excluded from an assistance unit.

(a) The
following individuals who are part of the assistance unit determined under subdivision 2
are ineligible to receive MFIP:

deleted text begin (1) individuals who are recipients of Supplemental Security Income or Minnesota
supplemental aid;
deleted text end

deleted text begin (2) deleted text end new text begin (1) new text end individuals disqualified from the food stamp or food support program or
MFIP, until the disqualification ends;

deleted text begin (3) deleted text end new text begin (2) new text end children on whose behalf federal, state or local foster care payments are made,
except as provided in sections 256J.13, subdivision 2, and 256J.74, subdivision 2; and

deleted text begin (4) deleted text end new text begin (3) new text end children receiving ongoing monthly adoption assistance payments under
section 259.67.

(b) The exclusion of a person under this subdivision does not alter the mandatory
assistance unit composition.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 16.

Minnesota Statutes 2008, section 256J.24, subdivision 4, is amended to read:

Subd. 4.

Individuals who may elect to be included in the assistance unit.

(a) The
minor child's eligible caregiver may choose to be in the assistance unit, if the caregiver
is not required to be in the assistance unit under subdivision 2. If the eligible caregiver
chooses to be in the assistance unit, that person's spouse must also be in the unit.

(b) Any minor child not related as a sibling, stepsibling, or adopted sibling to the
minor child in the unit, but for whom there is an eligible caregiver may elect to be in
the unit.

(c) A foster care provider of a minor child who is receiving federal, state, or local
foster care maintenance payments may elect to receive MFIP if the provider meets the
definition of caregiver under section 256J.08, subdivision 11. If the provider chooses to
receive MFIP, the spouse of the provider must also be included in the assistance unit with
the provider. The provider and spouse are eligible for assistance even if the only minor
child living in the provider's home is receiving foster care maintenance payments.

(d) The adult caregiver or caregivers of a minor parent are eligible to be a separate
assistance unit from the minor parent and the minor parent's child when:

(1) the adult caregiver or caregivers have no other minor children in the household;

(2) the minor parent and the minor parent's child are living together with the adult
caregiver or caregivers; and

(3) the minor parent and the minor parent's child receive MFIP deleted text begin , or would be eligible
to receive MFIP, if they were not receiving SSI benefits deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 17.

Minnesota Statutes 2008, section 256J.28, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Choice of stand-alone food support for MFIP assistance units. new text end

new text begin MFIP
assistance units that receive no MFIP cash benefits may be eligible for more food support
under the stand-alone food support program than they are receiving under the food portion
of MFIP. County financial workers shall discuss the option of receiving stand-alone food
support with participants at the time they lose their MFIP cash benefit. If requested by
the participant, financial workers shall calculate the benefit the family would receive
on stand-alone food support. Participants are not required to complete a food support
application when MFIP is canceled but they must provide the necessary verifications to
determine eligibility for the stand-alone food support program.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 18.

Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:

Subd. 3a.

Rental subsidies; unearned income.

(a) Effective July 1, 2003, the
county agency shall count $50 of the value of public and assisted rental subsidies provided
through the Department of Housing and Urban Development (HUD) as unearned income
to the cash portion of the MFIP grant. The full amount of the subsidy must be counted as
unearned income when the subsidy is less than $50. The income from this subsidy shall
be budgeted according to section 256J.34.

(b) The provisions of this subdivision shall not apply to an MFIP assistance unit
which includes a participant who is:

(1) age 60 or older;

(2) a caregiver who is suffering from an illness, injury, or incapacity that has been
certified by a qualified professional when the illness, injury, or incapacity is expected
to continue for more than 30 days and prevents the person from obtaining or retaining
employment; or

(3) a caregiver whose presence in the home is required due to the illness or
incapacity of another member in the assistance unit, a relative in the household, or a foster
child in the household when the illness or incapacity and the need for the participant's
presence in the home has been certified by a qualified professional and is expected to
continue for more than 30 days.

(c) The provisions of this subdivision shall not apply to an MFIP assistance unit
where the parental caregiver is an SSI new text begin or Retirement, Survivors, Disability Insurance
(RSDI) new text end recipient.

(d) Prior to implementing this provision, the commissioner must identify the MFIP
participants subject to this provision and provide written notice to these participants at
least 30 days before the first grant reduction. The notice must inform the participant of the
basis for the potential grant reduction, the exceptions to the provision, if any, and inform
the participant of the steps necessary to claim an exception. A person who is found not to
meet one of the exceptions to the provision must be notified and informed of the right to a
fair hearing under section 256J.40. The notice must also inform the participant that the
participant may be eligible for a rent reduction resulting from a reduction in the MFIP
grant and encourage the participant to contact the local housing authority.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 19.

Minnesota Statutes 2008, section 256J.37, subdivision 9, is amended to read:

Subd. 9.

Unearned income.

(a) The county agency must apply unearned income
to the MFIP standard of need. When determining the amount of unearned income, the
county agency must deduct the costs necessary to secure payments of unearned income.
These costs include legal fees, medical fees, and mandatory deductions such as federal
and state income taxes.

(b) The county agency must convert unearned income received on a periodic basis to
monthly amounts by prorating the income over the number of months represented by the
frequency of the payments. The county agency must begin counting the monthly amount
in the month the periodic payment is received and budget it according to the assistance
unit's budget cycle.

new text begin (c) The county agency must deduct the fees paid from SSI and Retirement,
Survivors, Disability Insurance (RSDI) benefits to organizational representative payees.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 20.

Minnesota Statutes 2009 Supplement, section 256J.575, subdivision 3,
is amended to read:

Subd. 3.

Eligibility.

(a) The following MFIP participants are eligible for the
services under this section:

(1) a participant who meets the requirements for or has been granted a hardship
extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for
the participant to have reached or be approaching 60 months of eligibility for this section
to apply;

(2) a participant who is applying for new text begin or receiving new text end Supplemental Security Income or
Social Security disability insurance;

(3) a participant who is a noncitizen who has been in the United States for 12 or
fewer months; and

(4) a participant who is age 60 or older.

deleted text begin (b) Families must meet all other eligibility requirements for MFIP established in
this chapter. Families are eligible for financial assistance to the same extent as if they
were participating in MFIP.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end A participant under paragraph (a), clause (3), must be provided with English
as a second language opportunities and skills training for up to 12 months. After 12
months, the case manager and participant must determine whether the participant should
continue with English as a second language classes or skills training, or both, and continue
to receive family stabilization services.

deleted text begin (d) deleted text end new text begin (c) new text end If a county agency or employment services provider has information that
an MFIP participant may meet the eligibility criteria set forth in this subdivision, the
county agency or employment services provider must assist the participant in obtaining
the documentation necessary to determine eligibility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2010.
new text end

Sec. 21.

Minnesota Statutes 2008, section 257.75, subdivision 7, is amended to read:

Subd. 7.

Hospital and Department of Health deleted text begin distribution of educational
materials deleted text end ; recognition form.

Hospitals that provide obstetric services and the state
registrar of vital statistics shall distribute the educational materials and recognition
of parentage forms prepared by the commissioner of human services to new parents
deleted text begin and deleted text end new text begin , new text end shall assist parents in understanding the recognition of parentage form, including
following the provisions for notice under subdivision 5 new text begin , shall aid new parents in properly
completing the recognition of parentage form, including providing notary services, and
shall timely file the completed recognition of parentage form with the office of the state
registrar of vital statistics new text end . On and after January 1, 1994, hospitals may not distribute the
declaration of parentage forms.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2010.
new text end

Sec. 22.

Minnesota Statutes 2008, section 517.08, subdivision 1c, is amended to read:

Subd. 1c.

Disposition of license fee.

(a) Of the marriage license fee collected
pursuant to subdivision 1b, paragraph (a), $25 must be retained by the county. The local
registrar must pay $85 to the commissioner of management and budget to be deposited
as follows:

(1) deleted text begin $50 deleted text end new text begin $55 new text end in the general fund;

(2) $3 in the state government special revenue fund to be appropriated to the
commissioner of public safety for parenting time centers under section 119A.37;

(3) $2 in the special revenue fund to be appropriated to the commissioner of health
for developing and implementing the MN ENABL program under section 145.9255; new text begin and
new text end

(4) $25 in the special revenue fund is appropriated to the commissioner of
employment and economic development for the displaced homemaker program under
section 116L.96 deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (5) $5 in the special revenue fund is appropriated to the commissioner of human
services for the Minnesota Healthy Marriage and Responsible Fatherhood Initiative under
section 256.742.
deleted text end

(b) Of the $40 fee under subdivision 1b, paragraph (b), $25 must be retained by the
county. The local registrar must pay $15 to the commissioner of management and budget
to be deposited as follows:

(1) $5 as provided in paragraph (a), clauses (2) and (3); and

(2) $10 in the special revenue fund is appropriated to the commissioner of
employment and economic development for the displaced homemaker program under
section 116L.96.

deleted text begin (c) The increase in the marriage license fee under paragraph (a) provided for in Laws
2004, chapter 273, and disbursement of the increase in that fee to the special fund for the
Minnesota Healthy Marriage and Responsible Fatherhood Initiative under paragraph (a),
clause (5), is contingent upon the receipt of federal funding under United States Code, title
42, section 1315, for purposes of the initiative.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2010.
new text end

Sec. 23. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes, with the assistance of the Department of Human Services,
shall prepare legislation for the 2011 legislative session that identifies additional laws or
rules that require an amendment to effectuate the repeal of the general assistance program
under Minnesota Statutes, sections 256D.01 to 256D.21 with the exception of provisions
necessary to implement the personal needs allowance under sections 256D.01, subdivision
1b, and 256D.05, subdivision 1, paragraph (a), clauses (1) and (2). The legislation
must include any cross-reference corrections, including corrections to punctuation and
grammar, that are required as a result of the repeal.
new text end

Sec. 24. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2008, sections 256.742; and 256.979, subdivision 8, new text end new text begin are
repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2008, sections 256D.06, subdivision 2; and 256D.46, new text end new text begin are
repealed effective December 1, 2010.
new text end

new text begin (c) new text end new text begin Minnesota Rules, parts 9500.1200; 9500.1202; 9500.1206, subparts 1, 1a, 2, 3,
4a, 4b, 5, 5a, 6, 6a, 6b, 7a, 7b, 8, 8a, 9, 9a, 9b, 11, 11a, 12, 12a, 12b, 12c, 12d, 12e, 12f,
12g, 12h, 12k, 13a, 14, 14a, 15, 15a, 15b, 15c, 15d, 16a, 17, 18, 18a, 18b, 18c, 18d, 19a,
19b, 21, 22a, 22b, 23, 23a, 24, 24a, 24b, 25, 25a, 25b, 25c, 25d, 25e, 25f, 26, 26b, 26c,
28a, 28b, 28c, 28d, 28e, 29, 29a, 29b, 30, 32, 32b, 32c, 32d, 32e, 32f, and 33; 9500.1211;
9500.1213; 9500.1215; 9500.1219, subparts 1, 2, 3, and 4; 9500.1221; 9500.1223,
subparts 1, 2, 3, and 5; 9500.1225; 9500.1226, subparts 1, 5, 6, 7, 8, and 9; 9500.1231;
9500.1232, subpart 4; 9500.1233, subparts 1, 2, 3, and 5; 9500.1237, subparts 1, 2, 4, and
6; 9500.1239; 9500.1243; 9500.1245, subparts 1, 2, 3, 4, 5, 6, and 7; 9500.1248, subpart
3; 9500.1250; 9500.1254, subparts 1, 2, 4, 5, 6, and 7; 9500.1259, subparts 2, 3, and 4;
9500.1261; and 9500.1272, new text end new text begin are repealed effective December 1, 2010.
new text end

ARTICLE 4

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2008, section 62J.04, subdivision 3, is amended to read:

Subd. 3.

Cost containment duties.

The commissioner shall:

(1) establish statewide and regional cost containment goals for total health care
spending under this section and collect data as described in sections 62J.38 to deleted text begin 62J.41 deleted text end new text begin
62J.40 new text end to monitor statewide achievement of the cost containment goals;

(2) divide the state into no fewer than four regions, with one of those regions being
the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
Wright, and Sherburne Counties, for purposes of fostering the development of regional
health planning and coordination of health care delivery among regional health care
systems and working to achieve the cost containment goals;

(3) monitor the quality of health care throughout the state and take action as
necessary to ensure an appropriate level of quality;

(4) issue recommendations regarding uniform billing forms, uniform electronic
billing procedures and data interchanges, patient identification cards, and other uniform
claims and administrative procedures for health care providers and private and public
sector payers. In developing the recommendations, the commissioner shall review the
work of the work group on electronic data interchange (WEDI) and the American National
Standards Institute (ANSI) at the national level, and the work being done at the state and
local level. The commissioner may adopt rules requiring the use of the Uniform Bill
82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
forms or procedures;

(5) undertake health planning responsibilities;

(6) authorize, fund, or promote research and experimentation on new technologies
and health care procedures;

(7) within the limits of appropriations for these purposes, administer or contract for
statewide consumer education and wellness programs that will improve the health of
Minnesotans and increase individual responsibility relating to personal health and the
delivery of health care services, undertake prevention programs including initiatives to
improve birth outcomes, expand childhood immunization efforts, and provide start-up
grants for worksite wellness programs;

(8) undertake other activities to monitor and oversee the delivery of health care
services in Minnesota with the goal of improving affordability, quality, and accessibility of
health care for all Minnesotans; and

(9) make the cost containment goal data available to the public in a
consumer-oriented manner.

Sec. 2.

Minnesota Statutes 2008, section 62J.17, subdivision 4a, is amended to read:

Subd. 4a.

Expenditure reporting.

Each hospital, outpatient surgical center,
new text begin and new text end diagnostic imaging center deleted text begin , and physician clinic deleted text end shall report annually to the
commissioner on all major spending commitments, in the form and manner specified by
the commissioner. The report shall include the following information:

(a) a description of major spending commitments made during the previous year,
including the total dollar amount of major spending commitments and purpose of the
expenditures;

(b) the cost of land acquisition, construction of new facilities, and renovation of
existing facilities;

(c) the cost of purchased or leased medical equipment, by type of equipment;

(d) expenditures by type for specialty care and new specialized services;

(e) information on the amount and types of added capacity for diagnostic imaging
services, outpatient surgical services, and new specialized services; and

(f) information on investments in electronic medical records systems.

For hospitals and outpatient surgical centers, this information shall be included in reports
to the commissioner that are required under section 144.698. For diagnostic imaging
centers, this information shall be included in reports to the commissioner that are required
under section 144.565. deleted text begin For physician clinics, this information shall be included in reports
to the commissioner that are required under section 62J.41. For all other health care
providers that are subject to this reporting requirement, reports must be submitted to the
commissioner by March 1 each year for the preceding calendar year.
deleted text end

Sec. 3.

Minnesota Statutes 2008, section 62J.692, subdivision 4, is amended to read:

Subd. 4.

Distribution of funds.

(a) Following the distribution described under
paragraph (b), the commissioner shall annually distribute the available medical education
funds to all qualifying applicants based on a distribution formula that reflects a summation
of two factors:

(1) a public program volume factor, which is determined by the total volume of
public program revenue received by each training site as a percentage of all public
program revenue received by all training sites in the fund pool; and

(2) a supplemental public program volume factor, which is determined by providing
a supplemental payment of 20 percent of each training site's grant to training sites whose
public program revenue accounted for at least 0.98 percent of the total public program
revenue received by all eligible training sites. Grants to training sites whose public
program revenue accounted for less than 0.98 percent of the total public program revenue
received by all eligible training sites shall be reduced by an amount equal to the total
value of the supplemental payment.

Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue
are ineligible for funds available under this subdivision. For purposes of determining
training-site level grants to be distributed under paragraph (a), total statewide average
costs per trainee for medical residents is based on audited clinical training costs per trainee
in primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs
per trainee in clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students.

(b) $5,350,000 of the available medical education funds shall be distributed as
follows:

(1) $1,475,000 to the University of Minnesota Medical Center-Fairview;

(2) $2,075,000 to the University of Minnesota School of Dentistry; and

(3) $1,800,000 to the Academic Health Center.

(c) Funds distributed shall not be used to displace current funding appropriations
from federal or state sources.

(d) Funds shall be distributed to the sponsoring institutions indicating the amount
to be distributed to each of the sponsor's clinical medical education programs based on
the criteria in this subdivision and in accordance with the commissioner's approval letter.
Each clinical medical education program must distribute funds allocated under paragraph
(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
institutions, which are accredited through an organization recognized by the Department
of Education or the Centers for Medicare and Medicaid Services, may contract directly
with training sites to provide clinical training. To ensure the quality of clinical training,
those accredited sponsoring institutions must:

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and

(2) take necessary action if the contract requirements are not met. Action may
include the withholding of payments under this section or the removal of students from
the site.

(e) Any funds not distributed in accordance with the commissioner's approval letter
must be returned to the medical education and research fund within 30 days of receiving
notice from the commissioner. The commissioner shall distribute returned funds to the
appropriate training sites in accordance with the commissioner's approval letter.

(f) A maximum of $150,000 of the funds dedicated to the commissioner under
section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
administrative expenses associated with implementing this section.

new text begin (g) Beginning in fiscal year 2011, the amounts distributed in paragraph (b) shall be
reduced proportionally to achieve a state share reduction of $1,500,000.
new text end

Sec. 4.

Minnesota Statutes 2008, section 150A.22, is amended to read:

150A.22 DONATED DENTAL SERVICES.

(a) new text begin Within available appropriations, new text end the commissioner of health deleted text begin shall deleted text end new text begin may new text end contract
with the Minnesota Dental Association, or another appropriate and qualified organization
to develop and operate a donated dental services program to provide dental care to public
program recipients and the uninsured through dentists who volunteer their services
without compensation. As part of the contract, the commissioner shall include specific
performance and outcome measures that the contracting organization must meet. The
donated dental services program shall:

(1) establish a network of volunteer dentists, including dental specialties, to donate
dental services to eligible individuals;

(2) establish a system to refer eligible individuals to the appropriate volunteer
dentists; and

(3) develop and implement a public awareness campaign to educate eligible
individuals about the availability of the program.

(b) new text begin Available new text end funding for the program may be used for administrative or technical
support. The organization contracting with the commissioner shall provide an annual
report that accounts for funding appropriated to the program by the state, documents the
number of individuals served by the program and the number of dentists participating as
program providers, and provides data on meeting the specific performance and outcome
measures identified by the commissioner.

Sec. 5.

Minnesota Statutes 2009 Supplement, section 157.16, subdivision 3, is
amended to read:

Subd. 3.

Establishment fees; definitions.

(a) The following fees are required
for food and beverage service establishments, youth camps, hotels, motels, lodging
establishments, public pools, and resorts licensed under this chapter. Food and beverage
service establishments must pay the highest applicable fee under paragraph (d), clause
(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable
fee under paragraph (d), clause (6) or (7). The license fee for new operators previously
licensed under this chapter for the same calendar year is one-half of the appropriate annual
license fee, plus any penalty that may be required. The license fee for operators opening
on or after October 1 is one-half of the appropriate annual license fee, plus any penalty
that may be required.

(b) All food and beverage service establishments, except special event food stands,
and all hotels, motels, lodging establishments, public pools, and resorts shall pay an
annual base fee of $150.

(c) A special event food stand shall pay a flat fee of $50 annually. "Special event
food stand" means a fee category where food is prepared or served in conjunction with
celebrations, county fairs, or special events from a special event food stand as defined
in section 157.15.

(d) In addition to the base fee in paragraph (b), each food and beverage service
establishment, other than a special event food stand, and each hotel, motel, lodging
establishment, public pool, and resort shall pay an additional annual fee for each fee
category, additional food service, or required additional inspection specified in this
paragraph:

(1) Limited food menu selection, $60. "Limited food menu selection" means a fee
category that provides one or more of the following:

(i) prepackaged food that receives heat treatment and is served in the package;

(ii) frozen pizza that is heated and served;

(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;

(iv) soft drinks, coffee, or nonalcoholic beverages; or

(v) cleaning for eating, drinking, or cooking utensils, when the only food served
is prepared off site.

(2) Small establishment, including boarding establishments, $120. "Small
establishment" means a fee category that has no salad bar and meets one or more of
the following:

(i) possesses food service equipment that consists of no more than a deep fat fryer, a
grill, two hot holding containers, and one or more microwave ovens;

(ii) serves dipped ice cream or soft serve frozen desserts;

(iii) serves breakfast in an owner-occupied bed and breakfast establishment;

(iv) is a boarding establishment; or

(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum
patron seating capacity of not more than 50.

(3) Medium establishment, $310. "Medium establishment" means a fee category
that meets one or more of the following:

(i) possesses food service equipment that includes a range, oven, steam table, salad
bar, or salad preparation area;

(ii) possesses food service equipment that includes more than one deep fat fryer,
one grill, or two hot holding containers; or

(iii) is an establishment where food is prepared at one location and served at one or
more separate locations.

Establishments meeting criteria in clause (2), item (v), are not included in this fee
category.

(4) Large establishment, $540. "Large establishment" means either:

(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a
medium establishment, (B) seats more than 175 people, and (C) offers the full menu
selection an average of five or more days a week during the weeks of operation; or

(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium
establishment, and (B) prepares and serves 500 or more meals per day.

(5) Other food and beverage service, including food carts, mobile food units,
seasonal temporary food stands, and seasonal permanent food stands, $60.

(6) Beer or wine table service, $60. "Beer or wine table service" means a fee
category where the only alcoholic beverage service is beer or wine, served to customers
seated at tables.

(7) Alcoholic beverage service, other than beer or wine table service, $165.

"Alcohol beverage service, other than beer or wine table service" means a fee
category where alcoholic mixed drinks are served or where beer or wine are served from
a bar.

(8) Lodging per sleeping accommodation unit, $10, including hotels, motels,
lodging establishments, and resorts, up to a maximum of $1,000. "Lodging per sleeping
accommodation unit" means a fee category including the number of guest rooms, cottages,
or other rental units of a hotel, motel, lodging establishment, or resort; or the number of
beds in a dormitory.

(9) First public pool, $325; each additional public pool, $175. "Public pool" means a
fee category that has the meaning given in section 144.1222, subdivision 4.

(10) First spa, $175; each additional spa, $100. "Spa pool" means a fee category that
has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.

(11) Private sewer or water, $60. "Individual private water" means a fee category
with a water supply other than a community public water supply as defined in Minnesota
Rules, chapter 4720. "Individual private sewer" means a fee category with an individual
sewage treatment system which uses subsurface treatment and disposal.

(12) Additional food service, $150. "Additional food service" means a location at
a food service establishment, other than the primary food preparation and service area,
used to prepare or serve food to the public.

(13) Additional inspection fee, $360. "Additional inspection fee" means a fee to
conduct the second inspection each year for elementary and secondary education facility
school lunch programs when required by the Richard B. Russell National School Lunch
Act.

(e) A fee for review of construction plans must accompany the initial license
application for restaurants, hotels, motels, lodging establishments, resorts, seasonal food
stands, and mobile food units. The fee for this construction plan review is as follows:

Service Area	Type	Fee
Food	limited food menu	$275
	small establishment	$400
	medium establishment	$450
	large food establishment	$500
	additional food service	$150
Transient food service	food cart	$250
	seasonal permanent food stand	$250
	seasonal temporary food stand	$250
	mobile food unit	$350
Alcohol	beer or wine table service	$150
	alcohol service from bar	$250
Lodging	less than 25 rooms	$375
	25 to less than 100 rooms	$400
	100 rooms or more	$500
	less than five cabins	$350
	five to less than ten cabins	$400
	ten cabins or more	$450

(f) When existing food and beverage service establishments, hotels, motels, lodging
establishments, resorts, seasonal food stands, and mobile food units are extensively
remodeled, a fee must be submitted with the remodeling plans. The fee for this
construction plan review is as follows:

Service Area	Type	Fee
Food	limited food menu	$250
	small establishment	$300
	medium establishment	$350
	large food establishment	$400
	additional food service	$150
Transient food service	food cart	$250
	seasonal permanent food stand	$250
	seasonal temporary food stand	$250
	mobile food unit	$250
Alcohol	beer or wine table service	$150
	alcohol service from bar	$250
Lodging	less than 25 rooms	$250
	25 to less than 100 rooms	$300
	100 rooms or more	$450
	less than five cabins	$250
	five to less than ten cabins	$350
	ten cabins or more	$400

(g) Special event food stands are not required to submit construction or remodeling
plans for review.

(h) Youth camps shall pay an annual single fee for food and lodging as follows:

(1) camps with up to 99 campers, $325;

(2) camps with 100 to 199 campers, $550; and

(3) camps with 200 or more campers, $750.

new text begin (i) A youth camp which pays fees under paragraph (d) of this subdivision is not
required to pay fees under paragraph (h) of this subdivision.
new text end

Sec. 6.

Minnesota Statutes 2008, section 297F.10, subdivision 1, is amended to read:

Subdivision 1.

Tax and use tax on cigarettes.

Revenue received from cigarette
taxes, as well as related penalties, interest, license fees, and miscellaneous sources of
revenue shall be deposited by the commissioner in the state treasury and credited as
follows:

(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each
year thereafter must be credited to the Academic Health Center special revenue fund
hereby created and is annually appropriated to the Board of Regents at the University of
Minnesota for Academic Health Center funding at the University of Minnesota; and

(2) deleted text begin $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal year 2007 and each year
thereafter deleted text end new text begin The following amounts new text end must be credited to the medical education and research
costs account hereby created in the special revenue fund and is annually appropriated to
the commissioner of health for distribution under section 62J.692, subdivision 4 deleted text begin ; and deleted text end new text begin :
new text end

new text begin (i) $8,553,000 in fiscal year 2006;
new text end

new text begin (ii) $8,550,000 in fiscal year 2007 through fiscal year 2009;
new text end

new text begin (iii) $7,550,000 in fiscal year 2010; and
new text end

new text begin (iv) $7,050,000 in fiscal year 2011 and each year thereafter; and
new text end

(3) the balance of the revenues derived from taxes, penalties, and interest (under
this chapter) and from license fees and miscellaneous sources of revenue shall be credited
to the general fund.

Sec. 7.

Minnesota Statutes 2009 Supplement, section 327.15, subdivision 3, is
amended to read:

Subd. 3.

Fees, manufactured home parks and recreational camping areas.

(a)
The following fees are required for manufactured home parks and recreational camping
areas licensed under this chapter. Recreational camping areas and manufactured home
parks shall pay the highest applicable new text begin base new text end fee under paragraph deleted text begin (c) deleted text end new text begin (b) new text end . The license fee
for new operators of a manufactured home park or recreational camping area previously
licensed under this chapter for the same calendar year is one-half of the appropriate annual
license fee, plus any penalty that may be required. The license fee for operators opening
on or after October 1 is one-half of the appropriate annual license fee, plus any penalty
that may be required.

(b) All manufactured home parks and recreational camping areas shall pay the
following annual base fee:

(1) a manufactured home park, $150; and

(2) a recreational camping area with:

(i) 24 or less sites, $50;

(ii) 25 to 99 sites, $212; and

(iii) 100 or more sites, $300.

In addition to the base fee, manufactured home parks and recreational camping areas shall
pay $4 for each licensed site. This paragraph does not apply to special event recreational
camping areas deleted text begin or to deleted text end new text begin . new text end Operators of a manufactured home park or a recreational camping
area new text begin also new text end licensed under section 157.16 for the same location new text begin shall pay only one base fee,
whichever is the highest of the base fees found in this section or section 157.16 new text end .

(c) In addition to the fee in paragraph (b), each manufactured home park or
recreational camping area shall pay an additional annual fee for each fee category
specified in this paragraph:

(1) Manufactured home parks and recreational camping areas with public swimming
pools and spas shall pay the appropriate fees specified in section 157.16.

(2) Individual private sewer or water, $60. "Individual private water" means a fee
category with a water supply other than a community public water supply as defined in
Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a
subsurface sewage treatment system which uses subsurface treatment and disposal.

(d) The following fees must accompany a plan review application for initial
construction of a manufactured home park or recreational camping area:

(1) for initial construction of less than 25 sites, $375;

(2) for initial construction of 25 to 99 sites, $400; and

(3) for initial construction of 100 or more sites, $500.

(e) The following fees must accompany a plan review application when an existing
manufactured home park or recreational camping area is expanded:

(1) for expansion of less than 25 sites, $250;

(2) for expansion of 25 to 99 sites, $300; and

(3) for expansion of 100 or more sites, $450.

Sec. 8. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8; 62J.321,
subdivision 5a; 62J.381; and 62J.41, subdivisions 1 and 2, new text end new text begin are repealed.
new text end

ARTICLE 5

E-HEALTH TECHNOLOGY

Section 1.

Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 1a,
is amended to read:

Subd. 1a.

Definitions.

(a) "Certified electronic health record technology" means an
electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH
Act to meet the standards and implementation specifications adopted under section 3004
as applicable.

(b) "Commissioner" means the commissioner of health.

(c) "Pharmaceutical electronic data intermediary" means any entity that provides
the infrastructure to connect computer systems or other electronic devices utilized
by prescribing practitioners with those used by pharmacies, health plans, third-party
administrators, and pharmacy benefit managers in order to facilitate the secure
transmission of electronic prescriptions, refill authorization requests, communications,
and other prescription-related information between such entities.

(d) "HITECH Act" means the Health Information Technology for Economic and
Clinical Health Act in division A, title XIII and division B, title IV of the American
Recovery and Reinvestment Act of 2009, including federal regulations adopted under
that act.

(e) "Interoperable electronic health record" means an electronic health record that
securely exchanges health information with another electronic health record system that
meets new text begin requirements specified in subdivision 3, and new text end national requirements for certification
under the HITECH Act.

(f) "Qualified electronic health record" means an electronic record of health-related
information on an individual that includes patient demographic and clinical health
information and has the capacity to:

(1) provide clinical decision support;

(2) support physician order entry;

(3) capture and query information relevant to health care quality; and

(4) exchange electronic health information with, and integrate such information
from, other sources.

Sec. 2.

Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 3, is
amended to read:

Subd. 3.

Interoperable electronic health record requirements.

To meet the
requirements of subdivision 1, hospitals and health care providers must meet the following
criteria when implementing an interoperable electronic health records system within their
hospital system or clinical practice setting.

(a) The electronic health record must be a qualified electronic health record.

(b) The electronic health record must be certified by the Office of the National
Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and
health care providers deleted text begin only deleted text end if a certified electronic health record product for the provider's
particular practice setting is available. This criterion shall be considered met if a hospital
or health care provider is using an electronic health records system that has been certified
within the last three years, even if a more current version of the system has been certified
within the three-year period.

(c) The electronic health record must meet the standards established according to
section 3004 of the HITECH Act as applicable.

(d) The electronic health record must have the ability to generate information on
clinical quality measures and other measures reported under sections 4101, 4102, and
4201 of the HITECH Act.

new text begin (e) The electronic health record system must be connected to a state-certified
health information organization either directly or through a connection facilitated by a
state-certified health data intermediary as defined in section 62J.498.
new text end

deleted text begin (e) deleted text end new text begin (f) new text end A health care provider who is a prescriber or dispenser of legend drugs must
have an electronic health record system that meets the requirements of section 62J.497.

Sec. 3.

new text begin [62J.498] HEALTH INFORMATION EXCHANGE.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin The following definitions apply to sections 62J.498 to
62J.4982:
new text end

new text begin (a) "Clinical transaction" means any meaningful use transaction that is not covered
by section 62J.536.
new text end

new text begin (b) "Commissioner" means the commissioner of health.
new text end

new text begin (c) "Direct health information exchange" means the electronic transmission of
health-related information through a direct connection between the electronic health
record systems of health care providers without the use of a health data intermediary.
new text end

new text begin (d) "Health care provider" or "provider" means a health care provider or provider as
defined in section 62J.03, subdivision 8.
new text end

new text begin (e) "Health data intermediary" means an entity that provides the infrastructure to
connect computer systems or other electronic devices used by health care providers,
laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit
managers to facilitate the secure transmission of health information, including
pharmaceutical electronic data intermediaries as defined in section 62J.495. This does not
include health care providers engaged in direct health information exchange.
new text end

new text begin (f) "Health information exchange" means the electronic transmission of
health-related information between organizations according to nationally recognized
standards.
new text end

new text begin (g) "Health information exchange service provider" means a health data intermediary
or health information organization that has been issued a certificate of authority by the
commissioner under section 62J.4981.
new text end

new text begin (h) "Health information organization" means an organization that oversees, governs,
and facilitates the exchange of health-related information among organizations according
to nationally recognized standards.
new text end

new text begin (i) "HITECH Act" means the Health Information Technology for Economic and
Clinical Health Act as defined in section 62J.495.
new text end

new text begin (j) "Major participating entity" means:
new text end

new text begin (1) a participating entity that receives compensation for services that is greater
than 30 percent of the health information organization's gross annual revenues from the
health information exchange service provider;
new text end

new text begin (2) a participating entity providing administrative, financial, or management services
to the health information organization, if the total payment for all services provided by the
participating entity exceeds three percent of the gross revenue of the health information
organization; and
new text end

new text begin (3) a participating entity that nominates or appoints 30 percent or more of the board
of directors of the health information organization.
new text end

new text begin (k) "Meaningful use" means use of certified electronic health record technology that
includes e-prescribing, and is connected in a manner that provides for the electronic
exchange of health information and used for the submission of clinical quality measures
as established by the Center for Medicare and Medicaid Services and the Minnesota
Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH
Act.
new text end

new text begin (l) "Meaningful use transaction" means an electronic transaction that a health care
provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare
penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
new text end

new text begin (m) "Participating entity" means any of the following persons, health care providers,
companies, or other organizations with which a health information organization or health
data intermediary has contracts or other agreements for the provision of health information
exchange service providers:
new text end

new text begin (1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
licensed under the laws of this state or registered with the commissioner;
new text end

new text begin (2) a health care provider, and any other health care professional otherwise licensed
under the laws of this state or registered with the commissioner;
new text end

new text begin (3) a group, professional corporation, or other organization that provides the
services of individuals or entities identified in clause (2), including but not limited to a
medical clinic, a medical group, a home health care agency, an urgent care center, and
an emergent care center;
new text end

new text begin (4) a health plan as defined in section 62A.011, subdivision 3; and
new text end

new text begin (5) a state agency as defined in section 13.02, subdivision 17.
new text end

new text begin (n) "Reciprocal agreement" means an arrangement in which two or more health
information exchange service providers agree to share in-kind services and resources to
allow for the pass-through of meaningful use transactions.
new text end

new text begin (o) "State-certified health data intermediary" means a health data intermediary that:
new text end

new text begin (1) provides a subset of the meaningful use transaction capabilities necessary for
hospitals and providers to achieve meaningful use of electronic health records;
new text end

new text begin (2) is not exclusively engaged in the exchange of meaningful use transactions
covered by section 62J.536; and
new text end

new text begin (3) has been issued a certificate of authority to operate in Minnesota.
new text end

new text begin (p) "State-certified health information organization" means a nonprofit health
information organization that provides transaction capabilities necessary to fully support
clinical transactions required for meaningful use of electronic health records that has been
issued a certificate of authority to operate in Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Health information exchange oversight. new text end

new text begin (a) The commissioner shall
establish a Health Information Exchange Oversight Board. The board shall be charged
with advising the commissioner on regulatory action necessary to protect the public
interest on matters pertaining to health information exchange. The board shall:
new text end

new text begin (1) review and recommend applications from health data intermediaries and health
information organizations for certificates of authority to operate in Minnesota;
new text end

new text begin (2) work in consultation with the commissioner to provide ongoing monitoring to
ensure compliance with criteria established under sections 62J.498 to 62J.4982;
new text end

new text begin (3) assist the commissioner's response to public complaints related to health
information exchange services;
new text end

new text begin (4) make recommendations to the commissioner on enforcement actions including
the imposition of fines, suspension, or revocation of certificates of authority as outlined
in section 62J.4982;
new text end

new text begin (5) provide a biannual report to the commissioner on the status of health information
exchange services that includes but is not limited to:
new text end

new text begin (i) recommendations on actions necessary to ensure that health information exchange
services are adequate to meet the needs of Minnesota citizens and providers statewide;
new text end

new text begin (ii) recommendations on enforcement actions to ensure that health information
exchange service providers act in the public interest without causing disruption in health
information exchange services;
new text end

new text begin (iii) recommendations on updates to criteria for obtaining certificates of authority
under this section; and
new text end

new text begin (iv) recommendations on standard operating procedures for health information
exchange, including but not limited to the management of consumer preferences;
new text end

new text begin (6) other duties as assigned by the commissioner.
new text end

new text begin (b) The Health Information Exchange Oversight Board shall consist of seven
members, including:
new text end

new text begin (1) two public members who do not have a material financial interest in health
information exchange services; and
new text end

new text begin (2) five health care stakeholders who:
new text end

new text begin (i) are broadly representative of the Minnesota health care community;
new text end

new text begin (ii) reflect the geography of the state; and
new text end

new text begin (iii) have at least three years of practical experience in the use of electronic health
records or health information exchange services immediately preceding appointment.
new text end

new text begin (c) Members of the Health Information Exchange Oversight Board shall not be
employed by the Department of Health, but the board shall be staffed by an employee
of the department who shall serve as an ex officio, nonvoting member of the board.
The board shall meet at least quarterly. The commissioner may require more frequent
board meetings as needed. The compensation, terms, removal of members, and filling of
vacancies on the board are governed by section 15.0575.
new text end

new text begin (d) The Health Information Exchange Oversight Board shall not be subject to
chapter 13D when the board is considering contracts as described in section 62J.4981,
subdivision 4, paragraph (a), clause (5).
new text end

new text begin (e) When the Health Information Exchange Oversight Board is actively considering
a suspension or revocation of a certificate of authority as described in section 62J.4982,
subdivision 3, all investigatory data that are collected, created, or maintained related to the
suspension or revocation are classified as confidential data on individuals and as protected
nonpublic data in the case of data not on individuals.
new text end

new text begin (f) After the commissioner makes a final determination regarding a suspension or
revocation of a certificate of authority, all Health Information Exchange Oversight Board
minutes, orders for hearing, findings of fact, conclusions of law, and the specification of
the final disciplinary action, are classified as public data.
new text end

new text begin (g) The Health Information Exchange Oversight Board may make any data classified
as protected nonpublic or confidential under this section accessible to an appropriate
person or agency if the commissioner determines that failure to make the data accessible is
likely to create a clear and present danger to public health or safety.
new text end

Sec. 4.

new text begin [62J.4981] CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
INFORMATION EXCHANGE SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Authority to require organizations to apply. new text end

new text begin The commissioner
shall require an entity providing health information exchange services to apply for a
certificate of authority under this section. An applicant may continue to operate until
the commissioner acts on the application. If the application is denied, the applicant is
considered a health information organization whose certificate of authority has been
revoked under section 62J.4982, subdivision 2, paragraph (d).
new text end

new text begin Subd. 2. new text end

new text begin Certificate of authority for health data intermediaries. new text end

new text begin (a) A health
data intermediary that provides health information exchange services for the transmission
of one or more clinical transactions necessary for hospitals, providers, or eligible
professionals to achieve meaningful use must be registered with the state and comply with
requirements established in this section.
new text end

new text begin (b) Notwithstanding any law to the contrary, any corporation organized to do so
may apply to the commissioner for a certificate of authority to establish and operate as
a health data intermediary in compliance with this section. No person shall establish or
operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers
to purchase or receive advance or periodic consideration in conjunction with a health
data intermediary contract unless the organization has a certificate of authority or has an
application under active consideration under this section.
new text end

new text begin (c) In issuing the certificate of authority, the commissioner shall determine whether
the applicant for the certificate of authority has demonstrated that the applicant meets
the following minimum criteria:
new text end

new text begin (1) interoperate with at least one state-certified health information organization;
new text end

new text begin (2) provide an option for Minnesota entities to connect to their services through at
least one state-certified health information organization;
new text end

new text begin (3) have a record locator service as defined in section 144.291, subdivision 2,
paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8,
when conducting meaningful use transactions; and
new text end

new text begin (4) hold reciprocal agreements with at least one state-certified health information
organization to enable access to record locator services to find patient data, and for the
transmission and receipt of meaningful use transactions consistent with the format and
content required by national standards established by Centers for Medicare and Medicaid
Services. Reciprocal agreements must meet the requirements established in subdivision 5.
new text end

new text begin Subd. 3. new text end

new text begin Certificate of authority for health information organizations. new text end

new text begin (a)
A health information organization that provides all electronic transaction capabilities
necessary to support clinical transactions necessary for meaningful use of electronic health
records must obtain a certificate of authority from the commissioner and demonstrate
compliance with the criteria in paragraph (c).
new text end

new text begin (b) Notwithstanding any law to the contrary, a nonprofit corporation organized to do
so may apply for a certificate of authority to establish and operate a health information
organization under this section. No person shall establish or operate a health information
organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive
advance or periodic consideration in conjunction with a health information organization
or health information contract unless the organization has a certificate of authority under
this section.
new text end

new text begin (c) In issuing the certificate of authority, the commissioner shall determine whether
the applicant for the certificate of authority has demonstrated that the applicant meets
the following minimum criteria:
new text end

new text begin (1) the entity is a legally established, nonprofit organization;
new text end

new text begin (2) appropriate insurance, including liability insurance, for the operation of the
health information organization is in place and sufficient to protect the interest of the
public and participating entities;
new text end

new text begin (3) strategic and operational plans clearly address how the organization will expand
technical capacity of the health information organization to support providers in achieving
meaningful use of electronic health records over time;
new text end

new text begin (4) the entity addresses the parameters to be used with participating entities and
other health information organizations for meaningful use transactions, compliance with
Minnesota law, and interstate health information exchange in trust agreements;
new text end

new text begin (5) the entity's board of directors is comprised of members that broadly represent the
health information organization's participating entities and consumers;
new text end

new text begin (6) the entity maintains a professional staff responsible to the board of directors with
the capacity to ensure accountability to the organization's mission;
new text end

new text begin (7) the organization is compliant with criteria established under the Health
Information Exchange Accreditation Program of the Electronic Healthcare Network
Accreditation Commission (EHNAC) or equivalent criteria established by the
commissioner;
new text end

new text begin (8) the entity maintains a record locator service as defined in section 144.291,
subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293,
subdivision 8, when conducting meaningful use transactions;
new text end

new text begin (9) the organization demonstrates interoperability with all other state-certified health
information organizations using nationally recognized standards;
new text end

new text begin (10) the organization demonstrates compliance with all privacy and security
requirements required by state and federal law; and
new text end

new text begin (11) the organization uses financial policies and procedures consistent with generally
accepted accounting principles and has an independent audit of the organization's
financials on an annual basis.
new text end

new text begin (d) Health information organizations that have obtained a certificate of authority
must:
new text end

new text begin (1) meet the requirements established for connecting to the Nationwide Health
Information Network (NHIN) within the federally mandated timeline or within a time
frame established by the commissioner and published in the State Register. If the state
timeline for implementation varies from the federal timeline, the State Register notice
shall include an explanation for the variation;
new text end

new text begin (2) annually submit strategic and operational plans for review by the Health
Information Exchange Oversight Board that address:
new text end

new text begin (i) increasing adoption rates to include a sufficient number of participating entities to
achieve financial sustainability; and
new text end

new text begin (ii) progress in achieving objectives included in previously submitted strategic
and operational plans across the following domains: business and technical operations,
technical infrastructure, legal and policy issues, finance, and organizational governance;
new text end

new text begin (3) develop and maintain a business plan that addresses:
new text end

new text begin (i) plans for ensuring the necessary capacity to support meaningful use transactions;
new text end

new text begin (ii) approach for attaining financial sustainability, including public and private
financing strategies, and rate structures;
new text end

new text begin (iii) rates of adoption, utilization, and transaction volume, and mechanisms to
support health information exchange; and
new text end

new text begin (iv) an explanation of methods employed to address the needs of community clinics,
critical access hospitals, and free clinics in accessing health information exchange services;
new text end

new text begin (4) annually submit a rate plan outlining fee structures for health information
exchange services for approval by the commissioner. The commissioner shall approve the
rate plan if it:
new text end

new text begin (i) distributes costs equitably among users of health information services;
new text end

new text begin (ii) provides predictable costs for participating entities;
new text end

new text begin (iii) covers all costs associated with conducting the full range of meaningful use
clinical transactions, including access to health information retrieved through other
state-certified health information exchange service providers; and
new text end

new text begin (iv) provides for a predictable revenue stream for the health information organization
and generates sufficient resources to maintain operating costs and develop technical
infrastructure necessary to serve the public interest;
new text end

new text begin (5) enter into reciprocal agreements with all other state-certified health information
organizations to enable access to record locator services to find patient data, and
transmission and receipt of meaningful use transactions consistent with the format and
content required by national standards established by Centers for Medicare and Medicaid
Services. Reciprocal agreements must meet the requirements in subdivision 5; and
new text end

new text begin (6) comply with additional requirements for the certification or recertification
of health information organizations that may be established by the commissioner, in
consultation with the Health Information Exchange Oversight Board.
new text end

new text begin Subd. 4. new text end

new text begin Application for certificate of authority for health information exchange
service providers. new text end

new text begin (a) Each application for a certificate of authority shall be in a form
prescribed by the commissioner and verified by an officer or authorized representative of
the applicant. Each application shall include the following:
new text end

new text begin (1) a copy of the basic organizational document, if any, of the applicant and of
each major participating entity, such as the articles of incorporation, or other applicable
documents, and all amendments to it;
new text end

new text begin (2) a list of the names, addresses, and official positions of the following:
new text end

new text begin (i) all members of the board of directors, and the principal officers and, if applicable,
shareholders of the applicant organization; and
new text end

new text begin (ii) all members of the board of directors, and the principal officers of each major
participating entity and, if applicable, each shareholder beneficially owning more than ten
percent of any voting stock of the major participating entity;
new text end

new text begin (3) the name and address of each participating entity and the agreed-upon duration
of each contract or agreement if applicable;
new text end

new text begin (4) a copy of each standard agreement or contract intended to bind the participating
entities and the health information organization. Contractual provisions shall be consistent
with the purposes of this section, in regard to the services to be performed under the
standard agreement or contract, the manner in which payment for services is determined,
the nature and extent of responsibilities to be retained by the health information
organization, and contractual termination provisions;
new text end

new text begin (5) a copy of each contract intended to bind major participating entities and the
health information organization. The Health Information Exchange Oversight Board
shall consider contract information provided under this section in a closed session as
provided for in section 62J.498, subdivision 2, paragraph (c). Contract information filed
with the commissioner under this section shall be nonpublic as defined in section 13.02,
subdivision 9;
new text end

new text begin (6) a statement generally describing the health information organization, its health
information exchange contracts, facilities, and personnel, including a statement describing
the manner in which the applicant proposes to provide participants with comprehensive
health information exchange services;
new text end

new text begin (7) financial statements showing the applicant's assets, liabilities, and sources
of financial support, including a copy of the applicant's most recent certified financial
statement;
new text end

new text begin (8) strategic and operational plans that specifically address how the organization
will expand technical capacity of the health information organization to support providers
in achieving meaningful use of electronic health records over time, a description of
the proposed method of marketing the services, a schedule of proposed charges, and a
financial plan that includes a three-year projection of the expenses and income and other
sources of future capital;
new text end

new text begin (9) a statement reasonably describing the geographic area or areas to be served and
the type or types of participants to be served;
new text end

new text begin (10) a description of the complaint procedures to be used as required under this
section;
new text end

new text begin (11) a description of the mechanism by which participating entities will have an
opportunity to participate in matters of policy and operation;
new text end

new text begin (12) a copy of any pertinent agreements between the health information organization
and insurers, including liability insurers, demonstrating coverage is in place;
new text end

new text begin (13) a copy of the conflict of interest policy that applies to all members of the board
of directors and the principal officers of the health information organization; and
new text end

new text begin (14) other information as the commissioner may reasonably require to be provided.
new text end

new text begin (b) Thirty days after the receipt of the application for a certificate of authority,
the commissioner shall determine whether or not the application submitted meets the
requirements for completion in paragraph (a), and notify the applicant of any further
information required for the application to be processed.
new text end

new text begin (c) Ninety days after the receipt of a complete application for a certificate of
authority, the commissioner shall issue a certificate of authority to the applicant if the
commissioner determines that the applicant meets the minimum criteria requirements
of subdivision 2 for health data intermediaries or subdivision 3 for health information
organizations. If the commissioner determines that the applicant is not qualified, the
commissioner shall notify the applicant and specify the reasons for disqualification.
new text end

new text begin (d) Upon being granted a certificate of authority to operate as a health information
organization, the organization must operate in compliance with the provisions of this
section. Noncompliance may result in the imposition of a fine or the suspension or
revocation of the certificate of authority according to section 62J.4982.
new text end

new text begin Subd. 5. new text end

new text begin Reciprocal agreements between health information exchange entities.
new text end

new text begin (a) Reciprocal agreements between two health information organizations or between a
health information organization and a health data intermediary must include a fair and
equitable model for charges between the entities that:
new text end

new text begin (1) does not impede the secure transmission of transactions necessary to achieve
meaningful use;
new text end

new text begin (2) does not charge a fee for the exchange of meaningful use transactions transmitted
according to nationally recognized standards where no additional value-added service
is rendered to the sending or receiving health information organization or health data
intermediary either directly or on behalf of the client;
new text end

new text begin (3) is consistent with fair market value and proportionately reflects the value-added
services accessed as a result of the agreement; and
new text end

new text begin (4) prevents health care stakeholders from being charged multiple times for the
same service.
new text end

new text begin (b) Reciprocal agreements are subject to review and approval by the Health
Information Exchange Oversight Board.
new text end

new text begin (c) Nothing in this section precludes a state-certified health information organization
or state-certified health data intermediary from entering into contractual agreements for
the provision of value-added services beyond meaningful use.
new text end

Sec. 5.

new text begin [62J.4982] ENFORCEMENT AUTHORITY; COMPLIANCE.
new text end

new text begin Subdivision 1. new text end

new text begin Penalties and enforcement. new text end

new text begin (a) The commissioner may, for any
violation of statute or rule applicable to a health information exchange service provider,
levy an administrative penalty in an amount up to $25,000 for each violation. In
determining the level of an administrative penalty, the commissioner shall consider the
following factors:
new text end

new text begin (1) the number of participating entities affected by the violation;
new text end

new text begin (2) the effect of the violation on participating entities' access to health information
exchange services;
new text end

new text begin (3) if only one participating entity is affected, the effect of the violation on the
patients of that entity;
new text end

new text begin (4) whether the violation is an isolated incident or part of a pattern of violations;
new text end

new text begin (5) the economic benefits derived by the health information organization or a health
data intermediary by virtue of the violation;
new text end

new text begin (6) whether the violation hindered or facilitated an individual's ability to obtain
health care;
new text end

new text begin (7) whether the violation was intentional;
new text end

new text begin (8) whether the violation was beyond the direct control of the health information
exchange service provider;
new text end

new text begin (9) any history of prior compliance with the provisions of this section, including
violations;
new text end

new text begin (10) whether and to what extent the health information exchange service provider
attempted to correct previous violations;
new text end

new text begin (11) how the health information exchange service provider responded to technical
assistance from the commissioner provided in the context of a compliance effort; and
new text end

new text begin (12) the financial condition of the health information exchange service provider
including, but not limited to, whether the health information exchange service provider
had financial difficulties that affected its ability to comply or whether the imposition of an
administrative monetary penalty would jeopardize the ability of the health information
exchange service provider to continue to deliver health information exchange services.
new text end

new text begin Reasonable notice in writing to the health information exchange service provider
shall be given of the intent to levy the penalty and the reasons for them. A health
information exchange service provider may have 15 days within which to contest whether
the finding of facts constitute a violation of sections 62J.4981 and 62J.4982, according to
the contested case and judicial review provisions of sections 14.57 to 14.69.
new text end

new text begin (b) If the commissioner has reason to believe that a violation of section 62J.4981 or
62J.4982 has occurred or is likely, the commissioner may confer with the persons involved
before commencing action under subdivision 2. The commissioner may notify the health
information exchange service provider and the representatives, or other persons who
appear to be involved in the suspected violation, to arrange a voluntary conference with
the alleged violators or their authorized representatives. The purpose of the conference is
to attempt to learn the facts about the suspected violation and, if it appears that a violation
has occurred or is threatened, to find a way to correct or prevent it. The conference is
not governed by any formal procedural requirements, and may be conducted as the
commissioner considers appropriate.
new text end

new text begin (c) The commissioner may issue an order directing a health information exchange
service provider or a representative of a health information exchange service provider to
cease and desist from engaging in any act or practice in violation of sections 62J.4981
and 62J.4982.
new text end

new text begin (d) Within 20 days after service of the order to cease and desist, a health information
exchange service provider may contest whether the finding of facts constitutes a violation
of sections 62J.4981 and 62J.4982 according to the contested case and judicial review
provisions of sections 14.57 to 14.69.
new text end

new text begin (e) In the event of noncompliance with a cease and desist order issued under this
subdivision, the commissioner may institute a proceeding to obtain injunctive relief or
other appropriate relief in Ramsey County District Court.
new text end

new text begin Subd. 2. new text end

new text begin Suspension or revocation of certificates of authority. new text end

new text begin (a) The
commissioner may suspend or revoke a certificate of authority issued to a health
data intermediary or health information organization under section 62J.4981 if the
commissioner finds that:
new text end

new text begin (1) the health information exchange service provider is operating significantly
in contravention of its basic organizational document, or in a manner contrary to that
described in and reasonably inferred from any other information submitted under section
62J.4981, unless amendments to the submissions have been filed with and approved by
the commissioner;
new text end

new text begin (2) the health information exchange service provider is unable to fulfill its
obligations to furnish comprehensive health information exchange services as required
under its health information exchange contract;
new text end

new text begin (3) the health information exchange service provider is no longer financially solvent
or may not reasonably be expected to meet its obligations to participating entities;
new text end

new text begin (4) the health information exchange service provider has failed to implement a
mechanism affording the participating entities an opportunity to participate in matters
of policy and operation;
new text end

new text begin (5) the health information exchange service provider has failed to implement the
complaint system in a manner designed to reasonably resolve valid complaints;
new text end

new text begin (6) the health information exchange service provider, or any person acting with its
sanction, has advertised or merchandised its services in an untrue, misleading, deceptive,
or unfair manner;
new text end

new text begin (7) the continued operation of the health information exchange service provider
would be hazardous to its participating entities or the patients served by the participating
entities; or
new text end

new text begin (8) the health information exchange service provider has otherwise failed to
substantially comply with section 62J.4981 or with any other statute or administrative rule
applicable to health information organizations, or has submitted false information in any
report required under sections 62J.498 to 62J.4982.
new text end

new text begin (b) A certificate of authority shall be suspended or revoked only after meeting the
requirements of subdivision 3.
new text end

new text begin (c) If the certificate of authority of a health information exchange service provider is
suspended, the health information exchange service provider shall not, during the period
of suspension, enroll any additional participating entities, and shall not engage in any
advertising or solicitation.
new text end

new text begin (d) If the certificate of authority of a health information exchange service provider is
revoked, the organization shall proceed, immediately following the effective date of the
order of revocation, to wind up its affairs, and shall conduct no further business except as
necessary to the orderly conclusion of the affairs of the organization. The organization
shall engage in no further advertising or solicitation. The commissioner may, by written
order, permit further operation of the organization as the commissioner finds to be in the
best interest of participating entities, to the end that participating entities will be given the
greatest practical opportunity to access continuing health information exchange services.
new text end

new text begin Subd. 3. new text end

new text begin Denial, suspension, and revocation; administrative procedures. new text end

new text begin (a)
When the commissioner has cause to believe that grounds for the denial, suspension,
or revocation of a certificate of authority exists, the commissioner shall notify the
health information exchange service provider in writing stating the grounds for denial,
suspension, or revocation and setting a time within 20 days for a hearing on the matter.
new text end

new text begin (b) After a hearing before the Health Information Exchange Oversight Board, or
upon the failure of the health information exchange service provider to appear at the
hearing, the commissioner shall consider the recommendations of the Health Information
Exchange Oversight Board and take action as deemed necessary and shall issue written
findings that shall be mailed to the health information exchange service provider.
new text end

new text begin (c) If suspension or revocation is proposed according to this section, the
commissioner must deliver, or send by certified mail with return receipt requested, to the
health information exchange service provider written notice of the commissioner's intent
to impose a penalty. This notice of proposed determination must include:
new text end

new text begin (1) a reference to the statutory basis for the penalty;
new text end

new text begin (2) a description of the findings of fact regarding the violations with respect to
which the penalty is proposed;
new text end

new text begin (3) the amount of the proposed penalty;
new text end

new text begin (4) any circumstances described in subdivision 1, paragraph (a), that were considered
in determining the amount of the proposed penalty;
new text end

new text begin (5) instructions for responding to the notice, including a statement of the health
information exchange service provider's right to a contested case proceeding and a
statement that failure to request a contested case proceeding within 30 calendar days
permits the imposition of the proposed penalty; and
new text end

new text begin (6) the address to which the contested case proceeding request must be sent.
new text end

new text begin Subd. 4. new text end

new text begin Coordination. new text end

new text begin (a) The commissioner shall, to the extent possible, seek
the advice of the Minnesota e-Health Advisory Committee, in the review and update of
criteria for the certification and recertification of health information exchange service
providers when implementing sections 62J.498 to 62J.4982.
new text end

new text begin (b) By January 1, 2011, the commissioner shall report to the governor and the
legislature on the status of health information exchange in Minnesota, and provide
recommendations on further action necessary to facilitate the secure electronic movement
of health information among health providers that will enable Minnesota providers and
hospitals to meet meaningful use exchange requirements.
new text end

new text begin Subd. 5. new text end

new text begin Expedited rulemaking. new text end

new text begin The commissioner may use the expedited
rulemaking process under section 14.389 to carry out the duties of sections 62J.498 to
62J.4982. The commissioner shall be exempt from section 14.125 for purposes of this
section.
new text end

new text begin Subd. 6. new text end

new text begin Fees and monetary penalties. new text end

new text begin (a) Every health information exchange
service provider subject to sections 62J.4981 and 62J.4982 shall be assessed fees as
follows:
new text end

new text begin (1) filing an application for certificate of authority to operate as a health information
organization, $15,000;
new text end

new text begin (2) filing an application for certificate of authority to operate as a health data
intermediary, $10,000;
new text end

new text begin (3) annual health information organization certificate fee, $20,000;
new text end

new text begin (4) annual health data intermediary certificate fee, $10,000; and
new text end

new text begin (5) fees for other filings, as specified by rule.
new text end

new text begin (b) Administrative monetary penalties imposed under this subdivision shall be
deposited into a revolving fund and are appropriated to the commissioner for the purposes
of sections 62J.498 to 62J.4982.
new text end

ARTICLE 6

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1. new text begin SUMMARY OF APPROPRIATIONS. new text end

new text begin The amounts shown in this section summarize direct appropriations, by fund, made
in this article.
new text end

		new text begin 2010 new text end		new text begin 2011 new text end		new text begin Total new text end
new text begin General new text end	new text begin $ new text end	new text begin (15,895,000) new text end	new text begin $ new text end	new text begin (142,886,000) new text end	new text begin $ new text end	new text begin (158,781,000) new text end
new text begin State Government Special Revenue new text end		new text begin (1,609,000) new text end		new text begin (1,040,000) new text end		new text begin (2,649,000) new text end
new text begin Health Care Access new text end		new text begin (1,525,000) new text end		new text begin (156,840,000) new text end		new text begin (158,365,000) new text end
new text begin Federal TANF new text end		new text begin -0- new text end		new text begin 28,000 new text end		new text begin 28,000 new text end
new text begin Total new text end	new text begin $ new text end	new text begin (19,029,000) new text end	new text begin $ new text end	new text begin (272,766,000) new text end	new text begin $ new text end	new text begin (291,795,000) new text end

Sec. 2. new text begin HEALTH 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 2009, chapter 79, article 13,
as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes
specified in this article. The appropriations are from the general fund and are available
for the fiscal years indicated for each purpose. The figures "2010" and "2011" 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, 2010, or June 30, 2011, respectively.
Supplemental appropriations and reductions to appropriations for the fiscal year ending
June 30, 2010, 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 2010 new text end		new text begin 2011 new text end

Sec. 3. 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 (14,921,000) new text end

new text begin (259,768,000) new text end

new text begin Appropriations by Fund new text end
	new text begin 2010 new text end	new text begin 2011 new text end
new text begin General new text end	new text begin (13,819,000) new text end	new text begin (142,253,000) new text end
new text begin State Government Special Revenue new text end	new text begin (8,000) new text end	new text begin (16,000) new text end
new text begin Health Care Access new text end	new text begin (1,094,000) new text end	new text begin (145,499,000) new text end
new text begin Federal TANF new text end	new text begin -0- new text end	new text begin 28,000,000 new text end

new text begin 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:
new text end

new text begin (1) fiscal year 2011, .......;
new text end

new text begin (2) fiscal year 2012, .......; and
new text end

new text begin (3) fiscal year 2013, .......;
new text end

new text begin Notwithstanding any provision to the
contrary, this rider expires June 30, 2013.
new text end

new text begin TANF Financing and Maintenance of
Effort. The commissioner of human
services, with the approval of the
commissioner of management and budget,
and after notification of the chairs of the
relevant senate budget division and house of
representatives finance division, may adjust
the amount of TANF transfers between the
MFIP transition year child care assistance
program and MFIP grant programs within the
fiscal year, and within the current biennium
and the biennium ending June 30, 2013,
to ensure that state and federal match and
maintenance of effort requirements are
met. These transfers and amounts shall be
reported to the chairs of the senate and house
of representatives Finance Committees, the
senate Health and Human Services Budget
Division, the house of representatives Health
Care and Human Services Finance Division,
and Early Childhood Finance and Policy
Division by December 1 of each fiscal
year. Notwithstanding any provision to the
contrary, this provision expires June 30,
2013.
new text end

new text begin Special Revenue Fund Transfers.
new text end

new text begin (1) Notwithstanding any law to the contrary,
the commissioner shall transfer $1,023,000
of the special revenue fund account balances
to the general fund by June 30, 2010.
new text end

new text begin (2) The commissioner shall transfer $905,000
of the special revenue fund earnings in fiscal
years 2012 and 2013 to the general fund by
June 30, 2013. Notwithstanding any contrary
provision, this provision shall not expire.
new text end

new text begin (3) The actual transfers made under this rider
must be separately identified and reported as
part of the quarterly reporting of transfers
to the chairs of the relevant senate budget
division and house of representatives finance
division.
new text end

new text begin The appropriation reductions for each
purpose are shown in the following
subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Agency Management; Financial Operations new text end

new text begin (8,000) new text end

new text begin (16,000) new text end

new text begin This appropriation reduction is from the state
government special revenue fund.
new text end

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

new text begin 172,000 new text end

new text begin 49,580,000 new text end

new text begin TANF Funding for the Working Family
Tax Credit. In addition to the amounts
specified in Minnesota Statutes, section
290.0671, subdivision 6, $172,000 of TANF
funds in fiscal year 2010 and $49,580,000
of TANF funds in fiscal year 2011 are
appropriated to the commissioner of
human services to reimburse the cost of
the working family tax credit for eligible
families. Beginning January 1, 2011, the
commissioner shall reimburse the general
fund on a monthly basis according to a
schedule based on the pattern of working
family credit expenditures through June 20,
2011.
new text end

new text begin TANF Transfer to Federal Child Care
and Development Fund. The following
additional TANF fund amounts are
appropriated to the commissioner for the
purposes of MFIP and transition year child
care under Minnesota Statutes, section
119B.05:
new text end

new text begin (1) fiscal year 2012, $5,000,000; and
new text end

new text begin (2) fiscal year 2013, $5,000,000.
new text end

new text begin 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.
new text end

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

new text begin (a) MFIP and Diversionary Work Program Grants new text end

new text begin -0- new text end

new text begin (21,348,000) new text end

new text begin This appropriation reduction is from the
federal TANF fund.
new text end

new text begin (b) Support Services Grants new text end

new text begin -0- new text end

new text begin -0- new text end

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

new text begin -0- new text end

new text begin (814,000) new text end

new text begin (d) Basic Sliding Fee Child Care Assistance Grants new text end

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

new text begin (5,876,000) new text end

new text begin Basic Sliding Fee Allocation. For calendar
year 2011, a county may terminate child
care assistance for families already receiving
assistance if the county basic sliding fee
allocation is reduced below the county's
allocation for calendar year 2010 by an
amount that the county demonstrates cannot
be absorbed without terminating assistance.
The county must consult with and obtain
approval from the commissioner before
terminating assistance to families under this
provision. If approved, the county must
follow procedures outlined in Minnesota
Rules, part 3400.0183, subpart 1, item B.
new text end

new text begin new text begin Base Adjustment. new text end The general fund base is
decreased by $3,302,000 in fiscal year 2012
and decreased by $3,553,000 in fiscal year
2013.
new text end

new text begin (e) Child Support Enforcement Grants new text end

new text begin -0- new text end

new text begin (300,000) new text end

new text begin Minnesota Healthy Marriage and
Responsible Fatherhood Initiative Fee.
Notwithstanding Minnesota Statutes, section
517.08, the balance and the fee revenue
available to the commissioner of human
services for the healthy marriage and
responsible fatherhood initiative in the state
government special revenue fund must be
transferred to and deposited into the general
fund by June 30 of each fiscal year.
new text end

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

new text begin -0- new text end

new text begin (21,294,000) new text end

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

new text begin -0- new text end

new text begin (452,000) new text end

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

new text begin -0- new text end

new text begin (882,000) new text end

new text begin (i) Children's Mental Health Grants new text end

new text begin (200,000) new text end

new text begin (1,410,000) new text end

new text begin (j) Other Children and Economic Assistance Grants new text end

new text begin -0- new text end

new text begin 5,592,000 new text end

new text begin new text begin Short-Term Aid Grants to Counties. new text end Of
the general fund appropriation, $6,000,000 in
fiscal year 2011 is for short-term aid grants
under Minnesota Statutes, section 256D.441.
The base for this program is $11,000,000 in
fiscal year 2012 and $11,000,000 in fiscal
year 2013.
new text end

new text begin Subd. 5. new text end new text begin Children and Economic Assistance Management new text end

new text begin (a) Children and Economic Assistance Administration new text end

new text begin (172,000) new text end

new text begin (232,000) new text end

new text begin This appropriation reduction is from the
federal TANF fund.
new text end

new text begin (b) Children and Economic Assistance Operations new text end

new text begin (1,408,000) new text end

new text begin (1,491,000) new text end

new text begin Suspension of Food Support Retailer Fees.
Under the legislative approval requirement
in Laws 1998, chapter 407, article 6, section
116, the commissioner may eliminate
the transaction payment to retailers for
electronic benefits transfer (EBT) costs.
By January 15, 2011, the commissioner
shall make a report and recommendation
to the house of representatives and senate
finance committees with jurisdiction over the
supplemental nutrition assistance program on
whether to reinstitute the fee effective July 1,
2011. The report must include information
on EBT usage trends and retailer fee costs.
new text end

new text begin Subd. 6. new text end new text begin Basic Health Care Grants new text end

new text begin (a) MinnesotaCare Grants new text end

new text begin -0- new text end

new text begin (140,979,000) new text end

new text begin This appropriation reduction is from the
health care access fund.
new text end

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

new text begin -0- new text end

new text begin (27,635,000) new text end

new text begin Medical Education Research Costs
(MERC). In fiscal year 2011, the
commissioner shall reduce the amount
transferred to the medical education research
fund under Minnesota Statutes, section
256B.69, subdivision 5c, paragraph (a), by
$18,802,463, so as to provide no amount
for general distribution under Minnesota
Statutes, section 62J.692, subdivision 7,
clause (5). This is a onetime reduction.
new text end

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

new text begin -0- new text end

new text begin (16,221,000) new text end

new text begin (d) Other Health Care Grants new text end

new text begin Minnesota COBRA Premium Subsidy.
Unexpended funds appropriated in fiscal year
2010 for COBRA grants under Laws 2009,
chapter 79, article 5, section 78, do not cancel
and are available to the commissioner for
fiscal year 2011 COBRA grant expenditures.
new text end

new text begin Subd. 7. new text end new text begin Health Care Management new text end

new text begin (a) Health Care Administration new text end

new text begin (2,998,000) new text end

new text begin (5,320,000) new text end

new text begin Minnesota Senior Health Options
Reimbursement. Effective July 1, 2011,
federal administrative reimbursement
resulting from the Minnesota senior
health options project is appropriated
to the commissioner for this activity.
Notwithstanding any contrary provision, this
provision expires June 30, 2013.
new text end

new text begin Utilization Review. Effective July 1,
2011, federal administrative reimbursement
resulting from prior authorization and
inpatient admission certification by a
professional review organization shall be
dedicated to, and is appropriated to, the
commissioner for these activities. A portion
of these funds must be used for activities to
decrease unnecessary pharmaceutical costs
in medical assistance. Notwithstanding any
contrary provision, this provision expires
June 30, 2013.
new text end

new text begin (b) Health Care Operations new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 2,000 new text end
new text begin Health Care Access new text end	new text begin (1,094,000) new text end	new text begin (4,520,000) new text end

new text begin Base Adjustment. The health care access
fund base for health care operations is
reduced by $1,451,000 in fiscal year 2012
and $1,581,000 in fiscal year 2013.
new text end

new text begin Subd. 8. new text end new text begin Continuing Care Grants new text end

new text begin (a) Aging and Adult Services Grants new text end

new text begin -0- new text end

new text begin (272,000) new text end

new text begin Base Adjustment. The general fund base for
aging and adult services grants is reduced by
$268,000 in fiscal year 2012 and $291,000 in
fiscal year 2013.
new text end

new text begin (b) Alternative Care Grants new text end

new text begin -0- new text end

new text begin (701,000) new text end

new text begin new text begin Base Adjustment. new text end The base for alternative
care grants is reduced by $164,000 in fiscal
year 2012 and $255,000 in fiscal year 2013.
new text end

new text begin (c) Medical Assistance Long-Term Care Facilities Grants new text end

new text begin -0- new text end

new text begin (9,911,000) new text end

new text begin (d) Medical Assistance Long-Term Care Waivers and Home Care Grants new text end

new text begin -0- new text end

new text begin (23,636,000) new text end

new text begin Manage Growth in Traumatic Brain
Injury and Community Alternatives for
Disabled Individuals Waivers. During
the fiscal year beginning July 1, 2010, the
commissioner shall allocate money for home
and community-based waiver programs
under Minnesota Statutes, section 256B.49,
to ensure a reduction in state spending that is
equivalent to limiting the caseload growth
of the TBI waiver to six allocations per
month and the CADI waiver to 60 allocations
per month. The limits do not apply: (1)
when there is an approved plan for nursing
facility bed closures for individuals under
age 65 who require relocation due to the
bed closure; (2) to fiscal year 2009 waiver
allocations delayed due to unallotment; or (3)
to transfers authorized by the commissioner
from the personal care assistance program
of individuals having a home care rating of
CS, MT, or HL. Priorities for the allocation
of funds must be for individuals anticipated
to be discharged from institutional settings or
who are at imminent risk of a placement in
an institutional setting.
new text end

new text begin Manage Growth in the Developmental
Disability (DD) Waiver. The commissioner
shall manage the growth in the DD waiver
by limiting the allocations included in the
November 2010 forecast to six additional
diversion allocations each month for the
calendar year that begins on January 1,
2011. Additional allocations must be
made available for transfers authorized by
the commissioner from the personal care
assistance program of individuals having a
home care rating of CS, MT, or HL. This
provision is effective through December 31,
2011.
new text end

new text begin (e) Adult Mental Health Grants new text end

new text begin (3,700,000) new text end

new text begin (200,000) new text end

new text begin Compulsive Gambling Special Revenue
Account. $149,000 for fiscal year 2010
and $27,000 for fiscal year 2011 from
the compulsive gambling special revenue
account established under Minnesota
Statutes, section 245.982, must be transferred
and deposited into the general fund by June
30 of each respective fiscal year.
new text end

new text begin Compulsive Gambling Lottery Prize Fund
Appropriation. Of the lottery prize fund
appropriation for compulsive gambling,
$48,000 for fiscal year 2010 and $47,000
for fiscal year 2011 must be transferred and
deposited into the general fund by June 30 of
each respective fiscal year.
new text end

new text begin (f) Deaf and Hard-of-Hearing Grants new text end

new text begin -0- new text end

new text begin (37,000) new text end

new text begin new text begin Base Adjustment. new text end The general fund base for
deaf and hard-of-hearing grants is reduced
by $12,000 in fiscal year 2012 and $9,000 in
fiscal year 2013.
new text end

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

new text begin -0- new text end

new text begin (5,300,000) new text end

new text begin new text begin Consolidated Chemical Dependency
Treatment Fund Balance. new text end $4,800,000
must be transferred from the consolidated
chemical dependency treatment fund and
deposited into the general fund by June 30,
2010.
new text end

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

new text begin (389,000) new text end

new text begin -0- new text end

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

new text begin -0- new text end

new text begin (2,646,000) new text end

new text begin new text begin HIV Grants. new text end The general fund appropriation
for the HIV drug and insurance grant
program shall be reduced by $2,037,000 in
fiscal year 2011 and increased by $2,037,000
in fiscal year 2013. These adjustments are
onetime and must not be applied to the base.
Notwithstanding any contrary provision, this
provision expires June 30, 2013.
new text end

new text begin new text begin Base Adjustment. new text end The general fund base is
increased by $1,819,000 in fiscal year 2012
and is increased by $3,813,000 in fiscal year
2013.
new text end

new text begin Subd. 9. new text end new text begin Continuing Care Management new text end

new text begin -0- new text end

new text begin 341,000 new text end

new text begin Provider Rate Reduction Evaluation.
$341,000 is appropriated to the commissioner
in fiscal year 2011 to monitor and report on
changes in recipient access to continuing care
services funded under Minnesota's Medicaid
program resulting from rate reductions. The
commissioner shall provide preliminary
results of the monitoring to the house of
representatives and senate committees and
divisions with jurisdiction over continuing
care by February 15, 2011, and shall report
updated results by December 31, 2012.
new text end

new text begin Base Adjustment. The general fund base
for continuing care management is decreased
by $79,000 in fiscal year 2012 and $79,000
in fiscal year 2013.
new text end

new text begin Compulsive Gambling Special Revenue
Administration. $6,000 for fiscal year
2010 and $4,000 for fiscal year 2011 must
be transferred from the lottery prize fund
appropriation for compulsive gambling
administration to the general fund by June 30
of each respective fiscal year.
new text end

new text begin Subd. 10. new text end new text begin State-Operated Services new text end

new text begin new text begin Obsolete Laundry Depreciation Account. new text end
$669,000, or the balance, whichever is
greater, must be transferred from the
state-operated services laundry depreciation
account in the special revenue fund and
deposited into the general fund by June 30,
2010.
new text end

new text begin Adult Mental Health Services new text end

new text begin 48,000 new text end

new text begin (2,210,000) new text end

new text begin Subd. 11. new text end new text begin Contingent Appropriations Reductions. new text end

new text begin Upon enactment of the extension of
the enhanced federal medical assistance
percentage (FMAP) under Public Law 111-5
to June 30, 2011, that is contained in the
president's budget for federal fiscal year 2011
or contained in House Resolution 2847, the
federal "Jobs for Main Street Act, 2010," or
subsequent federal legislation, the reductions
identified in each clause shall be made to
the specified general fund appropriations
for fiscal year 2011. These contingent
reductions, if implemented, are in addition
to the reductions specified in subdivision 6,
paragraphs (a), (b), and (c), and subdivision
8, paragraphs (c) and (d), respectively.
new text end

new text begin (1) MinnesotaCare Grants new text end

new text begin -0- new text end

new text begin (9,200,000) new text end

new text begin (2) Medical Assistance Basic Health Care Grants - Families and Children new text end

new text begin -0- new text end

new text begin (109,662,500) new text end

new text begin (3) Medical Assistance Basic Health Care Grants - Elderly and Disabled new text end

new text begin -0- new text end

new text begin (110,437,500) new text end

new text begin (4) Medical Assistance Long-Term Care Facilities Grants new text end

new text begin -0- new text end

new text begin (51,925,000) new text end

new text begin (5) Medical Assistance Long-Term Care Waivers and Home Care Grants new text end

new text begin -0- new text end

new text begin (115,475,000) new text end

Sec. 4. new text begin COMMISSIONER OF HEALTH 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 2010 new text end		new text begin 2011 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 (4,123,000) new text end

new text begin $ new text end

new text begin (12,349,000) new text end

new text begin Appropriations by Fund new text end
	new text begin 2010 new text end	new text begin 2011 new text end
new text begin General new text end	new text begin (2,392,000) new text end	new text begin (426,000) new text end
new text begin State Government Special Revenue new text end	new text begin (1,300,000) new text end	new text begin (582,000) new text end
new text begin Health Care Access new text end	new text begin (431,000) new text end	new text begin (11,341,000) new text end

new text begin Subd. 2. new text end new text begin Community and Family Health new text end

new text begin Appropriations by Fund new text end
	new text begin 2010 new text end	new text begin 2011 new text end
new text begin General new text end	new text begin (221,000) new text end	new text begin (121,000) new text end
new text begin Health Care Access new text end	new text begin (45,000) new text end	new text begin (10,040,000) new text end

new text begin new text begin Statewide Health Improvement Program. new text end
Of the health care access fund reductions,
$10,000,000 in fiscal year 2011 is
for reductions to the statewide health
improvement program. This reduction is
onetime.
new text end

new text begin new text begin Base Level Adjustment. new text end The general fund
base is reduced by $33,000 in fiscal year
2012 and by $33,000 in fiscal year 2013.
new text end

new text begin Subd. 3. new text end new text begin Policy, Quality and Compliance new text end

new text begin Appropriations by Fund new text end
	new text begin 2010 new text end	new text begin 2011 new text end
new text begin General new text end	new text begin (1,797,000) new text end	new text begin -0- new text end
new text begin State Government Special Revenue new text end	new text begin (600,000) new text end	new text begin (232,000) new text end
new text begin Health Care Access new text end	new text begin (386,000) new text end	new text begin (1,301,000) new text end

new text begin new text begin Health Care Reform. new text end Funds appropriated
in Laws 2008, chapter 358, article 5, section
4, subdivision 3, for health reform activities
to implement Laws 2008, chapter 358,
article 4, are available until expended.
Notwithstanding any contrary provision in
this article, this provision shall not expire.
new text end

new text begin new text begin Rural Hospital Capital Improvement
Grants. new text end Of the general fund reductions in
fiscal year 2010, $1,755,000 is for the rural
hospital capital improvement grant program.
new text end

new text begin new text begin Federally Qualified Health Centers. new text end Of
the health care access fund reductions,
$1,000,000 in fiscal year 2011 is for the
reduction of grants to federally qualified
health centers. This is a onetime reduction.
new text end

new text begin new text begin Donated Dental Program Grants. new text end Of the
health care access fund reduction, $63,000
in fiscal year 2011 is for the elimination of
grant funding to the donated dental service
program.
new text end

new text begin new text begin Health Information Exchange Oversight. new text end
Of the state government special revenue fund
appropriations, $140,000 in fiscal year 2011
is for administrative support of the Health
Information Exchange Oversight Board
established in Minnesota Statutes, section
62J.498, subdivision 2.
new text end

new text begin new text begin Base Level Adjustment. new text end The general fund
base is decreased by $133,000 in fiscal year
2012 and $133,000 in fiscal year 2013. The
health care access fund base is increased by
$959,000 in fiscal year 2012 and $1,079,000
in fiscal year 2013. The state government
special revenue fund base is increased by
$367,000 in fiscal year 2012 and $362,000 in
fiscal year 2013.
new text end

new text begin Subd. 4. new text end new text begin Health Protection new text end

new text begin Appropriations by Fund new text end
	new text begin 2010 new text end	new text begin 2011 new text end
new text begin General new text end	new text begin (374,000) new text end	new text begin (205,000) new text end
new text begin State Government Special Revenue new text end	new text begin (700,000) new text end	new text begin (350,000) new text end

new text begin new text begin Lead Base Grant Program. new text end Of the general
fund reduction, $25,000 in fiscal year 2010
and fiscal year 2011 is for the elimination
of state funding for the temporary lead-safe
housing base grant program.
new text end

new text begin new text begin Base Adjustment. new text end The general fund base is
decreased by $100,000 in fiscal year 2012
and $100,000 in fiscal year 2013. The state
government special revenue fund is increased
by $350,000 in fiscal year 2012 and $350,000
in fiscal year 2013.
new text end

new text begin Subd. 5. new text end new text begin Administrative Support Services new text end

new text begin -0- new text end

new text begin (100,000) new text end

Sec. 5. new text begin HEALTH-RELATED BOARDS 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 (290,000) new text end

new text begin $ new text end

new text begin (421,000) new text end

new text begin The appropriations and reductions in this
section are from the state government special
revenue fund.
new text end

new text begin In fiscal year 2010, $301,000 shall be
transferred from the state government special
revenue fund to the general fund. In fiscal
year 2011, $441,000 shall be transferred from
the state government special revenue fund
to the general fund. These transfers are in
addition to those made in Laws 2009, chapter
79, article 13, section 5, as amended by Laws
2009, chapter 173, article 2, section 3.
new text end

new text begin The reductions and transfers in this section
are onetime in the fiscal year 2010-2011
biennium.
new text end

new text begin The appropriations and reductions for
each purpose are shown in the following
subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Board of Chiropractic Examiners new text end

new text begin (9,000) new text end

new text begin (14,000) new text end

new text begin Subd. 3. new text end new text begin Board of Dentistry new text end

new text begin (21,000) new text end

new text begin (31,000) new text end

new text begin Subd. 4. new text end new text begin Board of Dietetic and Nutrition Practice new text end

new text begin (2,000) new text end

new text begin (3,000) new text end

new text begin Subd. 5. new text end new text begin Board of Marriage and Family Therapy new text end

new text begin (2,000) new text end

new text begin (4,000) new text end

new text begin Subd. 6. new text end new text begin Board of Medical Practice new text end

new text begin (73,000) new text end

new text begin (112,000) new text end

new text begin Subd. 7. new text end new text begin Board of Nursing new text end

new text begin (62,000) new text end

new text begin (100,000) new text end

new text begin Subd. 8. new text end new text begin Board of Nursing Home Administrators new text end				new text begin (36,000) new text end		new text begin (31,000) new text end
new text begin (a) Administrative Services Unit-Operating Costs new text end				new text begin (11,000) new text end		new text begin (16,000) new text end
new text begin (b) Administrative Services Unit-Retirement Costs new text end				new text begin (5,000) new text end		new text begin -0- new text end
new text begin (c) Administrative Services Unit-Volunteer Health Care Provider Program new text end				new text begin (1,000) new text end		new text begin (3,000) new text end
new text begin (d) Administrative Services Unit-Contested Cases and Other Legal Proceedings new text end				new text begin (15,000) new text end		new text begin (6,000) new text end

new text begin Subd. 9. new text end new text begin Board of Optometry new text end

new text begin (2,000) new text end

new text begin (3,000) new text end

new text begin Subd. 10. new text end new text begin Board of Pharmacy new text end

new text begin (28,000) new text end

new text begin (42,000) new text end

new text begin Subd. 11. new text end new text begin Board of Physical Therapy new text end

new text begin (6,000) new text end

new text begin (9,000) new text end

new text begin Subd. 12. new text end new text begin Board of Podiatry new text end

new text begin (1,000) new text end

new text begin (2,000) new text end

new text begin Subd. 13. new text end new text begin Board of Psychology new text end

new text begin (16,000) new text end

new text begin (24,000) new text end

new text begin Subd. 14. new text end new text begin Board of Social Work new text end

new text begin (18,000) new text end

new text begin (28,000) new text end

new text begin Subd. 15. new text end new text begin Board of Veterinary Medicine new text end

new text begin (4,000) new text end

new text begin (6,000) new text end

new text begin Subd. 16. new text end new text begin Board of Behavioral Health and Therapy new text end

new text begin (8,000) new text end

new text begin (12,000) new text end

Sec. 6. new text begin EMERGENCY MEDICAL SERVICES BOARD new text end

new text begin 432,000 new text end

new text begin (154,000) new text end

new text begin Appropriations by Fund new text end
	new text begin 2010 new text end	new text begin 2011 new text end
new text begin General new text end	new text begin 445,000 new text end	new text begin (133,000) new text end
new text begin State Government Special Revenue new text end	new text begin (13,000) new text end	new text begin (21,000) new text end

new text begin (a) Longevity Award and Incentive Program new text end

new text begin (19,000) new text end

new text begin (19,000) new text end

new text begin (b) Health Professional Services Program new text end

new text begin (13,000) new text end

new text begin (21,000) new text end

new text begin This reduction is from the state government
special revenue fund and is onetime in the
2010-2011 biennium.
new text end

new text begin $10,000 in fiscal year 2010 and $24,000
in fiscal year 2011 shall be transferred to
the general fund from the portion of the
emergency medical services relief account
in the special revenue fund otherwise
designated for distribution by the Emergency
Medical Services Board under Minnesota
Statutes, section 169.686, subdivision 3.
These transfers are onetime in the 2010-2011
biennium.
new text end

Sec. 7. new text begin COUNCIL ON DISABILITY new text end

new text begin $ new text end

new text begin (10,000) new text end

new text begin $ new text end

new text begin (16,000) new text end

Sec. 8. new text begin OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES new text end

new text begin $ new text end

new text begin (31,000) new text end

new text begin $ new text end

new text begin (50,000) new text end

Sec. 9. new text begin OMBUDSPERSON FOR FAMILIES new text end

new text begin $ new text end

new text begin (4,000) new text end

new text begin $ new text end

new text begin (8,000) new text end

Sec. 10.

Minnesota Statutes 2008, section 214.40, subdivision 7, is amended to read:

Subd. 7.

Medical professional liability insurance.

(a) new text begin Within the limit of funds
appropriated for this program, new text end the administrative services unit must purchase medical
professional liability insurance, if available, for a health care provider who is registered in
accordance with subdivision 4 and who is not otherwise covered by a medical professional
liability insurance policy or self-insured plan either personally or through another facility
or employer. new text begin The administrative services unit is authorized to prorate payments or
otherwise limit the number of participants in the program if the costs of the insurance for
eligible providers exceed the funds appropriated for the program.
new text end

(b) Coverage purchased under this subdivision must be limited to the provision of
health care services performed by the provider for which the provider does not receive
direct monetary compensation.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2009 Supplement, section 252.025, subdivision 7, is
amended to read:

Subd. 7.

Minnesota extended treatment options.

The commissioner shall develop
by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who
have developmental disabilities and exhibit severe behaviors which present a risk to
public safety. This program is statewide and must provide specialized residential services
in Cambridge and an array of community-based services with sufficient levels of care
and a sufficient number of specialists to ensure that individuals referred to the program
receive the appropriate care. The individuals working in the community-based services
under this section are state employees supervised by the commissioner of human services.
deleted text begin No layoffs shall occur as a result of restructuring under this section.
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. 12.

Laws 2009, chapter 79, article 3, section 18, is amended to read:

Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED
MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE
ANOKA-METRO REGIONAL TREATMENT CENTER.

In consultation with community partners, the commissioner of human services
shall develop an array of community-based services to transform the current services
now provided to patients at the Anoka-Metro Regional Treatment Center. The
community-based services may be provided in facilities with 16 or fewer beds, and must
provide the appropriate level of care for the patients being admitted to the facilities.
The planning for this transition must be completed by October 1, 2009, with an initial
report to the committee chairs of health and human services by November 30, 2009, and
a semiannual report on progress until the transition is completed. The commissioner of
human services shall solicit interest from stakeholders and potential community partners.
The individuals working in the community-based services facilities under this section are
state employees supervised by the commissioner of human services. deleted text begin No layoffs shall
occur as a result of restructuring under this section.
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. 13.

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

Subdivision 1. Total Appropriation

$

5,225,451,000

$

6,002,864,000

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

Receipts for Systems Projects.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state system account authorized in
Minnesota Statutes, section 256.014. Money
appropriated for computer projects approved
by the Minnesota Office of Enterprise
Technology, funded by the legislature, and
approved by the commissioner of finance,
may be transferred from one project to
another and from development to operations
as the commissioner of human services
considers necessary, except that any transfers
to one project that exceed $1,000,000 or
multiple transfers to one project that exceed
$1,000,000 in total require the express
approval of the legislature. The preceding
requirement for legislative approval does not
apply to transfers made to establish a project's
initial operating budget each year; instead,
the requirements of section 11, subdivision
2, of this article apply to those transfers. Any
unexpended balance in the appropriation
for these projects does not cancel but is
available for ongoing development and
operations. Any computer project with a
total cost exceeding $1,000,000, including,
but not limited to, a replacement for the
proposed HealthMatch system, shall not be
commenced without the express approval of
the legislature.

HealthMatch Systems Project. In fiscal
year 2010, $3,054,000 shall be transferred
from the HealthMatch account in the state
systems account in the special revenue fund
to the general fund.

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

TANF Maintenance of Effort.

(a) In order to meet the basic 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
noncitizen MFIP recipients who qualify
for the medical assistance without federal
financial participation program under
Minnesota Statutes, section 256B.06,
subdivision 4, paragraphs (d), (e), and (j);
deleted text begin and
deleted text end

(6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (7) qualifying Minnesota education credit
expenditures under Minnesota Statutes,
section 290.0674.
new text end

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

(c) For fiscal years beginning with state
fiscal year 2003, the commissioner shall
ensure that the maintenance of effort used
by the commissioner of finance for the
February and November forecasts required
under Minnesota Statutes, section 16A.103,
contains expenditures under paragraph (a),
clause (1), equal to at least 16 percent of
the total required under Code of Federal
Regulations, title 45, section 263.1.

(d) 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 to the extent such expenditures
or other qualified expenditures are otherwise
available after considering the expenditures
allowed in this section.

(e) 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.

(f) Notwithstanding any contrary provision
in this article, this provision expires June 30,
2013.

Working Family Credit Expenditures as
TANF/MOE. The commissioner may claim
as TANF/MOE up to $6,707,000 per year of
working family credit expenditures for fiscal
year 2010 through fiscal year 2011.

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

(1) fiscal year 2010, deleted text begin $50,973,000 deleted text end new text begin
$50,897,000 new text end ;

(2) fiscal year 2011, deleted text begin $53,793,000 deleted text end new text begin
$54,243,000 new text end ;

(3) fiscal year 2012, deleted text begin $23,516,000 deleted text end new text begin
$23,345,000 new text end ; and

(4) fiscal year 2013, deleted text begin $16,808,000 deleted text end new text begin
$16,585,000 new text end .

Notwithstanding any contrary provision in
this article, this rider expires June 30, 2013.

Food Stamps Employment and Training.
(a) The commissioner shall apply for and
claim the maximum allowable federal
matching funds under United States Code,
title 7, section 2025, paragraph (h), for
state expenditures made on behalf of family
stabilization services participants voluntarily
engaged in food stamp employment and
training activities, where appropriate.

(b) Notwithstanding Minnesota Statutes,
sections 256D.051, subdivisions 1a, 6b,
and 6c, and 256J.626, federal food stamps
employment and training funds received
as reimbursement of MFIP consolidated
fund grant expenditures for diversionary
work program participants and child
care assistance program expenditures for
two-parent families must be deposited in the
general fund. The amount of funds must be
limited to $3,350,000 in fiscal year 2010
and $4,440,000 in fiscal years 2011 through
2013, contingent on approval by the federal
Food and Nutrition Service.

(c) 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, 2013.

ARRA Food Support Administration.
The funds available for food support
administration under the American Recovery
and Reinvestment Act (ARRA) of 2009
are appropriated to the commissioner
to pay actual costs of implementing the
food support benefit increases, increased
eligibility determinations, and outreach. Of
these funds, 20 percent shall be allocated
to the commissioner and 80 percent shall
be allocated to counties. The commissioner
shall allocate the county portion based on
caseload. Reimbursement shall be based on
actual costs reported by counties through
existing processes. Tribal reimbursement
must be made from the state portion based
on a caseload factor equivalent to that of a
county.

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.

Emergency Fund for the TANF Program.
TANF Emergency Contingency funds
available under the American Recovery
and Reinvestment Act of 2009 (Public Law
111-5) are appropriated to the commissioner.
The commissioner must request TANF
Emergency Contingency funds from the
Secretary of the Department of Health
and Human Services to the extent the
commissioner meets or expects to meet the
requirements of section 403(c) of the Social
Security Act. The commissioner must seek
to maximize such grants. The funds received
must be used as appropriated. Each county
must maintain the county's current level of
emergency assistance funding under the
MFIP consolidated fund and use the funds
under this paragraph to supplement existing
emergency assistance funding levels.

Sec. 14.

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

Subd. 3. Revenue and Pass-Through Revenue Expenditures

68,337,000

70,505,000

This appropriation is from the federal TANF
fund.

TANF Transfer to Federal Child Care
and Development Fund. The following
TANF fund amounts are appropriated to the
commissioner for the purposes of MFIP and
transition year child care under Minnesota
Statutes, section 119B.05:

(1) fiscal year 2010, deleted text begin $6,531,000 deleted text end new text begin $862,000 new text end ;

(2) fiscal year 2011, deleted text begin $10,241,000 deleted text end new text begin $978,000 new text end ;

(3) fiscal year 2012, deleted text begin $10,826,000 deleted text end new text begin $0 new text end ; and

(4) fiscal year 2013, deleted text begin $4,046,000 deleted text end new text begin $0 new text end .

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.

Sec. 15.

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

Subd. 4. Children and Economic Assistance Grants

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

(a) MFIP/DWP Grants

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

(b) Support Services Grants

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

MFIP Consolidated Fund. The MFIP
consolidated fund TANF appropriation is
reduced by $1,854,000 in fiscal year 2010
and fiscal year 2011.

Notwithstanding Minnesota Statutes, section
256J.626, subdivision 8, paragraph (b), the
commissioner shall reduce proportionately
the reimbursement to counties for
administrative expenses.

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 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.

Supported Work. Of the TANF
appropriation, $4,700,000 in fiscal year 2010
and $4,700,000 in fiscal year 2011 are to the
commissioner for supported work for MFIP
recipients and is available until expended.
Supported work includes paid transitional
work experience and a continuum of
employment assistance, including outreach
and recruitment, program orientation
and intake, testing and assessment, job
development and marketing, preworksite
training, supported worksite experience,
job coaching, and postplacement follow-up,
in addition to extensive case management
and referral services. This is a onetime
appropriation.

Base Adjustment. The general fund base
is reduced by $3,783,000 in each of fiscal
years 2012 and 2013. The TANF fund base
is increased by $5,004,000 in each of fiscal
years 2012 and 2013.

Integrated Services Program Funding.
The TANF appropriation for integrated
services program funding is $1,250,000 in
fiscal year 2010 and $0 in fiscal year 2011
and the base for fiscal years 2012 and 2013
is $0.

TANF Emergency Fund; Nonrecurrent
Short-Term Benefits. new text begin (1) new text end TANF emergency
contingency fund grants received due to
increases in expenditures for nonrecurrent
short-term benefits must be used to offset the
increase in these expenditures for counties
under the MFIP consolidated fund, under
Minnesota Statutes, section 256J.626,
and the diversionary work program. The
commissioner shall develop procedures
to maximize reimbursement of these
expenditures over the TANF emergency fund
base year quarters. Growth in expenditures
for the diversionary work program over the
amount expended in the calendar quarters in
the TANF emergency fund base year shall be
used to leverage these funds.

new text begin (2) To the extent that the commissioner
can claim eligible tax credit growth as
nonrecurrent short-term benefits, the
commissioner shall use those funds to
leverage the increased expenditures in clause
(1).
new text end

new text begin (3) TANF emergency funds for nonrecurrent
short-term benefits received in excess of the
amounts necessary for clauses (1) and (2)
shall be used to reimburse the general fund
for the costs of eligible tax credits in fiscal
year 2011. The amount of such funds shall
not exceed $28,000,000.
new text end

(c) MFIP Child Care Assistance Grants

61,171,000

65,214,000

Acceleration of ARRA Child Care and
Development Fund Expenditure. The
commissioner must liquidate all child care
and development money available under
the American Recovery and Reinvestment
Act (ARRA) of 2009, Public Law 111-5,
by September 30, 2010. In order to expend
those funds by September 30, 2010, the
commissioner may redesignate and expend
the ARRA child care and development funds
appropriated in fiscal year 2011 for purposes
under this section for related purposes that
will allow liquidation by September 30,
2010. Child care and development funds
otherwise available to the commissioner
for those related purposes shall be used to
fund the purposes from which the ARRA
child care and development funds had been
redesignated.

School Readiness Service Agreements.
$400,000 in fiscal year 2010 and $400,000
in fiscal year 2011 are from the federal
TANF fund to the commissioner of human
services consistent with federal regulations
for the purpose of school readiness service
agreements under Minnesota Statutes,
section 119B.231. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

(d) Basic Sliding Fee Child Care Assistance Grants

40,100,000

45,092,000

School Readiness Service Agreements.
$257,000 in fiscal year 2010 and $257,000
in fiscal year 2011 are from the general
fund for the purpose of school readiness
service agreements under Minnesota
Statutes, section 119B.231. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

Child Care Development Fund
Unexpended Balance. In addition to
the amount provided in this section, the
commissioner shall expend $5,244,000 in
fiscal year 2010 from the federal child care
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.

Basic Sliding Fee. $4,000,000 in fiscal year
2010 and $4,000,000 in fiscal year 2011 are
from the federal child care development
funds received from the American Recovery
and Reinvestment Act of 2009, Public
Law 111-5, to the commissioner of human
services consistent with federal regulations
for the purpose of basic sliding fee child care
assistance under Minnesota Statutes, section
119B.03. This is a onetime appropriation.
Any unexpended balance the first year is
available in the second year.

Basic Sliding Fee Allocation for Calendar
Year 2010. Notwithstanding Minnesota
Statutes, section 119B.03, subdivision 6,
in calendar year 2010, basic sliding fee
funds shall be distributed according to
this provision. Funds shall be allocated
first in amounts equal to each county's
guaranteed floor, according to Minnesota
Statutes, section 119B.03, subdivision 8,
with any remaining available funds allocated
according to the following formula:

(a) Up to one-fourth of the funds shall be
allocated in proportion to the number of
families participating in the transition year
child care program as reported during and
averaged over the most recent six months
completed at the time of the notice of
allocation. Funds in excess of the amount
necessary to serve all families in this category
shall be allocated according to paragraph (d).

(b) Up to three-fourths of the funds shall
be allocated in proportion to the average
of each county's most recent six months of
reported waiting list as defined in Minnesota
Statutes, section 119B.03, subdivision 2, and
the reinstatement list of those families whose
assistance was terminated with the approval
of the commissioner under Minnesota Rules,
part 3400.0183, subpart 1. Funds in excess
of the amount necessary to serve all families
in this category shall be allocated according
to paragraph (d).

(c) The amount necessary to serve all families
in paragraphs (a) and (b) shall be calculated
based on the basic sliding fee average cost of
care per family in the county with the highest
cost in the most recently completed calendar
year.

(d) Funds in excess of the amount necessary
to serve all families in paragraphs (a) and
(b) shall be allocated in proportion to each
county's total expenditures for the basic
sliding fee child care program reported
during the most recent fiscal year completed
at the time of the notice of allocation. To
the extent that funds are available, and
notwithstanding Minnesota Statutes, section
119B.03, subdivision 8, for the period
January 1, 2011, to December 31, 2011, each
county's guaranteed floor must be equal to its
original calendar year 2010 allocation.

Base Adjustment. The general fund base is
decreased by $257,000 in each of fiscal years
2012 and 2013.

(e) Child Care Development Grants

1,487,000

1,487,000

Family, friends, and neighbor grants.
$375,000 in fiscal year 2010 and $375,000
in fiscal year 2011 are from the child
care development fund required targeted
quality funds for quality expansion and
infant/toddler from the American Recovery
and Reinvestment Act of 2009, Public
Law 111-5, to the commissioner of human
services for family, friends, and neighbor
grants under Minnesota Statutes, section
119B.232. This appropriation may be used
on programs receiving family, friends, and
neighbor grant funds as of June 30, 2009,
or on new programs or projects. This is a
onetime appropriation. Any unexpended
balance the first year is available in the
second year.

Voluntary quality rating system training,
coaching, consultation, and supports.
$633,000 in fiscal year 2010 and $633,000
in fiscal year 2011 are from the federal child
care development fund required targeted
quality funds for quality expansion and
infant/toddler from the American Recovery
and Reinvestment Act of 2009, Public
Law 111-5, to the commissioner of human
services consistent with federal regulations
for the purpose of providing grants to provide
statewide child-care provider training,
coaching, consultation, and supports to
prepare for the voluntary Minnesota quality
rating system rating tool. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

Voluntary quality rating system. $184,000
in fiscal year 2010 and $1,200,000 in fiscal
year 2011 are from the federal child care
development fund required targeted funds for
quality expansion and infant/toddler from the
American Recovery and Reinvestment Act of
2009, Public Law 111-5, to the commissioner
of human services consistent with federal
regulations for the purpose of implementing
the voluntary Parent Aware quality star
rating system pilot in coordination with the
Minnesota Early Learning Foundation. The
appropriation for the first year is to complete
and promote the voluntary Parent Aware
quality rating system pilot program through
June 30, 2010, and the appropriation for
the second year is to continue the voluntary
Minnesota quality rating system pilot
through June 30, 2011. This is a onetime
appropriation. Any unexpended balance the
first year is available in the second year.

(f) Child Support Enforcement Grants

3,705,000

3,705,000

(g) Children's Services Grants

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

Base Adjustment. The general fund base is
decreased by $5,371,000 in fiscal year 2012
and decreased $5,371,000 in fiscal year 2013.

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
2010 and fiscal year 2011 for the adoption
incentive grants are appropriated to the
commissioner for postadoption services
including parent support groups.

Adoption Assistance and Relative Custody
Assistance. The commissioner may transfer
unencumbered appropriation balances for
adoption assistance and relative custody
assistance between fiscal years and between
programs.

(h) Children and Community Services Grants

67,663,000

67,542,000

Targeted Case Management Temporary
Funding Adjustment. The commissioner
shall recover from each county and tribe
receiving a targeted case management
temporary funding payment in fiscal year
2008 an amount equal to that payment. The
commissioner shall recover one-half of the
funds by February 1, 2010, and the remainder
by February 1, 2011. At the commissioner's
discretion and at the request of a county
or tribe, the commissioner may revise
the payment schedule, but full payment
must not be delayed beyond May 1, 2011.
The commissioner may use the recovery
procedure under Minnesota Statutes, section
256.017, to recover the funds. Recovered
funds must be deposited into the general
fund.

(i) General Assistance Grants

48,215,000

48,608,000

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 $7,889,812 in fiscal year 2010 and
$7,889,812 in fiscal year 2011. Funds
to counties must be allocated by the
commissioner using the allocation method
specified in Minnesota Statutes, section
256D.06.

(j) Minnesota Supplemental Aid Grants

33,930,000

35,191,000

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

(k) Group Residential Housing Grants

111,778,000

114,034,000

Group Residential Housing Costs
Refinanced. (a) Effective July 1, 2011, the
commissioner shall increase the home and
community-based service rates and county
allocations provided to programs for persons
with disabilities established under section
1915(c) of the Social Security Act to the
extent that these programs will be paying
for the costs above the rate established
in Minnesota Statutes, section 256I.05,
subdivision 1.

(b) For persons receiving services under
Minnesota Statutes, section 245A.02, who
reside in licensed adult foster care beds
for which a difficulty of care payment
was being made under Minnesota Statutes,
section 256I.05, subdivision 1c, paragraph
(b), counties may request an exception to
the individual's service authorization not to
exceed the difference between the client's
monthly service expenditures plus the
amount of the difficulty of care payment.

(l) Children's Mental Health Grants

16,885,000

16,882,000

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.

(m) Other Children and Economic Assistance Grants

16,047,000

15,339,000

Fraud Prevention Grants. Of this
appropriation, $228,000 in fiscal year 2010
and deleted text begin $228,000 deleted text end new text begin $379,000 new text end in fiscal year 2011
is to the commissioner for fraud prevention
grants to counties.

Homeless and Runaway Youth. $218,000
in fiscal year 2010 is for the Runaway
and Homeless Youth Act under Minnesota
Statutes, section 256K.45. Funds shall be
spent in each area of the continuum of care
to ensure that programs are meeting the
greatest need. Any unexpended balance in
the first year is available in the second year.
Beginning July 1, 2011, the base is increased
by $119,000 each year.

ARRA Homeless Youth Funds. To the
extent permitted under federal law, the
commissioner shall designate $2,500,000
of the Homeless Prevention and Rapid
Re-Housing Program funds provided under
the American Recovery and Reinvestment
Act of 2009, Public Law 111-5, for agencies
providing homelessness prevention and rapid
rehousing services to youth.

Supportive Housing Services. $1,500,000
each year is for supportive services under
Minnesota Statutes, section 256K.26. This is
a onetime appropriation.

Community Action Grants. Community
action grants are reduced one time by
$1,794,000 each year. This reduction is due
to the availability of federal funds under the
American Recovery and Reinvestment Act.

Base Adjustment. The general fund base
is increased by deleted text begin $773,000 deleted text end new text begin $903,000 new text end in fiscal
year 2012 and deleted text begin $773,000 deleted text end new text begin $413,000 new text end in fiscal
year 2013.

Federal ARRA Funds for Existing
Programs. deleted text begin (a) deleted text end new text begin (1) new text end Federal funds received by
the commissioner for the emergency food
and shelter program from the American
Recovery and Reinvestment Act of 2009,
Public Law 111-5, but not previously
approved by the legislature are appropriated
to the commissioner for the purposes of the
grant program.

deleted text begin (b) deleted text end new text begin (2) new text end Federal funds received by the
commissioner for the emergency shelter
grant program including the Homelessness
Prevention and Rapid Re-Housing
Program from the American Recovery and
Reinvestment Act of 2009, Public Law
111-5, are appropriated to the commissioner
for the purposes of the grant programs.

deleted text begin (c) deleted text end new text begin (3) new text end Federal funds received by the
commissioner for the emergency food
assistance program from the American
Recovery and Reinvestment Act of 2009,
Public Law 111-5, are appropriated to the
commissioner for the purposes of the grant
program.

deleted text begin (d) deleted text end new text begin (4) new text end Federal funds received by the
commissioner for senior congregate meals
and senior home-delivered meals from the
American Recovery and Reinvestment Act
of 2009, Public Law 111-5, are appropriated
to the commissioner for the Minnesota Board
on Aging, for purposes of the grant programs.

deleted text begin (e) deleted text end new text begin (5) new text end Federal funds received by the
commissioner for the community services
block grant program from the American
Recovery and Reinvestment Act of 2009,
Public Law 111-5, are appropriated to the
commissioner for the purposes of the grant
program.

Long-Term Homeless Supportive
Service Fund Appropriation. To the
extent permitted under federal law, the
commissioner shall designate $3,000,000
of the Homelessness Prevention and Rapid
Re-Housing Program funds provided under
the American Recovery and Reinvestment
Act of 2009, Public Law, 111-5, to the
long-term homeless service fund under
Minnesota Statutes, section 256K.26. This
appropriation shall become available by July
1, 2009. This paragraph is effective the day
following final enactment.

Sec. 16.

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

Subd. 8. Continuing Care Grants

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

(a) Aging and Adult Services Grants

13,499,000

15,805,000

Base Adjustment. The general fund base is
increased by $5,751,000 in fiscal year 2012
and $6,705,000 in fiscal year 2013.

Information and Assistance
Reimbursement. Federal administrative
reimbursement obtained from information
and assistance services provided by the
Senior LinkAge or Disability Linkage lines
to people who are identified as eligible for
medical assistance shall be appropriated to
the commissioner for this activity.

Community Service Development Grant
Reduction. Funding for community service
development grants must be reduced by
$260,000 for fiscal year 2010; $284,000 in
fiscal year 2011; $43,000 in fiscal year 2012;
and $43,000 in fiscal year 2013. Base level
funding shall be restored in fiscal year 2014.

Community Service Development Grant
Community Initiative. Funding for
community service development grants shall
be used to offset the cost of aging support
grants. Base level funding shall be restored
in fiscal year 2014.

Senior Nutrition Use of Federal Funds.
For fiscal year 2010, general fund grants
for home-delivered meals and congregate
dining shall be reduced by $500,000. The
commissioner must replace these general
fund reductions with equal amounts from
federal funding for senior nutrition from the
American Recovery and Reinvestment Act
of 2009.

(b) Alternative Care Grants

50,234,000

48,576,000

Base Adjustment. The general fund base is
decreased by $3,598,000 in fiscal year 2012
and $3,470,000 in fiscal year 2013.

Alternative Care Transfer. Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but must be transferred to the
medical assistance account.

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

367,444,000

419,749,000

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

853,567,000

1,039,517,000

Manage Growth in TBI and CADI
Waivers. During the fiscal years beginning
on July 1, 2009, and July 1, 2010, the
commissioner shall allocate money for home
and community-based waiver programs
under Minnesota Statutes, section 256B.49,
to ensure a reduction in state spending that is
equivalent to limiting the caseload growth of
the TBI waiver to 12.5 allocations per month
each year of the biennium and the CADI
waiver to 95 allocations per month each year
of the biennium. Limits do not apply: (1)
when there is an approved plan for nursing
facility bed closures for individuals under
age 65 who require relocation due to the
bed closure; (2) to fiscal year 2009 waiver
allocations delayed due to unallotment; or (3)
to transfers authorized by the commissioner
from the personal care assistance program
of individuals having a home care rating
of "CS," "MT," or "HL." Priorities for the
allocation of funds must be for individuals
anticipated to be discharged from institutional
settings or who are at imminent risk of a
placement in an institutional setting.

Manage Growth in DD Waiver. The
commissioner shall manage the growth in
the DD waiver by limiting the allocations
included in the February 2009 forecast to 15
additional diversion allocations each month
for the calendar years that begin on January
1, 2010, and January 1, 2011. Additional
allocations must be made available for
transfers authorized by the commissioner
from the personal care program of individuals
having a home care rating of "CS," "MT,"
or "HL."

Adjustment to Lead Agency Waiver
Allocations. Prior to the availability of the
alternative license defined in Minnesota
Statutes, section 245A.11, subdivision 8,
the commissioner shall reduce lead agency
waiver allocations for the purposes of
implementing a moratorium on corporate
foster care.

Alternatives to Personal Care Assistance
Services. Base level funding of $3,237,000
in fiscal year 2012 and $4,856,000 in
fiscal year 2013 is to implement alternative
services to personal care assistance services
for persons with mental health and other
behavioral challenges who can benefit
from other services that more appropriately
meet their needs and assist them in living
independently in the community. These
services may include, but not be limited to, a
1915(i) state plan option.

(e) Mental Health Grants

Appropriations by Fund
General	77,739,000	77,739,000
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.

(f) Deaf and Hard-of-Hearing Grants

1,930,000

1,917,000

(g) Chemical Dependency Entitlement Grants

111,303,000

122,822,000

Payments for Substance Abuse Treatment.
For services provided during fiscal years
2010 and 2011, county-negotiated rates
and provider claims to the consolidated
chemical dependency fund must not exceed new text begin
the lesser of: (1) new text end rates charged for these
services on January 1, 2009 new text begin ; or (2) 160
percent of the average rate on January 1,
2009, for each group of vendors with similar
attributes new text end . For services provided in fiscal
years 2012 and 2013, new text begin the new text end statewide deleted text begin average
rates deleted text end new text begin aggregate payment new text end under the new
rate methodology to be developed under
Minnesota Statutes, section 254B.12, must
not exceed the deleted text begin average rates charged for
these services on January 1, 2009, plus a
state share increase of $3,787,000 for fiscal
year 2012 and $5,023,000 for fiscal year
2013 deleted text end new text begin projected aggregate payment under
the rates in effect for fiscal year 2010 minus
1.25 percent new text end . Notwithstanding any provision
to the contrary in this article, this provision
expires on June 30, 2013.

Chemical Dependency Special Revenue
Account. For fiscal year 2010, $750,000
must be transferred from the consolidated
chemical dependency treatment fund
administrative account and deposited into the
general fund.

County CD Share of MA Costs for
ARRA Compliance. Notwithstanding the
provisions of Minnesota Statutes, chapter
254B, for chemical dependency services
provided during the period October 1, 2008,
to December 31, 2010, and reimbursed by
medical assistance at the enhanced federal
matching rate provided under the American
Recovery and Reinvestment Act of 2009, the
county share is 30 percent of the nonfederal
share. This provision is effective the day
following final enactment.

(h) Chemical Dependency Nonentitlement Grants

1,729,000

1,729,000

(i) Other Continuing Care Grants

19,201,000

17,528,000

Base Adjustment. The general fund base is
increased by $2,639,000 in fiscal year 2012
and increased by $3,854,000 in fiscal year
2013.

Technology Grants. $650,000 in fiscal
year 2010 and $1,000,000 in fiscal year
2011 are for technology grants, case
consultation, evaluation, and consumer
information grants related to developing and
supporting alternatives to shift-staff foster
care residential service models.

Other Continuing Care Grants; HIV
Grants. Money appropriated for the HIV
drug and insurance grant program in fiscal
year 2010 may be used in either year of the
biennium.

Quality Assurance Commission. Effective
July 1, 2009, state funding for the quality
assurance commission under Minnesota
Statutes, section 256B.0951, is canceled.

Sec. 17.

Laws 2009, chapter 79, article 13, section 5, subdivision 8, as amended by
Laws 2009, chapter 173, article 2, section 3, subdivision 8, is amended to read:

Subd. 8. Board of Nursing Home Administrators

1,211,000

1,023,000

Administrative Services Unit - Operating
Costs. Of this appropriation, $524,000
in fiscal year 2010 and $526,000 in
fiscal year 2011 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
2010, $201,000 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, $79,000 in fiscal year 2010
and $89,000 in fiscal year 2011 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
2010 and $200,000 in fiscal year 2011 are
for costs of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards funded
under this section new text begin and for unforeseen
expenditures of an urgent nature new text end . 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
finance. This appropriation does not cancel.
Any unencumbered and unspent balances
remain available for these expenditures in
subsequent fiscal years. new text begin The boards receiving
funds under this section shall include these
amounts when setting fees to cover their
costs.
new text end

Sec. 18. new text begin LOCAL SHARE PAYMENT MODIFICATION REQUIRED FOR
EXTENSION OF ENHANCED FMAP.
new text end

new text begin Upon federal enactment of an extension of the enhanced federal medical assistance
percentage (FMAP) originally provided under Public Law 111-5 to June 30, 2011,
effective from January 1, 2011, through June 30, 2011, the state shall reduce Hennepin
County's monthly contribution to the nonfederal share of medical assistance costs to the
percentage required on September 1, 2008, to meet federal requirements for enhanced
federal medical assistance percentage (FMAP) originally provided under Public Law
111-5. Upon enactment of this extension of the enhanced FMAP, notwithstanding the
requirements of Minnesota Statutes 2008, section 256B.19, subdivision 1c, paragraph (d),
for the period beginning January 1, 2011, through June 30, 2011, Hennepin County's
monthly payment under that provision is reduced to $434,688.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal enactment of an
extension of enhanced FMAP from January 1, 2011, through June 30, 2011.
new text end

Sec. 19. new text begin CAPITATION PAYMENTS.
new text end

new text begin Upon federal enactment of an extension of the enhanced federal medical assistance
percentage (FMAP) originally provided under Public Law 111-5 to June 30, 2011,
effective from January 1, 2011, through June 30, 2011, the commissioner of human
services shall increase capitation payments made to the Metropolitan Health Plan under
Minnesota Statutes, section 256B.19, subdivision 1c, paragraph (c), by $6,800,000. The
increased amount includes federal matching funds.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal enactment of an
extension of enhanced FMAP from January 1, 2011, through June 30, 2011.
new text end

Sec. 20. new text begin COUNTY CHEMICAL DEPENDENCY SHARE OF MEDICAL
ASSISTANCE COSTS REQUIRED FOR EXTENSION OF ENHANCED FMAP.
new text end

new text begin Upon federal enactment of an extension of the enhanced federal medical assistance
percentage (FMAP) originally provided under Public Law 111-5 to June 30, 2011,
and notwithstanding the provisions of Minnesota Statutes, chapter 254B, for chemical
dependency services provided during the period January 1, 2011, through June 20, 2011,
and reimbursed by medical assistance at the enhanced FMAP rate, the county share is 30
percent of the nonfederal share.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal enactment of an
extension of enhanced FMAP from January 1, 2011, through June 30, 2011.
new text end

Sec. 21. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2011, unless a
different expiration date is explicit.
new text end

Sec. 22. new text begin EFFECTIVE DATE.
new text end

new text begin The provisions in this article are effective July 1, 2010, unless a different effective
date is explicit.
new text end