SF 760A

Conference Committee Report - 87th Legislature (2011 - 2012) Posted on 01/15/2013 08:29pm

1.1CONFERENCE COMMITTEE REPORT ON S.F. No. 760

1.2A bill for an act

1.3relating to state government; establishing the health and human services budget;
1.4modifying provisions related to continuing care, chemical and mental health,
1.5children and family services, human services licensing, health care programs,
1.6the Department of Health, and health licensing boards; appropriating money to
1.7the departments of health and human services and other health-related boards
1.8and councils; making forecast adjustments; requiring reports; imposing fees;
1.9imposing criminal penalties;amending Minnesota Statutes 2010, sections 8.31,
1.10subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.04, subdivision 3;
1.1162J.17, subdivision 4a; 62J.692, subdivisions 4, 7; 103I.005, subdivisions
1.122, 8, 12, by adding a subdivision; 103I.101, subdivisions 2, 5; 103I.105;
1.13103I.111, subdivision 8; 103I.205, subdivision 4; 103I.208, subdivision 2;
1.14103I.501; 103I.531, subdivision 5; 103I.535, subdivision 6; 103I.641; 103I.711,
1.15subdivision 1; 103I.715, subdivision 2; 119B.011, subdivision 13; 119B.09,
1.16subdivision 10, by adding subdivisions; 119B.125, by adding a subdivision;
1.17119B.13, subdivisions 1, 1a, 7; 144.125, subdivisions 1, 3; 144.128; 144.396,
1.18subdivisions 5, 6; 145.925, subdivision 1; 145.928, subdivisions 7, 8; 148.108, by
1.19adding a subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231;
1.20151.07; 151.101; 151.102, by adding a subdivision; 151.12; 151.13, subdivision
1.211; 151.19; 151.25; 151.47, subdivision 1; 151.48; 152.12, subdivision 3;
1.22245A.10, subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision
1.232b; 245A.143, subdivision 1; 245C.10, by adding a subdivision; 254B.03,
1.24subdivision 4; 254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01,
1.25subdivisions 14, 24, 29, by adding a subdivision; 256.969, subdivision 2b;
1.26256B.04, subdivision 18; 256B.056, subdivisions 1a, 3; 256B.057, subdivision
1.279; 256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 12, 13e,
1.2817, 17a, 18, 19a, 25, 31a, by adding subdivisions; 256B.0651, subdivision 1;
1.29256B.0652, subdivision 6; 256B.0653, subdivisions 2, 6; 256B.0911, subdivision
1.303a; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 6,
1.3110; 256B.14, by adding a subdivision; 256B.431, subdivisions 2r, 32, 42, by
1.32adding a subdivision; 256B.437, subdivision 6; 256B.441, subdivisions 50a,
1.3359; 256B.48, subdivision 1; 256B.49, subdivision 16a; 256B.69, subdivisions
1.344, 5a, by adding a subdivision; 256B.76, subdivision 4; 256D.02, subdivision
1.3512a; 256D.031, subdivisions 6, 7, 9; 256D.44, subdivision 5; 256D.47; 256D.49,
1.36subdivision 3; 256E.30, subdivision 2; 256E.35, subdivisions 5, 6; 256J.12,
1.37subdivisions 1a, 2; 256J.37, by adding a subdivision; 256J.38, subdivision 1;
1.38256L.04, subdivision 7; 256L.05, by adding a subdivision; 256L.11, subdivision
1.397; 256L.12, subdivision 9; 297F.10, subdivision 1; 393.07, subdivision 10;
1.40402A.10, subdivisions 4, 5; 402A.15; 518A.51; Laws 2008, chapter 363, article
1.4118, section 3, subdivision 5; Laws 2010, First Special Session chapter 1, article
1.4215, section 3, subdivision 6; article 25, section 3, subdivision 6; proposing
1.43coding for new law in Minnesota Statutes, chapters 1; 145; 148; 151; 214; 256;
2.1256B; 256L; proposing coding for new law as Minnesota Statutes, chapter
2.2256N; repealing Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a,
2.36a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 103I.005,
2.4subdivision 20; 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3,
2.54; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 145.925;
2.6145A.14, subdivisions 1, 2a; 245A.10, subdivision 5; 256.979, subdivisions
2.75, 6, 7, 10; 256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e;
2.8256B.0653, subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e,
2.92; 256D.03, subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05,
2.10subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3;
2.11256D.06, subdivisions 1, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6;
2.12256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws
2.132010, First Special Session chapter 1, article 16, sections 6; 7; Minnesota Rules,
2.14parts 3400.0130, subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11,
2.1512, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5;
2.164651.0120; 4651.0130; 4651.0140; 4651.0150; 9500.1243, subpart 3.
2.17May 17, 2011
2.18The Honorable Michelle L. Fischbach
2.19President of the Senate
2.20The Honorable Kurt Zellers
2.21Speaker of the House of Representatives
2.22We, the undersigned conferees for S.F. No. 760 report that we have agreed upon the
2.23items in dispute and recommend as follows:
2.24That the House recede from its amendments and that S.F. No. 760 be further
2.25amended as follows:
2.26Delete everything after the enacting clause and insert:

2.27
"ARTICLE 1

2.28CHILDREN AND FAMILY SERVICES

2.29    Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to
2.30read:
2.31    Subd. 13. Family. "Family" means parents, stepparents, guardians and their spouses,
2.32or other eligible relative caregivers and their spouses, and their blood related dependent
2.33children and adoptive siblings under the age of 18 years living in the same home including
2.34children temporarily absent from the household in settings such as schools, foster care, and
2.35residential treatment facilities or parents, stepparents, guardians and their spouses, or other
2.36relative caregivers and their spouses temporarily absent from the household in settings
2.37such as schools, military service, or rehabilitation programs. An adult family member who
2.38is not in an authorized activity under this chapter may be temporarily absent for up to 60
2.39days. When a minor parent or parents and his, her, or their child or children are living with
2.40other relatives, and the minor parent or parents apply for a child care subsidy, "family"
2.41means only the minor parent or parents and their child or children. An adult age 18 or
2.42older who meets this definition of family and is a full-time high school or postsecondary
3.1student may be considered a dependent member of the family unit if 50 percent or more of
3.2the adult's support is provided by the parents, stepparents, guardians, and their spouses or
3.3eligible relative caregivers and their spouses residing in the same household.
3.4EFFECTIVE DATE.This section is effective April 16, 2012.

3.5    Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:
3.6    Subd. 4. Assistance. (a) A family is limited to a lifetime total of 12 months of
3.7assistance under subdivision 2. The maximum rate of assistance is equal to 90 68 percent
3.8of the rate established under section 119B.13 for care of infants in licensed family child
3.9care in the applicant's county of residence.
3.10(b) A participating family must report income and other family changes as specified
3.11in the county's plan under section 119B.08, subdivision 3.
3.12(c) Persons who are admitted to the at-home infant child care program retain their
3.13position in any basic sliding fee program. Persons leaving the at-home infant child care
3.14program reenter the basic sliding fee program at the position they would have occupied.
3.15(d) Assistance under this section does not establish an employer-employee
3.16relationship between any member of the assisted family and the county or state.
3.17EFFECTIVE DATE.This section is effective October 31, 2011.

3.18    Sec. 3. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
3.19to read:
3.20    Subd. 9a. Child care centers; assistance. (a) For the purposes of this subdivision,
3.21"qualifying child" means a child who satisfies both of the following:
3.22(1) is not a child or dependent of an employee of the child care provider; and
3.23(2) does not reside with an employee of the child care provider.
3.24(b) Funds distributed under this chapter must not be paid for child care services
3.25that are provided for a child by a child care provider who employs either the parent of
3.26the child or a person who resides with the child, unless at all times at least 50 percent of
3.27the children for whom the child care provider is providing care are qualifying children
3.28under paragraph (a).
3.29(c) If a child care provider satisfies the requirements for payment under paragraph
3.30(b), but the percentage of qualifying children under paragraph (a) for whom the provider
3.31is providing care falls below 50 percent, the provider shall have four weeks to raise the
3.32percentage of qualifying children for whom the provider is providing care to at least 50
4.1percent before payments to the provider are discontinued for child care services provided
4.2for a child who is not a qualifying child.
4.3EFFECTIVE DATE.This section is effective January 1, 2013.

4.4    Sec. 4. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
4.5    Subd. 10. Payment of funds. All federal, state, and local child care funds must
4.6be paid directly to the parent when a provider cares for children in the children's own
4.7home. In all other cases, all federal, state, and local child care funds must be paid directly
4.8to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible
4.9family. Funds distributed under this chapter must not be used for child care services that
4.10are provided for a child by a child care provider who resides in the same household or
4.11occupies the same residence as the child.
4.12EFFECTIVE DATE.This section is effective March 5, 2012.

4.13    Sec. 5. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
4.14to read:
4.15    Subd. 13. Child care in the child's home. Child care assistance must only be
4.16authorized in the child's home if the child's parents have authorized activities outside of
4.17the home and if one or more of the following circumstances are met:
4.18(1) the parents' qualifying activity occurs during times when out-of-home care is
4.19not available. If child care is needed during any period when out-of-home care is not
4.20available, in-home care can be approved for the entire time care is needed;
4.21(2) the family lives in an area where out-of-home care is not available; or
4.22(3) a child has a verified illness or disability that would place the child or other
4.23children in an out-of-home facility at risk or creates a hardship for the child and the family
4.24to take the child out of the home to a child care home or center.
4.25EFFECTIVE DATE.This section is effective March 5, 2012.

4.26    Sec. 6. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision
4.27to read:
4.28    Subd. 1b. Training required. (a) Effective November 1, 2011, prior to initial
4.29authorization as required in subdivision 1, a legal nonlicensed family child care provider
4.30must complete first aid and CPR training and provide the verification of first aid and CPR
4.31training to the county. The training documentation must have valid effective dates as of
5.1the date the registration request is submitted to the county and the training must have been
5.2provided by an individual approved to provide first aid and CPR instruction.
5.3(b) Legal nonlicensed family child care providers with an authorization effective
5.4before November 1, 2011, must be notified of the requirements before October 1, 2011, or
5.5at authorization, and must meet the requirements upon renewal of an authorization that
5.6occurs on or after January 1, 2012.
5.7(c) Upon each reauthorization after the authorization period when the initial first aid
5.8and CPR training requirements are met, a legal nonlicensed family child care provider
5.9must provide verification of at least eight hours of additional training listed in the
5.10Minnesota Center for Professional Development Registry.
5.11(d) This subdivision only applies to legal nonlicensed family child care providers.

5.12    Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
5.13    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006 October 31, 2011,
5.14the maximum rate paid for child care assistance in any county or multicounty region under
5.15the child care fund shall be the rate for like-care arrangements in the county effective
5.16January July 1, 2006, increased decreased by six five percent.
5.17    (b) Rate changes shall be implemented for services provided in September 2006
5.18unless a participant eligibility redetermination or a new provider agreement is completed
5.19between July 1, 2006, and August 31, 2006.
5.20    As necessary, appropriate notice of adverse action must be made according to
5.21Minnesota Rules, part 3400.0185, subparts 3 and 4.
5.22    New cases approved on or after July 1, 2006, shall have the maximum rates under
5.23paragraph (a), implemented immediately.
5.24    (c) (b) Every year, the commissioner shall survey rates charged by child care
5.25providers in Minnesota to determine the 75th percentile for like-care arrangements in
5.26counties. When the commissioner determines that, using the commissioner's established
5.27protocol, the number of providers responding to the survey is too small to determine
5.28the 75th percentile rate for like-care arrangements in a county or multicounty region,
5.29the commissioner may establish the 75th percentile maximum rate based on like-care
5.30arrangements in a county, region, or category that the commissioner deems to be similar.
5.31    (d) (c) A rate which includes a special needs rate paid under subdivision 3 or under a
5.32school readiness service agreement paid under section 119B.231, may be in excess of the
5.33maximum rate allowed under this subdivision.
5.34    (e) (d) The department shall monitor the effect of this paragraph on provider rates.
5.35The county shall pay the provider's full charges for every child in care up to the maximum
6.1established. The commissioner shall determine the maximum rate for each type of care
6.2on an hourly, full-day, and weekly basis, including special needs and disability care. The
6.3maximum payment to a provider for one day of care must not exceed the daily rate. The
6.4maximum payment to a provider for one week of care must not exceed the weekly rate.
6.5(e) Child care providers receiving reimbursement under this chapter must not be
6.6paid activity fees or an additional amount above the maximum rates for care provided
6.7during nonstandard hours for families receiving assistance.
6.8    (f) When the provider charge is greater than the maximum provider rate allowed,
6.9the parent is responsible for payment of the difference in the rates in addition to any
6.10family co-payment fee.
6.11    (g) All maximum provider rates changes shall be implemented on the Monday
6.12following the effective date of the maximum provider rate.
6.13EFFECTIVE DATE.Paragraph (d) is effective April 16, 2012. Paragraph (e)
6.14is effective September 3, 2012.

6.15    Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
6.16    Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal
6.17nonlicensed family child care providers receiving reimbursement under this chapter must
6.18be paid on an hourly basis for care provided to families receiving assistance.
6.19(b) The maximum rate paid to legal nonlicensed family child care providers must be
6.2080 68 percent of the county maximum hourly rate for licensed family child care providers.
6.21In counties where the maximum hourly rate for licensed family child care providers is
6.22higher than the maximum weekly rate for those providers divided by 50, the maximum
6.23hourly rate that may be paid to legal nonlicensed family child care providers is the rate
6.24equal to the maximum weekly rate for licensed family child care providers divided by 50
6.25and then multiplied by 0.80 0.68. The maximum payment to a provider for one day of care
6.26must not exceed the maximum hourly rate times ten. The maximum payment to a provider
6.27for one week of care must not exceed the maximum hourly rate times 50.
6.28(c) A rate which includes a special needs rate paid under subdivision 3 may be in
6.29excess of the maximum rate allowed under this subdivision.
6.30(d) Legal nonlicensed family child care providers receiving reimbursement under
6.31this chapter may not be paid registration fees for families receiving assistance.
6.32EFFECTIVE DATE.This section is effective April 16, 2012, except the
6.33amendment changing 80 to 68 and 0.80 to 0.68 is effective October 31, 2011.

7.1    Sec. 9. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
7.2    Subd. 7. Absent days. (a) Licensed child care providers may and license-exempt
7.3centers must not be reimbursed for more than 25 ten full-day absent days per child,
7.4excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days,
7.5unless the child has a documented medical condition that causes more frequent absences.
7.6Absences due to a documented medical condition of a parent or sibling who lives in the
7.7same residence as the child receiving child care assistance do not count against the 25-day
7.8absent day limit in a fiscal year. Documentation of medical conditions must be on the
7.9forms and submitted according to the timelines established by the commissioner. A public
7.10health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a
7.11provider sends a child home early due to a medical reason, including, but not limited to,
7.12fever or contagious illness, the child care center director or lead teacher may verify the
7.13illness in lieu of a medical practitioner. Legal nonlicensed family child care providers
7.14must not be reimbursed for absent days. If a child attends for part of the time authorized to
7.15be in care in a day, but is absent for part of the time authorized to be in care in that same
7.16day, the absent time will must be reimbursed but the time will must not count toward the
7.17ten consecutive or 25 cumulative absent day limits limit. Children in families where at
7.18least one parent is under the age of 21, does not have a high school or general equivalency
7.19diploma, and is a student in a school district or another similar program that provides or
7.20arranges for child care, as well as parenting, social services, career and employment
7.21supports, and academic support to achieve high school graduation, may be exempt from
7.22the absent day limits upon request of the program and approval of the county. If a child
7.23attends part of an authorized day, payment to the provider must be for the full amount
7.24of care authorized for that day. Child care providers may must only be reimbursed for
7.25absent days if the provider has a written policy for child absences and charges all other
7.26families in care for similar absences.
7.27    (b) Child care providers must be reimbursed for up to ten federal or state holidays
7.28or designated holidays per year when the provider charges all families for these days
7.29and the holiday or designated holiday falls on a day when the child is authorized to be
7.30in attendance. Parents may substitute other cultural or religious holidays for the ten
7.31recognized state and federal holidays. Holidays do not count toward the ten consecutive
7.32or 25 cumulative absent day limits limit.
7.33    (c) A family or child care provider may must not be assessed an overpayment for an
7.34absent day payment unless (1) there was an error in the amount of care authorized for the
7.35family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
7.36the family or provider did not timely report a change as required under law.
8.1    (d) The provider and family must receive notification of the number of absent days
8.2used upon initial provider authorization for a family and when the family has used 15
8.3cumulative absent days. Upon statewide implementation of the Minnesota Electronic
8.4Child Care System, the provider and family shall receive notification of the number of
8.5absent days used upon initial provider authorization for a family and ongoing notification
8.6of the number of absent days used as of the date of the notification.
8.7    (e) A county may pay for more absent days than the statewide absent day policy
8.8established under this subdivision if current market practice in the county justifies payment
8.9for those additional days. County policies for payment of absent days in excess of the
8.10statewide absent day policy and justification for these county policies must be included in
8.11the county's child care fund plan under section 119B.08, subdivision 3.
8.12EFFECTIVE DATE.This section is effective January 1, 2013.

8.13    Sec. 10. [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
8.14    Subdivision 1. Electronic benefit transfer (EBT) card. Cash benefits for the
8.15general assistance and Minnesota supplemental aid programs under chapter 256D and
8.16programs under chapter 256J must be issued on a separate EBT card with the name of the
8.17head of household printed on the card. The card must include the following statement: "It
8.18is unlawful to use this card to purchase tobacco products or alcoholic beverages." This
8.19card must be issued within 30 calendar days of an eligibility determination. During the
8.20initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT
8.21card without a name printed on the card. This card may be the same card on which food
8.22support benefits are issued and does not need to meet the requirements of this section.
8.23    Subd. 2. EBT card use restricted to Minnesota vendors. EBT cardholders
8.24receiving cash benefits under the general assistance and Minnesota supplemental aid
8.25programs under chapter 256D or programs under chapter 256J are prohibited from using
8.26their EBT cards at vendors located outside of Minnesota. This subdivision does not apply
8.27to food support benefits.
8.28    Subd. 3. Prohibited purchases. EBT debit cardholders in programs listed under
8.29subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products
8.30and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for
8.31an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic
8.32beverages with the cardholder's EBT card. Violation of this subdivision is a petty
8.33misdemeanor. A retailer must not be held liable for the crime of another under section
8.34609.05, for actions taken under this subdivision.
9.1EFFECTIVE DATE.Subdivisions 1 and 2 of this section are effective June 1, 2012.

9.2    Sec. 11. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to
9.3read:
9.4    Subd. 12a. Resident; general assistance medical care. (a) For purposes of
9.5eligibility for general assistance and general assistance medical care, a person must be a
9.6resident of this state.
9.7(b) A "resident" is a person living in the state for at least 30 days with the intention of
9.8making the person's home here and not for any temporary purpose. Time spent in a shelter
9.9for battered women shall count toward satisfying the 30-day residency requirement. All
9.10applicants for these programs are required to demonstrate the requisite intent and can do
9.11so in any of the following ways:
9.12(1) by showing that the applicant maintains a residence at a verified address, other
9.13than a place of public accommodation. An applicant may verify a residence address by
9.14presenting a valid state driver's license,; a state identification card,; a voter registration
9.15card,; a rent receipt,; a statement by the landlord, apartment manager, or homeowner
9.16verifying that the individual is residing at the address,; or other form of verification
9.17approved by the commissioner; or
9.18(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
9.193, item C.
9.20(c) For general assistance medical care, a county agency shall waive the 30-day
9.21residency requirement in cases of medical emergencies. For general assistance, a county
9.22shall waive the 30-day residency requirement where unusual hardship would result from
9.23denial of general assistance. For purposes of this subdivision, "unusual hardship" means
9.24the applicant is without shelter or is without available resources for food.
9.25The county agency must report to the commissioner within 30 days on any waiver
9.26granted under this section. The county shall not deny an application solely because the
9.27applicant does not meet at least one of the criteria in this subdivision, but shall continue to
9.28process the application and leave the application pending until the residency requirement
9.29is met or until eligibility or ineligibility is established.
9.30(d) For purposes of paragraph (c), the following definitions apply (1) "metropolitan
9.31statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes
9.32any shelter that is located within the metropolitan statistical area containing the county
9.33and for which the applicant is eligible, provided the applicant does not have to travel more
9.34than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
9.35does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
10.1(e) Migrant workers as defined in section 256J.08 and, until March 31, 1998, their
10.2immediate families are exempt from the residency requirements of this section, provided
10.3the migrant worker provides verification that the migrant family worked in this state
10.4within the last 12 months and earned at least $1,000 in gross wages during the time the
10.5migrant worker worked in this state.
10.6(f) For purposes of eligibility for emergency general assistance, the 30-day residency
10.7requirement under this section shall not be waived.
10.8(g) (e) If any provision of this subdivision is enjoined from implementation or found
10.9unconstitutional by any court of competent jurisdiction, the remaining provisions shall
10.10remain valid and shall be given full effect.
10.11EFFECTIVE DATE.This section is effective October 1, 2012.

10.12    Sec. 12. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:
10.13    Subdivision 1. Eligibility. (a) Each assistance unit with income and resources
10.14less than the standard of assistance established by the commissioner and with a member
10.15who is a resident of the state shall be eligible for and entitled to general assistance if
10.16the assistance unit is:
10.17(1) a person who is suffering from a professionally certified permanent or temporary
10.18illness, injury, or incapacity which is expected to continue for more than 30 90 days and
10.19which prevents the person from obtaining or retaining employment;
10.20(2) a person whose presence in the home on a substantially continuous basis is
10.21required because of the professionally certified illness, injury, incapacity, or the age of
10.22another member of the household;
10.23(3) (2) a person who has been placed in, and is residing in, a licensed or certified
10.24facility for purposes of physical or mental health or rehabilitation, or in an approved
10.25chemical dependency domiciliary facility, if the placement is based on illness or incapacity
10.26and is according to a plan developed or approved by the county agency through its
10.27director or designated representative;
10.28(4) (3) a person who resides in a shelter facility described in subdivision 3;
10.29(5) (4) a person not described in clause (1) or (3) (2) who is diagnosed by a licensed
10.30physician, psychological practitioner, or other qualified professional, as developmentally
10.31disabled or mentally ill, and that condition prevents the person from obtaining or retaining
10.32employment;
10.33(6) a person who has an application pending for, or is appealing termination of
10.34benefits from, the Social Security disability program or the program of supplemental
10.35security income for the aged, blind, and disabled, provided the person has a professionally
11.1certified permanent or temporary illness, injury, or incapacity which is expected to
11.2continue for more than 30 days and which prevents the person from obtaining or retaining
11.3employment;
11.4(7) a person who is unable to obtain or retain employment because advanced age
11.5significantly affects the person's ability to seek or engage in substantial work;
11.6(8) (5) a person who has been assessed by a vocational specialist and, in consultation
11.7with the county agency, has been determined to be unemployable for purposes of this
11.8clause; a person is considered employable if there exist positions of employment in the
11.9local labor market, regardless of the current availability of openings for those positions,
11.10that the person is capable of performing. The person's eligibility under this category must
11.11be reassessed at least annually. The county agency must provide notice to the person not
11.12later than 30 days before annual eligibility under this item ends, informing the person of the
11.13date annual eligibility will end and the need for vocational assessment if the person wishes
11.14to continue eligibility under this clause. For purposes of establishing eligibility under this
11.15clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
11.16(9) (6) a person who is determined by the county agency, according to permanent
11.17rules adopted by the commissioner, to be learning disabled have a condition that qualifies
11.18under Minnesota's special education rules as a specific learning disability, provided that if
11.19a rehabilitation plan for the person is developed or approved by the county agency, and
11.20the person is following the plan;
11.21(10) (7) a child under the age of 18 who is not living with a parent, stepparent, or
11.22legal custodian, and only if: the child is legally emancipated or living with an adult with
11.23the consent of an agency acting as a legal custodian; the child is at least 16 years of age
11.24and the general assistance grant is approved by the director of the county agency or a
11.25designated representative as a component of a social services case plan for the child; or the
11.26child is living with an adult with the consent of the child's legal custodian and the county
11.27agency. For purposes of this clause, "legally emancipated" means a person under the age
11.28of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of
11.29the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv)
11.30is otherwise considered emancipated under Minnesota law, and for whom county social
11.31services has not determined that a social services case plan is necessary, for reasons other
11.32than the child has failed or refuses to cooperate with the county agency in developing
11.33the plan;
11.34(11) (8) a person who is eligible for displaced homemaker services, programs, or
11.35assistance under section 116L.96, but only if that person is enrolled as a full-time student;
12.1(12) a person who lives more than four hours round-trip traveling time from any
12.2potential suitable employment;
12.3(13) (9) a person who is involved with protective or court-ordered services that
12.4prevent the applicant or recipient from working at least four hours per day; or
12.5(14) a person over age 18 whose primary language is not English and who is
12.6attending high school at least half time; or
12.7(15) (10) a person whose alcohol and drug addiction is a material factor that
12.8contributes to the person's disability; applicants who assert this clause as a basis for
12.9eligibility must be assessed by the county agency to determine if they are amenable
12.10to treatment; if the applicant is determined to be not amenable to treatment, but is
12.11otherwise eligible for benefits, then general assistance must be paid in vendor form, for
12.12the individual's shelter costs up to the limit of the grant amount, with the residual, if
12.13any, paid according to section 256D.09, subdivision 2a; if the applicant is determined
12.14to be amenable to treatment, then in order to receive benefits, the applicant must be in
12.15a treatment program or on a waiting list and the benefits must be paid in vendor form,
12.16for the individual's shelter costs, up to the limit of the grant amount, with the residual, if
12.17any, paid according to section 256D.09, subdivision 2a.
12.18(b) As a condition of eligibility under paragraph (a), clauses (1), (3) (2), (5) (4),
12.19(8) (5), and (9) (6), the recipient must complete an interim assistance agreement and
12.20must apply for other maintenance benefits as specified in section 256D.06, subdivision
12.215 , and must comply with efforts to determine the recipient's eligibility for those other
12.22maintenance benefits.
12.23(c) The burden of providing documentation for a county agency to use to verify
12.24eligibility for general assistance or for exemption from the food stamp employment
12.25and training program is upon the applicant or recipient. The county agency shall use
12.26documents already in its possession to verify eligibility, and shall help the applicant or
12.27recipient obtain other existing verification necessary to determine eligibility which the
12.28applicant or recipient does not have and is unable to obtain.
12.29EFFECTIVE DATE.This section is effective May 1, 2012.

12.30    Sec. 13. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:
12.31    Subd. 2. Emergency need. (a) Notwithstanding the provisions of subdivision 1, a
12.32grant of emergency general assistance shall, to the extent funds are available, be made to
12.33an eligible single adult, married couple, or family for an emergency need, as defined in
12.34rules promulgated by the commissioner, where the recipient requests temporary assistance
12.35not exceeding 30 days if an emergency situation appears to exist and the individual or
13.1family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP under
13.2written criteria adopted by the county agency. If an applicant or recipient relates facts
13.3to the county agency which may be sufficient to constitute an emergency situation, the
13.4county agency shall, to the extent funds are available, advise the person of the procedure
13.5for applying for assistance according to this subdivision.
13.6    (b) The applicant must be ineligible for assistance under chapter 256J, must have
13.7annual net income no greater than 200 percent of the federal poverty guidelines for the
13.8previous calendar year, and may receive an emergency general assistance grant is available
13.9to a recipient not more than once in any 12-month period.
13.10    (c) Funding for an emergency general assistance program is limited to the
13.11appropriation. Each fiscal year, the commissioner shall allocate to counties the money
13.12appropriated for emergency general assistance grants based on each county agency's
13.13average share of state's emergency general expenditures for the immediate past three fiscal
13.14years as determined by the commissioner, and may reallocate any unspent amounts to
13.15other counties. No county shall be allocated less than $1,000 for a fiscal year.
13.16    (d) Any emergency general assistance expenditures by a county above the amount of
13.17the commissioner's allocation to the county must be made from county funds.
13.18EFFECTIVE DATE.This section is effective November 1, 2011.

13.19    Sec. 14. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
13.20    Subd. 5. Special needs. In addition to the state standards of assistance established in
13.21subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
13.22Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
13.23center, or a group residential housing facility.
13.24    (a) The county agency shall pay a monthly allowance for medically prescribed
13.25diets if the cost of those additional dietary needs cannot be met through some other
13.26maintenance benefit. The need for special diets or dietary items must be prescribed by
13.27a licensed physician. Costs for special diets shall be determined as percentages of the
13.28allotment for a one-person household under the thrifty food plan as defined by the United
13.29States Department of Agriculture. The types of diets and the percentages of the thrifty
13.30food plan that are covered are as follows:
13.31    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
13.32    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
13.33of thrifty food plan;
13.34    (3) controlled protein diet, less than 40 grams and requires special products, 125
13.35percent of thrifty food plan;
14.1    (4) low cholesterol diet, 25 percent of thrifty food plan;
14.2    (5) high residue diet, 20 percent of thrifty food plan;
14.3    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
14.4    (7) gluten-free diet, 25 percent of thrifty food plan;
14.5    (8) lactose-free diet, 25 percent of thrifty food plan;
14.6    (9) antidumping diet, 15 percent of thrifty food plan;
14.7    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
14.8    (11) ketogenic diet, 25 percent of thrifty food plan.
14.9    (b) Payment for nonrecurring special needs must be allowed for necessary home
14.10repairs or necessary repairs or replacement of household furniture and appliances using
14.11the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
14.12as long as other funding sources are not available.
14.13    (c) A fee for guardian or conservator service is allowed at a reasonable rate
14.14negotiated by the county or approved by the court. This rate shall not exceed five percent
14.15of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
14.16guardian or conservator is a member of the county agency staff, no fee is allowed.
14.17    (d) The county agency shall continue to pay a monthly allowance of $68 for
14.18restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
14.191990, and who eats two or more meals in a restaurant daily. The allowance must continue
14.20until the person has not received Minnesota supplemental aid for one full calendar month
14.21or until the person's living arrangement changes and the person no longer meets the criteria
14.22for the restaurant meal allowance, whichever occurs first.
14.23    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
14.24is allowed for representative payee services provided by an agency that meets the
14.25requirements under SSI regulations to charge a fee for representative payee services. This
14.26special need is available to all recipients of Minnesota supplemental aid regardless of
14.27their living arrangement.
14.28    (f) (a)(1) Notwithstanding the language in this subdivision, An amount equal to the
14.29maximum allotment authorized by the federal Food Stamp Program for a single individual
14.30which is in effect on the first day of July of each year will be added to the standards of
14.31assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
14.32as shelter needy and are: (i) relocating from an institution, or an adult mental health
14.33residential treatment program under section 256B.0622; (ii) eligible for the self-directed
14.34supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
14.35community-based waiver recipients living in their own home or rented or leased apartment
15.1which is not owned, operated, or controlled by a provider of service not related by blood
15.2or marriage, unless allowed under paragraph (g) (b).
15.3    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
15.4shelter needy benefit under this paragraph is considered a household of one. An eligible
15.5individual who receives this benefit prior to age 65 may continue to receive the benefit
15.6after the age of 65.
15.7    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
15.8exceed 40 percent of the assistance unit's gross income before the application of this
15.9special needs standard. "Gross income" for the purposes of this section is the applicant's or
15.10recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
15.11in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
15.12state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
15.13considered shelter needy for purposes of this paragraph.
15.14(g) Notwithstanding this subdivision, (b) To access housing and services as provided
15.15in paragraph (f) (a), the recipient may choose housing that may be owned, operated, or
15.16controlled by the recipient's service provider. In a multifamily building of four or more
15.17units, the maximum number of apartments that may be used by recipients of this program
15.18shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.
15.19EFFECTIVE DATE.This section is effective August 1, 2011.

15.20    Sec. 15. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:
15.21    Subdivision 1. Eligibility. A county agency must grant emergency Minnesota
15.22supplemental aid, to the extent funds are available, if the recipient is without adequate
15.23resources to resolve an emergency that, if unresolved, will threaten the health or safety of
15.24the recipient. For the purposes of this section, the term "recipient" includes persons for
15.25whom a group residential housing benefit is being paid under sections 256I.01 to 256I.06.
15.26Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency
15.27need may apply for emergency general assistance under section 256D.06, subdivision 2.
15.28EFFECTIVE DATE.This section is effective November 1, 2011.

15.29    Sec. 16. Minnesota Statutes 2010, section 256D.47, is amended to read:
15.30256D.47 PAYMENT METHODS.
15.31Minnesota supplemental aid payments must be issued to the recipient, a protective
15.32payee, or a conservator or guardian of the recipient's estate in the form of county warrants
15.33immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the
16.1recipient's account in a financial institution. Minnesota supplemental aid payments must
16.2be issued regularly on the first day of the month. The supplemental aid warrants must be
16.3mailed only to the address at which the recipient resides, unless another address has been
16.4approved in advance by the county agency. Vendor payments must not be issued by the
16.5county agency except for nonrecurring emergency need payments; at the request of the
16.6recipient; for special needs, other than special diets; or when the agency determines the
16.7need for protective payments exist.
16.8EFFECTIVE DATE.This section is effective August 1, 2011.

16.9    Sec. 17. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
16.10    Subd. 5. Household eligibility; participation. (a) To be eligible for state or TANF
16.11matching funds in the family assets for independence initiative, a household must meet the
16.12eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
16.13in Title IV, section 408 of that act.
16.14(b) Each participating household must sign a family asset agreement that includes
16.15the amount of scheduled deposits into its savings account, the proposed use, and the
16.16proposed savings goal. A participating household must agree to complete an economic
16.17literacy training program.
16.18Participating households may only deposit money that is derived from household
16.19earned income or from state and federal income tax credits.

16.20    Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
16.21    Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a
16.22participating household must transfer funds withdrawn from a family asset account to its
16.23matching fund custodial account held by the fiscal agent, according to the family asset
16.24agreement. The fiscal agent must determine if the match request is for a permissible use
16.25consistent with the household's family asset agreement.
16.26The fiscal agent must ensure the household's custodial account contains the
16.27applicable matching funds to match the balance in the household's account, including
16.28interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches
16.29must be provided as follows:
16.30(1) from state grant and TANF funds a matching contribution of $1.50 for every $1
16.31of funds withdrawn from the family asset account equal to the lesser of $720 per year or a
16.32$3,000 lifetime limit; and
17.1(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
17.2of funds withdrawn from the family asset account equal to the lesser of $720 per year or
17.3a $3,000 lifetime limit.
17.4(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
17.5direct payment to the vendor of the goods or services for the permissible use.

17.6    Sec. 19. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision
17.7to read:
17.8    Subd. 8. Supplementary services. "Supplementary services" means services
17.9provided to residents of group residential housing providers in addition to room and
17.10board including, but not limited to, oversight and up to 24-hour supervision, medication
17.11reminders, assistance with transportation, arranging for meetings and appointments, and
17.12arranging for medical and social services.

17.13    Sec. 20. Minnesota Statutes 2010, section 256I.04, subdivision 1, is amended to read:
17.14    Subdivision 1. Individual eligibility requirements. An individual is eligible for
17.15and entitled to a group residential housing payment to be made on the individual's behalf
17.16if the county agency has approved the individual's residence in a group residential housing
17.17setting and the individual meets the requirements in paragraph (a) or (b) this section.
17.18(a) The individual is aged, blind, or is over 18 years of age and disabled as
17.19determined under the criteria used by the title II program of the Social Security Act,
17.20and meets the resource restrictions and standards of the supplemental security income
17.21program, and the individual's countable income after deducting the (1) exclusions and
17.22disregards of the SSI program, (2) the medical assistance personal needs allowance
17.23under section 256B.35, and (3) an amount equal to the income actually made available
17.24to a community spouse by an elderly waiver recipient under the provisions of sections
17.25256B.0575, paragraph (a) , clause (4), and 256B.058, subdivision 2, is less than the
17.26monthly rate specified in the county agency's agreement with the provider of group
17.27residential housing in which the individual resides.
17.28(b) The individual meets a category of eligibility under section 256D.05, subdivision
17.291 , paragraph (a), and the individual's resources are less than the standards specified by
17.30section 256D.08, and the individual's countable income as determined under sections
17.31256D.01 to 256D.21, less the medical assistance personal needs allowance under section
17.32256B.35 is less than the monthly rate specified in the county agency's agreement with the
17.33provider of group residential housing in which the individual resides.
18.1(b) Each individual with income and resources less than the standard of assistance
18.2established by the commissioner and who is a resident of the state shall be eligible for and
18.3entitled to group residential housing if the assistance unit is:
18.4(1) a person who is suffering from a professionally certified permanent or temporary
18.5illness, injury, or incapacity which is expected to continue for more than 90 days and
18.6which prevents the person from obtaining or retaining employment;
18.7(2) a person who has been placed in, and is residing in, a licensed or certified facility
18.8for purposes of physical or mental health or rehabilitation, or in an approved chemical
18.9dependency domiciliary facility, if the placement is based on illness or incapacity and is
18.10according to a plan developed or approved by the county agency through its director or
18.11designated representative;
18.12(3) a person not described in clause (1) or (2) who is diagnosed by a licensed
18.13physician, psychological practitioner, or other qualified professional, as developmentally
18.14disabled or mentally ill, and that condition prevents the person from obtaining or retaining
18.15employment;
18.16(4) a person who has been assessed by a vocational specialist and, in consultation
18.17with the county agency, has been determined to be unemployable for purposes of this
18.18clause; a person is considered employable if there exist positions of employment in the
18.19local labor market, regardless of the current availability of openings for those positions,
18.20that the person is capable of performing. The person's eligibility under this category must
18.21be reassessed at least annually. The county agency must provide notice to the person not
18.22later than 30 days before annual eligibility under this item ends, informing the person of the
18.23date annual eligibility will end and the need for vocational assessment if the person wishes
18.24to continue eligibility under this clause. For purposes of establishing eligibility under this
18.25clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
18.26(5) a person who is determined by the county agency, according to permanent rules
18.27adopted by the commissioner, to have a condition that qualifies under Minnesota's special
18.28education rules as a specific learning disability, provided that a rehabilitation plan for
18.29the person is developed or approved by the county agency, and the person is following
18.30the plan; or
18.31(6) a person whose alcohol and drug addiction is a material factor that contributes
18.32to the person's disability.
18.33(c) As a condition of eligibility under paragraph (b), the recipient must complete an
18.34interim assistance agreement and must apply for other maintenance benefits as specified in
18.35section 256N.35, and must comply with efforts to determine the recipient's eligibility for
18.36those other maintenance benefits.
19.1(d) As a condition of eligibility under this section, the recipient must complete
19.2at least 20 hours per month of volunteer or paid work. The county of residence shall
19.3determine what may be included as volunteer work. Recipients must provide monthly
19.4proof of volunteer work on the forms established by the county. A person who is unable
19.5to obtain or retain 20 hours per month of volunteer or paid work due to a professionally
19.6certified illness, injury, disability, or incapacity must not be made ineligible for group
19.7residential housing under this section.
19.8(e) The burden of providing documentation for a county agency to use to verify
19.9eligibility under this section is upon the applicant or recipient. The county agency shall
19.10use documents already in its possession to verify eligibility, and shall help the applicant or
19.11recipient obtain other existing verification necessary to determine eligibility which the
19.12applicant or recipient does not have and is unable to obtain.
19.13EFFECTIVE DATE.This section is effective October 1, 2012.

19.14    Sec. 21. Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read:
19.15    Subd. 2b. Group residential housing agreements. (a) Agreements between county
19.16agencies and providers of group residential housing must be in writing and must specify
19.17the name and address under which the establishment subject to the agreement does
19.18business and under which the establishment, or service provider, if different from the
19.19group residential housing establishment, is licensed by the Department of Health or the
19.20Department of Human Services; the specific license or registration from the Department
19.21of Health or the Department of Human Services held by the provider and the number
19.22of beds subject to that license; the address of the location or locations at which group
19.23residential housing is provided under this agreement; the per diem and monthly rates that
19.24are to be paid from group residential housing funds for each eligible resident at each
19.25location; the number of beds at each location which are subject to the group residential
19.26housing agreement; whether the license holder is a not-for-profit corporation under section
19.27501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to
19.28the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections.
19.29Group residential housing agreements may be terminated with or without cause by either
19.30the county or the provider with two calendar months prior notice.
19.31(b) Counties must not enter into agreements with providers of group residential
19.32housing that are licensed as board and lodging with special services and that do not include
19.33a residency requirement of at least 20 hours per month of volunteer or paid work. A person
19.34who is unable to obtain or retain 20 hours per month of volunteer or paid work due to a
19.35professionally certified illness, injury, disability, or incapacity must not be made ineligible
20.1for group residential housing under this section. This paragraph does not apply to group
20.2residential housing providers who serve people aged 21 or younger if the residents are
20.3required to attend school or improve independent living skills.
20.4EFFECTIVE DATE.This section is effective May 1, 2012.

20.5    Sec. 22. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:
20.6    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
20.7256I.04, subdivision 3 , the county agency may negotiate a payment not to exceed $426.37
20.8for other services necessary to provide room and board provided by the group residence
20.9if the residence is licensed by or registered by the Department of Health, or licensed by
20.10the Department of Human Services to provide services in addition to room and board,
20.11and if the provider of services is not also concurrently receiving funding for services for
20.12a recipient under a home and community-based waiver under title XIX of the Social
20.13Security Act; or funding from the medical assistance program under section 256B.0659,
20.14for personal care services for residents in the setting; or residing in a setting which
20.15receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is
20.16available for other necessary services through a home and community-based waiver, or
20.17personal care services under section 256B.0659, then the GRH rate is limited to the rate
20.18set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary
20.19service rate exceed $426.37. The registration and licensure requirement does not apply to
20.20establishments which are exempt from state licensure because they are located on Indian
20.21reservations and for which the tribe has prescribed health and safety requirements. Service
20.22payments under this section may be prohibited under rules to prevent the supplanting of
20.23federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
20.24the approval of the Secretary of Health and Human Services to provide home and
20.25community-based waiver services under title XIX of the Social Security Act for residents
20.26who are not eligible for an existing home and community-based waiver due to a primary
20.27diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is
20.28determined to be cost-effective.
20.29(b) The commissioner is authorized to make cost-neutral transfers from the GRH
20.30fund for beds under this section to other funding programs administered by the department
20.31after consultation with the county or counties in which the affected beds are located.
20.32The commissioner may also make cost-neutral transfers from the GRH fund to county
20.33human service agencies for beds permanently removed from the GRH census under a plan
20.34submitted by the county agency and approved by the commissioner. The commissioner
20.35shall report the amount of any transfers under this provision annually to the legislature.
21.1(c) The provisions of paragraph (b) do not apply to a facility that has its
21.2reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).
21.3    (d) Counties must not negotiate supplementary service rates with providers of group
21.4residential housing that are licensed as board and lodging with special services and that
21.5do not encourage a policy of sobriety on their premises.
21.6EFFECTIVE DATE.This section is effective May 1, 2012.

21.7    Sec. 23. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:
21.8    Subd. 1a. 30-day 60-day residency requirement. An assistance unit is considered
21.9to have established residency in this state only when a child or caregiver has resided in this
21.10state for at least 30 60 consecutive days with the intention of making the person's home
21.11here and not for any temporary purpose. The birth of a child in Minnesota to a member
21.12of the assistance unit does not automatically establish the residency in this state under
21.13this subdivision of the other members of the assistance unit. Time spent in a shelter for
21.14battered women shall count toward satisfying the 30-day 60-day residency requirement.

21.15    Sec. 24. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
21.16    Subd. 2. Exceptions. (a) A county shall waive the 30-day residency requirement
21.17where unusual hardship would result from denial of assistance.
21.18(b) For purposes of this section, unusual hardship means an assistance unit:
21.19(1) is without alternative shelter; or
21.20(2) is without available resources for food.
21.21(c) For purposes of this subdivision, the following definitions apply (1) "metropolitan
21.22statistical area" is as defined by the U.S. Census Bureau; (2) "alternative shelter" includes
21.23any shelter that is located within the metropolitan statistical area containing the county and
21.24for which the family is eligible, provided the assistance unit does not have to travel more
21.25than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2)
21.26does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
21.27(d) Applicants are considered to meet the residency requirement under subdivision
21.281a if they once resided in Minnesota and:
21.29(1) joined the United States armed services, returned to Minnesota within 30 days of
21.30leaving the armed services, and intend to remain in Minnesota; or
21.31(2) left to attend school in another state, paid nonresident tuition or Minnesota
21.32tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of
21.33graduation with the intent to remain in Minnesota.
21.34(e) (b) The 30-day 60-day residence requirement is met when:
22.1(1) a minor child or a minor caregiver moves from another state to the residence of
22.2a relative caregiver; and
22.3(2) the relative caregiver has resided in Minnesota for at least 30 60 consecutive
22.4days and:
22.5(i) the minor caregiver applies for and receives MFIP; or
22.6(ii) the relative caregiver applies for assistance for the minor child but does not
22.7choose to be a member of the MFIP assistance unit.

22.8    Sec. 25. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:
22.9    Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of
22.10all nonexcluded real and personal property of the assistance unit must not exceed $2,000
22.11for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
22.12(19) must be excluded when determining the equity value of real and personal property:
22.13    (1) a licensed vehicle up to a loan value of less than or equal to $15,000 $10,000. If
22.14the assistance unit owns more than one licensed vehicle, the county agency shall determine
22.15the loan value of all additional vehicles and exclude the combined loan value of less than
22.16or equal to $7,500. The county agency shall apply any excess loan value as if it were
22.17equity value to the asset limit described in this section, excluding: (i) the value of one
22.18vehicle per physically disabled person when the vehicle is needed to transport the disabled
22.19unit member; this exclusion does not apply to mentally disabled people; (ii) the value of
22.20special equipment for a disabled member of the assistance unit; and (iii) any vehicle used
22.21for long-distance travel, other than daily commuting, for the employment of a unit member.
22.22    To establish the loan value of vehicles, a county agency must use the N.A.D.A.
22.23Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not
22.24listed in the guidebook, or when the applicant or participant disputes the loan value listed
22.25in the guidebook as unreasonable given the condition of the particular vehicle, the county
22.26agency may require the applicant or participant document the loan value by securing a
22.27written statement from a motor vehicle dealer licensed under section 168.27, stating
22.28the amount that the dealer would pay to purchase the vehicle. The county agency shall
22.29reimburse the applicant or participant for the cost of a written statement that documents
22.30a lower loan value;
22.31    (2) the value of life insurance policies for members of the assistance unit;
22.32    (3) one burial plot per member of an assistance unit;
22.33    (4) the value of personal property needed to produce earned income, including
22.34tools, implements, farm animals, inventory, business loans, business checking and
22.35savings accounts used at least annually and used exclusively for the operation of a
23.1self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
23.2is to produce income and if the vehicles are essential for the self-employment business;
23.3    (5) the value of personal property not otherwise specified which is commonly
23.4used by household members in day-to-day living such as clothing, necessary household
23.5furniture, equipment, and other basic maintenance items essential for daily living;
23.6    (6) the value of real and personal property owned by a recipient of Supplemental
23.7Security Income or Minnesota supplemental aid;
23.8    (7) the value of corrective payments, but only for the month in which the payment
23.9is received and for the following month;
23.10    (8) a mobile home or other vehicle used by an applicant or participant as the
23.11applicant's or participant's home;
23.12    (9) money in a separate escrow account that is needed to pay real estate taxes or
23.13insurance and that is used for this purpose;
23.14    (10) money held in escrow to cover employee FICA, employee tax withholding,
23.15sales tax withholding, employee worker compensation, business insurance, property rental,
23.16property taxes, and other costs that are paid at least annually, but less often than monthly;
23.17    (11) monthly assistance payments for the current month's or short-term emergency
23.18needs under section 256J.626, subdivision 2;
23.19    (12) the value of school loans, grants, or scholarships for the period they are
23.20intended to cover;
23.21    (13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
23.22in escrow for a period not to exceed three months to replace or repair personal or real
23.23property;
23.24    (14) income received in a budget month through the end of the payment month;
23.25    (15) savings from earned income of a minor child or a minor parent that are set aside
23.26in a separate account designated specifically for future education or employment costs;
23.27    (16) the federal earned income credit, Minnesota working family credit, state and
23.28federal income tax refunds, state homeowners and renters credits under chapter 290A,
23.29property tax rebates and other federal or state tax rebates in the month received and the
23.30following month;
23.31    (17) payments excluded under federal law as long as those payments are held in a
23.32separate account from any nonexcluded funds;
23.33    (18) the assets of children ineligible to receive MFIP benefits because foster care or
23.34adoption assistance payments are made on their behalf; and
23.35    (19) the assets of persons whose income is excluded under section 256J.21,
23.36subdivision 2 , clause (43).
24.1EFFECTIVE DATE.This section is effective October 1, 2011.

24.2    Sec. 26. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision
24.3to read:
24.4    Subd. 3c. Treatment of Supplemental Security Income. The county shall reduce
24.5the cash portion of the MFIP grant by $50 per adult SSI recipient who resides in the
24.6household, and who would otherwise be included in the MFIP assistance unit under
24.7section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient status under
24.8section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient receives less
24.9than $50 of SSI, only the amount received shall be used in calculating the MFIP cash
24.10assistance payment. This provision does not apply to relative caregivers who could elect
24.11to be included in the MFIP assistance unit under section 256J.24, subdivision 4, unless the
24.12caregiver's children or stepchildren are included in the MFIP assistance unit.
24.13EFFECTIVE DATE.This section is effective May 1, 2012.

24.14    Sec. 27. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:
24.15    Subd. 13. Work activity. (a) "Work activity" means any activity in a participant's
24.16approved employment plan that leads to employment. For purposes of the MFIP program,
24.17this includes activities that meet the definition of work activity under the participation
24.18requirements of TANF. Work activity includes:
24.19    (1) unsubsidized employment, including work study and paid apprenticeships or
24.20internships;
24.21    (2) subsidized private sector or public sector employment, including grant diversion
24.22as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid
24.23work experience, and supported work when a wage subsidy is provided;
24.24    (3) unpaid work experience, including community service, volunteer work,
24.25the community work experience program as specified in section 256J.67, unpaid
24.26apprenticeships or internships, and supported work when a wage subsidy is not provided.
24.27Unpaid work experience is only an option if the participant has been unable to obtain or
24.28maintain paid employment in the competitive labor market, and no paid work experience
24.29programs are available to the participant. Prior to placing a participant in unpaid work,
24.30the county must inform the participant that the participant will be notified if a paid work
24.31experience or supported work position becomes available. Unless a participant consents in
24.32writing to participate in unpaid work experience, the participant's employment plan may
24.33only include unpaid work experience if including the unpaid work experience in the plan
24.34will meet the following criteria:
25.1    (i) the unpaid work experience will provide the participant specific skills or
25.2experience that cannot be obtained through other work activity options where the
25.3participant resides or is willing to reside; and
25.4    (ii) the skills or experience gained through the unpaid work experience will result
25.5in higher wages for the participant than the participant could earn without the unpaid
25.6work experience;
25.7    (4) job search including job readiness assistance, job clubs, job placement,
25.8job-related counseling, and job retention services;
25.9    (5) job readiness education, including English as a second language (ESL) or
25.10functional work literacy classes as limited by the provisions of section 256J.531,
25.11subdivision 2 , general educational development (GED) course work, high school
25.12completion, and adult basic education as limited by the provisions of section 256J.531,
25.13subdivision 1 ;
25.14    (6) job skills training directly related to employment, including education and
25.15training that can reasonably be expected to lead to employment, as limited by the
25.16provisions of section 256J.53;
25.17    (7) providing child care services to a participant who is working in a community
25.18service program;
25.19    (8) activities included in the employment plan that is developed under section
25.20256J.521, subdivision 3 ; and
25.21    (9) preemployment activities including chemical and mental health assessments,
25.22treatment, and services; learning disabilities services; child protective services; family
25.23stabilization services; or other programs designed to enhance employability.
25.24(b) "Work activity" does not include activities done for political purposes as defined
25.25in section 211B.01, subdivision 6.

25.26    Sec. 28. Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read:
25.27    Subd. 2. Approval of postsecondary education or training. (a) In order for a
25.28postsecondary education or training program to be an approved activity in an employment
25.29plan, the plan must include additional work activities if the education and training
25.30activities do not meet the minimum hours required to meet the federal work participation
25.31rate under Code of Federal Regulations, title 45, sections 261.31 and 261.35 participant
25.32must be working in unsubsidized employment at least 10 hours per week.
25.33    (b) Participants seeking approval of a postsecondary education or training plan
25.34must provide documentation that:
25.35    (1) the employment goal can only be met with the additional education or training;
26.1    (2) there are suitable employment opportunities that require the specific education or
26.2training in the area in which the participant resides or is willing to reside;
26.3    (3) the education or training will result in significantly higher wages for the
26.4participant than the participant could earn without the education or training;
26.5    (4) the participant can meet the requirements for admission into the program; and
26.6    (5) there is a reasonable expectation that the participant will complete the training
26.7program based on such factors as the participant's MFIP assessment, previous education,
26.8training, and work history; current motivation; and changes in previous circumstances.
26.9(c) The hourly unsubsidized employment requirement does not apply for intensive
26.10education or training programs lasting 12 weeks or less when full-time attendance is
26.11required.

26.12    Sec. 29. [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
26.13The adult assistance grant program is a capped allocation to counties that can be
26.14spent in a flexible manner, to the extent funds are available, for adult assistance.
26.15EFFECTIVE DATE.This section is effective October 1, 2012.

26.16    Sec. 30. [256N.20] DEFINITIONS.
26.17    Subdivision 1. Scope. For the purposes of sections 256N.01 to 256N.80, the terms
26.18defined in this section have the meanings given them.
26.19    Subd. 2. Adult assistance. "Adult assistance" means a capped allocation provided
26.20or arranged for by county boards for ongoing emergency needs, special diets, or special
26.21needs as determined by the county.
26.22    Subd. 3. Commissioner. "Commissioner" means the commissioner of human
26.23services.
26.24    Subd. 4. County board. "County board" means the board of county commissioners
26.25in each county.
26.26    Subd. 5. Eligible participant. "Eligible participant" means low-income adults who
26.27meet the residency requirements under section 256N.22, and who were previously eligible
26.28for programs under subdivision 6 are eligible for adult assistance. The commissioner may
26.29develop more specific eligibility criteria.
26.30    Subd. 6. Former programs. "Former programs" means funding for:
26.31(1) general assistance;
26.32(2) emergency general assistance;
26.33(3) emergency supplemental aid; and
26.34(4) Minnesota supplemental aid special needs and special diets.
27.1EFFECTIVE DATE.This section is effective October 1, 2012.

27.2    Sec. 31. [256N.22] RESIDENCY.
27.3(a) For purposes of eligibility for adult assistance, a person must be a resident of
27.4this state.
27.5(b) A "resident" is a person living in the state for at least 60 days with the intention of
27.6making the person's home here and not for any temporary purpose. Time spent in a shelter
27.7for battered women shall count toward satisfying the 60-day residency requirement. All
27.8applicants for these programs are required to demonstrate the requisite intent and may do
27.9so in any of the following ways:
27.10(1) by showing that the applicant maintains a residence at a verified address, other
27.11than a place of public accommodation. An applicant may verify a residence address by
27.12presenting a valid state driver's license, a state identification card, a voter registration
27.13card, or a rent receipt; or
27.14(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
27.153, item C.
27.16(c) The county shall not deny an application solely because the applicant does not
27.17meet at least one of the criteria in this subdivision, but shall continue to process the
27.18application and leave the application pending until the residency requirement is met or
27.19until eligibility or ineligibility is established.
27.20(d) If any provision of this subdivision is enjoined from implementation or found
27.21unconstitutional by any court of competent jurisdiction, the remaining provisions shall
27.22remain valid and shall be given full effect.
27.23EFFECTIVE DATE.This section is effective October 1, 2012.

27.24    Sec. 32. [256N.25] PROGRAM EVALUATION.
27.25    Subdivision 1. County evaluation. Each county shall submit to the commissioner
27.26data from the past calendar year on the outcomes and performance indicators, and
27.27information as to how grant funds are being spent on the target population. The
27.28commissioner shall prescribe standard methods to be used by the counties in providing
27.29the data. The data shall be submitted no later than March 1 of each year, beginning with
27.30March 1, 2013. The commissioner shall define outcomes and performance indicators.
27.31    Subd. 2. Statewide evaluation. Six months after the end of the first full calendar
27.32year and biennially thereafter, the commissioner shall prepare a report on the counties'
27.33progress in improving the outcomes of adults related to safety and well-being. This report
27.34shall be disseminated electronically throughout the state.
28.1EFFECTIVE DATE.This section is effective October 1, 2012.

28.2    Sec. 33. [256N.30] FUNDING.
28.3    Subdivision 1. Assistance. (a) Counties may use the capped allocation for adult
28.4assistance for individuals under section 256N.20, subdivision 2.
28.5(b) The county agency shall, within available appropriations, provide a personal
28.6needs allowance to individuals eligible for group residential housing under section
28.7256I.04, subdivision 1, paragraph (b), and to other individuals who reside in licensed
28.8residential facilities other than group residential housing. The county may determine the
28.9amount of the personal needs allowance based on the individual's net income and need.
28.10(c) In determining the amount of assistance, the county shall disregard the first
28.11$150 of earned income per month. In addition, the county shall disregard additional
28.12earned income up to a maximum of $500 per month for individuals residing in facilities or
28.13group residential housing for whom the county agency has approved a discharge plan that
28.14includes work. The additional amount disregarded must be placed in a separate savings
28.15account by the eligible individual, to be used upon discharge from the residential facility
28.16into the community, up to a maximum of $2,000.
28.17(d) The county shall give priority to eligible individuals who are enrolled in a
28.1812-month residential chemical dependency treatment program.
28.19    Subd. 2. Allocation. Funding for the adult assistance grant program is limited to the
28.20appropriation. The commissioner shall allocate to counties the money appropriated for the
28.21program based on each county agency's average share of the state's former programs under
28.22section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts
28.23to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any
28.24adult assistance aid expenditures by a county above the amount of the commissioner's
28.25allocation to the county must be made from county funds.
28.26EFFECTIVE DATE.This section is effective October 1, 2012.

28.27    Sec. 34. [256N.35] APPLICANT REQUIREMENTS.
28.28(a) Any applicant, otherwise eligible for adult assistance and possibly eligible for
28.29federal maintenance benefits from any other source shall: (1) make application for those
28.30benefits within 30 days of the adult assistance application; and (2) execute an interim
28.31assistance authorization on a form as directed by the commissioner.
28.32(b) The commissioner shall review a denial of an application for other federal
28.33maintenance benefits and may require a recipient of adult assistance to file an appeal of
28.34the denial if appropriate.
29.1(c) If found eligible for maintenance benefits, and maintenance benefits were
29.2received during the period in which adult assistance was also being received, the recipient
29.3shall be required to reimburse the state for the interim assistance paid. Reimbursement
29.4shall not exceed the amount of adult assistance paid during the time period to which the
29.5other maintenance benefits apply.
29.6(d) The commissioner may contract with the county agencies, qualified agencies,
29.7organizations, or persons to provide advocacy and support services to process claims for
29.8federal disability benefits for applicants or recipients of services or benefits supervised by
29.9the commissioner using money retained under this section.
29.10(e) The commissioner may provide methods by which county agencies shall identify,
29.11refer, and assist recipients who may be eligible for benefits under federal programs for the
29.12disabled.
29.13(f) The total amount of interim assistance recoveries retained under this section
29.14for advocacy, support, and claim processing services shall not exceed 35 percent of the
29.15interim assistance recoveries in the prior fiscal year.
29.16EFFECTIVE DATE.This section is effective October 1, 2012.

29.17    Sec. 35. Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read:
29.18    Subd. 3. Juvenile treatment screening team. (a) The responsible social services
29.19agency shall establish a juvenile treatment screening team to conduct screenings and
29.20prepare case plans under this subdivision section 245.487, subdivision 3, and chapters
29.21260C and 260D. Screenings shall be conducted within 15 days of a request for a screening.
29.22The team, which may be the team constituted under section 245.4885 or 256B.092 or
29.23Minnesota Rules, parts 9530.6600 to 9530.6655, shall consist of social workers, juvenile
29.24justice professionals, and persons with expertise in the treatment of juveniles who are
29.25emotionally disabled, chemically dependent, or have a developmental disability. The team
29.26shall involve parents or guardians in the screening process as appropriate, and the child's
29.27parent, guardian, or permanent legal custodian under section 260C.201, subdivision 11.
29.28The team may be the same team as defined in section 260B.157, subdivision 3.
29.29(b) The social services agency shall determine whether a child brought to its
29.30attention for the purposes described in this section is an Indian child, as defined in section
29.31260C.007, subdivision 21 , and shall determine the identity of the Indian child's tribe, as
29.32defined in section 260.755, subdivision 9. When a child to be evaluated is an Indian child,
29.33the team provided in paragraph (a) shall include a designated representative of the Indian
29.34child's tribe, unless the child's tribal authority declines to appoint a representative. The
30.1Indian child's tribe may delegate its authority to represent the child to any other federally
30.2recognized Indian tribe, as defined in section 260.755, subdivision 12.
30.3(c) If the court, prior to, or as part of, a final disposition, proposes to place a child:
30.4(1) for the primary purpose of treatment for an emotional disturbance, a
30.5developmental disability, or chemical dependency in a residential treatment facility out
30.6of state or in one which is within the state and licensed by the commissioner of human
30.7services under chapter 245A; or
30.8(2) in any out-of-home setting potentially exceeding 30 days in duration, including a
30.9postdispositional placement in a facility licensed by the commissioner of corrections or
30.10human services, the court shall ascertain whether the child is an Indian child and shall
30.11notify the county welfare agency and, if the child is an Indian child, shall notify the Indian
30.12child's tribe. The county's juvenile treatment screening team must either: (i) screen and
30.13evaluate the child and file its recommendations with the court within 14 days of receipt
30.14of the notice; or (ii) elect not to screen a given case and notify the court of that decision
30.15within three working days.
30.16(d) If the screening team has elected to screen and evaluate the child, The child
30.17may not be placed for the primary purpose of treatment for an emotional disturbance, a
30.18developmental disability, or chemical dependency, in a residential treatment facility out of
30.19state nor in a residential treatment facility within the state that is licensed under chapter
30.20245A, unless one of the following conditions applies:
30.21(1) a treatment professional certifies that an emergency requires the placement
30.22of the child in a facility within the state;
30.23(2) the screening team has evaluated the child and recommended that a residential
30.24placement is necessary to meet the child's treatment needs and the safety needs of the
30.25community, that it is a cost-effective means of meeting the treatment needs, and that it
30.26will be of therapeutic value to the child; or
30.27(3) the court, having reviewed a screening team recommendation against placement,
30.28determines to the contrary that a residential placement is necessary. The court shall state
30.29the reasons for its determination in writing, on the record, and shall respond specifically
30.30to the findings and recommendation of the screening team in explaining why the
30.31recommendation was rejected. The attorney representing the child and the prosecuting
30.32attorney shall be afforded an opportunity to be heard on the matter.
30.33(e) When the county's juvenile treatment screening team has elected to screen and
30.34evaluate a child determined to be an Indian child, the team shall provide notice to the
30.35tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a
31.1member of the tribe or as a person eligible for membership in the tribe, and permit the
31.2tribe's representative to participate in the screening team.
31.3(f) When the Indian child's tribe or tribal health care services provider or Indian
31.4Health Services provider proposes to place a child for the primary purpose of treatment
31.5for an emotional disturbance, a developmental disability, or co-occurring emotional
31.6disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by
31.7the child's tribe shall submit necessary documentation to the county juvenile treatment
31.8screening team, which must invite the Indian child's tribe to designate a representative to
31.9the screening team.

31.10    Sec. 36. Minnesota Statutes 2010, section 260D.01, is amended to read:
31.11260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
31.12    (a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care
31.13for treatment" provisions of the Juvenile Court Act.
31.14    (b) The juvenile court has original and exclusive jurisdiction over a child in
31.15voluntary foster care for treatment upon the filing of a report or petition required under
31.16this chapter. All obligations of the agency to a child and family in foster care contained in
31.17chapter 260C not inconsistent with this chapter are also obligations of the agency with
31.18regard to a child in foster care for treatment under this chapter.
31.19    (c) This chapter shall be construed consistently with the mission of the children's
31.20mental health service system as set out in section 245.487, subdivision 3, and the duties
31.21of an agency under section 256B.092, 260C.157, and Minnesota Rules, parts 9525.0004
31.22to 9525.0016, to meet the needs of a child with a developmental disability or related
31.23condition. This chapter:
31.24    (1) establishes voluntary foster care through a voluntary foster care agreement as the
31.25means for an agency and a parent to provide needed treatment when the child must be in
31.26foster care to receive necessary treatment for an emotional disturbance or developmental
31.27disability or related condition;
31.28    (2) establishes court review requirements for a child in voluntary foster care for
31.29treatment due to emotional disturbance or developmental disability or a related condition;
31.30    (3) establishes the ongoing responsibility of the parent as legal custodian to visit the
31.31child, to plan together with the agency for the child's treatment needs, to be available and
31.32accessible to the agency to make treatment decisions, and to obtain necessary medical,
31.33dental, and other care for the child; and
31.34    (4) applies to voluntary foster care when the child's parent and the agency agree that
31.35the child's treatment needs require foster care either:
32.1    (i) due to a level of care determination by the agency's screening team informed by
32.2the diagnostic and functional assessment under section 245.4885; or
32.3    (ii) due to a determination regarding the level of services needed by the responsible
32.4social services' screening team under section 256B.092, and Minnesota Rules, parts
32.59525.0004 to 9525.0016.
32.6    (d) This chapter does not apply when there is a current determination under section
32.7626.556 that the child requires child protective services or when the child is in foster care
32.8for any reason other than treatment for the child's emotional disturbance or developmental
32.9disability or related condition. When there is a determination under section 626.556 that
32.10the child requires child protective services based on an assessment that there are safety
32.11and risk issues for the child that have not been mitigated through the parent's engagement
32.12in services or otherwise, or when the child is in foster care for any reason other than
32.13the child's emotional disturbance or developmental disability or related condition, the
32.14provisions of chapter 260C apply.
32.15    (e) The paramount consideration in all proceedings concerning a child in voluntary
32.16foster care for treatment is the safety, health, and the best interests of the child. The
32.17purpose of this chapter is:
32.18    (1) to ensure a child with a disability is provided the services necessary to treat or
32.19ameliorate the symptoms of the child's disability;
32.20    (2) to preserve and strengthen the child's family ties whenever possible and in the
32.21child's best interests, approving the child's placement away from the child's parents only
32.22when the child's need for care or treatment requires it and the child cannot be maintained
32.23in the home of the parent; and
32.24    (3) to ensure the child's parent retains legal custody of the child and associated
32.25decision-making authority unless the child's parent willfully fails or is unable to make
32.26decisions that meet the child's safety, health, and best interests. The court may not find
32.27that the parent willfully fails or is unable to make decisions that meet the child's needs
32.28solely because the parent disagrees with the agency's choice of foster care facility, unless
32.29the agency files a petition under chapter 260C, and establishes by clear and convincing
32.30evidence that the child is in need of protection or services.
32.31    (f) The legal parent-child relationship shall be supported under this chapter by
32.32maintaining the parent's legal authority and responsibility for ongoing planning for the
32.33child and by the agency's assisting the parent, where necessary, to exercise the parent's
32.34ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing
32.35planning means:
33.1    (1) actively participating in the planning and provision of educational services,
33.2medical, and dental care for the child;
33.3    (2) actively planning and participating with the agency and the foster care facility
33.4for the child's treatment needs; and
33.5    (3) planning to meet the child's need for safety, stability, and permanency, and the
33.6child's need to stay connected to the child's family and community.
33.7    (g) The provisions of section 260.012 to ensure placement prevention, family
33.8reunification, and all active and reasonable effort requirements of that section apply. This
33.9chapter shall be construed consistently with the requirements of the Indian Child Welfare
33.10Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the
33.11Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

33.12    Sec. 37. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:
33.13    Subd. 10a. Expedited issuance of food stamps. The commissioner of human
33.14services shall continually monitor the expedited issuance of food stamp benefits to ensure
33.15that each county complies with federal regulations and that households eligible for
33.16expedited issuance of food stamps are identified, processed, and certified within the time
33.17frames prescribed in federal regulations.
33.18County food stamp offices shall screen and issue food stamps to applicants on the
33.19day of application. Applicants who meet the federal criteria for expedited issuance and
33.20have an immediate need for food assistance shall receive either: within five working days
33.21(1) a manual Authorization to Participate (ATP) card; or
33.22(2) the immediate issuance of food stamp coupons benefits.
33.23The local food stamp agency shall conspicuously post in each food stamp office a
33.24notice of the availability of and the procedure for applying for expedited issuance and
33.25verbally advise each applicant of the availability of the expedited process.

33.26    Sec. 38. Minnesota Statutes 2010, section 518A.51, is amended to read:
33.27518A.51 FEES FOR IV-D SERVICES.
33.28(a) When a recipient of IV-D services is no longer receiving assistance under the
33.29state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the
33.30public authority responsible for child support enforcement must notify the recipient,
33.31within five working days of the notification of ineligibility, that IV-D services will be
33.32continued unless the public authority is notified to the contrary by the recipient. The
33.33notice must include the implications of continuing to receive IV-D services, including the
33.34available services and fees, cost recovery fees, and distribution policies relating to fees.
34.1(b) An application fee of $25 shall be paid by the person who applies for child
34.2support and maintenance collection services, except persons who are receiving public
34.3assistance as defined in section 256.741 and the diversionary work program under section
34.4256J.95 , persons who transfer from public assistance to nonpublic assistance status, and
34.5minor parents and parents enrolled in a public secondary school, area learning center, or
34.6alternative learning program approved by the commissioner of education.
34.7(c) In the case of an individual who has never received assistance under a state
34.8program funded under Title IV-A of the Social Security Act and for whom the public
34.9authority has collected at least $500 of support, the public authority must impose an
34.10annual federal collections fee of $25 for each case in which services are furnished. This
34.11fee must be retained by the public authority from support collected on behalf of the
34.12individual, but not from the first $500 collected.
34.13(d) When the public authority provides full IV-D services to an obligee who has
34.14applied for those services, upon written notice to the obligee, the public authority must
34.15charge a cost recovery fee of one percent of the amount collected. This fee must be
34.16deducted from the amount of the child support and maintenance collected and not assigned
34.17under section 256.741 before disbursement to the obligee. This fee does not apply to an
34.18obligee who:
34.19(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,
34.20medical assistance, or MinnesotaCare programs; or
34.21(2) has received assistance under the state's title IV-A or IV-E foster care programs,
34.22until the person has not received this assistance for 24 consecutive months.
34.23 (e) When the public authority provides full IV-D services to an obligor who has
34.24applied for such services, upon written notice to the obligor, the public authority must
34.25charge a cost recovery fee of one percent of the monthly court-ordered child support and
34.26maintenance obligation. The fee may be collected through income withholding, as well
34.27as by any other enforcement remedy available to the public authority responsible for
34.28child support enforcement.
34.29 (f) Fees assessed by state and federal tax agencies for collection of overdue support
34.30owed to or on behalf of a person not receiving public assistance must be imposed on the
34.31person for whom these services are provided. The public authority upon written notice to
34.32the obligee shall assess a fee of $25 to the person not receiving public assistance for each
34.33successful federal tax interception. The fee must be withheld prior to the release of the
34.34funds received from each interception and deposited in the general fund.
34.35 (g) Federal collections fees collected under paragraph (c) and cost recovery
34.36fees collected under paragraphs (d) and (e), retained by the commissioner of human
35.1services, shall be considered child support program income according to Code of Federal
35.2Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
35.3account established under paragraph (i). The commissioner of human services must elect
35.4to recover costs based on either actual or standardized costs.
35.5 (h) The limitations of this section on the assessment of fees shall not apply to
35.6the extent inconsistent with the requirements of federal law for receiving funds for the
35.7programs under Title IV-A and Title IV-D of the Social Security Act, United States Code,
35.8title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
35.9 (i) The commissioner of human services is authorized to establish a special revenue
35.10fund account to receive the federal collections fees collected under paragraph (c) and cost
35.11recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of
35.12these fees may be retained for expenditures necessary to administer the fees and must be
35.13transferred to the child support system special revenue account. The remaining nonfederal
35.14share of the federal collections fees and cost recovery fees must be retained by the
35.15commissioner and dedicated to the child support general fund county performance-based
35.16grant account authorized under sections 256.979 and 256.9791. The commissioner shall
35.17distribute the remaining nonfederal share of these fees to the counties quarterly using the
35.18methodology specified in section 256.979, subdivision 11. The funds received by the
35.19counties must be reinvested in the child support enforcement program, and the counties
35.20shall not reduce the funding of their child support programs by the amount of funding
35.21distributed.

35.22    Sec. 39. REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES,
35.23GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.
35.24Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must
35.25negotiate with their third-party processors to block EBT card cash transactions at their
35.26places of business and withdrawals of cash at automatic teller machines located in their
35.27places of business.

35.28    Sec. 40. MINNESOTA EBT BUSINESS TASK FORCE.
35.29    Subdivision 1. Members. The Minnesota EBT Business Task Force includes seven
35.30members, appointed as follows:
35.31(1) two members of the Minnesota house of representatives appointed by the speaker
35.32of the house;
35.33(2) two members of the Minnesota senate appointed by the senate majority leader;
35.34(3) the commissioner of human services, or designee;
36.1(4) an appointee of the Minnesota Grocers Association; and
36.2(5) a credit card processor, appointed by the commissioner of human services.
36.3    Subd. 2. Duties. The Minnesota EBT Business Task Force shall create a workable
36.4strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the
36.5general assistance program and Minnesota supplemental aid program under Minnesota
36.6Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT
36.7cards. The task force will consider cost to the state, feasibility of execution at retail, and
36.8ease of use and privacy for EBT cardholders.
36.9    Subd. 3. Report. The task force will report back to the legislative committees with
36.10jurisdiction over health and human services policy and finance by April 1, 2012, with
36.11recommendations related to the task force duties under subdivision 2.
36.12    Subd. 4. Expiration. The task force expires on June 30, 2012.

36.13    Sec. 41. STREAMLINING CHILDREN AND COMMUNITY SERVICES ACT
36.14REPORTING REQUIREMENTS.
36.15    The commissioner of human services and county human services representatives, in
36.16consultation with other interested parties, shall develop a streamlined alternative to current
36.17reporting requirements related to the Children and Community Services Act service plan.
36.18The commissioner shall submit recommendations and draft legislation to the chairs and
36.19ranking minority members of the committees having jurisdiction over human services no
36.20later than November 15, 2012.

36.21    Sec. 42. REVISOR'S INSTRUCTION.
36.22The revisor of statutes shall make conforming amendments and correct statutory
36.23cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and
36.24related repealers in this article.

36.25    Sec. 43. REPEALER.
36.26(a) Minnesota Statutes 2010, section 256.9862, subdivision 2, is repealed effective
36.27February 1, 2012.
36.28(b) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10;
36.29256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a;
36.30256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2,
36.315, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, and 6; 256D.10; 256D.13; 256D.15;
36.32256D.16; 256D.35, subdivision 8b; and 256D.46, are repealed effective October 1, 2012.
37.1(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September
37.23, 2012.
37.3(d) Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, are
37.4repealed effective November 1, 2011.

37.5
ARTICLE 2

37.6DEPARTMENT OF HEALTH

37.7    Section 1. Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended to read:
37.8    Subd. 7. Consistent administrative expenses and investment income reporting.
37.9(a) Every health maintenance organization must directly allocate administrative expenses
37.10to specific lines of business or products when such information is available. The definition
37.11of administrative expenses must be consistent with that of the National Association of
37.12Insurance Commissioners (NAIC) as provided in the most current NAIC blank. Remaining
37.13expenses that cannot be directly allocated must be allocated based on other methods, as
37.14recommended by the Advisory Group on Administrative Expenses. Health maintenance
37.15organizations must submit this information, including administrative expenses for dental
37.16services, using the reporting template provided by the commissioner of health.
37.17(b) Every health maintenance organization must allocate investment income based
37.18on cumulative net income over time by business line or product and must submit this
37.19information, including investment income for dental services, using the reporting template
37.20provided by the commissioner of health.

37.21    Sec. 2. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
37.22    Subd. 3. Cost containment duties. The commissioner shall:
37.23(1) establish statewide and regional cost containment goals for total health care
37.24spending under this section and collect data as described in sections 62J.38 to 62J.41 and
37.2562J.40 to monitor statewide achievement of the cost containment goals;
37.26(2) divide the state into no fewer than four regions, with one of those regions being
37.27the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
37.28Wright, and Sherburne Counties, for purposes of fostering the development of regional
37.29health planning and coordination of health care delivery among regional health care
37.30systems and working to achieve the cost containment goals;
37.31(3) monitor the quality of health care throughout the state and take action as
37.32necessary to ensure an appropriate level of quality;
37.33(4) issue recommendations regarding uniform billing forms, uniform electronic
37.34billing procedures and data interchanges, patient identification cards, and other uniform
38.1claims and administrative procedures for health care providers and private and public
38.2sector payers. In developing the recommendations, the commissioner shall review the
38.3work of the work group on electronic data interchange (WEDI) and the American National
38.4Standards Institute (ANSI) at the national level, and the work being done at the state and
38.5local level. The commissioner may adopt rules requiring the use of the Uniform Bill
38.682/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
38.7version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
38.8forms or procedures;
38.9(5) undertake health planning responsibilities;
38.10(6) authorize, fund, or promote research and experimentation on new technologies
38.11and health care procedures;
38.12(7) within the limits of appropriations for these purposes, administer or contract for
38.13statewide consumer education and wellness programs that will improve the health of
38.14Minnesotans and increase individual responsibility relating to personal health and the
38.15delivery of health care services, undertake prevention programs including initiatives to
38.16improve birth outcomes, expand childhood immunization efforts, and provide start-up
38.17grants for worksite wellness programs;
38.18(8) undertake other activities to monitor and oversee the delivery of health care
38.19services in Minnesota with the goal of improving affordability, quality, and accessibility of
38.20health care for all Minnesotans; and
38.21(9) make the cost containment goal data available to the public in a
38.22consumer-oriented manner.
38.23EFFECTIVE DATE.This section is effective July 1, 2011.

38.24    Sec. 3. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
38.25    Subd. 4a. Expenditure reporting. Each hospital, outpatient surgical center,
38.26diagnostic imaging center, and physician clinic shall report annually to the commissioner
38.27on all major spending commitments, in the form and manner specified by the
38.28commissioner. The report shall include the following information:
38.29    (a) a description of major spending commitments made during the previous year,
38.30including the total dollar amount of major spending commitments and purpose of the
38.31expenditures;
38.32    (b) the cost of land acquisition, construction of new facilities, and renovation of
38.33existing facilities;
38.34    (c) the cost of purchased or leased medical equipment, by type of equipment;
38.35    (d) expenditures by type for specialty care and new specialized services;
39.1    (e) information on the amount and types of added capacity for diagnostic imaging
39.2services, outpatient surgical services, and new specialized services; and
39.3    (f) information on investments in electronic medical records systems.
39.4For hospitals and outpatient surgical centers, this information shall be included in reports
39.5to the commissioner that are required under section 144.698. For diagnostic imaging
39.6centers, this information shall be included in reports to the commissioner that are required
39.7under section 144.565. For physician clinics, this information shall be included in reports
39.8to the commissioner that are required under section 62J.41. For all other health care
39.9providers that are subject to this reporting requirement, reports must be submitted to the
39.10commissioner by March 1 each year for the preceding calendar year.
39.11EFFECTIVE DATE.This section is effective July 1, 2011.

39.12    Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
39.13to read:
39.14    Subd. 7. Exemption. Any clinical practice with a total annual net revenue of less
39.15than $500,000, and that has not received a state or federal grant for implementation
39.16of electronic health records, is exempt from the requirements of subdivision 1. This
39.17subdivision expires December 31, 2020.

39.18    Sec. 5. Minnesota Statutes 2010, section 62J.692, is amended to read:
39.1962J.692 MEDICAL EDUCATION.
39.20    Subdivision 1. Definitions. For purposes of this section, the following definitions
39.21apply:
39.22    (a) "Accredited clinical training" means the clinical training provided by a
39.23medical education program that is accredited through an organization recognized by the
39.24Department of Education, the Centers for Medicare and Medicaid Services, or another
39.25national body who reviews the accrediting organizations for multiple disciplines and
39.26whose standards for recognizing accrediting organizations are reviewed and approved by
39.27the commissioner of health in consultation with the Medical Education and Research
39.28Advisory Committee.
39.29    (b) "Commissioner" means the commissioner of health.
39.30    (c) "Clinical medical education program" means the accredited clinical training of
39.31physicians (medical students and residents), doctor of pharmacy practitioners, doctors
39.32of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
40.1registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
40.2physician assistants.
40.3    (d) "Sponsoring institution" means a hospital, school, or consortium located in
40.4Minnesota that sponsors and maintains primary organizational and financial responsibility
40.5for a clinical medical education program in Minnesota and which is accountable to the
40.6accrediting body.
40.7    (e) "Teaching institution" means a hospital, medical center, clinic, or other
40.8organization that conducts a clinical medical education program in Minnesota.
40.9    (f) "Trainee" means a student or resident involved in a clinical medical education
40.10program.
40.11    (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
40.12equivalent counts, that are at training sites located in Minnesota with currently active
40.13medical assistance enrollment status and a National Provider Identification (NPI) number
40.14where training occurs in either an inpatient or ambulatory patient care setting and where
40.15the training is funded, in part, by patient care revenues. Training that occurs in nursing
40.16facility settings is not eligible for funding under this section.
40.17    Subd. 3. Application process. (a) A clinical medical education program
40.18conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy
40.19practitioners, dentists, chiropractors, or physician assistants is eligible for funds under
40.20subdivision 4 or 11, as appropriate, if the program:
40.21(1) is funded, in part, by patient care revenues;
40.22(2) occurs in patient care settings that face increased financial pressure as a result
40.23of competition with nonteaching patient care entities; and
40.24(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
40.25A clinical medical education program that trains pediatricians is requested to include
40.26in its program curriculum training in case management and medication management for
40.27children suffering from mental illness to be eligible for funds under subdivision 4.
40.28(b) A clinical medical education program for advanced practice nursing is eligible
40.29for funds under subdivision 4 or 11, as appropriate, if the program meets the eligibility
40.30requirements in paragraph (a), clauses (1) to (3), and is sponsored by the University of
40.31Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part
40.32of the Minnesota State Colleges and Universities system or members of the Minnesota
40.33Private College Council.
40.34(c) Applications must be submitted to the commissioner by a sponsoring institution
40.35on behalf of an eligible clinical medical education program and must be received by
41.1October 31 of each year for distribution in the following year. An application for funds
41.2must contain the following information:
41.3(1) the official name and address of the sponsoring institution and the official
41.4name and site address of the clinical medical education programs on whose behalf the
41.5sponsoring institution is applying;
41.6(2) the name, title, and business address of those persons responsible for
41.7administering the funds;
41.8(3) for each clinical medical education program for which funds are being sought;
41.9the type and specialty orientation of trainees in the program; the name, site address, and
41.10medical assistance provider number and national provider identification number of each
41.11training site used in the program; the federal tax identification number of each training site
41.12used in the program, where available; the total number of trainees at each training site; and
41.13the total number of eligible trainee FTEs at each site; and
41.14(4) other supporting information the commissioner deems necessary to determine
41.15program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
41.16equitable distribution of funds.
41.17(d) An application must include the information specified in clauses (1) to (3) for
41.18each clinical medical education program on an annual basis for three consecutive years.
41.19After that time, an application must include the information specified in clauses (1) to (3)
41.20when requested, at the discretion of the commissioner:
41.21(1) audited clinical training costs per trainee for each clinical medical education
41.22program when available or estimates of clinical training costs based on audited financial
41.23data;
41.24(2) a description of current sources of funding for clinical medical education costs,
41.25including a description and dollar amount of all state and federal financial support,
41.26including Medicare direct and indirect payments; and
41.27(3) other revenue received for the purposes of clinical training.
41.28(e) An applicant that does not provide information requested by the commissioner
41.29shall not be eligible for funds for the current funding cycle.
41.30    Subd. 4. Distribution of funds. (a) Following the distribution described under
41.31paragraph (b), the commissioner shall annually distribute the available medical education
41.32funds to all qualifying applicants based on a distribution formula that reflects a summation
41.33of two factors:
41.34    (1) a public program volume factor, which is determined by the total volume of
41.35public program revenue received by each training site as a percentage of all public
41.36program revenue received by all training sites in the fund pool; and
42.1    (2) a supplemental public program volume factor, which is determined by providing
42.2a supplemental payment of 20 percent of each training site's grant to training sites whose
42.3public program revenue accounted for at least 0.98 percent of the total public program
42.4revenue received by all eligible training sites. Grants to training sites whose public
42.5program revenue accounted for less than 0.98 percent of the total public program revenue
42.6received by all eligible training sites shall be reduced by an amount equal to the total
42.7value of the supplemental payment.
42.8    Public program revenue for the distribution formula includes revenue from medical
42.9assistance, prepaid medical assistance, general assistance medical care, and prepaid
42.10general assistance medical care. Training sites that receive no public program revenue
42.11are ineligible for funds available under this subdivision. For purposes of determining
42.12training-site level grants to be distributed under paragraph (a), total statewide average
42.13costs per trainee for medical residents is based on audited clinical training costs per trainee
42.14in primary care clinical medical education programs for medical residents. Total statewide
42.15average costs per trainee for dental residents is based on audited clinical training costs
42.16per trainee in clinical medical education programs for dental students. Total statewide
42.17average costs per trainee for pharmacy residents is based on audited clinical training costs
42.18per trainee in clinical medical education programs for pharmacy students. Training sites
42.19whose training site level grant is less than $1,000, based on the formula described in this
42.20paragraph, are ineligible for funds available under this subdivision.
42.21    (b) $5,350,000 $2,680,000 of the available medical education funds shall be
42.22distributed as follows:
42.23    (1) $1,475,000 $740,000 to the University of Minnesota Medical Center-Fairview;
42.24    (2) $2,075,000 $970,000 to the University of Minnesota School of Dentistry; and
42.25    (3) $1,800,000 $970,000 to the Academic Health Center. $150,000 of the funds
42.26distributed to the Academic Health Center under this paragraph shall be used for a
42.27program to assist internationally trained physicians who are legal residents and who
42.28commit to serving underserved Minnesota communities in a health professional shortage
42.29area to successfully compete for family medicine residency programs at the University
42.30of Minnesota.
42.31    (c) Funds distributed shall not be used to displace current funding appropriations
42.32from federal or state sources.
42.33    (d) Funds shall be distributed to the sponsoring institutions indicating the amount
42.34to be distributed to each of the sponsor's clinical medical education programs based on
42.35the criteria in this subdivision and in accordance with the commissioner's approval letter.
42.36Each clinical medical education program must distribute funds allocated under paragraph
43.1(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
43.2institutions, which are accredited through an organization recognized by the Department
43.3of Education or the Centers for Medicare and Medicaid Services, may contract directly
43.4with training sites to provide clinical training. To ensure the quality of clinical training,
43.5those accredited sponsoring institutions must:
43.6    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
43.7training conducted at sites; and
43.8    (2) take necessary action if the contract requirements are not met. Action may
43.9include the withholding of payments under this section or the removal of students from
43.10the site.
43.11    (e) Any funds not distributed in accordance with the commissioner's approval letter
43.12must be returned to the medical education and research fund within 30 days of receiving
43.13notice from the commissioner. The commissioner shall distribute returned funds to the
43.14appropriate training sites in accordance with the commissioner's approval letter.
43.15    (f) A maximum of $150,000 of the funds dedicated to the commissioner under
43.16section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
43.17administrative expenses associated with implementing this section.
43.18    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section
43.19must sign and submit a medical education grant verification report (GVR) to verify that
43.20the correct grant amount was forwarded to each eligible training site. If the sponsoring
43.21institution fails to submit the GVR by the stated deadline, or to request and meet
43.22the deadline for an extension, the sponsoring institution is required to return the full
43.23amount of funds received to the commissioner within 30 days of receiving notice from
43.24the commissioner. The commissioner shall distribute returned funds to the appropriate
43.25training sites in accordance with the commissioner's approval letter.
43.26    (b) The reports must provide verification of the distribution of the funds and must
43.27include:
43.28    (1) the total number of eligible trainee FTEs in each clinical medical education
43.29program;
43.30    (2) the name of each funded program and, for each program, the dollar amount
43.31distributed to each training site;
43.32    (3) documentation of any discrepancies between the initial grant distribution notice
43.33included in the commissioner's approval letter and the actual distribution;
43.34    (4) a statement by the sponsoring institution stating that the completed grant
43.35verification report is valid and accurate; and
44.1    (5) other information the commissioner, with advice from the advisory committee,
44.2deems appropriate to evaluate the effectiveness of the use of funds for medical education.
44.3    (c) By February 15 of each year, the commissioner, with advice from the
44.4advisory committee, shall provide an annual summary report to the legislature on the
44.5implementation of this section.
44.6    Subd. 6. Other available funds. The commissioner is authorized to distribute, in
44.7accordance with subdivision 4 or 11, as appropriate, funds made available through:
44.8(1) voluntary contributions by employers or other entities;
44.9(2) allocations for the commissioner of human services to support medical education
44.10and research; and
44.11(3) other sources as identified and deemed appropriate by the legislature for
44.12inclusion in the fund.
44.13    Subd. 7. Transfers from the commissioner of human services. Of the amount
44.14transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
44.15$21,714,000 shall be distributed as follows:
44.16(1) $2,157,000 shall be distributed by the commissioner to the University of
44.17Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
44.18(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
44.19Medical Center for clinical medical education;
44.20(3) $17,400,000 shall be distributed by the commissioner to the University of
44.21Minnesota Board of Regents for purposes of medical education;
44.22(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
44.23dental innovation grants in accordance with subdivision 7a; and
44.24(5) the remainder of the amount transferred according to section 256B.69,
44.25subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
44.26clinical medical education programs that meet the qualifications of subdivision 3 based on
44.27the formula in subdivision 4, paragraph (a), or 11, as appropriate.
44.28    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
44.29shall award grants to teaching institutions and clinical training sites for projects that
44.30increase dental access for underserved populations and promote innovative clinical
44.31training of dental professionals. In awarding the grants, the commissioner, in consultation
44.32with the commissioner of human services, shall consider the following:
44.33(1) potential to successfully increase access to an underserved population;
44.34(2) the long-term viability of the project to improve access beyond the period
44.35of initial funding;
44.36(3) evidence of collaboration between the applicant and local communities;
45.1(4) the efficiency in the use of the funding; and
45.2(5) the priority level of the project in relation to state clinical education, access,
45.3and workforce goals.
45.4(b) The commissioner shall periodically evaluate the priorities in awarding the
45.5innovations grants in order to ensure that the priorities meet the changing workforce
45.6needs of the state.
45.7    Subd. 8. Federal financial participation. The commissioner of human services
45.8shall seek to maximize federal financial participation in payments for medical education
45.9and research costs.
45.10    The commissioner shall use physician clinic rates where possible to maximize
45.11federal financial participation. Any additional funds that become available must be
45.12distributed under subdivision 4, paragraph (a), or 11, as appropriate.
45.13    Subd. 9. Review of eligible providers. The commissioner and the Medical
45.14Education and Research Costs Advisory Committee may review provider groups included
45.15in the definition of a clinical medical education program to assure that the distribution of
45.16the funds continue to be consistent with the purpose of this section. The results of any
45.17such reviews must be reported to the Legislative Commission on Health Care Access.
45.18    Subd. 11. Distribution of funds. (a) Upon receiving federal approval, the
45.19commissioner shall annually distribute the available medical education funds to all
45.20qualifying applicants based on the distribution formula provided in this subdivision, which
45.21supersedes the formula described in subdivision 4, paragraph (a).
45.22(1) Following the distribution of funds described under subdivision 4, paragraph
45.23(b), the commissioner shall annually distribute the available medical education funds
45.24to all qualifying applicants based on a distribution formula that reflects a summation
45.25of two factors:
45.26(i) a public program volume factor, which is determined by the total volume of
45.27public program revenue received by each training site as a percentage of all public
45.28program revenue received by all training sites in the fund pool; and
45.29(ii) a supplemental public program volume factor, which is determined by providing
45.30a supplemental payment of 20 percent of each training site's grant to training sites whose
45.31public program revenue accounted for at least 0.98 percent of the total public program
45.32revenue received by all eligible training sites. Grants to training sites whose public
45.33program revenue accounted for less than 0.98 percent of the total public program revenue
45.34received by all eligible training sites shall be reduced by an amount equal to the total
45.35value of the supplemental payment.
46.1Public program revenue for the distribution formula includes revenue from medical
46.2assistance, prepaid medical assistance, general assistance medical care, and prepaid
46.3general assistance medical care. Training sites that receive no public program revenue are
46.4ineligible for funds available under this subdivision. For purposes of determining training
46.5site level grants to be distributed under paragraph (a), total statewide average costs per
46.6trainee for medical residents is based on audited clinical training costs per trainee in
46.7primary care clinical medical education programs for medical residents. Total statewide
46.8average costs per trainee for dental residents is based on audited clinical training costs
46.9per trainee in clinical medical education programs for dental students. Total statewide
46.10average costs per trainee for pharmacy residents is based on audited clinical training costs
46.11per trainee in clinical medical education programs for pharmacy students.
46.12(2) Ten percent of available medical education funds shall be used to create a primary
46.13care bonus pool. Grants to eligible training sites under this clause shall be determined by
46.14dividing the total number of eligible FTE trainees from primary care medicine, advanced
46.15practice nursing, or physician assistant programs at all eligible training sites by the amount
46.16of funds available in the primary care bonus pool to determine a grant per primary care
46.17FTE; each eligible training site shall receive a grant equal to the grant per primary care
46.18FTE multiplied by the number of eligible primary care FTE's at the training site.
46.19(3) After determining the grant amount for each training site under clause (1), items
46.20(i) and (ii), and clause (2), the commissioner shall calculate a grant per eligible trainee for
46.21each training site. Any training site whose grant per eligible trainee is greater than the
46.2295th percentile grant per eligible trainee shall have the grant amount reduced to the 95th
46.23percentile grant per eligible trainee. Grants in excess of this amount for any training site
46.24shall be redistributed based on the criteria in clause (4).
46.25Any training site with fewer than 0.1 FTE eligible trainees from all programs or a
46.26calculated grant less than $1,000 based on the formula described in clauses (1) and (2)
46.27shall be eliminated from the distribution; the calculated grants for these training sites shall
46.28be redistributed based on the criteria in clause (4).
46.29(4) The commissioner shall award from available funds appropriated for this purpose
46.30and equally divided between the following programs:
46.31(i) the community mental health center grants program under section 145.9272; and
46.32(ii) the community health centers development grants program under section
46.33145.987.
46.34If federal approval for this funding mechanism is not received for either of the grant
46.35programs described in this paragraph, available funds will be provided to the remaining
46.36grant program described in this paragraph. If none of the grant programs described in this
47.1paragraph receive federal approval, available funds will be distributed to eligible training
47.2sites based on the formula in clauses (1) to (3).
47.3(b) Funds distributed shall not be used to displace current funding appropriations
47.4from federal or state sources.
47.5(c) Funds shall be distributed to the sponsoring institutions indicating the amount
47.6to be distributed to each of the sponsor's clinical medical education programs based on
47.7the criteria in this subdivision and according to the commissioner's approval letter. Each
47.8clinical medical education program must distribute funds allocated under paragraph
47.9(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
47.10institutions, which are accredited through an organization recognized by the Department
47.11of Education or the Centers for Medicare and Medicaid Services, may contract directly
47.12with training sites to provide clinical training. To ensure the quality of clinical training,
47.13those accredited sponsoring institutions must:
47.14(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
47.15training conducted at sites; and
47.16(2) take necessary action if the contract requirements are not met. Action may
47.17include the withholding of payments under this section or the removal of students from
47.18the site.
47.19(d) Any funds not distributed according to the commissioner's approval letter must
47.20be returned to the medical education and research fund within 30 days of receiving
47.21notice from the commissioner. The commissioner shall distribute returned funds to the
47.22appropriate training sites according to the commissioner's approval letter.
47.23(e) A maximum of $150,000 of the funds dedicated to the commissioner under
47.24section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
47.25administrative expenses associated with implementing this section.

47.26    Sec. 6. [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING
47.27MEASURES.
47.28    Subdivision 1. Data from providers. (a) By July 1, 2012, the commissioner
47.29shall review currently available quality measures and make recommendations for future
47.30measurement aimed at improving assessment and care related to Alzheimer's disease and
47.31other dementia diagnoses, including improved rates and results of cognitive screening,
47.32rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment
47.33plans.
47.34(b) The commissioner may contract with a private entity to complete the
47.35requirements in this subdivision. If the commissioner contracts with a private entity
48.1already under contract through section 62U.02, then the commissioner may use a sole
48.2source contract and is exempt from competitive procurement processes.
48.3    Subd. 2. Learning collaborative. By July 1, 2012, the commissioner shall
48.4develop a health care home learning collaborative curriculum that includes screening and
48.5education on best practices regarding identification and management of Alzheimer's and
48.6other dementia patients under section 256B.0751, subdivision 5, for providers, clinics,
48.7care coordinators, clinic administrators, patient partners and families, and community
48.8resources including public health.
48.9    Subd. 3. Comparison data. The commissioner, with the commissioner of human
48.10services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly
48.11review existing and forthcoming literature in order to estimate differences in the outcomes
48.12and costs of current practices for caring for those with Alzheimer's disease and other
48.13dementias, compared to the outcomes and costs resulting from:
48.14(1) earlier identification of Alzheimer's and other dementias;
48.15(2) improved support of family caregivers; and
48.16(3) improved collaboration between medical care management and community-based
48.17supports.
48.18    Subd. 4. Reporting. By January 15, 2013, the commissioner must report to the
48.19legislature on progress toward establishment and collection of quality measures required
48.20under this section.

48.21    Sec. 7. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:
48.22    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
48.23apply.
48.24(b) "Dentist" means an individual who is licensed to practice dentistry.
48.25(c) "Designated rural area" means:
48.26(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin,
48.27Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead,
48.28Rochester, and St. Cloud; or
48.29(2) a municipal corporation, as defined under section 471.634, that is physically
48.30located, in whole or in part, in an area defined as a designated rural area under clause (1).
48.31an area defined as a small rural area or isolated rural area according to the four category
48.32classifications of the Rural Urban Commuting Area system developed for the United
48.33States Health Resources and Services Administration.
49.1(d) "Emergency circumstances" means those conditions that make it impossible for
49.2the participant to fulfill the service commitment, including death, total and permanent
49.3disability, or temporary disability lasting more than two years.
49.4(e) "Medical resident" means an individual participating in a medical residency in
49.5family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
49.6(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
49.7anesthetist, advanced clinical nurse specialist, or physician assistant.
49.8(g) "Nurse" means an individual who has completed training and received all
49.9licensing or certification necessary to perform duties as a licensed practical nurse or
49.10registered nurse.
49.11(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
49.12study designed to prepare registered nurses for advanced practice as nurse-midwives.
49.13(i) "Nurse practitioner" means a registered nurse who has graduated from a program
49.14of study designed to prepare registered nurses for advanced practice as nurse practitioners.
49.15(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
49.16(k) "Physician" means an individual who is licensed to practice medicine in the areas
49.17of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
49.18(l) "Physician assistant" means a person licensed under chapter 147A.
49.19(m) "Qualified educational loan" means a government, commercial, or foundation
49.20loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
49.21expenses related to the graduate or undergraduate education of a health care professional.
49.22(n) "Underserved urban community" means a Minnesota urban area or population
49.23included in the list of designated primary medical care health professional shortage areas
49.24(HPSAs), medically underserved areas (MUAs), or medically underserved populations
49.25(MUPs) maintained and updated by the United States Department of Health and Human
49.26Services.

49.27    Sec. 8. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
49.28    Subd. 5. Statewide tobacco prevention grants. (a) To the extent funds are
49.29appropriated for the purposes of this subdivision, the commissioner of health shall, within
49.30available appropriations, award competitive grants to eligible applicants for projects and
49.31initiatives directed at the prevention of tobacco use. The project areas for grants include:
49.32(1) statewide public education and information campaigns which include
49.33implementation at the local level; and
49.34(2) coordinated special projects, including training and technical assistance, a
49.35resource clearinghouse, and contracts with ethnic and minority communities.
50.1(b) Eligible applicants may include, but are not limited to, nonprofit organizations,
50.2colleges and universities, professional health associations, community health boards, and
50.3other health care organizations. Applicants must submit proposals to the commissioner.
50.4The proposals must specify the strategies to be implemented to target tobacco use among
50.5youth, and must take into account the need for a coordinated statewide tobacco prevention
50.6effort.
50.7(c) The commissioner must give priority to applicants who demonstrate that the
50.8proposed project:
50.9(1) is research based or based on proven effective strategies;
50.10(2) is designed to coordinate with other activities and education messages related
50.11to other health initiatives;
50.12(3) utilizes and enhances existing prevention activities and resources; or
50.13(4) involves innovative approaches preventing tobacco use among youth.

50.14    Sec. 9. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:
50.15    Subd. 6. Local tobacco prevention grants. (a) The commissioner shall award
50.16grants, within available appropriations, to eligible applicants for local and regional
50.17projects and initiatives directed at tobacco prevention in coordination with other health
50.18areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related
50.19problems. The project areas for grants include:
50.20(1) school-based tobacco prevention programs aimed at youth and parents;
50.21(2) local public awareness and education projects aimed at tobacco prevention in
50.22coordination with locally assessed community public health needs pursuant to chapter
50.23145A; or
50.24(3) local initiatives aimed at reducing high-risk behavior in youth associated with
50.25tobacco use and the health consequences of these behaviors.
50.26(b) Eligible applicants may include, but are not limited to, community health boards,
50.27school districts, community clinics, Indian tribes, nonprofit organizations, and other health
50.28care organizations. Applicants must submit proposals to the commissioner. The proposals
50.29must specify the strategies to be implemented to target tobacco use among youth, and must
50.30be targeted to achieve the outcomes established in subdivision 2.
50.31(c) The commissioner must give priority to applicants who demonstrate that the
50.32proposed project or initiative is:
50.33(1) supported by the community in which the applicant serves;
50.34(2) is based on research or on proven effective strategies;
51.1(3) is designed to coordinate with other community activities related to other health
51.2initiatives;
51.3(4) incorporates an understanding of the role of community in influencing behavioral
51.4changes among youth regarding tobacco use and other high-risk health-related behaviors;
51.5or
51.6(5) addresses disparities among populations of color related to tobacco use and
51.7other high-risk health-related behaviors.
51.8(d) The commissioner shall divide the state into specific geographic regions and
51.9allocate a percentage of the money available for distribution to projects or initiatives
51.10aimed at that geographic region. If the commissioner does not receive a sufficient number
51.11of grant proposals from applicants that serve a particular region or the proposals submitted
51.12do not meet the criteria developed by the commissioner, the commissioner shall provide
51.13technical assistance and expertise to ensure the development of adequate proposals
51.14aimed at addressing the public health needs of that region. In awarding the grants, the
51.15commissioner shall consider locally assessed community public health needs pursuant to
51.16chapter 145A.

51.17    Sec. 10. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:
51.18    Subd. 2a. Standards. Notwithstanding the exemptions in subdivisions 8 and 9, the
51.19commissioner shall accredit laboratories according to the most current environmental
51.20laboratory accreditation standards under subdivision 1 and as accepted by the accreditation
51.21bodies recognized by the National Environmental Laboratory Accreditation Program
51.22(NELAP) of the NELAC Institute.

51.23    Sec. 11. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:
51.24    Subd. 7. Initial accreditation and annual accreditation renewal. (a) The
51.25commissioner shall issue or renew accreditation after receipt of the completed application
51.26and documentation required in this section, provided the laboratory maintains compliance
51.27with the standards specified in subdivision 2a, notwithstanding any exemptions under
51.28subdivisions 8 and 9, and attests to the compliance on the application form.
51.29(b) The commissioner shall prorate the fees in subdivision 3 for laboratories
51.30applying for accreditation after December 31. The fees are prorated on a quarterly basis
51.31beginning with the quarter in which the commissioner receives the completed application
51.32from the laboratory.
51.33(c) Applications for renewal of accreditation must be received by November 1 and
51.34no earlier than October 1 of each year. The commissioner shall send annual renewal
52.1notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
52.2not exempt laboratories from meeting the annual November 1 renewal date.
52.3(d) The commissioner shall issue all accreditations for the calendar year for which
52.4the application is made, and the accreditation shall expire on December 31 of that year.
52.5(e) The accreditation of any laboratory that fails to submit a renewal application
52.6and fees to the commissioner expires automatically on December 31 without notice or
52.7further proceeding. Any person who operates a laboratory as accredited after expiration of
52.8accreditation or without having submitted an application and paid the fees is in violation
52.9of the provisions of this section and is subject to enforcement action under sections
52.10144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired
52.11accreditation may reapply under subdivision 6.

52.12    Sec. 12. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
52.13to read:
52.14    Subd. 8. Exemption from national standards for quality control and personnel
52.15requirements. Effective January 1, 2012, a laboratory that analyzes samples for
52.16compliance with a permit issued under section 115.03, subdivision 5, may request
52.17exemption from the personnel requirements and specific quality control provisions for
52.18microbiology and chemistry stated in the national standards as incorporated by reference
52.19in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
52.20(1) complies with the methodology and quality control requirements, where
52.21available, in the most recent, approved edition of the Standard Methods for the
52.22Examination of Water and Wastewater as published by the Water Environment Federation;
52.23and
52.24(2) supplies the name of the person meeting the requirements in section 115.73, or
52.25the personnel requirements in the national standard pursuant to subdivision 2a.
52.26A laboratory applying for this exemption shall not apply for simultaneous
52.27accreditation under the national standard.

52.28    Sec. 13. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
52.29to read:
52.30    Subd. 9. Exemption from national standards for proficiency testing frequency.
52.31(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under
52.32the exemption in subdivision 8 must obtain an acceptable proficiency test result for each
52.33of the laboratory's accredited or requested fields of testing. The laboratory must analyze
53.1proficiency samples selected from one of two annual proficiency testing studies scheduled
53.2by the commissioner.
53.3(b) If a laboratory fails to successfully complete the first scheduled proficiency
53.4study, the laboratory shall:
53.5(1) obtain and analyze a supplemental test sample within 15 days of receiving the
53.6test report for the initial failed attempt; and
53.7(2) participate in the second annual study as scheduled by the commissioner.
53.8(c) If a laboratory does not submit results or fails two consecutive proficiency
53.9samples, the commissioner will revoke the laboratory's accreditation for the affected
53.10fields of testing.
53.11(d) The commissioner may require a laboratory to analyze additional proficiency
53.12testing samples beyond what is required in this subdivision if information available to
53.13the commissioner indicates that the laboratory's analysis for the field of testing does not
53.14meet the requirements for accreditation.
53.15(e) The commissioner may collect from laboratories accredited under the exemption
53.16in subdivision 8 any additional costs required to administer this subdivision and
53.17subdivision 8.

53.18    Sec. 14. Minnesota Statutes 2010, section 144A.102, is amended to read:
53.19144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS;
53.20PENALTIES.
53.21(a) By January 2000, the commissioner of health shall work with providers to
53.22examine state and federal rules and regulations governing the provision of care in licensed
53.23nursing facilities and apply for federal waivers and identify necessary changes in state
53.24law to:
53.25(1) allow the use of civil money penalties imposed upon nursing facilities to abate
53.26any deficiencies identified in a nursing facility's plan of correction; and
53.27(2) stop the accrual of any fine imposed by the Health Department when a follow-up
53.28inspection survey is not conducted by the department within the regulatory deadline.
53.29(b) By January 2012, the commissioner of health shall work with providers and
53.30the ombudsman for long-term care to examine state and federal rules and regulations
53.31governing the provision of care in licensed nursing facilities and apply for federal waivers
53.32and identify necessary changes in state law to:
53.33(1) eliminate the requirement for written plans of correction from nursing homes for
53.34federal deficiencies issued at a scope and severity that is not widespread, harmful, or in
53.35immediate jeopardy; and
54.1(2) issue the federal survey form electronically to nursing homes.
54.2The commissioner shall issue a report to the legislative chairs of the committees
54.3with jurisdiction over health and human services by January 31, 2012, on the status of
54.4implementation of this paragraph.

54.5    Sec. 15. Minnesota Statutes 2010, section 144A.61, is amended by adding a
54.6subdivision to read:
54.7    Subd. 9. Electronic transmission. The commissioner of health must accept
54.8electronic transmission of applications and supporting documentation for interstate
54.9endorsement for the nursing assistant registry.

54.10    Sec. 16. Minnesota Statutes 2010, section 144E.123, is amended to read:
54.11144E.123 PREHOSPITAL CARE DATA.
54.12    Subdivision 1. Collection and maintenance. A licensee shall collect and provide
54.13prehospital care data to the board in a manner prescribed by the board. At a minimum,
54.14the data must include items identified by the board that are part of the National Uniform
54.15Emergency Medical Services Data Set. A licensee shall maintain prehospital care data
54.16for every response.
54.17    Subd. 2. Copy to receiving hospital. If a patient is transported to a hospital, a copy
54.18of the ambulance report delineating prehospital medical care given shall be provided
54.19to the receiving hospital.
54.20    Subd. 3. Review. Prehospital care data may be reviewed by the board or its
54.21designees. The data shall be classified as private data on individuals under chapter 13, the
54.22Minnesota Government Data Practices Act.
54.23    Subd. 4. Penalty. Failure to report all information required by the board under this
54.24section shall constitute grounds for license revocation.
54.25    Subd. 5. Working group. By October 1, 2011, the board must convene a working
54.26group composed of six members, three of which must be appointed by the board and three
54.27of which must be appointed by the Minnesota Ambulance Association, to redesign the
54.28board's policies related to collection of data from licenses. The issues to be considered
54.29include, but are not limited to, the following: user-friendly reporting requirements; data
54.30sets; improved accuracy of reported information; appropriate use of information gathered
54.31through the reporting system; and methods for minimizing the financial impact of data
54.32reporting on licenses, particularly for rural volunteer services. The working group must
54.33report its findings and recommendations to the board no later than July 1, 2012.
55.1EFFECTIVE DATE.This section is effective the day following final enactment.

55.2    Sec. 17. [145.4221] HUMAN CLONING PROHIBITED.
55.3    Subdivision 1. Definitions. (a) For purposes of this section, the following terms
55.4have the meanings given.
55.5(b) "Human cloning" means human asexual reproduction accomplished by
55.6introducing nuclear material from one or more human somatic cells into a fertilized
55.7or unfertilized oocyte whose nuclear material has been removed or inactivated so as
55.8to produce a living organism at any stage of development that is genetically virtually
55.9identical to an existing or previously existing human organism.
55.10(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes,
55.11obtained or derived from a living or deceased human body at any stage of development.
55.12    Subd. 2. Prohibition on cloning. No person or entity, whether public or private,
55.13may:
55.14(1) perform or attempt to perform human cloning;
55.15(2) participate in an attempt to perform human cloning;
55.16(3) ship, import, or receive for any purpose an embryo produced by human cloning
55.17or any product derived from such an embryo; or
55.18(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic
55.19cell, for the purpose of human cloning.
55.20    Subd. 3. Scientific research. Nothing in this section shall restrict areas of scientific
55.21research not specifically prohibited by this section, including research in the use of nuclear
55.22transfer or other cloning techniques to produce molecules, DNA, cells other than human
55.23embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this
55.24section shall restrict, inhibit, or make unlawful the scientific field of stem cell research,
55.25unless explicitly prohibited.
55.26    Subd. 4. Penalties. Any person or entity that knowingly or recklessly violates
55.27subdivision 2 is guilty of a misdemeanor.
55.28    Subd. 5. Severability. If any provision, section, subdivision, sentence, clause,
55.29phrase, or word in this section or the application thereof to any person or circumstance is
55.30found to be unconstitutional, the same is hereby declared to be severable and the remainder
55.31of this section shall remain effective notwithstanding such unconstitutional provision. The
55.32legislature declares that it would have passed this section and each provision, subdivision,
55.33sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section,
55.34subdivision, sentence, clause, phrase, or word is declared unconstitutional.
56.1EFFECTIVE DATE.This section is effective August 1, 2011, and applies to crimes
56.2committed on or after that date.

56.3    Sec. 18. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:
56.4    Subdivision 1. Eligible organizations; purpose. The commissioner of health may,
56.5within available appropriations, make special grants to cities, counties, groups of cities or
56.6counties, or nonprofit corporations to provide prepregnancy family planning services.

56.7    Sec. 19. Minnesota Statutes 2010, section 145.925, subdivision 2, is amended to read:
56.8    Subd. 2. Prohibition. The commissioner shall not make special grants pursuant to
56.9this section to any nonprofit corporation which performs abortions eligible organization
56.10that performs abortions or provides referrals for abortion services. No state funds shall be
56.11used under contract from a grantee to any nonprofit corporation which performs abortions.
56.12This provision shall not apply to hospitals licensed pursuant to sections 144.50 to 144.56,
56.13or health maintenance organizations certified pursuant to chapter 62D eligible organization
56.14that performs abortions or provides referrals for abortion services.

56.15    Sec. 20. [145.9271] WHITE EARTH BAND URBAN CLINIC.
56.16    Subdivision 1. Establish urban clinic. The White Earth Band of Ojibwe Indians
56.17shall establish and operate one or more health care clinics in the Minneapolis area or
56.18greater Minnesota to serve members of the White Earth Tribe and may use funds received
56.19under this section for application to qualify as a federally qualified health center.
56.20    Subd. 2. Grant agreements. Before receiving the funds under this section, the
56.21White Earth Band of Ojibwe Indians is requested to submit to the commissioner of health
56.22a work plan and budget that describes its annual plan for the funds. The commissioner will
56.23incorporate the work plan and budget into a grant agreement between the commissioner
56.24and the White Earth Band of Ojibwe Indians. Before each successive disbursement, the
56.25White Earth Band of Ojibwe Indians is requested to submit a narrative progress report and
56.26an expenditure report to the commissioner.

56.27    Sec. 21. [145.9272] COMMUNITY MENTAL HEALTH CENTER GRANTS.
56.28    Subdivision 1. Definitions. For purposes of this section, "community mental
56.29health center" means an entity that is eligible for payment under section 256B.0625,
56.30subdivision 5.
56.31    Subd. 2. Allocation of subsidies. The commissioner of health shall distribute, from
56.32money appropriated for this purpose, grants to community mental health centers operating
57.1in the state on July 1 of the year 2011 and each subsequent year for community mental
57.2health center services to low-income consumers and patients with mental illness. The
57.3amount of each grant shall be in proportion to each community mental health center's
57.4revenues received from state health care programs in the most recent calendar year for
57.5which data is available.
57.6EFFECTIVE DATE.This section is effective July 1, 2011, or upon federal
57.7approval of the funding mechanism set out in Minnesota Statutes, section 62J.692,
57.8subdivision 11, whichever is later.

57.9    Sec. 22. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
57.10    Subd. 7. Community grant program; immunization rates and infant mortality
57.11rates. (a) The commissioner shall, within available appropriations, award grants to
57.12eligible applicants for local or regional projects and initiatives directed at reducing health
57.13disparities in one or both of the following priority areas:
57.14(1) decreasing racial and ethnic disparities in infant mortality rates; or
57.15(2) increasing adult and child immunization rates in nonwhite racial and ethnic
57.16populations.
57.17(b) The commissioner may award up to 20 percent of the funds available as planning
57.18grants. Planning grants must be used to address such areas as community assessment,
57.19coordination activities, and development of community supported strategies.
57.20(c) Eligible applicants may include, but are not limited to, faith-based organizations,
57.21social service organizations, community nonprofit organizations, community health
57.22boards, tribal governments, and community clinics. Applicants must submit proposals to
57.23the commissioner. A proposal must specify the strategies to be implemented to address
57.24one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the
57.25outcomes established according to subdivision 3.
57.26(d) The commissioner shall give priority to applicants who demonstrate that their
57.27proposed project or initiative:
57.28(1) is supported by the community the applicant will serve;
57.29(2) is research-based or based on promising strategies;
57.30(3) is designed to complement other related community activities;
57.31(4) utilizes strategies that positively impact both priority areas;
57.32(5) reflects racially and ethnically appropriate approaches; and
57.33(6) will be implemented through or with community-based organizations that reflect
57.34the race or ethnicity of the population to be reached.

58.1    Sec. 23. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
58.2    Subd. 8. Community grant program; other health disparities. (a) The
58.3commissioner shall, within available appropriations, award grants to eligible applicants
58.4for local or regional projects and initiatives directed at reducing health disparities in
58.5one or more of the following priority areas:
58.6(1) decreasing racial and ethnic disparities in morbidity and mortality rates from
58.7breast and cervical cancer;
58.8(2) decreasing racial and ethnic disparities in morbidity and mortality rates from
58.9HIV/AIDS and sexually transmitted infections;
58.10(3) decreasing racial and ethnic disparities in morbidity and mortality rates from
58.11cardiovascular disease;
58.12(4) decreasing racial and ethnic disparities in morbidity and mortality rates from
58.13diabetes; or
58.14(5) decreasing racial and ethnic disparities in morbidity and mortality rates from
58.15accidental injuries or violence.
58.16(b) The commissioner may award up to 20 percent of the funds available as planning
58.17grants. Planning grants must be used to address such areas as community assessment,
58.18determining community priority areas, coordination activities, and development of
58.19community supported strategies.
58.20(c) Eligible applicants may include, but are not limited to, faith-based organizations,
58.21social service organizations, community nonprofit organizations, community health
58.22boards, and community clinics. Applicants shall submit proposals to the commissioner.
58.23A proposal must specify the strategies to be implemented to address one or more of
58.24the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes
58.25established according to subdivision 3.
58.26(d) The commissioner shall give priority to applicants who demonstrate that their
58.27proposed project or initiative:
58.28(1) is supported by the community the applicant will serve;
58.29(2) is research-based or based on promising strategies;
58.30(3) is designed to complement other related community activities;
58.31(4) utilizes strategies that positively impact more than one priority area;
58.32(5) reflects racially and ethnically appropriate approaches; and
58.33(6) will be implemented through or with community-based organizations that reflect
58.34the race or ethnicity of the population to be reached.

59.1    Sec. 24. [145.987] COMMUNITY HEALTH CENTERS DEVELOPMENT
59.2GRANTS.
59.3(a) The commissioner of health shall award grants from money appropriated for this
59.4purpose to expand community health centers, as defined in section 145.9269, subdivision
59.51, in the state through the establishment of new community health centers or sites in
59.6areas defined as small rural areas or isolated rural areas according to the four category
59.7classification of the Rural Urban Commuting Area system developed for the United States
59.8Health Resources and Services Administration or serving underserved patient populations.
59.9(b) Grant funds may be used to pay for:
59.10(1) costs for an organization to develop and submit a proposal to the federal
59.11government for the designation of a new community health center or site; and
59.12(2) costs of planning, designing, remodeling, constructing, or purchasing equipment
59.13for a new center or site.
59.14Funds may not be used for operating costs.
59.15(c) The commissioner shall award grants on a competitive basis.
59.16EFFECTIVE DATE.This section is effective July 1, 2011, or upon federal
59.17approval of the funding mechanism set out in Minnesota Statutes, section 62J.692,
59.18subdivision 11, whichever is later.

59.19    Sec. 25. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:
59.20    Subd. 3. Requirements for programs; process. (a) Community health boards
59.21and tribal governments that receive funding under this section must submit a plan to
59.22the commissioner describing a multidisciplinary approach to targeted home visiting for
59.23families. The plan must be submitted on forms provided by the commissioner. At a
59.24minimum, the plan must include the following:
59.25    (1) a description of outreach strategies to families prenatally or at birth;
59.26    (2) provisions for the seamless delivery of health, safety, and early learning services;
59.27    (3) methods to promote continuity of services when families move within the state;
59.28    (4) a description of the community demographics;
59.29    (5) a plan for meeting outcome measures; and
59.30    (6) a proposed work plan that includes:
59.31    (i) coordination to ensure nonduplication of services for children and families;
59.32    (ii) a description of the strategies to ensure that children and families at greatest risk
59.33receive appropriate services; and
59.34    (iii) collaboration with multidisciplinary partners including public health,
59.35ECFE, Head Start, community health workers, social workers, community home
60.1visiting programs, school districts, and other relevant partners. Letters of intent from
60.2multidisciplinary partners must be submitted with the plan.
60.3    (b) Each program that receives funds must accomplish the following program
60.4requirements:
60.5    (1) use a community-based strategy to provide preventive and early intervention
60.6home visiting services;
60.7    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
60.8home visit must occur prenatally or as soon after birth as possible and must include a
60.9public health nursing assessment by a public health nurse;
60.10    (3) offer, at a minimum, information on infant care, child growth and development,
60.11positive parenting, preventing diseases, preventing exposure to environmental hazards,
60.12and support services available in the community;
60.13    (4) provide information on and referrals to health care services, if needed, including
60.14information on and assistance in applying for health care coverage for which the child or
60.15family may be eligible; and provide information on preventive services, developmental
60.16assessments, and the availability of public assistance programs as appropriate;
60.17    (5) provide youth development programs when appropriate;
60.18    (6) recruit home visitors who will represent, to the extent possible, the races,
60.19cultures, and languages spoken by families that may be served;
60.20    (7) train and supervise home visitors in accordance with the requirements established
60.21under subdivision 4;
60.22    (8) maximize resources and minimize duplication by coordinating or contracting
60.23with local social and human services organizations, education organizations, and other
60.24appropriate governmental entities and community-based organizations and agencies;
60.25    (9) utilize appropriate racial and ethnic approaches to providing home visiting
60.26services; and
60.27    (10) connect eligible families, as needed, to additional resources available in the
60.28community, including, but not limited to, early care and education programs, health or
60.29mental health services, family literacy programs, employment agencies, social services,
60.30and child care resources and referral agencies.
60.31    (c) When available, programs that receive funds under this section must offer or
60.32provide the family with a referral to center-based or group meetings that meet at least
60.33once per month for those families identified with additional needs. The meetings must
60.34focus on further enhancing the information, activities, and skill-building addressed during
60.35home visitation; offering opportunities for parents to meet with and support each other;
61.1and offering infants and toddlers a safe, nurturing, and stimulating environment for
61.2socialization and supervised play with qualified teachers.
61.3    (d) Funds available under this section shall not be used for medical services. The
61.4commissioner shall establish an administrative cost limit for recipients of funds. The
61.5outcome measures established under subdivision 6 must be specified to recipients of
61.6funds at the time the funds are distributed.
61.7    (e) Data collected on individuals served by the home visiting programs must remain
61.8confidential and must not be disclosed by providers of home visiting services without a
61.9specific informed written consent that identifies disclosures to be made. Upon request,
61.10agencies providing home visiting services must provide recipients with information on
61.11disclosures, including the names of entities and individuals receiving the information and
61.12the general purpose of the disclosure. Prospective and current recipients of home visiting
61.13services must be told and informed in writing that written consent for disclosure of data is
61.14not required for access to home visiting services.
61.15(f) Upon initial contact with a family, programs that receive funding under this
61.16section must receive permission from the family to share with other family service
61.17providers information about services the family is receiving and unmet needs of the family
61.18in order to select a lead agency for the family and coordinate available resources. For
61.19purposes of this paragraph, the term "family service providers" includes local public
61.20health, social services, school districts, Head Start programs, health care providers, and
61.21other public agencies.

61.22    Sec. 26. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision
61.23to read:
61.24    Subd. 7a. Limited food establishment. "Limited food establishment" means a food
61.25and beverage service establishment that primarily provides beverages that consist of
61.26combining dry mixes and water or ice for immediate service to the consumer. Limited
61.27food establishments must use equipment and utensils that are nontoxic, durable, and retain
61.28their characteristic qualities under normal use conditions and may request a variance for
61.29plumbing requirements from the commissioner.
61.30EFFECTIVE DATE.This section is effective July 1, 2011, and applies to
61.31applications for licensure submitted on or after that date.

61.32    Sec. 27. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision
61.33to read:
62.1    Subd. 5. Variance requests. (a) A person may request a variance from all parts of
62.2Minnesota Rules, chapter 4626, except as provided in paragraph (b) or Minnesota Rules,
62.3chapter 4626. At the time of application for plan review, the person, operator, or submitter
62.4must be notified of the right to request variances.
62.5(b) No variance may be requested or approved for the following parts of Minnesota
62.6Rules, chapter 4626:
62.7(1) Minnesota Rules, part 4626.0020, subpart 35;
62.8(2) Minnesota Rules, parts 4626.0040 to 4626.0060;
62.9(3) Minnesota Rules, parts 4626.0065 to 4626.0100;
62.10(4) Minnesota Rules, parts 4626.0105 to 4626.0120;
62.11(5) Minnesota Rules, part 4626.1565;
62.12(6) Minnesota Rules, parts 4626.1590 and 4626.1595; and
62.13(7) Minnesota Rules, parts 4626.1600 to 4626.1675.

62.14    Sec. 28. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
62.15    Subdivision 1. Tax and use tax on cigarettes. Revenue received from cigarette
62.16taxes, as well as related penalties, interest, license fees, and miscellaneous sources of
62.17revenue shall be deposited by the commissioner in the state treasury and credited as
62.18follows:
62.19(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each
62.20year thereafter must be credited to the Academic Health Center special revenue fund
62.21hereby created and is annually appropriated to the Board of Regents at the University of
62.22Minnesota for Academic Health Center funding at the University of Minnesota; and
62.23(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal year years 2007 and
62.24each year thereafter through fiscal year 2011 and $6,244,000 each fiscal year thereafter
62.25must be credited to the medical education and research costs account hereby created in
62.26the special revenue fund and is annually appropriated to the commissioner of health for
62.27distribution under section 62J.692, subdivision 4 or 11, as appropriate; and
62.28(3) the balance of the revenues derived from taxes, penalties, and interest (under
62.29this chapter) and from license fees and miscellaneous sources of revenue shall be credited
62.30to the general fund.

62.31    Sec. 29. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
62.32RESPONSIBILITIES.
62.33(a) The commissioner of health, in consultation with the commissioner of human
62.34services, shall evaluate and recommend options for reorganizing health and human
63.1services regulatory responsibilities in both agencies to provide better efficiency and
63.2operational cost savings while maintaining the protection of the health, safety, and welfare
63.3of the public. Regulatory responsibilities that are to be evaluated are those found in
63.4Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B,
63.5149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50,
63.6144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
63.7(b) The evaluation and recommendations shall be submitted in a report to the
63.8legislative committees with jurisdiction over health and human services no later than
63.9February 15, 2012, and shall include, at a minimum, the following:
63.10(1) whether the regulatory responsibilities of each agency should be combined into
63.11a separate agency;
63.12(2) whether the regulatory responsibilities of each agency should be merged into
63.13an existing agency;
63.14(3) what cost savings would result by merging the activities regardless of where
63.15they are located;
63.16(4) what additional costs would result if the activities were merged;
63.17(5) whether there are additional regulatory responsibilities in both agencies that
63.18should be considered in any reorganization; and
63.19(6) for each option recommended, projected cost and a timetable and identification
63.20of the necessary steps and requirements for a successful transition period.

63.21    Sec. 30. STUDY OF FOR-PROFIT HEALTH MAINTENANCE
63.22ORGANIZATIONS.
63.23The commissioner of health shall contract with an entity with expertise in health
63.24economics and health care delivery and quality to study the efficiency, costs, service
63.25quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to
63.26not-for-profit health maintenance organizations operating in Minnesota and other states.
63.27The study findings must address whether the state of Minnesota could: (1) reduce medical
63.28assistance and MinnesotaCare costs and costs of providing coverage to state employees;
63.29and (2) maintain or improve the quality of care provided to state health care program
63.30enrollees and state employees if for-profit health maintenance organizations were allowed
63.31to operate in the state. The commissioner shall require the entity under contract to report
63.32study findings to the commissioner and the legislature by January 15, 2012.

63.33    Sec. 31. MINNESOTA TASK FORCE ON PREMATURITY.
64.1    Subdivision 1. Establishment. The Minnesota Task Force on Prematurity is
64.2established to evaluate and make recommendations on methods for reducing prematurity
64.3and improving premature infant health care in the state.
64.4    Subd. 2. Membership; meetings; staff. (a) The task force shall be composed of at
64.5least the following members, who serve at the pleasure of their appointing authority:
64.6(1) 15 representatives of the Minnesota Prematurity Coalition including, but not
64.7limited to, health care providers who treat pregnant women or neonates, organizations
64.8focused on preterm births, early childhood education and development professionals, and
64.9families affected by prematurity;
64.10(2) one representative appointed by the commissioner of human services;
64.11(3) two representatives appointed by the commissioner of health;
64.12(4) one representative appointed by the commissioner of education;
64.13(5) two members of the house of representatives, one appointed by the speaker of
64.14the house and one appointed by the minority leader; and
64.15(6) two members of the senate, appointed according to the rules of the senate.
64.16(b) Members of the task force serve without compensation or payment of expenses.
64.17(c) The commissioner of health must convene the first meeting of the Minnesota
64.18Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
64.19least quarterly. Staffing and technical assistance shall be provided by the Minnesota
64.20Perinatal Coalition.
64.21    Subd. 3. Duties. The task force must report the current state of prematurity in
64.22Minnesota and develop recommendations on strategies for reducing prematurity and
64.23improving premature infant health care in the state by considering the following:
64.24(1) standards of care for premature infants born less than 37 weeks gestational age,
64.25including recommendations to improve hospital discharge and follow-up care procedures;
64.26(2) coordination of information among appropriate professional and advocacy
64.27organizations on measures to improve health care for infants born prematurely;
64.28(3) identification and centralization of available resources to improve access and
64.29awareness for caregivers of premature infants;
64.30(4) development and dissemination of evidence-based practices through networking
64.31and educational opportunities;
64.32(5) a review of relevant evidence-based research regarding the causes and effects of
64.33premature births in Minnesota;
64.34(6) a review of relevant evidence-based research regarding premature infant health
64.35care, including methods for improving quality of and access to care for premature infants;
65.1(7) a review of the potential improvements in health status related to the use of
65.2health care homes to provide and coordinate pregnancy-related services; and
65.3(8) identification of gaps in public reporting measures and possible effects of these
65.4measures on prematurity rates.
65.5    Subd. 4. Report; expiration. (a) By November 30, 2011, the task force must submit
65.6a report on the current state of prematurity in Minnesota to the chairs of the legislative
65.7policy committees on health and human services.
65.8(b) By January 15, 2013, the task force must report its final recommendations,
65.9including any draft legislation necessary for implementation, to the chairs of the legislative
65.10policy committees on health and human services.
65.11(c) This task force expires on January 31, 2013, or upon submission of the final
65.12report required in paragraph (b), whichever is earlier.

65.13    Sec. 32. NURSING HOME REGULATORY EFFICIENCY.
65.14The commissioner of health must work with long-term care providers, provider
65.15associations, and consumer advocates to clarify for the benefit of providers, survey
65.16teams, and investigators from the office of health facility complaints all of the situations
65.17that providers must report and are required to report to the department under federal
65.18certification regulations and to the common entry point under the Minnesota Vulnerable
65.19Adults Act. The commissioner must produce decision trees, flow sheets, or other
65.20reproducible materials to guide the parties and to reduce the number of unnecessary
65.21reports.

65.22    Sec. 33. REPEALER.
65.23(a) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8;
65.2462J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; 144.1464; 144.147; and
65.25144.1499, are repealed.
65.26(b) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,
65.2714, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5;
65.284651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.

65.29
ARTICLE 3

65.30MISCELLANEOUS

65.31    Section 1. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to
65.32read:
66.1    Subd. 4. Special family day care homes. Nonresidential child care programs
66.2serving 14 or fewer children that are conducted at a location other than the license holder's
66.3own residence shall be licensed under this section and the rules governing family day
66.4care or group family day care if:
66.5(a) the license holder is the primary provider of care and the nonresidential child
66.6care program is conducted in a dwelling that is located on a residential lot;
66.7(b) the license holder is an employer who may or may not be the primary provider
66.8of care, and the purpose for the child care program is to provide child care services to
66.9children of the license holder's employees;
66.10(c) the license holder is a church or religious organization;
66.11(d) the license holder is a community collaborative child care provider. For
66.12purposes of this subdivision, a community collaborative child care provider is a provider
66.13participating in a cooperative agreement with a community action agency as defined in
66.14section 256E.31; or
66.15(e) the license holder is a not-for-profit agency that provides child care in a dwelling
66.16located on a residential lot and the license holder maintains two or more contracts with
66.17community employers or other community organizations to provide child care services.
66.18The county licensing agency may grant a capacity variance to a license holder licensed
66.19under this paragraph to exceed the licensed capacity of 14 children by no more than five
66.20children during transition periods related to the work schedules of parents, if the license
66.21holder meets the following requirements:
66.22(1) the program does not exceed a capacity of 14 children more than a cumulative
66.23total of four hours per day;
66.24(2) the program meets a one to seven staff-to-child ratio during the variance period;
66.25(3) all employees receive at least an extra four hours of training per year than
66.26required in the rules governing family child care each year;
66.27(4) the facility has square footage required per child under Minnesota Rules, part
66.289502.0425;
66.29(5) the program is in compliance with local zoning regulations;
66.30(6) the program is in compliance with the applicable fire code as follows:
66.31(i) if the program serves more than five children older than 2-1/2 years of age,
66.32but no more than five children 2-1/2 years of age or less, the applicable fire code is
66.33educational occupancy, as provided in Group E Occupancy under the Minnesota State
66.34Fire Code 2003, Section 202; or
67.1(ii) if the program serves more than five children 2-1/2 years of age or less, the
67.2applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire
67.3Code 2003, Section 202; and
67.4(7) any age and capacity limitations required by the fire code inspection and square
67.5footage determinations shall be printed on the license.; or
67.6(f) the license holder is the primary provider of care and has located the licensed
67.7child care program in a commercial space, if the license holder meets the following
67.8requirements:
67.9(1) the program is in compliance with local zoning regulations;
67.10(2) the program is in compliance with the applicable fire code as follows:
67.11(i) if the program serves more than five children older than 2-1/2 years of age,
67.12but no more than five children 2-1/2 years of age or less, the applicable fire code is
67.13educational occupancy, as provided in Group E Occupancy under the Minnesota State
67.14Fire Code 2003, Section 202; or
67.15(ii) if the program serves more than five children 2-1/2 years of age or less, the
67.16applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire
67.17Code 2003, Section 202;
67.18(3) any age and capacity limitations required by the fire code inspection and square
67.19footage determinations are printed on the license; and
67.20(4) the license holder prominently displays the license issued by the commissioner
67.21which contains the statement "This special family child care provider is not licensed as a
67.22child care center."

67.23    Sec. 2. Minnesota Statutes 2010, section 245C.03, is amended by adding a subdivision
67.24to read:
67.25    Subd. 7. Children's therapeutic services and supports providers. The
67.26commissioner shall conduct background studies according to this chapter when initiated
67.27by a children's therapeutic services and supports provider under section 256B.0943.

67.28    Sec. 3. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
67.29to read:
67.30    Subd. 8. Children's therapeutic services and supports providers. The
67.31commissioner shall recover the cost of background studies required under section
67.32245C.03, subdivision 7, for the purposes of children's therapeutic services and supports
67.33under section 256B.0943, through a fee of no more than $20 per study charged to
68.1the license holder. The fees collected under this subdivision are appropriated to the
68.2commissioner for the purpose of conducting background studies.

68.3    Sec. 4. Minnesota Statutes 2010, section 256B.04, subdivision 14a, is amended to read:
68.4    Subd. 14a. Level of need determination. Nonemergency medical transportation
68.5level of need determinations must be performed by a physician, a registered nurse working
68.6under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
68.7licensed practical nurse, or a discharge planner.
68.8 Nonemergency medical transportation level of need determinations must not be
68.9performed more than annually on any individual, unless the individual's circumstances
68.10have sufficiently changed so as to require a new level of need determination. No entity
68.11shall charge, and the commissioner shall pay, no more than $25 for performing a level of
68.12need determination regarding any person receiving nonemergency medical transportation,
68.13including special transportation.
68.14Special transportation services to eligible persons who need a stretcher-accessible
68.15vehicle from an inpatient or outpatient hospital are exempt from a level of need
68.16determination if the special transportation services have been ordered by the eligible
68.17person's physician, registered nurse working under direct supervision of a physician,
68.18physician's assistant, nurse practitioner, licensed practical nurse, or discharge planner
68.19pursuant to Medicare guidelines.
68.20 Individuals transported to or residing in licensed nursing facilities are exempt from a
68.21level of need determination and are eligible for special transportation services until the
68.22individual no longer resides in a licensed nursing facility. If a person authorized by this
68.23subdivision to perform a level of need determination determines that an individual requires
68.24stretcher transportation, the individual is presumed to maintain that level of need until
68.25otherwise determined by a person authorized to perform a level of need determination, or
68.26for six months, whichever is sooner.

68.27    Sec. 5. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
68.28read:
68.29    Subd. 17. Transportation costs. (a) Medical assistance covers medical
68.30transportation costs incurred solely for obtaining emergency medical care or transportation
68.31costs incurred by eligible persons in obtaining emergency or nonemergency medical
68.32care when paid directly to an ambulance company, common carrier, or other recognized
68.33providers of transportation services. Medical transportation must be provided by:
68.34(1) an ambulance, as defined in section 144E.001, subdivision 2;
69.1(2) special transportation; or
69.2(3) common carrier including, but not limited to, bus, taxicab, other commercial
69.3carrier, or private automobile.
69.4(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
69.5part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
69.6would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
69.7transportation, or private automobile.
69.8The commissioner may use an order by the recipient's attending physician to certify that
69.9the recipient requires special transportation services. Special transportation providers
69.10shall perform driver-assisted services for eligible individuals. Driver-assisted service
69.11includes passenger pickup at and return to the individual's residence or place of business,
69.12assistance with admittance of the individual to the medical facility, and assistance in
69.13passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special
69.14transportation providers must obtain written documentation from the health care service
69.15provider who is serving the recipient being transported, identifying the time that the
69.16recipient arrived. Special transportation providers may not bill for separate base rates for
69.17the continuation of a trip beyond the original destination. Special transportation providers
69.18must take recipients to the nearest appropriate health care provider, using the most direct
69.19route as determined by a commercially available mileage software program approved by
69.20the commissioner. The minimum medical assistance reimbursement rates for special
69.21transportation services are:
69.22(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
69.23eligible persons who need a wheelchair-accessible van;
69.24(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
69.25eligible persons who do not need a wheelchair-accessible van; and
69.26(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
69.27special transportation services to eligible persons who need a stretcher-accessible vehicle;
69.28(2) the base rates for special transportation services in areas defined under RUCA
69.29to be super rural shall be equal to the reimbursement rate established in clause (1) plus
69.3011.3 percent; and
69.31(3) for special transportation services in areas defined under RUCA to be rural
69.32or super rural areas:
69.33(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
69.34percent of the respective mileage rate in clause (1); and
69.35(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
69.36112.5 percent of the respective mileage rate in clause (1).
70.1(c) For purposes of reimbursement rates for special transportation services under
70.2paragraph (b), the zip code of the recipient's place of residence shall determine whether
70.3the urban, rural, or super rural reimbursement rate applies.
70.4(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
70.5means a census-tract based classification system under which a geographical area is
70.6determined to be urban, rural, or super rural.

70.7    Sec. 6. Minnesota Statutes 2010, section 256B.0943, is amended by adding a
70.8subdivision to read:
70.9    Subd. 5a. Background studies. The requirements for background studies under
70.10this section may be met by a children's therapeutic services and supports services agency
70.11through the commissioner's NETStudy system as provided under sections 245C.03,
70.12subdivision 7, and 245C.10, subdivision 8.

70.13    Sec. 7. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision
70.14to read:
70.15    Subd. 3a. Spousal contribution. (a) For purposes of this subdivision, the following
70.16terms have the meanings given:
70.17(1) "commissioner" means the commissioner of human services;
70.18(2) "community spouse" means the spouse, who lives in the community, of an
70.19individual receiving long-term care services in a long-term care facility or home care
70.20services pursuant to the Medicaid waiver for elderly services under section 256B.0915
70.21or the alternative care program under section 256B.0913. A community spouse does not
70.22include a spouse living in the community who receives a monthly income allowance under
70.23section 256B.058, subdivision 2, or who receives home and community-based services
70.24under section 256B.0915, 256B.092, or 256B.49, or the alternative care program under
70.25section 256B.0913;
70.26(3) "cost of care" means the actual fee-for-service costs or capitated payments for
70.27the long-term care spouse;
70.28(4) "department" means the Department of Human Services;
70.29(5) "disabled child" means a blind or permanently and totally disabled son or
70.30daughter of any age based on the Social Security Administration disability standards;
70.31(6) "income" means earned and unearned income, attributable to the community
70.32spouse, used to calculate the adjusted gross income on the prior year's income tax return.
70.33Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
71.1(7) "long-term care spouse" means the spouse who is receiving long-term care
71.2services in a long-term care facility or home and community based services pursuant
71.3to the Medicaid waiver for elderly services under section 256B.0915 or the alternative
71.4care program under section 256B.0913.
71.5(b) The community spouse of a long-term care spouse who receives medical
71.6assistance or alternative care services has an obligation to contribute to the cost of care.
71.7The community spouse must pay a monthly fee on a sliding fee scale based on the
71.8community spouse's income. If a minor or disabled child resides with and receives care
71.9from the community spouse, then no fee shall be assessed.
71.10(c) For a community spouse with an income equal to or greater than 250 percent of
71.11the federal poverty guidelines for a family of two and less than 545 percent of the federal
71.12poverty guidelines for a family of two, the spousal contribution shall be determined using
71.13a sliding fee scale established by the commissioner that begins at 7.5 percent of the
71.14community spouse's income and increases to 15 percent for those with an income of up to
71.15545 percent of the federal poverty guidelines for a family of two.
71.16(d) For a community spouse with an income equal to or greater than 545 percent of
71.17the federal poverty guidelines for a family of two and less than 750 percent of the federal
71.18poverty guidelines for a family of two, the spousal contribution shall be determined using
71.19a sliding fee scale established by the commissioner that begins at 15 percent of the
71.20community spouse's income and increases to 25 percent for those with an income of up to
71.21750 percent of the federal poverty guidelines for a family of two.
71.22(e) For a community spouse with an income equal to or greater than 750 percent of
71.23the federal poverty guidelines for a family of two and less than 975 percent of the federal
71.24poverty guidelines for a family of two, the spousal contribution shall be determined using
71.25a sliding fee scale established by the commissioner that begins at 25 percent of the
71.26community spouse's income and increases to 33 percent for those with an income of up to
71.27975 percent of the federal poverty guidelines for a family of two.
71.28(f) For a community spouse with an income equal to or greater than 975 percent of
71.29the federal poverty guidelines for a family of two, the spousal contribution shall be 33
71.30percent of the community spouse's income.
71.31(g) The spousal contribution shall be explained in writing at the time eligibility
71.32for medical assistance or alternative care is being determined. In addition to explaining
71.33the formula used to determine the fee, the county or tribal agency shall provide written
71.34information describing how to request a variance for undue hardship, how a contribution
71.35may be reviewed or redetermined, the right to appeal a contribution determination, and
71.36that the consequences for not complying with a request to provide information shall be
72.1an assessment against the community spouse for the full cost of care for the long-term
72.2care spouse.
72.3(h) The contribution shall be assessed for each month the long-term care spouse
72.4has a community spouse and is eligible for medical assistance payment of long-term
72.5care services or alternative care.
72.6(i) The spousal contribution shall be reviewed at least once every 12 months and
72.7when there is a loss or gain in income in excess of ten percent. Thirty days prior to a
72.8review or redetermination, written notice must be provided to the community spouse
72.9and must contain the amount the spouse is required to contribute, notice of the right to
72.10redetermination and appeal, and the telephone number of the division at the agency that is
72.11responsible for redetermination and review. If, after review, the contribution amount is to
72.12be adjusted, the county or tribal agency shall mail a written notice to the community spouse
72.1330 days in advance of the effective date of the change in the amount of the contribution.
72.14(1) The spouse shall notify the county or tribal agency within 30 days of a gain or
72.15loss in income in excess of ten percent and provide the agency supporting documentation
72.16to verify the need for redetermination of the fee.
72.17(2) When a spouse requests a review or redetermination of the contribution amount,
72.18a request for information shall be sent to the spouse within ten calendar days after the
72.19county or tribal agency receives the request for review.
72.20(3) No action shall be taken on a review or redetermination until the required
72.21information is received by the county or tribal agency.
72.22(4) The review of the spousal contribution shall be completed within ten days after
72.23the county or tribal agency receives completed information that verifies a loss or gain in
72.24income in excess of ten percent.
72.25(5) An increase in the contribution amount is effective in the month in which the
72.26increase in income occurs.
72.27(6) A decrease in the contribution amount is effective in the month the spouse
72.28verifies the reduction in income, retroactive to no longer than six months.
72.29(j) In no case shall the spousal contribution exceed the amount of medical assistance
72.30expended or the cost of alternative care services for the care of the long-term care spouse.
72.31Annually, upon redetermination, or at termination of eligibility, the total amount of
72.32medical assistance paid or costs of alternative care for the care of the long-term care spouse
72.33and the total amount of the spousal contribution shall be compared. If the total amount
72.34of the spousal contribution exceeds the total amount of medical assistance expended or
72.35cost of alternative care, then the agency shall reimburse the community spouse the excess
73.1amount if the long-term care spouse is no longer receiving services, or apply the excess
73.2amount to the spousal contribution due until the excess amount is exhausted.
73.3(k) A community spouse may request a variance by submitting a written request
73.4and supporting documentation that payment of the calculated contribution would cause
73.5an undue hardship. An undue hardship is defined as the inability to pay the calculated
73.6contribution due to medical expenses incurred by the community spouse. Documentation
73.7must include proof of medical expenses incurred by the community spouse since the last
73.8annual redetermination of the contribution amount that are not reimbursable by any public
73.9or private source, and are a type, regardless of amount, that would be allowable as a
73.10federal tax deduction under the Internal Revenue Code.
73.11(1) A spouse who requests a variance from a notice of an increase in the amount
73.12of spousal contribution shall continue to make monthly payments at the lower amount
73.13pending determination of the variance request. A spouse who requests a variance from
73.14the initial determination shall not be required to make a payment pending determination
73.15of the variance request. Payments made pending outcome of the variance request that
73.16result in overpayment must be returned to the spouse, if the long-term care spouse is no
73.17longer receiving services, or applied to the spousal contribution in the current year. If the
73.18variance is denied, the spouse shall pay the additional amount due from the effective date
73.19of the increase or the total amount due from the effective date of the original notice of
73.20determination of the spousal contribution.
73.21(2) A spouse who is granted a variance shall sign a written agreement in which the
73.22spouse agrees to report to the county or tribal agency any changes in circumstances that
73.23gave rise to the undue hardship variance.
73.24(3) When the county or tribal agency receives a request for a variance, written notice
73.25of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days
73.26after the county or tribal agency receives the financial information required in this clause.
73.27The granting of a variance will necessitate a written agreement between the spouse and the
73.28county or tribal agency with regard to the specific terms of the variance. The variance
73.29will not become effective until the written agreement is signed by the spouse. If the
73.30county or tribal agency denies in whole or in part the request for a variance, the denial
73.31notice shall set forth in writing the reasons for the denial that address the specific hardship
73.32and right to appeal.
73.33(4) If a variance is granted, the term of the variance shall not exceed 12 months
73.34unless otherwise determined by the county or tribal agency.
73.35(5) Undue hardship does not include action taken by a spouse which divested or
73.36diverted income in order to avoid being assessed a spousal contribution.
74.1(l) A spouse aggrieved by an action under this subdivision has the right to appeal
74.2under subdivision 4. If the spouse appeals on or before the effective date of an increase
74.3in the spousal fee, the spouse shall continue to make payments to the county or tribal
74.4agency in the lower amount while the appeal is pending. A spouse appealing an initial
74.5determination of a spousal contribution shall not be required to make monthly payments
74.6pending an appeal decision. Payments made that result in an overpayment shall be
74.7reimbursed to the spouse if the long-term care spouse is no longer receiving services, or
74.8applied to the spousal contribution remaining in the current year. If the county or tribal
74.9agency's determination is affirmed, the community spouse shall pay within 90 calendar
74.10days of the order the total amount due from the effective date of the original notice of
74.11determination of the spousal contribution. The commissioner's order is binding on the
74.12spouse and the agency and shall be implemented subject to section 256.045, subdivision 7.
74.13No additional notice is required to enforce the commissioner's order.
74.14(m) If the county or tribal agency finds that notice of the payment obligation was
74.15given to the community spouse and the spouse was determined to be able to pay, but that
74.16the spouse failed or refused to pay, a cause of action exists against the community spouse
74.17for that portion of medical assistance payment of long-term care services or alternative
74.18care services granted after notice was given to the community spouse. The action may be
74.19brought by the county or tribal agency in the county where assistance was granted for the
74.20assistance together with the costs of disbursements incurred due to the action. In addition
74.21to granting the county or tribal agency a money judgment, the court may, upon a motion or
74.22order to show cause, order continuing contributions by a community spouse found able to
74.23repay the county or tribal agency. The order shall be effective only for the period of time
74.24during which a contribution shall be assessed.
74.25    (n) Counties and tribes are entitled to one-half of the nonfederal share of
74.26contributions made under this section for long-term care spouses on medical assistance
74.27that are directly attributed to county or tribal efforts. Counties and tribes are entitled to
74.2825 percent of the contributions made under this section for long-term care spouses on
74.29alternative care directly attributed to county or tribal efforts.
74.30EFFECTIVE DATE.This section is effective July 1, 2012.

74.31    Sec. 8. Minnesota Statutes 2010, section 326B.175, is amended to read:
74.32326B.175 ELEVATORS, ENTRANCES SEALED.
74.33    Except as provided in section 326B.188, it shall be the duty of the department and
74.34the licensing authority of any municipality which adopts any such ordinance whenever
75.1it finds any such elevator under its jurisdiction in use in violation of any provision of
75.2sections 326B.163 to 326B.178 to seal the entrances of such elevator and attach a notice
75.3forbidding the use of such elevator until the provisions thereof are complied with.

75.4    Sec. 9. [326B.188] COMPLIANCE WITH ELEVATOR CODE CHANGES.
75.5(a) This section applies to code requirements for existing elevators and related
75.6devices under Minnesota Rules, chapter 1307, where the deadline set by law for meeting
75.7the code requirements is January 29, 2012, or later.
75.8(b) If the department or municipality conducting elevator inspections within its
75.9jurisdiction notifies the owner of an existing elevator or related device of the code
75.10requirements before the effective date of this section, the owner may submit a compliance
75.11plan by December 30, 2011. If the department or municipality does not notify the owner
75.12of an existing elevator or related device of the code requirements before the effective
75.13date of this section, the department or municipality shall notify the owner of the code
75.14requirements and permit the owner to submit a compliance plan by December 30, 2011, or
75.15within 60 days after the date of notification, whichever is later.
75.16(c) Any compliance plan submitted under this section must result in compliance with
75.17the code requirements by the later of January 29, 2012, or three years after submission of
75.18the compliance plan. Elevators and related devices that are not in compliance with the
75.19code requirements by the later of January 29, 2012, or three years after the submission of
75.20the compliance plan may be taken out of service as provided in section 326B.175.

75.21    Sec. 10. NONEMERGENCY MEDICAL TRANSPORTATION SINGLE
75.22ADMINISTRATIVE STRUCTURE PROPOSAL.
75.23(a) The commissioner of human services shall develop a proposal to create a single
75.24administrative structure for providing nonemergency medical transportation services to
75.25fee-for-service medical assistance recipients. This proposal must consolidate access and
75.26special transportation into one administrative structure with the goal of standardizing
75.27eligibility determination processes, scheduling arrangements, billing procedures, data
75.28collection, and oversight mechanisms in order to enhance coordination, improve
75.29accountability, and lessen confusion.
75.30(b) In developing the proposal, the commissioner shall:
75.31(1) examine the current responsibilities performed by the counties and the
75.32Department of Human Services and consider the shift in costs if these responsibilities are
75.33changed;
76.1(2) identify key performance measures to assess the cost effectiveness of
76.2nonemergency medical transportation statewide, including a process to collect, audit,
76.3and report data;
76.4(3) develop a statewide complaint system for medical assistance recipients using
76.5special transportation;
76.6(4) establish a standardized billing process;
76.7(5) establish a process that provides public input from interested parties before
76.8special transportation eligibility policies are implemented or significantly changed;
76.9(6) establish specific eligibility criteria that include the frequency of eligibility
76.10assessments and the length of time a recipient remains eligible for special transportation;
76.11(7) develop a reimbursement method to compensate volunteers for no-load miles
76.12when transporting recipients to or from health-related appointments; and
76.13(8) establish specific eligibility criteria to maximize the use of public transportation
76.14by recipients who are without a physical, mental, or other impairment that would prohibit
76.15safely accessing and using public transportation.
76.16(c) In developing the proposal, the commissioner shall consult with the
76.17nonemergency medical transportation advisory council established under paragraph (d).
76.18(d) The commissioner shall establish the nonemergency medical transportation
76.19advisory council to assist the commissioner in developing a single administrative structure
76.20for providing nonemergency medical transportation services. The council shall be
76.21comprised of:
76.22(1) one representative each from the departments of human services and
76.23transportation;
76.24(2) one representative each from the following organizations: the Minnesota State
76.25Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC
76.26of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County
76.27Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit
76.28Association, legal aid, the Minnesota Ambulance Association, the National Alliance on
76.29Mental Illness, Medical Transportation Management, and other transportation providers;
76.30and
76.31(3) four members from the house of representatives, two from the majority party
76.32and two from the minority party, appointed by the speaker, and four members from the
76.33senate, two from the majority party and two from the minority party, appointed by the
76.34Subcommittee on Committees of the Committee on Rules and Administration.
77.1The council is governed by Minnesota Statutes, section 15.509, except that members
77.2shall not receive per diems. The commissioner of human services shall fund all costs
77.3related to the council from existing resources.
77.4(e) The commissioner shall submit the proposal and draft legislation necessary for
77.5implementation to the chairs and ranking minority members of the senate and house of
77.6representatives committees or divisions with jurisdiction over health care policy and
77.7finance by January 15, 2012.

77.8
ARTICLE 4

77.9HEALTH RELATED LICENSING

77.10    Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:
77.11    Subdivision 1. Renewal fees. All persons practicing chiropractic within this state,
77.12or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the
77.13Board of Chiropractic Examiners a renewal fee set by the board in accordance with section
77.1416A.1283, with a penalty set by the board for each month or portion thereof for which a
77.15license fee is in arrears and upon payment of the renewal and upon compliance with all the
77.16rules of the board, shall be entitled to renewal of their license.

77.17    Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision
77.18to read:
77.19    Subd. 4. Animal chiropractic. (a) Animal chiropractic registration fee is $125.
77.20(b) Animal chiropractic registration renewal fee is $75.
77.21(c) Animal chiropractic inactive renewal fee is $25.

77.22    Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
77.23    Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise
77.24rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
77.25provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula
77.26and standards for schools and courses preparing persons for licensure under sections
77.27148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses
77.28at such times as it may deem necessary. It shall approve such schools and courses as
77.29meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine,
77.30license, and renew the license of duly qualified applicants. It shall hold examinations
77.31at least once in each year at such time and place as it may determine. It shall by rule
77.32adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for
77.33registration and renewal of registration as defined in section 148.231. It shall maintain a
78.1record of all persons licensed by the board to practice professional or practical nursing and
78.2all registered nurses who hold Minnesota licensure and registration and are certified as
78.3advanced practice registered nurses. It shall cause the prosecution of all persons violating
78.4sections 148.171 to 148.285 and have power to incur such necessary expense therefor.
78.5It shall register public health nurses who meet educational and other requirements
78.6established by the board by rule, including payment of a fee. Prior to the adoption of rules,
78.7the board shall use the same procedures used by the Department of Health to certify public
78.8health nurses. It shall have power to issue subpoenas, and to compel the attendance of
78.9witnesses and the production of all necessary documents and other evidentiary material.
78.10Any board member may administer oaths to witnesses, or take their affirmation. It shall
78.11keep a record of all its proceedings.
78.12(b) The board shall have access to hospital, nursing home, and other medical records
78.13of a patient cared for by a nurse under review. If the board does not have a written consent
78.14from a patient permitting access to the patient's records, the nurse or facility shall delete
78.15any data in the record that identifies the patient before providing it to the board. The board
78.16shall have access to such other records as reasonably requested by the board to assist the
78.17board in its investigation. Nothing herein may be construed to allow access to any records
78.18protected by section 145.64. The board shall maintain any records obtained pursuant to
78.19this paragraph as investigative data under chapter 13.
78.20(c) The board may accept and expend grants or gifts of money or in-kind services
78.21from a person, a public or private entity, or any other source for purposes consistent with
78.22the board's role and within the scope of its statutory authority.
78.23(d) The board may accept registration fees for meetings and conferences conducted
78.24for the purposes of board activities that are within the scope of its authority.

78.25    Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
78.26    Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration
78.27fee and permit fee, and in accordance with rules of the board, the board may issue
78.28a nonrenewable temporary permit to practice professional or practical nursing to an
78.29applicant for licensure or reregistration who is not the subject of a pending investigation
78.30or disciplinary action, nor disqualified for any other reason, under the following
78.31circumstances:
78.32(a) The applicant for licensure by examination under section 148.211, subdivision
78.331 , has graduated from an approved nursing program within the 60 days preceding board
78.34receipt of an affidavit of graduation or transcript and has been authorized by the board to
78.35write the licensure examination for the first time in the United States. The permit holder
79.1must practice professional or practical nursing under the direct supervision of a registered
79.2nurse. The permit is valid from the date of issue until the date the board takes action on
79.3the application or for 60 days whichever occurs first.
79.4(b) The applicant for licensure by endorsement under section 148.211, subdivision 2,
79.5is currently licensed to practice professional or practical nursing in another state, territory,
79.6or Canadian province. The permit is valid from submission of a proper request until the
79.7date of board action on the application or for 60 days, whichever comes first.
79.8(c) (b) The applicant for licensure by endorsement under section 148.211,
79.9subdivision 2 , or for reregistration under section 148.231, subdivision 5, is currently
79.10registered in a formal, structured refresher course or its equivalent for nurses that includes
79.11clinical practice.
79.12(d) The applicant for licensure by examination under section 148.211, subdivision
79.131 , who graduated from a nursing program in a country other than the United States or
79.14Canada has completed all requirements for licensure except registering for and taking the
79.15nurse licensure examination for the first time in the United States. The permit holder must
79.16practice professional nursing under the direct supervision of a registered nurse. The permit
79.17is valid from the date of issue until the date the board takes action on the application or for
79.1860 days, whichever occurs first.

79.19    Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:
79.20148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION;
79.21VERIFICATION.
79.22    Subdivision 1. Registration. Every person licensed to practice professional or
79.23practical nursing must maintain with the board a current registration for practice as a
79.24registered nurse or licensed practical nurse which must be renewed at regular intervals
79.25established by the board by rule. No certificate of registration shall be issued by the board
79.26to a nurse until the nurse has submitted satisfactory evidence of compliance with the
79.27procedures and minimum requirements established by the board.
79.28The fee for periodic registration for practice as a nurse shall be determined by the
79.29board by rule law. A penalty fee shall be added for any application received after the
79.30required date as specified by the board by rule. Upon receipt of the application and the
79.31required fees, the board shall verify the application and the evidence of completion of
79.32continuing education requirements in effect, and thereupon issue to the nurse a certificate
79.33of registration for the next renewal period.
80.1    Subd. 4. Failure to register. Any person licensed under the provisions of sections
80.2148.171 to 148.285 who fails to register within the required period shall not be entitled to
80.3practice nursing in this state as a registered nurse or licensed practical nurse.
80.4    Subd. 5. Reregistration. A person whose registration has lapsed desiring to
80.5resume practice shall make application for reregistration, submit satisfactory evidence of
80.6compliance with the procedures and requirements established by the board, and pay the
80.7registration reregistration fee for the current period to the board. A penalty fee shall be
80.8required from a person who practiced nursing without current registration. Thereupon, the
80.9registration certificate shall be issued to the person who shall immediately be placed on
80.10the practicing list as a registered nurse or licensed practical nurse.
80.11    Subd. 6. Verification. A person licensed under the provisions of sections 148.171 to
80.12148.285 who requests the board to verify a Minnesota license to another state, territory,
80.13or country or to an agency, facility, school, or institution shall pay a fee to the board
80.14for each verification.

80.15    Sec. 6. [148.242] FEES.
80.16The fees specified in section 148.243 are nonrefundable and must be deposited in
80.17the state government special revenue fund.

80.18    Sec. 7. [148.243] FEE AMOUNTS.
80.19    Subdivision 1. Licensure by examination. The fee for licensure by examination is
80.20$105.
80.21    Subd. 2. Reexamination fee. The reexamination fee is $60.
80.22    Subd. 3. Licensure by endorsement. The fee for licensure by endorsement is $105.
80.23    Subd. 4. Registration renewal. The fee for registration renewal is $85.
80.24    Subd. 5. Reregistration. The fee for reregistration is $105.
80.25    Subd. 6. Replacement license. The fee for a replacement license is $20.
80.26    Subd. 7. Public health nurse certification. The fee for public health nurse
80.27certification is $30.
80.28    Subd. 8. Drug Enforcement Administration verification for Advanced Practice
80.29Registered Nurse (APRN). The Drug Enforcement Administration verification for
80.30APRN is $50.
80.31    Subd. 9. Licensure verification other than through Nursys. The fee for
80.32verification of licensure status other than through Nursys verification is $20.
80.33    Subd. 10. Verification of examination scores. The fee for verification of
80.34examination scores is $20.
81.1    Subd. 11. Microfilmed licensure application materials. The fee for a copy of
81.2microfilmed licensure application materials is $20.
81.3    Subd. 12. Nursing business registration; initial application. The fee for the initial
81.4application for nursing business registration is $100.
81.5    Subd. 13. Nursing business registration; annual application. The fee for the
81.6annual application for nursing business registration is $25.
81.7    Subd. 14. Practicing without current registration. The fee for practicing without
81.8current registration is two times the amount of the current registration renewal fee for any
81.9part of the first calendar month, plus the current registration renewal fee for any part of
81.10any subsequent month up to 24 months.
81.11    Subd. 15. Practicing without current APRN certification. The fee for practicing
81.12without current APRN certification is $200 for the first month or any part thereof, plus
81.13$100 for each subsequent month or part thereof.
81.14    Subd. 16. Dishonored check fee. The service fee for a dishonored check is as
81.15provided in section 604.113.
81.16    Subd. 17. Border state registry fee. The initial application fee for border state
81.17registration is $50. Any subsequent notice of employment change to remain or be
81.18reinstated on the registry is $50.

81.19    Sec. 8. [148.2855] NURSE LICENSURE COMPACT.
81.20The Nurse Licensure Compact is enacted into law and entered into with all other
81.21jurisdictions legally joining in it, in the form substantially as follows:

81.22ARTICLE 1

81.23DEFINITIONS

81.24As used in this compact:
81.25(a) "Adverse action" means a home or remote state action.
81.26(b) "Alternative program" means a voluntary, nondisciplinary monitoring program
81.27approved by a nurse licensing board.
81.28(c) "Coordinated licensure information system" means an integrated process for
81.29collecting, storing, and sharing information on nurse licensure and enforcement activities
81.30related to nurse licensure laws, which is administered by a nonprofit organization
81.31composed of and controlled by state nurse licensing boards.
81.32(d) "Current significant investigative information" means:
81.33(1) investigative information that a licensing board, after a preliminary inquiry that
81.34includes notification and an opportunity for the nurse to respond if required by state law,
82.1has reason to believe is not groundless and, if proved true, would indicate more than a
82.2minor infraction; or
82.3(2) investigative information that indicates that the nurse represents an immediate
82.4threat to public health and safety regardless of whether the nurse has been notified and
82.5had an opportunity to respond.
82.6(e) "Home state" means the party state which is the nurse's primary state of residence.
82.7(f) "Home state action" means any administrative, civil, equitable, or criminal
82.8action permitted by the home state's laws which are imposed on a nurse by the home
82.9state's licensing board or other authority including actions against an individual's license
82.10such as revocation, suspension, probation, or any other action which affects a nurse's
82.11authorization to practice.
82.12(g) "Licensing board" means a party state's regulatory body responsible for issuing
82.13nurse licenses.
82.14(h) "Multistate licensure privilege" means current, official authority from a
82.15remote state permitting the practice of nursing as either a registered nurse or a licensed
82.16practical/vocational nurse in the party state. All party states have the authority, according
82.17to existing state due process law, to take actions against the nurse's privilege such as
82.18revocation, suspension, probation, or any other action which affects a nurse's authorization
82.19to practice.
82.20(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those
82.21terms are defined by each party state's practice laws.
82.22(j) "Party state" means any state that has adopted this compact.
82.23(k) "Remote state" means a party state other than the home state:
82.24(1) where the patient is located at the time nursing care is provided; or
82.25(2) in the case of the practice of nursing not involving a patient, in the party state
82.26where the recipient of nursing practice is located.
82.27(l) "Remote state action" means:
82.28(1) any administrative, civil, equitable, or criminal action permitted by a remote
82.29state's laws which are imposed on a nurse by the remote state's licensing board or other
82.30authority including actions against an individual's multistate licensure privilege to practice
82.31in the remote state; and
82.32(2) cease and desist and other injunctive or equitable orders issued by remote states
82.33or the licensing boards of those states.
82.34(m) "State" means a state, territory, or possession of the United States, the District of
82.35Columbia, or the Commonwealth of Puerto Rico.
83.1(n) "State practice laws" means individual party state laws and regulations that
83.2govern the practice of nursing, define the scope of nursing practice, and create the
83.3methods and grounds for imposing discipline. State practice laws does not include the
83.4initial qualifications for licensure or requirements necessary to obtain and retain a license,
83.5except for qualifications or requirements of the home state.

83.6ARTICLE 2

83.7GENERAL PROVISIONS AND JURISDICTION

83.8(a) A license to practice registered nursing issued by a home state to a resident in
83.9that state will be recognized by each party state as authorizing a multistate licensure
83.10privilege to practice as a registered nurse in the party state. A license to practice licensed
83.11practical/vocational nursing issued by a home state to a resident in that state will be
83.12recognized by each party state as authorizing a multistate licensure privilege to practice
83.13as a licensed practical/vocational nurse in the party state. In order to obtain or retain a
83.14license, an applicant must meet the home state's qualifications for licensure and license
83.15renewal as well as all other applicable state laws.
83.16(b) Party states may, according to state due process laws, limit or revoke the
83.17multistate licensure privilege of any nurse to practice in their state and may take any other
83.18actions under their applicable state laws necessary to protect the health and safety of
83.19their citizens. If a party state takes such action, it shall promptly notify the administrator
83.20of the coordinated licensure information system. The administrator of the coordinated
83.21licensure information system shall promptly notify the home state of any such actions by
83.22remote states.
83.23(c) Every nurse practicing in a party state must comply with the state practice laws of
83.24the state in which the patient is located at the time care is rendered. In addition, the practice
83.25of nursing is not limited to patient care, but shall include all nursing practice as defined by
83.26the state practice laws of the party state. The practice of nursing will subject a nurse to the
83.27jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
83.28(d) This compact does not affect additional requirements imposed by states for
83.29advanced practice registered nursing. However, a multistate licensure privilege to practice
83.30registered nursing granted by a party state shall be recognized by other party states as a
83.31license to practice registered nursing if one is required by state law as a precondition for
83.32qualifying for advanced practice registered nurse authorization.
83.33(e) Individuals not residing in a party state shall continue to be able to apply for
83.34nurse licensure as provided for under the laws of each party state. However, the license
83.35granted to these individuals will not be recognized as granting the privilege to practice
83.36nursing in any other party state unless explicitly agreed to by that party state.

84.1ARTICLE 3

84.2APPLICATIONS FOR LICENSURE IN A PARTY STATE

84.3(a) Upon application for a license, the licensing board in a party state shall ascertain,
84.4through the coordinated licensure information system, whether the applicant has ever held
84.5or is the holder of a license issued by any other state, whether there are any restrictions
84.6on the multistate licensure privilege, and whether any other adverse action by a state
84.7has been taken against the license.
84.8(b) A nurse in a party state shall hold licensure in only one party state at a time,
84.9issued by the home state.
84.10(c) A nurse who intends to change primary state of residence may apply for licensure
84.11in the new home state in advance of the change. However, new licenses will not be
84.12issued by a party state until after a nurse provides evidence of change in primary state of
84.13residence satisfactory to the new home state's licensing board.
84.14(d) When a nurse changes primary state of residence by:
84.15(1) moving between two party states, and obtains a license from the new home state,
84.16the license from the former home state is no longer valid;
84.17(2) moving from a nonparty state to a party state, and obtains a license from the new
84.18home state, the individual state license issued by the nonparty state is not affected and will
84.19remain in full force if so provided by the laws of the nonparty state; or
84.20(3) moving from a party state to a nonparty state, the license issued by the prior
84.21home state converts to an individual state license, valid only in the former home state,
84.22without the multistate licensure privilege to practice in other party states.

84.23ARTICLE 4

84.24ADVERSE ACTIONS

84.25In addition to the general provisions described in article 2, the provisions in this
84.26article apply.
84.27(a) The licensing board of a remote state shall promptly report to the administrator
84.28of the coordinated licensure information system any remote state actions including the
84.29factual and legal basis for the action, if known. The licensing board of a remote state shall
84.30also promptly report any significant current investigative information yet to result in a
84.31remote state action. The administrator of the coordinated licensure information system
84.32shall promptly notify the home state of any reports.
84.33(b) The licensing board of a party state shall have the authority to complete any
84.34pending investigation for a nurse who changes primary state of residence during the
84.35course of the investigation. The board shall also have the authority to take appropriate
84.36action, and shall promptly report the conclusion of the investigation to the administrator
85.1of the coordinated licensure information system. The administrator of the coordinated
85.2licensure information system shall promptly notify the new home state of any action.
85.3(c) A remote state may take adverse action affecting the multistate licensure
85.4privilege to practice within that party state. However, only the home state shall have the
85.5power to impose adverse action against the license issued by the home state.
85.6(d) For purposes of imposing adverse actions, the licensing board of the home state
85.7shall give the same priority and effect to reported conduct received from a remote state as
85.8it would if the conduct had occurred within the home state. In so doing, it shall apply its
85.9own state laws to determine appropriate action.
85.10(e) The home state may take adverse action based on the factual findings of the
85.11remote state, provided each state follows its own procedures for imposing the adverse
85.12action.
85.13(f) Nothing in this compact shall override a party state's decision that participation
85.14in an alternative program may be used in lieu of licensure action and that participation
85.15shall remain nonpublic if required by the party state's laws.
85.16Party states must require nurses who enter any alternative programs to agree not to
85.17practice in any other party state during the term of the alternative program without prior
85.18authorization from the other party state.

85.19ARTICLE 5

85.20ADDITIONAL AUTHORITIES INVESTED IN

85.21PARTY STATE NURSE LICENSING BOARDS

85.22Notwithstanding any other laws, party state nurse licensing boards shall have the
85.23authority to:
85.24(1) if otherwise permitted by state law, recover from the affected nurse the costs of
85.25investigation and disposition of cases resulting from any adverse action taken against
85.26that nurse;
85.27(2) issue subpoenas for both hearings and investigations which require the attendance
85.28and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse
85.29licensing board in a party state for the attendance and testimony of witnesses, and the
85.30production of evidence from another party state, shall be enforced in the latter state by
85.31any court of competent jurisdiction according to the practice and procedure of that court
85.32applicable to subpoenas issued in proceedings pending before it. The issuing authority
85.33shall pay any witness fees, travel expenses, mileage, and other fees required by the service
85.34statutes of the state where the witnesses and evidence are located;
85.35(3) issue cease and desist orders to limit or revoke a nurse's authority to practice
85.36in the nurse's state; and
86.1(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).

86.2ARTICLE 6

86.3COORDINATED LICENSURE INFORMATION SYSTEM

86.4(a) All party states shall participate in a cooperative effort to create a coordinated
86.5database of all licensed registered nurses and licensed practical/vocational nurses. This
86.6system shall include information on the licensure and disciplinary history of each
86.7nurse, as contributed by party states, to assist in the coordination of nurse licensure and
86.8enforcement efforts.
86.9(b) Notwithstanding any other provision of law, all party states' licensing boards shall
86.10promptly report adverse actions, actions against multistate licensure privileges, any current
86.11significant investigative information yet to result in adverse action, denials of applications,
86.12and the reasons for the denials to the coordinated licensure information system.
86.13(c) Current significant investigative information shall be transmitted through the
86.14coordinated licensure information system only to party state licensing boards.
86.15(d) Notwithstanding any other provision of law, all party states' licensing boards
86.16contributing information to the coordinated licensure information system may designate
86.17information that may not be shared with nonparty states or disclosed to other entities or
86.18individuals without the express permission of the contributing state.
86.19(e) Any personally identifiable information obtained by a party state's licensing
86.20board from the coordinated licensure information system may not be shared with nonparty
86.21states or disclosed to other entities or individuals except to the extent permitted by the
86.22laws of the party state contributing the information.
86.23(f) Any information contributed to the coordinated licensure information system that
86.24is subsequently required to be expunged by the laws of the party state contributing that
86.25information shall also be expunged from the coordinated licensure information system.
86.26(g) The compact administrators, acting jointly with each other and in consultation
86.27with the administrator of the coordinated licensure information system, shall formulate
86.28necessary and proper procedures for the identification, collection, and exchange of
86.29information under this compact.

86.30ARTICLE 7

86.31COMPACT ADMINISTRATION AND

86.32INTERCHANGE OF INFORMATION

86.33(a) The head or designee of the nurse licensing board of each party state shall be the
86.34administrator of this compact for that state.
86.35(b) The compact administrator of each party state shall furnish to the compact
86.36administrator of each other party state any information and documents including, but not
87.1limited to, a uniform data set of investigations, identifying information, licensure data, and
87.2disclosable alternative program participation information to facilitate the administration of
87.3this compact.
87.4(c) Compact administrators shall have the authority to develop uniform rules to
87.5facilitate and coordinate implementation of this compact. These uniform rules shall be
87.6adopted by party states under the authority in article 5, clause (4).

87.7ARTICLE 8

87.8IMMUNITY

87.9A party state or the officers, employees, or agents of a party state's nurse licensing
87.10board who acts in good faith according to the provisions of this compact shall not be
87.11liable for any act or omission while engaged in the performance of their duties under
87.12this compact. Good faith shall not include willful misconduct, gross negligence, or
87.13recklessness.

87.14ARTICLE 9

87.15ENACTMENT, WITHDRAWAL, AND AMENDMENT

87.16(a) This compact shall become effective for each state when it has been enacted by
87.17that state. Any party state may withdraw from this compact by repealing the nurse licensure
87.18compact, but no withdrawal shall take effect until six months after the withdrawing state
87.19has given notice of the withdrawal to the executive heads of all other party states.
87.20(b) No withdrawal shall affect the validity or applicability by the licensing boards
87.21of states remaining party to the compact of any report of adverse action occurring prior
87.22to the withdrawal.
87.23(c) Nothing contained in this compact shall be construed to invalidate or prevent any
87.24nurse licensure agreement or other cooperative arrangement between a party state and a
87.25nonparty state that is made according to the other provisions of this compact.
87.26(d) This compact may be amended by the party states. No amendment to this
87.27compact shall become effective and binding upon the party states until it is enacted into
87.28the laws of all party states.

87.29ARTICLE 10

87.30CONSTRUCTION AND SEVERABILITY

87.31(a) This compact shall be liberally construed to effectuate the purposes of the
87.32compact. The provisions of this compact shall be severable and if any phrase, clause,
87.33sentence, or provision of this compact is declared to be contrary to the constitution of any
87.34party state or of the United States or the applicability thereof to any government, agency,
87.35person, or circumstance is held invalid, the validity of the remainder of this compact and
87.36the applicability of it to any government, agency, person, or circumstance shall not be
88.1affected by it. If this compact is held contrary to the constitution of any party state, the
88.2compact shall remain in full force and effect for the remaining party states and in full force
88.3and effect for the party state affected as to all severable matters.
88.4(b) In the event party states find a need for settling disputes arising under this
88.5compact:
88.6(1) the party states may submit the issues in dispute to an arbitration panel which
88.7shall be comprised of an individual appointed by the compact administrator in the home
88.8state, an individual appointed by the compact administrator in the remote states involved,
88.9and an individual mutually agreed upon by the compact administrators of the party states
88.10involved in the dispute; and
88.11(2) the decision of a majority of the arbitrators shall be final and binding.

88.12    Sec. 9. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
88.13EXISTING LAWS.
88.14(a) A nurse practicing professional or practical nursing in Minnesota under the
88.15authority of section 148.2855 shall have the same obligations, privileges, and rights as if
88.16the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section
88.17148.2855, the Board of Nursing shall comply with and follow all laws and rules with
88.18respect to registered and licensed practical nurses practicing professional or practical
88.19nursing in Minnesota under the authority of section 148.2855, and all such individuals
88.20shall be governed and regulated as if they were licensed by the board.
88.21(b) Section 148.2855 does not relieve employers of nurses from complying with
88.22statutorily imposed obligations.
88.23(c) Section 148.2855 does not supersede existing state labor laws.
88.24(d) For purposes of the Minnesota Government Data Practices Act, chapter 13,
88.25an individual not licensed as a nurse under sections 148.171 to 148.285 who practices
88.26professional or practical nursing in Minnesota under the authority of section 148.2855 is
88.27considered to be a licensee of the board.
88.28(e) Uniform rules developed by the compact administrators shall not be subject
88.29to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101,
88.3014.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
88.31(f) Proceedings brought against an individual's multistate privilege shall be
88.32adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject
88.33to judicial review as provided for in sections 14.63 to 14.69.
88.34(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4;
88.35144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917,
89.1subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40,
89.2subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are
89.3licensed as registered or licensed practical nurses in the home state shall be considered
89.4to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to
89.5registered nurses or the practice of professional nursing, then only holders of a multistate
89.6privilege who are licensed as registered nurses in the home state shall be considered
89.7licensees.
89.8(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557
89.9apply to individuals not licensed as registered or licensed practical nurses under sections
89.10148.171 to 148.285 who practice professional or practical nursing in Minnesota under
89.11the authority of section 148.2855.
89.12(i) The board may take action against an individual's multistate privilege based on
89.13the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or
89.14requiring the board to take corrective or disciplinary action.
89.15(j) The board may take all forms of disciplinary action provided for in section
89.16148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision
89.176, against an individual's multistate privilege.
89.18(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals
89.19who practice professional or practical nursing in Minnesota under the authority of section
89.20148.2855.
89.21(l) The cooperation requirements of section 148.265 apply to individuals who
89.22practice professional or practical nursing in Minnesota under the authority of section
89.23148.2855.
89.24(m) The provisions of section 148.283 shall not apply to individuals who practice
89.25professional or practical nursing in Minnesota under the authority of section 148.2855.
89.26(n) Complaints against individuals who practice professional or practical nursing
89.27in Minnesota under the authority of section 148.2855 shall be handled as provided in
89.28sections 214.10 and 214.103.
89.29(o) All provisions of section 148.2855 authorizing or requiring the board to provide
89.30data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
89.31(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a
89.32remote state any active investigative data regarding a complaint investigation against a
89.33nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable
89.34assurances from the remote state that the data will be maintained with the same protections
89.35as provided in Minnesota law.
90.1(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice
90.2professional or practical nursing in Minnesota under the authority of section 148.2855
90.3when the practice involves direct physical contact between the nurse and a patient.
90.4(r) A nurse practicing professional or practical nursing in Minnesota under the
90.5authority of section 148.2855 must comply with any criminal background check required
90.6under Minnesota law.

90.7    Sec. 10. [148.2857] WITHDRAWAL FROM COMPACT.
90.8The governor may withdraw the state from the compact in section 148.2855 if
90.9the Board of Nursing notifies the governor that a party state to the compact changed
90.10the party state's requirements for nurse licensure after July 1, 2009, and that the party
90.11state's requirements, as changed, are substantially lower than the requirements for nurse
90.12licensure in this state.

90.13    Sec. 11. [148.2858] MISCELLANEOUS PROVISIONS.
90.14(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board"
90.15means the executive director of the board.
90.16(b) The Board of Nursing shall have the authority to recover from a nurse practicing
90.17professional or practical nursing in Minnesota under the authority of section 148.2855
90.18the costs of investigation and disposition of cases resulting from any adverse action
90.19taken against the nurse.
90.20(c) The board may implement a system of identifying individuals who practice
90.21professional or practical nursing in Minnesota under the authority of section 148.2855.

90.22    Sec. 12. [148.2859] NURSE LICENSURE COMPACT ADVISORY
90.23COMMITTEE.
90.24    Subdivision 1. Establishment; membership. A Nurse Licensure Compact Advisory
90.25Committee is established to advise the compact administrator in the implementation of
90.26section 148.2855. Members of the advisory committee shall be appointed by the board
90.27and shall be composed of representatives of Minnesota nursing organizations, Minnesota
90.28licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses
90.29who provide home care, Minnesota licensed advanced practice registered nurses, and
90.30public members as defined in section 214.02.
90.31    Subd. 2. Duties. The advisory committee shall advise the compact administrator in
90.32the implementation of section 148.2855.
91.1    Subd. 3. Organization. The advisory committee shall be organized and
91.2administered under section 15.059.

91.3    Sec. 13. Minnesota Statutes 2010, section 148B.17, is amended to read:
91.4148B.17 FEES.
91.5    Subdivision. 1. Fees; Board of Marriage and Family Therapy. Each board shall
91.6by rule establish The board's fees, including late fees, for licenses and renewals are
91.7established so that the total fees collected by the board will as closely as possible equal
91.8anticipated expenditures during the fiscal biennium, as provided in section 16A.1285.
91.9Fees must be credited to accounts the board's account in the state government special
91.10revenue fund.
91.11    Subd. 2. Licensure and application fees. Nonrefundable licensure and application
91.12fees charged by the board are as follows:
91.13(1) application fee for national examination is $220;
91.14(2) application fee for Licensed Marriage and Family Therapist (LMFT) state
91.15examination is $110;
91.16(3) initial LMFT license fee is prorated, but cannot exceed $125;
91.17(4) annual renewal fee for LMFT license is $125;
91.18(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
91.19license renewal is $50;
91.20(6) application fee for LMFT licensure by reciprocity is $340;
91.21(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
91.22license is $75;
91.23(8) annual renewal fee for LAMFT license is $75;
91.24(9) late fee for LAMFT renewal is $50;
91.25(10) fee for reinstatement of license is $150; and
91.26(11) fee for emeritus status is $125.
91.27    Subd. 3. Other fees. Other fees charged by the board are as follows:
91.28(1) sponsor application fee for approval of a continuing education course is $60;
91.29(2) fee for license verification by mail is $10;
91.30(3) duplicate license fee is $25;
91.31(4) duplicate renewal card fee is $10;
91.32(5) fee for licensee mailing list is $60;
91.33(6) fee for a rule book is $10; and
91.34(7) fees as authorized by section 148B.175, subdivision 6, clause (7).

92.1    Sec. 14. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:
92.2    Subd. 2. Fee. Each applicant shall pay a nonrefundable application fee set by
92.3the board under section 148B.17.

92.4    Sec. 15. Minnesota Statutes 2010, section 148B.52, is amended to read:
92.5148B.52 DUTIES OF THE BOARD.
92.6(a) The Board of Behavioral Health and Therapy shall:
92.7(1) establish by rule appropriate techniques, including examinations and other
92.8methods, for determining whether applicants and licensees are qualified under sections
92.9148B.50 to 148B.593;
92.10(2) establish by rule standards for professional conduct, including adoption of a
92.11Code of Professional Ethics and requirements for continuing education and supervision;
92.12(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593;
92.13(4) establish by rule standards for initial education including coursework for
92.14licensure and content of professional education;
92.15(5) establish, maintain, and publish annually a register of current licensees and
92.16approved supervisors;
92.17(6) establish initial and renewal application and examination fees sufficient to cover
92.18operating expenses of the board and its agents in accordance with section 16A.1283;
92.19(7) educate the public about the existence and content of the laws and rules for
92.20licensed professional counselors to enable consumers to file complaints against licensees
92.21who may have violated the rules; and
92.22(8) periodically evaluate its rules in order to refine the standards for licensing
92.23professional counselors and to improve the methods used to enforce the board's standards.
92.24(b) The board may appoint a professional discipline committee for each occupational
92.25licensure regulated by the board, and may appoint a board member as chair. The
92.26professional discipline committee shall consist of five members representative of the
92.27licensed occupation and shall provide recommendations to the board with regard to rule
92.28techniques, standards, procedures, and related issues specific to the licensed occupation.

92.29    Sec. 16. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:
92.30    Subd. 2. Application fees. Each applicant shall submit with a license, advanced
92.31dental therapist certificate, or permit application a nonrefundable fee in the following
92.32amounts in order to administratively process an application:
92.33(1) dentist, $140;
92.34(2) full faculty dentist, $140;
93.1(2) (3) limited faculty dentist, $140;
93.2(3) (4) resident dentist or dental provider, $55;
93.3(5) advanced dental therapist, $100;
93.4(4) (6) dental therapist, $100;
93.5(5) (7) dental hygienist, $55;
93.6(6) (8) licensed dental assistant, $55; and
93.7(7) (9) dental assistant with a permit as described in Minnesota Rules, part
93.83100.8500, subpart 3, $15.

93.9    Sec. 17. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:
93.10    Subd. 3. Initial license or permit fees. Along with the application fee, each of the
93.11following applicants shall submit a separate prorated initial license or permit fee. The
93.12prorated initial fee shall be established by the board based on the number of months of the
93.13applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to
93.14exceed the following monthly fee amounts:
93.15(1) dentist or full faculty dentist, $14 times the number of months of the initial term;
93.16(2) dental therapist, $10 times the number of months of the initial term;
93.17(3) dental hygienist, $5 times the number of months of the initial term;
93.18(4) licensed dental assistant, $3 times the number of months of the initial term; and
93.19(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
93.20subpart 3, $1 times the number of months of the initial term.

93.21    Sec. 18. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:
93.22    Subd. 4. Annual license fees. Each limited faculty or resident dentist shall submit
93.23with an annual license renewal application a fee established by the board not to exceed
93.24the following amounts:
93.25(1) limited faculty dentist, $168; and
93.26(2) resident dentist or dental provider, $59.

93.27    Sec. 19. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:
93.28    Subd. 5. Biennial license or permit fees. Each of the following applicants shall
93.29submit with a biennial license or permit renewal application a fee as established by the
93.30board, not to exceed the following amounts:
93.31(1) dentist or full faculty dentist, $336;
93.32(2) dental therapist, $180;
93.33(3) dental hygienist, $118;
94.1(4) licensed dental assistant, $80; and
94.2(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
94.3subpart 3, $24.

94.4    Sec. 20. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:
94.5    Subd. 8. Duplicate license or certificate fee. Each applicant shall submit, with
94.6a request for issuance of a duplicate of the original license, or of an annual or biennial
94.7renewal certificate for a license or permit, a fee in the following amounts:
94.8(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental
94.9assistant license, $35; and
94.10(2) annual or biennial renewal certificates, $10.

94.11    Sec. 21. Minnesota Statutes 2010, section 150A.091, is amended by adding a
94.12subdivision to read:
94.13    Subd. 16. Failure of professional development portfolio audit. A licensee shall
94.14submit a fee as established by the board not to exceed the amount of $250 after failing
94.15two consecutive professional development portfolio audits and, thereafter, for each failed
94.16professional development portfolio audit under Minnesota Rules, part 3100.5300.

94.17    Sec. 22. [151.065] FEE AMOUNTS.
94.18    Subdivision 1. Application fees. Application fees for licensure and registration
94.19are as follows:
94.20(1) pharmacist licensed by examination, $130;
94.21(2) pharmacist licensed by reciprocity, $225;
94.22(3) pharmacy intern, $30;
94.23(4) pharmacy technician, $30;
94.24(5) pharmacy, $190;
94.25(6) drug wholesaler, legend drugs only, $200;
94.26(7) drug wholesaler, legend and nonlegend drugs, $200;
94.27(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
94.28(9) drug wholesaler, medical gases, $150;
94.29(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
94.30(11) drug manufacturer, legend drugs only, $200;
94.31(12) drug manufacturer, legend and nonlegend drugs, $200;
94.32(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
94.33(14) drug manufacturer, medical gases, $150;
95.1(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
95.2(16) medical gas distributor, $75;
95.3(17) controlled substance researcher, $50; and
95.4(18) pharmacy professional corporation, $100.
95.5    Subd. 2. Original license fee. The pharmacist original licensure fee, $130.
95.6    Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees
95.7are as follows:
95.8(1) pharmacist, $130;
95.9(2) pharmacy technician, $30;
95.10(3) pharmacy, $190;
95.11(4) drug wholesaler, legend drugs only, $200;
95.12(5) drug wholesaler, legend and nonlegend drugs, $200;
95.13(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
95.14(7) drug wholesaler, medical gases, $150;
95.15(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
95.16(9) drug manufacturer, legend drugs only, $200;
95.17(10) drug manufacturer, legend and nonlegend drugs, $200;
95.18(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;
95.19(12) drug manufacturer, medical gases, $150;
95.20(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
95.21(14) medical gas distributor, $75;
95.22(15) controlled substance researcher, $50; and
95.23(16) pharmacy professional corporation, $45.
95.24    Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses
95.25and certificates are as follows:
95.26(1) intern affidavit, $15;
95.27(2) duplicate small license, $15; and
95.28(3) duplicate large certificate, $25.
95.29    Subd. 5. Late fees. All annual renewal fees are subject to a 50 percent late fee if
95.30the renewal fee and application are not received by the board prior to the date specified
95.31by the board.
95.32    Subd. 6. Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's
95.33license to lapse may reinstate the license with board approval and upon payment of any
95.34fees and late fees in arrears, up to a maximum of $1,000.
96.1(b) A pharmacy technician who has allowed the technician's registration to lapse
96.2may reinstate the registration with board approval and upon payment of any fees and late
96.3fees in arrears, up to a maximum of $90.
96.4(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical
96.5gas distributor who has allowed the license of the establishment to lapse may reinstate the
96.6license with board approval and upon payment of any fees and late fees in arrears.
96.7(d) A controlled substance researcher who has allowed the researcher's registration
96.8to lapse may reinstate the registration with board approval and upon payment of any fees
96.9and late fees in arrears.
96.10(e) A pharmacist owner of a professional corporation who has allowed the
96.11corporation's registration to lapse may reinstate the registration with board approval and
96.12upon payment of any fees and late fees in arrears.

96.13    Sec. 23. Minnesota Statutes 2010, section 151.07, is amended to read:
96.14151.07 MEETINGS; EXAMINATION FEE.
96.15The board shall meet at times as may be necessary and as it may determine to
96.16examine applicants for licensure and to transact its other business, giving reasonable
96.17notice of all examinations by mail to known applicants therefor. The secretary shall record
96.18the names of all persons licensed by the board, together with the grounds upon which
96.19the right of each to licensure was claimed. The fee for examination shall be in such the
96.20 amount as the board may determine specified in section 151.065, which fee may in the
96.21discretion of the board be returned to applicants not taking the examination.

96.22    Sec. 24. Minnesota Statutes 2010, section 151.101, is amended to read:
96.23151.101 INTERNSHIP.
96.24Upon payment of the fee specified in section 151.065, the board may license register
96.25as an intern any natural persons who have satisfied the board that they are of good moral
96.26character, not physically or mentally unfit, and who have successfully completed the
96.27educational requirements for intern licensure registration prescribed by the board. The
96.28board shall prescribe standards and requirements for interns, pharmacist-preceptors, and
96.29internship training but may not require more than one year of such training.
96.30The board in its discretion may accept internship experience obtained in another
96.31state provided the internship requirements in such other state are in the opinion of the
96.32board equivalent to those herein provided.

97.1    Sec. 25. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision
97.2to read:
97.3    Subd. 3. Registration fee. The board shall not register an individual as a pharmacy
97.4technician unless all applicable fees specified in section 151.065 have been paid.

97.5    Sec. 26. Minnesota Statutes 2010, section 151.12, is amended to read:
97.6151.12 RECIPROCITY; LICENSURE.
97.7The board may in its discretion grant licensure without examination to any
97.8pharmacist licensed by the Board of Pharmacy or a similar board of another state which
97.9accords similar recognition to licensees of this state; provided, the requirements for
97.10licensure in such other state are in the opinion of the board equivalent to those herein
97.11provided. The fee for licensure shall be in such the amount as the board may determine by
97.12rule specified in section 151.065.

97.13    Sec. 27. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
97.14    Subdivision 1. Renewal fee. Every person licensed by the board as a pharmacist
97.15shall pay to the board a the annual renewal fee to be fixed by it specified in section
97.16151.065. The board may promulgate by rule a charge to be assessed for the delinquent
97.17payment of a fee. the late fee specified in section 151.065 if the renewal fee and
97.18application are not received by the board prior to the date specified by the board. It shall
97.19be unlawful for any person licensed as a pharmacist who refuses or fails to pay such any
97.20applicable renewal or late fee to practice pharmacy in this state. Every certificate and
97.21license shall expire at the time therein prescribed.

97.22    Sec. 28. Minnesota Statutes 2010, section 151.19, is amended to read:
97.23151.19 REGISTRATION; FEES.
97.24    Subdivision 1. Pharmacy registration. The board shall require and provide for the
97.25annual registration of every pharmacy now or hereafter doing business within this state.
97.26Upon the payment of a any applicable fee to be set by the board specified in section
97.27151.065, the board shall issue a registration certificate in such form as it may prescribe to
97.28such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be
97.29displayed in a conspicuous place in the pharmacy for which it is issued and expire on the
97.3030th day of June following the date of issue. It shall be unlawful for any person to conduct
97.31a pharmacy unless such certificate has been issued to the person by the board.
97.32    Subd. 2. Nonresident pharmacies. The board shall require and provide for an
97.33annual nonresident special pharmacy registration for all pharmacies located outside of this
98.1state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
98.2prescription medications into this state. Nonresident special pharmacy registration shall
98.3be granted by the board upon payment of any applicable fee specified in section 151.065
98.4and the disclosure and certification by a pharmacy:
98.5    (1) that it is licensed in the state in which the dispensing facility is located and from
98.6which the drugs are dispensed;
98.7    (2) the location, names, and titles of all principal corporate officers and all
98.8pharmacists who are dispensing drugs to residents of this state;
98.9    (3) that it complies with all lawful directions and requests for information from
98.10the Board of Pharmacy of all states in which it is licensed or registered, except that it
98.11shall respond directly to all communications from the board concerning emergency
98.12circumstances arising from the dispensing of drugs to residents of this state;
98.13    (4) that it maintains its records of drugs dispensed to residents of this state so that the
98.14records are readily retrievable from the records of other drugs dispensed;
98.15    (5) that it cooperates with the board in providing information to the Board of
98.16Pharmacy of the state in which it is licensed concerning matters related to the dispensing
98.17of drugs to residents of this state;
98.18    (6) that during its regular hours of operation, but not less than six days per week, for
98.19a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
98.20communication between patients in this state and a pharmacist at the pharmacy who has
98.21access to the patients' records; the toll-free number must be disclosed on the label affixed
98.22to each container of drugs dispensed to residents of this state; and
98.23    (7) that, upon request of a resident of a long-term care facility located within the
98.24state of Minnesota, the resident's authorized representative, or a contract pharmacy or
98.25licensed health care facility acting on behalf of the resident, the pharmacy will dispense
98.26medications prescribed for the resident in unit-dose packaging or, alternatively, comply
98.27with the provisions of section 151.415, subdivision 5.
98.28    Subd. 3. Sale of federally restricted medical gases. The board shall require and
98.29provide for the annual registration of every person or establishment not licensed as a
98.30pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
98.31medical gases. Upon the payment of a any applicable fee to be set by the board specified
98.32in section 151.065, the board shall issue a registration certificate in such form as it may
98.33prescribe to those persons or places that may be qualified to sell or distribute federally
98.34restricted medical gases. The certificate shall be displayed in a conspicuous place in the
98.35business for which it is issued and expire on the date set by the board. It is unlawful for
99.1a person to sell or distribute federally restricted medical gases unless a certificate has
99.2been issued to that person by the board.

99.3    Sec. 29. Minnesota Statutes 2010, section 151.25, is amended to read:
99.4151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
99.5The board shall require and provide for the annual registration of every person
99.6engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes,
99.7now or hereafter doing business with accounts in this state. Upon a payment of a any
99.8applicable fee as set by the board specified in section 151.065, the board shall issue a
99.9registration certificate in such form as it may prescribe to such manufacturer. Such
99.10registration certificate shall be displayed in a conspicuous place in such manufacturer's
99.11or wholesaler's place of business for which it is issued and expire on the date set by the
99.12board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals,
99.13or poisons for medicinal purposes unless such a certificate has been issued to the person
99.14by the board. It shall be unlawful for any person engaged in the manufacture of drugs,
99.15medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell
99.16legend drugs to other than a pharmacy, except as provided in this chapter.

99.17    Sec. 30. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
99.18    Subdivision 1. Requirements. All wholesale drug distributors are subject to the
99.19requirements in paragraphs (a) to (f).
99.20(a) No person or distribution outlet shall act as a wholesale drug distributor without
99.21first obtaining a license from the board and paying the required any applicable fee
99.22specified in section 151.065.
99.23(b) No license shall be issued or renewed for a wholesale drug distributor to operate
99.24unless the applicant agrees to operate in a manner prescribed by federal and state law and
99.25according to the rules adopted by the board.
99.26(c) The board may require a separate license for each facility directly or indirectly
99.27owned or operated by the same business entity within the state, or for a parent entity
99.28with divisions, subsidiaries, or affiliate companies within the state, when operations
99.29are conducted at more than one location and joint ownership and control exists among
99.30all the entities.
99.31(d) As a condition for receiving and retaining a wholesale drug distributor license
99.32issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
99.33and will continuously maintain:
99.34(1) adequate storage conditions and facilities;
100.1(2) minimum liability and other insurance as may be required under any applicable
100.2federal or state law;
100.3(3) a viable security system that includes an after hours central alarm, or comparable
100.4entry detection capability; restricted access to the premises; comprehensive employment
100.5applicant screening; and safeguards against all forms of employee theft;
100.6(4) a system of records describing all wholesale drug distributor activities set forth
100.7in section 151.44 for at least the most recent two-year period, which shall be reasonably
100.8accessible as defined by board regulations in any inspection authorized by the board;
100.9(5) principals and persons, including officers, directors, primary shareholders,
100.10and key management executives, who must at all times demonstrate and maintain their
100.11capability of conducting business in conformity with sound financial practices as well
100.12as state and federal law;
100.13(6) complete, updated information, to be provided to the board as a condition for
100.14obtaining and retaining a license, about each wholesale drug distributor to be licensed,
100.15including all pertinent corporate licensee information, if applicable, or other ownership,
100.16principal, key personnel, and facilities information found to be necessary by the board;
100.17(7) written policies and procedures that assure reasonable wholesale drug distributor
100.18preparation for, protection against, and handling of any facility security or operation
100.19problems, including, but not limited to, those caused by natural disaster or government
100.20emergency, inventory inaccuracies or product shipping and receiving, outdated product
100.21or other unauthorized product control, appropriate disposition of returned goods, and
100.22product recalls;
100.23(8) sufficient inspection procedures for all incoming and outgoing product
100.24shipments; and
100.25(9) operations in compliance with all federal requirements applicable to wholesale
100.26drug distribution.
100.27(e) An agent or employee of any licensed wholesale drug distributor need not seek
100.28licensure under this section.
100.29(f) A wholesale drug distributor shall file with the board an annual report, in a
100.30form and on the date prescribed by the board, identifying all payments, honoraria,
100.31reimbursement or other compensation authorized under section 151.461, clauses (3) to
100.32(5), paid to practitioners in Minnesota during the preceding calendar year. The report
100.33shall identify the nature and value of any payments totaling $100 or more, to a particular
100.34practitioner during the year, and shall identify the practitioner. Reports filed under this
100.35provision are public data.

101.1    Sec. 31. Minnesota Statutes 2010, section 151.48, is amended to read:
101.2151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
101.3(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business
101.4in the state without first obtaining a license from the board and paying the required any
101.5applicable fee specified in section 151.065.
101.6(b) Application for an out-of-state wholesale drug distributor license under this
101.7section shall be made on a form furnished by the board.
101.8(c) No person acting as principal or agent for any out-of-state wholesale drug
101.9distributor may sell or distribute drugs in the state unless the distributor has obtained
101.10a license.
101.11(d) The board may adopt regulations that permit out-of-state wholesale drug
101.12distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state
101.13wholesale drug distributor:
101.14(1) possesses a valid license granted by another state under legal standards
101.15comparable to those that must be met by a wholesale drug distributor of this state as
101.16prerequisites for obtaining a license under the laws of this state; and
101.17(2) can show that the other state would extend reciprocal treatment under its own
101.18laws to a wholesale drug distributor of this state.

101.19    Sec. 32. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
101.20    Subd. 3. Research project use of controlled substances. Any qualified person
101.21may use controlled substances in the course of a bona fide research project but cannot
101.22administer or dispense such drugs to human beings unless such drugs are prescribed,
101.23dispensed and administered by a person lawfully authorized to do so. Every person
101.24who engages in research involving the use of such substances shall apply annually for
101.25registration by the state Board of Pharmacy and shall pay any applicable fee specified in
101.26section 151.065, provided that such registration shall not be required if the person is
101.27covered by and has complied with federal laws covering such research projects.

101.28    Sec. 33. [214.107] HEALTH-RELATED LICENSING BOARDS
101.29ADMINISTRATIVE SERVICES UNIT.
101.30    Subdivision 1. Establishment. An administrative services unit is established
101.31for the health-related licensing boards in section 214.01, subdivision 2, to perform
101.32administrative, financial, and management functions common to all the boards in a manner
101.33that streamlines services, reduces expenditures, targets the use of state resources, and
101.34meets the mission of public protection.
102.1    Subd. 2. Authority. The administrative services unit shall act as an agent of the
102.2boards.
102.3    Subd. 3. Funding. (a) The administrative service unit shall apportion among the
102.4health-related licensing boards an amount to be allocated to each health-related licensing
102.5board. The amount apportioned to each board shall equal each board's share of the annual
102.6operating costs for the unit and shall be deposited into the state government special
102.7revenue fund.
102.8(b) The administrative services unit may receive and expend reimbursements for
102.9services performed for other agencies.

102.10    Sec. 34. EFFECTIVE DATE.
102.11Sections 8 to 12 are effective upon implementation of the coordinated licensure
102.12information system defined in Minnesota Statutes, section 148.2855, but no sooner than
102.13July 1, 2012.

102.14
ARTICLE 5

102.15HEALTH CARE

102.16    Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
102.17    Subdivision 1. Citation. This section shall be known as and may be cited as the
102.18"Freedom of Choice in Health Care Act."
102.19    Subd. 2. Definitions. (a) For purposes of this section, the following terms have
102.20the meaning given them.
102.21(b) "Health care service" means any service, treatment, or provision of a product for
102.22the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise
102.23maintain or improve physical or mental health, subject to all laws and rules regulating
102.24health service providers and products within the state of Minnesota.
102.25(c) "Mode of securing" means to purchase directly or on credit or by trade, or to
102.26contract for third-party payment by insurance or other legal means as authorized by the
102.27state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored
102.28health care benefits under such conditions as may legally be required as a condition of
102.29such benefits, or any combination of the same.
102.30(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding,
102.31surcharge, fee, or any other imposed consequence established by law or rule of a
102.32government or its subdivision or agency that is used to punish or discourage the exercise
102.33of rights protected under this section.
103.1    Subd. 3. Statement of public policy. (a) The power to require or regulate a person's
103.2choice in the mode of securing health care services, or to impose a penalty related to that
103.3choice, is not found in the Constitution of the United States of America, and is therefore a
103.4power reserved to the people pursuant to the Ninth Amendment, and to the several states
103.5pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign
103.6power to declare the public policy of the state of Minnesota regarding the right of all
103.7persons residing in the state in choosing the mode of securing health care services.
103.8(b) It is hereby declared that the public policy of the state of Minnesota, consistent
103.9with our constitutionally recognized and inalienable rights of liberty, is that every person
103.10within the state of Minnesota is and shall be free to choose or decline to choose any mode
103.11of securing health care services without penalty or threat of penalty.
103.12(c) The policy stated under this section shall not be applied to impair any right of
103.13contract related to the provision of health care services to any person or group.
103.14    Subd. 4. Enforcement. (a) No public official, employee, or agent of the state of
103.15Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or
103.16effectuate any penalty in the state of Minnesota that violates the public policy set forth
103.17in this section.
103.18(b) The attorney general shall take any action as is provided in this section or section
103.198.31 in the defense or prosecution of rights protected under this section.

103.20    Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
103.21    Subdivision 1. Investigate offenses against provisions of certain designated
103.22sections; assist in enforcement. (a) The attorney general shall investigate violations of the
103.23law of this state respecting unfair, discriminatory, and other unlawful practices in business,
103.24commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act
103.25(sections 317A.001 to 317A.909), the Act Against Unfair Discrimination and Competition
103.26(sections 325D.01 to 325D.07), the Unlawful Trade Practices Act (sections 325D.09 to
103.27325D.16), the Antitrust Act (sections 325D.49 to 325D.66), section 325F.67 and other
103.28laws against false or fraudulent advertising, the antidiscrimination acts contained in
103.29section 325D.67, the act against monopolization of food products (section 325D.68),
103.30the act regulating telephone advertising services (section 325E.39), the Prevention of
103.31Consumer Fraud Act (sections 325F.68 to 325F.70), and chapter 53A regulating currency
103.32exchanges and assist in the enforcement of those laws as in this section provided.
103.33(b) The attorney general shall seek injunctive and any other appropriate relief as
103.34expeditiously as possible to preserve the rights and property of the residents of Minnesota,
103.35and to defend as necessary the state of Minnesota, its officials, employees, and agents in
104.1the event that any law or regulation violating the public policy set forth in the Freedom
104.2of Choice in Health Care Act in this section is enacted by any government, subdivision,
104.3or agency thereof.
104.4(c) The attorney general shall seek injunctive and any other appropriate relief
104.5as expeditiously as possible in the event that any law or regulation violating the public
104.6policy set forth in the Freedom of Choice in Health Care Act in this section is enacted
104.7without adequate federal funding to the state to ensure affordable health care coverage
104.8is available to the residents of Minnesota.

104.9    Sec. 3. Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read:
104.10    Subd. 3a. Private remedies. In addition to the remedies otherwise provided by law,
104.11any person injured by a violation of any of the laws referred to in subdivision 1 or a
104.12violation of the public policy in section 1.06 may bring a civil action and recover damages,
104.13together with costs and disbursements, including costs of investigation and reasonable
104.14attorney's fees, and receive other equitable relief as determined by the court. The court
104.15may, as appropriate, enter a consent judgment or decree without the finding of illegality.
104.16In any action brought by the attorney general pursuant to this section, the court may award
104.17any of the remedies allowable under this subdivision. An action under this subdivision
104.18for any violation of section 1.06 is in the public interest.

104.19    Sec. 4. Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read:
104.20    Subdivision 1. Establishment. The association shall establish the following
104.21maximum premiums to be charged for membership in the comprehensive health insurance
104.22plan:
104.23(a) the premium for the number one qualified plan shall range from a minimum of
104.24101 percent to a maximum of 125 percent of the weighted average of rates charged by
104.25those insurers and health maintenance organizations with individuals enrolled in:
104.26(1) $1,000 annual deductible individual plans of insurance in force in Minnesota;
104.27(2) individual health maintenance organization contracts of coverage with a $1,000
104.28annual deductible which are in force in Minnesota; and
104.29(3) other plans of coverage similar to plans offered by the association based on
104.30generally accepted actuarial principles;
104.31(b) the premium for the number two qualified plan shall range from a minimum of
104.32101 percent to a maximum of 125 percent of the weighted average of rates charged by
104.33those insurers and health maintenance organizations with individuals enrolled in:
104.34(1) $500 annual deductible individual plans of insurance in force in Minnesota;
105.1(2) individual health maintenance organization contracts of coverage with a $500
105.2annual deductible which are in force in Minnesota; and
105.3(3) other plans of coverage similar to plans offered by the association based on
105.4generally accepted actuarial principles;
105.5(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible
105.6shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted
105.7average of rates charged by those insurers and health maintenance organizations with
105.8individuals enrolled in:
105.9(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in
105.10force in Minnesota; and
105.11(2) individual health maintenance organization contracts of coverage with a $2,000,
105.12$5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or
105.13(3) other plans of coverage similar to plans offered by the association based on
105.14generally accepted actuarial principles;
105.15(d) the premium for each type of Medicare supplement plan required to be offered
105.16by the association pursuant to section 62E.12 shall range from a minimum of 101 percent
105.17to a maximum of 125 percent of the weighted average of rates charged by those insurers
105.18and health maintenance organizations with individuals enrolled in:
105.19(1) Medicare supplement plans in force in Minnesota;
105.20(2) health maintenance organization Medicare supplement contracts of coverage
105.21which are in force in Minnesota; and
105.22(3) other plans of coverage similar to plans offered by the association based on
105.23generally accepted actuarial principles; and
105.24(e) the charge for health maintenance organization coverage shall be based on
105.25generally accepted actuarial principles.; and
105.26(f) the premium for a high-deductible, basic plan offered under section 62E.121 shall
105.27range from a minimum of 101 percent to a maximum of 125 percent of the weighted
105.28average of rates charged by those insurers and health maintenance organizations offering
105.29comparable plans outside of the Minnesota Comprehensive Health Association.
105.30The list of insurers and health maintenance organizations whose rates are used to
105.31establish the premium for coverage offered by the association pursuant to paragraphs (a)
105.32to (d) and (f) shall be established by the commissioner on the basis of information which
105.33shall be provided to the association by all insurers and health maintenance organizations
105.34annually at the commissioner's request. This information shall include the number of
105.35individuals covered by each type of plan or contract specified in paragraphs (a) to (d) and
105.36(f) that is sold, issued, and renewed by the insurers and health maintenance organizations,
106.1including those plans or contracts available only on a renewal basis. The information shall
106.2also include the rates charged for each type of plan or contract.
106.3In establishing premiums pursuant to this section, the association shall utilize
106.4generally accepted actuarial principles, provided that the association shall not discriminate
106.5in charging premiums based upon sex. In order to compute a weighted average for each
106.6type of plan or contract specified under paragraphs (a) to (d) and (f), the association
106.7shall, using the information collected pursuant to this subdivision, list insurers and health
106.8maintenance organizations in rank order of the total number of individuals covered by
106.9each insurer or health maintenance organization. The association shall then compute
106.10a weighted average of the rates charged for coverage by all the insurers and health
106.11maintenance organizations by:
106.12(1) multiplying the numbers of individuals covered by each insurer or health
106.13maintenance organization by the rates charged for coverage;
106.14(2) separately summing both the number of individuals covered by all the insurers
106.15and health maintenance organizations and all the products computed under clause (1); and
106.16(3) dividing the total of the products computed under clause (1) by the total number
106.17of individuals covered.
106.18The association may elect to use a sample of information from the insurers and
106.19health maintenance organizations for purposes of computing a weighted average. In no
106.20case, however, may a sample used by the association to compute a weighted average
106.21include information from fewer than the two insurers or health maintenance organizations
106.22highest in rank order.

106.23    Sec. 5. [62E.121] HIGH-DEDUCTIBLE, BASIC PLAN.
106.24    Subdivision 1. Required offering. The Minnesota Comprehensive Health
106.25Association shall offer a high-deductible, basic plan that meets the requirements specified
106.26in this section. The high-deductible, basic plan is a one-person plan. Any dependents
106.27must be covered separately.
106.28    Subd. 2. Annual deductible; out-of-pocket maximum. (a) The plan shall provide
106.29the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000.
106.30The in-network annual out-of-pocket maximum for each annual deductible option shall be
106.31$1,000 greater than the amount of the annual deductible.
106.32(b) The deductible is subject to an annual increase based on the change in the
106.33Consumer Price Index (CPI).
106.34    Subd. 3. Office visits for nonpreventive care. The following co-payments shall
106.35apply for each of the first three office visits per calendar year for nonpreventive care:
107.1(1) $30 per visit for the $3,000 annual deductible option;
107.2(2) $40 per visit for the $6,000 annual deductible option;
107.3(3) $50 per visit for the $9,000 annual deductible option; and
107.4(4) $60 per visit for the $12,000 annual deductible option.
107.5For the fourth and subsequent visits during the calendar year, 80 percent coverage is
107.6provided under all deductible options, after the deductible is met.
107.7    Subd. 4. Preventive care. One hundred percent coverage is provided for preventive
107.8care, and no co-payment, coinsurance, or deductible requirements apply.
107.9    Subd. 5. Prescription drugs. A $10 co-payment applies to preferred generic drugs.
107.10Preferred brand-name drugs require an enrollee payment of 100 percent of the health
107.11plan's discounted rate.
107.12    Subd. 6. Convenience care center visits. A $20 co-payment applies for the first
107.13three convenience care center visits during a calendar year. For the fourth and subsequent
107.14visits during a calendar year, 80 percent coverage is provided after the deductible is met.
107.15    Subd. 7. Urgent care center visits. A $100 co-payment applies for the first urgent
107.16care center visit during a calendar year. For the second and subsequent visits during a
107.17calendar year, 80 percent coverage is provided after the deductible is met.
107.18    Subd. 8. Emergency room visits. A $200 co-payment applies for the first
107.19emergency room visit during a calendar year. For the second and subsequent visits during
107.20a calendar year, 80 percent coverage is provided after the deductible is met.
107.21    Subd. 9. Lab and x-ray; hospital services; ambulance; surgery. Lab and x-ray
107.22services, hospital services, ambulance services, and surgery are covered at 80 percent
107.23after the deductible is met.
107.24    Subd. 10. Eyewear. The health plan pays up to $50 per calendar year for eyewear.
107.25    Subd. 11. Maternity. Maternity, labor and delivery, and postpartum care are not
107.26covered. One hundred percent coverage is provided for prenatal care and no deductible
107.27applies.
107.28    Subd. 12. Other eligible health care services. Other eligible health care services
107.29are covered at 80 percent after the deductible is met.
107.30    Subd. 13. Option to remove mental health and substance abuse coverage.
107.31Enrollees have the option of removing mental health and substance abuse coverage in
107.32exchange for a reduced premium.
107.33    Subd. 14. Option to upgrade prescription drug coverage. Enrollees have
107.34the option to upgrade prescription drug coverage to include coverage for preferred
107.35brand-name drugs with a $50 co-payment and coverage for nonpreferred drugs with a
107.36$100 co-payment in exchange for an increased premium.
108.1    Subd. 15. Out-of-network services. (a) The out-of-network annual deductible is
108.2double the in-network annual deductible.
108.3(b) There is no out-of-pocket maximum for out-of-network services.
108.4(c) Benefits for out-of-network services are covered at 60 percent after the deductible
108.5is met.
108.6(d) The lifetime maximum benefit for out-of-network services is $1,000,000.
108.7    Subd. 16. Services not covered. Services not covered include: custodial care
108.8or rest care; most dental services; cosmetic services; refractive eye surgery; infertility
108.9services; and services that are investigational, not medically necessary, or received while
108.10on military duty.

108.11    Sec. 6. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision
108.12to read:
108.13    Subd. 4f. Waiver of preexisting conditions for persons covered by healthy
108.14Minnesota contribution program. A person may enroll in the comprehensive plan with
108.15a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
108.16the healthy Minnesota contribution program, and has been denied coverage as described
108.17under section 256L.031, subdivision 6.

108.18    Sec. 7. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:
108.19    Subd. 9. Growth limits; federal programs. The commissioners of health and
108.20human services shall establish a rate methodology for Medicare and Medicaid risk-based
108.21contracting with health plan companies that is consistent with statewide growth limits.
108.22The methodology shall be presented for review by the Minnesota Health Care Commission
108.23and the Legislative Commission on Health Care Access prior to the submission of a
108.24waiver request to the Centers for Medicare and Medicaid Services and subsequent
108.25implementation of the methodology.

108.26    Sec. 8. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
108.27    Subd. 7. Transfers from the commissioner of human services. Of the amount
108.28transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
108.29$21,714,000 shall be distributed as follows:
108.30(1) $2,157,000 shall be distributed by the commissioner to the University of
108.31Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
108.32(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
108.33Medical Center for clinical medical education;
109.1(3) $17,400,000 shall be distributed by the commissioner to the University of
109.2Minnesota Board of Regents for purposes of medical education;
109.3(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
109.4dental innovation grants in accordance with subdivision 7a; and
109.5(5) the remainder of the amount transferred according to section 256B.69,
109.6subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
109.7clinical medical education programs that meet the qualifications of subdivision 3 based on
109.8the formula in subdivision 4, paragraph (a), or subdivision 11, as appropriate.

109.9    Sec. 9. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:
109.10    Subd. 9. Review of eligible providers. The commissioner and the Medical
109.11Education and Research Costs Advisory Committee may review provider groups included
109.12in the definition of a clinical medical education program to assure that the distribution of
109.13the funds continue to be consistent with the purpose of this section. The results of any
109.14such reviews must be reported to the Legislative Commission on Health Care Access
109.15chairs and ranking minority members of the legislative committees with jurisdiction over
109.16health care policy and finance.

109.17    Sec. 10. [62J.824] BILLING FOR PROCEDURES TO CORRECT MEDICAL
109.18ERRORS PROHIBITED.
109.19A health care provider shall not bill a patient, and shall not be reimbursed, for
109.20any operation, treatment, or other care that is provided to reverse, correct, or otherwise
109.21minimize the affects of an adverse health care event, as described in section 144.7065,
109.22subdivisions 2 to 7, for which that health care provider is responsible.

109.23    Sec. 11. Minnesota Statutes 2010, section 62Q.32, is amended to read:
109.2462Q.32 LOCAL OMBUDSPERSON.
109.25County board or community health service agencies may establish an office of
109.26ombudsperson to provide a system of consumer advocacy for persons receiving health
109.27care services through a health plan company. The ombudsperson's functions may include,
109.28but are not limited to:
109.29(a) mediation or advocacy on behalf of a person accessing the complaint and appeal
109.30procedures to ensure that necessary medical services are provided by the health plan
109.31company; and
109.32(b) investigation of the quality of services provided to a person and determine the
109.33extent to which quality assurance mechanisms are needed or any other system change
110.1may be needed. The commissioner of health shall make recommendations for funding
110.2these functions including the amount of funding needed and a plan for distribution. The
110.3commissioner shall submit these recommendations to the Legislative Commission on
110.4Health Care Access by January 15, 1996.

110.5    Sec. 12. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:
110.6    Subd. 3. Provider peer grouping. (a) The commissioner shall develop a peer
110.7grouping system for providers based on a combined measure that incorporates both
110.8provider risk-adjusted cost of care and quality of care, and for specific conditions as
110.9determined by the commissioner. In developing this system, the commissioner shall
110.10consult and coordinate with health care providers, health plan companies, state agencies,
110.11and organizations that work to improve health care quality in Minnesota. For purposes of
110.12the final establishment of the peer grouping system, the commissioner shall not contract
110.13with any private entity, organization, or consortium of entities that has or will have a direct
110.14financial interest in the outcome of the system.
110.15    (b) By no later than October 15, 2010, the commissioner shall disseminate
110.16information to providers on their total cost of care, total resource use, total quality of care,
110.17and the total care results of the grouping developed under this subdivision in comparison
110.18to an appropriate peer group. Any analyses or reports that identify providers may only be
110.19published after the provider has been provided the opportunity by the commissioner to
110.20review the underlying data and submit comments. Providers may be given any data for
110.21which they are the subject of the data. The provider shall have 30 days to review the data
110.22for accuracy and initiate an appeal as specified in paragraph (d).
110.23    (c) By no later than January 1, 2011, the commissioner shall disseminate information
110.24to providers on their condition-specific cost of care, condition-specific resource use,
110.25condition-specific quality of care, and the condition-specific results of the grouping
110.26developed under this subdivision in comparison to an appropriate peer group. Any
110.27analyses or reports that identify providers may only be published after the provider has
110.28been provided the opportunity by the commissioner to review the underlying data and
110.29submit comments. Providers may be given any data for which they are the subject of the
110.30data. The provider shall have 30 days to review the data for accuracy and initiate an
110.31appeal as specified in paragraph (d).
110.32(d) The commissioner shall establish an appeals process to resolve disputes from
110.33providers regarding the accuracy of the data used to develop analyses or reports. When
110.34a provider appeals the accuracy of the data used to calculate the peer grouping system
110.35results, the provider shall:
111.1(1) clearly indicate the reason they believe the data used to calculate the peer group
111.2system results are not accurate;
111.3(2) provide evidence and documentation to support the reason that data was not
111.4accurate; and
111.5(3) cooperate with the commissioner, including allowing the commissioner access to
111.6data necessary and relevant to resolving the dispute.
111.7If a provider does not meet the requirements of this paragraph, a provider's appeal shall be
111.8considered withdrawn. The commissioner shall not publish results for a specific provider
111.9under paragraph (e) or (f) while that provider has an unresolved appeal.
111.10    (e) Beginning January 1, 2011, the commissioner shall, no less than annually,
111.11publish information on providers' total cost, total resource use, total quality, and the results
111.12of the total care portion of the peer grouping process. The results that are published must
111.13be on a risk-adjusted basis.
111.14(f) Beginning March 30, 2011, the commissioner shall no less than annually publish
111.15information on providers' condition-specific cost, condition-specific resource use, and
111.16condition-specific quality, and the results of the condition-specific portion of the peer
111.17grouping process. The results that are published must be on a risk-adjusted basis.
111.18(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing
111.19information under paragraph (e) or (f), the commissioner shall ensure the scientific
111.20validity and reliability of the results according to the standards described in paragraph (h).
111.21If additional time is needed to establish the scientific validity and reliability of the results,
111.22the commissioner may delay the dissemination of data to providers under paragraph (b)
111.23or (c), or the publication of information under paragraph (e) or (f). If the delay is more
111.24than 60 days, the commissioner shall report in writing to the Legislative Commission on
111.25Health Care Access chairs and ranking minority members of the legislative committees
111.26with jurisdiction over health care policy and finance the following information:
111.27(1) the reason for the delay;
111.28(2) the actions being taken to resolve the delay and establish the scientific validity
111.29and reliability of the results; and
111.30(3) the new dates by which the results shall be disseminated.
111.31If there is a delay under this paragraph, the commissioner must disseminate the
111.32information to providers under paragraph (b) or (c) at least 90 days before publishing
111.33results under paragraph (e) or (f).
111.34(h) The commissioner's assurance of valid and reliable clinic and hospital peer
111.35grouping performance results shall include, at a minimum, the following:
111.36(1) use of the best available evidence, research, and methodologies; and
112.1(2) establishment of an explicit minimum reliability threshold developed in
112.2collaboration with the subjects of the data and the users of the data, at a level not below
112.3nationally accepted standards where such standards exist.
112.4In achieving these thresholds, the commissioner shall not aggregate clinics that are not
112.5part of the same system or practice group. The commissioner shall consult with and solicit
112.6feedback from representatives of physician clinics and hospitals during the peer grouping
112.7data analysis process to obtain input on the methodological options prior to final analysis
112.8and on the design, development, and testing of provider reports.

112.9    Sec. 13. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:
112.10    Subd. 9. Uses of information. (a) By no later than 12 months after the commissioner
112.11publishes the information in subdivision 3, paragraph (e): For product renewals or for
112.12new products that are offered, after 12 months have elapsed from publication by the
112.13commissioner of the information in subdivision 3, paragraph (e):
112.14    (1) the commissioner of management and budget shall use the information and
112.15methods developed under subdivision 3 to strengthen incentives for members of the state
112.16employee group insurance program to use high-quality, low-cost providers;
112.17    (2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer
112.18health benefits to their employees must offer plans that differentiate providers on their
112.19cost and quality performance and create incentives for members to use better-performing
112.20providers;
112.21    (3) all health plan companies shall use the information and methods developed
112.22under subdivision 3 to develop products that encourage consumers to use high-quality,
112.23low-cost providers; and
112.24    (4) health plan companies that issue health plans in the individual market or the
112.25small employer market must offer at least one health plan that uses the information
112.26developed under subdivision 3 to establish financial incentives for consumers to choose
112.27higher-quality, lower-cost providers through enrollee cost-sharing or selective provider
112.28networks.
112.29    (b) By January 1, 2011, the commissioner of health shall report to the governor
112.30and the legislature on recommendations to encourage health plan companies to promote
112.31widespread adoption of products that encourage the use of high-quality, low-cost providers.
112.32The commissioner's recommendations may include tax incentives, public reporting of
112.33health plan performance, regulatory incentives or changes, and other strategies.

112.34    Sec. 14. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:
113.1    Subd. 2. Legislative oversight. Beginning January 15, 2009, the commissioner
113.2of health shall submit to the Legislative Commission on Health Care Access chairs and
113.3ranking minority members of the legislative committees with jurisdiction over health care
113.4policy and finance periodic progress reports on the implementation of this chapter and
113.5sections 256B.0751 to 256B.0754.

113.6    Sec. 15. Minnesota Statutes 2010, section 256.01, subdivision 2b, is amended to read:
113.7    Subd. 2b. Performance payments. The commissioner shall develop and implement
113.8a pay-for-performance system to provide performance payments to eligible medical
113.9groups and clinics that demonstrate optimum care in serving individuals with chronic
113.10diseases who are enrolled in health care programs administered by the commissioner under
113.11chapters 256B, 256D, and 256L. The commissioner may receive any federal matching
113.12money that is made available through the medical assistance program for managed care
113.13oversight contracted through vendors, including consumer surveys, studies, and external
113.14quality reviews as required by the federal Balanced Budget Act of 1997, Code of Federal
113.15Regulations, title 42, part 438-managed care, subpart E-external quality review. Any
113.16federal money received for managed care oversight is appropriated to the commissioner
113.17for this purpose. The commissioner may expend the federal money received in either
113.18year of the biennium.

113.19    Sec. 16. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
113.20to read:
113.21    Subd. 33. Contingency contract fees. (a) When the commissioner enters into
113.22a contingency-based contract for the purpose of recovering medical assistance or
113.23MinnesotaCare funds, the commissioner may retain that portion of the recovered funds
113.24equal to the amount of the contingency fee.
113.25(b) Amounts attributed to new recoveries under this subdivision are appropriated
113.26to the commissioner to the extent they fulfill the payment terms of the contract with the
113.27vendor and shall be deposited into an account in a fund other than the general fund for
113.28purposes of fulfilling the terms of the vendor contract.

113.29    Sec. 17. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
113.30    Subd. 2b. Operating payment rates. In determining operating payment rates for
113.31admissions occurring on or after the rate year beginning January 1, 1991, and every two
113.32years after, or more frequently as determined by the commissioner, the commissioner
113.33shall obtain operating data from an updated base year and establish operating payment
114.1rates per admission for each hospital based on the cost-finding methods and allowable
114.2costs of the Medicare program in effect during the base year. Rates under the general
114.3assistance medical care, medical assistance, and MinnesotaCare programs shall not be
114.4rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months
114.5of the rebased period beginning January 1, 2009. For the first 24 months of the rebased
114.6period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota
114.7long-term hospital shall be rebased effective January 1, 2011, based on its most recent
114.8Medicare cost report ending on or before September 1, 2008, with the provisions under
114.9subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent
114.10rate setting periods in which the base years are updated, a Minnesota long-term hospital's
114.11base year shall remain within the same period as other hospitals. Effective January 1,
114.122013, rates shall be rebased at full value Rates must not be rebased to more current data
114.13for the first six months of the rebased period beginning January 1, 2013. The base year
114.14operating payment rate per admission is standardized by the case mix index and adjusted
114.15by the hospital cost index, relative values, and disproportionate population adjustment.
114.16The cost and charge data used to establish operating rates shall only reflect inpatient
114.17services covered by medical assistance and shall not include property cost information
114.18and costs recognized in outlier payments.

114.19    Sec. 18. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
114.20    Subd. 18. Applications for medical assistance. (a) The state agency may
114.21take applications for medical assistance and conduct eligibility determinations for
114.22MinnesotaCare enrollees.
114.23    (b) The commissioner of human services shall modify the Minnesota health care
114.24programs application form to add a question asking applicants whether they have ever
114.25served in the United States military.
114.26EFFECTIVE DATE.This section is effective August 1, 2011.

114.27    Sec. 19. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
114.28    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
114.29medical assistance, a person must not individually own more than $3,000 in assets, or if a
114.30member of a household with two family members, husband and wife, or parent and child,
114.31the household must not own more than $6,000 in assets, plus $200 for each additional
114.32legal dependent. In addition to these maximum amounts, an eligible individual or family
114.33may accrue interest on these amounts, but they must be reduced to the maximum at the
114.34time of an eligibility redetermination. The accumulation of the clothing and personal
115.1needs allowance according to section 256B.35 must also be reduced to the maximum at
115.2the time of the eligibility redetermination. The value of assets that are not considered in
115.3determining eligibility for medical assistance is the value of those assets excluded under
115.4the supplemental security income program for aged, blind, and disabled persons, with
115.5the following exceptions:
115.6    (1) household goods and personal effects are not considered;
115.7    (2) capital and operating assets of a trade or business that the local agency determines
115.8are necessary to the person's ability to earn an income are not considered;
115.9    (3) motor vehicles are excluded to the same extent excluded by the supplemental
115.10security income program;
115.11    (4) assets designated as burial expenses are excluded to the same extent excluded by
115.12the supplemental security income program. Burial expenses funded by annuity contracts
115.13or life insurance policies must irrevocably designate the individual's estate as contingent
115.14beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
115.15    (5) effective upon federal approval, for a person who no longer qualifies as an
115.16employed person with a disability due to loss of earnings, assets allowed while eligible
115.17for medical assistance under section 256B.057, subdivision 9, are not considered for 12
115.18months, beginning with the first month of ineligibility as an employed person with a
115.19disability, to the extent that the person's total assets remain within the allowed limits of
115.20section 256B.057, subdivision 9, paragraph (c).
115.21    (b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
115.2215.
115.23EFFECTIVE DATE.This section is effective October 1, 2011.

115.24    Sec. 20. Minnesota Statutes 2010, section 256B.056, subdivision 4, is amended to read:
115.25    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
115.26section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
115.27the federal poverty guidelines. Effective January 1, 2000, and each successive January,
115.28recipients of supplemental security income may have an income up to the supplemental
115.29security income standard in effect on that date.
115.30    (b) To be eligible for medical assistance, families and children may have an income
115.31up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
115.32AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
115.331996, shall be increased by three percent.
115.34    (c) Effective July 1, 2002, to be eligible for medical assistance, families and children
115.35may have an income up to 100 percent of the federal poverty guidelines for the family size.
116.1    (d) To be eligible for medical assistance under section 256B.055, subdivision 15, a
116.2person may have an income up to 75 percent of federal poverty guidelines for the family
116.3size.
116.4    (e) (d) In computing income to determine eligibility of persons under paragraphs
116.5(a) to (d) (c) who are not residents of long-term care facilities, the commissioner shall
116.6disregard increases in income as required by Public Law Numbers 94-566, section 503;
116.799-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration
116.8unusual medical expense payments are considered income to the recipient.
116.9EFFECTIVE DATE.This section is effective October 1, 2011.

116.10    Sec. 21. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
116.11    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
116.12to citizens of the United States, qualified noncitizens as defined in this subdivision, and
116.13other persons residing lawfully in the United States. Citizens or nationals of the United
116.14States must cooperate in obtaining satisfactory documentary evidence of citizenship or
116.15nationality according to the requirements of the federal Deficit Reduction Act of 2005,
116.16Public Law 109-171.
116.17(b) "Qualified noncitizen" means a person who meets one of the following
116.18immigration criteria:
116.19(1) admitted for lawful permanent residence according to United States Code, title 8;
116.20(2) admitted to the United States as a refugee according to United States Code,
116.21title 8, section 1157;
116.22(3) granted asylum according to United States Code, title 8, section 1158;
116.23(4) granted withholding of deportation according to United States Code, title 8,
116.24section 1253(h);
116.25(5) paroled for a period of at least one year according to United States Code, title 8,
116.26section 1182(d)(5);
116.27(6) granted conditional entrant status according to United States Code, title 8,
116.28section 1153(a)(7);
116.29(7) determined to be a battered noncitizen by the United States Attorney General
116.30according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
116.31title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
116.32(8) is a child of a noncitizen determined to be a battered noncitizen by the United
116.33States Attorney General according to the Illegal Immigration Reform and Immigrant
116.34Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
116.35Public Law 104-200; or
117.1(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
117.2Law 96-422, the Refugee Education Assistance Act of 1980.
117.3(c) All qualified noncitizens who were residing in the United States before August
117.422, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
117.5medical assistance with federal financial participation.
117.6(d) All qualified noncitizens who entered the United States on or after August 22,
117.71996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
117.8medical assistance with federal financial participation through November 30, 1996.
117.9Beginning December 1, 1996, qualified noncitizens who entered the United States
117.10on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
117.11chapter are eligible for medical assistance with federal participation for five years if they
117.12meet one of the following criteria:
117.13(i) refugees admitted to the United States according to United States Code, title 8,
117.14section 1157;
117.15(ii) persons granted asylum according to United States Code, title 8, section 1158;
117.16(iii) persons granted withholding of deportation according to United States Code,
117.17title 8, section 1253(h);
117.18(iv) veterans of the United States armed forces with an honorable discharge for
117.19a reason other than noncitizen status, their spouses and unmarried minor dependent
117.20children; or
117.21(v) persons on active duty in the United States armed forces, other than for training,
117.22their spouses and unmarried minor dependent children.
117.23Beginning December 1, 1996, qualified noncitizens who do not meet one of the
117.24criteria in items (i) to (v) are eligible for medical assistance without federal financial
117.25participation as described in paragraph (j).
117.26Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant
117.27women who are noncitizens described in paragraph (b) or (e) who are lawfully in the
117.28United States as defined in Code of Federal Regulations, title 8, section 103.12, and who
117.29otherwise meet eligibility requirements of this chapter, are eligible for medical assistance
117.30with federal financial participation as provided by the federal Children's Health Insurance
117.31Program Reauthorization Act of 2009, Public Law 111-3.
117.32(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
117.33are lawfully present in the United States, as defined in Code of Federal Regulations, title
117.348, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are
117.35eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
117.36with the United States Citizenship and Immigration Services to pursue any applicable
118.1immigration status, including citizenship, that would qualify them for medical assistance
118.2with federal financial participation.
118.3(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
118.4for medical assistance with federal financial participation through December 31, 1996.
118.5(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
118.6medical assistance without federal financial participation as described in paragraph (j).
118.7(3) Beginning December 1, 1996, persons residing in the United States prior to
118.8August 22, 1996, who were not receiving medical assistance and persons who arrived on
118.9or after August 22, 1996, are eligible for medical assistance without federal financial
118.10participation as described in paragraph (j).
118.11(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this
118.12chapter are eligible for the benefits as provided in paragraphs (g) (f) to (i) (h). For purposes
118.13of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United
118.14States Code, title 8, section 1101(a)(15).
118.15(g) (f) Payment shall also be made for care and services that are furnished to
118.16noncitizens, regardless of immigration status, who otherwise meet the eligibility
118.17requirements of this chapter, if such care and services are necessary for the treatment of an
118.18emergency medical condition, except for organ transplants and related care and services
118.19and routine prenatal care.
118.20(h) (g) For purposes of this subdivision, the term "emergency medical condition"
118.21means a medical condition that meets the requirements of United States Code, title 42,
118.22section 1396b(v).
118.23(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
118.24of an emergency medical condition are limited to the following:
118.25(i) services delivered in an emergency room or by an ambulance service licensed
118.26under chapter 144E that are directly related to the treatment of an emergency medical
118.27condition;
118.28(ii) services delivered in an inpatient hospital setting following admission from an
118.29emergency room or clinic for an acute emergency condition; and
118.30(iii) follow-up services that are directly related to the original service provided
118.31to treat the emergency medical condition and are covered by the global payment made
118.32to the provider.
118.33    (2) Services for the treatment of emergency medical conditions do not include:
118.34(i) services delivered in an emergency room or inpatient setting to treat a
118.35nonemergency condition;
118.36(ii) organ transplants and related care;
119.1(iii) services for routine prenatal care;
119.2(iv) continuing care, including long-term care, nursing facility services, home health
119.3care, adult day care, day training, or supportive living services;
119.4(v) elective surgery;
119.5(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
119.6part of an emergency room visit;
119.7(vii) preventative health care and family planning services;
119.8(viii) dialysis;
119.9(ix) chemotherapy or therapeutic radiation services;
119.10(x) rehabilitation services;
119.11(xi) physical, occupational, or speech therapy;
119.12(xii) transportation services;
119.13(xiii) case management;
119.14(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
119.15(xv) dental services;
119.16(xvi) hospice care;
119.17(xvii) audiology services and hearing aids;
119.18(xviii) podiatry services;
119.19(xix) chiropractic services;
119.20(xx) immunizations;
119.21(xxi) vision services and eyeglasses;
119.22(xxii) waiver services;
119.23(xxiii) individualized education programs; or
119.24(xxiv) chemical dependency treatment.
119.25(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
119.26nonimmigrants, or lawfully present as designated in paragraph (e) and who in the United
119.27States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by
119.28a group health plan or health insurance coverage according to Code of Federal Regulations,
119.29title 42, section 457.310, and who otherwise meet the eligibility requirements of this
119.30chapter, are eligible for medical assistance through the period of pregnancy, including
119.31labor and delivery, and 60 days postpartum, to the extent federal funds are available under
119.32title XXI of the Social Security Act, and the state children's health insurance program.
119.33(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
119.34lawfully residing in the United States as described in paragraph (e), who are ineligible
119.35for medical assistance with federal financial participation and who otherwise meet the
119.36eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
120.1assistance without federal financial participation. Qualified noncitizens as described
120.2in paragraph (d) are only eligible for medical assistance without federal financial
120.3participation for five years from their date of entry into the United States.
120.4(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
120.5services from a nonprofit center established to serve victims of torture and are otherwise
120.6ineligible for medical assistance under this chapter are eligible for medical assistance
120.7without federal financial participation. These individuals are eligible only for the period
120.8during which they are receiving services from the center. Individuals eligible under this
120.9paragraph shall not be required to participate in prepaid medical assistance.

120.10    Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
120.11subdivision to read:
120.12    Subd. 3q. Evidence-based childbirth program. (a) The commissioner shall
120.13implement a program to reduce the number of elective inductions of labor prior to 39
120.14weeks' gestation. In this subdivision, the term "elective induction of labor" means the
120.15use of artificial means to stimulate labor in a woman without the presence of a medical
120.16condition affecting the woman or the child that makes the onset of labor a medical
120.17necessity. The program must promote the implementation of policies within hospitals
120.18providing services to recipients of medical assistance or MinnesotaCare that prohibit the
120.19use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by
120.20the attending providers.
120.21(b) For all births covered by medical assistance or MinnesotaCare on or after
120.22January 1, 2012, a payment for professional services associated with the delivery of a
120.23child in a hospital must not be made unless the provider has submitted information about
120.24the nature of the labor and delivery including any induction of labor that was performed
120.25in conjunction with that specific birth. The information must be on a form prescribed by
120.26the commissioner.
120.27(c) The requirements in paragraph (b) must not apply to deliveries performed
120.28at a hospital that has policies and processes in place that have been approved by the
120.29commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process
120.30for review of hospital induction policies must be established by the commissioner and
120.31review of policies must occur at the discretion of the commissioner. The commissioner's
120.32decision to approve or rescind approval must include verification and review of items
120.33including, but not limited to:
120.34(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
121.1(2) policies that encourage providers to document and communicate with patients a
121.2final expected date of delivery by 20 weeks' gestation that includes data from ultrasound
121.3measurements as applicable;
121.4(3) policies that encourage patient education regarding elective inductions, and
121.5requires documentation of the processes used to educate patients;
121.6(4) ongoing quality improvement review as determined by the commissioner; and
121.7(5) any data that has been collected by the commissioner.
121.8(d) All hospitals must report annually to the commissioner induction information
121.9for all births that were covered by medical assistance or MinnesotaCare in a format and
121.10manner to be established by the commissioner.
121.11(e) The commissioner at any time may choose not to implement or may discontinue
121.12any or all aspects of the program if the commissioner is able to determine that hospitals
121.13representing at least 90 percent of births covered by medical assistance or MinnesotaCare
121.14have approved policies in place.
121.15EFFECTIVE DATE.This section is effective January 1, 2012.

121.16    Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to
121.17read:
121.18    Subd. 8. Physical therapy. (a) Medical assistance covers physical therapy and
121.19related services, including specialized maintenance therapy. Specialized maintenance
121.20therapy is covered for recipients age 20 and under.
121.21(b) Authorization by the commissioner is required to provide medically necessary
121.22services to a recipient beyond any of the following onetime service thresholds, or a lower
121.23threshold where one has been established by the commissioner for a specified service: (1)
121.2480 units of any approved CPT code other than modalities; (2) 20 modality sessions; and
121.25(3) three evaluations or reevaluations. Services provided by a physical therapy assistant
121.26shall be reimbursed at the same rate as services performed by a physical therapist when
121.27the services of the physical therapy assistant are provided under the direction of a physical
121.28therapist who is on the premises. Services provided by a physical therapy assistant that
121.29are provided under the direction of a physical therapist who is not on the premises shall
121.30be reimbursed at 65 percent of the physical therapist rate.
121.31EFFECTIVE DATE.This section is effective July 1, 2011, for services provided
121.32on a fee-for-service basis, and January 1, 2012, for services provided by a managed care
121.33plan or county-based purchasing plan.

122.1    Sec. 24. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to
122.2read:
122.3    Subd. 8a. Occupational therapy. (a) Medical assistance covers occupational
122.4therapy and related services, including specialized maintenance therapy. Specialized
122.5maintenance therapy is covered for recipients age 20 and under.
122.6(b) Authorization by the commissioner is required to provide medically necessary
122.7services to a recipient beyond any of the following onetime service thresholds, or a lower
122.8threshold where one has been established by the commissioner for a specified service:
122.9(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or
122.10reevaluations. Services provided by an occupational therapy assistant shall be reimbursed
122.11at the same rate as services performed by an occupational therapist when the services of
122.12the occupational therapy assistant are provided under the direction of the occupational
122.13therapist who is on the premises. Services provided by an occupational therapy assistant
122.14that are provided under the direction of an occupational therapist who is not on the
122.15premises shall be reimbursed at 65 percent of the occupational therapist rate.
122.16EFFECTIVE DATE.This section is effective July 1, 2011, for services provided
122.17on a fee-for-service basis, and January 1, 2012, for services provided by a managed care
122.18plan or county-based purchasing plan.

122.19    Sec. 25. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to
122.20read:
122.21    Subd. 8b. Speech-language pathology and audiology services. (a) Medical
122.22assistance covers speech-language pathology and related services, including specialized
122.23maintenance therapy. Specialized maintenance therapy is covered for recipients age
122.2420 and under.
122.25(b) Authorization by the commissioner is required to provide medically necessary
122.26speech-language pathology services to a recipient beyond any of the following
122.27onetime service thresholds, or a lower threshold where one has been established by the
122.28commissioner for a specified service: (1) 50 treatment sessions with any combination of
122.29approved CPT codes; and (2) one evaluation.
122.30(c) Medical assistance covers audiology services and related services. Services
122.31provided by a person who has been issued a temporary registration under section
122.32148.5161 shall be reimbursed at the same rate as services performed by a speech-language
122.33pathologist or audiologist as long as the requirements of section 148.5161, subdivision
122.343 , are met.
123.1EFFECTIVE DATE.This section is effective July 1, 2011, for services provided
123.2on a fee-for-service basis, and January 1, 2012, for services provided by a managed care
123.3plan or county-based purchasing plan.

123.4    Sec. 26. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to
123.5read:
123.6    Subd. 8c. Care management; rehabilitation services. (a) Effective July 1, 1999,
123.7onetime thresholds shall replace annual thresholds for provision of rehabilitation services
123.8described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in
123.9amount and description as the thresholds prescribed by the Department of Human Services
123.10health care programs provider manual for calendar year 1997, except they will not be
123.11renewed annually, and they will include sensory skills and cognitive training skills.
123.12(b) A care management approach for authorization of rehabilitation services beyond
123.13the threshold described in subdivisions 8, 8a, and 8b shall be instituted in conjunction
123.14with the onetime thresholds. The care management approach shall require the provider
123.15and the department rehabilitation reviewer to work together directly through written
123.16communication, or telephone communication when appropriate, to establish a medically
123.17necessary care management plan. Authorization for rehabilitation services shall include
123.18approval for up to 12 months of services at a time without additional documentation from
123.19the provider during the extended period, when the rehabilitation services are medically
123.20necessary due to an ongoing health condition.
123.21(c) The commissioner shall implement an expedited five-day turnaround time to
123.22review authorization requests for recipients who need emergency rehabilitation services
123.23and who have exhausted their onetime threshold limit for those services.
123.24EFFECTIVE DATE.This section is effective July 1, 2011.

123.25    Sec. 27. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to
123.26read:
123.27    Subd. 8e. Chiropractic services. Payment for chiropractic services is limited to
123.28one annual evaluation and 12 24 visits per year unless prior authorization of a greater
123.29number of visits is obtained.

123.30    Sec. 28. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
123.31subdivision to read:
123.32    Subd. 8f. Acupuncture services. Medical assistance covers acupuncture, as defined
123.33in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by
124.1another Minnesota licensed practitioner for whom acupuncture is within the practitioner's
124.2scope of practice and who has specific acupuncture training or credentialing.

124.3    Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to
124.4read:
124.5    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
124.6shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
124.7or the maximum allowable cost set by the federal government or by the commissioner
124.8plus the fixed dispensing fee; or the usual and customary price charged to the public. The
124.9amount of payment basis must be reduced to reflect all discount amounts applied to the
124.10charge by any provider/insurer agreement or contract for submitted charges to medical
124.11assistance programs. The net submitted charge may not be greater than the patient liability
124.12for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
124.13for intravenous solutions which must be compounded by the pharmacist shall be $8 per
124.14bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
124.15nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
124.16nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
124.17includes quantity and other special discounts except time and cash discounts. Effective
124.18July 1, 2009, The actual acquisition cost of a drug shall be estimated by the commissioner,
124.19at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic
124.20factor drugs shall be estimated at the average wholesale price minus 30 percent. wholesale
124.21acquisition cost plus four percent for independently owned pharmacies located in a
124.22designated rural area within Minnesota, and at wholesale acquisition cost plus two percent
124.23for all other pharmacies. A pharmacy is "independently owned" if it is one of four or
124.24fewer pharmacies under the same ownership nationally. A "designated rural area" means
124.25an area defined as a small rural area or isolated rural area according to the four-category
124.26classification of the Rural Urban Commuting Area system developed for the United States
124.27Health Resources and Services Administration. Wholesale acquisition cost is defined as
124.28the manufacturer's list price for a drug or biological to wholesalers or direct purchasers
124.29in the United States, not including prompt pay or other discounts, rebates, or reductions
124.30in price, for the most recent month for which information is available, as reported in
124.31wholesale price guides or other publications of drug or biological pricing data. The
124.32maximum allowable cost of a multisource drug may be set by the commissioner and it
124.33shall be comparable to, but no higher than, the maximum amount paid by other third-party
124.34payors in this state who have maximum allowable cost programs. Establishment of the
125.1amount of payment for drugs shall not be subject to the requirements of the Administrative
125.2Procedure Act.
125.3    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
125.4to pharmacists for legend drug prescriptions dispensed to residents of long-term care
125.5facilities when a unit dose blister card system, approved by the department, is used. Under
125.6this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
125.7The National Drug Code (NDC) from the drug container used to fill the blister card must
125.8be identified on the claim to the department. The unit dose blister card containing the
125.9drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
125.10that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
125.11will be required to credit the department for the actual acquisition cost of all unused
125.12drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
125.13manufacturer's unopened package. The commissioner may permit the drug clozapine to be
125.14dispensed in a quantity that is less than a 30-day supply.
125.15    (c) Whenever a maximum allowable cost has been set for a multisource drug,
125.16payment shall be on the basis of the lower of the usual and customary price charged
125.17to the public or the maximum allowable cost established by the commissioner unless
125.18prior authorization for the brand name product has been granted according to the criteria
125.19established by the Drug Formulary Committee as required by subdivision 13f, paragraph
125.20(a), and the prescriber has indicated "dispense as written" on the prescription in a manner
125.21consistent with section 151.21, subdivision 2.
125.22    (d) The basis for determining the amount of payment for drugs administered in an
125.23outpatient setting shall be the lower of the usual and customary cost submitted by the
125.24provider or the amount established for Medicare by the 106 percent of the average sales
125.25price as determined by the United States Department of Health and Human Services
125.26pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales
125.27price is unavailable, the amount of payment must be lower of the usual and customary cost
125.28submitted by the provider or the wholesale acquisition cost.
125.29    (e) The commissioner may negotiate lower reimbursement rates for specialty
125.30pharmacy products than the rates specified in paragraph (a). The commissioner may
125.31require individuals enrolled in the health care programs administered by the department
125.32to obtain specialty pharmacy products from providers with whom the commissioner has
125.33negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
125.34used by a small number of recipients or recipients with complex and chronic diseases
125.35that require expensive and challenging drug regimens. Examples of these conditions
125.36include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
126.1C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
126.2of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
126.3biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
126.4that require complex care. The commissioner shall consult with the formulary committee
126.5to develop a list of specialty pharmacy products subject to this paragraph. In consulting
126.6with the formulary committee in developing this list, the commissioner shall take into
126.7consideration the population served by specialty pharmacy products, the current delivery
126.8system and standard of care in the state, and access to care issues. The commissioner shall
126.9have the discretion to adjust the reimbursement rate to prevent access to care issues.
126.10(f) Home infusion therapy services provided by home infusion therapy pharmacies
126.11must be paid at rates according to subdivision 8d.
126.12EFFECTIVE DATE.This section is effective July 1, 2011, or upon federal
126.13approval, whichever is later.

126.14    Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to
126.15read:
126.16    Subd. 13h. Medication therapy management services. (a) Medical assistance
126.17and general assistance medical care cover medication therapy management services for
126.18a recipient taking four three or more prescriptions to treat or prevent two one or more
126.19chronic medical conditions, or; a recipient with a drug therapy problem that is identified
126.20by the commissioner or identified by a pharmacist and approved by the commissioner; or
126.21prior authorized by the commissioner that has resulted or is likely to result in significant
126.22nondrug program costs. The commissioner may cover medical therapy management
126.23services under MinnesotaCare if the commissioner determines this is cost-effective. For
126.24purposes of this subdivision, "medication therapy management" means the provision
126.25of the following pharmaceutical care services by a licensed pharmacist to optimize the
126.26therapeutic outcomes of the patient's medications:
126.27    (1) performing or obtaining necessary assessments of the patient's health status;
126.28    (2) formulating a medication treatment plan;
126.29    (3) monitoring and evaluating the patient's response to therapy, including safety
126.30and effectiveness;
126.31    (4) performing a comprehensive medication review to identify, resolve, and prevent
126.32medication-related problems, including adverse drug events;
126.33    (5) documenting the care delivered and communicating essential information to
126.34the patient's other primary care providers;
127.1    (6) providing verbal education and training designed to enhance patient
127.2understanding and appropriate use of the patient's medications;
127.3    (7) providing information, support services, and resources designed to enhance
127.4patient adherence with the patient's therapeutic regimens; and
127.5    (8) coordinating and integrating medication therapy management services within the
127.6broader health care management services being provided to the patient.
127.7Nothing in this subdivision shall be construed to expand or modify the scope of practice of
127.8the pharmacist as defined in section 151.01, subdivision 27.
127.9    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
127.10must meet the following requirements:
127.11    (1) have a valid license issued under chapter 151;
127.12    (2) have graduated from an accredited college of pharmacy on or after May 1996, or
127.13completed a structured and comprehensive education program approved by the Board of
127.14Pharmacy and the American Council of Pharmaceutical Education for the provision and
127.15documentation of pharmaceutical care management services that has both clinical and
127.16didactic elements;
127.17    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
127.18have developed a structured patient care process that is offered in a private or semiprivate
127.19patient care area that is separate from the commercial business that also occurs in the
127.20setting, or in home settings, excluding including long-term care and settings, group homes,
127.21if the service is ordered by the provider-directed care coordination team and facilities
127.22providing assisted living services, but excluding skilled nursing facilities; and
127.23    (4) make use of an electronic patient record system that meets state standards.
127.24    (c) For purposes of reimbursement for medication therapy management services,
127.25the commissioner may enroll individual pharmacists as medical assistance and general
127.26assistance medical care providers. The commissioner may also establish contact
127.27requirements between the pharmacist and recipient, including limiting the number of
127.28reimbursable consultations per recipient.
127.29(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
127.30within a reasonable geographic distance of the patient, a pharmacist who meets the
127.31requirements may provide the services via two-way interactive video. Reimbursement
127.32shall be at the same rates and under the same conditions that would otherwise apply to
127.33the services provided. To qualify for reimbursement under this paragraph, the pharmacist
127.34providing the services must meet the requirements of paragraph (b), and must be located
127.35within an ambulatory care setting approved by the commissioner. The patient must also
128.1be located within an ambulatory care setting approved by the commissioner. Services
128.2provided under this paragraph may not be transmitted into the patient's residence.
128.3(e) The commissioner shall establish a pilot project for an intensive medication
128.4therapy management program for patients identified by the commissioner with multiple
128.5chronic conditions and a high number of medications who are at high risk of preventable
128.6hospitalizations, emergency room use, medication complications, and suboptimal
128.7treatment outcomes due to medication-related problems. For purposes of the pilot
128.8project, medication therapy management services may be provided in a patient's home
128.9or community setting, in addition to other authorized settings. The commissioner may
128.10waive existing payment policies and establish special payment rates for the pilot project.
128.11The pilot project must be designed to produce a net savings to the state compared to the
128.12estimated costs that would otherwise be incurred for similar patients without the program.
128.13The pilot project must begin by January 1, 2010, and end June 30, 2012.
128.14EFFECTIVE DATE.This section is effective July 1, 2011.

128.15    Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
128.16read:
128.17    Subd. 17. Transportation costs. (a) Medical assistance covers medical
128.18transportation costs incurred solely for obtaining emergency medical care or transportation
128.19costs incurred by eligible persons in obtaining emergency or nonemergency medical
128.20care when paid directly to an ambulance company, common carrier, or other recognized
128.21providers of transportation services. Medical transportation must be provided by:
128.22(1) an ambulance, as defined in section 144E.001, subdivision 2;
128.23(2) special transportation; or
128.24(3) common carrier including, but not limited to, bus, taxicab, other commercial
128.25carrier, or private automobile.
128.26(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
128.27part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
128.28would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
128.29transportation, or private automobile.
128.30The commissioner may use an order by the recipient's attending physician to certify that
128.31the recipient requires special transportation services. Special transportation providers shall
128.32perform driver-assisted services for eligible individuals. Driver-assisted service includes
128.33passenger pickup at and return to the individual's residence or place of business, assistance
128.34with admittance of the individual to the medical facility, and assistance in passenger
128.35securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation
129.1providers must obtain written documentation from the health care service provider who
129.2is serving the recipient being transported, identifying the time that the recipient arrived.
129.3Special transportation providers may not bill for separate base rates for the continuation of
129.4a trip beyond the original destination. Special transportation providers must take recipients
129.5to the nearest appropriate health care provider, using the most direct route. The minimum
129.6medical assistance reimbursement rates for special transportation services are:
129.7(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
129.8eligible persons who need a wheelchair-accessible van;
129.9(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
129.10eligible persons who do not need a wheelchair-accessible van; and
129.11(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
129.12special transportation services to eligible persons who need a stretcher-accessible vehicle;
129.13(2) the base rates for special transportation services in areas defined under RUCA
129.14to be super rural shall be equal to the reimbursement rate established in clause (1) plus
129.1511.3 percent; and
129.16(3) for special transportation services in areas defined under RUCA to be rural
129.17or super rural areas:
129.18(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
129.19percent of the respective mileage rate in clause (1); and
129.20(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
129.21112.5 percent of the respective mileage rate in clause (1).
129.22(c) For purposes of reimbursement rates for special transportation services under
129.23paragraph (b), the zip code of the recipient's place of residence shall determine whether
129.24the urban, rural, or super rural reimbursement rate applies.
129.25(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
129.26means a census-tract based classification system under which a geographical area is
129.27determined to be urban, rural, or super rural.
129.28(e) Effective for services provided on or after July 1, 2011, nonemergency
129.29transportation rates, including special transportation, taxi, and other commercial carriers,
129.30are reduced 4.5 percent. Payments made to managed care plans and county-based
129.31purchasing plans must be reduced for services provided on or after January 1, 2012,
129.32to reflect this reduction.

129.33    Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to
129.34read:
130.1    Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
130.2ambulance services. Providers shall bill ambulance services according to Medicare
130.3criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
130.4for services rendered on or after July 1, 2001, medical assistance payments for ambulance
130.5services shall be paid at the Medicare reimbursement rate or at the medical assistance
130.6payment rate in effect on July 1, 2000, whichever is greater.
130.7(b) Effective for services provided on or after July 1, 2011, ambulance services
130.8payment rates are reduced 4.5 percent. Payments made to managed care plans and
130.9county-based purchasing plans must be reduced for services provided on or after January
130.101, 2012, to reflect this reduction.

130.11    Sec. 33. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to
130.12read:
130.13    Subd. 18. Bus or taxicab transportation. To the extent authorized by rule of the
130.14state agency, medical assistance covers costs of the most appropriate and cost-effective
130.15form of transportation incurred by any ambulatory eligible person for obtaining
130.16nonemergency medical care.

130.17    Sec. 34. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
130.18subdivision to read:
130.19    Subd. 25b. Authorization with third-party liability. (a) Except as otherwise
130.20allowed under this subdivision or required under federal or state regulations, the
130.21commissioner must not consider a request for authorization of a service when the recipient
130.22has coverage from a third-party payer unless the provider requesting authorization has
130.23made a good faith effort to receive payment or authorization from the third-party payer.
130.24A good faith effort is established by supplying with the authorization request to the
130.25commissioner the following:
130.26(1) a determination of payment for the service from the third-party payer, a
130.27determination of authorization for the service from the third-party payer, or a verification
130.28of noncoverage of the service by the third-party payer; and
130.29(2) the information or records required by the department to document the reason for
130.30the determination or to validate noncoverage from the third-party payer.
130.31(b) A provider requesting authorization for services covered by Medicare is not
130.32required to bill Medicare before requesting authorization from the commissioner if the
130.33provider has reason to believe that a service covered by Medicare is not eligible for
130.34payment. The provider must document that, because of recent claim experiences with
131.1Medicare or because of written communication from Medicare, coverage is not available
131.2for the service.
131.3(c) Authorization is not required if a third-party payer has made payment that is
131.4equal to or greater than 60 percent of the maximum payment amount for the service
131.5allowed under medical assistance.

131.6    Sec. 35. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to
131.7read:
131.8    Subd. 31a. Augmentative and alternative communication systems. (a) Medical
131.9assistance covers augmentative and alternative communication systems consisting of
131.10electronic or nonelectronic devices and the related components necessary to enable a
131.11person with severe expressive communication limitations to produce or transmit messages
131.12or symbols in a manner that compensates for that disability.
131.13(b) Until the volume of systems purchased increases to allow a discount price, the
131.14commissioner shall reimburse augmentative and alternative communication manufacturers
131.15and vendors at the manufacturer's suggested retail price for augmentative and alternative
131.16communication systems and related components. The commissioner shall separately
131.17reimburse providers for purchasing and integrating individual communication systems
131.18which are unavailable as a package from an augmentative and alternative communication
131.19vendor. Augmentative and alternative communication systems must be paid the lower
131.20of the:
131.21(1) submitted charge; or
131.22(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
131.23manufacturers of augmentative and alternative communication systems; or
131.24(ii) manufacturer's invoice charge plus 20 percent for providers that are not
131.25manufacturers of augmentative and alternative communication systems.
131.26(c) Reimbursement rates established by this purchasing program are not subject to
131.27Minnesota Rules, part 9505.0445, item S or T.

131.28    Sec. 36. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
131.29subdivision to read:
131.30    Subd. 55. Payment for noncovered services. (a) Except when specifically
131.31prohibited by the commissioner or federal law, a provider may seek payment from the
131.32recipient for services not eligible for payment under the medical assistance program when
131.33the provider, prior to delivering the service, reviews and considers all other available
131.34covered alternatives with the recipient and obtains a signed acknowledgment from the
132.1recipient of the potential of the recipient's liability. The signed acknowledgment must be
132.2in a form approved by the commissioner.
132.3(b) Conditions under which a provider must not request payment from the recipient
132.4include, but are not limited to:
132.5(1) a service that requires prior authorization, unless authorization has been denied
132.6as not medically necessary and all other therapeutic alternatives have been reviewed;
132.7(2) a service for which payment has been denied for reasons relating to billing
132.8requirements;
132.9(3) standard shipping or delivery and setup of medical equipment or medical
132.10supplies;
132.11(4) services that are included in the recipient's long term care per diem;
132.12(5) the recipient is enrolled in the Restricted Recipient Program and the provider is
132.13one of a provider type designated for the recipient's health care services; and
132.14(6) the noncovered service is a prescriptive drug identified by the commissioner as
132.15having the potential for abuse and overuse, except where payment by the recipient is
132.16specifically approved by the commissioner on the date of service based upon compelling
132.17evidence supplied by the prescribing provider that establishes medical necessity for that
132.18particular drug.
132.19(c) The payment requested from recipients for noncovered services under this
132.20subdivision must not exceed the provider's usual and customary charge for the actual
132.21service received by the recipient. A recipient must not be billed for the difference between
132.22what medical assistance paid for the service or would pay for a less costly alternative
132.23service.

132.24    Sec. 37. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
132.25subdivision to read:
132.26    Subd. 56. Medical service coordination. (a) Medical assistance covers in-reach
132.27community-based service coordination that is performed in a hospital emergency
132.28department as an eligible procedure under a state healthcare program or private insurance
132.29for a frequent user. A frequent user is defined as an individual who has frequented the
132.30hospital emergency department for services three or more times in the previous four
132.31consecutive months. In-reach community-based service coordination includes navigating
132.32services to address a client's mental health, chemical health, social, economic, and housing
132.33needs, or any other activity targeted at reducing the incidence of emergency room and
132.34other nonmedically necessary health care utilization.
133.1(b) Reimbursement must be made in 15-minute increments under current Medicaid
133.2mental health social work reimbursement methodology and allowed for up to 60 days
133.3posthospital discharge based upon the specific identified emergency department visit or
133.4inpatient admitting event. A frequent user who is participating in care coordination within
133.5a health care home framework is ineligible for reimbursement under this subdivision.
133.6Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in
133.7social work, public health, corrections, or a related field. The commissioner shall submit
133.8any necessary application for waivers to the Centers for Medicare and Medicaid Services
133.9to implement this subdivision.
133.10(c) For the purposes of this subdivision, "in-reach community-based service
133.11coordination" means the practice of a community-based worker with training, knowledge,
133.12skills, and ability to access a continuum of services, including housing, transportation,
133.13chemical and mental health treatment, employment, and peer support services, by working
133.14with an organization's staff to transition an individual back into the individual's living
133.15environment. In-reach community-based service coordination includes working with the
133.16individual during their discharge and for up to a defined amount of time in the individual's
133.17living environment, reducing the individual's need for readmittance.

133.18    Sec. 38. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
133.19subdivision to read:
133.20    Subd. 57. Payment for Part B Medicare crossover claims. Effective for services
133.21provided on or after January 1, 2012, medical assistance payment for an enrollee's cost
133.22sharing associated with Medicare Part B is limited to an amount up to the medical
133.23assistance total allowed, when the medical assistance rate exceeds the amount paid by
133.24Medicare.
133.25EFFECTIVE DATE.This section is effective January 1, 2012.

133.26    Sec. 39. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
133.27subdivision to read:
133.28    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
133.29Medical assistance covers early and periodic screening, diagnosis, and treatment services
133.30(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate
133.31established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

133.32    Sec. 40. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
133.33subdivision to read:
134.1    Subd. 59. Services provided by advanced dental therapists and dental
134.2therapists. Medical assistance covers services provided by advanced dental therapists
134.3and dental therapists when provided within the scope of practice identified in sections
134.4150A.105 and 150A.106.

134.5    Sec. 41. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to
134.6read:
134.7    Subdivision 1. Co-payments Cost-sharing. (a) Except as provided in subdivision
134.82, the medical assistance benefit plan shall include the following co-payments cost-sharing
134.9for all recipients, effective for services provided on or after October 1, 2003, and before
134.10January 1, 2009 July 1, 2011:
134.11    (1) $3 per nonpreventive visit, except as provided in paragraph (c). For purposes
134.12of this subdivision, a visit means an episode of service which is required because of
134.13a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
134.14ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
134.15midwife, advanced practice nurse, audiologist, optician, or optometrist;
134.16    (2) $3 for eyeglasses;
134.17    (3) $6 $3.50 for nonemergency visits to a hospital-based emergency room, except
134.18that this co-payment shall be increased to $20 upon federal approval; and
134.19    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
134.20subject to a $12 per month maximum for prescription drug co-payments. No co-payments
134.21shall apply to antipsychotic drugs when used for the treatment of mental illness.;
134.22(5) a family deductible equal to the maximum amount allowed under Code of
134.23Federal Regulations, title 42, part 447.54; and
134.24    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall
134.25include the following co-payments for all recipients, effective for services provided on
134.26or after January 1, 2009:
134.27    (1) $3.50 for nonemergency visits to a hospital-based emergency room;
134.28    (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
134.29subject to a $7 per month maximum for prescription drug co-payments. No co-payments
134.30shall apply to antipsychotic drugs when used for the treatment of mental illness; and
134.31    (3) (6) for individuals identified by the commissioner with income at or below 100
134.32percent of the federal poverty guidelines, total monthly co-payments cost-sharing must
134.33not exceed five percent of family income. For purposes of this paragraph, family income
134.34is the total earned and unearned income of the individual and the individual's spouse, if
135.1the spouse is enrolled in medical assistance and also subject to the five percent limit on
135.2co-payments cost-sharing.
135.3    (c) (b) Recipients of medical assistance are responsible for all co-payments and
135.4deductibles in this subdivision.
135.5(c) Effective January 1, 2012, or upon federal approval, whichever is later, the
135.6following co-payments for nonpreventive visits shall apply to providers included in
135.7provider peer grouping:
135.8(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of
135.9care per medical assistance enrollee is at the 60th percentile or lower for providers of
135.10the same type;
135.11(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care
135.12per medical assistance enrollee is greater than the 60th percentile but does not exceed the
135.1380th percentile for providers of the same type; and
135.14(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of
135.15care per medical assistance enrollee is greater than the 80th percentile for providers of
135.16the same type.
135.17Each managed care and county-based purchasing plan shall calculate the average,
135.18risk-adjusted, total annual cost of care for providers under this paragraph using a
135.19methodology approved by the commissioner. The commissioner shall develop a
135.20methodology for calculating the average, risk-adjusted, total annual cost of care for
135.21fee-for-service providers.
135.22(d) The commissioner shall seek any federal waivers and approvals necessary to
135.23increase the co-payment for nonemergency visits to a hospital-based emergency room
135.24under paragraph (a), clause (3), and to implement paragraph (c).

135.25    Sec. 42. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to
135.26read:
135.27    Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following
135.28exceptions:
135.29(1) children under the age of 21;
135.30(2) pregnant women for services that relate to the pregnancy or any other medical
135.31condition that may complicate the pregnancy;
135.32(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
135.33intermediate care facility for the developmentally disabled;
135.34(4) recipients receiving hospice care;
135.35(5) 100 percent federally funded services provided by an Indian health service;
136.1(6) emergency services;
136.2(7) family planning services;
136.3(8) services that are paid by Medicare, resulting in the medical assistance program
136.4paying for the coinsurance and deductible; and
136.5(9) co-payments that exceed one per day per provider for nonpreventive visits,
136.6eyeglasses, and nonemergency visits to a hospital-based emergency room.

136.7    Sec. 43. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to
136.8read:
136.9    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider shall
136.10be reduced by the amount of the co-payment or deductible, except that reimbursements
136.11shall not be reduced:
136.12    (1) once a recipient has reached the $12 per month maximum or the $7 per month
136.13maximum effective January 1, 2009, for prescription drug co-payments; or
136.14    (2) for a recipient identified by the commissioner under 100 percent of the federal
136.15poverty guidelines who has met their monthly five percent co-payment cost-sharing limit.
136.16    (b) The provider collects the co-payment or deductible from the recipient. Providers
136.17may not deny services to recipients who are unable to pay the co-payment or deductible.
136.18    (c) Medical assistance reimbursement to fee-for-service providers and payments to
136.19managed care plans shall not be increased as a result of the removal of co-payments or
136.20deductibles effective on or after January 1, 2009.

136.21    Sec. 44. Minnesota Statutes 2010, section 256B.0644, is amended to read:
136.22256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
136.23PROGRAMS.
136.24    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
136.25health maintenance organization, as defined in chapter 62D, must participate as a provider
136.26or contractor in the medical assistance program, general assistance medical care program,
136.27and MinnesotaCare as a condition of participating as a provider in health insurance plans
136.28and programs or contractor for state employees established under section 43A.18, the
136.29public employees insurance program under section 43A.316, for health insurance plans
136.30offered to local statutory or home rule charter city, county, and school district employees,
136.31the workers' compensation system under section 176.135, and insurance plans provided
136.32through the Minnesota Comprehensive Health Association under sections 62E.01 to
136.3362E.19 . The limitations on insurance plans offered to local government employees shall
137.1not be applicable in geographic areas where provider participation is limited by managed
137.2care contracts with the Department of Human Services.
137.3    (b) For providers other than health maintenance organizations, participation in the
137.4medical assistance program means that:
137.5     (1) the provider accepts new medical assistance, general assistance medical care,
137.6and MinnesotaCare patients;
137.7    (2) for providers other than dental service providers, at least 20 percent of the
137.8provider's patients are covered by medical assistance, general assistance medical care,
137.9and MinnesotaCare as their primary source of coverage; or
137.10    (3) for dental service providers, at least ten percent of the provider's patients are
137.11covered by medical assistance, general assistance medical care, and MinnesotaCare as
137.12their primary source of coverage, or the provider accepts new medical assistance and
137.13MinnesotaCare patients who are children with special health care needs. For purposes
137.14of this section, "children with special health care needs" means children up to age 18
137.15who: (i) require health and related services beyond that required by children generally;
137.16and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
137.17condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
137.18cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
137.19neurological diseases; visual impairment or deafness; Down syndrome and other genetic
137.20disorders; autism; fetal alcohol syndrome; and other conditions designated by the
137.21commissioner after consultation with representatives of pediatric dental providers and
137.22consumers.
137.23    (c) Patients seen on a volunteer basis by the provider at a location other than
137.24the provider's usual place of practice may be considered in meeting the participation
137.25requirement in this section. The commissioner shall establish participation requirements
137.26for health maintenance organizations. The commissioner shall provide lists of participating
137.27medical assistance providers on a quarterly basis to the commissioner of management and
137.28budget, the commissioner of labor and industry, and the commissioner of commerce. Each
137.29of the commissioners shall develop and implement procedures to exclude as participating
137.30providers in the program or programs under their jurisdiction those providers who do
137.31not participate in the medical assistance program. The commissioner of management
137.32and budget shall implement this section through contracts with participating health and
137.33dental carriers.
137.34    (d) For purposes of paragraphs (a) and (b), participation in the general assistance
137.35medical care program applies only to pharmacy providers.
138.1    (e) A provider described in section 256B.76, subdivision 5, may limit the eligibility
138.2of new medical assistance, general assistance medical care, and MinnesotaCare patients
138.3for specific categories of rehabilitative services, if medical assistance, general assistance
138.4medical care, and MinnesotaCare patients served by the provider in the aggregate exceed
138.530 percent of the provider's overall patient population.

138.6    Sec. 45. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to
138.7read:
138.8    Subd. 4. Alternative models and waivers of requirements. (a) Nothing in this
138.9section shall preclude the continued development of existing medical or health care
138.10home projects currently operating or under development by the commissioner of human
138.11services or preclude the commissioner from establishing alternative models and payment
138.12mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs
138.13under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term
138.14care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and
138.15medical assistance, are in the waiting period for Medicare, or who have other primary
138.16coverage.
138.17(b) The commissioner of health shall waive health care home certification
138.18requirements if an applicant demonstrates that compliance with a certification requirement
138.19will create a major financial hardship or is not feasible, and the applicant establishes an
138.20alternative way to accomplish the objectives of the certification requirement.

138.21    Sec. 46. Minnesota Statutes 2010, section 256B.0751, is amended by adding a
138.22subdivision to read:
138.23    Subd. 8. Coordination with local services. The health care home and the county
138.24shall coordinate care and services provided to patients enrolled with a health care home
138.25who have complex medical needs or a disability, and who need and are eligible for
138.26additional local services administered by counties, including but not limited to waivered
138.27services, mental health services, social services, public health services, transportation, and
138.28housing. The coordination of care and services must be as provided in the plan established
138.29by the patient and health care home.

138.30    Sec. 47. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
138.31    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
138.32and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
138.33January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
139.1renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
139.231, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
139.3issue separate contracts with requirements specific to services to medical assistance
139.4recipients age 65 and older.
139.5    (b) A prepaid health plan providing covered health services for eligible persons
139.6pursuant to chapters 256B and 256L is responsible for complying with the terms of its
139.7contract with the commissioner. Requirements applicable to managed care programs
139.8under chapters 256B and 256L established after the effective date of a contract with the
139.9commissioner take effect when the contract is next issued or renewed.
139.10    (c) Effective for services rendered on or after January 1, 2003, the commissioner
139.11shall withhold five percent of managed care plan payments under this section and
139.12county-based purchasing plan payments under section 256B.692 for the prepaid medical
139.13assistance program pending completion of performance targets. Each performance target
139.14must be quantifiable, objective, measurable, and reasonably attainable, except in the case
139.15of a performance target based on a federal or state law or rule. Criteria for assessment
139.16of each performance target must be outlined in writing prior to the contract effective
139.17date. The managed care plan must demonstrate, to the commissioner's satisfaction,
139.18that the data submitted regarding attainment of the performance target is accurate. The
139.19commissioner shall periodically change the administrative measures used as performance
139.20targets in order to improve plan performance across a broader range of administrative
139.21services. The performance targets must include measurement of plan efforts to contain
139.22spending on health care services and administrative activities. The commissioner may
139.23adopt plan-specific performance targets that take into account factors affecting only one
139.24plan, including characteristics of the plan's enrollee population. The withheld funds
139.25must be returned no sooner than July of the following year if performance targets in the
139.26contract are achieved. The commissioner may exclude special demonstration projects
139.27under subdivision 23.
139.28    (d) Effective for services rendered on or after January 1, 2009, through December
139.2931, 2009, the commissioner shall withhold three percent of managed care plan payments
139.30under this section and county-based purchasing plan payments under section 256B.692
139.31for the prepaid medical assistance program. The withheld funds must be returned no
139.32sooner than July 1 and no later than July 31 of the following year. The commissioner may
139.33exclude special demonstration projects under subdivision 23.
139.34(e) Effective for services provided on or after January 1, 2010, the commissioner
139.35shall require that managed care plans use the assessment and authorization processes,
139.36forms, timelines, standards, documentation, and data reporting requirements, protocols,
140.1billing processes, and policies consistent with medical assistance fee-for-service or the
140.2Department of Human Services contract requirements consistent with medical assistance
140.3fee-for-service or the Department of Human Services contract requirements for all
140.4personal care assistance services under section 256B.0659.
140.5(f) Effective for services rendered on or after January 1, 2010, through December
140.631, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
140.7under this section and county-based purchasing plan payments under section 256B.692
140.8for the prepaid medical assistance program. The withheld funds must be returned no
140.9sooner than July 1 and no later than July 31 of the following year. The commissioner may
140.10exclude special demonstration projects under subdivision 23.
140.11(g) Effective for services rendered on or after January 1, 2011, the commissioner
140.12shall include as part of the performance targets described in paragraph (c) a reduction in
140.13the health plan's emergency room utilization rate for state health care program enrollees
140.14by a measurable rate of five percent from the plan's utilization rate for state health care
140.15program enrollees for the previous calendar year.
140.16The withheld funds must be returned no sooner than July 1 and no later than July 31
140.17of the following calendar year if the managed care plan demonstrates to the satisfaction of
140.18the commissioner that a reduction in the utilization rate was achieved.
140.19The withhold described in this paragraph shall continue for each consecutive
140.20contract period until the plan's emergency room utilization rate for state health care
140.21program enrollees is reduced by 25 percent of the plan's emergency room utilization
140.22rate for state health care program enrollees for calendar year 2009. Hospitals shall
140.23cooperate with the health plans in meeting this performance target and shall accept
140.24payment withholds that may be returned to the hospitals if the performance target is
140.25achieved. The commissioner shall structure the withhold so that the commissioner returns
140.26a portion of the withheld funds in amounts commensurate with achieved reductions in
140.27utilization less than the targeted amount. The withhold in this paragraph does not apply to
140.28county-based purchasing plans.
140.29(h) Effective for services rendered on or after January 1, 2012, the commissioner
140.30shall include as part of the performance targets described in paragraph (c) a reduction in
140.31the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous
140.32hospitalization of a patient regardless of the reason for the hospitalization for state health
140.33care program enrollees by a measurable rate of five percent from the plan's utilization rate
140.34for state health care program enrollees for the previous calendar year.
140.35The withheld funds must be returned no sooner than July 1 and no later than July 31
140.36of the following calendar year if the managed care plan or county-based purchasing plan
141.1demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
141.2rate was achieved.
141.3The withhold described in this paragraph must continue for each consecutive
141.4contract period until the plan's subsequent hospitalization rate for state health care
141.5program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
141.6for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
141.7with the plans in meeting this performance target and shall accept payment withholds that
141.8must be returned to the hospitals if the performance target is achieved. The commissioner
141.9shall structure the withhold so that the commissioner returns a portion of the withheld
141.10funds in amounts commensurate with achieved reductions in utilization less than the
141.11targeted amount.
141.12(h) (i) Effective for services rendered on or after January 1, 2011, through December
141.1331, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments
141.14under this section and county-based purchasing plan payments under section 256B.692
141.15for the prepaid medical assistance program. The withheld funds must be returned no
141.16sooner than July 1 and no later than July 31 of the following year. The commissioner may
141.17exclude special demonstration projects under subdivision 23.
141.18(i) (j) Effective for services rendered on or after January 1, 2012, through December
141.1931, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
141.20under this section and county-based purchasing plan payments under section 256B.692
141.21for the prepaid medical assistance program. The withheld funds must be returned no
141.22sooner than July 1 and no later than July 31 of the following year. The commissioner may
141.23exclude special demonstration projects under subdivision 23.
141.24(j) (k) Effective for services rendered on or after January 1, 2013, through December
141.2531, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
141.26under this section and county-based purchasing plan payments under section 256B.692
141.27for the prepaid medical assistance program. The withheld funds must be returned no
141.28sooner than July 1 and no later than July 31 of the following year. The commissioner may
141.29exclude special demonstration projects under subdivision 23.
141.30(k) (l) Effective for services rendered on or after January 1, 2014, the commissioner
141.31shall withhold three percent of managed care plan payments under this section and
141.32county-based purchasing plan payments under section 256B.692 for the prepaid medical
141.33assistance program. The withheld funds must be returned no sooner than July 1 and
141.34no later than July 31 of the following year. The commissioner may exclude special
141.35demonstration projects under subdivision 23.
142.1(l) (m) A managed care plan or a county-based purchasing plan under section
142.2256B.692 may include as admitted assets under section 62D.044 any amount withheld
142.3under this section that is reasonably expected to be returned.
142.4(m) (n) Contracts between the commissioner and a prepaid health plan are exempt
142.5from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
142.6(a), and 7.
142.7(n) (o) The return of the withhold under paragraphs (d), (f), and (h) to (k) is not
142.8subject to the requirements of paragraph (c).

142.9    Sec. 48. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:
142.10    Subd. 5c. Medical education and research fund. (a) The commissioner of human
142.11services shall transfer each year to the medical education and research fund established
142.12under section 62J.692, an amount specified in this subdivision. The commissioner shall
142.13calculate the following:
142.14(1) an amount equal to the reduction in the prepaid medical assistance payments as
142.15specified in this clause. Until January 1, 2002, the county medical assistance capitation
142.16base rate prior to plan specific adjustments and after the regional rate adjustments under
142.17subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
142.18metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
142.19January 1, 2002, the county medical assistance capitation base rate prior to plan specific
142.20adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
142.21metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
142.22facility and elderly waiver payments and demonstration project payments operating
142.23under subdivision 23 are excluded from this reduction. The amount calculated under
142.24this clause shall not be adjusted for periods already paid due to subsequent changes to
142.25the capitation payments;
142.26(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
142.27section;
142.28(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
142.29paid under this section; and
142.30(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
142.31under this section.
142.32(b) This subdivision shall be effective upon approval of a federal waiver which
142.33allows federal financial participation in the medical education and research fund. Effective
142.34July 1, 2009, and thereafter, The transfers required by amount specified under paragraph
142.35(a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009.
143.1Any excess shall first reduce the amounts otherwise required to be transferred specified
143.2under paragraph (a), clauses (2) to (4). Any excess following this reduction shall
143.3proportionally reduce the transfers amount specified under paragraph (a), clause (1).
143.4(c) Beginning July 1, 2009 2011, of the amounts amount in paragraph (a), the
143.5commissioner shall transfer $21,714,000 each fiscal year to the medical education and
143.6research fund. The balance of the transfers under paragraph (a) shall be transferred to the
143.7medical education and research fund no earlier than July 1 of the following fiscal year.
143.8(d) Beginning July 1, 2011, of the amount in paragraph (a), following the transfer
143.9under paragraph (c), the commissioner shall transfer to the medical education research
143.10fund $4,024,000 in fiscal year 2012 and $4,626,000 in fiscal year 2013 and thereafter.

143.11    Sec. 49. Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:
143.12    Subd. 28. Medicare special needs plans; medical assistance basic health care.
143.13    (a) The commissioner may contract with qualified Medicare-approved special needs
143.14plans to provide medical assistance basic health care services to persons with disabilities,
143.15including those with developmental disabilities. Basic health care services include:
143.16    (1) those services covered by the medical assistance state plan except for ICF/MR
143.17services, home and community-based waiver services, case management for persons with
143.18developmental disabilities under section 256B.0625, subdivision 20a, and personal care
143.19and certain home care services defined by the commissioner in consultation with the
143.20stakeholder group established under paragraph (d); and
143.21    (2) basic health care services may also include risk for up to 100 days of nursing
143.22facility services for persons who reside in a noninstitutional setting and home health
143.23services related to rehabilitation as defined by the commissioner after consultation with
143.24the stakeholder group.
143.25    The commissioner may exclude other medical assistance services from the basic
143.26health care benefit set. Enrollees in these plans can access any excluded services on the
143.27same basis as other medical assistance recipients who have not enrolled.
143.28    Unless a person is otherwise required to enroll in managed care, enrollment in these
143.29plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
143.30enrollment with an option to opt out is not voluntary enrollment.
143.31    (b) Beginning January 1, 2007, the commissioner may contract with qualified
143.32Medicare special needs plans to provide basic health care services under medical
143.33assistance to persons who are dually eligible for both Medicare and Medicaid and those
143.34Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
143.35The commissioner shall consult with the stakeholder group under paragraph (d) in
144.1developing program specifications for these services. The commissioner shall report to
144.2the chairs of the house of representatives and senate committees with jurisdiction over
144.3health and human services policy and finance by February 1, 2007, on implementation
144.4of these programs and the need for increased funding for the ombudsman for managed
144.5care and other consumer assistance and protections needed due to enrollment in managed
144.6care of persons with disabilities. Payment for Medicaid services provided under this
144.7subdivision for the months of May and June will be made no earlier than July 1 of the
144.8same calendar year.
144.9    (c) Notwithstanding subdivision 4, beginning January 1, 2008 2012, the
144.10commissioner may expand contracting under this subdivision to all shall enroll persons
144.11with disabilities not otherwise required to enroll in managed care under this section,
144.12unless the individual chooses to opt out of enrollment. The commissioner shall establish
144.13enrollment and opt out procedures consistent with applicable enrollment procedures under
144.14this subdivision.
144.15    (d) The commissioner shall establish a state-level stakeholder group to provide
144.16advice on managed care programs for persons with disabilities, including both MnDHO
144.17and contracts with special needs plans that provide basic health care services as described
144.18in paragraphs (a) and (b). The stakeholder group shall provide advice on program
144.19expansions under this subdivision and subdivision 23, including:
144.20    (1) implementation efforts;
144.21    (2) consumer protections; and
144.22    (3) program specifications such as quality assurance measures, data collection and
144.23reporting, and evaluation of costs, quality, and results.
144.24    (e) Each plan under contract to provide medical assistance basic health care services
144.25shall establish a local or regional stakeholder group, including representatives of the
144.26counties covered by the plan, members, consumer advocates, and providers, for advice on
144.27issues that arise in the local or regional area.
144.28    (f) The commissioner is prohibited from providing the names of potential enrollees
144.29to health plans for marketing purposes. The commissioner may shall mail no more than
144.30two sets of marketing materials per contract year to potential enrollees on behalf of health
144.31plans, in which case at the health plan's request. The marketing materials shall be mailed
144.32by the commissioner within 30 days of receipt of these materials from the health plan. The
144.33health plans shall cover any costs incurred by the commissioner for mailing marketing
144.34materials.

145.1    Sec. 50. Minnesota Statutes 2010, section 256B.69, is amended by adding a
145.2subdivision to read:
145.3    Subd. 30. Provider payment rates. (a) Each managed care and county-based plan
145.4shall, by October 1, 2011, array all providers within each provider type, employed by or
145.5under contract with the plan, by their average total annual cost of care for serving medical
145.6assistance and MinnesotaCare enrollees for the most recent reporting year for which data
145.7is available, risk-adjusted for enrollee demographics and health status.
145.8(b) Beginning January 1, 2012, and each contract year thereafter, each managed
145.9care and county-based purchasing plan shall implement a progressive payment withhold
145.10methodology for each provider type, under which the withhold for a provider increases
145.11proportionally as the provider's risk-adjusted total annual cost increases, relative to other
145.12providers of the same type. For purposes of this paragraph, the risk-adjusted total annual
145.13cost of care is the dollar amount calculated under paragraph (a).
145.14(c) At the end of each contract year, each plan shall array all providers within each
145.15provider type by their average total annual cost of care for serving medical assistance and
145.16MinnesotaCare enrollees for that contract year, risk-adjusted for enrollee demographics
145.17and health status. For each provider whose risk-adjusted total annual cost of care is at or
145.18below the 70th percentile of providers of the same type or specialty, the plan shall return
145.19the full amount of any withhold. For each provider whose risk-adjusted total annual cost
145.20of care is above the 70th percentile, the plan shall return only the portion of the withhold
145.21sufficient to bring the provider's payment rate to the average for providers within the
145.22provider type whose risk-adjusted total annual cost of care is at the 70th percentile. Each
145.23plan shall reduce provider payments only as allowed under paragraph (f).
145.24(d) Each managed care and county-based purchasing plan must establish an appeals
145.25process to allow providers to appeal determinations of risk-adjusted total annual cost of
145.26care. Each plan's appeals process must be approved by the commissioner.
145.27(e) The commissioner shall require each plan to submit to the commissioner, in
145.28the form and manner specified by the commissioner, all provider payment data and
145.29information on the withhold methodology that the commissioner determines is necessary
145.30to verify compliance with this subdivision.
145.31(f) The commissioner, for the contract year beginning January 1, 2012, shall reduce
145.32plan capitation rates by ten percent from the rates that would otherwise apply, absent
145.33application of this subdivision. The reduced rate shall be the historical base rate for
145.34negotiating capitation rates for future contract years. The commissioner may recommend
145.35additional reductions in capitation rates for future contract years to the legislature, if the
145.36commissioner determines this is necessary to ensure that health care providers under
146.1contract with managed care and county-based purchasing plans practice in an efficient
146.2manner. Effective for services rendered on or after January 1, 2012, managed care plans
146.3and county-based purchasing plans contracted with the state to administer the health
146.4care programs provided under sections 256B.69, 256B.692, and 256L.12, may reduce
146.5payments made to providers employed or under contract with the plan. However, a
146.6managed care or county-based purchasing plan is prohibited from: (1) reducing payments
146.7made to providers whose risk-adjusted total annual cost of care is at or below the 70th
146.8percentile of providers of the same type or specialty, or at or below the 80th percentile
146.9for provider types or specialties currently subject to plan care management requirements
146.10that in the aggregate are more extensive than those that apply to other provider types or
146.11specialties, or for which a majority of services are currently subject to prior authorization
146.12by the plan and (2) reducing payments to hospitals described under the Social Security
146.13Act, title 18, section 1886, subsection (d), paragraph (l), and subparagraph (B), clause (iii).
146.14(g) The commissioner of human services, in consultation with the commissioner of
146.15health, shall develop and provide to managed care and county-based purchasing plans, by
146.16September 1, 2011, standard criteria and definitions necessary for consistent calculation
146.17of the total annual risk-adjusted cost of care across plans. The commissioner may use
146.18encounter data to implement this subdivision, and may provide encounter data or analyses
146.19to plans.
146.20(h) For purposes of this subdivision, "provider" means a vendor of medical care
146.21as defined in section 256B.02, subdivision 7, for which sufficient encounter data on
146.22utilization and costs is available to implement this subdivision.
146.23(i) A managed care or county-based purchasing plan must use the methodology
146.24described in paragraphs (a) to (e), unless the plan develops an alternative model consistent
146.25with the purpose of this subdivision.
146.26EFFECTIVE DATE.This section is effective the day following final enactment.

146.27    Sec. 51. Minnesota Statutes 2010, section 256B.69, is amended by adding a
146.28subdivision to read:
146.29    Subd. 32. Health education. The commissioner shall require managed care and
146.30county-based purchasing plans, as a condition of contract, to provide health education,
146.31wellness training, and information about the availability and benefits of preventive
146.32services to all medical assistance and MinnesotaCare enrollees, beginning January 1,
146.332012. Plan initiatives developed or implemented to comply with this requirement must be
146.34approved by the commissioner.

147.1    Sec. 52. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
147.2    Subd. 4. Critical access dental providers. (a) Effective for dental services
147.3rendered on or after January 1, 2002, the commissioner shall increase reimbursements
147.4to dentists and dental clinics deemed by the commissioner to be critical access dental
147.5providers. For dental services rendered on or after July 1, 2007, the commissioner shall
147.6increase reimbursement by 30 percent above the reimbursement rate that would otherwise
147.7be paid to the critical access dental provider. The commissioner shall pay the managed
147.8care plans and county-based purchasing plans in amounts sufficient to reflect increased
147.9reimbursements to critical access dental providers as approved by the commissioner.
147.10(b) The commissioner shall designate the following dentists and dental clinics as
147.11critical access dental providers:
147.12    (1) nonprofit community clinics that:
147.13(i) have nonprofit status in accordance with chapter 317A;
147.14(ii) have tax exempt status in accordance with the Internal Revenue Code, section
147.15501(c)(3);
147.16(iii) are established to provide oral health services to patients who are low income,
147.17uninsured, have special needs, and are underserved;
147.18(iv) have professional staff familiar with the cultural background of the clinic's
147.19patients;
147.20(v) charge for services on a sliding fee scale designed to provide assistance to
147.21low-income patients based on current poverty income guidelines and family size;
147.22(vi) do not restrict access or services because of a patient's financial limitations
147.23or public assistance status; and
147.24(vii) have free care available as needed;
147.25    (2) federally qualified health centers, rural health clinics, and public health clinics;
147.26    (3) county owned and operated hospital-based dental clinics;
147.27(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
147.28accordance with chapter 317A with more than 10,000 patient encounters per year with
147.29patients who are uninsured or covered by medical assistance, general assistance medical
147.30care, or MinnesotaCare; and
147.31(5) a dental clinic associated with an oral health or dental education program owned
147.32and operated by the University of Minnesota or an institution within the Minnesota State
147.33Colleges and Universities system.
147.34     (c) The commissioner may designate a dentist or dental clinic as a critical access
147.35dental provider if the dentist or dental clinic is willing to provide care to patients covered
148.1by medical assistance, general assistance medical care, or MinnesotaCare at a level which
148.2significantly increases access to dental care in the service area.
148.3(d) Notwithstanding paragraph (a), critical access payments must not be made for
148.4dental services provided from April 1, 2010, through June 30, 2010.
148.5(e) Notwithstanding section 256B.04, subdivision 2, the commissioner of human
148.6services shall not adopt rules governing this section or section 256L.11, subdivision 7.
148.7EFFECTIVE DATE.This section is effective July 1, 2011.

148.8    Sec. 53. [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE
148.9DEMONSTRATION PROJECT.
148.10    Subdivision 1. Establishment and implementation. The commissioner of
148.11human services, in consultation with the commissioner of health, shall contract
148.12with a Minnesota-based academic and research institution specializing in providing
148.13complementary and alternative medicine education and clinical services to establish and
148.14implement a five-year demonstration project in conjunction with federally qualified health
148.15centers and federally qualified health center look-alikes as defined in section 145.9269, to
148.16improve the quality and cost-effectiveness of care provided under medical assistance to
148.17enrollees with neck and back problems. The demonstration project must maximize the use
148.18of complementary and alternative medicine-oriented primary care providers, including but
148.19not limited to physicians and chiropractors. The demonstration project must be designed
148.20to significantly improve physical and mental health for enrollees who present with
148.21neck and back problems while decreasing medical treatment costs. The commissioner,
148.22in consultation with the commissioner of health, shall deliver services through the
148.23demonstration project beginning July 1, 2011, or upon federal approval, whichever is later.
148.24    Subd. 2. RFP and project criteria. The commissioner, in consultation with the
148.25commissioner of health, shall develop and issue a request for proposal (RFP) for the
148.26demonstration project. The RFP must require the academic and research institution
148.27selected to demonstrate a proven track record over at least five years of conducting
148.28high-quality, federally funded clinical research. The RFP shall specify the state costs
148.29directly related to the requirements of this section and shall require that the selected
148.30institution pay those costs to the state. The institution and the federally qualified health
148.31centers and federally qualified health center look-alikes shall also:
148.32(1) provide patient education, provider education, and enrollment training
148.33components on health and lifestyle issues in order to promote enrollee responsibility for
148.34health care decisions, enhance productivity, prepare enrollees to reenter the workforce,
148.35and reduce future health care expenditures;
149.1(2) use high-quality and cost-effective integrated disease management that includes
149.2the best practices of traditional and complementary and alternative medicine;
149.3(3) incorporate holistic medical care, appropriate nutrition, exercise, medications,
149.4and conflict resolution techniques;
149.5(4) include a provider education component that makes use of professional
149.6organizations representing chiropractors, nurses, and other primary care providers
149.7and provides appropriate educational materials and activities in order to improve the
149.8integration of traditional medical care with licensed chiropractic services and other
149.9alternative health care services and achieve program enrollment objectives; and
149.10(5) provide to the commissioner the information and data necessary for the
149.11commissioner to prepare the annual reports required under subdivision 6.
149.12    Subd. 3. Enrollment. Enrollees from the program shall be selected by the
149.13commissioner from current enrollees in the prepaid medical assistance program who
149.14have, or are determined to be at significant risk of developing, neck and back problems.
149.15Participation in the demonstration project shall be voluntary. The commissioner shall
149.16seek to enroll, over the term of the demonstration project, ten percent of current and
149.17future medical assistance enrollees who have, or are determined to be at significant risk
149.18of developing, neck and back problems.
149.19    Subd. 4. Federal approval. The commissioner shall seek any federal waivers and
149.20approvals necessary to implement the demonstration project.
149.21    Subd. 5. Project costs. The commissioner shall require the academic and research
149.22institution selected, federally qualified health centers, and federally qualified health center
149.23look-alikes to fund all costs of the demonstration project. Amounts received under
149.24subdivision 2 are appropriated to the commissioner for the purposes of this section.
149.25    Subd. 6. Annual reports. The commissioner, in consultation with the commissioner
149.26of health, beginning December 15, 2011, and each December 15 thereafter through
149.27December 15, 2015, shall report annually to the legislature on the functional and mental
149.28improvements of the populations served by the demonstration project, patient satisfaction,
149.29and the cost-effectiveness of the program. The reports must also include data on hospital
149.30admissions, days in hospital, rates of outpatient surgery and other services, and drug
149.31utilization. The report, due December 15, 2015, must include recommendations on
149.32whether the demonstration project should be continued and expanded.

149.33    Sec. 54. [256B.841] MINNESOTA CHOICE WAIVER APPLICATION AND
149.34PROCESS.
149.35    Subdivision 1. Intent. It is the intent of the legislature that medical assistance be:
150.1(1) a sustainable, cost-effective, person-centered, and opportunity-driven program
150.2utilizing competitive and value-based purchasing to maximize available service options;
150.3and
150.4(2) a results-oriented system of coordinated care that focuses on independence
150.5and choice, promotes accountability and transparency, encourages and rewards healthy
150.6outcomes and responsible choices, and promotes efficiency.
150.7    Subd. 2. Waiver application. (a) By September 1, 2011, the commissioner of
150.8human services shall apply for a waiver and any necessary state plan amendments from
150.9the secretary of the United States Department of Health and Human Services, including,
150.10but not limited to, a waiver of the appropriate sections of title XIX of the federal Social
150.11Security Act, United States Code, title 42, section 1396 et seq., or other provisions of
150.12federal law that provide program flexibility and under which Minnesota will operate
150.13all facets of the state's medical assistance program. For purposes of this section, and
150.14256B.842, and 256B.843, this waiver shall be known as the Minnesota Consumer Health
150.15Opportunities and Innovative Care Excellence (CHOICE) waiver.
150.16(b) The commissioner of human services shall provide the legislative committees
150.17with jurisdiction over health and human services finance and policy with the CHOICE
150.18waiver application and financial and other related materials, at least ten days prior to
150.19submitting the application and materials to the federal Centers for Medicare and Medicaid
150.20Services.
150.21(c) If the state's CHOICE waiver application is approved, the commissioner of
150.22human services shall:
150.23(1) notify the chairs of the legislative committees with jurisdiction over health and
150.24human services finance and policy and allow the legislative committees with jurisdiction
150.25over health and human services finance and policy to review the terms of the CHOICE
150.26waiver; and
150.27(2) not implement the CHOICE waiver until ten legislative days have passed
150.28following notification of the chairs.
150.29    Subd. 3. Rulemaking; legislative proposals. Upon acceptance of the terms of the
150.30CHOICE waiver, the commissioner of human services shall:
150.31(1) adopt rules to implement the CHOICE waiver; and
150.32(2) propose any legislative changes necessary to implement the terms of the
150.33CHOICE waiver.
150.34    Subd. 4. Joint commission on waiver implementation. (a) After acceptance of the
150.35terms of the CHOICE waiver, the governor shall establish a joint commission on CHOICE
150.36waiver implementation. The commission shall consist of eight members; four of whom
151.1shall be members of the senate, not more than three from the same political party, to be
151.2appointed by the Subcommittee on Committees of the senate Committee on Rules and
151.3Administration, and four of whom shall be members of the house of representatives, not
151.4more than three from the same political party, to be appointed by the speaker of the house.
151.5(b) The commission shall:
151.6(1) oversee implementation of the CHOICE waiver;
151.7(2) confer as necessary with state agency commissioners;
151.8(3) make recommendations on services covered under the medical assistance
151.9program;
151.10(4) monitor and make recommendations on quality and access to care under the
151.11CHOICE waiver; and
151.12(5) make recommendations for the efficient and cost-effective administration of the
151.13medical assistance program under the terms of the CHOICE waiver.

151.14    Sec. 55. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE
151.15REFORM.
151.16    Subdivision 1. Goals for reform. In developing the CHOICE waiver application
151.17and implementing the CHOICE waiver, the commissioner of human services shall ensure
151.18that the reformed medical assistance program is a person-centered, financially sustainable,
151.19and cost-effective program.
151.20    Subd. 2. Reformed medical assistance criteria. The reformed medical assistance
151.21program established through the CHOICE waiver must:
151.22(1) empower consumers to make informed and cost-effective choices about their
151.23health and offer consumers rewards for healthy decisions;
151.24(2) ensure adequate access to needed services;
151.25(3) enable consumers to receive individualized health care that is outcome-oriented
151.26and focused on prevention, disease management, recovery, and maintaining independence;
151.27(4) promote competition between health care providers to ensure best value
151.28purchasing, leverage resources, and to create opportunities for improving service quality
151.29and performance;
151.30(5) redesign purchasing and payment methods and encourage and reward
151.31high-quality and cost-effective care by incorporating and expanding upon current payment
151.32reform and quality of care initiatives including, but not limited to, those initiatives
151.33authorized under chapter 62U; and
152.1(6) continually improve technology to take advantage of recent innovations and
152.2advances that help decision makers, consumers, and providers make informed and
152.3cost-effective decisions regarding health care.
152.4    Subd. 3. Annual report. The commissioner of human services shall annually
152.5submit a report to the governor and the legislature, beginning December 1, 2012, and each
152.6December 1 thereafter, describing the status of the administration and implementation
152.7of the CHOICE waiver.

152.8    Sec. 56. [256B.843] CHOICE WAIVER APPLICATION REQUIREMENTS.
152.9    Subdivision 1. Requirements for CHOICE waiver request. The commissioner
152.10shall seek federal approval to:
152.11(1) enter into a five-year agreement with the United States Department of Health and
152.12Human Services and Centers for Medicaid and Medicare Services (CMS) under section
152.131115a to waive, as part of the CHOICE waiver, provisions of title XIX of the federal
152.14Social Security Act, United States Code, title 42, section 1396 et seq., requiring:
152.15(i) statewideness to allow for the provision of different services in different areas or
152.16regions of the state;
152.17(ii) comparability of services to allow for the provision of different services to
152.18members of the same or different coverage groups;
152.19(iii) no prohibitions restricting the amount, duration, and scope of services included
152.20in the medical assistance state plan;
152.21(iv) no prohibitions limiting freedom of choice of providers; and
152.22(v) retroactive payment for medical assistance, at the state's discretion;
152.23(2) waive the applicable provisions of title XIX of the federal Social Security Act,
152.24United States Code, title 42, section 1396 et seq., in order to:
152.25(i) expand cost sharing requirements above the five percent of income threshold for
152.26beneficiaries in certain populations;
152.27(ii) establish health savings or power accounts that encourage and reward
152.28beneficiaries who reach certain prevention and wellness targets; and
152.29(iii) implement a tiered set of parameters to use as the basis for determining
152.30long-term service care and setting needs;
152.31(3) modify income and resource rules in a manner consistent with the goals of the
152.32reformed program;
152.33(4) provide enrollees with a choice of appropriate private sector health coverage
152.34options, with full federal financial participation;
153.1(5) treat payments made toward the cost of care as a monthly premium for
153.2beneficiaries receiving home and community-based services when applicable;
153.3(6) provide health coverage and services to individuals over the age of 65 that are
153.4limited in scope and are available only in the home and community-based setting;
153.5(7) consolidate all home and community-based services currently provided under
153.6title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c),
153.7into a single program of home and community-based services that include options for
153.8consumer direction and shared living;
153.9(8) expand disease management, care coordination, and wellness programs for all
153.10medical assistance recipients; and
153.11(9) empower and encourage able-bodied medical assistance recipients to work,
153.12whenever possible.
153.13    Subd. 2. Agency coordination. The commissioner shall establish an intraagency
153.14assessment and coordination unit to ensure that decision making and program planning for
153.15recipients who may need long-term care, residential placement, and community support
153.16services are coordinated. The assessment and coordination unit shall determine level of
153.17care, develop service plans and a service budget, make referrals to appropriate settings,
153.18provide education and choice counseling to consumers and providers, track utilization,
153.19and monitor outcomes.

153.20    Sec. 57. Minnesota Statutes 2010, section 256D.03, subdivision 3, is amended to read:
153.21    Subd. 3. General assistance medical care; eligibility. (a) Beginning April 1,
153.222010 October 1, 2011, the general assistance medical care program shall be administered
153.23according to section 256D.031, unless otherwise stated, except for outpatient prescription
153.24drug coverage, which shall continue to be administered under this section and funded
153.25under section 256D.031, subdivision 9, beginning June 1, 2010.
153.26    (b) Outpatient prescription drug coverage under general assistance medical care is
153.27limited to prescription drugs that:
153.28    (1) are covered under the medical assistance program as described in section
153.29256B.0625, subdivisions 13 and 13d; and
153.30    (2) are provided by manufacturers that have fully executed general assistance
153.31medical care rebate agreements with the commissioner and comply with the agreements.
153.32Outpatient prescription drug coverage under general assistance medical care must conform
153.33to coverage under the medical assistance program according to section 256B.0625,
153.34subdivisions 13 to 13h.
154.1    (c) Outpatient prescription drug coverage does not include drugs administered in a
154.2clinic or other outpatient setting.
154.3    (d) For the period beginning April 1, 2010, to May 31, 2010, general assistance
154.4medical care covers the services listed in subdivision 4.
154.5EFFECTIVE DATE.This section is effective October 1, 2011.

154.6    Sec. 58. Minnesota Statutes 2010, section 256D.031, subdivision 1, is amended to read:
154.7    Subdivision 1. Eligibility. (a) Except as provided under subdivision 2, general
154.8assistance medical care may be paid for any individual who is not eligible for medical
154.9assistance under chapter 256B, including eligibility for medical assistance based on a
154.10spenddown of excess income according to section 256B.056, subdivision 5, and who:
154.11(1) is receiving assistance under section 256D.05, except for families with children
154.12who are eligible under the Minnesota family investment program (MFIP), or who is
154.13having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
154.14(2) is a resident of Minnesota and has gross countable income not in excess of 75
154.15percent of federal poverty guidelines for the family size, using a six-month budget period,
154.16and whose equity in assets is not in excess of $1,000 per assistance unit.
154.17(2) is a resident of Minnesota and has gross countable income that is equal to or less
154.18than 125 percent of the federal poverty guidelines for the family size, using a six-month
154.19budget period, and who meets the asset limit specified in section 256L.17, subdivision 2.
154.20Exempt assets, the reduction of excess assets, and the waiver of excess assets must
154.21conform to the medical assistance program in section 256B.056, subdivisions 3 and 3d,
154.22except that the maximum amount of undistributed funds in a trust that could be distributed
154.23to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's
154.24discretion under the terms of the trust, must be applied toward the asset maximum.
154.25(b) The commissioner shall adjust the income standards under this section each July
154.261 by the annual update of the federal poverty guidelines following publication by the
154.27United States Department of Health and Human Services.

154.28    Sec. 59. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
154.29    Subd. 6. Coordinated care delivery systems. (a) Effective June 1, 2010 October
154.301, 2011, the commissioner shall contract with hospitals or groups of hospitals, or
154.31county-based purchasing plans, that qualify under paragraph (b) and agree to deliver
154.32services according to this subdivision. Contracting hospitals or plans shall develop
154.33and implement a coordinated care delivery system to provide health care services to
154.34individuals who are eligible for general assistance medical care under this section and who
155.1either choose to receive services through the coordinated care delivery system or who are
155.2enrolled by the commissioner under paragraph (c). The health care services provided by
155.3the system must include: (1) the services described in subdivision 4 with the exception
155.4of outpatient prescription drug coverage but shall include drugs administered in a clinic
155.5or other outpatient setting; or (2) a set of comprehensive and medically necessary health
155.6services that the recipients might reasonably require to be maintained in good health and
155.7that has been approved by the commissioner, including at a minimum, but not limited
155.8to, emergency care, medical transportation services, inpatient hospital and physician
155.9care, outpatient health services, preventive health services, mental health services,
155.10and prescription drugs administered in a clinic or other outpatient setting. Outpatient
155.11prescription drug coverage is covered on a fee-for-service basis in accordance with section
155.12256D.03, subdivision 3 , and funded under subdivision 9. A hospital or plan establishing a
155.13coordinated care delivery system under this subdivision must ensure that the requirements
155.14of this subdivision are met.
155.15    (b) A hospital or group of hospitals, or a county-based purchasing plan established
155.16under section 256B.692, may contract with the commissioner to develop and implement a
155.17coordinated care delivery system as follows: if the hospital or group of hospitals or plan
155.18agrees to satisfy the requirements of this subdivision.
155.19    (1) effective June 1, 2010, a hospital qualifies under this subdivision if: (i) during
155.20calendar year 2008, it received fee-for-service payments for services to general assistance
155.21medical care recipients (A) equal to or greater than $1,500,000, or (B) equal to or greater
155.22than 1.3 percent of net patient revenue; or (ii) a contract with the hospital is necessary to
155.23provide geographic access or to ensure that at least 80 percent of enrollees have access to
155.24a coordinated care delivery system; and
155.25    (2) effective December 1, 2010, a Minnesota hospital not qualified under clause
155.26(1) may contract with the commissioner under this subdivision if it agrees to satisfy the
155.27requirements of this subdivision.
155.28Participation by hospitals or plans shall become effective quarterly on June 1, September
155.291, December 1, or March 1 October 1, January 1, April 1, or July 1. Hospital or plan
155.30participation is effective for a period of 12 months and may be renewed for successive
155.3112-month periods.
155.32    (c) Applicants and recipients may enroll in any available coordinated care delivery
155.33system statewide. If more than one coordinated care delivery system is available, the
155.34applicant or recipient shall be allowed to choose among the systems. The commissioner
155.35may assign an applicant or recipient to a coordinated care delivery system if no choice
155.36is made by the applicant or recipient. The commissioner shall consider a recipient's zip
156.1code, city of residence, county of residence, or distance from a participating coordinated
156.2care delivery system when determining default assignment. An applicant or recipient
156.3may decline enrollment in a coordinated care delivery system but services excluding
156.4outpatient prescription drug coverage are only available through a coordinated care
156.5delivery system. Upon enrollment into a coordinated care delivery system, the recipient
156.6must agree to receive all nonemergency services through the coordinated care delivery
156.7system. Enrollment in a coordinated care delivery system is for six months and may be
156.8renewed for additional six-month periods, except that initial enrollment is for six months
156.9or until the end of a recipient's period of general assistance medical care eligibility,
156.10whichever occurs first. A recipient who continues to meet the eligibility requirements of
156.11this section is not eligible to enroll in MinnesotaCare during a period of enrollment in a
156.12coordinated care delivery system. From June 1, 2010, to February 28, 2011, applicants
156.13and recipients not enrolled in a coordinated care delivery system may seek services from
156.14a hospital eligible for reimbursement under the temporary uncompensated care pool
156.15established under subdivision 8. After February 28, 2011, services are available only
156.16through a coordinated care delivery system.
156.17    (d) The hospital or plan may contract and coordinate with providers and clinics
156.18for the delivery of services and shall contract with essential community providers as
156.19defined under section 62Q.19, subdivision 1, paragraph (a), clauses (1) and (2), to the
156.20extent practicable. When contracting with providers and clinics, the hospital or plan
156.21shall give preference to providers and clinics certified as health care homes under section
156.22256B.0751. The hospital or plan must contract with federally qualified health centers or
156.23federally qualified health center look-alikes, as defined in section 145.9269, subdivision 1,
156.24and essential community providers as defined in section 62Q.19, that agree to accept the
156.25terms, conditions, and payment rates offered by the hospital or plan to similarly situated
156.26providers, except that reimbursement to federally qualified health centers and federally
156.27qualified health center look-alikes must comply with federal law. If a provider or clinic or
156.28health center contracts with a hospital or plan to provide services through the coordinated
156.29care delivery system, the provider may not refuse to provide services to any recipient
156.30enrolled in the system, and payment for services shall be negotiated with the hospital or
156.31plan and paid by the hospital or plan from the system's allocation under subdivision 7.
156.32    (e) A coordinated care delivery system must:
156.33    (1) provide the covered services required under paragraph (a) to recipients enrolled
156.34in the coordinated care delivery system, and comply with the requirements of subdivision
156.354, paragraphs (b) to (g);
156.36    (2) establish a process to monitor enrollment and ensure the quality of care provided;
157.1    (3) in cooperation with counties, coordinate the delivery of health care services with
157.2existing homeless prevention, supportive housing, and rent subsidy programs and funding
157.3administered by the Minnesota Housing Finance Agency under chapter 462A; and
157.4    (4) adopt innovative and cost-effective methods of care delivery and coordination,
157.5which may include the use of allied health professionals, telemedicine, patient educators,
157.6care coordinators, and community health workers.
157.7    (f) The hospital or plan may require a recipient to designate a primary care provider
157.8or a primary care clinic. The hospital or plan may limit the delivery of services to a
157.9network of providers who have contracted with the hospital or plan to deliver services in
157.10accordance with this subdivision, and require a recipient to seek services only within this
157.11network. The hospital or plan may also require a referral to a provider before the service
157.12is eligible for payment. A coordinated care delivery system is not required to provide
157.13payment to a provider who is not employed by or under contract with the system for
157.14services provided to a recipient enrolled in the system, except in cases of an emergency.
157.15For purposes of this section, emergency services are defined in accordance with Code of
157.16Federal Regulations, title 42, section 438.114 (a).
157.17    (g) A recipient enrolled in a coordinated care delivery system has the right to appeal
157.18to the commissioner according to section 256.045.
157.19    (h) The state shall not be liable for the payment of any cost or obligation incurred
157.20by the coordinated care delivery system.
157.21    (i) The hospital or plan must provide the commissioner with data necessary for
157.22assessing enrollment, quality of care, cost, and utilization of services. Each hospital or
157.23plan must provide, on a quarterly basis on a form prescribed by the commissioner for each
157.24recipient served by the coordinated care delivery system, the services provided, the cost of
157.25services provided, and the actual payment amount for the services provided and any other
157.26information the commissioner deems necessary to claim federal Medicaid match. The
157.27commissioner must provide this data to the legislature on a quarterly basis.
157.28    (j) Effective June 1, 2010, The provisions of section 256.9695, subdivision 2,
157.29paragraph (b), do not apply to general assistance medical care provided under this section.
157.30    (k) Notwithstanding any other provision in this section to the contrary, for
157.31participation beginning September 1, 2010, the commissioner shall offer the same contract
157.32terms related to shall negotiate an enrollment threshold formula and financial liability
157.33protections to with a hospital or group of hospitals or plan qualified under this subdivision
157.34to develop and implement a coordinated care delivery system as those contained in the
157.35coordinated care delivery system contracts effective June 1, 2010.
158.1    (l) If sections 256B.055, subdivision 15, and 256B.056, subdivisions 3 and 4, are
158.2implemented effective July 1, 2010, this subdivision must not be implemented.
158.3EFFECTIVE DATE.This section is effective October 1, 2011.

158.4    Sec. 60. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
158.5    Subd. 7. Payments; rate setting for the hospital coordinated care delivery
158.6system. (a) Effective for general assistance medical care services, with the exception
158.7of outpatient prescription drug coverage, provided on or after June 1, 2010, through a
158.8coordinated care delivery system, the commissioner shall allocate the annual appropriation
158.9for the coordinated care delivery system to hospitals or plans participating under
158.10subdivision 6 in quarterly payments, beginning on the first scheduled warrant on or after
158.11June 1, 2010 October 1, 2011. The payment shall be allocated among all hospitals or
158.12plans qualified to participate on the allocation date as follows: based upon the enrollment
158.13thresholds negotiated with the commissioner.
158.14    (1) each hospital or group of hospitals shall be allocated an initial amount based on
158.15the hospital's or group of hospitals' pro rata share of calendar year 2008 payments for
158.16general assistance medical care services to all participating hospitals;
158.17    (2) the initial allocations to Hennepin County Medical Center; Regions Hospital;
158.18Saint Mary's Medical Center; and the University of Minnesota Medical Center, Fairview,
158.19shall be increased to 110 percent of the value determined in clause (1);
158.20    (3) the initial allocation to hospitals not listed in clause (2) shall be reduced a pro rata
158.21amount in order to keep the allocations within the limit of available appropriations; and
158.22    (4) the amounts determined under clauses (1) to (3) shall be allocated to participating
158.23hospitals.
158.24    The commissioner may prospectively reallocate payments to participating hospitals
158.25or plans on a biannual basis to ensure that final allocations reflect actual coordinated
158.26care delivery system enrollment. The 2008 base year shall be updated by one calendar
158.27year each June 1, beginning June 1, 2011.
158.28    (b) Beginning June 1, 2010, and every quarter beginning in June thereafter, the
158.29commissioner shall make one-third of the quarterly payment in June and the remaining
158.30two-thirds of the quarterly payment in July to each participating hospital or group of
158.31hospitals.
158.32    (c) (b) In order to be reimbursed under this section, nonhospital providers of health
158.33care services shall contract with one or more hospitals or plans described in paragraph (a)
158.34to provide services to general assistance medical care recipients through the coordinated
158.35care delivery system established by the hospital or plan. The hospital or plan shall
159.1reimburse bills submitted by nonhospital providers participating under this paragraph at a
159.2rate negotiated between the hospital or plan and the nonhospital provider.
159.3    (d) (c) The commissioner shall apply for federal matching funds under section
159.4256B.199 , paragraphs (a) to (d), for expenditures under this subdivision.
159.5    (e) (d) Outpatient prescription drug coverage is provided in accordance with section
159.6256D.03, subdivision 3 , and paid on a fee-for-service basis under subdivision 9.
159.7EFFECTIVE DATE.This section is effective October 1, 2011.

159.8    Sec. 61. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:
159.9    Subd. 9. Prescription drug pool. (a) The commissioner shall establish an outpatient
159.10prescription drug pool, effective June 1, 2010 October 1, 2011. Money in the pool must
159.11be used to reimburse pharmacies and other pharmacy service providers as defined in
159.12Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed
159.13to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates
159.14established in section 256B.0625, subdivision 13e. Outpatient prescription drug coverage
159.15is subject to the availability of funds in the pool. If the commissioner forecasts that
159.16expenditures under this subdivision will exceed the appropriation for this purpose, the
159.17commissioner may bring recommendations to the Legislative Advisory Commission on
159.18methods to resolve the shortfall.
159.19(b) Effective June 1, 2010 January 1, 2012, coordinated care delivery systems
159.20established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an
159.21assessment equal to 20 percent of payments for the prescribed drugs for recipients of
159.22services through that coordinated care delivery system, as calculated by the commissioner
159.23based on the most recent available data.

159.24    Sec. 62. Minnesota Statutes 2010, section 256D.031, subdivision 10, is amended to
159.25read:
159.26    Subd. 10. Assistance for veterans. Hospitals and plans participating in the
159.27coordinated care delivery system under subdivision 6 shall consult with counties, county
159.28veterans service officers, and the Veterans Administration to identify other programs for
159.29which general assistance medical care recipients enrolled in their system are qualified.

159.30    Sec. 63. Minnesota Statutes 2010, section 256L.01, subdivision 4a, is amended to read:
159.31    Subd. 4a. Gross individual or gross family income. (a) "Gross individual or gross
159.32family income" for nonfarm self-employed means income calculated for the 12-month
159.33six-month period of eligibility using as a baseline the adjusted gross income reported
160.1on the applicant's federal income tax form for the previous year and adding back in
160.2depreciation, and carryover net operating loss amounts that apply to the business in which
160.3the family is currently engaged.
160.4(b) "Gross individual or gross family income" for farm self-employed means
160.5income calculated for the 12-month six-month period of eligibility using as the baseline
160.6the adjusted gross income reported on the applicant's federal income tax form for the
160.7previous year.
160.8(c) "Gross individual or gross family income" means the total income for all family
160.9members, calculated for the 12-month six-month period of eligibility.

160.10    Sec. 64. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:
160.11    Subd. 3. Financial management. (a) The commissioner shall manage spending for
160.12the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
160.13each state revenue and expenditure forecast, the commissioner must make an assessment
160.14of the expected expenditures for the covered services for the remainder of the current
160.15biennium and for the following biennium. The estimated expenditure, including the
160.16reserve, shall be compared to an estimate of the revenues that will be available in the health
160.17care access fund. Based on this comparison, and after consulting with the chairs of the
160.18house of representatives Ways and Means Committee and the senate Finance Committee,
160.19and the Legislative Commission on Health Care Access, the commissioner shall, as
160.20necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
160.21remain within the limits of available revenues for the remainder of the current biennium
160.22and for the following biennium. The commissioner shall not hire additional staff using
160.23appropriations from the health care access fund until the commissioner of management
160.24and budget makes a determination that the adjustments implemented under paragraph (b)
160.25are sufficient to allow MinnesotaCare expenditures to remain within the limits of available
160.26revenues for the remainder of the current biennium and for the following biennium.
160.27(b) The adjustments the commissioner shall use must be implemented in this order:
160.28first, stop enrollment of single adults and households without children; second, upon 45
160.29days' notice, stop coverage of single adults and households without children already
160.30enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium
160.31subsidy amounts by ten percent for families with gross annual income above 200 percent
160.32of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium
160.33subsidy amounts by ten percent for families with gross annual income at or below 200
160.34percent; and fifth, require applicants to be uninsured for at least six months prior to
160.35eligibility in the MinnesotaCare program. If these measures are insufficient to limit the
161.1expenditures to the estimated amount of revenue, the commissioner shall further limit
161.2enrollment or decrease premium subsidies.

161.3    Sec. 65. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:
161.4    Subd. 5. Co-payments and coinsurance Cost-sharing. (a) Except as provided in
161.5paragraphs (b) and, (c), and (h), the MinnesotaCare benefit plan shall include the following
161.6co-payments and coinsurance cost-sharing requirements for all enrollees:
161.7    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
161.8subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
161.9    (2) $3 per prescription for adult enrollees;
161.10    (3) $25 for eyeglasses for adult enrollees;
161.11    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
161.12episode of service which is required because of a recipient's symptoms, diagnosis, or
161.13established illness, and which is delivered in an ambulatory setting by a physician or
161.14physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
161.15audiologist, optician, or optometrist; and
161.16    (5) $6 for nonemergency visits to a hospital-based emergency room for services
161.17provided through December 31, 2010, and $3.50 effective January 1, 2011; and
161.18(6) a family deductible equal to the maximum amount allowed under Code of
161.19Federal Regulations, title 42, part 447.54.
161.20    (b) Paragraph (a), clause (1), does and paragraph (e) do not apply to parents and
161.21relative caretakers of children under the age of 21.
161.22    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
161.23    (d) Paragraph (a), clause (4), does not apply to mental health services.
161.24    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
161.25poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
161.26and who are not pregnant shall be financially responsible for the coinsurance amount, if
161.27applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
161.28    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
161.29or changes from one prepaid health plan to another during a calendar year, any charges
161.30submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
161.31expenses incurred by the enrollee for inpatient services, that were submitted or incurred
161.32prior to enrollment, or prior to the change in health plans, shall be disregarded.
161.33(g) MinnesotaCare reimbursements to fee-for-service providers and payments to
161.34managed care plans or county-based purchasing plans shall not be increased as a result of
161.35the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
162.1(h) Effective January 1, 2012, the following co-payments for nonpreventive visits
162.2shall apply to enrollees who are adults without children eligible under section 256L.04,
162.3subdivision 7:
162.4(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of care
162.5per MinnesotaCare enrollee is at the 60th percentile or lower for providers of the same
162.6type;
162.7(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care
162.8per MinnesotaCare enrollee is greater than the 60th percentile but does not exceed the
162.980th percentile for providers of the same type; and
162.10(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of
162.11care per MinnesotaCare enrollee is greater than the 80th percentile for providers of the
162.12same type.
162.13Each managed care and county-based purchasing plan shall calculate the average,
162.14risk-adjusted, total annual cost of care for providers under this paragraph using a
162.15methodology that has been approved by the commissioner.

162.16    Sec. 66. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
162.17    Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
162.18the commissioner shall provide each MinnesotaCare enrollee eligible under section
162.19256L.04, subdivision 7, with family income greater than 125 percent of the federal poverty
162.20guidelines with a monthly defined contribution to purchase health coverage under a health
162.21plan as defined in section 62A.011, subdivision 3.
162.22(b) Beginning January 1, 2012, the commissioner shall provide each MinnesotaCare
162.23adult enrollee eligible under section 256L.04, subdivision 1, with family income greater
162.24than 133 percent of the federal poverty guidelines with a monthly defined contribution to
162.25purchase health coverage under a health plan as defined in section 62A.011, subdivision 3,
162.26offered by a health plan company as defined in section 62Q.01, subdivision 4.
162.27(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums
162.28under section 256L.15 and are exempt from the managed care enrollment requirement
162.29of section 256L.12.
162.30(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
162.31eligible under paragraph (a) or (b) unless otherwise provided in this section. Covered
162.32services, cost sharing, disenrollment for nonpayment of premium, enrollee appeal rights
162.33and complaint procedures, and the effective date of coverage for enrollees eligible under
162.34paragraph (a) shall be as provided under the terms of the health plan purchased by the
162.35enrollee.
163.1(e) Unless otherwise provided in this section, all MinnesotaCare requirements
163.2related to eligibility, income and asset methodology, income reporting, and program
163.3administration, continue to apply to enrollees obtaining coverage under this section.
163.4    Subd. 2. Use of defined contribution; health plan requirements. (a) An enrollee
163.5may use up to the monthly defined contribution to pay premiums for coverage under a
163.6health plan as defined in section 62A.011, subdivision 3.
163.7(b) An enrollee must select a health plan within three calendar months of approval of
163.8MinnesotaCare eligibility. If a health plan is not selected and purchased within this time
163.9period, the enrollee must reapply and must meet all eligibility criteria.
163.10(c) A health plan purchased under this section must:
163.11(1) provide coverage for mental health and chemical dependency treatment services;
163.12and
163.13(2) comply with the coverage limitations specified in section 256L.03, subdivision
163.141, the second paragraph.
163.15    Subd. 3. Determination of defined contribution amount. (a) The commissioner
163.16shall determine the defined contribution sliding scale using the base contribution specified
163.17in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
163.18for defined contributions that provides:
163.19(1) persons with the lowest eligible household income with a defined contribution
163.20of 110 percent of the base contribution;
163.21(2) persons with household incomes equal to 175 percent of the federal poverty
163.22guidelines with a defined contribution of 100 percent of the base contribution;
163.23(3) persons with household incomes equal to or greater than 250 percent of
163.24the federal poverty guidelines with a defined contribution of 80 percent of the base
163.25contribution; and
163.26(4) persons with household incomes in evenly spaced increments between the
163.27percentages of the federal poverty guideline or income level specified in clauses (1) to (3)
163.28with a base contribution that is a percentage interpolated from the defined contribution
163.29percentages specified in clauses (1) to (3).

163.30	Under 19	$105
163.31	19-29	$125
163.32	30-34	$135
163.33	35-39	$140
163.34	40-44	$175
163.35	45-49	$215
163.36	50-54	$295
164.1	55-59	$345
164.2	60+	$360

164.3(b) The commissioner shall multiply the defined contribution amounts developed
164.4under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
164.5health plan by a health plan company and who purchase coverage through the Minnesota
164.6Comprehensive Health Association.
164.7    Subd. 4. Administration by commissioner. (a) The commissioner shall administer
164.8the defined contributions. The commissioner shall:
164.9    (1) calculate and process defined contributions for enrollees; and
164.10    (2) pay the defined contribution amount to health plan companies or the Minnesota
164.11Comprehensive Health Association, as applicable, for enrollee health plan coverage.
164.12(b) Nonpayment of a health plan premium shall result in disenrollment from
164.13MinnesotaCare effective the first day of the calendar month following the calendar month
164.14for which the premium was due. Persons disenrolled for nonpayment or who voluntarily
164.15terminate coverage may not reenroll until four calendar months have elapsed.
164.16    Subd. 5. Assistance to enrollees. The commissioner of human services, in
164.17consultation with the commissioner of commerce, shall develop an efficient and
164.18cost-effective method of referring eligible applicants to professional insurance agent
164.19associations.
164.20    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
164.21January 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual
164.22health market by a health plan company in accordance with section 62A.65 are eligible
164.23for coverage through a health plan offered by the Minnesota Comprehensive Health
164.24Association and may enroll in MCHA in accordance with section 62E.14. Any difference
164.25between the revenue and covered losses to the MCHA related to implementation of this
164.26section shall be paid to the MCHA from the health care access fund.
164.27    Subd. 7. Federal approval. The commissioner shall seek all federal waivers and
164.28approvals necessary to implement coverage under this section for MinnesotaCare enrollees
164.29eligible under subdivision 1. The commissioner shall seek the continuation of federal
164.30financial participation for the adult enrollees eligible under section 256L.04, subdivision 1.

164.31    Sec. 67. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:
164.32    Subdivision 1. Families with children. (a) Families with children with family
164.33income equal to or less than 275 percent of the federal poverty guidelines for the
164.34applicable family size shall be eligible for MinnesotaCare according to this section. All
165.1other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
165.2to enrollment under section 256L.07, shall apply unless otherwise specified.
165.3    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
165.4if the children are eligible. Children may be enrolled separately without enrollment by
165.5parents. However, if one parent in the household enrolls, both parents must enroll, unless
165.6other insurance is available. If one child from a family is enrolled, all children must
165.7be enrolled, unless other insurance is available. If one spouse in a household enrolls,
165.8the other spouse in the household must also enroll, unless other insurance is available.
165.9Families cannot choose to enroll only certain uninsured members.
165.10    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
165.11to the MinnesotaCare program. These persons are no longer counted in the parental
165.12household and may apply as a separate household.
165.13    (d) Beginning July 1, 2010, or upon federal approval, whichever is later, Parents are
165.14not eligible for MinnesotaCare if their gross income exceeds $57,500 $50,000.
165.15    (e) Children formerly enrolled in medical assistance and automatically deemed
165.16eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
165.17from the requirements of this section until renewal.
165.18(f) [Reserved.]

165.19    Sec. 68. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
165.20    Subd. 7. Single adults and households with no children. (a) The definition of
165.21eligible persons, through September 30, 2011, includes all individuals and households
165.22with no children who have gross family incomes that are equal to or less than 200 250
165.23percent of the federal poverty guidelines.
165.24    (b) Effective July 1, 2009 October 1, 2011, the definition of eligible persons includes
165.25all individuals and households with no children who have gross family incomes that are
165.26greater than 125 percent of the federal poverty guidelines and equal to or less than 250
165.27percent of the federal poverty guidelines.
165.28EFFECTIVE DATE.This section is effective October 1, 2011.

165.29    Sec. 69. Minnesota Statutes 2010, section 256L.04, subdivision 10, is amended to read:
165.30    Subd. 10. Citizenship requirements. Eligibility for MinnesotaCare is limited to
165.31citizens or nationals of the United States, qualified noncitizens, and other persons residing
165.32lawfully in the United States as described in section 256B.06, subdivision 4, paragraphs
165.33(a) to (e) and (j) who are eligible for medical assistance with federal participation
165.34according to United States Code, title 8, section 1612. Undocumented noncitizens and
166.1nonimmigrants are ineligible for MinnesotaCare. For purposes of this subdivision, a
166.2nonimmigrant is an individual in one or more of the classes listed in United States Code,
166.3title 8, section 1101(a)(15), and an undocumented noncitizen is an individual who resides
166.4in the United States without the approval or acquiescence of the United States Citizenship
166.5and Immigration Services. Families with children who are citizens or nationals of
166.6the United States must cooperate in obtaining satisfactory documentary evidence of
166.7citizenship or nationality according to the requirements of the federal Deficit Reduction
166.8Act of 2005, Public Law 109-171.
166.9EFFECTIVE DATE.This section is effective January 1, 2012.

166.10    Sec. 70. Minnesota Statutes 2010, section 256L.05, subdivision 2, is amended to read:
166.11    Subd. 2. Commissioner's duties. (a) The commissioner or county agency shall
166.12use electronic verification as the primary method of income verification. If there is a
166.13discrepancy between reported income and electronically verified income, an individual
166.14may be required to submit additional verification. In addition, the commissioner shall
166.15perform random audits to verify reported income and eligibility. The commissioner
166.16may execute data sharing arrangements with the Department of Revenue and any other
166.17governmental agency in order to perform income verification related to eligibility and
166.18premium payment under the MinnesotaCare program.
166.19(b) In determining eligibility for MinnesotaCare, the commissioner shall require
166.20applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
166.21income. The commissioner shall also require applicants and enrollees , and their spouses
166.22or parents, who are age 21 and over and employed 20 or more hours per week by any one
166.23employer, to verify that they do not have access to employer-subsidized coverage as
166.24described in section 256L.07, subdivision 2. Data collected is nonpublic data as defined
166.25in section 13.02, subdivision 9.

166.26    Sec. 71. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:
166.27    Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007 2011, an enrollee's
166.28eligibility must be renewed every 12 six months. The 12-month period begins in the
166.29month after the month the application is approved.
166.30    (b) Each new period of eligibility must take into account any changes in
166.31circumstances that impact eligibility and premium amount. An enrollee must provide all
166.32the information needed to redetermine eligibility by the first day of the month that ends
166.33the eligibility period. If there is no change in circumstances, the enrollee may renew
166.34eligibility at designated locations that include community clinics and health care providers'
167.1offices. The designated sites shall forward the renewal forms to the commissioner. The
167.2commissioner may establish criteria and timelines for sites to forward applications to the
167.3commissioner or county agencies. The premium for the new period of eligibility must be
167.4received as provided in section 256L.06 in order for eligibility to continue.
167.5    (c) An enrollee who fails to submit renewal forms and related documentation
167.6necessary for verification of continued eligibility in a timely manner shall remain eligible
167.7for one additional month beyond the end of the current eligibility period before being
167.8disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
167.9additional month.

167.10    Sec. 72. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
167.11to read:
167.12    Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants
167.13for MinnesotaCare who identify themselves as veterans are referred to a county veterans
167.14service officer for assistance in applying to the United States Department of Veterans
167.15Affairs for any veterans benefits for which they may be eligible.

167.16    Sec. 73. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:
167.17    Subdivision 1. General requirements. (a) Children enrolled in the original
167.18children's health plan as of September 30, 1992, children who enrolled in the
167.19MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
167.20article 4, section 17, and children who have family gross incomes that are equal to or
167.21less than 150 percent of the federal poverty guidelines are eligible without meeting
167.22the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
167.23long as they maintain continuous coverage in the MinnesotaCare program or medical
167.24assistance. Children who apply for MinnesotaCare on or after the implementation date
167.25of the employer-subsidized health coverage program as described in Laws 1998, chapter
167.26407, article 5, section 45, who have family gross incomes that are equal to or less than 150
167.27percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
167.28be eligible for MinnesotaCare.
167.29    (b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
167.30income increases above 275 percent of the federal poverty guidelines the limits described
167.31in section 256L.04, subdivision 1, are no longer eligible for the program and shall be
167.32disenrolled by the commissioner. Beginning January 1, 2008,
167.33(c) Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7,
167.34whose income increases above 200 percent of the federal poverty guidelines or 250
168.1percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
168.2the program and shall be disenrolled by the commissioner.
168.3(d) For persons disenrolled under this subdivision, MinnesotaCare coverage
168.4terminates the last day of the calendar month following the month in which the
168.5commissioner determines that the income of a family or individual exceeds program
168.6income limits.
168.7    (b) (e) Notwithstanding paragraph (a) (b), children may remain enrolled in
168.8MinnesotaCare if ten percent of their gross individual or gross family income as defined
168.9in section 256L.01, subdivision 4, is less than the annual premium for a six-month
168.10policy with a $500 deductible available through the Minnesota Comprehensive Health
168.11Association. Children who are no longer eligible for MinnesotaCare under this clause shall
168.12be given a 12-month notice period from the date that ineligibility is determined before
168.13disenrollment. The premium for children remaining eligible under this clause shall be the
168.14maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
168.15    (c) (f) Notwithstanding paragraphs (a) and (b) (e), parents are not eligible for
168.16MinnesotaCare if gross household income exceeds $57,500 for the 12-month $25,000 for
168.17the six-month period of eligibility.

168.18    Sec. 74. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
168.19    Subd. 7. Critical access dental providers. Effective for dental services provided to
168.20MinnesotaCare enrollees on or after January 1, 2007, July 1, 2011, the commissioner shall
168.21increase payment rates to dentists and dental clinics deemed by the commissioner to be
168.22critical access providers under section 256B.76, subdivision 4, by 50 30 percent above
168.23the payment rate that would otherwise be paid to the provider. The commissioner shall
168.24pay the prepaid health plans under contract with the commissioner amounts sufficient to
168.25reflect this rate increase. The prepaid health plan must pass this rate increase to providers
168.26who have been identified by the commissioner as critical access dental providers under
168.27section 256B.76, subdivision 4.

168.28    Sec. 75. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
168.29    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
168.30per capita, where possible. The commissioner may allow health plans to arrange for
168.31inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
168.32an independent actuary to determine appropriate rates.
168.33    (b) For services rendered on or after January 1, 2004, the commissioner shall
168.34withhold five percent of managed care plan payments and county-based purchasing
169.1plan payments under this section pending completion of performance targets. Each
169.2performance target must be quantifiable, objective, measurable, and reasonably attainable,
169.3except in the case of a performance target based on a federal or state law or rule. Criteria
169.4for assessment of each performance target must be outlined in writing prior to the
169.5contract effective date. The managed care plan must demonstrate, to the commissioner's
169.6satisfaction, that the data submitted regarding attainment of the performance target is
169.7accurate. The commissioner shall periodically change the administrative measures used
169.8as performance targets in order to improve plan performance across a broader range of
169.9administrative services. The performance targets must include measurement of plan
169.10efforts to contain spending on health care services and administrative activities. The
169.11commissioner may adopt plan-specific performance targets that take into account factors
169.12affecting only one plan, such as characteristics of the plan's enrollee population. The
169.13withheld funds must be returned no sooner than July 1 and no later than July 31 of the
169.14following calendar year if performance targets in the contract are achieved.
169.15(c) For services rendered on or after January 1, 2011, the commissioner shall
169.16withhold an additional three percent of managed care plan or county-based purchasing
169.17plan payments under this section. The withheld funds must be returned no sooner than
169.18July 1 and no later than July 31 of the following calendar year. The return of the withhold
169.19under this paragraph is not subject to the requirements of paragraph (b).
169.20(d) Effective for services rendered on or after January 1, 2011, the commissioner
169.21shall include as part of the performance targets described in paragraph (b) a reduction in
169.22the plan's emergency room utilization rate for state health care program enrollees by a
169.23measurable rate of five percent from the plan's utilization rate for the previous calendar
169.24year.
169.25The withheld funds must be returned no sooner than July 1 and no later than July 31
169.26of the following calendar year if the managed care plan demonstrates to the satisfaction of
169.27the commissioner that a reduction in the utilization rate was achieved.
169.28The withhold described in this paragraph shall continue for each consecutive
169.29contract period until the plan's emergency room utilization rate for state health care
169.30program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
169.31for state health care program enrollees for calendar year 2009. Hospitals shall cooperate
169.32with the health plans in meeting this performance target and shall accept payment
169.33withholds that may be returned to the hospitals if the performance target is achieved. The
169.34commissioner shall structure the withhold so that the commissioner returns a portion of
169.35the withheld funds in amounts commensurate with achieved reductions in utilization less
170.1than the targeted amount. The withhold described in this paragraph does not apply to
170.2county-based purchasing plans.
170.3(e) Effective for services provided on or after January 1, 2012, the commissioner
170.4shall include as part of the performance targets described in paragraph (b) a reduction in
170.5the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous
170.6hospitalization of a patient regardless of the reason for the hospitalization for state health
170.7care program enrollees by a measurable rate of five percent from the plan's hospitalization
170.8rate for the previous calendar year.
170.9The withheld funds must be returned no sooner than July 1 and no later than July 31
170.10of the following calendar year if the managed care plan or county-based purchasing plan
170.11demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
170.12rate was achieved.
170.13The withhold described in this paragraph must continue for each consecutive
170.14contract period until the plan's subsequent hospitalization rate for state health care
170.15program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
170.16for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
170.17with the plans in meeting this performance target and shall accept payment withholds that
170.18must be returned to the hospitals if the performance target is achieved. The commissioner
170.19shall structure the withhold so that the commissioner returns a portion of the withheld
170.20funds in amounts commensurate with achieved reductions in utilizations less than the
170.21targeted amount. The withhold described in this paragraph does not apply to county-based
170.22purchasing plans.
170.23(e) (f) A managed care plan or a county-based purchasing plan under section
170.24256B.692 may include as admitted assets under section 62D.044 any amount withheld
170.25under this section that is reasonably expected to be returned.

170.26    Sec. 76. Minnesota Statutes 2010, section 256L.15, subdivision 1a, is amended to read:
170.27    Subd. 1a. Payment options. The commissioner may offer the following payment
170.28options to an enrollee:
170.29(1) payment by check;
170.30(2) payment by credit card;
170.31(3) payment by recurring automatic checking withdrawal;
170.32(4) payment by onetime electronic transfer of funds;
170.33(5) payment by wage withholding with the consent of the employer and the
170.34employee; or
170.35(6) payment by using state tax refund payments.
171.1The commissioner shall include information about the payment options on each
171.2premium notice. At application or reapplication, a MinnesotaCare applicant or enrollee
171.3may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to
171.4collect funds from the applicant's or enrollee's refund for the purposes of meeting all or
171.5part of the applicant's or enrollee's MinnesotaCare premium obligation. The applicant or
171.6enrollee may authorize the commissioner to apply for the state working family tax credit
171.7on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be
171.8subject to the $10 fee under section 270A.07, subdivision 1.

171.9    Sec. 77. PLAN TO COORDINATE CARE FOR CHILDREN WITH HIGH-COST
171.10MENTAL HEALTH CONDITIONS.
171.11The commissioner of human services shall develop and submit to the legislature
171.12by December 15, 2011, a plan to provide care coordination to medical assistance and
171.13MinnesotaCare enrollees who are children with high-cost mental health conditions. For
171.14purposes of this section, a child has a "high-cost mental health condition" if mental health
171.15and medical expenses over the past year totalled $100,000 or more. For purposes of this
171.16section, "care coordination" means collaboration between an advanced practice nurse and
171.17primary care physicians and specialists to manage care; development of mental health
171.18management plans for recurrent mental health issues; oversight and coordination of all
171.19aspects of care in partnership with families; organization of medical, treatment, and
171.20therapy information into a summary of critical information; coordination and appropriate
171.21sequencing of evaluations and multiple appointments; information and assistance with
171.22accessing resources; and telephone triage for behavior or other problems.

171.23    Sec. 78. REGULATORY SIMPLIFICATION AND REDUCTION OF
171.24PROVIDER REPORTING AND DATA SUBMITTAL REQUIREMENTS.
171.25    Subdivision 1. Regulatory simplification and report reduction work group. The
171.26commissioner of management and budget shall convene a regulatory simplification and
171.27report reduction work group of persons designated by the commissioners of health, human
171.28services, and commerce to eliminate redundant, unnecessary, and obsolete state mandated
171.29reporting or data submittal requirements for health care providers or group purchasers
171.30related to health care costs, quality, utilization, access, or patient encounters or related to
171.31provider or group purchaser, monitoring, finances, and regulation. For purposes of this
171.32section, the term "health care providers or group purchasers" has the meaning provided
171.33in Minnesota Statutes, section 62J.03, subdivisions 6 and 8, except that it also includes
171.34nursing homes.
172.1    Subd. 2. Plan development and other duties. (a) The commissioner of
172.2management and budget, in consultation with the work group, shall develop a plan for
172.3regulatory simplification and report reduction activities of the commissioners of health,
172.4human services, and commerce that considers collection and regulation of the following
172.5in a coordinated manner:
172.6(1) encounter data;
172.7(2) group purchaser provider network data;
172.8(3) financial reporting;
172.9(4) reporting and documentation requirements relating to member communications
172.10and marketing materials;
172.11(5) state regulation and oversight of group purchasers;
172.12(6) requirements and procedures for denial, termination, or reduction of services
172.13and member appeals and grievances; and
172.14(7) state performance improvement projects, requirements, and procedures.
172.15(b) The commissioners of health, human services, and commerce, following
172.16consultation with the work group, shall present to the legislature by January 1, 2012,
172.17proposals to implement their recommendations.
172.18    Subd. 3. New reporting and other duties. (a) The commissioner of management
172.19and budget, in consultation with the work group and the commissioners of health, human
172.20services, and commerce, shall develop criteria to be used by the commissioners in
172.21determining whether to establish new reporting and data submittal requirements. These
172.22criteria must support the establishment of new reporting and data submittal requirements
172.23only:
172.24(1) if required by a federal agency or state statute;
172.25(2) if needed for a state regulatory audit or corrective action plan;
172.26(3) if needed to monitor or protect public health;
172.27(4) if needed to manage the cost and quality of Minnesota's public health insurance
172.28programs; or
172.29(5) if a review and analysis by the commissioner of the relevant agency has
172.30documented the necessity, importance, and administrative cost of the requirement, and
172.31has determined that the information sought cannot be efficiently obtained through another
172.32state or federal report.
172.33(b) The commissioners of health, human services, and commerce, following
172.34consultation with the work group, may propose to the legislature new provider and group
172.35purchaser reporting and data submittal requirements to take effect on or after July 1, 2012.
173.1These proposals shall include an analysis of the extent to which the requirements meet
173.2the criteria developed under paragraph (a).

173.3    Sec. 79. SPECIALIZED MAINTENANCE THERAPY.
173.4The commissioner of human services shall evaluate whether providing medical
173.5assistance coverage for specialized maintenance therapy for enrollees with serious and
173.6persistent mental illness who are at risk of hospitalization will improve the quality of
173.7care and lower medical assistance spending by reducing rates of hospitalization. The
173.8commissioner shall present findings and recommendations to the chairs and ranking
173.9minority members of the legislative committees with jurisdiction over health and human
173.10services finance and policy by December 15, 2011.

173.11    Sec. 80. BENEFIT SET OPTIONS.
173.12The commissioner of human services shall analyze and provide recommendations
173.13for state plan amendments that would provide different benefits for different demographic
173.14populations under the medical assistance program as permitted under federal law, with the
173.15goal of tailoring more cost-effective coverage based on unique needs of the demographic
173.16population. The commissioner shall report these recommendations to the chairs and
173.17ranking minority members of the senate and house health and human services committees
173.18by January 15, 2012.

173.19    Sec. 81. REDUCING HOSPITALIZATION RATES.
173.20The commissioner of human services, by January 15, 2012, shall present
173.21recommendations to the legislature to reduce hospitalization rates for state health care
173.22program enrollees who are children with high-cost medical conditions.

173.23    Sec. 82. MEDICAID FRAUD PREVENTION AND DETECTION.
173.24    Subdivision 1. Request for proposals. By October 31, 2011, the commissioner
173.25of human services shall issue a request for proposals to prevent and detect Medicaid
173.26fraud and mispayment. The request for proposals shall require the vendor to provide
173.27data analytics capabilities, including, but not limited to, predictive modeling techniques
173.28and other forms of advanced analytics, technical assistance, claims review, and medical
173.29record and documentation investigations, to detect and investigate improper payments
173.30both before and after payments are made.
174.1    Subd. 2. Proof of concept phase. The selected vendor, at no cost to the state, shall
174.2be required to apply its analytics and investigations on a subset of data provided by the
174.3commissioner to demonstrate the direct recoveries of the solution.
174.4    Subd. 3. Data confidentiality. Data provided by the commissioner to the vendor
174.5under this section must maintain the confidentiality of the information.
174.6    Subd. 4. Full implementation phase. The request for proposal must require the
174.7commissioner to implement the recommendations provided by the vendor if the work
174.8done under the requirements of subdivision 2 provides recoveries directly related to the
174.9investigations to the state. After full implementation, the vendor shall be paid from
174.10recoveries directly attributable to the work done by the vendor, according to the terms and
174.11performance measures negotiated in the contract.
174.12    Subd. 5. Selection of vendor. The commissioner of human services shall select a
174.13vendor from the responses to the request for proposal by January 31, 2012.
174.14    Subd. 6. Progress report. The commissioner shall provide a report describing the
174.15progress made under this section to the governor and the chairs and ranking minority
174.16members of the legislative committees with jurisdiction over the Department of Human
174.17Services by June 15, 2012. The report shall provide a dynamic scoring analysis of the
174.18work described in the report.

174.19    Sec. 83. WOUND CARE TREATMENT.
174.20The commissioner of human services, through the health services policy committee
174.21established under Minnesota Statutes, section 256B.0625, subdivision 3c, shall study
174.22the effectiveness of new strategies for wound care treatment for medical assistance and
174.23MinnesotaCare enrollees with diabetes, including but not limited to the use of new wound
174.24care technologies, assessment tools, and reporting programs. The commissioner shall
174.25present recommendations by December 15, 2011, to the legislature on whether these
174.26new strategies for wound care treatment should be covered under medical assistance
174.27and MinnesotaCare.

174.28    Sec. 84. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN
174.29FEDERAL HEALTH CARE REFORMS.
174.30State funds must not be expended in the planning or implementation of the Patient
174.31Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care
174.32and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no
175.1provisions of the act may be implemented, until the constitutionality of the act has been
175.2affirmed by the United States Supreme Court.
175.3EFFECTIVE DATE.This section is effective the day following final enactment.

175.4    Sec. 85. COMMISSIONER'S ACTIONS; REPEAL OF EARLY MEDICAL
175.5ASSISTANCE EXPANSION.
175.6    (a) Effective October 1, 2011, the commissioner of human services shall suspend
175.7implementation and administration of Minnesota Statutes 2010, sections 256B.055,
175.8subdivision 15; 256B.056, subdivision 3, paragraph (b); and 256B.056, subdivision 4,
175.9paragraph (d). The commissioner shall refer persons enrolled under these provisions, and
175.10applicants for coverage under these provisions, to the general assistance medical care
175.11program established under Minnesota Statutes, section 256D.031.
175.12(b) The commissioner shall seek all federal approvals and waivers necessary
175.13to implement Minnesota Statutes, section 256D.031, and to ensure federal financial
175.14participation for the population covered under Minnesota Statutes, section 256D.031.

175.15    Sec. 86. GENERAL ASSISTANCE MEDICAL CARE PROGRAM;
175.16PROVISIONS REVIVED.
175.17    Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter
175.181, article 16, section 47, the following statutes are revived and have the force of law
175.19effective October 1, 2011:
175.20    (1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 6, 7, and 8;
175.21    (2) Minnesota Statutes 2010, section 256D.031, subdivisions 1, 2, 3, 4, 6, 7, 9,
175.22and 10; and
175.23    (3) Laws 2010, chapter 200, article 1, section 18.

175.24    Sec. 87. REPEALER.
175.25(a) Minnesota Statutes 2010, section 62J.07, subdivisions 1, 2, and 3, are repealed.
175.26(b) Minnesota Statutes 2010, section 256L.07, subdivision 7, exempting eligibility
175.27for children formally under medical assistance, is repealed retroactively from October
175.281, 2008, and federal approval is no longer necessary.
175.29(c) The amendment in Laws 2009, chapter 79, article 5, section 55, as amended by
175.30Laws 2009, chapter 173, article 1, section 36, (256L.04, subdivision 1, children deemed
175.31eligible are exempt from eligibility requirements) is repealed retroactively from January
175.321, 2009, and federal approval is no longer necessary.
176.1(d) Laws 2009, chapter 79, article 5, section 56, (256L.04, subdivision 1b,
176.2exemption from income limit for children) is repealed retroactively from July 1, 2009,
176.3and federal approval is no longer necessary.
176.4(e) Laws 2009, chapter 79, article 5, section 60, (256L.05, subdivision 1c, open
176.5enrollment and streamlined application) is repealed retroactively from July 1, 2009,
176.6and federal approval is no longer necessary.
176.7(f) Laws 2009, chapter 79, article 5, section 66, (256L.07, subdivision 8, automatic
176.8eligibility certain children) is repealed retroactively from July 1, 2009, and federal
176.9approval is no longer necessary.
176.10(g) The amendment in Laws 2009, chapter 79, article 5, section 57, (256L.04,
176.11subdivision 7a, ineligibility for adults with certain income) is repealed retroactively
176.12from July 1, 2009, and federal approval is no longer necessary.
176.13(h) The amendment in Laws 2009, chapter 79, article 5, section 61, (256L.05,
176.14subdivision 3, children eligibility following termination from foster care) is repealed
176.15retroactively from July 1, 2009, and federal approval is no longer necessary.
176.16(i) The amendment in Laws 2009, chapter 79, article 5, section 62, (256L.05,
176.17subdivision 3a, exemption from cancellation for nonrenewal for children) is repealed
176.18retroactively from July 1, 2009, and federal approval is no longer necessary.
176.19(j) The amendment in Laws 2009, chapter 79, article 5, section 63, (256L.07,
176.20subdivision 1, children whose gross family income is greater than 275 percent FPG
176.21may remain enrolled) is repealed retroactively from July 1, 2009, and federal approval is
176.22no longer necessary.
176.23(k) The amendment in Laws 2009, chapter 79, article 5, section 64, (256L.07,
176.24subdivision 2, exempts children from requirement not to have employer-subsidized
176.25coverage) is repealed retroactively from July 1, 2009, and federal approval is no longer
176.26necessary.
176.27(l) The amendment in Laws 2009, chapter 79, article 5, section 65, (256L.07,
176.28subdivision 3, requires children with family gross income over 200 percent of FPG
176.29to have had no health coverage for four months prior to application) is repealed
176.30retroactively from July 1, 2009, and federal approval is no longer necessary.
176.31(m) The amendment in Laws 2009, chapter 79, article 5, section 68, (256L.15,
176.32subdivision 2, children in families with income less than 200 percent FPG pay no
176.33premium) is repealed retroactively from July 1, 2009, and federal approval is no longer
176.34necessary.
176.35(n) The amendment in Laws 2009, chapter 79, article 5, section 69, (256L.15,
176.36subdivision 3, exempts children with family income below 200 percent FPG from
177.1sliding fee scale) is repealed retroactively from July 1, 2009, and federal approval is
177.2no longer necessary.
177.3(o) Laws 2009, chapter 79, article 5, section 79, (uncoded federal approval) is
177.4repealed the day following final enactment.
177.5(p) Minnesota Statutes 2010, section 256B.057, subdivision 2c, (extended medical
177.6assistance for certain children) is repealed.
177.7(q) The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9,
177.8(renewal rolling month and premium grace month) are repealed.

177.9    Sec. 88. REPEALER.
177.10Minnesota Statutes 2010, sections 256B.055, subdivision 15; and 256B.0756, are
177.11repealed effective October 1, 2011.

177.12
ARTICLE 6

177.13CONTINUING CARE

177.14    Section 1. [15.996] PERFORMANCE-BASED ORGANIZATIONS.
177.15    Subdivision 1. Designation. The governor may designate one or more programs
177.16within the Department of Human Services and within up to two other executive branch
177.17state agencies whose missions involve people with disabilities as performance-based
177.18organizations. The goal of the performance-based organization designation is to provide
177.19the best services in the most cost-effective manner to people with disabilities. For a
177.20program that is designated as a performance-based organization, the agency providing
177.21services or another governmental or private organization under contract with the agency
177.22may enter into a performance-based agreement that allows the agency or the entity under
177.23contract with the agency more flexibility in its operations in exchange for a greater level of
177.24accountability. With any required legislative approval, a performance-based organization
177.25agreement may exempt an agency or an outside entity providing services from one or
177.26more procedural laws, rules, or policies that otherwise would govern the program.
177.27    Subd. 2. Performance-based organization agreement. Designation of a
177.28performance-based organization must be implemented through a performance-based
177.29organization agreement. A performance-based organization agreement may be between
177.30the governor and an agency, if an agency is to provide services under the agreement, or
177.31between an agency and an outside entity, if the outside entity is to provide the services. A
177.32performance-based organization agreement must:
177.33(1) describe the programs subject to the agreement;
178.1(2) specify the procedural laws, rules, or policies that will not apply to the
178.2performance-based organization, why waiver or variance from these laws, rules, or
178.3policies is necessary to achieve desired outcomes, and a description of alternative means
178.4of accomplishing the purposes of those laws, rules, or policies;
178.5(3) contain procedures for oversight of the performance-based organization,
178.6including requirements and procedures for program and financial audits;
178.7(4) if the performance-based organization involves a nonstate entity, contain
178.8provisions governing assumption of liability, and types and amounts of insurance coverage
178.9to be obtained;
178.10(5) specify the duration of the agreement; and
178.11(6) specify measurable performance-based outcomes for achieving program
178.12goals, time periods during which these outcomes will be measured and reported, and
178.13consequences for not meeting the performance-based outcomes.
178.14    Subd. 3. Duration; legislative approval; reporting. (a) A performance-based
178.15organization agreement may be up to three years and may be renewed.
178.16(b) The chief executive of the state agency whose program is subject to a
178.17performance-based organization must report to the chairs and ranking minority members
178.18of legislative policy and finance committees with jurisdiction over the program on the
178.19proposed content of the performance-based organization, and specifically describing
178.20any procedural laws, rules, and policies that will not apply. The legislature must
178.21approve a performance-based organization before the state agency may enter into a
178.22performance-based agreement.

178.23    Sec. 2. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:
178.24    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
178.25child, including a child determined eligible for medical assistance without consideration of
178.26parental income, must contribute to the cost of services used by making monthly payments
178.27on a sliding scale based on income, unless the child is married or has been married,
178.28parental rights have been terminated, or the child's adoption is subsidized according to
178.29section 259.67 or through title IV-E of the Social Security Act. The parental contribution
178.30is a partial or full payment for medical services provided for diagnostic, therapeutic,
178.31curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
178.32defined in United States Code, title 26, section 213, needed by the child with a chronic
178.33illness or disability.
179.1    (b) For households with adjusted gross income equal to or greater than 100 percent
179.2of federal poverty guidelines, the parental contribution shall be computed by applying the
179.3following schedule of rates to the adjusted gross income of the natural or adoptive parents:
179.4    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
179.5poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
179.6contribution is $4 per month;
179.7    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
179.8poverty guidelines and less than or equal to 545 525 percent of federal poverty guidelines,
179.9the parental contribution shall be determined using a sliding fee scale established by the
179.10commissioner of human services which begins at one percent of adjusted gross income at
179.11175 percent of federal poverty guidelines and increases to 7.5 eight percent of adjusted
179.12gross income for those with adjusted gross income up to 545 525 percent of federal
179.13poverty guidelines;
179.14    (3) if the adjusted gross income is greater than 545 525 percent of federal
179.15poverty guidelines and less than 675 percent of federal poverty guidelines, the parental
179.16contribution shall be 7.5 9.5 percent of adjusted gross income;
179.17    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
179.18poverty guidelines and less than 975 900 percent of federal poverty guidelines, the parental
179.19contribution shall be determined using a sliding fee scale established by the commissioner
179.20of human services which begins at 7.5 9.5 percent of adjusted gross income at 675 percent
179.21of federal poverty guidelines and increases to ten 12 percent of adjusted gross income for
179.22those with adjusted gross income up to 975 900 percent of federal poverty guidelines; and
179.23    (5) if the adjusted gross income is equal to or greater than 975 900 percent of
179.24federal poverty guidelines, the parental contribution shall be 12.5 13.5 percent of adjusted
179.25gross income.
179.26    If the child lives with the parent, the annual adjusted gross income is reduced by
179.27$2,400 prior to calculating the parental contribution. If the child resides in an institution
179.28specified in section 256B.35, the parent is responsible for the personal needs allowance
179.29specified under that section in addition to the parental contribution determined under this
179.30section. The parental contribution is reduced by any amount required to be paid directly to
179.31the child pursuant to a court order, but only if actually paid.
179.32    (c) The household size to be used in determining the amount of contribution under
179.33paragraph (b) includes natural and adoptive parents and their dependents, including the
179.34child receiving services. Adjustments in the contribution amount due to annual changes
179.35in the federal poverty guidelines shall be implemented on the first day of July following
179.36publication of the changes.
180.1    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
180.2natural or adoptive parents determined according to the previous year's federal tax form,
180.3except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
180.4have been used to purchase a home shall not be counted as income.
180.5    (e) The contribution shall be explained in writing to the parents at the time eligibility
180.6for services is being determined. The contribution shall be made on a monthly basis
180.7effective with the first month in which the child receives services. Annually upon
180.8redetermination or at termination of eligibility, if the contribution exceeded the cost of
180.9services provided, the local agency or the state shall reimburse that excess amount to
180.10the parents, either by direct reimbursement if the parent is no longer required to pay a
180.11contribution, or by a reduction in or waiver of parental fees until the excess amount is
180.12exhausted. All reimbursements must include a notice that the amount reimbursed may be
180.13taxable income if the parent paid for the parent's fees through an employer's health care
180.14flexible spending account under the Internal Revenue Code, section 125, and that the
180.15parent is responsible for paying the taxes owed on the amount reimbursed.
180.16    (f) The monthly contribution amount must be reviewed at least every 12 months;
180.17when there is a change in household size; and when there is a loss of or gain in income
180.18from one month to another in excess of ten percent. The local agency shall mail a written
180.19notice 30 days in advance of the effective date of a change in the contribution amount.
180.20A decrease in the contribution amount is effective in the month that the parent verifies a
180.21reduction in income or change in household size.
180.22    (g) Parents of a minor child who do not live with each other shall each pay the
180.23contribution required under paragraph (a). An amount equal to the annual court-ordered
180.24child support payment actually paid on behalf of the child receiving services shall be
180.25deducted from the adjusted gross income of the parent making the payment prior to
180.26calculating the parental contribution under paragraph (b).
180.27    (h) The contribution under paragraph (b) shall be increased by an additional five
180.28percent if the local agency determines that insurance coverage is available but not
180.29obtained for the child. For purposes of this section, "available" means the insurance is a
180.30benefit of employment for a family member at an annual cost of no more than five percent
180.31of the family's annual income. For purposes of this section, "insurance" means health
180.32and accident insurance coverage, enrollment in a nonprofit health service plan, health
180.33maintenance organization, self-insured plan, or preferred provider organization.
180.34    Parents who have more than one child receiving services shall not be required
180.35to pay more than the amount for the child with the highest expenditures. There shall
180.36be no resource contribution from the parents. The parent shall not be required to pay
181.1a contribution in excess of the cost of the services provided to the child, not counting
181.2payments made to school districts for education-related services. Notice of an increase in
181.3fee payment must be given at least 30 days before the increased fee is due.
181.4    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
181.5in the 12 months prior to July 1:
181.6    (1) the parent applied for insurance for the child;
181.7    (2) the insurer denied insurance;
181.8    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
181.9a complaint or appeal, in writing, to the commissioner of health or the commissioner of
181.10commerce, or litigated the complaint or appeal; and
181.11    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
181.12    For purposes of this section, "insurance" has the meaning given in paragraph (h).
181.13    A parent who has requested a reduction in the contribution amount under this
181.14paragraph shall submit proof in the form and manner prescribed by the commissioner or
181.15county agency, including, but not limited to, the insurer's denial of insurance, the written
181.16letter or complaint of the parents, court documents, and the written response of the insurer
181.17approving insurance. The determinations of the commissioner or county agency under this
181.18paragraph are not rules subject to chapter 14.
181.19(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
181.202013, the parental contribution shall be computed by applying the following contribution
181.21schedule to the adjusted gross income of the natural or adoptive parents:
181.22(1) if the adjusted gross income is equal to or greater than 100 percent of federal
181.23poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
181.24contribution is $4 per month;
181.25(2) if the adjusted gross income is equal to or greater than 175 percent of federal
181.26poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
181.27the parental contribution shall be determined using a sliding fee scale established by the
181.28commissioner of human services which begins at one percent of adjusted gross income
181.29at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
181.30gross income for those with adjusted gross income up to 525 percent of federal poverty
181.31guidelines;
181.32(3) if the adjusted gross income is greater than 525 percent of federal poverty
181.33guidelines and less than 675 percent of federal poverty guidelines, the parental contribution
181.34shall be 9.5 percent of adjusted gross income;
181.35(4) if the adjusted gross income is equal to or greater than 675 percent of federal
181.36poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
182.1contribution shall be determined using a sliding fee scale established by the commissioner
182.2of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
182.3federal poverty guidelines and increases to 12 percent of adjusted gross income for those
182.4with adjusted gross income up to 900 percent of federal poverty guidelines; and
182.5(5) if the adjusted gross income is equal to or greater than 900 percent of federal
182.6poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
182.7income. If the child lives with the parent, the annual adjusted gross income is reduced by
182.8$2,400 prior to calculating the parental contribution. If the child resides in an institution
182.9specified in section 256B.35, the parent is responsible for the personal needs allowance
182.10specified under that section in addition to the parental contribution determined under this
182.11section. The parental contribution is reduced by any amount required to be paid directly to
182.12the child pursuant to a court order, but only if actually paid.

182.13    Sec. 3. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
182.14    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
182.15Linkage Line, a to serve as Minnesota's neutral access point for statewide consumer
182.16disability information, referral, and assistance system for people with disabilities and
182.17chronic illnesses that. The Disability Linkage Line shall:
182.18(1) deliver information and assistance based on national and state standards;
182.19    (1) provides (2) provide information about state and federal eligibility requirements,
182.20benefits, and service options;
182.21(3) provide benefits and options counseling;
182.22    (2) makes (4) make referrals to appropriate support entities;
182.23    (3) delivers information and assistance based on national and state standards;
182.24    (4) assists (5) educate people to on their options so they can make well-informed
182.25decisions choices; and
182.26    (5) supports (6) help support the timely resolution of service access and benefit
182.27issues.;
182.28(7) inform people of their long-term community services and supports;
182.29(8) provide necessary resources and supports that can lead to employment and
182.30increased economic stability of people with disabilities; and
182.31(9) serve as the technical assistance and help center for the Web-based tool,
182.32Minnesota's Disability Benefits 101.org.
182.33EFFECTIVE DATE.This section is effective July 1, 2011.

182.34    Sec. 4. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
183.1    Subd. 29. State medical review team. (a) To ensure the timely processing of
183.2determinations of disability by the commissioner's state medical review team under
183.3sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
183.4(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence
183.5submitted by county agencies with a referral and seek additional information from
183.6providers, applicants, and enrollees to support the determination of disability where
183.7necessary. Disability shall be determined according to the rules of title XVI and title
183.8XIX of the Social Security Act and pertinent rules and policies of the Social Security
183.9Administration.
183.10    (b) Prior to a denial or withdrawal of a requested determination of disability due
183.11to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
183.12necessary and appropriate to a determination of disability, and (2) assist applicants and
183.13enrollees to obtain the evidence, including, but not limited to, medical examinations
183.14and electronic medical records.
183.15(c) The commissioner shall provide the chairs of the legislative committees with
183.16jurisdiction over health and human services finance and budget the following information
183.17on the activities of the state medical review team by February 1 of each year:
183.18(1) the number of applications to the state medical review team that were denied,
183.19approved, or withdrawn;
183.20(2) the average length of time from receipt of the application to a decision;
183.21(3) the number of appeals, appeal results, and the length of time taken from the date
183.22the person involved requested an appeal for a written decision to be made on each appeal;
183.23(4) for applicants, their age, health coverage at the time of application, hospitalization
183.24history within three months of application, and whether an application for Social Security
183.25or Supplemental Security Income benefits is pending; and
183.26(5) specific information on the medical certification, licensure, or other credentials
183.27of the person or persons performing the medical review determinations and length of
183.28time in that position.
183.29(d) Any appeal made under section 256.045, subdivision 3, of a disability
183.30determination made by the state medical review team must be decided according to the
183.31timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is
183.32not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the
183.33appeal must be immediately reviewed by the chief appeals referee.
183.34EFFECTIVE DATE.This section is effective July 1, 2011.

184.1    Sec. 5. Minnesota Statutes 2010, section 256B.04, is amended by adding a subdivision
184.2to read:
184.3    Subd. 20. Money Follows the Person Rebalancing demonstration project. In
184.4accordance with federal law governing Money Follows the Person Rebalancing funds,
184.5amounts equal to the value of enhanced federal funding resulting from the operation of the
184.6demonstration project grant must be transferred from the medical assistance account in
184.7the general fund to an account in the special revenue fund. Funds in the special revenue
184.8fund account do not cancel and are appropriated to the commissioner to carry out the
184.9goals of the Money Follows the Person Rebalancing demonstration project as required
184.10under the approved federal plan for the use of the funds, and may be transferred to the
184.11medical assistance account if applicable.

184.12    Sec. 6. Minnesota Statutes 2010, section 256B.05, is amended by adding a subdivision
184.13to read:
184.14    Subd. 5. Obligation of local agency to process medical assistance applications
184.15within established timelines. The local agency must act on an application for medical
184.16assistance within ten working days of receipt of all information needed to act on the
184.17application but no later than required under Minnesota Rules, part 9505.0090, subparts
184.182 and 3.

184.19    Sec. 7. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
184.20    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
184.21medical assistance, a person must not individually own more than $3,000 in assets, or if a
184.22member of a household with two family members, husband and wife, or parent and child,
184.23the household must not own more than $6,000 in assets, plus $200 for each additional
184.24legal dependent. In addition to these maximum amounts, an eligible individual or family
184.25may accrue interest on these amounts, but they must be reduced to the maximum at the
184.26time of an eligibility redetermination. The accumulation of the clothing and personal
184.27needs allowance according to section 256B.35 must also be reduced to the maximum at
184.28the time of the eligibility redetermination. The value of assets that are not considered in
184.29determining eligibility for medical assistance is the value of those assets excluded under
184.30the supplemental security income program for aged, blind, and disabled persons, with
184.31the following exceptions:
184.32(1) household goods and personal effects are not considered;
184.33(2) capital and operating assets of a trade or business that the local agency determines
184.34are necessary to the person's ability to earn an income are not considered;
185.1(3) motor vehicles are excluded to the same extent excluded by the supplemental
185.2security income program;
185.3(4) assets designated as burial expenses are excluded to the same extent excluded by
185.4the supplemental security income program. Burial expenses funded by annuity contracts
185.5or life insurance policies must irrevocably designate the individual's estate as contingent
185.6beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
185.7(5) effective upon federal approval, for a person who no longer qualifies as an
185.8employed person with a disability due to loss of earnings, assets allowed while eligible
185.9for medical assistance under section 256B.057, subdivision 9, are not considered for 12
185.10months, beginning with the first month of ineligibility as an employed person with a
185.11disability, to the extent that the person's total assets remain within the allowed limits of
185.12section 256B.057, subdivision 9, paragraph (c) (d).
185.13(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
185.1415.
185.15EFFECTIVE DATE.This section is effective January 1, 2014.

185.16    Sec. 8. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
185.17    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
185.18for a person who is employed and who:
185.19(1) but for excess earnings or assets, meets the definition of disabled under the
185.20Supplemental Security Income program;
185.21(2) is at least 16 but less than 65 years of age;
185.22(3) meets the asset limits in paragraph (c) (d); and
185.23(4) pays a premium and other obligations under paragraph (e).
185.24    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
185.25for medical assistance under this subdivision, a person must have more than $65 of earned
185.26income. Earned income must have Medicare, Social Security, and applicable state and
185.27federal taxes withheld. The person must document earned income tax withholding. Any
185.28spousal income or assets shall be disregarded for purposes of eligibility and premium
185.29determinations.
185.30(b) (c) After the month of enrollment, a person enrolled in medical assistance under
185.31this subdivision who:
185.32(1) is temporarily unable to work and without receipt of earned income due to a
185.33medical condition, as verified by a physician, may retain eligibility for up to four calendar
185.34months; or
186.1(2) effective January 1, 2004, loses employment for reasons not attributable to the
186.2enrollee, and is without receipt of earned income may retain eligibility for up to four
186.3consecutive months after the month of job loss. To receive a four-month extension,
186.4enrollees must verify the medical condition or provide notification of job loss. All other
186.5eligibility requirements must be met and the enrollee must pay all calculated premium
186.6costs for continued eligibility.
186.7(c) (d) For purposes of determining eligibility under this subdivision, a person's
186.8assets must not exceed $20,000, excluding:
186.9(1) all assets excluded under section 256B.056;
186.10(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
186.11Keogh plans, and pension plans; and
186.12(3) medical expense accounts set up through the person's employer.; and
186.13(4) spousal assets, including spouse's share of jointly held assets.
186.14(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
186.15earned income disregard. To be eligible, a person applying for medical assistance under
186.16this subdivision must have earned income above the disregard level.
186.17(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
186.18Security, and applicable state and federal income taxes must be withheld. To be eligible,
186.19a person must document earned income tax withholding.
186.20(e)(1) A person whose earned and unearned income is equal to or greater than 100
186.21percent of federal poverty guidelines for the applicable family size must pay a premium
186.22to be eligible for medical assistance under this subdivision. (e) All enrollees must pay a
186.23premium to be eligible for medical assistance under this subdivision, except as provided
186.24under section 256.01, subdivision 18b.
186.25(1) An enrollee must pay the greater of a $65 premium or the premium shall be
186.26calculated based on the person's gross earned and unearned income and the applicable
186.27family size using a sliding fee scale established by the commissioner, which begins at
186.28one percent of income at 100 percent of the federal poverty guidelines and increases
186.29to 7.5 percent of income for those with incomes at or above 300 percent of the federal
186.30poverty guidelines.
186.31(2) Annual adjustments in the premium schedule based upon changes in the federal
186.32poverty guidelines shall be effective for premiums due in July of each year.
186.33(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
186.34medical assistance under this subdivision. An enrollee shall pay the greater of a $35
186.35premium or the premium calculated in clause (1).
187.1(3) Effective November 1, 2003, All enrollees who receive unearned income must
187.2pay one-half of one five percent of unearned income in addition to the premium amount,
187.3except as provided under section 256.01, subdivision 18b.
187.4(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
187.5percent of the federal poverty guidelines and who are also enrolled in Medicare, the
187.6commissioner must reimburse the enrollee for Medicare Part B premiums under section
187.7256B.0625, subdivision 15, paragraph (a).
187.8(5) (4) Increases in benefits under title II of the Social Security Act shall not be
187.9counted as income for purposes of this subdivision until July 1 of each year.
187.10(f) A person's eligibility and premium shall be determined by the local county
187.11agency. Premiums must be paid to the commissioner. All premiums are dedicated to
187.12the commissioner.
187.13(g) Any required premium shall be determined at application and redetermined at
187.14the enrollee's six-month income review or when a change in income or household size is
187.15reported. Enrollees must report any change in income or household size within ten days
187.16of when the change occurs. A decreased premium resulting from a reported change in
187.17income or household size shall be effective the first day of the next available billing month
187.18after the change is reported. Except for changes occurring from annual cost-of-living
187.19increases, a change resulting in an increased premium shall not affect the premium amount
187.20until the next six-month review.
187.21(h) Premium payment is due upon notification from the commissioner of the
187.22premium amount required. Premiums may be paid in installments at the discretion of
187.23the commissioner.
187.24(i) Nonpayment of the premium shall result in denial or termination of medical
187.25assistance unless the person demonstrates good cause for nonpayment. Good cause exists
187.26if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
187.27D, are met. Except when an installment agreement is accepted by the commissioner,
187.28all persons disenrolled for nonpayment of a premium must pay any past due premiums
187.29as well as current premiums due prior to being reenrolled. Nonpayment shall include
187.30payment with a returned, refused, or dishonored instrument. The commissioner may
187.31require a guaranteed form of payment as the only means to replace a returned, refused,
187.32or dishonored instrument.
187.33(j) The commissioner shall notify enrollees annually beginning at least 24 months
187.34before the person's 65th birthday of the medical assistance eligibility rules affecting
187.35income, assets, and treatment of a spouse's income and assets that will be applied upon
187.36reaching age 65.
188.1(k) For enrollees whose income does not exceed 200 percent of the federal poverty
188.2guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
188.3the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
188.4paragraph (a).
188.5EFFECTIVE DATE.This section is effective January 1, 2014, for adults age 21 or
188.6older, and October 1, 2019, for children age 16 to before the child's 21st birthday.

188.7    Sec. 9. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to
188.8read:
188.9    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
188.10must meet the following requirements:
188.11    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years
188.12of age with these additional requirements:
188.13    (i) supervision by a qualified professional every 60 days; and
188.14    (ii) employment by only one personal care assistance provider agency responsible
188.15for compliance with current labor laws;
188.16    (2) be employed by a personal care assistance provider agency;
188.17    (3) enroll with the department as a personal care assistant after clearing a background
188.18study. Except as provided in subdivision 11a, before a personal care assistant provides
188.19services, the personal care assistance provider agency must initiate a background study on
188.20the personal care assistant under chapter 245C, and the personal care assistance provider
188.21agency must have received a notice from the commissioner that the personal care assistant
188.22is:
188.23    (i) not disqualified under section 245C.14; or
188.24    (ii) is disqualified, but the personal care assistant has received a set aside of the
188.25disqualification under section 245C.22;
188.26    (4) be able to effectively communicate with the recipient and personal care
188.27assistance provider agency;
188.28    (5) be able to provide covered personal care assistance services according to the
188.29recipient's personal care assistance care plan, respond appropriately to recipient needs,
188.30and report changes in the recipient's condition to the supervising qualified professional
188.31or physician;
188.32    (6) not be a consumer of personal care assistance services;
188.33    (7) maintain daily written records including, but not limited to, time sheets under
188.34subdivision 12;
189.1    (8) effective January 1, 2010, complete standardized training as determined
189.2by the commissioner before completing enrollment. The training must be available
189.3in languages other than English and to those who need accommodations due to
189.4disabilities. Personal care assistant training must include successful completion of the
189.5following training components: basic first aid, vulnerable adult, child maltreatment,
189.6OSHA universal precautions, basic roles and responsibilities of personal care assistants
189.7including information about assistance with lifting and transfers for recipients, emergency
189.8preparedness, orientation to positive behavioral practices, fraud issues, and completion of
189.9time sheets. Upon completion of the training components, the personal care assistant must
189.10demonstrate the competency to provide assistance to recipients;
189.11    (9) complete training and orientation on the needs of the recipient within the first
189.12seven days after the services begin; and
189.13    (10) be limited to providing and being paid for up to 275 hours per month, except
189.14that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
189.152011, of personal care assistance services regardless of the number of recipients being
189.16served or the number of personal care assistance provider agencies enrolled with. The
189.17number of hours worked per day shall not be disallowed by the department unless in
189.18violation of the law.
189.19    (b) A legal guardian may be a personal care assistant if the guardian is not being paid
189.20for the guardian services and meets the criteria for personal care assistants in paragraph (a).
189.21    (c) Effective January 1, 2010, Persons who do not qualify as a personal care assistant
189.22include parents and stepparents of minors, spouses, paid legal guardians, family foster
189.23care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or
189.24staff of a residential setting. When the personal care assistant is a relative of the recipient,
189.25the commissioner shall pay 80 percent of the provider rate. For purposes of this section,
189.26relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or
189.27older, an adult child, a grandparent, or a grandchild.
189.28EFFECTIVE DATE.This section is effective October 1, 2011.

189.29    Sec. 10. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to
189.30read:
189.31    Subd. 28. Personal care assistance provider agency; required documentation.
189.32(a) Required documentation must be completed and kept in the personal care assistance
189.33provider agency file or the recipient's home residence. The required documentation
189.34consists of:
189.35(1) employee files, including:
190.1(i) applications for employment;
190.2(ii) background study requests and results;
190.3(iii) orientation records about the agency policies;
190.4(iv) trainings completed with demonstration of competence;
190.5(v) supervisory visits;
190.6(vi) evaluations of employment; and
190.7(vii) signature on fraud statement;
190.8(2) recipient files, including:
190.9(i) demographics;
190.10(ii) emergency contact information and emergency backup plan;
190.11(iii) personal care assistance service plan;
190.12(iv) personal care assistance care plan;
190.13(v) month-to-month service use plan;
190.14(vi) all communication records;
190.15(vii) start of service information, including the written agreement with recipient; and
190.16(viii) date the home care bill of rights was given to the recipient;
190.17(3) agency policy manual, including:
190.18(i) policies for employment and termination;
190.19(ii) grievance policies with resolution of consumer grievances;
190.20(iii) staff and consumer safety;
190.21(iv) staff misconduct; and
190.22(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
190.23resolution of consumer grievances;
190.24(4) time sheets for each personal care assistant along with completed activity sheets
190.25for each recipient served; and
190.26(5) agency marketing and advertising materials and documentation of marketing
190.27activities and costs; and
190.28(6) for each personal care assistant, whether or not the personal care assistant is
190.29providing care to a relative as defined in subdivision 11.
190.30(b) The commissioner may assess a fine of up to $500 on provider agencies that do
190.31not consistently comply with the requirements of this subdivision.

190.32    Sec. 11. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to
190.33read:
190.34    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
190.35    (a) "Long-term care consultation services" means:
191.1    (1) assistance in identifying services needed to maintain an individual in the most
191.2inclusive environment;
191.3    (2) providing recommendations on cost-effective community services that are
191.4available to the individual;
191.5    (3) development of an individual's person-centered community support plan;
191.6    (4) providing information regarding eligibility for Minnesota health care programs;
191.7    (5) face-to-face long-term care consultation assessments, which may be completed
191.8in a hospital, nursing facility, intermediate care facility for persons with developmental
191.9disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
191.10residence;
191.11    (6) federally mandated screening to determine the need for an institutional level of
191.12care under subdivision 4a;
191.13    (7) determination of home and community-based waiver service eligibility
191.14including level of care determination for individuals who need an institutional level of
191.15care as defined under section 144.0724, subdivision 11, or 256B.092, service eligibility
191.16including state plan home care services identified in sections 256B.0625, subdivisions
191.176 , 7, and 19, paragraphs (a) and (c), and 256B.0657, based on assessment and support
191.18plan development with appropriate referrals, including the option for consumer-directed
191.19community self-directed supports;
191.20    (8) providing recommendations for nursing facility placement when there are no
191.21cost-effective community services available; and
191.22    (9) assistance to transition people back to community settings after facility
191.23admission; and
191.24(10) providing notice to the individual or legal representative of the annual and
191.25monthly average authorized amount for traditional agency services and self-directed
191.26services under section 256B.0657 for which the recipient is found eligible.
191.27    (b) "Long-term care options counseling" means the services provided by the linkage
191.28lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
191.29telephone assistance and follow up once a long-term care consultation assessment has
191.30been completed.
191.31    (c) "Minnesota health care programs" means the medical assistance program under
191.32chapter 256B and the alternative care program under section 256B.0913.
191.33    (d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
191.34plans administering long-term care consultation assessment and support planning services.
191.35EFFECTIVE DATE.This section is effective January 1, 2012.

192.1    Sec. 12. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to
192.2read:
192.3    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
192.4services planning, or other assistance intended to support community-based living,
192.5including persons who need assessment in order to determine waiver or alternative
192.6care program eligibility, must be visited by a long-term care consultation team within
192.715 calendar 20 calendar days after the date on which an assessment was requested or
192.8recommended. After January 1, 2011, these requirements also apply to personal care
192.9assistance services, private duty nursing, and home health agency services, on timelines
192.10established in subdivision 5. Face-to-face assessments must be conducted according
192.11to paragraphs (b) to (i).
192.12    (b) The county may utilize a team of either the social worker or public health nurse,
192.13or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
192.14assessment in a face-to-face interview. The consultation team members must confer
192.15regarding the most appropriate care for each individual screened or assessed.
192.16    (c) The assessment must be comprehensive and include a person-centered
192.17assessment of the health, psychological, functional, environmental, and social needs of
192.18referred individuals and provide information necessary to develop a support plan that
192.19meets the consumers needs, using an assessment form provided by the commissioner.
192.20    (d) The assessment must be conducted in a face-to-face interview with the person
192.21being assessed and the person's legal representative, as required by legally executed
192.22documents, and other individuals as requested by the person, who can provide information
192.23on the needs, strengths, and preferences of the person necessary to develop a support
192.24plan that ensures the person's health and safety, but who is not a provider of service or
192.25has any financial interest in the provision of services. For persons who are to be assessed
192.26for elderly waiver customized living services under section 256B.0915, and with the
192.27permission of the person being assessed or the persons' designated or legal representative,
192.28the client's current or proposed provider of services may submit a copy of the provider's
192.29nursing assessment or written report outlining their recommendations regarding the
192.30client's care needs. The person conducting the assessment will notify the provider of the
192.31date by which this information is to be submitted. This information shall be provided to
192.32the person conducting the assessment prior to the assessment.
192.33    (e) The person, or the person's legal representative, must be provided with
192.34written recommendations for community-based services, including consumer-directed
192.35self-directed options, or institutional care that include documentation that the most
192.36cost-effective alternatives available were offered to the individual. For purposes of
193.1this requirement, "cost-effective alternatives" means community services and living
193.2arrangements that cost the same as or less than institutional care. For persons determined
193.3eligible for services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the
193.4community support plan must also include the estimated annual and monthly average
193.5authorized budget amount for those services.
193.6    (f)(1) If the person chooses to use community-based services, the person or the
193.7person's legal representative must be provided with a written community support plan,
193.8regardless of whether the individual is eligible for Minnesota health care programs. The
193.9written community support plan must include:
193.10    (i) a summary of assessed needs as defined in paragraphs (c) and (d);
193.11    (ii) the individual's options and choices to meet identified needs, including all
193.12available options for case management services and providers;
193.13    (iii) identification of health and safety risks and how those risks will be addressed,
193.14including personal risk management strategies;
193.15    (iv) referral information; and
193.16    (v) informal caregiver supports, if applicable.
193.17    (2) For persons determined eligible for services defined under subdivision 1a,
193.18paragraph (a), clauses (7) to (10), the community support plan must also include:
193.19    (i) identification of individual goals;
193.20    (ii) identification of short-term and long-term service outcomes. Short-term service
193.21outcomes are defined as achievable within six months;
193.22    (iii) a recommended schedule for case management visits. When achievement of
193.23short-term service outcomes may affect the amount of service required, the schedule must
193.24be at least every six months and must reflect evaluation and progress toward identified
193.25short-term service outcomes; and
193.26    (iv) the estimated annual and monthly budget amount for services.
193.27    (3) In addition, for persons determined eligible for state plan home care under
193.28subdivision 1a, paragraph (a), clause (8), the person or person's representative must also
193.29receive a copy of the home care service plan developed by a certified assessor.
193.30(4) A person may request assistance in identifying community supports without
193.31participating in a complete assessment. Upon a request for assistance identifying
193.32community support, the person must be transferred or referred to the services available
193.33under sections 256.975, subdivision 7, and 256.01, subdivision 24, for telephone
193.34assistance and follow up.
194.1    (g) The person has the right to make the final decision between institutional
194.2placement and community placement after the recommendations have been provided,
194.3except as provided in subdivision 4a, paragraph (c).
194.4    (h) The team must give the person receiving assessment or support planning, or
194.5the person's legal representative, materials, and forms supplied by the commissioner
194.6containing the following information:
194.7    (1) the need for and purpose of preadmission screening if the person selects nursing
194.8facility placement;
194.9    (2) the role of the long-term care consultation assessment and support planning in
194.10waiver and alternative care program eligibility determination;
194.11    (3) information about Minnesota health care programs;
194.12    (4) the person's freedom to accept or reject the recommendations of the team;
194.13    (5) the person's right to confidentiality under the Minnesota Government Data
194.14Practices Act, chapter 13;
194.15    (6) the long-term care consultant's decision regarding the person's need for
194.16institutional level of care as determined under criteria established in section 144.0724,
194.17subdivision 11 , or 256B.092; and
194.18(7) the person's right to appeal the decision regarding the need for nursing facility
194.19level of care or the county's final decisions regarding public programs eligibility according
194.20to section 256.045, subdivision 3.
194.21    (i) Face-to-face assessment completed as part of eligibility determination for
194.22the alternative care, elderly waiver, community alternatives for disabled individuals,
194.23community alternative care, and traumatic brain injury waiver programs under sections
194.24256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more
194.25than 60 calendar days after the date of assessment. The effective eligibility start date
194.26for these programs can never be prior to the date of assessment. If an assessment was
194.27completed more than 60 days before the effective waiver or alternative care program
194.28eligibility start date, assessment and support plan information must be updated in a
194.29face-to-face visit and documented in the department's Medicaid Management Information
194.30System (MMIS). The updated assessment may be completed by face-to-face visit, written
194.31communication, or telephone as determined by the commissioner to establish statewide
194.32consistency. The effective date of program eligibility in this case cannot be prior to the
194.33date the updated assessment is completed.
194.34EFFECTIVE DATE.This section is effective January 1, 2012.

195.1    Sec. 13. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to
195.2read:
195.3    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
195.4    (a) Funding for services under the alternative care program is available to persons who
195.5meet the following criteria:
195.6    (1) the person has been determined by a community assessment under section
195.7256B.0911 to be a person who would require the level of care provided in a nursing
195.8facility, but for the provision of services under the alternative care program. Effective
195.9January 1, 2011, this determination must be made according to the criteria established in
195.10section 144.0724, subdivision 11;
195.11    (2) the person is age 65 or older;
195.12    (3) the person would be eligible for medical assistance within 135 days of admission
195.13to a nursing facility;
195.14    (4) the person is not ineligible for the payment of long-term care services by the
195.15medical assistance program due to an asset transfer penalty under section 256B.0595 or
195.16equity interest in the home exceeding $500,000 as stated in section 256B.056;
195.17    (5) the person needs long-term care services that are not funded through other
195.18state or federal funding, or other health insurance or other third-party insurance such as
195.19long-term care insurance;
195.20    (6) except for individuals described in clause (7), the monthly cost of the alternative
195.21care services funded by the program for this person does not exceed 75 percent of the
195.22monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
195.23does not prohibit the alternative care client from payment for additional services, but in no
195.24case may the cost of additional services purchased under this section exceed the difference
195.25between the client's monthly service limit defined under section 256B.0915, subdivision
195.263 , and the alternative care program monthly service limit defined in this paragraph. If
195.27care-related supplies and equipment or environmental modifications and adaptations are or
195.28will be purchased for an alternative care services recipient, the costs may be prorated on a
195.29monthly basis for up to 12 consecutive months beginning with the month of purchase.
195.30If the monthly cost of a recipient's other alternative care services exceeds the monthly
195.31limit established in this paragraph, the annual cost of the alternative care services shall be
195.32determined. In this event, the annual cost of alternative care services shall not exceed 12
195.33times the monthly limit described in this paragraph;
195.34    (7) for individuals assigned a case mix classification A as described under section
195.35256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
195.36living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming,
196.1or walking, or (iii) a dependency score of less than three if eating is the only dependency
196.2and eating when the dependency score in eating is three or greater as determined by
196.3an assessment performed under section 256B.0911, the monthly cost of alternative
196.4care services funded by the program cannot exceed $600 $593 per month for all new
196.5participants enrolled in the program on or after July 1, 2009 2011. This monthly limit
196.6shall be applied to all other participants who meet this criteria at reassessment. This
196.7monthly limit shall be increased annually as described in section 256B.0915, subdivision
196.83a , paragraph (a). This monthly limit does not prohibit the alternative care client from
196.9payment for additional services, but in no case may the cost of additional services
196.10purchased exceed the difference between the client's monthly service limit defined in this
196.11clause and the limit described in clause (6) for case mix classification A; and
196.12(8) the person is making timely payments of the assessed monthly fee.
196.13A person is ineligible if payment of the fee is over 60 days past due, unless the person
196.14agrees to:
196.15    (i) the appointment of a representative payee;
196.16    (ii) automatic payment from a financial account;
196.17    (iii) the establishment of greater family involvement in the financial management of
196.18payments; or
196.19    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
196.20    The lead agency may extend the client's eligibility as necessary while making
196.21arrangements to facilitate payment of past-due amounts and future premium payments.
196.22Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
196.23reinstated for a period of 30 days.
196.24    (b) Alternative care funding under this subdivision is not available for a person
196.25who is a medical assistance recipient or who would be eligible for medical assistance
196.26without a spenddown or waiver obligation. A person whose initial application for medical
196.27assistance and the elderly waiver program is being processed may be served under the
196.28alternative care program for a period up to 60 days. If the individual is found to be eligible
196.29for medical assistance, medical assistance must be billed for services payable under the
196.30federally approved elderly waiver plan and delivered from the date the individual was
196.31found eligible for the federally approved elderly waiver plan. Notwithstanding this
196.32provision, alternative care funds may not be used to pay for any service the cost of which:
196.33(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
196.34or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
196.35to participate in the federally approved elderly waiver program under the special income
196.36standard provision.
197.1    (c) Alternative care funding is not available for a person who resides in a licensed
197.2nursing home, certified boarding care home, hospital, or intermediate care facility, except
197.3for case management services which are provided in support of the discharge planning
197.4process for a nursing home resident or certified boarding care home resident to assist with
197.5a relocation process to a community-based setting.
197.6    (d) Alternative care funding is not available for a person whose income is greater
197.7than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
197.8to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
197.9year for which alternative care eligibility is determined, who would be eligible for the
197.10elderly waiver with a waiver obligation.

197.11    Sec. 14. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to
197.12read:
197.13    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
197.14waivered services to an individual elderly waiver client except for individuals described
197.15in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
197.16mix resident class to which the elderly waiver client would be assigned under Minnesota
197.17Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
197.18as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
197.19which the resident assessment system as described in section 256B.438 for nursing home
197.20rate determination is implemented. Effective on the first day of the state fiscal year in
197.21which the resident assessment system as described in section 256B.438 for nursing home
197.22rate determination is implemented and the first day of each subsequent state fiscal year, the
197.23monthly limit for the cost of waivered services to an individual elderly waiver client shall
197.24be the rate of the case mix resident class to which the waiver client would be assigned
197.25under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
197.26previous state fiscal year, adjusted by the greater of any legislatively adopted home and
197.27community-based services percentage rate increase or the average statewide percentage
197.28increase in nursing facility payment rates adjustment.
197.29    (b) The monthly limit for the cost of waivered services to an individual elderly
197.30waiver client assigned to a case mix classification A under paragraph (a) with:
197.31(1) no dependencies in activities of daily living,; or
197.32(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
197.33walking, or (3) a dependency score of less than three if eating is the only dependency,
197.34and eating when the dependency score in eating is three or greater as determined by an
197.35assessment performed under section 256B.0911
198.1 shall be the lower of the case mix classification amount for case mix A as determined
198.2under paragraph (a) or the case mix classification amount for case mix A $1,750 per
198.3month effective on October July 1, 2008 2011, per month for all new participants enrolled
198.4in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all
198.5other participants who meet this criteria at reassessment. This monthly limit shall be
198.6increased annually as described in paragraph (a).
198.7(c) If extended medical supplies and equipment or environmental modifications are
198.8or will be purchased for an elderly waiver client, the costs may be prorated for up to
198.912 consecutive months beginning with the month of purchase. If the monthly cost of a
198.10recipient's waivered services exceeds the monthly limit established in paragraph (a) or
198.11(b), the annual cost of all waivered services shall be determined. In this event, the annual
198.12cost of all waivered services shall not exceed 12 times the monthly limit of waivered
198.13services as described in paragraph (a) or (b).

198.14    Sec. 15. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to
198.15read:
198.16    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
198.17facility. (a) For a person who is a nursing facility resident at the time of requesting a
198.18determination of eligibility for elderly waivered services, a monthly conversion budget
198.19limit for the cost of elderly waivered services may be requested. The monthly conversion
198.20budget limit for the cost of elderly waiver services shall be the resident class assigned
198.21under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing
198.22facility where the resident currently resides until July 1 of the state fiscal year in which
198.23the resident assessment system as described in section 256B.438 for nursing home rate
198.24determination is implemented. Effective on July 1 of the state fiscal year in which the
198.25resident assessment system as described in section 256B.438 for nursing home rate
198.26determination is implemented, the monthly conversion budget limit for the cost of elderly
198.27waiver services shall be based on the per diem nursing facility rate as determined by the
198.28resident assessment system as described in section 256B.438 for that resident residents
198.29in the nursing facility where the resident elderly waiver applicant currently resides
198.30multiplied. The monthly conversion budget limit shall be calculated by multiplying the
198.31per diem by 365 and, divided by 12, less and reduced by the recipient's maintenance needs
198.32allowance as described in subdivision 1d. The initially approved monthly conversion rate
198.33may budget limit shall be adjusted by the greater of any subsequent legislatively adopted
198.34home and community-based services percentage rate increase or the average statewide
198.35percentage increase in nursing facility payment rates annually as described in subdivision
199.13a, paragraph (a). The limit under this subdivision only applies to persons discharged from
199.2a nursing facility after a minimum 30-day stay and found eligible for waivered services
199.3on or after July 1, 1997. For conversions from the nursing home to the elderly waiver
199.4with consumer directed community support services, the conversion rate limit is equal to
199.5the nursing facility rate per diem used to calculate the monthly conversion budget limit
199.6must be reduced by a percentage equal to the percentage difference between the consumer
199.7directed services budget limit that would be assigned according to the federally approved
199.8waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
199.9    (b) The following costs must be included in determining the total monthly costs
199.10for the waiver client:
199.11    (1) cost of all waivered services, including extended medical specialized supplies
199.12and equipment and environmental modifications and accessibility adaptations; and
199.13    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
199.14by medical assistance.

199.15    Sec. 16. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to
199.16read:
199.17    Subd. 3e. Customized living service rate. (a) Payment for customized living
199.18services shall be a monthly rate authorized by the lead agency within the parameters
199.19established by the commissioner. The payment agreement must delineate the amount of
199.20each component service included in the recipient's customized living service plan. The
199.21lead agency shall ensure that there is a documented need within the parameters established
199.22by the commissioner for all component customized living services authorized.
199.23(b) The payment rate must be based on the amount of component services to be
199.24provided utilizing component rates established by the commissioner. Counties and tribes
199.25shall use tools issued by the commissioner to develop and document customized living
199.26service plans and rates.
199.27(c) Component service rates must not exceed payment rates for comparable elderly
199.28waiver or medical assistance services and must reflect economies of scale. Customized
199.29living services must not include rent or raw food costs.
199.30    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
199.31individualized monthly authorized payment for the customized living service plan shall
199.32not exceed 50 percent of the greater of either the statewide or any of the geographic
199.33groups' weighted average monthly nursing facility rate of the case mix resident class
199.34to which the elderly waiver eligible client would be assigned under Minnesota Rules,
199.35parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
200.1in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
200.2resident assessment system as described in section 256B.438 for nursing home rate
200.3determination is implemented. Effective on July 1 of the state fiscal year in which
200.4the resident assessment system as described in section 256B.438 for nursing home
200.5rate determination is implemented and July 1 of each subsequent state fiscal year, the
200.6individualized monthly authorized payment for the services described in this clause shall
200.7not exceed the limit which was in effect on June 30 of the previous state fiscal year
200.8updated annually based on legislatively adopted changes to all service rate maximums for
200.9home and community-based service providers.
200.10(e) Effective July 1, 2011, the individualized monthly payment for the customized
200.11living service plan for individuals described in subdivision 3a, paragraph (b), must be the
200.12monthly authorized payment limit for customized living for individuals classified as case
200.13mix A, reduced by 25 percent. This rate limit must be applied to all new participants
200.14enrolled in the program on or after July 1, 2011, who meet the criteria described in
200.15subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
200.16meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
200.17    (e) (f) Customized living services are delivered by a provider licensed by the
200.18Department of Health as a class A or class F home care provider and provided in a
200.19building that is registered as a housing with services establishment under chapter 144D.
200.20Licensed home care providers are subject to section 256B.0651, subdivision 14.
200.21(g) A provider may not bill or otherwise charge an elderly waiver participant or their
200.22family for additional units of any allowable component service beyond those available
200.23under the service rate limits described in paragraph (d), nor for additional units of any
200.24allowable component service beyond those approved in the service plan by the lead agency.

200.25    Sec. 17. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to
200.26read:
200.27    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
200.28payment rate for 24-hour customized living services is a monthly rate authorized by the
200.29lead agency within the parameters established by the commissioner of human services.
200.30The payment agreement must delineate the amount of each component service included in
200.31each recipient's customized living service plan. The lead agency shall ensure that there is a
200.32documented need within the parameters established by the commissioner for all component
200.33customized living services authorized. The lead agency shall not authorize 24-hour
200.34customized living services unless there is a documented need for 24-hour supervision.
201.1(b) For purposes of this section, "24-hour supervision" means that the recipient
201.2requires assistance due to needs related to one or more of the following:
201.3    (1) intermittent assistance with toileting, positioning, or transferring;
201.4    (2) cognitive or behavioral issues;
201.5    (3) a medical condition that requires clinical monitoring; or
201.6    (4) for all new participants enrolled in the program on or after January July 1, 2011,
201.7and all other participants at their first reassessment after January July 1, 2011, dependency
201.8in at least two three of the following activities of daily living as determined by assessment
201.9under section 256B.0911: bathing; dressing; grooming; walking; or eating when the
201.10dependency score in eating is three or greater; and needs medication management and at
201.11least 50 hours of service per month. The lead agency shall ensure that the frequency and
201.12mode of supervision of the recipient and the qualifications of staff providing supervision
201.13are described and meet the needs of the recipient.
201.14(c) The payment rate for 24-hour customized living services must be based on the
201.15amount of component services to be provided utilizing component rates established by the
201.16commissioner. Counties and tribes will use tools issued by the commissioner to develop
201.17and document customized living plans and authorize rates.
201.18(d) Component service rates must not exceed payment rates for comparable elderly
201.19waiver or medical assistance services and must reflect economies of scale.
201.20(e) The individually authorized 24-hour customized living payments, in combination
201.21with the payment for other elderly waiver services, including case management, must not
201.22exceed the recipient's community budget cap specified in subdivision 3a. Customized
201.23living services must not include rent or raw food costs.
201.24(f) The individually authorized 24-hour customized living payment rates shall not
201.25exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
201.26living services in effect and in the Medicaid management information systems on March
201.2731, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
201.28to 9549.0059, to which elderly waiver service clients are assigned. When there are
201.29fewer than 50 authorizations in effect in the case mix resident class, the commissioner
201.30shall multiply the calculated service payment rate maximum for the A classification by
201.31the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
201.329549.0059, to determine the applicable payment rate maximum. Service payment rate
201.33maximums shall be updated annually based on legislatively adopted changes to all service
201.34rates for home and community-based service providers.
201.35    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
201.36may establish alternative payment rate systems for 24-hour customized living services in
202.1housing with services establishments which are freestanding buildings with a capacity of
202.216 or fewer, by applying a single hourly rate for covered component services provided
202.3in either:
202.4    (1) licensed corporate adult foster homes; or
202.5    (2) specialized dementia care units which meet the requirements of section 144D.065
202.6and in which:
202.7    (i) each resident is offered the option of having their own apartment; or
202.8    (ii) the units are licensed as board and lodge establishments with maximum capacity
202.9of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
202.10subparts 1, 2, 3, and 4, item A.
202.11(h) A provider may not bill or otherwise charge an elderly waiver participant or their
202.12family for additional units of any allowable component service beyond those available
202.13under the service rate limits described in paragraph (e), nor for additional units of any
202.14allowable component service beyond those approved in the service plan by the lead agency.

202.15    Sec. 18. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to
202.16read:
202.17    Subd. 10. Waiver payment rates; managed care organizations. The
202.18commissioner shall adjust the elderly waiver capitation payment rates for managed care
202.19organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
202.20service rate limits for customized living services and 24-hour customized living services
202.21under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical
202.22assistance rates paid to customized living providers by managed care organizations under
202.23this section shall not exceed the maximum service rate limits and component rates as
202.24determined by the commissioner under subdivisions 3e and 3h.

202.25    Sec. 19. Minnesota Statutes 2010, section 256B.0916, subdivision 6a, is amended to
202.26read:
202.27    Subd. 6a. Statewide availability of consumer-directed community self-directed
202.28 support services. (a) The commissioner shall submit to the federal Health Care Financing
202.29Administration by August 1, 2001, an amendment to the home and community-based
202.30waiver for persons with developmental disabilities under section 256B.092 and by April 1,
202.312005, for waivers under sections 256B.0915 and 256B.49, to make consumer-directed
202.32community self-directed support services available in every county of the state by January
202.331, 2002.
203.1(b) Until the waiver amendment for self-directed community supports is effective, if
203.2a county declines to meet the requirements for provision of consumer-directed community
203.3self-directed supports, the commissioner shall contract with another county, a group of
203.4counties, or a private agency to plan for and administer consumer-directed community
203.5self-directed supports in that county.
203.6(c) The state of Minnesota, county agencies, tribal governments, or administrative
203.7entities under contract to participate in the implementation and administration of the home
203.8and community-based waiver for persons with developmental disabilities, shall not be
203.9liable for damages, injuries, or liabilities sustained through the purchase of support by the
203.10individual, the individual's family, legal representative, or the authorized representative
203.11with funds received through the consumer-directed community self-directed support
203.12service under this section. Liabilities include but are not limited to: workers' compensation
203.13liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment
203.14Tax Act (FUTA).
203.15EFFECTIVE DATE.This section is effective July 1, 2011.

203.16    Sec. 20. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to
203.17read:
203.18    Subd. 1b. Individual service Coordinated services and support plan. The
203.19individual service Each recipient of case management services and any legal representative
203.20shall be provided a written copy of the coordinated services and support plan must, which:
203.21(1) include is developed within ten working days after the case manager receives the
203.22community support plan from the certified assessor under section 256B.0911;
203.23(2) includes the results of the assessment information on the person's need for
203.24service, including identification of service needs that will be or that are met by the person's
203.25relatives, friends, and others, as well as community services used by the general public;
203.26(3) reasonably assures the health, safety, and welfare of the recipient;
203.27(2) identify (4) identifies the person's preferences for services as stated by the person,
203.28the person's legal guardian or conservator, or the parent if the person is a minor;
203.29(5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
203.30paragraph (o), of service and support providers;
203.31(3) identify (6) identifies long- and short-range goals for the person;
203.32(4) identify (7) identifies specific services and the amount and frequency of the
203.33services to be provided to the person based on assessed needs, preferences, and available
203.34resources. The individual service plan shall also specify other services the person needs
203.35that are not available, and other services the person needs that are not available. The
204.1individual coordinated services and support plan shall also specify service outcomes and
204.2the provider's responsibility to monitor the achievement of the service outcomes;
204.3(5) identify (8) identifies the need for an individual program individual's provider
204.4plan to be developed by the provider according to the respective state and federal licensing
204.5and certification standards, and additional assessments to be completed or arranged by the
204.6provider after service initiation;
204.7(6) identify (9) identifies provider responsibilities to implement and make
204.8recommendations for modification to the individual service coordinated services and
204.9support plan;
204.10(7) include (10) includes notice of the right to have assessments completed and
204.11service plans developed within specified time periods, the right to appeal action or
204.12inaction, and the right to request a conciliation conference or a hearing an appeal under
204.13section 256.045;
204.14(8) be (11) is agreed upon and signed by the person, the person's legal guardian
204.15or conservator, or the parent if the person is a minor, and the authorized county
204.16representative; and
204.17(9) be (12) is reviewed by a health professional if the person has overriding medical
204.18needs that impact the delivery of services.
204.19Service planning formats developed for interagency planning such as transition,
204.20vocational, and individual family service plans may be substituted for service planning
204.21formats developed by county agencies.
204.22EFFECTIVE DATE.This section is effective January 1, 2013.

204.23    Sec. 21. Minnesota Statutes 2010, section 256B.092, subdivision 1e, is amended to
204.24read:
204.25    Subd. 1e. Case management service monitoring, coordination, and evaluation,
204.26and monitoring of services duties. (a) If the individual service coordinated services and
204.27support plan identifies the need for individual program provider plans for authorized
204.28services, the case manager management service provider shall assure that individual
204.29program the individual provider plans are developed by the providers according to clauses
204.30(2) to (5). The providers shall assure that the individual program provider plans:
204.31(1) are developed according to the respective state and federal licensing and
204.32certification requirements;
204.33(2) are designed to achieve the goals of the individual service plan;
204.34(3) are consistent with other aspects of the individual service coordinated services
204.35and support plan;
205.1(4) assure the health and safety of the person; and
205.2(5) are developed with consistent and coordinated approaches to services and service
205.3outcomes among the various service providers.
205.4(b) The case manager management service provider shall monitor the provision of
205.5services:
205.6(1) to assure that the individual service coordinated services and support plan is
205.7being followed according to paragraph (a);
205.8(2) to identify any changes or modifications that might be needed in the individual
205.9service coordinated services and support plan, including changes resulting from
205.10recommendations of current service providers;
205.11(3) to determine if the person's legal rights are protected, and if not, notify the
205.12person's legal guardian or conservator, or the parent if the person is a minor, protection
205.13services, or licensing agencies as appropriate; and
205.14(4) to determine if the person, the person's legal guardian or conservator, or the
205.15parent if the person is a minor, is satisfied with the services provided.
205.16(c) If the provider fails to develop or carry out the individual program provider plan
205.17according to paragraph (a), the case manager shall notify the person's legal guardian or
205.18conservator, or the parent if the person is a minor, the provider, the respective licensing
205.19and certification agencies, and the county board where the services are being provided. In
205.20addition, the case manager shall identify other steps needed to assure the person receives
205.21the services identified in the individual service coordinated services and support plan.
205.22EFFECTIVE DATE.This section is effective January 1, 2012.

205.23    Sec. 22. Minnesota Statutes 2010, section 256B.092, subdivision 1g, is amended to
205.24read:
205.25    Subd. 1g. Conditions not requiring development of individual service a
205.26coordinated services and support plan. Unless otherwise required by federal law, the
205.27county agency is not required to complete an individual service a coordinated services and
205.28support plan as defined in subdivision 1b for:
205.29(1) persons whose families are requesting respite care for their family member who
205.30resides with them, or whose families are requesting a family support grant and are not
205.31requesting purchase or arrangement of habilitative services; and
205.32(2) persons with developmental disabilities, living independently without authorized
205.33services or receiving funding for services at a rehabilitation facility as defined in section
205.34268A.01, subdivision 6 , and not in need of or requesting additional services.
206.1EFFECTIVE DATE.This section is effective January 1, 2012.

206.2    Sec. 23. Minnesota Statutes 2010, section 256B.092, subdivision 3, is amended to read:
206.3    Subd. 3. Authorization and termination of services. County agency case managers
206.4Lead agencies, under rules of the commissioner, shall authorize and terminate services
206.5of community and regional treatment center providers according to individual service
206.6coordinated services and support plans. Services provided to persons with developmental
206.7disabilities may only be authorized and terminated by case managers according to (1)
206.8rules of the commissioner and (2) the individual service coordinated services and support
206.9plan as defined in subdivision 1b. Medical assistance services not needed shall not be
206.10authorized by county lead agencies or funded by the commissioner. When purchasing or
206.11arranging for unlicensed respite care services for persons with overriding health needs, the
206.12county agency shall seek the advice of a health care professional in assessing provider
206.13staff training needs and skills necessary to meet the medical needs of the person.
206.14EFFECTIVE DATE.This section is effective January 1, 2012.

206.15    Sec. 24. Minnesota Statutes 2010, section 256B.092, subdivision 8, is amended to read:
206.16    Subd. 8. Screening team Additional certified assessor duties. The screening team
206.17certified assessor shall:
206.18(1) review diagnostic data;
206.19(2) review health, social, and developmental assessment data using a uniform
206.20screening comprehensive assessment tool specified by the commissioner;
206.21(3) identify the level of services appropriate to maintain the person in the most
206.22normal and least restrictive setting that is consistent with the person's treatment needs;
206.23(4) identify other noninstitutional public assistance or social service that may prevent
206.24or delay long-term residential placement;
206.25(5) assess whether a person is in need of long-term residential care;
206.26(6) make recommendations regarding placement services and payment for: (i) social
206.27service or public assistance support, or both, to maintain a person in the person's own home
206.28or other place of residence; (ii) training and habilitation service, vocational rehabilitation,
206.29and employment training activities; (iii) community residential placement services; (iv)
206.30regional treatment center placement; or (v) (iv) a home and community-based service
206.31alternative to community residential placement or regional treatment center placement;
206.32(7) evaluate the availability, location, and quality of the services listed in clause
206.33(6), including the impact of placement alternatives services and supports options on the
207.1person's ability to maintain or improve existing patterns of contact and involvement with
207.2parents and other family members;
207.3(8) identify the cost implications of recommendations in clause (6) and provide
207.4written notice of the annual and monthly average authorized amount to be spent for
207.5services for the recipient;
207.6(9) make recommendations to a court as may be needed to assist the court in making
207.7decisions regarding commitment of persons with developmental disabilities; and
207.8(10) inform the person and the person's legal guardian or conservator, or the parent if
207.9the person is a minor, that appeal may be made to the commissioner pursuant to section
207.10256.045 .
207.11EFFECTIVE DATE.This section is effective January 1, 2012.

207.12    Sec. 25. [256B.0961] STATE QUALITY ASSURANCE, QUALITY
207.13IMPROVEMENT, AND LICENSING SYSTEM.
207.14    Subdivision 1. Scope. (a) In order to improve the quality of services provided to
207.15Minnesotans with disabilities and to meet the requirements of the federally approved
207.16home and community-based waivers under section 1915c of the Social Security Act, a
207.17State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans
207.18receiving disability services is enacted. This system is a partnership between the
207.19Department of Human Services and the State Quality Council established under
207.20subdivision 3.
207.21    (b) This system is a result of the recommendations from the Department of Human
207.22Services' licensing and alternative quality assurance study mandated under Laws 2005,
207.23First Special Session chapter 4, article 7, section 57, and presented to the legislature
207.24in February 2007.
207.25    (c) The disability services eligible under this section include:
207.26    (1) the home and community-based services waiver programs for persons with
207.27developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
207.28including traumatic brain injuries and services for those who qualify for nursing facility
207.29level of care or hospital facility level of care;
207.30    (2) home care services under section 256B.0651;
207.31    (3) family support grants under section 252.32;
207.32    (4) consumer support grants under section 256.476;
207.33    (5) semi-independent living services under section 252.275; and
207.34    (6) services provided through an intermediate care facility for the developmentally
207.35disabled.
208.1    (d) For purposes of this section, the following definitions apply:
208.2    (1) "commissioner" means the commissioner of human services;
208.3    (2) "council" means the State Quality Council under subdivision 3;
208.4    (3) "Quality Assurance Commission" means the commission under section
208.5256B.0951; and
208.6    (4) "system" means the State Quality Assurance, Quality Improvement and
208.7Licensing System under this section.
208.8    Subd. 2. Duties of the commissioner of human services. (a) The commissioner of
208.9human services shall establish the State Quality Council under subdivision 3.
208.10    (b) The commissioner shall initially delegate authority to perform licensing
208.11functions and activities according to section 245A.16 to a host county in Region 10. The
208.12commissioner must not license or reimburse a participating facility, program, or service
208.13located in Region 10 if the commissioner has received notification from the host county
208.14that the facility, program, or service has failed to qualify for licensure.
208.15    (c) The commissioner may conduct random licensing inspections based on outcomes
208.16adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services
208.17eligible under this section. The role of the random inspections is to verify that the system
208.18protects the safety and well-being of persons served and maintains the availability of
208.19high-quality services for persons with disabilities.
208.20    (d) The commissioner shall ensure that the federal home and community-based
208.21waiver requirements are met and that incidents that may have jeopardized safety and health
208.22or violated services-related assurances, civil and human rights, and other protections
208.23designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and
208.24acted upon in a timely manner.
208.25    (e) The commissioner shall seek a federal waiver by July 1, 2012 to allow
208.26intermediate care facilities for persons with developmental disabilities to participate in
208.27this system.
208.28    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
208.29Council which must define regional quality councils, and carry out a community-based,
208.30person-directed quality review component, and a comprehensive system for effective
208.31incident reporting, investigation, analysis, and follow-up.
208.32    (b) By August 1, 2011, the commissioner of human services shall appoint the
208.33members of the initial State Quality Council. Members shall include representatives
208.34from the following groups:
208.35    (1) disability service recipients and their family members;
209.1    (2) during the first two years of the State Quality Council, there must be at least three
209.2members from the Region 10 stakeholders. As regional quality councils are formed under
209.3subdivision 4, each regional quality council shall appoint one member;
209.4    (3) disability service providers;
209.5    (4) disability advocacy groups; and
209.6    (5) county human services agencies and staff from the Department of Human
209.7Services and Ombudsman for Mental Health and Developmental Disabilities.
209.8    (c) Members of the council who do not receive a salary or wages from an employer
209.9for time spent on council duties may receive a per diem payment when performing council
209.10duties and functions.
209.11    (d) The State Quality Council shall:
209.12    (1) assist the Department of Human Services in fulfilling federally mandated
209.13obligations by monitoring disability service quality and quality assurance and
209.14improvement practices in Minnesota; and
209.15    (2) establish state quality improvement priorities with methods for achieving results
209.16and provide an annual report to the legislative committees with jurisdiction over policy
209.17and funding of disability services on the outcomes, improvement priorities, and activities
209.18undertaken by the commission during the previous state fiscal year.
209.19    (e) The State Quality Council, in partnership with the commissioner, shall:
209.20    (1) approve and direct implementation of the community-based, person-directed
209.21system established in this section;
209.22    (2) recommend an appropriate method of funding this system, and determine the
209.23feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
209.24    (3) approve measurable outcomes in the areas of health and safety, consumer
209.25evaluation, education and training, providers, and systems;
209.26    (4) establish variable licensure periods not to exceed three years based on outcomes
209.27achieved; and
209.28    (5) in cooperation with the Quality Assurance Commission, design a transition plan
209.29for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
209.30    (f) The State Quality Council shall notify the commissioner of human services that a
209.31facility, program, or service has been reviewed by quality assurance team members under
209.32subdivision 4, paragraph (b), clause (13), and qualifies for a license.
209.33    (g) The State Quality Council, in partnership with the commissioner, shall establish
209.34an ongoing review process for the system. The review shall take into account the
209.35comprehensive nature of the system which is designed to evaluate the broad spectrum of
210.1licensed and unlicensed entities that provide services to persons with disabilities. The
210.2review shall address efficiencies and effectiveness of the system.
210.3    (h) The State Quality Council may recommend to the commissioner certain
210.4variances from the standards governing licensure of programs for persons with disabilities
210.5in order to improve the quality of services so long as the recommended variances do
210.6not adversely affect the health or safety of persons being served or compromise the
210.7qualifications of staff to provide services.
210.8    (i) The safety standards, rights, or procedural protections referenced under
210.9subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
210.10recommendations to the commissioner or to the legislature in the report required under
210.11paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
210.12procedural protections referenced under subdivision 2, paragraph (c).
210.13    (j) The State Quality Council may hire staff to perform the duties assigned in this
210.14subdivision.
210.15    Subd. 4. Regional quality councils. (a) The commissioner shall establish, as
210.16selected by the State Quality Council, regional quality councils of key stakeholders,
210.17including regional representatives of:
210.18    (1) disability service recipients and their family members;
210.19    (2) disability service providers;
210.20    (3) disability advocacy groups; and
210.21    (4) county human services agencies and staff from the Department of Human
210.22Services and Ombudsman for Mental Health and Developmental Disabilities.
210.23    (b) Each regional quality council shall:
210.24    (1) direct and monitor the community-based, person-directed quality assurance
210.25system in this section;
210.26    (2) approve a training program for quality assurance team members under clause
210.27(13);
210.28    (3) review summary reports from quality assurance team reviews and make
210.29recommendations to the State Quality Council regarding program licensure;
210.30    (4) make recommendations to the State Quality Council regarding the system;
210.31    (5) resolve complaints between the quality assurance teams, counties, providers,
210.32persons receiving services, their families, and legal representatives;
210.33    (6) analyze and review quality outcomes and critical incident data reporting
210.34incidents of life safety concerns immediately to the Department of Human Services
210.35licensing division;
211.1    (7) provide information and training programs for persons with disabilities and their
211.2families and legal representatives on service options and quality expectations;
211.3    (8) disseminate information and resources developed to other regional quality
211.4councils;
211.5    (9) respond to state-level priorities;
211.6    (10) establish regional priorities for quality improvement;
211.7    (11) submit an annual report to the State Quality Council on the status, outcomes,
211.8improvement priorities, and activities in the region;
211.9    (12) choose a representative to participate on the State Quality Council and assume
211.10other responsibilities consistent with the priorities of the State Quality Council; and
211.11    (13) recruit, train, and assign duties to members of quality assurance teams, taking
211.12into account the size of the service provider, the number of services to be reviewed,
211.13the skills necessary for the team members to complete the process, and ensure that no
211.14team member has a financial, personal, or family relationship with the facility, program,
211.15or service being reviewed or with anyone served at the facility, program, or service.
211.16Quality assurance teams must be comprised of county staff, persons receiving services
211.17or the person's families, legal representatives, members of advocacy organizations,
211.18providers, and other involved community members. Team members must complete
211.19the training program approved by the regional quality council and must demonstrate
211.20performance-based competency. Team members may be paid a per diem and reimbursed
211.21for expenses related to their participation in the quality assurance process.
211.22    (c) The commissioner shall monitor the safety standards, rights, and procedural
211.23protections for the monitoring of psychotropic medications and those identified under
211.24sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2)
211.25and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause
211.26(7); 626.556; and 626.557.
211.27    (d) The regional quality councils may hire staff to perform the duties assigned in
211.28this subdivision.
211.29    (e) The regional quality councils may charge fees for their services.
211.30    (f) The quality assurance process undertaken by a regional quality council consists of
211.31an evaluation by a quality assurance team of the facility, program, or service. The process
211.32must include an evaluation of a random sample of persons served. The sample must be
211.33representative of each service provided. The sample size must be at least five percent but
211.34not less than two persons served. All persons must be given the opportunity to be included
211.35in the quality assurance process in addition to those chosen for the random sample.
212.1    (g) A facility, program, or service may contest a licensing decision of the regional
212.2quality council as permitted under chapter 245A.
212.3    Subd. 5. Annual survey of service recipients. The commissioner, in consultation
212.4with the State Quality Council, shall conduct an annual independent statewide survey
212.5of service recipients, randomly selected, to determine the effectiveness and quality
212.6of disability services. The survey must be consistent with the system performance
212.7expectations of the Centers for Medicare and Medicaid Services (CMS) Quality
212.8Framework. The survey must analyze whether desired outcomes for persons with different
212.9demographic, diagnostic, health, and functional needs, who are receiving different types
212.10of services in different settings and with different costs, have been achieved. Annual
212.11statewide and regional reports of the results must be published and used to assist regions,
212.12counties, and providers to plan and measure the impact of quality improvement activities.
212.13    Subd. 6. Mandated reporters. Members of the State Quality Council under
212.14subdivision 3, the regional quality councils under subdivision 4, and quality assurance
212.15team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as
212.16defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16.
212.17EFFECTIVE DATE.(a) Subdivisions 1 to 6 are effective July 1, 2011.
212.18    (b) The jurisdictions of the regional quality councils in subdivision 4 must be
212.19defined, with implementation dates, by July 1, 2012. During the biennium beginning July
212.201, 2011, the Quality Assurance Commission shall continue to implement the alternative
212.21licensing system under this section.

212.22    Sec. 26. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to
212.23read:
212.24    Subd. 2r. Payment restrictions on leave days. (a) Effective July 1, 1993, the
212.25commissioner shall limit payment for leave days in a nursing facility to 79 percent of that
212.26nursing facility's total payment rate for the involved resident.
212.27(b) For services rendered on or after July 1, 2003, for facilities reimbursed under this
212.28section or section 256B.434, the commissioner shall limit payment for leave days in a
212.29nursing facility to 60 percent of that nursing facility's total payment rate for the involved
212.30resident.
212.31(c) For services rendered on or after July 1, 2011, for facilities reimbursed under
212.32this chapter, the commissioner shall limit payment for leave days in a nursing facility
212.33to 30 percent of that nursing facility's total payment rate for the involved resident, and
212.34shall allow this payment only when the occupancy of the nursing facility, inclusive of
213.1bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules,
213.2part 9505.0415.

213.3    Sec. 27. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to
213.4read:
213.5    Subd. 32. Payment during first 90 30 days. (a) For rate years beginning on or after
213.6July 1, 2001, the total payment rate for a facility reimbursed under this section, section
213.7256B.434, or any other section for the first 90 paid days after admission shall be:
213.8(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical
213.9assistance rate for each case mix class;
213.10(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent
213.11of the facility's medical assistance rate for each case mix class;
213.12(3) beginning with the 91st paid day after admission, the payment rate shall be the
213.13rate otherwise determined under this section, section 256B.434, or any other section; and
213.14(4) payments under this paragraph apply to admissions occurring on or after July 1,
213.152001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
213.16(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for
213.17a facility reimbursed under this section, section 256B.434, or any other section shall be:
213.18(1) for the first 30 calendar days after admission, the rate shall be 120 percent of
213.19the facility's medical assistance rate for each RUG class;
213.20(2) beginning with the 31st calendar day after admission, the payment rate shall be
213.21the rate otherwise determined under this section, section 256B.434, or any other section;
213.22and
213.23(3) payments under this paragraph apply to admissions occurring on or after July
213.241, 2003 2011.
213.25(c) Effective January 1, 2004, (b) The enhanced rates under this subdivision shall not
213.26be allowed if a resident has resided during the previous 30 calendar days in:
213.27(1) the same nursing facility;
213.28(2) a nursing facility owned or operated by a related party; or
213.29(3) a nursing facility or part of a facility that closed or was in the process of closing.

213.30    Sec. 28. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:
213.31    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
213.32have their payment rates determined under this section rather than section 256B.431, the
213.33commissioner shall establish a rate under this subdivision. The nursing facility must enter
213.34into a written contract with the commissioner.
214.1    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
214.2contract under this section is the payment rate the facility would have received under
214.3section 256B.431.
214.4    (c) A nursing facility's case mix payment rates for the second and subsequent years
214.5of a facility's contract under this section are the previous rate year's contract payment
214.6rates plus an inflation adjustment and, for facilities reimbursed under this section or
214.7section 256B.431, an adjustment to include the cost of any increase in Health Department
214.8licensing fees for the facility taking effect on or after July 1, 2001. The index for the
214.9inflation adjustment must be based on the change in the Consumer Price Index-All Items
214.10(United States City average) (CPI-U) forecasted by the commissioner of management and
214.11budget's national economic consultant, as forecasted in the fourth quarter of the calendar
214.12year preceding the rate year. The inflation adjustment must be based on the 12-month
214.13period from the midpoint of the previous rate year to the midpoint of the rate year for
214.14which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
214.152000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
214.16July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, October 1, 2011, and
214.17October 1, 2012. this paragraph shall apply only to the property-related payment rate,
214.18except that adjustments to include the cost of any increase in Health Department licensing
214.19fees taking effect on or after July 1, 2001, shall be provided. For the rate years beginning
214.20on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall
214.21be suspended. Beginning in 2005, adjustment to the property payment rate under this
214.22section and section 256B.431 shall be effective on October 1. In determining the amount
214.23of the property-related payment rate adjustment under this paragraph, the commissioner
214.24shall determine the proportion of the facility's rates that are property-related based on the
214.25facility's most recent cost report.
214.26    (d) The commissioner shall develop additional incentive-based payments of up to
214.27five percent above a facility's operating payment rate for achieving outcomes specified
214.28in a contract. The commissioner may solicit contract amendments and implement those
214.29which, on a competitive basis, best meet the state's policy objectives. The commissioner
214.30shall limit the amount of any incentive payment and the number of contract amendments
214.31under this paragraph to operate the incentive payments within funds appropriated for this
214.32purpose. The contract amendments may specify various levels of payment for various
214.33levels of performance. Incentive payments to facilities under this paragraph may be in the
214.34form of time-limited rate adjustments or onetime supplemental payments. In establishing
214.35the specified outcomes and related criteria, the commissioner shall consider the following
214.36state policy objectives:
215.1    (1) successful diversion or discharge of residents to the residents' prior home or other
215.2community-based alternatives;
215.3    (2) adoption of new technology to improve quality or efficiency;
215.4    (3) improved quality as measured in the Nursing Home Report Card;
215.5    (4) reduced acute care costs; and
215.6    (5) any additional outcomes proposed by a nursing facility that the commissioner
215.7finds desirable.
215.8    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
215.9take action to come into compliance with existing or pending requirements of the life
215.10safety code provisions or federal regulations governing sprinkler systems must receive
215.11reimbursement for the costs associated with compliance if all of the following conditions
215.12are met:
215.13    (1) the expenses associated with compliance occurred on or after January 1, 2005,
215.14and before December 31, 2008;
215.15    (2) the costs were not otherwise reimbursed under subdivision 4f or section
215.16144A.071 or 144A.073; and
215.17    (3) the total allowable costs reported under this paragraph are less than the minimum
215.18threshold established under section 256B.431, subdivision 15, paragraph (e), and
215.19subdivision 16.
215.20The commissioner shall use money appropriated for this purpose to provide to qualifying
215.21nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
215.222008. Nursing facilities that have spent money or anticipate the need to spend money
215.23to satisfy the most recent life safety code requirements by (1) installing a sprinkler
215.24system or (2) replacing all or portions of an existing sprinkler system may submit to the
215.25commissioner by June 30, 2007, on a form provided by the commissioner the actual
215.26costs of a completed project or the estimated costs, based on a project bid, of a planned
215.27project. The commissioner shall calculate a rate adjustment equal to the allowable
215.28costs of the project divided by the resident days reported for the report year ending
215.29September 30, 2006. If the costs from all projects exceed the appropriation for this
215.30purpose, the commissioner shall allocate the money appropriated on a pro rata basis
215.31to the qualifying facilities by reducing the rate adjustment determined for each facility
215.32by an equal percentage. Facilities that used estimated costs when requesting the rate
215.33adjustment shall report to the commissioner by January 31, 2009, on the use of this
215.34money on a form provided by the commissioner. If the nursing facility fails to provide
215.35the report, the commissioner shall recoup the money paid to the facility for this purpose.
215.36If the facility reports expenditures allowable under this subdivision that are less than
216.1the amount received in the facility's annualized rate adjustment, the commissioner shall
216.2recoup the difference.

216.3    Sec. 29. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
216.4    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
216.5services shall calculate the amount of the planned closure rate adjustment available under
216.6subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
216.7(1) the amount available is the net reduction of nursing facility beds multiplied
216.8by $2,080;
216.9(2) the total number of beds in the nursing facility or facilities receiving the planned
216.10closure rate adjustment must be identified;
216.11(3) capacity days are determined by multiplying the number determined under
216.12clause (2) by 365; and
216.13(4) the planned closure rate adjustment is the amount available in clause (1), divided
216.14by capacity days determined under clause (3).
216.15(b) A planned closure rate adjustment under this section is effective on the first day
216.16of the month following completion of closure of the facility designated for closure in the
216.17application and becomes part of the nursing facility's total operating payment rate.
216.18(c) Applicants may use the planned closure rate adjustment to allow for a property
216.19payment for a new nursing facility or an addition to an existing nursing facility or as an
216.20operating payment rate adjustment. Applications approved under this subdivision are
216.21exempt from other requirements for moratorium exceptions under section 144A.073,
216.22subdivisions 2 and 3.
216.23(d) Upon the request of a closing facility, the commissioner must allow the facility a
216.24closure rate adjustment as provided under section 144A.161, subdivision 10.
216.25(e) A facility that has received a planned closure rate adjustment may reassign it
216.26to another facility that is under the same ownership at any time within three years of its
216.27effective date. The amount of the adjustment shall be computed according to paragraph (a).
216.28(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
216.29the commissioner shall recalculate planned closure rate adjustments for facilities that
216.30delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
216.31bed dollar amount. The recalculated planned closure rate adjustment shall be effective
216.32from the date the per bed dollar amount is increased.
216.33(g) For planned closures approved after June 30, 2009, the commissioner of human
216.34services shall calculate the amount of the planned closure rate adjustment available under
216.35subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
217.1(h) Beginning July 16, 2011, the commissioner shall no longer accept applications
217.2for planned closure rate adjustments under subdivision 3.

217.3    Sec. 30. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to
217.4read:
217.5    Subd. 50a. Determination of proximity adjustments. (a) For a nursing facility
217.6located in close proximity to another nursing facility of the same facility group type but in
217.7a different peer group and that has higher limits for care-related or other operating costs,
217.8the commissioner shall adjust the limits in accordance with clauses (1) to (4):
217.9    (1) determine the difference between the limits;
217.10    (2) determine the distance between the two facilities, by the shortest driving route. If
217.11the distance exceeds 20 miles, no adjustment shall be made;
217.12    (3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a
217.13percentage; and
217.14    (4) increase the limits for the nursing facility with the lower limits by the value
217.15determined in clause (1) multiplied by the value determined in clause (3).
217.16(b) Effective October 1, 2011, nursing facilities located no more than one-quarter
217.17mile from a peer group with higher limits under either subdivision 50 or 51, may receive
217.18an operating rate adjustment. The operating payment rates of a lower-limit peer group
217.19facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer
217.20group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer
217.21group facility. Peer groups are those defined in subdivision 30. The nearest facility must
217.22be determined by the most direct driving route.

217.23    Sec. 31. Minnesota Statutes 2010, section 256B.441, is amended by adding a
217.24subdivision to read:
217.25    Subd. 61. Rate increase for low-rate facilities. Effective October 1, 2011,
217.26operating payment rates of all nursing facilities that are reimbursed under this section or
217.27section 256B.434 shall be increased for a resource utilization group rate with a weight
217.28of 1.00 by up to 2.45 percent, but not to exceed for the same resource utilization group
217.29weight the rate of the facility at the 18th percentile of all nursing facilities in the state. The
217.30percentage of the operating payment rate for each facility to be case-mix adjusted shall be
217.31equal to the percentage that is case-mix adjusted in that facility's operating payment rate
217.32on the preceding September 30.

217.33    Sec. 32. Minnesota Statutes 2010, section 256B.48, subdivision 1, is amended to read:
218.1    Subdivision 1. Prohibited practices. A nursing facility is not eligible to receive
218.2medical assistance payments unless it refrains from all of the following:.
218.3(a) Charging private paying residents rates for similar services which exceed those
218.4which are approved by the state agency for medical assistance recipients as determined by
218.5the prospective desk audit rate, except under the following circumstances:
218.6(1) the nursing facility may:
218.7(1) (i) charge private paying residents a higher rate for a private room,; and
218.8(2) (ii) charge for special services which are not included in the daily rate if medical
218.9assistance residents are charged separately at the same rate for the same services in
218.10addition to the daily rate paid by the commissioner;
218.11(2) effective July 1, 2011, through September 30, 2012, nursing facilities may
218.12charge private paying residents rates up to two percent higher than the allowable medical
218.13assistance payment rate determined by the commissioner for the RUGS group currently
218.14assigned to the resident; and
218.15(3) effective for rate years beginning October 1, 2012, and after, nursing facilities
218.16may charge private paying residents rates greater than the allowable medical assistance
218.17payment rate determined by the commissioner for the RUGS group currently assigned
218.18to the resident by up to two percent more than the differential in effect on the prior
218.19September 30. Nothing in this section precludes a nursing facility from charging a rate
218.20allowable under the facility's single room election option under Minnesota Rules, part
218.219549.0060, subpart 11, or the enhanced rates under section 256B.431, subdivision 32.
218.22Services covered by the payment rate must be the same regardless of payment source.
218.23Special services, if offered, must be available to all residents in all areas of the nursing
218.24facility and charged separately at the same rate. Residents are free to select or decline
218.25special services. Special services must not include services which must be provided by
218.26the nursing facility in order to comply with licensure or certification standards and that
218.27if not provided would result in a deficiency or violation by the nursing facility. Services
218.28beyond those required to comply with licensure or certification standards must not be
218.29charged separately as a special service if they were included in the payment rate for the
218.30previous reporting year. A nursing facility that charges a private paying resident a rate in
218.31violation of this clause paragraph is subject to an action by the state of Minnesota or any of
218.32its subdivisions or agencies for civil damages. A private paying resident or the resident's
218.33legal representative has a cause of action for civil damages against a nursing facility that
218.34charges the resident rates in violation of this clause paragraph. The damages awarded shall
218.35include three times the payments that result from the violation, together with costs and
218.36disbursements, including reasonable attorneys' attorney fees or their equivalent. A private
219.1paying resident or the resident's legal representative, the state, subdivision or agency, or a
219.2nursing facility may request a hearing to determine the allowed rate or rates at issue in
219.3the cause of action. Within 15 calendar days after receiving a request for such a hearing,
219.4the commissioner shall request assignment of an administrative law judge under sections
219.514.48 to 14.56 to conduct the hearing as soon as possible or according to agreement by
219.6the parties. The administrative law judge shall issue a report within 15 calendar days
219.7following the close of the hearing. The prohibition set forth in this clause paragraph shall
219.8not apply to facilities licensed as boarding care facilities which are not certified as skilled
219.9or intermediate care facilities level I or II for reimbursement through medical assistance.
219.10(b)(1) Charging, soliciting, accepting, or receiving from an applicant for admission
219.11to the facility, or from anyone acting in behalf of the applicant, as a condition of admission,
219.12expediting the admission, or as a requirement for the individual's continued stay, any fee,
219.13deposit, gift, money, donation, or other consideration not otherwise required as payment
219.14under the state plan. For residents on medical assistance, medical assistance payments
219.15according to the state plan must be accepted as payment in full for continued stay, except
219.16where otherwise provided for under statute;
219.17(2) requiring an individual, or anyone acting in behalf of the individual, to loan
219.18any money to the nursing facility;
219.19(3) requiring an individual, or anyone acting in behalf of the individual, to promise
219.20to leave all or part of the individual's estate to the facility; or
219.21(4) requiring a third-party guarantee of payment to the facility as a condition of
219.22admission, expedited admission, or continued stay in the facility.
219.23Nothing in this paragraph would prohibit discharge for nonpayment of services in
219.24accordance with state and federal regulations.
219.25(c) Requiring any resident of the nursing facility to utilize a vendor of health care
219.26services chosen by the nursing facility. A nursing facility may require a resident to use
219.27pharmacies that utilize unit dose packing systems approved by the Minnesota Board of
219.28Pharmacy, and may require a resident to use pharmacies that are able to meet the federal
219.29regulations for safe and timely administration of medications such as systems with specific
219.30number of doses, prompt delivery of medications, or access to medications on a 24-hour
219.31basis. Notwithstanding the provisions of this paragraph, nursing facilities shall not restrict
219.32a resident's choice of pharmacy because the pharmacy utilizes a specific system of unit
219.33dose drug packing.
219.34(d) Providing differential treatment on the basis of status with regard to public
219.35assistance.
220.1(e) Discriminating in admissions, services offered, or room assignment on the
220.2basis of status with regard to public assistance or refusal to purchase special services.
220.3Discrimination in admissions discrimination, services offered, or room assignment shall
220.4include, but is not limited to:
220.5(1) basing admissions decisions upon assurance by the applicant to the nursing
220.6facility, or the applicant's guardian or conservator, that the applicant is neither eligible for
220.7nor will seek information or assurances regarding current or future eligibility for public
220.8assistance for payment of nursing facility care costs; and
220.9(2) engaging in preferential selection from waiting lists based on an applicant's
220.10ability to pay privately or an applicant's refusal to pay for a special service.
220.11The collection and use by a nursing facility of financial information of any applicant
220.12pursuant to a preadmission screening program established by law shall not raise an
220.13inference that the nursing facility is utilizing that information for any purpose prohibited
220.14by this paragraph.
220.15(f) Requiring any vendor of medical care as defined by section 256B.02, subdivision
220.167 , who is reimbursed by medical assistance under a separate fee schedule, to pay any
220.17amount based on utilization or service levels or any portion of the vendor's fee to the
220.18nursing facility except as payment for renting or leasing space or equipment or purchasing
220.19support services from the nursing facility as limited by section 256B.433. All agreements
220.20must be disclosed to the commissioner upon request of the commissioner. Nursing
220.21facilities and vendors of ancillary services that are found to be in violation of this provision
220.22shall each be subject to an action by the state of Minnesota or any of its subdivisions or
220.23agencies for treble civil damages on the portion of the fee in excess of that allowed by
220.24this provision and section 256B.433. Damages awarded must include three times the
220.25excess payments together with costs and disbursements including reasonable attorney's
220.26fees or their equivalent.
220.27(g) Refusing, for more than 24 hours, to accept a resident returning to the same
220.28bed or a bed certified for the same level of care, in accordance with a physician's order
220.29authorizing transfer, after receiving inpatient hospital services.
220.30(h) For a period not to exceed 180 days, the commissioner may continue to make
220.31medical assistance payments to a nursing facility or boarding care home which is in
220.32violation of this section if extreme hardship to the residents would result. In these cases
220.33the commissioner shall issue an order requiring the nursing facility to correct the violation.
220.34The nursing facility shall have 20 days from its receipt of the order to correct the violation.
220.35If the violation is not corrected within the 20-day period the commissioner may reduce
220.36the payment rate to the nursing facility by up to 20 percent. The amount of the payment
221.1rate reduction shall be related to the severity of the violation and shall remain in effect
221.2until the violation is corrected. The nursing facility or boarding care home may appeal the
221.3commissioner's action pursuant to the provisions of chapter 14 pertaining to contested
221.4cases. An appeal shall be considered timely if written notice of appeal is received by the
221.5commissioner within 20 days of notice of the commissioner's proposed action.
221.6In the event that the commissioner determines that a nursing facility is not eligible
221.7for reimbursement for a resident who is eligible for medical assistance, the commissioner
221.8may authorize the nursing facility to receive reimbursement on a temporary basis until the
221.9resident can be relocated to a participating nursing facility.
221.10Certified beds in facilities which do not allow medical assistance intake on July 1,
221.111984, or after shall be deemed to be decertified for purposes of section 144A.071 only.

221.12    Sec. 33. Minnesota Statutes 2010, section 256B.49, subdivision 13, is amended to read:
221.13    Subd. 13. Case management. (a) Each recipient of a home and community-based
221.14waiver under this section shall be provided case management services according to
221.15section 256B.092, subdivisions 1a, 1b, and 1e, by qualified vendors as described in the
221.16federally approved waiver application. The case management service activities provided
221.17will include:
221.18    (1) assessing the needs of the individual within 20 working days of a recipient's
221.19request;
221.20    (2) developing the written individual service plan within ten working days after the
221.21assessment is completed;
221.22    (3) informing the recipient or the recipient's legal guardian or conservator of service
221.23options;
221.24    (4) assisting the recipient in the identification of potential service providers;
221.25    (5) assisting the recipient to access services;
221.26    (6) coordinating, evaluating, and monitoring of the services identified in the service
221.27plan;
221.28    (7) completing the annual reviews of the service plan; and
221.29    (8) informing the recipient or legal representative of the right to have assessments
221.30completed and service plans developed within specified time periods, and to appeal county
221.31action or inaction under section 256.045, subdivision 3, including the determination of
221.32nursing facility level of care.
221.33    (b) The case manager may delegate certain aspects of the case management service
221.34activities to another individual provided there is oversight by the case manager. The case
222.1manager may not delegate those aspects which require professional judgment including
222.2assessments, reassessments, and care plan development.
222.3EFFECTIVE DATE.This section is effective January 1, 2012.

222.4    Sec. 34. Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read:
222.5    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
222.6strengths, informal support systems, and need for services shall be completed within 20
222.7working days of the recipient's request as provided in section 256B.0911. Reassessment
222.8of each recipient's strengths, support systems, and need for services shall be conducted
222.9at least every 12 months and at other times when there has been a significant change in
222.10the recipient's functioning.
222.11(b) There must be a determination that the client requires a hospital level of care or a
222.12nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and
222.13subsequent assessments to initiate and maintain participation in the waiver program.
222.14(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
222.15appropriate to determine nursing facility level of care for purposes of medical assistance
222.16payment for nursing facility services, only face-to-face assessments conducted according
222.17to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
222.18determination or a nursing facility level of care determination must be accepted for
222.19purposes of initial and ongoing access to waiver services payment.
222.20(d) Persons with developmental disabilities who apply for services under the nursing
222.21facility level waiver programs shall be screened for the appropriate level of care according
222.22to section 256B.092.
222.23(e) Recipients who are found eligible for home and community-based services under
222.24this section before their 65th birthday may remain eligible for these services after their
222.2565th birthday if they continue to meet all other eligibility factors.
222.26(f) The commissioner shall develop criteria to identify recipients whose level of
222.27functioning is reasonably expected to improve and reassess these recipients to establish
222.28a baseline assessment. Recipients who meet these criteria must have a comprehensive
222.29transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
222.30reassessed every six months until there has been no significant change in the recipient's
222.31functioning for at least 12 months. After there has been no significant change in the
222.32recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
222.33informal support systems, and need for services shall be conducted at least every 12
222.34months and at other times when there has been a significant change in the recipient's
223.1functioning. Counties, case managers, and service providers are responsible for conducting
223.2these reassessments and shall complete the reassessments out of existing funds.
223.3EFFECTIVE DATE.This section is effective January 1, 2012, except for paragraph
223.4(f), which is effective July 1, 2013.

223.5    Sec. 35. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:
223.6    Subd. 15. Individualized service Coordinated services and support plan;
223.7comprehensive transitional service plan; maintenance service plan. (a) Each recipient
223.8of home and community-based waivered services shall be provided a copy of the written
223.9service coordinated services and support plan which: that complies with the requirements
223.10of section 256B.092, subdivisions 1b and 1e.
223.11(1) is developed and signed by the recipient within ten working days of the
223.12completion of the assessment;
223.13(2) meets the assessed needs of the recipient;
223.14(3) reasonably ensures the health and safety of the recipient;
223.15(4) promotes independence;
223.16(5) allows for services to be provided in the most integrated settings; and
223.17(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
223.18paragraph (p), of service and support providers.
223.19(b) In developing the comprehensive transitional service plan, the individual
223.20receiving services, the case manager, and the guardian, if applicable, will identify
223.21the transitional service plan fundamental service outcome and anticipated timeline to
223.22achieve this outcome. Within the first 20 days following a recipient's request for an
223.23assessment or reassessment, the transitional service planning team must be identified. A
223.24team leader must be identified who will be responsible for assigning responsibility and
223.25communicating with team members to ensure implementation of the transition plan and
223.26ongoing assessment and communication process. The team leader should be an individual,
223.27such as the case manager or guardian, who has the opportunity to follow the recipient to
223.28the next level of service.
223.29Within ten days following an assessment, a comprehensive transitional service plan
223.30must be developed incorporating elements of a comprehensive functional assessment and
223.31including short-term measurable outcomes and timelines for achievement of and reporting
223.32on these outcomes. Functional milestones must also be identified and reported according
223.33to the timelines agreed upon by the transitional service planning team. In addition, the
223.34comprehensive transitional service plan must identify additional supports that may assist
223.35in the achievement of the fundamental service outcome such as the development of greater
224.1natural community support, increased collaboration among agencies, and technological
224.2supports.
224.3The timelines for reporting on functional milestones will prompt a reassessment of
224.4services provided, the units of services, rates, and appropriate service providers. It is
224.5the responsibility of the transitional service planning team leader to review functional
224.6milestone reporting to determine if the milestones are consistent with observable skills
224.7and that milestone achievement prompts any needed changes to the comprehensive
224.8transitional service plan.
224.9For those whose fundamental transitional service outcome involves the need to
224.10procure housing, a plan for the recipient to seek the resources necessary to secure the least
224.11restrictive housing possible should be incorporated into the plan, including employment
224.12and public supports such as housing access and shelter needy funding.
224.13(c) Counties and other agencies responsible for funding community placement and
224.14ongoing community supportive services are responsible for the implementation of the
224.15comprehensive transitional service plans. Oversight responsibilities include both ensuring
224.16effective transitional service delivery and efficient utilization of funding resources.
224.17(d) Following one year of transitional services, the transitional services planning
224.18team will make a determination as to whether or not the individual receiving services
224.19requires the current level of continuous and consistent support in order to maintain the
224.20recipient's current level of functioning. Recipients who are determined to have not had
224.21a significant change in functioning for 12 months must move from a transitional to a
224.22maintenance service plan. Recipients on a maintenance service plan must be reassessed
224.23to determine if the recipient would benefit from a transitional service plan at least every
224.2412 months and at other times when there has been a significant change in the recipient's
224.25functioning. This assessment should consider any changes to technological or natural
224.26community supports.
224.27(b) (e) When a county is evaluating denials, reductions, or terminations of home
224.28and community-based services under section 256B.49 for an individual, the case manager
224.29shall offer to meet with the individual or the individual's guardian in order to discuss the
224.30prioritization of service needs within the individualized service plan, comprehensive
224.31transitional service plan, or maintenance service plan. The reduction in the authorized
224.32services for an individual due to changes in funding for waivered services may not exceed
224.33the amount needed to ensure medically necessary services to meet the individual's health,
224.34safety, and welfare.
224.35EFFECTIVE DATE.This section is effective January 1, 2012, except for
224.36paragraphs (b), (c), and (d), which are effective July 1, 2013.

225.1    Sec. 36. Minnesota Statutes 2010, section 256B.5012, is amended by adding a
225.2subdivision to read:
225.3    Subd. 9. ICF/MR rate increase. Effective July 1, 2011, the commissioner shall
225.4increase the daily rate to $138.23 at an intermediate care facility for the developmentally
225.5disabled located in Clearwater County and classified as a class A facility with 15 beds.
225.6EFFECTIVE DATE.This section is effective July 1, 2011.

225.7    Sec. 37. Minnesota Statutes 2010, section 256B.5012, is amended by adding a
225.8subdivision to read:
225.9    Subd. 10. ICF/MR rate adjustment. For each facility reimbursed under this
225.10section, except for a facility located in Clearwater County and classified as a class A
225.11facility with 15 beds, the commissioner shall decrease operating payment rates equal
225.12to 0.095 percent of the operating payment rates in effect on June 30, 2011. For each
225.13facility, the commissioner shall apply the rate reduction, based on occupied beds, using the
225.14percentage specified in this subdivision multiplied by the total payment rate, including the
225.15variable rate but excluding the property-related payment rate, in effect on the preceding
225.16date. The total rate reduction shall include the adjustment provided in section 256B.501,
225.17subdivision 12.

225.18    Sec. 38. Minnesota Statutes 2010, section 256G.02, subdivision 6, is amended to read:
225.19    Subd. 6. Excluded time. "Excluded time" means:
225.20(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter
225.21other than an emergency shelter, halfway house, foster home, semi-independent living
225.22domicile or services program, residential facility offering care, board and lodging facility
225.23or other institution for the hospitalization or care of human beings, as defined in section
225.24144.50 , 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter,
225.25or correctional facility; or any facility based on an emergency hold under sections
225.26253B.05, subdivisions 1 and 2 , and 253B.07, subdivision 6;
225.27(b) any period an applicant spends on a placement basis in a training and habilitation
225.28program, including a rehabilitation facility or work or employment program as defined
225.29in section 268A.01; or receiving personal care assistance services pursuant to section
225.30256B.0659; semi-independent living services provided under section 252.275, and
225.31Minnesota Rules, parts 9525.0500 to 9525.0660; or day training and habilitation programs
225.32and assisted living services; and
225.33(c) any placement for a person with an indeterminate commitment, including
225.34independent living.
226.1EFFECTIVE DATE.This section is effective July 1, 2011.

226.2    Sec. 39. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by
226.3Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special
226.4Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read:

226.5

Subd. 8.Continuing Care Grants

226.6The amounts that may be spent from the
226.7appropriation for each purpose are as follows:

226.8

(a) Aging and Adult Services Grants

13,499,000

15,805,000

226.9Base Adjustment. The general fund base is
226.10increased by $5,751,000 in fiscal year 2012
226.11and $6,705,000 in fiscal year 2013.
226.12Information and Assistance
226.13Reimbursement. Federal administrative
226.14reimbursement obtained from information
226.15and assistance services provided by the
226.16Senior LinkAge or Disability Linkage lines
226.17to people who are identified as eligible for
226.18medical assistance shall be appropriated to
226.19the commissioner for this activity.
226.20Community Service Development Grant
226.21Reduction. Funding for community service
226.22development grants must be reduced by
226.23$260,000 for fiscal year 2010; $284,000 in
226.24fiscal year 2011; $43,000 in fiscal year 2012;
226.25and $43,000 in fiscal year 2013. Base level
226.26funding shall be restored in fiscal year 2014.
226.27Community Service Development Grant
226.28Community Initiative. Funding for
226.29community service development grants shall
226.30be used to offset the cost of aging support
226.31grants. Base level funding shall be restored
226.32in fiscal year 2014.
227.1Senior Nutrition Use of Federal Funds.
227.2For fiscal year 2010, general fund grants
227.3for home-delivered meals and congregate
227.4dining shall be reduced by $500,000. The
227.5commissioner must replace these general
227.6fund reductions with equal amounts from
227.7federal funding for senior nutrition from the
227.8American Recovery and Reinvestment Act
227.9of 2009.

227.10

(b) Alternative Care Grants

50,234,000

48,576,000

227.11Base Adjustment. The general fund base is
227.12decreased by $3,598,000 in fiscal year 2012
227.13and $3,470,000 in fiscal year 2013.
227.14Alternative Care Transfer. Any money
227.15allocated to the alternative care program that
227.16is not spent for the purposes indicated does
227.17not cancel but must be transferred to the
227.18medical assistance account.

227.19 227.20

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

367,444,000

419,749,000

227.21 227.22

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

853,567,000

1,039,517,000

227.23Manage Growth in TBI and CADI
227.24Waivers. During the fiscal years beginning
227.25on July 1, 2009, and July 1, 2010, the
227.26commissioner shall allocate money for home
227.27and community-based waiver programs
227.28under Minnesota Statutes, section 256B.49,
227.29to ensure a reduction in state spending that is
227.30equivalent to limiting the caseload growth of
227.31the TBI waiver to 12.5 allocations per month
227.32each year of the biennium and the CADI
227.33waiver to 95 allocations per month each year
227.34of the biennium. Limits do not apply: (1)
227.35when there is an approved plan for nursing
228.1facility bed closures for individuals under
228.2age 65 who require relocation due to the
228.3bed closure; (2) to fiscal year 2009 waiver
228.4allocations delayed due to unallotment; or (3)
228.5to transfers authorized by the commissioner
228.6from the personal care assistance program
228.7of individuals having a home care rating
228.8of "CS," "MT," or "HL." Priorities for the
228.9allocation of funds must be for individuals
228.10anticipated to be discharged from institutional
228.11settings or who are at imminent risk of a
228.12placement in an institutional setting.
228.13Manage Growth in DD Waiver. The
228.14commissioner shall manage the growth in
228.15the DD waiver by limiting the allocations
228.16included in the February 2009 forecast to 15
228.17additional diversion allocations each month
228.18for the calendar years that begin on January
228.191, 2010, and January 1, 2011. Additional
228.20allocations must be made available for
228.21transfers authorized by the commissioner
228.22from the personal care program of individuals
228.23having a home care rating of "CS," "MT,"
228.24or "HL."
228.25Adjustment to Lead Agency Waiver
228.26Allocations. Prior to the availability of the
228.27alternative license defined in Minnesota
228.28Statutes, section 245A.11, subdivision 8,
228.29the commissioner shall reduce lead agency
228.30waiver allocations for the purposes of
228.31implementing a moratorium on corporate
228.32foster care.
228.33Alternatives to Personal Care Assistance
228.34Services. Base level funding of $3,237,000
228.35in fiscal year 2012 and $4,856,000 in
229.1fiscal year 2013 is to implement alternative
229.2services to personal care assistance services
229.3for persons with mental health and other
229.4behavioral challenges who can benefit
229.5from other services that more appropriately
229.6meet their needs and assist them in living
229.7independently in the community. These
229.8services may include, but not be limited to, a
229.91915(i) state plan option.

229.10

(e) Mental Health Grants

229.11	Appropriations by Fund
229.12	General	77,739,000	77,739,000
229.13	Health Care Access	750,000	750,000
229.14	Lottery Prize	1,508,000	1,508,000

229.15Funding Usage. Up to 75 percent of a fiscal
229.16year's appropriation for adult mental health
229.17grants may be used to fund allocations in that
229.18portion of the fiscal year ending December
229.1931.

229.20

(f) Deaf and Hard-of-Hearing Grants

1,930,000

1,917,000

229.21

(g) Chemical Dependency Entitlement Grants

111,303,000

122,822,000

229.22Payments for Substance Abuse Treatment.
229.23For placements beginning during fiscal years
229.242010 and 2011, county-negotiated rates and
229.25provider claims to the consolidated chemical
229.26dependency fund must not exceed the lesser
229.27of:
229.28(1) rates charged for these services on
229.29January 1, 2009; or
229.30(2) 160 percent of the average rate on January
229.311, 2009, for each group of vendors with
229.32similar attributes.
229.33Rates for fiscal years 2010 and 2011 must
229.34not exceed 160 percent of the average rate on
230.1January 1, 2009, for each group of vendors
230.2with similar attributes.
230.3Effective July 1, 2010, rates that were above
230.4the average rate on January 1, 2009, are
230.5reduced by five percent from the rates in
230.6effect on June 1, 2010. Rates below the
230.7average rate on January 1, 2009, are reduced
230.8by 1.8 percent from the rates in effect on
230.9June 1, 2010. Services provided under
230.10this section by state-operated services are
230.11exempt from the rate reduction. For services
230.12provided in fiscal years 2012 and 2013, the
230.13statewide aggregate payment under the new
230.14rate methodology to be developed under
230.15Minnesota Statutes, section 254B.12, must
230.16not exceed the projected aggregate payment
230.17under the rates in effect for fiscal year 2011
230.18excluding the rate reduction for rates that
230.19were below the average on January 1, 2009,
230.20plus a state share increase of $3,787,000 for
230.21fiscal year 2012 and $5,023,000 for fiscal
230.22year 2013. Notwithstanding any provision
230.23to the contrary in this article, this provision
230.24expires on June 30, 2013.
230.25Chemical Dependency Special Revenue
230.26Account. For fiscal year 2010, $750,000
230.27must be transferred from the consolidated
230.28chemical dependency treatment fund
230.29administrative account and deposited into the
230.30general fund.
230.31County CD Share of MA Costs for
230.32ARRA Compliance. Notwithstanding the
230.33provisions of Minnesota Statutes, chapter
230.34254B, for chemical dependency services
230.35provided during the period October 1, 2008,
231.1to December 31, 2010, and reimbursed by
231.2medical assistance at the enhanced federal
231.3matching rate provided under the American
231.4Recovery and Reinvestment Act of 2009, the
231.5county share is 30 percent of the nonfederal
231.6share. This provision is effective the day
231.7following final enactment.

231.8 231.9

(h) Chemical Dependency Nonentitlement Grants

1,729,000

1,729,000

231.10

(i) Other Continuing Care Grants

19,201,000

17,528,000

231.11Base Adjustment. The general fund base is
231.12increased by $2,639,000 in fiscal year 2012
231.13and increased by $3,854,000 in fiscal year
231.142013.
231.15Technology Grants. $650,000 in fiscal
231.16year 2010 and $1,000,000 in fiscal year
231.172011 are for technology grants, case
231.18consultation, evaluation, and consumer
231.19information grants related to developing and
231.20supporting alternatives to shift-staff foster
231.21care residential service models.
231.22Other Continuing Care Grants; HIV
231.23Grants. Money appropriated for the HIV
231.24drug and insurance grant program in fiscal
231.25year 2010 may be used in either year of the
231.26biennium.
231.27Quality Assurance Commission. Effective
231.28July 1, 2009, state funding for the quality
231.29assurance commission under Minnesota
231.30Statutes, section 256B.0951, is canceled.

231.31    Sec. 40. ESTABLISHMENT OF RATES FOR SHARED HOME AND
231.32COMMUNITY-BASED WAIVER SERVICES.
231.33By January 1, 2012, the commissioner shall establish rates to begin paying for
231.34in-home services and personal supports under all of the home and community-based
232.1waiver services programs consistent with the standards in Minnesota Statutes, section
232.2256B.4912, subdivision 2.

232.3    Sec. 41. ESTABLISHMENT OF RATE FOR CASE MANAGEMENT
232.4SERVICES.
232.5By July 1, 2012, the commissioner shall establish the rate to be paid for case
232.6management services under Minnesota Statutes, sections 256B.0621, subdivision 2, clause
232.7(4), 256B.092, and 256B.49, consistent with the standards in Minnesota Statutes, section
232.8256B.4912, subdivision 2.

232.9    Sec. 42. RECOMMENDATIONS FOR FURTHER CASE MANAGEMENT
232.10REDESIGN.
232.11By February 1, 2012, the commissioner of human services shall develop a legislative
232.12report with specific recommendations and language for proposed legislation to be effective
232.13July 1, 2012, for the following:
232.14(1) definitions of service and consolidation of standards and rates to the extent
232.15appropriate for all types of medical assistance case management services, including
232.16targeted case management under Minnesota Statutes, sections 256B.0621; 256B.0625,
232.17subdivision 20; and 256B.0924; mental health case management services for children
232.18and adults, all types of home and community-based waiver case management, and case
232.19management under Minnesota Rules, parts 9525.0004 to 9525.0036. This work shall be
232.20completed in collaboration with efforts under Minnesota Statutes, section 256B.4912;
232.21(2) recommendations on county of financial responsibility requirements and quality
232.22assurance measures for case management;
232.23(3) identification of county administrative functions that may remain entwined in
232.24case management service delivery models; and
232.25(4) implementation of a methodology to fully fund county case management
232.26administrative functions.

232.27    Sec. 43. MY LIFE, MY CHOICES TASK FORCE.
232.28    Subdivision 1. Establishment. The My Life, My Choices Task Force is established
232.29to create a system of supports and services for people with disabilities governed by the
232.30following principles:
232.31(1) freedom to act as a consumer of services in the marketplace;
232.32(2) freedom to choose to take as much risk as any other citizen;
232.33(3) more choices in levels of service that may vary throughout life;
233.1(4) opportunity to work with a trusted advocate and fiscal support entity to manage a
233.2personal budget and to be accountable for reporting spending and personal outcomes;
233.3(5) opportunity to live with minimal constraints instead of minimal freedoms; and
233.4(6) ability to consolidate funding streams into an individualized budget.
233.5    Subd. 2. Membership. The My Life, My Choices Task Force shall consist of:
233.6(1) the lieutenant governor;
233.7(2) the commissioner of human services, or the commissioner's designee;
233.8(3) a representative of the Minnesota Chamber of Commerce;
233.9(4) a county representative appointed by the Association of Minnesota Counties;
233.10(5) seven members appointed by the governor as follows: one administrative law
233.11judge, one labor representative, two family members of people with disabilities, and three
233.12individual members with different disabilities;
233.13(6) two members appointed by the speaker of the house as follows: a representative
233.14of a disability advocacy organization, and a representative of a disability legal services
233.15advocacy organization; and
233.16(7) three members appointed by the majority leader of the senate, including two
233.17representatives from nonprofit organizations, one of which serves all 87 counties and
233.18one that serves persons with disabilities and employs fewer than 50 people, and a
233.19representative of a philanthropic organization.
233.20    Appointed nongovernmental members of the task force shall serve as staff for the
233.21task force and take on responsibilities of coordinating meetings, reporting on committee
233.22recommendations, and providing other staff support as needed to meet the responsibilities
233.23of the task force as described in subdivision 3. The chairs and ranking minority members
233.24of the legislative committees with jurisdiction over health and human services policy and
233.25finance shall serve as ex officio members.
233.26    Subd. 3. Duties. The task force shall make recommendations, including proposed
233.27legislation, and report to the legislative committees with jurisdiction over health and
233.28human services policy and finance by November 15, 2011, on creating a system of
233.29supports and services for people with disabilities by July 1, 2012, as governed by the
233.30principles under subdivision 1. In making recommendations and proposed legislation, the
233.31council shall work in conjunction with the Consumer-Directed Community Supports Task
233.32Force and shall include self-directed planning, individual budgeting, choice of trusted
233.33partner, self-directed purchasing of services and supports, reporting of outcomes, ability to
233.34share in any savings, and any additional rules or laws that may need to be waived.
234.1    Subd. 4. Expense reimbursement. The members of the task force shall not be
234.2reimbursed by the state for expenses related to the duties of the task force. The task force
234.3shall be independently staffed and coordinated by nongovernmental appointees who
234.4serve on the task force, and no state dollars shall be appropriated for expenses related to
234.5the task force under this section.
234.6    Subd. 5. Expiration. The task force expires on July 1, 2013.
234.7EFFECTIVE DATE.This section is effective the day following final enactment.

234.8    Sec. 44. DIRECTION TO OMBUDSMAN FOR LONG-TERM CARE.
234.9The Office of Ombudsman for Long-Term Care shall develop a work group to
234.10address issues about, but not limited to: housing with services fees, staffing, and quality
234.11assurance. The work group shall include, but not be limited to: consumers, relatives of
234.12consumers, advocates, and providers. The Office of Ombudsman for Long-Term Care
234.13shall present a report with recommendations related to housing with services fees, staffing,
234.14and quality assurance to the legislative committees with jurisdiction over health and
234.15human services policy and finance by January 15, 2012.

234.16    Sec. 45. DIRECTION TO COUNTIES.
234.17Counties must inform individuals who have had a level of service reduction of
234.18their right to request an informal review conference with their case worker and any other
234.19relevant county staff.

234.20    Sec. 46. NURSING FACILITY PILOT PROJECT.
234.21    Subdivision 1. Report. The commissioner of human services, in consultation with
234.22the commissioner of health, stakeholders, and experts, shall provide to the legislature
234.23recommendations by November 15, 2011, on how to develop a project to demonstrate a
234.24new approach to caring for certain individuals in nursing facilities.
234.25    Subd. 2. Contents of report. The recommendations shall address the:
234.26(1) nature of the demonstration in terms of timing, size, qualifications to participate,
234.27participation selection criteria and postdemonstration options for the demonstration and
234.28for participating facilities;
234.29(2) nature of needed new form of licensure;
235.1(3) characteristics of the individuals the new model is intended to serve and
235.2comparison of these characteristics with those individuals served by existing models of
235.3care;
235.4(4) quality standards for licensure addressing management, types and amounts of
235.5staffing, safety, infection control, care processes, quality improvement, and resident rights;
235.6(5) characteristics of inspection process;
235.7(6) funding for inspection process;
235.8(7) enforcement authorities;
235.9(8) role of Medicare;
235.10(9) participation in the elderly waiver program, including rate setting;
235.11(10) nature of any federal approval or waiver requirements and the method and
235.12timing of obtaining them;
235.13(11) consumer rights; and
235.14(12) methods and resources needed to evaluate the effectiveness of the model with
235.15regards to cost and quality.

235.16
ARTICLE 7

235.17CHEMICAL AND MENTAL HEALTH

235.18    Section 1. Minnesota Statutes 2010, section 246B.10, is amended to read:
235.19246B.10 LIABILITY OF COUNTY; REIMBURSEMENT.
235.20    The civilly committed sex offender's county shall pay to the state a portion of the
235.21cost of care provided in the Minnesota sex offender program to a civilly committed sex
235.22offender who has legally settled in that county. A county's payment must be made from
235.23the county's own sources of revenue and payments must equal ten 25 percent of the cost of
235.24care, as determined by the commissioner, for each day or portion of a day, that the civilly
235.25committed sex offender spends at the facility. If payments received by the state under this
235.26chapter exceed 90 75 percent of the cost of care, the county is responsible for paying the
235.27state the remaining amount. The county is not entitled to reimbursement from the civilly
235.28committed sex offender, the civilly committed sex offender's estate, or from the civilly
235.29committed sex offender's relatives, except as provided in section 246B.07.
235.30EFFECTIVE DATE.This section is effective for all individuals who are civilly
235.31committed to the Minnesota sex offender program on or after August 1, 2011.

235.32    Sec. 2. Minnesota Statutes 2010, section 252.025, subdivision 7, is amended to read:
235.33    Subd. 7. Minnesota extended treatment options. The commissioner shall develop
235.34by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who
236.1have developmental disabilities and exhibit severe behaviors which present a risk to
236.2public safety. This program is statewide and must provide specialized residential services
236.3in Cambridge and an array of community-based services with sufficient levels of care
236.4and a sufficient number of specialists to ensure that individuals referred to the program
236.5receive the appropriate care. The individuals working in the community-based services
236.6under this section are state employees supervised by the commissioner of human services.
236.7No midcontract layoffs shall occur as a result of restructuring under this section, but
236.8layoffs may occur as a normal consequence of a low census or closure of the facility
236.9due to decreased census.

236.10    Sec. 3. Minnesota Statutes 2010, section 253B.212, is amended to read:
236.11253B.212 COMMITMENT; RED LAKE BAND OF CHIPPEWA INDIANS;
236.12WHITE EARTH BAND OF OJIBWE.
236.13    Subdivision 1. Cost of care; commitment by tribal court order; Red Lake
236.14Band of Chippewa Indians. The commissioner of human services may contract with
236.15and receive payment from the Indian Health Service of the United States Department of
236.16Health and Human Services for the care and treatment of those members of the Red
236.17Lake Band of Chippewa Indians who have been committed by tribal court order to the
236.18Indian Health Service for care and treatment of mental illness, developmental disability, or
236.19chemical dependency. The contract shall provide that the Indian Health Service may not
236.20transfer any person for admission to a regional center unless the commitment procedure
236.21utilized by the tribal court provided due process protections similar to those afforded
236.22by sections 253B.05 to 253B.10.
236.23    Subd. 1a. Cost of care; commitment by tribal court order; White Earth Band of
236.24Ojibwe Indians. The commissioner of human services may contract with and receive
236.25payment from the Indian Health Service of the United States Department of Health and
236.26Human Services for the care and treatment of those members of the White Earth Band
236.27of Ojibwe Indians who have been committed by tribal court order to the Indian Health
236.28Service for care and treatment of mental illness, developmental disability, or chemical
236.29dependency. The tribe may also contract directly with the commissioner for treatment
236.30of those members of the White Earth Band who have been committed by tribal court
236.31order to the White Earth Department of Health for care and treatment of mental illness,
236.32developmental disability, or chemical dependency. The contract shall provide that the
236.33Indian Health Service and the White Earth Band shall not transfer any person for admission
236.34to a regional center unless the commitment procedure utilized by the tribal court provided
236.35due process protections similar to those afforded by sections 253B.05 to 253B.10.
237.1    Subd. 2. Effect given to tribal commitment order. When, under an agreement
237.2entered into pursuant to subdivision 1 subdivisions 1 or 1a, the Indian Health Service
237.3applies to a regional center for admission of a person committed to the jurisdiction of the
237.4health service by the tribal court as a person who is mentally ill, developmentally disabled,
237.5or chemically dependent, the commissioner may treat the patient with the consent of
237.6the Indian Health Service.
237.7A person admitted to a regional center pursuant to this section has all the rights
237.8accorded by section 253B.03. In addition, treatment reports, prepared in accordance with
237.9the requirements of section 253B.12, subdivision 1, shall be filed with the Indian Health
237.10Service within 60 days of commencement of the patient's stay at the facility. A subsequent
237.11treatment report shall be filed with the Indian Health Service within six months of the
237.12patient's admission to the facility or prior to discharge, whichever comes first. Provisional
237.13discharge or transfer of the patient may be authorized by the head of the treatment facility
237.14only with the consent of the Indian Health Service. Discharge from the facility to the
237.15Indian Health Service may be authorized by the head of the treatment facility after notice
237.16to and consultation with the Indian Health Service.

237.17    Sec. 4. Minnesota Statutes 2010, section 254B.03, subdivision 1, is amended to read:
237.18    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical
237.19dependency services to persons residing within its jurisdiction who meet criteria
237.20established by the commissioner for placement in a chemical dependency residential
237.21or nonresidential treatment service subject to the limitations on residential chemical
237.22dependency treatment in section 254B.04, subdivision 1. Chemical dependency money
237.23must be administered by the local agencies according to law and rules adopted by the
237.24commissioner under sections 14.001 to 14.69.
237.25    (b) In order to contain costs, the commissioner of human services shall select eligible
237.26vendors of chemical dependency services who can provide economical and appropriate
237.27treatment. Unless the local agency is a social services department directly administered by
237.28a county or human services board, the local agency shall not be an eligible vendor under
237.29section 254B.05. The commissioner may approve proposals from county boards to provide
237.30services in an economical manner or to control utilization, with safeguards to ensure that
237.31necessary services are provided. If a county implements a demonstration or experimental
237.32medical services funding plan, the commissioner shall transfer the money as appropriate.
237.33    (c) A culturally specific vendor that provides assessments under a variance under
237.34Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
237.35persons not covered by the variance.

238.1    Sec. 5. Minnesota Statutes 2010, section 254B.03, subdivision 4, is amended to read:
238.2    Subd. 4. Division of costs. Except for services provided by a county under
238.3section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03,
238.4subdivision 4 , paragraph (b), the county shall, out of local money, pay the state for
238.516.14 22.95 percent of the cost of chemical dependency services, including those services
238.6provided to persons eligible for medical assistance under chapter 256B and general
238.7assistance medical care under chapter 256D. Counties may use the indigent hospitalization
238.8levy for treatment and hospital payments made under this section. 16.14 22.95 percent
238.9of any state collections from private or third-party pay, less 15 percent for the cost of
238.10payment and collections, must be distributed to the county that paid for a portion of the
238.11treatment under this section.
238.12EFFECTIVE DATE.This section is effective for claims processed beginning
238.13July 1, 2011.

238.14    Sec. 6. Minnesota Statutes 2010, section 254B.04, subdivision 1, is amended to read:
238.15    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
238.16Regulations, title 25, part 20, persons eligible for medical assistance benefits under
238.17sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
238.18the income standards of section 256B.056, subdivision 4, and persons eligible for general
238.19assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
238.20dependency fund services subject to the following limitations: (1) no more than three
238.21residential chemical dependency treatment episodes for the same person in a four-year
238.22period of time unless the person meets the criteria established by the commissioner of
238.23human services; and (2) no more than four residential chemical dependency treatment
238.24episodes in a lifetime unless the person meets the criteria established by the commissioner
238.25of human services. For purposes of this section, "episode" means a span of treatment
238.26without interruption of 30 days or more. State money appropriated for this paragraph must
238.27be placed in a separate account established for this purpose.
238.28Persons with dependent children who are determined to be in need of chemical
238.29dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
238.30a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
238.31local agency to access needed treatment services. Treatment services must be appropriate
238.32for the individual or family, which may include long-term care treatment or treatment in a
238.33facility that allows the dependent children to stay in the treatment facility. The county
238.34shall pay for out-of-home placement costs, if applicable.
239.1(b) A person not entitled to services under paragraph (a), but with family income
239.2that is less than 215 percent of the federal poverty guidelines for the applicable family
239.3size, shall be eligible to receive chemical dependency fund services within the limit
239.4of funds appropriated for this group for the fiscal year. If notified by the state agency
239.5of limited funds, a county must give preferential treatment to persons with dependent
239.6children who are in need of chemical dependency treatment pursuant to an assessment
239.7under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
239.86 , or 260C.212. A county may spend money from its own sources to serve persons under
239.9this paragraph. State money appropriated for this paragraph must be placed in a separate
239.10account established for this purpose.
239.11(c) Persons whose income is between 215 percent and 412 percent of the federal
239.12poverty guidelines for the applicable family size shall be eligible for chemical dependency
239.13services on a sliding fee basis, within the limit of funds appropriated for this group for the
239.14fiscal year. Persons eligible under this paragraph must contribute to the cost of services
239.15according to the sliding fee scale established under subdivision 3. A county may spend
239.16money from its own sources to provide services to persons under this paragraph. State
239.17money appropriated for this paragraph must be placed in a separate account established
239.18for this purpose.
239.19EFFECTIVE DATE.This section is effective for all chemical dependency
239.20residential treatment beginning on or after July 1, 2011.

239.21    Sec. 7. Minnesota Statutes 2010, section 254B.04, is amended by adding a subdivision
239.22to read:
239.23    Subd. 2a. Eligibility for treatment in residential settings. Notwithstanding
239.24provisions of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's
239.25discretion in making placements to residential treatment settings, a person eligible for
239.26services under this section must score at level 4 on assessment dimensions related to
239.27relapse, continued use, and recovery environment in order to be assigned to services with
239.28a room and board component reimbursed under this section.

239.29    Sec. 8. Minnesota Statutes 2010, section 254B.06, subdivision 2, is amended to read:
239.30    Subd. 2. Allocation of collections. The commissioner shall allocate all federal
239.31financial participation collections to a special revenue account. The commissioner shall
239.32allocate 83.86 77.05 percent of patient payments and third-party payments to the special
239.33revenue account and 16.14 22.95 percent to the county financially responsible for the
239.34patient.
240.1EFFECTIVE DATE.This section is effective for claims processed beginning
240.2July 1, 2011.

240.3    Sec. 9. Minnesota Statutes 2010, section 256B.0625, subdivision 41, is amended to
240.4read:
240.5    Subd. 41. Residential services for children with severe emotional disturbance.
240.6Medical assistance covers rehabilitative services in accordance with section 256B.0945
240.7that are provided by a county or an American Indian tribe through a residential facility,
240.8for children who have been diagnosed with severe emotional disturbance and have been
240.9determined to require the level of care provided in a residential facility.
240.10EFFECTIVE DATE.This section is effective October 1, 2011.

240.11    Sec. 10. Minnesota Statutes 2010, section 256B.0945, subdivision 4, is amended to
240.12read:
240.13    Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041,
240.14payments to counties for residential services provided by a residential facility shall only
240.15be made of federal earnings for services provided under this section, and the nonfederal
240.16share of costs for services provided under this section shall be paid by the county from
240.17sources other than federal funds or funds used to match other federal funds. Payment to
240.18counties for services provided according to this section shall be a proportion of the per
240.19day contract rate that relates to rehabilitative mental health services and shall not include
240.20payment for costs or services that are billed to the IV-E program as room and board.
240.21    (b) Per diem rates paid to providers under this section by prepaid plans shall be
240.22the proportion of the per-day contract rate that relates to rehabilitative mental health
240.23services and shall not include payment for group foster care costs or services that are
240.24billed to the county of financial responsibility. Services provided in facilities located in
240.25bordering states are eligible for reimbursement on a fee-for-service basis only as described
240.26in paragraph (a) and are not covered under prepaid health plans.
240.27    (c) Payment for mental health rehabilitative services provided under this section by
240.28or under contract with an American Indian tribe or tribal organization or by agencies
240.29operated by or under contract with an American Indian tribe or tribal organization must
240.30be made according to section 256B.0625, subdivision 34, or other relevant federally
240.31approved rate-setting methodology.
240.32(d) The commissioner shall set aside a portion not to exceed five percent of the
240.33federal funds earned for county expenditures under this section to cover the state costs of
241.1administering this section. Any unexpended funds from the set-aside shall be distributed
241.2to the counties in proportion to their earnings under this section.
241.3EFFECTIVE DATE.This section is effective October 1, 2011.

241.4    Sec. 11. COMMUNITY MENTAL HEALTH SERVICES; USE OF
241.5BEHAVIORAL HEALTH HOSPITALS.
241.6The commissioner shall issue a written report to the chairs and ranking minority
241.7members of the house and senate committees with jurisdiction of health and human
241.8services by December 31, 2011, on how the community behavioral health hospital
241.9facilities will be fully utilized to meet the mental health needs of regions in which the
241.10hospitals are located. The commissioner must consult with the regional planning work
241.11groups for adult mental health and must include the recommendations of the work groups
241.12in the legislative report. The report must address future use of community behavioral
241.13health hospitals that are not certified as Medicaid eligible by CMS or have a less than 65
241.14percent licensed bed occupancy rate, and using the facilities for another purpose that will
241.15meet the mental health needs of residents of the region. The regional planning work
241.16groups shall work with the commissioner to prioritize the needs of their regions. These
241.17priorities, by region, must be included in the commissioner's report to the legislature.

241.18    Sec. 12. INTEGRATED DUAL DIAGNOSIS TREATMENT.
241.19(a) The commissioner shall require individuals who perform chemical dependency
241.20assessments or mental health diagnostic assessments to use screening tools approved
241.21by the commissioner in order to identify whether an individual who is the subject of
241.22the assessment screens positive for co-occurring mental health or chemical dependency
241.23disorders. Screening for co-occurring disorders must begin no later than December 31,
241.242011.
241.25(b) The commissioner shall adopt rules as necessary to implement this section. The
241.26commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing
241.27a certification process for integrated dual disorder treatment providers and a system
241.28through which individuals receive integrated dual diagnosis treatment if assessed as having
241.29both a substance use disorder and either a serious mental illness or emotional disturbance.
241.30(c) The commissioner shall apply for any federal waivers necessary to secure, to the
241.31extent allowed by law, federal financial participation for the provision of integrated dual
241.32diagnosis treatment to persons with co-occurring disorders.

241.33    Sec. 13. REGIONAL TREATMENT CENTERS; EMPLOYEES; REPORT.
242.1The commissioner shall issue a report to the legislative committees with jurisdiction
242.2over health and human services finance no later than December 31, 2011, which provides
242.3the number of employees in management positions at the Anoka-Metro Regional
242.4Treatment Center and the Minnesota Security Hospital at St. Peter and the ratio of
242.5management to direct-care staff for each facility.

242.6    Sec. 14. COMMISSIONER'S CRITERIA FOR RESIDENTIAL TREATMENT.
242.7The commissioner shall develop specific criteria to approve treatment for individuals
242.8who require residential chemical dependency treatment in excess of the maximum allowed
242.9in section 254B.04, subdivision 1, due to co-occurring disorders, including disorders
242.10related to cognition, traumatic brain injury, or documented disability. Criteria shall be
242.11developed for use no later than October 1, 2011.

242.12    Sec. 15. REPEALER.
242.13Laws 2009, chapter 79, article 3, section 18, as amended by Laws 2010, First Special
242.14Session chapter 1, article 19, section 19, is repealed.

242.15
ARTICLE 8

242.16REDESIGNING SERVICE DELIVERY

242.17    Section 1. Minnesota Statutes 2010, section 256.01, subdivision 14, is amended to read:
242.18    Subd. 14. Child welfare reform pilots. The commissioner of human services
242.19shall encourage local reforms in the delivery of child welfare services, within available
242.20appropriations, and is authorized to approve local pilot programs which focus on reforming
242.21the child protection and child welfare systems in Minnesota. Authority to approve pilots
242.22includes authority to waive existing state rules as needed to accomplish reform efforts.
242.23Notwithstanding section 626.556, subdivision 10, 10b, or 10d, the commissioner may
242.24authorize programs to use alternative methods of investigating and assessing reports of
242.25child maltreatment, provided that the programs comply with the provisions of section
242.26626.556 dealing with the rights of individuals who are subjects of reports or investigations,
242.27including notice and appeal rights and data practices requirements. Pilot programs must
242.28be required to address responsibility for safety and protection of children, be time limited,
242.29and include evaluation of the pilot program.

242.30    Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 14b, is amended to read:
242.31    Subd. 14b. American Indian child welfare projects. (a) The commissioner of
242.32human services may authorize projects to test tribal delivery of child welfare services to
243.1American Indian children and their parents and custodians living on the reservation.
243.2The commissioner has authority to solicit and determine which tribes may participate
243.3in a project. Grants may be issued to Minnesota Indian tribes to support the projects.
243.4The commissioner may waive existing state rules as needed to accomplish the projects.
243.5Notwithstanding section 626.556, the commissioner may authorize projects to use
243.6alternative methods of investigating and assessing reports of child maltreatment, provided
243.7that the projects comply with the provisions of section 626.556 dealing with the rights
243.8of individuals who are subjects of reports or investigations, including notice and appeal
243.9rights and data practices requirements. The commissioner may seek any federal approvals
243.10necessary to carry out the projects as well as seek and use any funds available to the
243.11commissioner, including use of federal funds, foundation funds, existing grant funds,
243.12and other funds. The commissioner is authorized to advance state funds as necessary to
243.13operate the projects. Federal reimbursement applicable to the projects is appropriated
243.14to the commissioner for the purposes of the projects. The projects must be required to
243.15address responsibility for safety, permanency, and well-being of children.
243.16(b) For the purposes of this section, "American Indian child" means a person under
243.1718 years of age who is a tribal member or eligible for membership in one of the tribes
243.18chosen for a project under this subdivision and who is residing on the reservation of
243.19that tribe.
243.20(c) In order to qualify for an American Indian child welfare project, a tribe must:
243.21(1) be one of the existing tribes with reservation land in Minnesota;
243.22(2) have a tribal court with jurisdiction over child custody proceedings;
243.23(3) have a substantial number of children for whom determinations of maltreatment
243.24have occurred;
243.25(4) have capacity to respond to reports of abuse and neglect under section 626.556;
243.26(5) provide a wide range of services to families in need of child welfare services; and
243.27(6) have a tribal-state title IV-E agreement in effect.
243.28(d) Grants awarded under this section may be used for the nonfederal costs of
243.29providing child welfare services to American Indian children on the tribe's reservation,
243.30including costs associated with:
243.31(1) assessment and prevention of child abuse and neglect;
243.32(2) family preservation;
243.33(3) facilitative, supportive, and reunification services;
243.34(4) out-of-home placement for children removed from the home for child protective
243.35purposes; and
244.1(5) other activities and services approved by the commissioner that further the goals
244.2of providing safety, permanency, and well-being of American Indian children.
244.3(e) When a tribe has initiated a project and has been approved by the commissioner
244.4to assume child welfare responsibilities for American Indian children of that tribe under
244.5this section, the affected county social service agency is relieved of responsibility for
244.6responding to reports of abuse and neglect under section 626.556 for those children
244.7during the time within which the tribal project is in effect and funded. The commissioner
244.8shall work with tribes and affected counties to develop procedures for data collection,
244.9evaluation, and clarification of ongoing role and financial responsibilities of the county
244.10and tribe for child welfare services prior to initiation of the project. Children who have not
244.11been identified by the tribe as participating in the project shall remain the responsibility
244.12of the county. Nothing in this section shall alter responsibilities of the county for law
244.13enforcement or court services.
244.14(f) Participating tribes may conduct children's mental health screenings under section
244.15245.4874, subdivision 1 , paragraph (a), clause (14), for children who are eligible for the
244.16initiative and living on the reservation and who meet one of the following criteria:
244.17(1) the child must be receiving child protective services;
244.18(2) the child must be in foster care; or
244.19(3) the child's parents must have had parental rights suspended or terminated.
244.20Tribes may access reimbursement from available state funds for conducting the screenings.
244.21Nothing in this section shall alter responsibilities of the county for providing services
244.22under section 245.487.
244.23(g) Participating tribes may establish a local child mortality review panel. In
244.24establishing a local child mortality review panel, the tribe agrees to conduct local child
244.25mortality reviews for child deaths or near-fatalities occurring on the reservation under
244.26subdivision 12. Tribes with established child mortality review panels shall have access
244.27to nonpublic data and shall protect nonpublic data under subdivision 12, paragraphs (c)
244.28to (e). The tribe shall provide written notice to the commissioner and affected counties
244.29when a local child mortality review panel has been established and shall provide data upon
244.30request of the commissioner for purposes of sharing nonpublic data with members of the
244.31state child mortality review panel in connection to an individual case.
244.32(h) The commissioner shall collect information on outcomes relating to child safety,
244.33permanency, and well-being of American Indian children who are served in the projects.
244.34Participating tribes must provide information to the state in a format and completeness
244.35deemed acceptable by the state to meet state and federal reporting requirements.
245.1    (i) In consultation with the White Earth Band, the commissioner shall develop
245.2and submit to the chairs and ranking minority members of the legislative committees
245.3with jurisdiction over health and human services a plan to transfer legal responsibility
245.4for providing child protective services to White Earth Band member children residing in
245.5Hennepin County to the White Earth Band. The plan shall include a financing proposal,
245.6definitions of key terms, statutory amendments required, and other provisions required to
245.7implement the plan. The commissioner shall submit the plan by January 15, 2012.

245.8    Sec. 3. Minnesota Statutes 2010, section 256B.69, is amended by adding a subdivision
245.9to read:
245.10    Subd. 30. Provision of required materials in alternative formats. (a) For the
245.11purposes of this subdivision, "alternative format" means a medium other than paper and
245.12"prepaid health plan" means managed care plans and county-based purchasing plans.
245.13(b) A prepaid health plan may provide in an alternative format a provider directory
245.14and certificate of coverage, or materials otherwise required to be available in writing
245.15under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's
245.16contract with the prepaid health plan, if the following conditions are met:
245.17(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the
245.18enrollee that:
245.19(i) an alternative format is available and the enrollee affirmatively requests of
245.20the prepaid health plan that the provider directory, certificate of coverage, or materials
245.21otherwise required under Code of Federal Regulations, title 42, section 438.10, or under
245.22the commissioner's contract with the prepaid health plan be provided in an alternative
245.23format; and
245.24(ii) a record of the enrollee request is retained by the prepaid health plan in the
245.25form of written direction from the enrollee or a documented telephone call followed by a
245.26confirmation letter to the enrollee from the prepaid health plan that explains that the
245.27enrollee may change the request at any time;
245.28(2) the materials are sent to a secure electronic mailbox and are made available at a
245.29password-protected secure electronic Web site or on a data storage device if the materials
245.30contain enrollee data that is individually identifiable;
245.31(3) the enrollee is provided a customer service number on the enrollee's membership
245.32card that may be called to request a paper version of the materials provided in an
245.33alternative format; and
245.34(4) the materials provided in an alternative format meets all other requirements of
245.35the commissioner regarding content, size of the typeface, and any required time frames
246.1for distribution. "Required time frames for distribution" must permit sufficient time for
246.2prepaid health plans to distribute materials in alternative formats upon receipt of enrollees'
246.3requests for the materials.
246.4(c) A prepaid health plan may provide in an alternative format its primary care
246.5network list to the commissioner and to local agencies within its service area. The
246.6commissioner or local agency, as applicable, shall inform a potential enrollee of the
246.7availability of a prepaid health plan's primary care network list in an alternative format. If
246.8the potential enrollee requests an alternative format of the prepaid health plan's primary
246.9care network list, a record of that request shall be retained by the commissioner or local
246.10agency. The potential enrollee is permitted to withdraw the request at any time.
246.11The prepaid health plan shall submit sufficient paper versions of the primary
246.12care network list to the commissioner and to local agencies within its service area to
246.13accommodate potential enrollee requests for paper versions of the primary care network
246.14list.
246.15(d) A prepaid health plan may provide in an alternative format materials otherwise
246.16required to be available in writing under Code of Federal Regulations, title 42, section
246.17438.10, or under the commissioner's contract with the prepaid health plan, if the conditions
246.18of paragraphs (b), (c), and (e), are met for persons who are eligible for enrollment in
246.19managed care.
246.20(e) The commissioner shall seek any federal Medicaid waivers within 90 days after
246.21the effective date of this subdivision that are necessary to provide alternative formats of
246.22required material to enrollees of prepaid health plans as authorized under this subdivision.
246.23(f) The commissioner shall consult with managed care plans, county-based
246.24purchasing plans, counties, and other interested parties to determine how materials
246.25required to be made available to enrollees under Code of Federal Regulations, title 42,
246.26section 438.10, or under the commissioner's contract with a prepaid health plan may
246.27be provided in an alternative format on the basis that the enrollee has not opted in to
246.28receive the alternative format. The commissioner shall consult with managed care
246.29plans, county-based purchasing plans, counties, and other interested parties to develop
246.30recommendations relating to the conditions that must be met for an opt-out process
246.31to be granted.

246.32    Sec. 4. Minnesota Statutes 2010, section 256D.09, subdivision 6, is amended to read:
246.33    Subd. 6. Recovery of overpayments. (a) If an amount of general assistance or
246.34family general assistance is paid to a recipient in excess of the payment due, it shall be
247.1recoverable by the county agency. The agency shall give written notice to the recipient of
247.2its intention to recover the overpayment.
247.3(b) Except as provided for interim assistance in section 256D.06, subdivision
247.45, when an overpayment occurs, the county agency shall recover the overpayment
247.5from a current recipient by reducing the amount of aid payable to the assistance unit of
247.6which the recipient is a member, for one or more monthly assistance payments, until
247.7the overpayment is repaid. All county agencies in the state shall reduce the assistance
247.8payment by three percent of the assistance unit's standard of need in nonfraud cases and
247.9ten percent where fraud has occurred, or the amount of the monthly payment, whichever is
247.10less, for all overpayments.
247.11(c) In cases when there is both an overpayment and underpayment, the county
247.12agency shall offset one against the other in correcting the payment.
247.13(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual,
247.14in addition to the aid reductions provided in this subdivision, to include further voluntary
247.15reductions in the grant level agreed to in writing by the individual, until the total amount
247.16of the overpayment is repaid.
247.17(e) The county agency shall make reasonable efforts to recover overpayments to
247.18persons no longer on assistance under standards adopted in rule by the commissioner
247.19of human services. The county agency need not attempt to recover overpayments of
247.20less than $35 paid to an individual no longer on assistance if the individual does not
247.21receive assistance again within three years, unless the individual has been convicted of
247.22violating section 256.98.
247.23(f) Establishment of an overpayment is limited to 12 months prior to the month of
247.24discovery due to agency error and six years prior to the month of discovery due to client
247.25error or an intentional program violation determined under section 256.046.

247.26    Sec. 5. Minnesota Statutes 2010, section 256D.49, subdivision 3, is amended to read:
247.27    Subd. 3. Overpayment of monthly grants and recovery of ATM errors. (a) When
247.28the county agency determines that an overpayment of the recipient's monthly payment
247.29of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment
247.30to the recipient. If the person is no longer receiving Minnesota supplemental aid, the
247.31county agency may request voluntary repayment or pursue civil recovery. If the person is
247.32receiving Minnesota supplemental aid, the county agency shall recover the overpayment
247.33by withholding an amount equal to three percent of the standard of assistance for the
247.34recipient or the total amount of the monthly grant, whichever is less.
248.1(b) Establishment of an overpayment is limited to 12 months from the date of
248.2discovery due to agency error. Establishment of an overpayment is limited to six years
248.3prior to the month of discovery due to client error or an intentional program violation
248.4determined under section 256.046.
248.5(c) For recipients receiving benefits via electronic benefit transfer, if the overpayment
248.6is a result of an automated teller machine (ATM) dispensing funds in error to the recipient,
248.7the agency may recover the ATM error by immediately withdrawing funds from the
248.8recipient's electronic benefit transfer account, up to the amount of the error.
248.9(d) Residents of nursing homes, regional treatment centers, and licensed residential
248.10facilities with negotiated rates shall not have overpayments recovered from their personal
248.11needs allowance.

248.12    Sec. 6. Minnesota Statutes 2010, section 256J.38, subdivision 1, is amended to read:
248.13    Subdivision 1. Scope of overpayment. (a) When a participant or former participant
248.14receives an overpayment due to agency, client, or ATM error, or due to assistance received
248.15while an appeal is pending and the participant or former participant is determined
248.16ineligible for assistance or for less assistance than was received, the county agency must
248.17recoup or recover the overpayment using the following methods:
248.18(1) reconstruct each affected budget month and corresponding payment month;
248.19(2) use the policies and procedures that were in effect for the payment month; and
248.20(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the
248.21calculation of the overpayment when the unit has not reported within two calendar months
248.22following the end of the month in which the income was received.
248.23(b) Establishment of an overpayment is limited to 12 months prior to the month of
248.24discovery due to agency error. Establishment of an overpayment is limited to six years
248.25prior to the month of discovery due to client error or an intentional program violation
248.26determined under section 256.046.

248.27    Sec. 7. Minnesota Statutes 2010, section 393.07, subdivision 10, is amended to read:
248.28    Subd. 10. Food stamp program; Maternal and Child Nutrition Act. (a) The local
248.29social services agency shall establish and administer the food stamp program according
248.30to rules of the commissioner of human services, the supervision of the commissioner as
248.31specified in section 256.01, and all federal laws and regulations. The commissioner of
248.32human services shall monitor food stamp program delivery on an ongoing basis to ensure
248.33that each county complies with federal laws and regulations. Program requirements to be
248.34monitored include, but are not limited to, number of applications, number of approvals,
249.1number of cases pending, length of time required to process each application and deliver
249.2benefits, number of applicants eligible for expedited issuance, length of time required
249.3to process and deliver expedited issuance, number of terminations and reasons for
249.4terminations, client profiles by age, household composition and income level and sources,
249.5and the use of phone certification and home visits. The commissioner shall determine the
249.6county-by-county and statewide participation rate.
249.7(b) On July 1 of each year, the commissioner of human services shall determine a
249.8statewide and county-by-county food stamp program participation rate. The commissioner
249.9may designate a different agency to administer the food stamp program in a county if the
249.10agency administering the program fails to increase the food stamp program participation
249.11rate among families or eligible individuals, or comply with all federal laws and regulations
249.12governing the food stamp program. The commissioner shall review agency performance
249.13annually to determine compliance with this paragraph.
249.14(c) A person who commits any of the following acts has violated section 256.98 or
249.15609.821 , or both, and is subject to both the criminal and civil penalties provided under
249.16those sections:
249.17(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
249.18willful statement or misrepresentation, or intentional concealment of a material fact, food
249.19stamps or vouchers issued according to sections 145.891 to 145.897 to which the person
249.20is not entitled or in an amount greater than that to which that person is entitled or which
249.21specify nutritional supplements to which that person is not entitled; or
249.22(2) presents or causes to be presented, coupons or vouchers issued according to
249.23sections 145.891 to 145.897 for payment or redemption knowing them to have been
249.24received, transferred or used in a manner contrary to existing state or federal law; or
249.25(3) willfully uses, possesses, or transfers food stamp coupons, authorization to
249.26purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner
249.27contrary to existing state or federal law, rules, or regulations; or
249.28(4) buys or sells food stamp coupons, authorization to purchase cards, other
249.29assistance transaction devices, vouchers issued according to sections 145.891 to 145.897,
249.30or any food obtained through the redemption of vouchers issued according to sections
249.31145.891 to 145.897 for cash or consideration other than eligible food.
249.32(d) A peace officer or welfare fraud investigator may confiscate food stamps,
249.33authorization to purchase cards, or other assistance transaction devices found in the
249.34possession of any person who is neither a recipient of the food stamp program nor
249.35otherwise authorized to possess and use such materials. Confiscated property shall be
249.36disposed of as the commissioner may direct and consistent with state and federal food
250.1stamp law. The confiscated property must be retained for a period of not less than 30 days
250.2to allow any affected person to appeal the confiscation under section 256.045.
250.3(e) Food stamp overpayment claims which are due in whole or in part to client error
250.4shall be established by the county agency for a period of six years from the date of any
250.5resultant overpayment Establishment of an overpayment is limited to 12 months prior to
250.6the month of discovery due to agency error. Establishment of an overpayment is limited
250.7to six years prior to the month of discovery due to client error or an intentional program
250.8violation determined under section 256.046.
250.9(f) With regard to the federal tax revenue offset program only, recovery incentives
250.10authorized by the federal food and consumer service shall be retained at the rate of 50
250.11percent by the state agency and 50 percent by the certifying county agency.
250.12(g) A peace officer, welfare fraud investigator, federal law enforcement official,
250.13or the commissioner of health may confiscate vouchers found in the possession of any
250.14person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise
250.15authorized to possess and use such vouchers. Confiscated property shall be disposed of
250.16as the commissioner of health may direct and consistent with state and federal law. The
250.17confiscated property must be retained for a period of not less than 30 days.
250.18(h) The commissioner of human services may seek a waiver from the United States
250.19Department of Agriculture to allow the state to specify foods that may and may not be
250.20purchased in Minnesota with benefits funded by the federal Food Stamp Program. The
250.21commissioner shall consult with the members of the house of representatives and senate
250.22policy committees having jurisdiction over food support issues in developing the waiver.
250.23The commissioner, in consultation with the commissioners of health and education, shall
250.24develop a broad public health policy related to improved nutrition and health status. The
250.25commissioner must seek legislative approval prior to implementing the waiver.

250.26    Sec. 8. Minnesota Statutes 2010, section 402A.10, subdivision 4, is amended to read:
250.27    Subd. 4. Essential human services or essential services. "Essential human
250.28services" or "essential services" means assistance and services to recipients or potential
250.29recipients of public welfare and other services delivered by counties or tribes that are
250.30mandated in federal and state law that are to be available in all counties of the state.

250.31    Sec. 9. Minnesota Statutes 2010, section 402A.10, subdivision 5, is amended to read:
250.32    Subd. 5. Service delivery authority. "Service delivery authority" means a single
250.33county, or group consortium of counties operating by execution of a joint powers
250.34agreement under section 471.59 or other contractual agreement, that has voluntarily
251.1chosen by resolution of the county board of commissioners to participate in the redesign
251.2under this chapter or has been assigned by the commissioner pursuant to section 402A.18.
251.3A service delivery authority includes an Indian tribe or group of tribes that have voluntarily
251.4chosen by resolution of tribal government to participate in redesign under this chapter.

251.5    Sec. 10. Minnesota Statutes 2010, section 402A.15, is amended to read:
251.6402A.15 STEERING COMMITTEE ON PERFORMANCE AND OUTCOME
251.7REFORMS.
251.8    Subdivision 1. Duties. (a) The Steering Committee on Performance and Outcome
251.9Reforms shall develop a uniform process to establish and review performance and outcome
251.10standards for all essential human services based on the current level of resources available,
251.11and to shall develop appropriate reporting measures and a uniform accountability process
251.12for responding to a county's or human service delivery authority's failure to make adequate
251.13progress on achieving performance measures. The accountability process shall focus on
251.14the performance measures rather than inflexible implementation requirements.
251.15(b) The steering committee shall:
251.16(1) by November 1, 2009, establish an agreed-upon list of essential services;
251.17(2) by February 15, 2010, develop and recommend to the legislature a uniform,
251.18graduated process, in addition to the remedies identified in section 402A.18, for responding
251.19to a county's failure to make adequate progress on achieving performance measures; and
251.20(3) by December 15, 2012, for each essential service, make recommendations
251.21to the legislature regarding (1) (i) performance measures and goals based on those
251.22measures for each essential service, (2) and (ii) a system for reporting on the performance
251.23measures and goals, and (3) appropriate resources, including funding, needed to achieve
251.24those performance measures and goals. The resource recommendations shall take into
251.25consideration program demand and the unique differences of local areas in geography and
251.26the populations served. Priority shall be given to services with the greatest variation in
251.27availability and greatest administrative demands. By January 15 of each year starting
251.28January 15, 2011, the steering committee shall report its recommendations to the governor
251.29and legislative committees with jurisdiction over health and human services. As part of its
251.30report, the steering committee shall, as appropriate, recommend statutory provisions, rules
251.31and requirements, and reports that should be repealed or eliminated.
251.32(c) As far as possible, the performance measures, reporting system, and funding
251.33shall be consistent across program areas. The development of performance measures shall
251.34consider the manner in which data will be collected and performance will be reported.
251.35The steering committee shall consider state and local administrative costs related to
252.1collecting data and reporting outcomes when developing performance measures. The
252.2steering committee shall correlate the performance measures and goals to available levels
252.3of resources, including state and local funding. The steering committee shall also identify
252.4and incorporate federal performance measures in its recommendations for those program
252.5areas where federal funding is contingent on meeting federal performance standards. The
252.6steering committee shall take into consideration that the goal of implementing changes
252.7to program monitoring and reporting the progress toward achieving outcomes is to
252.8significantly minimize the cost of administrative requirements and to allow funds freed
252.9by reduced administrative expenditures to be used to provide additional services, allow
252.10flexibility in service design and management, and focus energies on achieving program
252.11and client outcomes.
252.12(d) In making its recommendations, the steering committee shall consider input from
252.13the council established in section 402A.20. The steering committee shall review the
252.14measurable goals established in a memorandum of understanding entered into under
252.15section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied
252.16as statewide performance outcomes.
252.17(e) The steering committee shall form work groups that include persons who provide
252.18or receive essential services and representatives of organizations who advocate on behalf
252.19of those persons.
252.20(f) By December 15, 2009, the steering committee shall establish a three-year
252.21schedule for completion of its work. The schedule shall be published on the Department of
252.22Human Services Web site and reported to the legislative committees with jurisdiction over
252.23health and human services. In addition, the commissioner shall post quarterly updates on
252.24the progress of the steering committee on the Department of Human Services Web site.
252.25    Subd. 2. Composition. (a) The steering committee shall include:
252.26(1) the commissioner of human services, or designee, and two additional
252.27representatives of the department;
252.28(2) two county commissioners, representative of rural and urban counties, selected
252.29by the Association of Minnesota Counties;
252.30(3) two county directors of human services, representative of rural and urban
252.31counties, selected by the Minnesota Association of County Social Service Administrators;
252.32and
252.33(4) three clients or client advocates representing different populations receiving
252.34services from the Department of Human Services, who are appointed by the commissioner.
253.1(b) The commissioner, or designee, and a county commissioner shall serve as
253.2cochairs of the committee. The committee shall be convened within 60 days of May
253.315, 2009.
253.4(c) State agency staff shall serve as informational resources and staff to the steering
253.5committee. Statewide county associations may assemble county program data as required.
253.6(d) To promote information sharing and coordination between the steering committee
253.7and council, one of the county representatives from paragraph (a), clause (2), and one of the
253.8county representatives from paragraph (a), clause (3), must also serve as a representative
253.9on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).

253.10    Sec. 11. Minnesota Statutes 2010, section 402A.18, is amended to read:
253.11402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET
253.12PERFORMANCE OUTCOMES.
253.13    Subdivision 1. Underperforming county; specific service. If the commissioner
253.14determines that a county or service delivery authority is deficient in achieving minimum
253.15performance outcomes for a specific essential service, the commissioner may impose the
253.16following remedies and adjust state and federal program allocations accordingly:
253.17(1) voluntary incorporation of the administration and operation of the specific
253.18essential service with an existing service delivery authority or another county. A
253.19service delivery authority or county incorporating an underperforming county shall
253.20not be financially liable for the costs associated with remedying performance outcome
253.21deficiencies;
253.22(2) mandatory incorporation of the administration and operation of the specific
253.23essential service with an existing service delivery authority or another county. A
253.24service delivery authority or county incorporating an underperforming county shall
253.25not be financially liable for the costs associated with remedying performance outcome
253.26deficiencies; or
253.27(3) transfer of authority for program administration and operation of the specific
253.28essential service to the commissioner.
253.29    Subd. 2. Underperforming county; more than one-half of service services. If
253.30the commissioner determines that a county or service delivery authority is deficient in
253.31achieving minimum performance outcomes for more than one-half of the defined essential
253.32service services, the commissioner may impose the following remedies:
253.33(1) voluntary incorporation of the administration and operation of the specific
253.34essential service services with an existing service delivery authority or another county.
253.35A service delivery authority or county incorporating an underperforming county shall
254.1not be financially liable for the costs associated with remedying performance outcome
254.2deficiencies;
254.3(2) mandatory incorporation of the administration and operation of the specific
254.4essential service services with an existing service delivery authority or another county.
254.5A service delivery authority or county incorporating an underperforming county shall
254.6not be financially liable for the costs associated with remedying performance outcome
254.7deficiencies; or
254.8(3) transfer of authority for program administration and operation of the specific
254.9essential service services to the commissioner.
254.10    Subd. 2a. Financial responsibility of underperforming county. A county subject
254.11to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of
254.12the essential service or essential services the amount of nonfederal and nonstate funding
254.13needed to remedy performance outcome deficiencies.
254.14    Subd. 3. Conditions prior to imposing remedies. Before the commissioner may
254.15impose the remedies authorized under this section, the following conditions must be met:
254.16(1) the county or service delivery authority determined by the commissioner
254.17to be deficient in achieving minimum performance outcomes has the opportunity, in
254.18coordination with the council, to develop a program outcome improvement plan. The
254.19program outcome improvement plan must be developed no later than six months from the
254.20date of the deficiency determination; and
254.21(2) the council has conducted an assessment of the program outcome improvement
254.22plan to determine if the county or service delivery authority has made satisfactory
254.23progress toward performance outcomes and has made a recommendation about remedies
254.24to the commissioner. The review assessment and recommendation must be made to the
254.25commissioner within 12 months from the date of the deficiency determination.

254.26    Sec. 12. Minnesota Statutes 2010, section 402A.20, is amended to read:
254.27402A.20 COUNCIL.
254.28    Subdivision 1. Council. (a) The State-County Results, Accountability, and Service
254.29Delivery Redesign Council is established. Appointed council members must be appointed
254.30by their respective agencies, associations, or governmental units by November 1, 2009.
254.31The council shall be cochaired by the commissioner of human services, or designee, and a
254.32county representative from paragraph (b), clause (4) or (5), appointed by the Association
254.33of Minnesota Counties. Recommendations of the council must be approved by a majority
254.34of the voting council members. The provisions of section 15.059 do not apply to this
254.35council, and this council does not expire.
255.1(b) The council must consist of the following members:
255.2(1) two legislators appointed by the speaker of the house, one from the minority
255.3and one from the majority;
255.4(2) two legislators appointed by the Senate Rules Committee, one from the majority
255.5and one from the minority;
255.6(3) the commissioner of human services, or designee, and three employees from
255.7the department;
255.8(4) two county commissioners appointed by the Association of Minnesota Counties;
255.9(5) two county representatives appointed by the Minnesota Association of County
255.10Social Service Administrators;
255.11(6) one representative appointed by AFSCME as a nonvoting member; and
255.12(7) one representative appointed by the Teamsters as a nonvoting member.
255.13(c) Administrative support to the council may be provided by the Association of
255.14Minnesota Counties and affiliates.
255.15(d) Member agencies and associations are responsible for initial and subsequent
255.16appointments to the council.
255.17    Subd. 2. Council duties. The council shall:
255.18(1) provide review of the service delivery redesign process, including proposed
255.19memoranda of understanding to establish a service delivery authority to conduct and
255.20administer experimental projects to test new methods and procedures of delivering
255.21services;
255.22(2) certify, in accordance with section 402A.30, subdivision 4, the formation of
255.23a service delivery authority, including the memorandum of understanding in section
255.24402A.30, subdivision 2, paragraph (b);
255.25(3) ensure the consistency of the memorandum of understanding entered into
255.26under section 402A.30, subdivision 2, paragraph (b), with the performance standards
255.27recommended by the steering committee and enacted by the legislature;
255.28(4) (2) ensure the consistency of the memorandum of understanding, to the extent
255.29appropriate, or with other memorandum of understanding entered into by other service
255.30delivery authorities;
255.31(3) review and make recommendations on applications from a service delivery
255.32authority for waivers of statutory or rule program requirements that are needed for
255.33flexibility to determine the most cost-effective means of achieving specified measurable
255.34goals in a redesign of human services delivery;
255.35(5) (4) establish a process to take public input on the service delivery framework
255.36specified in the memorandum of understanding in section 402A.30, subdivision 2,
256.1paragraph (b) scope of essential services over which a service delivery authority has
256.2jurisdiction;
256.3(6) (5) form work groups as necessary to carry out the duties of the council under the
256.4redesign;
256.5(7) (6) serve as a forum for resolving conflicts among participating counties and
256.6tribes or between participating counties or tribes and the commissioner of human services,
256.7provided nothing in this section is intended to create a formal binding legal process;
256.8(8) (7) engage in the program improvement process established in section 402A.18,
256.9subdivision 3; and
256.10(9) (8) identify and recommend incentives for counties and tribes to participate in
256.11human services service delivery authorities.
256.12    Subd. 3. Program evaluation. By December 15, 2014, the council shall request
256.13consideration by the legislative auditor for a reevaluation under section 3.971, subdivision
256.147, of those aspects of the program evaluation of human services administration reported
256.15in January 2007 affected by this chapter.

256.16    Sec. 13. [402A.35] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
256.17    Subdivision 1. Requirements for establishing a service delivery authority.
256.18(a) A county, tribe, or consortium of counties is eligible to establish a service delivery
256.19authority if:
256.20(1) the county, tribe, or consortium of counties is:
256.21(i) a single county with a population of 55,000 or more;
256.22(ii) a consortium of counties with a total combined population of 55,000 or more;
256.23(iii) a consortium of four or more counties in reasonable geographic proximity
256.24without regard to population; or
256.25(iv) one or more tribes with a total combined population of 25,000 or more.
256.26The council may recommend that the commissioner of human services exempt a
256.27single county, tribe, or consortium of counties from the minimum population standard if
256.28the county, tribe, or consortium of counties can demonstrate that it can otherwise meet
256.29the requirements of this chapter.
256.30(b) A service delivery authority shall:
256.31(1) comply with current state and federal law, including any existing federal or state
256.32performance measures and performance measures under section 402A.15 when they are
256.33enacted into law, except where waivers are approved by the commissioner. Nothing
256.34in this subdivision requires the establishment of performance measures under section
257.1402A.15 prior to a service delivery authority participating in the service delivery redesign
257.2under this chapter;
257.3(2) define the scope of essential services over which the service delivery authority
257.4has jurisdiction;
257.5(3) designate a single administrative structure to oversee the delivery of those
257.6services included in a proposal for a redesigned service or services and identify a single
257.7administrative agent for purposes of contact and communication with the department;
257.8(4) identify the waivers from statutory or rule program requirements that are needed
257.9to ensure greater local control and flexibility to determine the most cost-effective means of
257.10achieving specified measurable goals that the participating service delivery authority is
257.11expected to achieve;
257.12(5) set forth a reasonable level of targeted reductions in overhead and administrative
257.13costs for each service delivery authority participating in the service delivery redesign;
257.14(6) set forth the terms under which a county, tribe, or consortium of counties
257.15may withdraw from participation. In the case of withdrawal of any or all parties or
257.16the dissolution of the service delivery authority, the employees shall continue to be
257.17represented by the same exclusive representative or representatives and continue to be
257.18covered by the same collective bargaining union agreement until a new agreement is
257.19negotiated or the collective bargaining agreement term ends; and
257.20(7) set forth a structure for managing the terms and conditions of employment of the
257.21employees as provided in section 402A.40.
257.22(c) Once a county, tribe, or consortium of counties establishes a service delivery
257.23authority, no county, tribe, or consortium of counties that is a member of the service
257.24delivery authority may participate as a member of any other service delivery authority.
257.25The service delivery authority may allow an additional county, a tribe, or a consortium of
257.26counties to join the service delivery authority subject to the approval of the council and
257.27the commissioner.
257.28(d) Nothing in this chapter precludes local governments from using sections 465.81
257.29and 465.82 to establish procedures for local governments to merge, with the consent
257.30of the voters. Nothing in this chapter limits the authority of a county board or tribal
257.31council to enter into contractual agreements for services not covered by the provisions
257.32of a memorandum of understanding establishing a service delivery authority with other
257.33agencies or with other units of government.
257.34    Subd. 2. Relief from statutory requirements. (a) Unless otherwise identified in
257.35the memorandum of understanding, any county, tribe, or consortium of counties forming a
257.36service delivery authority is exempt from the provisions of sections 245.465; 245.4835;
258.1245.4874; 245.492, subdivision 2; 245.4932; 256F.13; 256J.626, subdivision 2, paragraph
258.2(b); and 256M.30.
258.3(b) This subdivision does not preclude any county, tribe, or consortium of counties
258.4forming a service delivery authority from requesting additional waivers from statutory and
258.5rule requirements to ensure greater local control and flexibility.
258.6    Subd. 3. Duties. The service delivery authority shall:
258.7(1) within the scope of essential services set forth in the memorandum of
258.8understanding establishing the authority, carry out the responsibilities required of local
258.9agencies under chapter 393 and human services boards under chapter 402;
258.10(2) manage the public resources devoted to human services and other public services
258.11delivered or purchased by the counties or tribes that are subsidized or regulated by the
258.12Department of Human Services under chapters 245 to 261;
258.13(3) employ staff to assist in carrying out its duties;
258.14(4) develop and maintain a continuity of operations plan to ensure the continued
258.15operation or resumption of essential human services functions in the event of any business
258.16interruption according to local, state, and federal emergency planning requirements;
258.17(5) receive and expend funds received for the redesign process under the
258.18memorandum of understanding;
258.19(6) plan and deliver services directly or through contract with other governmental,
258.20tribal, or nongovernmental providers;
258.21(7) rent, purchase, sell, and otherwise dispose of real and personal property as
258.22necessary to carry out the redesign; and
258.23(8) carry out any other service designated as a responsibility of a county.
258.24    Subd. 4. Process for establishing a service delivery authority. (a) The county,
258.25tribe, or consortium of counties meeting the requirements of section 402A.30 and
258.26proposing to establish a service delivery authority shall present to the council:
258.27(1) in conjunction with the commissioner, a proposed memorandum of understanding
258.28meeting the requirements of subdivision 1, paragraph (b), and outlining:
258.29(i) the details of the proposal;
258.30(ii) the state, tribal, and local resources, which may include, but are not limited to,
258.31funding, administrative and technology support, and other requirements necessary for
258.32the service delivery authority; and
258.33(iii) the relief available to the service delivery authority if the resource commitments
258.34identified in item (ii) are not met; and
259.1(2) a board resolution from the board of commissioners of each participating county
259.2stating the county's intent to participate, or in the case of a tribe, a resolution from tribal
259.3government, stating the tribe's intent to participate.
259.4(b) After the council has considered and recommended approval of a proposed
259.5memorandum of understanding, the commissioner may finalize and execute the
259.6memorandum of understanding.
259.7    Subd. 5. Commissioner authority to seek waivers. The commissioner may use the
259.8authority under section 256.01, subdivision 2, paragraph (l), to grant waivers identified as
259.9part of a proposed service delivery authority under subdivision 1, paragraph (b), clause
259.10(4), except that waivers granted under this section must be approved by the council under
259.11section 402A.20 rather than the Legislative Advisory Committee.

259.12    Sec. 14. [402A.40] TRANSITION TO NEW BARGAINING UNIT STRUCTURE.
259.13    Subdivision 1. Application of section. Notwithstanding the provisions of section
259.14179A.12 or any other law, this section governs, where contrary to other law, the initial
259.15certification and decertification, if any, of exclusive representatives for service delivery
259.16authorities. Employees of a service delivery authority are public employees under section
259.17179A.03, subdivision 14. Service delivery authorities are public employers under section
259.18179A.03, subdivision 15.
259.19    Subd. 2. Existing majority. The commissioner of the Minnesota Bureau of
259.20Mediation Services shall certify an employee organization for employees of a service
259.21delivery authority as exclusive representative for an appropriate unit upon a petition
259.22filed with the commissioner by the organization demonstrating that the petitioner is
259.23certified pursuant to section 179A.12 as the exclusive representative of a majority of the
259.24employees included within the unit as of that date. Two or more employee organizations
259.25that represent the employees in a unit may petition jointly under this subdivision, provided
259.26that any organization may withdraw from a joint certification in favor of the remaining
259.27organizations on 30 days' notice to the remaining organizations, the employer, and the
259.28commissioner, without affecting the rights and obligations of the remaining organizations
259.29or the employer. The commissioner shall make a determination on a timely petition within
259.3045 days of its receipt.
259.31    Subd. 3. No existing majority. (a) If no exclusive representative is certified under
259.32subdivision 2, the commissioner shall certify an employee organization as exclusive
259.33representative for an appropriate unit established upon a petition filed by the organization
259.34within the time period provided in subdivision 2 demonstrating that the petitioner is
259.35certified under section 179A.12 as the exclusive representative of fewer than a majority
260.1of the employees included within the unit if no other employee organization so certified
260.2has filed a petition within the time period provided in subdivision 2 and a majority of the
260.3employees in the unit are represented by employee organizations under section 179A.12
260.4on the date of the petition. Two or more employee organizations, each of which represents
260.5employees included in the unit may petition jointly under this paragraph, provided that
260.6any organization may withdraw from a joint certification in favor of the remaining
260.7organizations on 30 days' notice to the remaining organizations, the employer, and the
260.8commissioner without affecting the rights and obligations of the remaining organizations
260.9or the employer. The commissioner shall make a determination on a timely petition within
260.1045 days of its receipt.
260.11(b) If no exclusive representative is certified under paragraph (a) or subdivision 2,
260.12and an employee organization petitions the commissioner within 90 days of the creation of
260.13the service delivery authority demonstrating that a majority of the employees included
260.14within an appropriate unit wish to be represented by the petitioner, where this majority
260.15is evidenced by current dues deduction rights, signed statements from employees in
260.16counties within the service delivery authority that are not currently represented by any
260.17employee organization plainly indicating that the signatories wish to be represented for
260.18collective bargaining purposes by the petitioner rather than by any other organization,
260.19or a combination of those, the commissioner shall certify the petitioner as exclusive
260.20representative of the employees in the unit. The commissioner shall make a determination
260.21on a timely petition within 45 days of its receipt.
260.22(c) If no exclusive representative is certified under paragraph (a) or (b) or subdivision
260.232, and an employee organization petitions the commissioner subsequent to the creation
260.24of the service delivery authority demonstrating that at least 30 percent of the employees
260.25included within an appropriate unit wish to be represented by the petitioner, where this 30
260.26percent is evidenced by current dues deduction rights, signed statements from employees
260.27in counties within the service delivery authority that are not currently represented by any
260.28employee organization plainly indicating that the signatories wish to be represented for
260.29collective bargaining purposes by the petitioner rather than by any other organization, or a
260.30combination of those, the commissioner shall conduct a secret ballot election to determine
260.31the wishes of the majority. The election must be conducted within 45 days of receipt or
260.32final decision on any petitions filed pursuant to subdivision 2, whichever is later. The
260.33election is governed by section 179A.12, where not inconsistent with other provisions
260.34of this section.
261.1    Subd. 4. Decertification. The commissioner may not consider a petition for
261.2decertification of an exclusive representative certified under this section for one year after
261.3certification, unless section 179A.20, subdivision 6, applies.
261.4    Subd. 5. Continuing contract. (a) The terms and conditions of collective
261.5bargaining agreements covering the employees of service delivery authorities remain in
261.6effect until a successor agreement becomes effective or, if no employee organization
261.7petitions to represent the employees of the service delivery authority, until six months
261.8after the establishment of the service delivery authority.
261.9(b) Any accrued leave, including but not limited to sick leave, vacation time,
261.10compensatory leave or paid time off, or severance pay benefits accumulated under policies
261.11of the previously employing county or a collective bargaining agreement between the
261.12previously employing county and an exclusive representative shall continue to apply in the
261.13newly created service delivery authority for the employees of the previously employing
261.14county. An employee who was eligible for the benefits of the Family and Medical Leave
261.15Act at the previously employing county shall continue to be eligible at the newly created
261.16service delivery authority.
261.17(c) If it is necessary, prior to the negotiation of a new collective bargaining
261.18agreement, to lay off an employee of a service delivery authority and if two or more
261.19employees previously performed the work, seniority based on continuous length of
261.20service with a service delivery authority member county shall be the determining factor
261.21in determining which qualified employee shall be offered the job by the service delivery
261.22authority. An employee whose work is being transferred to the service delivery authority
261.23shall have the option of being laid off.
261.24    Subd. 6. Contract and representation responsibilities. (a) The exclusive
261.25representatives of units of employees certified prior to the creation of the service delivery
261.26authority remain responsible for administration of their contracts and for other contractual
261.27duties and have the right to dues and fair share fee deduction and other contractual
261.28privileges and rights until a contract is agreed upon with the service delivery authority.
261.29Exclusive representatives of service delivery authority employees certified after the
261.30creation of the service delivery authority are immediately upon certification responsible
261.31for bargaining on behalf of employees within the unit. They are also responsible for
261.32administering grievances arising under previous contracts covering employees included
261.33within the unit that remain unresolved upon agreement with the service delivery authority
261.34on a contract. Where the employer does not object, these responsibilities may be varied by
261.35agreement between the outgoing and incoming exclusive representatives. All other rights
261.36and duties of representation begin upon the creation of a service delivery authority, except
262.1that exclusive representatives certified upon or after the creation of the service delivery
262.2authority shall immediately, upon certification, have the right to all employer information
262.3and all forms of access to employees within the bargaining unit which would be permitted
262.4to the current contract holder, including the rights in section 179A.07, subdivision 6. This
262.5section does not affect an existing collective bargaining contract. Incoming exclusive
262.6representatives are immediately, upon certification, responsible for bargaining on behalf of
262.7all previously unrepresented employees assigned to their units.
262.8(b) Nothing in this section prevents an exclusive representative certified after
262.9the effective dates of these provisions from assessing fair share or dues deductions
262.10immediately upon certification if the employees were unrepresented for collective
262.11bargaining purposes before that certification.

262.12    Sec. 15. COUNTY ELECTRONIC VERIFICATION PROCEDURES.
262.13The commissioner of human services shall define which public assistance program
262.14requirements may be electronically verified for the purposes of determining eligibility,
262.15and shall also define procedures for electronic verification. The commissioner of human
262.16services shall report back to the chairs and ranking minority members of the legislative
262.17committees with jurisdiction over these issues by January 15, 2012, with draft legislation
262.18to implement the procedures if legislation is necessary for purposes of implementation.

262.19    Sec. 16. ALIGNMENT OF PROGRAM POLICY AND PROCEDURES.
262.20The commissioner of human services, in consultation with counties and other key
262.21stakeholders, shall analyze and develop recommendations to align program policy and
262.22procedures across all public assistance programs to simplify and streamline program
262.23eligibility and access. The commissioner shall report back to the chairs and ranking
262.24minority members of the legislative committees with jurisdiction over these issues by
262.25January 15, 2013, with draft legislation to implement the recommendations.

262.26    Sec. 17. ALTERNATIVE STRATEGIES FOR CERTAIN
262.27REDETERMINATIONS.
262.28The commissioner of human services shall develop and implement by January 15,
262.292012, a simplified process to redetermine eligibility for recipient populations in the medical
262.30assistance, Minnesota supplemental aid, food support, and group residential housing
262.31programs who are eligible based upon disability, age, or chronic medical conditions, and
262.32who are expected to experience minimal change in income or assets from month to month.
262.33The commissioner shall apply for any federal waivers needed to implement this section.

263.1    Sec. 18. SIMPLIFICATION OF ELIGIBILITY AND ENROLLMENT
263.2PROCESS.
263.3(a) The commissioner of human services shall issue a request for information for an
263.4integrated service delivery system for health care programs, food support, cash assistance,
263.5and child care. The commissioner shall determine, in consultation with partners in
263.6paragraph (c), if the products meet departments' and counties' functions. The request for
263.7information may incorporate a performance-based vendor financing option in which the
263.8vendor shares the risk of the project's success. The health care system must be developed
263.9in phases with the capacity to integrate food support, cash assistance, and child care
263.10programs as funds are available. The request for information must require that the system:
263.11(1) streamline eligibility determinations and case processing to support statewide
263.12eligibility processing;
263.13(2) enable interested persons to determine eligibility for each program, and to apply
263.14for programs online in a manner that the applicant will be asked only those questions
263.15relevant to the programs for which the person is applying;
263.16(3) leverage technology that has been operational in other state environments with
263.17similar requirements; and
263.18(4) include Web-based application, worker application processing support, and the
263.19opportunity for expansion.
263.20(b) The commissioner shall issue a final report, including the implementation plan,
263.21to the chairs and ranking minority members of the legislative committees with jurisdiction
263.22over health and human services no later than October 31, 2011.
263.23(c) The commissioner shall partner with counties, a service delivery authority
263.24established under Minnesota Statutes, chapter 402A, the Office of Enterprise Technology,
263.25other state agencies, and service partners to develop an integrated service delivery
263.26framework, which will simplify and streamline human services eligibility and enrollment
263.27processes. The primary objectives for the simplification effort include significantly
263.28improved eligibility processing productivity resulting in reduced time for eligibility
263.29determination and enrollment, increased customer service for applicants and recipients of
263.30services, increased program integrity, and greater administrative flexibility.
263.31(d) The commissioner, along with a county representative appointed by the
263.32Association of Minnesota Counties, shall report specific implementation progress to the
263.33legislature annually beginning May 15, 2012.
263.34(e) The commissioner shall work with the Minnesota Association of County Social
263.35Service Administrators and the Office of Enterprise Technology to develop collaborative
263.36task forces, as necessary, to support implementation of the service delivery components
264.1under this paragraph. The commissioner must evaluate, develop, and include as part
264.2of the integrated eligibility and enrollment service delivery framework, the following
264.3minimum components:
264.4(1) screening tools for applicants to determine potential eligibility as part of an
264.5online application process;
264.6(2) the capacity to use databases to electronically verify application and renewal
264.7data as required by law;
264.8(3) online accounts accessible by applicants and enrollees;
264.9(4) an interactive voice response system, available statewide, that provides case
264.10information for applicants, enrollees, and authorized third parties;
264.11(5) an electronic document management system that provides electronic transfer of
264.12all documents required for eligibility and enrollment processes; and
264.13(6) a centralized customer contact center that applicants, enrollees, and authorized
264.14third parties can use statewide to receive program information, application assistance,
264.15and case information, report changes, make cost-sharing payments, and conduct other
264.16eligibility and enrollment transactions.
264.17(f) Subject to a legislative appropriation, the commissioner of human services shall
264.18issue a request for proposal for the appropriate phase of an integrated service delivery
264.19system for health care programs, food support, cash assistance, and child care.
264.20EFFECTIVE DATE.This section is effective the day following final enactment.

264.21    Sec. 19. WHITE EARTH BAND OF OJIBWE HUMAN SERVICES PROJECT.
264.22(a) The commissioner of human services, in consultation with the White Earth Band
264.23of Ojibwe, shall transfer legal responsibility to the tribe for providing human services to
264.24tribal members and their families who reside on or off the reservation in Mahnomen
264.25County. The transfer shall include:
264.26(1) financing, including federal and state funds, grants, and foundation funds; and
264.27(2) services to eligible tribal members and families defined as it applies to state
264.28programs being transferred to the tribe.
264.29(b) The determination as to which programs will be transferred to the tribe and
264.30the timing of the transfer of the programs shall be made by a consensus decision of the
264.31governing body of the tribe and the commissioner. The commissioner shall waive existing
264.32rules and seek all federal approvals and waivers as needed to carry out the transfer.
264.33(c) When the commissioner approves transfer of programs and the tribe assumes
264.34responsibility under this section, Mahnomen County is relieved of responsibility for
264.35providing program services to tribal members and their families who live on or off the
265.1reservation while the tribal project is in effect and funded, except that a family member
265.2who is not a White Earth member may choose to receive services through the tribe or the
265.3county. The commissioner shall have authority to redirect funds provided to Mahnomen
265.4County for these services, including administrative expenses, to the White Earth Band
265.5of Ojibwe Indians.
265.6(d) Upon the successful transfer of legal responsibility for providing human services
265.7for tribal members and their families who reside on and off the reservation in Mahnomen
265.8County, the commissioner and the White Earth Band of Ojibwe shall develop a plan to
265.9transfer legal responsibility for providing human services for tribal members and their
265.10families who reside on or off reservation in Clearwater and Becker Counties.
265.11(e) No later than January 15, 2012, the commissioner shall submit a written
265.12report detailing the transfer progress to the chairs and ranking minority members of the
265.13legislative committees with jurisdiction over health and human services. If legislation is
265.14needed to fully complete the transfer of legal responsibility for providing human services,
265.15the commissioner shall submit proposed legislation along with the written report.

265.16    Sec. 20. REPEALER.
265.17(a) Minnesota Statutes 2010, sections 402A.30; and 402A.45, are repealed.
265.18(b) Minnesota Rules, part 9500.1243, subpart 3, is repealed.

265.19
ARTICLE 9

265.20HUMAN SERVICES FORECAST ADJUSTMENTS

265.21 265.22

Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT APPROPRIATIONS.

265.23The sums shown are added to, or if shown in parentheses, are subtracted from the
265.24appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter
265.25173, article 2; Laws 2010, First Special Session chapter 1, articles 15, 23, and 25; and
265.26Laws 2010, Second Special Session chapter 1, article 3, to the commissioner of human
265.27services and for the purposes specified in this article. The appropriations are from the
265.28general fund or another named fund and are available for the fiscal year indicated for
265.29each purpose. The figure "2011" used in this article means that the appropriation or
265.30appropriations listed are available for the fiscal year ending June 30, 2011.

265.31 265.32

Sec. 2. COMMISSIONER OF HUMAN SERVICES

265.33

Subdivision 1.Total Appropriation

$

(235,463,000)

266.1	Appropriations by Fund
266.2			2011
266.3	General		(381,869,000)
266.4	Health Care Access		169,514,000
266.5	Federal TANF		(23,108,000)

266.6The amounts that may be spent for each
266.7purpose are specified in the following
266.8subdivisions.

266.9

Subd. 2.Revenue and Pass-through

732,000

266.10This appropriation is from the federal TANF
266.11fund.

266.12 266.13

Subd. 3.Children and Economic Assistance Grants

266.14	Appropriations by Fund
266.15	General		(7,098,000)
266.16	Federal TANF		(23,840,000)

266.17

(a) MFIP/DWP Grants

266.18	Appropriations by Fund
266.19	General		18,715,000
266.20	Federal TANF		(23,840,000)

266.21

(b) MFIP Child Care Assistance Grants

(24,394,000)

266.22

(c) General Assistance Grants

(664,000)

266.23

(d) Minnesota Supplemental Aid Grants

793,000

266.24

(e) Group Residential Housing Grants

(1,548,000)

266.25

Subd. 4.Basic Health Care Grants

266.26	Appropriations by Fund
266.27	General		(335,050,000)
266.28	Health Care Access		169,514,000

266.29

(a) MinnesotaCare Grants

169,514,000

266.30This appropriation is from the health care
266.31access fund.

266.32 266.33

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

(49,368,000)

267.1 267.2

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

(43,258,000)

267.3 267.4

(d) Medical Assistance Basic Health Care - Adults without Children

(242,424,000)

267.5

Subd. 5.Continuing Care Grants

(39,721,000)

267.6 267.7

(a) Medical Assistance Long-Term Care Facilities

(14,627,000)

267.8 267.9

(b) Medical Assistance Long-Term Care Waivers

(44,718,000)

267.10

(c) Chemical Dependency Entitlement Grants

19,624,000

267.11    Sec. 3. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision 6,
267.12is amended to read:

267.13

Subd. 6.Health Care Grants

267.14

(a) MinnesotaCare Grants

998,000

(13,376,000)

267.15This appropriation is from the health care
267.16access fund.
267.17Health Care Access Fund Transfer to
267.18General Fund. The commissioner of
267.19management and budget shall transfer the
267.20following amounts in the following years
267.21from the health care access fund to the
267.22general fund: $998,000 $0 in fiscal year
267.232010; $176,704,000 $59,901,000 in fiscal
267.24year 2011; $141,041,000 in fiscal year 2012;
267.25and $286,150,000 in fiscal year 2013. If at
267.26any time the governor issues an executive
267.27order not to participate in early medical
267.28assistance expansion, no funds shall be
267.29transferred from the health care access
267.30fund to the general fund until early medical
267.31assistance expansion takes effect. This
267.32paragraph is effective the day following final
267.33enactment.
268.1MinnesotaCare Ratable Reduction.
268.2Effective for services rendered on or after
268.3July 1, 2010, to December 31, 2013,
268.4MinnesotaCare payments to managed care
268.5plans under Minnesota Statutes, section
268.6256L.12 , for single adults and households
268.7without children whose income is greater
268.8than 75 percent of federal poverty guidelines
268.9shall be reduced by 15 percent. Effective
268.10for services provided from July 1, 2010, to
268.11June 30, 2011, this reduction shall apply to
268.12all services. Effective for services provided
268.13from July 1, 2011, to December 31, 2013, this
268.14reduction shall apply to all services except
268.15inpatient hospital services. Notwithstanding
268.16any contrary provision of this article, this
268.17paragraph shall expire on December 31,
268.182013.

268.19 268.20

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

-0-

295,512,000

268.21Critical Access Dental. Of the general
268.22fund appropriation, $731,000 in fiscal year
268.232011 is to the commissioner for critical
268.24access dental provider reimbursement
268.25payments under Minnesota Statutes, section
268.26256B.76 subdivision 4. This is a onetime
268.27appropriation.
268.28Nonadministrative Rate Reduction. For
268.29services rendered on or after July 1, 2010,
268.30to December 31, 2013, the commissioner
268.31shall reduce contract rates paid to managed
268.32care plans under Minnesota Statutes,
268.33sections 256B.69 and 256L.12, and to
268.34county-based purchasing plans under
268.35Minnesota Statutes, section 256B.692, by
268.36three percent of the contract rate attributable
269.1to nonadministrative services in effect on
269.2June 30, 2010. Notwithstanding any contrary
269.3provision in this article, this rider expires on
269.4December 31, 2013.

269.5 269.6

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

-0-

(30,265,000)

269.7 269.8

(d) General Assistance Medical Care Grants

-0-

(75,389,000) (59,583,000)

269.9The reduction to general assistance medical
269.10care grants is contingent upon the effective
269.11date in Laws 2010, First Special Session
269.12chapter 1, article 16, section 48. The
269.13reduction shall be reestimated based upon
269.14the actual effective date of the law. The
269.15commissioner of management and budget
269.16shall make adjustments in fiscal year
269.172011 to general assistance medical care
269.18appropriations to conform to the total
269.19expected expenditure reductions specified in
269.20this section.

269.21

(e) Other Health Care Grants

-0-

(7,000,000)

269.22Cobra Carryforward. Unexpended funds
269.23appropriated in fiscal year 2010 for COBRA
269.24grants under Laws 2009, chapter 79, article
269.255, section 78, do not cancel and are available
269.26to the commissioner for fiscal year 2011
269.27COBRA grant expenditures. Up to $111,000
269.28of the fiscal year 2011 appropriation for
269.29COBRA grants provided in Laws 2009,
269.30chapter 79, article 13, section 3, subdivision
269.316, may be used by the commissioner for costs
269.32related to administration of the COBRA
269.33grants.

269.34    Sec. 4. EFFECTIVE DATE.
270.1This article is effective the day following final enactment.

270.2
ARTICLE 10

270.3HEALTH AND HUMAN SERVICES APPROPRIATIONS

270.4

Section 1. SUMMARY OF APPROPRIATIONS.

270.5The amounts shown in this section summarize direct appropriations, by fund, made
270.6in this article.

270.7			2012		2013		Total
270.8	General	$	5,564,457,000	$	5,407,093,000	$	10,971,550,000
270.9 270.10	State Government Special Revenue		63,700,000		63,475,000		127,175,000
270.11	Health Care Access		317,467,000		306,733,000		624,200,000
270.12	Federal TANF		286,744,000		258,466,000		545,210,000
270.13	Lottery Prize Fund		1,665,000		1,665,000		3,330,000
270.14	Total	$	6,234,032,000	$	6,037,432,000	$	12,271,464,000

270.15

Sec. 2. HUMAN SERVICES APPROPRIATIONS.

270.16The sums shown in the columns marked "Appropriations" are appropriated to the
270.17agencies and for the purposes specified in this article. The appropriations are from the
270.18general fund, or another named fund, and are available for the fiscal years indicated
270.19for each purpose. The figures "2012" and "2013" used in this article mean that the
270.20appropriations listed under them are available for the fiscal year ending June 30, 2012, or
270.21June 30, 2013, respectively. "The first year" is fiscal year 2012. "The second year" is fiscal
270.22year 2013. "The biennium" is fiscal years 2012 and 2013.

270.23				APPROPRIATIONS
270.24				Available for the Year
270.25				Ending June 30
270.26					2012		2013

270.27 270.28

Sec. 3. COMMISSIONER OF HUMAN SERVICES

270.29

Subdivision 1.Total Appropriation

$

6,078,510,000

$

5,891,475,000

270.30	Appropriations by Fund
270.31		2012	2013
270.32	General	5,489,816,000	5,337,566,000
270.33 270.34	State Government Special Revenue	565,000	565,000
270.35	Health Care Access	306,086,000	299,578,000
270.36	Federal TANF	280,378,000	252,101,000
270.37	Lottery Prize Fund	1,665,000	1,665,000

271.1Receipts for Systems Projects.
271.2Appropriations and federal receipts for
271.3information systems projects for MAXIS,
271.4PRISM, MMIS, and SSIS must be deposited
271.5in the state systems account authorized in
271.6Minnesota Statutes, section 256.014. Money
271.7appropriated for computer projects approved
271.8by the Minnesota Office of Enterprise
271.9Technology, funded by the legislature,
271.10and approved by the commissioner
271.11of management and budget, may be
271.12transferred from one project to another
271.13and from development to operations as the
271.14commissioner of human services considers
271.15necessary. Any unexpended balance in
271.16the appropriation for these projects does
271.17not cancel but is available for ongoing
271.18development and operations.
271.19Nonfederal Share Transfers. The
271.20nonfederal share of activities for which
271.21federal administrative reimbursement is
271.22appropriated to the commissioner may be
271.23transferred to the special revenue fund.
271.24TANF Maintenance of Effort.
271.25(a) In order to meet the basic maintenance
271.26of effort (MOE) requirements of the TANF
271.27block grant specified under Code of Federal
271.28Regulations, title 45, section 263.1, the
271.29commissioner may only report nonfederal
271.30money expended for allowable activities
271.31listed in the following clauses as TANF/MOE
271.32expenditures:
271.33(1) MFIP cash, diversionary work program,
271.34and food assistance benefits under Minnesota
271.35Statutes, chapter 256J;
272.1(2) the child care assistance programs
272.2under Minnesota Statutes, sections 119B.03
272.3and 119B.05, and county child care
272.4administrative costs under Minnesota
272.5Statutes, section 119B.15;
272.6(3) state and county MFIP administrative
272.7costs under Minnesota Statutes, chapters
272.8256J and 256K;
272.9(4) state, county, and tribal MFIP
272.10employment services under Minnesota
272.11Statutes, chapters 256J and 256K;
272.12(5) qualifying working family credit
272.13expenditures under Minnesota Statutes,
272.14section 290.0671; and
272.15(6) qualifying Minnesota education credit
272.16expenditures under Minnesota Statutes,
272.17section 290.0674.
272.18(b) The commissioner shall ensure that
272.19sufficient qualified nonfederal expenditures
272.20are made each year to meet the state's
272.21TANF/MOE requirements. For the activities
272.22listed in paragraph (a), clauses (2) to
272.23(6), the commissioner may only report
272.24expenditures that are excluded from the
272.25definition of assistance under Code of
272.26Federal Regulations, title 45, section 260.31.
272.27(c) For fiscal years beginning with state fiscal
272.28year 2003, the commissioner shall assure
272.29that the maintenance of effort used by the
272.30commissioner of management and budget
272.31for the February and November forecasts
272.32required under Minnesota Statutes, section
272.3316A.103, contains expenditures under
272.34paragraph (a), clause (1), equal to at least 16
273.1percent of the total required under Code of
273.2Federal Regulations, title 45, section 263.1.
273.3(d) Minnesota Statutes, section 256.011,
273.4subdivision 3, which requires that federal
273.5grants or aids secured or obtained under that
273.6subdivision be used to reduce any direct
273.7appropriations provided by law, do not apply
273.8if the grants or aids are federal TANF funds.
273.9(e) For the federal fiscal years beginning on
273.10or after October 1, 2007, the commissioner
273.11may not claim an amount of TANF/MOE in
273.12excess of the 75 percent standard in Code
273.13of Federal Regulations, title 45, section
273.14263.1(a)(2), except:
273.15(1) to the extent necessary to meet the 80
273.16percent standard under Code of Federal
273.17Regulations, title 45, section 263.1(a)(1),
273.18if it is determined by the commissioner
273.19that the state will not meet the TANF work
273.20participation target rate for the current year;
273.21(2) to provide any additional amounts
273.22under Code of Federal Regulations, title 45,
273.23section 264.5, that relate to replacement of
273.24TANF funds due to the operation of TANF
273.25penalties; and
273.26(3) to provide any additional amounts that
273.27may contribute to avoiding or reducing
273.28TANF work participation penalties through
273.29the operation of the excess MOE provisions
273.30of Code of Federal Regulations, title 45,
273.31section 261.43(a)(2).
273.32For the purposes of clauses (1) to (3),
273.33the commissioner may supplement the
273.34MOE claim with working family credit
274.1expenditures or other qualified expenditures
274.2to the extent such expenditures are otherwise
274.3available after considering the expenditures
274.4allowed in this subdivision.
274.5(f) Notwithstanding any contrary provision
274.6in this article, paragraphs (a) to (e) expire
274.7June 30, 2015.
274.8Working Family Credit Expenditures
274.9as TANF/MOE. The commissioner may
274.10claim as TANF maintenance of effort up to
274.11$6,707,000 per year of working family credit
274.12expenditures for fiscal years 2012 and 2013.
274.13Working Family Credit Expenditures
274.14to be Claimed for TANF/MOE. The
274.15commissioner may count the following
274.16amounts of working family credit
274.17expenditures as TANF/MOE:
274.18(1) fiscal year 2012, $37,517,000;
274.19(2) fiscal year 2013, $28,171,000;
274.20(3) fiscal year 2014, $34,097,000; and
274.21(4) fiscal year 2015, $34,100,000.
274.22Notwithstanding any contrary provision in
274.23this article, this rider expires June 30, 2015.
274.24TANF Transfer to Federal Child Care
274.25and Development Fund. (a) The following
274.26TANF fund amounts are appropriated
274.27to the commissioner for purposes of
274.28MFIP/Transition Year Child Care Assistance
274.29under Minnesota Statutes, section 119B.05:
274.30(1) fiscal year 2012, $25,020,000;
274.31(2) fiscal year 2013, $12,020,000;
274.32(3) fiscal year 2014, $15,818,000; and
275.1(4) fiscal year 2015, $15,818,000.
275.2(b) The commissioner shall authorize the
275.3transfer of sufficient TANF funds to the
275.4federal child care and development fund to
275.5meet this appropriation and shall ensure that
275.6all transferred funds are expended according
275.7to federal child care and development fund
275.8regulations.
275.9Food Stamps Employment and Training
275.10Funds. (a) Notwithstanding Minnesota
275.11Statutes, sections 256D.051, subdivisions 1a,
275.126b, and 6c, and 256J.626, federal food stamps
275.13employment and training funds received
275.14as reimbursement for child care assistance
275.15program expenditures must be deposited in
275.16the general fund. The amount of funds must
275.17be limited to $500,000 per year in fiscal
275.18years 2012 through 2015, contingent upon
275.19approval by the federal Food and Nutrition
275.20Service.
275.21(b) Consistent with the receipt of these
275.22federal funds, the commissioner may
275.23adjust the level of working family credit
275.24expenditures claimed as TANF maintenance
275.25of effort. Notwithstanding any contrary
275.26provision in this article, this rider expires
275.27June 30, 2015.
275.28ARRA Food Support Benefit Increases.
275.29The funds provided for food support benefit
275.30increases under the Supplemental Nutrition
275.31Assistance Program provisions of the
275.32American Recovery and Reinvestment Act
275.33(ARRA) of 2009 must be used for benefit
275.34increases beginning July 1, 2009.
276.1Supplemental Security Interim Assistance
276.2Reimbursement Funds. $2,800,000 of
276.3uncommitted revenue available to the
276.4commissioner of human services for SSI
276.5advocacy and outreach services must be
276.6transferred to and deposited into the general
276.7fund by October 1, 2011.
276.8Transfer. By June 30, 2012, the
276.9commissioner of management and budget
276.10must transfer $49,694,000 from the health
276.11care access fund to the general fund. By June
276.1230, 2013, the commissioner of management
276.13and budget must transfer $5,000,000 from the
276.14health care access fund to the general fund.

276.15

Subd. 2.Central Office Operations

276.16The amounts that may be spent from this
276.17appropriation for each purpose are as follows:

276.18

(a) Operations

276.19	Appropriations by Fund
276.20	General	72,547,000	71,077,000
276.21	Health Care Access	11,508,000	11,508,000
276.22 276.23	State Government Special Revenue	440,000	440,000
276.24	Federal TANF	222,000	222,000

276.25DHS Receipt Center Accounting. The
276.26commissioner is authorized to transfer
276.27appropriations to, and account for DHS
276.28receipt center operations in, the special
276.29revenue fund.
276.30Administrative Recovery; Set-Aside. The
276.31commissioner may invoice local entities
276.32through the SWIFT accounting system as an
276.33alternative means to recover the actual cost
276.34of administering the following provisions:
277.1(1) Minnesota Statutes, section 125A.744,
277.2subdivision 3;
277.3(2) Minnesota Statutes, section 245.495,
277.4paragraph (b);
277.5(3) Minnesota Statutes, section 256B.0625,
277.6subdivision 20, paragraph (k);
277.7(4) Minnesota Statutes, section 256B.0924,
277.8subdivision 6, paragraph (g);
277.9(5) Minnesota Statutes, section 256B.0945,
277.10subdivision 4, paragraph (d); and
277.11(6) Minnesota Statutes, section 256F.10,
277.12subdivision 6, paragraph (b).
277.13Payments for Cost Settlements. The
277.14commissioner is authorized to use amounts
277.15repaid to the general assistance medical care
277.16program under Minnesota Statutes 2009
277.17Supplement, section 256D.03, subdivision
277.183, to pay cost settlements for claims for
277.19services provided prior to June 1, 2010.
277.20Notwithstanding any contrary provision in
277.21this article, this provision does not expire.
277.22Base Adjustment. The general fund base
277.23for fiscal year 2014 shall be increased by
277.24$68,000 and decreased by $11,000 in fiscal
277.25year 2015.

277.26

(b) Children and Families

277.27	Appropriations by Fund
277.28	General	9,457,000	9,337,000
277.29	Federal TANF	2,160,000	2,160,000

277.30Financial Institution Data Match and
277.31Payment of Fees. The commissioner is
277.32authorized to allocate up to $310,000 each
277.33year in fiscal years 2012 and 2013 from the
278.1PRISM special revenue account to make
278.2payments to financial institutions in exchange
278.3for performing data matches between account
278.4information held by financial institutions
278.5and the public authority's database of child
278.6support obligors as authorized by Minnesota
278.7Statutes, section 13B.06, subdivision 7.
278.8Base Adjustment. The general fund base
278.9is decreased by $47,000 in fiscal years 2014
278.10and 2015.

278.11

(c) Health Care

278.12	Appropriations by Fund
278.13	General	16,376,000	16,278,000
278.14	Health Care Access	22,623,000	26,926,000

278.15Minnesota Senior Health Options
278.16Reimbursement. Federal administrative
278.17reimbursement resulting from the Minnesota
278.18senior health options project is appropriated
278.19to the commissioner for this activity.
278.20Utilization Review. Federal administrative
278.21reimbursement resulting from prior
278.22authorization and inpatient admission
278.23certification by a professional review
278.24organization shall be dedicated to the
278.25commissioner for these purposes. A portion
278.26of these funds must be used for activities to
278.27decrease unnecessary pharmaceutical costs
278.28in medical assistance.
278.29Base Adjustment. The general fund base
278.30shall be decreased by $2,000 in fiscal year
278.312014 and $114,000 in fiscal year 2015.
278.32The health care access fund base is decreased
278.33by $411,000 in fiscal year 2014 and $880,000
278.34in fiscal year 2015.

279.1

(d) Continuing Care

279.2	Appropriations by Fund
279.3	General	18,078,000	17,864,000
279.4 279.5	State Government Special Revenue	125,000	125,000

279.6Region 10 Administrative Expenses.
279.7$100,000 is appropriated each fiscal
279.8year, beginning in fiscal year 2012, for
279.9the administration of the State Quality
279.10Improvement and Licensing System under
279.11Minnesota Statutes, section 256B.0961.
279.12Base Adjustment. The general fund base is
279.13decreased by $662,000 in fiscal year 2014
279.14and $762,000 in fiscal year 2015.

279.15

(e) Chemical and Mental Health

279.16	Appropriations by Fund
279.17	General	4,194,000	4,194,000
279.18	Lottery Prize	157,000	157,000

279.19

Subd. 3.Forecasted Programs

279.20The amounts that may be spent from this
279.21appropriation for each purpose are as follows:

279.22

(a) MFIP/DWP Grants

279.23	Appropriations by Fund
279.24	General	83,986,000	88,187,000
279.25	Federal TANF	84,425,000	75,417,000

279.26

(b) MFIP Child Care Assistance Grants

39,012,000

44,805,000

279.27 279.28

(c) General Assistance Grants and Adult Assistance

48,774,000

44,003,000

279.29General Assistance Standard. The
279.30commissioner shall set the monthly standard
279.31of assistance for general assistance units
279.32consisting of an adult recipient who is
279.33childless and unmarried or living apart
279.34from parents or a legal guardian at $203.
280.1The commissioner may reduce this amount
280.2according to Laws 1997, chapter 85, article
280.33, section 54. This paragraph expires
280.4September 30, 2012.
280.5Emergency General Assistance. The
280.6amount appropriated for emergency general
280.7assistance funds is limited to no more
280.8than $7,089,812 in fiscal year 2012 and
280.9$1,682,453 in fiscal year 2013. Funds
280.10to counties shall be allocated by the
280.11commissioner using the allocation method
280.12specified in Minnesota Statutes, section
280.13256D.06. This paragraph expires September
280.1430, 2012.
280.15Base Adjustment. The general fund base
280.16for adult assistance is $44,512,000 in fiscal
280.17years 2014 and 2015.

280.18

(d) Minnesota Supplemental Aid Grants

34,460,000

33,532,000

280.19Emergency Minnesota Supplemental
280.20Aid Funds. The amount appropriated for
280.21emergency Minnesota supplemental aid
280.22funds is limited to no more than $367,000
280.23in fiscal year 2012. Funds to counties shall
280.24be allocated by the commissioner using the
280.25allocation method specified in Minnesota
280.26Statutes, section 256D.46. This paragraph
280.27expires September 30, 2012.

280.28

(e) Group Residential Housing Grants

121,080,000

129,238,000

280.29

(f) MinnesotaCare Grants

271,430,000

260,619,000

280.30This appropriation is from the health care
280.31access fund.

280.32

(g) GAMC Grants

174,150,000

232,200,000

281.1General Assistance Medical Care
281.2Payments. For general assistance medical
281.3care payments under Minnesota Statutes,
281.4section 256D.031:
281.5$120,150,000 in fiscal year 2012 and
281.6$160,200,000 in fiscal year 2013 are for
281.7payments to coordinated care delivery
281.8systems under Minnesota Statutes, section
281.9256D.031, subdivision 7; and
281.10$54,000,000 in fiscal year 2012 and
281.11$72,000,000 in fiscal year 2013 are for
281.12payments for prescription drugs under
281.13Minnesota Statutes, section 256D.031,
281.14subdivision 9.
281.15Any amount under paragraph (g) that is not
281.16spent in the first year does not cancel and is
281.17available for payments in the second year.
281.18The commissioner may transfer any
281.19unexpended amount under Minnesota
281.20Statutes, section 256D.031, subdivision 9,
281.21after the final allocation in fiscal year 2011 to
281.22make payments under Minnesota Statutes,
281.23section 256D.031, subdivision 7.

281.24

(h) Medical Assistance Grants

4,175,592,000

3,938,873,000

281.25Managed Care Incentive Payments. The
281.26commissioner shall not make managed care
281.27incentive payments for expanding preventive
281.28services. This provision does not expire.
281.29Capitation Payment Delay. The
281.30commissioner shall delay 71 percent of the
281.31medical assistance capitation payment for
281.32families with children to managed care plans
281.33and county-based purchasing plans due in
281.34May of 2013 until July of 2013.
282.1Reduction of Rates for Congregate
282.2Living for Individuals with Lower Needs.
282.3Beginning October 1, 2011, lead agencies
282.4must reduce rates in effect on January 1,
282.52011, by ten percent for individuals with
282.6lower needs living in foster care settings
282.7where the license holder does not share the
282.8residence with recipients on the CADI, DD,
282.9and TBI waivers and customized living
282.10settings for CADI and TBI. Lead agencies
282.11must adjust contracts within 60 days of the
282.12effective date.
282.13Reduction of Lead Agency Waiver
282.14Allocations to Implement Rate Reductions
282.15for Congregate Living for Individuals
282.16with Lower Needs. Beginning October 1,
282.172011, the commissioner shall reduce lead
282.18agency waiver allocations to implement the
282.19reduction of rates for individuals with lower
282.20needs living in foster care settings where the
282.21license holder does not share the residence
282.22with recipients on the CADI, DD, and TBI
282.23waivers and customized living settings for
282.24CADI and TBI.
282.25Manage Elderly Waiver Growth.
282.26Beginning July 1, 2011, and ending on June
282.2730, 2013, the commissioner shall manage
282.28the elderly waiver so that the number of
282.29people does not exceed the number on June
282.3030, 2011.
282.31Reduce customized living and 24-hour
282.32customized living component rates.
282.33Effective July 1, 2011, the commissioner
282.34shall reduce elderly waiver customized living
282.35and 24-hour customized living component
283.1service spending by ten percent through
283.2reductions in component rates and service
283.3rate limits. The commissioner shall adjust
283.4the elderly waiver capitation payment
283.5rates for managed care organizations paid
283.6under Minnesota Statutes, section 256B.69,
283.7subdivisions 6a and 23, to reflect reductions
283.8in component spending for customized living
283.9services and 24-hour customized living
283.10services under Minnesota Statutes, section
283.11256B.0915, subdivisions 3e and 3h, for the
283.12contract period beginning January 1, 2012.
283.13To implement the reduction specified in
283.14this provision, capitation rates paid by the
283.15commissioner to managed care organizations
283.16under Minnesota Statutes, section 256B.69,
283.17shall reflect a 20 percent reduction for the
283.18specified services for the period January 1,
283.192012, to June 30, 2012, and a ten percent
283.20reduction for those services on or after July
283.211, 2012.
283.22Limit Growth in the Developmental
283.23Disability Waiver. For the biennium
283.24beginning July 1, 2011, the commissioner
283.25shall limit the developmental disability
283.26waiver to the number of recipients served
283.27in March 2010. If necessary to achieve
283.28this level, the commissioner shall not
283.29refill waiver openings until the number of
283.30waiver recipients reaches the March 2010
283.31level. Once the March 2010 enrollment
283.32level is reached, the commissioner shall
283.33refill vacated openings to maintain the
283.34March 2010 enrollment level. To the
283.35extent possible, waiver allocations shall
283.36be available to individuals who meet the
284.1priorities for accessing waiver services
284.2described in Minnesota Statutes, section
284.3256B.092, subdivision 12. The limits do not
284.4include conversions from intermediate care
284.5facilities for persons with developmental
284.6disabilities. When implementing the waiver
284.7enrollment limits under this provision, it
284.8is an absolute defense to an appeal under
284.9Minnesota Statutes, section 256.045, if
284.10the commissioner or lead agency proves
284.11that it followed the established written
284.12procedures and criteria and determined that
284.13home and community-based services could
284.14not be provided to the person within the
284.15appropriations or lead agency's allocation of
284.16home and community-based services money.
284.17Limit Growth in the Community
284.18Alternatives for Disabled Individuals
284.19Waiver. For the biennium beginning
284.20July 1, 2011, the commissioner shall limit
284.21the community alternatives for disabled
284.22individuals waiver to the number of
284.23recipients served in March 2010. If necessary
284.24to achieve this level, the commissioner shall
284.25not refill waiver openings until the number
284.26of waiver recipients reaches the March 2010
284.27level. Once the March 2010 enrollment
284.28level is reached, the commissioner shall
284.29refill vacated openings to maintain the
284.30March 2010 enrollment level. To the
284.31extent possible, waiver allocations shall
284.32be available to individuals who meet the
284.33priorities for accessing waiver services
284.34described in Minnesota Statutes, section
284.35256B.49, subdivision 11a. The limits include
284.36conversions and diversions, unless the
285.1commissioner has approved a plan to convert
285.2funding due to the closure or downsizing
285.3of a residential facility or nursing facility
285.4to serve directly affected individuals on
285.5the community alternatives for disabled
285.6individuals waiver. When implementing
285.7the waiver enrollment limits under this
285.8provision, it is an absolute defense to an
285.9appeal under Minnesota Statutes, section
285.10256.045, if the commissioner or lead agency
285.11proves that it followed the established written
285.12procedures and criteria and determined that
285.13home and community-based services could
285.14not be provided to the person within the
285.15appropriations or lead agency's allocation of
285.16home and community-based services money.
285.17Limit Growth in the Waiver for
285.18Individuals with Traumatic Brain Injury.
285.19For the biennium beginning July 1, 2011, the
285.20commissioner shall limit the traumatic brain
285.21injury waiver to the number of recipients
285.22served in March 2010. If necessary to
285.23achieve this level, the commissioner shall
285.24not refill waiver openings until the number
285.25of waiver recipients reaches the March 2010
285.26level. Once the March 2010 enrollment
285.27level is reached, the commissioner shall
285.28refill vacated openings to maintain the
285.29March 2010 enrollment level. To the
285.30extent possible, waiver allocations shall
285.31be available to individuals who meet the
285.32priorities for accessing waiver services
285.33described in Minnesota Statutes, section
285.34256B.49, subdivision 11a. The limits include
285.35conversions and diversions, unless the
285.36commissioner has approved a plan to convert
286.1funding due to the closure or downsizing of a
286.2residential facility or nursing facility to serve
286.3directly affected individuals on the traumatic
286.4brain injury waiver. When implementing
286.5the waiver enrollment limits under this
286.6provision, it is an absolute defense to an
286.7appeal under Minnesota Statutes, section
286.8256.045, if the commissioner or lead agency
286.9proves that it followed the established written
286.10procedures and criteria and determined that
286.11home and community-based services could
286.12not be provided to the person within the
286.13appropriations or lead agency's allocation of
286.14home and community-based services money.
286.15Personal Care Assistance Relative
286.16Care. The commissioner shall adjust the
286.17capitation payment rates for managed care
286.18organizations paid under Minnesota Statutes,
286.19section 256B.69, to reflect the rate reductions
286.20for personal care assistance provided by
286.21a relative pursuant to Minnesota Statutes,
286.22section 256B.0659, subdivision 11.

286.23

(i) Alternative Care Grants

45,727,000

47,877,000

286.24Alternative Care Transfer. Any money
286.25allocated to the alternative care program that
286.26is not spent for the purposes indicated does
286.27not cancel but shall be transferred to the
286.28medical assistance account.

286.29

(j) Chemical Dependency Entitlement Grants

108,568,000

123,095,000

286.30

Subd. 4.Grant Programs

286.31The amounts that may be spent from this
286.32appropriation for each purpose are as follows:

286.33

(a) Support Services Grants

287.1	Appropriations by Fund
287.2	General	8,715,000	8,715,000
287.3	Federal TANF	100,525,000	94,611,000

287.4MFIP Consolidated Fund Grants. The
287.5TANF fund base is reduced by $10,000,000
287.6each year beginning in fiscal year 2012.
287.7Subsidized Employment Funding Through
287.8ARRA. The commissioner is authorized to
287.9apply for TANF emergency fund grants for
287.10subsidized employment activities. Growth
287.11in expenditures for subsidized employment
287.12within the supported work program and the
287.13MFIP consolidated fund over the amount
287.14expended in the calendar year quarters in
287.15the TANF emergency fund base year shall
287.16be used to leverage the TANF emergency
287.17fund grants for subsidized employment and
287.18to fund supported work. The commissioner
287.19shall develop procedures to maximize
287.20reimbursement of these expenditures over the
287.21TANF emergency fund base year quarters,
287.22and may contract directly with employers
287.23and providers to maximize these TANF
287.24emergency fund grants.

287.25 287.26

(b) Basic Sliding Fee Child Care Assistance Grants

36,067,000

37,342,000

287.27Base Adjustment. The general fund base is
287.28decreased by $1,490,000 in fiscal year 2014
287.29and $867,000 in fiscal year 2015.
287.30Child Care and Development Fund
287.31Unexpended Balance. In addition to
287.32the amount provided in this section, the
287.33commissioner shall expend $5,000,000
287.34in fiscal year 2012 from the federal child
287.35care and development fund unexpended
288.1balance for basic sliding fee child care under
288.2Minnesota Statutes, section 119B.03. The
288.3commissioner shall ensure that all child
288.4care and development funds are expended
288.5according to the federal child care and
288.6development fund regulations.

288.7

(c) Child Care Development Grants

232,000

232,000

288.8Base Adjustment. The general fund base is
288.9increased by $1,255,000 is fiscal years 2014
288.10and 2015.

288.11

(d) Child Support Enforcement Grants

50,000

50,000

288.12Federal Child Support Demonstration
288.13Grants. Federal administrative
288.14reimbursement resulting from the federal
288.15child support grant expenditures authorized
288.16under section 1115a of the Social Security
288.17Act is appropriated to the commissioner for
288.18this activity.

288.19

(e) Children's Services Grants

288.20	Appropriations by Fund
288.21	General	45,654,000	45,654,000
288.22	Federal TANF	140,000	140,000

288.23Adoption Assistance and Relative Custody
288.24Assistance Payments. $1,661,000 each
288.25year is for continuation of current payments
288.26for adoption assistance and relative custody
288.27assistance.
288.28Adoption Assistance and Relative Custody
288.29Assistance Transfer. The commissioner
288.30may transfer unencumbered appropriation
288.31balances for adoption assistance and relative
288.32custody assistance between fiscal years and
288.33between programs.
289.1Privatized Adoption Grants. Federal
289.2reimbursement for privatized adoption grant
289.3and foster care recruitment grant expenditures
289.4is appropriated to the commissioner for
289.5adoption grants and foster care and adoption
289.6administrative purposes.
289.7Adoption Assistance Incentive Grants.
289.8Federal funds available during fiscal year
289.92012 and fiscal year 2013 for adoption
289.10incentive grants are appropriated to the
289.11commissioner for these purposes.
289.12Base Adjustment. The general fund base is
289.13increased by $1,134,000 is fiscal years 2014
289.14and 2015.

289.15

(f) Children and Community Services Grants

54,301,000

52,301,000

289.16

(g) Children and Economic Support Grants

289.17	Appropriations by Fund
289.18	General	15,770,000	15,772,000
289.19	Federal TANF	700,000	0

289.20Long-Term Homeless Services. $700,000
289.21is appropriated from the federal TANF
289.22fund for the biennium beginning July
289.231, 2011, to the commissioner of human
289.24services for long-term homeless services
289.25for low-income homeless families under
289.26Minnesota Statutes, section 256K.26. This
289.27is a onetime appropriation and is not added
289.28to the base.
289.29Base Adjustment. The general fund base is
289.30increased by $42,000 in fiscal year 2014 and
289.31$43,000 in fiscal year 2015.

289.32

(h) Health Care Grants

150,000

150,000

289.33This appropriation is from the health care
289.34access fund.
290.1Surplus Appropriation Canceled. Of the
290.2health care access fund appropriation in
290.3Laws 2009, chapter 79, article 13, section 3,
290.4subdivision 6, paragraph (e), for the COBRA
290.5premium state subsidy program, $11,750,000
290.6must be canceled in fiscal year 2011. This
290.7provision is effective the day following final
290.8enactment.

290.9

(i) Aging and Adult Services Grants

18,734,000

18,910,000

290.10Aging Grants Reduction. Effective July
290.111, 2011, funding for grants made under
290.12Minnesota Statutes, sections 256.9754 and
290.13256B.0917, subdivision 13, is reduced by
290.14$3,600,000 for each year of the biennium.
290.15These reductions are onetime and do
290.16not affect base funding for the 2014-2015
290.17biennium. Grants made during the 2012-2013
290.18biennium under Minnesota Statutes, section
290.19256B.9754, must not be used for new
290.20construction or building renovation.
290.21Base Level Adjustment. The general fund
290.22base is increased by $3,600,000 in fiscal year
290.232014 and increased by $3,600,000 in fiscal
290.24year 2015.

290.25

(j) Deaf and Hard-of-Hearing Grants

1,936,000

1,767,000

290.26

(k) Disabilities Grants

15,438,000

18,432,000

290.27HIV Grants. The general fund appropriation
290.28for the HIV drug and insurance grant
290.29program shall be reduced by $2,425,000 in
290.30fiscal year 2012 and increased by $2,425,000
290.31in fiscal year 2014. These adjustments are
290.32onetime and shall not be applied to the base.
290.33Notwithstanding any contrary provision, this
290.34provision expires June 30, 2014. Money
291.1appropriated for the HIV drug and insurance
291.2grant program in fiscal year 2014 may be
291.3used in either year of the biennium.
291.4Region 10. Any unspent allocation for
291.5Region 10 Quality Assurance from the
291.6biennium beginning on July 1, 2009, may be
291.7carried over into the biennium beginning on
291.8July 1, 2011.
291.9Base Level Adjustment. The general fund
291.10base is increased by $2,425,000 in fiscal year
291.112014 only.
291.12Local Planning Grants for Creating
291.13Alternatives to Congregate Living for
291.14Individuals with Lower Needs. The
291.15commissioner shall make available a total
291.16of $250,000 per year in local planning
291.17grants, beginning July 1, 2011, to assist
291.18lead agencies and provider organizations in
291.19developing alternatives to congregate living
291.20within the available level of resources for the
291.21home and community-based services waivers
291.22for persons with disabilities.

291.23

(l) Adult Mental Health Grants

291.24	Appropriations by Fund
291.25	General	69,957,000	69,957,000
291.26	Health Care Access	375,000	375,000
291.27	Lottery Prize Fund	1,508,000	1,508,000

291.28Funding Usage. Up to 75 percent of a fiscal
291.29year's appropriation for adult mental health
291.30grants may be used to fund allocations in that
291.31portion of the fiscal year ending December
291.3231.
291.33Base Adjustment. The general fund base is
291.34increased by $813,000 in fiscal years 2014
292.1and 2015. The health care access fund base
292.2is increased by $375,000 in fiscal years 2014
292.3and 2015.

292.4

(m) Children's Mental Health Grants

14,251,000

14,251,000

292.5Funding Usage. Up to 75 percent of a fiscal
292.6year's appropriation for children's mental
292.7health grants may be used to fund allocations
292.8in that portion of the fiscal year ending
292.9December 31.
292.10Base Adjustment. The general fund base is
292.11increased by $2,431,000 in fiscal years 2014
292.12and 2015.

292.13 292.14

(n) Chemical Dependency Nonentitlement Grants

1,336,000

1,336,000

292.15

Subd. 5.State-Operated Services

292.16Transfer Authority Related to
292.17State-Operated Services. Money
292.18appropriated for state-operated services
292.19may be transferred between fiscal years
292.20of the biennium with the approval of the
292.21commissioner of management and budget.

292.22

(a) State-Operated Services Mental Health

115,286,000

115,135,000

292.23The commissioner shall close the Community
292.24Behavioral Health Hospital-Willmar on or
292.25before June 30, 2011. The commissioner
292.26shall relocate the Child and Adolescent
292.27Behavioral Health Hospital located in
292.28the former Willmar Regional Treatment
292.29Center to the facility previously housing
292.30the Community Behavioral Health
292.31Hospital-Willmar.

292.32

(b) Minnesota Security Hospital

69,582,000

69,582,000

292.33

Subd. 6.Sex Offender Program

70,416,000

67,570,000

293.1Transfer Authority Related to Minnesota
293.2Sex Offender Program. Money
293.3appropriated for the Minnesota sex offender
293.4program may be transferred between fiscal
293.5years of the biennium with the approval
293.6of the commissioner of management and
293.7budget.
293.8Minnesota Sex Offender Program
293.9Reduction. The fiscal year 2011 general
293.10fund appropriation for Minnesota sex
293.11offender services under Laws 2009, chapter
293.1279, article 13, section 3, subdivision 10,
293.13paragraph (b), is reduced by $3,000,000.
293.14This paragraph is effective the day following
293.15final enactment.

293.16

Subd. 7.Technical Activities

92,206,000

79,551,000

293.17This appropriation is from the federal TANF
293.18fund.
293.19Base Level Adjustment. The TANF fund
293.20base is increased by $4,155,000 in fiscal year
293.212014 and increased by $4,582,000 in fiscal
293.22year 2015.

293.23

Sec. 4. COMMISSIONER OF HEALTH

293.24

Subdivision 1.Total Appropriation

$

132,589,000

$

123,237,000

293.25	Appropriations by Fund
293.26		2012	2013
293.27	General	69,455,000	64,341,000
293.28 293.29	State Government Special Revenue	45,387,000	45,376,000
293.30	Health Care Access	11,381,000	7,155,000
293.31	Federal TANF	6,366,000	6,365,000

293.32The amounts that may be spent for each
293.33purpose are specified in the following
293.34subdivisions.

294.1 294.2

Subd. 2.Community and Family Health Promotion

294.3	Appropriations by Fund
294.4	General	43,539,000	38,799,000
294.5 294.6	State Government Special Revenue	1,033,000	1,033,000
294.7	Health Care Access	1,719,000	1,719,000
294.8	Federal TANF	6,366,000	6,365,000

294.9TANF Appropriations. (1) $578,000 of the
294.10TANF funds is appropriated each year to the
294.11commissioner for family planning grants
294.12under Minnesota Statutes, section 145.925.
294.13(2) $1,790,000 of the TANF funds is
294.14appropriated each year to the commissioner
294.15for home visiting and nutritional services
294.16listed under Minnesota Statutes, section
294.17145.882, subdivision 7, clauses (6) and (7).
294.18Funds must be distributed to community
294.19health boards according to Minnesota
294.20Statutes, section 145A.131, subdivision 1.
294.21(3) $1,000,000 of the TANF funds is
294.22appropriated each year to the commissioner
294.23for decreasing infant mortality rates under
294.24Minnesota Statutes, section 145.928,
294.25subdivision 7.
294.26(4) $2,998,000 of the TANF funds is
294.27appropriated each year to the commissioner
294.28for the family home visiting grant program
294.29according to Minnesota Statutes, section
294.30145A.17. $2,000,000 of the funding must
294.31be distributed to community health boards
294.32according to Minnesota Statutes, section
294.33145A.131, subdivision 1. $998,000 of
294.34the funding must be distributed to tribal
294.35governments based on Minnesota Statutes,
294.36section 145A.14, subdivision 2a.
295.1(5) The commissioner may use up to 7.06
295.2percent of the funds appropriated each fiscal
295.3year to conduct the ongoing evaluations
295.4required under Minnesota Statutes, section
295.5145A.17, subdivision 7, and training and
295.6technical assistance as required under
295.7Minnesota Statutes, section 145A.17,
295.8subdivisions 4 and 5.
295.9TANF Carryforward. Any unexpended
295.10balance of the TANF appropriation in the
295.11first year of the biennium does not cancel but
295.12is available for the second year.
295.13Base Level Adjustment. The general fund
295.14base is decreased by $5,000 in fiscal years
295.152014 and 2015.

295.16

Subd. 3.Policy Quality and Compliance

295.17	Appropriations by Fund
295.18	General	10,395,000	10,023,000
295.19 295.20	State Government Special Revenue	14,026,000	14,083,000
295.21	Health Care Access	9,662,000	5,436,000

295.22Medical Education and Research
295.23Costs (MERC) Fund Transfers. The
295.24commissioner of management and budget
295.25shall transfer $9,800,000 from the MERC
295.26fund to the general fund by October 1, 2011.
295.27White Earth Clinic. Of the general fund
295.28appropriation, $500,000 in the first year and
295.29$200,000 in the second year is for a grant
295.30to the White Earth Band of Ojibwe Indians.
295.31If the White Earth Band of Ojibwe Indians
295.32accepts this grant, funds must be used for
295.33the White Earth Clinic under Minnesota
295.34Statutes, section 145.9271. The base for this
296.1program is $200,000 for each of fiscal years
296.22014 and 2015.
296.3Comprehensive Advanced Life Support.
296.4Of the general fund appropriation, $31,000
296.5each year is added to the base of the
296.6comprehensive advanced life support
296.7(CALS) program under Minnesota Statutes,
296.8section 144.6062.
296.9Unused Federal Match Funds. Of the
296.10funds appropriated in Laws 2009, chapter
296.1179, article 13, section 4, subdivision 3, for
296.12state matching funds for the federal Health
296.13Information Technology for Economic and
296.14Clinical Health Act, $2,800,000 is transferred
296.15to the health care access fund by October 1,
296.162011.
296.17Loan Forgiveness. $1,014,000 is
296.18appropriated from the health care access
296.19fund in fiscal year 2012 for the department to
296.20fulfill existing obligations of loan forgiveness
296.21agreements. This funding is available
296.22through fiscal year 2014. In addition, prior
296.23year funds appropriated for loan forgiveness
296.24and required to fulfill existing obligations do
296.25not expire and are available until expended.
296.26Administrative Reports. Of the general
296.27fund appropriation, $82,000 in fiscal year
296.282012 and $10,000 in fiscal year 2013
296.29are for transfer to the commissioner of
296.30management and budget for the reduction of
296.31the administrative report study.
296.32Base Level Adjustment. The state
296.33government special revenue fund base shall
296.34be reduced by $141,000 in fiscal years 2014
297.1and 2015. The health care access base shall
297.2be increased by $600,000 in fiscal year 2014.

297.3

Subd. 4.Health Protection

297.4	Appropriations by Fund
297.5	General	9,370,000	9,370,000
297.6 297.7	State Government Special Revenue	30,328,000	30,260,000

297.8

Subd. 5.Administrative Support Services

6,151,000

6,149,000

297.9

Sec. 5. COUNCIL ON DISABILITY

$

524,000

$

524,000

297.10 297.11 297.12

Sec. 6. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,655,000

$

1,655,000

297.13Funds appropriated for fiscal year 2011 are
297.14available until expended.

297.15

Sec. 7. OMBUDSPERSON FOR FAMILIES

$

265,000

$

265,000

297.16

Sec. 8. HEALTH-RELATED BOARDS

297.17

Subdivision 1.Total Appropriation

$

17,748,000

$

17,534,000

297.18This appropriation is from the state
297.19government special revenue fund. The
297.20amounts that may be spent for each purpose
297.21are specified in the following subdivisions.

297.22

Subd. 2.Board of Chiropractic Examiners

469,000

469,000

297.23

Subd. 3.Board of Dentistry

1,829,000

1,814,000

297.24Health Professional Services Program. Of
297.25this appropriation, $704,000 in fiscal year
297.262012 and $704,000 in fiscal year 2013 from
297.27the state government special revenue fund are
297.28for the health professional services program.

297.29 297.30

Subd. 4.Board of Dietetic and Nutrition Practice

110,000

110,000

297.31 297.32

Subd. 5.Board of Marriage and Family Therapy

192,000

167,000

298.1Rulemaking. Of this appropriation, $25,000
298.2in fiscal year 2012 is for rulemaking. This is
298.3a onetime appropriation.

298.4

Subd. 6.Board of Medical Practice

3,866,000

3,866,000

298.5

Subd. 7.Board of Nursing

3,694,000

3,551,000

298.6 298.7

Subd. 8.Board of Nursing Home Administrators

2,153,000

2,145,000

298.8Rulemaking. Of this appropriation, $44,000
298.9in fiscal year 2012 is for rulemaking. This is
298.10a onetime appropriation.
298.11Electronic Licensing System Adaptors.
298.12Of this appropriation, $761,000 in fiscal
298.13year 2013 from the state government special
298.14revenue fund is to the administrative services
298.15unit to cover the costs to connect to the
298.16e-licensing system. Minnesota Statutes,
298.17section 16E.22. Base level funding for this
298.18activity in fiscal year 2014 shall be $100,000.
298.19Base level funding for this activity in fiscal
298.20year 2015 shall be $50,000.
298.21Development and Implementation of a
298.22Disciplinary, Regulatory, Licensing and
298.23Information Management System. Of this
298.24appropriation, $800,000 in fiscal year 2012
298.25and $300,000 in fiscal year 2013 are for the
298.26development of a shared system. Base level
298.27funding for this activity in fiscal year 2014
298.28shall be $50,000.
298.29Administrative Services Unit - Operating
298.30Costs. Of this appropriation, $526,000
298.31in fiscal year 2012 and $526,000 in
298.32fiscal year 2013 are for operating costs
298.33of the administrative services unit. The
298.34administrative services unit may receive
299.1and expend reimbursements for services
299.2performed by other agencies.
299.3Administrative Services Unit - Retirement
299.4Costs. Of this appropriation in fiscal year
299.52012, $225,000 is for onetime retirement
299.6costs in the health-related boards. This
299.7funding may be transferred to the health
299.8boards incurring those costs for their
299.9payment. These funds are available either
299.10year of the biennium.
299.11Administrative Services Unit - Volunteer
299.12Health Care Provider Program. Of this
299.13appropriation, $150,000 in fiscal year 2012
299.14and $150,000 in fiscal year 2013 are to pay
299.15for medical professional liability coverage
299.16required under Minnesota Statutes, section
299.17214.40.
299.18Administrative Services Unit - Contested
299.19Cases and Other Legal Proceedings. Of
299.20this appropriation, $200,000 in fiscal year
299.212012 and $200,000 in fiscal year 2013 are
299.22for costs of contested case hearings and other
299.23unanticipated costs of legal proceedings
299.24involving health-related boards funded
299.25under this section. Upon certification of a
299.26health-related board to the administrative
299.27services unit that the costs will be incurred
299.28and that there is insufficient money available
299.29to pay for the costs out of money currently
299.30available to that board, the administrative
299.31services unit is authorized to transfer money
299.32from this appropriation to the board for
299.33payment of those costs with the approval
299.34of the commissioner of management and
299.35budget. This appropriation does not cancel.
300.1Any unencumbered and unspent balances
300.2remain available for these expenditures in
300.3subsequent fiscal years.
300.4Base Adjustment. The State Government
300.5Special Revenue Fund base is decreased by
300.6$911,000 in fiscal year 2014 and $1,011,000
300.7in fiscal year 2015.

300.8

Subd. 9.Board of Optometry

106,000

106,000

300.9

Subd. 10.Board of Pharmacy

2,341,000

2,344,000

300.10Prescription Electronic Reporting. Of
300.11this appropriation, $356,000 in fiscal year
300.122012 and $356,000 in fiscal year 2013 from
300.13the state government special revenue fund
300.14are to the board to operate the prescription
300.15electronic reporting system in Minnesota
300.16Statutes, section 152.126. Base level funding
300.17for this activity in fiscal year 2014 shall be
300.18$356,000.

300.19

Subd. 11.Board of Physical Therapy

389,000

345,000

300.20Rulemaking. Of this appropriation, $44,000
300.21in fiscal year 2012 is for rulemaking. This is
300.22a onetime appropriation.

300.23

Subd. 12.Board of Podiatry

75,000

75,000

300.24

Subd. 13.Board of Psychology

846,000

846,000

300.25

Subd. 14.Board of Social Work

1,036,000

1,053,000

300.26

Subd. 15.Board of Veterinary Medicine

228,000

229,000

300.27 300.28

Subd. 16.Board of Behavioral Health and Therapy

414,000

414,000

300.29 300.30

Sec. 9. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

2,742,000

$

2,742,000

300.31Regional Grants. $585,000 in fiscal year
300.322012 and $585,000 in fiscal year 2013 are
301.1for regional emergency medical services
301.2programs, to be distributed equally to the
301.3eight emergency medical service regions.
301.4Notwithstanding Minnesota Statutes, section
301.5144E.50, 100 percent of the appropriation
301.6shall be granted to the emergency medical
301.7service regions.
301.8Cooper/Sams Volunteer Ambulance
301.9Program. $700,000 in fiscal year 2012 and
301.10$700,000 in fiscal year 2013 are for the
301.11Cooper/Sams volunteer ambulance program
301.12under Minnesota Statutes, section 144E.40.
301.13(a) Of this amount, $611,000 in fiscal year
301.142012 and $611,000 in fiscal year 2013
301.15are for the ambulance service personnel
301.16longevity award and incentive program,
301.17under Minnesota Statutes, section 144E.40.
301.18(b) Of this amount, $89,000 in fiscal year
301.192012 and $89,000 in fiscal year 2013 are
301.20for the operations of the ambulance service
301.21personnel longevity award and incentive
301.22program, under Minnesota Statutes, section
301.23144E.40.
301.24Ambulance Training Grant. $361,000 in
301.25fiscal year 2012 and $361,000 in fiscal year
301.262013 are for training grants.
301.27EMSRB Board Operations. $1,096,000 in
301.28fiscal year 2012 and $1,096,000 in fiscal year
301.292013 are for operations.

301.30    Sec. 10. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
301.31to read:
301.32    Subd. 33. Federal administrative reimbursement dedicated. Federal
301.33administrative reimbursement resulting from the following activities is appropriated to the
301.34commissioner for the designated purposes:
302.1(1) reimbursement for the Minnesota senior health options project; and
302.2(2) reimbursement related to prior authorization and inpatient admission certification
302.3by a professional review organization. A portion of these funds must be used for activities
302.4to decrease unnecessary pharmaceutical costs in medical assistance.

302.5    Sec. 11. Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision
302.66, is amended to read:

302.7

Subd. 6.Continuing Care Grants

302.8

(a) Aging and Adult Services Grants

(3,600,000)

(3,600,000)

302.9Community Service/Service Development
302.10Grants Reduction. Effective retroactively
302.11from July 1, 2009, funding for grants made
302.12under Minnesota Statutes, sections 256.9754
302.13and 256B.0917, subdivision 13, is reduced by
302.14$5,807,000 $3,600,000 for each year of the
302.15biennium. Grants made during the biennium
302.16under Minnesota Statutes, section 256.9754,
302.17shall not be used for new construction or
302.18building renovation.
302.19Aging Grants Delay. Aging grants must be
302.20reduced by $917,000 in fiscal year 2011 and
302.21increased by $917,000 in fiscal year 2012.
302.22These adjustments are onetime and must not
302.23be applied to the base. This provision expires
302.24June 30, 2012.

302.25 302.26

(b) Medical Assistance Long-Term Care Facilities Grants

(3,827,000)

(2,745,000)

302.27ICF/MR Variable Rates Suspension.
302.28Effective retroactively from July 1, 2009,
302.29to June 30, 2010, no new variable rates
302.30shall be authorized for intermediate care
302.31facilities for persons with developmental
302.32disabilities under Minnesota Statutes, section
302.33256B.5013, subdivision 1 .
303.1ICF/MR Occupancy Rate Adjustment
303.2Suspension. Effective retroactively from
303.3July 1, 2009, to June 30, 2011, approval
303.4of new applications for occupancy rate
303.5adjustments for unoccupied short-term
303.6beds under Minnesota Statutes, section
303.7256B.5013, subdivision 7 , is suspended.

303.8 303.9

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

(2,318,000)

(5,807,000)

303.10Developmental Disability Waiver Acuity
303.11Factor. Effective retroactively from January
303.121, 2010, the January 1, 2010, one percent
303.13growth factor in the developmental disability
303.14waiver allocations under Minnesota Statutes,
303.15section 256B.092, subdivisions 4 and 5,
303.16that is attributable to changes in acuity,
303.17is suspended to June 30, 2011 eliminated.
303.18Effective January 1, 2012, the one percent
303.19growth factor in the developmental
303.20disability waiver allocations is eliminated.
303.21Notwithstanding any law to the contrary, this
303.22provision does not expire.

303.23

(d) Adult Mental Health Grants

(5,000,000)

-0-

303.24

(e) Chemical Dependency Entitlement Grants

(3,622,000)

(3,622,000)

303.25 303.26

(f) Chemical Dependency Nonentitlement Grants

(393,000)

(393,000)

303.27 303.28

(g) Other Continuing Care Grants

-0-

(2,500,000) (1,414,000)

303.29Other Continuing Care Grants Delay.
303.30Other continuing care grants must be reduced
303.31by $1,414,000 in fiscal year 2011 and
303.32increased by $1,414,000 in fiscal year 2012.
303.33These adjustments are onetime and must not
303.34be applied to the base. This provision expires
303.35June 30, 2012.

304.1

(h) Deaf and Hard-of-Hearing Grants

-0-

(169,000)

304.2Deaf and Hard-of-Hearing Grants Delay.
304.3Effective retroactively from July 1, 2010,
304.4deaf and hard-of-hearing grants must be
304.5reduced by $169,000 in fiscal year 2011 and
304.6increased by $169,000 in fiscal year 2012.
304.7These adjustments are onetime and must not
304.8be applied to the base. This provision expires
304.9June 30, 2012.

304.10    Sec. 12. TRANSFERS.
304.11    Subdivision 1. Grants. The commissioner of human services, with the approval
304.12of the commissioner of management and budget, and after notification of the chairs of
304.13the senate health and human services budget and policy committee and the house of
304.14representatives health and human services finance committee, may transfer unencumbered
304.15appropriation balances for the biennium ending June 30, 2013, within fiscal years among
304.16the MFIP; general assistance; general assistance medical care under Minnesota Statutes,
304.17section 256D.03, subdivision 3; medical assistance; MFIP child care assistance under
304.18Minnesota Statutes, section 119B.05; Minnesota supplemental aid; MinnesotaCare,
304.19and group residential housing programs, and the entitlement portion of the chemical
304.20dependency consolidated treatment fund, and between fiscal years of the biennium.
304.21    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
304.22money may be transferred within the Departments of Health and Human Services as the
304.23commissioners consider necessary, with the advance approval of the commissioner of
304.24management and budget. The commissioner shall inform the chairs of the senate health
304.25and human services budget and policy committee and the house of representatives health
304.26and human services finance committee quarterly about transfers made under this provision.

304.27    Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
304.28The commissioners of health and human services shall not use indirect cost
304.29allocations to pay for the operational costs of any program for which they are responsible.

304.30    Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
304.31All uncodified language contained in this article expires on June 30, 2013, unless a
304.32different expiration date is explicit.

305.1    Sec. 15. EFFECTIVE DATE.
305.2The provisions in this article are effective July 1, 2011, unless a different effective
305.3date is specified."
305.4Delete the title and insert:

305.5"A bill for an act

305.6relating to state government; establishing the health and human services
305.7budget; making changes to children and family services, Department of Health,
305.8miscellaneous provisions, health licensing fees, health care, and continuing
305.9care; redesigning service delivery; making changes to chemical and mental
305.10health; modifying fee schedules; modifying program eligibility requirements;
305.11authorizing rulemaking; imposing criminal penalties; requiring reports;
305.12appropriating money for the Departments of Health and Human Services and
305.13other health-related boards and councils; making forecast adjustments;amending
305.14Minnesota Statutes 2010, sections 8.31, subdivisions 1, 3a; 62D.08, subdivision
305.157; 62E.08, subdivision 1; 62E.14, by adding a subdivision; 62J.04, subdivisions
305.163, 9; 62J.17, subdivision 4a; 62J.495, by adding a subdivision; 62J.692; 62Q.32;
305.1762U.04, subdivisions 3, 9; 62U.06, subdivision 2; 119B.011, subdivision 13;
305.18119B.035, subdivision 4; 119B.09, subdivision 10, by adding subdivisions;
305.19119B.125, by adding a subdivision; 119B.13, subdivisions 1, 1a, 7; 144.1501,
305.20subdivision 1; 144.396, subdivisions 5, 6; 144.98, subdivisions 2a, 7, by adding
305.21subdivisions; 144A.102; 144A.61, by adding a subdivision; 144E.123; 145.925,
305.22subdivisions 1, 2; 145.928, subdivisions 7, 8; 145A.17, subdivision 3; 148.07,
305.23subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2;
305.24148.212, subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52;
305.25150A.091, subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101;
305.26151.102, by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25;
305.27151.47, subdivision 1; 151.48; 152.12, subdivision 3; 157.15, by adding a
305.28subdivision; 157.20, by adding a subdivision; 245A.14, subdivision 4; 245C.03,
305.29by adding a subdivision; 245C.10, by adding a subdivision; 246B.10; 252.025,
305.30subdivision 7; 252.27, subdivision 2a; 253B.212; 254B.03, subdivisions 1, 4;
305.31254B.04, subdivision 1, by adding a subdivision; 254B.06, subdivision 2; 256.01,
305.32subdivisions 2b, 14, 14b, 24, 29, by adding a subdivision; 256.969, subdivision
305.332b; 256B.04, subdivisions 14a, 18, by adding a subdivision; 256B.05, by
305.34adding a subdivision; 256B.056, subdivisions 3, 4; 256B.057, subdivision 9;
305.35256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 8e, 13e, 13h,
305.3617, 17a, 18, 31a, 41, by adding subdivisions; 256B.0631, subdivisions 1, 2,
305.373; 256B.0644; 256B.0659, subdivisions 11, 28; 256B.0751, subdivision 4, by
305.38adding a subdivision; 256B.0911, subdivisions 1a, 3a; 256B.0913, subdivision
305.394; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 10; 256B.0916, subdivision 6a;
305.40256B.092, subdivisions 1b, 1e, 1g, 3, 8; 256B.0943, by adding a subdivision;
305.41256B.0945, subdivision 4; 256B.14, by adding a subdivision; 256B.431,
305.42subdivisions 2r, 32; 256B.434, subdivision 4; 256B.437, subdivision 6;
305.43256B.441, subdivision 50a, by adding a subdivision; 256B.48, subdivision
305.441; 256B.49, subdivisions 13, 14, 15; 256B.5012, by adding subdivisions;
305.45256B.69, subdivisions 5a, 5c, 28, by adding subdivisions; 256B.76, subdivision
305.464; 256D.02, subdivision 12a; 256D.03, subdivision 3; 256D.031, subdivisions
305.471, 6, 7, 9, 10; 256D.05, subdivision 1; 256D.06, subdivision 2; 256D.09,
305.48subdivision 6; 256D.44, subdivision 5; 256D.46, subdivision 1; 256D.47;
305.49256D.49, subdivision 3; 256E.35, subdivisions 5, 6; 256G.02, subdivision
305.506; 256I.03, by adding a subdivision; 256I.04, subdivisions 1, 2b; 256I.05,
305.51subdivision 1a; 256J.12, subdivisions 1a, 2; 256J.20, subdivision 3; 256J.37, by
305.52adding a subdivision; 256J.38, subdivision 1; 256J.49, subdivision 13; 256J.53,
305.53subdivision 2; 256L.01, subdivision 4a; 256L.02, subdivision 3; 256L.03,
305.54subdivision 5; 256L.04, subdivisions 1, 7, 10; 256L.05, subdivisions 2, 3a, by
305.55adding a subdivision; 256L.07, subdivision 1; 256L.11, subdivision 7; 256L.12,
306.1subdivision 9; 256L.15, subdivision 1a; 260C.157, subdivision 3; 260D.01;
306.2297F.10, subdivision 1; 326B.175; 393.07, subdivisions 10, 10a; 402A.10,
306.3subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 518A.51; Laws 2009, chapter
306.479, article 13, section 3, subdivision 8, as amended; Laws 2010, First Special
306.5Session chapter 1, article 15, section 3, subdivision 6; article 25, section 3,
306.6subdivision 6; proposing coding for new law in Minnesota Statutes, chapters 1;
306.715; 62E; 62J; 62U; 145; 148; 151; 214; 256; 256B; 256L; 326B; 402A; proposing
306.8coding for new law as Minnesota Statutes, chapter 256N; repealing Minnesota
306.9Statutes 2010, sections 62J.07, subdivisions 1, 2, 3; 62J.17, subdivisions 1, 3,
306.105a, 6a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1464;
306.11144.147; 144.1499; 256.979, subdivisions 5, 6, 7, 10; 256.9791; 256.9862,
306.12subdivision 2; 256B.055, subdivision 15; 256B.057, subdivision 2c; 256B.0756;
306.13256D.01, subdivisions 1, 1a, 1b, 1e, 2; 256D.03, subdivisions 1, 2, 2a; 256D.05,
306.14subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2, 5, 7, 8;
306.15256D.09, subdivisions 1, 2, 2a, 2b, 5, 6; 256D.10; 256D.13; 256D.15; 256D.16;
306.16256D.35, subdivision 8b; 256D.46; 256L.07, subdivision 7; 402A.30; 402A.45;
306.17Laws 2008, chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 3,
306.18section 18, as amended; article 5, sections 55, as amended; 56; 57; 60; 61; 62; 63;
306.1964; 65; 66; 68; 69; 79; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100,
306.20subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21,
306.2122, 23; 4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140;
306.224651.0150; 9500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5."

307.1	We request the adoption of this report and repassage of the bill.
307.2	Senate Conferees:
307.3	.....		.....
307.4	David W. Hann		Michelle R. Benson
307.5	.....		.....
307.6	Gretchen Hoffman		Scott J. Newman
307.7	.....
307.8	Sean Nienow
307.9	House Conferees:
307.10	.....		.....
307.11	Jim Abeler		Steve Gottwalt
307.12	.....		.....
307.13	Mary Kiffmeyer		Kathy Lohmer
307.14	.....
307.15	Thomas Huntley