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SF 10

as introduced - 87th Legislature, 2011 1st Special Session (2011 - 2012) Posted on 07/20/2011 12:19am

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

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A bill for an act
relating to state government; establishing the health and human services
budget; making changes to children and family services, Department of Health,
miscellaneous provisions, health licensing and fees, human services licensing,
health care, and continuing care; redesigning service delivery; making changes
to chemical and mental health; modifying fee schedules; modifying program
eligibility requirements; authorizing rulemaking; imposing criminal penalties;
requiring reports; appropriating money for the Departments of Health and
Human Services and other health-related boards and councils; amending
Minnesota Statutes 2010, sections 13.461, subdivision 24a; 62E.14, by adding a
subdivision; 62J.04, subdivisions 3, 9; 62J.17, subdivision 4a; 62J.495, by adding
subdivisions; 62J.692; 62Q.32; 62U.04, subdivisions 3, 9; 62U.06, subdivision
2; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision
1; 103I.525, subdivision 2; 103I.531, subdivision 2; 103I.535, subdivision 2;
103I.541, subdivision 2c; 119B.011, subdivision 13; 119B.035, subdivision
4; 119B.09, subdivision 10, by adding subdivisions; 119B.125, by adding a
subdivision; 119B.13, subdivisions 1, 1a, 7; 144.1464, subdivision 1; 144.1501,
subdivision 1; 144.98, subdivisions 2a, 7, by adding subdivisions; 144A.102;
144A.61, by adding a subdivision; 144E.123; 145A.17, subdivision 3; 148.07,
subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2; 148.212,
subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52; 150A.091,
subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101; 151.102,
by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; 151.47,
subdivision 1; 151.48; 152.12, subdivision 3; 157.15, by adding a subdivision;
157.20, by adding a subdivision; 245A.03, subdivision 7, as amended; 245A.10,
subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision 2b; 245A.14,
subdivision 4; 245A.143, subdivision 1; 245C.03, by adding a subdivision;
245C.10, by adding subdivisions; 246B.10; 253B.212; 254B.03, subdivision 4;
254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01, subdivisions
14b, 24, 29, by adding subdivisions; 256.969, subdivisions 2, 2b, by adding a
subdivision; 256B.02, by adding a subdivision; 256B.03, by adding subdivisions;
256B.04, subdivision 18, by adding subdivisions; 256B.05, by adding a
subdivision; 256B.056, subdivision 3; 256B.057, subdivision 9; 256B.06,
subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 8e, 13e, 13h, 17, 17a, 18,
19a, 25, 31, 31a, 41, by adding subdivisions; 256B.0631, subdivisions 1, 2, 3;
256B.064, subdivision 2; 256B.0641, subdivision 1; 256B.0652, subdivision
6; 256B.0659, subdivisions 11, 28; 256B.0751, subdivision 4, by adding a
subdivision; 256B.0911, subdivisions 1a, 3a, 3c, 4a; 256B.0913, subdivision
4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 5, 10; 256B.0943, by adding a
subdivision; 256B.0945, subdivision 4; 256B.14, by adding a subdivision;
256B.19, subdivision 1e; 256B.196, subdivisions 2, 3, 5; 256B.199; 256B.431,
subdivisions 2r, 2t, 32; 256B.434, subdivision 4; 256B.437, subdivision 6;
256B.438, subdivisions 1, 3, 4, by adding a subdivision; 256B.441, subdivisions
50a, 55a, by adding subdivisions; 256B.49, subdivisions 12, 14, 15, 16a, by
adding a subdivision; 256B.5012, by adding subdivisions; 256B.69, subdivisions
5a, 5c, 28, by adding subdivisions; 256B.76, subdivisions 1, 2, 4; 256B.766;
256D.05, subdivision 1; 256D.06, subdivision 2; 256D.09, subdivision 6;
256D.46, subdivision 1; 256D.49, subdivision 3; 256E.35, subdivisions 5, 6;
256I.03, by adding a subdivision; 256I.05, subdivision 1a; 256J.20, subdivision
3; 256J.38, subdivision 1; 256J.49, subdivision 13; 256L.02, subdivision 3;
256L.03, subdivision 5; 256L.04, subdivisions 1, 10; 256L.05, subdivision
3a, by adding a subdivision; 256L.09, subdivision 2; 256L.11, subdivisions
6, 7; 256L.12, subdivision 9; 256L.15, subdivision 1; 256M.01; 256M.10,
subdivision 2; 256M.20, subdivisions 1, 2, 3; 256M.30; 256M.40; 256M.50;
256M.60, subdivision 1; 256M.70, subdivision 2; 256M.80; 295.52, by adding
a subdivision; 297F.10, subdivision 1; 393.07, subdivisions 10, 10a; 402A.10,
subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 518A.51; Laws 2009, chapter
79, article 5, sections 17, as amended; 18, as amended; 22, as amended; article
8, sections 4, as amended; 51, as amended; article 13, section 3, subdivision
8, as amended; Laws 2009, chapter 173, article 1, section 17, as amended;
Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 6;
proposing coding for new law in Minnesota Statutes, chapters 62U; 148; 151;
214; 256; 256B; 256L; 402A; repealing Minnesota Statutes 2010, sections
13.4967, subdivision 3; 62J.07, subdivisions 1, 2, 3; 62J.321, subdivision
5a; 62J.381; 62J.41, subdivisions 1, 2; 144.1499; 245A.10, subdivision 5;
256.979, subdivisions 5, 6, 7, 10; 256.9791; 256B.057, subdivision 2c; 256B.69,
subdivision 9b; 256L.07, subdivision 7; 256M.10, subdivision 5; 256M.60,
subdivision 2; 256M.70, subdivision 1; 295.50, subdivisions 1, 1a, 2, 2a, 3, 4,
6, 6a, 7, 9b, 9c, 10a, 10b, 12b, 13, 14, 15; 295.51, subdivisions 1, 1a; 295.52,
subdivisions 1, 1a, 2, 3, 4, 4a, 5, 6, 7; 295.53, subdivisions 1, 2, 3, 4a; 295.54;
295.55; 295.56; 295.57; 295.58; 295.581; 295.582; 295.59; 402A.30; 402A.45;
Laws 2008, chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 5,
section 62; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100, subparts
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23;
4651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140; 4651.0150;
9500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5.

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

ARTICLE 1

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to
read:


Subd. 13.

Family.

"Family" means parents, stepparents, guardians and their spouses,
or other eligible relative caregivers and their spouses, and their blood related dependent
children and adoptive siblings under the age of 18 years living in the same home including
children temporarily absent from the household in settings such as schools, foster care, and
residential treatment facilities or parents, stepparents, guardians and their spouses, or other
relative caregivers and their spouses temporarily absent from the household in settings
such as schools, military service, or rehabilitation programs. An adult family member who
is not in an authorized activity under this chapter may be temporarily absent for up to 60
days.
When a minor parent or parents and his, her, or their child or children are living with
other relatives, and the minor parent or parents apply for a child care subsidy, "family"
means only the minor parent or parents and their child or children. An adult age 18 or
older who meets this definition of family and is a full-time high school or postsecondary
student may be considered a dependent member of the family unit if 50 percent or more of
the adult's support is provided by the parents, stepparents, guardians, and their spouses or
eligible relative caregivers and their spouses residing in the same household.

EFFECTIVE DATE.

This section is effective April 16, 2012.

Sec. 2.

Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:


Subd. 4.

Assistance.

(a) A family is limited to a lifetime total of 12 months of
assistance under subdivision 2. The maximum rate of assistance is equal to 90 68 percent
of the rate established under section 119B.13 for care of infants in licensed family child
care in the applicant's county of residence.

(b) A participating family must report income and other family changes as specified
in the county's plan under section 119B.08, subdivision 3.

(c) Persons who are admitted to the at-home infant child care program retain their
position in any basic sliding fee program. Persons leaving the at-home infant child care
program reenter the basic sliding fee program at the position they would have occupied.

(d) Assistance under this section does not establish an employer-employee
relationship between any member of the assisted family and the county or state.

EFFECTIVE DATE.

This section is effective October 31, 2011.

Sec. 3.

Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
to read:


Subd. 9a.

Child care centers; assistance.

(a) For the purposes of this subdivision,
"qualifying child" means a child who satisfies both of the following:

(1) is not a child or dependent of an employee of the child care provider; and

(2) does not reside with an employee of the child care provider.

(b) Funds distributed under this chapter must not be paid for child care services
that are provided for a child by a child care provider who employs either the parent of
the child or a person who resides with the child, unless at all times at least 50 percent of
the children for whom the child care provider is providing care are qualifying children
under paragraph (a).

(c) If a child care provider satisfies the requirements for payment under paragraph
(b), but the percentage of qualifying children under paragraph (a) for whom the provider
is providing care falls below 50 percent, the provider shall have four weeks to raise the
percentage of qualifying children for whom the provider is providing care to at least 50
percent before payments to the provider are discontinued for child care services provided
for a child who is not a qualifying child.

EFFECTIVE DATE.

This section is effective January 1, 2013.

Sec. 4.

Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:


Subd. 10.

Payment of funds.

All federal, state, and local child care funds must
be paid directly to the parent when a provider cares for children in the children's own
home. In all other cases, all federal, state, and local child care funds must be paid directly
to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible
family. Funds distributed under this chapter must not be used for child care services that
are provided for a child by a child care provider who resides in the same household or
occupies the same residence as the child.

EFFECTIVE DATE.

This section is effective March 5, 2012.

Sec. 5.

Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
to read:


Subd. 13.

Child care in the child's home.

Child care assistance must only be
authorized in the child's home if the child's parents have authorized activities outside of
the home and if one or more of the following circumstances are met:

(1) the parents' qualifying activity occurs during times when out-of-home care is
not available. If child care is needed during any period when out-of-home care is not
available, in-home care can be approved for the entire time care is needed;

(2) the family lives in an area where out-of-home care is not available; or

(3) a child has a verified illness or disability that would place the child or other
children in an out-of-home facility at risk or creates a hardship for the child and the family
to take the child out of the home to a child care home or center.

EFFECTIVE DATE.

This section is effective March 5, 2012.

Sec. 6.

Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision
to read:


Subd. 1b.

Training required.

(a) Effective November 1, 2011, prior to initial
authorization as required in subdivision 1, a legal nonlicensed family child care provider
must complete first aid and CPR training and provide the verification of first aid and CPR
training to the county. The training documentation must have valid effective dates as of
the date the registration request is submitted to the county and the training must have been
provided by an individual approved to provide first aid and CPR instruction.

(b) Legal nonlicensed family child care providers with an authorization effective
before November 1, 2011, must be notified of the requirements before October 1, 2011, or
at authorization, and must meet the requirements upon renewal of an authorization that
occurs on or after January 1, 2012.

(c) Upon each reauthorization after the authorization period when the initial first aid
and CPR training requirements are met, a legal nonlicensed family child care provider
must provide verification of at least eight hours of additional training listed in the
Minnesota Center for Professional Development Registry.

(d) This subdivision only applies to legal nonlicensed family child care providers.

Sec. 7.

Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:


Subdivision 1.

Subsidy restrictions.

(a) Beginning July 1, 2006 October 31, 2011,
the maximum rate paid for child care assistance in any county or multicounty region under
the child care fund shall be the rate for like-care arrangements in the county effective
January July 1, 2006, increased decreased by six 2.5 percent.

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

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

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

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

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

(e) (d) The department shall monitor the effect of this paragraph on provider rates.
The county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care
on an hourly, full-day, and weekly basis, including special needs and disability care. The
maximum payment to a provider for one day of care must not exceed the daily rate. The
maximum payment to a provider for one week of care must not exceed the weekly rate.

(e) Child care providers receiving reimbursement under this chapter must not be
paid activity fees or an additional amount above the maximum rates for care provided
during nonstandard hours for families receiving assistance.

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

(g) All maximum provider rates changes shall be implemented on the Monday
following the effective date of the maximum provider rate.

EFFECTIVE DATE.

Paragraph (d) is effective April 16, 2012. Paragraph (e)
is effective September 3, 2012.

Sec. 8.

Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:


Subd. 1a.

Legal nonlicensed family child care provider rates.

(a) Legal
nonlicensed family child care providers receiving reimbursement under this chapter must
be paid on an hourly basis for care provided to families receiving assistance.

(b) The maximum rate paid to legal nonlicensed family child care providers must be
80 68 percent of the county maximum hourly rate for licensed family child care providers.
In counties where the maximum hourly rate for licensed family child care providers is
higher than the maximum weekly rate for those providers divided by 50, the maximum
hourly rate that may be paid to legal nonlicensed family child care providers is the rate
equal to the maximum weekly rate for licensed family child care providers divided by 50
and then multiplied by 0.80 0.68. The maximum payment to a provider for one day of care
must not exceed the maximum hourly rate times ten. The maximum payment to a provider
for one week of care must not exceed the maximum hourly rate times 50
.

(c) A rate which includes a special needs rate paid under subdivision 3 may be in
excess of the maximum rate allowed under this subdivision.

(d) Legal nonlicensed family child care providers receiving reimbursement under
this chapter may not be paid registration fees for families receiving assistance.

EFFECTIVE DATE.

This section is effective April 16, 2012, except the
amendment changing 80 to 68 and 0.80 to 0.68 is effective October 31, 2011.

Sec. 9.

Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:


Subd. 7.

Absent days.

(a) Licensed child care providers may and license-exempt
centers must
not be reimbursed for more than 25 ten full-day absent days per child,
excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days,
unless the child has a documented medical condition that causes more frequent absences.
Absences due to a documented medical condition of a parent or sibling who lives in the
same residence as the child receiving child care assistance do not count against the 25-day
absent day limit in a fiscal year. Documentation of medical conditions must be on the
forms and submitted according to the timelines established by the commissioner. A public
health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a
provider sends a child home early due to a medical reason, including, but not limited to,
fever or contagious illness, the child care center director or lead teacher may verify the
illness in lieu of a medical practitioner
. Legal nonlicensed family child care providers
must not be reimbursed for absent days.
If a child attends for part of the time authorized to
be in care in a day, but is absent for part of the time authorized to be in care in that same
day, the absent time will must be reimbursed but the time will must not count toward the
ten consecutive or 25 cumulative absent day limits limit. Children in families where at
least one parent is under the age of 21, does not have a high school or general equivalency
diploma, and is a student in a school district or another similar program that provides or
arranges for child care, as well as parenting, social services, career and employment
supports, and academic support to achieve high school graduation, may be exempt from
the absent day limits upon request of the program and approval of the county. If a child
attends part of an authorized day, payment to the provider must be for the full amount
of care authorized for that day.
Child care providers may must only be reimbursed for
absent days if the provider has a written policy for child absences and charges all other
families in care for similar absences.

(b) Child care providers must be reimbursed for up to ten federal or state holidays
or designated holidays per year when the provider charges all families for these days
and the holiday or designated holiday falls on a day when the child is authorized to be
in attendance. Parents may substitute other cultural or religious holidays for the ten
recognized state and federal holidays. Holidays do not count toward the ten consecutive
or 25 cumulative
absent day limits limit.

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

(d) The provider and family must receive notification of the number of absent days
used upon initial provider authorization for a family and when the family has used 15
cumulative absent days. Upon statewide implementation of the Minnesota Electronic
Child Care System, the
provider and family shall receive notification of the number of
absent days used upon initial provider authorization for a family and ongoing notification
of the number of absent days used as of the date of the notification.

(e) A county may pay for more absent days than the statewide absent day policy
established under this subdivision if current market practice in the county justifies payment
for those additional days. County policies for payment of absent days in excess of the
statewide absent day policy and justification for these county policies must be included in
the county's child care fund plan under section 119B.08, subdivision 3.

EFFECTIVE DATE.

This section is effective January 1, 2013.

Sec. 10.

[256.987] ELECTRONIC BENEFIT TRANSFER CARD.

Subdivision 1.

Electronic benefit transfer (EBT) card.

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

Subd. 2.

Prohibited purchases.

EBT debit cardholders in programs listed under
subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products
and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for
an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic
beverages with the cardholder's EBT card. Any unlawful use under this subdivision shall
constitute fraud and result in disqualification from the program under section 256.98,
subdivision 8.

EFFECTIVE DATE.

Subdivision 1 is effective June 1, 2012.

Sec. 11.

Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:


Subdivision 1.

Eligibility.

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

(1) a person who is suffering from a professionally certified permanent or temporary
illness, injury, or incapacity which is expected to continue for more than 30 45 days and
which prevents the person from obtaining or retaining employment;

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

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

(4) a person who resides in a shelter facility described in subdivision 3;

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

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

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

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

(9) a person who is determined by the county agency, according to permanent rules
adopted by the commissioner, to be learning disabled have a condition that qualifies
under Minnesota's special education rules as a specific learning disability
, provided that if
a rehabilitation plan for the person is developed or approved by the county agency, and
the person is following the plan;

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

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

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

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

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

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

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

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

EFFECTIVE DATE.

This section is effective May 1, 2012.

Sec. 12.

Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:


Subd. 2.

Emergency need.

(a) Notwithstanding the provisions of subdivision 1, a
grant of emergency general assistance shall, to the extent funds are available, be made to
an eligible single adult, married couple, or family for an emergency need, as defined in
rules promulgated by the commissioner,
where the recipient requests temporary assistance
not exceeding 30 days if an emergency situation appears to exist and the individual or
family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP
under
written criteria adopted by the county agency
. If an applicant or recipient relates facts
to the county agency which may be sufficient to constitute an emergency situation, the
county agency shall, to the extent funds are available, advise the person of the procedure
for applying for assistance according to this subdivision.

(b) The applicant must be ineligible for assistance under chapter 256J, must have
annual net income no greater than 200 percent of the federal poverty guidelines for the
previous calendar year, and may receive
an emergency general assistance grant is available
to a recipient
not more than once in any 12-month period.

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

(d) Any emergency general assistance expenditures by a county above the amount of
the commissioner's allocation to the county must be made from county funds.

EFFECTIVE DATE.

This section is effective November 1, 2011.

Sec. 13.

Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:


Subdivision 1.

Eligibility.

A county agency must grant emergency Minnesota
supplemental aid, to the extent funds are available, if the recipient is without adequate
resources to resolve an emergency that, if unresolved, will threaten the health or safety of
the recipient. For the purposes of this section, the term "recipient" includes persons for
whom a group residential housing benefit is being paid under sections 256I.01 to 256I.06.

Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency
need may apply for emergency general assistance under section 256D.06, subdivision 2.

EFFECTIVE DATE.

This section is effective November 1, 2011.

Sec. 14.

Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:


Subd. 5.

Household eligibility; participation.

(a) To be eligible for state or TANF
matching funds in the family assets for independence initiative, a household must meet the
eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
in Title IV, section 408 of that act.

(b) Each participating household must sign a family asset agreement that includes
the amount of scheduled deposits into its savings account, the proposed use, and the
proposed savings goal. A participating household must agree to complete an economic
literacy training program.

Participating households may only deposit money that is derived from household
earned income or from state and federal income tax credits.

Sec. 15.

Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:


Subd. 6.

Withdrawal; matching; permissible uses.

(a) To receive a match, a
participating household must transfer funds withdrawn from a family asset account to its
matching fund custodial account held by the fiscal agent, according to the family asset
agreement. The fiscal agent must determine if the match request is for a permissible use
consistent with the household's family asset agreement.

The fiscal agent must ensure the household's custodial account contains the
applicable matching funds to match the balance in the household's account, including
interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches
must be provided as follows:

(1) from state grant and TANF funds a matching contribution of $1.50 for every $1
of funds withdrawn from the family asset account equal to the lesser of $720 per year or a
$3,000 lifetime limit; and

(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
of funds withdrawn from the family asset account equal to the lesser of $720 per year or
a $3,000 lifetime limit.

(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
direct payment to the vendor of the goods or services for the permissible use.

Sec. 16.

Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision
to read:


Subd. 8.

Supplementary services.

"Supplementary services" means services
provided to residents of group residential housing providers in addition to room and
board including, but not limited to, oversight and up to 24-hour supervision, medication
reminders, assistance with transportation, arranging for meetings and appointments, and
arranging for medical and social services.

Sec. 17.

Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:


Subd. 1a.

Supplementary service rates.

(a) Subject to the provisions of section
256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37
for other services necessary to provide room and board provided by the group residence
if the residence is licensed by or registered by the Department of Health, or licensed by
the Department of Human Services to provide services in addition to room and board,
and if the provider of services is not also concurrently receiving funding for services for
a recipient under a home and community-based waiver under title XIX of the Social
Security Act; or funding from the medical assistance program under section 256B.0659,
for personal care services for residents in the setting; or residing in a setting which
receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is
available for other necessary services through a home and community-based waiver, or
personal care services under section 256B.0659, then the GRH rate is limited to the rate
set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary
service rate exceed $426.37. The registration and licensure requirement does not apply to
establishments which are exempt from state licensure because they are located on Indian
reservations and for which the tribe has prescribed health and safety requirements. Service
payments under this section may be prohibited under rules to prevent the supplanting of
federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
the approval of the Secretary of Health and Human Services to provide home and
community-based waiver services under title XIX of the Social Security Act for residents
who are not eligible for an existing home and community-based waiver due to a primary
diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is
determined to be cost-effective.

(b) The commissioner is authorized to make cost-neutral transfers from the GRH
fund for beds under this section to other funding programs administered by the department
after consultation with the county or counties in which the affected beds are located.
The commissioner may also make cost-neutral transfers from the GRH fund to county
human service agencies for beds permanently removed from the GRH census under a plan
submitted by the county agency and approved by the commissioner. The commissioner
shall report the amount of any transfers under this provision annually to the legislature.

(c) The provisions of paragraph (b) do not apply to a facility that has its
reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

(d) Counties must not negotiate supplementary service rates with providers of group
residential housing that are licensed as board and lodging with special services and that
do not encourage a policy of sobriety on their premises.

EFFECTIVE DATE.

This section is effective May 1, 2012.

Sec. 18.

Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:


Subd. 3.

Other property limitations.

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

(1) a licensed vehicle up to a loan value of less than or equal to $15,000 $10,000. If
the assistance unit owns more than one licensed vehicle, the county agency shall determine
the loan value of all additional vehicles and exclude the combined loan value of less than
or equal to $7,500. The county agency shall apply any excess loan value as if it were
equity value to the asset limit described in this section, excluding: (i) the value of one
vehicle per physically disabled person when the vehicle is needed to transport the disabled
unit member; this exclusion does not apply to mentally disabled people; (ii) the value of
special equipment for a disabled member of the assistance unit; and (iii) any vehicle used
for long-distance travel, other than daily commuting, for the employment of a unit member.

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

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

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

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

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

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

(7) the value of corrective payments, but only for the month in which the payment
is received and for the following month;

(8) a mobile home or other vehicle used by an applicant or participant as the
applicant's or participant's home;

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

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

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

(12) the value of school loans, grants, or scholarships for the period they are
intended to cover;

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

(14) income received in a budget month through the end of the payment month;

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

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

(17) payments excluded under federal law as long as those payments are held in a
separate account from any nonexcluded funds;

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

(19) the assets of persons whose income is excluded under section 256J.21,
subdivision 2
, clause (43).

EFFECTIVE DATE.

This section is effective October 1, 2011.

Sec. 19.

Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:


Subd. 13.

Work activity.

(a) "Work activity" means any activity in a participant's
approved employment plan that leads to employment. For purposes of the MFIP program,
this includes activities that meet the definition of work activity under the participation
requirements of TANF. Work activity includes:

(1) unsubsidized employment, including work study and paid apprenticeships or
internships;

(2) subsidized private sector or public sector employment, including grant diversion
as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid
work experience, and supported work when a wage subsidy is provided;

(3) unpaid work experience, including community service, volunteer work,
the community work experience program as specified in section 256J.67, unpaid
apprenticeships or internships, and supported work when a wage subsidy is not provided.
Unpaid work experience is only an option if the participant has been unable to obtain or
maintain paid employment in the competitive labor market, and no paid work experience
programs are available to the participant. Prior to placing a participant in unpaid work,
the county must inform the participant that the participant will be notified if a paid work
experience or supported work position becomes available. Unless a participant consents in
writing to participate in unpaid work experience, the participant's employment plan may
only include unpaid work experience if including the unpaid work experience in the plan
will meet the following criteria:

(i) the unpaid work experience will provide the participant specific skills or
experience that cannot be obtained through other work activity options where the
participant resides or is willing to reside; and

(ii) the skills or experience gained through the unpaid work experience will result
in higher wages for the participant than the participant could earn without the unpaid
work experience;

(4) job search including job readiness assistance, job clubs, job placement,
job-related counseling, and job retention services;

(5) job readiness education, including English as a second language (ESL) or
functional work literacy classes as limited by the provisions of section 256J.531,
subdivision 2
, general educational development (GED) course work, high school
completion, and adult basic education as limited by the provisions of section 256J.531,
subdivision 1
;

(6) job skills training directly related to employment, including education and
training that can reasonably be expected to lead to employment, as limited by the
provisions of section 256J.53;

(7) providing child care services to a participant who is working in a community
service program;

(8) activities included in the employment plan that is developed under section
256J.521, subdivision 3; and

(9) preemployment activities including chemical and mental health assessments,
treatment, and services; learning disabilities services; child protective services; family
stabilization services; or other programs designed to enhance employability.

(b) "Work activity" does not include activities done for political purposes as defined
in section 211B.01, subdivision 6.

Sec. 20.

Minnesota Statutes 2010, section 256M.01, is amended to read:


256M.01 CITATION.

Sections 256M.01 to 256M.80 may be cited as the "Children and Community
Services
Vulnerable Children and Adults Act." This act establishes a fund to address the
needs of vulnerable children, adolescents, and adults within each county in accordance
with a service plan entered into by the board of county commissioners of each county
and the commissioner. The service plan shall specify the outcomes to be achieved, the
general strategies to be employed, and the respective state and county roles. The service
plan shall be reviewed and updated every two years, or sooner if both the state and the
county deem it necessary.

Sec. 21.

Minnesota Statutes 2010, section 256M.10, subdivision 2, is amended to read:


Subd. 2.

Children and community Vulnerable children and adults services.

(a) "Children and communityVulnerable children and adults services" means services
provided or arranged for by county boards for vulnerable children, adolescents and other
individuals in transition from childhood to adulthood,
under chapter 260C, and sections
626.556 and 626.5561,
and adults under section 626.557 who experience dependency,
abuse, or neglect, poverty, disability, chronic health conditions, or other factors, including
ethnicity and race, that may result in poor outcomes or disparities,
as well as services
for family members to support those individuals. These services may be provided
by professionals or nonprofessionals, including the person's natural supports in the
community. For the purpose of this chapter, "vulnerable children" means children and
adolescents.

(b) Children and community Vulnerable children and adults services do not include
services under the public assistance programs known as the Minnesota family investment
program, Minnesota supplemental aid, medical assistance, general assistance, general
assistance medical care, MinnesotaCare, or community health services.

Sec. 22.

Minnesota Statutes 2010, section 256M.20, subdivision 1, is amended to read:


Subdivision 1.

General supervision.

Each year the commissioner shall allocate
funds to each county with an approved service plan according to section 256M.40 and
service plans under section 256M.30. The funds shall be used to address the needs of
vulnerable children, adolescents, and adults. The commissioner, in consultation with
counties, shall provide technical assistance and evaluate county performance in achieving
outcomes.

Sec. 23.

Minnesota Statutes 2010, section 256M.20, subdivision 2, is amended to read:


Subd. 2.

Additional duties.

The commissioner shall:

(1) provide necessary information and assistance to each county for establishing
baselines and desired improvements on mental health, safety, permanency, and well-being
for vulnerable children and adolescents adults;

(2) provide training, technical assistance, and other supports to each county board
to assist in needs assessment, planning, implementation, and monitoring of outcomes
and service quality;

(3) use data collection, evaluation of service outcomes, and the review and approval
of county service plans to supervise county performance in the delivery of children and
community
services;

(4) specify requirements for reports, including fiscal reports to account for funds
distributed;

(5) request waivers from federal programs as necessary to implement this section;
and

(6) have authority under sections 14.055 and 14.056 to grant a variance to existing
state rules as needed to eliminate barriers to achieving desired outcomes.

Sec. 24.

Minnesota Statutes 2010, section 256M.20, subdivision 3, is amended to read:


Subd. 3.

Sanctions.

The commissioner shall establish and maintain a monitoring
program designed to reduce the possibility of noncompliance with federal laws and
federal
, regulations, and performance standards that may result in federal fiscal sanctions.
If a county is not complying with federal law or federal regulation and the noncompliance
may result in federal fiscal sanctions, the commissioner may withhold a portion of the
county's share of state and federal funds for that program. The amount withheld must be
equal to the percentage difference between the level of compliance maintained by the
county and the level of compliance required by the federal regulations, multiplied by the
county's share of state and federal funds for the program. The state and federal funds may
be withheld until the county is found to be in compliance with all federal laws or federal
regulations applicable to the program. If a county remains out of compliance for more
than six consecutive months, the commissioner may reallocate the withheld funds to
counties that are in compliance with the federal regulations.

Sec. 25.

Minnesota Statutes 2010, section 256M.30, is amended to read:


256M.30 SERVICE PLAN.

Subdivision 1.

Service plan submitted to commissioner.

Effective January 1,
2004, and each two-year period thereafter 2012, each county must have a biennial service
plan approved by the commissioner in order to receive funds. Counties may submit
multicounty or regional service plans. Plans must be updated as needed to reflect current
county policy and procedures regarding requirements and use of funds under this chapter.

Subd. 2.

Contents.

The service plan shall be completed in a form prescribed by
the commissioner. The plan must include:

(1) a statement of the needs of the vulnerable children, adolescents, and adults who
experience the conditions defined in section 256M.10, subdivision 2, paragraph (a), and
strengths and resources available in the community to address those needs;

(2) strategies the county will pursue to achieve the performance targets. Strategies
must include specification of how funds under this section and other community resources
will be used to achieve desired performance targets;

(3) a description of the county's process to solicit public input and a summary of
that input;

(4) beginning with the service plans submitted for the period from January 1, 2006,
through December 31, 2007,
performance targets on statewide indicators for each county
to measure outcomes of children's mental health, and child vulnerable children and adult's
safety, permanency, and well-being. The commissioner shall consult with counties and
other stakeholders to develop these indicators and collect baseline data to inform the
establishment of individual county performance targets for the 2006-2007 2012-2013
biennium and subsequent plans years; and

(5) a budget for services to be provided with funds under this section. The county
must budget at least 40 percent of funds appropriated under sections 256M.01 to 256M.80
for services to ensure the mental health, safety, permanency, and well-being of children
from low-income families. The commissioner may reduce the portion of child and
community services funds that must be budgeted by a county for services to children in
low-income families if:

(i) the incidence of children in low-income families within the county's population is
significantly below the statewide median; or

(ii) the county has successfully achieved past performance targets for children's
mental health, and child safety, permanency, and well-being and its proposed service plan
is judged by the commissioner to provide an adequate level of service to the population
with less funding.

Subd. 3.

Continuity of services.

In developing the plan required under this section,
a county shall endeavor, within the limits of funds available, to consider the continuing
need for services and programs for children and persons with disabilities that were funded
by the former children's services and community service grants.

Subd. 4.

Information.

The commissioner shall provide each county with
information and technical assistance needed to complete the service plan, including:
information on children's mental health, and child and adult safety, permanency, and
well-being in the county; comparisons with other counties; baseline performance on
outcome measures; and promising program practices.

Subd. 5.

Timelines.

The preliminary service plan must be submitted to the
commissioner by October 15, 2003, and October 15 of every two years thereafter 2011.

Subd. 6.

Public comment.

The county board must determine how citizens in the
county will participate in the development of the service plan and provide opportunities
for such participation. The county must allow a period of no less than 30 days prior to
the submission of the plan to the commissioner to solicit comments from the public on
the contents of the plan.

Subd. 7.

Commissioner's responsibilities.

The commissioner must, within 60
days of receiving each county service plan,
inform the county if the service plan has
been approved. If the service plan is not approved, the commissioner must inform the
county of any revisions needed for approval.

Sec. 26.

Minnesota Statutes 2010, section 256M.40, is amended to read:


256M.40 CHILDREN AND COMMUNITY SERVICES GRANT
ALLOCATION.

Subdivision 1.

Formula.

The commissioner shall allocate state funds appropriated
for children and community services grants under this chapter to each county board on a
calendar year basis in an amount determined according to the formula in paragraphs
(a) to (c) (e).

(a) For July 1, 2003, through December 31, 2003, the commissioner shall allocate
funds to each county equal to that county's allocation for the grants under section 256M.10,
subdivision 5
, for calendar year 2003 less payments made on or before June 30, 2003.

(b) For calendar year 2004 and 2005, the commissioner shall allocate available funds
to each county in proportion to that county's share of the calendar year 2003 allocations
for the grants under section 256M.10, subdivision 5.

(c) For calendar year 2006 and each calendar year thereafter, the commissioner
shall allocate available funds to each county in proportion to that county's share in the
preceding calendar year.

(a) For calendar years 2011 and 2012, the commissioner shall allocate available
funds to each county in proportion to that county's share in calendar year 2010.

(b) For calendar year 2013, the commissioner shall allocate available funds to each
county as follows:

(1) 75 percent must be distributed on the basis of the county share in calendar year
2012;

(2) five percent must be distributed on the basis of the number of persons residing in
the county as determined by the most recent data of the state demographer;

(3) ten percent must be distributed on the basis of the number of vulnerable children
that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in
the county as determined by the most recent data of the commissioner; and

(4) ten percent must be distributed on the basis of the number of vulnerable adults
that are subjects of reports under section 626.557 in the county as determined by the most
recent data of the commissioner.

(c) For calendar year 2014, the commissioner shall allocate available funds to each
county as follows:

(1) 50 percent must be distributed on the basis of the county share in calendar year
2012;

(2) Ten percent must be distributed on the basis of the number of persons residing in
the county as determined by the most recent data of the state demographer;

(3) 20 percent must be distributed on the basis of the number of vulnerable children
that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
county as determined by the most recent data of the commissioner; and

(4) 20 percent must be distributed on the basis of the number of vulnerable adults
that are subjects of reports under section 626.557 in the county as determined by the most
recent data of the commissioner.

(d) For calendar year 2015, the commissioner shall allocate available funds to each
county as follows:

(1) 25 percent must be distributed on the basis of the county share in calendar year
2012;

(2) 15 percent must be distributed on the basis of the number of persons residing in
the county as determined by the most recent data of the state demographer;

(3) 30 percent must be distributed on the basis of the number of vulnerable children
that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
county as determined by the most recent data of the commissioner; and

(4) 30 percent must be distributed on the basis of the number of vulnerable adults
that are subjects of reports under section 626.557 in the county as determined by the most
recent data of the commissioner.

(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall
allocate available funds to each county as follows:

(1) 20 percent must be distributed on the basis of the number of persons residing in
the county as determined by the most recent data of the state demographer;

(2) 40 percent must be distributed on the basis of the number of vulnerable children
that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
county as determined by the most recent data of the commissioner; and

(3) 40 percent must be distributed on the basis of the number of vulnerable adults
that are subjects of reports under section 626.557 in the county as determined by the most
recent data of the commissioner.

Subd. 3.

Payments.

Calendar year allocations under subdivision 1 shall be paid to
counties on or before July 10 of each year.

Sec. 27.

Minnesota Statutes 2010, section 256M.50, is amended to read:


256M.50 FEDERAL CHILDREN AND COMMUNITY SERVICES GRANT
ALLOCATION.

In federal fiscal year 2004 2012 and subsequent years, money for social services
received from the federal government to reimburse counties for social service expenditures
according to Title XX of the Social Security Act shall be allocated to each county
according to section 256M.40, except for funds allocated for administrative purposes and
migrant day care. Title XX funds must not be used for any expenditures prohibited by
section 2005 of the Social Security Act and all federal certification requirements under
title XX must be met by counties receiving title XX funds under this chapter.

Sec. 28.

Minnesota Statutes 2010, section 256M.60, subdivision 1, is amended to read:


Subdivision 1.

Responsibilities.

The county board of each county shall be
responsible for administration and funding of children and community services as defined
in section 256M.10, subdivision 1. Each county board shall singly or in combination with
other county boards use funds available to the county under Laws 2003, First Special
Session chapter 14, to carry out these responsibilities. The county board shall coordinate
and facilitate the effective use of formal and informal helping systems to best support and
nurture children, adolescents, and adults within the county who experience dependency,
abuse, neglect, poverty, disability, chronic health conditions, or other factors, including
ethnicity and race, that may result in poor outcomes or disparities, as well as services
for family members to support such individuals. This includes assisting individuals
to function at the highest level of ability while maintaining family and community
relationships to the greatest extent possible.

Sec. 29.

Minnesota Statutes 2010, section 256M.70, subdivision 2, is amended to read:


Subd. 2.

Identification of services to be provided.

If a county has made reasonable
efforts to provide services according to the service plan under section 256M.30, but funds
appropriated for purposes of sections 256M.01 to 256M.80 are insufficient, then the
county may limit services that do not meet the following criteria while giving the highest
funding priority to clauses (1), and (2), and (3):

(1) services needed to protect individuals from maltreatment, abuse, and neglect;

(2) emergency and crisis services needed to protect clients from physical, emotional,
or psychological harm;

(3) services that maintain a person in the person's home or least restrictive setting;

(4) assessment of persons applying for services and referral to appropriate services
when necessary; and

(5) public guardianship services;.

(6) case management for persons with developmental disabilities, children with
serious emotional disturbances, and adults with serious and persistent mental illness; and

(7) fulfilling licensing responsibilities delegated to the county by the commissioner
under section 245A.16.

Sec. 30.

Minnesota Statutes 2010, section 256M.80, is amended to read:


256M.80 PROGRAM EVALUATION.

Subdivision 1.

County evaluation.

Each county shall submit to the commissioner
data from the past calendar year on the outcomes and performance indicators in the service
plan. The commissioner shall prescribe standard methods to be used by the counties
in providing the data. The data shall be submitted no later than March 1 of each year,
beginning with March 1, 2005
.

Subd. 2.

Statewide evaluation.

Six months after the end of the first full calendar
year and annually thereafter, the commissioner shall prepare a report on make public the
counties' progress in improving the outcomes of vulnerable children, adolescents, and
adults related to mental health, safety, permanency, and well-being. This report shall be
disseminated throughout the state.

Sec. 31.

Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:


Subd. 10a.

Expedited issuance of food stamps.

The commissioner of human
services shall continually monitor the expedited issuance of food stamp benefits to ensure
that each county complies with federal regulations and that households eligible for
expedited issuance of food stamps are identified, processed, and certified within the time
frames prescribed in federal regulations.

County food stamp offices shall screen and issue food stamps to applicants on the
day of application. Applicants who meet the federal criteria for expedited issuance and
have an immediate need for food assistance shall receive either: within five working days

(1) a manual Authorization to Participate (ATP) card; or

(2) the immediate issuance of food stamp coupons benefits.

The local food stamp agency shall conspicuously post in each food stamp office a
notice of the availability of and the procedure for applying for expedited issuance and
verbally advise each applicant of the availability of the expedited process.

Sec. 32.

Minnesota Statutes 2010, section 518A.51, is amended to read:


518A.51 FEES FOR IV-D SERVICES.

(a) When a recipient of IV-D services is no longer receiving assistance under the
state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the
public authority responsible for child support enforcement must notify the recipient,
within five working days of the notification of ineligibility, that IV-D services will be
continued unless the public authority is notified to the contrary by the recipient. The
notice must include the implications of continuing to receive IV-D services, including the
available services and fees, cost recovery fees, and distribution policies relating to fees.

(b) An application fee of $25 shall be paid by the person who applies for child
support and maintenance collection services, except persons who are receiving public
assistance as defined in section 256.741 and the diversionary work program under section
256J.95, persons who transfer from public assistance to nonpublic assistance status, and
minor parents and parents enrolled in a public secondary school, area learning center, or
alternative learning program approved by the commissioner of education.

(c) In the case of an individual who has never received assistance under a state
program funded under title IV-A of the Social Security Act and for whom the public
authority has collected at least $500 of support, the public authority must impose an
annual federal collections fee of $25 for each case in which services are furnished. This
fee must be retained by the public authority from support collected on behalf of the
individual, but not from the first $500 collected.

(d) When the public authority provides full IV-D services to an obligee who has
applied for those services, upon written notice to the obligee, the public authority must
charge a cost recovery fee of one two percent of the amount collected. This fee must
be deducted from the amount of the child support and maintenance collected and not
assigned under section 256.741 before disbursement to the obligee. This fee does not
apply to an obligee who:

(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,
medical assistance, or MinnesotaCare programs; or

(2) has received assistance under the state's title IV-A or IV-E foster care programs,
until the person has not received this assistance for 24 consecutive months.

(e) When the public authority provides full IV-D services to an obligor who has
applied for such services, upon written notice to the obligor, the public authority must
charge a cost recovery fee of one two percent of the monthly court-ordered child support
and maintenance obligation. The fee may be collected through income withholding, as
well as by any other enforcement remedy available to the public authority responsible for
child support enforcement.

(f) Fees assessed by state and federal tax agencies for collection of overdue support
owed to or on behalf of a person not receiving public assistance must be imposed on the
person for whom these services are provided. The public authority upon written notice to
the obligee shall assess a fee of $25 to the person not receiving public assistance for each
successful federal tax interception. The fee must be withheld prior to the release of the
funds received from each interception and deposited in the general fund.

(g) Federal collections fees collected under paragraph (c) and cost recovery
fees collected under paragraphs (d) and (e) retained by the commissioner of human
services
shall be considered child support program income according to Code of Federal
Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
account established under paragraph (i). The commissioner of human services must elect
to recover costs based on either actual or standardized costs.

(h) The limitations of this section on the assessment of fees shall not apply to
the extent inconsistent with the requirements of federal law for receiving funds for the
programs under title IV-A and title IV-D of the Social Security Act, United States Code,
title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.

(i) The commissioner of human services is authorized to establish a special revenue
fund account to receive the federal collections fees collected under paragraph (c) and cost
recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of
these fees may be retained for expenditures necessary to administer the fees and must be
transferred to the child support system special revenue account. The remaining nonfederal
share of the federal collections fees and cost recovery fees must be retained by the
commissioner and dedicated to the child support general fund county performance-based
grant account authorized under sections 256.979 and 256.9791.

(j) The nonfederal share of the cost recovery fee revenue must be retained by the
commissioner and distributed as follows:

(1) one-half of the revenue must be transferred to the child support system special
revenue account to support the state's administration of the child support enforcement
program and its federally mandated automated system;

(2) an additional portion of the revenue must be transferred to the child support
system special revenue account for expenditures necessary to administer the fees; and

(3) the remaining portion of the revenue must be distributed to the counties to aid the
counties in funding their child support enforcement programs.

(k) The nonfederal share of the federal collections fees must be distributed to the
counties to aid them in funding their child support enforcement programs.

(l) The commissioner of human services shall distribute quarterly any of the funds
dedicated to the counties under paragraphs (j) and (k) using the methodology specified in
section 256.979, subdivision 11. The funds received by the counties must be reinvested in
the child support enforcement program and the counties must not reduce the funding of
their child support programs by the amount of the funding distributed.

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 33. REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES,
GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.

Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must
negotiate with their third-party processors to block EBT card cash transactions at their
places of business and withdrawals of cash at automatic teller machines located in their
places of business.

Sec. 34. MINNESOTA EBT BUSINESS TASK FORCE.

Subdivision 1.

Members.

The Minnesota EBT Business Task Force includes seven
members, appointed as follows:

(1) two members of the Minnesota house of representatives appointed by the speaker
of the house;

(2) two members of the Minnesota senate appointed by the senate majority leader;

(3) the commissioner of human services, or designee;

(4) an appointee of the Minnesota Grocers Association; and

(5) a credit card processor, appointed by the commissioner of human services.

Subd. 2.

Duties.

The Minnesota EBT Business Task Force shall create a workable
strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the
general assistance program and Minnesota supplemental aid program under Minnesota
Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT
cards. The task force will consider cost to the state, feasibility of execution at retail, and
ease of use and privacy for EBT cardholders.

Subd. 3.

Report.

The task force will report back to the legislative committees with
jurisdiction over health and human services policy and finance by April 1, 2012, with
recommendations related to the task force duties under subdivision 2.

Subd. 4.

Expiration.

The task force expires on June 30, 2012.

Sec. 35. REPEALER.

(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; and
256.9791,
are repealed effective retroactively from July 1, 2011.

(b) Minnesota Statutes 2010, sections 256M.10, subdivision 5; 256M.60, subdivision
2; and 256M.70, subdivision 1,
are repealed.

(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September
3, 2012.
(d) Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, are
repealed effective November 1, 2011.

ARTICLE 2

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:


Subd. 3.

Cost containment duties.

The commissioner shall:

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

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

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

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

(5) undertake health planning responsibilities;

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

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

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

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

Sec. 2.

Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:


Subd. 4a.

Expenditure reporting.

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

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

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

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

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

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

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

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

Sec. 3.

Minnesota Statutes 2010, section 62J.692, is amended to read:


62J.692 MEDICAL EDUCATION.

Subdivision 1.

Definitions.

For purposes of this section, the following definitions
apply:

(a) "Accredited clinical training" means the clinical training provided by a
medical education program that is accredited through an organization recognized by the
Department of Education, the Centers for Medicare and Medicaid Services, or another
national body who reviews the accrediting organizations for multiple disciplines and
whose standards for recognizing accrediting organizations are reviewed and approved by
the commissioner of health in consultation with the Medical Education and Research
Advisory Committee.

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

(c) "Clinical medical education program" means the accredited clinical training of
physicians (medical students and residents), doctor of pharmacy practitioners, doctors
of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
physician assistants.

(d) "Sponsoring institution" means a hospital, school, or consortium located in
Minnesota that sponsors and maintains primary organizational and financial responsibility
for a clinical medical education program in Minnesota and which is accountable to the
accrediting body.

(e) "Teaching institution" means a hospital, medical center, clinic, or other
organization that conducts a clinical medical education program in Minnesota.

(f) "Trainee" means a student or resident involved in a clinical medical education
program.

(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
equivalent counts, that are at training sites located in Minnesota with currently active
medical assistance enrollment status and a National Provider Identification (NPI) number
where training occurs in either an inpatient or ambulatory patient care setting and where
the training is funded, in part, by patient care revenues. Training that occurs in nursing
facility settings is not eligible for funding under this section.

Subd. 3.

Application process.

(a) A clinical medical education program
conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy
practitioners, dentists, chiropractors, or physician assistants is eligible for funds under
subdivision 4 if the program:

(1) is funded, in part, by patient care revenues;

(2) occurs in patient care settings that face increased financial pressure as a result
of competition with nonteaching patient care entities; and

(3) emphasizes primary care or specialties that are in undersupply in Minnesota.

A clinical medical education program that trains pediatricians is requested to include
in its program curriculum training in case management and medication management for
children suffering from mental illness to be eligible for funds under subdivision 4.

(b) A clinical medical education program for advanced practice nursing is eligible for
funds under subdivision 4 if the program meets the eligibility requirements in paragraph
(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health
Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges
and Universities system or members of the Minnesota Private College Council.

(c) Applications must be submitted to the commissioner by a sponsoring institution
on behalf of an eligible clinical medical education program and must be received by
October 31 of each year for distribution in the following year. An application for funds
must contain the following information:

(1) the official name and address of the sponsoring institution and the official
name and site address of the clinical medical education programs on whose behalf the
sponsoring institution is applying;

(2) the name, title, and business address of those persons responsible for
administering the funds;

(3) for each clinical medical education program for which funds are being sought;
the type and specialty orientation of trainees in the program; the name, site address, and
medical assistance provider number and national provider identification number of each
training site used in the program; the federal tax identification number of each training site
used in the program, where available;
the total number of trainees at each training site; and
the total number of eligible trainee FTEs at each site; and

(4) other supporting information the commissioner deems necessary to determine
program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
equitable distribution of funds.

(d) An application must include the information specified in clauses (1) to (3) for
each clinical medical education program on an annual basis for three consecutive years.
After that time, an application must include the information specified in clauses (1) to (3)
when requested, at the discretion of the commissioner:

(1) audited clinical training costs per trainee for each clinical medical education
program when available or estimates of clinical training costs based on audited financial
data;

(2) a description of current sources of funding for clinical medical education costs,
including a description and dollar amount of all state and federal financial support,
including Medicare direct and indirect payments; and

(3) other revenue received for the purposes of clinical training.

(e) An applicant that does not provide information requested by the commissioner
shall not be eligible for funds for the current funding cycle.

Subd. 4.

Distribution of funds.

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

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

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

Public program revenue for the distribution formula includes revenue from medical
assistance, prepaid medical assistance, general assistance medical care, and prepaid
general assistance medical care. Training sites that receive no public program revenue
are ineligible for funds available under this subdivision. For purposes of determining
training-site level grants to be distributed under paragraph (a), total statewide average
costs per trainee for medical residents is based on audited clinical training costs per trainee
in primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs
per trainee in clinical medical education programs for dental students. Total statewide
average costs per trainee for pharmacy residents is based on audited clinical training costs
per trainee in clinical medical education programs for pharmacy students. Training sites
whose training site level grant is less than $1,000, based on the formula described in this
paragraph, are ineligible for funds available under this subdivision.

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

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

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

(3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to
the Academic Health Center under this paragraph shall be used for a program to assist
internationally trained physicians who are legal residents and who commit to serving
underserved Minnesota communities in a health professional shortage area to successfully
compete for family medicine residency programs at the University of Minnesota.

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

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

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

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

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

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

Subd. 5.

Report.

(a) Sponsoring institutions receiving funds under this section
must sign and submit a medical education grant verification report (GVR) to verify that
the correct grant amount was forwarded to each eligible training site. If the sponsoring
institution fails to submit the GVR by the stated deadline, or to request and meet
the deadline for an extension, the sponsoring institution is required to return the full
amount of funds received to the commissioner within 30 days of receiving notice from
the commissioner. The commissioner shall distribute returned funds to the appropriate
training sites in accordance with the commissioner's approval letter.

(b) The reports must provide verification of the distribution of the funds and must
include:

(1) the total number of eligible trainee FTEs in each clinical medical education
program;

(2) the name of each funded program and, for each program, the dollar amount
distributed to each training site;

(3) documentation of any discrepancies between the initial grant distribution notice
included in the commissioner's approval letter and the actual distribution;

(4) a statement by the sponsoring institution stating that the completed grant
verification report is valid and accurate; and

(5) other information the commissioner, with advice from the advisory committee,
deems appropriate to evaluate the effectiveness of the use of funds for medical education.

(c) By February 15 of each year, the commissioner, with advice from the
advisory committee, shall provide an annual summary report to the legislature on the
implementation of this section.

Subd. 6.

Other available funds.

The commissioner is authorized to distribute, in
accordance with subdivision 4, funds made available through:

(1) voluntary contributions by employers or other entities;

(2) allocations for the commissioner of human services to support medical education
and research; and

(3) other sources as identified and deemed appropriate by the legislature for
inclusion in the fund.

Subd. 7.

Transfers from the commissioner of human services.

Of the amount
transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
$21,714,000 shall be distributed as follows:

(1) $2,157,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;

(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
Medical Center for clinical medical education;

(3) $17,400,000 shall be distributed by the commissioner to the University of
Minnesota Board of Regents for purposes of medical education;

(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
dental innovation grants in accordance with subdivision 7a; and

(5) the remainder of the amount transferred according to section 256B.69,
subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
clinical medical education programs that meet the qualifications of subdivision 3 based on
the formula in subdivision 4, paragraph (a).

Subd. 7a.

Clinical medical education innovations grants.

(a) The commissioner
shall award grants to teaching institutions and clinical training sites for projects that
increase dental access for underserved populations and promote innovative clinical
training of dental professionals. In awarding the grants, the commissioner, in consultation
with the commissioner of human services, shall consider the following:

(1) potential to successfully increase access to an underserved population;

(2) the long-term viability of the project to improve access beyond the period
of initial funding;

(3) evidence of collaboration between the applicant and local communities;

(4) the efficiency in the use of the funding; and

(5) the priority level of the project in relation to state clinical education, access,
and workforce goals.

(b) The commissioner shall periodically evaluate the priorities in awarding the
innovations grants in order to ensure that the priorities meet the changing workforce
needs of the state.

Subd. 8.

Federal financial participation.

The commissioner of human services
shall seek to maximize federal financial participation in payments for medical education
and research costs.

The commissioner shall use physician clinic rates where possible to maximize
federal financial participation. Any additional funds that become available must be
distributed under subdivision 4, paragraph (a).

Subd. 9.

Review of eligible providers.

The commissioner and the Medical
Education and Research Costs Advisory Committee may review provider groups included
in the definition of a clinical medical education program to assure that the distribution of
the funds continue to be consistent with the purpose of this section. The results of any
such reviews must be reported to the Legislative Commission on Health Care Access.

Sec. 4.

[62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING
MEASURES.

Subdivision 1.

Data from providers.

(a) By July 1, 2012, the commissioner
shall review currently available quality measures and make recommendations for future
measurement aimed at improving assessment and care related to Alzheimer's disease and
other dementia diagnoses, including improved rates and results of cognitive screening,
rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment
plans.

(b) The commissioner may contract with a private entity to complete the
requirements in this subdivision. If the commissioner contracts with a private entity
already under contract through section 62U.02, then the commissioner may use a sole
source contract and is exempt from competitive procurement processes.

Subd. 2.

Learning collaborative.

By July 1, 2012, the commissioner shall
develop a health care home learning collaborative curriculum that includes screening and
education on best practices regarding identification and management of Alzheimer's and
other dementia patients under section 256B.0751, subdivision 5, for providers, clinics,
care coordinators, clinic administrators, patient partners and families, and community
resources including public health.

Subd. 3.

Comparison data.

The commissioner, with the commissioner of human
services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly
review existing and forthcoming literature in order to estimate differences in the outcomes
and costs of current practices for caring for those with Alzheimer's disease and other
dementias, compared to the outcomes and costs resulting from:

(1) earlier identification of Alzheimer's and other dementias;

(2) improved support of family caregivers; and

(3) improved collaboration between medical care management and community-based
supports.

Subd. 4.

Reporting.

By January 15, 2013, the commissioner must report to the
legislature on progress toward establishment and collection of quality measures required
under this section.

Sec. 5.

Minnesota Statutes 2010, section 103I.101, subdivision 6, is amended to read:


Subd. 6.

Fees for variances.

The commissioner shall charge a nonrefundable
application fee of $215 $235 to cover the administrative cost of processing a request for a
variance or modification of rules adopted by the commissioner under this chapter.

Sec. 6.

Minnesota Statutes 2010, section 103I.208, subdivision 1, is amended to read:


Subdivision 1.

Well notification fee.

The well notification fee to be paid by a
property owner is:

(1) for a new water supply well, $215 $235, which includes the state core function
fee;

(2) for a well sealing, $50 $65 for each well, which includes the state core function
fee, except that for monitoring wells constructed on a single property, having depths
within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of
$50 $65; and

(3) for construction of a dewatering well, $215 $235, which includes the state core
function fee, for each dewatering well except a dewatering project comprising five or
more dewatering wells shall be assessed a single fee of $1,075 $1,175 for the dewatering
wells recorded on the notification.

Sec. 7.

Minnesota Statutes 2010, section 103I.208, subdivision 2, is amended to read:


Subd. 2.

Permit fee.

The permit fee to be paid by a property owner is:

(1) for a water supply well that is not in use under a maintenance permit, $175
annually;

(2) for construction of a monitoring well, $215 $235, which includes the state
core function fee;

(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;

(4) for a monitoring well owned by a federal agency, state agency, or local unit of
government that is unsealed under a maintenance permit, $50 annually. "Local unit of
government" means a statutory or home rule charter city, town, county, or soil and water
conservation district, watershed district, an organization formed for the joint exercise of
powers under section 471.59, a board of health or community health board, or other
special purpose district or authority with local jurisdiction in water and related land
resources management;

(5) for monitoring wells used as a leak detection device at a single motor fuel retail
outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
chemical facility site, the construction permit fee is $215 $235, which includes the state
core function fee, per site regardless of the number of wells constructed on the site, and
the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site
regardless of the number of monitoring wells located on site;

(6) for a groundwater thermal exchange device, in addition to the notification fee for
water supply wells, $215 $235, which includes the state core function fee;

(7) for a vertical heat exchanger with less than ten tons of heating/cooling capacity,
$215 $235;

(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity,
$425 $475;

(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling
capacity, $650 $700;

(10) for a dewatering well that is unsealed under a maintenance permit, $175
annually for each dewatering well, except a dewatering project comprising more than five
dewatering wells shall be issued a single permit for $875 annually for dewatering wells
recorded on the permit; and

(11) for an elevator boring, $215 $235 for each boring.

Sec. 8.

Minnesota Statutes 2010, section 103I.235, subdivision 1, is amended to read:


Subdivision 1.

Disclosure of wells to buyer.

(a) Before signing an agreement to
sell or transfer real property, the seller must disclose in writing to the buyer information
about the status and location of all known wells on the property, by delivering to the buyer
either a statement by the seller that the seller does not know of any wells on the property,
or a disclosure statement indicating the legal description and county, and a map drawn
from available information showing the location of each well to the extent practicable.
In the disclosure statement, the seller must indicate, for each well, whether the well is in
use, not in use, or sealed.

(b) At the time of closing of the sale, the disclosure statement information, name and
mailing address of the buyer, and the quartile, section, township, and range in which each
well is located must be provided on a well disclosure certificate signed by the seller or a
person authorized to act on behalf of the seller.

(c) A well disclosure certificate need not be provided if the seller does not know
of any wells on the property and the deed or other instrument of conveyance contains
the statement: "The Seller certifies that the Seller does not know of any wells on the
described real property."

(d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
required by this subdivision shall be signed by the buyer or a person authorized to act on
behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
certificate is not required if the following statement appears on the deed followed by the
signature of the grantee or, if there is more than one grantee, the signature of at least one
of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
described real property." The statement and signature of the grantee may be on the front
or back of the deed or on an attached sheet and an acknowledgment of the statement by
the grantee is not required for the deed to be recordable.

(e) This subdivision does not apply to the sale, exchange, or transfer of real property:

(1) that consists solely of a sale or transfer of severed mineral interests; or

(2) that consists of an individual condominium unit as described in chapters 515
and 515B.

(f) For an area owned in common under chapter 515 or 515B the association or other
responsible person must report to the commissioner by July 1, 1992, the location and
status of all wells in the common area. The association or other responsible person must
notify the commissioner within 30 days of any change in the reported status of wells.

(g) If the seller fails to provide a required well disclosure certificate, the buyer, or
a person authorized to act on behalf of the buyer, may sign a well disclosure certificate
based on the information provided on the disclosure statement required by this section
or based on other available information.

(h) A county recorder or registrar of titles may not record a deed or other instrument
of conveyance dated after October 31, 1990, for which a certificate of value is required
under section 272.115, or any deed or other instrument of conveyance dated after October
31, 1990, from a governmental body exempt from the payment of state deed tax, unless
the deed or other instrument of conveyance contains the statement made in accordance
with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all
the information required by paragraph (b) or (d). The county recorder or registrar of titles
must not accept a certificate unless it contains all the required information. The county
recorder or registrar of titles shall note on each deed or other instrument of conveyance
accompanied by a well disclosure certificate that the well disclosure certificate was
received. The notation must include the statement "No wells on property" if the disclosure
certificate states there are no wells on the property. The well disclosure certificate shall not
be filed or recorded in the records maintained by the county recorder or registrar of titles.
After noting "No wells on property" on the deed or other instrument of conveyance, the
county recorder or registrar of titles shall destroy or return to the buyer the well disclosure
certificate. The county recorder or registrar of titles shall collect from the buyer or the
person seeking to record a deed or other instrument of conveyance, a fee of $45 $50
for receipt of a completed well disclosure certificate. By the tenth day of each month,
the county recorder or registrar of titles shall transmit the well disclosure certificates
to the commissioner of health. By the tenth day after the end of each calendar quarter,
the county recorder or registrar of titles shall transmit to the commissioner of health
$37.50 $42.50 of the fee for each well disclosure certificate received during the quarter.
The commissioner shall maintain the well disclosure certificate for at least six years. The
commissioner may store the certificate as an electronic image. A copy of that image
shall be as valid as the original.

(i) No new well disclosure certificate is required under this subdivision if the buyer
or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed
or other instrument of conveyance that the status and number of wells on the property
have not changed since the last previously filed well disclosure certificate. The following
statement, if followed by the signature of the person making the statement, is sufficient
to comply with the certification requirement of this paragraph: "I am familiar with the
property described in this instrument and I certify that the status and number of wells on
the described real property have not changed since the last previously filed well disclosure
certificate." The certification and signature may be on the front or back of the deed or on
an attached sheet and an acknowledgment of the statement is not required for the deed or
other instrument of conveyance to be recordable.

(j) The commissioner in consultation with county recorders shall prescribe the form
for a well disclosure certificate and provide well disclosure certificate forms to county
recorders and registrars of titles and other interested persons.

(k) Failure to comply with a requirement of this subdivision does not impair:

(1) the validity of a deed or other instrument of conveyance as between the parties
to the deed or instrument or as to any other person who otherwise would be bound by
the deed or instrument; or

(2) the record, as notice, of any deed or other instrument of conveyance accepted for
filing or recording contrary to the provisions of this subdivision.

Sec. 9.

Minnesota Statutes 2010, section 103I.525, subdivision 2, is amended to read:


Subd. 2.

Certification application fee.

(a) The application fee for certification
as a representative of a well contractor is $75. The commissioner may not act on an
application until the application fee is paid.

(b) The renewal fee for certification as a representative of a well contractor is $75.
The commissioner may not renew a certification until the renewal fee is paid.

Sec. 10.

Minnesota Statutes 2010, section 103I.531, subdivision 2, is amended to read:


Subd. 2.

Certification application fee.

(a) The application fee for certification as a
representative of a limited well/boring contractor is $75. The commissioner may not act
on an application until the application fee is paid.

(b) The renewal fee for certification as a representative of a limited well/boring
contractor is $75. The commissioner may not renew a certification until the renewal
fee is paid.

Sec. 11.

Minnesota Statutes 2010, section 103I.535, subdivision 2, is amended to read:


Subd. 2.

Certification application fee.

(a) The application fee for certification as a
representative of an elevator boring contractor is $75. The commissioner may not act on
an application until the application fee is paid.

(b) The renewal fee for certification as a representative of an elevator boring
contractor is $75. The commissioner may not renew a certification until the renewal
fee is paid.

Sec. 12.

Minnesota Statutes 2010, section 103I.541, subdivision 2c, is amended to read:


Subd. 2c.

Certification application fee.

(a) The application fee for certification as a
representative of a monitoring well contractor is $75. The commissioner may not act on
an application until the application fee is paid.

(b) The renewal fee for certification as a representative of a monitoring well
contractor is $75. The commissioner may not renew a certification until the renewal
fee is paid.

Sec. 13.

Minnesota Statutes 2010, section 144.1464, subdivision 1, is amended to read:


Subdivision 1.

Summer internships.

The commissioner of health, through a
contract with a nonprofit organization as required by subdivision 4, shall award grants,
within available appropriations,
to hospitals, clinics, nursing facilities, and home care
providers to establish a secondary and postsecondary summer health care intern program.
The purpose of the program is to expose interested secondary and postsecondary pupils to
various careers within the health care profession.

Sec. 14.

Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Dentist" means an individual who is licensed to practice dentistry.

(c) "Designated rural area" means:

(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin,
Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead,
Rochester, and St. Cloud; or

(2) a municipal corporation, as defined under section 471.634, that is physically
located, in whole or in part, in an area defined as a designated rural area under clause (1).

an area defined as a small rural area or isolated rural area according to the four category
classifications of the Rural Urban Commuting Area system developed for the United
States Health Resources and Services Administration.

(d) "Emergency circumstances" means those conditions that make it impossible for
the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

(e) "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.

(g) "Nurse" means an individual who has completed training and received all
licensing or certification necessary to perform duties as a licensed practical nurse or
registered nurse.

(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
study designed to prepare registered nurses for advanced practice as nurse-midwives.

(i) "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.

(j) "Pharmacist" means an individual with a valid license issued under chapter 151.

(k) "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(l) "Physician assistant" means a person licensed under chapter 147A.

(m) "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

(n) "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

Sec. 15.

Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:


Subd. 2a.

Standards.

Notwithstanding the exemptions in subdivisions 8 and 9, the
commissioner shall accredit laboratories according to the most current environmental
laboratory accreditation standards under subdivision 1 and as accepted by the accreditation
bodies recognized by the National Environmental Laboratory Accreditation Program
(NELAP) of the NELAC Institute.

Sec. 16.

Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:


Subd. 7.

Initial accreditation and annual accreditation renewal.

(a) The
commissioner shall issue or renew accreditation after receipt of the completed application
and documentation required in this section, provided the laboratory maintains compliance
with the standards specified in subdivision 2a, notwithstanding any exemptions under
subdivisions 8 and 9
, and attests to the compliance on the application form.

(b) The commissioner shall prorate the fees in subdivision 3 for laboratories
applying for accreditation after December 31. The fees are prorated on a quarterly basis
beginning with the quarter in which the commissioner receives the completed application
from the laboratory.

(c) Applications for renewal of accreditation must be received by November 1 and
no earlier than October 1 of each year. The commissioner shall send annual renewal
notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
not exempt laboratories from meeting the annual November 1 renewal date.

(d) The commissioner shall issue all accreditations for the calendar year for which
the application is made, and the accreditation shall expire on December 31 of that year.

(e) The accreditation of any laboratory that fails to submit a renewal application
and fees to the commissioner expires automatically on December 31 without notice or
further proceeding. Any person who operates a laboratory as accredited after expiration of
accreditation or without having submitted an application and paid the fees is in violation
of the provisions of this section and is subject to enforcement action under sections
144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired
accreditation may reapply under subdivision 6.

Sec. 17.

Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
to read:


Subd. 8.

Exemption from national standards for quality control and personnel
requirements.

Effective January 1, 2012, a laboratory that analyzes samples for
compliance with a permit issued under section 115.03, subdivision 5, may request
exemption from the personnel requirements and specific quality control provisions for
microbiology and chemistry stated in the national standards as incorporated by reference
in subdivision 2a. The commissioner shall grant the exemption if the laboratory:

(1) complies with the methodology and quality control requirements, where
available, in the most recent, approved edition of the Standard Methods for the
Examination of Water and Wastewater as published by the Water Environment Federation;
and

(2) supplies the name of the person meeting the requirements in section 115.73, or
the personnel requirements in the national standard pursuant to subdivision 2a.

A laboratory applying for this exemption shall not apply for simultaneous
accreditation under the national standard.

Sec. 18.

Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
to read:


Subd. 9.

Exemption from national standards for proficiency testing frequency.

(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under
the exemption in subdivision 8 must obtain an acceptable proficiency test result for each
of the laboratory's accredited or requested fields of testing. The laboratory must analyze
proficiency samples selected from one of two annual proficiency testing studies scheduled
by the commissioner.

(b) If a laboratory fails to successfully complete the first scheduled proficiency
study, the laboratory shall:

(1) obtain and analyze a supplemental test sample within 15 days of receiving the
test report for the initial failed attempt; and

(2) participate in the second annual study as scheduled by the commissioner.

(c) If a laboratory does not submit results or fails two consecutive proficiency
samples, the commissioner will revoke the laboratory's accreditation for the affected
fields of testing.

(d) The commissioner may require a laboratory to analyze additional proficiency
testing samples beyond what is required in this subdivision if information available to
the commissioner indicates that the laboratory's analysis for the field of testing does not
meet the requirements for accreditation.

(e) The commissioner may collect from laboratories accredited under the exemption
in subdivision 8 any additional costs required to administer this subdivision and
subdivision 8.

Sec. 19.

Minnesota Statutes 2010, section 144A.102, is amended to read:


144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS;
PENALTIES.

(a) By January 2000, the commissioner of health shall work with providers to
examine state and federal rules and regulations governing the provision of care in licensed
nursing facilities and apply for federal waivers and identify necessary changes in state
law to:

(1) allow the use of civil money penalties imposed upon nursing facilities to abate
any deficiencies identified in a nursing facility's plan of correction; and

(2) stop the accrual of any fine imposed by the Health Department when a follow-up
inspection survey is not conducted by the department within the regulatory deadline.

(b) By January 2012, the commissioner of health shall work with providers and
the ombudsman for long-term care to examine state and federal rules and regulations
governing the provision of care in licensed nursing facilities and apply for federal waivers
and identify necessary changes in state law to:

(1) eliminate the requirement for written plans of correction from nursing homes for
federal deficiencies issued at a scope and severity that is not widespread, harmful, or in
immediate jeopardy; and

(2) issue the federal survey form electronically to nursing homes.

The commissioner shall issue a report to the legislative chairs of the committees
with jurisdiction over health and human services by January 31, 2012, on the status of
implementation of this paragraph.

Sec. 20.

Minnesota Statutes 2010, section 144A.61, is amended by adding a
subdivision to read:


Subd. 9.

Electronic transmission.

The commissioner of health must accept
electronic transmission of applications and supporting documentation for interstate
endorsement for the nursing assistant registry.

Sec. 21.

Minnesota Statutes 2010, section 144E.123, is amended to read:


144E.123 PREHOSPITAL CARE DATA.

Subdivision 1.

Collection and maintenance.

A licensee shall collect and provide
prehospital care data to the board in a manner prescribed by the board. At a minimum,
the data must include items identified by the board that are part of the National Uniform
Emergency Medical Services Data Set. A licensee shall maintain prehospital care data
for every response.

Subd. 2.

Copy to receiving hospital.

If a patient is transported to a hospital, a copy
of the ambulance report delineating prehospital medical care given shall be provided
to the receiving hospital.

Subd. 3.

Review.

Prehospital care data may be reviewed by the board or its
designees. The data shall be classified as private data on individuals under chapter 13, the
Minnesota Government Data Practices Act.

Subd. 4.

Penalty.

Failure to report all information required by the board under this
section shall constitute grounds for license revocation.

Subd. 5.

Working group.

By October 1, 2011, the board must convene a working
group composed of six members, three of which must be appointed by the board and three
of which must be appointed by the Minnesota Ambulance Association, to redesign the
board's policies related to collection of data from licenses. The issues to be considered
include, but are not limited to, the following: user-friendly reporting requirements; data
sets; improved accuracy of reported information; appropriate use of information gathered
through the reporting system; and methods for minimizing the financial impact of data
reporting on licenses, particularly for rural volunteer services. The working group must
report its findings and recommendations to the board no later than July 1, 2012.

Sec. 22.

Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:


Subd. 3.

Requirements for programs; process.

(a) Community health boards
and tribal governments that receive funding under this section must submit a plan to
the commissioner describing a multidisciplinary approach to targeted home visiting for
families. The plan must be submitted on forms provided by the commissioner. At a
minimum, the plan must include the following:

(1) a description of outreach strategies to families prenatally or at birth;

(2) provisions for the seamless delivery of health, safety, and early learning services;

(3) methods to promote continuity of services when families move within the state;

(4) a description of the community demographics;

(5) a plan for meeting outcome measures; and

(6) a proposed work plan that includes:

(i) coordination to ensure nonduplication of services for children and families;

(ii) a description of the strategies to ensure that children and families at greatest risk
receive appropriate services; and

(iii) collaboration with multidisciplinary partners including public health,
ECFE, Head Start, community health workers, social workers, community home
visiting programs, school districts, and other relevant partners. Letters of intent from
multidisciplinary partners must be submitted with the plan.

(b) Each program that receives funds must accomplish the following program
requirements:

(1) use a community-based strategy to provide preventive and early intervention
home visiting services;

(2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
home visit must occur prenatally or as soon after birth as possible and must include a
public health nursing assessment by a public health nurse;

(3) offer, at a minimum, information on infant care, child growth and development,
positive parenting, preventing diseases, preventing exposure to environmental hazards,
and support services available in the community;

(4) provide information on and referrals to health care services, if needed, including
information on and assistance in applying for health care coverage for which the child or
family may be eligible; and provide information on preventive services, developmental
assessments, and the availability of public assistance programs as appropriate;

(5) provide youth development programs when appropriate;

(6) recruit home visitors who will represent, to the extent possible, the races,
cultures, and languages spoken by families that may be served;

(7) train and supervise home visitors in accordance with the requirements established
under subdivision 4;

(8) maximize resources and minimize duplication by coordinating or contracting
with local social and human services organizations, education organizations, and other
appropriate governmental entities and community-based organizations and agencies;

(9) utilize appropriate racial and ethnic approaches to providing home visiting
services; and

(10) connect eligible families, as needed, to additional resources available in the
community, including, but not limited to, early care and education programs, health or
mental health services, family literacy programs, employment agencies, social services,
and child care resources and referral agencies.

(c) When available, programs that receive funds under this section must offer or
provide the family with a referral to center-based or group meetings that meet at least
once per month for those families identified with additional needs. The meetings must
focus on further enhancing the information, activities, and skill-building addressed during
home visitation; offering opportunities for parents to meet with and support each other;
and offering infants and toddlers a safe, nurturing, and stimulating environment for
socialization and supervised play with qualified teachers.

(d) Funds available under this section shall not be used for medical services. The
commissioner shall establish an administrative cost limit for recipients of funds. The
outcome measures established under subdivision 6 must be specified to recipients of
funds at the time the funds are distributed.

(e) Data collected on individuals served by the home visiting programs must remain
confidential and must not be disclosed by providers of home visiting services without a
specific informed written consent that identifies disclosures to be made. Upon request,
agencies providing home visiting services must provide recipients with information on
disclosures, including the names of entities and individuals receiving the information and
the general purpose of the disclosure. Prospective and current recipients of home visiting
services must be told and informed in writing that written consent for disclosure of data is
not required for access to home visiting services.

(f) Upon initial contact with a family, programs that receive funding under this
section must receive permission from the family to share with other family service
providers information about services the family is receiving and unmet needs of the family
in order to select a lead agency for the family and coordinate available resources. For
purposes of this paragraph, the term "family service providers" includes local public
health, social services, school districts, Head Start programs, health care providers, and
other public agencies.

Sec. 23.

Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision
to read:


Subd. 7a.

Limited food establishment.

"Limited food establishment" means a food
and beverage service establishment that primarily provides beverages that consist of
combining dry mixes and water or ice for immediate service to the consumer. Limited
food establishments must use equipment and utensils that are nontoxic, durable, and retain
their characteristic qualities under normal use conditions and may request a variance for
plumbing requirements from the commissioner.

EFFECTIVE DATE.

This section is effective the day following final enactment
and applies to applications for licensure submitted on or after that date.

Sec. 24.

Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision
to read:


Subd. 5.

Variance requests.

(a) A person may request a variance from all parts of
Minnesota Rules, chapter 4626, except as provided in paragraph (b) or Minnesota Rules,
chapter 4626. At the time of application for plan review, the person, operator, or submitter
must be notified of the right to request variances.

(b) No variance may be requested or approved for the following parts of Minnesota
Rules, chapter 4626:

(1) Minnesota Rules, part 4626.0020, subpart 35;

(2) Minnesota Rules, parts 4626.0040 to 4626.0060;

(3) Minnesota Rules, parts 4626.0065 to 4626.0100;

(4) Minnesota Rules, parts 4626.0105 to 4626.0120;

(5) Minnesota Rules, part 4626.1565;

(6) Minnesota Rules, parts 4626.1590 and 4626.1595; and

(7) Minnesota Rules, parts 4626.1600 to 4626.1675.

Sec. 25.

Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:


Subdivision 1.

Tax and use tax on cigarettes.

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

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

(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal year years 2007 and
each year thereafter
through fiscal year 2011 and $3,937,000 each year thereafter must be
credited to the medical education and research costs account hereby created in the special
revenue fund and is annually appropriated to the commissioner of health for distribution
under section 62J.692, subdivision 4; and

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

Sec. 26. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
RESPONSIBILITIES.

(a) The commissioner of health, in consultation with the commissioner of human
services, shall evaluate and recommend options for reorganizing health and human
services regulatory responsibilities in both agencies to provide better efficiency and
operational cost savings while maintaining the protection of the health, safety, and welfare
of the public. Regulatory responsibilities that are to be evaluated are those found in
Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B,
149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50,
144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.

(b) The evaluation and recommendations shall be submitted in a report to the
legislative committees with jurisdiction over health and human services no later than
February 15, 2012, and shall include, at a minimum, the following:

(1) whether the regulatory responsibilities of each agency should be combined into
a separate agency;

(2) whether the regulatory responsibilities of each agency should be merged into
an existing agency;

(3) what cost savings would result by merging the activities regardless of where
they are located;

(4) what additional costs would result if the activities were merged;

(5) whether there are additional regulatory responsibilities in both agencies that
should be considered in any reorganization; and

(6) for each option recommended, projected cost and a timetable and identification
of the necessary steps and requirements for a successful transition period.

Sec. 27. MINNESOTA TASK FORCE ON PREMATURITY.

Subdivision 1.

Establishment.

The Minnesota Task Force on Prematurity is
established to evaluate and make recommendations on methods for reducing prematurity
and improving premature infant health care in the state.

Subd. 2.

Membership; meetings; staff.

(a) The task force shall be composed of at
least the following members, who serve at the pleasure of their appointing authority:

(1) 15 representatives of the Minnesota Prematurity Coalition including, but not
limited to, health care providers who treat pregnant women or neonates, organizations
focused on preterm births, early childhood education and development professionals, and
families affected by prematurity;

(2) one representative appointed by the commissioner of human services;

(3) two representatives appointed by the commissioner of health;

(4) one representative appointed by the commissioner of education;

(5) two members of the house of representatives, one appointed by the speaker of
the house and one appointed by the minority leader; and

(6) two members of the senate, appointed according to the rules of the senate.

(b) Members of the task force serve without compensation or payment of expenses.

(c) The commissioner of health must convene the first meeting of the Minnesota
Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
least quarterly. Staffing and technical assistance shall be provided by the Minnesota
Perinatal Coalition.

Subd. 3.

Duties.

The task force must report the current state of prematurity in
Minnesota and develop recommendations on strategies for reducing prematurity and
improving premature infant health care in the state by considering the following:

(1) standards of care for premature infants born less than 37 weeks gestational age,
including recommendations to improve hospital discharge and follow-up care procedures;

(2) coordination of information among appropriate professional and advocacy
organizations on measures to improve health care for infants born prematurely;

(3) identification and centralization of available resources to improve access and
awareness for caregivers of premature infants;

(4) development and dissemination of evidence-based practices through networking
and educational opportunities;

(5) a review of relevant evidence-based research regarding the causes and effects of
premature births in Minnesota;

(6) a review of relevant evidence-based research regarding premature infant health
care, including methods for improving quality of and access to care for premature infants;

(7) a review of the potential improvements in health status related to the use of
health care homes to provide and coordinate pregnancy-related services; and

(8) identification of gaps in public reporting measures and possible effects of these
measures on prematurity rates.

Subd. 4.

Report; expiration.

(a) By November 30, 2011, the task force must submit
a report on the current state of prematurity in Minnesota to the chairs of the legislative
policy committees on health and human services.

(b) By January 15, 2013, the task force must report its final recommendations,
including any draft legislation necessary for implementation, to the chairs of the legislative
policy committees on health and human services.

(c) This task force expires on January 31, 2013, or upon submission of the final
report required in paragraph (b), whichever is earlier.

Sec. 28. NURSING HOME REGULATORY EFFICIENCY.

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

Sec. 29. REPEALER.

(a) Minnesota Statutes 2010, sections 62J.321, subdivision 5a; 62J.381; 62J.41,
subdivisions 1 and 2; and 144.1499,
are repealed.

(b) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,
14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5;
4651.0120; 4651.0130; 4651.0140; and 4651.0150,
are repealed.

Sec. 30. EFFECTIVE DATE.

This article is effective the day following final enactment.

ARTICLE 3

MISCELLANEOUS

Section 1.

Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to
read:


Subd. 4.

Special family day care homes.

Nonresidential child care programs
serving 14 or fewer children that are conducted at a location other than the license holder's
own residence shall be licensed under this section and the rules governing family day
care or group family day care if:

(a) the license holder is the primary provider of care and the nonresidential child
care program is conducted in a dwelling that is located on a residential lot;

(b) the license holder is an employer who may or may not be the primary provider
of care, and the purpose for the child care program is to provide child care services to
children of the license holder's employees;

(c) the license holder is a church or religious organization;

(d) the license holder is a community collaborative child care provider. For
purposes of this subdivision, a community collaborative child care provider is a provider
participating in a cooperative agreement with a community action agency as defined in
section 256E.31; or

(e) the license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this paragraph to exceed the licensed capacity of 14 children by no more than five
children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:

(1) the program does not exceed a capacity of 14 children more than a cumulative
total of four hours per day;

(2) the program meets a one to seven staff-to-child ratio during the variance period;

(3) all employees receive at least an extra four hours of training per year than
required in the rules governing family child care each year;

(4) the facility has square footage required per child under Minnesota Rules, part
9502.0425;

(5) the program is in compliance with local zoning regulations;

(6) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age,
but no more than five children 2-1/2 years of age or less, the applicable fire code is
educational occupancy, as provided in Group E Occupancy under the Minnesota State
Fire Code 2003, Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the
applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire
Code 2003, Section 202; and

(7) any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the license.; or

(f) the license holder is the primary provider of care and has located the licensed
child care program in a commercial space, if the license holder meets the following
requirements:

(1) the program is in compliance with local zoning regulations;

(2) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age,
but no more than five children 2-1/2 years of age or less, the applicable fire code is
educational occupancy, as provided in Group E Occupancy under the Minnesota State
Fire Code 2003, Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the
applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire
Code 2003, Section 202;

(3) any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and

(4) the license holder prominently displays the license issued by the commissioner
which contains the statement "This special family child care provider is not licensed as a
child care center."

Sec. 2.

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


Subd. 7.

Children's therapeutic services and supports providers.

The
commissioner shall conduct background studies according to this chapter when initiated
by a children's therapeutic services and supports provider under section 256B.0943.

Sec. 3.

Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
to read:


Subd. 8.

Children's therapeutic services and supports providers.

The
commissioner shall recover the cost of background studies required under section
245C.03, subdivision 7, for the purposes of children's therapeutic services and supports
under section 256B.0943, through a fee of no more than $20 per study charged to
the license holder. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 4.

Minnesota Statutes 2010, section 256B.0943, is amended by adding a
subdivision to read:


Subd. 5a.

Background studies.

The requirements for background studies under
this section may be met by a children's therapeutic services and supports services agency
through the commissioner's NETStudy system as provided under sections 245C.03,
subdivision 7, and 245C.10, subdivision 8.

Sec. 5.

Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision
to read:


Subd. 3a.

Spousal contribution.

(a) For purposes of this subdivision, the following
terms have the meanings given:

(1) "commissioner" means the commissioner of human services;

(2) "community spouse" means the spouse, who lives in the community, of an
individual receiving long-term care services in a long-term care facility or home care
services pursuant to the Medicaid waiver for elderly services under section 256B.0915
or the alternative care program under section 256B.0913. A community spouse does not
include a spouse living in the community who receives a monthly income allowance under
section 256B.058, subdivision 2, or who receives home and community-based services
under section 256B.0915, 256B.092, or 256B.49, or the alternative care program under
section 256B.0913;

(3) "cost of care" means the actual fee-for-service costs or capitated payments for
the long-term care spouse;

(4) "department" means the Department of Human Services;

(5) "disabled child" means a blind or permanently and totally disabled son or
daughter of any age based on the Social Security Administration disability standards;

(6) "income" means earned and unearned income, attributable to the community
spouse, used to calculate the adjusted gross income on the prior year's income tax return.
Evidence of income includes, but is not limited to, W-2 and 1099 forms; and

(7) "long-term care spouse" means the spouse who is receiving long-term care
services in a long-term care facility or home and community based services pursuant
to the Medicaid waiver for elderly services under section 256B.0915 or the alternative
care program under section 256B.0913.

(b) The community spouse of a long-term care spouse who receives medical
assistance or alternative care services has an obligation to contribute to the cost of care.
The community spouse must pay a monthly fee on a sliding fee scale based on the
community spouse's income. If a minor or disabled child resides with and receives care
from the community spouse, then no fee shall be assessed.

(c) For a community spouse with an income equal to or greater than 250 percent of
the federal poverty guidelines for a family of two and less than 545 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 7.5 percent of the
community spouse's income and increases to 15 percent for those with an income of up to
545 percent of the federal poverty guidelines for a family of two.

(d) For a community spouse with an income equal to or greater than 545 percent of
the federal poverty guidelines for a family of two and less than 750 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 15 percent of the
community spouse's income and increases to 25 percent for those with an income of up to
750 percent of the federal poverty guidelines for a family of two.

(e) For a community spouse with an income equal to or greater than 750 percent of
the federal poverty guidelines for a family of two and less than 975 percent of the federal
poverty guidelines for a family of two, the spousal contribution shall be determined using
a sliding fee scale established by the commissioner that begins at 25 percent of the
community spouse's income and increases to 33 percent for those with an income of up to
975 percent of the federal poverty guidelines for a family of two.

(f) For a community spouse with an income equal to or greater than 975 percent of
the federal poverty guidelines for a family of two, the spousal contribution shall be 33
percent of the community spouse's income.

(g) The spousal contribution shall be explained in writing at the time eligibility
for medical assistance or alternative care is being determined. In addition to explaining
the formula used to determine the fee, the county or tribal agency shall provide written
information describing how to request a variance for undue hardship, how a contribution
may be reviewed or redetermined, the right to appeal a contribution determination, and
that the consequences for not complying with a request to provide information shall be
an assessment against the community spouse for the full cost of care for the long-term
care spouse.

(h) The contribution shall be assessed for each month the long-term care spouse
has a community spouse and is eligible for medical assistance payment of long-term
care services or alternative care.

(i) The spousal contribution shall be reviewed at least once every 12 months and
when there is a loss or gain in income in excess of ten percent. Thirty days prior to a
review or redetermination, written notice must be provided to the community spouse
and must contain the amount the spouse is required to contribute, notice of the right to
redetermination and appeal, and the telephone number of the division at the agency that is
responsible for redetermination and review. If, after review, the contribution amount is to
be adjusted, the county or tribal agency shall mail a written notice to the community spouse
30 days in advance of the effective date of the change in the amount of the contribution.

(1) The spouse shall notify the county or tribal agency within 30 days of a gain or
loss in income in excess of ten percent and provide the agency supporting documentation
to verify the need for redetermination of the fee.

(2) When a spouse requests a review or redetermination of the contribution amount,
a request for information shall be sent to the spouse within ten calendar days after the
county or tribal agency receives the request for review.

(3) No action shall be taken on a review or redetermination until the required
information is received by the county or tribal agency.

(4) The review of the spousal contribution shall be completed within ten days after
the county or tribal agency receives completed information that verifies a loss or gain in
income in excess of ten percent.

(5) An increase in the contribution amount is effective in the month in which the
increase in income occurs.

(6) A decrease in the contribution amount is effective in the month the spouse
verifies the reduction in income, retroactive to no longer than six months.

(j) In no case shall the spousal contribution exceed the amount of medical assistance
expended or the cost of alternative care services for the care of the long-term care spouse.
Annually, upon redetermination, or at termination of eligibility, the total amount of
medical assistance paid or costs of alternative care for the care of the long-term care spouse
and the total amount of the spousal contribution shall be compared. If the total amount
of the spousal contribution exceeds the total amount of medical assistance expended or
cost of alternative care, then the agency shall reimburse the community spouse the excess
amount if the long-term care spouse is no longer receiving services, or apply the excess
amount to the spousal contribution due until the excess amount is exhausted.

(k) A community spouse may request a variance by submitting a written request
and supporting documentation that payment of the calculated contribution would cause
an undue hardship. An undue hardship is defined as the inability to pay the calculated
contribution due to medical expenses incurred by the community spouse. Documentation
must include proof of medical expenses incurred by the community spouse since the last
annual redetermination of the contribution amount that are not reimbursable by any public
or private source, and are a type, regardless of amount, that would be allowable as a
federal tax deduction under the Internal Revenue Code.

(1) A spouse who requests a variance from a notice of an increase in the amount
of spousal contribution shall continue to make monthly payments at the lower amount
pending determination of the variance request. A spouse who requests a variance from
the initial determination shall not be required to make a payment pending determination
of the variance request. Payments made pending outcome of the variance request that
result in overpayment must be returned to the spouse, if the long-term care spouse is no
longer receiving services, or applied to the spousal contribution in the current year. If the
variance is denied, the spouse shall pay the additional amount due from the effective date
of the increase or the total amount due from the effective date of the original notice of
determination of the spousal contribution.

(2) A spouse who is granted a variance shall sign a written agreement in which the
spouse agrees to report to the county or tribal agency any changes in circumstances that
gave rise to the undue hardship variance.

(3) When the county or tribal agency receives a request for a variance, written notice
of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days
after the county or tribal agency receives the financial information required in this clause.
The granting of a variance will necessitate a written agreement between the spouse and the
county or tribal agency with regard to the specific terms of the variance. The variance
will not become effective until the written agreement is signed by the spouse. If the
county or tribal agency denies in whole or in part the request for a variance, the denial
notice shall set forth in writing the reasons for the denial that address the specific hardship
and right to appeal.

(4) If a variance is granted, the term of the variance shall not exceed 12 months
unless otherwise determined by the county or tribal agency.

(5) Undue hardship does not include action taken by a spouse which divested or
diverted income in order to avoid being assessed a spousal contribution.

(l) A spouse aggrieved by an action under this subdivision has the right to appeal
under subdivision 4. If the spouse appeals on or before the effective date of an increase
in the spousal fee, the spouse shall continue to make payments to the county or tribal
agency in the lower amount while the appeal is pending. A spouse appealing an initial
determination of a spousal contribution shall not be required to make monthly payments
pending an appeal decision. Payments made that result in an overpayment shall be
reimbursed to the spouse if the long-term care spouse is no longer receiving services, or
applied to the spousal contribution remaining in the current year. If the county or tribal
agency's determination is affirmed, the community spouse shall pay within 90 calendar
days of the order the total amount due from the effective date of the original notice of
determination of the spousal contribution. The commissioner's order is binding on the
spouse and the agency and shall be implemented subject to section 256.045, subdivision 7.
No additional notice is required to enforce the commissioner's order.

(m) If the county or tribal agency finds that notice of the payment obligation was
given to the community spouse and the spouse was determined to be able to pay, but that
the spouse failed or refused to pay, a cause of action exists against the community spouse
for that portion of medical assistance payment of long-term care services or alternative
care services granted after notice was given to the community spouse. The action may be
brought by the county or tribal agency in the county where assistance was granted for the
assistance together with the costs of disbursements incurred due to the action. In addition
to granting the county or tribal agency a money judgment, the court may, upon a motion or
order to show cause, order continuing contributions by a community spouse found able to
repay the county or tribal agency. The order shall be effective only for the period of time
during which a contribution shall be assessed.

(n) Counties and tribes are entitled to one-half of the nonfederal share of
contributions made under this section for long-term care spouses on medical assistance
that are directly attributed to county or tribal efforts. Counties and tribes are entitled to
25 percent of the contributions made under this section for long-term care spouses on
alternative care directly attributed to county or tribal efforts.

EFFECTIVE DATE.

This section is effective July 1, 2012.

Sec. 6. NONEMERGENCY MEDICAL TRANSPORTATION SINGLE
ADMINISTRATIVE STRUCTURE PROPOSAL.

(a) The commissioner of human services shall develop a proposal to create a single
administrative structure for providing nonemergency medical transportation services to
fee-for-service medical assistance recipients. This proposal must consolidate access and
special transportation into one administrative structure with the goal of standardizing
eligibility determination processes, scheduling arrangements, billing procedures, data
collection, and oversight mechanisms in order to enhance coordination, improve
accountability, and lessen confusion.

(b) In developing the proposal, the commissioner shall:

(1) examine the current responsibilities performed by the counties and the
Department of Human Services and consider the shift in costs if these responsibilities are
changed;

(2) identify key performance measures to assess the cost effectiveness of
nonemergency medical transportation statewide, including a process to collect, audit,
and report data;

(3) develop a statewide complaint system for medical assistance recipients using
special transportation;

(4) establish a standardized billing process;

(5) establish a process that provides public input from interested parties before
special transportation eligibility policies are implemented or significantly changed;

(6) establish specific eligibility criteria that include the frequency of eligibility
assessments and the length of time a recipient remains eligible for special transportation;

(7) develop a reimbursement method to compensate volunteers for no-load miles
when transporting recipients to or from health-related appointments; and

(8) establish specific eligibility criteria to maximize the use of public transportation
by recipients who are without a physical, mental, or other impairment that would prohibit
safely accessing and using public transportation.

(c) In developing the proposal, the commissioner shall consult with the
nonemergency medical transportation advisory council established under paragraph (d).

(d) The commissioner shall establish the nonemergency medical transportation
advisory council to assist the commissioner in developing a single administrative structure
for providing nonemergency medical transportation services. The council shall include,
but not be limited to:

(1) one representative each from the Departments of Human Services and
Transportation;

(2) one representative each from the following organizations: the Minnesota State
Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC
of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County
Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit
Association, legal aid, the Minnesota Ambulance Association, the National Alliance on
Mental Illness, Medical Transportation Management, and other transportation providers;
and

(3) four members from the house of representatives, two from the majority party
and two from the minority party, appointed by the speaker, and four members from the
senate, two from the majority party and two from the minority party, appointed by the
Subcommittee on Committees of the Committee on Rules and Administration.

The council is governed by Minnesota Statutes, section 15.509, except that members
shall not receive per diems. The commissioner of human services shall fund all costs
related to the council from existing resources.

(e) The commissioner shall submit the proposal and draft legislation necessary for
implementation to the chairs and ranking minority members of the senate and house of
representatives committees or divisions with jurisdiction over health care policy and
finance by January 15, 2012.

ARTICLE 4

DEPARTMENT OF HUMAN SERVICES LICENSING

Section 1.

Minnesota Statutes 2010, section 245A.10, subdivision 1, is amended to
read:


Subdivision 1.

Application or license fee required, programs exempt from fee.

(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
of applications and inspection of programs which are licensed under this chapter.

(b) Except as provided under subdivision 2, no application or license fee shall be
charged for child foster care, adult foster care, or family and group family child care or
state-operated programs, unless the state-operated program is an intermediate care facility
for persons with developmental disabilities (ICF/MR)
.

Sec. 2.

Minnesota Statutes 2010, section 245A.10, subdivision 3, is amended to read:


Subd. 3.

Application fee for initial license or certification.

(a) For fees required
under subdivision 1, an applicant for an initial license or certification issued by the
commissioner shall submit a $500 application fee with each new application required
under this subdivision. The application fee shall not be prorated, is nonrefundable, and
is in lieu of the annual license or certification fee that expires on December 31. The
commissioner shall not process an application until the application fee is paid.

(b) Except as provided in clauses (1) to (3) (4), an applicant shall apply for a license
to provide services at a specific location.

(1) For a license to provide residential-based habilitation services to persons with
developmental disabilities under chapter 245B, an applicant shall submit an application
for each county in which the services will be provided. Upon licensure, the license
holder may provide services to persons in that county plus no more than three persons
at any one time in each of up to ten additional counties. A license holder in one county
may not provide services under the home and community-based waiver for persons with
developmental disabilities to more than three people in a second county without holding
a separate license for that second county. Applicants or licensees providing services
under this clause to not more than three persons remain subject to the inspection fees
established in section 245A.10, subdivision 2, for each location. The license issued by
the commissioner must state the name of each additional county where services are being
provided to persons with developmental disabilities. A license holder must notify the
commissioner before making any changes that would alter the license information listed
under section 245A.04, subdivision 7, paragraph (a), including any additional counties
where persons with developmental disabilities are being served.

(2) For a license to provide supported employment, crisis respite, or
semi-independent living services to persons with developmental disabilities under chapter
245B, an applicant shall submit a single application to provide services statewide.

(3) For a license to provide independent living assistance for youth under section
245A.22, an applicant shall submit a single application to provide services statewide.

(4) For a license for a private agency to provide foster care or adoption services
under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
application to provide services statewide.

Sec. 3.

Minnesota Statutes 2010, section 245A.10, subdivision 4, is amended to read:


Subd. 4.

License or certification fee for certain programs.

(a) Child care centers
and programs with a licensed capacity shall pay an annual nonrefundable license or
certification
fee based on the following schedule:

Licensed Capacity
Child Care Center
License Fee
Other Program
License Fee
1 to 24 persons
$225 $200
$400
25 to 49 persons
$340 $300
$600
50 to 74 persons
$450 $400
$800
75 to 99 persons
$565 $500
$1,000
100 to 124 persons
$675 $600
$1,200
125 to 149 persons
$900 $700
$1,400
150 to 174 persons
$1,050 $800
$1,600
175 to 199 persons
$1,200 $900
$1,800
200 to 224 persons
$1,350
$1,000
$2,000
225 or more persons
$1,500
$1,100
$2,500

(b) A day training and habilitation program serving persons with developmental
disabilities or related conditions shall be assessed a pay an annual nonrefundable license
fee based on the following schedule in paragraph (a) unless the license holder serves more
than 50 percent of the same persons at two or more locations in the community.
:

Licensed Capacity
License Fee
1 to 24 persons
$800
25 to 49 persons
$1,000
50 to 74 persons
$1,200
75 to 99 persons
$1,400
100 to 124 persons
$1,600
125 to 149 persons
$1,800
150 or more persons
$2,000

Except as provided in paragraph (c), when a day training and habilitation program
serves more than 50 percent of the same persons in two or more locations in a community,
the day training and habilitation program shall pay a license fee based on the licensed
capacity of the largest facility and the other facility or facilities shall be charged a license
fee based on a licensed capacity of a residential program serving one to 24 persons.

(c) When a day training and habilitation program serving persons with developmental
disabilities or related conditions seeks a single license allowed under section 245B.07,
subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
capacity for each location.

(d) A program licensed to provide supported employment services to persons
with developmental disabilities under chapter 245B shall pay an annual nonrefundable
license fee of $650.

(e) A program licensed to provide crisis respite services to persons with
developmental disabilities under chapter 245B shall pay an annual nonrefundable license
fee of $700.

(f) A program licensed to provide semi-independent living services to persons
with developmental disabilities under chapter 245B shall pay an annual nonrefundable
license fee of $700.

(g) A program licensed to provide residential-based habilitation services under the
home and community-based waiver for persons with developmental disabilities shall pay
an annual license fee that includes a base rate of $690 plus $60 times the number of clients
served on the first day of July of the current license year.

(h) A residential program certified by the Department of Health as an intermediate
care facility for persons with developmental disabilities (ICF/MR) and a noncertified
residential program licensed to provide health or rehabilitative services for persons
with developmental disabilities shall pay an annual nonrefundable license fee based on
the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$535
25 to 49 persons
$735
50 or more persons
$935

(i) A chemical dependency treatment program licensed under Minnesota Rules, parts
9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual
nonrefundable license fee based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$600
25 to 49 persons
$800
50 to 74 persons
$1,000
75 to 99 persons
$1,200
100 or more persons
$1,400

(j) A chemical dependency program licensed under Minnesota Rules, parts
9530.6510 to 9530.6590, to provide detoxification services shall pay an annual
nonrefundable license fee based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$760
25 to 49 persons
$960
50 or more persons
$1,160

(k) Except for child foster care, a residential facility licensed under Minnesota
Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$1,000
25 to 49 persons
$1,100
50 to 74 persons
$1,200
75 to 99 persons
$1,300
100 or more persons
$1,400

(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
fee based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$2,525
25 or more persons
$2,725

(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
license fee based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$450
25 to 49 persons
$650
50 to 74 persons
$850
75 to 99 persons
$1,050
100 or more persons
$1,250

(n) A program licensed to provide independent living assistance for youth under
section 245A.22 shall pay an annual nonrefundable license fee of $1,500.

(o) A private agency licensed to provide foster care and adoption services under
Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
license fee of $875.

(p) A program licensed as an adult day care center licensed under Minnesota Rules,
parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on
the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$500
25 to 49 persons
$700
50 to 74 persons
$900
75 to 99 persons
$1,100
100 or more persons
$1,300

(q) A program licensed to provide treatment services to persons with sexual
psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.

(r) A mental health center or mental health clinic requesting certification for
purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
mental health center or mental health clinic provides services at a primary location with
satellite facilities, the satellite facilities shall be certified with the primary location without
an additional charge.

Sec. 4.

Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision
to read:


Subd. 7.

Human services licensing fees to recover expenditures.

Notwithstanding
section 16A.1285, subdivision 2, related to activities for which the commissioner charges
a fee, the commissioner must plan to fully recover direct expenditures for licensing
activities under this chapter over a five-year period. The commissioner may have
anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
revenues accumulated in previous bienniums.

Sec. 5.

Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision
to read:


Subd. 8.

Deposit of license fees.

A human services licensing account is created in
the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
be deposited in the human services licensing account and are annually appropriated to the
commissioner for licensing activities authorized under this chapter.

Sec. 6.

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


Subd. 2b.

Adult foster care; family adult day services.

An adult foster care
license holder licensed under the conditions in subdivision 2a may also provide family
adult day care for adults age 55 age 18 or over if no persons in the adult foster or family
adult day services program have a serious and persistent mental illness or a developmental
disability
. Family adult day services provided in a licensed adult foster care setting must
be provided as specified under section 245A.143. Authorization to provide family adult
day services in the adult foster care setting shall be printed on the license certificate by
the commissioner. Adult foster care homes licensed under this section and family adult
day services licensed under section 245A.143 shall not be subject to licensure by the
commissioner of health under the provisions of chapter 144, 144A, 157, or any other
law requiring facility licensure by the commissioner of health. A separate license is not
required to provide family adult day services in a licensed adult foster care home.

Sec. 7.

Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read:


Subdivision 1.

Scope.

(a) The licensing standards in this section must be met to
obtain and maintain a license to provide family adult day services. For the purposes of this
section, family adult day services means a program operating fewer than 24 hours per day
that provides functionally impaired adults, none of which are under age 55, have serious
or persistent mental illness, or have developmental disabilities,
age 18 or older with an
individualized and coordinated set of services including health services, social services,
and nutritional services that are directed at maintaining or improving the participants'
capabilities for self-care.

(b) A family adult day services license shall only be issued when the services are
provided in the license holder's primary residence, and the license holder is the primary
provider of care. The license holder may not serve more than eight adults at one time,
including residents, if any, served under a license issued under Minnesota Rules, parts
9555.5105 to 9555.6265.

(c) An adult foster care license holder may provide family adult day services under
the license holder's adult foster care license
if the license holder meets the requirements
of this section.

(d) When an applicant or license holder submits an application for initial licensure
or relicensure for both adult foster care and family adult day services, the county agency
shall process the request as a single application and shall conduct concurrent routine
licensing inspections.

(e) Adult foster care license holders providing family adult day services under their
foster care license on March 30, 2004, shall be permitted to continue providing these
services with no additional requirements until their adult foster care license is due for
renewal. At the time of relicensure, an adult foster care license holder may continue to
provide family adult day services upon demonstration of compliance with this section.
Adult foster care license holders who provide only family adult day services on August 1,
2004, may apply for a license under this section instead of an adult foster care license.

Sec. 8.

Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
to read:


Subd. 9.

Human services licensed programs.

The commissioner shall recover
the cost of background studies required under section 245C.03, subdivision 1, for all
programs that are licensed by the commissioner, except child foster care and family child
care, through a fee of no more than $20 per study charged to the license holder. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.

Sec. 9.

Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read:


Subd. 16a.

Medical assistance reimbursement.

(a) The commissioner shall
seek federal approval for medical assistance reimbursement of independent living skills
services, foster care waiver service, supported employment, prevocational service, and
structured day service under the home and community-based waiver for persons with a
traumatic brain injury, the community alternatives for disabled individuals waivers, and
the community alternative care waivers.

(b) Medical reimbursement shall be made only when the provider demonstrates
evidence of its capacity to meet basic health, safety, and protection standards through
the following methods:

(1) for independent living skills services, supported employment, prevocational
service, and structured day service through one of the methods in paragraphs (c) and
(d); and

(2) for foster care waiver services through the method in paragraph (e).

(c) The provider is licensed to provide services under chapter 245B and agrees
to apply these standards to services funded through the traumatic brain injury,
community alternatives for disabled persons, or community alternative care home and
community-based waivers.

(d) The commissioner shall certify that the provider has policies and procedures
governing the following:

(1) protection of the consumer's rights and privacy;

(2) risk assessment and planning;

(3) record keeping and reporting of incidents and emergencies with documentation
of corrective action if needed;

(4) service outcomes, regular reviews of progress, and periodic reports;

(5) complaint and grievance procedures;

(6) service termination or suspension;

(7) necessary training and supervision of direct care staff that includes:

(i) documentation in personnel files of 20 hours of orientation training in providing
training related to service provision;

(ii) training in recognizing the symptoms and effects of certain disabilities, health
conditions, and positive behavioral supports and interventions;

(iii) a minimum of five hours of related training annually; and

(iv) when applicable:

(A) safe medication administration;

(B) proper handling of consumer funds; and

(C) compliance with prohibitions and standards developed by the commissioner to
satisfy federal requirements regarding the use of restraints and restrictive interventions.
The commissioner shall review at least biennially that each service provider's policies
and procedures governing basic health, safety, and protection of rights continue to meet
minimum standards.

(e) The commissioner shall seek federal approval for Medicaid reimbursement
of foster care services under the home and community-based waiver for persons with
a traumatic brain injury, the community alternatives for disabled individuals waiver,
and community alternative care waiver when the provider demonstrates evidence of
its capacity to meet basic health, safety, and protection standards. The commissioner
shall verify that the adult foster care provider is licensed under Minnesota Rules, parts
9555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster
care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and
certify that the provider has policies and procedures that govern:

(1) compliance with prohibitions and standards developed by the commissioner to
meet federal requirements regarding the use of restraints and restrictive interventions;

(2) documentation of service needs and outcomes, regular reviews of progress,
and periodic reports; and

(3) safe medication management and administration.

The commissioner shall review at least biennially that each service provider's policies and
procedures governing basic health, safety, and protection of rights standards continue to
meet minimum standards.

(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement
of family adult day services under all disability waivers. After the waiver is granted, the
commissioner shall include family adult day services in the common services menu that
is currently under development.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 10. REPEALER.

Minnesota Statutes 2010, section 245A.10, subdivision 5, is repealed.

ARTICLE 5

HEALTH-RELATED LICENSING

Section 1.

Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:


Subdivision 1.

Renewal fees.

All persons practicing chiropractic within this state,
or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the
Board of Chiropractic Examiners a renewal fee set by the board in accordance with section
16A.1283
, with a penalty set by the board for each month or portion thereof for which a
license fee is in arrears and upon payment of the renewal and upon compliance with all the
rules of the board, shall be entitled to renewal of their license.

Sec. 2.

Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision
to read:


Subd. 4.

Animal chiropractic.

(a) Animal chiropractic registration fee is $125.

(b) Animal chiropractic registration renewal fee is $75.

(c) Animal chiropractic inactive renewal fee is $25.

Sec. 3.

Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:


Subd. 2.

Powers.

(a) The board is authorized to adopt and, from time to time, revise
rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula
and standards for schools and courses preparing persons for licensure under sections
148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses
at such times as it may deem necessary. It shall approve such schools and courses as
meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine,
license, and renew the license of duly qualified applicants. It shall hold examinations
at least once in each year at such time and place as it may determine. It shall by rule
adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for
registration and renewal of registration as defined in section 148.231. It shall maintain a
record of all persons licensed by the board to practice professional or practical nursing and
all registered nurses who hold Minnesota licensure and registration and are certified as
advanced practice registered nurses. It shall cause the prosecution of all persons violating
sections 148.171 to 148.285 and have power to incur such necessary expense therefor.
It shall register public health nurses who meet educational and other requirements
established by the board by rule, including payment of a fee. Prior to the adoption of rules,
the board shall use the same procedures used by the Department of Health to certify public
health nurses.
It shall have power to issue subpoenas, and to compel the attendance of
witnesses and the production of all necessary documents and other evidentiary material.
Any board member may administer oaths to witnesses, or take their affirmation. It shall
keep a record of all its proceedings.

(b) The board shall have access to hospital, nursing home, and other medical records
of a patient cared for by a nurse under review. If the board does not have a written consent
from a patient permitting access to the patient's records, the nurse or facility shall delete
any data in the record that identifies the patient before providing it to the board. The board
shall have access to such other records as reasonably requested by the board to assist the
board in its investigation. Nothing herein may be construed to allow access to any records
protected by section 145.64. The board shall maintain any records obtained pursuant to
this paragraph as investigative data under chapter 13.

(c) The board may accept and expend grants or gifts of money or in-kind services
from a person, a public or private entity, or any other source for purposes consistent with
the board's role and within the scope of its statutory authority.

(d) The board may accept registration fees for meetings and conferences conducted
for the purposes of board activities that are within the scope of its authority.

Sec. 4.

Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:


Subdivision 1.

Issuance.

Upon receipt of the applicable licensure or reregistration
fee and permit fee, and in accordance with rules of the board, the board may issue
a nonrenewable temporary permit to practice professional or practical nursing to an
applicant for licensure or reregistration who is not the subject of a pending investigation
or disciplinary action, nor disqualified for any other reason, under the following
circumstances:

(a) The applicant for licensure by examination under section 148.211, subdivision
1
, has graduated from an approved nursing program within the 60 days preceding board
receipt of an affidavit of graduation or transcript and has been authorized by the board to
write the licensure examination for the first time in the United States. The permit holder
must practice professional or practical nursing under the direct supervision of a registered
nurse. The permit is valid from the date of issue until the date the board takes action on
the application or for 60 days whichever occurs first.

(b) The applicant for licensure by endorsement under section 148.211, subdivision 2,
is currently licensed to practice professional or practical nursing in another state, territory,
or Canadian province. The permit is valid from submission of a proper request until the
date of board action on the application or for 60 days, whichever comes first.

(c) (b) The applicant for licensure by endorsement under section 148.211,
subdivision 2
, or for reregistration under section 148.231, subdivision 5, is currently
registered in a formal, structured refresher course or its equivalent for nurses that includes
clinical practice.

(d) The applicant for licensure by examination under section 148.211, subdivision
1
, who graduated from a nursing program in a country other than the United States or
Canada has completed all requirements for licensure except registering for and taking the
nurse licensure examination for the first time in the United States. The permit holder must
practice professional nursing under the direct supervision of a registered nurse. The permit
is valid from the date of issue until the date the board takes action on the application or for
60 days, whichever occurs first.

Sec. 5.

Minnesota Statutes 2010, section 148.231, is amended to read:


148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION;
VERIFICATION.

Subdivision 1.

Registration.

Every person licensed to practice professional or
practical nursing must maintain with the board a current registration for practice as a
registered nurse or licensed practical nurse which must be renewed at regular intervals
established by the board by rule. No certificate of registration shall be issued by the board
to a nurse until the nurse has submitted satisfactory evidence of compliance with the
procedures and minimum requirements established by the board.

The fee for periodic registration for practice as a nurse shall be determined by the
board by rule law. A penalty fee shall be added for any application received after the
required date as specified by the board by rule.
Upon receipt of the application and the
required fees, the board shall verify the application and the evidence of completion of
continuing education requirements in effect, and thereupon issue to the nurse a certificate
of
registration for the next renewal period.

Subd. 4.

Failure to register.

Any person licensed under the provisions of sections
148.171 to 148.285 who fails to register within the required period shall not be entitled to
practice nursing in this state as a registered nurse or licensed practical nurse.

Subd. 5.

Reregistration.

A person whose registration has lapsed desiring to
resume practice shall make application for reregistration, submit satisfactory evidence of
compliance with the procedures and requirements established by the board, and pay the
registration reregistration fee for the current period to the board. A penalty fee shall be
required from a person who practiced nursing without current registration. Thereupon, the
registration certificate shall be issued to the person who shall immediately be placed on
the practicing list as a registered nurse or licensed practical nurse.

Subd. 6.

Verification.

A person licensed under the provisions of sections 148.171 to
148.285 who requests the board to verify a Minnesota license to another state, territory,
or country or to an agency, facility, school, or institution shall pay a fee to the board
for each verification.

Sec. 6.

[148.242] FEES.

The fees specified in section 148.243 are nonrefundable and must be deposited in
the state government special revenue fund.

Sec. 7.

[148.243] FEE AMOUNTS.

Subdivision 1.

Licensure by examination.

The fee for licensure by examination is
$105.

Subd. 2.

Reexamination fee.

The reexamination fee is $60.

Subd. 3.

Licensure by endorsement.

The fee for licensure by endorsement is $105.

Subd. 4.

Registration renewal.

The fee for registration renewal is $85.

Subd. 5.

Reregistration.

The fee for reregistration is $105.

Subd. 6.

Replacement license.

The fee for a replacement license is $20.

Subd. 7.

Public health nurse certification.

The fee for public health nurse
certification is $30.

Subd. 8.

Drug Enforcement Administration verification for Advanced Practice
Registered Nurse (APRN).

The Drug Enforcement Administration verification for
APRN is $50.

Subd. 9.

Licensure verification other than through Nursys.

The fee for
verification of licensure status other than through Nursys verification is $20.

Subd. 10.

Verification of examination scores.

The fee for verification of
examination scores is $20.

Subd. 11.

Microfilmed licensure application materials.

The fee for a copy of
microfilmed licensure application materials is $20.

Subd. 12.

Nursing business registration; initial application.

The fee for the initial
application for nursing business registration is $100.

Subd. 13.

Nursing business registration; annual application.

The fee for the
annual application for nursing business registration is $25.

Subd. 14.

Practicing without current registration.

The fee for practicing without
current registration is two times the amount of the current registration renewal fee for any
part of the first calendar month, plus the current registration renewal fee for any part of
any subsequent month up to 24 months.

Subd. 15.

Practicing without current APRN certification.

The fee for practicing
without current APRN certification is $200 for the first month or any part thereof, plus
$100 for each subsequent month or part thereof.

Subd. 16.

Dishonored check fee.

The service fee for a dishonored check is as
provided in section 604.113.

Subd. 17.

Border state registry fee.

The initial application fee for border state
registration is $50. Any subsequent notice of employment change to remain or be
reinstated on the registry is $50.

Sec. 8.

Minnesota Statutes 2010, section 148B.17, is amended to read:


148B.17 FEES.

Subdivision. 1.

Fees; Board of Marriage and Family Therapy.

Each board shall
by rule establish
The board's fees, including late fees, for licenses and renewals are
established
so that the total fees collected by the board will as closely as possible equal
anticipated expenditures during the fiscal biennium, as provided in section 16A.1285.
Fees must be credited to accounts the board's account in the state government special
revenue fund.

Subd. 2.

Licensure and application fees.

Nonrefundable licensure and application
fees charged by the board are as follows:

(1) application fee for national examination is $220;

(2) application fee for Licensed Marriage and Family Therapist (LMFT) state
examination is $110;

(3) initial LMFT license fee is prorated, but cannot exceed $125;

(4) annual renewal fee for LMFT license is $125;

(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
license renewal is $50;

(6) application fee for LMFT licensure by reciprocity is $340;

(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
license is $75;

(8) annual renewal fee for LAMFT license is $75;

(9) late fee for LAMFT renewal is $50;

(10) fee for reinstatement of license is $150; and

(11) fee for emeritus status is $125.

Subd. 3.

Other fees.

Other fees charged by the board are as follows:

(1) sponsor application fee for approval of a continuing education course is $60;

(2) fee for license verification by mail is $10;

(3) duplicate license fee is $25;

(4) duplicate renewal card fee is $10;

(5) fee for licensee mailing list is $60;

(6) fee for a rule book is $10; and

(7) fees as authorized by section 148B.175, subdivision 6, clause (7).

Sec. 9.

Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:


Subd. 2.

Fee.

Each applicant shall pay a nonrefundable application fee set by
the board
under section 148B.17.

Sec. 10.

Minnesota Statutes 2010, section 148B.52, is amended to read:


148B.52 DUTIES OF THE BOARD.

(a) The Board of Behavioral Health and Therapy shall:

(1) establish by rule appropriate techniques, including examinations and other
methods, for determining whether applicants and licensees are qualified under sections
148B.50 to 148B.593;

(2) establish by rule standards for professional conduct, including adoption of a
Code of Professional Ethics and requirements for continuing education and supervision;

(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593;

(4) establish by rule standards for initial education including coursework for
licensure and content of professional education;

(5) establish, maintain, and publish annually a register of current licensees and
approved supervisors;

(6) establish initial and renewal application and examination fees sufficient to cover
operating expenses of the board and its agents in accordance with section 16A.1283;

(7) educate the public about the existence and content of the laws and rules for
licensed professional counselors to enable consumers to file complaints against licensees
who may have violated the rules; and

(8) periodically evaluate its rules in order to refine the standards for licensing
professional counselors and to improve the methods used to enforce the board's standards.

(b) The board may appoint a professional discipline committee for each occupational
licensure regulated by the board, and may appoint a board member as chair. The
professional discipline committee shall consist of five members representative of the
licensed occupation and shall provide recommendations to the board with regard to rule
techniques, standards, procedures, and related issues specific to the licensed occupation.

Sec. 11.

Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:


Subd. 2.

Application fees.

Each applicant shall submit with a license, advanced
dental therapist certificate,
or permit application a nonrefundable fee in the following
amounts in order to administratively process an application:

(1) dentist, $140;

(2) full faculty dentist, $140;

(2) (3) limited faculty dentist, $140;

(3) (4) resident dentist or dental provider, $55;

(5) advanced dental therapist, $100;

(4) (6) dental therapist, $100;

(5) (7) dental hygienist, $55;

(6) (8) licensed dental assistant, $55; and

(7) (9) dental assistant with a permit as described in Minnesota Rules, part
3100.8500, subpart 3, $15.

Sec. 12.

Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:


Subd. 3.

Initial license or permit fees.

Along with the application fee, each of the
following applicants shall submit a separate prorated initial license or permit fee. The
prorated initial fee shall be established by the board based on the number of months of the
applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to
exceed the following monthly fee amounts:

(1) dentist or full faculty dentist, $14 times the number of months of the initial term;

(2) dental therapist, $10 times the number of months of the initial term;

(3) dental hygienist, $5 times the number of months of the initial term;

(4) licensed dental assistant, $3 times the number of months of the initial term; and

(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
subpart 3, $1 times the number of months of the initial term.

Sec. 13.

Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:


Subd. 4.

Annual license fees.

Each limited faculty or resident dentist shall submit
with an annual license renewal application a fee established by the board not to exceed
the following amounts:

(1) limited faculty dentist, $168; and

(2) resident dentist or dental provider, $59.

Sec. 14.

Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:


Subd. 5.

Biennial license or permit fees.

Each of the following applicants shall
submit with a biennial license or permit renewal application a fee as established by the
board, not to exceed the following amounts:

(1) dentist or full faculty dentist, $336;

(2) dental therapist, $180;

(3) dental hygienist, $118;

(4) licensed dental assistant, $80; and

(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
subpart 3, $24.

Sec. 15.

Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:


Subd. 8.

Duplicate license or certificate fee.

Each applicant shall submit, with
a request for issuance of a duplicate of the original license, or of an annual or biennial
renewal certificate for a license or permit, a fee in the following amounts:

(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental
assistant license, $35; and

(2) annual or biennial renewal certificates, $10.

Sec. 16.

Minnesota Statutes 2010, section 150A.091, is amended by adding a
subdivision to read:


Subd. 16.

Failure of professional development portfolio audit.

A licensee shall
submit a fee as established by the board not to exceed the amount of $250 after failing
two consecutive professional development portfolio audits and, thereafter, for each failed
professional development portfolio audit under Minnesota Rules, part 3100.5300.

Sec. 17.

[151.065] FEE AMOUNTS.

Subdivision 1.

Application fees.

Application fees for licensure and registration
are as follows:

(1) pharmacist licensed by examination, $130;

(2) pharmacist licensed by reciprocity, $225;

(3) pharmacy intern, $30;

(4) pharmacy technician, $30;

(5) pharmacy, $190;

(6) drug wholesaler, legend drugs only, $200;

(7) drug wholesaler, legend and nonlegend drugs, $200;

(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;

(9) drug wholesaler, medical gases, $150;

(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;

(11) drug manufacturer, legend drugs only, $200;

(12) drug manufacturer, legend and nonlegend drugs, $200;

(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;

(14) drug manufacturer, medical gases, $150;

(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;

(16) medical gas distributor, $75;

(17) controlled substance researcher, $50; and

(18) pharmacy professional corporation, $100.

Subd. 2.

Original license fee.

The pharmacist original licensure fee, $130.

Subd. 3.

Annual renewal fees.

Annual licensure and registration renewal fees
are as follows:

(1) pharmacist, $130;

(2) pharmacy technician, $30;

(3) pharmacy, $190;

(4) drug wholesaler, legend drugs only, $200;

(5) drug wholesaler, legend and nonlegend drugs, $200;

(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;

(7) drug wholesaler, medical gases, $150;

(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;

(9) drug manufacturer, legend drugs only, $200;

(10) drug manufacturer, legend and nonlegend drugs, $200;

(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;

(12) drug manufacturer, medical gases, $150;

(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;

(14) medical gas distributor, $75;

(15) controlled substance researcher, $50; and

(16) pharmacy professional corporation, $45.

Subd. 4.

Miscellaneous fees.

Fees for issuance of affidavits and duplicate licenses
and certificates are as follows:

(1) intern affidavit, $15;

(2) duplicate small license, $15; and

(3) duplicate large certificate, $25.

Subd. 5.

Late fees.

All annual renewal fees are subject to a 50 percent late fee if
the renewal fee and application are not received by the board prior to the date specified
by the board.

Subd. 6.

Reinstatement fees.

(a) A pharmacist who has allowed the pharmacist's
license to lapse may reinstate the license with board approval and upon payment of any
fees and late fees in arrears, up to a maximum of $1,000.

(b) A pharmacy technician who has allowed the technician's registration to lapse
may reinstate the registration with board approval and upon payment of any fees and late
fees in arrears, up to a maximum of $90.

(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical
gas distributor who has allowed the license of the establishment to lapse may reinstate the
license with board approval and upon payment of any fees and late fees in arrears.

(d) A controlled substance researcher who has allowed the researcher's registration
to lapse may reinstate the registration with board approval and upon payment of any fees
and late fees in arrears.

(e) A pharmacist owner of a professional corporation who has allowed the
corporation's registration to lapse may reinstate the registration with board approval and
upon payment of any fees and late fees in arrears.

Sec. 18.

Minnesota Statutes 2010, section 151.07, is amended to read:


151.07 MEETINGS; EXAMINATION FEE.

The board shall meet at times as may be necessary and as it may determine to
examine applicants for licensure and to transact its other business, giving reasonable
notice of all examinations by mail to known applicants therefor. The secretary shall record
the names of all persons licensed by the board, together with the grounds upon which
the right of each to licensure was claimed. The fee for examination shall be in such the
amount as the board may determine specified in section 151.065, which fee may in the
discretion of the board be returned to applicants not taking the examination.

Sec. 19.

Minnesota Statutes 2010, section 151.101, is amended to read:


151.101 INTERNSHIP.

Upon payment of the fee specified in section 151.065, the board may license register
as an intern any natural persons who have satisfied the board that they are of good moral
character, not physically or mentally unfit, and who have successfully completed the
educational requirements for intern licensure registration prescribed by the board. The
board shall prescribe standards and requirements for interns, pharmacist-preceptors, and
internship training but may not require more than one year of such training.

The board in its discretion may accept internship experience obtained in another
state provided the internship requirements in such other state are in the opinion of the
board equivalent to those herein provided.

Sec. 20.

Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision
to read:


Subd. 3.

Registration fee.

The board shall not register an individual as a pharmacy
technician unless all applicable fees specified in section 151.065 have been paid.

Sec. 21.

Minnesota Statutes 2010, section 151.12, is amended to read:


151.12 RECIPROCITY; LICENSURE.

The board may in its discretion grant licensure without examination to any
pharmacist licensed by the Board of Pharmacy or a similar board of another state which
accords similar recognition to licensees of this state; provided, the requirements for
licensure in such other state are in the opinion of the board equivalent to those herein
provided. The fee for licensure shall be in such the amount as the board may determine by
rule
specified in section 151.065.

Sec. 22.

Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:


Subdivision 1.

Renewal fee.

Every person licensed by the board as a pharmacist
shall pay to the board a the annual renewal fee to be fixed by it specified in section
151.065
. The board may promulgate by rule a charge to be assessed for the delinquent
payment of a fee.
the late fee specified in section 151.065 if the renewal fee and
application are not received by the board prior to the date specified by the board.
It shall
be unlawful for any person licensed as a pharmacist who refuses or fails to pay such any
applicable
renewal or late fee to practice pharmacy in this state. Every certificate and
license shall expire at the time therein prescribed.

Sec. 23.

Minnesota Statutes 2010, section 151.19, is amended to read:


151.19 REGISTRATION; FEES.

Subdivision 1.

Pharmacy registration.

The board shall require and provide for the
annual registration of every pharmacy now or hereafter doing business within this state.
Upon the payment of a any applicable fee to be set by the board specified in section
151.065
, the board shall issue a registration certificate in such form as it may prescribe to
such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be
displayed in a conspicuous place in the pharmacy for which it is issued and expire on the
30th day of June following the date of issue. It shall be unlawful for any person to conduct
a pharmacy unless such certificate has been issued to the person by the board.

Subd. 2.

Nonresident pharmacies.

The board shall require and provide for an
annual nonresident special pharmacy registration for all pharmacies located outside of this
state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
prescription medications into this state. Nonresident special pharmacy registration shall
be granted by the board upon payment of any applicable fee specified in section 151.065
and
the disclosure and certification by a pharmacy:

(1) that it is licensed in the state in which the dispensing facility is located and from
which the drugs are dispensed;

(2) the location, names, and titles of all principal corporate officers and all
pharmacists who are dispensing drugs to residents of this state;

(3) that it complies with all lawful directions and requests for information from
the Board of Pharmacy of all states in which it is licensed or registered, except that it
shall respond directly to all communications from the board concerning emergency
circumstances arising from the dispensing of drugs to residents of this state;

(4) that it maintains its records of drugs dispensed to residents of this state so that the
records are readily retrievable from the records of other drugs dispensed;

(5) that it cooperates with the board in providing information to the Board of
Pharmacy of the state in which it is licensed concerning matters related to the dispensing
of drugs to residents of this state;

(6) that during its regular hours of operation, but not less than six days per week, for
a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
communication between patients in this state and a pharmacist at the pharmacy who has
access to the patients' records; the toll-free number must be disclosed on the label affixed
to each container of drugs dispensed to residents of this state; and

(7) that, upon request of a resident of a long-term care facility located within the
state of Minnesota, the resident's authorized representative, or a contract pharmacy or
licensed health care facility acting on behalf of the resident, the pharmacy will dispense
medications prescribed for the resident in unit-dose packaging or, alternatively, comply
with the provisions of section 151.415, subdivision 5.

Subd. 3.

Sale of federally restricted medical gases.

The board shall require and
provide for the annual registration of every person or establishment not licensed as a
pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
medical gases. Upon the payment of a any applicable fee to be set by the board specified
in section 151.065
, the board shall issue a registration certificate in such form as it may
prescribe to those persons or places that may be qualified to sell or distribute federally
restricted medical gases. The certificate shall be displayed in a conspicuous place in the
business for which it is issued and expire on the date set by the board. It is unlawful for
a person to sell or distribute federally restricted medical gases unless a certificate has
been issued to that person by the board.

Sec. 24.

Minnesota Statutes 2010, section 151.25, is amended to read:


151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.

The board shall require and provide for the annual registration of every person
engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes,
now or hereafter doing business with accounts in this state. Upon a payment of a any
applicable
fee as set by the board specified in section 151.065, the board shall issue a
registration certificate in such form as it may prescribe to such manufacturer. Such
registration certificate shall be displayed in a conspicuous place in such manufacturer's
or wholesaler's place of business for which it is issued and expire on the date set by the
board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals,
or poisons for medicinal purposes unless such a certificate has been issued to the person
by the board. It shall be unlawful for any person engaged in the manufacture of drugs,
medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell
legend drugs to other than a pharmacy, except as provided in this chapter.

Sec. 25.

Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:


Subdivision 1.

Requirements.

All wholesale drug distributors are subject to the
requirements in paragraphs (a) to (f).

(a) No person or distribution outlet shall act as a wholesale drug distributor without
first obtaining a license from the board and paying the required any applicable fee
specified in section 151.065
.

(b) No license shall be issued or renewed for a wholesale drug distributor to operate
unless the applicant agrees to operate in a manner prescribed by federal and state law and
according to the rules adopted by the board.

(c) The board may require a separate license for each facility directly or indirectly
owned or operated by the same business entity within the state, or for a parent entity
with divisions, subsidiaries, or affiliate companies within the state, when operations
are conducted at more than one location and joint ownership and control exists among
all the entities.

(d) As a condition for receiving and retaining a wholesale drug distributor license
issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
and will continuously maintain:

(1) adequate storage conditions and facilities;

(2) minimum liability and other insurance as may be required under any applicable
federal or state law;

(3) a viable security system that includes an after hours central alarm, or comparable
entry detection capability; restricted access to the premises; comprehensive employment
applicant screening; and safeguards against all forms of employee theft;

(4) a system of records describing all wholesale drug distributor activities set forth
in section 151.44 for at least the most recent two-year period, which shall be reasonably
accessible as defined by board regulations in any inspection authorized by the board;

(5) principals and persons, including officers, directors, primary shareholders,
and key management executives, who must at all times demonstrate and maintain their
capability of conducting business in conformity with sound financial practices as well
as state and federal law;

(6) complete, updated information, to be provided to the board as a condition for
obtaining and retaining a license, about each wholesale drug distributor to be licensed,
including all pertinent corporate licensee information, if applicable, or other ownership,
principal, key personnel, and facilities information found to be necessary by the board;

(7) written policies and procedures that assure reasonable wholesale drug distributor
preparation for, protection against, and handling of any facility security or operation
problems, including, but not limited to, those caused by natural disaster or government
emergency, inventory inaccuracies or product shipping and receiving, outdated product
or other unauthorized product control, appropriate disposition of returned goods, and
product recalls;

(8) sufficient inspection procedures for all incoming and outgoing product
shipments; and

(9) operations in compliance with all federal requirements applicable to wholesale
drug distribution.

(e) An agent or employee of any licensed wholesale drug distributor need not seek
licensure under this section.

(f) A wholesale drug distributor shall file with the board an annual report, in a
form and on the date prescribed by the board, identifying all payments, honoraria,
reimbursement or other compensation authorized under section 151.461, clauses (3) to
(5), paid to practitioners in Minnesota during the preceding calendar year. The report
shall identify the nature and value of any payments totaling $100 or more, to a particular
practitioner during the year, and shall identify the practitioner. Reports filed under this
provision are public data.

Sec. 26.

Minnesota Statutes 2010, section 151.48, is amended to read:


151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.

(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business
in the state without first obtaining a license from the board and paying the required any
applicable
fee specified in section 151.065.

(b) Application for an out-of-state wholesale drug distributor license under this
section shall be made on a form furnished by the board.

(c) No person acting as principal or agent for any out-of-state wholesale drug
distributor may sell or distribute drugs in the state unless the distributor has obtained
a license.

(d) The board may adopt regulations that permit out-of-state wholesale drug
distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state
wholesale drug distributor:

(1) possesses a valid license granted by another state under legal standards
comparable to those that must be met by a wholesale drug distributor of this state as
prerequisites for obtaining a license under the laws of this state; and

(2) can show that the other state would extend reciprocal treatment under its own
laws to a wholesale drug distributor of this state.

Sec. 27.

Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:


Subd. 3.

Research project use of controlled substances.

Any qualified person
may use controlled substances in the course of a bona fide research project but cannot
administer or dispense such drugs to human beings unless such drugs are prescribed,
dispensed and administered by a person lawfully authorized to do so. Every person
who engages in research involving the use of such substances shall apply annually for
registration by the state Board of Pharmacy and shall pay any applicable fee specified in
section 151.065,
provided that such registration shall not be required if the person is
covered by and has complied with federal laws covering such research projects.

Sec. 28.

[214.107] HEALTH-RELATED LICENSING BOARDS
ADMINISTRATIVE SERVICES UNIT.

Subdivision 1.

Establishment.

An administrative services unit is established
for the health-related licensing boards in section 214.01, subdivision 2, to perform
administrative, financial, and management functions common to all the boards in a manner
that streamlines services, reduces expenditures, targets the use of state resources, and
meets the mission of public protection.

Subd. 2.

Authority.

The administrative services unit shall act as an agent of the
boards.

Subd. 3.

Funding.

(a) The administrative service unit shall apportion among the
health-related licensing boards an amount to be allocated to each health-related licensing
board. The amount apportioned to each board shall equal each board's share of the annual
operating costs for the unit and shall be deposited into the state government special
revenue fund.

(b) The administrative services unit may receive and expend reimbursements for
services performed for other agencies.

Sec. 29. REGISTRATION AND LICENSE RENEWALS; HEALTH-RELATED
LICENSING BOARDS.

For licenses and registrations due to be renewed between July 1, 2011, and the day
following final enactment of this section, no health-related licensing board, as defined
in Minnesota Statutes, section 214.01, subdivision 2, shall assess a late fee or initiate
disciplinary action against a licensee or registrant for failure to timely renew a valid
license or registration if the renewal application is submitted to the proper licensing
board by July 31, 2011.

Sec. 30. EFFECTIVE DATE.

This article is effective the day following final enactment.

ARTICLE 6

HEALTH CARE

Section 1.

Minnesota Statutes 2010, section 13.461, subdivision 24a, is amended to
read:


Subd. 24a.

Managed care plans.

Data provided to the commissioner of human
services by managed care plans relating to contracts and provider payment rates are
classified under section 256B.69, subdivisions 9a and 9b 9c.

Sec. 2.

Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision
to read:


Subd. 4g.

Waiver of preexisting conditions for persons covered by healthy
Minnesota contribution program.

A person may enroll in the comprehensive plan with
a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
the healthy Minnesota contribution program, and has been denied coverage as described
under section 256L.031, subdivision 6.

EFFECTIVE DATE.

This section is effective July 1, 2012.

Sec. 3.

Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:


Subd. 9.

Growth limits; federal programs.

The commissioners of health and
human services shall establish a rate methodology for Medicare and Medicaid risk-based
contracting with health plan companies that is consistent with statewide growth limits.
The methodology shall be presented for review by the Minnesota Health Care Commission
and the Legislative Commission on Health Care Access prior to the submission of a
waiver request to the Centers for Medicare and Medicaid Services and subsequent
implementation of the methodology.

Sec. 4.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 7.

Authority to administer Minnesota electronic health record incentives
program.

The commissioner of human services shall administer an electronic health
record incentives program according to section 4201 of the American Recovery and
Reinvestment Act, Public Law 111-5 and Code of Federal Regulations, title 42, part 495.

Sec. 5.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 8.

Definitions.

For purposes of subdivisions 7 to 11, the following terms
have the meanings given.

(a) "Certified electronic health record technology" has the same meaning as defined
in Code of Federal Regulations, title 42, part 495.4.

(b) "Commissioner" means the commissioner of the Department of Human Services.

(c) "National Level Repository" or "NLR" has the same meaning as defined in Code
of Federal Regulations, title 42, part 495.

(d) "SMHP" means the state Medicaid health information technology plan.

(e) "MEIP" means the Minnesota electronic health record incentive program in
this section.

(f) "Pediatrician" means a physician who is certified by either the American Board
of Pediatrics or the American Osteopathic Board of Pediatrics.

Sec. 6.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 9.

Registration, application, and payment processing.

(a) Eligible
providers and eligible hospitals must successfully complete the NLR registration process
defined by the Centers for Medicare and Medicaid Services before applying for the
Minnesota electronic health record incentives program.

(b) The commissioner shall collect any improper payments made under the
Minnesota electronic health record incentives program.

(c) Eligible providers and eligible hospitals enrolled in the Minnesota electronic
health record incentives program must retain all records supporting eligibility for a
minimum of six years.

(d) The commissioner shall determine the allowable methodology options to be used
by eligible providers and eligible hospitals for purposes of attesting to and calculating
their Medicaid patient volume per Code of Federal Regulations, title 42, part 495.306.

(e) Minnesota electronic health record incentives program payments must be
processed and paid to the tax identification number designated by the eligible provider
or eligible hospital.

(f) The payment mechanism for Minnesota electronic health record incentives
program payments must be determined by the commissioner.

(g) The commissioner shall determine the 12-month period selected by the state as
referenced in Code of Federal Regulation, title 42, part 495.310(g)(1)(i)(B).

Sec. 7.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 10.

Audits.

The commissioner is authorized to audit an eligible provider or
eligible hospital that applies for an incentive payment through the Minnesota electronic
health record incentives program, both before and after payment determination. The
commissioner is authorized to use state and federal laws, regulations, and circulars to
develop the department's audit criteria.

Sec. 8.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 11.

Provider appeals.

An eligible provider or eligible hospital who has
received notification of an adverse action related to the Minnesota electronic health record
incentives program may appeal the action pursuant to subdivision 8.

Sec. 9.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 12.

MEIP appeals.

An eligible provider or eligible hospital who has received
notice of an appealable issue related to the Minnesota electronic health record incentives
program may appeal the action in accordance with procedures in this section.

Sec. 10.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 13.

Definitions.

For purposes of subdivisions 12 to 15, the following terms
have the meanings given.

(a) "Provider" means an eligible provider or eligible hospital for purposes of the
Minnesota electronic health record incentives program.

(b) "Appealable issue" means one or more of the following issues related to the
Minnesota electronic health record incentives program:

(1) incentive payments;

(2) incentive payment amounts;

(3) provider eligibility determination; or

(4) demonstration of adopting, implementing, and upgrading, and meaningful use
eligibility for incentives.

Sec. 11.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 14.

Filing an appeal.

To appeal, the provider shall file with the commissioner
a written notice of appeal. The appeal must be postmarked or received by the
commissioner within 30 days of the date of issuance specified in the notice of action
regarding the appealable issue. The notice of appeal must specify:

(1) the appealable issues;

(2) each disputed item;

(3) the reason for the dispute;

(4) the total dollar amount in dispute;

(5) the computation that the provider believes is correct;

(6) the authority relied upon for each disputed item;

(7) the name and address of the person or firm with whom contacts may be made
regarding the appeal; and

(8) other information required by the commissioner.

Sec. 12.

Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
to read:


Subd. 15.

Appeals review process.

(a) Upon receipt of an appeal notice
satisfying subdivision 14, the commissioner shall review the appeal and issue a written
appeal determination on each appealed item with 90 days. Upon mutual agreement, the
commissioner and the provider may extend the time for issuing a determination for a
specified period. The commissioner shall notify the provider by first class mail of the
appeal determination. The appeal determination takes effect upon the date of issuance
specified in the determination.

(b) In reviewing the appeal, the commissioner may request additional written or oral
information from the provider.

(c) The provider has the right to present information by telephone, in writing, or
in person concerning the appeal to the commissioner prior to the issuance of the appeal
determination within 30 days of the date the appeal was received by the commissioner.
The provider must request an in-person conference in writing, separate from the appeal
letter. Statements made during the review process are not admissible in a contested case
hearing absent an express stipulation by the parties to the contested case.

(d) For an appeal item on which the provider disagrees with the appeal determination,
the provider may file with the commissioner a written demand for a contested case
hearing to determine the proper resolution of specified appeal items. The demand must
be postmarked or received by the commissioner within 30 days of the date of issuance
specified in the determination. A contested case demand for an appeal item nullifies
the written appeal determination issued by the commissioner for that appeal item. The
commissioner shall refer any contested case demand to the Office of the Attorney General.

(e) A contested case hearing must be heard by an administrative law judge according
to sections 14.48 to 14.56. In any proceeding under this section, the appealing party must
demonstrate by a preponderance of the evidence that the Minnesota electronic health
record incentives program eligibility determination is incorrect.

(f) Regardless of any appeal, the Minnesota electronic health record incentives
program eligibility determination must remain in effect until final resolution of the appeal.

(g) The commissioner has discretion to issue to the provider a proposed resolution
for specified appeal items upon a request from the provider filed separately from the
notice of appeal. The proposed resolution is final upon written acceptance by the provider
within 30 days of the date the proposed resolution was mailed to or personally received by
the provider, whichever is earlier.

Sec. 13.

Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:


Subd. 9.

Review of eligible providers.

The commissioner and the Medical
Education and Research Costs Advisory Committee may review provider groups included
in the definition of a clinical medical education program to assure that the distribution of
the funds continue to be consistent with the purpose of this section. The results of any
such reviews must be reported to the Legislative Commission on Health Care Access
chairs and ranking minority members of the legislative committees with jurisdiction over
health care policy and finance
.

Sec. 14.

Minnesota Statutes 2010, section 62Q.32, is amended to read:


62Q.32 LOCAL OMBUDSPERSON.

County board or community health service agencies may establish an office of
ombudsperson to provide a system of consumer advocacy for persons receiving health
care services through a health plan company. The ombudsperson's functions may include,
but are not limited to:

(a) mediation or advocacy on behalf of a person accessing the complaint and appeal
procedures to ensure that necessary medical services are provided by the health plan
company; and

(b) investigation of the quality of services provided to a person and determine the
extent to which quality assurance mechanisms are needed or any other system change
may be needed. The commissioner of health shall make recommendations for funding
these functions including the amount of funding needed and a plan for distribution. The
commissioner shall submit these recommendations to the Legislative Commission on
Health Care Access by January 15, 1996.

Sec. 15.

Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:


Subd. 3.

Provider peer grouping.

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

(b) By no later than October 15, 2010, the commissioner shall disseminate
information to providers on their total cost of care, total resource use, total quality of care,
and the total care results of the grouping developed under this subdivision in comparison
to an appropriate peer group. Any analyses or reports that identify providers may only be
published after the provider has been provided the opportunity by the commissioner to
review the underlying data and submit comments. Providers may be given any data for
which they are the subject of the data. The provider shall have 30 days to review the data
for accuracy and initiate an appeal as specified in paragraph (d).

(c) By no later than January 1, 2011, the commissioner shall disseminate information
to providers on their condition-specific cost of care, condition-specific resource use,
condition-specific quality of care, and the condition-specific results of the grouping
developed under this subdivision in comparison to an appropriate peer group. Any
analyses or reports that identify providers may only be published after the provider has
been provided the opportunity by the commissioner to review the underlying data and
submit comments. Providers may be given any data for which they are the subject of the
data. The provider shall have 30 days to review the data for accuracy and initiate an
appeal as specified in paragraph (d).

(d) The commissioner shall establish an appeals process to resolve disputes from
providers regarding the accuracy of the data used to develop analyses or reports. When
a provider appeals the accuracy of the data used to calculate the peer grouping system
results, the provider shall:

(1) clearly indicate the reason they believe the data used to calculate the peer group
system results are not accurate;

(2) provide evidence and documentation to support the reason that data was not
accurate; and

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

If a provider does not meet the requirements of this paragraph, a provider's appeal shall be
considered withdrawn. The commissioner shall not publish results for a specific provider
under paragraph (e) or (f) while that provider has an unresolved appeal.

(e) Beginning January 1, 2011, the commissioner shall, no less than annually,
publish information on providers' total cost, total resource use, total quality, and the results
of the total care portion of the peer grouping process. The results that are published must
be on a risk-adjusted basis.

(f) Beginning March 30, 2011, the commissioner shall no less than annually publish
information on providers' condition-specific cost, condition-specific resource use, and
condition-specific quality, and the results of the condition-specific portion of the peer
grouping process. The results that are published must be on a risk-adjusted basis.

(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing
information under paragraph (e) or (f), the commissioner shall ensure the scientific
validity and reliability of the results according to the standards described in paragraph (h).
If additional time is needed to establish the scientific validity and reliability of the results,
the commissioner may delay the dissemination of data to providers under paragraph (b)
or (c), or the publication of information under paragraph (e) or (f). If the delay is more
than 60 days, the commissioner shall report in writing to the Legislative Commission on
Health Care Access
chairs and ranking minority members of the legislative committees
with jurisdiction over health care policy and finance
the following information:

(1) the reason for the delay;

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

(3) the new dates by which the results shall be disseminated.

If there is a delay under this paragraph, the commissioner must disseminate the
information to providers under paragraph (b) or (c) at least 90 days before publishing
results under paragraph (e) or (f).

(h) The commissioner's assurance of valid and reliable clinic and hospital peer
grouping performance results shall include, at a minimum, the following:

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

(2) establishment of an explicit minimum reliability threshold developed in
collaboration with the subjects of the data and the users of the data, at a level not below
nationally accepted standards where such standards exist.

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

Sec. 16.

Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:


Subd. 9.

Uses of information.

(a) By no later than 12 months after the commissioner
publishes the information in subdivision 3, paragraph (e):
For product renewals or for
new products that are offered, after 12 months have elapsed from publication by the
commissioner of the information in subdivision 3, paragraph (e):

(1) the commissioner of management and budget shall use the information and
methods developed under subdivision 3 to strengthen incentives for members of the state
employee group insurance program to use high-quality, low-cost providers;

(2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer
health benefits to their employees must offer plans that differentiate providers on their
cost and quality performance and create incentives for members to use better-performing
providers;

(3) all health plan companies shall use the information and methods developed
under subdivision 3 to develop products that encourage consumers to use high-quality,
low-cost providers; and

(4) health plan companies that issue health plans in the individual market or the
small employer market must offer at least one health plan that uses the information
developed under subdivision 3 to establish financial incentives for consumers to choose
higher-quality, lower-cost providers through enrollee cost-sharing or selective provider
networks.

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

Sec. 17.

Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:


Subd. 2.

Legislative oversight.

Beginning January 15, 2009, the commissioner
of health shall submit to the Legislative Commission on Health Care Access chairs and
ranking minority members of the legislative committees with jurisdiction over health care
policy and finance
periodic progress reports on the implementation of this chapter and
sections 256B.0751 to 256B.0754.

Sec. 18.

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


Subd. 33.

Contingency contract fees.

(a) When the commissioner enters into
a contingency-based contract for the purpose of recovering medical assistance or
MinnesotaCare funds, the commissioner may retain that portion of the recovered funds
equal to the amount of the contingency fee.

(b) Amounts attributed to new recoveries under this subdivision are appropriated
to the commissioner to the extent they fulfill the payment terms of the contract with the
vendor and shall be deposited into an account in a fund other than the general fund for
purposes of fulfilling the terms of the vendor contract.

EFFECTIVE DATE.

This section is effective retroactive from July 1, 2011.

Sec. 19.

Minnesota Statutes 2010, section 256.969, subdivision 2, is amended to read:


Subd. 2.

Diagnostic categories.

The commissioner shall use to the extent possible
existing diagnostic classification systems, including the system used by the Medicare
program to determine the relative values of inpatient services and case mix indices. The
commissioner may combine diagnostic classifications into diagnostic categories and may
establish separate categories and numbers of categories based on program eligibility or
hospital peer group. Relative values shall be recalculated when the base year is changed.
Relative value determinations shall include paid claims for admissions during each
hospital's base year. The commissioner may extend the time period forward to obtain
sufficiently valid information to establish relative values. Relative value determinations
shall not include property cost data, Medicare crossover data, and data on admissions
that are paid a per day transfer rate under subdivision 14. The computation of the base
year cost per admission must include identified outlier cases and their weighted costs
up to the point that they become outlier cases, but must exclude costs recognized in
outlier payments beyond that point. The commissioner may recategorize the diagnostic
classifications and recalculate relative values and case mix indices to reflect actual hospital
practices, the specific character of specialty hospitals, or to reduce variances within the
diagnostic categories after notice in the State Register and a 30-day comment period. The
commissioner shall recategorize the diagnostic classifications and recalculate relative
values and case mix indices based on the two-year schedule in effect prior to January 1,
2013, reflected in subdivision 2b. The first recategorization shall occur January 1, 2013,
and shall occur every two years after. When rates are not rebased under subdivision 2b,
the commissioner may establish relative values and case mix indices based on charge data
and may update the base year to the most recent data available.

Sec. 20.

Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:


Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner shall
obtain operating data from an updated base year and establish operating payment rates
per admission for each hospital based on the cost-finding methods and allowable costs of
the Medicare program in effect during the base year. Rates under the general assistance
medical care, medical assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, January 1, 2005, for the first 24 months of the
rebased period beginning January 1, 2009. For the first 24 months of the rebased period
beginning January 1, 2011, rates shall not be rebased, except that a Minnesota long-term
hospital shall be rebased effective January 1, 2011, based on its most recent Medicare cost
report ending on or before September 1, 2008, with the provisions under subdivisions 9
and 23, based on the rates in effect on December 31, 2010. For subsequent rate setting
periods in which the base years are updated, a Minnesota long-term hospital's base year
shall remain within the same period as other hospitals. Effective January 1, 2013, and after,
rates shall not be rebased at full value. The base year operating payment rate per admission
is standardized by the case mix index and adjusted by the hospital cost index, relative
values, and disproportionate population adjustment. The cost and charge data used to
establish operating rates shall only reflect inpatient services covered by medical assistance
and shall not include property cost information and costs recognized in outlier payments.

Sec. 21.

Minnesota Statutes 2010, section 256.969, is amended by adding a subdivision
to read:


Subd. 3c.

Rateable reduction and readmissions reduction.

(a) The total payment
for fee for service admissions occurring on or after September 1, 2011, through June 30,
2015, made to hospitals for inpatient services before third-party liability and spenddown,
is reduced ten percent from the current statutory rates. Facilities defined under subdivision
16, long-term hospitals as determined under the Medicare program, children's hospitals
whose inpatients are predominantly under 18 years of age, and payments under managed
care are excluded from this paragraph.

(b) Effective for admissions occurring during calendar year 2010 and each year
after, the commissioner shall calculate a regional readmission rate for admissions to all
hospitals occurring within 30 days of a previous discharge. The commissioner may
adjust the readmission rate taking into account factors such as the medical relationship,
complicating conditions, and sequencing of treatment between the initial admission and
subsequent readmissions.

(c) Effective for payments to all hospitals on or after July 1, 2013, through June 30,
2015, the reduction in paragraph (a) is reduced one percentage point for every percentage
point reduction in the overall readmissions rate between the two previous calendar years
to a maximum of five percent.

Sec. 22.

Minnesota Statutes 2010, section 256B.02, is amended by adding a
subdivision to read:


Subd. 16.

Termination; terminate.

"Termination" or "terminate" for a provider
means a state Medicaid program, state children's health insurance program, or Medicare
program has taken an action to revoke the provider's billing privileges, the provider has
exhausted all appeal rights or the timeline for appeal has expired, there is no expectation
by the provider, Medicaid program, state children's health insurance program, or Medicare
program that the revocation is temporary, the provider will be required to reenroll to
reinstate billing privileges, and the termination occurred for cause, including fraud,
integrity, or quality.

Sec. 23.

Minnesota Statutes 2010, section 256B.03, is amended by adding a
subdivision to read:


Subd. 4.

Prohibition on payments to providers outside of the United States.

Payments for medical assistance must not be made:

(1) for services delivered or items supplied outside of the United States; or

(2) to a provider, financial institution, or entity located outside of the United States.

Sec. 24.

Minnesota Statutes 2010, section 256B.03, is amended by adding a
subdivision to read:


Subd. 5.

Ordering or referring providers.

Claims for payments for supplies or
services that are based on an order or referral of a provider must include the ordering or
referring provider's national provider identifier (NPI). Claims for supplies or services
ordered or referred by a vendor who is not enrolled in medical assistance are not covered.

Sec. 25.

Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:


Subd. 18.

Applications for medical assistance.

(a) The state agency may
take applications for medical assistance and conduct eligibility determinations for
MinnesotaCare enrollees.

(b) The commissioner of human services shall modify the Minnesota health care
programs application form to add a question asking applicants whether they have ever
served in the United States military.

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 26.

Minnesota Statutes 2010, section 256B.04, is amended by adding a
subdivision to read:


Subd. 21.

Provider enrollment.

(a) If the commissioner or the Centers for
Medicare and Medicaid Services determines that a provider is designated "high-risk," the
commissioner may withhold payment from providers within that category upon initial
enrollment for a 90-day period. The withholding for each provider must begin on the date
of the first submission of a claim.

(b) The commissioner may require, as a condition of enrollment in medical
assistance, that a provider within a particular industry sector or category establish a
compliance program that contains the core elements established by the Centers for
Medicare and Medicaid Services.

(c) The commissioner may revoke the enrollment of an ordering or rendering
provider for a period of not more than one year, if the provider fails to maintain and,
upon request from the commissioner, provide access to documentation relating to written
orders or requests for payment for durable medical equipment, certifications for home
health services, or referrals for other items or services written or ordered by such provider,
when the commissioner has identified a pattern of a lack of documentation. A pattern
means a failure to maintain documentation or provide access to documentation on more
than one occasion.

(d) The commissioner shall terminate or deny the enrollment of any individual or
entity if the individual or entity has been terminated from participation in Medicare or
under the Medicaid program or Children's Health Insurance Program of any other state.

(e) As a condition of enrollment in medical assistance, the commissioner shall
require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
and Medicaid Services or the Minnesota Department of Human Services permit the
Centers for Medicare and Medicaid Services, its agents, or its designated contractors and
the state agency, its agents, or its designated contractors to conduct unannounced on-site
inspections of any provider location.

(f) As a condition of enrollment in medical assistance, the commissioner shall
require that a high-risk provider, or a person with a direct or indirect ownership interest in
the provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is
designated high-risk for fraud, waste, or abuse.

Sec. 27.

Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:


Subd. 4.

Citizenship requirements.

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

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

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

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

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

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

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

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

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

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

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

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

(d) All qualified noncitizens who entered the United States on or after August 22,
1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation through November 30, 1996.

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

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

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

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

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

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

Beginning December 1, 1996, qualified noncitizens who do not meet one of the
criteria in items (i) to (v) are eligible for medical assistance without federal financial
participation as described in paragraph (j).

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

(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
are lawfully present in the United States, as defined in Code of Federal Regulations, title
8, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are
eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
with the United States Citizenship and Immigration Services to pursue any applicable
immigration status, including citizenship, that would qualify them for medical assistance
with federal financial participation.

(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
for medical assistance with federal financial participation through December 31, 1996.

(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
medical assistance without federal financial participation as described in paragraph (j).

(3) Beginning December 1, 1996, persons residing in the United States prior to
August 22, 1996, who were not receiving medical assistance and persons who arrived on
or after August 22, 1996, are eligible for medical assistance without federal financial
participation as described in paragraph (j).

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

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

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

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

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

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

(iii) follow-up services that are directly related to the original service provided
to treat the emergency medical condition and are covered by the global payment made
to the provider.

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

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

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

(iii) services for routine prenatal care;

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

(v) elective surgery;

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

(vii) preventative health care and family planning services;

(viii) dialysis;

(ix) chemotherapy or therapeutic radiation services;

(x) rehabilitation services;

(xi) physical, occupational, or speech therapy;

(xii) transportation services;

(xiii) case management;

(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;

(xv) dental services;

(xvi) hospice care;

(xvii) audiology services and hearing aids;

(xviii) podiatry services;

(xix) chiropractic services;

(xx) immunizations;

(xxi) vision services and eyeglasses;

(xxii) waiver services;

(xxiii) individualized education programs; or

(xxiv) chemical dependency treatment.

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

(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
lawfully residing in the United States as described in paragraph (e), who are ineligible
for medical assistance with federal financial participation and who otherwise meet the
eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
assistance without federal financial participation. Qualified noncitizens as described
in paragraph (d) are only eligible for medical assistance without federal financial
participation for five years from their date of entry into the United States.

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

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 28.

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


Subd. 3q.

Evidence-based childbirth program.

(a) The commissioner shall
implement a program to reduce the number of elective inductions of labor prior to 39
weeks' gestation. In this subdivision, the term "elective induction of labor" means the
use of artificial means to stimulate labor in a woman without the presence of a medical
condition affecting the woman or the child that makes the onset of labor a medical
necessity. The program must promote the implementation of policies within hospitals
providing services to recipients of medical assistance or MinnesotaCare that prohibit the
use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by
the attending providers.

(b) For all births covered by medical assistance or MinnesotaCare on or after
January 1, 2012, a payment for professional services associated with the delivery of a
child in a hospital must not be made unless the provider has submitted information about
the nature of the labor and delivery including any induction of labor that was performed
in conjunction with that specific birth. The information must be on a form prescribed by
the commissioner.

(c) The requirements in paragraph (b) must not apply to deliveries performed
at a hospital that has policies and processes in place that have been approved by the
commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process
for review of hospital induction policies must be established by the commissioner and
review of policies must occur at the discretion of the commissioner. The commissioner's
decision to approve or rescind approval must include verification and review of items
including, but not limited to:

(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;

(2) policies that encourage providers to document and communicate with patients a
final expected date of delivery by 20 weeks' gestation that includes data from ultrasound
measurements as applicable;

(3) policies that encourage patient education regarding elective inductions, and
requires documentation of the processes used to educate patients;

(4) ongoing quality improvement review as determined by the commissioner; and

(5) any data that has been collected by the commissioner.

(d) All hospitals must report annually to the commissioner induction information
for all births that were covered by medical assistance or MinnesotaCare in a format and
manner to be established by the commissioner.

(e) The commissioner at any time may choose not to implement or may discontinue
any or all aspects of the program if the commissioner is able to determine that hospitals
representing at least 90 percent of births covered by medical assistance or MinnesotaCare
have approved policies in place.

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 29.

Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to
read:


Subd. 8.

Physical therapy.

(a) Medical assistance covers physical therapy and
related services, including specialized maintenance therapy. Specialized maintenance
therapy is covered for recipients age 20 and under.

(b) Authorization by the commissioner is required to provide medically necessary
services to a recipient beyond any of the following onetime service thresholds, or a lower
threshold where one has been established by the commissioner for a specified service: (1)
80 units of any approved CPT code other than modalities; (2) 20 modality sessions; and
(3) three evaluations or reevaluations
. Services provided by a physical therapy assistant
shall be reimbursed at the same rate as services performed by a physical therapist when
the services of the physical therapy assistant are provided under the direction of a physical
therapist who is on the premises. Services provided by a physical therapy assistant that
are provided under the direction of a physical therapist who is not on the premises shall
be reimbursed at 65 percent of the physical therapist rate.

EFFECTIVE DATE.

The amendment to paragraph (a) is effective January 1, 2012.
The amendment to paragraph (b) is effective March 1, 2012.

Sec. 30.

Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to
read:


Subd. 8a.

Occupational therapy.

(a) Medical assistance covers occupational
therapy and related services, including specialized maintenance therapy. Specialized
maintenance therapy is covered for recipients age 20 and under.

(b) Authorization by the commissioner is required to provide medically necessary
services to a recipient beyond any of the following onetime service thresholds, or a lower
threshold where one has been established by the commissioner for a specified service:
(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or
reevaluations
. Services provided by an occupational therapy assistant shall be reimbursed
at the same rate as services performed by an occupational therapist when the services of
the occupational therapy assistant are provided under the direction of the occupational
therapist who is on the premises. Services provided by an occupational therapy assistant
that are provided under the direction of an occupational therapist who is not on the
premises shall be reimbursed at 65 percent of the occupational therapist rate.

EFFECTIVE DATE.

The amendment to paragraph (a) is effective January 1, 2012.
The amendment to paragraph (b) is effective March 1, 2012.

Sec. 31.

Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to
read:


Subd. 8b.

Speech-language pathology and audiology services.

(a) Medical
assistance covers speech-language pathology and related services, including specialized
maintenance therapy
. Specialized maintenance therapy is covered for recipients age
20 and under.

(b) Authorization by the commissioner is required to provide medically necessary
speech-language pathology
services to a recipient beyond any of the following
onetime service thresholds, or a lower threshold where one has been established by the
commissioner for a specified service: (1) 50 treatment sessions with any combination of
approved CPT codes; and (2) one evaluation
.

(c) Medical assistance covers audiology services and related services. Services
provided by a person who has been issued a temporary registration under section
148.5161 shall be reimbursed at the same rate as services performed by a speech-language
pathologist or audiologist as long as the requirements of section 148.5161, subdivision
3
, are met.

EFFECTIVE DATE.

The amendment to paragraph (a) is effective January 1, 2012.
The amendment to paragraph (b) is effective March 1, 2012.

Sec. 32.

Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to
read:


Subd. 8c.

Care management; rehabilitation services.

(a) Effective July 1, 1999,
onetime thresholds shall replace annual thresholds for provision of rehabilitation services
described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount
and description as the thresholds prescribed by the Department of Human Services health
care programs provider manual for calendar year 1997, except they will not be renewed
annually, and they will include sensory skills and cognitive training skills.

(b) (a) A care management approach for authorization of rehabilitation services
beyond the threshold described in subdivisions 8, 8a, and 8b shall be instituted in
conjunction with the onetime thresholds
. The care management approach shall require
the provider and the department rehabilitation reviewer to work together directly through
written communication, or telephone communication when appropriate, to establish a
medically necessary care management plan. Authorization for rehabilitation services
shall include approval for up to 12 six months of services at a time without additional
documentation from the provider during the extended period, when the rehabilitation
services are medically necessary due to an ongoing health condition.

(c) (b) The commissioner shall implement an expedited five-day turnaround time to
review authorization requests for recipients who need emergency rehabilitation services
and who have exhausted their onetime threshold limit for those services.

EFFECTIVE DATE.

This section is effective March 1, 2012.

Sec. 33.

Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to
read:


Subd. 8e.

Chiropractic services.

Payment for chiropractic services is limited to
one annual evaluation and 12 24 visits per year unless prior authorization of a greater
number of visits is obtained.

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 34.

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


Subd. 8f.

Acupuncture services.

Medical assistance covers acupuncture, as defined
in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by
another Minnesota licensed practitioner for whom acupuncture is within the practitioner's
scope of practice and who has specific acupuncture training or credentialing.

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 35.

Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to
read:


Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment
shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
or
the maximum allowable cost set by the federal government or by the commissioner
plus the fixed dispensing fee; or the usual and customary price charged to the public. The
amount of payment basis must be reduced to reflect all discount amounts applied to the
charge by any provider/insurer agreement or contract for submitted charges to medical
assistance programs. The net submitted charge may not be greater than the patient liability
for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
for intravenous solutions which must be compounded by the pharmacist shall be $8 per
bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
includes quantity and other special discounts except time and cash discounts. Effective
July 1, 2009,
The actual acquisition cost of a drug shall be estimated by the commissioner,
at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic
factor drugs shall be estimated at the average wholesale price minus 30 percent.
wholesale
acquisition cost plus four percent for independently owned pharmacies located in a
designated rural area within Minnesota, and at wholesale acquisition cost plus two percent
for all other pharmacies. A pharmacy is "independently owned" if it is one of four or
fewer pharmacies under the same ownership nationally. A "designated rural area" means
an area defined as a small rural area or isolated rural area according to the four-category
classification of the Rural Urban Commuting Area system developed for the United States
Health Resources and Services Administration. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers
in the United States, not including prompt pay or other discounts, rebates, or reductions
in price, for the most recent month for which information is available, as reported in
wholesale price guides or other publications of drug or biological pricing data.
The
maximum allowable cost of a multisource drug may be set by the commissioner and it
shall be comparable to, but no higher than, the maximum amount paid by other third-party
payors in this state who have maximum allowable cost programs. Establishment of the
amount of payment for drugs shall not be subject to the requirements of the Administrative
Procedure Act.

(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
to pharmacists for legend drug prescriptions dispensed to residents of long-term care
facilities when a unit dose blister card system, approved by the department, is used. Under
this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
The National Drug Code (NDC) from the drug container used to fill the blister card must
be identified on the claim to the department. The unit dose blister card containing the
drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
will be required to credit the department for the actual acquisition cost of all unused
drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
manufacturer's unopened package. The commissioner may permit the drug clozapine to be
dispensed in a quantity that is less than a 30-day supply.

(c) Whenever a maximum allowable cost has been set for a multisource drug,
payment shall be on the basis of the lower of the usual and customary price charged
to the public or
the maximum allowable cost established by the commissioner unless
prior authorization for the brand name product has been granted according to the criteria
established by the Drug Formulary Committee as required by subdivision 13f, paragraph
(a), and the prescriber has indicated "dispense as written" on the prescription in a manner
consistent with section 151.21, subdivision 2.

(d) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider or the amount established for Medicare by the 106 percent of the average sales
price as determined by the
United States Department of Health and Human Services
pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales
price is unavailable, the amount of payment must be lower of the usual and customary cost
submitted by the provider or the wholesale acquisition cost.

(e) The commissioner may negotiate lower reimbursement rates for specialty
pharmacy products than the rates specified in paragraph (a). The commissioner may
require individuals enrolled in the health care programs administered by the department
to obtain specialty pharmacy products from providers with whom the commissioner has
negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
used by a small number of recipients or recipients with complex and chronic diseases
that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
that require complex care. The commissioner shall consult with the formulary committee
to develop a list of specialty pharmacy products subject to this paragraph. In consulting
with the formulary committee in developing this list, the commissioner shall take into
consideration the population served by specialty pharmacy products, the current delivery
system and standard of care in the state, and access to care issues. The commissioner shall
have the discretion to adjust the reimbursement rate to prevent access to care issues.

(f) Home infusion therapy services provided by home infusion therapy pharmacies
must be paid at rates according to subdivision 8d.

EFFECTIVE DATE.

This section is effective September 1, 2011, or upon federal
approval, whichever is later.

Sec. 36.

Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to
read:


Subd. 13h.

Medication therapy management services.

(a) Medical assistance
and general assistance medical care cover medication therapy management services for
a recipient taking four three or more prescriptions to treat or prevent two one or more
chronic medical conditions, or; a recipient with a drug therapy problem that is identified
by the commissioner or identified by a pharmacist and approved by the commissioner;
or
prior authorized by the commissioner that has resulted or is likely to result in significant
nondrug program costs. The commissioner may cover medical therapy management
services under MinnesotaCare if the commissioner determines this is cost-effective. For
purposes of this subdivision, "medication therapy management" means the provision
of the following pharmaceutical care services by a licensed pharmacist to optimize the
therapeutic outcomes of the patient's medications:

(1) performing or obtaining necessary assessments of the patient's health status;

(2) formulating a medication treatment plan;

(3) monitoring and evaluating the patient's response to therapy, including safety
and effectiveness;

(4) performing a comprehensive medication review to identify, resolve, and prevent
medication-related problems, including adverse drug events;

(5) documenting the care delivered and communicating essential information to
the patient's other primary care providers;

(6) providing verbal education and training designed to enhance patient
understanding and appropriate use of the patient's medications;

(7) providing information, support services, and resources designed to enhance
patient adherence with the patient's therapeutic regimens; and

(8) coordinating and integrating medication therapy management services within the
broader health care management services being provided to the patient.

Nothing in this subdivision shall be construed to expand or modify the scope of practice of
the pharmacist as defined in section 151.01, subdivision 27.

(b) To be eligible for reimbursement for services under this subdivision, a pharmacist
must meet the following requirements:

(1) have a valid license issued under chapter 151;

(2) have graduated from an accredited college of pharmacy on or after May 1996, or
completed a structured and comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education for the provision and
documentation of pharmaceutical care management services that has both clinical and
didactic elements;

(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
have developed a structured patient care process that is offered in a private or semiprivate
patient care area that is separate from the commercial business that also occurs in the
setting, or in home settings, excluding including long-term care and settings, group homes,
if the service is ordered by the provider-directed care coordination team and facilities
providing assisted living services, but excluding skilled nursing facilities
; and

(4) make use of an electronic patient record system that meets state standards.

(c) For purposes of reimbursement for medication therapy management services,
the commissioner may enroll individual pharmacists as medical assistance and general
assistance medical care providers. The commissioner may also establish contact
requirements between the pharmacist and recipient, including limiting the number of
reimbursable consultations per recipient.

(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
within a reasonable geographic distance of the patient, a pharmacist who meets the
requirements may provide the services via two-way interactive video. Reimbursement
shall be at the same rates and under the same conditions that would otherwise apply to
the services provided. To qualify for reimbursement under this paragraph, the pharmacist
providing the services must meet the requirements of paragraph (b), and must be located
within an ambulatory care setting approved by the commissioner. The patient must also
be located within an ambulatory care setting approved by the commissioner. Services
provided under this paragraph may not be transmitted into the patient's residence.

(e) The commissioner shall establish a pilot project for an intensive medication
therapy management program for patients identified by the commissioner with multiple
chronic conditions and a high number of medications who are at high risk of preventable
hospitalizations, emergency room use, medication complications, and suboptimal
treatment outcomes due to medication-related problems. For purposes of the pilot
project, medication therapy management services may be provided in a patient's home
or community setting, in addition to other authorized settings. The commissioner may
waive existing payment policies and establish special payment rates for the pilot project.
The pilot project must be designed to produce a net savings to the state compared to the
estimated costs that would otherwise be incurred for similar patients without the program.
The pilot project must begin by January 1, 2010, and end June 30, 2012.

EFFECTIVE DATE.

This section is effective September 1, 2011, or upon federal
approval, whichever is later.

Sec. 37.

Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
read:


Subd. 17.

Transportation costs.

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

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

(2) special transportation; or

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 38.

Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to
read:


Subd. 17a.

Payment for ambulance services.

(a) Medical assistance covers
ambulance services. Providers shall bill ambulance services according to Medicare
criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
for services rendered on or after July 1, 2001, medical assistance payments for ambulance
services shall be paid at the Medicare reimbursement rate or at the medical assistance
payment rate in effect on July 1, 2000, whichever is greater.

(b) Effective for services provided on or after September 1, 2011, ambulance
services payment rates are reduced 4.5 percent. Payments made to managed care plans
and county-based purchasing plans must be reduced for services provided on or after
January 1, 2012, to reflect this reduction.

Sec. 39.

Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to
read:


Subd. 18.

Bus or taxicab transportation.

To the extent authorized by rule of the
state agency, medical assistance covers costs of the most appropriate and cost-effective
form of transportation incurred by any ambulatory eligible person for obtaining
nonemergency medical care.

Sec. 40.

Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to
read:


Subd. 25.

Prior authorization required.

(a) The commissioner shall publish
in the Minnesota health care programs provider manual and on the department's Web
site a list of health services that require prior authorization, as well as the criteria and
standards used to select health services on the list. The list and the criteria and standards
used to formulate it are not subject to the requirements of sections 14.001 to 14.69. The
commissioner's decision whether prior authorization is required for a health service is not
subject to administrative appeal.

(b) The commissioner shall implement a modernized electronic system for providers
to request prior authorization. The modernized electronic system must include at least the
following functionalities:

(1) authorizations are recipient-centric, not provider-centric;

(2) adequate flexibility to support authorizations for an episode of care, continuous
drug therapy, or for individual onetime services and allows an ordering and a rendering
provider to both submit information into one request;

(3) allows providers to review previous authorization requests and determine where
a submitted request is within the authorization process;

(4) supports automated workflows that allow providers to securely submit medical
information that can be accessed by medical and pharmacy review vendors as well as
department staff; and

(5) supports development of automated clinical algorithms that can verify
information and provide responses in real time.

(c) The system described in paragraph (b) shall be completed by March 1, 2012. All
authorization requests submitted on and after March 1, 2012, or upon completion of the
modernized authorization system, whichever is later, must be submitted electronically by
providers, except requests for drugs dispensed by an outpatient pharmacy, services that
are provided outside of the state and surrounding local trade area, and services included
on a service agreement.

Sec. 41.

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


Subd. 25b.

Authorization with third-party liability.

(a) Except as otherwise
allowed under this subdivision or required under federal or state regulations, the
commissioner must not consider a request for authorization of a service when the recipient
has coverage from a third-party payer unless the provider requesting authorization has
made a good faith effort to receive payment or authorization from the third-party payer.
A good faith effort is established by supplying with the authorization request to the
commissioner the following:

(1) a determination of payment for the service from the third-party payer, a
determination of authorization for the service from the third-party payer, or a verification
of noncoverage of the service by the third-party payer; and

(2) the information or records required by the department to document the reason for
the determination or to validate noncoverage from the third-party payer.

(b) A provider requesting authorization for services covered by Medicare is not
required to bill Medicare before requesting authorization from the commissioner if the
provider has reason to believe that a service covered by Medicare is not eligible for
payment. The provider must document that, because of recent claim experiences with
Medicare or because of written communication from Medicare, coverage is not available
for the service.

(c) Authorization is not required if a third-party payer has made payment that is
equal to or greater than 60 percent of the maximum payment amount for the service
allowed under medical assistance.

EFFECTIVE DATE.

This section is effective September 1, 2011.

Sec. 42.

Minnesota Statutes 2010, section 256B.0625, subdivision 31, is amended to
read:


Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall
be made for wheelchairs and wheelchair accessories for recipients who are residents
of intermediate care facilities for the developmentally disabled. Reimbursement for
wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
conditions and limitations as coverage for recipients who do not reside in institutions. A
wheelchair purchased outside of the facility's payment rate is the property of the recipient.
The commissioner may set reimbursement rates for specified categories of medical
supplies at levels below the Medicare payment rate.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics,
orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
enrollment requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic,
orthotic, or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or
similar durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with
the Medicare program's supplier and quality standards and the vendor serves primarily
pediatric patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical
condition or is generally used primarily for a medical purpose.

Sec. 43.

Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to
read:


Subd. 31a.

Augmentative and alternative communication systems.

(a) Medical
assistance covers augmentative and alternative communication systems consisting of
electronic or nonelectronic devices and the related components necessary to enable a
person with severe expressive communication limitations to produce or transmit messages
or symbols in a manner that compensates for that disability.

(b) Until the volume of systems purchased increases to allow a discount price, the
commissioner shall reimburse augmentative and alternative communication manufacturers
and vendors at the manufacturer's suggested retail price for augmentative and alternative
communication systems and related components. The commissioner shall separately
reimburse providers for purchasing and integrating individual communication systems
which are unavailable as a package from an augmentative and alternative communication
vendor.
Augmentative and alternative communication systems must be paid the lower
of the:

(1) submitted charge; or

(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
manufacturers of augmentative and alternative communication systems; or

(ii) manufacturer's invoice charge plus 20 percent for providers that are not
manufacturers of augmentative and alternative communication systems.

(c) Reimbursement rates established by this purchasing program are not subject to
Minnesota Rules, part 9505.0445, item S or T.

EFFECTIVE DATE.

This section is effective September 1, 2011.

Sec. 44.

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


Subd. 55.

Payment for noncovered services.

(a) Except when specifically
prohibited by the commissioner or federal law, a provider may seek payment from the
recipient for services not eligible for payment under the medical assistance program when
the provider, prior to delivering the service, reviews and considers all other available
covered alternatives with the recipient and obtains a signed acknowledgment from the
recipient of the potential of the recipient's liability. The signed acknowledgment must be
in a form approved by the commissioner.

(b) Conditions under which a provider must not request payment from the recipient
include, but are not limited to:

(1) a service that requires prior authorization, unless authorization has been denied
as not medically necessary and all other therapeutic alternatives have been reviewed;

(2) a service for which payment has been denied for reasons relating to billing
requirements;

(3) standard shipping or delivery and setup of medical equipment or medical
supplies;

(4) services that are included in the recipient's long term care per diem;

(5) the recipient is enrolled in the Restricted Recipient Program and the provider is
one of a provider type designated for the recipient's health care services; and

(6) the noncovered service is a prescription drug identified by the commissioner as
having the potential for abuse and overuse, except where payment by the recipient is
specifically approved by the commissioner on the date of service based upon compelling
evidence supplied by the prescribing provider that establishes medical necessity for that
particular drug.

(c) The payment requested from recipients for noncovered services under this
subdivision must not exceed the provider's usual and customary charge for the actual
service received by the recipient. A recipient must not be billed for the difference between
what medical assistance paid for the service or would pay for a less costly alternative
service.

EFFECTIVE DATE.

This section is effective September 1, 2011.

Sec. 45.

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


Subd. 56.

Medical service coordination.

(a) Medical assistance covers in-reach
community-based service coordination that is performed in a hospital emergency
department as an eligible procedure under a state healthcare program or private insurance
for a frequent user. A frequent user is defined as an individual who has frequented the
hospital emergency department for services three or more times in the previous four
consecutive months. In-reach community-based service coordination includes navigating
services to address a client's mental health, chemical health, social, economic, and housing
needs, or any other activity targeted at reducing the incidence of emergency room and
other nonmedically necessary health care utilization.

(b) Reimbursement must be made in 15-minute increments under current Medicaid
mental health social work reimbursement methodology and allowed for up to 60 days
posthospital discharge based upon the specific identified emergency department visit or
inpatient admitting event. A frequent user who is participating in care coordination within
a health care home framework is ineligible for reimbursement under this subdivision.
Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in
social work, public health, corrections, or a related field. The commissioner shall submit
any necessary application for waivers to the Centers for Medicare and Medicaid Services
to implement this subdivision.

(c) For the purposes of this subdivision, "in-reach community-based service
coordination" means the practice of a community-based worker with training, knowledge,
skills, and ability to access a continuum of services, including housing, transportation,
chemical and mental health treatment, employment, and peer support services, by working
with an organization's staff to transition an individual back into the individual's living
environment. In-reach community-based service coordination includes working with the
individual during their discharge and for up to a defined amount of time in the individual's
living environment, reducing the individual's need for readmittance.

EFFECTIVE DATE.

This section is effective retroactive from January 1, 2011.

Sec. 46.

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


Subd. 57.

Payment for Part B Medicare crossover claims.

Effective for services
provided on or after January 1, 2012, medical assistance payment for an enrollee's
cost-sharing associated with Medicare Part B is limited to an amount up to the medical
assistance total allowed, when the medical assistance rate exceeds the amount paid by
Medicare. Excluded from this limitation are payments for mental health services and
payments for dialysis services provided to end stage renal disease patients. The exclusion
for mental health services does not apply to payments for physician services provided by
psychiatrists and advanced practice nurses with a specialty in mental health.

Sec. 47.

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


Subd. 58.

Early and periodic screening, diagnosis, and treatment services.

Medical assistance covers early and periodic screening, diagnosis, and treatment services
(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate
established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

Sec. 48.

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


Subd. 59.

Services provided by advanced dental therapists and dental
therapists.

Medical assistance covers services provided by advanced dental therapists
and dental therapists when provided within the scope of practice identified in sections
150A.105 and 150A.106.

EFFECTIVE DATE.

This section is effective September 1, 2011.

Sec. 49.

Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to
read:


Subdivision 1.

Co-payments Cost-sharing.

(a) Except as provided in subdivision
2, the medical assistance benefit plan shall include the following co-payments cost-sharing
for all recipients, effective for services provided on or after October 1, 2003, and before
January 1, 2009
September 1, 2011:

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

(2) $3 for eyeglasses;

(3) $6 $3.50 for nonemergency visits to a hospital-based emergency room, except
that this co-payment shall be increased to $20 upon federal approval
; and

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

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

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

(1) $3.50 for nonemergency visits to a hospital-based emergency room;

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

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

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

Sec. 50.

Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to
read:


Subd. 2.

Exceptions.

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

(1) children under the age of 21;

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

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

(4) recipients receiving hospice care;

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

(6) emergency services;

(7) family planning services;

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

(9) co-payments that exceed one per day per provider for nonpreventive visits,
eyeglasses, and nonemergency visits to a hospital-based emergency room.

EFFECTIVE DATE.

This section is effective September 1, 2011, for services
provided on a fee-for-service basis and January 1, 2012, for services provided by a
managed care plan or county-based purchasing plan.

Sec. 51.

Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to
read:


Subd. 3.

Collection.

(a) The medical assistance reimbursement to the provider shall
be reduced by the amount of the co-payment or deductible, except that reimbursements
shall not be reduced:

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

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

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

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

EFFECTIVE DATE.

This section is effective September 1, 2011, for services
provided on a fee-for-service basis, and January 1, 2012, for services provided by a
managed care plan or county-based purchasing plan.

Sec. 52.

Minnesota Statutes 2010, section 256B.064, subdivision 2, is amended to read:


Subd. 2.

Imposition of monetary recovery and sanctions.

(a) The commissioner
shall determine any monetary amounts to be recovered and sanctions to be imposed upon
a vendor of medical care under this section. Except as provided in paragraphs (b) and
(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
without prior notice and an opportunity for a hearing, according to chapter 14, on the
commissioner's proposed action, provided that the commissioner may suspend or reduce
payment to a vendor of medical care, except a nursing home or convalescent care facility,
after notice and prior to the hearing if in the commissioner's opinion that action is
necessary to protect the public welfare and the interests of the program.

(b) Except for a nursing home or convalescent care facility, when the commissioner
finds good cause not to suspend payments under Code of Federal Regulations, title 42,
section 455.23(e) or (f),
the commissioner may shall withhold or reduce payments to a
vendor of medical care without providing advance notice of such withholding or reduction
if either of the following occurs:

(1) the vendor is convicted of a crime involving the conduct described in subdivision
1a; or

(2) the commissioner receives reliable evidence of fraud or willful misrepresentation
by the vendor.
determines there is a credible allegation of fraud for which an investigation
is pending under the program. A credible allegation of fraud is an allegation which has
been verified by the state, from any source, including but not limited to:

(i) fraud hotline complaints;

(ii) claims data mining; and

(iii) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations.

Allegations are considered to be credible when they have an indicia of reliability
and the state agency has reviewed all allegations, facts, and evidence carefully and acts
judiciously on a case-by-case basis.

(c) The commissioner must send notice of the withholding or reduction of payments
under paragraph (b) within five days of taking such action unless requested in writing by a
law enforcement agency to temporarily withhold the notice
. The notice must:

(1) state that payments are being withheld according to paragraph (b);

(2) set forth the general allegations as to the nature of the withholding action, but
need not disclose any specific information concerning an ongoing investigation;

(2) (3) except in the case of a conviction for conduct described in subdivision 1a,
state that the withholding is for a temporary period and cite the circumstances under which
withholding will be terminated;

(3) (4) identify the types of claims to which the withholding applies; and

(4) (5) inform the vendor of the right to submit written evidence for consideration by
the commissioner.

The withholding or reduction of payments will not continue after the commissioner
determines there is insufficient evidence of fraud or willful misrepresentation by the
vendor, or after legal proceedings relating to the alleged fraud or willful misrepresentation
are completed, unless the commissioner has sent notice of intention to impose monetary
recovery or sanctions under paragraph (a).

(d) The commissioner may shall suspend or terminate a vendor's participation in
the program without providing advance notice and an opportunity for a hearing when the
suspension or termination is required because of the vendor's exclusion from participation
in Medicare. Within five days of taking such action, the commissioner must send notice of
the suspension or termination. The notice must:

(1) state that suspension or termination is the result of the vendor's exclusion from
Medicare;

(2) identify the effective date of the suspension or termination; and

(3) inform the vendor of the need to be reinstated to Medicare before reapplying for
participation in the program; and.

(4) inform the vendor of the right to submit written evidence for consideration by
the commissioner.

(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
sanction is to be imposed, a vendor may request a contested case, as defined in section
14.02, subdivision 3, by filing with the commissioner a written request of appeal. The
appeal request must be received by the commissioner no later than 30 days after the date
the notification of monetary recovery or sanction was mailed to the vendor. The appeal
request must specify:

(1) each disputed item, the reason for the dispute, and an estimate of the dollar
amount involved for each disputed item;

(2) the computation that the vendor believes is correct;

(3) the authority in statute or rule upon which the vendor relies for each disputed
item;

(4) the name and address of the person or entity with whom contacts may be made
regarding the appeal; and

(5) other information required by the commissioner.

Sec. 53.

Minnesota Statutes 2010, section 256B.0641, subdivision 1, is amended to
read:


Subdivision 1.

Recovery procedures; sources.

Notwithstanding section 256B.72
or any law or rule to the contrary, when the commissioner or the federal government
determines that an overpayment has been made by the state to any medical assistance
vendor, the commissioner shall recover the overpayment as follows:

(1) if the federal share of the overpayment amount is due and owing to the federal
government under federal law and regulations, the commissioner shall recover from the
medical assistance vendor the federal share of the determined overpayment amount paid
to that provider using the schedule of payments required by the federal government;

(2) if the overpayment to a medical assistance vendor is due to a retroactive
adjustment made because the medical assistance vendor's temporary payment rate was
higher than the established desk audit payment rate or because of a department error in
calculating a payment rate, the commissioner shall recover from the medical assistance
vendor the total amount of the overpayment within 120 days after the date on which
written notice of the adjustment is sent to the medical assistance vendor or according to a
schedule of payments approved by the commissioner; and

(3) a medical assistance vendor is liable for the overpayment amount owed by
a long-term care provider if the vendors or their owners are under common control
or ownership.; and

(4) in order to collect past due obligations to the department, the commissioner shall
make any necessary adjustments to payments to a provider or vendor that has the same tax
identification number as is assigned to a provider or vendor with past due obligations.

Sec. 54.

Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to
read:


Subd. 4.

Alternative models and waivers of requirements.

(a) Nothing in this
section shall preclude the continued development of existing medical or health care
home projects currently operating or under development by the commissioner of human
services or preclude the commissioner from establishing alternative models and payment
mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs
under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term
care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and
medical assistance, are in the waiting period for Medicare, or who have other primary
coverage.

(b) The commissioner of health shall waive health care home certification
requirements if an applicant demonstrates that compliance with a certification requirement
will create a major financial hardship or is not feasible, and the applicant establishes an
alternative way to accomplish the objectives of the certification requirement.

EFFECTIVE DATE.

This section is effective September 1, 2011.

Sec. 55.

Minnesota Statutes 2010, section 256B.0751, is amended by adding a
subdivision to read:


Subd. 8.

Coordination with local services.

The health care home and the county
shall coordinate care and services provided to patients enrolled with a health care home
who have complex medical needs or a disability, and who need and are eligible for
additional local services administered by counties, including but not limited to waivered
services, mental health services, social services, public health services, transportation, and
housing. The coordination of care and services must be as provided in the plan established
by the patient and health care home.

EFFECTIVE DATE.

This section is effective September 1, 2011.

Sec. 56.

Minnesota Statutes 2010, section 256B.196, subdivision 2, is amended to read:


Subd. 2.

Commissioner's duties.

(a) For the purposes of this subdivision and
subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
services upper payment limit for nonstate government hospitals. The commissioner shall
then determine the amount of a supplemental payment to Hennepin County Medical
Center and Regions Hospital for these services that would increase medical assistance
spending in this category to the aggregate upper payment limit for all nonstate government
hospitals in Minnesota. In making this determination, the commissioner shall allot the
available increases between Hennepin County Medical Center and Regions Hospital
based on the ratio of medical assistance fee-for-service outpatient hospital payments to
the two facilities. The commissioner shall adjust this allotment as necessary based on
federal approvals, the amount of intergovernmental transfers received from Hennepin and
Ramsey Counties, and other factors, in order to maximize the additional total payments.
The commissioner shall inform Hennepin County and Ramsey County of the periodic
intergovernmental transfers necessary to match federal Medicaid payments available
under this subdivision in order to make supplementary medical assistance payments to
Hennepin County Medical Center and Regions Hospital equal to an amount that when
combined with existing medical assistance payments to nonstate governmental hospitals
would increase total payments to hospitals in this category for outpatient services to
the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
receipt of these periodic transfers, the commissioner shall make supplementary payments
to Hennepin County Medical Center and Regions Hospital.

(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians and other billing professionals affiliated
with Hennepin County Medical Center and with Regions Hospital. The upper payment
limit shall be based on the average commercial rate or be determined using another method
acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
necessary to match the federal Medicaid payments available under this subdivision in
order to make supplementary payments to physicians and other billing professionals
affiliated with Hennepin County Medical Center and to make supplementary payments
to physicians and other billing professionals affiliated with
Regions Hospital through
HealthPartners Medical Group
equal to the difference between the established medical
assistance payment for physician and other billing professional services and the upper
payment limit. Upon receipt of these periodic transfers, the commissioner shall make
supplementary payments to physicians of and other billing professionals affiliated with
Hennepin Faculty Associates County Medical Center and shall make supplementary
payments to physicians and other billing professionals affiliated with Regions Hospital
through
HealthPartners Medical Group.

(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make
monthly voluntary intergovernmental transfers to the commissioner in amounts not to
exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from
Ramsey County. The commissioner shall increase the medical assistance capitation
payments to any licensed health plan under contract with the medical assistance program
that agrees to make enhanced payments to Hennepin County Medical Center or Regions
Hospital. The increase shall be in an amount equal to the annual value of the monthly
transfers plus federal financial participation, with each health plan receiving its pro rata
share of the increase based on the pro rata share of medical assistance admissions to
Hennepin County Medical Center and Regions Hospital by those plans. Upon the request
of the commissioner, health plans shall submit individual-level cost data for verification
purposes. The commissioner may ratably reduce these payments on a pro rata basis in
order to satisfy federal requirements for actuarial soundness. If payments are reduced,
transfers shall be reduced accordingly. Any licensed health plan that receives increased
medical assistance capitation payments under the intergovernmental transfer described in
this paragraph shall increase its medical assistance payments to Hennepin County Medical
Center and Regions Hospital by the same amount as the increased payments received in
the capitation payment described in this paragraph.

(d) The commissioner shall inform Hennepin County and Ramsey County the
transferring governmental entities
on an ongoing basis of the need for any changes needed
in the intergovernmental transfers in order to continue the payments under paragraphs (a)
to (c), at their maximum level, including increases in upper payment limits, changes in the
federal Medicaid match, and other factors.

(e) The payments in paragraphs (a) to (c) shall be implemented independently of
each other, subject to federal approval and to the receipt of transfers under subdivision 3.

Sec. 57.

Minnesota Statutes 2010, section 256B.196, subdivision 3, is amended to read:


Subd. 3.

Intergovernmental transfers.

Based on the determination by the
commissioner under subdivision 2, Hennepin County and Ramsey County shall make
periodic intergovernmental transfers to the commissioner for the purposes of subdivision
2, paragraphs (a) to (c) and (b). All of the intergovernmental transfers made by Hennepin
County shall be used to match federal payments to Hennepin County Medical Center
under subdivision 2, paragraph (a);, and to physicians and other billing professionals
affiliated with Hennepin Faculty Associates County Medical Center under subdivision
2, paragraph (b); and to Metropolitan Health Plan under subdivision 2, paragraph
(c)
. All of the intergovernmental transfers made by Ramsey County shall be used to
match federal payments to Regions Hospital under subdivision 2, paragraph (a);, and
to physicians and other billing professionals affiliated with Regions Hospital through
HealthPartners Medical Group under subdivision 2, paragraph (b); and to HealthPartners
under subdivision 2, paragraph (c)
.

Sec. 58.

Minnesota Statutes 2010, section 256B.196, subdivision 5, is amended to read:


Subd. 5.

Recession period.

Each type of intergovernmental transfer in subdivision
2, paragraphs (a) to (d), for payment periods from October 1, 2008, through December 31,
2010
June 30, 2013, is voluntary on the part of Hennepin and Ramsey Counties, meaning
that the transfer must be agreed to, in writing, by the counties prior to any payments being
issued. One agreement on each type of transfer shall cover the entire recession period.

Sec. 59.

[256B.198] PAYMENTS FOR NONHOSPITAL-BASED
GOVERNMENTAL HEALTH CENTERS.

(a) The commissioner may make payments to nonhospital-based health centers
operated by a governmental entity for the difference between the expenditures incurred
by the health center for patients eligible for medical assistance, and the payments to the
health center for medical assistance permitted elsewhere under this chapter.

(b) The nonfederal share of payments authorized under paragraph (a) shall be
provided through certified public expenditures authorized under section 256B.199,
paragraph (b).

(c) Effective July 1, 2013, or no earlier than 12 months after implementation of a
total cost of care demonstration project, Hennepin County may receive federal matching
funds for certified public expenditures under paragraph (a), if the county participates in
a total cost of care demonstration project under sections 256B.0755 and 256B.0756, or
another total cost of care demonstration project approved by the commissioner, and the
county exceeds the minimum performance threshold established by the commissioner for
the demonstration project. The value of the federal matching funds for the certified public
expenditures allocated to Hennepin County shall be equal to the value of savings achieved
above the minimum performance threshold. The same proportion of federal matching
funds for certified public expenditure allocated to Hennepin County based on savings
achieved under the demonstration project shall continue after the demonstration project
and must continue to be paid to Hennepin County each year thereafter.

(d) Beginning July 1, 2014, or no earlier than 12 months after the initial allocation
under paragraph (c) if a portion of the federal matching funds for certified public
expenditure remains with the state, the commissioner shall annually determine if the
savings from county's total cost of care demonstration project exceeded the savings from
the previous year and allocate federal matching funds for certified public expenditures to
Hennepin County equal to the amount of savings achieved above the amount achieved
in the previous year. The proportion of federal matching funds for certified public
expenditure allocated to Hennepin County shall be paid to Hennepin County each
year thereafter, until no federal matching funds for certified public expenditures under
paragraph (a) remain with the state.

(e) Nothing under this subdivision precludes Hennepin County from receiving
an additional gain-sharing payment or relieves the county from paying a downside
risk-sharing payment to the state under the demonstration project under section 256B.0755.

Sec. 60.

Minnesota Statutes 2010, section 256B.199, is amended to read:


256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.

(a) Effective July 1, 2007, the commissioner shall apply for federal matching
funds for the expenditures in paragraphs (b) and (c). Effective September 1, 2011, the
commissioner shall apply for matching funds for expenditures in paragraph (e).

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

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

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

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

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

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

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

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

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

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

(e) For services provided on or after September 1, 2011, the commissioner shall
apply for additional federal matching funds available as disproportionate share hospital
payments under the MinnesotaCare program according to the requirements and conditions
of paragraph (c). A hospital may elect on an annual basis to not be a disproportionate
share hospital for purposes of this paragraph, if the hospital does not qualify for a payment
under section 256.969, subdivision 9, paragraph (b).

Sec. 61.

Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:


Subd. 5a.

Managed care contracts.

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

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

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

(d) Effective for services rendered on or after January 1, 2009, through December
31, 2009, the commissioner shall withhold three percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.

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

(f) Effective for services rendered on or after January 1, 2010, through December
31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.

(g) Effective for services rendered on or after January 1, 2011, through December
31, 2011,
the commissioner shall include as part of the performance targets described
in paragraph (c) a reduction in the health plan's emergency room utilization rate for
state health care program enrollees by a measurable rate of five percent from the plan's
utilization rate for state health care program enrollees for the previous calendar year.
Effective for services rendered on or after January 1, 2012, the commissioner shall include
as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared
to the previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization
rate was achieved.

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
for state health care program enrollees for calendar year 2009 medical assistance and
MinnesotaCare enrollees for calendar year 2011
. Hospitals shall cooperate with the health
plans in meeting this performance target and shall accept payment withholds that may be
returned to the hospitals if the performance target is achieved. The commissioner shall
structure the withhold so that the commissioner returns a portion of the withheld funds
in amounts commensurate with achieved reductions in utilization less than the targeted
amount. The withhold in this paragraph does not apply to county-based purchasing plans.

(h) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction
in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than five percent of the plan's hospital admission rate for medical
assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared to the
previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved.

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

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

The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved.

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

(j) Effective for services rendered on or after January 1, 2011, through December 31,
2011, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(i) (k) Effective for services rendered on or after January 1, 2012, through December
31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.

(j) (l) Effective for services rendered on or after January 1, 2013, through December
31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.

(k) (m) Effective for services rendered on or after January 1, 2014, the commissioner
shall withhold three percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. The withheld funds must be returned no sooner than July 1 and
no later than July 31 of the following year. The commissioner may exclude special
demonstration projects under subdivision 23.

(l) (n) A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this section that is reasonably expected to be returned.

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

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

Sec. 62.

Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:


Subd. 5c.

Medical education and research fund.

(a) The commissioner of human
services shall transfer each year to the medical education and research fund established
under section 62J.692, an amount specified in this subdivision. The commissioner shall
calculate
the following:

(1) an amount equal to the reduction in the prepaid medical assistance payments as
specified in this clause. Until January 1, 2002, the county medical assistance capitation
base rate prior to plan specific adjustments and after the regional rate adjustments under
subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
January 1, 2002, the county medical assistance capitation base rate prior to plan specific
adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
facility and elderly waiver payments and demonstration project payments operating
under subdivision 23 are excluded from this reduction. The amount calculated under
this clause shall not be adjusted for periods already paid due to subsequent changes to
the capitation payments;

(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
section;

(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
paid under this section; and

(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
under this section.

(b) This subdivision shall be effective upon approval of a federal waiver which
allows federal financial participation in the medical education and research fund. Effective
July 1, 2009, and thereafter,
The transfers required by amount specified under paragraph
(a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009.
Any excess shall first reduce the amounts otherwise required to be transferred specified
under paragraph (a), clauses (2) to (4). Any excess following this reduction shall
proportionally reduce the transfers amount specified under paragraph (a), clause (1).

(c) Beginning July September 1, 2009 2011, of the amounts amount in paragraph
(a), the commissioner shall transfer $21,714,000 each fiscal year to the medical education
and research fund. The balance of the transfers under paragraph (a) shall be transferred to
the medical education and research fund no earlier than July 1 of the following fiscal year.

(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
transfer under paragraph (c), the commissioner shall transfer to the medical education
research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 in fiscal year
2014 and thereafter.

Sec. 63.

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


Subd. 9c.

Managed care financial reporting.

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

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

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

(2) revenues by program, including investment income;

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

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

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

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

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

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

(5) contribution to reserve, by program.

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

Sec. 64.

Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:


Subd. 28.

Medicare special needs plans; medical assistance basic health care.

(a) The commissioner may contract with qualified Medicare-approved special needs
plans to provide medical assistance basic health care services to persons with disabilities,
including those with developmental disabilities. Basic health care services include:

(1) those services covered by the medical assistance state plan except for ICF/MR
services, home and community-based waiver services, case management for persons with
developmental disabilities under section 256B.0625, subdivision 20a, and personal care
and certain home care services defined by the commissioner in consultation with the
stakeholder group established under paragraph (d); and

(2) basic health care services may also include risk for up to 100 days of nursing
facility services for persons who reside in a noninstitutional setting and home health
services related to rehabilitation as defined by the commissioner after consultation with
the stakeholder group.

The commissioner may exclude other medical assistance services from the basic
health care benefit set. Enrollees in these plans can access any excluded services on the
same basis as other medical assistance recipients who have not enrolled.

Unless a person is otherwise required to enroll in managed care, enrollment in these
plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
enrollment with an option to opt out is not voluntary enrollment.

(b) Beginning January 1, 2007, the commissioner may contract with qualified
Medicare special needs plans to provide basic health care services under medical
assistance to persons who are dually eligible for both Medicare and Medicaid and those
Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
The commissioner shall consult with the stakeholder group under paragraph (d) in
developing program specifications for these services. The commissioner shall report to
the chairs of the house of representatives and senate committees with jurisdiction over
health and human services policy and finance by February 1, 2007, on implementation
of these programs and the need for increased funding for the ombudsman for managed
care and other consumer assistance and protections needed due to enrollment in managed
care of persons with disabilities. Payment for Medicaid services provided under this
subdivision for the months of May and June will be made no earlier than July 1 of the
same calendar year.

(c) Notwithstanding subdivision 4, beginning January 1, 2008 2012, the
commissioner may expand contracting under this subdivision to all shall enroll persons
with disabilities not otherwise required to enroll in managed care under this section,
unless the individual chooses to opt out of enrollment. The commissioner shall establish
enrollment and opt out procedures consistent with applicable enrollment procedures under
this subdivision
.

(d) The commissioner shall establish a state-level stakeholder group to provide
advice on managed care programs for persons with disabilities, including both MnDHO
and contracts with special needs plans that provide basic health care services as described
in paragraphs (a) and (b). The stakeholder group shall provide advice on program
expansions under this subdivision and subdivision 23, including:

(1) implementation efforts;

(2) consumer protections; and

(3) program specifications such as quality assurance measures, data collection and
reporting, and evaluation of costs, quality, and results.

(e) Each plan under contract to provide medical assistance basic health care services
shall establish a local or regional stakeholder group, including representatives of the
counties covered by the plan, members, consumer advocates, and providers, for advice on
issues that arise in the local or regional area.

(f) The commissioner is prohibited from providing the names of potential enrollees
to health plans for marketing purposes. The commissioner may shall mail no more than
two sets of
marketing materials per contract year to potential enrollees on behalf of health
plans, in which case at the health plan's request. The marketing materials shall be mailed
by the commissioner within 30 days of receipt of these materials from the health plan.
The
health plans shall cover any costs incurred by the commissioner for mailing marketing
materials.

Sec. 65.

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


Subd. 30.

Payment reduction.

(a) Beginning September 1, 2011, the commissioner
shall reduce payments and limit future rate increases paid to managed care plans and
county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved
on a statewide aggregate basis by program. The commissioner may use competitive
bidding, payment reductions, or other reductions to achieve the reductions and limits
in this subdivision.

(b) Beginning September 1, 2011, the commissioner shall reduce payments to
managed care plans and county-based purchasing plans as follows:

(1) 2.0 percent for medical assistance elderly basic care. This shall not apply
to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
services;

(2) 2.82 percent for medical assistance families and children;

(3) 10.1 percent for medical assistance adults without children; and

(4) 6.0 percent for MinnesotaCare families and children.

(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed
care plans and county-based purchasing plans for calendar year 2012 to a percentage of
the rates in effect on August 31, 2011, as follows:

(1) 98 percent for medical assistance elderly basic care. This shall not apply to
Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
services;

(2) 97.18 percent for medical assistance families and children;

(3) 89.9 percent for medical assistance adults without children; and

(4) 94 percent for MinnesotaCare families and children.

(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit
the maximum annual trend increases to rates paid to managed care plans and county-based
purchasing plans as follows:

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
services;

(2) 5.0 percent for medical assistance special needs basic care;

(3) 2.0 percent for medical assistance families and children;

(4) 3.0 percent for medical assistance adults without children;

(5) 3.0 percent for MinnesotaCare families and children; and

(6) 3.0 percent for MinnesotaCare adults without children.

(e) The commissioner may limit trend increases to less than the maximum.
Beginning July 1, 2014, the commissioner shall limit the maximum annual trend increases
to rates paid to managed care plans and county-based purchasing plans as follows for
calendar years 2014 and 2015:

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
services;

(2) 5.0 percent for medical assistance special needs basic care;

(3) 2.0 percent for medical assistance families and children;

(4) 3.0 percent for medical assistance adults without children;

(5) 3.0 percent for MinnesotaCare families and children; and

(6) 4.0 percent for MinnesotaCare adults without children.

The commissioner may limit trend increases to less than the maximum.

Sec. 66.

Minnesota Statutes 2010, section 256B.76, subdivision 1, is amended to read:


Subdivision 1.

Physician reimbursement.

(a) Effective for services rendered on
or after October 1, 1992, the commissioner shall make payments for physician services
as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care,"
"critical care," cesarean delivery and pharmacologic management provided to psychiatric
patients, and level three codes for enhanced services for prenatal high risk, shall be paid
at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
30, 1992. If the rate on any procedure code within these categories is different than the
rate that would have been paid under the methodology in section 256B.74, subdivision 2,
then the larger rate shall be paid;

(2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992; and

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect
on September 30, 1992.

(b) Effective for services rendered on or after January 1, 2000, payment rates for
physician and professional services shall be increased by three percent over the rates
in effect on December 31, 1999, except for home health agency and family planning
agency services. The increases in this paragraph shall be implemented January 1, 2000,
for managed care.

(c) Effective for services rendered on or after July 1, 2009, payment rates for
physician and professional services shall be reduced by five percent, except that for the
period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
for the medical assistance and general assistance medical care programs, over the rates in
effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
to office or other outpatient visits, preventive medicine visits and family planning visits
billed by physicians, advanced practice nurses, or physician assistants in a family planning
agency or in one of the following primary care practices: general practice, general internal
medicine, general pediatrics, general geriatrics, and family medicine. This reduction
and the reductions in paragraph (d) do not apply to federally qualified health centers,
rural health centers, and Indian health services. Effective October 1, 2009, payments
made to managed care plans and county-based purchasing plans under sections 256B.69,
256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.

(d) Effective for services rendered on or after July 1, 2010, payment rates for
physician and professional services shall be reduced an additional seven percent over
the five percent reduction in rates described in paragraph (c). This additional reduction
does not apply to physical therapy services, occupational therapy services, and speech
pathology and related services provided on or after July 1, 2010. This additional reduction
does not apply to physician services billed by a psychiatrist or an advanced practice nurse
with a specialty in mental health. Effective October 1, 2010, payments made to managed
care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
256L.12 shall reflect the payment reduction described in this paragraph.

(e) Effective for services rendered on or after September 1, 2011, through June 30,
2013, payment rates for physician and professional services shall be reduced three percent
from the rates in effect on August 31, 2011. This reduction does not apply to physical
therapy services, occupational therapy services, and speech pathology and related services.

Sec. 67.

Minnesota Statutes 2010, section 256B.76, subdivision 2, is amended to read:


Subd. 2.

Dental reimbursement.

(a) Effective for services rendered on or after
October 1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
percent above the rate in effect on June 30, 1992; and

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases.

(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.

(c) Effective for services rendered on or after January 1, 2000, payment rates for
dental services shall be increased by three percent over the rates in effect on December
31, 1999.

(d) Effective for services provided on or after January 1, 2002, payment for
diagnostic examinations and dental x-rays provided to children under age 21 shall be the
lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.

(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
2000, for managed care.

(f) Effective for dental services rendered on or after October 1, 2010, by a
state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
on the Medicare principles of reimbursement. This payment shall be effective for services
rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
county-based purchasing plans.

(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
year, a supplemental state payment equal to the difference between the total payments
in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
services for the operation of the dental clinics.

(h) If the cost-based payment system for state-operated dental clinics described in
paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
designated as critical access dental providers under subdivision 4, paragraph (b), and shall
receive the critical access dental reimbursement rate as described under subdivision 4,
paragraph (a).

(i) Effective for services rendered on or after September 1, 2011, through June 30,
2013, payment rates for dental services shall be reduced by three percent. This reduction
does not apply to state-operated dental clinics in paragraph (f).

Sec. 68.

Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:


Subd. 4.

Critical access dental providers.

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

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

(1) nonprofit community clinics that:

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

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

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

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

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

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

(vii) have free care available as needed;

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

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

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

(5) a dental clinic associated with an oral health or dental education program owned
and
operated by the University of Minnesota or an institution within the Minnesota State
Colleges and Universities system.

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

(d) Notwithstanding paragraph (a), critical access payments must not be made for
dental services provided from April 1, 2010, through June 30, 2010.

EFFECTIVE DATE.

This section is effective September 1, 2011.

Sec. 69.

Minnesota Statutes 2010, section 256B.766, is amended to read:


256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.

(a) Effective for services provided on or after July 1, 2009, total payments for basic
care services, shall be reduced by three percent, except that for the period July 1, 2009,
through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
assistance and general assistance medical care programs, prior to third-party liability and
spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
therapy services, occupational therapy services, and speech-language pathology and
related services as basic care services. The reduction in this paragraph shall apply to
physical therapy services, occupational therapy services, and speech-language pathology
and related services provided on or after July 1, 2010.

(b) Payments made to managed care plans and county-based purchasing plans shall
be reduced for services provided on or after October 1, 2009, to reflect the reduction
effective July 1, 2009, and payments made to the plans shall be reduced effective October
1, 2010, to reflect the reduction effective July 1, 2010.

(c) Effective for services provided on or after September 1, 2011, through June 30,
2013, total payments for outpatient hospital facility fees shall be reduced by five percent
from the rates in effect on August 31, 2011.

(d) Effective for services provided on or after September 1, 2011, through June
30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
and durable medical equipment not subject to a volume purchase contract, prosthetics
and orthotics, renal dialysis services, laboratory services, public health nursing services,
physical therapy services, occupational therapy services, speech therapy services,
eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
purchase contract, anesthesia services, and hospice services shall be reduced by three
percent from the rates in effect on August 31, 2011.

(e) This section does not apply to physician and professional services, inpatient
hospital services, family planning services, mental health services, dental services,
prescription drugs, medical transportation, federally qualified health centers, rural health
centers, Indian health services, and Medicare cost-sharing.

Sec. 70.

[256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE
DEMONSTRATION PROJECT.

Subdivision 1.

Establishment and implementation.

The commissioner of human
services shall contract with a Minnesota-based academic or clinical research institution or
institutions specializing in providing complementary and alternative medicine education
and clinical services to establish and implement a five-year demonstration project in
conjunction with federally qualified health centers or federally qualified health center
"look-alikes" as defined in section 145.9269, to improve the quality and cost-effectiveness
of care provided under medical assistance to enrollees with neck and back problems.
The demonstration project must maximize the use of complementary and alternative
medicine-oriented primary care providers, including but not limited to physicians and
chiropractors. The demonstration project must be designed to significantly improve
physical and mental health for enrollees who present with neck and back problems
while decreasing medical treatment costs. The commissioner, in consultation with the
commissioner of health, shall deliver services through the demonstration project beginning
January 1, 2012, or upon federal approval, whichever is later.

Subd. 2.

RFP and project criteria.

The commissioner shall develop and issue a
request for proposal (RFP) for the demonstration project. The RFP must require the
academic or clinical research institution or institutions selected to demonstrate a proven
track record over at least five years of conducting high-quality, federally funded clinical
research. The RFP shall specify the state costs directly related to the requirements of this
section and shall require that the selected institution pay those costs to the state. The
institution and the federally qualified health centers and federally qualified health center
"look-alikes" shall also:

(1) provide patient education, provider education, and enrollment training
components on health and lifestyle issues in order to promote enrollee responsibility for
health care decisions, enhance productivity, prepare enrollees to reenter the workforce,
and reduce future health care expenditures;

(2) use high-quality and cost-effective integrated disease management that includes
the best practices of traditional and complementary and alternative medicine;

(3) incorporate holistic medical care, appropriate nutrition, exercise, medications,
and conflict resolution techniques;

(4) include a provider education component that makes use of professional
organizations representing chiropractors, nurses, and other primary care providers
and provides appropriate educational materials and activities in order to improve the
integration of traditional medical care with licensed chiropractic services and other
alternative health care services and achieve program enrollment objectives; and

(5) provide to the commissioner the information and data necessary for the
commissioner to prepare the annual reports required under subdivision 6.

Subd. 3.

Enrollment.

Enrollees from the program shall be selected by the
commissioner from current enrollees in the prepaid medical assistance program who
have, or are determined to be at significant risk of developing, neck and back problems.
Participation in the demonstration project shall be voluntary. The commissioner shall
seek to enroll, over the term of the demonstration project, ten percent of current and
future medical assistance enrollees who have, or are determined to be at significant risk
of developing, neck and back problems.

Subd. 4.

Federal approval.

The commissioner shall seek any federal waivers and
approvals necessary to implement the demonstration project.

Subd. 5.

Project costs.

The commissioner shall require the academic or clinical
research institution or institutions selected, federally qualified health centers, and federally
qualified health center "look-alikes" to fund all costs of the demonstration project.
Amounts received under subdivision 2 are appropriated to the commissioner for the
purposes of this section.

Subd. 6.

Annual reports.

The commissioner, beginning December 15, 2012, and
each December 15 thereafter through December 15, 2015, shall report annually to the
legislature on the functional and mental improvements of the populations served by the
demonstration project, patient satisfaction, and the cost-effectiveness of the program. The
reports must also include data on hospital admissions, days in hospital, rates of outpatient
surgery and other services, and drug utilization. The report, due December 15, 2015, must
include recommendations on whether the demonstration project should be continued
and expanded.

Sec. 71.

Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:


Subd. 3.

Financial management.

(a) The commissioner shall manage spending for
the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
each state revenue and expenditure forecast, the commissioner must make an assessment
of the expected expenditures for the covered services for the remainder of the current
biennium and for the following biennium. The estimated expenditure, including the
reserve, shall be compared to an estimate of the revenues that will be available in the health
care access fund. Based on this comparison, and after consulting with the chairs of the
house of representatives Ways and Means Committee and the senate Finance Committee,
and the Legislative Commission on Health Care Access, the commissioner shall, as
necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
remain within the limits of available revenues for the remainder of the current biennium
and for the following biennium. The commissioner shall not hire additional staff using
appropriations from the health care access fund until the commissioner of management
and budget makes a determination that the adjustments implemented under paragraph (b)
are sufficient to allow MinnesotaCare expenditures to remain within the limits of available
revenues for the remainder of the current biennium and for the following biennium.

(b) The adjustments the commissioner shall use must be implemented in this order:
first, stop enrollment of single adults and households without children; second, upon 45
days' notice, stop coverage of single adults and households without children already
enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium
subsidy amounts by ten percent for families with gross annual income above 200 percent
of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium
subsidy amounts by ten percent for families with gross annual income at or below 200
percent; and fifth, require applicants to be uninsured for at least six months prior to
eligibility in the MinnesotaCare program. If these measures are insufficient to limit the
expenditures to the estimated amount of revenue, the commissioner shall further limit
enrollment or decrease premium subsidies.

Sec. 72.

Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:


Subd. 5.

Co-payments and coinsurance Cost-sharing.

(a) Except as provided
in paragraphs (b) and (c), the MinnesotaCare benefit plan shall include the following
co-payments and coinsurance cost-sharing requirements for all enrollees:

(1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;

(2) $3 per prescription for adult enrollees;

(3) $25 for eyeglasses for adult enrollees;

(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist; and

(5) $6 for nonemergency visits to a hospital-based emergency room for services
provided through December 31, 2010, and $3.50 effective January 1, 2011; and

(6) a family deductible equal to the maximum amount allowed under Code of
Federal Regulations, title 42, part 447.54
.

(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
children under the age of 21.

(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.

(d) Paragraph (a), clause (4), does not apply to mental health services.

(e) Adult enrollees with family gross income that exceeds 200 percent of the federal
poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
and who are not pregnant shall be financially responsible for the coinsurance amount, if
applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.

(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
or changes from one prepaid health plan to another during a calendar year, any charges
submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
expenses incurred by the enrollee for inpatient services, that were submitted or incurred
prior to enrollment, or prior to the change in health plans, shall be disregarded.

(g) MinnesotaCare reimbursements to fee-for-service providers and payments to
managed care plans or county-based purchasing plans shall not be increased as a result of
the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 73.

[256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.

Subdivision 1.

Defined contributions to enrollees.

(a) Beginning July 1, 2012, the
commissioner shall provide each MinnesotaCare enrollee eligible under section 256L.04,
subdivision 7, with family income equal to or greater than 200 percent of the federal
poverty guidelines with a monthly defined contribution to purchase health coverage under
a health plan as defined in section 62A.011, subdivision 3.

(b) Enrollees eligible under this section shall not be charged premiums under
section 256L.15 and are exempt from the managed care enrollment requirement of section
256L.12.

(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
eligible under this section unless otherwise provided in this section. Covered services, cost
sharing, disenrollment for nonpayment of premium, enrollee appeal rights and complaint
procedures, and the effective date of coverage for enrollees eligible under this section shall
be as provided under the terms of the health plan purchased by the enrollee.

(d) Unless otherwise provided in this section, all MinnesotaCare requirements
related to eligibility, income and asset methodology, income reporting, and program
administration, continue to apply to enrollees obtaining coverage under this section.

Subd. 2.

Use of defined contribution; health plan requirements.

(a) An enrollee
may use up to the monthly defined contribution to pay premiums for coverage under a
health plan as defined in section 62A.011, subdivision 3.

(b) An enrollee must select a health plan within three calendar months of approval of
MinnesotaCare eligibility. If a health plan is not selected and purchased within this time
period, the enrollee must reapply and must meet all eligibility criteria.

(c) A health plan purchased under this section must:

(1) provide coverage for mental health and chemical dependency treatment services;
and

(2) comply with the coverage limitations specified in section 256L.03, subdivision
1, the second paragraph.

Subd. 3.

Determination of defined contribution amount.

(a) The commissioner
shall determine the defined contribution sliding scale using the base contribution specified
in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
for defined contributions that provides:

(1) persons with household incomes equal to 200 percent of the federal poverty
guidelines with a defined contribution of 93 percent of the base contribution;

(2) persons with household incomes equal to 250 percent of the federal poverty
guidelines with a defined contribution of 80 percent of the base contribution; and

(3) persons with household incomes in evenly spaced increments between the
percentages of the federal poverty guideline or income level specified in clauses (1) and
(2) with a base contribution that is a percentage interpolated from the defined contribution
percentages specified in clauses (1) and (2).

19-29
$125
30-34
$135
35-39
$140
40-44
$175
45-49
$215
50-54
$295
55-59
$345
60+
$360

(b) The commissioner shall multiply the defined contribution amounts developed
under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
health plan by a health plan company and who purchase coverage through the Minnesota
Comprehensive Health Association.

Subd. 4.

Administration by commissioner.

(a) The commissioner shall administer
the defined contributions. The commissioner shall:

(1) calculate and process defined contributions for enrollees; and

(2) pay the defined contribution amount to health plan companies or the Minnesota
Comprehensive Health Association, as applicable, for enrollee health plan coverage.

(b) Nonpayment of a health plan premium shall result in disenrollment from
MinnesotaCare effective the first day of the calendar month following the calendar month
for which the premium was due. Persons disenrolled for nonpayment or who voluntarily
terminate coverage may not reenroll until four calendar months have elapsed.

Subd. 5.

Assistance to enrollees.

The commissioner of human services, in
consultation with the commissioner of commerce, shall develop an efficient and
cost-effective method of referring eligible applicants to professional insurance agent
associations.

Subd. 6.

Minnesota Comprehensive Health Association (MCHA).

Beginning
July 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual health
market by a health plan company in accordance with section 62A.65 are eligible
for coverage through a health plan offered by the Minnesota Comprehensive Health
Association and may enroll in MCHA in accordance with section 62E.14. Any difference
between the revenue and actual covered losses to MCHA related to the implementation of
this section are appropriated annually to the commissioner of human services from the
health care access fund and shall be paid to MCHA.

Subd. 7.

Federal approval.

The commissioner shall seek federal financial
participation for the adult enrollees eligible under this section.

Sec. 74.

Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:


Subdivision 1.

Families with children.

(a) Families with children with family
income equal to or less than 275 percent of the federal poverty guidelines for the
applicable family size shall be eligible for MinnesotaCare according to this section. All
other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
to enrollment under section 256L.07, shall apply unless otherwise specified.

(b) Parents who enroll in the MinnesotaCare program must also enroll their children,
if the children are eligible. Children may be enrolled separately without enrollment by
parents. However, if one parent in the household enrolls, both parents must enroll, unless
other insurance is available. If one child from a family is enrolled, all children must
be enrolled, unless other insurance is available. If one spouse in a household enrolls,
the other spouse in the household must also enroll, unless other insurance is available.
Families cannot choose to enroll only certain uninsured members.

(c) Beginning October 1, 2003, the dependent sibling definition no longer applies
to the MinnesotaCare program. These persons are no longer counted in the parental
household and may apply as a separate household.

(d) Beginning July 1, 2010, or upon federal approval, whichever is later, Parents are
not eligible for MinnesotaCare if their gross income exceeds $57,500.

(e) Children formerly enrolled in medical assistance and automatically deemed
eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
from the requirements of this section until renewal.

(f) [Reserved.]

Sec. 75.

Minnesota Statutes 2010, section 256L.04, subdivision 10, is amended to read:


Subd. 10.

Citizenship requirements.

Eligibility for MinnesotaCare is limited
to citizens or nationals of the United States, qualified noncitizens, and other persons
residing lawfully in the United States as described in section 256B.06, subdivision 4,
paragraphs (a) to (e) and (j)
defined in Code of Federal Regulations, title 8, section 103.12.
Undocumented noncitizens and nonimmigrants are ineligible for MinnesotaCare. For
purposes of this subdivision, a nonimmigrant is an individual in one or more of the classes
listed in United States Code, title 8, section 1101(a)(15), and an undocumented noncitizen
is an individual who resides in the United States without the approval or acquiescence
of the United States Citizenship and Immigration Services. Families with children who
are citizens or nationals of the United States must cooperate in obtaining satisfactory
documentary evidence of citizenship or nationality according to the requirements of the
federal Deficit Reduction Act of 2005, Public Law 109-171.

EFFECTIVE DATE.

This section is effective January 1, 2012.

Sec. 76.

Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:


Subd. 3a.

Renewal of eligibility.

(a) Beginning July 1, 2007, an enrollee's eligibility
must be renewed every 12 months. The 12-month period begins in the month after the
month the application is approved.

(b) Each new period of eligibility must take into account any changes in
circumstances that impact eligibility and premium amount. An enrollee must provide all
the information needed to redetermine eligibility by the first day of the month that ends
the eligibility period. If there is no change in circumstances, the enrollee may renew
eligibility at designated locations that include community clinics and health care providers'
offices. The designated sites shall forward the renewal forms to the commissioner. The
commissioner may establish criteria and timelines for sites to forward applications to the
commissioner or county agencies. The premium for the new period of eligibility must be
received as provided in section 256L.06 in order for eligibility to continue.

(c) An enrollee who fails to submit renewal forms and related documentation
necessary for verification of continued eligibility in a timely manner shall remain eligible
for one additional month beyond the end of the current eligibility period before being
disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
additional month.

(d) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8,
the first period of renewal begins the month the enrollee turns 21 years of age.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 77.

Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
to read:


Subd. 6.

Referral of veterans.

The commissioner shall ensure that all applicants
for MinnesotaCare who identify themselves as veterans are referred to a county veterans
service officer for assistance in applying to the United States Department of Veterans
Affairs for any veterans benefits for which they may be eligible.

Sec. 78.

Minnesota Statutes 2010, section 256L.09, subdivision 2, is amended to read:


Subd. 2.

Residency requirement.

(a) To be eligible for health coverage under
the MinnesotaCare program, adults without children must be permanent residents of
Minnesota.

(b) To be eligible for health coverage under the MinnesotaCare program, pregnant
women, individuals, and families, and with children must meet the residency requirements
as provided by Code of Federal Regulations, title 42, section 435.403, except that the
provisions of section 256B.056, subdivision 1, shall apply upon receipt of federal approval.

EFFECTIVE DATE.

This section is effective the day following final enactment
or upon federal approval of federal financial participation for adults without children,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.

Sec. 79.

Minnesota Statutes 2010, section 256L.11, subdivision 6, is amended to read:


Subd. 6.

Enrollees 18 or older.

Payment by the MinnesotaCare program for
inpatient hospital services provided to MinnesotaCare enrollees eligible under section
256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 2,
with family gross income that exceeds 175 percent of the federal poverty guidelines
and who are not pregnant, who are 18 years old or older on the date of admission to the
inpatient hospital must be in accordance with paragraphs (a) and (b). Payment for adults
who are not pregnant and are eligible under section 256L.04, subdivisions 1 and 2, and
whose incomes are equal to or less than 175 percent of the federal poverty guidelines,
shall be as provided for under paragraph (c).

(a) If the medical assistance rate minus any co-payment required under section
256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's
benefit limit under section 256L.03, subdivision 3, payment must be the medical
assistance rate minus any co-payment required under section 256L.03, subdivision 4. The
hospital must not seek payment from the enrollee in addition to the co-payment. The
MinnesotaCare payment plus the co-payment must be treated as payment in full.

(b) If the medical assistance rate minus any co-payment required under section
256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit
under section 256L.03, subdivision 3, payment must be the lesser of:

(1) the amount remaining in the enrollee's benefit limit; or

(2) charges submitted for the inpatient hospital services less any co-payment
established under section 256L.03, subdivision 4.

The hospital may seek payment from the enrollee for the amount by which usual and
customary charges exceed the payment under this paragraph. If payment is reduced under
section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the
enrollee for the amount of the reduction.

(c) For admissions occurring on or after July 1, 2011, for single adults and
households without children who are eligible under section 256L.04, subdivision 7, the
commissioner shall pay hospitals directly, up to the medical assistance payment rate,
for inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus
any co-payment required under section 256L.03, subdivision 5. Inpatient services paid
directly by the commissioner under this paragraph do not include chemical dependency
hospital-based and residential treatment.

Sec. 80.

Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:


Subd. 7.

Critical access dental providers.

Effective for dental services provided
to MinnesotaCare enrollees on or after January 1, 2007, through August 31, 2011, the
commissioner shall increase payment rates to dentists and dental clinics deemed by the
commissioner to be critical access providers under section 256B.76, subdivision 4, by 50
percent above the payment rate that would otherwise be paid to the provider. Effective for
dental services provided on or after September 1, 2011, the commissioner shall increase
the payment rate by 30 percent above the payment rate that would otherwise be paid to
the provider.
The commissioner shall pay the prepaid health plans under contract with
the commissioner amounts sufficient to reflect this rate increase. The prepaid health plan
must pass this rate increase to providers who have been identified by the commissioner as
critical access dental providers under section 256B.76, subdivision 4.

Sec. 81.

Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:


Subd. 9.

Rate setting; performance withholds.

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

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

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

(d) Effective for services rendered on or after January 1, 2011, through December
31, 2011,
the commissioner shall include as part of the performance targets described in
paragraph (b) a reduction in the plan's emergency room utilization rate for state health care
program enrollees by a measurable rate of five percent from the plan's utilization rate for
the previous calendar year. Effective for services rendered on or after January 1, 2012, the
commissioner shall include as part of the performance targets described in paragraph (b) a
reduction in the health plan's emergency department utilization rate for medical assistance
and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
the withhold each year, the managed care plan or county-based purchasing plan must
achieve a qualifying reduction of no less than ten percent of the plan's utilization rate for
medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared
to the previous calendar year, until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization
rate was achieved.

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
for state health care program enrollees for calendar year 2009 medical assistance and
MinnesotaCare enrollees for calendar year 2011
. Hospitals shall cooperate with the health
plans in meeting this performance target and shall accept payment withholds that may
be returned to the hospitals if the performance target is achieved. The commissioner
shall structure the withhold so that the commissioner returns a portion of the withheld
funds in amounts commensurate with achieved reductions in utilization less than the
targeted amount. The withhold described in this paragraph does not apply to county-based
purchasing plans.

(e) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction
in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than five percent of the plan's hospital admission rate for medical
assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared to the
previous calendar year, until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved.

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

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

The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the subsequent
hospitalization rate was achieved.

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

(g) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
section that is reasonably expected to be returned.

Sec. 82.

Minnesota Statutes 2010, section 256L.15, subdivision 1, is amended to read:


Subdivision 1.

Premium determination.

(a) Families with children and individuals
shall pay a premium determined according to subdivision 2.

(b) Pregnant women and children under age two are exempt from the provisions
of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
for failure to pay premiums. For pregnant women, this exemption continues until the
first day of the month following the 60th day postpartum. Women who remain enrolled
during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
disenrolled on the first of the month following the 60th day postpartum for the penalty
period that otherwise applies under section 256L.06, unless they begin paying premiums.

(c) Members of the military and their families who meet the eligibility criteria
for MinnesotaCare upon eligibility approval made within 24 months following the end
of the member's tour of active duty shall have their premiums paid by the commissioner.
The effective date of coverage for an individual or family who meets the criteria of this
paragraph shall be the first day of the month following the month in which eligibility is
approved. This exemption applies for 12 months. This paragraph expires June 30, 2010.
If the expiration of this provision is in violation of section 5001 of Public Law 111-5, this
provision will expire on the date when it is no longer subject to section 5001 of Public Law
111-5. The commissioner of human services shall notify the revisor of statutes of that date.

Sec. 83.

Minnesota Statutes 2010, section 295.52, is amended by adding a subdivision
to read:


Subd. 8.

Contingent reduction in tax rate.

(a) By December 1 of each year,
beginning in 2011, the commissioner of management and budget shall determine the
projected balance in the health care access fund for the biennium.

(b) If the commissioner of management and budget determines that the projected
balance in the health care access fund for the biennium reflects a ratio of revenues to
expenditures and transfers greater than 125 percent, and if the actual cash balance in the
fund is adequate, as determined by the commissioner of management and budget, the
commissioner, in consultation with the commissioner of revenue, shall reduce the tax rates
levied under subdivisions 1, 1a, 2, 3, and 4, for the subsequent calendar year sufficient
to reduce the structural balance in the fund. The rate may be reduced to the extent that
the projected revenues for the biennium do not exceed 125 percent of expenditures and
transfers. The new rate shall be rounded to the nearest one-tenth of one percent. The rate
reduction under this paragraph expires at the end of each calendar year and is subject to an
annual redetermination by the commissioner of management and budget.

(c) For purposes of the analysis defined in paragraph (b), the commissioner of
management and budget shall include projected revenues, notwithstanding the repeal of
the tax imposed under this section effective January 1, 2020.

Sec. 84.

Laws 2009, chapter 79, article 5, section 17, the effective date, as amended by
Laws 2010, First Special Session chapter 1, article 24, section 9, is amended to read:


EFFECTIVE DATE.

This section is effective January 1, 2011 October 1, 2019, or
upon federal approval and on the date when it is no longer subject to the maintenance of
effort requirements of section 5001 of Public Law 111-5
the date it is no longer subject
to the maintenance of effort requirement in Public Law 111-148
. The commissioner of
human services shall notify the revisor of statutes of that date.

Sec. 85.

Laws 2009, chapter 79, article 5, section 18, the effective date, as amended by
Laws 2010, First Special Session chapter 1, article 24, section 10, is amended to read:


EFFECTIVE DATE.

This section is effective upon federal approval and on the
date when it is no longer subject to the maintenance of effort requirements of section
5001 of Public Law 111-5
January 1, 2014, or upon the date it is no longer subject to the
maintenance of effort requirement in Public Law 111-148
. The commissioner of human
services shall notify the revisor of statutes when federal approval is obtained.

Sec. 86.

Laws 2009, chapter 79, article 5, section 22, the effective date, as amended by
Laws 2010, First Special Session chapter 1, article 24, section 11, is amended to read:


EFFECTIVE DATE.

This section is effective for periods of ineligibility established
on or after January 1, 2011 2014, unless it is in violation of section 5001 of Public Law
111-5. If it is in violation of that section, then it shall be effective on the date when it is
no longer subject to maintenance of effort requirements of section 5001 of Public Law
111-5
or upon the date it is no longer subject to the maintenance of effort requirement
in Public Law 111-148
. The commissioner of human services shall notify the revisor of
statutes of that date.

Sec. 87.

Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by
Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read:


EFFECTIVE DATE.

The section is effective July 1, 2011 January 1, 2014, or
upon the date it is no longer subject to the maintenance effort requirement in Public Law
111-148
.

Sec. 88.

Laws 2009, chapter 173, article 1, section 17, the effective date, as amended
by Laws 2010, First Special Session chapter 1, article 24, section 13, is amended to read:


EFFECTIVE DATE.

This section is effective for pooled trust accounts established
on or after January 1, 2011 2014, unless it is in violation of section 5001 of Public Law
111-5
or upon the date it is no longer subject to the maintenance of effort requirement in
Public Law 111-148
. If it is in violation of that section, then it shall be effective on the
date when it is no longer subject to maintenance of effort requirements of section 5001
of Public Law 111-5.
The commissioner of human services shall notify the revisor of
statutes of that date.

Sec. 89. PLAN TO COORDINATE CARE FOR CHILDREN WITH HIGH-COST
MENTAL HEALTH CONDITIONS.

The commissioner of human services shall develop and submit to the legislature
by January 15, 2012, a plan to provide care coordination to medical assistance and
MinnesotaCare enrollees who are children with high-cost mental health conditions. For
purposes of this section, a child has a "high-cost mental health condition" if mental health
and medical expenses over the past year totalled $100,000 or more. For purposes of this
section, "care coordination" means collaboration between an advanced practice nurse and
primary care physicians and specialists to manage care; development of mental health
management plans for recurrent mental health issues; oversight and coordination of all
aspects of care in partnership with families; organization of medical, treatment, and
therapy information into a summary of critical information; coordination and appropriate
sequencing of evaluations and multiple appointments; information and assistance with
accessing resources; and telephone triage for behavior or other problems.

Sec. 90. REGULATORY SIMPLIFICATION AND REDUCTION OF
PROVIDER REPORTING AND DATA SUBMITTAL REQUIREMENTS.

Subdivision 1.

Regulatory simplification and report reduction work group.

The
commissioner of management and budget shall convene a regulatory simplification and
report reduction work group of persons designated by the commissioners of health, human
services, and commerce to eliminate redundant, unnecessary, and obsolete state mandated
reporting or data submittal requirements for health care providers or group purchasers
related to health care costs, quality, utilization, access, or patient encounters or related to
provider or group purchaser, monitoring, finances, and regulation. For purposes of this
section, the term "health care providers or group purchasers" has the meaning provided
in Minnesota Statutes, section 62J.03, subdivisions 6 and 8, except that it also includes
nursing homes.

Subd. 2.

Plan development and other duties.

(a) The commissioner of
management and budget, in consultation with the work group, shall develop a plan for
regulatory simplification and report reduction activities of the commissioners of health,
human services, and commerce that considers collection and regulation of the following
in a coordinated manner:

(1) encounter data;

(2) group purchaser provider network data;

(3) financial reporting;

(4) reporting and documentation requirements relating to member communications
and marketing materials;

(5) state regulation and oversight of group purchasers;

(6) requirements and procedures for denial, termination, or reduction of services
and member appeals and grievances; and

(7) state performance improvement projects, requirements, and procedures.

(b) The commissioners of health, human services, and commerce, following
consultation with the work group, shall present to the legislature by February 15, 2012,
proposals to implement their recommendations.

Subd. 3.

New reporting and other duties.

(a) The commissioner of management
and budget, in consultation with the work group and the commissioners of health, human
services, and commerce, shall develop criteria to be used by the commissioners in
determining whether to establish new reporting and data submittal requirements. These
criteria must support the establishment of new reporting and data submittal requirements
only:

(1) if required by a federal agency or state statute;

(2) if needed for a state regulatory audit or corrective action plan;

(3) if needed to monitor or protect public health;

(4) if needed to manage the cost and quality of Minnesota's public health insurance
programs; or

(5) if a review and analysis by the commissioner of the relevant agency has
documented the necessity, importance, and administrative cost of the requirement, and
has determined that the information sought cannot be efficiently obtained through another
state or federal report.

(b) The commissioners of health, human services, and commerce, following
consultation with the work group, may propose to the legislature new provider and group
purchaser reporting and data submittal requirements to take effect on or after July 1, 2012.
These proposals shall include an analysis of the extent to which the requirements meet
the criteria developed under paragraph (a).

Sec. 91. SPECIALIZED MAINTENANCE THERAPY.

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

Sec. 92. REDUCING HOSPITALIZATION RATES.

The commissioner of human services, by January 15, 2012, shall present
recommendations to the legislature to reduce hospitalization rates for state health care
program enrollees who are children with high-cost medical conditions.

Sec. 93. MEDICAID FRAUD PREVENTION AND DETECTION.

Subdivision 1.

Request for proposals.

By December 31, 2011, the commissioner
of human services shall issue a request for proposals to prevent and detect Medicaid
fraud and mispayment. The request for proposals shall require the vendor to provide
data analytics capabilities, including, but not limited to, predictive modeling techniques
and other forms of advanced analytics, technical assistance, claims review, and medical
record and documentation investigations, to detect and investigate improper payments
both before and after payments are made.

Subd. 2.

Proof of concept phase.

The selected vendor, at no cost to the state, shall
be required to apply its analytics and investigations on a subset of data provided by the
commissioner to demonstrate the direct recoveries of the solution.

Subd. 3.

Data confidentiality.

Data provided by the commissioner to the vendor
under this section must maintain the confidentiality of the information.

Subd. 4.

Full implementation phase.

The request for proposal must require the
commissioner to implement the recommendations provided by the vendor if the work
done under the requirements of subdivision 2 provides recoveries directly related to the
investigations to the state. After full implementation, the vendor shall be paid from
recoveries directly attributable to the work done by the vendor, according to the terms and
performance measures negotiated in the contract.

Subd. 5.

Selection of vendor.

The commissioner of human services shall select a
vendor from the responses to the request for proposal by January 31, 2012.

Subd. 6.

Progress report.

The commissioner shall provide a report describing the
progress made under this section to the governor and the chairs and ranking minority
members of the legislative committees with jurisdiction over the Department of Human
Services by June 15, 2012. The report shall provide a dynamic scoring analysis of the
work described in the report.

Sec. 94. CAPITATION PAYMENT DELAY.

The commissioner shall delay $135,000,000 of the medical assistance and
MinnesotaCare capitation payment to managed care plans and county-based purchasing
plans due in May 2013 and the payment due in April 2013 for special needs basic care
until July 1, 2013. The payment shall be made no earlier than July 1, 2013, and no later
than July 31, 2013.

The commissioner shall delay $135,000,000 of the medical assistance and
MinnesotaCare capitation payment to managed care plans and county-based purchasing
plans due in the second quarter of calendar year 2015 and the April 2015 payment for
special needs basic care until July 1, 2015. The payment shall be made no earlier than July
1, 2015, and no later than July 31, 2015.

Sec. 95. MINNESOTA AUTISM SPECTRUM DISORDER TASK FORCE.

Subdivision 1.

Members.

(a) The Autism Spectrum Disorder Task Force is
composed of 19 members, appointed as follows:

(1) two members of the senate, one appointed by the majority leader and one
appointed by the minority leader;

(2) two members of the house of representatives, one from the majority party,
appointed by the speaker of the house, and one from the minority party, appointed by
the minority leader;

(3) two members who are family members of individuals with autism spectrum
disorder (ASD), one of whom shall be appointed by the majority leader of the senate, and
one of whom shall be appointed by the speaker of the house;

(4) one member appointed by the Minnesota chapter of the American Academy of
Pediatrics who is a developmental behavioral pediatrician;

(5) one member appointed by the Minnesota Academy of Family Physicians who is
a family practice physician;

(6) one member appointed by the Minnesota Psychological Association who is a
neuropsychologist;

(7) one member appointed by the majority leader of the senate who represents a
minority autism community;

(8) one member representing the directors of public school student support services;

(9) one member appointed by the Minnesota Council of Health Plans;

(10) three members who represent autism advocacy groups, two of whom shall be
appointed by the speaker of the house and one of whom shall be appointed by the majority
leader of the senate; and

(11) one member appointed by each of the respective commissioners of the
following departments: education, employment and economic development, health, and
human services.

(b) Appointments must be made by September 1, 2011. The senate member
appointed by the majority leader of the senate shall convene the first meeting of the
task force no later than October 1, 2011. The task force shall elect a chair from among
members at the first meeting. The task force shall meet at least six times per year.

Subd. 2.

Duties.

(a) The task force shall develop an autism spectrum disorder
statewide strategic plan that focuses on improving awareness, early diagnosis, and
intervention and on ensuring delivery of treatment and services for individuals diagnosed
with an autism spectrum disorder, including the coordination and accessibility of
cost-effective treatments and services throughout the individual's lifetime.

(b) The task force shall coordinate with existing efforts relating to autism spectrum
disorders at the Departments of Education, Employment and Economic Development,
Health, and Human Services and at the University of Minnesota and other agencies and
organizations as the task force deems appropriate.

Subd. 3.

Report.

The task force shall submit its strategic plan to the legislature
by January 15, 2013. The task force shall continue to provide assistance with the
implementation of the strategic plan, as approved by the legislature, and shall submit
a progress report by January 15, 2014, and by January 15, 2015, on the status of
implementation of the strategic plan, including any draft legislation necessary for
implementation.

Subd. 4.

Expiration.

The task force expires June 30, 2015, unless extended by law.

Sec. 96. COMPETITIVE BIDDING PILOT.

For managed care contracts effective January 1, 2012, the commissioner of
human services is required to establish a competitive price bidding pilot for nonelderly,
nondisabled adults and children in medical assistance and MinnesotaCare in the
seven-county metropolitan area. The pilot must allow a minimum of two managed care
organizations to serve the metropolitan area. The pilot shall expire after two full calendar
years on December 31, 2013. The commissioner of human service shall conduct an
evaluation of the pilot to determine the cost-effectiveness and impacts to provider access
at the end of the two-year period.

Sec. 97. REPEALER.

Subdivision 1.

Legislative Oversight Commission.

Minnesota Statutes 2010,
section 62J.07, subdivisions 1, 2, and 3,
are repealed.

Subd. 2.

Children formally under medical assistance.

Minnesota Statutes 2010,
section 256L.07, subdivision 7,
exempting eligibility for children formally under
medical assistance,
is repealed retroactively from October 1, 2008, and federal approval
is no longer necessary.

Subd. 3.

Extending medical assistance.

Minnesota Statutes 2010, section
256B.057, subdivision 2c,
(extended medical assistance for certain children) is
repealed.

Subd. 4.

Minnesota Statutes 2010, section 256B.69, subdivision 9b, is repealed.

Subd. 5.

The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9,
(renewal rolling month and premium grace month) are repealed.

Subd. 6.

MinnesotaCare provider taxes.

Minnesota Statutes 2010, sections
13.4967, subdivision 3; 295.50, subdivisions 1, 1a, 2, 2a, 3, 4, 6, 6a, 7, 9b, 9c, 10a, 10b,
12b, 13, 14, and 15; 295.51, subdivisions 1 and 1a; 295.52, subdivisions 1, 1a, 2, 3, 4,
4a, 5, 6, and 7; 295.53, subdivisions 1, 2, 3, and 4a; 295.54; 295.55; 295.56; 295.57;
295.58; 295.581; 295.582; and 295.59,
are repealed effective for gross revenues received
after December 31, 2019.

Subd. 7.

Renewal of medical assistance eligibility.

The amendment in Laws 2009,
chapter 79, article 5, section 62,
is repealed retroactively from July 1, 2009.

Sec. 98. EFFECTIVE DATE.

This article is effective the day following final enactment unless another effective
date is specified in this article.

ARTICLE 7

CONTINUING CARE

Section 1.

Minnesota Statutes 2010, section 245A.03, subdivision 7, as amended by
Laws 2011, chapter 86, section 4, is amended to read:


Subd. 7.

Licensing moratorium.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(e) When a foster care recipient moves out of a foster home that is not the primary
residence of the license holder according to section 256B.49, subdivision 15, paragraph
(f), the county shall immediately inform the Department of Human Services Licensing
Division, and the department shall immediately decrease the licensed capacity for the
home. A decreased licensed capacity according to this paragraph is not subject to appeal
under this chapter.

Sec. 2.

Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:


Subd. 24.

Disability Linkage Line.

The commissioner shall establish the Disability
Linkage Line, a to serve as Minnesota's neutral access point for statewide consumer
disability
information, referral, and assistance system for people with disabilities and
chronic illnesses that
. The Disability Linkage Line shall:

(1) deliver information and assistance based on national and state standards;

(1) provides (2) provide information about state and federal eligibility requirements,
benefits, and service options;

(3) provide benefits and options counseling;

(2) makes (4) make referrals to appropriate support entities;

(3) delivers information and assistance based on national and state standards;

(4) assists (5) educate people to on their options so they can make well-informed
decisions choices; and

(5) supports (6) help support the timely resolution of service access and benefit
issues.;

(7) inform people of their long-term community services and supports;

(8) provide necessary resources and supports that can lead to employment and
increased economic stability of people with disabilities; and

(9) serve as the technical assistance and help center for the Web-based tool,
Minnesota's Disability Benefits 101.org.

Sec. 3.

Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:


Subd. 29.

State medical review team.

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under
sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
(j),
and 256B.055, subdivision 12, the commissioner shall review all medical evidence
submitted by county agencies with a referral and seek additional information from
providers, applicants, and enrollees to support the determination of disability where
necessary. Disability shall be determined according to the rules of title XVI and title
XIX of the Social Security Act and pertinent rules and policies of the Social Security
Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due
to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
necessary and appropriate to a determination of disability, and (2) assist applicants and
enrollees to obtain the evidence, including, but not limited to, medical examinations
and electronic medical records.

(c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:

(1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;

(2) the average length of time from receipt of the application to a decision;

(3) the number of appeals, appeal results, and the length of time taken from the date
the person involved requested an appeal for a written decision to be made on each appeal;

(4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and

(5) specific information on the medical certification, licensure, or other credentials
of the person or persons performing the medical review determinations and length of
time in that position.

(d) Any appeal made under section 256.045, subdivision 3, of a disability
determination made by the state medical review team must be decided according to the
timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is
not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the
appeal must be immediately reviewed by the chief appeals referee.

Sec. 4.

Minnesota Statutes 2010, section 256B.04, is amended by adding a subdivision
to read:


Subd. 20.

Money Follows the Person Rebalancing demonstration project.

In
accordance with federal law governing Money Follows the Person Rebalancing funds,
amounts equal to the value of enhanced federal funding resulting from the operation of the
demonstration project grant must be transferred from the medical assistance account in
the general fund to an account in the special revenue fund. Funds in the special revenue
fund account do not cancel and are appropriated to the commissioner to carry out the
goals of the Money Follows the Person Rebalancing demonstration project as required
under the approved federal plan for the use of the funds, and may be transferred to the
medical assistance account if applicable.

Sec. 5.

Minnesota Statutes 2010, section 256B.05, is amended by adding a subdivision
to read:


Subd. 5.

Obligation of local agency to process medical assistance applications
within established timelines.

The local agency must act on an application for medical
assistance within ten working days of receipt of all information needed to act on the
application but no later than required under Minnesota Rules, part 9505.0090, subparts
2 and 3.

Sec. 6.

Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:


Subd. 3.

Asset limitations for individuals and families.

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

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

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

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

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

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

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

EFFECTIVE DATE.

This section is effective January 1, 2014.

Sec. 7.

Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:


Subd. 9.

Employed persons with disabilities.

(a) Medical assistance may be paid
for a person who is employed and who:

(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;

(2) is at least 16 but less than 65 years of age;

(3) meets the asset limits in paragraph (c) (d); and

(4) pays a premium and other obligations under paragraph (e).

(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding.
Any
spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.

(b) (c) After the month of enrollment, a person enrolled in medical assistance under
this subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a
medical condition, as verified by a physician, may retain eligibility for up to four calendar
months
; or

(2) effective January 1, 2004, loses employment for reasons not attributable to the
enrollee, and is without receipt of earned income may retain eligibility for up to four
consecutive months after the month of job loss. To receive a four-month extension,
enrollees must verify the medical condition or provide notification of job loss. All other
eligibility requirements must be met and the enrollee must pay all calculated premium
costs for continued eligibility.

(c) (d) For purposes of determining eligibility under this subdivision, a person's
assets must not exceed $20,000, excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
Keogh plans, and pension plans; and

(3) medical expense accounts set up through the person's employer.; and

(4) spousal assets, including spouse's share of jointly held assets.

(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
earned income disregard. To be eligible, a person applying for medical assistance under
this subdivision must have earned income above the disregard level.

(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
Security, and applicable state and federal income taxes must be withheld. To be eligible,
a person must document earned income tax withholding.

(e)(1) A person whose earned and unearned income is equal to or greater than 100
percent of federal poverty guidelines for the applicable family size must pay a premium
to be eligible for medical assistance under this subdivision.
(e) All enrollees must pay a
premium to be eligible for medical assistance under this subdivision, except as provided
under section 256.01, subdivision 18b.

(1) An enrollee must pay the greater of a $65 premium or the premium shall be
calculated
based on the person's gross earned and unearned income and the applicable
family size using a sliding fee scale established by the commissioner, which begins at
one percent of income at 100 percent of the federal poverty guidelines and increases
to 7.5 percent of income for those with incomes at or above 300 percent of the federal
poverty guidelines.

(2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.

(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
medical assistance under this subdivision. An enrollee shall pay the greater of a $35
premium or the premium calculated in clause (1).

(3) Effective November 1, 2003, All enrollees who receive unearned income must
pay one-half of one five percent of unearned income in addition to the premium amount,
except as provided under section 256.01, subdivision 18b
.

(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
percent of the federal poverty guidelines and who are also enrolled in Medicare, the
commissioner must reimburse the enrollee for Medicare Part B premiums under section
256B.0625, subdivision 15, paragraph (a).

(5) (4) Increases in benefits under title II of the Social Security Act shall not be
counted as income for purposes of this subdivision until July 1 of each year.

(f) A person's eligibility and premium shall be determined by the local county
agency. Premiums must be paid to the commissioner. All premiums are dedicated to
the commissioner.

(g) Any required premium shall be determined at application and redetermined at
the enrollee's six-month income review or when a change in income or household size is
reported. Enrollees must report any change in income or household size within ten days
of when the change occurs. A decreased premium resulting from a reported change in
income or household size shall be effective the first day of the next available billing month
after the change is reported. Except for changes occurring from annual cost-of-living
increases, a change resulting in an increased premium shall not affect the premium amount
until the next six-month review.

(h) Premium payment is due upon notification from the commissioner of the
premium amount required. Premiums may be paid in installments at the discretion of
the commissioner.

(i) Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. Good cause exists
if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
D, are met. Except when an installment agreement is accepted by the commissioner,
all persons disenrolled for nonpayment of a premium must pay any past due premiums
as well as current premiums due prior to being reenrolled. Nonpayment shall include
payment with a returned, refused, or dishonored instrument. The commissioner may
require a guaranteed form of payment as the only means to replace a returned, refused,
or dishonored instrument.

(j) The commissioner shall notify enrollees annually beginning at least 24 months
before the person's 65th birthday of the medical assistance eligibility rules affecting
income, assets, and treatment of a spouse's income and assets that will be applied upon
reaching age 65.

(k) For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
paragraph (a).

EFFECTIVE DATE.

This section is effective January 1, 2014, for adults age 21 or
older, and October 1, 2019, for children age 16 to before the child's 21st birthday.

Sec. 8.

Minnesota Statutes 2010, section 256B.0625, subdivision 19a, is amended to
read:


Subd. 19a.

Personal care assistance services.

Medical assistance covers personal
care assistance services in a recipient's home. Effective January 1, 2010, to qualify for
personal care assistance services, a recipient must require assistance and be determined
dependent in one activity of daily living as defined in section 256B.0659, subdivision 1,
paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1,
paragraph (c). Beginning July 1, 2011, to qualify for personal care assistance services, a
recipient must require assistance and be determined dependent in at least two activities
of daily living as defined in section 256B.0659.
Recipients or responsible parties must
be able to identify the recipient's needs, direct and evaluate task accomplishment, and
provide for health and safety. Approved hours may be used outside the home when normal
life activities take them outside the home. To use personal care assistance services at
school, the recipient or responsible party must provide written authorization in the care
plan identifying the chosen provider and the daily amount of services to be used at school.
Total hours for services, whether actually performed inside or outside the recipient's
home, cannot exceed that which is otherwise allowed for personal care assistance services
in an in-home setting according to sections 256B.0651 to 256B.0656. Medical assistance
does not cover personal care assistance services for residents of a hospital, nursing facility,
intermediate care facility, health care facility licensed by the commissioner of health, or
unless a resident who is otherwise eligible is on leave from the facility and the facility
either pays for the personal care assistance services or forgoes the facility per diem for the
leave days that personal care assistance services are used. All personal care assistance
services must be provided according to sections 256B.0651 to 256B.0656. Personal care
assistance services may not be reimbursed if the personal care assistant is the spouse or
paid guardian of the recipient or the parent of a recipient under age 18, or the responsible
party or the family foster care provider of a recipient who cannot direct the recipient's own
care unless, in the case of a foster care provider, a county or state case manager visits
the recipient as needed, but not less than every six months, to monitor the health and
safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding
the provisions of section 256B.0659, the unpaid guardian or conservator of an adult,
who is not the responsible party and not the personal care provider organization, may be
reimbursed to provide personal care assistance services to the recipient if the guardian or
conservator meets all criteria for a personal care assistant according to section 256B.0659,
and shall not be considered to have a service provider interest for purposes of participation
on the screening team under section 256B.092, subdivision 7.

Sec. 9.

Minnesota Statutes 2010, section 256B.0652, subdivision 6, is amended to read:


Subd. 6.

Authorization; personal care assistance and qualified professional.

(a) All personal care assistance services, supervision by a qualified professional, and
additional services beyond the limits established in subdivision 11, must be authorized
by the commissioner or the commissioner's designee before services begin except for the
assessments established in subdivision 11 and section 256B.0911. The authorization for
personal care assistance and qualified professional services under section 256B.0659 must
be completed within 30 days after receiving a complete request.

(b) The amount of personal care assistance services authorized must be based
on the recipient's home care rating. The home care rating shall be determined by the
commissioner or the commissioner's designee based on information submitted to the
commissioner identifying the following for recipients with dependencies in two or more
activities of daily living
:

(1) total number of dependencies of activities of daily living as defined in section
256B.0659;

(2) presence of complex health-related needs as defined in section 256B.0659; and

(3) presence of Level I behavior as defined in section 256B.0659.

(c) For purposes meeting the criteria in paragraph (b), the methodology to determine
total time for personal care assistance services for each home care rating is based on
the median paid units per day for each home care rating from fiscal year 2007 data for
the personal care assistance program. Each home care rating has a base level of hours
assigned. Additional time is added through the assessment and identification of the
following:

(1) 30 additional minutes per day for a dependency in each critical activity of daily
living as defined in section 256B.0659;

(2) 30 additional minutes per day for each complex health-related function as
defined in section 256B.0659; and

(3) 30 additional minutes per day for each behavior issue as defined in section
256B.0659, subdivision 4, paragraph (d).

(d) Effective July 1, 2011, the home care rating for recipients who have a dependency
in one activity of daily living or Level I behavior shall equal no more than two units per
day. Recipients with this home care rating are not subject to the methodology in paragraph
(c) and are not eligible for more than two units per day.

(e) A limit of 96 units of qualified professional supervision may be authorized for
each recipient receiving personal care assistance services. A request to the commissioner
to exceed this total in a calendar year must be requested by the personal care provider
agency on a form approved by the commissioner.

Sec. 10.

Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to
read:


Subd. 11.

Personal care assistant; requirements.

(a) A personal care assistant
must meet the following requirements:

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years
of age with these additional requirements:

(i) supervision by a qualified professional every 60 days; and

(ii) employment by only one personal care assistance provider agency responsible
for compliance with current labor laws;

(2) be employed by a personal care assistance provider agency;

(3) enroll with the department as a personal care assistant after clearing a background
study. Except as provided in subdivision 11a, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study on
the personal care assistant under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:

(i) not disqualified under section 245C.14; or

(ii) is disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;

(4) be able to effectively communicate with the recipient and personal care
assistance provider agency;

(5) be able to provide covered personal care assistance services according to the
recipient's personal care assistance care plan, respond appropriately to recipient needs,
and report changes in the recipient's condition to the supervising qualified professional
or physician;

(6) not be a consumer of personal care assistance services;

(7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;

(8) effective January 1, 2010, complete standardized training as determined
by the commissioner before completing enrollment. The training must be available
in languages other than English and to those who need accommodations due to
disabilities. Personal care assistant training must include successful completion of the
following training components: basic first aid, vulnerable adult, child maltreatment,
OSHA universal precautions, basic roles and responsibilities of personal care assistants
including information about assistance with lifting and transfers for recipients, emergency
preparedness, orientation to positive behavioral practices, fraud issues, and completion of
time sheets. Upon completion of the training components, the personal care assistant must
demonstrate the competency to provide assistance to recipients;

(9) complete training and orientation on the needs of the recipient within the first
seven days after the services begin; and

(10) be limited to providing and being paid for up to 275 hours per month, except
that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
2011, of personal care assistance services regardless of the number of recipients being
served or the number of personal care assistance provider agencies enrolled with. The
number of hours worked per day shall not be disallowed by the department unless in
violation of the law.

(b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).

(c) Effective January 1, 2010, Persons who do not qualify as a personal care assistant
include parents and stepparents of minors, spouses, paid legal guardians, family foster
care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or
staff of a residential setting. When the personal care assistant is a relative of the recipient,
the commissioner shall pay 80 percent of the provider rate. For purposes of this section,
relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or
older, an adult child, a grandparent, or a grandchild.

EFFECTIVE DATE.

This section is effective October 1, 2011.

Sec. 11.

Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to
read:


Subd. 28.

Personal care assistance provider agency; required documentation.

(a) Required documentation must be completed and kept in the personal care assistance
provider agency file or the recipient's home residence. The required documentation
consists of:

(1) employee files, including:

(i) applications for employment;

(ii) background study requests and results;

(iii) orientation records about the agency policies;

(iv) trainings completed with demonstration of competence;

(v) supervisory visits;

(vi) evaluations of employment; and

(vii) signature on fraud statement;

(2) recipient files, including:

(i) demographics;

(ii) emergency contact information and emergency backup plan;

(iii) personal care assistance service plan;

(iv) personal care assistance care plan;

(v) month-to-month service use plan;

(vi) all communication records;

(vii) start of service information, including the written agreement with recipient; and

(viii) date the home care bill of rights was given to the recipient;

(3) agency policy manual, including:

(i) policies for employment and termination;

(ii) grievance policies with resolution of consumer grievances;

(iii) staff and consumer safety;

(iv) staff misconduct; and

(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
resolution of consumer grievances;

(4) time sheets for each personal care assistant along with completed activity sheets
for each recipient served; and

(5) agency marketing and advertising materials and documentation of marketing
activities and costs; and

(6) for each personal care assistant, whether or not the personal care assistant is
providing care to a relative as defined in subdivision 11
.

(b) The commissioner may assess a fine of up to $500 on provider agencies that do
not consistently comply with the requirements of this subdivision.

Sec. 12.

Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to
read:


Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

(a) "Long-term care consultation services" means:

(1) assistance in identifying services needed to maintain an individual in the most
inclusive environment;

(2) providing recommendations on cost-effective community services that are
available to the individual;

(3) development of an individual's person-centered community support plan;

(4) providing information regarding eligibility for Minnesota health care programs;

(5) face-to-face long-term care consultation assessments, which may be completed
in a hospital, nursing facility, intermediate care facility for persons with developmental
disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
residence;

(6) federally mandated screening to determine the need for an institutional level of
care under subdivision 4a;

(7) determination of home and community-based waiver service eligibility including
level of care determination for individuals who need an institutional level of care as
defined under section 144.0724, subdivision 11, determined under section 256B.0911,
subdivision 4a, paragraph (d),
or 256B.092, service eligibility including state plan home
care services identified in sections 256B.0625, subdivisions 6, 7, and 19, paragraphs
(a) and (c), and 256B.0657, based on assessment and support plan development with
appropriate referrals, including the option for consumer-directed community supports;

(8) providing recommendations for nursing facility placement when there are no
cost-effective community services available; and

(9) assistance to transition people back to community settings after facility
admission.

(b) "Long-term care options counseling" means the services provided by the linkage
lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
telephone assistance and follow up once a long-term care consultation assessment has
been completed.

(c) "Minnesota health care programs" means the medical assistance program under
chapter 256B and the alternative care program under section 256B.0913.

(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
plans administering long-term care consultation assessment and support planning services.

Sec. 13.

Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to
read:


Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment,
services planning, or other assistance intended to support community-based living,
including persons who need assessment in order to determine waiver or alternative care
program eligibility, must be visited by a long-term care consultation team within 15
calendar days after the date on which an assessment was requested or recommended. After
January 1, 2011, these requirements also apply to personal care assistance services, private
duty nursing, and home health agency services, on timelines established in subdivision 5.
Face-to-face assessments must be conducted according to paragraphs (b) to (i).

(b) The county may utilize a team of either the social worker or public health nurse,
or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
assessment in a face-to-face interview. The consultation team members must confer
regarding the most appropriate care for each individual screened or assessed.

(c) The assessment must be comprehensive and include a person-centered
assessment of the health, psychological, functional, environmental, and social needs of
referred individuals and provide information necessary to develop a support plan that
meets the consumers needs, using an assessment form provided by the commissioner.

(d) The assessment must be conducted in a face-to-face interview with the person
being assessed and the person's legal representative, as required by legally executed
documents, and other individuals as requested by the person, who can provide information
on the needs, strengths, and preferences of the person necessary to develop a support plan
that ensures the person's health and safety, but who is not a provider of service or has any
financial interest in the provision of services.

(e) The person, or the person's legal representative, must be provided with written
recommendations for community-based services, including consumer-directed options,
or institutional care that include documentation that the most cost-effective alternatives
available were offered to the individual, and alternatives to residential settings, including,
but not limited to, foster care settings that are not the primary residence of the license
holder
. For purposes of this requirement, "cost-effective alternatives" means community
services and living arrangements that cost the same as or less than institutional care.

(f) If the person chooses to use community-based services, the person or the person's
legal representative must be provided with a written community support plan, regardless
of whether the individual is eligible for Minnesota health care programs. A person may
request assistance in identifying community supports without participating in a complete
assessment. Upon a request for assistance identifying community support, the person must
be transferred or referred to the services available under sections 256.975, subdivision 7,
and 256.01, subdivision 24, for telephone assistance and follow up.

(g) The person has the right to make the final decision between institutional
placement and community placement after the recommendations have been provided,
except as provided in subdivision 4a, paragraph (c).

(h) The team must give the person receiving assessment or support planning, or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) the need for and purpose of preadmission screening if the person selects nursing
facility placement;

(2) the role of the long-term care consultation assessment and support planning in
waiver and alternative care program eligibility determination;

(3) information about Minnesota health care programs;

(4) the person's freedom to accept or reject the recommendations of the team;

(5) the person's right to confidentiality under the Minnesota Government Data
Practices Act, chapter 13;

(6) the long-term care consultant's decision regarding the person's need for
institutional level of care as determined under criteria established in section 144.0724,
subdivision 11
, or 256B.092; and

(7) the person's right to appeal the decision regarding the need for nursing facility
level of care or the county's final decisions regarding public programs eligibility according
to section 256.045, subdivision 3.

(i) Face-to-face assessment completed as part of eligibility determination for
the alternative care, elderly waiver, community alternatives for disabled individuals,
community alternative care, and traumatic brain injury waiver programs under sections
256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
than 60 calendar days after the date of assessment. The effective eligibility start date
for these programs can never be prior to the date of assessment. If an assessment was
completed more than 60 days before the effective waiver or alternative care program
eligibility start date, assessment and support plan information must be updated in a
face-to-face visit and documented in the department's Medicaid Management Information
System (MMIS). The effective date of program eligibility in this case cannot be prior to
the date the updated assessment is completed.

Sec. 14.

Minnesota Statutes 2010, section 256B.0911, subdivision 3c, is amended to
read:


Subd. 3c.

Transition to Consultation for housing with services.

(a) Housing
with services establishments offering or providing assisted living under chapter 144G
shall inform all prospective residents of the availability of and contact information
for transitional consultation services under this subdivision prior to executing a lease
or contract with the prospective resident.
The purpose of transitional long-term care
consultation for registered housing with services is to support persons with current or
anticipated long-term care needs in making informed choices among options that include
the most cost-effective and least restrictive settings, and to delay spenddown to eligibility
for publicly funded programs by connecting people to alternative services in their homes
before transition to housing with services. Regardless of the consultation,
. Prospective
residents maintain the right to choose housing with services or assisted living if that
option is their preference.

(b) Transitional consultation Registered housing with services establishments
shall inform all prospective residents of the availability of long-term care consultation
and the need to receive and verify the consultation prior to signing a lease or contract.
Long-term care consultation for registered housing with
services are is provided as
determined by the commissioner of human services in partnership with county long-term
care consultation units, and the Area Agencies on Aging, and are a combination of
telephone-based and in-person assistance provided under models developed by the
commissioner. The consultation shall be performed in a manner that provides objective
and complete information. Transitional consultation
. The service is delivered under a
partnership between lead agencies as defined in subdivision 1a, paragraph (d), and the
Area Agencies on Aging, and is a point of entry to a combination of telephone-based
long-term care options counseling provided by Senior LinkAge Line and in-person
long-term care consultation provided by lead agencies. The point of entry service
must be
provided within five working days of the request of the prospective resident as follows:

(1) the consultation must be provided by a qualified professional as determined by
the commissioner
shall be performed in a manner that provides objective and complete
information
;

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

(3) the prospective resident shall be informed of the availability of long-term care
consultation services described in subdivision 3a that are available
a face-to-face visit at
no charge to the prospective resident to assist the prospective resident in assessment and
planning to meet the prospective resident's long-term care needs. The Senior LinkAge Line
and long-term care consultation team shall give the highest priority to referrals who are at
highest risk of nursing facility placement or as needed for determining eligibility.
; and

(4) verification of counseling shall be generated and provided to the prospective
resident by Senior LinkAge Line upon completion of the telephone-based counseling.

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

(1) inform all prospective residents of the availability of and contact information for
consultation services under this subdivision;

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

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

EFFECTIVE DATE.

This section is effective October 1, 2011.

Sec. 15.

Minnesota Statutes 2010, section 256B.0911, subdivision 4a, is amended to
read:


Subd. 4a.

Preadmission screening activities related to nursing facility
admissions.

(a) All applicants to Medicaid certified nursing facilities, including certified
boarding care facilities, must be screened prior to admission regardless of income, assets,
or funding sources for nursing facility care, except as described in subdivision 4b. The
purpose of the screening is to determine the need for nursing facility level of care as
described in paragraph (d) and to complete activities required under federal law related to
mental illness and developmental disability as outlined in paragraph (b).

(b) A person who has a diagnosis or possible diagnosis of mental illness or
developmental disability must receive a preadmission screening before admission
regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need
for further evaluation and specialized services, unless the admission prior to screening is
authorized by the local mental health authority or the local developmental disabilities case
manager, or unless authorized by the county agency according to Public Law 101-508.

The following criteria apply to the preadmission screening:

(1) the county must use forms and criteria developed by the commissioner to identify
persons who require referral for further evaluation and determination of the need for
specialized services; and

(2) the evaluation and determination of the need for specialized services must be
done by:

(i) a qualified independent mental health professional, for persons with a primary or
secondary diagnosis of a serious mental illness; or

(ii) a qualified developmental disability professional, for persons with a primary or
secondary diagnosis of developmental disability. For purposes of this requirement, a
qualified developmental disability professional must meet the standards for a qualified
developmental disability professional under Code of Federal Regulations, title 42, section
483.430.

(c) The local county mental health authority or the state developmental disability
authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
nursing facility if the individual does not meet the nursing facility level of care criteria or
needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
purposes of this section, "specialized services" for a person with developmental disability
means active treatment as that term is defined under Code of Federal Regulations, title
42, section 483.440 (a)(1).

(d) The determination of the need for nursing facility level of care must be made
according to criteria established developed by the commissioner, and in section 144.0724,
subdivision 11
, and
256B.092, using forms developed by the commissioner. Effective no
sooner than on or after July 1, 2012, for individuals age 21 and older, and on or after
October 1, 2019, for individuals under age 21, the determination of need for nursing
facility level of care shall be based on criteria in section 144.0724, subdivision 11.
In
assessing a person's needs, consultation team members shall have a physician available for
consultation and shall consider the assessment of the individual's attending physician, if
any. The individual's physician must be included if the physician chooses to participate.
Other personnel may be included on the team as deemed appropriate by the county.

Sec. 16.

Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to
read:


Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a) Funding for services under the alternative care program is available to persons who
meet the following criteria:

(1) the person has been determined by a community assessment under section
256B.0911 to be a person who would require the level of care provided in a nursing
facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for
the provision of services under the alternative care program. Effective January 1, 2011,
this determination must be made according to the criteria established in section 144.0724,
subdivision 11
;

(2) the person is age 65 or older;

(3) the person would be eligible for medical assistance within 135 days of admission
to a nursing facility;

(4) the person is not ineligible for the payment of long-term care services by the
medical assistance program due to an asset transfer penalty under section 256B.0595 or
equity interest in the home exceeding $500,000 as stated in section 256B.056;

(5) the person needs long-term care services that are not funded through other
state or federal funding, or other health insurance or other third-party insurance such as
long-term care insurance;

(6) except for individuals described in clause (7), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
does not prohibit the alternative care client from payment for additional services, but in no
case may the cost of additional services purchased under this section exceed the difference
between the client's monthly service limit defined under section 256B.0915, subdivision
3
, and the alternative care program monthly service limit defined in this paragraph. If
care-related supplies and equipment or environmental modifications and adaptations are or
will be purchased for an alternative care services recipient, the costs may be prorated on a
monthly basis for up to 12 consecutive months beginning with the month of purchase.
If the monthly cost of a recipient's other alternative care services exceeds the monthly
limit established in this paragraph, the annual cost of the alternative care services shall be
determined. In this event, the annual cost of alternative care services shall not exceed 12
times the monthly limit described in this paragraph;

(7) for individuals assigned a case mix classification A as described under section
256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily
living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming,
or walking, or (iii) a dependency score of less than three if eating is the only dependency
and eating when the dependency score in eating is three or greater
as determined by
an assessment performed under section 256B.0911, the monthly cost of alternative
care services funded by the program cannot exceed $600 $593 per month for all new
participants enrolled in the program on or after July 1, 2009 2011. This monthly limit
shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in section 256B.0915, subdivision
3a
, paragraph (a). This monthly limit does not prohibit the alternative care client from
payment for additional services, but in no case may the cost of additional services
purchased exceed the difference between the client's monthly service limit defined in this
clause and the limit described in clause (6) for case mix classification A; and

(8) the person is making timely payments of the assessed monthly fee.

A person is ineligible if payment of the fee is over 60 days past due, unless the person
agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments.

The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

(b) Alternative care funding under this subdivision is not available for a person
who is a medical assistance recipient or who would be eligible for medical assistance
without a spenddown or waiver obligation. A person whose initial application for medical
assistance and the elderly waiver program is being processed may be served under the
alternative care program for a period up to 60 days. If the individual is found to be eligible
for medical assistance, medical assistance must be billed for services payable under the
federally approved elderly waiver plan and delivered from the date the individual was
found eligible for the federally approved elderly waiver plan. Notwithstanding this
provision, alternative care funds may not be used to pay for any service the cost of which:
(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
to participate in the federally approved elderly waiver program under the special income
standard provision.

(c) Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.

(d) Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
year for which alternative care eligibility is determined, who would be eligible for the
elderly waiver with a waiver obligation.

Sec. 17.

Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to
read:


Subd. 3a.

Elderly waiver cost limits.

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

(b) The monthly limit for the cost of waivered services to an individual elderly
waiver client assigned to a case mix classification A under paragraph (a) with:

(1) no dependencies in activities of daily living,; or

(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
walking, or (3) a dependency score of less than three if eating is the only dependency,
and eating when the dependency score in eating is three or greater as determined by an
assessment performed under section 256B.0911

shall be the lower of the case mix classification amount for case mix A as determined
under paragraph (a) or the case mix classification amount for case mix A
$1,750 per
month
effective on October July 1, 2008 2011, per month for all new participants enrolled
in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all
other participants who meet this criteria at reassessment. This monthly limit shall be
increased annually as described in paragraph (a).

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

Sec. 18.

Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to
read:


Subd. 3b.

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

(a) For a person who is a nursing facility resident at the time of requesting a
determination of eligibility for elderly waivered services, a monthly conversion budget
limit for the cost of elderly waivered services may be requested. The monthly conversion
budget limit for the cost of elderly waiver services shall be the resident class assigned
under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing
facility where the resident currently resides until July 1 of the state fiscal year in which
the resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented. Effective on July 1 of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented, the monthly conversion budget limit for the cost of elderly
waiver services shall be based on the per diem nursing facility rate as determined by the
resident assessment system as described in section 256B.438 for that resident residents
in the nursing facility where the resident elderly waiver applicant currently resides
multiplied. The monthly conversion budget limit shall be calculated by multiplying the
per diem
by 365 and, divided by 12, less and reduced by the recipient's maintenance needs
allowance as described in subdivision 1d. The initially approved monthly conversion rate
may
budget limit shall be adjusted by the greater of any subsequent legislatively adopted
home and community-based services percentage rate increase or the average statewide
percentage increase in nursing facility payment rates
annually as described in subdivision
3a, paragraph (a)
. The limit under this subdivision only applies to persons discharged from
a nursing facility after a minimum 30-day stay and found eligible for waivered services
on or after July 1, 1997. For conversions from the nursing home to the elderly waiver
with consumer directed community support services, the conversion rate limit is equal to
the
nursing facility rate per diem used to calculate the monthly conversion budget limit
must be
reduced by a percentage equal to the percentage difference between the consumer
directed services budget limit that would be assigned according to the federally approved
waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.

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

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

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

Sec. 19.

Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to
read:


Subd. 3e.

Customized living service rate.

(a) Payment for customized living
services shall be a monthly rate authorized by the lead agency within the parameters
established by the commissioner. The payment agreement must delineate the amount of
each component service included in the recipient's customized living service plan. The
lead agency shall ensure that there is a documented need within the parameters established
by the commissioner for all component customized living services authorized.

(b) The payment rate must be based on the amount of component services to be
provided utilizing component rates established by the commissioner. Counties and tribes
shall use tools issued by the commissioner to develop and document customized living
service plans and rates.

(c) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale. Customized
living services must not include rent or raw food costs.

(d) With the exception of individuals described in subdivision 3a, paragraph (b), the
individualized monthly authorized payment for the customized living service plan shall
not exceed 50 percent of the greater of either the statewide or any of the geographic
groups' weighted average monthly nursing facility rate of the case mix resident class
to which the elderly waiver eligible client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented. Effective on July 1 of the state fiscal year in which
the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and July 1 of each subsequent state fiscal year, the
individualized monthly authorized payment for the services described in this clause shall
not exceed the limit which was in effect on June 30 of the previous state fiscal year
updated annually based on legislatively adopted changes to all service rate maximums for
home and community-based service providers.

(e) Effective July 1, 2011, the individualized monthly payment for the customized
living service plan for individuals described in subdivision 3a, paragraph (b), must be the
monthly authorized payment limit for customized living for individuals classified as case
mix A, reduced by 25 percent. This rate limit must be applied to all new participants
enrolled in the program on or after July 1, 2011, who meet the criteria described in
subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
meet the criteria described in subdivision 3a, paragraph (b), at reassessment.

(e) (f) Customized living services are delivered by a provider licensed by the
Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.
Licensed home care providers are subject to section 256B.0651, subdivision 14.

(g) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (d), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.

Sec. 20.

Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to
read:


Subd. 3h.

Service rate limits; 24-hour customized living services.

(a) The
payment rate for 24-hour customized living services is a monthly rate authorized by the
lead agency within the parameters established by the commissioner of human services.
The payment agreement must delineate the amount of each component service included in
each recipient's customized living service plan. The lead agency shall ensure that there is a
documented need within the parameters established by the commissioner for all component
customized living services authorized. The lead agency shall not authorize 24-hour
customized living services unless there is a documented need for 24-hour supervision.

(b) For purposes of this section, "24-hour supervision" means that the recipient
requires assistance due to needs related to one or more of the following:

(1) intermittent assistance with toileting, positioning, or transferring;

(2) cognitive or behavioral issues;

(3) a medical condition that requires clinical monitoring; or

(4) for all new participants enrolled in the program on or after January July 1, 2011,
and all other participants at their first reassessment after January July 1, 2011, dependency
in at least two three of the following activities of daily living as determined by assessment
under section 256B.0911: bathing; dressing; grooming; walking; or eating when the
dependency score in eating is three or greater
; and needs medication management and at
least 50 hours of service per month. The lead agency shall ensure that the frequency and
mode of supervision of the recipient and the qualifications of staff providing supervision
are described and meet the needs of the recipient.

(c) The payment rate for 24-hour customized living services must be based on the
amount of component services to be provided utilizing component rates established by the
commissioner. Counties and tribes will use tools issued by the commissioner to develop
and document customized living plans and authorize rates.

(d) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale.

(e) The individually authorized 24-hour customized living payments, in combination
with the payment for other elderly waiver services, including case management, must not
exceed the recipient's community budget cap specified in subdivision 3a. Customized
living services must not include rent or raw food costs.

(f) The individually authorized 24-hour customized living payment rates shall not
exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
living services in effect and in the Medicaid management information systems on March
31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
to 9549.0059, to which elderly waiver service clients are assigned. When there are
fewer than 50 authorizations in effect in the case mix resident class, the commissioner
shall multiply the calculated service payment rate maximum for the A classification by
the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
9549.0059, to determine the applicable payment rate maximum. Service payment rate
maximums shall be updated annually based on legislatively adopted changes to all service
rates for home and community-based service providers.

(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
may establish alternative payment rate systems for 24-hour customized living services in
housing with services establishments which are freestanding buildings with a capacity of
16 or fewer, by applying a single hourly rate for covered component services provided
in either:

(1) licensed corporate adult foster homes; or

(2) specialized dementia care units which meet the requirements of section 144D.065
and in which:

(i) each resident is offered the option of having their own apartment; or

(ii) the units are licensed as board and lodge establishments with maximum capacity
of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
subparts 1, 2, 3, and 4, item A.

(h) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (e), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.

Sec. 21.

Minnesota Statutes 2010, section 256B.0915, subdivision 5, is amended to
read:


Subd. 5.

Assessments and reassessments for waiver clients.

(a) Each client
shall receive an initial assessment of strengths, informal supports, and need for services
in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
client served under the elderly waiver must be conducted at least every 12 months and
at other times when the case manager determines that there has been significant change
in the client's functioning. This may include instances where the client is discharged
from the hospital. There must be a determination that the client requires nursing facility
level of care as defined in section 144.0724, subdivision 11 256B.0911, subdivision 4a,
paragraph (d)
, at initial and subsequent assessments to initiate and maintain participation
in the waiver program.

(b) Regardless of other assessments identified in section 144.0724, subdivision
4, as appropriate to determine nursing facility level of care for purposes of medical
assistance payment for nursing facility services, only face-to-face assessments conducted
according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
level of care determination will be accepted for purposes of initial and ongoing access to
waiver service payment.

Sec. 22.

Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to
read:


Subd. 10.

Waiver payment rates; managed care organizations.

The
commissioner shall adjust the elderly waiver capitation payment rates for managed care
organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
service rate limits for customized living services and 24-hour customized living services
under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical
assistance rates paid to customized living providers by managed care organizations under
this section shall not exceed the maximum service rate limits and component rates as
determined by the commissioner under subdivisions 3e and 3h.

Sec. 23.

[256B.0961] STATE QUALITY ASSURANCE, QUALITY
IMPROVEMENT, AND LICENSING SYSTEM.

Subdivision 1.

Scope.

(a) In order to improve the quality of services provided to
Minnesotans with disabilities and to meet the requirements of the federally approved
home and community-based waivers under section 1915c of the Social Security Act, a
State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans
receiving disability services is enacted. This system is a partnership between the
Department of Human Services and the State Quality Council established under
subdivision 3.

(b) This system is a result of the recommendations from the Department of Human
Services' licensing and alternative quality assurance study mandated under Laws 2005,
First Special Session chapter 4, article 7, section 57, and presented to the legislature
in February 2007.

(c) The disability services eligible under this section include:

(1) the home and community-based services waiver programs for persons with
developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
including traumatic brain injuries and services for those who qualify for nursing facility
level of care or hospital facility level of care;

(2) home care services under section 256B.0651;

(3) family support grants under section 252.32;

(4) consumer support grants under section 256.476;

(5) semi-independent living services under section 252.275; and

(6) services provided through an intermediate care facility for the developmentally
disabled.

(d) For purposes of this section, the following definitions apply:

(1) "commissioner" means the commissioner of human services;

(2) "council" means the State Quality Council under subdivision 3;

(3) "Quality Assurance Commission" means the commission under section
256B.0951; and

(4) "system" means the State Quality Assurance, Quality Improvement and
Licensing System under this section.

Subd. 2.

Duties of the commissioner of human services.

(a) The commissioner of
human services shall establish the State Quality Council under subdivision 3.

(b) The commissioner shall initially delegate authority to perform licensing
functions and activities according to section 245A.16 to a host county in Region 10. The
commissioner must not license or reimburse a participating facility, program, or service
located in Region 10 if the commissioner has received notification from the host county
that the facility, program, or service has failed to qualify for licensure.

(c) The commissioner may conduct random licensing inspections based on outcomes
adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services
eligible under this section. The role of the random inspections is to verify that the system
protects the safety and well-being of persons served and maintains the availability of
high-quality services for persons with disabilities.

(d) The commissioner shall ensure that the federal home and community-based
waiver requirements are met and that incidents that may have jeopardized safety and health
or violated services-related assurances, civil and human rights, and other protections
designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and
acted upon in a timely manner.

(e) The commissioner shall seek a federal waiver by July 1, 2012 to allow
intermediate care facilities for persons with developmental disabilities to participate in
this system.

Subd. 3.

State Quality Council.

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

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