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Capital IconMinnesota Legislature

HF 2614

4th Engrossment - 86th Legislature (2009 - 2010) Posted on 05/13/2010 12:10am

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

Bill Text Versions

Engrossments
Introduction Posted on 01/08/2010
1st Engrossment Posted on 05/03/2010
2nd Engrossment Posted on 05/03/2010
3rd Engrossment Posted on 05/05/2010
4th Engrossment Posted on 05/13/2010
Committee Engrossments
1st Committee Engrossment Posted on 04/28/2010
Conference Committee Reports
CCR-HF2614A Posted on 05/12/2010

Current Version - 4th Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 1.39 2.1 2.2 2.3 2.4
2.5 2.6
2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22
2.23
2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 3.34 3.35 3.36 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19
4.20
4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10
5.11
5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 6.34 6.35 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30
7.31
7.32 7.33 7.34 7.35 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23
8.24
8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 8.34 8.35 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24
9.25
9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29
10.30
10.31 10.32 10.33 10.34 10.35 11.1 11.2 11.3 11.4 11.5 11.6
11.7
11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 11.34 11.35 12.1 12.2
12.3
12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23
12.24
12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 13.1 13.2 13.3 13.4 13.5
13.6 13.7
13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21
13.22 13.23
13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 14.1 14.2 14.3
14.4 14.5
14.6 14.7 14.8 14.9 14.10
14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 14.34 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 15.35 15.36 16.1 16.2 16.3 16.4 16.5 16.6 16.7
16.8
16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25
16.26
16.27 16.28 16.29 16.30 16.31 16.32 16.33 17.1 17.2 17.3 17.4
17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30
17.31
17.32 17.33 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27
18.28
18.29 18.30 18.31 18.32 18.33 18.34 18.35 19.1 19.2 19.3 19.4 19.5 19.6 19.7
19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 19.35 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26
20.27
20.28 20.29 20.30 20.31 20.32 20.33 20.34 20.35 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10
21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 22.35 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 23.35 24.1 24.2 24.3 24.4 24.5 24.6 24.7
24.8
24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 24.34 24.35 25.1 25.2 25.3 25.4 25.5
25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 25.34 25.35 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 26.34 26.35 26.36 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 27.35 27.36
28.1
28.2 28.3 28.4 28.5 28.6
28.7
28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24
28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32
29.1
29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11
29.12
29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33 29.34 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29
30.30
30.31 30.32 30.33 30.34 30.35 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27
31.28
31.29 31.30 31.31 31.32 31.33 31.34 31.35 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 32.35 32.36 33.1 33.2 33.3 33.4 33.5
33.6
33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22
33.23 33.24 33.25 33.26 33.27 33.28 33.29
33.30 33.31 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18
34.19
34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 34.34 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9
35.10
35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22
35.23
35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23
36.24
36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 36.34 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26
37.27 37.28 37.29 37.30 37.31 37.32 37.33 37.34 37.35 38.1 38.2 38.3 38.4 38.5
38.6
38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18
38.19
38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 39.34 39.35 39.36 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8
40.9
40.10 40.11 40.12 40.13 40.14 40.15
40.16
40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 40.33 41.1 41.2
41.3 41.4 41.5
41.6 41.7
41.8 41.9
41.10
41.11 41.12
41.13
41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25
41.26
41.27 41.28 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20
42.21
42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30
42.31 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19
43.20
43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28
43.29
43.30 43.31 43.32 44.1 44.2 44.3 44.4
44.5
44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17
44.18
44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26
44.27 44.28 44.29 44.30 44.31
44.32
45.1 45.2
45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33
46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16
46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33 46.34 46.35 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20
47.21 47.22 47.23 47.24
47.25 47.26 47.27 47.28 47.29
47.30 47.31 47.32 47.33 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15
48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 48.34 48.35 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 49.33 49.34 49.35 49.36 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 50.34 50.35 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 51.34 51.35 51.36 52.1 52.2 52.3 52.4 52.5
52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21
52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 52.34 53.1 53.2 53.3 53.4
53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 53.34 53.35 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 54.35 55.1 55.2 55.3 55.4 55.5 55.6 55.7
55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 55.34 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 56.34 56.35 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18
57.19
57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 57.33 57.34 57.35 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31
58.32
58.33 58.34 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 59.33 59.34 59.35 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18
60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28
60.29 60.30 60.31 60.32 60.33 60.34 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 61.34 61.35 61.36 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21
62.22
62.23 62.24 62.25 62.26 62.27 62.28
62.29
62.30 62.31 62.32 62.33 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 63.34 63.35 63.36 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 64.34 64.35 64.36 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 65.33 65.34 65.35 65.36 66.1 66.2
66.3 66.4
66.5
66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 66.34 67.1 67.2 67.3
67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22
67.23
67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32
67.33 68.1 68.2 68.3
68.4 68.5
68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13
68.14
68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23
68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34
69.35
70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 70.34 70.35 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8
71.9 71.10
71.11
71.12 71.13
71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27
71.28 71.29
71.30 71.31 71.32 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11
72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 72.34 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33 73.34 73.35 73.36 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 74.34 74.35 74.36 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33 75.34 75.35 75.36 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 76.34 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 77.33 77.34 77.35 77.36 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8
78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33 78.34 78.35 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 79.33 79.34 79.35 79.36 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8
80.9 80.10 80.11 80.12 80.13
80.14 80.15 80.16 80.17 80.18
80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27
80.28 80.29 80.30 80.31 80.32 81.1 81.2 81.3
81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 81.33 81.34 81.35 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15
82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24
82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33 82.34 83.1 83.2 83.3 83.4 83.5 83.6
83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17
83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29
83.30 83.31 83.32 83.33 84.1 84.2
84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 84.33 84.34 84.35 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30
85.31 85.32 85.33 85.34 85.35 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 86.34 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 87.34 87.35 87.36 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13
88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 88.33 88.34 89.1 89.2 89.3
89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28
89.29 89.30 89.31 89.32 89.33 89.34 90.1 90.2 90.3 90.4 90.5
90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23
90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32
90.33 91.1 91.2
91.3 91.4
91.5 91.6
91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19
91.20
91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13
92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 92.33 92.34 92.35 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22
93.23 93.24 93.25 93.26 93.27 93.28
93.29 93.30 93.31 93.32 93.33 93.34 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9
94.10
94.11 94.12 94.13 94.14
94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 94.32 94.33 94.34 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 95.34 95.35 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 96.33 96.34 96.35 96.36
97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18
97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31
97.32 97.33 97.34 98.1 98.2
98.3 98.4 98.5 98.6 98.7 98.8 98.9
98.10
98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33
99.1 99.2 99.3 99.4 99.5 99.6
99.7 99.8 99.9 99.10 99.11 99.12 99.13
99.14 99.15 99.16 99.17 99.18
99.19
99.20 99.21 99.22 99.23
99.24
99.25 99.26
99.27 99.28 99.29 99.30 99.31 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 100.33 100.34 100.35 100.36 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17
101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 101.33 101.34 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 102.34 102.35 102.36 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 103.34 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 104.34 104.35 104.36 104.37 104.38 104.39 104.40 104.41 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10
105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 105.33 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19
106.20 106.21 106.22 106.23 106.24 106.25 106.26
106.27 106.28
106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25
107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 107.34 107.35 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 108.33 108.34 108.35 108.36 109.1 109.2 109.3 109.4 109.5 109.6
109.7 109.8
109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 109.33 109.34 109.35 110.1 110.2 110.3 110.4 110.5
110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 110.34 110.35 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8
111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24
111.25 111.26
111.27 111.28 111.29 111.30 111.31 111.32 111.33 111.34
112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16
112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 112.34 112.35 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29
113.30 113.31
114.1 114.2
114.3 114.4 114.5 114.6 114.7 114.8 114.9
114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27
114.28 114.29 114.30 114.31 114.32 114.33 114.34 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16
115.17 115.18 115.19 115.20 115.21 115.22 115.23
115.24
115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26
116.27 116.28 116.29 116.30 116.31 116.32 116.33 116.34 116.35 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14
117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 117.33
118.1 118.2
118.3 118.4 118.5 118.6 118.7
118.8 118.9
118.10 118.11 118.12 118.13
118.14 118.15
118.16 118.17 118.18 118.19
118.20 118.21
118.22 118.23 118.24 118.25 118.26
118.27 118.28
118.29
119.1 119.2
119.3 119.4 119.5 119.6 119.7
119.8 119.9
119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20
119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 120.1 120.2
120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 120.34 120.35 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 121.33 121.34 121.35 121.36 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 123.34 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 125.34 125.35 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 126.34 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 127.33 127.34 127.35 127.36 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 128.34 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 129.34 129.35 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 130.34 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 131.33 131.34 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 132.33 132.34 132.35 132.36 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 133.34 133.35 133.36 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 134.33 134.34 134.35 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 135.34 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 136.34 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 137.34 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 138.34 138.35 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 139.34 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 140.34 140.35
141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 141.33 141.34 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33 142.34 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20
143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29
143.30 143.31 143.32 143.33 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 144.34 144.35 145.1 145.2 145.3
145.4 145.5
145.6 145.7 145.8 145.9
145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19
145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27
145.28 145.29 145.30 145.31 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8
146.9
146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 146.34 146.35 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 147.34 147.35 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 148.33 148.34 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 149.33 149.34 149.35 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 150.33 150.34 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 151.33 151.34 151.35 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 152.34 152.35 152.36 153.1 153.2 153.3 153.4 153.5 153.6
153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29
153.30 153.31 153.32 153.33 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 154.35 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 155.35 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 156.34 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 157.33 157.34 157.35 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 158.33 158.34 158.35 158.36 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 159.34 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 160.33 160.34 160.35 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 161.34 161.35 161.36 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 162.34 162.35 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 163.33 163.34 163.35 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 164.34 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 165.33 165.34 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 166.34 166.35 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29
167.30 167.31 167.32 167.33 167.34 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 168.34 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 169.33 169.34 169.35 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34 170.35 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 171.33 171.34 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 172.33 172.34 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20
173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33 173.34 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 174.34 174.35 174.36 175.1 175.2
175.3 175.4 175.5
175.6 175.7 175.8

A bill for an act
relating to state government; state health care programs; continuing care;
children and family services; health care reform; Department of Health;
public health; health plans; increasing fees and surcharges; requiring reports;
making supplemental and contingent appropriations and reductions for the
Departments of Health and Human Services and other health-related boards
and councils; amending Minnesota Statutes 2008, sections 62D.08, by adding
a subdivision; 62J.692, subdivision 4; 62Q.19, subdivision 1; 144.05, by
adding a subdivision; 144.226, subdivision 3; 144.293, subdivision 4; 144.651,
subdivision 2; 144.9504, by adding a subdivision; 144A.51, subdivision 5;
144D.03, subdivision 2, by adding a subdivision; 144D.04, subdivision 2;
144E.37; 144G.06; 152.126, as amended; 214.40, subdivision 7; 246.18, by
adding a subdivision; 254B.01, subdivision 2; 254B.02, subdivisions 1, 5;
254B.03, subdivision 4; 254B.05, subdivision 4; 254B.06, subdivision 2;
254B.09, subdivision 8; 256.9657, subdivisions 2, 3, 3a; 256.969, subdivisions
21, 26, by adding a subdivision; 256B.055, by adding a subdivision; 256B.056,
subdivisions 3, 4; 256B.057, subdivision 9; 256B.0625, subdivisions 8, 8a, 8b,
18a, 22, 31, by adding subdivisions; 256B.0631, subdivisions 1, 3; 256B.0644,
as amended; 256B.0915, by adding a subdivision; 256B.19, subdivision 1c;
256B.5012, by adding a subdivision; 256B.69, subdivisions 20, as amended,
27, by adding a subdivision; 256B.692, subdivision 1; 256B.76, subdivisions
2, 4; 256D.03, subdivision 3b; 256D.0515; 256I.05, by adding a subdivision;
256J.24, subdivision 6; 256L.07, by adding a subdivision; 256L.11, subdivision
6; 256L.12, subdivisions 5, 9, by adding a subdivision; 256L.15, subdivision
1; 517.08, subdivision 1c, as amended; Minnesota Statutes 2009 Supplement,
sections 157.16, subdivision 3; 252.27, subdivision 2a; 256.969, subdivisions 2b,
3a; 256.975, subdivision 7; 256B.0625, subdivision 13h; 256B.0653, subdivision
5; 256B.0659, subdivision 11; 256B.0911, subdivisions 1a, 3c; 256B.441,
subdivision 55; 256B.69, subdivisions 5a, 23; 256B.76, subdivision 1; 256B.766;
256D.03, subdivision 3, as amended; 256J.425, subdivision 3; 256L.03,
subdivision 5; 327.15, subdivision 3; 517.08, subdivision 1b; Laws 2005, First
Special Session chapter 4, article 8, section 66, as amended; Laws 2009, chapter
79, article 3, section 18; article 5, sections 17; 18; 22; 75, subdivision 1; 78,
subdivision 5; article 8, sections 2; 51; 84; article 13, sections 3, subdivisions
1, as amended, 3, as amended, 4, as amended, 8, as amended; 5, subdivision 8,
as amended; Laws 2009, chapter 173, article 1, section 17; Laws 2010, chapter
200, article 1, sections 12; 16; 21; article 2, section 2, subdivisions 1, 5, 8;
proposing coding for new law in Minnesota Statutes, chapters 62D; 62E; 62Q;
137; 144; 144D; 246; 254B; 256; 256B; repealing Minnesota Statutes 2008,
sections 254B.02, subdivisions 2, 3, 4; 254B.09, subdivisions 4, 5, 7; 256D.03,
subdivisions 3, 3a, 5, 6, 7, 8; Minnesota Statutes 2009 Supplement, section
256J.621; Laws 2010, chapter 200, article 1, sections 12; 18; 19.

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

ARTICLE 1

HEALTH CARE

Section 1.

Minnesota Statutes 2008, section 256.9657, subdivision 2, is amended to
read:


Subd. 2.

Hospital surcharge.

(a) Effective October 1, 1992, each Minnesota
hospital except facilities of the federal Indian Health Service and regional treatment
centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net
patient revenues excluding net Medicare revenues reported by that provider to the health
care cost information system according to the schedule in subdivision 4.

(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56
percent.

(c) new text beginEffective July 1, 2010, the surcharge under paragraph (b) is increased to 2.63
percent.
new text end

new text begin (d) Effective October 1, 2011, the surcharge under paragraph (c) is reduced to
2.30 percent.
new text end

new text begin (e) new text endNotwithstanding the Medicare cost finding and allowable cost principles, the
hospital surcharge is not an allowable cost for purposes of rate setting under sections
256.9685 to 256.9695.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2008, section 256.9657, subdivision 3, is amended to read:


Subd. 3.

Surcharge on HMOs and community integrated service networks.

(a)
Effective October 1, 1992, each health maintenance organization with a certificate of
authority issued by the commissioner of health under chapter 62D and each community
integrated service network licensed by the commissioner under chapter 62N shall pay to
the commissioner of human services a surcharge equal to six-tenths of one percent of the
total premium revenues of the health maintenance organization or community integrated
service network as reported to the commissioner of health according to the schedule in
subdivision 4.

(b) new text beginEffective October 1, 2010, in addition to the surcharge under paragraph (a), each
health maintenance organization shall pay to the commissioner a surcharge equal to 0.85
percent of total premium revenues and each county-based purchasing plan authorized
under section 256B.692 shall pay to the commissioner a surcharge equal to 1.45 percent
of the total premium revenues of the plan, as reported to the commissioner of health,
according to the payment schedule in subdivision 4. Notwithstanding section 256.9656,
money collected under this paragraph shall be deposited in the health care access fund
established in section 16A.724.
new text end

new text begin (c) new text endFor purposes of this subdivision, total premium revenue means:

(1) premium revenue recognized on a prepaid basis from individuals and groups
for provision of a specified range of health services over a defined period of time which
is normally one month, excluding premiums paid to a health maintenance organization
or community integrated service network from the Federal Employees Health Benefit
Program;

(2) premiums from Medicare wrap-around subscribers for health benefits which
supplement Medicare coverage;

(3) Medicare revenue, as a result of an arrangement between a health maintenance
organization or a community integrated service network and the Centers for Medicare
and Medicaid Services of the federal Department of Health and Human Services, for
services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
1395w-24, respectively, as they may be amended from time to time; and

(4) medical assistance revenue, as a result of an arrangement between a health
maintenance organization or community integrated service network and a Medicaid state
agency, for services to a medical assistance beneficiary.

If advance payments are made under clause (1) or (2) to the health maintenance
organization or community integrated service network for more than one reporting period,
the portion of the payment that has not yet been earned must be treated as a liability.

deleted text begin (c)deleted text endnew text begin (d)new text end When a health maintenance organization or community integrated service
network merges or consolidates with or is acquired by another health maintenance
organization or community integrated service network, the surviving corporation or the
new corporation shall be responsible for the annual surcharge originally imposed on
each of the entities or corporations subject to the merger, consolidation, or acquisition,
regardless of whether one of the entities or corporations does not retain a certificate of
authority under chapter 62D or a license under chapter 62N.

deleted text begin (d)deleted text endnew text begin (e)new text end Effective July 1 of each year, the surviving corporation's or the new
corporation's surcharge shall be based on the revenues earned in the second previous
calendar year by all of the entities or corporations subject to the merger, consolidation,
or acquisition regardless of whether one of the entities or corporations does not retain a
certificate of authority under chapter 62D or a license under chapter 62N until the total
premium revenues of the surviving corporation include the total premium revenues of all
the merged entities as reported to the commissioner of health.

deleted text begin (e)deleted text endnew text begin (f)new text end When a health maintenance organization or community integrated service
network, which is subject to liability for the surcharge under this chapter, transfers,
assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
of the health maintenance organization or community integrated service network.

deleted text begin (f)deleted text endnew text begin (g)new text end In the event a health maintenance organization or community integrated
service network converts its licensure to a different type of entity subject to liability
for the surcharge under this chapter, but survives in the same or substantially similar
form, the surviving entity remains liable for the surcharge regardless of whether one of
the entities or corporations does not retain a certificate of authority under chapter 62D
or a license under chapter 62N.

deleted text begin (g)deleted text endnew text begin (h)new text end The surcharge assessed to a health maintenance organization or community
integrated service network ends when the entity ceases providing services for premiums
and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

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


Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner shall
obtain operating data from an updated base year and establish operating payment rates
per admission for each hospital based on the cost-finding methods and allowable costs of
the Medicare program in effect during the base year. Rates under the general assistance
medical care, medical assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, January 1, 2005, for the first 24 months of the
rebased period beginning January 1, 2009. For the first deleted text beginthreedeleted text endnew text begin 24 new text end months of the rebased
period beginning January 1, 2011, rates shall new text begin not new text endbe rebased deleted text beginat 74.25 percent of the full
value of the rebasing percentage change. From April 1, 2011, to March 31, 2012, rates
shall be rebased at 39.2 percent of the full value of the rebasing percentage change
deleted text endnew text begin, 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
new text end.
Effective deleted text beginApril 1, 2012deleted text endnew text begin January 1, 2013new text end, rates shall be rebased at full value. The base year
operating payment rate per admission is standardized by the case mix index and adjusted
by the hospital cost index, relative values, and disproportionate population adjustment.
The cost and charge data used to establish operating rates shall only reflect inpatient
services covered by medical assistance and shall not include property cost information
and costs recognized in outlier payments.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

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


Subd. 3a.

Payments.

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

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

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

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

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

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

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

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

new text begin (i) In order to offset the ratable reductions provided for in this subdivision, the total
payment rate for medical assistance fee-for-service admissions occurring on or after July
1, 2010, to June 30, 2011, made to Minnesota hospitals for inpatient services before
third-party liability and spenddown, shall be increased by five percent from the current
statutory rates. Effective July 1, 2011, the rate increase under this paragraph shall be
reduced to 1.96 percent. For purposes of this paragraph, medical assistance does not
include general assistance medical care. The commissioner shall not adjust rates paid to a
prepaid health plan under contract with the commissioner to reflect payments provided
in this paragraph. The commissioner may utilize a settlement process to adjust rates in
excess of the Medicare upper limits on payments.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 5.

Minnesota Statutes 2008, section 256.969, subdivision 21, is amended to read:


Subd. 21.

Mental health or chemical dependency admissions; rates.

new text begin(a)
new text endAdmissions under the general assistance medical care program occurring on or after
July 1, 1990, and admissions under medical assistance, excluding general assistance
medical care, occurring on or after July 1, 1990, and on or before September 30, 1992,
that are classified to a diagnostic category of mental health or chemical dependency
shall have rates established according to the methods of subdivision 14, except the per
day rate shall be multiplied by a factor of 2, provided that the total of the per day rates
shall not exceed the per admission rate. This methodology shall also apply when a hold
or commitment is ordered by the court for the days that inpatient hospital services are
medically necessary. Stays which are medically necessary for inpatient hospital services
and covered by medical assistance shall not be billable to any other governmental entity.
Medical necessity shall be determined under criteria established to meet the requirements
of section 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b).

new text begin (b) In order to ensure adequate access for the provision of mental health services
and to encourage broader delivery of these services outside the nonstate governmental
hospital setting, payment rates for medical assistance admissions occurring on or after
July 1, 2010, at a Minnesota private, not-for-profit hospital above the 75th percentile of all
Minnesota private, nonprofit hospitals for diagnosis-related groups 424 to 432 and 521
to 523 admissions paid by medical assistance for admissions occurring in calendar year
2007, shall be increased for these diagnosis-related groups at a percentage calculated to
cost not more than $10,000,000 each fiscal year, including state and federal shares. For
purposes of this paragraph, medical assistance does not include general assistance medical
care. The commissioner shall not adjust rates paid to a prepaid health plan under contract
with the commissioner to reflect payments provided in this paragraph. The commissioner
may utilize a settlement process to adjust rates in excess of the Medicare upper limits
on payments.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2008, section 256.969, subdivision 26, is amended to read:


Subd. 26.

Greater Minnesota payment adjustment after June 30, 2001.

(a) For
admissions occurring after June 30, 2001, the commissioner shall pay fee-for-service
inpatient admissions for the diagnosis-related groups specified in paragraph (b) at hospitals
located outside of the seven-county metropolitan area at the higher of:

(1) the hospital's current payment rate for the diagnostic category to which the
diagnosis-related group belongs, exclusive of disproportionate population adjustments
received under subdivision 9 and hospital payment adjustments received under subdivision
23; or

(2) 90 percent of the average payment rate for that diagnostic category for hospitals
located within the seven-county metropolitan area, exclusive of disproportionate
population adjustments received under subdivision 9 and hospital payment adjustments
received under subdivisions 20 and 23.

(b) The payment increases provided in paragraph (a) apply to the following
diagnosis-related groups, as they fall within the diagnostic categories:

(1) 370 cesarean section with complicating diagnosis;

(2) 371 cesarean section without complicating diagnosis;

(3) 372 vaginal delivery with complicating diagnosis;

(4) 373 vaginal delivery without complicating diagnosis;

(5) 386 extreme immaturity and respiratory distress syndrome, neonate;

(6) 388 full-term neonates with other problems;

(7) 390 prematurity without major problems;

(8) 391 normal newborn;

(9) 385 neonate, died or transferred to another acute care facility;

(10) 425 acute adjustment reaction and psychosocial dysfunction;

(11) 430 psychoses;

(12) 431 childhood mental disorders; and

(13) 164-167 appendectomy.

new text begin (c) For medical assistance admissions occurring on or after July 1, 2010, the
payment rate under paragraph (a), clause (2), shall be increased to 100 percent from 90
percent. For purposes of this paragraph, medical assistance does not include general
assistance medical care. The commissioner shall not adjust rates paid to a prepaid
health plan under contract with the commissioner to reflect payments provided in this
paragraph. The commissioner may utilize a settlement process to adjust rates in excess of
the Medicare upper limits on payments.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
to read:


new text begin Subd. 31. new text end

new text begin Hospital payment adjustment after June 30, 2010. new text end

new text begin (a) For medical
assistance admissions occurring on or after July 1, 2010, to March 31, 2011, the
commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:
new text end

new text begin (1) for a hospital with total admissions reimbursed by government payers equal to or
greater than 50 percent, payment rates for inpatient hospital services shall be increased for
each admission by $250 multiplied by 437 percent;
new text end

new text begin (2) for a hospital with total admissions reimbursed by government payers equal to
or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital
services shall be increased for each admission by $250 multiplied by 349.6 percent; and
new text end

new text begin (3) for a hospital with total admissions reimbursed by government payers of less
than 40 percent, payment rates for inpatient hospital services shall be increased for each
admission by $250 multiplied by 262.2 percent.
new text end

new text begin (b) For medical assistance admissions occurring on or after April 1, 2011, the
commissioner shall increase rates at Minnesota private, not-for-profit hospitals as follows:
new text end

new text begin (1) for a hospital with total admissions reimbursed by government payers equal to or
greater than 50 percent, payment rates for inpatient hospital services shall be increased for
each admission by $250 multiplied by 145 percent;
new text end

new text begin (2) for a hospital with total admissions reimbursed by government payers equal to
or greater than 40 percent but less than 50 percent, payment rates for inpatient hospital
services shall be increased for each admission by $250 multiplied by 116 percent; and
new text end

new text begin (3) for a hospital with total admissions reimbursed by government payers of less
than 40 percent, payment rates for inpatient hospital services shall be increased for each
admission by $250 multiplied by 87 percent.
new text end

new text begin (c) For purposes of paragraphs (a) and (b), "government payers" means Medicare,
medical assistance, MinnesotaCare, and general assistance medical care.
new text end

new text begin (d) For medical assistance admissions occurring on or after July 1, 2010, to March
31, 2011, the commissioner shall increase rates for inpatient hospital services at Minnesota
hospitals by $850 for each admission. For medical assistance admissions occurring on
or after April 1, 2011, the payment under this paragraph shall be reduced to $320 per
admission.
new text end

new text begin (e) For purposes of this subdivision, medical assistance does not include general
assistance medical care. The commissioner shall not adjust rates paid to a prepaid
health plan under contract with the commissioner to reflect payments provided in this
subdivision. The commissioner may utilize a settlement process to adjust rates in excess
of the Medicare upper limits on payments.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2008, section 256B.055, is amended by adding a
subdivision to read:


new text begin Subd. 15. new text end

new text begin Adults without children. new text end

new text begin Medical assistance may be paid for a person
who is:
new text end

new text begin (1) at least age 21 and under age 65;
new text end

new text begin (2) not pregnant;
new text end

new text begin (3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
of the Social Security Act;
new text end

new text begin (4) not an adult in a family with children as defined in section 256L.01, subdivision
3a; and
new text end

new text begin (5) not described in another subdivision of this section.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2008, section 256B.056, subdivision 3, is amended to read:


Subd. 3.

Asset limitations for individuals and families.

new text begin(a) new text endTo 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).

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Minnesota Statutes 2008, section 256B.056, subdivision 4, is amended to read:


Subd. 4.

Income.

(a) To be eligible for medical assistance, a person eligible under
section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
the federal poverty guidelines. Effective January 1, 2000, and each successive January,
recipients of supplemental security income may have an income up to the supplemental
security income standard in effect on that date.

(b) To be eligible for medical assistance, families and children may have an income
up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
1996, shall be increased by three percent.

(c) Effective July 1, 2002, to be eligible for medical assistance, families and children
may have an income up to 100 percent of the federal poverty guidelines for the family size.

(d) new text beginEffective June 1, 2010, to be eligible for medical assistance under section
256B.055, subdivision 15, a person may have an income up to 75 percent of federal
poverty guidelines for the family size.
new text end

new text begin (e) new text endIn computing income to determine eligibility of persons under paragraphs (a) to
deleted text begin (c)deleted text end new text begin(d) new text endwho are not residents of long-term care facilities, the commissioner shall disregard
increases in income as required by Public Law Numbers 94-566, section 503; 99-272;
and 99-509. Veterans aid and attendance benefits and Veterans Administration unusual
medical expense payments are considered income to the recipient.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to
read:


Subd. 8.

Physical therapy.

Medical assistance covers physical therapy and related
servicesdeleted text begin, including specialized maintenance therapydeleted text end. new text beginAuthorization 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.
new text endServices 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2010, for services provided
through fee-for-service, and January 1, 2011, for services provided through managed care.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to
read:


Subd. 8a.

Occupational therapy.

Medical assistance covers occupational therapy
and related servicesdeleted text begin, including specialized maintenance therapydeleted text end. new text beginAuthorization 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.
new text endServices 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2010, for services provided
through fee-for-service, and January 1, 2011, for services provided through managed care.
new text end

Sec. 13.

Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to
read:


Subd. 8b.

Speech language pathology and audiology services.

Medical assistance
covers speech language pathology and related servicesdeleted text begin, including specialized maintenance
therapy
deleted text end. new text beginAuthorization 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) 50 treatment sessions with any combination of approved CPT codes; and
(2) one evaluation.
new text endMedical 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2010, for services provided
through fee-for-service, and January 1, 2011, for services provided through managed care.
new text end

Sec. 14.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 8d. new text end

new text begin Chiropractic services. new text end

new text begin Payment for chiropractic services is limited to
one annual evaluation and 12 visits per year unless prior authorization of a greater number
of visits is obtained.
new text end

Sec. 15.

Minnesota Statutes 2009 Supplement, 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 or more prescriptions to treat or prevent two or more chronic
medical conditions, or a recipient with a drug therapy problem that is identified 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 long-term care and group homes, if the service is
ordered by the provider-directed care coordination team; 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) new text beginIf 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.
new text end

new text begin (e) new text endThe 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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2008, section 256B.0625, subdivision 18a, is amended to
read:


Subd. 18a.

Access to medical services.

(a) Medical assistance reimbursement for
meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
$6.50 for lunch, or $8 for dinner.

(b) Medical assistance reimbursement for lodging for persons traveling to receive
medical care may not exceed $50 per day unless prior authorized by the local agency.

(c) Medical assistance direct mileage reimbursement to the eligible person or the
eligible person's driver may not exceed 20 cents per mile.

(d) Regardless of the number of employees that an enrolled health care provider
may have, medical assistance covers sign and oral language interpreter services when
provided by an enrolled health care provider during the course of providing a direct,
person-to-person covered health care service to an enrolled recipient with limited English
proficiency or who has a hearing loss and uses interpreting services.new text begin Coverage for
face-to-face oral language interpreter services shall be provided only if the oral language
interpreter used by the enrolled health care provider is listed in the registry or roster
established under section 144.058.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2008, section 256B.0625, subdivision 31, is amended to
read:


Subd. 31.

Medical supplies and equipment.

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.new text begin
The commissioner may set reimbursement rates for specified categories of medical
supplies at levels below the Medicare payment rate.
new text end

Sec. 18.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 54. new text end

new text begin Services provided in birth centers. new text end

new text begin (a) Medical assistance covers
services provided in a licensed birth center by a licensed health professional if the service
would otherwise be covered if provided in a hospital.
new text end

new text begin (b) Facility services provided by a birth center shall be paid at the lower of billed
charges or 70 percent of the statewide average for a facility payment rate made to a
hospital for an uncomplicated vaginal birth as determined using the most recent calendar
year for which complete claims data is available. If a recipient is transported from a birth
center to a hospital prior to the delivery, the payment for facility services to the birth center
shall be the lower of billed charges or 15 percent of the average facility payment made to a
hospital for the services provided for an uncomplicated vaginal delivery as determined
using the most recent calendar year for which complete claims data is available.
new text end

new text begin (c) Nursery care services provided by a birth center shall be paid the lower of billed
charges or 70 percent of the statewide average for a payment rate paid to a hospital for
nursery care as determined by using the most recent calendar year for which complete
claims data is available.
new text end

new text begin (d) Professional services provided by traditional midwives licensed under chapter
147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a
physician performing the same services. If a recipient is transported from a birth center to
a hospital prior to the delivery, a licensed traditional midwife who does not perform the
delivery may not bill for any delivery services. Services are not covered if provided by an
unlicensed traditional midwife.
new text end

new text begin (e) The commissioner shall apply for any necessary waivers from the Centers for
Medicare and Medicaid Services to allow birth centers and birth center providers to be
reimbursed.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 19.

Minnesota Statutes 2008, section 256B.0631, subdivision 1, is amended to
read:


Subdivision 1.

Co-payments.

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

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

(2) $3 for eyeglasses;

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

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

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

(1) deleted text begin$6deleted text endnew text begin $3.50new text end 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) for individuals identified by the commissioner with income at or below 100
percent of the federal poverty guidelines, total monthly co-payments must not exceed five
percent of family income. For purposes of this paragraph, family income is the total
earned and unearned income of the individual and the individual's spouse, if the spouse is
enrolled in medical assistance and also subject to the five percent limit on co-payments.

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

Minnesota Statutes 2008, section 256B.0631, subdivision 3, is amended to
read:


Subd. 3.

Collection.

(a) The medical assistance reimbursement to the provider
shall be reduced by the amount of the co-payment, except that 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 limit.

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

(c) Medical assistance reimbursement to fee-for-service providers and payments to
managed care plans shall not be increased as a result of the removal of deleted text beginthedeleted text end co-payments
effective new text beginon or after new text endJanuary 1, 2009.

Sec. 21.

Minnesota Statutes 2008, section 256B.0644, as amended by Laws 2010,
chapter 200, article 1, section 6, is amended to read:


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

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

(b) For providers other than health maintenance organizations, participation in the
medical assistance program means that:

(1) the provider accepts new medical assistance, general assistance medical care,
and MinnesotaCare patients;

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

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

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

deleted text begin (d) Any hospital or other provider that is participating in a coordinated care
delivery system under section 256D.031, subdivision 6, or receives payments from the
uncompensated care pool under section 256D.031, subdivision 8, shall not refuse to
provide services to any patient enrolled in general assistance medical care regardless of
the availability or the amount of payment.
deleted text end

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

Minnesota Statutes 2009 Supplement, section 256B.0653, subdivision 5,
is amended to read:


Subd. 5.

Home care therapies.

(a) Home care therapies include the following:
physical therapy, occupational therapy, respiratory therapy, and speech and language
pathology therapy services.

(b) Home care therapies must be:

(1) provided in the recipient's residence after it has been determined the recipient is
unable to access outpatient therapy;

(2) prescribed, ordered, or referred by a physician and documented in a plan of care
and reviewed, according to Minnesota Rules, part 9505.0390;

(3) assessed by an appropriate therapist; and

(4) provided by a Medicare-certified home health agency enrolled as a Medicaid
provider agency.

(c) Restorative deleted text beginand specialized maintenancedeleted text end therapies must be provided according to
Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be
used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.

(d) For both physical and occupational therapies, the therapist and the therapist's
assistant may not both bill for services provided to a recipient on the same day.

Sec. 23.

new text begin [256B.0755] HEALTH CARE DELIVERY SYSTEMS
DEMONSTRATION PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Implementation. new text end

new text begin (a) The commissioner shall develop and
authorize a demonstration project to test alternative and innovative health care delivery
systems, including accountable care organizations that provide services to a specified
patient population for an agreed upon total cost of care or risk-gain sharing payment
arrangement. The commissioner shall develop a request for proposals for participation in
the demonstration project in consultation with hospitals, primary care providers, health
plans, and other key stakeholders.
new text end

new text begin (b) In developing the request for proposals, the commissioner shall:
new text end

new text begin (1) establish uniform statewide methods of forecasting utilization and cost of care
for the appropriate Minnesota public program populations, to be used by the commissioner
for the health care delivery system projects;
new text end

new text begin (2) identify key indicators of quality, access, patient satisfaction, and other
performance indicators that will be measured, in addition to indicators for measuring
cost savings;
new text end

new text begin (3) allow maximum flexibility to encourage innovation and variation so that a variety
of provider collaborations are able to become health care delivery systems;
new text end

new text begin (4) encourage and authorize different levels and types of financial risk;
new text end

new text begin (5) encourage and authorize projects representing a wide variety of geographic
locations, patient populations, provider relationships, and care coordination models;
new text end

new text begin (6) encourage projects that involve close partnerships between the health care
delivery system and counties and nonprofit agencies that provide services to patients
enrolled with the health care delivery system, including social services, public health,
mental health, community-based services, and continuing care;
new text end

new text begin (7) encourage projects established by community hospitals, clinics, and other
providers in rural communities;
new text end

new text begin (8) identify required covered services for a total cost of care model or services
considered in whole or partially in an analysis of utilization for a risk/gain sharing model;
new text end

new text begin (9) establish a mechanism to monitor enrollment;
new text end

new text begin (10) establish quality standards for the delivery system demonstrations; and
new text end

new text begin (11) encourage participation of privately insured population so as to create sufficient
alignment in demonstration systems.
new text end

new text begin (c) To be eligible to participate in the demonstration project, a health care delivery
system must:
new text end

new text begin (1) provide required covered services and care coordination to recipients enrolled in
the health care delivery system;
new text end

new text begin (2) establish a process to monitor enrollment and ensure the quality of care provided;
new text end

new text begin (3) in cooperation with counties and community social service agencies, coordinate
the delivery of health care services with existing social services programs;
new text end

new text begin (4) provide a system for advocacy and consumer protection; and
new text end

new text begin (5) adopt innovative and cost-effective methods of care delivery and coordination,
which may include the use of allied health professionals, telemedicine, patient educators,
care coordinators, and community health workers.
new text end

new text begin (d) A health care delivery system demonstration may be formed by the following
groups of providers of services and suppliers if they have established a mechanism for
shared governance:
new text end

new text begin (1) professionals in group practice arrangements;
new text end

new text begin (2) networks of individual practices of professionals;
new text end

new text begin (3) partnerships or joint venture arrangements between hospitals and ACO
professionals;
new text end

new text begin (4) hospitals employing professionals; and
new text end

new text begin (5) other groups of providers of services and suppliers as the commissioner
determines appropriate.
new text end

new text begin A managed care plan or county-based purchasing plan may participate in this
demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).
new text end

new text begin A health care delivery system may contract with a managed care plan or a
county-based purchasing plan to provide administrative services, including the
administration of a payment system using the payment methods established by the
commissioner for health care delivery systems.
new text end

new text begin (e) The commissioner may require a health care delivery system to enter into
additional third-party contractual relationships for the assessment of risk and purchase of
stop loss insurance or another form of insurance risk management related to the delivery
of care described in paragraph (c).
new text end

new text begin Subd. 2. new text end

new text begin Enrollment. new text end

new text begin (a) Individuals eligible for medical assistance or
MinnesotaCare shall be eligible for enrollment in a health care delivery system.
new text end

new text begin (b) Eligible applicants and recipients may enroll in a health care delivery system if
a system serves the county in which the applicant or recipient resides. If more than one
health care delivery system serves a county, the applicant or recipient shall be allowed
to choose among the delivery systems. The commissioner may assign an applicant or
recipient to a health care delivery system if a health care delivery system is available and
no choice has been made by the applicant or recipient.
new text end

new text begin Subd. 3. new text end

new text begin Accountability. new text end

new text begin (a) Health care delivery systems must accept responsibility
for the quality of care based on standards established under subdivision 1, paragraph (b),
clause (10), and the cost of care or utilization of services provided to its enrollees under
subdivision 1, paragraph (b), clause (1).
new text end

new text begin (b) A health care delivery system may contract and coordinate with providers and
clinics for the delivery of services and shall contract with community health clinics,
federally qualified health centers, and rural clinics to the extent practicable.
new text end

new text begin Subd. 4. new text end

new text begin Payment system. new text end

new text begin (a) In developing a payment system for health care
delivery systems, the commissioner shall establish a total cost of care benchmark or a
risk/gain sharing payment model to be paid for services provided to the recipients enrolled
in a health care delivery system.
new text end

new text begin (b) The payment system may include incentive payments to health care delivery
systems that meet or exceed annual quality and performance targets realized through
the coordination of care.
new text end

new text begin (c) An amount equal to the savings realized to the general fund as a result of the
demonstration project shall be transferred each fiscal year to the health care access fund.
new text end

new text begin Subd. 5. new text end

new text begin Outpatient prescription drug coverage. new text end

new text begin Outpatient prescription drug
coverage may be provided through accountable care organizations only if the delivery
method qualifies for federal prescription drug rebates.
new text end

new text begin Subd. 6. new text end

new text begin Federal approval. new text end

new text begin The commissioner shall apply for any federal waivers
or other federal approval required to implement this section. The commissioner shall
also apply for any applicable grant or demonstration under the Patient Protection and
Affordable Health Care Act, Public Law 111-148, or the Health Care and Education
Reconciliation Act of 2010, Public Law 111-152, that would further the purposes of or
assist in the establishment of accountable care organizations.
new text end

new text begin Subd. 7. new text end

new text begin Expansion. new text end

new text begin The commissioner shall explore the expansion of the
demonstration project to include additional medical assistance and MinnesotaCare
enrollees, and shall seek participation of Medicare in demonstration projects. The
commissioner shall seek to include participation of privately insured persons and Medicare
recipients in the health care delivery demonstration.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

new text begin [256B.0756] HENNEPIN AND RAMSEY COUNTIES PILOT
PROGRAM.
new text end

new text begin (a) The commissioner, upon federal approval of a new waiver request or amendment
of an existing demonstration, may establish a pilot program in Hennepin County or
Ramsey County, or both, to test alternative and innovative integrated health care delivery
networks.
new text end

new text begin (b) Individuals eligible for the pilot program shall be individuals who are eligible for
medical assistance under Minnesota Statutes, section 256B.055, subdivision 15, and who
reside in Hennepin County or Ramsey County.
new text end

new text begin (c) Individuals enrolled in the pilot shall be enrolled in an integrated health care
delivery network in their county of residence. The integrated health care delivery network
in Hennepin County shall be a network, such as an accountable care organization or a
community-based collaborative care network, created by or including Hennepin County
Medical Center. The integrated health care delivery network in Ramsey County shall be
a network, such as an accountable care organization or community-based collaborative
care network, created by or including Regions Hospital.
new text end

new text begin (d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for
Hennepin County and 3,500 enrollees for Ramsey County.
new text end

new text begin (e) In developing a payment system for the pilot programs, the commissioner shall
establish a total cost of care for the recipients enrolled in the pilot programs that equals
the cost of care that would otherwise be spent for these enrollees in the prepaid medical
assistance program.
new text end

new text begin (f) Counties may transfer funds necessary to support the nonfederal share of
payments for integrated health care delivery networks in their county. Such transfers per
county shall not exceed 15 percent of the expected expenses for county enrollees.
new text end

new text begin (g) The commissioner shall apply to the federal government for, or as appropriate,
cooperate with counties, providers, or other entities that are applying for any applicable
grant or demonstration under the Patient Protection and Affordable Health Care Act, Public
Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law
111-152, that would further the purposes of or assist in the creation of an integrated health
care delivery network for the purposes of this subdivision, including, but not limited to, a
global payment demonstration or the community-based collaborative care network grants.
new text end

Sec. 25.

Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 5a,
is amended to read:


Subd. 5a.

Managed care contracts.

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

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

(c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section and
county-based purchasing deleted text beginplan's payment ratedeleted text endnew text begin plan paymentsnew text end under section 256B.692 for
the prepaid medical assistance and general assistance medical care programs pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance target
based on a federal or state law or rule. Criteria for assessment of each performance target
must be outlined in writing prior to the contract effective date. The 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 and general assistance medical care programs. The withheld
funds must be returned no sooner than July 1 and no later than July 31 of the following
year. The commissioner may exclude special demonstration projects under subdivision 23.

The return of the withhold under this paragraph is not subject to the requirements of
paragraph (c).

(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 3.5 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.

new text begin (g) Effective for services rendered on or after January 1, 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.
new text end

new text begin The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization
rate was achieved.
new text end

new text begin 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. 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.
new text end

deleted text begin (g)deleted text endnew text begin (h)new text end Effective for services rendered on or after January 1, 2011, through December
31, 2011, the commissioner shall withhold four 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.

deleted text begin (h)deleted text endnew text begin (i)new text end 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.

deleted text begin (i)deleted text endnew text begin (j)new text end 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.

deleted text begin (j)deleted text endnew text begin (k)new text end 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 and prepaid general assistance medical care programs. The withheld funds must
be returned no sooner than July 1 and no later than July 31 of the following year. The
commissioner may exclude special demonstration projects under subdivision 23.

deleted text begin (k)deleted text endnew text begin (l)new text end 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.

deleted text begin (l)deleted text endnew text begin (m)new text end 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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2008, section 256B.69, is amended by adding a
subdivision to read:


new text begin Subd. 5k. new text end

new text begin Rate modifications. new text end

new text begin For services rendered on or after October 1, 2010,
the total payment made to managed care plans and county-based purchasing plans under
the medical assistance program shall be increased by 1.28 percent.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2008, section 256B.69, subdivision 20, as amended by
Laws 2010, chapter 200, article 1, section 10, is amended to read:


Subd. 20.

Ombudsperson.

deleted text begin(a)deleted text end The commissioner shall designate an ombudsperson
to advocate for persons required to enroll in prepaid health plans under this section. The
ombudsperson shall advocate for recipients enrolled in prepaid health plans through
complaint and appeal procedures and ensure that necessary medical services are provided
either by the prepaid health plan directly or by referral to appropriate social services. At
the time of enrollment in a prepaid health plan, the local agency shall inform recipients
about the ombudsperson program and their right to a resolution of a complaint by the
prepaid health plan if they experience a problem with the plan or its providers.

deleted text begin (b) The commissioner shall designate an ombudsperson to advocate for persons
enrolled in a care coordination delivery system under section 256D.031. The
ombudsperson shall advocate for recipients enrolled in a care coordination delivery
system through the state appeal process and assist enrollees in accessing necessary
medical services through the care coordination delivery systems directly or by referral to
appropriate services. At the time of enrollment in a care coordination delivery system, the
local agency shall inform recipients about the ombudsperson program.
deleted text end

Sec. 28.

Minnesota Statutes 2008, section 256B.69, subdivision 27, is amended to read:


Subd. 27.

Information for persons with limited English-language proficiency.

Managed care contracts entered into under this section and deleted text beginsections 256D.03, subdivision
4
, paragraph (c), and
deleted text end new text beginsection new text end256L.12 must require demonstration providers to provide
language assistance to enrollees that ensures meaningful access to its programs and
services according to Title VI of the Civil Rights Act and federal regulations adopted
under that law or any guidance from the United States Department of Health and Human
Services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from April 1, 2010.
new text end

Sec. 29.

Minnesota Statutes 2008, section 256B.692, subdivision 1, is amended to read:


Subdivision 1.

In general.

County boards or groups of county boards may elect
to purchase or provide health care services on behalf of persons eligible for medical
assistance deleted text beginand general assistance medical caredeleted text end who would otherwise be required to or may
elect to participate in the prepaid medical assistance deleted text beginor prepaid general assistance medical
care programs
deleted text end according to deleted text beginsectionsdeleted text end new text beginsection new text end256B.69 deleted text beginand 256D.03deleted text end. Counties that elect to
purchase or provide health care under this section must provide all services included in
prepaid managed care programs according to deleted text beginsectionsdeleted text end new text beginsection new text end256B.69, subdivisions 1
to 22
deleted text begin, and 256D.03deleted text end. County-based purchasing under this section is governed by section
256B.69, unless otherwise provided for under this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from April 1, 2010.
new text end

Sec. 30.

Minnesota Statutes 2009 Supplement, 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 over the rates in effect
on June 30, 2009. This reduction deleted text begindoesdeleted text end new text beginand the reductions in paragraph (d) do new text endnot 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 deleted text begindoesdeleted text end
new text begin and the reductions in paragraph (d) do new text endnot 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.

new text begin (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
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 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.
new text end

new text begin (e) Effective for services rendered on or after October 1, 2010, payment rates for
physician and professional services billed by physicians employed by and clinics owned
by a nonprofit health maintenance organization shall be increased by 25 percent. 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 increase
described in this paragraph.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 31.

Minnesota Statutes 2008, 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.

new text begin (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.
new text end

new text begin (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.
new text end

new text begin (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).
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 32.

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


Subd. 4.

Critical access dental providers.

new text begin(a) new text endEffective 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 deleted text beginhealth plan
companies
deleted text endnew text begin managed care plans and county-based purchasing plans new text end in amounts sufficient
to reflect increased reimbursements to critical access dental providers as approved by the
commissioner. deleted text beginIn determining which dentists and dental clinics shall be deemed critical
access dental providers, the commissioner shall review:
deleted text end

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

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

new text begin (i) have nonprofit status in accordance with chapter 317A;
new text end

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

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

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

new text begin (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;
new text end

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

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

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

(3) deleted text beginwhether the level of services provided by the dentist or dental clinic is critical
to maintaining adequate levels of patient access within the service area
deleted text endnew text begin county owned
and operated hospital-based dental clinics;
new text end

new text begin (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
new text end

new text begin (5) a dental clinic associated with an oral health or dental education program
operated by the University of Minnesota or an institution within the Minnesota State
Colleges and Universities system
new text end.

deleted text begin In the absence of a critical access dental provider in a service area,deleted text end new text begin (c) new text endThe
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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 33.

Minnesota Statutes 2009 Supplement, 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, prior to third-party liability and
spenddown calculation.new text begin This reduction applies to physical therapy services, occupational
therapy services, and speech language pathology and related services provided on or after
July 1, 2010. 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. Effective October 1, 2010, payments made to managed care
and county-based purchasing plans shall reflect the July 1, 2010, payment adjustments in
this paragraph.
new text end 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 this reduction.

(b) 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. 34.

new text begin [256B.767] MEDICARE PAYMENT LIMIT.
new text end

new text begin Effective for services rendered on or after July 1, 2010, fee-for-service payment rates
for physician and professional services under section 256B.76, subdivision 1, and basic
care services subject to the rate reduction specified in section 256B.766, shall not exceed
the Medicare payment rate for the applicable service. The commissioner shall implement
this section after any other rate adjustment that is effective July 1, 2010, and shall reduce
rates under this section by first reducing or eliminating provider rate add-ons.
new text end

Sec. 35.

Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, as
amended by Laws 2010, chapter 200, article 1, section 11, is amended to read:


Subd. 3.

General assistance medical care; eligibility.

(a) Beginning April 1, 2010,
the general assistance medical care program shall be administered according to section
256D.031, unless otherwise stated, except for outpatient prescription drug coverage,
which shall continue to be administered under this section and funded under section
256D.031, subdivision 9, beginning June 1, 2010.

(b) Outpatient prescription drug coverage under general assistance medical care is
limited to prescription drugs that:

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

(2) are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with the agreements.
Outpatient prescription drug coverage under general assistance medical care must conform
to coverage under the medical assistance program according to section 256B.0625,
subdivisions 13
to deleted text begin13gdeleted text endnew text begin 13hnew text end.

(c) Outpatient prescription drug coverage does not include drugs administered in a
clinic or other outpatient setting.

new text begin (d) For the period beginning April 1, 2010, to May 31, 2010, general assistance
medical care covers the services listed in subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from April 1, 2010.
new text end

Sec. 36.

Minnesota Statutes 2008, section 256D.03, subdivision 3b, is amended to read:


Subd. 3b.

Cooperation.

deleted text begin(a)deleted text end General assistance deleted text beginor general assistance medical caredeleted text end
applicants and recipients must cooperate with the state and local agency to identify
potentially liable third-party payors and assist the state in obtaining third-party payments.
Cooperation includes identifying any third party who may be liable for care and services
provided under this chapter to the applicant, recipient, or any other family member for
whom application is made and providing relevant information to assist the state in pursuing
a potentially liable third party. deleted text beginGeneral assistance medical care applicants and recipients
must cooperate by providing information about any group health plan in which they may
be eligible to enroll. They must cooperate with the state and local agency in determining
if the plan is cost-effective. For purposes of this subdivision, coverage provided by the
Minnesota Comprehensive Health Association under chapter 62E shall not be considered
group health plan coverage or cost-effective by the state and local agency. If the plan is
determined cost-effective and the premium will be paid by the state or local agency or is
available at no cost to the person, they must enroll or remain enrolled in the group health
plan. Cost-effective insurance premiums approved for payment by the state agency and
paid by the local agency are eligible for reimbursement according to subdivision 6.
deleted text end

deleted text begin (b) Effective for all premiums due on or after June 30, 1997, general assistance
medical care does not cover premiums that a recipient is required to pay under a qualified
or Medicare supplement plan issued by the Minnesota Comprehensive Health Association.
General assistance medical care shall continue to cover premiums for recipients who are
covered under a plan issued by the Minnesota Comprehensive Health Association on June
30, 1997, for a period of six months following receipt of the notice of termination or
until December 31, 1997, whichever is later.
deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Minnesota Statutes 2008, section 256D.031, subdivision 5, as added by Laws
2010, chapter 200, article 1, section 12, subdivision 5, is amended to read:


Subd. 5.

Payment rates and contract modification; April 1, 2010, to deleted text beginMay 31deleted text endnew text begin
June 30
new text end, 2010.

(a) For the period April 1, 2010, to deleted text beginMay 31deleted text endnew text begin June 30new text end, 2010, general
assistance medical care shall be paid on a fee-for-service basis. Fee-for-service payment
rates for services other than outpatient prescription drugs shall be set at 37 percent of the
payment rate in effect on March 31, 2010new text begin, except that for the period June 1, 2010, to June
30, 2010, fee-for-service payment rates for services other than prescription drugs shall be
set at 27 percent of the payment rate in effect on March 31, 2010
new text end.

(b) Outpatient prescription drugs covered under section 256D.03, subdivision
3
, provided on or after April 1, 2010, to deleted text beginMay 31deleted text endnew text begin June 30new text end, 2010, shall be paid on a
fee-for-service basis according to section 256B.0625, subdivisions 13 to 13g.

new text begin EFFECTIVE DATE. new text end

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

Sec. 38.

Minnesota Statutes 2009 Supplement, section 256L.03, subdivision 5, is
amended to read:


Subd. 5.

Co-payments and coinsurance.

(a) Except as provided in paragraphs (b)
and (c), the MinnesotaCare benefit plan shall include the following co-payments and
coinsurance 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 roomnew text begin for services
provided through December 31, 2010, and $3.50 effective January 1, 2011
new text end.

(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.

new text begin (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.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 39.

Minnesota Statutes 2008, 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) deleted text beginFor admissions occurring during the period of July 1, 1997, through June 30,
1998, 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, the commissioner shall pay hospitals directly, up to the medical assistance
payment rate, for inpatient hospital benefits in excess of the $10,000 annual inpatient
benefit limit.
deleted text end new text begin 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.
new text end

Sec. 40.

Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
to read:


new text begin Subd. 9. new text end

new text begin Firefighters; volunteer ambulance attendants. new text end

new text begin (a) For purposes of this
subdivision, "qualified individual" means:
new text end

new text begin (1) a volunteer firefighter with a department as defined in section 299N.01,
subdivision 2, who has passed the probationary period; and
new text end

new text begin (2) a volunteer ambulance attendant as defined in section 144E.001, subdivision 15.
new text end

new text begin (b) A qualified individual who documents to the satisfaction of the commissioner
status as a qualified individual by completing and submitting a one-page form developed
by the commissioner is eligible for MinnesotaCare without meeting other eligibility
requirements of this chapter, but must pay premiums equal to the average expected
capitation rate for adults with no children paid under section 256L.12. Individuals eligible
under this subdivision shall receive coverage for the benefit set provided to adults with no
children.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 41.

Minnesota Statutes 2008, section 256L.12, subdivision 5, is amended to read:


Subd. 5.

Eligibility for other state programs.

MinnesotaCare enrollees who
become eligible for medical assistance deleted text beginor general assistance medical caredeleted text end will remain in
the same managed care plan if the managed care plan has a contract for that population.
deleted text begin Effective January 1, 1998,deleted text end MinnesotaCare enrollees who were formerly eligible for
general assistance medical care pursuant to section 256D.03, subdivision 3, within six
months of MinnesotaCare enrollment and were enrolled in a prepaid health plan pursuant
to section 256D.03, subdivision 4, paragraph (c), must remain in the same managed care
plan if the managed care plan has a contract for that population. Managed care plans must
participate in the MinnesotaCare deleted text beginand general assistance medical care programsdeleted text end new text beginprogram
new text endunder a contract with the Department of Human Services in service areas where they
participate in the medical assistance program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from April 1, 2010.
new text end

Sec. 42.

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


Subd. 9.

Rate setting; performance withholds.

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

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

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

new text begin (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).
new text end

new text begin (d) Effective for services rendered on or after January 1, 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.
new text end

new text begin The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization
rate was achieved.
new text end

new text begin 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. 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.
new text end

new text begin (e) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
section that is reasonably expected to be returned.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 43.

Minnesota Statutes 2008, section 256L.12, is amended by adding a subdivision
to read:


new text begin Subd. 9c. new text end

new text begin Rate setting; increase effective October 1, 2010. new text end

new text begin For services
rendered on or after October 1, 2010, the total payment made to managed care plans and
county-based purchasing plans under MinnesotaCare for families with children shall be
increased by 1.28 percent.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 44.

Laws 2009, chapter 79, article 5, section 75, subdivision 1, is amended to read:


Subdivision 1.

Medical assistance coverage.

The commissioner of human services
shall establish a demonstration project to provide additional medical assistance coverage
for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth
who are burdened by health disparities associated with the cumulative health impact
of toxic environmental exposures. Under this demonstration project, the additional
medical assistance coverage for this population must include, but is not limited to, new text beginhome
environmental assessments for triggers of asthma, and in-home asthma education on the
proper medical management of asthma by a certified asthma educator or public health
nurse with asthma management training, and must be limited to two visits per child. The
home visit payment rates must be based on a rate commensurate with a first-time visit rate
and follow-up visit rate. Coverage also includes
new text endthe following durable medical equipment:
high efficiency particulate air (HEPA) cleaners, HEPA vacuum cleaners, allergy bed and
pillow encasements, high filtration filters for forced air gas furnaces, and dehumidifiers
with medical tubing to connect the appliance to a floor drain, if the listed item is deleted text beginmedically
necessary
deleted text end new text beginuseful new text endto reduce asthma symptoms. Provision of these items new text beginof durable medical
equipment
new text endmust be preceded by a home environmental assessment for triggers of asthma
and in-home asthma education on the proper medical management of asthma by a Certified
Asthma Educator or public health nurse with asthma management training.

Sec. 45.

Laws 2009, chapter 79, article 5, section 78, subdivision 5, is amended to read:


Subd. 5.

Expiration.

This sectionnew text begin, with the exception of subdivision 4,new text end expires
deleted text begin December 31, 2010deleted text endnew text begin August 31, 2011. Subdivision 4 expires February 28, 2012new text end.

Sec. 46.

Laws 2010, chapter 200, article 1, section 12, the effective date, is amended to
read:


EFFECTIVE DATE.

This sectionnew text begin, except for subdivision 4, new text end is effective for services
rendered on or after April 1, 2010.new text begin Subdivision 4 of this section is effective June 1, 2010.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 47.

Laws 2010, chapter 200, article 1, section 16, is amended by adding an
effective date to read:


new text begin EFFECTIVE DATE. new text end

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

Sec. 48.

Laws 2010, chapter 200, article 1, section 21, is amended to read:


Sec. 21. REPEALER.

(a) Minnesota Statutes 2008, sections 256.742; 256.979, subdivision 8; and 256D.03,
subdivision 9, are repealed effective April 1, 2010.

(b) Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 4, is repealed
effectivedeleted text begin Aprildeleted text endnew text begin Junenew text end 1, 2010.

(c) Minnesota Statutes 2008, section 256B.195, subdivisions 4 and 5, are repealed
effective for federal fiscal year 2010.

(d) Minnesota Statutes 2009 Supplement, section 256B.195, subdivisions 1, 2, and
3, are repealed effective for federal fiscal year 2010.

(e) Minnesota Statutes 2008, sections 256L.07, subdivision 6; 256L.15, subdivision
4; and 256L.17, subdivision 7, are repealed deleted text beginJanuary 1, 2011deleted text endnew text begin July 1, 2010new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from April 1, 2010.
new text end

Sec. 49.

Laws 2010, chapter 200, article 2, section 2, subdivision 1, is amended to read:


Subdivision 1.

Total Appropriation

$
(7,985,000)
$
(93,128,000)
Appropriations by Fund
2010
2011
General
34,807,000
118,493,000
Health Care Access
(42,792,000)
(211,621,000)

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

new text begin Special Revenue Fund Transfers.
new text end

new text begin (a) The commissioner shall transfer the
following amounts from special revenue
fund balances to the general fund by June
30 of each respective fiscal year: $410,000
for fiscal year 2010, and $412,000 for fiscal
year 2011.
new text end

new text begin (b) Actual transfers made under paragraph
(a) must be separately identified and reported
as part of the quarterly reporting of transfers
to the chairs of the relevant senate budget
division and house of representatives finance
division.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 50.

Laws 2010, chapter 200, article 2, section 2, subdivision 5, is amended to read:


Subd. 5.

Health Care Management

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

Health Care Administration.
(2,998,000)
(5,270,000)

Base Adjustment. The general fund base
for health care administration is reduced by
deleted text begin $182,000deleted text endnew text begin $36,000 new text end in fiscal year 2012 and
deleted text begin $182,000deleted text endnew text begin $36,000 new text end in fiscal year 2013.

Sec. 51.

Laws 2010, chapter 200, article 2, section 2, subdivision 8, is amended to read:


Subd. 8.

Transfers

The commissioner must transfer $29,538,000
in fiscal year 2010 and $18,462,000 in fiscal
year 2011 from the health care access fund to
the general fund. This is a onetime transfer.

The commissioner must transfer $4,800,000
from the consolidated chemical dependency
treatment fund to the general fund by June
30, 2010.

Compulsive Gambling deleted text beginSpecial Revenuedeleted text end
Administration.
new text beginThe lottery prize fund
appropriation for compulsive gambling
administration is reduced by
new text end$6,000 for fiscal
year 2010 and $4,000 for fiscal year 2011deleted text begin
must be transferred from the lottery prize
fund appropriation for compulsive gambling
administration to the general fund by June
30 of each respective fiscal year
deleted text end.new text begin These are
onetime reductions.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 52. new text beginPREPAID HEALTH PLAN RATES.
new text end

new text begin In negotiating the prepaid health plan contract rates for services rendered on or
after January 1, 2011, the commissioner of human services shall take into consideration
and the rates shall reflect the anticipated savings in the medical assistance program due
to extending medical assistance coverage to services provided in licensed birth centers,
the anticipated use of these services within the medical assistance population, and the
reduced medical assistance costs associated with the use of birth centers for normal,
low-risk deliveries.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 53. new text beginSTATE PLAN AMENDMENT; FEDERAL APPROVAL.
new text end

new text begin The commissioner of human services shall submit a Medicaid state plan amendment
to receive federal fund participation for adults without children whose income is equal
to or less than 75 percent of federal poverty guidelines in accordance with the Patient
Protection and Affordable Care Act, Public Law 111-148, or the Health Care and
Education Reconciliation Act of 2010, Public Law 111-152. The effective date of the
state plan amendment shall be June 1, 2010.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 54. new text beginUPPER PAYMENT LIMIT REPORT.
new text end

new text begin Each January 15, beginning in 2011, the commissioner of human services shall
report the following information to the chairs of the house of representatives and senate
finance committees and divisions with responsibility for human services appropriations:
new text end

new text begin (1) the estimated room within the Medicare hospital upper payment limit for the
federal year beginning on October 1 of the year the report is made;
new text end

new text begin (2) the amount of a rate increase under Minnesota Statutes, section 256.969,
subdivision 3a, paragraph (i), that would increase medical assistance hospital spending
to the upper payment limit; and
new text end

new text begin (3) the amount of a surcharge increase under Minnesota Statutes, section 256.9657,
subdivision 2, needed to generate the state share of the potential rate increase under
clause (2).
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 55. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall edit Minnesota Statutes and Minnesota Rules to remove
references to the general assistance medical care program and references to Minnesota
Statutes, section 256D.03, subdivision 3, or Minnesota Statutes, chapter 256D, as it
pertains to general assistance medical care and make other changes as may be necessary
to remove references to the general assistance medical care program. The revisor may
consult with the Department of Human Services when making editing decisions on the
removal of these references.
new text end

Sec. 56. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2008, section 256D.03, subdivisions 3, 3a, 5, 6, 7, and 8, new text end new text begin
are repealed July 1, 2010.
new text end

new text begin (b) new text end new text begin Laws 2010, chapter 200, article 1, sections 12; 18; and 19, new text end new text begin are repealed July
1, 2010.
new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 2

CONTINUING CARE

Section 1.

Minnesota Statutes 2008, section 144D.03, subdivision 2, is amended to
read:


Subd. 2.

Registration information.

The establishment shall provide the following
information to the commissioner in order to be registered:

(1) the business name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners are not natural persons, identification of the type of business entity
of the owner or owners, and the names and addresses of the officers and members of the
governing body, or comparable persons for partnerships, limited liability corporations, or
other types of business organizations of the owner or owners;

(3) the name and mailing address of the managing agent, whether through
management agreement or lease agreement, of the establishment, if different from the
owner or owners, and the name of the on-site manager, if any;

(4) verification that the establishment has entered into a housing with services
contract, as required in section 144D.04, with each resident or resident's representative;

(5) verification that the establishment is complying with the requirements of section
325F.72, if applicable;

(6) the name and address of at least one natural person who shall be responsible
for dealing with the commissioner on all matters provided for in sections 144D.01 to
144D.06, and on whom personal service of all notices and orders shall be made, and who
shall be authorized to accept service on behalf of the owner or owners and the managing
agent, if any; deleted text beginanddeleted text end

(7) the signature of the authorized representative of the owner or owners or, if
the owner or owners are not natural persons, signatures of at least two authorized
representatives of each owner, one of which shall be an officer of the ownernew text begin; and
new text end

new text begin (8) whether services are included in the base rate to be paid by the residentnew text end.

Personal service on the person identified under clause (6) by the owner or owners in
the registration shall be considered service on the owner or owners, and it shall not be a
defense to any action that personal service was not made on each individual or entity. The
designation of one or more individuals under this subdivision shall not affect the legal
responsibility of the owner or owners under sections 144D.01 to 144D.06.

Sec. 2.

Minnesota Statutes 2008, section 144D.03, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin Certificate of transitional consultation. new text end

new text begin (a) A housing with services
establishment shall not execute a contract or allow a prospective resident to move in until
the establishment has received certification from the Senior LinkAge Line that transition
to housing with services consultation under section 256B.0911, subdivision 3c, has been
completed. Prospective residents may be allowed to move in on an emergency basis prior
to receiving a certificate, however, the certification must occur within 30 calendar days of
admission. The housing with services establishment shall maintain copies of contracts and
certificates for audit for a period of three years. The Senior LinkAge Line shall issue a
certification within 24 hours of a contact by a prospective resident.
new text end

new text begin (b) This subdivision applies to housing with services establishments that are required
to register under section 144D.02 and:
new text end

new text begin (1) include any service in the base rate as described in the contract established
under section 144D.04; or
new text end

new text begin (2) require residents to purchase services as a condition of tenancy.
new text end

Sec. 3.

Minnesota Statutes 2008, section 144D.04, subdivision 2, is amended to read:


Subd. 2.

Contents of contract.

A housing with services contract, which need not be
entitled as such to comply with this section, shall include at least the following elements
in itself or through supporting documents or attachments:

(1) the name, street address, and mailing address of the establishment;

(2) the name and mailing address of the owner or owners of the establishment and, if
the owner or owners is not a natural person, identification of the type of business entity
of the owner or owners;

(3) the name and mailing address of the managing agent, through management
agreement or lease agreement, of the establishment, if different from the owner or owners;

(4) the name and address of at least one natural person who is authorized to accept
service of process on behalf of the owner or owners and managing agent;

(5) a statement describing the registration and licensure status of the establishment
and any provider providing health-related or supportive services under an arrangement
with the establishment;

(6) the term of the contract;

(7) a description of the services to be provided to the resident in the base rate to be
paid by residentnew text begin, including a delineation of the portion of the base rate that constitutes rent
and a delineation of charges for each service included in the base rate
new text end;

(8) a description of any additional services, including home care services, available
for an additional fee from the establishment directly or through arrangements with the
establishment, and a schedule of fees charged for these services;

(9) a description of the process through which the contract may be modified,
amended, or terminated;

(10) a description of the establishment's complaint resolution process available
to residents including the toll-free complaint line for the Office of Ombudsman for
Long-Term Care;

(11) the resident's designated representative, if any;

(12) the establishment's referral procedures if the contract is terminated;

(13) requirements of residency used by the establishment to determine who may
reside or continue to reside in the housing with services establishment;

(14) billing and payment procedures and requirements;

(15) a statement regarding the ability of residents to receive services from service
providers with whom the establishment does not have an arrangement;

(16) a statement regarding the availability of public funds for payment for residence
or services in the establishment; and

(17) a statement regarding the availability of and contact information for
long-term care consultation services under section 256B.0911 in the county in which the
establishment is located.

Sec. 4.

new text begin [144D.08] UNIFORM CONSUMER INFORMATION GUIDE.
new text end

new text begin All housing with services establishments shall make available to all prospective
and current residents information consistent with the uniform format and the required
components adopted by the commissioner under section 144G.06.
new text end

Sec. 5.

new text begin [144D.09] TERMINATION OF LEASE.
new text end

new text begin The housing with services establishment shall include with notice of termination
of lease information about how to contact the ombudsman for long-term care, including
the address and phone number along with a statement of how to request problem-solving
assistance.
new text end

Sec. 6.

Minnesota Statutes 2008, section 144G.06, is amended to read:


144G.06 UNIFORM CONSUMER INFORMATION GUIDE.

(a) The commissioner of health shall establish an advisory committee consisting
of representatives of consumers, providers, county and state officials, and other
groups the commissioner considers appropriate. The advisory committee shall present
recommendations to the commissioner on:

(1) a format for a guide to be used by individual providers of assisted living, as
defined in section 144G.01, that includes information about services offered by that
provider,new text begin which services may be covered by Medicare,new text end service costs, and other relevant
provider-specific information, as well as a statement of philosophy and values associated
with assisted living, presented in uniform categories that facilitate comparison with guides
issued by other providers; and

(2) requirements for informing assisted living clients, as defined in section 144G.01,
of their applicable legal rights.

(b) The commissioner, after reviewing the recommendations of the advisory
committee, shall adopt a uniform format for the guide to be used by individual providers,
and the required components of materials to be used by providers to inform assisted
living clients of their legal rights, and shall make the uniform format and the required
components available to assisted living providers.

Sec. 7.

Minnesota Statutes 2009 Supplement, section 252.27, subdivision 2a, is
amended to read:


Subd. 2a.

Contribution amount.

(a) The natural or adoptive parents of a minor
child, including a child determined eligible for medical assistance without consideration of
parental income, must contribute to the cost of services used by making monthly payments
on a sliding scale based on income, unless the child is married or has been married,
parental rights have been terminated, or the child's adoption is subsidized according to
section 259.67 or through title IV-E of the Social Security Act. The parental contribution
is a partial or full payment for medical services provided for diagnostic, therapeutic,
curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
defined in United States Code, title 26, section 213, needed by the child with a chronic
illness or disability.

(b) For households with adjusted gross income equal to or greater than 100 percent
of federal poverty guidelines, the parental contribution shall be computed by applying the
following schedule of rates to the adjusted gross income of the natural or adoptive parents:

(1) if the adjusted gross income is equal to or greater than 100 percent of federal
poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
contribution is $4 per month;

(2) if the adjusted gross income is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
the parental contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at one percent of adjusted gross income
at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
gross income for those with adjusted gross income up to 545 percent of federal poverty
guidelines;

(3) if the adjusted gross income is greater than 545 percent of federal poverty
guidelines and less than 675 percent of federal poverty guidelines, the parental
contribution shall be 7.5 percent of adjusted gross income;

(4) if the adjusted gross income is equal to or greater than 675 percent of federal
poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
federal poverty guidelines and increases to ten percent of adjusted gross income for those
with adjusted gross income up to 975 percent of federal poverty guidelines; and

(5) if the adjusted gross income is equal to or greater than 975 percent of federal
poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
income.

If the child lives with the parent, the annual adjusted gross income is reduced by
$2,400 prior to calculating the parental contribution. If the child resides in an institution
specified in section 256B.35, the parent is responsible for the personal needs allowance
specified under that section in addition to the parental contribution determined under this
section. The parental contribution is reduced by any amount required to be paid directly to
the child pursuant to a court order, but only if actually paid.

(c) The household size to be used in determining the amount of contribution under
paragraph (b) includes natural and adoptive parents and their dependents, including the
child receiving services. Adjustments in the contribution amount due to annual changes
in the federal poverty guidelines shall be implemented on the first day of July following
publication of the changes.

(d) For purposes of paragraph (b), "income" means the adjusted gross income of the
natural or adoptive parents determined according to the previous year's federal tax form,
except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
have been used to purchase a home shall not be counted as income.

(e) The contribution shall be explained in writing to the parents at the time eligibility
for services is being determined. The contribution shall be made on a monthly basis
effective with the first month in which the child receives services. Annually upon
redetermination or at termination of eligibility, if the contribution exceeded the cost of
services provided, the local agency or the state shall reimburse that excess amount to
the parents, either by direct reimbursement if the parent is no longer required to pay a
contribution, or by a reduction in or waiver of parental fees until the excess amount is
exhausted. All reimbursements must include a notice that the amount reimbursed may be
taxable income if the parent paid for the parent's fees through an employer's health care
flexible spending account under the Internal Revenue Code, section 125, and that the
parent is responsible for paying the taxes owed on the amount reimbursed.

(f) The monthly contribution amount must be reviewed at least every 12 months;
when there is a change in household size; and when there is a loss of or gain in income
from one month to another in excess of ten percent. The local agency shall mail a written
notice 30 days in advance of the effective date of a change in the contribution amount.
A decrease in the contribution amount is effective in the month that the parent verifies a
reduction in income or change in household size.

(g) Parents of a minor child who do not live with each other shall each pay the
contribution required under paragraph (a). An amount equal to the annual court-ordered
child support payment actually paid on behalf of the child receiving services shall be
deducted from the adjusted gross income of the parent making the payment prior to
calculating the parental contribution under paragraph (b).

(h) The contribution under paragraph (b) shall be increased by an additional five
percent if the local agency determines that insurance coverage is available but not
obtained for the child. For purposes of this section, "available" means the insurance is a
benefit of employment for a family member at an annual cost of no more than five percent
of the family's annual income. For purposes of this section, "insurance" means health
and accident insurance coverage, enrollment in a nonprofit health service plan, health
maintenance organization, self-insured plan, or preferred provider organization.

Parents who have more than one child receiving services shall not be required
to pay more than the amount for the child with the highest expenditures. There shall
be no resource contribution from the parents. The parent shall not be required to pay
a contribution in excess of the cost of the services provided to the child, not counting
payments made to school districts for education-related services. Notice of an increase in
fee payment must be given at least 30 days before the increased fee is due.

(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
in the 12 months prior to July 1:

(1) the parent applied for insurance for the child;

(2) the insurer denied insurance;

(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
a complaint or appeal, in writing, to the commissioner of health or the commissioner of
commerce, or litigated the complaint or appeal; and

(4) as a result of the dispute, the insurer reversed its decision and granted insurance.

For purposes of this section, "insurance" has the meaning given in paragraph (h).

A parent who has requested a reduction in the contribution amount under this
paragraph shall submit proof in the form and manner prescribed by the commissioner or
county agency, including, but not limited to, the insurer's denial of insurance, the written
letter or complaint of the parents, court documents, and the written response of the insurer
approving insurance. The determinations of the commissioner or county agency under this
paragraph are not rules subject to chapter 14.

new text begin (j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
2013, the parental contribution shall be computed by applying the following contribution
schedule to the adjusted gross income of the natural or adoptive parents:
new text end

new text begin (1) if the adjusted gross income is equal to or greater than 100 percent of federal
poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
contribution is $4 per month;
new text end

new text begin (2) if the adjusted gross income is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
the parental contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at one percent of adjusted gross income
at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
gross income for those with adjusted gross income up to 525 percent of federal poverty
guidelines;
new text end

new text begin (3) if the adjusted gross income is greater than 525 percent of federal poverty
guidelines and less than 675 percent of federal poverty guidelines, the parental contribution
shall be 9.5 percent of adjusted gross income;
new text end

new text begin (4) if the adjusted gross income is equal to or greater than 675 percent of federal
poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
federal poverty guidelines and increases to 12 percent of adjusted gross income for those
with adjusted gross income up to 900 percent of federal poverty guidelines; and
new text end

new text begin (5) if the adjusted gross income is equal to or greater than 900 percent of federal
poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
income. If the child lives with the parent, the annual adjusted gross income is reduced by
$2,400 prior to calculating the parental contribution. If the child resides in an institution
specified in section 256B.35, the parent is responsible for the personal needs allowance
specified under that section in addition to the parental contribution determined under this
section. The parental contribution is reduced by any amount required to be paid directly to
the child pursuant to a court order, but only if actually paid.
new text end

Sec. 8.

new text begin [256.4825] REPORT REGARDING PROGRAMS AND SERVICES FOR
PEOPLE WITH DISABILITIES.
new text end

new text begin The Minnesota State Council on Disability, the Minnesota Consortium for Citizens
with Disabilities, and the Arc of Minnesota may submit an annual report by January 15 of
each year, beginning in 2012, to the chairs and ranking minority members of the legislative
committees with jurisdiction over programs serving people with disabilities as provided in
this section. The report must describe the existing state policies and goals for programs
serving people with disabilities including, but not limited to, programs for employment,
transportation, housing, education, quality assurance, consumer direction, physical and
programmatic access, and health. The report must provide data and measurements to
assess the extent to which the policies and goals are being met. The commissioner of
human services and the commissioners of other state agencies administering programs for
people with disabilities shall cooperate with the Minnesota State Council on Disability,
the Minnesota Consortium for Citizens with Disabilities, and the Arc of Minnesota and
provide those organizations with existing published information and reports that will assist
in the preparation of the report.
new text end

Sec. 9.

Minnesota Statutes 2008, section 256.9657, subdivision 3a, is amended to read:


Subd. 3a.

ICF/MR license surcharge.

new text begin(a) new text endEffective July 1, 2003, each
non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay
to the commissioner an annual surcharge according to the schedule in subdivision 4,
paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of
licensed beds is reduced, the surcharge shall be based on the number of remaining licensed
beds the second month following the receipt of timely notice by the commissioner of
human services that beds have been delicensed. The facility must notify the commissioner
of health in writing when beds are delicensed. The commissioner of health must notify
the commissioner of human services within ten working days after receiving written
notification. If the notification is received by the commissioner of human services by
the 15th of the month, the invoice for the second following month must be reduced to
recognize the delicensing of beds. The commissioner may reduce, and may subsequently
restore, the surcharge under this subdivision based on the commissioner's determination of
a permissible surcharge.

new text begin (b) Effective July 1, 2010, the surcharge under paragraph (a) is increased to $4,037
per licensed bed.
new text end

Sec. 10.

Minnesota Statutes 2009 Supplement, section 256.975, subdivision 7, is
amended to read:


Subd. 7.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(iii) the long-term care consultation team for those who are appropriate for relocation
service coordination due to high-risk factors or psychological or physical disability.

Sec. 11.

Minnesota Statutes 2008, 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)new text begin but for excess earnings or assets,new text end 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); and

(4) deleted text begineffective November 1, 2003,deleted text end pays a premium and other obligations under
paragraph (e).

Any spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.

(b) 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, 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) 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.

(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. The premium shall be 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. 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 percent of unearned income in addition to the premium amount.

(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) 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.

new text begin (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.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Minnesota Statutes 2009 Supplement, section 256B.0659, subdivision 11,
is amended to read:


Subd. 11.

Personal care assistant; requirements.

(a) A personal care assistant
must meet the following requirements:

(1) be at least 18 years of age with the exception of persons who are 16 or 17 years
of age with these additional requirements:

(i) supervision by a qualified professional every 60 days; and

(ii) employment by only one personal care assistance provider agency responsible
for compliance with current labor laws;

(2) be employed by a personal care assistance provider agency;

(3) enroll with the department as a personal care assistant after clearing a background
study. 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. 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 deleted text begin310deleted text endnew text begin 275 new text end hours per month of
personal care assistance services regardless of the number of recipients being served or the
number of personal care assistance provider agencies enrolled with.

(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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 3c,
is amended to read:


Subd. 3c.

Transition to housing with services.

(a) Housing with services
establishments deleted text beginoffering or providing assisted living under chapter 144Gdeleted text end shall inform
all prospective residents of the deleted text beginavailability of and contact information for transitional
consultation services under this subdivision prior to executing a lease or contract with
the prospective resident
deleted text endnew text begin requirement to contact the Senior LinkAge Line for long-term
care options counseling and transitional consultation. The Senior LinkAge Line shall
provide a certificate to the prospective resident and also send a copy of the certificate to
the housing with services establishment that the prospective resident chooses, verifying
that consultation has been provided to the prospective resident or the prospective
resident's legal representative. The housing with services establishment shall not execute a
contract or allow a prospective resident to move in until the establishment has received
certification from the Senior LinkAge Line. Prospective residents refusing to contact the
Senior LinkAge Line are required to sign a waiver form supplied by the provider. The
housing with services establishment shall maintain copies of contracts, waiver forms, and
certificates for audit for a period of three years
new text end. The purpose of transitional long-term care
consultation 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 services are provided as determined by the
commissioner of human services in partnership with county long-term care consultation
unitsdeleted text begin, and the Area Agencies on Agingdeleted text endnew text begin under section 144D.03, subdivision 3new text end, 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 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;

(2) the consultation must include a review of the prospective resident's reasons for
considering assisted living, 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 settings that may meet the prospective resident's
needs; deleted text beginand
deleted text end

(3) the prospective resident shall be informed of the availability of long-term care
consultation services described in subdivision 3a that are available 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 eligibilitydeleted text begin.deleted text endnew text begin;
new text end

new text begin (4) a prospective resident does not include a person moving from the community,
a hospital, or an institutional setting to housing with services during nonworking hours
when:
new text end

new text begin (i) the move is based on a recent precipitating event that precludes the person from
living safely in the community or institution, such as sustaining injury, unanticipated
discharge from hospital or nursing facility, inability of caregivers to provide needed care,
lack of access to needed care or services, or declining health status; and
new text end

new text begin (ii) the Senior LinkAge Line is contacted within ten working days following the
move to the registered housing with services, or as soon as is reasonable considering
the prospective resident's condition; and
new text end

new text begin (5) the Senior LinkAge Line may provide the long-term care options counseling and
transitional consultation service.
new text end

Sec. 14.

Minnesota Statutes 2008, section 256B.0915, is amended by adding a
subdivision to read:


new text begin Subd. 3i. new text end

new text begin Rate reduction for customized living and 24-hour customized living
services.
new text end

new text begin (a) Effective July 1, 2010, the commissioner shall reduce service component
rates and service rate limits for customized living services and 24-hour customized living
services, from the rates in effect on June 30, 2010, by five percent.
new text end

new text begin (b) To implement the rate reductions in this subdivision, capitation rates paid by the
commissioner to managed care organizations under section 256B.69 shall reflect a ten
percent reduction for the specified services for the period January 1, 2011, to June 30,
2011, and a five percent reduction for those services on and after July 1, 2011.
new text end

Sec. 15.

Minnesota Statutes 2009 Supplement, section 256B.441, subdivision 55,
is amended to read:


Subd. 55.

Phase-in of rebased operating payment rates.

(a) For the rate years
beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
under this section shall be phased in by blending the operating rate with the operating
payment rate determined under section 256B.434. For purposes of this subdivision, the
rate to be used that is determined under section 256B.434 shall not include the portion of
the operating payment rate related to performance-based incentive payments under section
256B.434, subdivision 4, paragraph (d). For the rate year beginning October 1, 2008, the
operating payment rate for each facility shall be 13 percent of the operating payment rate
from this section, and 87 percent of the operating payment rate from section 256B.434.
deleted text begin For the rate year beginning October 1, 2009, the operating payment rate for each facility
shall be 14 percent of the operating payment rate from this section, and 86 percent of
the operating payment rate from section 256B.434. For rate years beginning October 1,
2010; October 1, 2011; and October 1, 2012,
deleted text endnew text begin For the rate period from October 1, 2009, to
September 30, 2013,
new text end no rate adjustments shall be implemented under this section, but shall
be determined under section 256B.434. For the rate year beginning October 1, 2013, the
operating payment rate for each facility shall be 65 percent of the operating payment rate
from this section, and 35 percent of the operating payment rate from section 256B.434.
For the rate year beginning October 1, 2014, the operating payment rate for each facility
shall be 82 percent of the operating payment rate from this section, and 18 percent of the
operating payment rate from section 256B.434. For the rate year beginning October 1,
2015, the operating payment rate for each facility shall be the operating payment rate
determined under this section. The blending of operating payment rates under this section
shall be performed separately for each RUG's class.

(b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
to the operating payment rate increases under paragraph (a) by creating a minimum
percentage increase and a maximum percentage increase.

(1) Each nursing facility that receives a blended October 1, 2008, operating payment
rate increase under paragraph (a) of less than one percent, when compared to its operating
payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
shall receive a rate adjustment of one percent.

(2) The commissioner shall determine a maximum percentage increase that will
result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
facilities with a blended October 1, 2008, operating payment rate increase under paragraph
(a) greater than the maximum percentage increase determined by the commissioner, when
compared to its operating payment rate on September 30, 2008, computed using rates with
a RUG's weight of 1.00, shall receive the maximum percentage increase.

(3) Nursing facilities with a blended October 1, 2008, operating payment rate
increase under paragraph (a) greater than one percent and less than the maximum
percentage increase determined by the commissioner, when compared to its operating
payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
shall receive the blended October 1, 2008, operating payment rate increase determined
under paragraph (a).

(4) The October 1, 2009, through October 1, 2015, operating payment rate for
facilities receiving the maximum percentage increase determined in clause (2) shall be
the amount determined under paragraph (a) less the difference between the amount
determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
(2). This rate restriction does not apply to rate increases provided in any other section.

(c) A portion of the funds received under this subdivision that are in excess of
operating payment rates that a facility would have received under section 256B.434, as
determined in accordance with clauses (1) to (3), shall be subject to the requirements in
section 256B.434, subdivision 19, paragraphs (b) to (h).

(1) Determine the amount of additional funding available to a facility, which shall be
equal to total medical assistance resident days from the most recent reporting year times
the difference between the blended rate determined in paragraph (a) for the rate year being
computed and the blended rate for the prior year.

(2) Determine the portion of all operating costs, for the most recent reporting year,
that are compensation related. If this value exceeds 75 percent, use 75 percent.

(3) Subtract the amount determined in clause (2) from 75 percent.

(4) The portion of the fund received under this subdivision that shall be subject to
the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal
the amount determined in clause (1) times the amount determined in clause (3).

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

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


new text begin Subd. 9. new text end

new text begin Rate increase effective June 1, 2010. new text end

new text begin For rate periods beginning on or
after June 1, 2010, the commissioner shall increase the total operating payment rate for
each facility reimbursed under this section by $8.74 per day. The increase shall not be
subject to any annual percentage increase.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2009 Supplement, section 256B.69, subdivision 23,
is amended to read:


Subd. 23.

Alternative services; elderly and disabled persons.

(a) The
commissioner may implement demonstration projects to create alternative integrated
delivery systems for acute and long-term care services to elderly persons and persons
with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
coordination, improve access to quality services, and mitigate future cost increases.
The commissioner may seek federal authority to combine Medicare and Medicaid
capitation payments for the purpose of such demonstrations and may contract with
Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
services shall be administered according to the terms and conditions of the federal contract
and demonstration provisions. For the purpose of administering medical assistance funds,
demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
items B and C, which do not apply to persons enrolling in demonstrations under this
section. An initial open enrollment period may be provided. Persons who disenroll from
demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
the health plan's participation is subsequently terminated for any reason, the person shall
be provided an opportunity to select a new health plan and shall have the right to change
health plans within the first 60 days of enrollment in the second health plan. Persons
required to participate in health plans under this section who fail to make a choice of
health plan shall not be randomly assigned to health plans under these demonstrations.
Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
the commissioner may contract with managed care organizations, including counties, to
serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
disabled persons only. For persons with a primary diagnosis of developmental disability,
serious and persistent mental illness, or serious emotional disturbance, the commissioner
must ensure that the county authority has approved the demonstration and contracting
design. Enrollment in these projects for persons with disabilities shall be voluntary. The
commissioner shall not implement any demonstration project under this subdivision for
persons with a primary diagnosis of developmental disabilities, serious and persistent
mental illness, or serious emotional disturbance, without approval of the county board of
the county in which the demonstration is being implemented.

(b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
9525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
under this section projects for persons with developmental disabilities. The commissioner
may capitate payments for ICF/MR services, waivered services for developmental
disabilities, including case management services, day training and habilitation and
alternative active treatment services, and other services as approved by the state and by the
federal government. Case management and active treatment must be individualized and
developed in accordance with a person-centered plan. Costs under these projects may not
exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
and until four years after the pilot project implementation date, subcontractor participation
in the long-term care developmental disability pilot is limited to a nonprofit long-term
care system providing ICF/MR services, home and community-based waiver services,
and in-home services to no more than 120 consumers with developmental disabilities in
Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
prior to expansion of the developmental disability pilot project. This paragraph expires
four years after the implementation date of the pilot project.

(c) Before implementation of a demonstration project for disabled persons, the
commissioner must provide information to appropriate committees of the house of
representatives and senate and must involve representatives of affected disability groups
in the design of the demonstration projects.

(d) A nursing facility reimbursed under the alternative reimbursement methodology
in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a). The commissioner shall amend the state plan and
seek any federal waivers necessary to implement this paragraph.

(e) The commissioner, in consultation with the commissioners of commerce and
health, may approve and implement programs for all-inclusive care for the elderly (PACE)
according to federal laws and regulations governing that program and state laws or rules
applicable to participating providers. deleted text beginThe process for approval of these programs shall
begin only after the commissioner receives grant money in an amount sufficient to cover
the state share of the administrative and actuarial costs to implement the programs during
state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
account in the special revenue fund and are appropriated to the commissioner to be used
solely for the purpose of PACE administrative and actuarial costs.
deleted text end A PACE provider is
not required to be licensed or certified as a health plan company as defined in section
62Q.01, subdivision 4. Persons age 55 and older who have been screened by the county
and found to be eligible for services under the elderly waiver or community alternatives
for disabled individuals or who are already eligible for Medicaid but meet level of
care criteria for receipt of waiver services may choose to enroll in the PACE program.
Medicare and Medicaid services will be provided according to this subdivision and
federal Medicare and Medicaid requirements governing PACE providers and programs.
PACE enrollees will receive Medicaid home and community-based services through the
PACE provider as an alternative to services for which they would otherwise be eligible
through home and community-based waiver programs and Medicaid State Plan Services.
The commissioner shall establish Medicaid rates for PACE providers that do not exceed
costs that would have been incurred under fee-for-service or other relevant managed care
programs operated by the state.

(f) The commissioner shall seek federal approval to expand the Minnesota disability
health options (MnDHO) program established under this subdivision in stages, first to
regional population centers outside the seven-county metro area and then to all areas of
the state. Until July 1, 2009, expansion for MnDHO projects that include home and
community-based services is limited to the two projects and service areas in effect on
March 1, 2006. Enrollment in integrated MnDHO programs that include home and
community-based services shall remain voluntary. Costs for home and community-based
services included under MnDHO must not exceed costs that would have been incurred
under the fee-for-service program. Notwithstanding whether expansion occurs under
this paragraph, in determining MnDHO payment rates and risk adjustment methods deleted text beginfor
contract years starting in 2012,
deleted text end the commissioner must consider the methods used to
determine county allocations for home and community-based program participants. If
necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs
for home and community-based services, the commissioner shall achieve the reduction
by maintaining the base rate for contract deleted text beginyearsdeleted text end new text begin year new text end2010 deleted text beginand 2011deleted text end for services provided
under the community alternatives for disabled individuals waiver at the same level as for
contract year 2009. The commissioner may apply other reductions to MnDHO rates to
implement decreases in provider payment rates required by state law. new text beginEffective December
31, 2010, enrollment and operation of the MnDHO program in effect during 2010 shall
cease. The commissioner may reopen the program provided all applicable conditions of
this section are met.
new text endIn developing program specifications for expansion of integrated
programs, the commissioner shall involve and consult the state-level stakeholder group
established in subdivision 28, paragraph (d), including consultation on whether and how
to include home and community-based waiver programs. Plans deleted text beginfor further expansion ofdeleted text endnew text begin to
reopen
new text end MnDHO projects shall be presented to the chairs of the house of representatives
and senate committees with jurisdiction over health and human services policy and finance
deleted text begin by February 1, 2007deleted text endnew text begin prior to implementationnew text end.

(g) Notwithstanding section 256B.0261, health plans providing services under this
section are responsible for home care targeted case management and relocation targeted
case management. Services must be provided according to the terms of the waivers and
contracts approved by the federal government.

Sec. 18.

Laws 2009, chapter 79, article 8, section 51, the effective date, is amended to
read:


EFFECTIVE DATE.

This section is effective deleted text beginJanuarydeleted text endnew text begin Julynew text end 1, 2011.

Sec. 19.

Laws 2009, chapter 79, article 8, section 84, is amended to read:


Sec. 84. HOUSING OPTIONS.

The commissioner of human services, in consultation with the commissioner of
administration and the Minnesota Housing Finance Agency, and representatives of
counties, residents' advocacy groups, consumers of housing services, and provider
agencies shall explore ways to maximize the availability and affordability of housing
choices available to persons with disabilities or who need care assistance due to other
health challenges. A goal shall also be to minimize state physical plant costs in order to
serve more persons with appropriate program and care support. Consideration shall be
given to:

(1) improved access to rent subsidies;

(2) use of cooperatives, land trusts, and other limited equity ownership models;

(3) whether a public equity housing fund should be established that would maintain
the state's interest, to the extent paid from state funds, including group residential housing
and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that
when sold, the state would recover its share for a public equity fund to be used for future
public needs under this chapter;

(4) the desirability of the state acquiring an ownership interest or promoting the
use of publicly owned housing;

(5) promoting more choices in the market for accessible housing that meets the
needs of persons with physical challenges; deleted text beginand
deleted text end

(6) what consumer ownership models, if any, are appropriatenew text begin; and
new text end

new text begin (7) a review of the definition of home and community services and appropriate
settings where these services may be provided, including the number of people who
may reside under one roof, through the home and community-based waivers for seniors
and individuals with disabilities
new text end.

The commissioner shall provide a written report on the findings of the evaluation of
housing options to the chairs and ranking minority members of the house of representatives
and senate standing committees with jurisdiction over health and human services policy
and funding by December 15, 2010. This report shall replace the November 1, 2010,
annual report by the commissioner required in Minnesota Statutes, sections 256B.0916,
subdivision 7
, and 256B.49, subdivision 21.

Sec. 20. new text beginCASE MANAGEMENT REFORM.
new text end

new text begin (a) By February 1, 2011, the commissioner of human services shall provide specific
recommendations and language for proposed legislation to:
new text end

new text begin (1) define the administrative and the service functions of case management for
persons with disabilities and make changes to improve the funding for administrative
functions;
new text end

new text begin (2) standardize and simplify processes, standards, and timelines for case
management within the Department of Human Services, Disability Services Division,
including eligibility determinations, resource allocation, management of dollars, provision
for assignment of one case manager at a time per person, waiting lists, quality assurance,
host county concurrence requirements, county of financial responsibility provisions, and
waiver compliance; and
new text end

new text begin (3) increase opportunities for consumer choice of case management functions
involving service coordination.
new text end

new text begin (b) In developing these recommendations, the commissioner shall consider the
recommendations of the 2007 Redesigning Case Management Services for Persons
with Disabilities report and consult with existing stakeholder groups, which include
representatives of counties, disability and senior advocacy groups, service providers, and
representatives of agencies which provide contracted case management.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 21. new text beginCOMMISSIONER TO SEEK FEDERAL MATCH.
new text end

new text begin (a) The commissioner of human services shall seek federal financial participation
for eligible activity related to fiscal years 2010 and 2011 grants to Advocating Change
Together to establish a statewide self-advocacy network for persons with developmental
disabilities and for eligible activities under any future grants to the organization.
new text end

new text begin (b) The commissioner shall report to the chairs and ranking minority members of
the senate Health and Human Services Budget Division and the house of representatives
Health Care and Human Services Finance Division by December 15, 2010, with the
results of the application for federal matching funds.
new text end

Sec. 22. new text beginICF/MR RATE INCREASE.
new text end

new text begin The daily rate at an intermediate care facility for the developmentally disabled
located in Clearwater County and classified as a Class A facility with 15 beds shall be
increased from $112.73 to $138.23 for the rate period July 1, 2010, to June 30, 2011.
new text end

ARTICLE 3

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2008, section 256D.0515, is amended to read:


256D.0515 ASSET LIMITATIONS FOR FOOD STAMP HOUSEHOLDS.

All food stamp households must be determined eligible for the benefit discussed
under section 256.029. Food stamp households must demonstrate thatdeleted text begin:
deleted text end

deleted text begin (1)deleted text end their gross income deleted text beginmeets the federal Food Stamp requirements under United
deleted text enddeleted text beginStates Code, title 7, section 2014(c); anddeleted text end

deleted text begin (2) they have financial resources, excluding vehicles, of less than $7,000deleted text end new text beginis equal to
or less than 165 percent of the federal poverty guidelines for the same family size
new text end.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2008, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1n. new text end

new text begin Supplemental rate; Mahnomen County. new text end

new text begin Notwithstanding the
provisions of this section, for the rate period July 1, 2010, to June 30, 2011, a county
agency shall negotiate a supplemental service rate in addition to the rate specified in
subdivision 1, not to exceed $753 per month or the existing rate, including any legislative
authorized inflationary adjustments, for a group residential provider located in Mahnomen
County that operates a 28-bed facility providing 24-hour care to individuals who are
homeless, disabled, chemically dependent, mentally ill, or chronically homeless.
new text end

Sec. 3.

Minnesota Statutes 2008, section 256J.24, subdivision 6, is amended to read:


Subd. 6.

Family cap.

(a) MFIP assistance units shall not receive an increase in the
cash portion of the transitional standard as a result of the birth of a child, unless one of
the conditions under paragraph (b) is met. The child shall be considered a member of the
assistance unit according to subdivisions 1 to 3, but shall be excluded in determining
family size for purposes of determining the amount of the cash portion of the transitional
standard under subdivision 5. The child shall be included in determining family size for
purposes of determining the food portion of the transitional standard. The transitional
standard under this subdivision shall be the total of the cash and food portions as specified
in this paragraph. The family wage level under this subdivision shall be based on the
family size used to determine the food portion of the transitional standard.

(b) A child shall be included in determining family size for purposes of determining
the amount of the cash portion of the MFIP transitional standard when at least one of
the following conditions is met:

(1) for families receiving MFIP assistance on July 1, 2003, the child is born to the
adult parent before May 1, 2004;

(2) for families who apply for the diversionary work program under section 256J.95
or MFIP assistance on or after July 1, 2003, the child is born to the adult parent within
ten months of the date the family is eligible for assistance;

(3) the child was conceived as a result of a sexual assault or incest, provided that the
incident has been reported to a law enforcement agency;

(4) the child's mother is a minor caregiver as defined in section 256J.08, subdivision
59
, and the child, or multiple children, are the mother's first birth; deleted text beginordeleted text end

(5) new text beginthe child is the mother's first child subsequent to a pregnancy that did not result
in a live birth; or
new text end

new text begin (6) new text endany child previously excluded in determining family size under paragraph
(a) shall be included if the adult parent or parents have not received benefits from the
diversionary work program under section 256J.95 or MFIP assistance in the previous ten
months. An adult parent or parents who reapply and have received benefits from the
diversionary work program or MFIP assistance in the past ten months shall be under the
ten-month grace period of their previous application under clause (2).

(c) Income and resources of a child excluded under this subdivision, except child
support received or distributed on behalf of this child, must be considered using the same
policies as for other children when determining the grant amount of the assistance unit.

(d) The caregiver must assign support and cooperate with the child support
enforcement agency to establish paternity and collect child support on behalf of the
excluded child. Failure to cooperate results in the sanction specified in section 256J.46,
subdivisions 2 and 2a
. Current support paid on behalf of the excluded child shall be
distributed according to section 256.741, subdivision 15.

(e) County agencies must inform applicants of the provisions under this subdivision
at the time of each application and at recertification.

(f) Children excluded under this provision shall be deemed MFIP recipients for
purposes of child care under chapter 119B.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2009 Supplement, section 256J.425, subdivision 3, is
amended to read:


Subd. 3.

Hard-to-employ participants.

(a) An assistance unit subject to the time
limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under
a hardship extension if the participant who reached the time limit belongs to any of the
following groups:

(1) a person who is diagnosed by a licensed physician, psychological practitioner, or
other qualified professional, as developmentally disabled or mentally ill, and the condition
severely limits the person's ability to obtain or maintain suitable employment;

(2) a person who:

(i) has been assessed by a vocational specialist or the county agency to be
unemployable for purposes of this subdivision; or

(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
agency to be employable, but the condition severely limits the person's ability to obtain or
maintain suitable employment. The determination of IQ level must be made by a qualified
professional. In the case of a non-English-speaking person: (A) the determination must
be made by a qualified professional with experience conducting culturally appropriate
assessments, whenever possible; (B) the county may accept reports that identify an
IQ range as opposed to a specific score; (C) these reports must include a statement of
confidence in the results;

(3) a person who is determined by a qualified professional to be learning disabled,
and the condition severely limits the person's ability to obtain or maintain suitable
employment. For purposes of the initial approval of a learning disability extension, the
determination must have been made or confirmed within the previous 12 months. In the
case of a non-English-speaking person: (i) the determination must be made by a qualified
professional with experience conducting culturally appropriate assessments, whenever
possible; and (ii) these reports must include a statement of confidence in the results. If a
rehabilitation plan for a participant extended as learning disabled is developed or approved
by the county agency, the plan must be incorporated into the employment plan. However,
a rehabilitation plan does not replace the requirement to develop and comply with an
employment plan under section 256J.521; or

(4) a person who has been granted a family violence waiver, and who is complying
with an employment plan under section 256J.521, subdivision 3.

(b) For purposes of this deleted text beginsectiondeleted text endnew text begin chapternew text end, "severely limits the person's ability to obtain
or maintain suitable employment" meansnew text begin:
new text end

new text begin (1)new text end that a qualified professional has determined that the person's condition prevents
the person from working 20 or more hours per weeknew text begin; or
new text end

new text begin (2) for a person who meets the requirements of paragraph (a), clause (2), item (ii), or
clause (3), a qualified professional has determined the person's condition:
new text end

new text begin (i) significantly restricts the range of employment that the person is able to perform;
or
new text end

new text begin (ii) significantly interferes with the person's ability to obtain or maintain suitable
employment for 20 or more hours per week
new text end.

Sec. 5. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2009 Supplement, section 256J.621, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 4

MISCELLANEOUS

Section 1.

new text begin [62Q.545] COVERAGE OF PRIVATE DUTY NURSING SERVICES.
new text end

new text begin (a) Private duty nursing services, as provided under section 256B.0625, subdivision
7, with the exception of section 256B.0654, subdivision 4, shall be covered under a health
plan for persons who are concurrently covered by both the health plan and enrolled in
medical assistance under chapter 256B.
new text end

new text begin (b) For purposes of this section, a period of private duty nursing services may
be subject to the co-payment, coinsurance, deductible, or other enrollee cost-sharing
requirements that apply under the health plan. Cost-sharing requirements for private
duty nursing services must not place a greater financial burden on the insured or enrollee
than those requirements applied by the health plan to other similar services or benefits.
Nothing in this section is intended to prevent a health plan company from requiring
prior authorization by the health plan company for such services as required by section
256B.0625, subdivision 7, or use of contracted providers under the applicable provisions
of the health plan.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2010, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 2.

new text begin [137.32] MINNESOTA COUPLES ON THE BRINK PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin Within the limits of available appropriations, the
Board of Regents of the University of Minnesota is requested to develop and implement
a Minnesota couples on the brink project, as provided for in this section. The regents
may administer the project with federal grants, state appropriations, and in-kind services
received for this purpose.
new text end

new text begin Subd. 2. new text end

new text begin Purpose. new text end

new text begin The purpose of the project is to develop, evaluate, and
disseminate best practices for promoting successful reconciliation between married
persons who are considering or have commenced a marriage dissolution proceeding and
who choose to pursue reconciliation.
new text end

new text begin Subd. 3. new text end

new text begin Implementation. new text end

new text begin The regents shall:
new text end

new text begin (1) enter into contracts or manage a grant process for implementation of the project;
and
new text end

new text begin (2) develop and implement an evaluation component for the project.
new text end

Sec. 3.

Minnesota Statutes 2008, section 152.126, as amended by Laws 2009, chapter
79, article 11, sections 9, 10, and 11, is amended to read:


152.126 deleted text beginSCHEDULE II AND IIIdeleted text end CONTROLLED SUBSTANCES
PRESCRIPTION ELECTRONIC REPORTING SYSTEM.

Subdivision 1.

Definitions.

For purposes of this section, the terms defined in this
subdivision have the meanings given.

(a) "Board" means the Minnesota State Board of Pharmacy established under
chapter 151.

(b) "Controlled substances" means those substances listed in section 152.02,
subdivisions 3 to 5, and those substances defined by the board pursuant to section 152.02,
subdivisions 7
, 8, and 12.

(c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
30. Dispensing does not include the direct administering of a controlled substance to a
patient by a licensed health care professional.

(d) "Dispenser" means a person authorized by law to dispense a controlled substance,
pursuant to a valid prescription. For the purposes of this section, a dispenser does not
include a licensed hospital pharmacy that distributes controlled substances for inpatient
hospital care or a veterinarian who is dispensing prescriptions under section 156.18.

(e) "Prescriber" means a licensed health care professional who is authorized to
prescribe a controlled substance under section 152.12, subdivision 1.

(f) "Prescription" has the meaning given in section 151.01, subdivision 16.

Subd. 1a.

Treatment of intractable pain.

This section is not intended to limit or
interfere with the legitimate prescribing of controlled substances for pain. No prescriber
shall be subject to disciplinary action by a health-related licensing board for prescribing a
controlled substance according to the provisions of section 152.125.

Subd. 2.

Prescription electronic reporting system.

(a) The board shall establish
by January 1, 2010, an electronic system for reporting the information required under
subdivision 4 for all controlled substances dispensed within the state.

(b) The board may contract with a vendor for the purpose of obtaining technical
assistance in the design, implementation, operation, and maintenance of the electronic
reporting system.

Subd. 3.

Prescription Electronic Reporting Advisory Committee.

(a) The
board shall convene an advisory committee. The committee must include at least one
representative of:

(1) the Department of Health;

(2) the Department of Human Services;

(3) each health-related licensing board that licenses prescribers;

(4) a professional medical association, which may include an association of pain
management and chemical dependency specialists;

(5) a professional pharmacy association;

(6) a professional nursing association;

(7) a professional dental association;

(8) a consumer privacy or security advocate; and

(9) a consumer or patient rights organization.

(b) The advisory committee shall advise the board on the development and operation
of the electronic reporting system, including, but not limited to:

(1) technical standards for electronic prescription drug reporting;

(2) proper analysis and interpretation of prescription monitoring data; and

(3) an evaluation process for the program.

deleted text begin (c) The Board of Pharmacy, after consultation with the advisory committee, shall
present recommendations and draft legislation on the issues addressed by the advisory
committee under paragraph (b), to the legislature by December 15, 2007.
deleted text end

Subd. 4.

Reporting requirements; notice.

(a) Each dispenser must submit the
following data to the board or its designated vendor, subject to the notice required under
paragraph (d):

(1) name of the prescriber;

(2) national provider identifier of the prescriber;

(3) name of the dispenser;

(4) national provider identifier of the dispenser;

(5) prescription number;

(6) name of the patient for whom the prescription was written;

(7) address of the patient for whom the prescription was written;

(8) date of birth of the patient for whom the prescription was written;

(9) date the prescription was written;

(10) date the prescription was filled;

(11) name and strength of the controlled substance;

(12) quantity of controlled substance prescribed;

(13) quantity of controlled substance dispensed; and

(14) number of days supply.

(b) The dispenser must submit the required information by a procedure and in a
format established by the board. The board may allow dispensers to omit data listed in this
subdivision or may require the submission of data not listed in this subdivision provided
the omission or submission is necessary for the purpose of complying with the electronic
reporting or data transmission standards of the American Society for Automation in
Pharmacy, the National Council on Prescription Drug Programs, or other relevant national
standard-setting body.

(c) A dispenser is not required to submit this data for those controlled substance
prescriptions dispensed for:

(1) individuals residing in licensed skilled nursing or intermediate care facilities;

(2) individuals receiving assisted living services under chapter 144G or through a
medical assistance home and community-based waiver;

(3) individuals receiving medication intravenously;

(4) individuals receiving hospice and other palliative or end-of-life care; and

(5) individuals receiving services from a home care provider regulated under chapter
144A.

(d) A dispenser must not submit data under this subdivision unless a conspicuous
notice of the reporting requirements of this section is given to the patient for whom the
prescription was written.

Subd. 5.

Use of data by board.

(a) The board shall develop and maintain a database
of the data reported under subdivision 4. The board shall maintain data that could identify
an individual prescriber or dispenser in encrypted form. The database may be used by
permissible users identified under subdivision 6 for the identification of:

(1) individuals receiving prescriptions for controlled substances from prescribers
who subsequently obtain controlled substances from dispensers in quantities or with a
frequency inconsistent with generally recognized standards of use for those controlled
substances, including standards accepted by national and international pain management
associations; and

(2) individuals presenting forged or otherwise false or altered prescriptions for
controlled substances to dispensers.

(b) No permissible user identified under subdivision 6 may access the database
for the sole purpose of identifying prescribers of controlled substances for unusual or
excessive prescribing patterns without a valid search warrant or court order.

(c) No personnel of a state or federal occupational licensing board or agency may
access the database for the purpose of obtaining information to be used to initiate or
substantiate a disciplinary action against a prescriber.

(d) Data reported under subdivision 4 shall be retained by the board in the database
for a 12-month period, and shall be removed from the database new text beginno later than new text end12 months
from deleted text beginthe datedeleted text end new text beginthe last day of the month during which new text endthe data was received.

Subd. 6.

Access to reporting system data.

(a) Except as indicated in this
subdivision, the data submitted to the board under subdivision 4 is private data on
individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.

(b) Except as specified in subdivision 5, the following persons shall be considered
permissible users and may access the data submitted under subdivision 4 in the same or
similar manner, and for the same or similar purposes, as those persons who are authorized
to access similar private data on individuals under federal and state law:

(1) a prescribernew text begin or an agent or employee of the prescriber to whom the prescriber has
delegated the task of accessing the data
new text end, to the extent the information relates specifically to
a current patient, to whom the prescriber is prescribing or considering prescribing any
controlled substancenew text begin and with the provision that the prescriber remains responsible for the
use or misuse of data accessed by a delegated agent or employee
new text end;

(2) a dispensernew text begin or an agent or employee of the dispenser to whom the dispenser has
delegated the task of accessing the data
new text end, to the extent the information relates specifically
to a current patient to whom that dispenser is dispensing or considering dispensing any
controlled substancenew text begin and with the provision that the dispenser remains responsible for the
use or misuse of data accessed by a delegated agent or employee
new text end;

(3) an individual who is the recipient of a controlled substance prescription for
which data was submitted under subdivision 4, or a guardian of the individual, parent or
guardian of a minor, or health care agent of the individual acting under a health care
directive under chapter 145C;

(4) personnel of the board specifically assigned to conduct a bona fide investigation
of a specific licensee;

(5) personnel of the board engaged in the collection of controlled substance
prescription information as part of the assigned duties and responsibilities under this
section;

(6) authorized personnel of a vendor under contract with the board who are engaged
in the design, implementation, operation, and maintenance of the electronic reporting
system as part of the assigned duties and responsibilities of their employment, provided
that access to data is limited to the minimum amount necessary to carry out such duties
and responsibilities;

(7) federal, state, and local law enforcement authorities acting pursuant to a valid
search warrant; and

(8) personnel of the medical assistance program assigned to use the data collected
under this section to identify recipients whose usage of controlled substances may warrant
restriction to a single primary care physician, a single outpatient pharmacy, or a single
hospital.

For purposes of clause (3), access by an individual includes persons in the definition
of an individual under section 13.02.

(c) Any permissible user identified in paragraph (b), who directly accesses
the data electronically, shall implement and maintain a comprehensive information
security program that contains administrative, technical, and physical safeguards that
are appropriate to the user's size and complexity, and the sensitivity of the personal
information obtained. The permissible user shall identify reasonably foreseeable internal
and external risks to the security, confidentiality, and integrity of personal information
that could result in the unauthorized disclosure, misuse, or other compromise of the
information and assess the sufficiency of any safeguards in place to control the risks.

(d) The board shall not release data submitted under this section unless it is provided
with evidence, satisfactory to the board, that the person requesting the information is
entitled to receive the data.

(e) The board shall not release the name of a prescriber without the written consent
of the prescriber or a valid search warrant or court order. The board shall provide a
mechanism for a prescriber to submit to the board a signed consent authorizing the release
of the prescriber's name when data containing the prescriber's name is requested.

(f) The board shall maintain a log of all persons who access the data and shall ensure
that any permissible user complies with paragraph (c) prior to attaining direct access to
the data.

(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into
pursuant to subdivision 2. A vendor shall not use data collected under this section for
any purpose not specified in this section.

Subd. 7.

Disciplinary action.

(a) A dispenser who knowingly fails to submit data to
the board as required under this section is subject to disciplinary action by the appropriate
health-related licensing board.

(b) A prescriber or dispenser authorized to access the data who knowingly discloses
the data in violation of state or federal laws relating to the privacy of health care data
shall be subject to disciplinary action by the appropriate health-related licensing board,
and appropriate civil penalties.

Subd. 8.

Evaluation and reporting.

(a) The board shall evaluate the prescription
electronic reporting system to determine if the system is negatively impacting appropriate
prescribing practices of controlled substances. The board may contract with a vendor to
design and conduct the evaluation.

(b) The board shall submit the evaluation of the system to the legislature by deleted text beginJanuarydeleted text end
new text begin July new text end15, 2011.

Subd. 9.

Immunity from liability; no requirement to obtain information.

(a) A
pharmacist, prescriber, or other dispenser making a report to the program in good faith
under this section is immune from any civil, criminal, or administrative liability, which
might otherwise be incurred or imposed as a result of the report, or on the basis that the
pharmacist or prescriber did or did not seek or obtain or use information from the program.

(b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
to obtain information about a patient from the program, and the pharmacist, prescriber,
or other dispenser, if acting in good faith, is immune from any civil, criminal, or
administrative liability that might otherwise be incurred or imposed for requesting,
receiving, or using information from the program.

new text begin Subd. 10. new text end

new text begin Funding. new text end

new text begin (a) The board may seek grants and private funds from nonprofit
charitable foundations, the federal government, and other sources to fund the enhancement
and ongoing operations of the prescription electronic reporting system established under
this section. Any funds received shall be appropriated to the board for this purpose. The
board may not expend funds to enhance the program in a way that conflicts with this
section without seeking approval from the legislature.
new text end

new text begin (b) The administrative services unit for the health-related licensing boards shall
apportion between the Board of Medical Practice, the Board of Nursing, the Board of
Dentistry, the Board of Podiatric Medicine, the Board of Optometry, and the Board
of Pharmacy an amount to be paid through fees by each respective board. The amount
apportioned to each board shall equal each board's share of the annual appropriation to
the Board of Pharmacy from the state government special revenue fund for operating the
prescription electronic reporting system under this section. Each board's apportioned
share shall be based on the number of prescribers or dispensers that each board identified
in this paragraph licenses as a percentage of the total number of prescribers and dispensers
licensed collectively by these boards. Each respective board may adjust the fees that the
boards are required to collect to compensate for the amount apportioned to each board by
the administrative services unit.
new text end

Sec. 4.

new text begin [246.125] CHEMICAL AND MENTAL HEALTH SERVICES
TRANSFORMATION ADVISORY TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The Chemical and Mental Health Services
Transformation Advisory Task Force is established to make recommendations to the
commissioner of human services and the legislature on the continuum of services needed
to provide individuals with complex conditions including mental illness, chemical
dependency, traumatic brain injury, and developmental disabilities access to quality care
and the appropriate level of care across the state to promote wellness, reduce cost, and
improve efficiency.
new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin The Chemical and Mental Health Services Transformation
Advisory Task Force shall make recommendations to the commissioner and the legislature
no later than December 15, 2010, on the following:
new text end

new text begin (1) transformation needed to improve service delivery and provide a continuum of
care, such as transition of current facilities, closure of current facilities, or the development
of new models of care, including the redesign of the Anoka-Metro Regional Treatment
Center;
new text end

new text begin (2) gaps and barriers to accessing quality care, system inefficiencies, and cost
pressures;
new text end

new text begin (3) services that are best provided by the state and those that are best provided
in the community;
new text end

new text begin (4) an implementation plan to achieve integrated service delivery across the public,
private, and nonprofit sectors;
new text end

new text begin (5) an implementation plan to ensure that individuals with complex chemical and
mental health needs receive the appropriate level of care to achieve recovery and wellness;
and
new text end

new text begin (6) financing mechanisms that include all possible revenue sources to maximize
federal funding and promote cost efficiencies and sustainability.
new text end

new text begin Subd. 3. new text end

new text begin Membership. new text end

new text begin The advisory task force shall be composed of the following,
who will serve at the pleasure of their appointing authority:
new text end

new text begin (1) the commissioner of human services or the commissioner's designee, and two
additional representatives from the department;
new text end

new text begin (2) two legislators appointed by the speaker of the house, one from the minority
and one from the majority;
new text end

new text begin (3) two legislators appointed by the senate rules committee, one from the minority
and one from the majority;
new text end

new text begin (4) one representative appointed by AFSCME Council 5;
new text end

new text begin (5) one representative appointed by the ombudsman for mental health and
developmental disabilities;
new text end

new text begin (6) one representative appointed by the Minnesota Association of Professional
Employees;
new text end

new text begin (7) one representative appointed by the Minnesota Hospital Association;
new text end

new text begin (8) one representative appointed by the Minnesota Nurses Association;
new text end

new text begin (9) one representative appointed by NAMI-MN;
new text end

new text begin (10) one representative appointed by the Mental Health Association of Minnesota;
new text end

new text begin (11) one representative appointed by the Minnesota Association Of Community
Mental Health Programs;
new text end

new text begin (12) one representative appointed by the Minnesota Dental Association;
new text end

new text begin (13) three clients or client family members representing different populations
receiving services from state-operated services, who are appointed by the commissioner;
new text end

new text begin (14) one representative appointed by the chair of the state-operated services
governing board;
new text end

new text begin (15) one representative appointed by the Minnesota Disability Law Center;
new text end

new text begin (16) one representative appointed by the Consumer Survivor Network;
new text end

new text begin (17) one representative appointed by the Association of Residential Resources
in Minnesota;
new text end

new text begin (18) one representative appointed by the Minnesota Council of Child Caring
Agencies;
new text end

new text begin (19) one representative appointed by the Association of Minnesota Counties; and
new text end

new text begin (20) one representative appointed by the Minnesota Pharmacists Association.
new text end

new text begin The commissioner may appoint additional members to reflect stakeholders who
are not represented above.
new text end

new text begin Subd. 4. new text end

new text begin Administration. new text end

new text begin The commissioner shall convene the first meeting of the
advisory task force and shall provide administrative support and staff.
new text end

new text begin Subd. 5. new text end

new text begin Recommendations. new text end

new text begin The advisory task force must report its
recommendations to the commissioner and to the legislature no later than December
15, 2010.
new text end

new text begin Subd. 6. new text end

new text begin Member requirement. new text end

new text begin The commissioner shall provide per diem and
travel expenses pursuant to section 256.01, subdivision 6, for task force members who
are consumers or family members and whose participation on the task force is not as a
paid representative of any agency, organization, or association. Notwithstanding section
15.059, other task members are not eligible for per diem or travel reimbursement.
new text end

Sec. 5.

new text begin [246.128] NOTIFICATION TO LEGISLATURE REQUIRED.
new text end

new text begin The commissioner shall notify the chairs and ranking minority members of
the relevant legislative committees regarding the redesign, closure, or relocation of
state-operated services programs. The notification must include the advice of the Chemical
and Mental Health Services Transformation Advisory Task Force under section 246.125.
new text end

Sec. 6.

new text begin [246.129] LEGISLATIVE APPROVAL REQUIRED.
new text end

new text begin If the closure of a state-operated facility is proposed, and the department and
respective bargaining units fail to arrive at a mutually agreed upon solution to transfer
affected state employees to other state jobs, the closure of the facility requires legislative
approval. This does not apply to state-operated enterprise services.
new text end

Sec. 7.

Minnesota Statutes 2008, section 246.18, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin State-operated services account. new text end

new text begin The state-operated services account is
established in the special revenue fund. Revenue generated by new state-operated services
listed under this section established after July 1, 2010, that are not enterprise activities must
be deposited into the state-operated services account, unless otherwise specified in law:
new text end

new text begin (1) intensive residential treatment services;
new text end

new text begin (2) foster care services; and
new text end

new text begin (3) psychiatric extensive recovery treatment services.
new text end

Sec. 8.

Minnesota Statutes 2008, section 254B.01, subdivision 2, is amended to read:


Subd. 2.

American Indian.

For purposes of services provided under section
254B.09, subdivision deleted text begin7deleted text endnew text begin 8new text end, "American Indian" means a person who is a member of an
Indian tribe, and the commissioner shall use the definitions of "Indian" and "Indian tribe"
and "Indian organization" provided in Public Law 93-638. For purposes of services
provided under section 254B.09, subdivision deleted text begin4deleted text endnew text begin 6new text end, "American Indian" means a resident of
federally recognized tribal lands who is recognized as an Indian person by the federally
recognized tribal governing body.

Sec. 9.

Minnesota Statutes 2008, section 254B.02, subdivision 1, is amended to read:


Subdivision 1.

Chemical dependency treatment allocation.

The chemical
dependency deleted text beginfunds appropriated for allocationdeleted text endnew text begin treatment appropriation new text end shall be placed in
a special revenue account. The commissioner shall annually transfer funds from the
chemical dependency fund to pay for operation of the drug and alcohol abuse normative
evaluation system and to pay for all costs incurred by adding two positions for licensing
of chemical dependency treatment and rehabilitation programs located in hospitals for
which funds are not otherwise appropriated. deleted text beginSix percent of the remaining money must
be reserved for tribal allocation under section 254B.09, subdivisions 4 and 5. The
commissioner shall annually divide the money available in the chemical dependency
fund that is not held in reserve by counties from a previous allocation, or allocated to the
American Indian chemical dependency tribal account. Six percent of the remaining money
must be reserved for the nonreservation American Indian chemical dependency allocation
for treatment of American Indians by eligible vendors under section 254B.05, subdivision
1
.
deleted text end The remainder of the money deleted text beginmust be allocated among the counties according to the
following formula, using state demographer data and other data sources determined by
the commissioner:
deleted text end

deleted text begin (a) For purposes of this formula, American Indians and children under age 14 are
subtracted from the population of each county to determine the restricted population.
deleted text end

deleted text begin (b) The amount of chemical dependency fund expenditures for entitled persons for
services not covered by prepaid plans governed by section 256B.69 in the previous year is
divided by the amount of chemical dependency fund expenditures for entitled persons for
all services to determine the proportion of exempt service expenditures for each county.
deleted text end

deleted text begin (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt
service expenditures to determine the adjusted prepaid plan months of eligibility for
each county.
deleted text end

deleted text begin (d) The adjusted prepaid plan months of eligibility is added to the number of
restricted population fee for service months of eligibility for the Minnesota family
investment program, general assistance, and medical assistance and divided by the county
restricted population to determine county per capita months of covered service eligibility.
deleted text end

deleted text begin (e) The number of adjusted prepaid plan months of eligibility for the state is added
to the number of fee for service months of eligibility for the Minnesota family investment
program, general assistance, and medical assistance for the state restricted population and
divided by the state restricted population to determine state per capita months of covered
service eligibility.
deleted text end

deleted text begin (f) The county per capita months of covered service eligibility is divided by the
state per capita months of covered service eligibility to determine the county welfare
caseload factor.
deleted text end

deleted text begin (g) The median married couple income for the most recent three-year period
available for the state is divided by the median married couple income for the same period
for each county to determine the income factor for each county.
deleted text end

deleted text begin (h) The county restricted population is multiplied by the sum of the county welfare
caseload factor and the county income factor to determine the adjusted population.
deleted text end

deleted text begin (i) $15,000 shall be allocated to each county.
deleted text end

deleted text begin (j) The remaining funds shall be allocated proportional to the county adjusted
population
deleted text endnew text begin in the special revenue account must be used according to the requirements
in this chapter
new text end.

Sec. 10.

Minnesota Statutes 2008, section 254B.02, subdivision 5, is amended to read:


Subd. 5.

Administrative adjustment.

The commissioner may make payments to
local agencies from money allocated under this section to support administrative activities
under sections 254B.03 and 254B.04. The administrative payment must not exceed
new text begin the lesser of: (1) new text endfive percent of the first $50,000, four percent of the next $50,000, and
three percent of the remaining payments for services from the deleted text beginallocationdeleted text endnew text begin special revenue
account according to subdivision 1; or (2) the local agency administrative payment for
the fiscal year ending June 30, 2009, adjusted in proportion to the statewide change in
the appropriation for this chapter
new text end.

Sec. 11.

Minnesota Statutes 2008, section 254B.03, subdivision 4, is amended to read:


Subd. 4.

Division of costs.

Except for services provided by a county under
section 254B.09, subdivision 1, or services provided under section 256B.69 or 256D.03,
subdivision 4
, paragraph (b), the county shall, out of local money, pay the state for
deleted text begin 15deleted text endnew text begin 16.14new text end percent of the cost of chemical dependency services, including those services
provided to persons eligible for medical assistance under chapter 256B and general
assistance medical care under chapter 256D. Counties may use the indigent hospitalization
levy for treatment and hospital payments made under this section. deleted text beginFifteendeleted text endnew text begin 16.14new text end percent
of any state collections from private or third-party pay, less 15 percent deleted text beginofdeleted text endnew text begin fornew text end the cost
of payment and collections, must be distributed to the county that paid for a portion of
the treatment under this section. deleted text beginIf all funds allocated according to section 254B.02 are
exhausted by a county and the county has met or exceeded the base level of expenditures
under section 254B.02, subdivision 3, the county shall pay the state for 15 percent of the
costs paid by the state under this section. The commissioner may refuse to pay state funds
for services to persons not eligible under section 254B.04, subdivision 1, if the county
financially responsible for the persons has exhausted its allocation.
deleted text end

Sec. 12.

Minnesota Statutes 2008, section 254B.05, subdivision 4, is amended to read:


Subd. 4.

Regional treatment centers.

Regional treatment center chemical
dependency treatment units are eligible vendors. The commissioner may expand the
capacity of chemical dependency treatment units beyond the capacity funded by direct
legislative appropriation to serve individuals who are referred for treatment by counties
and whose treatment will be paid for deleted text beginwith a county's allocation under section 254B.02deleted text endnew text begin by
funding under this chapter
new text end or other funding sources. Notwithstanding the provisions of
sections 254B.03 to 254B.041, payment for any person committed at county request to
a regional treatment center under chapter 253B for chemical dependency treatment and
determined to be ineligible under the chemical dependency consolidated treatment fund,
shall become the responsibility of the county.

Sec. 13.

Minnesota Statutes 2008, section 254B.06, subdivision 2, is amended to read:


Subd. 2.

Allocation of collections.

The commissioner shall allocate all federal
financial participation collections to deleted text beginthe reserve fund under section 254B.02, subdivision 3deleted text endnew text begin
a special revenue account
new text end. The commissioner shall deleted text beginretain 85deleted text endnew text begin allocate 83.86new text end percent of
patient payments and third-party payments new text beginto the special revenue account new text endand deleted text beginallocate
the collections to the treatment allocation for the county that is financially responsible
for the person. Fifteen
deleted text endnew text begin 16.14new text end percent deleted text beginof patient and third-party payments must be paiddeleted text end
to the county financially responsible for the patient. deleted text beginCollections for patient payment and
third-party payment for services provided under section 254B.09 shall be allocated to the
allocation of the tribal unit which placed the person. Collections of federal financial
participation for services provided under section 254B.09 shall be allocated to the tribal
reserve account under section 254B.09, subdivision 5.
deleted text end

Sec. 14.

Minnesota Statutes 2008, section 254B.09, subdivision 8, is amended to read:


Subd. 8.

Payments to improve services to American Indians.

The commissioner
may set rates for chemical dependency services new text beginto American Indians new text endaccording to the
American Indian Health Improvement Act, Public Law 94-437, for eligible vendors.
These rates shall supersede rates set in county purchase of service agreements when
payments are made on behalf of clients eligible according to Public Law 94-437.

Sec. 15.

new text begin [254B.13] PILOT PROJECTS; CHEMICAL HEALTH CARE.
new text end

new text begin Subdivision 1. new text end

new text begin Authorization for pilot projects. new text end

new text begin The commissioner may approve
and implement pilot projects developed under the planning process required under Laws
2009, chapter 79, article 7, section 26, to provide alternatives to and enhance coordination
of the delivery of chemical health services required under section 254B.03.
new text end

new text begin Subd. 2. new text end

new text begin Program design and implementation. new text end

new text begin (a) The commissioner and counties
participating in the pilot projects shall continue to work in partnership to refine and
implement the pilot projects initiated under Laws 2009, chapter 79, article 7, section 26.
new text end

new text begin (b) The commissioner and counties participating in the pilot projects shall
complete the planning phase by June 30, 2010, and, if approved by the commissioner for
implementation, enter into agreements governing the operation of the pilot projects with
implementation scheduled no earlier than July 1, 2010.
new text end

new text begin Subd. 3. new text end

new text begin Program evaluation. new text end

new text begin The commissioner shall evaluate pilot projects under
this section and report the results of the evaluation to the chairs and ranking minority
members of the legislative committees with jurisdiction over chemical health issues by
January 15, 2013. Evaluation of the pilot projects must be based on outcome evaluation
criteria negotiated with the pilot projects prior to implementation.
new text end

new text begin Subd. 4. new text end

new text begin Notice of project discontinuation. new text end

new text begin Each county's participation in the
pilot project may be discontinued for any reason by the county or the commissioner of
human services after 30 days' written notice to the other party. Any unspent funds held
for the exiting county's pro rata share in the special revenue fund under the authority in
subdivision 5, paragraph (d), shall be transferred to the consolidated chemical dependency
treatment fund following discontinuation of the pilot project.
new text end

new text begin Subd. 5. new text end

new text begin Duties of commissioner. new text end

new text begin (a) Notwithstanding any other provisions in
this chapter, the commissioner may authorize pilot projects to use chemical dependency
treatment funds to pay for nontreatment pilot services:
new text end

new text begin (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
(a); and
new text end

new text begin (2) by vendors in addition to those authorized under section 254B.05 when not
providing chemical dependency treatment services.
new text end

new text begin (b) For purposes of this section, "nontreatment pilot services" include navigator
services, peer support, family engagement and support, housing support, rent subsidies,
supported employment, and independent living skills.
new text end

new text begin (c) State expenditures for chemical dependency services and nontreatment pilot
services provided by or through the pilot projects must not be greater than the chemical
dependency treatment fund expected share of forecasted expenditures in the absence of
the pilot projects. The commissioner may restructure the schedule of payments between
the state and participating counties under the local agency share and division of cost
provisions under section 254B.03, subdivisions 3 and 4, as necessary to facilitate the
operation of the pilot projects.
new text end

new text begin new text end

new text begin (d) To the extent that state fiscal year expenditures within a pilot project are less
than the expected share of forecasted expenditures in the absence of the pilot projects,
the commissioner shall deposit the unexpended funds in a separate account within the
consolidated chemical dependency treatment fund, and make these funds available for
expenditure by the pilot projects the following year. To the extent that treatment and
nontreatment pilot services expenditures within the pilot project exceed the amount
expected in the absence of the pilot projects, the pilot project county or counties are
responsible for the portion of nontreatment pilot services expenditures in excess of the
otherwise expected share of forecasted expenditures.
new text end

new text begin (e) The commissioner may waive administrative rule requirements that are
incompatible with the implementation of the pilot project, except that any chemical
dependency treatment funded under this section must continue to be provided by a
licensed treatment provider.
new text end

new text begin (f) The commissioner shall not approve or enter into any agreement related to pilot
projects authorized under this section that puts current or future federal funding at risk.
new text end

new text begin Subd. 6. new text end

new text begin Duties of county board. new text end

new text begin The county board, or other county entity that is
approved to administer a pilot project, shall:
new text end

new text begin (1) administer the pilot project in a manner consistent with the objectives described
in subdivision 2 and the planning process in subdivision 5;
new text end

new text begin (2) ensure that no one is denied chemical dependency treatment services for which
they would otherwise be eligible under section 254A.03, subdivision 3; and
new text end

new text begin (3) provide the commissioner with timely and pertinent information as negotiated
in agreements governing operation of the pilot projects.
new text end

Sec. 16.

Minnesota Statutes 2009 Supplement, section 517.08, subdivision 1b, is
amended to read:


Subd. 1b.

Term of license; fee; premarital education.

(a) The local registrar
shall examine upon oath the parties applying for a license relative to the legality of the
contemplated marriage. If one party is unable to appear in person, the party appearing
may complete the absent applicant's information. The local registrar shall provide a copy
of the marriage application to the party who is unable to appear, who must verify the
accuracy of the party's information in a notarized statement. The marriage license must
not be released until the verification statement has been received by the local registrar. If
at the expiration of a five-day period, on being satisfied that there is no legal impediment
to it, including the restriction contained in section 259.13, the local registrar shall issue
the license, containing the full names of the parties before and after marriage, and county
and state of residence, with the county seal attached, and make a record of the date of
issuance. The license shall be valid for a period of six months. Except as provided in
paragraph (c), the local registrar shall collect from the applicant a fee of deleted text begin$110deleted text endnew text begin $115new text end for
administering the oath, issuing, recording, and filing all papers required, and preparing
and transmitting to the state registrar of vital statistics the reports of marriage required
by this section. If the license should not be used within the period of six months due to
illness or other extenuating circumstances, it may be surrendered to the local registrar for
cancellation, and in that case a new license shall issue upon request of the parties of the
original license without fee. A local registrar who knowingly issues or signs a marriage
license in any manner other than as provided in this section shall pay to the parties
aggrieved an amount not to exceed $1,000.

(b) In case of emergency or extraordinary circumstances, a judge of the district court
of the county in which the application is made may authorize the license to be issued at
any time before expiration of the five-day period required under paragraph (a). A waiver
of the five-day waiting period must be in the following form:

STATE OF MINNESOTA, COUNTY OF .................... (insert county name)

APPLICATION FOR WAIVER OF MARRIAGE LICENSE WAITING PERIOD:

................................................................................. (legal names of the applicants)

Represent and state as follows:

That on ......................... (date of application) the applicants applied to the local
registrar of the above-named county for a license to marry.

That it is necessary that the license be issued before the expiration of five days
from the date of the application by reason of the following: (insert reason for requesting
waiver of waiting period)

.............................................................................................................

.............................................................................................................

.............................................................................................................

WHEREAS, the applicants request that the judge waive the required five-day
waiting period and the local registrar be authorized and directed to issue the marriage
license immediately.

Date: .............................

.......................................................................................

.......................................................................................

(Signatures of applicants)

Acknowledged before me on this ....... day of .................... .

..........................................

NOTARY PUBLIC

COURT ORDER AND AUTHORIZATION:

STATE OF MINNESOTA, COUNTY OF .................... (insert county name)

After reviewing the above application, I am satisfied that an emergency or
extraordinary circumstance exists that justifies the issuance of the marriage license before
the expiration of five days from the date of the application. IT IS HEREBY ORDERED
that the local registrar is authorized and directed to issue the license forthwith.

.....................................................

................................ (judge of district court)

................................ (date).

(c) The marriage license fee for parties who have completed at least 12 hours of
premarital education is $40. In order to qualify for the reduced license fee, the parties
must submit at the time of applying for the marriage license a signed, dated, and notarized
statement from the person who provided the premarital education on their letterhead
confirming that it was received. The premarital education must be provided by a licensed
or ordained minister or the minister's designee, a person authorized to solemnize marriages
under section 517.18, or a person authorized to practice marriage and family therapy under
section 148B.33. The education must include the use of a premarital inventory and the
teaching of communication and conflict management skills.

(d) The statement from the person who provided the premarital education under
paragraph (b) must be in the following form:

"I, .......................... (name of educator), confirm that .......................... (names of
both parties) received at least 12 hours of premarital education that included the use of a
premarital inventory and the teaching of communication and conflict management skills.
I am a licensed or ordained minister, a person authorized to solemnize marriages under
Minnesota Statutes, section 517.18, or a person licensed to practice marriage and family
therapy under Minnesota Statutes, section 148B.33."

The names of the parties in the educator's statement must be identical to the legal
names of the parties as they appear in the marriage license application. Notwithstanding
section 138.17, the educator's statement must be retained for seven years, after which
time it may be destroyed.

(e) If section 259.13 applies to the request for a marriage license, the local registrar
shall grant the marriage license without the requested name change. Alternatively, the local
registrar may delay the granting of the marriage license until the party with the conviction:

(1) certifies under oath that 30 days have passed since service of the notice for a
name change upon the prosecuting authority and, if applicable, the attorney general and no
objection has been filed under section 259.13; or

(2) provides a certified copy of the court order granting it. The parties seeking the
marriage license shall have the right to choose to have the license granted without the
name change or to delay its granting pending further action on the name change request.

Sec. 17.

Minnesota Statutes 2008, section 517.08, subdivision 1c, as amended by Laws
2010, chapter 200, article 1, section 17, is amended to read:


Subd. 1c.

Disposition of license fee.

(a) Of the marriage license fee collected
pursuant to subdivision 1b, paragraph (a), $25 must be retained by the county. The
local registrar must pay deleted text begin$85deleted text endnew text begin $90new text end to the commissioner of management and budget to be
deposited as follows:

(1) $55 in the general fund;

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

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

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

new text begin (5) $5 in the special revenue fund, which is appropriated to the Board of Regents
of the University of Minnesota for the Minnesota couples on the brink project under
section 137.32
new text end.

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

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

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

Sec. 18.

Laws 2009, chapter 79, article 3, section 18, is amended to read:


Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED
MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE
ANOKA-METRO REGIONAL TREATMENT CENTER.

deleted text begin In consultation with community partners, the commissioner of human servicesdeleted text endnew text begin
The Chemical and Mental Health Services Transformation Advisory Task Force
new text end shall
deleted text begin developdeleted text endnew text begin recommendnew text end an array of community-based services new text beginin the metro area new text endto transform
the current services now provided to patients at the Anoka-Metro Regional Treatment
Center. The community-based services may be deleted text beginprovided in facilities with 16 or fewer
beds, and must provide the appropriate level of care for the patients being admitted to
the facilities
deleted text endnew text begin established in partnership with private and public hospital organizations,
community mental health centers and other mental health community services providers,
and community partnerships, and must be staffed by state employees
new text end. The planning
for this transition must be completed by October 1, deleted text begin2009deleted text endnew text begin 2010new text end, with deleted text beginan initialdeleted text endnew text begin a new text end report
new text begin detailing the transition plan, services that will be provided, including incorporating peer
specialists where appropriate, the location of the services, and the number of patients
that will be served,
new text endto the committee chairs of health and human services by November
30, deleted text begin2009, and a semiannual report on progress until the transition is completed. The
commissioner of human services shall solicit interest from stakeholders and potential
community partners
deleted text endnew text begin 2010new text end. The individuals deleted text beginworking indeleted text end new text beginemployed by new text endthe community-based
services deleted text beginfacilitiesdeleted text end under this section are state employees supervised by the commissioner
of human services. No layoffs shall occur as a result of restructuring under this section.new text begin
Savings generated as a result of transitioning patients from the Anoka-Metro Regional
Treatment Center to community-based services may be used to fund supportive housing
staffed by state employees.
new text end

Sec. 19. new text beginREPORT ON HUMAN SERVICES FISCAL NOTES.
new text end

new text begin The commissioner of management and budget shall issue a report to the legislature
no later than November 15, 2010, making recommendations for improving the preparation
and delivery of fiscal notes under Minnesota Statutes, section 3.98, relating to human
services. The report shall consider: (1) the establishment of an independent fiscal
note office in the human services department and (2) transferring the responsibility for
preparing human services fiscal notes to the legislature. The report must include detailed
information regarding the financial costs, staff resources, training, access to information,
and data protection issues relative to the preparation of human services fiscal notes. The
report shall describe methods and procedures used by other states to insure independence
and accuracy of fiscal estimates on legislative proposals for changes in human services.
new text end

Sec. 20. new text beginPRESCRIPTION DRUG WASTE REDUCTION.
new text end

new text begin The Minnesota Board of Pharmacy, in cooperation with the commissioners of
human services, pollution control, health, veterans affairs, and corrections, shall study
prescription drug waste reduction techniques and technologies applicable to long-term
care facilities, veterans nursing homes, and correctional facilities. In conducting the
study, the commissioners shall consult with the Minnesota Pharmacists Association, the
University of Minnesota College of Pharmacy, University of Minnesota's Minnesota
Technical Assistance Project, consumers, long-term care providers, and other interested
parties. The board shall evaluate the extent to which new prescription drug waste reduction
techniques and technologies can reduce the amount of prescription drugs that enter the
waste stream and reduce state prescription drug costs. The techniques and technologies
studied must include, but are not limited to, daily, weekly, and automated dose dispensing.
The study must provide an estimate of the cost of adopting these and other techniques
and technologies, and an estimate of waste reduction and state prescription drug savings
that would result from adoption. The study must also evaluate methods of encouraging
the adoption of effective drug waste reduction techniques and technologies. The board
shall present recommendations on the adoption of new prescription drug waste reduction
techniques and technologies to the legislature by December 15, 2011.
new text end

Sec. 21. new text beginVETERINARY PRACTICE AND CONTROLLED SUBSTANCE
ABUSE STUDY.
new text end

new text begin The Board of Pharmacy, in consultation with the Prescription Electronic Reporting
Advisory Committee and the Board of Veterinary Medical Practice, shall study the issue
of the diversion of controlled substances from veterinary practice and report to the chairs
and ranking minority members of the senate health and human services policy and finance
division and the house of representatives health care and human services policy and
finance division by December 15, 2011, on recommendations to include veterinarians in
the prescription electronic reporting system in Minnesota Statutes, section 152.126.
new text end

Sec. 22. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, sections 254B.02, subdivisions 2, 3, and 4; and 254B.09,
subdivisions 4, 5, and 7,
new text end new text begin are repealed.
new text end

Sec. 23. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 8 to 14 and 22 are effective for claims paid on or after July 1, 2010.
new text end

ARTICLE 5

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2008, section 62D.08, is amended by adding a
subdivision to read:


new text begin Subd. 7. new text end

new text begin Consistent administrative expenses and investment income reporting.
new text end

new text begin (a) Every health maintenance organization must directly allocate administrative expenses
to specific lines of business or products when such information is available. Remaining
expenses that cannot be directly allocated must be allocated based on other methods, as
recommended by the Advisory Group on Administrative Expenses. Health maintenance
organizations must submit this information, including administrative expenses for dental
services, using the reporting template provided by the commissioner of health.
new text end

new text begin (b) Every health maintenance organization must allocate investment income based
on cumulative net income over time by business line or product and must submit this
information, including investment income for dental services, using the reporting template
provided by the commissioner of health.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

new text begin [62D.31] ADVISORY GROUP ON ADMINISTRATIVE EXPENSES.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The Advisory Group on Administrative Expenses
is established to make recommendations on the development of consistent guidelines
and reporting requirements, including development of a reporting template, for health
maintenance organizations and county-based purchasing plans that participate in publicly
funded programs.
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin The membership of the advisory group shall be comprised
of the following, who serve at the pleasure of their appointing authority:
new text end

new text begin (1) the commissioner of health or the commissioner's designee;
new text end

new text begin (2) the commissioner of human services or the commissioner's designee;
new text end

new text begin (3) the commissioner of commerce or the commissioner's designee; and
new text end

new text begin (4) representatives of health maintenance organizations and county-based purchasers
appointed by the commissioner of health.
new text end

new text begin Subd. 3. new text end

new text begin Administration. new text end

new text begin The commissioner of health shall convene the first
meeting of the advisory group by December 1, 2010, and shall provide administrative
support and staff. The commissioner of health may contract with a consultant to provide
professional assistance and expertise to the advisory group.
new text end

new text begin Subd. 4. new text end

new text begin Recommendations. new text end

new text begin The Advisory Group on Administrative Expenses
must report its recommendations, including any proposed legislation necessary to
implement the recommendations, to the commissioner of health and to the chairs and
ranking minority members of the legislative committees and divisions with jurisdiction
over health policy and finance by February 15, 2012.
new text end

new text begin Subd. 5. new text end

new text begin Expiration. new text end

new text begin This section expires after submission of the report required
under subdivision 4 or June 30, 2012, whichever is sooner.
new text end

Sec. 3.

Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:


Subdivision 1.

Designation.

(a) The commissioner shall designate essential
community providers. The criteria for essential community provider designation shall be
the following:

(1) a demonstrated ability to integrate applicable supportive and stabilizing services
with medical care for uninsured persons and high-risk and special needs populations,
underserved, and other special needs populations; and

(2) a commitment to serve low-income and underserved populations by meeting the
following requirements:

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

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

(iii) charges for services on a sliding fee schedule based on current poverty income
guidelines; and

(iv) does not restrict access or services because of a client's financial limitation;

(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
government, an Indian health service unit, or a community health board as defined in
chapter 145A;

(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
conditions; deleted text beginor
deleted text end

(5) a sole community hospital. For these rural hospitals, the essential community
provider designation applies to all health services provided, including both inpatient and
outpatient services. For purposes of this section, "sole community hospital" means a
rural hospital that:

(i) is eligible to be classified as a sole community hospital according to Code
of Federal Regulations, title 42, section 412.92, or is located in a community with a
population of less than 5,000 and located more than 25 miles from a like hospital currently
providing acute short-term services;

(ii) has experienced net operating income losses in two of the previous three
most recent consecutive hospital fiscal years for which audited financial information is
available; and

(iii) consists of 40 or fewer licensed bedsnew text begin; or
new text end

new text begin (6) a birth center licensed under section 144.615new text end.

(b) Prior to designation, the commissioner shall publish the names of all applicants
in the State Register. The public shall have 30 days from the date of publication to submit
written comments to the commissioner on the application. No designation shall be made
by the commissioner until the 30-day period has expired.

(c) The commissioner may designate an eligible provider as an essential community
provider for all the services offered by that provider or for specific services designated by
the commissioner.

(d) For the purpose of this subdivision, supportive and stabilizing services include at
a minimum, transportation, child care, cultural, and linguistic services where appropriate.

Sec. 4.

Minnesota Statutes 2008, section 144.05, is amended by adding a subdivision
to read:


new text begin Subd. 5. new text end

new text begin Firearms data. new text end

new text begin Notwithstanding any law to the contrary, the commissioner
of health is prohibited from collecting data on individuals regarding lawful firearm
ownership in the state or data related to an individual's right to carry a weapon under
section 624.714.
new text end

Sec. 5.

Minnesota Statutes 2008, section 144.226, subdivision 3, is amended to read:


Subd. 3.

Birth record surcharge.

new text begin(a) new text endIn addition to any fee prescribed under
subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
stillbirth record and for a certification that the vital record cannot be found. The local or
state registrar shall forward this amount to the commissioner of management and budget
for deposit into the account for the children's trust fund for the prevention of child abuse
established under section 256E.22. This surcharge shall not be charged under those
circumstances in which no fee for a certified birth or stillbirth record is permitted under
subdivision 1, paragraph (a). Upon certification by the commissioner of management and
budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.

new text begin (b) In addition to any fee prescribed under subdivision 1, there shall be a
nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
shall forward this amount to the commissioner of management and budget for deposit in
the general fund. This surcharge shall not be charged under those circumstances in which
no fee for a certified birth record is permitted under subdivision 1, paragraph (a).
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2008, section 144.293, subdivision 4, is amended to read:


Subd. 4.

Duration of consent.

Except as provided in this section, a consent is
valid for one year or for a deleted text beginlesserdeleted text end period specified in the consent or for a different period
provided by law.

Sec. 7.

new text begin [144.615] BIRTH CENTERS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions
have the meanings given them.
new text end

new text begin (b) "Birth center" means a facility licensed for the primary purpose of performing
low-risk deliveries that is not a hospital or licensed as part of a hospital and where births are
planned to occur away from the mother's usual residence following a low-risk pregnancy.
new text end

new text begin (c) "CABC" means the Commission for the Accreditation of Birth Centers.
new text end

new text begin (d) "Low-risk pregnancy" means a normal, uncomplicated prenatal course as
determined by documentation of adequate prenatal care and the anticipation of a normal
uncomplicated labor and birth, as defined by reasonable and generally accepted criteria
adopted by professional groups for maternal, fetal, and neonatal health care.
new text end

new text begin Subd. 2. new text end

new text begin License required. new text end

new text begin (a) Beginning January 1, 2011, no birth center shall be
established, operated, or maintained in the state without first obtaining a license from the
commissioner of health according to this section.
new text end

new text begin (b) A license issued under this section is not transferable or assignable and is subject
to suspension or revocation at any time for failure to comply with this section.
new text end

new text begin (c) A birth center licensed under this section shall not assert, represent, offer,
provide, or imply that the center is or may render care or services other than the services it
is permitted to render within the scope of the license or the accreditation issued.
new text end

new text begin (d) The license must be conspicuously posted in an area where patients are admitted.
new text end

new text begin Subd. 3. new text end

new text begin Temporary license. new text end

new text begin For new birth centers planning to begin operations
after January 1, 2011, the commissioner may issue a temporary license to the birth center
that is valid for a period of six months from the date of issuance. The birth center must
submit to the commissioner an application and applicable fee for licensure as required
under subdivision 4. The application must include the information required in subdivision
4, clauses (1) to (3) and (5) to (7), and documentation that the birth center has submitted
an application for accreditation to the CABC. Upon receipt of accreditation from the
CABC, the birth center must submit to the commissioner the information required in
subdivision 4, clause (4), and the applicable fee under subdivision 8. The commissioner
shall issue a new license.
new text end

new text begin Subd. 4. new text end

new text begin Application. new text end

new text begin An application for a license to operate a birth center and the
applicable fee under subdivision 8 must be submitted to the commissioner on a form
provided by the commissioner and must contain:
new text end

new text begin (1) the name of the applicant;
new text end

new text begin (2) the site location of the birth center;
new text end

new text begin (3) the name of the person in charge of the center;
new text end

new text begin (4) documentation that the accreditation described under subdivision 6 has been
issued, including the effective date and the expiration date of the accreditation, and the
date of the last site visit by the CABC;
new text end

new text begin (5) the number of patients the birth center is capable of serving at a given time;
new text end

new text begin (6) the names and license numbers, if applicable, of the health care professionals
on staff at the birth center; and
new text end

new text begin (7) any other information the commissioner deems necessary.
new text end

new text begin Subd. 5. new text end

new text begin Suspension, revocation, and refusal to renew. new text end

new text begin The commissioner may
refuse to grant or renew, or may suspend or revoke, a license on any of the grounds
described under section 144.55, subdivision 6, paragraph (a), clause (2), (3), or (4), or
upon the loss of accreditation by the CABC. The applicant or licensee is entitled to notice
and a hearing as described under section 144.55, subdivision 7, and a new license may be
issued after proper inspection of the birth center has been conducted.
new text end

new text begin Subd. 6. new text end

new text begin Standards for licensure. new text end

new text begin (a) To be eligible for licensure under this
section, a birth center must be accredited by the CABC or must obtain accreditation
within six months of the date of the application for licensure. If the birth center loses its
accreditation, the birth center must immediately notify the commissioner.
new text end

new text begin (b) The center must have procedures in place specifying criteria by which risk status
will be established and applied to each woman at admission and during labor.
new text end

new text begin (c) Upon request, the birth center shall provide the commissioner of health with any
material submitted by the birth center to the CABC as part of the accreditation process,
including the accreditation application, the self-evaluation report, the accreditation
decision letter from the CABC, and any reports from the CABC following a site visit.
new text end

new text begin Subd. 7. new text end

new text begin Limitations of services. new text end

new text begin (a) The following limitations apply to the services
performed at a birth center:
new text end

new text begin (1) surgical procedures must be limited to those normally accomplished during an
uncomplicated birth, including episiotomy and repair;
new text end

new text begin (2) no abortions may be administered; and
new text end

new text begin (3) no general or regional anesthesia may be administered.
new text end

new text begin (b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth
center if the administration of the anesthetic is performed within the scope of practice of a
health care professional.
new text end

new text begin Subd. 8. new text end

new text begin Fees. new text end

new text begin (a) The biennial license fee for a birth center is $365.
new text end

new text begin (b) The temporary license fee is $365.
new text end

new text begin (c) Fees shall be collected and deposited according to section 144.122.
new text end

new text begin Subd. 9. new text end

new text begin Renewal. new text end

new text begin (a) Except as provided in paragraph (b), a license issued under
this section expires two years from the date of issue.
new text end

new text begin (b) A temporary license issued under subdivision 3 expires six months from the date
of issue, and may be renewed for one additional six-month period.
new text end

new text begin (c) An application for renewal shall be submitted at least 60 days prior to expiration
of the license on forms prescribed by the commissioner of health.
new text end

new text begin Subd. 10. new text end

new text begin Records. new text end

new text begin All health records maintained on each client by a birth center
are subject to sections 144.292 to 144.298.
new text end

new text begin Subd. 11. new text end

new text begin Report. new text end

new text begin (a) The commissioner of health, in consultation with the
commissioner of human services and representatives of the licensed birth centers,
the American College of Obstetricians and Gynecologists, the American Academy
of Pediatrics, the Minnesota Hospital Association, and the Minnesota Ambulance
Association, shall evaluate the quality of care and outcomes for services provided in
licensed birth centers, including, but not limited to, the utilization of services provided at a
birth center, the outcomes of care provided to both mothers and newborns, and the numbers
of transfers to other health care facilities that are required and the reasons for the transfers.
The commissioner shall work with the birth centers to establish a process to gather and
analyze the data within protocols that protect the confidentiality of patient identification.
new text end

new text begin (b) The commissioner of health shall report the findings of the evaluation to the
legislature by January 15, 2014.
new text end

Sec. 8.

Minnesota Statutes 2008, section 144.651, subdivision 2, is amended to read:


Subd. 2.

Definitions.

For the purposes of this section, "patient" means a person
who is admitted to an acute care inpatient facility for a continuous period longer than
24 hours, for the purpose of diagnosis or treatment bearing on the physical or mental
health of that person. For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20,
"patient" also means a person who receives health care services at an outpatient surgical
centernew text begin or at a birth center licensed under section 144.615new text end. "Patient" also means a minor
who is admitted to a residential program as defined in section 253C.01. For purposes of
subdivisions 1, 3 to 16, 18, 20 and 30, "patient" also means any person who is receiving
mental health treatment on an outpatient basis or in a community support program or other
community-based program. "Resident" means a person who is admitted to a nonacute care
facility including extended care facilities, nursing homes, and boarding care homes for
care required because of prolonged mental or physical illness or disability, recovery from
injury or disease, or advancing age. For purposes of all subdivisions except subdivisions
28 and 29, "resident" also means a person who is admitted to a facility licensed as a board
and lodging facility under Minnesota Rules, parts 4625.0100 to 4625.2355, or a supervised
living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which operates
a rehabilitation program licensed under Minnesota Rules, parts 9530.4100 to 9530.4450.

Sec. 9.

Minnesota Statutes 2008, section 144.9504, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin Blood lead level guidelines. new text end

new text begin (a) By January 1, 2011, the commissioner
must revise clinical and case management guidelines to include recommendations
for protective health actions and follow-up services when a child's blood lead level
exceeds five micrograms of lead per deciliter of blood. The revised guidelines must be
implemented to the extent possible using available resources.
new text end

new text begin (b) In revising the clinical and case management guidelines for blood lead levels
greater than five micrograms of lead per deciliter of blood under this subdivision,
the commissioner of health must consult with a statewide organization representing
physicians, the public health department of Minneapolis and other public health
departments, one representative of the residential construction industry, and a nonprofit
organization with expertise in lead abatement.
new text end

Sec. 10.

Minnesota Statutes 2008, section 144A.51, subdivision 5, is amended to read:


Subd. 5.

Health facility.

"Health facility" means a facility or that part of a facility
which is required to be licensed pursuant to sections 144.50 to 144.58, new text begin144.615, new text endand a
facility or that part of a facility which is required to be licensed under any law of this state
which provides for the licensure of nursing homes.

Sec. 11.

Minnesota Statutes 2008, section 144E.37, is amended to read:


144E.37 COMPREHENSIVE ADVANCED LIFE SUPPORT.

The deleted text beginboarddeleted text endnew text begin commissioner of healthnew text end shall establish a comprehensive advanced
life-support educational program to train rural medical personnel, including physicians,
physician assistants, nurses, and allied health care providers, in a team approach to
anticipate, recognize, and treat life-threatening emergencies before serious injury or
cardiac arrest occurs.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12. new text beginHEALTH PLAN AND COUNTY ADMINISTRATIVE COST
REDUCTION; REPORTING REQUIREMENTS.
new text end

new text begin (a) Minnesota health plans and county-based purchasing plans may complete an
inventory of existing data collection and reporting requirements for health plans and
county-based purchasing plans and submit to the commissioners of health and human
services a list of data, documentation, and reports that:
new text end

new text begin (1) are collected from the same health plan or county-based purchasing plan more
than once;
new text end

new text begin (2) are collected directly from the health plan or county-based purchasing plan but
are available to the state agencies from other sources;
new text end

new text begin (3) are not currently being used by state agencies; or
new text end

new text begin (4) collect similar information more than once in different formats, at different
times, or by more than one state agency.
new text end

new text begin (b) The report to the commissioners may also identify the percentage of health
plan and county-based purchasing plan administrative time and expense attributed to
fulfilling reporting requirements and include recommendations regarding ways to reduce
duplicative reporting requirements.
new text end

new text begin (c) Upon receipt, the commissioners shall submit the inventory and recommendations
to the chairs of the appropriate legislative committees, along with their comments
and recommendations as to whether any action should be taken by the legislature to
establish a consolidated and streamlined reporting system under which data, reports, and
documentation are collected only once and only when needed for the state agencies to
fulfill their duties under law and applicable regulations.
new text end

Sec. 13. new text beginVENDOR ACCREDITATION SIMPLIFICATION.
new text end

new text begin The Minnesota Hospital Association must coordinate with the Minnesota
Credentialing Collaborative to make recommendations by January 1, 2012, on the
development of standard accreditation methods for vendor services provided within
hospitals and clinics. The recommendations must be consistent with requirements of
hospital credentialing organizations and applicable federal requirements.
new text end

Sec. 14. new text beginAPPLICATION PROCESS FOR HEALTH INFORMATION
EXCHANGE.
new text end

new text begin To the extent that the commissioner of health applies for additional federal funding
to support the commissioner's responsibilities of developing and maintaining state level
health information exchange under section 3013 of the HITECH Act, the commissioner of
health shall ensure that applications are made through an open process that provides health
information exchange service providers equal opportunity to receive funding.
new text end

Sec. 15. new text beginTRANSFER.
new text end

new text begin The powers and duties of the Emergency Medical Services Regulatory Board with
respect to the comprehensive advanced life-support educational program under Minnesota
Statutes, section 144E.37, are transferred to the commissioner of health under Minnesota
Statutes, section 15.039.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 16. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 144E.37, as
Minnesota Statutes, section 144.6062, and make all necessary changes in statutory
cross-references in Minnesota Statutes and Minnesota Rules.
new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 6

PUBLIC HEALTH

Section 1.

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


Subd. 4.

Distribution of funds.

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

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

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

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

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

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

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

(3) $1,800,000 to the Academic Health Center.new text begin $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.
new text end

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

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

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

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

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

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

Sec. 2.

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


Subd. 3.

Establishment fees; definitions.

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

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

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

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

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

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

(ii) frozen pizza that is heated and served;

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

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

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

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

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

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

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

(iv) is a boarding establishment; or

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 3.

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


Subd. 3.

Fees, manufactured home parks and recreational camping areas.

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

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

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

(2) a recreational camping area with:

(i) 24 or less sites, $50;

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

(iii) 100 or more sites, $300.

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 4. new text beginFOOD SUPPORT FOR CHILDREN WITH SEVERE ALLERGIES.
new text end

new text begin The commissioner of human services must seek a federal waiver from the federal
Department of Agriculture, Food and Nutrition Service, for the supplemental nutrition
assistance program, to increase the income eligibility requirements to 375 percent of the
federal poverty guidelines, in order to cover nutritional food products required to treat
or manage severe food allergies, including allergies to wheat and gluten, for infants and
children who have been diagnosed with life-threatening severe food allergies.
new text end

ARTICLE 7

HEALTH CARE REFORM

Section 1.

new text begin [62E.20] RELATIONSHIP TO TEMPORARY FEDERAL HIGH-RISK
POOL.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in
this subdivision have the meanings given.
new text end

new text begin (b) "Association" means the Minnesota Comprehensive Health Association.
new text end

new text begin (c) "Federal law" means Title I, subtitle B, section 1101, of the federal Patient
Protection and Affordable Care Act, Public Law 111-148, including any federal
regulations adopted under it.
new text end

new text begin (d) "Federal qualified high-risk pool" means an arrangement established by the
federal secretary of health and human services that meets the requirements of the federal
law.
new text end

new text begin Subd. 2. new text end

new text begin Timing of this section. new text end

new text begin This section applies beginning the date the
temporary federal qualified high-risk health pool created under the federal law begins
to provide coverage in this state.
new text end

new text begin Subd. 3. new text end

new text begin Maintenance of effort. new text end

new text begin The assessments made by the comprehensive
health association on its member insurers must comply with the maintenance of effort
requirement contained in paragraph (b), clause (3), of the federal law, to the extent that the
requirement applies to assessments made by the association.
new text end

new text begin Subd. 4. new text end

new text begin Coordination with state health care programs. new text end

new text begin The commissioner
of commerce and the Minnesota Comprehensive Health Association shall ensure that
applicants for coverage through the federal qualified high-risk pool, or through the
Minnesota Comprehensive Health Association, are referred to the medical assistance or
MinnesotaCare programs if they are determined to be potentially eligible for coverage
through those programs. The commissioner of human services shall ensure that applicants
for coverage under medical assistance or MinnesotaCare who are determined not to be
eligible for those programs are provided information about coverage through the federal
qualified high-risk pool and the Minnesota Comprehensive Health Association.
new text end

new text begin Subd. 5. new text end

new text begin Federal funding. new text end

new text begin Minnesota shall coordinate its efforts with the United
States Department of Health and Human Services (HHS) to obtain the federal funds to
implement in Minnesota the federal qualified high-risk pool.
new text end

Sec. 2.

new text begin [256B.0756] COORDINATED CARE THROUGH A HEALTH HOME.
new text end

new text begin Subdivision 1. new text end

new text begin Provision of coverage. new text end

new text begin (a) The commissioner shall provide
medical assistance coverage of health home services for eligible individuals with chronic
conditions who select a designated provider, a team of health care professionals, or a
health team as the individual's health home.
new text end

new text begin (b) The commissioner shall implement this section in compliance with the
requirements of the state option to provide health homes for enrollees with chronic
conditions, as provided under the Patient Protection and Affordable Care Act, Public
Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning
provided in that act.
new text end

new text begin Subd. 2. new text end

new text begin Eligible individual. new text end

new text begin An individual is eligible for health home services
under this section if the individual is eligible for medical assistance under this chapter
and has at least:
new text end

new text begin (1) two chronic conditions;
new text end

new text begin (2) one chronic condition and is at risk of having a second chronic condition; or
new text end

new text begin (3) one serious and persistent mental health condition.
new text end

new text begin Subd. 3. new text end

new text begin Health home services. new text end

new text begin (a) Health home services means comprehensive and
timely high-quality services that are provided by a health home. These services include:
new text end

new text begin (1) comprehensive care management;
new text end

new text begin (2) care coordination and health promotion;
new text end

new text begin (3) comprehensive transitional care, including appropriate follow-up, from inpatient
to other settings;
new text end

new text begin (4) patient and family support, including authorized representatives;
new text end

new text begin (5) referral to community and social support services, if relevant; and
new text end

new text begin (6) use of health information technology to link services, as feasible and appropriate.
new text end

new text begin (b) The commissioner shall maximize the number and type of services
included in this subdivision to the extent permissible under federal law, including
physician, outpatient, mental health treatment, and rehabilitation services necessary for
comprehensive transitional care following hospitalization.
new text end

new text begin Subd. 4. new text end

new text begin Health teams. new text end

new text begin The commissioner shall establish health teams to support
the patient-centered health home and provide the services described in subdivision 3 to
individuals eligible under subdivision 2. The commissioner shall apply for grants or
contracts as provided under section 3502 of the Patient Protection and Affordable Care
Act to establish health teams and provide capitated payments to primary care providers.
For purposes of this section, "health teams" means community-based, interdisciplinary,
inter-professional teams of health care providers that support primary care practices.
These providers may include medical specialists, nurses, advanced practice registered
nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers,
doctors of chiropractic, licensed complementary and alternative medicine practitioners,
and physician assistants.
new text end

new text begin Subd. 5. new text end

new text begin Payments. new text end

new text begin The commissioner shall make payments to each health home
and each health team for the provision of health home services to each eligible individual
with chronic conditions that selects the health home as a provider.
new text end

new text begin Subd. 6. new text end

new text begin Coordination. new text end

new text begin The commissioner, to the extent feasible, shall ensure that
the requirements and payment methods for health homes and health teams developed
under this section are consistent with the requirements and payment methods for health
care homes established under sections 256B.0751 and 256B.0753. The commissioner may
modify requirements and payment methods under sections 256B.0751 and 256B.0753 in
order to be consistent with federal health home requirements and payment methods.
new text end

new text begin Subd. 7. new text end

new text begin State plan amendment. new text end

new text begin The commissioner shall submit a state plan
amendment to implement this section to the federal Centers for Medicare and Medicaid
Services by January 1, 2011.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2011, or upon federal
approval, whichever is later.
new text end

Sec. 3. new text beginFEDERAL HEALTH CARE REFORM DEMONSTRATION PROJECTS
AND GRANTS.
new text end

new text begin (a) The commissioner of human services shall seek to participate in the following
demonstration projects, or apply for the following grants, as described in the federal
Patient Protection and Affordable Care Act, Public Law 111-148:
new text end

new text begin (1) the demonstration project to evaluate integrated care around a hospitalization,
Public Law 111-148, section 2704;
new text end

new text begin (2) the Medicaid global payment system demonstration project, Public Law 111-148,
section 2705, including a demonstration project for the specific population of childless
adults under 75 percent of federal poverty guidelines that were to be served by the general
assistance medical care program;
new text end

new text begin (3) the pediatric accountable care organization demonstration project, Public Law
111-148, section 2706;
new text end

new text begin (4) the Medicaid emergency psychiatric demonstration project, Public Law 111-148,
section 2707; and
new text end

new text begin (5) grants to provide incentives for prevention of chronic diseases in Medicaid,
Public Law 111-148, section 4108.
new text end

new text begin (b) The commissioner of human services shall report to the chairs and ranking
minority members of the house of representatives and senate committees or divisions with
jurisdiction over health care policy and finance on the status of the demonstration project
and grant applications. If the state is accepted as a demonstration project participant, or is
awarded a grant, the commissioner shall notify the chairs and ranking minority members
of those committees or divisions of any legislative changes necessary to implement the
demonstration projects or grants.
new text end

new text begin (c) The commissioner of health shall apply for federal grants available under the
federal Patient Protection and Affordable Care Act, Public Law 111-148, for purposes
of funding wellness and prevention, and health improvement programs. To the extent
possible under federal law, the commissioner of health must utilize the state health
improvement program, established under Minnesota Statutes, section 145.986, to
implement grant programs related to wellness and prevention, and health improvement,
for which the state receives funding under the federal Patient Protection and Affordable
Care Act, Public Law 111-148.
new text end

Sec. 4. new text beginHEALTH CARE REFORM TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Task force. new text end

new text begin (a) The governor shall convene a Health Care
Reform Task Force to advise and assist the governor and the legislature regarding state
implementation of federal health care reform legislation. For purposes of this section,
"federal health care reform legislation" means the Patient Protection and Affordable Care
Act, Public Law 111-148, and the health care reform provisions in the Health Care and
Education Reconciliation Act of 2010, Public Law 111-152. The task force shall consist of:
new text end

new text begin (1) two legislators from the house of representatives appointed by the speaker and
two legislators from the senate appointed by the Subcommittee on Committees of the
Committee on Rules and Administration;
new text end

new text begin (2) two representatives appointed by the governor to represent the governor and
state agencies;
new text end

new text begin (3) three persons appointed by the governor who have demonstrated leadership in
health care organizations, health plan companies, or health care trade or professional
associations;
new text end

new text begin (4) three persons appointed by the governor who have demonstrated leadership in
employer and group purchaser activities related to health system improvement of whom
two must be from a labor organization and one from the business community; and
new text end

new text begin (5) five persons appointed by the governor who have demonstrated expertise in the
areas of health care financing, access, and quality.
new text end

new text begin The governor is exempt from the requirements of the open appointments process
for purposes of appointing task force members. Members shall be appointed for one-year
terms and may be reappointed.
new text end

new text begin (b) The Department of Health, Department of Human Services, and Department of
Commerce shall provide staff support to the task force. The task force may accept outside
resources to help support its efforts.
new text end

new text begin (c) Task force members must be appointed by July 1, 2010. The task force must hold
its first meeting by July 15, 2010.
new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin (a) By December 15, 2010, the task force shall develop and
present to the legislature and the governor a preliminary report and recommendations on
state implementation of federal health care reform legislation. The report must include
recommendations for state law and program changes necessary to comply with the federal
health care reform legislation, and also recommendations for implementing provisions of
the federal legislation that are optional for states. In developing recommendations, the task
force shall consider the extent to which an approach maximizes federal funding to the state.
new text end

new text begin (b) The task force, in consultation with the governor and the legislature, shall also
establish timelines and criteria for future reports on state implementation of the federal
health care reform legislation.
new text end

Sec. 5. new text beginAMERICAN HEALTH BENEFIT EXCHANGE; PLANNING
PROVISIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Federal planning grants. new text end

new text begin The commissioners of commerce, health,
and human services shall jointly or separately apply to the federal secretary of health and
human services for one or more planning grants, including renewal grants, authorized
under section 1311 of the Patient Protection and Affordable Care Act, Public Law
111-148, including any future amendments of that provision, relating to state creation
of American Health Benefit Exchanges.
new text end

new text begin Subd. 2. new text end

new text begin Consideration of early creation and operation of exchange. new text end

new text begin (a) The
commissioners referenced in subdivision 1 shall analyze the advantages and disadvantages
to the state of planning to have a state health insurance exchange, similar to an American
Health Benefit Exchange referenced in subdivision 1, begin prior to the federal deadline
of January 1, 2014.
new text end

new text begin (b) The commissioners shall provide a written report to the legislature on the results
of the analysis required under paragraph (a) no later than December 15, 2010. The written
report must comply with Minnesota Statutes, sections 3.195 and 3.197.
new text end

ARTICLE 8

HUMAN SERVICES FORECAST ADJUSTMENTS

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

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

new text begin 2010
new text end
new text begin 2011
new text end
new text begin Total
new text end
new text begin General
new text end
new text begin $
new text end
new text begin (109,876,000)
new text end
new text begin $
new text end
new text begin (28,344,000)
new text end
new text begin $
new text end
new text begin (138,220,000)
new text end
new text begin Health Care Access
new text end
new text begin $
new text end
new text begin 99,654,000
new text end
new text begin $
new text end
new text begin 276,500,000
new text end
new text begin $
new text end
new text begin 376,154,000
new text end
new text begin Federal TANF
new text end
new text begin $
new text end
new text begin (9,830,000)
new text end
new text begin $
new text end
new text begin 15,133,000
new text end
new text begin $
new text end
new text begin 5,303,000
new text end
new text begin Total
new text end
new text begin $
new text end
new text begin (20,052,000)
new text end
new text begin $
new text end
new text begin 263,289,000
new text end
new text begin $
new text end
new text begin 243,237,000
new text end

Sec. 2. new text beginDEPARTMENT OF HUMAN SERVICES APPROPRIATION.new text end

new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown
in parentheses, subtracted from the appropriations in Laws 2009, chapter 79, article 13,
as amended by Laws 2009, chapter 173, article 2, to the agencies and for the purposes
specified in this article. The appropriations are from the general fund, or another named
fund, and are available for the fiscal years indicated for each purpose. The figures "2010"
and "2011" used in this article mean that the addition to or subtraction from appropriations
listed under them is available for the fiscal year ending June 30, 2010, or June 30, 2011,
respectively. "The first year" is fiscal year 2010. "The second year" is fiscal year 2011.
"The biennium" is fiscal years 2010 and 2011. Supplemental appropriations and reductions
for the fiscal year ending June 30, 2010, are effective the day following final enactment
unless a different effective date is explicit.
new text end

new text begin APPROPRIATIONS
new text end
new text begin Available for the Year
new text end
new text begin Ending June 30
new text end
new text begin 2010
new text end
new text begin 2011
new text end

Sec. 3. new text beginDEPARTMENT OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin (20,052,000)
new text end
new text begin $
new text end
new text begin 263,289,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2010
new text end
new text begin 2011
new text end
new text begin General
new text end
new text begin (109,876,000)
new text end
new text begin (28,344,000)
new text end
new text begin Health Care Access
new text end
new text begin 99,654,000
new text end
new text begin 276,500,000
new text end
new text begin Federal TANF
new text end
new text begin (9,830,000)
new text end
new text begin 15,133,000
new text end

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

new text begin Subd. 2. new text end

new text begin Revenue and Pass-through
new text end

new text begin Appropriations by Fund
new text end
new text begin Federal TANF
new text end
new text begin 390,000
new text end
new text begin (251,000)
new text end

new text begin Subd. 3. new text end

new text begin Children and Economic Assistance
Grants
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 4,489,000
new text end
new text begin (4,140,000)
new text end
new text begin Federal TANF
new text end
new text begin (10,220,000)
new text end
new text begin 15,384,000
new text end

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

new text begin (a) new text end new text begin MFIP Grants
new text end
new text begin General
new text end
new text begin 7,916,000
new text end
new text begin (14,481,000)
new text end
new text begin Federal TANF
new text end
new text begin (10,220,000)
new text end
new text begin 15,384,000
new text end
new text begin (b) new text end new text begin MFIP Child Care Assistance Grants
new text end
new text begin (7,832,000)
new text end
new text begin 2,579,000
new text end
new text begin (c) new text end new text begin General Assistance Grants
new text end
new text begin 875,000
new text end
new text begin 1,339,000
new text end
new text begin (d) new text end new text begin Minnesota Supplemental Aid Grants
new text end
new text begin 2,454,000
new text end
new text begin 3,843,000
new text end
new text begin (e) new text end new text begin Group Residential Housing Grants
new text end
new text begin 1,076,000
new text end
new text begin 2,580,000
new text end

new text begin Subd. 4. new text end

new text begin Basic Health Care Grants
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin (62,770,000)
new text end
new text begin 29,192,000
new text end
new text begin Health Care Access
new text end
new text begin 99,654,000
new text end
new text begin 276,500,000
new text end

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

new text begin (a) new text end new text begin MinnesotaCare Grants
new text end
new text begin Health Care Access
new text end
new text begin 99,654,000
new text end
new text begin 276,500,000
new text end
new text begin (b) new text end new text begin Medical Assistance Basic Health Care -
Families and Children
new text end
new text begin 1,165,000
new text end
new text begin 24,146,000
new text end
new text begin (c) new text end new text begin Medical Assistance Basic Health Care -
Elderly and Disabled
new text end
new text begin (63,935,000)
new text end
new text begin 5,046,000
new text end

new text begin Subd. 5. new text end

new text begin Continuing Care Grants
new text end

new text begin (51,595,000)
new text end
new text begin (53,396,000)
new text end

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

new text begin (a) new text end new text begin Medical Assistance Long-Term Care
Facilities
new text end
new text begin (3,774,000)
new text end
new text begin (8,275,000)
new text end
new text begin (b) new text end new text begin Medical Assistance Long-Term Care
Waivers
new text end
new text begin (27,710,000)
new text end
new text begin (22,452,000)
new text end
new text begin (c) new text end new text begin Chemical Dependency Entitlement Grants
new text end
new text begin (20,111,000)
new text end
new text begin (22,669,000)
new text end

Sec. 4. new text beginEFFECTIVE DATE.
new text end

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

ARTICLE 9

HUMAN SERVICES CONTINGENT APPROPRIATIONS

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

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

new text begin 2010
new text end
new text begin 2011
new text end
new text begin Total
new text end
new text begin General
new text end
new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 13,383,000
new text end
new text begin $
new text end
new text begin 13,383,000
new text end
new text begin Health Care Access
new text end
new text begin -0-
new text end
new text begin 686,000
new text end
new text begin 686,000
new text end
new text begin Total
new text end
new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 14,069,000
new text end
new text begin $
new text end
new text begin 14,069,000
new text end

Sec. 2. new text beginHEALTH AND HUMAN SERVICES CONTINGENT APPROPRIATIONS.new text end

new text begin (a) The sums shown in the columns marked "Appropriations" are added to the
appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter
173, article 2, to the agency and for the purposes specified in this bill. The appropriations
are from the general fund, or another named fund, and are available for the fiscal years
indicated for each purpose. The figures "2010" and "2011" used in this bill mean that the
addition to or subtraction from the appropriation listed under them is available for the
fiscal year ending June 30, 2010, or June 30, 2011, respectively.
new text end

new text begin (b) Upon enactment of the extension of the enhanced federal medical assistance
percentage (FMAP) under Public Law 111-5 to June 30, 2011, that is contained in the
president's budget for federal fiscal year 2011 or contained in House Resolution 2847,
the federal "Jobs for Main Street Act, 2010," or contained in House Resolution 4213,
"American Workers, State, and Business Relief Act of 2010," or subsequent federal
legislation, the appropriations identified in section 3 shall be made for fiscal year 2011.
new text end

new text begin APPROPRIATIONS
new text end
new text begin Available for the Year
new text end
new text begin Ending June 30
new text end
new text begin 2010
new text end
new text begin 2011
new text end

Sec. 3. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin -0-
new text end
new text begin $
new text end
new text begin 14,069,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2010
new text end
new text begin 2011
new text end
new text begin General
new text end
new text begin -0-
new text end
new text begin 13,383,000
new text end
new text begin Health Care Access
new text end
new text begin -0-
new text end
new text begin 686,000
new text end

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

new text begin Subd. 2. new text end

new text begin Basic Health Care Grants
new text end

new text begin (a) MinnesotaCare Grants
new text end
new text begin -0-
new text end
new text begin 686,000
new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin (b) Medical Assistance Basic Health Care
Grants - Families and Children
new text end
new text begin -0-
new text end
new text begin 6,297,000
new text end
new text begin (c) Medical Assistance Basic Health Care
Grants - Elderly and Disabled
new text end
new text begin -0-
new text end
new text begin 3,697,000
new text end

new text begin Subd. 3. new text end

new text begin Continuing Care Grants
new text end

new text begin (a) Medical Assistance - Long-Term Care
Facilities Grants
new text end
new text begin -0-
new text end
new text begin 2,486,000
new text end
new text begin (b) Medical Assistance Grants - Long-Term
Care Waivers and Home Care Grants
new text end
new text begin -0-
new text end
new text begin 547,000
new text end
new text begin (c) Chemical Dependency Entitlement Grants
new text end
new text begin -0-
new text end
new text begin 356,000
new text end

Sec. 4.

Minnesota Statutes 2008, section 256B.0625, subdivision 22, is amended to
read:


Subd. 22.

Hospice care.

Medical assistance covers hospice care services under
Public Law 99-272, section 9505, to the extent authorized by rulenew text begin, except that a recipient
age 21 or under who elects to receive hospice services does not waive coverage for
services that are related to the treatment of the condition for which a diagnosis of terminal
illness has been made
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactive from March 23, 2010.
new text end

Sec. 5.

Minnesota Statutes 2009 Supplement, 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 a institutional level of
care under section 256B.0911, deleted text beginsubdivision 4deleted text enddeleted text begin, paragraph (a)deleted text endnew text begin subdivision 4anew text end;

(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, or 256B.092, service eligibility including
state plan home care services identified in section 256B.0625, subdivisions 6, 7, and
19, paragraphs (a) and (c), based on assessment and support plan development with
appropriate referrals;

(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. 6.

Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:


Subd. 1c.

Additional portion of nonfederal share.

(a) Hennepin County shall
be responsible for a monthly transfer payment of $1,500,000, due before noon on the
15th of each month and the University of Minnesota shall be responsible for a monthly
transfer payment of $500,000 due before noon on the 15th of each month, beginning July
15, 1995. These sums shall be part of the designated governmental unit's portion of the
nonfederal share of medical assistance costs.

(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall
be $2,066,000 each month.

(c) Beginning July 1, 2001, the commissioner shall increase annual capitation
payments to the metropolitan health plan under section 256B.69 for the prepaid medical
assistance program by approximately deleted text begin$3,400,000, plus any available federal matching
funds,
deleted text endnew text begin $6,800,000new text end to recognize higher than average medical education costs.

(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a)
and (b) shall be reduced to $566,000, and the University of Minnesota's payment under
paragraph (a) shall be reduced to zero.new text begin Effective October 1, 2008, to December 31, 2010,
Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective
January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be
$566,000.
new text end

new text begin (e) Notwithstanding paragraph (d), upon federal enactment of an extension to June
30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally
provided under Public Law 111-5, for the six-month period from January 1, 2011, to June
30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.
new text end

Sec. 7.

Minnesota Statutes 2008, 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.
new text begin 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.
new text end

Sec. 8.

Laws 2005, First Special Session chapter 4, article 8, section 66, as amended by
Laws 2009, chapter 173, article 3, section 24, the effective date, is amended to read:


EFFECTIVE DATE.

Paragraph (a) is effective August 1, 2009, deleted text beginanddeleted text endnew text begin 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 commissioner of human services
shall notify the revisor of statutes of that date.
new text end Paragraph (e) is effective September 1,
2006.

Sec. 9.

Laws 2009, chapter 79, article 5, section 17, the effective date, is amended to
read:


EFFECTIVE DATE.

This section is effective January 1, 2011, or upon federal
approvaldeleted text begin, whichever is laterdeleted text endnew text begin 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 commissioner of human
services shall notify the revisor of statutes of that date
new text end.

Sec. 10.

Laws 2009, chapter 79, article 5, section 18, the effective date, is amended to
read:


EFFECTIVE DATE.

This section is effective deleted text beginJanuary 1, 2011deleted text endnew text begin 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 commissioner of human services
shall notify the revisor of statutes when federal approval is obtained
new text end.

Sec. 11.

Laws 2009, chapter 79, article 5, section 22, the effective date, is amended to
read:


EFFECTIVE DATE.

This section is effective for periods of ineligibility established
on or after January 1, 2011new text begin, 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. The
commissioner of human services shall notify the revisor of statutes of that date
new text end.

Sec. 12.

Laws 2009, chapter 79, article 8, section 4, the effective date, is amended to
read:


EFFECTIVE DATE.

The section is effective deleted text beginJanuarydeleted text endnew text begin Julynew text end 1, 2011.

Sec. 13.

Laws 2009, chapter 173, article 1, section 17, the effective date, is amended to
read:


EFFECTIVE DATE.

This section is effective for pooled trust accounts established
on or after January 1, 2011new text begin, 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. The
commissioner of human services shall notify the revisor of statutes of that date
new text