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S.F. No. 10,  as introduced - 2011 1st Special Session   Posted on Jul 19, 2011

1.1A bill for an act
1.2relating to state government; establishing the health and human services
1.3budget; making changes to children and family services, Department of Health,
1.4miscellaneous provisions, health licensing and fees, human services licensing,
1.5health care, and continuing care; redesigning service delivery; making changes
1.6to chemical and mental health; modifying fee schedules; modifying program
1.7eligibility requirements; authorizing rulemaking; imposing criminal penalties;
1.8requiring reports; appropriating money for the Departments of Health and
1.9Human Services and other health-related boards and councils; amending
1.10Minnesota Statutes 2010, sections 13.461, subdivision 24a; 62E.14, by adding a
1.11subdivision; 62J.04, subdivisions 3, 9; 62J.17, subdivision 4a; 62J.495, by adding
1.12subdivisions; 62J.692; 62Q.32; 62U.04, subdivisions 3, 9; 62U.06, subdivision
1.132; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision
1.141; 103I.525, subdivision 2; 103I.531, subdivision 2; 103I.535, subdivision 2;
1.15103I.541, subdivision 2c; 119B.011, subdivision 13; 119B.035, subdivision
1.164; 119B.09, subdivision 10, by adding subdivisions; 119B.125, by adding a
1.17subdivision; 119B.13, subdivisions 1, 1a, 7; 144.1464, subdivision 1; 144.1501,
1.18subdivision 1; 144.98, subdivisions 2a, 7, by adding subdivisions; 144A.102;
1.19144A.61, by adding a subdivision; 144E.123; 145A.17, subdivision 3; 148.07,
1.20subdivision 1; 148.108, by adding a subdivision; 148.191, subdivision 2; 148.212,
1.21subdivision 1; 148.231; 148B.17; 148B.33, subdivision 2; 148B.52; 150A.091,
1.22subdivisions 2, 3, 4, 5, 8, by adding a subdivision; 151.07; 151.101; 151.102,
1.23by adding a subdivision; 151.12; 151.13, subdivision 1; 151.19; 151.25; 151.47,
1.24subdivision 1; 151.48; 152.12, subdivision 3; 157.15, by adding a subdivision;
1.25157.20, by adding a subdivision; 245A.03, subdivision 7, as amended; 245A.10,
1.26subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision 2b; 245A.14,
1.27subdivision 4; 245A.143, subdivision 1; 245C.03, by adding a subdivision;
1.28245C.10, by adding subdivisions; 246B.10; 253B.212; 254B.03, subdivision 4;
1.29254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01, subdivisions
1.3014b, 24, 29, by adding subdivisions; 256.969, subdivisions 2, 2b, by adding a
1.31subdivision; 256B.02, by adding a subdivision; 256B.03, by adding subdivisions;
1.32256B.04, subdivision 18, by adding subdivisions; 256B.05, by adding a
1.33subdivision; 256B.056, subdivision 3; 256B.057, subdivision 9; 256B.06,
1.34subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 8e, 13e, 13h, 17, 17a, 18,
1.3519a, 25, 31, 31a, 41, by adding subdivisions; 256B.0631, subdivisions 1, 2, 3;
1.36256B.064, subdivision 2; 256B.0641, subdivision 1; 256B.0652, subdivision
1.376; 256B.0659, subdivisions 11, 28; 256B.0751, subdivision 4, by adding a
1.38subdivision; 256B.0911, subdivisions 1a, 3a, 3c, 4a; 256B.0913, subdivision
1.394; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 5, 10; 256B.0943, by adding a
2.1subdivision; 256B.0945, subdivision 4; 256B.14, by adding a subdivision;
2.2256B.19, subdivision 1e; 256B.196, subdivisions 2, 3, 5; 256B.199; 256B.431,
2.3subdivisions 2r, 2t, 32; 256B.434, subdivision 4; 256B.437, subdivision 6;
2.4256B.438, subdivisions 1, 3, 4, by adding a subdivision; 256B.441, subdivisions
2.550a, 55a, by adding subdivisions; 256B.49, subdivisions 12, 14, 15, 16a, by
2.6adding a subdivision; 256B.5012, by adding subdivisions; 256B.69, subdivisions
2.75a, 5c, 28, by adding subdivisions; 256B.76, subdivisions 1, 2, 4; 256B.766;
2.8256D.05, subdivision 1; 256D.06, subdivision 2; 256D.09, subdivision 6;
2.9256D.46, subdivision 1; 256D.49, subdivision 3; 256E.35, subdivisions 5, 6;
2.10256I.03, by adding a subdivision; 256I.05, subdivision 1a; 256J.20, subdivision
2.113; 256J.38, subdivision 1; 256J.49, subdivision 13; 256L.02, subdivision 3;
2.12256L.03, subdivision 5; 256L.04, subdivisions 1, 10; 256L.05, subdivision
2.133a, by adding a subdivision; 256L.09, subdivision 2; 256L.11, subdivisions
2.146, 7; 256L.12, subdivision 9; 256L.15, subdivision 1; 256M.01; 256M.10,
2.15subdivision 2; 256M.20, subdivisions 1, 2, 3; 256M.30; 256M.40; 256M.50;
2.16256M.60, subdivision 1; 256M.70, subdivision 2; 256M.80; 295.52, by adding
2.17a subdivision; 297F.10, subdivision 1; 393.07, subdivisions 10, 10a; 402A.10,
2.18subdivisions 4, 5; 402A.15; 402A.18; 402A.20; 518A.51; Laws 2009, chapter
2.1979, article 5, sections 17, as amended; 18, as amended; 22, as amended; article
2.208, sections 4, as amended; 51, as amended; article 13, section 3, subdivision
2.218, as amended; Laws 2009, chapter 173, article 1, section 17, as amended;
2.22Laws 2010, First Special Session chapter 1, article 15, section 3, subdivision 6;
2.23proposing coding for new law in Minnesota Statutes, chapters 62U; 148; 151;
2.24214; 256; 256B; 256L; 402A; repealing Minnesota Statutes 2010, sections
2.2513.4967, subdivision 3; 62J.07, subdivisions 1, 2, 3; 62J.321, subdivision
2.265a; 62J.381; 62J.41, subdivisions 1, 2; 144.1499; 245A.10, subdivision 5;
2.27256.979, subdivisions 5, 6, 7, 10; 256.9791; 256B.057, subdivision 2c; 256B.69,
2.28subdivision 9b; 256L.07, subdivision 7; 256M.10, subdivision 5; 256M.60,
2.29subdivision 2; 256M.70, subdivision 1; 295.50, subdivisions 1, 1a, 2, 2a, 3, 4,
2.306, 6a, 7, 9b, 9c, 10a, 10b, 12b, 13, 14, 15; 295.51, subdivisions 1, 1a; 295.52,
2.31subdivisions 1, 1a, 2, 3, 4, 4a, 5, 6, 7; 295.53, subdivisions 1, 2, 3, 4a; 295.54;
2.32295.55; 295.56; 295.57; 295.58; 295.581; 295.582; 295.59; 402A.30; 402A.45;
2.33Laws 2008, chapter 358, article 3, sections 8; 9; Laws 2009, chapter 79, article 5,
2.34section 62; Minnesota Rules, parts 3400.0130, subpart 8; 4651.0100, subparts
2.351, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23;
2.364651.0110, subparts 2, 2a, 3, 4, 5; 4651.0120; 4651.0130; 4651.0140; 4651.0150;
2.379500.1243, subpart 3; 9500.1261, subparts 3, items D, E, 4, 5.
2.38BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.39ARTICLE 1
2.40CHILDREN AND FAMILY SERVICES

2.41    Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to
2.42read:
2.43    Subd. 13. Family. "Family" means parents, stepparents, guardians and their spouses,
2.44or other eligible relative caregivers and their spouses, and their blood related dependent
2.45children and adoptive siblings under the age of 18 years living in the same home including
2.46children temporarily absent from the household in settings such as schools, foster care, and
2.47residential treatment facilities or parents, stepparents, guardians and their spouses, or other
2.48relative caregivers and their spouses temporarily absent from the household in settings
3.1such as schools, military service, or rehabilitation programs. An adult family member who
3.2is not in an authorized activity under this chapter may be temporarily absent for up to 60
3.3days. When a minor parent or parents and his, her, or their child or children are living with
3.4other relatives, and the minor parent or parents apply for a child care subsidy, "family"
3.5means only the minor parent or parents and their child or children. An adult age 18 or
3.6older who meets this definition of family and is a full-time high school or postsecondary
3.7student may be considered a dependent member of the family unit if 50 percent or more of
3.8the adult's support is provided by the parents, stepparents, guardians, and their spouses or
3.9eligible relative caregivers and their spouses residing in the same household.
3.10EFFECTIVE DATE.This section is effective April 16, 2012.

3.11    Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:
3.12    Subd. 4. Assistance. (a) A family is limited to a lifetime total of 12 months of
3.13assistance under subdivision 2. The maximum rate of assistance is equal to 90 68 percent
3.14of the rate established under section 119B.13 for care of infants in licensed family child
3.15care in the applicant's county of residence.
3.16(b) A participating family must report income and other family changes as specified
3.17in the county's plan under section 119B.08, subdivision 3.
3.18(c) Persons who are admitted to the at-home infant child care program retain their
3.19position in any basic sliding fee program. Persons leaving the at-home infant child care
3.20program reenter the basic sliding fee program at the position they would have occupied.
3.21(d) Assistance under this section does not establish an employer-employee
3.22relationship between any member of the assisted family and the county or state.
3.23EFFECTIVE DATE.This section is effective October 31, 2011.

3.24    Sec. 3. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
3.25to read:
3.26    Subd. 9a. Child care centers; assistance. (a) For the purposes of this subdivision,
3.27"qualifying child" means a child who satisfies both of the following:
3.28(1) is not a child or dependent of an employee of the child care provider; and
3.29(2) does not reside with an employee of the child care provider.
3.30(b) Funds distributed under this chapter must not be paid for child care services
3.31that are provided for a child by a child care provider who employs either the parent of
3.32the child or a person who resides with the child, unless at all times at least 50 percent of
4.1the children for whom the child care provider is providing care are qualifying children
4.2under paragraph (a).
4.3(c) If a child care provider satisfies the requirements for payment under paragraph
4.4(b), but the percentage of qualifying children under paragraph (a) for whom the provider
4.5is providing care falls below 50 percent, the provider shall have four weeks to raise the
4.6percentage of qualifying children for whom the provider is providing care to at least 50
4.7percent before payments to the provider are discontinued for child care services provided
4.8for a child who is not a qualifying child.
4.9EFFECTIVE DATE.This section is effective January 1, 2013.

4.10    Sec. 4. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
4.11    Subd. 10. Payment of funds. All federal, state, and local child care funds must
4.12be paid directly to the parent when a provider cares for children in the children's own
4.13home. In all other cases, all federal, state, and local child care funds must be paid directly
4.14to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible
4.15family. Funds distributed under this chapter must not be used for child care services that
4.16are provided for a child by a child care provider who resides in the same household or
4.17occupies the same residence as the child.
4.18EFFECTIVE DATE.This section is effective March 5, 2012.

4.19    Sec. 5. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
4.20to read:
4.21    Subd. 13. Child care in the child's home. Child care assistance must only be
4.22authorized in the child's home if the child's parents have authorized activities outside of
4.23the home and if one or more of the following circumstances are met:
4.24(1) the parents' qualifying activity occurs during times when out-of-home care is
4.25not available. If child care is needed during any period when out-of-home care is not
4.26available, in-home care can be approved for the entire time care is needed;
4.27(2) the family lives in an area where out-of-home care is not available; or
4.28(3) a child has a verified illness or disability that would place the child or other
4.29children in an out-of-home facility at risk or creates a hardship for the child and the family
4.30to take the child out of the home to a child care home or center.
4.31EFFECTIVE DATE.This section is effective March 5, 2012.

5.1    Sec. 6. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision
5.2to read:
5.3    Subd. 1b. Training required. (a) Effective November 1, 2011, prior to initial
5.4authorization as required in subdivision 1, a legal nonlicensed family child care provider
5.5must complete first aid and CPR training and provide the verification of first aid and CPR
5.6training to the county. The training documentation must have valid effective dates as of
5.7the date the registration request is submitted to the county and the training must have been
5.8provided by an individual approved to provide first aid and CPR instruction.
5.9(b) Legal nonlicensed family child care providers with an authorization effective
5.10before November 1, 2011, must be notified of the requirements before October 1, 2011, or
5.11at authorization, and must meet the requirements upon renewal of an authorization that
5.12occurs on or after January 1, 2012.
5.13(c) Upon each reauthorization after the authorization period when the initial first aid
5.14and CPR training requirements are met, a legal nonlicensed family child care provider
5.15must provide verification of at least eight hours of additional training listed in the
5.16Minnesota Center for Professional Development Registry.
5.17(d) This subdivision only applies to legal nonlicensed family child care providers.

5.18    Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
5.19    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006 October 31, 2011,
5.20the maximum rate paid for child care assistance in any county or multicounty region under
5.21the child care fund shall be the rate for like-care arrangements in the county effective
5.22January July 1, 2006, increased decreased by six 2.5 percent.
5.23    (b) Rate changes shall be implemented for services provided in September 2006
5.24unless a participant eligibility redetermination or a new provider agreement is completed
5.25between July 1, 2006, and August 31, 2006.
5.26    As necessary, appropriate notice of adverse action must be made according to
5.27Minnesota Rules, part 3400.0185, subparts 3 and 4.
5.28    New cases approved on or after July 1, 2006, shall have the maximum rates under
5.29paragraph (a), implemented immediately.
5.30    (c) (b) Every year, the commissioner shall survey rates charged by child care
5.31providers in Minnesota to determine the 75th percentile for like-care arrangements in
5.32counties. When the commissioner determines that, using the commissioner's established
5.33protocol, the number of providers responding to the survey is too small to determine
5.34the 75th percentile rate for like-care arrangements in a county or multicounty region,
6.1the commissioner may establish the 75th percentile maximum rate based on like-care
6.2arrangements in a county, region, or category that the commissioner deems to be similar.
6.3    (d) (c) A rate which includes a special needs rate paid under subdivision 3 or under a
6.4school readiness service agreement paid under section 119B.231, may be in excess of the
6.5maximum rate allowed under this subdivision.
6.6    (e) (d) The department shall monitor the effect of this paragraph on provider rates.
6.7The county shall pay the provider's full charges for every child in care up to the maximum
6.8established. The commissioner shall determine the maximum rate for each type of care
6.9on an hourly, full-day, and weekly basis, including special needs and disability care. The
6.10maximum payment to a provider for one day of care must not exceed the daily rate. The
6.11maximum payment to a provider for one week of care must not exceed the weekly rate.
6.12(e) Child care providers receiving reimbursement under this chapter must not be
6.13paid activity fees or an additional amount above the maximum rates for care provided
6.14during nonstandard hours for families receiving assistance.
6.15    (f) When the provider charge is greater than the maximum provider rate allowed,
6.16the parent is responsible for payment of the difference in the rates in addition to any
6.17family co-payment fee.
6.18    (g) All maximum provider rates changes shall be implemented on the Monday
6.19following the effective date of the maximum provider rate.
6.20EFFECTIVE DATE.Paragraph (d) is effective April 16, 2012. Paragraph (e)
6.21is effective September 3, 2012.

6.22    Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
6.23    Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal
6.24nonlicensed family child care providers receiving reimbursement under this chapter must
6.25be paid on an hourly basis for care provided to families receiving assistance.
6.26(b) The maximum rate paid to legal nonlicensed family child care providers must be
6.2780 68 percent of the county maximum hourly rate for licensed family child care providers.
6.28In counties where the maximum hourly rate for licensed family child care providers is
6.29higher than the maximum weekly rate for those providers divided by 50, the maximum
6.30hourly rate that may be paid to legal nonlicensed family child care providers is the rate
6.31equal to the maximum weekly rate for licensed family child care providers divided by 50
6.32and then multiplied by 0.80 0.68. The maximum payment to a provider for one day of care
6.33must not exceed the maximum hourly rate times ten. The maximum payment to a provider
6.34for one week of care must not exceed the maximum hourly rate times 50.
7.1(c) A rate which includes a special needs rate paid under subdivision 3 may be in
7.2excess of the maximum rate allowed under this subdivision.
7.3(d) Legal nonlicensed family child care providers receiving reimbursement under
7.4this chapter may not be paid registration fees for families receiving assistance.
7.5EFFECTIVE DATE.This section is effective April 16, 2012, except the
7.6amendment changing 80 to 68 and 0.80 to 0.68 is effective October 31, 2011.

7.7    Sec. 9. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
7.8    Subd. 7. Absent days. (a) Licensed child care providers may and license-exempt
7.9centers must not be reimbursed for more than 25 ten full-day absent days per child,
7.10excluding holidays, in a fiscal year, or for more than ten consecutive full-day absent days,
7.11unless the child has a documented medical condition that causes more frequent absences.
7.12Absences due to a documented medical condition of a parent or sibling who lives in the
7.13same residence as the child receiving child care assistance do not count against the 25-day
7.14absent day limit in a fiscal year. Documentation of medical conditions must be on the
7.15forms and submitted according to the timelines established by the commissioner. A public
7.16health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a
7.17provider sends a child home early due to a medical reason, including, but not limited to,
7.18fever or contagious illness, the child care center director or lead teacher may verify the
7.19illness in lieu of a medical practitioner. Legal nonlicensed family child care providers
7.20must not be reimbursed for absent days. If a child attends for part of the time authorized to
7.21be in care in a day, but is absent for part of the time authorized to be in care in that same
7.22day, the absent time will must be reimbursed but the time will must not count toward the
7.23ten consecutive or 25 cumulative absent day limits limit. Children in families where at
7.24least one parent is under the age of 21, does not have a high school or general equivalency
7.25diploma, and is a student in a school district or another similar program that provides or
7.26arranges for child care, as well as parenting, social services, career and employment
7.27supports, and academic support to achieve high school graduation, may be exempt from
7.28the absent day limits upon request of the program and approval of the county. If a child
7.29attends part of an authorized day, payment to the provider must be for the full amount
7.30of care authorized for that day. Child care providers may must only be reimbursed for
7.31absent days if the provider has a written policy for child absences and charges all other
7.32families in care for similar absences.
7.33    (b) Child care providers must be reimbursed for up to ten federal or state holidays
7.34or designated holidays per year when the provider charges all families for these days
7.35and the holiday or designated holiday falls on a day when the child is authorized to be
8.1in attendance. Parents may substitute other cultural or religious holidays for the ten
8.2recognized state and federal holidays. Holidays do not count toward the ten consecutive
8.3or 25 cumulative absent day limits limit.
8.4    (c) A family or child care provider may must not be assessed an overpayment for an
8.5absent day payment unless (1) there was an error in the amount of care authorized for the
8.6family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
8.7the family or provider did not timely report a change as required under law.
8.8    (d) The provider and family must receive notification of the number of absent days
8.9used upon initial provider authorization for a family and when the family has used 15
8.10cumulative absent days. Upon statewide implementation of the Minnesota Electronic
8.11Child Care System, the provider and family shall receive notification of the number of
8.12absent days used upon initial provider authorization for a family and ongoing notification
8.13of the number of absent days used as of the date of the notification.
8.14    (e) A county may pay for more absent days than the statewide absent day policy
8.15established under this subdivision if current market practice in the county justifies payment
8.16for those additional days. County policies for payment of absent days in excess of the
8.17statewide absent day policy and justification for these county policies must be included in
8.18the county's child care fund plan under section 119B.08, subdivision 3.
8.19EFFECTIVE DATE.This section is effective January 1, 2013.

8.20    Sec. 10. [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
8.21    Subdivision 1. Electronic benefit transfer (EBT) card. Cash benefits for the
8.22general assistance and Minnesota supplemental aid programs under chapter 256D and
8.23programs under chapter 256J must be issued on a separate EBT card with the name of the
8.24head of household printed on the card. The card must include the following statement: "It
8.25is unlawful to use this card to purchase tobacco products or alcoholic beverages." This
8.26card must be issued within 30 calendar days of an eligibility determination. During the
8.27initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT
8.28card without a name printed on the card. This card may be the same card on which food
8.29support benefits are issued and does not need to meet the requirements of this section.
8.30    Subd. 2. Prohibited purchases. EBT debit cardholders in programs listed under
8.31subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products
8.32and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for
8.33an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic
8.34beverages with the cardholder's EBT card. Any unlawful use under this subdivision shall
9.1constitute fraud and result in disqualification from the program under section 256.98,
9.2subdivision 8.
9.3EFFECTIVE DATE.Subdivision 1 is effective June 1, 2012.

9.4    Sec. 11. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:
9.5    Subdivision 1. Eligibility. (a) Each assistance unit with income and resources
9.6less than the standard of assistance established by the commissioner and with a member
9.7who is a resident of the state shall be eligible for and entitled to general assistance if
9.8the assistance unit is:
9.9(1) a person who is suffering from a professionally certified permanent or temporary
9.10illness, injury, or incapacity which is expected to continue for more than 30 45 days and
9.11which prevents the person from obtaining or retaining employment;
9.12(2) a person whose presence in the home on a substantially continuous basis is
9.13required because of the professionally certified illness, injury, incapacity, or the age of
9.14another member of the household;
9.15(3) a person who has been placed in, and is residing in, a licensed or certified facility
9.16for purposes of physical or mental health or rehabilitation, or in an approved chemical
9.17dependency domiciliary facility, if the placement is based on illness or incapacity and is
9.18according to a plan developed or approved by the county agency through its director or
9.19designated representative;
9.20(4) a person who resides in a shelter facility described in subdivision 3;
9.21(5) a person not described in clause (1) or (3) who is diagnosed by a licensed
9.22physician, psychological practitioner, or other qualified professional, as developmentally
9.23disabled or mentally ill, and that condition prevents the person from obtaining or retaining
9.24employment;
9.25(6) a person who has an application pending for, or is appealing termination of
9.26benefits from, the Social Security disability program or the program of supplemental
9.27security income for the aged, blind, and disabled, provided the person has a professionally
9.28certified permanent or temporary illness, injury, or incapacity which is expected to
9.29continue for more than 30 days and which prevents the person from obtaining or retaining
9.30employment;
9.31(7) a person who is unable to obtain or retain employment because advanced age
9.32significantly affects the person's ability to seek or engage in substantial work;
9.33(8) a person who has been assessed by a vocational specialist and, in consultation
9.34with the county agency, has been determined to be unemployable for purposes of this
9.35clause; a person is considered employable if there exist positions of employment in the
10.1local labor market, regardless of the current availability of openings for those positions,
10.2that the person is capable of performing. The person's eligibility under this category must
10.3be reassessed at least annually. The county agency must provide notice to the person not
10.4later than 30 days before annual eligibility under this item ends, informing the person of the
10.5date annual eligibility will end and the need for vocational assessment if the person wishes
10.6to continue eligibility under this clause. For purposes of establishing eligibility under this
10.7clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
10.8(9) a person who is determined by the county agency, according to permanent rules
10.9adopted by the commissioner, to be learning disabled have a condition that qualifies
10.10under Minnesota's special education rules as a specific learning disability, provided that if
10.11a rehabilitation plan for the person is developed or approved by the county agency, and
10.12the person is following the plan;
10.13(10) a child under the age of 18 who is not living with a parent, stepparent, or legal
10.14custodian, and only if: the child is legally emancipated or living with an adult with the
10.15consent of an agency acting as a legal custodian; the child is at least 16 years of age
10.16and the general assistance grant is approved by the director of the county agency or a
10.17designated representative as a component of a social services case plan for the child; or the
10.18child is living with an adult with the consent of the child's legal custodian and the county
10.19agency. For purposes of this clause, "legally emancipated" means a person under the age
10.20of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of
10.21the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv)
10.22is otherwise considered emancipated under Minnesota law, and for whom county social
10.23services has not determined that a social services case plan is necessary, for reasons other
10.24than the child has failed or refuses to cooperate with the county agency in developing
10.25the plan;
10.26(11) a person who is eligible for displaced homemaker services, programs, or
10.27assistance under section 116L.96, but only if that person is enrolled as a full-time student;
10.28(12) a person who lives more than four hours round-trip traveling time from any
10.29potential suitable employment;
10.30(13) (12) a person who is involved with protective or court-ordered services that
10.31prevent the applicant or recipient from working at least four hours per day;
10.32(14) (13) a person over age 18 whose primary language is not English and who is
10.33attending high school at least half time; or
10.34(15) (14) a person whose alcohol and drug addiction is a material factor that
10.35contributes to the person's disability; applicants who assert this clause as a basis for
10.36eligibility must be assessed by the county agency to determine if they are amenable
11.1to treatment; if the applicant is determined to be not amenable to treatment, but is
11.2otherwise eligible for benefits, then general assistance must be paid in vendor form, for
11.3the individual's shelter costs up to the limit of the grant amount, with the residual, if
11.4any, paid according to section 256D.09, subdivision 2a; if the applicant is determined
11.5to be amenable to treatment, then in order to receive benefits, the applicant must be in
11.6a treatment program or on a waiting list and the benefits must be paid in vendor form,
11.7for the individual's shelter costs, up to the limit of the grant amount, with the residual, if
11.8any, paid according to section 256D.09, subdivision 2a.
11.9(b) As a condition of eligibility under paragraph (a), clauses (1), (3), (5), (8), and
11.10(9), the recipient must complete an interim assistance agreement and must apply for other
11.11maintenance benefits as specified in section 256D.06, subdivision 5, and must comply
11.12with efforts to determine the recipient's eligibility for those other maintenance benefits.
11.13(c) The burden of providing documentation for a county agency to use to verify
11.14eligibility for general assistance or for exemption from the food stamp employment
11.15and training program is upon the applicant or recipient. The county agency shall use
11.16documents already in its possession to verify eligibility, and shall help the applicant or
11.17recipient obtain other existing verification necessary to determine eligibility which the
11.18applicant or recipient does not have and is unable to obtain.
11.19EFFECTIVE DATE.This section is effective May 1, 2012.

11.20    Sec. 12. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:
11.21    Subd. 2. Emergency need. (a) Notwithstanding the provisions of subdivision 1, a
11.22grant of emergency general assistance shall, to the extent funds are available, be made to
11.23an eligible single adult, married couple, or family for an emergency need, as defined in
11.24rules promulgated by the commissioner, where the recipient requests temporary assistance
11.25not exceeding 30 days if an emergency situation appears to exist and the individual or
11.26family is ineligible for MFIP or DWP or is not a participant of MFIP or DWP under
11.27written criteria adopted by the county agency. If an applicant or recipient relates facts
11.28to the county agency which may be sufficient to constitute an emergency situation, the
11.29county agency shall, to the extent funds are available, advise the person of the procedure
11.30for applying for assistance according to this subdivision.
11.31    (b) The applicant must be ineligible for assistance under chapter 256J, must have
11.32annual net income no greater than 200 percent of the federal poverty guidelines for the
11.33previous calendar year, and may receive an emergency general assistance grant is available
11.34to a recipient not more than once in any 12-month period.
12.1    (c) Funding for an emergency general assistance program is limited to the
12.2appropriation. Each fiscal year, the commissioner shall allocate to counties the money
12.3appropriated for emergency general assistance grants based on each county agency's
12.4average share of state's emergency general expenditures for the immediate past three fiscal
12.5years as determined by the commissioner, and may reallocate any unspent amounts to
12.6other counties. No county shall be allocated less than $1,000 for a fiscal year.
12.7    (d) Any emergency general assistance expenditures by a county above the amount of
12.8the commissioner's allocation to the county must be made from county funds.
12.9EFFECTIVE DATE.This section is effective November 1, 2011.

12.10    Sec. 13. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:
12.11    Subdivision 1. Eligibility. A county agency must grant emergency Minnesota
12.12supplemental aid, to the extent funds are available, if the recipient is without adequate
12.13resources to resolve an emergency that, if unresolved, will threaten the health or safety of
12.14the recipient. For the purposes of this section, the term "recipient" includes persons for
12.15whom a group residential housing benefit is being paid under sections 256I.01 to 256I.06.
12.16Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency
12.17need may apply for emergency general assistance under section 256D.06, subdivision 2.
12.18EFFECTIVE DATE.This section is effective November 1, 2011.

12.19    Sec. 14. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
12.20    Subd. 5. Household eligibility; participation. (a) To be eligible for state or TANF
12.21matching funds in the family assets for independence initiative, a household must meet the
12.22eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
12.23in Title IV, section 408 of that act.
12.24(b) Each participating household must sign a family asset agreement that includes
12.25the amount of scheduled deposits into its savings account, the proposed use, and the
12.26proposed savings goal. A participating household must agree to complete an economic
12.27literacy training program.
12.28Participating households may only deposit money that is derived from household
12.29earned income or from state and federal income tax credits.

12.30    Sec. 15. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
12.31    Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a
12.32participating household must transfer funds withdrawn from a family asset account to its
13.1matching fund custodial account held by the fiscal agent, according to the family asset
13.2agreement. The fiscal agent must determine if the match request is for a permissible use
13.3consistent with the household's family asset agreement.
13.4The fiscal agent must ensure the household's custodial account contains the
13.5applicable matching funds to match the balance in the household's account, including
13.6interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches
13.7must be provided as follows:
13.8(1) from state grant and TANF funds a matching contribution of $1.50 for every $1
13.9of funds withdrawn from the family asset account equal to the lesser of $720 per year or a
13.10$3,000 lifetime limit; and
13.11(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
13.12of funds withdrawn from the family asset account equal to the lesser of $720 per year or
13.13a $3,000 lifetime limit.
13.14(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
13.15direct payment to the vendor of the goods or services for the permissible use.

13.16    Sec. 16. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision
13.17to read:
13.18    Subd. 8. Supplementary services. "Supplementary services" means services
13.19provided to residents of group residential housing providers in addition to room and
13.20board including, but not limited to, oversight and up to 24-hour supervision, medication
13.21reminders, assistance with transportation, arranging for meetings and appointments, and
13.22arranging for medical and social services.

13.23    Sec. 17. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:
13.24    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
13.25256I.04, subdivision 3 , the county agency may negotiate a payment not to exceed $426.37
13.26for other services necessary to provide room and board provided by the group residence
13.27if the residence is licensed by or registered by the Department of Health, or licensed by
13.28the Department of Human Services to provide services in addition to room and board,
13.29and if the provider of services is not also concurrently receiving funding for services for
13.30a recipient under a home and community-based waiver under title XIX of the Social
13.31Security Act; or funding from the medical assistance program under section 256B.0659,
13.32for personal care services for residents in the setting; or residing in a setting which
13.33receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is
13.34available for other necessary services through a home and community-based waiver, or
14.1personal care services under section 256B.0659, then the GRH rate is limited to the rate
14.2set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary
14.3service rate exceed $426.37. The registration and licensure requirement does not apply to
14.4establishments which are exempt from state licensure because they are located on Indian
14.5reservations and for which the tribe has prescribed health and safety requirements. Service
14.6payments under this section may be prohibited under rules to prevent the supplanting of
14.7federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
14.8the approval of the Secretary of Health and Human Services to provide home and
14.9community-based waiver services under title XIX of the Social Security Act for residents
14.10who are not eligible for an existing home and community-based waiver due to a primary
14.11diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is
14.12determined to be cost-effective.
14.13(b) The commissioner is authorized to make cost-neutral transfers from the GRH
14.14fund for beds under this section to other funding programs administered by the department
14.15after consultation with the county or counties in which the affected beds are located.
14.16The commissioner may also make cost-neutral transfers from the GRH fund to county
14.17human service agencies for beds permanently removed from the GRH census under a plan
14.18submitted by the county agency and approved by the commissioner. The commissioner
14.19shall report the amount of any transfers under this provision annually to the legislature.
14.20(c) The provisions of paragraph (b) do not apply to a facility that has its
14.21reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).
14.22    (d) Counties must not negotiate supplementary service rates with providers of group
14.23residential housing that are licensed as board and lodging with special services and that
14.24do not encourage a policy of sobriety on their premises.
14.25EFFECTIVE DATE.This section is effective May 1, 2012.

14.26    Sec. 18. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:
14.27    Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of
14.28all nonexcluded real and personal property of the assistance unit must not exceed $2,000
14.29for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
14.30(19) must be excluded when determining the equity value of real and personal property:
14.31    (1) a licensed vehicle up to a loan value of less than or equal to $15,000 $10,000. If
14.32the assistance unit owns more than one licensed vehicle, the county agency shall determine
14.33the loan value of all additional vehicles and exclude the combined loan value of less than
14.34or equal to $7,500. The county agency shall apply any excess loan value as if it were
14.35equity value to the asset limit described in this section, excluding: (i) the value of one
15.1vehicle per physically disabled person when the vehicle is needed to transport the disabled
15.2unit member; this exclusion does not apply to mentally disabled people; (ii) the value of
15.3special equipment for a disabled member of the assistance unit; and (iii) any vehicle used
15.4for long-distance travel, other than daily commuting, for the employment of a unit member.
15.5    To establish the loan value of vehicles, a county agency must use the N.A.D.A.
15.6Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not
15.7listed in the guidebook, or when the applicant or participant disputes the loan value listed
15.8in the guidebook as unreasonable given the condition of the particular vehicle, the county
15.9agency may require the applicant or participant document the loan value by securing a
15.10written statement from a motor vehicle dealer licensed under section 168.27, stating
15.11the amount that the dealer would pay to purchase the vehicle. The county agency shall
15.12reimburse the applicant or participant for the cost of a written statement that documents
15.13a lower loan value;
15.14    (2) the value of life insurance policies for members of the assistance unit;
15.15    (3) one burial plot per member of an assistance unit;
15.16    (4) the value of personal property needed to produce earned income, including
15.17tools, implements, farm animals, inventory, business loans, business checking and
15.18savings accounts used at least annually and used exclusively for the operation of a
15.19self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
15.20is to produce income and if the vehicles are essential for the self-employment business;
15.21    (5) the value of personal property not otherwise specified which is commonly
15.22used by household members in day-to-day living such as clothing, necessary household
15.23furniture, equipment, and other basic maintenance items essential for daily living;
15.24    (6) the value of real and personal property owned by a recipient of Supplemental
15.25Security Income or Minnesota supplemental aid;
15.26    (7) the value of corrective payments, but only for the month in which the payment
15.27is received and for the following month;
15.28    (8) a mobile home or other vehicle used by an applicant or participant as the
15.29applicant's or participant's home;
15.30    (9) money in a separate escrow account that is needed to pay real estate taxes or
15.31insurance and that is used for this purpose;
15.32    (10) money held in escrow to cover employee FICA, employee tax withholding,
15.33sales tax withholding, employee worker compensation, business insurance, property rental,
15.34property taxes, and other costs that are paid at least annually, but less often than monthly;
15.35    (11) monthly assistance payments for the current month's or short-term emergency
15.36needs under section 256J.626, subdivision 2;
16.1    (12) the value of school loans, grants, or scholarships for the period they are
16.2intended to cover;
16.3    (13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
16.4in escrow for a period not to exceed three months to replace or repair personal or real
16.5property;
16.6    (14) income received in a budget month through the end of the payment month;
16.7    (15) savings from earned income of a minor child or a minor parent that are set aside
16.8in a separate account designated specifically for future education or employment costs;
16.9    (16) the federal earned income credit, Minnesota working family credit, state and
16.10federal income tax refunds, state homeowners and renters credits under chapter 290A,
16.11property tax rebates and other federal or state tax rebates in the month received and the
16.12following month;
16.13    (17) payments excluded under federal law as long as those payments are held in a
16.14separate account from any nonexcluded funds;
16.15    (18) the assets of children ineligible to receive MFIP benefits because foster care or
16.16adoption assistance payments are made on their behalf; and
16.17    (19) the assets of persons whose income is excluded under section 256J.21,
16.18subdivision 2
, clause (43).
16.19EFFECTIVE DATE.This section is effective October 1, 2011.

16.20    Sec. 19. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:
16.21    Subd. 13. Work activity. (a) "Work activity" means any activity in a participant's
16.22approved employment plan that leads to employment. For purposes of the MFIP program,
16.23this includes activities that meet the definition of work activity under the participation
16.24requirements of TANF. Work activity includes:
16.25    (1) unsubsidized employment, including work study and paid apprenticeships or
16.26internships;
16.27    (2) subsidized private sector or public sector employment, including grant diversion
16.28as specified in section 256J.69, on-the-job training as specified in section 256J.66, paid
16.29work experience, and supported work when a wage subsidy is provided;
16.30    (3) unpaid work experience, including community service, volunteer work,
16.31the community work experience program as specified in section 256J.67, unpaid
16.32apprenticeships or internships, and supported work when a wage subsidy is not provided.
16.33Unpaid work experience is only an option if the participant has been unable to obtain or
16.34maintain paid employment in the competitive labor market, and no paid work experience
16.35programs are available to the participant. Prior to placing a participant in unpaid work,
17.1the county must inform the participant that the participant will be notified if a paid work
17.2experience or supported work position becomes available. Unless a participant consents in
17.3writing to participate in unpaid work experience, the participant's employment plan may
17.4only include unpaid work experience if including the unpaid work experience in the plan
17.5will meet the following criteria:
17.6    (i) the unpaid work experience will provide the participant specific skills or
17.7experience that cannot be obtained through other work activity options where the
17.8participant resides or is willing to reside; and
17.9    (ii) the skills or experience gained through the unpaid work experience will result
17.10in higher wages for the participant than the participant could earn without the unpaid
17.11work experience;
17.12    (4) job search including job readiness assistance, job clubs, job placement,
17.13job-related counseling, and job retention services;
17.14    (5) job readiness education, including English as a second language (ESL) or
17.15functional work literacy classes as limited by the provisions of section 256J.531,
17.16subdivision 2
, general educational development (GED) course work, high school
17.17completion, and adult basic education as limited by the provisions of section 256J.531,
17.18subdivision 1
;
17.19    (6) job skills training directly related to employment, including education and
17.20training that can reasonably be expected to lead to employment, as limited by the
17.21provisions of section 256J.53;
17.22    (7) providing child care services to a participant who is working in a community
17.23service program;
17.24    (8) activities included in the employment plan that is developed under section
17.25256J.521, subdivision 3 ; and
17.26    (9) preemployment activities including chemical and mental health assessments,
17.27treatment, and services; learning disabilities services; child protective services; family
17.28stabilization services; or other programs designed to enhance employability.
17.29(b) "Work activity" does not include activities done for political purposes as defined
17.30in section 211B.01, subdivision 6.

17.31    Sec. 20. Minnesota Statutes 2010, section 256M.01, is amended to read:
17.32256M.01 CITATION.
17.33Sections 256M.01 to 256M.80 may be cited as the "Children and Community
17.34Services Vulnerable Children and Adults Act." This act establishes a fund to address the
17.35needs of vulnerable children, adolescents, and adults within each county in accordance
18.1with a service plan entered into by the board of county commissioners of each county
18.2and the commissioner. The service plan shall specify the outcomes to be achieved, the
18.3general strategies to be employed, and the respective state and county roles. The service
18.4plan shall be reviewed and updated every two years, or sooner if both the state and the
18.5county deem it necessary.

18.6    Sec. 21. Minnesota Statutes 2010, section 256M.10, subdivision 2, is amended to read:
18.7    Subd. 2. Children and community Vulnerable children and adults services.
18.8(a) "Children and communityVulnerable children and adults services" means services
18.9provided or arranged for by county boards for vulnerable children, adolescents and other
18.10individuals in transition from childhood to adulthood, under chapter 260C, and sections
18.11626.556 and 626.5561, and adults under section 626.557 who experience dependency,
18.12abuse, or neglect, poverty, disability, chronic health conditions, or other factors, including
18.13ethnicity and race, that may result in poor outcomes or disparities, as well as services
18.14for family members to support those individuals. These services may be provided
18.15by professionals or nonprofessionals, including the person's natural supports in the
18.16community. For the purpose of this chapter, "vulnerable children" means children and
18.17adolescents.
18.18(b) Children and community Vulnerable children and adults services do not include
18.19services under the public assistance programs known as the Minnesota family investment
18.20program, Minnesota supplemental aid, medical assistance, general assistance, general
18.21assistance medical care, MinnesotaCare, or community health services.

18.22    Sec. 22. Minnesota Statutes 2010, section 256M.20, subdivision 1, is amended to read:
18.23    Subdivision 1. General supervision. Each year the commissioner shall allocate
18.24funds to each county with an approved service plan according to section 256M.40 and
18.25service plans under section 256M.30. The funds shall be used to address the needs of
18.26vulnerable children, adolescents, and adults. The commissioner, in consultation with
18.27counties, shall provide technical assistance and evaluate county performance in achieving
18.28outcomes.

18.29    Sec. 23. Minnesota Statutes 2010, section 256M.20, subdivision 2, is amended to read:
18.30    Subd. 2. Additional duties. The commissioner shall:
18.31(1) provide necessary information and assistance to each county for establishing
18.32baselines and desired improvements on mental health, safety, permanency, and well-being
18.33for vulnerable children and adolescents adults;
19.1(2) provide training, technical assistance, and other supports to each county board
19.2to assist in needs assessment, planning, implementation, and monitoring of outcomes
19.3and service quality;
19.4(3) use data collection, evaluation of service outcomes, and the review and approval
19.5of county service plans to supervise county performance in the delivery of children and
19.6community services;
19.7(4) specify requirements for reports, including fiscal reports to account for funds
19.8distributed;
19.9(5) request waivers from federal programs as necessary to implement this section;
19.10and
19.11(6) have authority under sections 14.055 and 14.056 to grant a variance to existing
19.12state rules as needed to eliminate barriers to achieving desired outcomes.

19.13    Sec. 24. Minnesota Statutes 2010, section 256M.20, subdivision 3, is amended to read:
19.14    Subd. 3. Sanctions. The commissioner shall establish and maintain a monitoring
19.15program designed to reduce the possibility of noncompliance with federal laws and
19.16federal, regulations, and performance standards that may result in federal fiscal sanctions.
19.17If a county is not complying with federal law or federal regulation and the noncompliance
19.18may result in federal fiscal sanctions, the commissioner may withhold a portion of the
19.19county's share of state and federal funds for that program. The amount withheld must be
19.20equal to the percentage difference between the level of compliance maintained by the
19.21county and the level of compliance required by the federal regulations, multiplied by the
19.22county's share of state and federal funds for the program. The state and federal funds may
19.23be withheld until the county is found to be in compliance with all federal laws or federal
19.24regulations applicable to the program. If a county remains out of compliance for more
19.25than six consecutive months, the commissioner may reallocate the withheld funds to
19.26counties that are in compliance with the federal regulations.

19.27    Sec. 25. Minnesota Statutes 2010, section 256M.30, is amended to read:
19.28256M.30 SERVICE PLAN.
19.29    Subdivision 1. Service plan submitted to commissioner. Effective January 1,
19.302004, and each two-year period thereafter 2012, each county must have a biennial service
19.31plan approved by the commissioner in order to receive funds. Counties may submit
19.32multicounty or regional service plans. Plans must be updated as needed to reflect current
19.33county policy and procedures regarding requirements and use of funds under this chapter.
20.1    Subd. 2. Contents. The service plan shall be completed in a form prescribed by
20.2the commissioner. The plan must include:
20.3(1) a statement of the needs of the vulnerable children, adolescents, and adults who
20.4experience the conditions defined in section 256M.10, subdivision 2, paragraph (a), and
20.5strengths and resources available in the community to address those needs;
20.6(2) strategies the county will pursue to achieve the performance targets. Strategies
20.7must include specification of how funds under this section and other community resources
20.8will be used to achieve desired performance targets;
20.9(3) a description of the county's process to solicit public input and a summary of
20.10that input;
20.11(4) beginning with the service plans submitted for the period from January 1, 2006,
20.12through December 31, 2007, performance targets on statewide indicators for each county
20.13to measure outcomes of children's mental health, and child vulnerable children and adult's
20.14safety, permanency, and well-being. The commissioner shall consult with counties and
20.15other stakeholders to develop these indicators and collect baseline data to inform the
20.16establishment of individual county performance targets for the 2006-2007 2012-2013
20.17biennium and subsequent plans years; and
20.18(5) a budget for services to be provided with funds under this section. The county
20.19must budget at least 40 percent of funds appropriated under sections 256M.01 to 256M.80
20.20for services to ensure the mental health, safety, permanency, and well-being of children
20.21from low-income families. The commissioner may reduce the portion of child and
20.22community services funds that must be budgeted by a county for services to children in
20.23low-income families if:
20.24(i) the incidence of children in low-income families within the county's population is
20.25significantly below the statewide median; or
20.26(ii) the county has successfully achieved past performance targets for children's
20.27mental health, and child safety, permanency, and well-being and its proposed service plan
20.28is judged by the commissioner to provide an adequate level of service to the population
20.29with less funding.
20.30    Subd. 3. Continuity of services. In developing the plan required under this section,
20.31a county shall endeavor, within the limits of funds available, to consider the continuing
20.32need for services and programs for children and persons with disabilities that were funded
20.33by the former children's services and community service grants.
20.34    Subd. 4. Information. The commissioner shall provide each county with
20.35information and technical assistance needed to complete the service plan, including:
20.36information on children's mental health, and child and adult safety, permanency, and
21.1well-being in the county; comparisons with other counties; baseline performance on
21.2outcome measures; and promising program practices.
21.3    Subd. 5. Timelines. The preliminary service plan must be submitted to the
21.4commissioner by October 15, 2003, and October 15 of every two years thereafter 2011.
21.5    Subd. 6. Public comment. The county board must determine how citizens in the
21.6county will participate in the development of the service plan and provide opportunities
21.7for such participation. The county must allow a period of no less than 30 days prior to
21.8the submission of the plan to the commissioner to solicit comments from the public on
21.9the contents of the plan.
21.10    Subd. 7. Commissioner's responsibilities. The commissioner must, within 60
21.11days of receiving each county service plan, inform the county if the service plan has
21.12been approved. If the service plan is not approved, the commissioner must inform the
21.13county of any revisions needed for approval.

21.14    Sec. 26. Minnesota Statutes 2010, section 256M.40, is amended to read:
21.15256M.40 CHILDREN AND COMMUNITY SERVICES GRANT
21.16ALLOCATION.
21.17    Subdivision 1. Formula. The commissioner shall allocate state funds appropriated
21.18for children and community services grants under this chapter to each county board on a
21.19calendar year basis in an amount determined according to the formula in paragraphs
21.20(a) to (c) (e).
21.21(a) For July 1, 2003, through December 31, 2003, the commissioner shall allocate
21.22funds to each county equal to that county's allocation for the grants under section 256M.10,
21.23subdivision 5
, for calendar year 2003 less payments made on or before June 30, 2003.
21.24(b) For calendar year 2004 and 2005, the commissioner shall allocate available funds
21.25to each county in proportion to that county's share of the calendar year 2003 allocations
21.26for the grants under section 256M.10, subdivision 5.
21.27(c) For calendar year 2006 and each calendar year thereafter, the commissioner
21.28shall allocate available funds to each county in proportion to that county's share in the
21.29preceding calendar year.
21.30(a) For calendar years 2011 and 2012, the commissioner shall allocate available
21.31funds to each county in proportion to that county's share in calendar year 2010.
21.32(b) For calendar year 2013, the commissioner shall allocate available funds to each
21.33county as follows:
21.34(1) 75 percent must be distributed on the basis of the county share in calendar year
21.352012;
22.1(2) five percent must be distributed on the basis of the number of persons residing in
22.2the county as determined by the most recent data of the state demographer;
22.3(3) ten percent must be distributed on the basis of the number of vulnerable children
22.4that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in
22.5the county as determined by the most recent data of the commissioner; and
22.6(4) ten percent must be distributed on the basis of the number of vulnerable adults
22.7that are subjects of reports under section 626.557 in the county as determined by the most
22.8recent data of the commissioner.
22.9(c) For calendar year 2014, the commissioner shall allocate available funds to each
22.10county as follows:
22.11(1) 50 percent must be distributed on the basis of the county share in calendar year
22.122012;
22.13(2) Ten percent must be distributed on the basis of the number of persons residing in
22.14the county as determined by the most recent data of the state demographer;
22.15(3) 20 percent must be distributed on the basis of the number of vulnerable children
22.16that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
22.17county as determined by the most recent data of the commissioner; and
22.18(4) 20 percent must be distributed on the basis of the number of vulnerable adults
22.19that are subjects of reports under section 626.557 in the county as determined by the most
22.20recent data of the commissioner.
22.21(d) For calendar year 2015, the commissioner shall allocate available funds to each
22.22county as follows:
22.23(1) 25 percent must be distributed on the basis of the county share in calendar year
22.242012;
22.25(2) 15 percent must be distributed on the basis of the number of persons residing in
22.26the county as determined by the most recent data of the state demographer;
22.27(3) 30 percent must be distributed on the basis of the number of vulnerable children
22.28that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
22.29county as determined by the most recent data of the commissioner; and
22.30(4) 30 percent must be distributed on the basis of the number of vulnerable adults
22.31that are subjects of reports under section 626.557 in the county as determined by the most
22.32recent data of the commissioner.
22.33(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall
22.34allocate available funds to each county as follows:
22.35(1) 20 percent must be distributed on the basis of the number of persons residing in
22.36the county as determined by the most recent data of the state demographer;
23.1(2) 40 percent must be distributed on the basis of the number of vulnerable children
23.2that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
23.3county as determined by the most recent data of the commissioner; and
23.4(3) 40 percent must be distributed on the basis of the number of vulnerable adults
23.5that are subjects of reports under section 626.557 in the county as determined by the most
23.6recent data of the commissioner.
23.7    Subd. 3. Payments. Calendar year allocations under subdivision 1 shall be paid to
23.8counties on or before July 10 of each year.

23.9    Sec. 27. Minnesota Statutes 2010, section 256M.50, is amended to read:
23.10256M.50 FEDERAL CHILDREN AND COMMUNITY SERVICES GRANT
23.11ALLOCATION.
23.12In federal fiscal year 2004 2012 and subsequent years, money for social services
23.13received from the federal government to reimburse counties for social service expenditures
23.14according to Title XX of the Social Security Act shall be allocated to each county
23.15according to section 256M.40, except for funds allocated for administrative purposes and
23.16migrant day care. Title XX funds must not be used for any expenditures prohibited by
23.17section 2005 of the Social Security Act and all federal certification requirements under
23.18title XX must be met by counties receiving title XX funds under this chapter.

23.19    Sec. 28. Minnesota Statutes 2010, section 256M.60, subdivision 1, is amended to read:
23.20    Subdivision 1. Responsibilities. The county board of each county shall be
23.21responsible for administration and funding of children and community services as defined
23.22in section 256M.10, subdivision 1. Each county board shall singly or in combination with
23.23other county boards use funds available to the county under Laws 2003, First Special
23.24Session chapter 14, to carry out these responsibilities. The county board shall coordinate
23.25and facilitate the effective use of formal and informal helping systems to best support and
23.26nurture children, adolescents, and adults within the county who experience dependency,
23.27abuse, neglect, poverty, disability, chronic health conditions, or other factors, including
23.28ethnicity and race, that may result in poor outcomes or disparities, as well as services
23.29for family members to support such individuals. This includes assisting individuals
23.30to function at the highest level of ability while maintaining family and community
23.31relationships to the greatest extent possible.

23.32    Sec. 29. Minnesota Statutes 2010, section 256M.70, subdivision 2, is amended to read:
24.1    Subd. 2. Identification of services to be provided. If a county has made reasonable
24.2efforts to provide services according to the service plan under section 256M.30, but funds
24.3appropriated for purposes of sections 256M.01 to 256M.80 are insufficient, then the
24.4county may limit services that do not meet the following criteria while giving the highest
24.5funding priority to clauses (1), and (2), and (3):
24.6(1) services needed to protect individuals from maltreatment, abuse, and neglect;
24.7(2) emergency and crisis services needed to protect clients from physical, emotional,
24.8or psychological harm;
24.9(3) services that maintain a person in the person's home or least restrictive setting;
24.10(4) assessment of persons applying for services and referral to appropriate services
24.11when necessary; and
24.12(5) public guardianship services;.
24.13(6) case management for persons with developmental disabilities, children with
24.14serious emotional disturbances, and adults with serious and persistent mental illness; and
24.15(7) fulfilling licensing responsibilities delegated to the county by the commissioner
24.16under section 245A.16.

24.17    Sec. 30. Minnesota Statutes 2010, section 256M.80, is amended to read:
24.18256M.80 PROGRAM EVALUATION.
24.19    Subdivision 1. County evaluation. Each county shall submit to the commissioner
24.20data from the past calendar year on the outcomes and performance indicators in the service
24.21plan. The commissioner shall prescribe standard methods to be used by the counties
24.22in providing the data. The data shall be submitted no later than March 1 of each year,
24.23beginning with March 1, 2005.
24.24    Subd. 2. Statewide evaluation. Six months after the end of the first full calendar
24.25year and annually thereafter, the commissioner shall prepare a report on make public the
24.26counties' progress in improving the outcomes of vulnerable children, adolescents, and
24.27adults related to mental health, safety, permanency, and well-being. This report shall be
24.28disseminated throughout the state.

24.29    Sec. 31. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:
24.30    Subd. 10a. Expedited issuance of food stamps. The commissioner of human
24.31services shall continually monitor the expedited issuance of food stamp benefits to ensure
24.32that each county complies with federal regulations and that households eligible for
24.33expedited issuance of food stamps are identified, processed, and certified within the time
24.34frames prescribed in federal regulations.
25.1County food stamp offices shall screen and issue food stamps to applicants on the
25.2day of application. Applicants who meet the federal criteria for expedited issuance and
25.3have an immediate need for food assistance shall receive either: within five working days
25.4(1) a manual Authorization to Participate (ATP) card; or
25.5(2) the immediate issuance of food stamp coupons benefits.
25.6The local food stamp agency shall conspicuously post in each food stamp office a
25.7notice of the availability of and the procedure for applying for expedited issuance and
25.8verbally advise each applicant of the availability of the expedited process.

25.9    Sec. 32. Minnesota Statutes 2010, section 518A.51, is amended to read:
25.10518A.51 FEES FOR IV-D SERVICES.
25.11(a) When a recipient of IV-D services is no longer receiving assistance under the
25.12state's title IV-A, IV-E foster care, medical assistance, or MinnesotaCare programs, the
25.13public authority responsible for child support enforcement must notify the recipient,
25.14within five working days of the notification of ineligibility, that IV-D services will be
25.15continued unless the public authority is notified to the contrary by the recipient. The
25.16notice must include the implications of continuing to receive IV-D services, including the
25.17available services and fees, cost recovery fees, and distribution policies relating to fees.
25.18(b) An application fee of $25 shall be paid by the person who applies for child
25.19support and maintenance collection services, except persons who are receiving public
25.20assistance as defined in section 256.741 and the diversionary work program under section
25.21256J.95 , persons who transfer from public assistance to nonpublic assistance status, and
25.22minor parents and parents enrolled in a public secondary school, area learning center, or
25.23alternative learning program approved by the commissioner of education.
25.24(c) In the case of an individual who has never received assistance under a state
25.25program funded under title IV-A of the Social Security Act and for whom the public
25.26authority has collected at least $500 of support, the public authority must impose an
25.27annual federal collections fee of $25 for each case in which services are furnished. This
25.28fee must be retained by the public authority from support collected on behalf of the
25.29individual, but not from the first $500 collected.
25.30(d) When the public authority provides full IV-D services to an obligee who has
25.31applied for those services, upon written notice to the obligee, the public authority must
25.32charge a cost recovery fee of one two percent of the amount collected. This fee must
25.33be deducted from the amount of the child support and maintenance collected and not
25.34assigned under section 256.741 before disbursement to the obligee. This fee does not
25.35apply to an obligee who:
26.1(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,
26.2medical assistance, or MinnesotaCare programs; or
26.3(2) has received assistance under the state's title IV-A or IV-E foster care programs,
26.4until the person has not received this assistance for 24 consecutive months.
26.5 (e) When the public authority provides full IV-D services to an obligor who has
26.6applied for such services, upon written notice to the obligor, the public authority must
26.7charge a cost recovery fee of one two percent of the monthly court-ordered child support
26.8and maintenance obligation. The fee may be collected through income withholding, as
26.9well as by any other enforcement remedy available to the public authority responsible for
26.10child support enforcement.
26.11 (f) Fees assessed by state and federal tax agencies for collection of overdue support
26.12owed to or on behalf of a person not receiving public assistance must be imposed on the
26.13person for whom these services are provided. The public authority upon written notice to
26.14the obligee shall assess a fee of $25 to the person not receiving public assistance for each
26.15successful federal tax interception. The fee must be withheld prior to the release of the
26.16funds received from each interception and deposited in the general fund.
26.17 (g) Federal collections fees collected under paragraph (c) and cost recovery
26.18fees collected under paragraphs (d) and (e) retained by the commissioner of human
26.19services shall be considered child support program income according to Code of Federal
26.20Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund
26.21account established under paragraph (i). The commissioner of human services must elect
26.22to recover costs based on either actual or standardized costs.
26.23 (h) The limitations of this section on the assessment of fees shall not apply to
26.24the extent inconsistent with the requirements of federal law for receiving funds for the
26.25programs under title IV-A and title IV-D of the Social Security Act, United States Code,
26.26title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.
26.27 (i) The commissioner of human services is authorized to establish a special revenue
26.28fund account to receive the federal collections fees collected under paragraph (c) and cost
26.29recovery fees collected under paragraphs (d) and (e). A portion of the nonfederal share of
26.30these fees may be retained for expenditures necessary to administer the fees and must be
26.31transferred to the child support system special revenue account. The remaining nonfederal
26.32share of the federal collections fees and cost recovery fees must be retained by the
26.33commissioner and dedicated to the child support general fund county performance-based
26.34grant account authorized under sections 256.979 and 256.9791.
26.35(j) The nonfederal share of the cost recovery fee revenue must be retained by the
26.36commissioner and distributed as follows:
27.1(1) one-half of the revenue must be transferred to the child support system special
27.2revenue account to support the state's administration of the child support enforcement
27.3program and its federally mandated automated system;
27.4(2) an additional portion of the revenue must be transferred to the child support
27.5system special revenue account for expenditures necessary to administer the fees; and
27.6(3) the remaining portion of the revenue must be distributed to the counties to aid the
27.7counties in funding their child support enforcement programs.
27.8(k) The nonfederal share of the federal collections fees must be distributed to the
27.9counties to aid them in funding their child support enforcement programs.
27.10(l) The commissioner of human services shall distribute quarterly any of the funds
27.11dedicated to the counties under paragraphs (j) and (k) using the methodology specified in
27.12section 256.979, subdivision 11. The funds received by the counties must be reinvested in
27.13the child support enforcement program and the counties must not reduce the funding of
27.14their child support programs by the amount of the funding distributed.
27.15EFFECTIVE DATE.This section is effective January 1, 2012.

27.16    Sec. 33. REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES,
27.17GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.
27.18Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must
27.19negotiate with their third-party processors to block EBT card cash transactions at their
27.20places of business and withdrawals of cash at automatic teller machines located in their
27.21places of business.

27.22    Sec. 34. MINNESOTA EBT BUSINESS TASK FORCE.
27.23    Subdivision 1. Members. The Minnesota EBT Business Task Force includes seven
27.24members, appointed as follows:
27.25(1) two members of the Minnesota house of representatives appointed by the speaker
27.26of the house;
27.27(2) two members of the Minnesota senate appointed by the senate majority leader;
27.28(3) the commissioner of human services, or designee;
27.29(4) an appointee of the Minnesota Grocers Association; and
27.30(5) a credit card processor, appointed by the commissioner of human services.
27.31    Subd. 2. Duties. The Minnesota EBT Business Task Force shall create a workable
27.32strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the
27.33general assistance program and Minnesota supplemental aid program under Minnesota
27.34Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT
28.1cards. The task force will consider cost to the state, feasibility of execution at retail, and
28.2ease of use and privacy for EBT cardholders.
28.3    Subd. 3. Report. The task force will report back to the legislative committees with
28.4jurisdiction over health and human services policy and finance by April 1, 2012, with
28.5recommendations related to the task force duties under subdivision 2.
28.6    Subd. 4. Expiration. The task force expires on June 30, 2012.

28.7    Sec. 35. REPEALER.
28.8(a) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10; and
28.9256.9791, are repealed effective retroactively from July 1, 2011.
28.10(b) Minnesota Statutes 2010, sections 256M.10, subdivision 5; 256M.60, subdivision
28.112; and 256M.70, subdivision 1, are repealed.
28.12(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September
28.133, 2012.
28.14(d) Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, are
28.15repealed effective November 1, 2011.

28.16ARTICLE 2
28.17DEPARTMENT OF HEALTH

28.18    Section 1. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
28.19    Subd. 3. Cost containment duties. The commissioner shall:
28.20(1) establish statewide and regional cost containment goals for total health care
28.21spending under this section and collect data as described in sections 62J.38 to 62J.41 and
28.2262J.40 to monitor statewide achievement of the cost containment goals;
28.23(2) divide the state into no fewer than four regions, with one of those regions being
28.24the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
28.25Wright, and Sherburne Counties, for purposes of fostering the development of regional
28.26health planning and coordination of health care delivery among regional health care
28.27systems and working to achieve the cost containment goals;
28.28(3) monitor the quality of health care throughout the state and take action as
28.29necessary to ensure an appropriate level of quality;
28.30(4) issue recommendations regarding uniform billing forms, uniform electronic
28.31billing procedures and data interchanges, patient identification cards, and other uniform
28.32claims and administrative procedures for health care providers and private and public
28.33sector payers. In developing the recommendations, the commissioner shall review the
28.34work of the work group on electronic data interchange (WEDI) and the American National
29.1Standards Institute (ANSI) at the national level, and the work being done at the state and
29.2local level. The commissioner may adopt rules requiring the use of the Uniform Bill
29.382/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
29.4version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
29.5forms or procedures;
29.6(5) undertake health planning responsibilities;
29.7(6) authorize, fund, or promote research and experimentation on new technologies
29.8and health care procedures;
29.9(7) within the limits of appropriations for these purposes, administer or contract for
29.10statewide consumer education and wellness programs that will improve the health of
29.11Minnesotans and increase individual responsibility relating to personal health and the
29.12delivery of health care services, undertake prevention programs including initiatives to
29.13improve birth outcomes, expand childhood immunization efforts, and provide start-up
29.14grants for worksite wellness programs;
29.15(8) undertake other activities to monitor and oversee the delivery of health care
29.16services in Minnesota with the goal of improving affordability, quality, and accessibility of
29.17health care for all Minnesotans; and
29.18(9) make the cost containment goal data available to the public in a
29.19consumer-oriented manner.

29.20    Sec. 2. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
29.21    Subd. 4a. Expenditure reporting. Each hospital, outpatient surgical center,
29.22diagnostic imaging center, and physician clinic shall report annually to the commissioner
29.23on all major spending commitments, in the form and manner specified by the
29.24commissioner. The report shall include the following information:
29.25    (a) a description of major spending commitments made during the previous year,
29.26including the total dollar amount of major spending commitments and purpose of the
29.27expenditures;
29.28    (b) the cost of land acquisition, construction of new facilities, and renovation of
29.29existing facilities;
29.30    (c) the cost of purchased or leased medical equipment, by type of equipment;
29.31    (d) expenditures by type for specialty care and new specialized services;
29.32    (e) information on the amount and types of added capacity for diagnostic imaging
29.33services, outpatient surgical services, and new specialized services; and
29.34    (f) information on investments in electronic medical records systems.
30.1For hospitals and outpatient surgical centers, this information shall be included in reports
30.2to the commissioner that are required under section 144.698. For diagnostic imaging
30.3centers, this information shall be included in reports to the commissioner that are required
30.4under section 144.565. For physician clinics, this information shall be included in reports
30.5to the commissioner that are required under section 62J.41. For all other health care
30.6providers that are subject to this reporting requirement, reports must be submitted to the
30.7commissioner by March 1 each year for the preceding calendar year.

30.8    Sec. 3. Minnesota Statutes 2010, section 62J.692, is amended to read:
30.962J.692 MEDICAL EDUCATION.
30.10    Subdivision 1. Definitions. For purposes of this section, the following definitions
30.11apply:
30.12    (a) "Accredited clinical training" means the clinical training provided by a
30.13medical education program that is accredited through an organization recognized by the
30.14Department of Education, the Centers for Medicare and Medicaid Services, or another
30.15national body who reviews the accrediting organizations for multiple disciplines and
30.16whose standards for recognizing accrediting organizations are reviewed and approved by
30.17the commissioner of health in consultation with the Medical Education and Research
30.18Advisory Committee.
30.19    (b) "Commissioner" means the commissioner of health.
30.20    (c) "Clinical medical education program" means the accredited clinical training of
30.21physicians (medical students and residents), doctor of pharmacy practitioners, doctors
30.22of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
30.23registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
30.24physician assistants.
30.25    (d) "Sponsoring institution" means a hospital, school, or consortium located in
30.26Minnesota that sponsors and maintains primary organizational and financial responsibility
30.27for a clinical medical education program in Minnesota and which is accountable to the
30.28accrediting body.
30.29    (e) "Teaching institution" means a hospital, medical center, clinic, or other
30.30organization that conducts a clinical medical education program in Minnesota.
30.31    (f) "Trainee" means a student or resident involved in a clinical medical education
30.32program.
30.33    (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
30.34equivalent counts, that are at training sites located in Minnesota with currently active
30.35medical assistance enrollment status and a National Provider Identification (NPI) number
31.1where training occurs in either an inpatient or ambulatory patient care setting and where
31.2the training is funded, in part, by patient care revenues. Training that occurs in nursing
31.3facility settings is not eligible for funding under this section.
31.4    Subd. 3. Application process. (a) A clinical medical education program
31.5conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy
31.6practitioners, dentists, chiropractors, or physician assistants is eligible for funds under
31.7subdivision 4 if the program:
31.8(1) is funded, in part, by patient care revenues;
31.9(2) occurs in patient care settings that face increased financial pressure as a result
31.10of competition with nonteaching patient care entities; and
31.11(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
31.12A clinical medical education program that trains pediatricians is requested to include
31.13in its program curriculum training in case management and medication management for
31.14children suffering from mental illness to be eligible for funds under subdivision 4.
31.15(b) A clinical medical education program for advanced practice nursing is eligible for
31.16funds under subdivision 4 if the program meets the eligibility requirements in paragraph
31.17(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health
31.18Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges
31.19and Universities system or members of the Minnesota Private College Council.
31.20(c) Applications must be submitted to the commissioner by a sponsoring institution
31.21on behalf of an eligible clinical medical education program and must be received by
31.22October 31 of each year for distribution in the following year. An application for funds
31.23must contain the following information:
31.24(1) the official name and address of the sponsoring institution and the official
31.25name and site address of the clinical medical education programs on whose behalf the
31.26sponsoring institution is applying;
31.27(2) the name, title, and business address of those persons responsible for
31.28administering the funds;
31.29(3) for each clinical medical education program for which funds are being sought;
31.30the type and specialty orientation of trainees in the program; the name, site address, and
31.31medical assistance provider number and national provider identification number of each
31.32training site used in the program; the federal tax identification number of each training site
31.33used in the program, where available; the total number of trainees at each training site; and
31.34the total number of eligible trainee FTEs at each site; and
32.1(4) other supporting information the commissioner deems necessary to determine
32.2program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
32.3equitable distribution of funds.
32.4(d) An application must include the information specified in clauses (1) to (3) for
32.5each clinical medical education program on an annual basis for three consecutive years.
32.6After that time, an application must include the information specified in clauses (1) to (3)
32.7when requested, at the discretion of the commissioner:
32.8(1) audited clinical training costs per trainee for each clinical medical education
32.9program when available or estimates of clinical training costs based on audited financial
32.10data;
32.11(2) a description of current sources of funding for clinical medical education costs,
32.12including a description and dollar amount of all state and federal financial support,
32.13including Medicare direct and indirect payments; and
32.14(3) other revenue received for the purposes of clinical training.
32.15(e) An applicant that does not provide information requested by the commissioner
32.16shall not be eligible for funds for the current funding cycle.
32.17    Subd. 4. Distribution of funds. (a) Following the distribution described under
32.18paragraph (b), The commissioner shall annually distribute the available medical education
32.19funds to all qualifying applicants based on a distribution formula that reflects a summation
32.20of two factors:
32.21    (1) a public program volume factor, which is determined by the total volume of
32.22public program revenue received by each training site as a percentage of all public
32.23program revenue received by all training sites in the fund pool; and
32.24    (2) a supplemental public program volume factor, which is determined by providing
32.25a supplemental payment of 20 percent of each training site's grant to training sites whose
32.26public program revenue accounted for at least 0.98 percent of the total public program
32.27revenue received by all eligible training sites. Grants to training sites whose public
32.28program revenue accounted for less than 0.98 percent of the total public program revenue
32.29received by all eligible training sites shall be reduced by an amount equal to the total
32.30value of the supplemental payment.
32.31    Public program revenue for the distribution formula includes revenue from medical
32.32assistance, prepaid medical assistance, general assistance medical care, and prepaid
32.33general assistance medical care. Training sites that receive no public program revenue
32.34are ineligible for funds available under this subdivision. For purposes of determining
32.35training-site level grants to be distributed under paragraph (a), total statewide average
32.36costs per trainee for medical residents is based on audited clinical training costs per trainee
33.1in primary care clinical medical education programs for medical residents. Total statewide
33.2average costs per trainee for dental residents is based on audited clinical training costs
33.3per trainee in clinical medical education programs for dental students. Total statewide
33.4average costs per trainee for pharmacy residents is based on audited clinical training costs
33.5per trainee in clinical medical education programs for pharmacy students. Training sites
33.6whose training site level grant is less than $1,000, based on the formula described in this
33.7paragraph, are ineligible for funds available under this subdivision.
33.8    (b) $5,350,000 of the available medical education funds shall be distributed as
33.9follows:
33.10    (1) $1,475,000 to the University of Minnesota Medical Center-Fairview;
33.11    (2) $2,075,000 to the University of Minnesota School of Dentistry; and
33.12    (3) $1,800,000 to the Academic Health Center. $150,000 of the funds distributed to
33.13the Academic Health Center under this paragraph shall be used for a program to assist
33.14internationally trained physicians who are legal residents and who commit to serving
33.15underserved Minnesota communities in a health professional shortage area to successfully
33.16compete for family medicine residency programs at the University of Minnesota.
33.17    (c) (b) Funds distributed shall not be used to displace current funding appropriations
33.18from federal or state sources.
33.19    (d) (c) Funds shall be distributed to the sponsoring institutions indicating the amount
33.20to be distributed to each of the sponsor's clinical medical education programs based on
33.21the criteria in this subdivision and in accordance with the commissioner's approval letter.
33.22Each clinical medical education program must distribute funds allocated under paragraph
33.23(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
33.24institutions, which are accredited through an organization recognized by the Department
33.25of Education or the Centers for Medicare and Medicaid Services, may contract directly
33.26with training sites to provide clinical training. To ensure the quality of clinical training,
33.27those accredited sponsoring institutions must:
33.28    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
33.29training conducted at sites; and
33.30    (2) take necessary action if the contract requirements are not met. Action may
33.31include the withholding of payments under this section or the removal of students from
33.32the site.
33.33    (e) (d) Any funds not distributed in accordance with the commissioner's approval
33.34letter must be returned to the medical education and research fund within 30 days of
33.35receiving notice from the commissioner. The commissioner shall distribute returned funds
33.36to the appropriate training sites in accordance with the commissioner's approval letter.
34.1    (f) (e) A maximum of $150,000 of the funds dedicated to the commissioner
34.2under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
34.3administrative expenses associated with implementing this section.
34.4    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section
34.5must sign and submit a medical education grant verification report (GVR) to verify that
34.6the correct grant amount was forwarded to each eligible training site. If the sponsoring
34.7institution fails to submit the GVR by the stated deadline, or to request and meet
34.8the deadline for an extension, the sponsoring institution is required to return the full
34.9amount of funds received to the commissioner within 30 days of receiving notice from
34.10the commissioner. The commissioner shall distribute returned funds to the appropriate
34.11training sites in accordance with the commissioner's approval letter.
34.12    (b) The reports must provide verification of the distribution of the funds and must
34.13include:
34.14    (1) the total number of eligible trainee FTEs in each clinical medical education
34.15program;
34.16    (2) the name of each funded program and, for each program, the dollar amount
34.17distributed to each training site;
34.18    (3) documentation of any discrepancies between the initial grant distribution notice
34.19included in the commissioner's approval letter and the actual distribution;
34.20    (4) a statement by the sponsoring institution stating that the completed grant
34.21verification report is valid and accurate; and
34.22    (5) other information the commissioner, with advice from the advisory committee,
34.23deems appropriate to evaluate the effectiveness of the use of funds for medical education.
34.24    (c) By February 15 of each year, the commissioner, with advice from the
34.25advisory committee, shall provide an annual summary report to the legislature on the
34.26implementation of this section.
34.27    Subd. 6. Other available funds. The commissioner is authorized to distribute, in
34.28accordance with subdivision 4, funds made available through:
34.29(1) voluntary contributions by employers or other entities;
34.30(2) allocations for the commissioner of human services to support medical education
34.31and research; and
34.32(3) other sources as identified and deemed appropriate by the legislature for
34.33inclusion in the fund.
34.34    Subd. 7. Transfers from the commissioner of human services. Of the amount
34.35transferred according to section 256B.69, subdivision 5c, paragraph (a), clauses (1) to (4),
34.36$21,714,000 shall be distributed as follows:
35.1(1) $2,157,000 shall be distributed by the commissioner to the University of
35.2Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
35.3(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
35.4Medical Center for clinical medical education;
35.5(3) $17,400,000 shall be distributed by the commissioner to the University of
35.6Minnesota Board of Regents for purposes of medical education;
35.7(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
35.8dental innovation grants in accordance with subdivision 7a; and
35.9(5) the remainder of the amount transferred according to section 256B.69,
35.10subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
35.11clinical medical education programs that meet the qualifications of subdivision 3 based on
35.12the formula in subdivision 4, paragraph (a).
35.13    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
35.14shall award grants to teaching institutions and clinical training sites for projects that
35.15increase dental access for underserved populations and promote innovative clinical
35.16training of dental professionals. In awarding the grants, the commissioner, in consultation
35.17with the commissioner of human services, shall consider the following:
35.18(1) potential to successfully increase access to an underserved population;
35.19(2) the long-term viability of the project to improve access beyond the period
35.20of initial funding;
35.21(3) evidence of collaboration between the applicant and local communities;
35.22(4) the efficiency in the use of the funding; and
35.23(5) the priority level of the project in relation to state clinical education, access,
35.24and workforce goals.
35.25(b) The commissioner shall periodically evaluate the priorities in awarding the
35.26innovations grants in order to ensure that the priorities meet the changing workforce
35.27needs of the state.
35.28    Subd. 8. Federal financial participation. The commissioner of human services
35.29shall seek to maximize federal financial participation in payments for medical education
35.30and research costs.
35.31    The commissioner shall use physician clinic rates where possible to maximize
35.32federal financial participation. Any additional funds that become available must be
35.33distributed under subdivision 4, paragraph (a).
35.34    Subd. 9. Review of eligible providers. The commissioner and the Medical
35.35Education and Research Costs Advisory Committee may review provider groups included
35.36in the definition of a clinical medical education program to assure that the distribution of
36.1the funds continue to be consistent with the purpose of this section. The results of any
36.2such reviews must be reported to the Legislative Commission on Health Care Access.

36.3    Sec. 4. [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING
36.4MEASURES.
36.5    Subdivision 1. Data from providers. (a) By July 1, 2012, the commissioner
36.6shall review currently available quality measures and make recommendations for future
36.7measurement aimed at improving assessment and care related to Alzheimer's disease and
36.8other dementia diagnoses, including improved rates and results of cognitive screening,
36.9rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment
36.10plans.
36.11(b) The commissioner may contract with a private entity to complete the
36.12requirements in this subdivision. If the commissioner contracts with a private entity
36.13already under contract through section 62U.02, then the commissioner may use a sole
36.14source contract and is exempt from competitive procurement processes.
36.15    Subd. 2. Learning collaborative. By July 1, 2012, the commissioner shall
36.16develop a health care home learning collaborative curriculum that includes screening and
36.17education on best practices regarding identification and management of Alzheimer's and
36.18other dementia patients under section 256B.0751, subdivision 5, for providers, clinics,
36.19care coordinators, clinic administrators, patient partners and families, and community
36.20resources including public health.
36.21    Subd. 3. Comparison data. The commissioner, with the commissioner of human
36.22services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly
36.23review existing and forthcoming literature in order to estimate differences in the outcomes
36.24and costs of current practices for caring for those with Alzheimer's disease and other
36.25dementias, compared to the outcomes and costs resulting from:
36.26(1) earlier identification of Alzheimer's and other dementias;
36.27(2) improved support of family caregivers; and
36.28(3) improved collaboration between medical care management and community-based
36.29supports.
36.30    Subd. 4. Reporting. By January 15, 2013, the commissioner must report to the
36.31legislature on progress toward establishment and collection of quality measures required
36.32under this section.

36.33    Sec. 5. Minnesota Statutes 2010, section 103I.101, subdivision 6, is amended to read:
37.1    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable
37.2application fee of $215 $235 to cover the administrative cost of processing a request for a
37.3variance or modification of rules adopted by the commissioner under this chapter.

37.4    Sec. 6. Minnesota Statutes 2010, section 103I.208, subdivision 1, is amended to read:
37.5    Subdivision 1. Well notification fee. The well notification fee to be paid by a
37.6property owner is:
37.7    (1) for a new water supply well, $215 $235, which includes the state core function
37.8fee;
37.9    (2) for a well sealing, $50 $65 for each well, which includes the state core function
37.10fee, except that for monitoring wells constructed on a single property, having depths
37.11within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of
37.12$50 $65; and
37.13    (3) for construction of a dewatering well, $215 $235, which includes the state core
37.14function fee, for each dewatering well except a dewatering project comprising five or
37.15more dewatering wells shall be assessed a single fee of $1,075 $1,175 for the dewatering
37.16wells recorded on the notification.

37.17    Sec. 7. Minnesota Statutes 2010, section 103I.208, subdivision 2, is amended to read:
37.18    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:
37.19    (1) for a water supply well that is not in use under a maintenance permit, $175
37.20annually;
37.21    (2) for construction of a monitoring well, $215 $235, which includes the state
37.22core function fee;
37.23    (3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
37.24    (4) for a monitoring well owned by a federal agency, state agency, or local unit of
37.25government that is unsealed under a maintenance permit, $50 annually. "Local unit of
37.26government" means a statutory or home rule charter city, town, county, or soil and water
37.27conservation district, watershed district, an organization formed for the joint exercise of
37.28powers under section 471.59, a board of health or community health board, or other
37.29special purpose district or authority with local jurisdiction in water and related land
37.30resources management;
37.31(5) for monitoring wells used as a leak detection device at a single motor fuel retail
37.32outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
37.33chemical facility site, the construction permit fee is $215 $235, which includes the state
37.34core function fee, per site regardless of the number of wells constructed on the site, and
38.1the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site
38.2regardless of the number of monitoring wells located on site;
38.3    (6) for a groundwater thermal exchange device, in addition to the notification fee for
38.4water supply wells, $215 $235, which includes the state core function fee;
38.5    (7) for a vertical heat exchanger with less than ten tons of heating/cooling capacity,
38.6$215 $235;
38.7(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity,
38.8$425 $475;
38.9(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling
38.10capacity, $650 $700;
38.11    (10) for a dewatering well that is unsealed under a maintenance permit, $175
38.12annually for each dewatering well, except a dewatering project comprising more than five
38.13dewatering wells shall be issued a single permit for $875 annually for dewatering wells
38.14recorded on the permit; and
38.15    (11) for an elevator boring, $215 $235 for each boring.

38.16    Sec. 8. Minnesota Statutes 2010, section 103I.235, subdivision 1, is amended to read:
38.17    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to
38.18sell or transfer real property, the seller must disclose in writing to the buyer information
38.19about the status and location of all known wells on the property, by delivering to the buyer
38.20either a statement by the seller that the seller does not know of any wells on the property,
38.21or a disclosure statement indicating the legal description and county, and a map drawn
38.22from available information showing the location of each well to the extent practicable.
38.23In the disclosure statement, the seller must indicate, for each well, whether the well is in
38.24use, not in use, or sealed.
38.25    (b) At the time of closing of the sale, the disclosure statement information, name and
38.26mailing address of the buyer, and the quartile, section, township, and range in which each
38.27well is located must be provided on a well disclosure certificate signed by the seller or a
38.28person authorized to act on behalf of the seller.
38.29    (c) A well disclosure certificate need not be provided if the seller does not know
38.30of any wells on the property and the deed or other instrument of conveyance contains
38.31the statement: "The Seller certifies that the Seller does not know of any wells on the
38.32described real property."
38.33    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
38.34required by this subdivision shall be signed by the buyer or a person authorized to act on
38.35behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
39.1certificate is not required if the following statement appears on the deed followed by the
39.2signature of the grantee or, if there is more than one grantee, the signature of at least one
39.3of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
39.4described real property." The statement and signature of the grantee may be on the front
39.5or back of the deed or on an attached sheet and an acknowledgment of the statement by
39.6the grantee is not required for the deed to be recordable.
39.7    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:
39.8    (1) that consists solely of a sale or transfer of severed mineral interests; or
39.9    (2) that consists of an individual condominium unit as described in chapters 515
39.10and 515B.
39.11    (f) For an area owned in common under chapter 515 or 515B the association or other
39.12responsible person must report to the commissioner by July 1, 1992, the location and
39.13status of all wells in the common area. The association or other responsible person must
39.14notify the commissioner within 30 days of any change in the reported status of wells.
39.15    (g) If the seller fails to provide a required well disclosure certificate, the buyer, or
39.16a person authorized to act on behalf of the buyer, may sign a well disclosure certificate
39.17based on the information provided on the disclosure statement required by this section
39.18or based on other available information.
39.19    (h) A county recorder or registrar of titles may not record a deed or other instrument
39.20of conveyance dated after October 31, 1990, for which a certificate of value is required
39.21under section 272.115, or any deed or other instrument of conveyance dated after October
39.2231, 1990, from a governmental body exempt from the payment of state deed tax, unless
39.23the deed or other instrument of conveyance contains the statement made in accordance
39.24with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all
39.25the information required by paragraph (b) or (d). The county recorder or registrar of titles
39.26must not accept a certificate unless it contains all the required information. The county
39.27recorder or registrar of titles shall note on each deed or other instrument of conveyance
39.28accompanied by a well disclosure certificate that the well disclosure certificate was
39.29received. The notation must include the statement "No wells on property" if the disclosure
39.30certificate states there are no wells on the property. The well disclosure certificate shall not
39.31be filed or recorded in the records maintained by the county recorder or registrar of titles.
39.32After noting "No wells on property" on the deed or other instrument of conveyance, the
39.33county recorder or registrar of titles shall destroy or return to the buyer the well disclosure
39.34certificate. The county recorder or registrar of titles shall collect from the buyer or the
39.35person seeking to record a deed or other instrument of conveyance, a fee of $45 $50
39.36for receipt of a completed well disclosure certificate. By the tenth day of each month,
40.1the county recorder or registrar of titles shall transmit the well disclosure certificates
40.2to the commissioner of health. By the tenth day after the end of each calendar quarter,
40.3the county recorder or registrar of titles shall transmit to the commissioner of health
40.4$37.50 $42.50 of the fee for each well disclosure certificate received during the quarter.
40.5The commissioner shall maintain the well disclosure certificate for at least six years. The
40.6commissioner may store the certificate as an electronic image. A copy of that image
40.7shall be as valid as the original.
40.8    (i) No new well disclosure certificate is required under this subdivision if the buyer
40.9or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed
40.10or other instrument of conveyance that the status and number of wells on the property
40.11have not changed since the last previously filed well disclosure certificate. The following
40.12statement, if followed by the signature of the person making the statement, is sufficient
40.13to comply with the certification requirement of this paragraph: "I am familiar with the
40.14property described in this instrument and I certify that the status and number of wells on
40.15the described real property have not changed since the last previously filed well disclosure
40.16certificate." The certification and signature may be on the front or back of the deed or on
40.17an attached sheet and an acknowledgment of the statement is not required for the deed or
40.18other instrument of conveyance to be recordable.
40.19    (j) The commissioner in consultation with county recorders shall prescribe the form
40.20for a well disclosure certificate and provide well disclosure certificate forms to county
40.21recorders and registrars of titles and other interested persons.
40.22    (k) Failure to comply with a requirement of this subdivision does not impair:
40.23    (1) the validity of a deed or other instrument of conveyance as between the parties
40.24to the deed or instrument or as to any other person who otherwise would be bound by
40.25the deed or instrument; or
40.26    (2) the record, as notice, of any deed or other instrument of conveyance accepted for
40.27filing or recording contrary to the provisions of this subdivision.

40.28    Sec. 9. Minnesota Statutes 2010, section 103I.525, subdivision 2, is amended to read:
40.29    Subd. 2. Certification application fee. (a) The application fee for certification
40.30as a representative of a well contractor is $75. The commissioner may not act on an
40.31application until the application fee is paid.
40.32(b) The renewal fee for certification as a representative of a well contractor is $75.
40.33The commissioner may not renew a certification until the renewal fee is paid.

40.34    Sec. 10. Minnesota Statutes 2010, section 103I.531, subdivision 2, is amended to read:
41.1    Subd. 2. Certification application fee. (a) The application fee for certification as a
41.2representative of a limited well/boring contractor is $75. The commissioner may not act
41.3on an application until the application fee is paid.
41.4(b) The renewal fee for certification as a representative of a limited well/boring
41.5contractor is $75. The commissioner may not renew a certification until the renewal
41.6fee is paid.

41.7    Sec. 11. Minnesota Statutes 2010, section 103I.535, subdivision 2, is amended to read:
41.8    Subd. 2. Certification application fee. (a) The application fee for certification as a
41.9representative of an elevator boring contractor is $75. The commissioner may not act on
41.10an application until the application fee is paid.
41.11(b) The renewal fee for certification as a representative of an elevator boring
41.12contractor is $75. The commissioner may not renew a certification until the renewal
41.13fee is paid.

41.14    Sec. 12. Minnesota Statutes 2010, section 103I.541, subdivision 2c, is amended to read:
41.15    Subd. 2c. Certification application fee. (a) The application fee for certification as a
41.16representative of a monitoring well contractor is $75. The commissioner may not act on
41.17an application until the application fee is paid.
41.18(b) The renewal fee for certification as a representative of a monitoring well
41.19contractor is $75. The commissioner may not renew a certification until the renewal
41.20fee is paid.

41.21    Sec. 13. Minnesota Statutes 2010, section 144.1464, subdivision 1, is amended to read:
41.22    Subdivision 1. Summer internships. The commissioner of health, through a
41.23contract with a nonprofit organization as required by subdivision 4, shall award grants,
41.24within available appropriations, to hospitals, clinics, nursing facilities, and home care
41.25providers to establish a secondary and postsecondary summer health care intern program.
41.26The purpose of the program is to expose interested secondary and postsecondary pupils to
41.27various careers within the health care profession.

41.28    Sec. 14. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:
41.29    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
41.30apply.
41.31(b) "Dentist" means an individual who is licensed to practice dentistry.
41.32(c) "Designated rural area" means:
42.1(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin,
42.2Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead,
42.3Rochester, and St. Cloud; or
42.4(2) a municipal corporation, as defined under section 471.634, that is physically
42.5located, in whole or in part, in an area defined as a designated rural area under clause (1).
42.6an area defined as a small rural area or isolated rural area according to the four category
42.7classifications of the Rural Urban Commuting Area system developed for the United
42.8States Health Resources and Services Administration.
42.9(d) "Emergency circumstances" means those conditions that make it impossible for
42.10the participant to fulfill the service commitment, including death, total and permanent
42.11disability, or temporary disability lasting more than two years.
42.12(e) "Medical resident" means an individual participating in a medical residency in
42.13family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
42.14(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
42.15anesthetist, advanced clinical nurse specialist, or physician assistant.
42.16(g) "Nurse" means an individual who has completed training and received all
42.17licensing or certification necessary to perform duties as a licensed practical nurse or
42.18registered nurse.
42.19(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
42.20study designed to prepare registered nurses for advanced practice as nurse-midwives.
42.21(i) "Nurse practitioner" means a registered nurse who has graduated from a program
42.22of study designed to prepare registered nurses for advanced practice as nurse practitioners.
42.23(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
42.24(k) "Physician" means an individual who is licensed to practice medicine in the areas
42.25of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
42.26(l) "Physician assistant" means a person licensed under chapter 147A.
42.27(m) "Qualified educational loan" means a government, commercial, or foundation
42.28loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
42.29expenses related to the graduate or undergraduate education of a health care professional.
42.30(n) "Underserved urban community" means a Minnesota urban area or population
42.31included in the list of designated primary medical care health professional shortage areas
42.32(HPSAs), medically underserved areas (MUAs), or medically underserved populations
42.33(MUPs) maintained and updated by the United States Department of Health and Human
42.34Services.

42.35    Sec. 15. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:
43.1    Subd. 2a. Standards. Notwithstanding the exemptions in subdivisions 8 and 9, the
43.2commissioner shall accredit laboratories according to the most current environmental
43.3laboratory accreditation standards under subdivision 1 and as accepted by the accreditation
43.4bodies recognized by the National Environmental Laboratory Accreditation Program
43.5(NELAP) of the NELAC Institute.

43.6    Sec. 16. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:
43.7    Subd. 7. Initial accreditation and annual accreditation renewal. (a) The
43.8commissioner shall issue or renew accreditation after receipt of the completed application
43.9and documentation required in this section, provided the laboratory maintains compliance
43.10with the standards specified in subdivision 2a, notwithstanding any exemptions under
43.11subdivisions 8 and 9, and attests to the compliance on the application form.
43.12(b) The commissioner shall prorate the fees in subdivision 3 for laboratories
43.13applying for accreditation after December 31. The fees are prorated on a quarterly basis
43.14beginning with the quarter in which the commissioner receives the completed application
43.15from the laboratory.
43.16(c) Applications for renewal of accreditation must be received by November 1 and
43.17no earlier than October 1 of each year. The commissioner shall send annual renewal
43.18notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
43.19not exempt laboratories from meeting the annual November 1 renewal date.
43.20(d) The commissioner shall issue all accreditations for the calendar year for which
43.21the application is made, and the accreditation shall expire on December 31 of that year.
43.22(e) The accreditation of any laboratory that fails to submit a renewal application
43.23and fees to the commissioner expires automatically on December 31 without notice or
43.24further proceeding. Any person who operates a laboratory as accredited after expiration of
43.25accreditation or without having submitted an application and paid the fees is in violation
43.26of the provisions of this section and is subject to enforcement action under sections
43.27144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired
43.28accreditation may reapply under subdivision 6.

43.29    Sec. 17. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
43.30to read:
43.31    Subd. 8. Exemption from national standards for quality control and personnel
43.32requirements. Effective January 1, 2012, a laboratory that analyzes samples for
43.33compliance with a permit issued under section 115.03, subdivision 5, may request
43.34exemption from the personnel requirements and specific quality control provisions for
44.1microbiology and chemistry stated in the national standards as incorporated by reference
44.2in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
44.3(1) complies with the methodology and quality control requirements, where
44.4available, in the most recent, approved edition of the Standard Methods for the
44.5Examination of Water and Wastewater as published by the Water Environment Federation;
44.6and
44.7(2) supplies the name of the person meeting the requirements in section 115.73, or
44.8the personnel requirements in the national standard pursuant to subdivision 2a.
44.9A laboratory applying for this exemption shall not apply for simultaneous
44.10accreditation under the national standard.

44.11    Sec. 18. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
44.12to read:
44.13    Subd. 9. Exemption from national standards for proficiency testing frequency.
44.14(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under
44.15the exemption in subdivision 8 must obtain an acceptable proficiency test result for each
44.16of the laboratory's accredited or requested fields of testing. The laboratory must analyze
44.17proficiency samples selected from one of two annual proficiency testing studies scheduled
44.18by the commissioner.
44.19(b) If a laboratory fails to successfully complete the first scheduled proficiency
44.20study, the laboratory shall:
44.21(1) obtain and analyze a supplemental test sample within 15 days of receiving the
44.22test report for the initial failed attempt; and
44.23(2) participate in the second annual study as scheduled by the commissioner.
44.24(c) If a laboratory does not submit results or fails two consecutive proficiency
44.25samples, the commissioner will revoke the laboratory's accreditation for the affected
44.26fields of testing.
44.27(d) The commissioner may require a laboratory to analyze additional proficiency
44.28testing samples beyond what is required in this subdivision if information available to
44.29the commissioner indicates that the laboratory's analysis for the field of testing does not
44.30meet the requirements for accreditation.
44.31(e) The commissioner may collect from laboratories accredited under the exemption
44.32in subdivision 8 any additional costs required to administer this subdivision and
44.33subdivision 8.

45.1    Sec. 19. Minnesota Statutes 2010, section 144A.102, is amended to read:
45.2144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS;
45.3PENALTIES.
45.4(a) By January 2000, the commissioner of health shall work with providers to
45.5examine state and federal rules and regulations governing the provision of care in licensed
45.6nursing facilities and apply for federal waivers and identify necessary changes in state
45.7law to:
45.8(1) allow the use of civil money penalties imposed upon nursing facilities to abate
45.9any deficiencies identified in a nursing facility's plan of correction; and
45.10(2) stop the accrual of any fine imposed by the Health Department when a follow-up
45.11inspection survey is not conducted by the department within the regulatory deadline.
45.12(b) By January 2012, the commissioner of health shall work with providers and
45.13the ombudsman for long-term care to examine state and federal rules and regulations
45.14governing the provision of care in licensed nursing facilities and apply for federal waivers
45.15and identify necessary changes in state law to:
45.16(1) eliminate the requirement for written plans of correction from nursing homes for
45.17federal deficiencies issued at a scope and severity that is not widespread, harmful, or in
45.18immediate jeopardy; and
45.19(2) issue the federal survey form electronically to nursing homes.
45.20The commissioner shall issue a report to the legislative chairs of the committees
45.21with jurisdiction over health and human services by January 31, 2012, on the status of
45.22implementation of this paragraph.

45.23    Sec. 20. Minnesota Statutes 2010, section 144A.61, is amended by adding a
45.24subdivision to read:
45.25    Subd. 9. Electronic transmission. The commissioner of health must accept
45.26electronic transmission of applications and supporting documentation for interstate
45.27endorsement for the nursing assistant registry.

45.28    Sec. 21. Minnesota Statutes 2010, section 144E.123, is amended to read:
45.29144E.123 PREHOSPITAL CARE DATA.
45.30    Subdivision 1. Collection and maintenance. A licensee shall collect and provide
45.31prehospital care data to the board in a manner prescribed by the board. At a minimum,
45.32the data must include items identified by the board that are part of the National Uniform
45.33Emergency Medical Services Data Set. A licensee shall maintain prehospital care data
45.34for every response.
46.1    Subd. 2. Copy to receiving hospital. If a patient is transported to a hospital, a copy
46.2of the ambulance report delineating prehospital medical care given shall be provided
46.3to the receiving hospital.
46.4    Subd. 3. Review. Prehospital care data may be reviewed by the board or its
46.5designees. The data shall be classified as private data on individuals under chapter 13, the
46.6Minnesota Government Data Practices Act.
46.7    Subd. 4. Penalty. Failure to report all information required by the board under this
46.8section shall constitute grounds for license revocation.
46.9    Subd. 5. Working group. By October 1, 2011, the board must convene a working
46.10group composed of six members, three of which must be appointed by the board and three
46.11of which must be appointed by the Minnesota Ambulance Association, to redesign the
46.12board's policies related to collection of data from licenses. The issues to be considered
46.13include, but are not limited to, the following: user-friendly reporting requirements; data
46.14sets; improved accuracy of reported information; appropriate use of information gathered
46.15through the reporting system; and methods for minimizing the financial impact of data
46.16reporting on licenses, particularly for rural volunteer services. The working group must
46.17report its findings and recommendations to the board no later than July 1, 2012.

46.18    Sec. 22. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:
46.19    Subd. 3. Requirements for programs; process. (a) Community health boards
46.20and tribal governments that receive funding under this section must submit a plan to
46.21the commissioner describing a multidisciplinary approach to targeted home visiting for
46.22families. The plan must be submitted on forms provided by the commissioner. At a
46.23minimum, the plan must include the following:
46.24    (1) a description of outreach strategies to families prenatally or at birth;
46.25    (2) provisions for the seamless delivery of health, safety, and early learning services;
46.26    (3) methods to promote continuity of services when families move within the state;
46.27    (4) a description of the community demographics;
46.28    (5) a plan for meeting outcome measures; and
46.29    (6) a proposed work plan that includes:
46.30    (i) coordination to ensure nonduplication of services for children and families;
46.31    (ii) a description of the strategies to ensure that children and families at greatest risk
46.32receive appropriate services; and
46.33    (iii) collaboration with multidisciplinary partners including public health,
46.34ECFE, Head Start, community health workers, social workers, community home
47.1visiting programs, school districts, and other relevant partners. Letters of intent from
47.2multidisciplinary partners must be submitted with the plan.
47.3    (b) Each program that receives funds must accomplish the following program
47.4requirements:
47.5    (1) use a community-based strategy to provide preventive and early intervention
47.6home visiting services;
47.7    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
47.8home visit must occur prenatally or as soon after birth as possible and must include a
47.9public health nursing assessment by a public health nurse;
47.10    (3) offer, at a minimum, information on infant care, child growth and development,
47.11positive parenting, preventing diseases, preventing exposure to environmental hazards,
47.12and support services available in the community;
47.13    (4) provide information on and referrals to health care services, if needed, including
47.14information on and assistance in applying for health care coverage for which the child or
47.15family may be eligible; and provide information on preventive services, developmental
47.16assessments, and the availability of public assistance programs as appropriate;
47.17    (5) provide youth development programs when appropriate;
47.18    (6) recruit home visitors who will represent, to the extent possible, the races,
47.19cultures, and languages spoken by families that may be served;
47.20    (7) train and supervise home visitors in accordance with the requirements established
47.21under subdivision 4;
47.22    (8) maximize resources and minimize duplication by coordinating or contracting
47.23with local social and human services organizations, education organizations, and other
47.24appropriate governmental entities and community-based organizations and agencies;
47.25    (9) utilize appropriate racial and ethnic approaches to providing home visiting
47.26services; and
47.27    (10) connect eligible families, as needed, to additional resources available in the
47.28community, including, but not limited to, early care and education programs, health or
47.29mental health services, family literacy programs, employment agencies, social services,
47.30and child care resources and referral agencies.
47.31    (c) When available, programs that receive funds under this section must offer or
47.32provide the family with a referral to center-based or group meetings that meet at least
47.33once per month for those families identified with additional needs. The meetings must
47.34focus on further enhancing the information, activities, and skill-building addressed during
47.35home visitation; offering opportunities for parents to meet with and support each other;
48.1and offering infants and toddlers a safe, nurturing, and stimulating environment for
48.2socialization and supervised play with qualified teachers.
48.3    (d) Funds available under this section shall not be used for medical services. The
48.4commissioner shall establish an administrative cost limit for recipients of funds. The
48.5outcome measures established under subdivision 6 must be specified to recipients of
48.6funds at the time the funds are distributed.
48.7    (e) Data collected on individuals served by the home visiting programs must remain
48.8confidential and must not be disclosed by providers of home visiting services without a
48.9specific informed written consent that identifies disclosures to be made. Upon request,
48.10agencies providing home visiting services must provide recipients with information on
48.11disclosures, including the names of entities and individuals receiving the information and
48.12the general purpose of the disclosure. Prospective and current recipients of home visiting
48.13services must be told and informed in writing that written consent for disclosure of data is
48.14not required for access to home visiting services.
48.15(f) Upon initial contact with a family, programs that receive funding under this
48.16section must receive permission from the family to share with other family service
48.17providers information about services the family is receiving and unmet needs of the family
48.18in order to select a lead agency for the family and coordinate available resources. For
48.19purposes of this paragraph, the term "family service providers" includes local public
48.20health, social services, school districts, Head Start programs, health care providers, and
48.21other public agencies.

48.22    Sec. 23. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision
48.23to read:
48.24    Subd. 7a. Limited food establishment. "Limited food establishment" means a food
48.25and beverage service establishment that primarily provides beverages that consist of
48.26combining dry mixes and water or ice for immediate service to the consumer. Limited
48.27food establishments must use equipment and utensils that are nontoxic, durable, and retain
48.28their characteristic qualities under normal use conditions and may request a variance for
48.29plumbing requirements from the commissioner.
48.30EFFECTIVE DATE.This section is effective the day following final enactment
48.31and applies to applications for licensure submitted on or after that date.

48.32    Sec. 24. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision
48.33to read:
49.1    Subd. 5. Variance requests. (a) A person may request a variance from all parts of
49.2Minnesota Rules, chapter 4626, except as provided in paragraph (b) or Minnesota Rules,
49.3chapter 4626. At the time of application for plan review, the person, operator, or submitter
49.4must be notified of the right to request variances.
49.5(b) No variance may be requested or approved for the following parts of Minnesota
49.6Rules, chapter 4626:
49.7(1) Minnesota Rules, part 4626.0020, subpart 35;
49.8(2) Minnesota Rules, parts 4626.0040 to 4626.0060;
49.9(3) Minnesota Rules, parts 4626.0065 to 4626.0100;
49.10(4) Minnesota Rules, parts 4626.0105 to 4626.0120;
49.11(5) Minnesota Rules, part 4626.1565;
49.12(6) Minnesota Rules, parts 4626.1590 and 4626.1595; and
49.13(7) Minnesota Rules, parts 4626.1600 to 4626.1675.

49.14    Sec. 25. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
49.15    Subdivision 1. Tax and use tax on cigarettes. Revenue received from cigarette
49.16taxes, as well as related penalties, interest, license fees, and miscellaneous sources of
49.17revenue shall be deposited by the commissioner in the state treasury and credited as
49.18follows:
49.19(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each
49.20year thereafter must be credited to the Academic Health Center special revenue fund
49.21hereby created and is annually appropriated to the Board of Regents at the University of
49.22Minnesota for Academic Health Center funding at the University of Minnesota; and
49.23(2) $8,553,000 for fiscal year 2006 and $8,550,000 for fiscal year years 2007 and
49.24each year thereafter through fiscal year 2011 and $3,937,000 each year thereafter must be
49.25credited to the medical education and research costs account hereby created in the special
49.26revenue fund and is annually appropriated to the commissioner of health for distribution
49.27under section 62J.692, subdivision 4; and
49.28(3) the balance of the revenues derived from taxes, penalties, and interest (under
49.29this chapter) and from license fees and miscellaneous sources of revenue shall be credited
49.30to the general fund.

49.31    Sec. 26. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
49.32RESPONSIBILITIES.
49.33(a) The commissioner of health, in consultation with the commissioner of human
49.34services, shall evaluate and recommend options for reorganizing health and human
50.1services regulatory responsibilities in both agencies to provide better efficiency and
50.2operational cost savings while maintaining the protection of the health, safety, and welfare
50.3of the public. Regulatory responsibilities that are to be evaluated are those found in
50.4Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B,
50.5149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50,
50.6144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
50.7(b) The evaluation and recommendations shall be submitted in a report to the
50.8legislative committees with jurisdiction over health and human services no later than
50.9February 15, 2012, and shall include, at a minimum, the following:
50.10(1) whether the regulatory responsibilities of each agency should be combined into
50.11a separate agency;
50.12(2) whether the regulatory responsibilities of each agency should be merged into
50.13an existing agency;
50.14(3) what cost savings would result by merging the activities regardless of where
50.15they are located;
50.16(4) what additional costs would result if the activities were merged;
50.17(5) whether there are additional regulatory responsibilities in both agencies that
50.18should be considered in any reorganization; and
50.19(6) for each option recommended, projected cost and a timetable and identification
50.20of the necessary steps and requirements for a successful transition period.

50.21    Sec. 27. MINNESOTA TASK FORCE ON PREMATURITY.
50.22    Subdivision 1. Establishment. The Minnesota Task Force on Prematurity is
50.23established to evaluate and make recommendations on methods for reducing prematurity
50.24and improving premature infant health care in the state.
50.25    Subd. 2. Membership; meetings; staff. (a) The task force shall be composed of at
50.26least the following members, who serve at the pleasure of their appointing authority:
50.27(1) 15 representatives of the Minnesota Prematurity Coalition including, but not
50.28limited to, health care providers who treat pregnant women or neonates, organizations
50.29focused on preterm births, early childhood education and development professionals, and
50.30families affected by prematurity;
50.31(2) one representative appointed by the commissioner of human services;
50.32(3) two representatives appointed by the commissioner of health;
50.33(4) one representative appointed by the commissioner of education;
50.34(5) two members of the house of representatives, one appointed by the speaker of
50.35the house and one appointed by the minority leader; and
51.1(6) two members of the senate, appointed according to the rules of the senate.
51.2(b) Members of the task force serve without compensation or payment of expenses.
51.3(c) The commissioner of health must convene the first meeting of the Minnesota
51.4Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
51.5least quarterly. Staffing and technical assistance shall be provided by the Minnesota
51.6Perinatal Coalition.
51.7    Subd. 3. Duties. The task force must report the current state of prematurity in
51.8Minnesota and develop recommendations on strategies for reducing prematurity and
51.9improving premature infant health care in the state by considering the following:
51.10(1) standards of care for premature infants born less than 37 weeks gestational age,
51.11including recommendations to improve hospital discharge and follow-up care procedures;
51.12(2) coordination of information among appropriate professional and advocacy
51.13organizations on measures to improve health care for infants born prematurely;
51.14(3) identification and centralization of available resources to improve access and
51.15awareness for caregivers of premature infants;
51.16(4) development and dissemination of evidence-based practices through networking
51.17and educational opportunities;
51.18(5) a review of relevant evidence-based research regarding the causes and effects of
51.19premature births in Minnesota;
51.20(6) a review of relevant evidence-based research regarding premature infant health
51.21care, including methods for improving quality of and access to care for premature infants;
51.22(7) a review of the potential improvements in health status related to the use of
51.23health care homes to provide and coordinate pregnancy-related services; and
51.24(8) identification of gaps in public reporting measures and possible effects of these
51.25measures on prematurity rates.
51.26    Subd. 4. Report; expiration. (a) By November 30, 2011, the task force must submit
51.27a report on the current state of prematurity in Minnesota to the chairs of the legislative
51.28policy committees on health and human services.
51.29(b) By January 15, 2013, the task force must report its final recommendations,
51.30including any draft legislation necessary for implementation, to the chairs of the legislative
51.31policy committees on health and human services.
51.32(c) This task force expires on January 31, 2013, or upon submission of the final
51.33report required in paragraph (b), whichever is earlier.

51.34    Sec. 28. NURSING HOME REGULATORY EFFICIENCY.
52.1The commissioner of health must work with long-term care providers, provider
52.2associations, and consumer advocates to clarify for the benefit of providers, survey
52.3teams, and investigators from the office of health facility complaints all of the situations
52.4that providers must report and are required to report to the department under federal
52.5certification regulations and to the common entry point under the Minnesota Vulnerable
52.6Adults Act. The commissioner must produce decision trees, flow sheets, or other
52.7reproducible materials to guide the parties and to reduce the number of unnecessary
52.8reports.

52.9    Sec. 29. REPEALER.
52.10(a) Minnesota Statutes 2010, sections 62J.321, subdivision 5a; 62J.381; 62J.41,
52.11subdivisions 1 and 2; and 144.1499, are repealed.
52.12(b) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,
52.1314, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5;
52.144651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed.

52.15    Sec. 30. EFFECTIVE DATE.
52.16This article is effective the day following final enactment.

52.17ARTICLE 3
52.18MISCELLANEOUS

52.19    Section 1. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to
52.20read:
52.21    Subd. 4. Special family day care homes. Nonresidential child care programs
52.22serving 14 or fewer children that are conducted at a location other than the license holder's
52.23own residence shall be licensed under this section and the rules governing family day
52.24care or group family day care if:
52.25(a) the license holder is the primary provider of care and the nonresidential child
52.26care program is conducted in a dwelling that is located on a residential lot;
52.27(b) the license holder is an employer who may or may not be the primary provider
52.28of care, and the purpose for the child care program is to provide child care services to
52.29children of the license holder's employees;
52.30(c) the license holder is a church or religious organization;
52.31(d) the license holder is a community collaborative child care provider. For
52.32purposes of this subdivision, a community collaborative child care provider is a provider
53.1participating in a cooperative agreement with a community action agency as defined in
53.2section 256E.31; or
53.3(e) the license holder is a not-for-profit agency that provides child care in a dwelling
53.4located on a residential lot and the license holder maintains two or more contracts with
53.5community employers or other community organizations to provide child care services.
53.6The county licensing agency may grant a capacity variance to a license holder licensed
53.7under this paragraph to exceed the licensed capacity of 14 children by no more than five
53.8children during transition periods related to the work schedules of parents, if the license
53.9holder meets the following requirements:
53.10(1) the program does not exceed a capacity of 14 children more than a cumulative
53.11total of four hours per day;
53.12(2) the program meets a one to seven staff-to-child ratio during the variance period;
53.13(3) all employees receive at least an extra four hours of training per year than
53.14required in the rules governing family child care each year;
53.15(4) the facility has square footage required per child under Minnesota Rules, part
53.169502.0425;
53.17(5) the program is in compliance with local zoning regulations;
53.18(6) the program is in compliance with the applicable fire code as follows:
53.19(i) if the program serves more than five children older than 2-1/2 years of age,
53.20but no more than five children 2-1/2 years of age or less, the applicable fire code is
53.21educational occupancy, as provided in Group E Occupancy under the Minnesota State
53.22Fire Code 2003, Section 202; or
53.23(ii) if the program serves more than five children 2-1/2 years of age or less, the
53.24applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire
53.25Code 2003, Section 202; and
53.26(7) any age and capacity limitations required by the fire code inspection and square
53.27footage determinations shall be printed on the license.; or
53.28(f) the license holder is the primary provider of care and has located the licensed
53.29child care program in a commercial space, if the license holder meets the following
53.30requirements:
53.31(1) the program is in compliance with local zoning regulations;
53.32(2) the program is in compliance with the applicable fire code as follows:
53.33(i) if the program serves more than five children older than 2-1/2 years of age,
53.34but no more than five children 2-1/2 years of age or less, the applicable fire code is
53.35educational occupancy, as provided in Group E Occupancy under the Minnesota State
53.36Fire Code 2003, Section 202; or
54.1(ii) if the program serves more than five children 2-1/2 years of age or less, the
54.2applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire
54.3Code 2003, Section 202;
54.4(3) any age and capacity limitations required by the fire code inspection and square
54.5footage determinations are printed on the license; and
54.6(4) the license holder prominently displays the license issued by the commissioner
54.7which contains the statement "This special family child care provider is not licensed as a
54.8child care center."

54.9    Sec. 2. Minnesota Statutes 2010, section 245C.03, is amended by adding a subdivision
54.10to read:
54.11    Subd. 7. Children's therapeutic services and supports providers. The
54.12commissioner shall conduct background studies according to this chapter when initiated
54.13by a children's therapeutic services and supports provider under section 256B.0943.

54.14    Sec. 3. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
54.15to read:
54.16    Subd. 8. Children's therapeutic services and supports providers. The
54.17commissioner shall recover the cost of background studies required under section
54.18245C.03, subdivision 7, for the purposes of children's therapeutic services and supports
54.19under section 256B.0943, through a fee of no more than $20 per study charged to
54.20the license holder. The fees collected under this subdivision are appropriated to the
54.21commissioner for the purpose of conducting background studies.

54.22    Sec. 4. Minnesota Statutes 2010, section 256B.0943, is amended by adding a
54.23subdivision to read:
54.24    Subd. 5a. Background studies. The requirements for background studies under
54.25this section may be met by a children's therapeutic services and supports services agency
54.26through the commissioner's NETStudy system as provided under sections 245C.03,
54.27subdivision 7, and 245C.10, subdivision 8.

54.28    Sec. 5. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision
54.29to read:
54.30    Subd. 3a. Spousal contribution. (a) For purposes of this subdivision, the following
54.31terms have the meanings given:
54.32(1) "commissioner" means the commissioner of human services;
55.1(2) "community spouse" means the spouse, who lives in the community, of an
55.2individual receiving long-term care services in a long-term care facility or home care
55.3services pursuant to the Medicaid waiver for elderly services under section 256B.0915
55.4or the alternative care program under section 256B.0913. A community spouse does not
55.5include a spouse living in the community who receives a monthly income allowance under
55.6section 256B.058, subdivision 2, or who receives home and community-based services
55.7under section 256B.0915, 256B.092, or 256B.49, or the alternative care program under
55.8section 256B.0913;
55.9(3) "cost of care" means the actual fee-for-service costs or capitated payments for
55.10the long-term care spouse;
55.11(4) "department" means the Department of Human Services;
55.12(5) "disabled child" means a blind or permanently and totally disabled son or
55.13daughter of any age based on the Social Security Administration disability standards;
55.14(6) "income" means earned and unearned income, attributable to the community
55.15spouse, used to calculate the adjusted gross income on the prior year's income tax return.
55.16Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
55.17(7) "long-term care spouse" means the spouse who is receiving long-term care
55.18services in a long-term care facility or home and community based services pursuant
55.19to the Medicaid waiver for elderly services under section 256B.0915 or the alternative
55.20care program under section 256B.0913.
55.21(b) The community spouse of a long-term care spouse who receives medical
55.22assistance or alternative care services has an obligation to contribute to the cost of care.
55.23The community spouse must pay a monthly fee on a sliding fee scale based on the
55.24community spouse's income. If a minor or disabled child resides with and receives care
55.25from the community spouse, then no fee shall be assessed.
55.26(c) For a community spouse with an income equal to or greater than 250 percent of
55.27the federal poverty guidelines for a family of two and less than 545 percent of the federal
55.28poverty guidelines for a family of two, the spousal contribution shall be determined using
55.29a sliding fee scale established by the commissioner that begins at 7.5 percent of the
55.30community spouse's income and increases to 15 percent for those with an income of up to
55.31545 percent of the federal poverty guidelines for a family of two.
55.32(d) For a community spouse with an income equal to or greater than 545 percent of
55.33the federal poverty guidelines for a family of two and less than 750 percent of the federal
55.34poverty guidelines for a family of two, the spousal contribution shall be determined using
55.35a sliding fee scale established by the commissioner that begins at 15 percent of the
56.1community spouse's income and increases to 25 percent for those with an income of up to
56.2750 percent of the federal poverty guidelines for a family of two.
56.3(e) For a community spouse with an income equal to or greater than 750 percent of
56.4the federal poverty guidelines for a family of two and less than 975 percent of the federal
56.5poverty guidelines for a family of two, the spousal contribution shall be determined using
56.6a sliding fee scale established by the commissioner that begins at 25 percent of the
56.7community spouse's income and increases to 33 percent for those with an income of up to
56.8975 percent of the federal poverty guidelines for a family of two.
56.9(f) For a community spouse with an income equal to or greater than 975 percent of
56.10the federal poverty guidelines for a family of two, the spousal contribution shall be 33
56.11percent of the community spouse's income.
56.12(g) The spousal contribution shall be explained in writing at the time eligibility
56.13for medical assistance or alternative care is being determined. In addition to explaining
56.14the formula used to determine the fee, the county or tribal agency shall provide written
56.15information describing how to request a variance for undue hardship, how a contribution
56.16may be reviewed or redetermined, the right to appeal a contribution determination, and
56.17that the consequences for not complying with a request to provide information shall be
56.18an assessment against the community spouse for the full cost of care for the long-term
56.19care spouse.
56.20(h) The contribution shall be assessed for each month the long-term care spouse
56.21has a community spouse and is eligible for medical assistance payment of long-term
56.22care services or alternative care.
56.23(i) The spousal contribution shall be reviewed at least once every 12 months and
56.24when there is a loss or gain in income in excess of ten percent. Thirty days prior to a
56.25review or redetermination, written notice must be provided to the community spouse
56.26and must contain the amount the spouse is required to contribute, notice of the right to
56.27redetermination and appeal, and the telephone number of the division at the agency that is
56.28responsible for redetermination and review. If, after review, the contribution amount is to
56.29be adjusted, the county or tribal agency shall mail a written notice to the community spouse
56.3030 days in advance of the effective date of the change in the amount of the contribution.
56.31(1) The spouse shall notify the county or tribal agency within 30 days of a gain or
56.32loss in income in excess of ten percent and provide the agency supporting documentation
56.33to verify the need for redetermination of the fee.
56.34(2) When a spouse requests a review or redetermination of the contribution amount,
56.35a request for information shall be sent to the spouse within ten calendar days after the
56.36county or tribal agency receives the request for review.
57.1(3) No action shall be taken on a review or redetermination until the required
57.2information is received by the county or tribal agency.
57.3(4) The review of the spousal contribution shall be completed within ten days after
57.4the county or tribal agency receives completed information that verifies a loss or gain in
57.5income in excess of ten percent.
57.6(5) An increase in the contribution amount is effective in the month in which the
57.7increase in income occurs.
57.8(6) A decrease in the contribution amount is effective in the month the spouse
57.9verifies the reduction in income, retroactive to no longer than six months.
57.10(j) In no case shall the spousal contribution exceed the amount of medical assistance
57.11expended or the cost of alternative care services for the care of the long-term care spouse.
57.12Annually, upon redetermination, or at termination of eligibility, the total amount of
57.13medical assistance paid or costs of alternative care for the care of the long-term care spouse
57.14and the total amount of the spousal contribution shall be compared. If the total amount
57.15of the spousal contribution exceeds the total amount of medical assistance expended or
57.16cost of alternative care, then the agency shall reimburse the community spouse the excess
57.17amount if the long-term care spouse is no longer receiving services, or apply the excess
57.18amount to the spousal contribution due until the excess amount is exhausted.
57.19(k) A community spouse may request a variance by submitting a written request
57.20and supporting documentation that payment of the calculated contribution would cause
57.21an undue hardship. An undue hardship is defined as the inability to pay the calculated
57.22contribution due to medical expenses incurred by the community spouse. Documentation
57.23must include proof of medical expenses incurred by the community spouse since the last
57.24annual redetermination of the contribution amount that are not reimbursable by any public
57.25or private source, and are a type, regardless of amount, that would be allowable as a
57.26federal tax deduction under the Internal Revenue Code.
57.27(1) A spouse who requests a variance from a notice of an increase in the amount
57.28of spousal contribution shall continue to make monthly payments at the lower amount
57.29pending determination of the variance request. A spouse who requests a variance from
57.30the initial determination shall not be required to make a payment pending determination
57.31of the variance request. Payments made pending outcome of the variance request that
57.32result in overpayment must be returned to the spouse, if the long-term care spouse is no
57.33longer receiving services, or applied to the spousal contribution in the current year. If the
57.34variance is denied, the spouse shall pay the additional amount due from the effective date
57.35of the increase or the total amount due from the effective date of the original notice of
57.36determination of the spousal contribution.
58.1(2) A spouse who is granted a variance shall sign a written agreement in which the
58.2spouse agrees to report to the county or tribal agency any changes in circumstances that
58.3gave rise to the undue hardship variance.
58.4(3) When the county or tribal agency receives a request for a variance, written notice
58.5of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days
58.6after the county or tribal agency receives the financial information required in this clause.
58.7The granting of a variance will necessitate a written agreement between the spouse and the
58.8county or tribal agency with regard to the specific terms of the variance. The variance
58.9will not become effective until the written agreement is signed by the spouse. If the
58.10county or tribal agency denies in whole or in part the request for a variance, the denial
58.11notice shall set forth in writing the reasons for the denial that address the specific hardship
58.12and right to appeal.
58.13(4) If a variance is granted, the term of the variance shall not exceed 12 months
58.14unless otherwise determined by the county or tribal agency.
58.15(5) Undue hardship does not include action taken by a spouse which divested or
58.16diverted income in order to avoid being assessed a spousal contribution.
58.17(l) A spouse aggrieved by an action under this subdivision has the right to appeal
58.18under subdivision 4. If the spouse appeals on or before the effective date of an increase
58.19in the spousal fee, the spouse shall continue to make payments to the county or tribal
58.20agency in the lower amount while the appeal is pending. A spouse appealing an initial
58.21determination of a spousal contribution shall not be required to make monthly payments
58.22pending an appeal decision. Payments made that result in an overpayment shall be
58.23reimbursed to the spouse if the long-term care spouse is no longer receiving services, or
58.24applied to the spousal contribution remaining in the current year. If the county or tribal
58.25agency's determination is affirmed, the community spouse shall pay within 90 calendar
58.26days of the order the total amount due from the effective date of the original notice of
58.27determination of the spousal contribution. The commissioner's order is binding on the
58.28spouse and the agency and shall be implemented subject to section 256.045, subdivision 7.
58.29No additional notice is required to enforce the commissioner's order.
58.30(m) If the county or tribal agency finds that notice of the payment obligation was
58.31given to the community spouse and the spouse was determined to be able to pay, but that
58.32the spouse failed or refused to pay, a cause of action exists against the community spouse
58.33for that portion of medical assistance payment of long-term care services or alternative
58.34care services granted after notice was given to the community spouse. The action may be
58.35brought by the county or tribal agency in the county where assistance was granted for the
58.36assistance together with the costs of disbursements incurred due to the action. In addition
59.1to granting the county or tribal agency a money judgment, the court may, upon a motion or
59.2order to show cause, order continuing contributions by a community spouse found able to
59.3repay the county or tribal agency. The order shall be effective only for the period of time
59.4during which a contribution shall be assessed.
59.5    (n) Counties and tribes are entitled to one-half of the nonfederal share of
59.6contributions made under this section for long-term care spouses on medical assistance
59.7that are directly attributed to county or tribal efforts. Counties and tribes are entitled to
59.825 percent of the contributions made under this section for long-term care spouses on
59.9alternative care directly attributed to county or tribal efforts.
59.10EFFECTIVE DATE.This section is effective July 1, 2012.

59.11    Sec. 6. NONEMERGENCY MEDICAL TRANSPORTATION SINGLE
59.12ADMINISTRATIVE STRUCTURE PROPOSAL.
59.13(a) The commissioner of human services shall develop a proposal to create a single
59.14administrative structure for providing nonemergency medical transportation services to
59.15fee-for-service medical assistance recipients. This proposal must consolidate access and
59.16special transportation into one administrative structure with the goal of standardizing
59.17eligibility determination processes, scheduling arrangements, billing procedures, data
59.18collection, and oversight mechanisms in order to enhance coordination, improve
59.19accountability, and lessen confusion.
59.20(b) In developing the proposal, the commissioner shall:
59.21(1) examine the current responsibilities performed by the counties and the
59.22Department of Human Services and consider the shift in costs if these responsibilities are
59.23changed;
59.24(2) identify key performance measures to assess the cost effectiveness of
59.25nonemergency medical transportation statewide, including a process to collect, audit,
59.26and report data;
59.27(3) develop a statewide complaint system for medical assistance recipients using
59.28special transportation;
59.29(4) establish a standardized billing process;
59.30(5) establish a process that provides public input from interested parties before
59.31special transportation eligibility policies are implemented or significantly changed;
59.32(6) establish specific eligibility criteria that include the frequency of eligibility
59.33assessments and the length of time a recipient remains eligible for special transportation;
59.34(7) develop a reimbursement method to compensate volunteers for no-load miles
59.35when transporting recipients to or from health-related appointments; and
60.1(8) establish specific eligibility criteria to maximize the use of public transportation
60.2by recipients who are without a physical, mental, or other impairment that would prohibit
60.3safely accessing and using public transportation.
60.4(c) In developing the proposal, the commissioner shall consult with the
60.5nonemergency medical transportation advisory council established under paragraph (d).
60.6(d) The commissioner shall establish the nonemergency medical transportation
60.7advisory council to assist the commissioner in developing a single administrative structure
60.8for providing nonemergency medical transportation services. The council shall include,
60.9but not be limited to:
60.10(1) one representative each from the Departments of Human Services and
60.11Transportation;
60.12(2) one representative each from the following organizations: the Minnesota State
60.13Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC
60.14of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County
60.15Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit
60.16Association, legal aid, the Minnesota Ambulance Association, the National Alliance on
60.17Mental Illness, Medical Transportation Management, and other transportation providers;
60.18and
60.19(3) four members from the house of representatives, two from the majority party
60.20and two from the minority party, appointed by the speaker, and four members from the
60.21senate, two from the majority party and two from the minority party, appointed by the
60.22Subcommittee on Committees of the Committee on Rules and Administration.
60.23The council is governed by Minnesota Statutes, section 15.509, except that members
60.24shall not receive per diems. The commissioner of human services shall fund all costs
60.25related to the council from existing resources.
60.26(e) The commissioner shall submit the proposal and draft legislation necessary for
60.27implementation to the chairs and ranking minority members of the senate and house of
60.28representatives committees or divisions with jurisdiction over health care policy and
60.29finance by January 15, 2012.

60.30ARTICLE 4
60.31DEPARTMENT OF HUMAN SERVICES LICENSING

60.32    Section 1. Minnesota Statutes 2010, section 245A.10, subdivision 1, is amended to
60.33read:
61.1    Subdivision 1. Application or license fee required, programs exempt from fee.
61.2(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
61.3of applications and inspection of programs which are licensed under this chapter.
61.4(b) Except as provided under subdivision 2, no application or license fee shall be
61.5charged for child foster care, adult foster care, or family and group family child care or
61.6state-operated programs, unless the state-operated program is an intermediate care facility
61.7for persons with developmental disabilities (ICF/MR).

61.8    Sec. 2. Minnesota Statutes 2010, section 245A.10, subdivision 3, is amended to read:
61.9    Subd. 3. Application fee for initial license or certification. (a) For fees required
61.10under subdivision 1, an applicant for an initial license or certification issued by the
61.11commissioner shall submit a $500 application fee with each new application required
61.12under this subdivision. The application fee shall not be prorated, is nonrefundable, and
61.13is in lieu of the annual license or certification fee that expires on December 31. The
61.14commissioner shall not process an application until the application fee is paid.
61.15(b) Except as provided in clauses (1) to (3) (4), an applicant shall apply for a license
61.16to provide services at a specific location.
61.17(1) For a license to provide residential-based habilitation services to persons with
61.18developmental disabilities under chapter 245B, an applicant shall submit an application
61.19for each county in which the services will be provided. Upon licensure, the license
61.20holder may provide services to persons in that county plus no more than three persons
61.21at any one time in each of up to ten additional counties. A license holder in one county
61.22may not provide services under the home and community-based waiver for persons with
61.23developmental disabilities to more than three people in a second county without holding
61.24a separate license for that second county. Applicants or licensees providing services
61.25under this clause to not more than three persons remain subject to the inspection fees
61.26established in section 245A.10, subdivision 2, for each location. The license issued by
61.27the commissioner must state the name of each additional county where services are being
61.28provided to persons with developmental disabilities. A license holder must notify the
61.29commissioner before making any changes that would alter the license information listed
61.30under section 245A.04, subdivision 7, paragraph (a), including any additional counties
61.31where persons with developmental disabilities are being served.
61.32(2) For a license to provide supported employment, crisis respite, or
61.33semi-independent living services to persons with developmental disabilities under chapter
61.34245B, an applicant shall submit a single application to provide services statewide.
62.1(3) For a license to provide independent living assistance for youth under section
62.2245A.22 , an applicant shall submit a single application to provide services statewide.
62.3(4) For a license for a private agency to provide foster care or adoption services
62.4under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
62.5application to provide services statewide.

62.6    Sec. 3. Minnesota Statutes 2010, section 245A.10, subdivision 4, is amended to read:
62.7    Subd. 4. License or certification fee for certain programs. (a) Child care centers
62.8and programs with a licensed capacity shall pay an annual nonrefundable license or
62.9certification fee based on the following schedule:
62.10
62.11
Licensed Capacity
Child Care Center
License Fee
Other Program
License Fee
62.12
1 to 24 persons
$225$200
$400
62.13
25 to 49 persons
$340$300
$600
62.14
50 to 74 persons
$450$400
$800
62.15
75 to 99 persons
$565$500
$1,000
62.16
100 to 124 persons
$675$600
$1,200
62.17
125 to 149 persons
$900$700
$1,400
62.18
150 to 174 persons
$1,050$800
$1,600
62.19
175 to 199 persons
$1,200$900
$1,800
62.20
62.21
200 to 224 persons
$1,350
$1,000
$2,000
62.22
62.23
225 or more persons
$1,500
$1,100
$2,500
62.24    (b) A day training and habilitation program serving persons with developmental
62.25disabilities or related conditions shall be assessed a pay an annual nonrefundable license
62.26fee based on the following schedule in paragraph (a) unless the license holder serves more
62.27than 50 percent of the same persons at two or more locations in the community.:
62.28
Licensed Capacity
License Fee
62.29
1 to 24 persons
$800
62.30
25 to 49 persons
$1,000
62.31
50 to 74 persons
$1,200
62.32
75 to 99 persons
$1,400
62.33
100 to 124 persons
$1,600
62.34
125 to 149 persons
$1,800
62.35
150 or more persons
$2,000
62.36Except as provided in paragraph (c), when a day training and habilitation program
62.37serves more than 50 percent of the same persons in two or more locations in a community,
62.38the day training and habilitation program shall pay a license fee based on the licensed
63.1capacity of the largest facility and the other facility or facilities shall be charged a license
63.2fee based on a licensed capacity of a residential program serving one to 24 persons.
63.3    (c) When a day training and habilitation program serving persons with developmental
63.4disabilities or related conditions seeks a single license allowed under section 245B.07,
63.5subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
63.6capacity for each location.
63.7(d) A program licensed to provide supported employment services to persons
63.8with developmental disabilities under chapter 245B shall pay an annual nonrefundable
63.9license fee of $650.
63.10(e) A program licensed to provide crisis respite services to persons with
63.11developmental disabilities under chapter 245B shall pay an annual nonrefundable license
63.12fee of $700.
63.13(f) A program licensed to provide semi-independent living services to persons
63.14with developmental disabilities under chapter 245B shall pay an annual nonrefundable
63.15license fee of $700.
63.16(g) A program licensed to provide residential-based habilitation services under the
63.17home and community-based waiver for persons with developmental disabilities shall pay
63.18an annual license fee that includes a base rate of $690 plus $60 times the number of clients
63.19served on the first day of July of the current license year.
63.20(h) A residential program certified by the Department of Health as an intermediate
63.21care facility for persons with developmental disabilities (ICF/MR) and a noncertified
63.22residential program licensed to provide health or rehabilitative services for persons
63.23with developmental disabilities shall pay an annual nonrefundable license fee based on
63.24the following schedule:
63.25
Licensed Capacity
License Fee
63.26
1 to 24 persons
$535
63.27
25 to 49 persons
$735
63.28
50 or more persons
$935
63.29(i) A chemical dependency treatment program licensed under Minnesota Rules, parts
63.309530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual
63.31nonrefundable license fee based on the following schedule:
63.32
Licensed Capacity
License Fee
63.33
1 to 24 persons
$600
63.34
25 to 49 persons
$800
63.35
50 to 74 persons
$1,000
63.36
75 to 99 persons
$1,200
63.37
100 or more persons
$1,400
64.1(j) A chemical dependency program licensed under Minnesota Rules, parts
64.29530.6510 to 9530.6590, to provide detoxification services shall pay an annual
64.3nonrefundable license fee based on the following schedule:
64.4
Licensed Capacity
License Fee
64.5
1 to 24 persons
$760
64.6
25 to 49 persons
$960
64.7
50 or more persons
$1,160
64.8(k) Except for child foster care, a residential facility licensed under Minnesota
64.9Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
64.10based on the following schedule:
64.11
Licensed Capacity
License Fee
64.12
1 to 24 persons
$1,000
64.13
25 to 49 persons
$1,100
64.14
50 to 74 persons
$1,200
64.15
75 to 99 persons
$1,300
64.16
100 or more persons
$1,400
64.17(l) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
64.189520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
64.19fee based on the following schedule:
64.20
Licensed Capacity
License Fee
64.21
1 to 24 persons
$2,525
64.22
25 or more persons
$2,725
64.23(m) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
64.249570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
64.25license fee based on the following schedule:
64.26
Licensed Capacity
License Fee
64.27
1 to 24 persons
$450
64.28
25 to 49 persons
$650
64.29
50 to 74 persons
$850
64.30
75 to 99 persons
$1,050
64.31
100 or more persons
$1,250
64.32(n) A program licensed to provide independent living assistance for youth under
64.33section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
64.34(o) A private agency licensed to provide foster care and adoption services under
64.35Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
64.36license fee of $875.
65.1(p) A program licensed as an adult day care center licensed under Minnesota Rules,
65.2parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on
65.3the following schedule:
65.4
Licensed Capacity
License Fee
65.5
1 to 24 persons
$500
65.6
25 to 49 persons
$700
65.7
50 to 74 persons
$900
65.8
75 to 99 persons
$1,100
65.9
100 or more persons
$1,300
65.10(q) A program licensed to provide treatment services to persons with sexual
65.11psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
65.129515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
65.13(r) A mental health center or mental health clinic requesting certification for
65.14purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
65.15parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
65.16mental health center or mental health clinic provides services at a primary location with
65.17satellite facilities, the satellite facilities shall be certified with the primary location without
65.18an additional charge.

65.19    Sec. 4. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision
65.20to read:
65.21    Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding
65.22section 16A.1285, subdivision 2, related to activities for which the commissioner charges
65.23a fee, the commissioner must plan to fully recover direct expenditures for licensing
65.24activities under this chapter over a five-year period. The commissioner may have
65.25anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
65.26revenues accumulated in previous bienniums.

65.27    Sec. 5. Minnesota Statutes 2010, section 245A.10, is amended by adding a subdivision
65.28to read:
65.29    Subd. 8. Deposit of license fees. A human services licensing account is created in
65.30the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
65.31be deposited in the human services licensing account and are annually appropriated to the
65.32commissioner for licensing activities authorized under this chapter.

65.33    Sec. 6. Minnesota Statutes 2010, section 245A.11, subdivision 2b, is amended to read:
66.1    Subd. 2b. Adult foster care; family adult day services. An adult foster care
66.2license holder licensed under the conditions in subdivision 2a may also provide family
66.3adult day care for adults age 55 age 18 or over if no persons in the adult foster or family
66.4adult day services program have a serious and persistent mental illness or a developmental
66.5disability. Family adult day services provided in a licensed adult foster care setting must
66.6be provided as specified under section 245A.143. Authorization to provide family adult
66.7day services in the adult foster care setting shall be printed on the license certificate by
66.8the commissioner. Adult foster care homes licensed under this section and family adult
66.9day services licensed under section 245A.143 shall not be subject to licensure by the
66.10commissioner of health under the provisions of chapter 144, 144A, 157, or any other
66.11law requiring facility licensure by the commissioner of health. A separate license is not
66.12required to provide family adult day services in a licensed adult foster care home.

66.13    Sec. 7. Minnesota Statutes 2010, section 245A.143, subdivision 1, is amended to read:
66.14    Subdivision 1. Scope. (a) The licensing standards in this section must be met to
66.15obtain and maintain a license to provide family adult day services. For the purposes of this
66.16section, family adult day services means a program operating fewer than 24 hours per day
66.17that provides functionally impaired adults, none of which are under age 55, have serious
66.18or persistent mental illness, or have developmental disabilities, age 18 or older with an
66.19individualized and coordinated set of services including health services, social services,
66.20and nutritional services that are directed at maintaining or improving the participants'
66.21capabilities for self-care.
66.22(b) A family adult day services license shall only be issued when the services are
66.23provided in the license holder's primary residence, and the license holder is the primary
66.24provider of care. The license holder may not serve more than eight adults at one time,
66.25including residents, if any, served under a license issued under Minnesota Rules, parts
66.269555.5105 to 9555.6265.
66.27(c) An adult foster care license holder may provide family adult day services under
66.28the license holder's adult foster care license if the license holder meets the requirements
66.29of this section.
66.30(d) When an applicant or license holder submits an application for initial licensure
66.31or relicensure for both adult foster care and family adult day services, the county agency
66.32shall process the request as a single application and shall conduct concurrent routine
66.33licensing inspections.
66.34(e) Adult foster care license holders providing family adult day services under their
66.35foster care license on March 30, 2004, shall be permitted to continue providing these
67.1services with no additional requirements until their adult foster care license is due for
67.2renewal. At the time of relicensure, an adult foster care license holder may continue to
67.3provide family adult day services upon demonstration of compliance with this section.
67.4Adult foster care license holders who provide only family adult day services on August 1,
67.52004, may apply for a license under this section instead of an adult foster care license.

67.6    Sec. 8. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
67.7to read:
67.8    Subd. 9. Human services licensed programs. The commissioner shall recover
67.9the cost of background studies required under section 245C.03, subdivision 1, for all
67.10programs that are licensed by the commissioner, except child foster care and family child
67.11care, through a fee of no more than $20 per study charged to the license holder. The fees
67.12collected under this subdivision are appropriated to the commissioner for the purpose of
67.13conducting background studies.

67.14    Sec. 9. Minnesota Statutes 2010, section 256B.49, subdivision 16a, is amended to read:
67.15    Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
67.16seek federal approval for medical assistance reimbursement of independent living skills
67.17services, foster care waiver service, supported employment, prevocational service, and
67.18structured day service under the home and community-based waiver for persons with a
67.19traumatic brain injury, the community alternatives for disabled individuals waivers, and
67.20the community alternative care waivers.
67.21    (b) Medical reimbursement shall be made only when the provider demonstrates
67.22evidence of its capacity to meet basic health, safety, and protection standards through
67.23the following methods:
67.24(1) for independent living skills services, supported employment, prevocational
67.25service, and structured day service through one of the methods in paragraphs (c) and
67.26(d); and
67.27(2) for foster care waiver services through the method in paragraph (e).
67.28    (c) The provider is licensed to provide services under chapter 245B and agrees
67.29to apply these standards to services funded through the traumatic brain injury,
67.30community alternatives for disabled persons, or community alternative care home and
67.31community-based waivers.
67.32    (d) The commissioner shall certify that the provider has policies and procedures
67.33governing the following:
67.34    (1) protection of the consumer's rights and privacy;
68.1    (2) risk assessment and planning;
68.2    (3) record keeping and reporting of incidents and emergencies with documentation
68.3of corrective action if needed;
68.4    (4) service outcomes, regular reviews of progress, and periodic reports;
68.5    (5) complaint and grievance procedures;
68.6    (6) service termination or suspension;
68.7    (7) necessary training and supervision of direct care staff that includes:
68.8    (i) documentation in personnel files of 20 hours of orientation training in providing
68.9training related to service provision;
68.10    (ii) training in recognizing the symptoms and effects of certain disabilities, health
68.11conditions, and positive behavioral supports and interventions;
68.12    (iii) a minimum of five hours of related training annually; and
68.13    (iv) when applicable:
68.14    (A) safe medication administration;
68.15    (B) proper handling of consumer funds; and
68.16    (C) compliance with prohibitions and standards developed by the commissioner to
68.17satisfy federal requirements regarding the use of restraints and restrictive interventions.
68.18The commissioner shall review at least biennially that each service provider's policies
68.19and procedures governing basic health, safety, and protection of rights continue to meet
68.20minimum standards.
68.21    (e) The commissioner shall seek federal approval for Medicaid reimbursement
68.22of foster care services under the home and community-based waiver for persons with
68.23a traumatic brain injury, the community alternatives for disabled individuals waiver,
68.24and community alternative care waiver when the provider demonstrates evidence of
68.25its capacity to meet basic health, safety, and protection standards. The commissioner
68.26shall verify that the adult foster care provider is licensed under Minnesota Rules, parts
68.279555.5105 to 9555.6265; that the child foster care provider is licensed as a family foster
68.28care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340, and
68.29certify that the provider has policies and procedures that govern:
68.30    (1) compliance with prohibitions and standards developed by the commissioner to
68.31meet federal requirements regarding the use of restraints and restrictive interventions;
68.32    (2) documentation of service needs and outcomes, regular reviews of progress,
68.33and periodic reports; and
68.34(3) safe medication management and administration.
69.1The commissioner shall review at least biennially that each service provider's policies and
69.2procedures governing basic health, safety, and protection of rights standards continue to
69.3meet minimum standards.
69.4(f) The commissioner shall seek federal waiver approval for Medicaid reimbursement
69.5of family adult day services under all disability waivers. After the waiver is granted, the
69.6commissioner shall include family adult day services in the common services menu that
69.7is currently under development.
69.8EFFECTIVE DATE.This section is effective the day following final enactment.

69.9    Sec. 10. REPEALER.
69.10Minnesota Statutes 2010, section 245A.10, subdivision 5, is repealed.

69.11ARTICLE 5
69.12HEALTH-RELATED LICENSING

69.13    Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:
69.14    Subdivision 1. Renewal fees. All persons practicing chiropractic within this state,
69.15or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the
69.16Board of Chiropractic Examiners a renewal fee set by the board in accordance with section
69.1716A.1283, with a penalty set by the board for each month or portion thereof for which a
69.18license fee is in arrears and upon payment of the renewal and upon compliance with all the
69.19rules of the board, shall be entitled to renewal of their license.

69.20    Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision
69.21to read:
69.22    Subd. 4. Animal chiropractic. (a) Animal chiropractic registration fee is $125.
69.23(b) Animal chiropractic registration renewal fee is $75.
69.24(c) Animal chiropractic inactive renewal fee is $25.

69.25    Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
69.26    Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise
69.27rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
69.28provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula
69.29and standards for schools and courses preparing persons for licensure under sections
69.30148.171 to 148.285. It shall conduct or provide for surveys of such schools and courses
69.31at such times as it may deem necessary. It shall approve such schools and courses as
70.1meet the requirements of sections 148.171 to 148.285 and board rules. It shall examine,
70.2license, and renew the license of duly qualified applicants. It shall hold examinations
70.3at least once in each year at such time and place as it may determine. It shall by rule
70.4adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for
70.5registration and renewal of registration as defined in section 148.231. It shall maintain a
70.6record of all persons licensed by the board to practice professional or practical nursing and
70.7all registered nurses who hold Minnesota licensure and registration and are certified as
70.8advanced practice registered nurses. It shall cause the prosecution of all persons violating
70.9sections 148.171 to 148.285 and have power to incur such necessary expense therefor.
70.10It shall register public health nurses who meet educational and other requirements
70.11established by the board by rule, including payment of a fee. Prior to the adoption of rules,
70.12the board shall use the same procedures used by the Department of Health to certify public
70.13health nurses. It shall have power to issue subpoenas, and to compel the attendance of
70.14witnesses and the production of all necessary documents and other evidentiary material.
70.15Any board member may administer oaths to witnesses, or take their affirmation. It shall
70.16keep a record of all its proceedings.
70.17(b) The board shall have access to hospital, nursing home, and other medical records
70.18of a patient cared for by a nurse under review. If the board does not have a written consent
70.19from a patient permitting access to the patient's records, the nurse or facility shall delete
70.20any data in the record that identifies the patient before providing it to the board. The board
70.21shall have access to such other records as reasonably requested by the board to assist the
70.22board in its investigation. Nothing herein may be construed to allow access to any records
70.23protected by section 145.64. The board shall maintain any records obtained pursuant to
70.24this paragraph as investigative data under chapter 13.
70.25(c) The board may accept and expend grants or gifts of money or in-kind services
70.26from a person, a public or private entity, or any other source for purposes consistent with
70.27the board's role and within the scope of its statutory authority.
70.28(d) The board may accept registration fees for meetings and conferences conducted
70.29for the purposes of board activities that are within the scope of its authority.

70.30    Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
70.31    Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration
70.32fee and permit fee, and in accordance with rules of the board, the board may issue
70.33a nonrenewable temporary permit to practice professional or practical nursing to an
70.34applicant for licensure or reregistration who is not the subject of a pending investigation
71.1or disciplinary action, nor disqualified for any other reason, under the following
71.2circumstances:
71.3(a) The applicant for licensure by examination under section 148.211, subdivision
71.41
, has graduated from an approved nursing program within the 60 days preceding board
71.5receipt of an affidavit of graduation or transcript and has been authorized by the board to
71.6write the licensure examination for the first time in the United States. The permit holder
71.7must practice professional or practical nursing under the direct supervision of a registered
71.8nurse. The permit is valid from the date of issue until the date the board takes action on
71.9the application or for 60 days whichever occurs first.
71.10(b) The applicant for licensure by endorsement under section 148.211, subdivision 2,
71.11is currently licensed to practice professional or practical nursing in another state, territory,
71.12or Canadian province. The permit is valid from submission of a proper request until the
71.13date of board action on the application or for 60 days, whichever comes first.
71.14(c) (b) The applicant for licensure by endorsement under section 148.211,
71.15subdivision 2
, or for reregistration under section 148.231, subdivision 5, is currently
71.16registered in a formal, structured refresher course or its equivalent for nurses that includes
71.17clinical practice.
71.18(d) The applicant for licensure by examination under section 148.211, subdivision
71.191
, who graduated from a nursing program in a country other than the United States or
71.20Canada has completed all requirements for licensure except registering for and taking the
71.21nurse licensure examination for the first time in the United States. The permit holder must
71.22practice professional nursing under the direct supervision of a registered nurse. The permit
71.23is valid from the date of issue until the date the board takes action on the application or for
71.2460 days, whichever occurs first.

71.25    Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:
71.26148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION;
71.27VERIFICATION.
71.28    Subdivision 1. Registration. Every person licensed to practice professional or
71.29practical nursing must maintain with the board a current registration for practice as a
71.30registered nurse or licensed practical nurse which must be renewed at regular intervals
71.31established by the board by rule. No certificate of registration shall be issued by the board
71.32to a nurse until the nurse has submitted satisfactory evidence of compliance with the
71.33procedures and minimum requirements established by the board.
71.34The fee for periodic registration for practice as a nurse shall be determined by the
71.35board by rule law. A penalty fee shall be added for any application received after the
72.1required date as specified by the board by rule. Upon receipt of the application and the
72.2required fees, the board shall verify the application and the evidence of completion of
72.3continuing education requirements in effect, and thereupon issue to the nurse a certificate
72.4of registration for the next renewal period.
72.5    Subd. 4. Failure to register. Any person licensed under the provisions of sections
72.6148.171 to 148.285 who fails to register within the required period shall not be entitled to
72.7practice nursing in this state as a registered nurse or licensed practical nurse.
72.8    Subd. 5. Reregistration. A person whose registration has lapsed desiring to
72.9resume practice shall make application for reregistration, submit satisfactory evidence of
72.10compliance with the procedures and requirements established by the board, and pay the
72.11registration reregistration fee for the current period to the board. A penalty fee shall be
72.12required from a person who practiced nursing without current registration. Thereupon, the
72.13registration certificate shall be issued to the person who shall immediately be placed on
72.14the practicing list as a registered nurse or licensed practical nurse.
72.15    Subd. 6. Verification. A person licensed under the provisions of sections 148.171 to
72.16148.285 who requests the board to verify a Minnesota license to another state, territory,
72.17or country or to an agency, facility, school, or institution shall pay a fee to the board
72.18for each verification.

72.19    Sec. 6. [148.242] FEES.
72.20The fees specified in section 148.243 are nonrefundable and must be deposited in
72.21the state government special revenue fund.

72.22    Sec. 7. [148.243] FEE AMOUNTS.
72.23    Subdivision 1. Licensure by examination. The fee for licensure by examination is
72.24$105.
72.25    Subd. 2. Reexamination fee. The reexamination fee is $60.
72.26    Subd. 3. Licensure by endorsement. The fee for licensure by endorsement is $105.
72.27    Subd. 4. Registration renewal. The fee for registration renewal is $85.
72.28    Subd. 5. Reregistration. The fee for reregistration is $105.
72.29    Subd. 6. Replacement license. The fee for a replacement license is $20.
72.30    Subd. 7. Public health nurse certification. The fee for public health nurse
72.31certification is $30.
72.32    Subd. 8. Drug Enforcement Administration verification for Advanced Practice
72.33Registered Nurse (APRN). The Drug Enforcement Administration verification for
72.34APRN is $50.
73.1    Subd. 9. Licensure verification other than through Nursys. The fee for
73.2verification of licensure status other than through Nursys verification is $20.
73.3    Subd. 10. Verification of examination scores. The fee for verification of
73.4examination scores is $20.
73.5    Subd. 11. Microfilmed licensure application materials. The fee for a copy of
73.6microfilmed licensure application materials is $20.
73.7    Subd. 12. Nursing business registration; initial application. The fee for the initial
73.8application for nursing business registration is $100.
73.9    Subd. 13. Nursing business registration; annual application. The fee for the
73.10annual application for nursing business registration is $25.
73.11    Subd. 14. Practicing without current registration. The fee for practicing without
73.12current registration is two times the amount of the current registration renewal fee for any
73.13part of the first calendar month, plus the current registration renewal fee for any part of
73.14any subsequent month up to 24 months.
73.15    Subd. 15. Practicing without current APRN certification. The fee for practicing
73.16without current APRN certification is $200 for the first month or any part thereof, plus
73.17$100 for each subsequent month or part thereof.
73.18    Subd. 16. Dishonored check fee. The service fee for a dishonored check is as
73.19provided in section 604.113.
73.20    Subd. 17. Border state registry fee. The initial application fee for border state
73.21registration is $50. Any subsequent notice of employment change to remain or be
73.22reinstated on the registry is $50.

73.23    Sec. 8. Minnesota Statutes 2010, section 148B.17, is amended to read:
73.24148B.17 FEES.
73.25    Subdivision. 1. Fees; Board of Marriage and Family Therapy. Each board shall
73.26by rule establish The board's fees, including late fees, for licenses and renewals are
73.27established so that the total fees collected by the board will as closely as possible equal
73.28anticipated expenditures during the fiscal biennium, as provided in section 16A.1285.
73.29Fees must be credited to accounts the board's account in the state government special
73.30revenue fund.
73.31    Subd. 2. Licensure and application fees. Nonrefundable licensure and application
73.32fees charged by the board are as follows:
73.33(1) application fee for national examination is $220;
73.34(2) application fee for Licensed Marriage and Family Therapist (LMFT) state
73.35examination is $110;
74.1(3) initial LMFT license fee is prorated, but cannot exceed $125;
74.2(4) annual renewal fee for LMFT license is $125;
74.3(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
74.4license renewal is $50;
74.5(6) application fee for LMFT licensure by reciprocity is $340;
74.6(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
74.7license is $75;
74.8(8) annual renewal fee for LAMFT license is $75;
74.9(9) late fee for LAMFT renewal is $50;
74.10(10) fee for reinstatement of license is $150; and
74.11(11) fee for emeritus status is $125.
74.12    Subd. 3. Other fees. Other fees charged by the board are as follows:
74.13(1) sponsor application fee for approval of a continuing education course is $60;
74.14(2) fee for license verification by mail is $10;
74.15(3) duplicate license fee is $25;
74.16(4) duplicate renewal card fee is $10;
74.17(5) fee for licensee mailing list is $60;
74.18(6) fee for a rule book is $10; and
74.19(7) fees as authorized by section 148B.175, subdivision 6, clause (7).

74.20    Sec. 9. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:
74.21    Subd. 2. Fee. Each applicant shall pay a nonrefundable application fee set by
74.22the board under section 148B.17.

74.23    Sec. 10. Minnesota Statutes 2010, section 148B.52, is amended to read:
74.24148B.52 DUTIES OF THE BOARD.
74.25(a) The Board of Behavioral Health and Therapy shall:
74.26(1) establish by rule appropriate techniques, including examinations and other
74.27methods, for determining whether applicants and licensees are qualified under sections
74.28148B.50 to 148B.593;
74.29(2) establish by rule standards for professional conduct, including adoption of a
74.30Code of Professional Ethics and requirements for continuing education and supervision;
74.31(3) issue licenses to individuals qualified under sections 148B.50 to 148B.593;
74.32(4) establish by rule standards for initial education including coursework for
74.33licensure and content of professional education;
75.1(5) establish, maintain, and publish annually a register of current licensees and
75.2approved supervisors;
75.3(6) establish initial and renewal application and examination fees sufficient to cover
75.4operating expenses of the board and its agents in accordance with section 16A.1283;
75.5(7) educate the public about the existence and content of the laws and rules for
75.6licensed professional counselors to enable consumers to file complaints against licensees
75.7who may have violated the rules; and
75.8(8) periodically evaluate its rules in order to refine the standards for licensing
75.9professional counselors and to improve the methods used to enforce the board's standards.
75.10(b) The board may appoint a professional discipline committee for each occupational
75.11licensure regulated by the board, and may appoint a board member as chair. The
75.12professional discipline committee shall consist of five members representative of the
75.13licensed occupation and shall provide recommendations to the board with regard to rule
75.14techniques, standards, procedures, and related issues specific to the licensed occupation.

75.15    Sec. 11. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:
75.16    Subd. 2. Application fees. Each applicant shall submit with a license, advanced
75.17dental therapist certificate, or permit application a nonrefundable fee in the following
75.18amounts in order to administratively process an application:
75.19(1) dentist, $140;
75.20(2) full faculty dentist, $140;
75.21(2) (3) limited faculty dentist, $140;
75.22(3) (4) resident dentist or dental provider, $55;
75.23(5) advanced dental therapist, $100;
75.24(4) (6) dental therapist, $100;
75.25(5) (7) dental hygienist, $55;
75.26(6) (8) licensed dental assistant, $55; and
75.27(7) (9) dental assistant with a permit as described in Minnesota Rules, part
75.283100.8500, subpart 3, $15.

75.29    Sec. 12. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:
75.30    Subd. 3. Initial license or permit fees. Along with the application fee, each of the
75.31following applicants shall submit a separate prorated initial license or permit fee. The
75.32prorated initial fee shall be established by the board based on the number of months of the
75.33applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to
75.34exceed the following monthly fee amounts:
76.1(1) dentist or full faculty dentist, $14 times the number of months of the initial term;
76.2(2) dental therapist, $10 times the number of months of the initial term;
76.3(3) dental hygienist, $5 times the number of months of the initial term;
76.4(4) licensed dental assistant, $3 times the number of months of the initial term; and
76.5(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
76.6subpart 3, $1 times the number of months of the initial term.

76.7    Sec. 13. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:
76.8    Subd. 4. Annual license fees. Each limited faculty or resident dentist shall submit
76.9with an annual license renewal application a fee established by the board not to exceed
76.10the following amounts:
76.11(1) limited faculty dentist, $168; and
76.12(2) resident dentist or dental provider, $59.

76.13    Sec. 14. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:
76.14    Subd. 5. Biennial license or permit fees. Each of the following applicants shall
76.15submit with a biennial license or permit renewal application a fee as established by the
76.16board, not to exceed the following amounts:
76.17(1) dentist or full faculty dentist, $336;
76.18(2) dental therapist, $180;
76.19(3) dental hygienist, $118;
76.20(4) licensed dental assistant, $80; and
76.21(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
76.22subpart 3, $24.

76.23    Sec. 15. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:
76.24    Subd. 8. Duplicate license or certificate fee. Each applicant shall submit, with
76.25a request for issuance of a duplicate of the original license, or of an annual or biennial
76.26renewal certificate for a license or permit, a fee in the following amounts:
76.27(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental
76.28assistant license, $35; and
76.29(2) annual or biennial renewal certificates, $10.

76.30    Sec. 16. Minnesota Statutes 2010, section 150A.091, is amended by adding a
76.31subdivision to read:
77.1    Subd. 16. Failure of professional development portfolio audit. A licensee shall
77.2submit a fee as established by the board not to exceed the amount of $250 after failing
77.3two consecutive professional development portfolio audits and, thereafter, for each failed
77.4professional development portfolio audit under Minnesota Rules, part 3100.5300.

77.5    Sec. 17. [151.065] FEE AMOUNTS.
77.6    Subdivision 1. Application fees. Application fees for licensure and registration
77.7are as follows:
77.8(1) pharmacist licensed by examination, $130;
77.9(2) pharmacist licensed by reciprocity, $225;
77.10(3) pharmacy intern, $30;
77.11(4) pharmacy technician, $30;
77.12(5) pharmacy, $190;
77.13(6) drug wholesaler, legend drugs only, $200;
77.14(7) drug wholesaler, legend and nonlegend drugs, $200;
77.15(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
77.16(9) drug wholesaler, medical gases, $150;
77.17(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
77.18(11) drug manufacturer, legend drugs only, $200;
77.19(12) drug manufacturer, legend and nonlegend drugs, $200;
77.20(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
77.21(14) drug manufacturer, medical gases, $150;
77.22(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
77.23(16) medical gas distributor, $75;
77.24(17) controlled substance researcher, $50; and
77.25(18) pharmacy professional corporation, $100.
77.26    Subd. 2. Original license fee. The pharmacist original licensure fee, $130.
77.27    Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees
77.28are as follows:
77.29(1) pharmacist, $130;
77.30(2) pharmacy technician, $30;
77.31(3) pharmacy, $190;
77.32(4) drug wholesaler, legend drugs only, $200;
77.33(5) drug wholesaler, legend and nonlegend drugs, $200;
77.34(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
77.35(7) drug wholesaler, medical gases, $150;
78.1(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
78.2(9) drug manufacturer, legend drugs only, $200;
78.3(10) drug manufacturer, legend and nonlegend drugs, $200;
78.4(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;
78.5(12) drug manufacturer, medical gases, $150;
78.6(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
78.7(14) medical gas distributor, $75;
78.8(15) controlled substance researcher, $50; and
78.9(16) pharmacy professional corporation, $45.
78.10    Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses
78.11and certificates are as follows:
78.12(1) intern affidavit, $15;
78.13(2) duplicate small license, $15; and
78.14(3) duplicate large certificate, $25.
78.15    Subd. 5. Late fees. All annual renewal fees are subject to a 50 percent late fee if
78.16the renewal fee and application are not received by the board prior to the date specified
78.17by the board.
78.18    Subd. 6. Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's
78.19license to lapse may reinstate the license with board approval and upon payment of any
78.20fees and late fees in arrears, up to a maximum of $1,000.
78.21(b) A pharmacy technician who has allowed the technician's registration to lapse
78.22may reinstate the registration with board approval and upon payment of any fees and late
78.23fees in arrears, up to a maximum of $90.
78.24(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical
78.25gas distributor who has allowed the license of the establishment to lapse may reinstate the
78.26license with board approval and upon payment of any fees and late fees in arrears.
78.27(d) A controlled substance researcher who has allowed the researcher's registration
78.28to lapse may reinstate the registration with board approval and upon payment of any fees
78.29and late fees in arrears.
78.30(e) A pharmacist owner of a professional corporation who has allowed the
78.31corporation's registration to lapse may reinstate the registration with board approval and
78.32upon payment of any fees and late fees in arrears.

78.33    Sec. 18. Minnesota Statutes 2010, section 151.07, is amended to read:
78.34151.07 MEETINGS; EXAMINATION FEE.
79.1The board shall meet at times as may be necessary and as it may determine to
79.2examine applicants for licensure and to transact its other business, giving reasonable
79.3notice of all examinations by mail to known applicants therefor. The secretary shall record
79.4the names of all persons licensed by the board, together with the grounds upon which
79.5the right of each to licensure was claimed. The fee for examination shall be in such the
79.6 amount as the board may determine specified in section 151.065, which fee may in the
79.7discretion of the board be returned to applicants not taking the examination.

79.8    Sec. 19. Minnesota Statutes 2010, section 151.101, is amended to read:
79.9151.101 INTERNSHIP.
79.10Upon payment of the fee specified in section 151.065, the board may license register
79.11as an intern any natural persons who have satisfied the board that they are of good moral
79.12character, not physically or mentally unfit, and who have successfully completed the
79.13educational requirements for intern licensure registration prescribed by the board. The
79.14board shall prescribe standards and requirements for interns, pharmacist-preceptors, and
79.15internship training but may not require more than one year of such training.
79.16The board in its discretion may accept internship experience obtained in another
79.17state provided the internship requirements in such other state are in the opinion of the
79.18board equivalent to those herein provided.

79.19    Sec. 20. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision
79.20to read:
79.21    Subd. 3. Registration fee. The board shall not register an individual as a pharmacy
79.22technician unless all applicable fees specified in section 151.065 have been paid.

79.23    Sec. 21. Minnesota Statutes 2010, section 151.12, is amended to read:
79.24151.12 RECIPROCITY; LICENSURE.
79.25The board may in its discretion grant licensure without examination to any
79.26pharmacist licensed by the Board of Pharmacy or a similar board of another state which
79.27accords similar recognition to licensees of this state; provided, the requirements for
79.28licensure in such other state are in the opinion of the board equivalent to those herein
79.29provided. The fee for licensure shall be in such the amount as the board may determine by
79.30rule specified in section 151.065.

79.31    Sec. 22. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
80.1    Subdivision 1. Renewal fee. Every person licensed by the board as a pharmacist
80.2shall pay to the board a the annual renewal fee to be fixed by it specified in section
80.3151.065. The board may promulgate by rule a charge to be assessed for the delinquent
80.4payment of a fee. the late fee specified in section 151.065 if the renewal fee and
80.5application are not received by the board prior to the date specified by the board. It shall
80.6be unlawful for any person licensed as a pharmacist who refuses or fails to pay such any
80.7applicable renewal or late fee to practice pharmacy in this state. Every certificate and
80.8license shall expire at the time therein prescribed.

80.9    Sec. 23. Minnesota Statutes 2010, section 151.19, is amended to read:
80.10151.19 REGISTRATION; FEES.
80.11    Subdivision 1. Pharmacy registration. The board shall require and provide for the
80.12annual registration of every pharmacy now or hereafter doing business within this state.
80.13Upon the payment of a any applicable fee to be set by the board specified in section
80.14151.065, the board shall issue a registration certificate in such form as it may prescribe to
80.15such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be
80.16displayed in a conspicuous place in the pharmacy for which it is issued and expire on the
80.1730th day of June following the date of issue. It shall be unlawful for any person to conduct
80.18a pharmacy unless such certificate has been issued to the person by the board.
80.19    Subd. 2. Nonresident pharmacies. The board shall require and provide for an
80.20annual nonresident special pharmacy registration for all pharmacies located outside of this
80.21state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
80.22prescription medications into this state. Nonresident special pharmacy registration shall
80.23be granted by the board upon payment of any applicable fee specified in section 151.065
80.24and the disclosure and certification by a pharmacy:
80.25    (1) that it is licensed in the state in which the dispensing facility is located and from
80.26which the drugs are dispensed;
80.27    (2) the location, names, and titles of all principal corporate officers and all
80.28pharmacists who are dispensing drugs to residents of this state;
80.29    (3) that it complies with all lawful directions and requests for information from
80.30the Board of Pharmacy of all states in which it is licensed or registered, except that it
80.31shall respond directly to all communications from the board concerning emergency
80.32circumstances arising from the dispensing of drugs to residents of this state;
80.33    (4) that it maintains its records of drugs dispensed to residents of this state so that the
80.34records are readily retrievable from the records of other drugs dispensed;
81.1    (5) that it cooperates with the board in providing information to the Board of
81.2Pharmacy of the state in which it is licensed concerning matters related to the dispensing
81.3of drugs to residents of this state;
81.4    (6) that during its regular hours of operation, but not less than six days per week, for
81.5a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
81.6communication between patients in this state and a pharmacist at the pharmacy who has
81.7access to the patients' records; the toll-free number must be disclosed on the label affixed
81.8to each container of drugs dispensed to residents of this state; and
81.9    (7) that, upon request of a resident of a long-term care facility located within the
81.10state of Minnesota, the resident's authorized representative, or a contract pharmacy or
81.11licensed health care facility acting on behalf of the resident, the pharmacy will dispense
81.12medications prescribed for the resident in unit-dose packaging or, alternatively, comply
81.13with the provisions of section 151.415, subdivision 5.
81.14    Subd. 3. Sale of federally restricted medical gases. The board shall require and
81.15provide for the annual registration of every person or establishment not licensed as a
81.16pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
81.17medical gases. Upon the payment of a any applicable fee to be set by the board specified
81.18in section 151.065, the board shall issue a registration certificate in such form as it may
81.19prescribe to those persons or places that may be qualified to sell or distribute federally
81.20restricted medical gases. The certificate shall be displayed in a conspicuous place in the
81.21business for which it is issued and expire on the date set by the board. It is unlawful for
81.22a person to sell or distribute federally restricted medical gases unless a certificate has
81.23been issued to that person by the board.

81.24    Sec. 24. Minnesota Statutes 2010, section 151.25, is amended to read:
81.25151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
81.26The board shall require and provide for the annual registration of every person
81.27engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes,
81.28now or hereafter doing business with accounts in this state. Upon a payment of a any
81.29applicable fee as set by the board specified in section 151.065, the board shall issue a
81.30registration certificate in such form as it may prescribe to such manufacturer. Such
81.31registration certificate shall be displayed in a conspicuous place in such manufacturer's
81.32or wholesaler's place of business for which it is issued and expire on the date set by the
81.33board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals,
81.34or poisons for medicinal purposes unless such a certificate has been issued to the person
81.35by the board. It shall be unlawful for any person engaged in the manufacture of drugs,
82.1medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell
82.2legend drugs to other than a pharmacy, except as provided in this chapter.

82.3    Sec. 25. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
82.4    Subdivision 1. Requirements. All wholesale drug distributors are subject to the
82.5requirements in paragraphs (a) to (f).
82.6(a) No person or distribution outlet shall act as a wholesale drug distributor without
82.7first obtaining a license from the board and paying the required any applicable fee
82.8specified in section 151.065.
82.9(b) No license shall be issued or renewed for a wholesale drug distributor to operate
82.10unless the applicant agrees to operate in a manner prescribed by federal and state law and
82.11according to the rules adopted by the board.
82.12(c) The board may require a separate license for each facility directly or indirectly
82.13owned or operated by the same business entity within the state, or for a parent entity
82.14with divisions, subsidiaries, or affiliate companies within the state, when operations
82.15are conducted at more than one location and joint ownership and control exists among
82.16all the entities.
82.17(d) As a condition for receiving and retaining a wholesale drug distributor license
82.18issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
82.19and will continuously maintain:
82.20(1) adequate storage conditions and facilities;
82.21(2) minimum liability and other insurance as may be required under any applicable
82.22federal or state law;
82.23(3) a viable security system that includes an after hours central alarm, or comparable
82.24entry detection capability; restricted access to the premises; comprehensive employment
82.25applicant screening; and safeguards against all forms of employee theft;
82.26(4) a system of records describing all wholesale drug distributor activities set forth
82.27in section 151.44 for at least the most recent two-year period, which shall be reasonably
82.28accessible as defined by board regulations in any inspection authorized by the board;
82.29(5) principals and persons, including officers, directors, primary shareholders,
82.30and key management executives, who must at all times demonstrate and maintain their
82.31capability of conducting business in conformity with sound financial practices as well
82.32as state and federal law;
82.33(6) complete, updated information, to be provided to the board as a condition for
82.34obtaining and retaining a license, about each wholesale drug distributor to be licensed,
83.1including all pertinent corporate licensee information, if applicable, or other ownership,
83.2principal, key personnel, and facilities information found to be necessary by the board;
83.3(7) written policies and procedures that assure reasonable wholesale drug distributor
83.4preparation for, protection against, and handling of any facility security or operation
83.5problems, including, but not limited to, those caused by natural disaster or government
83.6emergency, inventory inaccuracies or product shipping and receiving, outdated product
83.7or other unauthorized product control, appropriate disposition of returned goods, and
83.8product recalls;
83.9(8) sufficient inspection procedures for all incoming and outgoing product
83.10shipments; and
83.11(9) operations in compliance with all federal requirements applicable to wholesale
83.12drug distribution.
83.13(e) An agent or employee of any licensed wholesale drug distributor need not seek
83.14licensure under this section.
83.15(f) A wholesale drug distributor shall file with the board an annual report, in a
83.16form and on the date prescribed by the board, identifying all payments, honoraria,
83.17reimbursement or other compensation authorized under section 151.461, clauses (3) to
83.18(5), paid to practitioners in Minnesota during the preceding calendar year. The report
83.19shall identify the nature and value of any payments totaling $100 or more, to a particular
83.20practitioner during the year, and shall identify the practitioner. Reports filed under this
83.21provision are public data.

83.22    Sec. 26. Minnesota Statutes 2010, section 151.48, is amended to read:
83.23151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
83.24(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business
83.25in the state without first obtaining a license from the board and paying the required any
83.26applicable fee specified in section 151.065.
83.27(b) Application for an out-of-state wholesale drug distributor license under this
83.28section shall be made on a form furnished by the board.
83.29(c) No person acting as principal or agent for any out-of-state wholesale drug
83.30distributor may sell or distribute drugs in the state unless the distributor has obtained
83.31a license.
83.32(d) The board may adopt regulations that permit out-of-state wholesale drug
83.33distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state
83.34wholesale drug distributor:
84.1(1) possesses a valid license granted by another state under legal standards
84.2comparable to those that must be met by a wholesale drug distributor of this state as
84.3prerequisites for obtaining a license under the laws of this state; and
84.4(2) can show that the other state would extend reciprocal treatment under its own
84.5laws to a wholesale drug distributor of this state.

84.6    Sec. 27. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
84.7    Subd. 3. Research project use of controlled substances. Any qualified person
84.8may use controlled substances in the course of a bona fide research project but cannot
84.9administer or dispense such drugs to human beings unless such drugs are prescribed,
84.10dispensed and administered by a person lawfully authorized to do so. Every person
84.11who engages in research involving the use of such substances shall apply annually for
84.12registration by the state Board of Pharmacy and shall pay any applicable fee specified in
84.13section 151.065, provided that such registration shall not be required if the person is
84.14covered by and has complied with federal laws covering such research projects.

84.15    Sec. 28. [214.107] HEALTH-RELATED LICENSING BOARDS
84.16ADMINISTRATIVE SERVICES UNIT.
84.17    Subdivision 1. Establishment. An administrative services unit is established
84.18for the health-related licensing boards in section 214.01, subdivision 2, to perform
84.19administrative, financial, and management functions common to all the boards in a manner
84.20that streamlines services, reduces expenditures, targets the use of state resources, and
84.21meets the mission of public protection.
84.22    Subd. 2. Authority. The administrative services unit shall act as an agent of the
84.23boards.
84.24    Subd. 3. Funding. (a) The administrative service unit shall apportion among the
84.25health-related licensing boards an amount to be allocated to each health-related licensing
84.26board. The amount apportioned to each board shall equal each board's share of the annual
84.27operating costs for the unit and shall be deposited into the state government special
84.28revenue fund.
84.29(b) The administrative services unit may receive and expend reimbursements for
84.30services performed for other agencies.

84.31    Sec. 29. REGISTRATION AND LICENSE RENEWALS; HEALTH-RELATED
84.32LICENSING BOARDS.
85.1For licenses and registrations due to be renewed between July 1, 2011, and the day
85.2following final enactment of this section, no health-related licensing board, as defined
85.3in Minnesota Statutes, section 214.01, subdivision 2, shall assess a late fee or initiate
85.4disciplinary action against a licensee or registrant for failure to timely renew a valid
85.5license or registration if the renewal application is submitted to the proper licensing
85.6board by July 31, 2011.

85.7    Sec. 30. EFFECTIVE DATE.
85.8This article is effective the day following final enactment.

85.9ARTICLE 6
85.10HEALTH CARE

85.11    Section 1. Minnesota Statutes 2010, section 13.461, subdivision 24a, is amended to
85.12read:
85.13    Subd. 24a. Managed care plans. Data provided to the commissioner of human
85.14services by managed care plans relating to contracts and provider payment rates are
85.15classified under section 256B.69, subdivisions 9a and 9b 9c.

85.16    Sec. 2. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision
85.17to read:
85.18    Subd. 4g. Waiver of preexisting conditions for persons covered by healthy
85.19Minnesota contribution program. A person may enroll in the comprehensive plan with
85.20a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
85.21the healthy Minnesota contribution program, and has been denied coverage as described
85.22under section 256L.031, subdivision 6.
85.23EFFECTIVE DATE.This section is effective July 1, 2012.

85.24    Sec. 3. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:
85.25    Subd. 9. Growth limits; federal programs. The commissioners of health and
85.26human services shall establish a rate methodology for Medicare and Medicaid risk-based
85.27contracting with health plan companies that is consistent with statewide growth limits.
85.28The methodology shall be presented for review by the Minnesota Health Care Commission
85.29and the Legislative Commission on Health Care Access prior to the submission of a
85.30waiver request to the Centers for Medicare and Medicaid Services and subsequent
85.31implementation of the methodology.

86.1    Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
86.2to read:
86.3    Subd. 7. Authority to administer Minnesota electronic health record incentives
86.4program. The commissioner of human services shall administer an electronic health
86.5record incentives program according to section 4201 of the American Recovery and
86.6Reinvestment Act, Public Law 111-5 and Code of Federal Regulations, title 42, part 495.

86.7    Sec. 5. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
86.8to read:
86.9    Subd. 8. Definitions. For purposes of subdivisions 7 to 11, the following terms
86.10have the meanings given.
86.11(a) "Certified electronic health record technology" has the same meaning as defined
86.12in Code of Federal Regulations, title 42, part 495.4.
86.13(b) "Commissioner" means the commissioner of the Department of Human Services.
86.14(c) "National Level Repository" or "NLR" has the same meaning as defined in Code
86.15of Federal Regulations, title 42, part 495.
86.16(d) "SMHP" means the state Medicaid health information technology plan.
86.17(e) "MEIP" means the Minnesota electronic health record incentive program in
86.18this section.
86.19(f) "Pediatrician" means a physician who is certified by either the American Board
86.20of Pediatrics or the American Osteopathic Board of Pediatrics.

86.21    Sec. 6. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
86.22to read:
86.23    Subd. 9. Registration, application, and payment processing. (a) Eligible
86.24providers and eligible hospitals must successfully complete the NLR registration process
86.25defined by the Centers for Medicare and Medicaid Services before applying for the
86.26Minnesota electronic health record incentives program.
86.27(b) The commissioner shall collect any improper payments made under the
86.28Minnesota electronic health record incentives program.
86.29(c) Eligible providers and eligible hospitals enrolled in the Minnesota electronic
86.30health record incentives program must retain all records supporting eligibility for a
86.31minimum of six years.
86.32(d) The commissioner shall determine the allowable methodology options to be used
86.33by eligible providers and eligible hospitals for purposes of attesting to and calculating
86.34their Medicaid patient volume per Code of Federal Regulations, title 42, part 495.306.
87.1(e) Minnesota electronic health record incentives program payments must be
87.2processed and paid to the tax identification number designated by the eligible provider
87.3or eligible hospital.
87.4(f) The payment mechanism for Minnesota electronic health record incentives
87.5program payments must be determined by the commissioner.
87.6(g) The commissioner shall determine the 12-month period selected by the state as
87.7referenced in Code of Federal Regulation, title 42, part 495.310(g)(1)(i)(B).

87.8    Sec. 7. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
87.9to read:
87.10    Subd. 10. Audits. The commissioner is authorized to audit an eligible provider or
87.11eligible hospital that applies for an incentive payment through the Minnesota electronic
87.12health record incentives program, both before and after payment determination. The
87.13commissioner is authorized to use state and federal laws, regulations, and circulars to
87.14develop the department's audit criteria.

87.15    Sec. 8. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
87.16to read:
87.17    Subd. 11. Provider appeals. An eligible provider or eligible hospital who has
87.18received notification of an adverse action related to the Minnesota electronic health record
87.19incentives program may appeal the action pursuant to subdivision 8.

87.20    Sec. 9. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
87.21to read:
87.22    Subd. 12. MEIP appeals. An eligible provider or eligible hospital who has received
87.23notice of an appealable issue related to the Minnesota electronic health record incentives
87.24program may appeal the action in accordance with procedures in this section.

87.25    Sec. 10. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
87.26to read:
87.27    Subd. 13. Definitions. For purposes of subdivisions 12 to 15, the following terms
87.28have the meanings given.
87.29(a) "Provider" means an eligible provider or eligible hospital for purposes of the
87.30Minnesota electronic health record incentives program.
87.31(b) "Appealable issue" means one or more of the following issues related to the
87.32Minnesota electronic health record incentives program:
88.1(1) incentive payments;
88.2(2) incentive payment amounts;
88.3(3) provider eligibility determination; or
88.4(4) demonstration of adopting, implementing, and upgrading, and meaningful use
88.5eligibility for incentives.

88.6    Sec. 11. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
88.7to read:
88.8    Subd. 14. Filing an appeal. To appeal, the provider shall file with the commissioner
88.9a written notice of appeal. The appeal must be postmarked or received by the
88.10commissioner within 30 days of the date of issuance specified in the notice of action
88.11regarding the appealable issue. The notice of appeal must specify:
88.12(1) the appealable issues;
88.13(2) each disputed item;
88.14(3) the reason for the dispute;
88.15(4) the total dollar amount in dispute;
88.16(5) the computation that the provider believes is correct;
88.17(6) the authority relied upon for each disputed item;
88.18(7) the name and address of the person or firm with whom contacts may be made
88.19regarding the appeal; and
88.20(8) other information required by the commissioner.

88.21    Sec. 12. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
88.22to read:
88.23    Subd. 15. Appeals review process. (a) Upon receipt of an appeal notice
88.24satisfying subdivision 14, the commissioner shall review the appeal and issue a written
88.25appeal determination on each appealed item with 90 days. Upon mutual agreement, the
88.26commissioner and the provider may extend the time for issuing a determination for a
88.27specified period. The commissioner shall notify the provider by first class mail of the
88.28appeal determination. The appeal determination takes effect upon the date of issuance
88.29specified in the determination.
88.30(b) In reviewing the appeal, the commissioner may request additional written or oral
88.31information from the provider.
88.32(c) The provider has the right to present information by telephone, in writing, or
88.33in person concerning the appeal to the commissioner prior to the issuance of the appeal
88.34determination within 30 days of the date the appeal was received by the commissioner.
89.1The provider must request an in-person conference in writing, separate from the appeal
89.2letter. Statements made during the review process are not admissible in a contested case
89.3hearing absent an express stipulation by the parties to the contested case.
89.4(d) For an appeal item on which the provider disagrees with the appeal determination,
89.5the provider may file with the commissioner a written demand for a contested case
89.6hearing to determine the proper resolution of specified appeal items. The demand must
89.7be postmarked or received by the commissioner within 30 days of the date of issuance
89.8specified in the determination. A contested case demand for an appeal item nullifies
89.9the written appeal determination issued by the commissioner for that appeal item. The
89.10commissioner shall refer any contested case demand to the Office of the Attorney General.
89.11(e) A contested case hearing must be heard by an administrative law judge according
89.12to sections 14.48 to 14.56. In any proceeding under this section, the appealing party must
89.13demonstrate by a preponderance of the evidence that the Minnesota electronic health
89.14record incentives program eligibility determination is incorrect.
89.15(f) Regardless of any appeal, the Minnesota electronic health record incentives
89.16program eligibility determination must remain in effect until final resolution of the appeal.
89.17(g) The commissioner has discretion to issue to the provider a proposed resolution
89.18for specified appeal items upon a request from the provider filed separately from the
89.19notice of appeal. The proposed resolution is final upon written acceptance by the provider
89.20within 30 days of the date the proposed resolution was mailed to or personally received by
89.21the provider, whichever is earlier.

89.22    Sec. 13. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:
89.23    Subd. 9. Review of eligible providers. The commissioner and the Medical
89.24Education and Research Costs Advisory Committee may review provider groups included
89.25in the definition of a clinical medical education program to assure that the distribution of
89.26the funds continue to be consistent with the purpose of this section. The results of any
89.27such reviews must be reported to the Legislative Commission on Health Care Access
89.28chairs and ranking minority members of the legislative committees with jurisdiction over
89.29health care policy and finance.

89.30    Sec. 14. Minnesota Statutes 2010, section 62Q.32, is amended to read:
89.3162Q.32 LOCAL OMBUDSPERSON.
89.32County board or community health service agencies may establish an office of
89.33ombudsperson to provide a system of consumer advocacy for persons receiving health
90.1care services through a health plan company. The ombudsperson's functions may include,
90.2but are not limited to:
90.3(a) mediation or advocacy on behalf of a person accessing the complaint and appeal
90.4procedures to ensure that necessary medical services are provided by the health plan
90.5company; and
90.6(b) investigation of the quality of services provided to a person and determine the
90.7extent to which quality assurance mechanisms are needed or any other system change
90.8may be needed. The commissioner of health shall make recommendations for funding
90.9these functions including the amount of funding needed and a plan for distribution. The
90.10commissioner shall submit these recommendations to the Legislative Commission on
90.11Health Care Access by January 15, 1996.

90.12    Sec. 15. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:
90.13    Subd. 3. Provider peer grouping. (a) The commissioner shall develop a peer
90.14grouping system for providers based on a combined measure that incorporates both
90.15provider risk-adjusted cost of care and quality of care, and for specific conditions as
90.16determined by the commissioner. In developing this system, the commissioner shall
90.17consult and coordinate with health care providers, health plan companies, state agencies,
90.18and organizations that work to improve health care quality in Minnesota. For purposes of
90.19the final establishment of the peer grouping system, the commissioner shall not contract
90.20with any private entity, organization, or consortium of entities that has or will have a direct
90.21financial interest in the outcome of the system.
90.22    (b) By no later than October 15, 2010, the commissioner shall disseminate
90.23information to providers on their total cost of care, total resource use, total quality of care,
90.24and the total care results of the grouping developed under this subdivision in comparison
90.25to an appropriate peer group. Any analyses or reports that identify providers may only be
90.26published after the provider has been provided the opportunity by the commissioner to
90.27review the underlying data and submit comments. Providers may be given any data for
90.28which they are the subject of the data. The provider shall have 30 days to review the data
90.29for accuracy and initiate an appeal as specified in paragraph (d).
90.30    (c) By no later than January 1, 2011, the commissioner shall disseminate information
90.31to providers on their condition-specific cost of care, condition-specific resource use,
90.32condition-specific quality of care, and the condition-specific results of the grouping
90.33developed under this subdivision in comparison to an appropriate peer group. Any
90.34analyses or reports that identify providers may only be published after the provider has
90.35been provided the opportunity by the commissioner to review the underlying data and
91.1submit comments. Providers may be given any data for which they are the subject of the
91.2data. The provider shall have 30 days to review the data for accuracy and initiate an
91.3appeal as specified in paragraph (d).
91.4(d) The commissioner shall establish an appeals process to resolve disputes from
91.5providers regarding the accuracy of the data used to develop analyses or reports. When
91.6a provider appeals the accuracy of the data used to calculate the peer grouping system
91.7results, the provider shall:
91.8(1) clearly indicate the reason they believe the data used to calculate the peer group
91.9system results are not accurate;
91.10(2) provide evidence and documentation to support the reason that data was not
91.11accurate; and
91.12(3) cooperate with the commissioner, including allowing the commissioner access to
91.13data necessary and relevant to resolving the dispute.
91.14If a provider does not meet the requirements of this paragraph, a provider's appeal shall be
91.15considered withdrawn. The commissioner shall not publish results for a specific provider
91.16under paragraph (e) or (f) while that provider has an unresolved appeal.
91.17    (e) Beginning January 1, 2011, the commissioner shall, no less than annually,
91.18publish information on providers' total cost, total resource use, total quality, and the results
91.19of the total care portion of the peer grouping process. The results that are published must
91.20be on a risk-adjusted basis.
91.21(f) Beginning March 30, 2011, the commissioner shall no less than annually publish
91.22information on providers' condition-specific cost, condition-specific resource use, and
91.23condition-specific quality, and the results of the condition-specific portion of the peer
91.24grouping process. The results that are published must be on a risk-adjusted basis.
91.25(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing
91.26information under paragraph (e) or (f), the commissioner shall ensure the scientific
91.27validity and reliability of the results according to the standards described in paragraph (h).
91.28If additional time is needed to establish the scientific validity and reliability of the results,
91.29the commissioner may delay the dissemination of data to providers under paragraph (b)
91.30or (c), or the publication of information under paragraph (e) or (f). If the delay is more
91.31than 60 days, the commissioner shall report in writing to the Legislative Commission on
91.32Health Care Access chairs and ranking minority members of the legislative committees
91.33with jurisdiction over health care policy and finance the following information:
91.34(1) the reason for the delay;
91.35(2) the actions being taken to resolve the delay and establish the scientific validity
91.36and reliability of the results; and
92.1(3) the new dates by which the results shall be disseminated.
92.2If there is a delay under this paragraph, the commissioner must disseminate the
92.3information to providers under paragraph (b) or (c) at least 90 days before publishing
92.4results under paragraph (e) or (f).
92.5(h) The commissioner's assurance of valid and reliable clinic and hospital peer
92.6grouping performance results shall include, at a minimum, the following:
92.7(1) use of the best available evidence, research, and methodologies; and
92.8(2) establishment of an explicit minimum reliability threshold developed in
92.9collaboration with the subjects of the data and the users of the data, at a level not below
92.10nationally accepted standards where such standards exist.
92.11In achieving these thresholds, the commissioner shall not aggregate clinics that are not
92.12part of the same system or practice group. The commissioner shall consult with and solicit
92.13feedback from representatives of physician clinics and hospitals during the peer grouping
92.14data analysis process to obtain input on the methodological options prior to final analysis
92.15and on the design, development, and testing of provider reports.

92.16    Sec. 16. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:
92.17    Subd. 9. Uses of information. (a) By no later than 12 months after the commissioner
92.18publishes the information in subdivision 3, paragraph (e): For product renewals or for
92.19new products that are offered, after 12 months have elapsed from publication by the
92.20commissioner of the information in subdivision 3, paragraph (e):
92.21    (1) the commissioner of management and budget shall use the information and
92.22methods developed under subdivision 3 to strengthen incentives for members of the state
92.23employee group insurance program to use high-quality, low-cost providers;
92.24    (2) all political subdivisions, as defined in section 13.02, subdivision 11, that offer
92.25health benefits to their employees must offer plans that differentiate providers on their
92.26cost and quality performance and create incentives for members to use better-performing
92.27providers;
92.28    (3) all health plan companies shall use the information and methods developed
92.29under subdivision 3 to develop products that encourage consumers to use high-quality,
92.30low-cost providers; and
92.31    (4) health plan companies that issue health plans in the individual market or the
92.32small employer market must offer at least one health plan that uses the information
92.33developed under subdivision 3 to establish financial incentives for consumers to choose
92.34higher-quality, lower-cost providers through enrollee cost-sharing or selective provider
92.35networks.
93.1    (b) By January 1, 2011, the commissioner of health shall report to the governor
93.2and the legislature on recommendations to encourage health plan companies to promote
93.3widespread adoption of products that encourage the use of high-quality, low-cost providers.
93.4The commissioner's recommendations may include tax incentives, public reporting of
93.5health plan performance, regulatory incentives or changes, and other strategies.

93.6    Sec. 17. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:
93.7    Subd. 2. Legislative oversight. Beginning January 15, 2009, the commissioner
93.8of health shall submit to the Legislative Commission on Health Care Access chairs and
93.9ranking minority members of the legislative committees with jurisdiction over health care
93.10policy and finance periodic progress reports on the implementation of this chapter and
93.11sections 256B.0751 to 256B.0754.

93.12    Sec. 18. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
93.13to read:
93.14    Subd. 33. Contingency contract fees. (a) When the commissioner enters into
93.15a contingency-based contract for the purpose of recovering medical assistance or
93.16MinnesotaCare funds, the commissioner may retain that portion of the recovered funds
93.17equal to the amount of the contingency fee.
93.18(b) Amounts attributed to new recoveries under this subdivision are appropriated
93.19to the commissioner to the extent they fulfill the payment terms of the contract with the
93.20vendor and shall be deposited into an account in a fund other than the general fund for
93.21purposes of fulfilling the terms of the vendor contract.
93.22EFFECTIVE DATE.This section is effective retroactive from July 1, 2011.

93.23    Sec. 19. Minnesota Statutes 2010, section 256.969, subdivision 2, is amended to read:
93.24    Subd. 2. Diagnostic categories. The commissioner shall use to the extent possible
93.25existing diagnostic classification systems, including the system used by the Medicare
93.26program to determine the relative values of inpatient services and case mix indices. The
93.27commissioner may combine diagnostic classifications into diagnostic categories and may
93.28establish separate categories and numbers of categories based on program eligibility or
93.29hospital peer group. Relative values shall be recalculated when the base year is changed.
93.30Relative value determinations shall include paid claims for admissions during each
93.31hospital's base year. The commissioner may extend the time period forward to obtain
93.32sufficiently valid information to establish relative values. Relative value determinations
93.33shall not include property cost data, Medicare crossover data, and data on admissions
94.1that are paid a per day transfer rate under subdivision 14. The computation of the base
94.2year cost per admission must include identified outlier cases and their weighted costs
94.3up to the point that they become outlier cases, but must exclude costs recognized in
94.4outlier payments beyond that point. The commissioner may recategorize the diagnostic
94.5classifications and recalculate relative values and case mix indices to reflect actual hospital
94.6practices, the specific character of specialty hospitals, or to reduce variances within the
94.7diagnostic categories after notice in the State Register and a 30-day comment period. The
94.8commissioner shall recategorize the diagnostic classifications and recalculate relative
94.9values and case mix indices based on the two-year schedule in effect prior to January 1,
94.102013, reflected in subdivision 2b. The first recategorization shall occur January 1, 2013,
94.11and shall occur every two years after. When rates are not rebased under subdivision 2b,
94.12the commissioner may establish relative values and case mix indices based on charge data
94.13and may update the base year to the most recent data available.

94.14    Sec. 20. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
94.15    Subd. 2b. Operating payment rates. In determining operating payment rates for
94.16admissions occurring on or after the rate year beginning January 1, 1991, and every two
94.17years after, or more frequently as determined by the commissioner, the commissioner shall
94.18obtain operating data from an updated base year and establish operating payment rates
94.19per admission for each hospital based on the cost-finding methods and allowable costs of
94.20the Medicare program in effect during the base year. Rates under the general assistance
94.21medical care, medical assistance, and MinnesotaCare programs shall not be rebased to
94.22more current data on January 1, 1997, January 1, 2005, for the first 24 months of the
94.23rebased period beginning January 1, 2009. For the first 24 months of the rebased period
94.24beginning January 1, 2011, rates shall not be rebased, except that a Minnesota long-term
94.25hospital shall be rebased effective January 1, 2011, based on its most recent Medicare cost
94.26report ending on or before September 1, 2008, with the provisions under subdivisions 9
94.27and 23, based on the rates in effect on December 31, 2010. For subsequent rate setting
94.28periods in which the base years are updated, a Minnesota long-term hospital's base year
94.29shall remain within the same period as other hospitals. Effective January 1, 2013, and after,
94.30rates shall not be rebased at full value. The base year operating payment rate per admission
94.31is standardized by the case mix index and adjusted by the hospital cost index, relative
94.32values, and disproportionate population adjustment. The cost and charge data used to
94.33establish operating rates shall only reflect inpatient services covered by medical assistance
94.34and shall not include property cost information and costs recognized in outlier payments.

95.1    Sec. 21. Minnesota Statutes 2010, section 256.969, is amended by adding a subdivision
95.2to read:
95.3    Subd. 3c. Rateable reduction and readmissions reduction. (a) The total payment
95.4for fee for service admissions occurring on or after September 1, 2011, through June 30,
95.52015, made to hospitals for inpatient services before third-party liability and spenddown,
95.6is reduced ten percent from the current statutory rates. Facilities defined under subdivision
95.716, long-term hospitals as determined under the Medicare program, children's hospitals
95.8whose inpatients are predominantly under 18 years of age, and payments under managed
95.9care are excluded from this paragraph.
95.10(b) Effective for admissions occurring during calendar year 2010 and each year
95.11after, the commissioner shall calculate a regional readmission rate for admissions to all
95.12hospitals occurring within 30 days of a previous discharge. The commissioner may
95.13adjust the readmission rate taking into account factors such as the medical relationship,
95.14complicating conditions, and sequencing of treatment between the initial admission and
95.15subsequent readmissions.
95.16(c) Effective for payments to all hospitals on or after July 1, 2013, through June 30,
95.172015, the reduction in paragraph (a) is reduced one percentage point for every percentage
95.18point reduction in the overall readmissions rate between the two previous calendar years
95.19to a maximum of five percent.

95.20    Sec. 22. Minnesota Statutes 2010, section 256B.02, is amended by adding a
95.21subdivision to read:
95.22    Subd. 16. Termination; terminate. "Termination" or "terminate" for a provider
95.23means a state Medicaid program, state children's health insurance program, or Medicare
95.24program has taken an action to revoke the provider's billing privileges, the provider has
95.25exhausted all appeal rights or the timeline for appeal has expired, there is no expectation
95.26by the provider, Medicaid program, state children's health insurance program, or Medicare
95.27program that the revocation is temporary, the provider will be required to reenroll to
95.28reinstate billing privileges, and the termination occurred for cause, including fraud,
95.29integrity, or quality.

95.30    Sec. 23. Minnesota Statutes 2010, section 256B.03, is amended by adding a
95.31subdivision to read:
95.32    Subd. 4. Prohibition on payments to providers outside of the United States.
95.33Payments for medical assistance must not be made:
95.34(1) for services delivered or items supplied outside of the United States; or
96.1(2) to a provider, financial institution, or entity located outside of the United States.

96.2    Sec. 24. Minnesota Statutes 2010, section 256B.03, is amended by adding a
96.3subdivision to read:
96.4    Subd. 5. Ordering or referring providers. Claims for payments for supplies or
96.5services that are based on an order or referral of a provider must include the ordering or
96.6referring provider's national provider identifier (NPI). Claims for supplies or services
96.7ordered or referred by a vendor who is not enrolled in medical assistance are not covered.

96.8    Sec. 25. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
96.9    Subd. 18. Applications for medical assistance. (a) The state agency may
96.10take applications for medical assistance and conduct eligibility determinations for
96.11MinnesotaCare enrollees.
96.12    (b) The commissioner of human services shall modify the Minnesota health care
96.13programs application form to add a question asking applicants whether they have ever
96.14served in the United States military.
96.15EFFECTIVE DATE.This section is effective January 1, 2012.

96.16    Sec. 26. Minnesota Statutes 2010, section 256B.04, is amended by adding a
96.17subdivision to read:
96.18    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
96.19Medicare and Medicaid Services determines that a provider is designated "high-risk," the
96.20commissioner may withhold payment from providers within that category upon initial
96.21enrollment for a 90-day period. The withholding for each provider must begin on the date
96.22of the first submission of a claim.
96.23(b) The commissioner may require, as a condition of enrollment in medical
96.24assistance, that a provider within a particular industry sector or category establish a
96.25compliance program that contains the core elements established by the Centers for
96.26Medicare and Medicaid Services.
96.27(c) The commissioner may revoke the enrollment of an ordering or rendering
96.28provider for a period of not more than one year, if the provider fails to maintain and,
96.29upon request from the commissioner, provide access to documentation relating to written
96.30orders or requests for payment for durable medical equipment, certifications for home
96.31health services, or referrals for other items or services written or ordered by such provider,
96.32when the commissioner has identified a pattern of a lack of documentation. A pattern
97.1means a failure to maintain documentation or provide access to documentation on more
97.2than one occasion.
97.3(d) The commissioner shall terminate or deny the enrollment of any individual or
97.4entity if the individual or entity has been terminated from participation in Medicare or
97.5under the Medicaid program or Children's Health Insurance Program of any other state.
97.6(e) As a condition of enrollment in medical assistance, the commissioner shall
97.7require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
97.8and Medicaid Services or the Minnesota Department of Human Services permit the
97.9Centers for Medicare and Medicaid Services, its agents, or its designated contractors and
97.10the state agency, its agents, or its designated contractors to conduct unannounced on-site
97.11inspections of any provider location.
97.12(f) As a condition of enrollment in medical assistance, the commissioner shall
97.13require that a high-risk provider, or a person with a direct or indirect ownership interest in
97.14the provider of five percent or higher, consent to criminal background checks, including
97.15fingerprinting, when required to do so under state law or by a determination by the
97.16commissioner or the Centers for Medicare and Medicaid Services that a provider is
97.17designated high-risk for fraud, waste, or abuse.

97.18    Sec. 27. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
97.19    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
97.20to citizens of the United States, qualified noncitizens as defined in this subdivision, and
97.21other persons residing lawfully in the United States. Citizens or nationals of the United
97.22States must cooperate in obtaining satisfactory documentary evidence of citizenship or
97.23nationality according to the requirements of the federal Deficit Reduction Act of 2005,
97.24Public Law 109-171.
97.25(b) "Qualified noncitizen" means a person who meets one of the following
97.26immigration criteria:
97.27(1) admitted for lawful permanent residence according to United States Code, title 8;
97.28(2) admitted to the United States as a refugee according to United States Code,
97.29title 8, section 1157;
97.30(3) granted asylum according to United States Code, title 8, section 1158;
97.31(4) granted withholding of deportation according to United States Code, title 8,
97.32section 1253(h);
97.33(5) paroled for a period of at least one year according to United States Code, title 8,
97.34section 1182(d)(5);
98.1(6) granted conditional entrant status according to United States Code, title 8,
98.2section 1153(a)(7);
98.3(7) determined to be a battered noncitizen by the United States Attorney General
98.4according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
98.5title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
98.6(8) is a child of a noncitizen determined to be a battered noncitizen by the United
98.7States Attorney General according to the Illegal Immigration Reform and Immigrant
98.8Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
98.9Public Law 104-200; or
98.10(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
98.11Law 96-422, the Refugee Education Assistance Act of 1980.
98.12(c) All qualified noncitizens who were residing in the United States before August
98.1322, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
98.14medical assistance with federal financial participation.
98.15(d) All qualified noncitizens who entered the United States on or after August 22,
98.161996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
98.17medical assistance with federal financial participation through November 30, 1996.
98.18Beginning December 1, 1996, qualified noncitizens who entered the United States
98.19on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
98.20chapter are eligible for medical assistance with federal participation for five years if they
98.21meet one of the following criteria:
98.22(i) refugees admitted to the United States according to United States Code, title 8,
98.23section 1157;
98.24(ii) persons granted asylum according to United States Code, title 8, section 1158;
98.25(iii) persons granted withholding of deportation according to United States Code,
98.26title 8, section 1253(h);
98.27(iv) veterans of the United States armed forces with an honorable discharge for
98.28a reason other than noncitizen status, their spouses and unmarried minor dependent
98.29children; or
98.30(v) persons on active duty in the United States armed forces, other than for training,
98.31their spouses and unmarried minor dependent children.
98.32Beginning December 1, 1996, qualified noncitizens who do not meet one of the
98.33criteria in items (i) to (v) are eligible for medical assistance without federal financial
98.34participation as described in paragraph (j).
98.35Notwithstanding paragraph (j), Beginning July 1, 2010, children and pregnant
98.36women who are noncitizens described in paragraph (b) or (e) who are lawfully present
99.1in the United States as defined in Code of Federal Regulations, title 8, section 103.12,
99.2and who otherwise meet eligibility requirements of this chapter, are eligible for medical
99.3assistance with federal financial participation as provided by the federal Children's Health
99.4Insurance Program Reauthorization Act of 2009, Public Law 111-3.
99.5(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
99.6are lawfully present in the United States, as defined in Code of Federal Regulations, title
99.78, section 103.12, and who otherwise meet the eligibility requirements of this chapter, are
99.8eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
99.9with the United States Citizenship and Immigration Services to pursue any applicable
99.10immigration status, including citizenship, that would qualify them for medical assistance
99.11with federal financial participation.
99.12(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
99.13for medical assistance with federal financial participation through December 31, 1996.
99.14(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
99.15medical assistance without federal financial participation as described in paragraph (j).
99.16(3) Beginning December 1, 1996, persons residing in the United States prior to
99.17August 22, 1996, who were not receiving medical assistance and persons who arrived on
99.18or after August 22, 1996, are eligible for medical assistance without federal financial
99.19participation as described in paragraph (j).
99.20(f) (e) Nonimmigrants who otherwise meet the eligibility requirements of this
99.21chapter are eligible for the benefits as provided in paragraphs (g) (f) to (i) (h). For purposes
99.22of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United
99.23States Code, title 8, section 1101(a)(15).
99.24(g) (f) Payment shall also be made for care and services that are furnished to
99.25noncitizens, regardless of immigration status, who otherwise meet the eligibility
99.26requirements of this chapter, if such care and services are necessary for the treatment of an
99.27emergency medical condition, except for organ transplants and related care and services
99.28and routine prenatal care.
99.29(h) (g) For purposes of this subdivision, the term "emergency medical condition"
99.30means a medical condition that meets the requirements of United States Code, title 42,
99.31section 1396b(v).
99.32(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
99.33of an emergency medical condition are limited to the following:
99.34(i) services delivered in an emergency room or by an ambulance service licensed
99.35under chapter 144E that are directly related to the treatment of an emergency medical
99.36condition;
100.1(ii) services delivered in an inpatient hospital setting following admission from an
100.2emergency room or clinic for an acute emergency condition; and
100.3(iii) follow-up services that are directly related to the original service provided
100.4to treat the emergency medical condition and are covered by the global payment made
100.5to the provider.
100.6    (2) Services for the treatment of emergency medical conditions do not include:
100.7(i) services delivered in an emergency room or inpatient setting to treat a
100.8nonemergency condition;
100.9(ii) organ transplants, stem cell transplants, and related care;
100.10(iii) services for routine prenatal care;
100.11(iv) continuing care, including long-term care, nursing facility services, home health
100.12care, adult day care, day training, or supportive living services;
100.13(v) elective surgery;
100.14(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
100.15part of an emergency room visit;
100.16(vii) preventative health care and family planning services;
100.17(viii) dialysis;
100.18(ix) chemotherapy or therapeutic radiation services;
100.19(x) rehabilitation services;
100.20(xi) physical, occupational, or speech therapy;
100.21(xii) transportation services;
100.22(xiii) case management;
100.23(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
100.24(xv) dental services;
100.25(xvi) hospice care;
100.26(xvii) audiology services and hearing aids;
100.27(xviii) podiatry services;
100.28(xix) chiropractic services;
100.29(xx) immunizations;
100.30(xxi) vision services and eyeglasses;
100.31(xxii) waiver services;
100.32(xxiii) individualized education programs; or
100.33(xxiv) chemical dependency treatment.
100.34(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
100.35nonimmigrants, or lawfully present as designated in paragraph (e) and who in the United
100.36States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by
101.1a group health plan or health insurance coverage according to Code of Federal Regulations,
101.2title 42, section 457.310, and who otherwise meet the eligibility requirements of this
101.3chapter, are eligible for medical assistance through the period of pregnancy, including
101.4labor and delivery, and 60 days postpartum, to the extent federal funds are available under
101.5title XXI of the Social Security Act, and the state children's health insurance program.
101.6(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
101.7lawfully residing in the United States as described in paragraph (e), who are ineligible
101.8for medical assistance with federal financial participation and who otherwise meet the
101.9eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
101.10assistance without federal financial participation. Qualified noncitizens as described
101.11in paragraph (d) are only eligible for medical assistance without federal financial
101.12participation for five years from their date of entry into the United States.
101.13(k) (j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
101.14services from a nonprofit center established to serve victims of torture and are otherwise
101.15ineligible for medical assistance under this chapter are eligible for medical assistance
101.16without federal financial participation. These individuals are eligible only for the period
101.17during which they are receiving services from the center. Individuals eligible under this
101.18paragraph shall not be required to participate in prepaid medical assistance.
101.19EFFECTIVE DATE.This section is effective January 1, 2012.

101.20    Sec. 28. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
101.21subdivision to read:
101.22    Subd. 3q. Evidence-based childbirth program. (a) The commissioner shall
101.23implement a program to reduce the number of elective inductions of labor prior to 39
101.24weeks' gestation. In this subdivision, the term "elective induction of labor" means the
101.25use of artificial means to stimulate labor in a woman without the presence of a medical
101.26condition affecting the woman or the child that makes the onset of labor a medical
101.27necessity. The program must promote the implementation of policies within hospitals
101.28providing services to recipients of medical assistance or MinnesotaCare that prohibit the
101.29use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by
101.30the attending providers.
101.31(b) For all births covered by medical assistance or MinnesotaCare on or after
101.32January 1, 2012, a payment for professional services associated with the delivery of a
101.33child in a hospital must not be made unless the provider has submitted information about
101.34the nature of the labor and delivery including any induction of labor that was performed
102.1in conjunction with that specific birth. The information must be on a form prescribed by
102.2the commissioner.
102.3(c) The requirements in paragraph (b) must not apply to deliveries performed
102.4at a hospital that has policies and processes in place that have been approved by the
102.5commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process
102.6for review of hospital induction policies must be established by the commissioner and
102.7review of policies must occur at the discretion of the commissioner. The commissioner's
102.8decision to approve or rescind approval must include verification and review of items
102.9including, but not limited to:
102.10(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
102.11(2) policies that encourage providers to document and communicate with patients a
102.12final expected date of delivery by 20 weeks' gestation that includes data from ultrasound
102.13measurements as applicable;
102.14(3) policies that encourage patient education regarding elective inductions, and
102.15requires documentation of the processes used to educate patients;
102.16(4) ongoing quality improvement review as determined by the commissioner; and
102.17(5) any data that has been collected by the commissioner.
102.18(d) All hospitals must report annually to the commissioner induction information
102.19for all births that were covered by medical assistance or MinnesotaCare in a format and
102.20manner to be established by the commissioner.
102.21(e) The commissioner at any time may choose not to implement or may discontinue
102.22any or all aspects of the program if the commissioner is able to determine that hospitals
102.23representing at least 90 percent of births covered by medical assistance or MinnesotaCare
102.24have approved policies in place.
102.25EFFECTIVE DATE.This section is effective January 1, 2012.

102.26    Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to
102.27read:
102.28    Subd. 8. Physical therapy. (a) Medical assistance covers physical therapy and
102.29related services, including specialized maintenance therapy. Specialized maintenance
102.30therapy is covered for recipients age 20 and under.
102.31(b) Authorization by the commissioner is required to provide medically necessary
102.32services to a recipient beyond any of the following onetime service thresholds, or a lower
102.33threshold where one has been established by the commissioner for a specified service: (1)
102.3480 units of any approved CPT code other than modalities; (2) 20 modality sessions; and
102.35(3) three evaluations or reevaluations. Services provided by a physical therapy assistant
103.1shall be reimbursed at the same rate as services performed by a physical therapist when
103.2the services of the physical therapy assistant are provided under the direction of a physical
103.3therapist who is on the premises. Services provided by a physical therapy assistant that
103.4are provided under the direction of a physical therapist who is not on the premises shall
103.5be reimbursed at 65 percent of the physical therapist rate.
103.6EFFECTIVE DATE.The amendment to paragraph (a) is effective January 1, 2012.
103.7The amendment to paragraph (b) is effective March 1, 2012.

103.8    Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to
103.9read:
103.10    Subd. 8a. Occupational therapy. (a) Medical assistance covers occupational
103.11therapy and related services, including specialized maintenance therapy. Specialized
103.12maintenance therapy is covered for recipients age 20 and under.
103.13(b) Authorization by the commissioner is required to provide medically necessary
103.14services to a recipient beyond any of the following onetime service thresholds, or a lower
103.15threshold where one has been established by the commissioner for a specified service:
103.16(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or
103.17reevaluations. Services provided by an occupational therapy assistant shall be reimbursed
103.18at the same rate as services performed by an occupational therapist when the services of
103.19the occupational therapy assistant are provided under the direction of the occupational
103.20therapist who is on the premises. Services provided by an occupational therapy assistant
103.21that are provided under the direction of an occupational therapist who is not on the
103.22premises shall be reimbursed at 65 percent of the occupational therapist rate.
103.23EFFECTIVE DATE.The amendment to paragraph (a) is effective January 1, 2012.
103.24The amendment to paragraph (b) is effective March 1, 2012.

103.25    Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to
103.26read:
103.27    Subd. 8b. Speech-language pathology and audiology services. (a) Medical
103.28assistance covers speech-language pathology and related services, including specialized
103.29maintenance therapy. Specialized maintenance therapy is covered for recipients age
103.3020 and under.
103.31(b) Authorization by the commissioner is required to provide medically necessary
103.32speech-language pathology services to a recipient beyond any of the following
103.33onetime service thresholds, or a lower threshold where one has been established by the
104.1commissioner for a specified service: (1) 50 treatment sessions with any combination of
104.2approved CPT codes; and (2) one evaluation.
104.3(c) Medical assistance covers audiology services and related services. Services
104.4provided by a person who has been issued a temporary registration under section
104.5148.5161 shall be reimbursed at the same rate as services performed by a speech-language
104.6pathologist or audiologist as long as the requirements of section 148.5161, subdivision
104.73
, are met.
104.8EFFECTIVE DATE.The amendment to paragraph (a) is effective January 1, 2012.
104.9The amendment to paragraph (b) is effective March 1, 2012.

104.10    Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to
104.11read:
104.12    Subd. 8c. Care management; rehabilitation services. (a) Effective July 1, 1999,
104.13onetime thresholds shall replace annual thresholds for provision of rehabilitation services
104.14described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in amount
104.15and description as the thresholds prescribed by the Department of Human Services health
104.16care programs provider manual for calendar year 1997, except they will not be renewed
104.17annually, and they will include sensory skills and cognitive training skills.
104.18(b) (a) A care management approach for authorization of rehabilitation services
104.19beyond the threshold described in subdivisions 8, 8a, and 8b shall be instituted in
104.20conjunction with the onetime thresholds. The care management approach shall require
104.21the provider and the department rehabilitation reviewer to work together directly through
104.22written communication, or telephone communication when appropriate, to establish a
104.23medically necessary care management plan. Authorization for rehabilitation services
104.24shall include approval for up to 12 six months of services at a time without additional
104.25documentation from the provider during the extended period, when the rehabilitation
104.26services are medically necessary due to an ongoing health condition.
104.27(c) (b) The commissioner shall implement an expedited five-day turnaround time to
104.28review authorization requests for recipients who need emergency rehabilitation services
104.29and who have exhausted their onetime threshold limit for those services.
104.30EFFECTIVE DATE.This section is effective March 1, 2012.

104.31    Sec. 33. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to
104.32read:
105.1    Subd. 8e. Chiropractic services. Payment for chiropractic services is limited to
105.2one annual evaluation and 12 24 visits per year unless prior authorization of a greater
105.3number of visits is obtained.
105.4EFFECTIVE DATE.This section is effective January 1, 2012.

105.5    Sec. 34. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
105.6subdivision to read:
105.7    Subd. 8f. Acupuncture services. Medical assistance covers acupuncture, as defined
105.8in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by
105.9another Minnesota licensed practitioner for whom acupuncture is within the practitioner's
105.10scope of practice and who has specific acupuncture training or credentialing.
105.11EFFECTIVE DATE.This section is effective January 1, 2012.

105.12    Sec. 35. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to
105.13read:
105.14    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
105.15shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
105.16or the maximum allowable cost set by the federal government or by the commissioner
105.17plus the fixed dispensing fee; or the usual and customary price charged to the public. The
105.18amount of payment basis must be reduced to reflect all discount amounts applied to the
105.19charge by any provider/insurer agreement or contract for submitted charges to medical
105.20assistance programs. The net submitted charge may not be greater than the patient liability
105.21for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
105.22for intravenous solutions which must be compounded by the pharmacist shall be $8 per
105.23bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
105.24nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
105.25nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
105.26includes quantity and other special discounts except time and cash discounts. Effective
105.27July 1, 2009, The actual acquisition cost of a drug shall be estimated by the commissioner,
105.28at average wholesale price minus 15 percent. The actual acquisition cost of antihemophilic
105.29factor drugs shall be estimated at the average wholesale price minus 30 percent. wholesale
105.30acquisition cost plus four percent for independently owned pharmacies located in a
105.31designated rural area within Minnesota, and at wholesale acquisition cost plus two percent
105.32for all other pharmacies. A pharmacy is "independently owned" if it is one of four or
105.33fewer pharmacies under the same ownership nationally. A "designated rural area" means
106.1an area defined as a small rural area or isolated rural area according to the four-category
106.2classification of the Rural Urban Commuting Area system developed for the United States
106.3Health Resources and Services Administration. Wholesale acquisition cost is defined as
106.4the manufacturer's list price for a drug or biological to wholesalers or direct purchasers
106.5in the United States, not including prompt pay or other discounts, rebates, or reductions
106.6in price, for the most recent month for which information is available, as reported in
106.7wholesale price guides or other publications of drug or biological pricing data. The
106.8maximum allowable cost of a multisource drug may be set by the commissioner and it
106.9shall be comparable to, but no higher than, the maximum amount paid by other third-party
106.10payors in this state who have maximum allowable cost programs. Establishment of the
106.11amount of payment for drugs shall not be subject to the requirements of the Administrative
106.12Procedure Act.
106.13    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
106.14to pharmacists for legend drug prescriptions dispensed to residents of long-term care
106.15facilities when a unit dose blister card system, approved by the department, is used. Under
106.16this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
106.17The National Drug Code (NDC) from the drug container used to fill the blister card must
106.18be identified on the claim to the department. The unit dose blister card containing the
106.19drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
106.20that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
106.21will be required to credit the department for the actual acquisition cost of all unused
106.22drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
106.23manufacturer's unopened package. The commissioner may permit the drug clozapine to be
106.24dispensed in a quantity that is less than a 30-day supply.
106.25    (c) Whenever a maximum allowable cost has been set for a multisource drug,
106.26payment shall be on the basis of the lower of the usual and customary price charged
106.27to the public or the maximum allowable cost established by the commissioner unless
106.28prior authorization for the brand name product has been granted according to the criteria
106.29established by the Drug Formulary Committee as required by subdivision 13f, paragraph
106.30(a), and the prescriber has indicated "dispense as written" on the prescription in a manner
106.31consistent with section 151.21, subdivision 2.
106.32    (d) The basis for determining the amount of payment for drugs administered in an
106.33outpatient setting shall be the lower of the usual and customary cost submitted by the
106.34provider or the amount established for Medicare by the 106 percent of the average sales
106.35price as determined by the United States Department of Health and Human Services
106.36pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales
107.1price is unavailable, the amount of payment must be lower of the usual and customary cost
107.2submitted by the provider or the wholesale acquisition cost.
107.3    (e) The commissioner may negotiate lower reimbursement rates for specialty
107.4pharmacy products than the rates specified in paragraph (a). The commissioner may
107.5require individuals enrolled in the health care programs administered by the department
107.6to obtain specialty pharmacy products from providers with whom the commissioner has
107.7negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
107.8used by a small number of recipients or recipients with complex and chronic diseases
107.9that require expensive and challenging drug regimens. Examples of these conditions
107.10include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
107.11C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
107.12of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
107.13biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
107.14that require complex care. The commissioner shall consult with the formulary committee
107.15to develop a list of specialty pharmacy products subject to this paragraph. In consulting
107.16with the formulary committee in developing this list, the commissioner shall take into
107.17consideration the population served by specialty pharmacy products, the current delivery
107.18system and standard of care in the state, and access to care issues. The commissioner shall
107.19have the discretion to adjust the reimbursement rate to prevent access to care issues.
107.20(f) Home infusion therapy services provided by home infusion therapy pharmacies
107.21must be paid at rates according to subdivision 8d.
107.22EFFECTIVE DATE.This section is effective September 1, 2011, or upon federal
107.23approval, whichever is later.

107.24    Sec. 36. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to
107.25read:
107.26    Subd. 13h. Medication therapy management services. (a) Medical assistance
107.27and general assistance medical care cover medication therapy management services for
107.28a recipient taking four three or more prescriptions to treat or prevent two one or more
107.29chronic medical conditions, or; a recipient with a drug therapy problem that is identified
107.30by the commissioner or identified by a pharmacist and approved by the commissioner; or
107.31prior authorized by the commissioner that has resulted or is likely to result in significant
107.32nondrug program costs. The commissioner may cover medical therapy management
107.33services under MinnesotaCare if the commissioner determines this is cost-effective. For
107.34purposes of this subdivision, "medication therapy management" means the provision
108.1of the following pharmaceutical care services by a licensed pharmacist to optimize the
108.2therapeutic outcomes of the patient's medications:
108.3    (1) performing or obtaining necessary assessments of the patient's health status;
108.4    (2) formulating a medication treatment plan;
108.5    (3) monitoring and evaluating the patient's response to therapy, including safety
108.6and effectiveness;
108.7    (4) performing a comprehensive medication review to identify, resolve, and prevent
108.8medication-related problems, including adverse drug events;
108.9    (5) documenting the care delivered and communicating essential information to
108.10the patient's other primary care providers;
108.11    (6) providing verbal education and training designed to enhance patient
108.12understanding and appropriate use of the patient's medications;
108.13    (7) providing information, support services, and resources designed to enhance
108.14patient adherence with the patient's therapeutic regimens; and
108.15    (8) coordinating and integrating medication therapy management services within the
108.16broader health care management services being provided to the patient.
108.17Nothing in this subdivision shall be construed to expand or modify the scope of practice of
108.18the pharmacist as defined in section 151.01, subdivision 27.
108.19    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
108.20must meet the following requirements:
108.21    (1) have a valid license issued under chapter 151;
108.22    (2) have graduated from an accredited college of pharmacy on or after May 1996, or
108.23completed a structured and comprehensive education program approved by the Board of
108.24Pharmacy and the American Council of Pharmaceutical Education for the provision and
108.25documentation of pharmaceutical care management services that has both clinical and
108.26didactic elements;
108.27    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
108.28have developed a structured patient care process that is offered in a private or semiprivate
108.29patient care area that is separate from the commercial business that also occurs in the
108.30setting, or in home settings, excluding including long-term care and settings, group homes,
108.31if the service is ordered by the provider-directed care coordination team and facilities
108.32providing assisted living services, but excluding skilled nursing facilities; and
108.33    (4) make use of an electronic patient record system that meets state standards.
108.34    (c) For purposes of reimbursement for medication therapy management services,
108.35the commissioner may enroll individual pharmacists as medical assistance and general
108.36assistance medical care providers. The commissioner may also establish contact
109.1requirements between the pharmacist and recipient, including limiting the number of
109.2reimbursable consultations per recipient.
109.3(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
109.4within a reasonable geographic distance of the patient, a pharmacist who meets the
109.5requirements may provide the services via two-way interactive video. Reimbursement
109.6shall be at the same rates and under the same conditions that would otherwise apply to
109.7the services provided. To qualify for reimbursement under this paragraph, the pharmacist
109.8providing the services must meet the requirements of paragraph (b), and must be located
109.9within an ambulatory care setting approved by the commissioner. The patient must also
109.10be located within an ambulatory care setting approved by the commissioner. Services
109.11provided under this paragraph may not be transmitted into the patient's residence.
109.12(e) The commissioner shall establish a pilot project for an intensive medication
109.13therapy management program for patients identified by the commissioner with multiple
109.14chronic conditions and a high number of medications who are at high risk of preventable
109.15hospitalizations, emergency room use, medication complications, and suboptimal
109.16treatment outcomes due to medication-related problems. For purposes of the pilot
109.17project, medication therapy management services may be provided in a patient's home
109.18or community setting, in addition to other authorized settings. The commissioner may
109.19waive existing payment policies and establish special payment rates for the pilot project.
109.20The pilot project must be designed to produce a net savings to the state compared to the
109.21estimated costs that would otherwise be incurred for similar patients without the program.
109.22The pilot project must begin by January 1, 2010, and end June 30, 2012.
109.23EFFECTIVE DATE.This section is effective September 1, 2011, or upon federal
109.24approval, whichever is later.

109.25    Sec. 37. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
109.26read:
109.27    Subd. 17. Transportation costs. (a) Medical assistance covers medical
109.28transportation costs incurred solely for obtaining emergency medical care or transportation
109.29costs incurred by eligible persons in obtaining emergency or nonemergency medical
109.30care when paid directly to an ambulance company, common carrier, or other recognized
109.31providers of transportation services. Medical transportation must be provided by:
109.32(1) an ambulance, as defined in section 144E.001, subdivision 2;
109.33(2) special transportation; or
109.34(3) common carrier including, but not limited to, bus, taxicab, other commercial
109.35carrier, or private automobile.
110.1(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
110.2part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
110.3would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
110.4transportation, or private automobile.
110.5The commissioner may use an order by the recipient's attending physician to certify that
110.6the recipient requires special transportation services. Special transportation providers shall
110.7perform driver-assisted services for eligible individuals. Driver-assisted service includes
110.8passenger pickup at and return to the individual's residence or place of business, assistance
110.9with admittance of the individual to the medical facility, and assistance in passenger
110.10securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation
110.11providers must obtain written documentation from the health care service provider who
110.12is serving the recipient being transported, identifying the time that the recipient arrived.
110.13Special transportation providers may not bill for separate base rates for the continuation of
110.14a trip beyond the original destination. Special transportation providers must take recipients
110.15to the nearest appropriate health care provider, using the most direct route. The minimum
110.16medical assistance reimbursement rates for special transportation services are:
110.17(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
110.18eligible persons who need a wheelchair-accessible van;
110.19(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
110.20eligible persons who do not need a wheelchair-accessible van; and
110.21(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
110.22special transportation services to eligible persons who need a stretcher-accessible vehicle;
110.23(2) the base rates for special transportation services in areas defined under RUCA
110.24to be super rural shall be equal to the reimbursement rate established in clause (1) plus
110.2511.3 percent; and
110.26(3) for special transportation services in areas defined under RUCA to be rural
110.27or super rural areas:
110.28(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
110.29percent of the respective mileage rate in clause (1); and
110.30(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
110.31112.5 percent of the respective mileage rate in clause (1).
110.32(c) For purposes of reimbursement rates for special transportation services under
110.33paragraph (b), the zip code of the recipient's place of residence shall determine whether
110.34the urban, rural, or super rural reimbursement rate applies.
111.1(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
111.2means a census-tract based classification system under which a geographical area is
111.3determined to be urban, rural, or super rural.
111.4(e) Effective for services provided on or after September 1, 2011, nonemergency
111.5transportation rates, including special transportation, taxi, and other commercial carriers,
111.6are reduced 4.5 percent. Payments made to managed care plans and county-based
111.7purchasing plans must be reduced for services provided on or after January 1, 2012,
111.8to reflect this reduction.

111.9    Sec. 38. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to
111.10read:
111.11    Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
111.12ambulance services. Providers shall bill ambulance services according to Medicare
111.13criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
111.14for services rendered on or after July 1, 2001, medical assistance payments for ambulance
111.15services shall be paid at the Medicare reimbursement rate or at the medical assistance
111.16payment rate in effect on July 1, 2000, whichever is greater.
111.17(b) Effective for services provided on or after September 1, 2011, ambulance
111.18services payment rates are reduced 4.5 percent. Payments made to managed care plans
111.19and county-based purchasing plans must be reduced for services provided on or after
111.20January 1, 2012, to reflect this reduction.

111.21    Sec. 39. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to
111.22read:
111.23    Subd. 18. Bus or taxicab transportation. To the extent authorized by rule of the
111.24state agency, medical assistance covers costs of the most appropriate and cost-effective
111.25form of transportation incurred by any ambulatory eligible person for obtaining
111.26nonemergency medical care.

111.27    Sec. 40. Minnesota Statutes 2010, section 256B.0625, subdivision 25, is amended to
111.28read:
111.29    Subd. 25. Prior authorization required. (a) The commissioner shall publish
111.30in the Minnesota health care programs provider manual and on the department's Web
111.31site a list of health services that require prior authorization, as well as the criteria and
111.32standards used to select health services on the list. The list and the criteria and standards
111.33used to formulate it are not subject to the requirements of sections 14.001 to 14.69. The
112.1commissioner's decision whether prior authorization is required for a health service is not
112.2subject to administrative appeal.
112.3(b) The commissioner shall implement a modernized electronic system for providers
112.4to request prior authorization. The modernized electronic system must include at least the
112.5following functionalities:
112.6(1) authorizations are recipient-centric, not provider-centric;
112.7(2) adequate flexibility to support authorizations for an episode of care, continuous
112.8drug therapy, or for individual onetime services and allows an ordering and a rendering
112.9provider to both submit information into one request;
112.10(3) allows providers to review previous authorization requests and determine where
112.11a submitted request is within the authorization process;
112.12(4) supports automated workflows that allow providers to securely submit medical
112.13information that can be accessed by medical and pharmacy review vendors as well as
112.14department staff; and
112.15(5) supports development of automated clinical algorithms that can verify
112.16information and provide responses in real time.
112.17(c) The system described in paragraph (b) shall be completed by March 1, 2012. All
112.18authorization requests submitted on and after March 1, 2012, or upon completion of the
112.19modernized authorization system, whichever is later, must be submitted electronically by
112.20providers, except requests for drugs dispensed by an outpatient pharmacy, services that
112.21are provided outside of the state and surrounding local trade area, and services included
112.22on a service agreement.

112.23    Sec. 41. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
112.24subdivision to read:
112.25    Subd. 25b. Authorization with third-party liability. (a) Except as otherwise
112.26allowed under this subdivision or required under federal or state regulations, the
112.27commissioner must not consider a request for authorization of a service when the recipient
112.28has coverage from a third-party payer unless the provider requesting authorization has
112.29made a good faith effort to receive payment or authorization from the third-party payer.
112.30A good faith effort is established by supplying with the authorization request to the
112.31commissioner the following:
112.32(1) a determination of payment for the service from the third-party payer, a
112.33determination of authorization for the service from the third-party payer, or a verification
112.34of noncoverage of the service by the third-party payer; and
113.1(2) the information or records required by the department to document the reason for
113.2the determination or to validate noncoverage from the third-party payer.
113.3(b) A provider requesting authorization for services covered by Medicare is not
113.4required to bill Medicare before requesting authorization from the commissioner if the
113.5provider has reason to believe that a service covered by Medicare is not eligible for
113.6payment. The provider must document that, because of recent claim experiences with
113.7Medicare or because of written communication from Medicare, coverage is not available
113.8for the service.
113.9(c) Authorization is not required if a third-party payer has made payment that is
113.10equal to or greater than 60 percent of the maximum payment amount for the service
113.11allowed under medical assistance.
113.12EFFECTIVE DATE.This section is effective September 1, 2011.

113.13    Sec. 42. Minnesota Statutes 2010, section 256B.0625, subdivision 31, is amended to
113.14read:
113.15    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
113.16supplies and equipment. Separate payment outside of the facility's payment rate shall
113.17be made for wheelchairs and wheelchair accessories for recipients who are residents
113.18of intermediate care facilities for the developmentally disabled. Reimbursement for
113.19wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
113.20conditions and limitations as coverage for recipients who do not reside in institutions. A
113.21wheelchair purchased outside of the facility's payment rate is the property of the recipient.
113.22The commissioner may set reimbursement rates for specified categories of medical
113.23supplies at levels below the Medicare payment rate.
113.24(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
113.25must enroll as a Medicare provider.
113.26(c) When necessary to ensure access to durable medical equipment, prosthetics,
113.27orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
113.28enrollment requirement if:
113.29(1) the vendor supplies only one type of durable medical equipment, prosthetic,
113.30orthotic, or medical supply;
113.31(2) the vendor serves ten or fewer medical assistance recipients per year;
113.32(3) the commissioner finds that other vendors are not available to provide same or
113.33similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
113.34(4) the vendor complies with all screening requirements in this chapter and Code of
113.35Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
114.1the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
114.2and Medicaid Services approved national accreditation organization as complying with
114.3the Medicare program's supplier and quality standards and the vendor serves primarily
114.4pediatric patients.
114.5(d) Durable medical equipment means a device or equipment that:
114.6(1) can withstand repeated use;
114.7(2) is generally not useful in the absence of an illness, injury, or disability; and
114.8(3) is provided to correct or accommodate a physiological disorder or physical
114.9condition or is generally used primarily for a medical purpose.

114.10    Sec. 43. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to
114.11read:
114.12    Subd. 31a. Augmentative and alternative communication systems. (a) Medical
114.13assistance covers augmentative and alternative communication systems consisting of
114.14electronic or nonelectronic devices and the related components necessary to enable a
114.15person with severe expressive communication limitations to produce or transmit messages
114.16or symbols in a manner that compensates for that disability.
114.17(b) Until the volume of systems purchased increases to allow a discount price, the
114.18commissioner shall reimburse augmentative and alternative communication manufacturers
114.19and vendors at the manufacturer's suggested retail price for augmentative and alternative
114.20communication systems and related components. The commissioner shall separately
114.21reimburse providers for purchasing and integrating individual communication systems
114.22which are unavailable as a package from an augmentative and alternative communication
114.23vendor. Augmentative and alternative communication systems must be paid the lower
114.24of the:
114.25(1) submitted charge; or
114.26(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
114.27manufacturers of augmentative and alternative communication systems; or
114.28(ii) manufacturer's invoice charge plus 20 percent for providers that are not
114.29manufacturers of augmentative and alternative communication systems.
114.30(c) Reimbursement rates established by this purchasing program are not subject to
114.31Minnesota Rules, part 9505.0445, item S or T.
114.32EFFECTIVE DATE.This section is effective September 1, 2011.

114.33    Sec. 44. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
114.34subdivision to read:
115.1    Subd. 55. Payment for noncovered services. (a) Except when specifically
115.2prohibited by the commissioner or federal law, a provider may seek payment from the
115.3recipient for services not eligible for payment under the medical assistance program when
115.4the provider, prior to delivering the service, reviews and considers all other available
115.5covered alternatives with the recipient and obtains a signed acknowledgment from the
115.6recipient of the potential of the recipient's liability. The signed acknowledgment must be
115.7in a form approved by the commissioner.
115.8(b) Conditions under which a provider must not request payment from the recipient
115.9include, but are not limited to:
115.10(1) a service that requires prior authorization, unless authorization has been denied
115.11as not medically necessary and all other therapeutic alternatives have been reviewed;
115.12(2) a service for which payment has been denied for reasons relating to billing
115.13requirements;
115.14(3) standard shipping or delivery and setup of medical equipment or medical
115.15supplies;
115.16(4) services that are included in the recipient's long term care per diem;
115.17(5) the recipient is enrolled in the Restricted Recipient Program and the provider is
115.18one of a provider type designated for the recipient's health care services; and
115.19(6) the noncovered service is a prescription drug identified by the commissioner as
115.20having the potential for abuse and overuse, except where payment by the recipient is
115.21specifically approved by the commissioner on the date of service based upon compelling
115.22evidence supplied by the prescribing provider that establishes medical necessity for that
115.23particular drug.
115.24(c) The payment requested from recipients for noncovered services under this
115.25subdivision must not exceed the provider's usual and customary charge for the actual
115.26service received by the recipient. A recipient must not be billed for the difference between
115.27what medical assistance paid for the service or would pay for a less costly alternative
115.28service.
115.29EFFECTIVE DATE.This section is effective September 1, 2011.

115.30    Sec. 45. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
115.31subdivision to read:
115.32    Subd. 56. Medical service coordination. (a) Medical assistance covers in-reach
115.33community-based service coordination that is performed in a hospital emergency
115.34department as an eligible procedure under a state healthcare program or private insurance
115.35for a frequent user. A frequent user is defined as an individual who has frequented the
116.1hospital emergency department for services three or more times in the previous four
116.2consecutive months. In-reach community-based service coordination includes navigating
116.3services to address a client's mental health, chemical health, social, economic, and housing
116.4needs, or any other activity targeted at reducing the incidence of emergency room and
116.5other nonmedically necessary health care utilization.
116.6(b) Reimbursement must be made in 15-minute increments under current Medicaid
116.7mental health social work reimbursement methodology and allowed for up to 60 days
116.8posthospital discharge based upon the specific identified emergency department visit or
116.9inpatient admitting event. A frequent user who is participating in care coordination within
116.10a health care home framework is ineligible for reimbursement under this subdivision.
116.11Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in
116.12social work, public health, corrections, or a related field. The commissioner shall submit
116.13any necessary application for waivers to the Centers for Medicare and Medicaid Services
116.14to implement this subdivision.
116.15(c) For the purposes of this subdivision, "in-reach community-based service
116.16coordination" means the practice of a community-based worker with training, knowledge,
116.17skills, and ability to access a continuum of services, including housing, transportation,
116.18chemical and mental health treatment, employment, and peer support services, by working
116.19with an organization's staff to transition an individual back into the individual's living
116.20environment. In-reach community-based service coordination includes working with the
116.21individual during their discharge and for up to a defined amount of time in the individual's
116.22living environment, reducing the individual's need for readmittance.
116.23EFFECTIVE DATE.This section is effective retroactive from January 1, 2011.

116.24    Sec. 46. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
116.25subdivision to read:
116.26    Subd. 57. Payment for Part B Medicare crossover claims. Effective for services
116.27provided on or after January 1, 2012, medical assistance payment for an enrollee's
116.28cost-sharing associated with Medicare Part B is limited to an amount up to the medical
116.29assistance total allowed, when the medical assistance rate exceeds the amount paid by
116.30Medicare. Excluded from this limitation are payments for mental health services and
116.31payments for dialysis services provided to end stage renal disease patients. The exclusion
116.32for mental health services does not apply to payments for physician services provided by
116.33psychiatrists and advanced practice nurses with a specialty in mental health.

117.1    Sec. 47. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
117.2subdivision to read:
117.3    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
117.4Medical assistance covers early and periodic screening, diagnosis, and treatment services
117.5(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate
117.6established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

117.7    Sec. 48. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
117.8subdivision to read:
117.9    Subd. 59. Services provided by advanced dental therapists and dental
117.10therapists. Medical assistance covers services provided by advanced dental therapists
117.11and dental therapists when provided within the scope of practice identified in sections
117.12150A.105 and 150A.106.
117.13EFFECTIVE DATE.This section is effective September 1, 2011.

117.14    Sec. 49. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to
117.15read:
117.16    Subdivision 1. Co-payments Cost-sharing. (a) Except as provided in subdivision
117.172, the medical assistance benefit plan shall include the following co-payments cost-sharing
117.18for all recipients, effective for services provided on or after October 1, 2003, and before
117.19January 1, 2009 September 1, 2011:
117.20    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
117.21of this subdivision, a visit means an episode of service which is required because of
117.22a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
117.23ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
117.24midwife, advanced practice nurse, audiologist, optician, or optometrist;
117.25    (2) $3 for eyeglasses;
117.26    (3) $6 $3.50 for nonemergency visits to a hospital-based emergency room, except
117.27that this co-payment shall be increased to $20 upon federal approval; and
117.28    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
117.29subject to a $12 per month maximum for prescription drug co-payments. No co-payments
117.30shall apply to antipsychotic drugs when used for the treatment of mental illness.;
117.31(5) effective January 1, 2012, a family deductible equal to the maximum amount
117.32allowed under Code of Federal Regulations, title 42, part 447.54; and
118.1    (b) Except as provided in subdivision 2, the medical assistance benefit plan shall
118.2include the following co-payments for all recipients, effective for services provided on
118.3or after January 1, 2009:
118.4    (1) $3.50 for nonemergency visits to a hospital-based emergency room;
118.5    (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
118.6subject to a $7 per month maximum for prescription drug co-payments. No co-payments
118.7shall apply to antipsychotic drugs when used for the treatment of mental illness; and
118.8    (3) (6) for individuals identified by the commissioner with income at or below 100
118.9percent of the federal poverty guidelines, total monthly co-payments cost-sharing must
118.10not exceed five percent of family income. For purposes of this paragraph, family income
118.11is the total earned and unearned income of the individual and the individual's spouse, if
118.12the spouse is enrolled in medical assistance and also subject to the five percent limit on
118.13co-payments cost-sharing.
118.14    (c) (b) Recipients of medical assistance are responsible for all co-payments and
118.15deductibles in this subdivision.

118.16    Sec. 50. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to
118.17read:
118.18    Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following
118.19exceptions:
118.20(1) children under the age of 21;
118.21(2) pregnant women for services that relate to the pregnancy or any other medical
118.22condition that may complicate the pregnancy;
118.23(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
118.24intermediate care facility for the developmentally disabled;
118.25(4) recipients receiving hospice care;
118.26(5) 100 percent federally funded services provided by an Indian health service;
118.27(6) emergency services;
118.28(7) family planning services;
118.29(8) services that are paid by Medicare, resulting in the medical assistance program
118.30paying for the coinsurance and deductible; and
118.31(9) co-payments that exceed one per day per provider for nonpreventive visits,
118.32eyeglasses, and nonemergency visits to a hospital-based emergency room.
118.33EFFECTIVE DATE.This section is effective September 1, 2011, for services
118.34provided on a fee-for-service basis and January 1, 2012, for services provided by a
118.35managed care plan or county-based purchasing plan.

119.1    Sec. 51. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to
119.2read:
119.3    Subd. 3. Collection. (a) The medical assistance reimbursement to the provider shall
119.4be reduced by the amount of the co-payment or deductible, except that reimbursements
119.5shall not be reduced:
119.6    (1) once a recipient has reached the $12 per month maximum or the $7 per month
119.7maximum effective January 1, 2009, for prescription drug co-payments; or
119.8    (2) for a recipient identified by the commissioner under 100 percent of the federal
119.9poverty guidelines who has met their monthly five percent co-payment cost-sharing limit.
119.10    (b) The provider collects the co-payment or deductible from the recipient. Providers
119.11may not deny services to recipients who are unable to pay the co-payment or deductible.
119.12    (c) Medical assistance reimbursement to fee-for-service providers and payments to
119.13managed care plans shall not be increased as a result of the removal of co-payments or
119.14deductibles effective on or after January 1, 2009.
119.15EFFECTIVE DATE.This section is effective September 1, 2011, for services
119.16provided on a fee-for-service basis, and January 1, 2012, for services provided by a
119.17managed care plan or county-based purchasing plan.

119.18    Sec. 52. Minnesota Statutes 2010, section 256B.064, subdivision 2, is amended to read:
119.19    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
119.20shall determine any monetary amounts to be recovered and sanctions to be imposed upon
119.21a vendor of medical care under this section. Except as provided in paragraphs (b) and
119.22(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
119.23without prior notice and an opportunity for a hearing, according to chapter 14, on the
119.24commissioner's proposed action, provided that the commissioner may suspend or reduce
119.25payment to a vendor of medical care, except a nursing home or convalescent care facility,
119.26after notice and prior to the hearing if in the commissioner's opinion that action is
119.27necessary to protect the public welfare and the interests of the program.
119.28(b) Except for a nursing home or convalescent care facility, when the commissioner
119.29finds good cause not to suspend payments under Code of Federal Regulations, title 42,
119.30section 455.23(e) or (f), the commissioner may shall withhold or reduce payments to a
119.31vendor of medical care without providing advance notice of such withholding or reduction
119.32if either of the following occurs:
119.33(1) the vendor is convicted of a crime involving the conduct described in subdivision
119.341a; or
120.1(2) the commissioner receives reliable evidence of fraud or willful misrepresentation
120.2by the vendor. determines there is a credible allegation of fraud for which an investigation
120.3is pending under the program. A credible allegation of fraud is an allegation which has
120.4been verified by the state, from any source, including but not limited to:
120.5(i) fraud hotline complaints;
120.6(ii) claims data mining; and
120.7(iii) patterns identified through provider audits, civil false claims cases, and law
120.8enforcement investigations.
120.9Allegations are considered to be credible when they have an indicia of reliability
120.10and the state agency has reviewed all allegations, facts, and evidence carefully and acts
120.11judiciously on a case-by-case basis.
120.12(c) The commissioner must send notice of the withholding or reduction of payments
120.13under paragraph (b) within five days of taking such action unless requested in writing by a
120.14law enforcement agency to temporarily withhold the notice. The notice must:
120.15(1) state that payments are being withheld according to paragraph (b);
120.16(2) set forth the general allegations as to the nature of the withholding action, but
120.17need not disclose any specific information concerning an ongoing investigation;
120.18(2) (3) except in the case of a conviction for conduct described in subdivision 1a,
120.19state that the withholding is for a temporary period and cite the circumstances under which
120.20withholding will be terminated;
120.21(3) (4) identify the types of claims to which the withholding applies; and
120.22(4) (5) inform the vendor of the right to submit written evidence for consideration by
120.23the commissioner.
120.24The withholding or reduction of payments will not continue after the commissioner
120.25determines there is insufficient evidence of fraud or willful misrepresentation by the
120.26vendor, or after legal proceedings relating to the alleged fraud or willful misrepresentation
120.27are completed, unless the commissioner has sent notice of intention to impose monetary
120.28recovery or sanctions under paragraph (a).
120.29(d) The commissioner may shall suspend or terminate a vendor's participation in
120.30the program without providing advance notice and an opportunity for a hearing when the
120.31suspension or termination is required because of the vendor's exclusion from participation
120.32in Medicare. Within five days of taking such action, the commissioner must send notice of
120.33the suspension or termination. The notice must:
120.34(1) state that suspension or termination is the result of the vendor's exclusion from
120.35Medicare;
120.36(2) identify the effective date of the suspension or termination; and
121.1(3) inform the vendor of the need to be reinstated to Medicare before reapplying for
121.2participation in the program; and.
121.3(4) inform the vendor of the right to submit written evidence for consideration by
121.4the commissioner.
121.5(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
121.6sanction is to be imposed, a vendor may request a contested case, as defined in section
121.714.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
121.8appeal request must be received by the commissioner no later than 30 days after the date
121.9the notification of monetary recovery or sanction was mailed to the vendor. The appeal
121.10request must specify:
121.11(1) each disputed item, the reason for the dispute, and an estimate of the dollar
121.12amount involved for each disputed item;
121.13(2) the computation that the vendor believes is correct;
121.14(3) the authority in statute or rule upon which the vendor relies for each disputed
121.15item;
121.16(4) the name and address of the person or entity with whom contacts may be made
121.17regarding the appeal; and
121.18(5) other information required by the commissioner.

121.19    Sec. 53. Minnesota Statutes 2010, section 256B.0641, subdivision 1, is amended to
121.20read:
121.21    Subdivision 1. Recovery procedures; sources. Notwithstanding section 256B.72
121.22or any law or rule to the contrary, when the commissioner or the federal government
121.23determines that an overpayment has been made by the state to any medical assistance
121.24vendor, the commissioner shall recover the overpayment as follows:
121.25(1) if the federal share of the overpayment amount is due and owing to the federal
121.26government under federal law and regulations, the commissioner shall recover from the
121.27medical assistance vendor the federal share of the determined overpayment amount paid
121.28to that provider using the schedule of payments required by the federal government;
121.29(2) if the overpayment to a medical assistance vendor is due to a retroactive
121.30adjustment made because the medical assistance vendor's temporary payment rate was
121.31higher than the established desk audit payment rate or because of a department error in
121.32calculating a payment rate, the commissioner shall recover from the medical assistance
121.33vendor the total amount of the overpayment within 120 days after the date on which
121.34written notice of the adjustment is sent to the medical assistance vendor or according to a
121.35schedule of payments approved by the commissioner; and
122.1(3) a medical assistance vendor is liable for the overpayment amount owed by
122.2a long-term care provider if the vendors or their owners are under common control
122.3or ownership.; and
122.4(4) in order to collect past due obligations to the department, the commissioner shall
122.5make any necessary adjustments to payments to a provider or vendor that has the same tax
122.6identification number as is assigned to a provider or vendor with past due obligations.

122.7    Sec. 54. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to
122.8read:
122.9    Subd. 4. Alternative models and waivers of requirements. (a) Nothing in this
122.10section shall preclude the continued development of existing medical or health care
122.11home projects currently operating or under development by the commissioner of human
122.12services or preclude the commissioner from establishing alternative models and payment
122.13mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs
122.14under section 256B.69, subdivisions 23 and 28, are enrolled in managed care long-term
122.15care programs under section 256B.69, subdivision 6b, are dually eligible for Medicare and
122.16medical assistance, are in the waiting period for Medicare, or who have other primary
122.17coverage.
122.18(b) The commissioner of health shall waive health care home certification
122.19requirements if an applicant demonstrates that compliance with a certification requirement
122.20will create a major financial hardship or is not feasible, and the applicant establishes an
122.21alternative way to accomplish the objectives of the certification requirement.
122.22EFFECTIVE DATE.This section is effective September 1, 2011.

122.23    Sec. 55. Minnesota Statutes 2010, section 256B.0751, is amended by adding a
122.24subdivision to read:
122.25    Subd. 8. Coordination with local services. The health care home and the county
122.26shall coordinate care and services provided to patients enrolled with a health care home
122.27who have complex medical needs or a disability, and who need and are eligible for
122.28additional local services administered by counties, including but not limited to waivered
122.29services, mental health services, social services, public health services, transportation, and
122.30housing. The coordination of care and services must be as provided in the plan established
122.31by the patient and health care home.
122.32EFFECTIVE DATE.This section is effective September 1, 2011.

123.1    Sec. 56. Minnesota Statutes 2010, section 256B.196, subdivision 2, is amended to read:
123.2    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
123.3subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
123.4services upper payment limit for nonstate government hospitals. The commissioner shall
123.5then determine the amount of a supplemental payment to Hennepin County Medical
123.6Center and Regions Hospital for these services that would increase medical assistance
123.7spending in this category to the aggregate upper payment limit for all nonstate government
123.8hospitals in Minnesota. In making this determination, the commissioner shall allot the
123.9available increases between Hennepin County Medical Center and Regions Hospital
123.10based on the ratio of medical assistance fee-for-service outpatient hospital payments to
123.11the two facilities. The commissioner shall adjust this allotment as necessary based on
123.12federal approvals, the amount of intergovernmental transfers received from Hennepin and
123.13Ramsey Counties, and other factors, in order to maximize the additional total payments.
123.14The commissioner shall inform Hennepin County and Ramsey County of the periodic
123.15intergovernmental transfers necessary to match federal Medicaid payments available
123.16under this subdivision in order to make supplementary medical assistance payments to
123.17Hennepin County Medical Center and Regions Hospital equal to an amount that when
123.18combined with existing medical assistance payments to nonstate governmental hospitals
123.19would increase total payments to hospitals in this category for outpatient services to
123.20the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
123.21receipt of these periodic transfers, the commissioner shall make supplementary payments
123.22to Hennepin County Medical Center and Regions Hospital.
123.23    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall
123.24determine an upper payment limit for physicians and other billing professionals affiliated
123.25with Hennepin County Medical Center and with Regions Hospital. The upper payment
123.26limit shall be based on the average commercial rate or be determined using another method
123.27acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
123.28inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
123.29necessary to match the federal Medicaid payments available under this subdivision in
123.30order to make supplementary payments to physicians and other billing professionals
123.31affiliated with Hennepin County Medical Center and to make supplementary payments
123.32to physicians and other billing professionals affiliated with Regions Hospital through
123.33HealthPartners Medical Group equal to the difference between the established medical
123.34assistance payment for physician and other billing professional services and the upper
123.35payment limit. Upon receipt of these periodic transfers, the commissioner shall make
123.36supplementary payments to physicians of and other billing professionals affiliated with
124.1Hennepin Faculty Associates County Medical Center and shall make supplementary
124.2payments to physicians and other billing professionals affiliated with Regions Hospital
124.3through HealthPartners Medical Group.
124.4    (c) Beginning January 1, 2010, Hennepin County and Ramsey County may make
124.5monthly voluntary intergovernmental transfers to the commissioner in amounts not to
124.6exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from
124.7Ramsey County. The commissioner shall increase the medical assistance capitation
124.8payments to any licensed health plan under contract with the medical assistance program
124.9that agrees to make enhanced payments to Hennepin County Medical Center or Regions
124.10Hospital. The increase shall be in an amount equal to the annual value of the monthly
124.11transfers plus federal financial participation, with each health plan receiving its pro rata
124.12share of the increase based on the pro rata share of medical assistance admissions to
124.13Hennepin County Medical Center and Regions Hospital by those plans. Upon the request
124.14of the commissioner, health plans shall submit individual-level cost data for verification
124.15purposes. The commissioner may ratably reduce these payments on a pro rata basis in
124.16order to satisfy federal requirements for actuarial soundness. If payments are reduced,
124.17transfers shall be reduced accordingly. Any licensed health plan that receives increased
124.18medical assistance capitation payments under the intergovernmental transfer described in
124.19this paragraph shall increase its medical assistance payments to Hennepin County Medical
124.20Center and Regions Hospital by the same amount as the increased payments received in
124.21the capitation payment described in this paragraph.
124.22    (d) The commissioner shall inform Hennepin County and Ramsey County the
124.23transferring governmental entities on an ongoing basis of the need for any changes needed
124.24in the intergovernmental transfers in order to continue the payments under paragraphs (a)
124.25to (c), at their maximum level, including increases in upper payment limits, changes in the
124.26federal Medicaid match, and other factors.
124.27    (e) The payments in paragraphs (a) to (c) shall be implemented independently of
124.28each other, subject to federal approval and to the receipt of transfers under subdivision 3.

124.29    Sec. 57. Minnesota Statutes 2010, section 256B.196, subdivision 3, is amended to read:
124.30    Subd. 3. Intergovernmental transfers. Based on the determination by the
124.31commissioner under subdivision 2, Hennepin County and Ramsey County shall make
124.32periodic intergovernmental transfers to the commissioner for the purposes of subdivision
124.332, paragraphs (a) to (c) and (b). All of the intergovernmental transfers made by Hennepin
124.34County shall be used to match federal payments to Hennepin County Medical Center
124.35under subdivision 2, paragraph (a);, and to physicians and other billing professionals
125.1 affiliated with Hennepin Faculty Associates County Medical Center under subdivision
125.22, paragraph (b); and to Metropolitan Health Plan under subdivision 2, paragraph
125.3(c). All of the intergovernmental transfers made by Ramsey County shall be used to
125.4match federal payments to Regions Hospital under subdivision 2, paragraph (a);, and
125.5to physicians and other billing professionals affiliated with Regions Hospital through
125.6HealthPartners Medical Group under subdivision 2, paragraph (b); and to HealthPartners
125.7under subdivision 2, paragraph (c).

125.8    Sec. 58. Minnesota Statutes 2010, section 256B.196, subdivision 5, is amended to read:
125.9    Subd. 5. Recession period. Each type of intergovernmental transfer in subdivision
125.102, paragraphs (a) to (d), for payment periods from October 1, 2008, through December 31,
125.112010 June 30, 2013, is voluntary on the part of Hennepin and Ramsey Counties, meaning
125.12that the transfer must be agreed to, in writing, by the counties prior to any payments being
125.13issued. One agreement on each type of transfer shall cover the entire recession period.

125.14    Sec. 59. [256B.198] PAYMENTS FOR NONHOSPITAL-BASED
125.15GOVERNMENTAL HEALTH CENTERS.
125.16(a) The commissioner may make payments to nonhospital-based health centers
125.17operated by a governmental entity for the difference between the expenditures incurred
125.18by the health center for patients eligible for medical assistance, and the payments to the
125.19health center for medical assistance permitted elsewhere under this chapter.
125.20(b) The nonfederal share of payments authorized under paragraph (a) shall be
125.21provided through certified public expenditures authorized under section 256B.199,
125.22paragraph (b).
125.23(c) Effective July 1, 2013, or no earlier than 12 months after implementation of a
125.24total cost of care demonstration project, Hennepin County may receive federal matching
125.25funds for certified public expenditures under paragraph (a), if the county participates in
125.26a total cost of care demonstration project under sections 256B.0755 and 256B.0756, or
125.27another total cost of care demonstration project approved by the commissioner, and the
125.28county exceeds the minimum performance threshold established by the commissioner for
125.29the demonstration project. The value of the federal matching funds for the certified public
125.30expenditures allocated to Hennepin County shall be equal to the value of savings achieved
125.31above the minimum performance threshold. The same proportion of federal matching
125.32funds for certified public expenditure allocated to Hennepin County based on savings
125.33achieved under the demonstration project shall continue after the demonstration project
125.34and must continue to be paid to Hennepin County each year thereafter.
126.1(d) Beginning July 1, 2014, or no earlier than 12 months after the initial allocation
126.2under paragraph (c) if a portion of the federal matching funds for certified public
126.3expenditure remains with the state, the commissioner shall annually determine if the
126.4savings from county's total cost of care demonstration project exceeded the savings from
126.5the previous year and allocate federal matching funds for certified public expenditures to
126.6Hennepin County equal to the amount of savings achieved above the amount achieved
126.7in the previous year. The proportion of federal matching funds for certified public
126.8expenditure allocated to Hennepin County shall be paid to Hennepin County each
126.9year thereafter, until no federal matching funds for certified public expenditures under
126.10paragraph (a) remain with the state.
126.11(e) Nothing under this subdivision precludes Hennepin County from receiving
126.12an additional gain-sharing payment or relieves the county from paying a downside
126.13risk-sharing payment to the state under the demonstration project under section 256B.0755.

126.14    Sec. 60. Minnesota Statutes 2010, section 256B.199, is amended to read:
126.15256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
126.16    (a) Effective July 1, 2007, the commissioner shall apply for federal matching
126.17funds for the expenditures in paragraphs (b) and (c). Effective September 1, 2011, the
126.18commissioner shall apply for matching funds for expenditures in paragraph (e).
126.19    (b) The commissioner shall apply for federal matching funds for certified public
126.20expenditures as follows:
126.21    (1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions
126.22Hospital, the University of Minnesota, and Fairview-University Medical Center shall
126.23report quarterly to the commissioner beginning June 1, 2007, payments made during the
126.24second previous quarter that may qualify for reimbursement under federal law;
126.25     (2) based on these reports, the commissioner shall apply for federal matching
126.26funds. These funds are appropriated to the commissioner for the payments under section
126.27256.969, subdivision 27 ; and
126.28     (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
126.29the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
126.30hospital payment money expected to be available in the current federal fiscal year.
126.31    (c) The commissioner shall apply for federal matching funds for general assistance
126.32medical care expenditures as follows:
126.33    (1) for hospital services occurring on or after July 1, 2007, general assistance medical
126.34care expenditures for fee-for-service inpatient and outpatient hospital payments made by
126.35the department shall be used to apply for federal matching funds, except as limited below:
127.1    (i) only those general assistance medical care expenditures made to an individual
127.2hospital that would not cause the hospital to exceed its individual hospital limits under
127.3section 1923 of the Social Security Act may be considered; and
127.4    (ii) general assistance medical care expenditures may be considered only to the extent
127.5of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
127.6    (2) all hospitals must provide any necessary expenditure, cost, and revenue
127.7information required by the commissioner as necessary for purposes of obtaining federal
127.8Medicaid matching funds for general assistance medical care expenditures.
127.9(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall
127.10apply for additional federal matching funds available as disproportionate share hospital
127.11payments under the American Recovery and Reinvestment Act of 2009. These funds shall
127.12be made available as the state share of payments under section 256.969, subdivision 28.
127.13The entities required to report certified public expenditures under paragraph (b), clause
127.14(1), shall report additional certified public expenditures as necessary under this paragraph.
127.15(e) For services provided on or after September 1, 2011, the commissioner shall
127.16apply for additional federal matching funds available as disproportionate share hospital
127.17payments under the MinnesotaCare program according to the requirements and conditions
127.18of paragraph (c). A hospital may elect on an annual basis to not be a disproportionate
127.19share hospital for purposes of this paragraph, if the hospital does not qualify for a payment
127.20under section 256.969, subdivision 9, paragraph (b).

127.21    Sec. 61. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
127.22    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
127.23and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
127.24January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
127.25renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
127.2631, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
127.27issue separate contracts with requirements specific to services to medical assistance
127.28recipients age 65 and older.
127.29    (b) A prepaid health plan providing covered health services for eligible persons
127.30pursuant to chapters 256B and 256L is responsible for complying with the terms of its
127.31contract with the commissioner. Requirements applicable to managed care programs
127.32under chapters 256B and 256L established after the effective date of a contract with the
127.33commissioner take effect when the contract is next issued or renewed.
127.34    (c) Effective for services rendered on or after January 1, 2003, the commissioner
127.35shall withhold five percent of managed care plan payments under this section and
128.1county-based purchasing plan payments under section 256B.692 for the prepaid medical
128.2assistance program pending completion of performance targets. Each performance target
128.3must be quantifiable, objective, measurable, and reasonably attainable, except in the case
128.4of a performance target based on a federal or state law or rule. Criteria for assessment
128.5of each performance target must be outlined in writing prior to the contract effective
128.6date. The managed care plan must demonstrate, to the commissioner's satisfaction,
128.7that the data submitted regarding attainment of the performance target is accurate. The
128.8commissioner shall periodically change the administrative measures used as performance
128.9targets in order to improve plan performance across a broader range of administrative
128.10services. The performance targets must include measurement of plan efforts to contain
128.11spending on health care services and administrative activities. The commissioner may
128.12adopt plan-specific performance targets that take into account factors affecting only one
128.13plan, including characteristics of the plan's enrollee population. The withheld funds
128.14must be returned no sooner than July of the following year if performance targets in the
128.15contract are achieved. The commissioner may exclude special demonstration projects
128.16under subdivision 23.
128.17    (d) Effective for services rendered on or after January 1, 2009, through December
128.1831, 2009, the commissioner shall withhold three percent of managed care plan payments
128.19under this section and county-based purchasing plan payments under section 256B.692
128.20for the prepaid medical assistance program. The withheld funds must be returned no
128.21sooner than July 1 and no later than July 31 of the following year. The commissioner may
128.22exclude special demonstration projects under subdivision 23.
128.23(e) Effective for services provided on or after January 1, 2010, the commissioner
128.24shall require that managed care plans use the assessment and authorization processes,
128.25forms, timelines, standards, documentation, and data reporting requirements, protocols,
128.26billing processes, and policies consistent with medical assistance fee-for-service or the
128.27Department of Human Services contract requirements consistent with medical assistance
128.28fee-for-service or the Department of Human Services contract requirements for all
128.29personal care assistance services under section 256B.0659.
128.30(f) Effective for services rendered on or after January 1, 2010, through December
128.3131, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
128.32under this section and county-based purchasing plan payments under section 256B.692
128.33for the prepaid medical assistance program. The withheld funds must be returned no
128.34sooner than July 1 and no later than July 31 of the following year. The commissioner may
128.35exclude special demonstration projects under subdivision 23.
129.1(g) Effective for services rendered on or after January 1, 2011, through December
129.231, 2011, the commissioner shall include as part of the performance targets described
129.3in paragraph (c) a reduction in the health plan's emergency room utilization rate for
129.4state health care program enrollees by a measurable rate of five percent from the plan's
129.5utilization rate for state health care program enrollees for the previous calendar year.
129.6Effective for services rendered on or after January 1, 2012, the commissioner shall include
129.7as part of the performance targets described in paragraph (c) a reduction in the health
129.8plan's emergency department utilization rate for medical assistance and MinnesotaCare
129.9enrollees, as determined by the commissioner. To earn the return of the withhold each
129.10year, the managed care plan or county-based purchasing plan must achieve a qualifying
129.11reduction of no less than ten percent of the plan's emergency department utilization rate for
129.12medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared
129.13to the previous calendar year until the final performance target is reached.
129.14The withheld funds must be returned no sooner than July 1 and no later than July
129.1531 of the following calendar year if the managed care plan or county-based purchasing
129.16plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization
129.17rate was achieved.
129.18The withhold described in this paragraph shall continue for each consecutive
129.19contract period until the plan's emergency room utilization rate for state health care
129.20program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
129.21for state health care program enrollees for calendar year 2009 medical assistance and
129.22MinnesotaCare enrollees for calendar year 2011. Hospitals shall cooperate with the health
129.23plans in meeting this performance target and shall accept payment withholds that may be
129.24returned to the hospitals if the performance target is achieved. The commissioner shall
129.25structure the withhold so that the commissioner returns a portion of the withheld funds
129.26in amounts commensurate with achieved reductions in utilization less than the targeted
129.27amount. The withhold in this paragraph does not apply to county-based purchasing plans.
129.28(h) Effective for services rendered on or after January 1, 2012, the commissioner
129.29shall include as part of the performance targets described in paragraph (c) a reduction
129.30in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
129.31enrollees, as determined by the commissioner. To earn the return of the withhold each
129.32year, the managed care plan or county-based purchasing plan must achieve a qualifying
129.33reduction of no less than five percent of the plan's hospital admission rate for medical
129.34assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared to the
129.35previous calendar year until the final performance target is reached.
130.1The withheld funds must be returned no sooner than July 1 and no later than July
130.231 of the following calendar year if the managed care plan or county-based purchasing
130.3plan demonstrates to the satisfaction of the commissioner that this reduction in the
130.4hospitalization rate was achieved.
130.5The withhold described in this paragraph shall continue until there is a 25 percent
130.6reduction in the hospital admission rate compared to the hospital admission rates in
130.7calendar year 2011, as determined by the commissioner. The hospital admissions in this
130.8performance target do not include the admissions applicable to the subsequent hospital
130.9admission performance target under paragraph (i). Hospitals shall cooperate with the
130.10plans in meeting this performance target and shall accept payment withholds that may be
130.11returned to the hospitals if the performance target is achieved.
130.12(i) Effective for services rendered on or after January 1, 2012, the commissioner
130.13shall include as part of the performance targets described in paragraph (c) a reduction in
130.14the plan's hospitalization admission rates for subsequent hospitalizations within 30 days
130.15of a previous hospitalization of a patient regardless of the reason, for medical assistance
130.16and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
130.17the withhold each year, the managed care plan or county-based purchasing plan must
130.18achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance
130.19and MinnesotaCare enrollees, excluding Medicare enrollees, of no less than five percent
130.20compared to the previous calendar year until the final performance target is reached.
130.21The withheld funds must be returned no sooner than July 1 and no later than July 31
130.22of the following calendar year if the managed care plan or county-based purchasing plan
130.23demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
130.24subsequent hospitalization rate was achieved.
130.25The withhold described in this paragraph must continue for each consecutive
130.26contract period until the plan's subsequent hospitalization rate for medical assistance and
130.27MinnesotaCare enrollees, excluding Medicare enrollees, is reduced by 25 percent of the
130.28plan's subsequent hospitalization rate for calendar year 2011. Hospitals shall cooperate
130.29with the plans in meeting this performance target and shall accept payment withholds that
130.30must be returned to the hospitals if the performance target is achieved.
130.31(j) Effective for services rendered on or after January 1, 2011, through December 31,
130.322011, the commissioner shall withhold 4.5 percent of managed care plan payments under
130.33this section and county-based purchasing plan payments under section 256B.692 for the
130.34prepaid medical assistance program. The withheld funds must be returned no sooner than
130.35July 1 and no later than July 31 of the following year. The commissioner may exclude
130.36special demonstration projects under subdivision 23.
131.1(i) (k) Effective for services rendered on or after January 1, 2012, through December
131.231, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
131.3under this section and county-based purchasing plan payments under section 256B.692
131.4for the prepaid medical assistance program. The withheld funds must be returned no
131.5sooner than July 1 and no later than July 31 of the following year. The commissioner may
131.6exclude special demonstration projects under subdivision 23.
131.7(j) (l) Effective for services rendered on or after January 1, 2013, through December
131.831, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
131.9under this section and county-based purchasing plan payments under section 256B.692
131.10for the prepaid medical assistance program. The withheld funds must be returned no
131.11sooner than July 1 and no later than July 31 of the following year. The commissioner may
131.12exclude special demonstration projects under subdivision 23.
131.13(k) (m) Effective for services rendered on or after January 1, 2014, the commissioner
131.14shall withhold three percent of managed care plan payments under this section and
131.15county-based purchasing plan payments under section 256B.692 for the prepaid medical
131.16assistance program. The withheld funds must be returned no sooner than July 1 and
131.17no later than July 31 of the following year. The commissioner may exclude special
131.18demonstration projects under subdivision 23.
131.19(l) (n) A managed care plan or a county-based purchasing plan under section
131.20256B.692 may include as admitted assets under section 62D.044 any amount withheld
131.21under this section that is reasonably expected to be returned.
131.22(m) (o) Contracts between the commissioner and a prepaid health plan are exempt
131.23from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
131.24(a), and 7.
131.25(n) (p) The return of the withhold under paragraphs (d), (f), and (h) (j) to (k) (m) is
131.26not subject to the requirements of paragraph (c).

131.27    Sec. 62. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:
131.28    Subd. 5c. Medical education and research fund. (a) The commissioner of human
131.29services shall transfer each year to the medical education and research fund established
131.30under section 62J.692, an amount specified in this subdivision. The commissioner shall
131.31calculate the following:
131.32(1) an amount equal to the reduction in the prepaid medical assistance payments as
131.33specified in this clause. Until January 1, 2002, the county medical assistance capitation
131.34base rate prior to plan specific adjustments and after the regional rate adjustments under
131.35subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
132.1metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
132.2January 1, 2002, the county medical assistance capitation base rate prior to plan specific
132.3adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
132.4metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
132.5facility and elderly waiver payments and demonstration project payments operating
132.6under subdivision 23 are excluded from this reduction. The amount calculated under
132.7this clause shall not be adjusted for periods already paid due to subsequent changes to
132.8the capitation payments;
132.9(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
132.10section;
132.11(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
132.12paid under this section; and
132.13(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
132.14under this section.
132.15(b) This subdivision shall be effective upon approval of a federal waiver which
132.16allows federal financial participation in the medical education and research fund. Effective
132.17July 1, 2009, and thereafter, The transfers required by amount specified under paragraph
132.18(a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009.
132.19Any excess shall first reduce the amounts otherwise required to be transferred specified
132.20under paragraph (a), clauses (2) to (4). Any excess following this reduction shall
132.21proportionally reduce the transfers amount specified under paragraph (a), clause (1).
132.22(c) Beginning July September 1, 2009 2011, of the amounts amount in paragraph
132.23(a), the commissioner shall transfer $21,714,000 each fiscal year to the medical education
132.24and research fund. The balance of the transfers under paragraph (a) shall be transferred to
132.25the medical education and research fund no earlier than July 1 of the following fiscal year.
132.26(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
132.27transfer under paragraph (c), the commissioner shall transfer to the medical education
132.28research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 in fiscal year
132.292014 and thereafter.

132.30    Sec. 63. Minnesota Statutes 2010, section 256B.69, is amended by adding a
132.31subdivision to read:
132.32    Subd. 9c. Managed care financial reporting. (a) The commissioner shall collect
132.33detailed data regarding financials, provider payments, provider rate methodologies, and
132.34other data as determined by the commissioner and managed care and county-based
132.35purchasing plans that are required to be submitted under this section. The commissioner,
133.1in consultation with the commissioners of health and commerce, and in consultation
133.2with managed care plans and county-based purchasing plans, shall set uniform criteria,
133.3definitions, and standards for the data to be submitted, and shall require managed care and
133.4county-based purchasing plans to comply with these criteria, definitions, and standards
133.5when submitting data under this section. In carrying out the responsibilities of this
133.6subdivision, the commissioner shall ensure that the data collection is implemented in an
133.7integrated and coordinated manner that avoids unnecessary duplication of effort. To the
133.8extent possible, the commissioner shall use existing data sources and streamline data
133.9collection in order to reduce public and private sector administrative costs. Nothing in
133.10this subdivision shall allow release of information that is nonpublic data pursuant to
133.11section 13.02.
133.12(b) Each managed care and county-based purchasing plan must annually provide
133.13to the commissioner the following information on state public programs, in the form
133.14and manner specified by the commissioner, according to guidelines developed by the
133.15commissioner in consultation with managed care plans and county-based purchasing
133.16plans under contract:
133.17(1) administrative expenses by category and subcategory consistent with
133.18administrative expense reporting to other state and federal regulatory agencies, by
133.19program;
133.20(2) revenues by program, including investment income;
133.21(3) nonadministrative service payments, provider payments, and reimbursement
133.22rates by provider type or service category, by program, paid by the managed care plan
133.23under this section or the county-based purchasing plan under section 256B.692 to
133.24providers and vendors for administrative services under contract with the plan, including
133.25but not limited to:
133.26(i) individual-level provider payment and reimbursement rate data;
133.27(ii) provider reimbursement rate methodologies by provider type, by program,
133.28including a description of alternative payment arrangements and payments outside the
133.29claims process;
133.30(iii) data on implementation of legislatively mandated provider rate changes; and
133.31(iv) individual-level provider payment and reimbursement rate data and plan-specific
133.32provider reimbursement rate methodologies by provider type, by program, including
133.33alternative payment arrangements and payments outside the claims process, provided to
133.34the commissioner under this subdivision are nonpublic data as defined in section 13.02;
133.35(4) data on the amount of reinsurance or transfer of risk by program; and
133.36(5) contribution to reserve, by program.
134.1(c) In the event a report is published or released based on data provided under
134.2this subdivision, the commissioner shall provide the report to managed care plans and
134.3county-based purchasing plans 30 days prior to the publication or release of the report.
134.4Managed care plans and county-based purchasing plans shall have 30 days to review the
134.5report and provide comment to the commissioner.

134.6    Sec. 64. Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:
134.7    Subd. 28. Medicare special needs plans; medical assistance basic health care.
134.8    (a) The commissioner may contract with qualified Medicare-approved special needs
134.9plans to provide medical assistance basic health care services to persons with disabilities,
134.10including those with developmental disabilities. Basic health care services include:
134.11    (1) those services covered by the medical assistance state plan except for ICF/MR
134.12services, home and community-based waiver services, case management for persons with
134.13developmental disabilities under section 256B.0625, subdivision 20a, and personal care
134.14and certain home care services defined by the commissioner in consultation with the
134.15stakeholder group established under paragraph (d); and
134.16    (2) basic health care services may also include risk for up to 100 days of nursing
134.17facility services for persons who reside in a noninstitutional setting and home health
134.18services related to rehabilitation as defined by the commissioner after consultation with
134.19the stakeholder group.
134.20    The commissioner may exclude other medical assistance services from the basic
134.21health care benefit set. Enrollees in these plans can access any excluded services on the
134.22same basis as other medical assistance recipients who have not enrolled.
134.23    Unless a person is otherwise required to enroll in managed care, enrollment in these
134.24plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
134.25enrollment with an option to opt out is not voluntary enrollment.
134.26    (b) Beginning January 1, 2007, the commissioner may contract with qualified
134.27Medicare special needs plans to provide basic health care services under medical
134.28assistance to persons who are dually eligible for both Medicare and Medicaid and those
134.29Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
134.30The commissioner shall consult with the stakeholder group under paragraph (d) in
134.31developing program specifications for these services. The commissioner shall report to
134.32the chairs of the house of representatives and senate committees with jurisdiction over
134.33health and human services policy and finance by February 1, 2007, on implementation
134.34of these programs and the need for increased funding for the ombudsman for managed
134.35care and other consumer assistance and protections needed due to enrollment in managed
135.1care of persons with disabilities. Payment for Medicaid services provided under this
135.2subdivision for the months of May and June will be made no earlier than July 1 of the
135.3same calendar year.
135.4    (c) Notwithstanding subdivision 4, beginning January 1, 2008 2012, the
135.5commissioner may expand contracting under this subdivision to all shall enroll persons
135.6with disabilities not otherwise required to enroll in managed care under this section,
135.7unless the individual chooses to opt out of enrollment. The commissioner shall establish
135.8enrollment and opt out procedures consistent with applicable enrollment procedures under
135.9this subdivision.
135.10    (d) The commissioner shall establish a state-level stakeholder group to provide
135.11advice on managed care programs for persons with disabilities, including both MnDHO
135.12and contracts with special needs plans that provide basic health care services as described
135.13in paragraphs (a) and (b). The stakeholder group shall provide advice on program
135.14expansions under this subdivision and subdivision 23, including:
135.15    (1) implementation efforts;
135.16    (2) consumer protections; and
135.17    (3) program specifications such as quality assurance measures, data collection and
135.18reporting, and evaluation of costs, quality, and results.
135.19    (e) Each plan under contract to provide medical assistance basic health care services
135.20shall establish a local or regional stakeholder group, including representatives of the
135.21counties covered by the plan, members, consumer advocates, and providers, for advice on
135.22issues that arise in the local or regional area.
135.23    (f) The commissioner is prohibited from providing the names of potential enrollees
135.24to health plans for marketing purposes. The commissioner may shall mail no more than
135.25two sets of marketing materials per contract year to potential enrollees on behalf of health
135.26plans, in which case at the health plan's request. The marketing materials shall be mailed
135.27by the commissioner within 30 days of receipt of these materials from the health plan. The
135.28health plans shall cover any costs incurred by the commissioner for mailing marketing
135.29materials.

135.30    Sec. 65. Minnesota Statutes 2010, section 256B.69, is amended by adding a
135.31subdivision to read:
135.32    Subd. 30. Payment reduction. (a) Beginning September 1, 2011, the commissioner
135.33shall reduce payments and limit future rate increases paid to managed care plans and
135.34county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved
135.35on a statewide aggregate basis by program. The commissioner may use competitive
136.1bidding, payment reductions, or other reductions to achieve the reductions and limits
136.2in this subdivision.
136.3(b) Beginning September 1, 2011, the commissioner shall reduce payments to
136.4managed care plans and county-based purchasing plans as follows:
136.5(1) 2.0 percent for medical assistance elderly basic care. This shall not apply
136.6to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
136.7services;
136.8(2) 2.82 percent for medical assistance families and children;
136.9(3) 10.1 percent for medical assistance adults without children; and
136.10(4) 6.0 percent for MinnesotaCare families and children.
136.11(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed
136.12care plans and county-based purchasing plans for calendar year 2012 to a percentage of
136.13the rates in effect on August 31, 2011, as follows:
136.14(1) 98 percent for medical assistance elderly basic care. This shall not apply to
136.15Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
136.16services;
136.17(2) 97.18 percent for medical assistance families and children;
136.18(3) 89.9 percent for medical assistance adults without children; and
136.19(4) 94 percent for MinnesotaCare families and children.
136.20(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit
136.21the maximum annual trend increases to rates paid to managed care plans and county-based
136.22purchasing plans as follows:
136.23(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
136.24to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
136.25services;
136.26(2) 5.0 percent for medical assistance special needs basic care;
136.27(3) 2.0 percent for medical assistance families and children;
136.28(4) 3.0 percent for medical assistance adults without children;
136.29(5) 3.0 percent for MinnesotaCare families and children; and
136.30(6) 3.0 percent for MinnesotaCare adults without children.
136.31(e) The commissioner may limit trend increases to less than the maximum.
136.32Beginning July 1, 2014, the commissioner shall limit the maximum annual trend increases
136.33to rates paid to managed care plans and county-based purchasing plans as follows for
136.34calendar years 2014 and 2015:
137.1(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
137.2to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
137.3services;
137.4(2) 5.0 percent for medical assistance special needs basic care;
137.5(3) 2.0 percent for medical assistance families and children;
137.6(4) 3.0 percent for medical assistance adults without children;
137.7(5) 3.0 percent for MinnesotaCare families and children; and
137.8(6) 4.0 percent for MinnesotaCare adults without children.
137.9The commissioner may limit trend increases to less than the maximum.

137.10    Sec. 66. Minnesota Statutes 2010, section 256B.76, subdivision 1, is amended to read:
137.11    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
137.12or after October 1, 1992, the commissioner shall make payments for physician services
137.13as follows:
137.14    (1) payment for level one Centers for Medicare and Medicaid Services' common
137.15procedural coding system codes titled "office and other outpatient services," "preventive
137.16medicine new and established patient," "delivery, antepartum, and postpartum care,"
137.17"critical care," cesarean delivery and pharmacologic management provided to psychiatric
137.18patients, and level three codes for enhanced services for prenatal high risk, shall be paid
137.19at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
137.2030, 1992. If the rate on any procedure code within these categories is different than the
137.21rate that would have been paid under the methodology in section 256B.74, subdivision 2,
137.22then the larger rate shall be paid;
137.23    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
137.24or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
137.25    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
137.26percentile of 1989, less the percent in aggregate necessary to equal the above increases
137.27except that payment rates for home health agency services shall be the rates in effect
137.28on September 30, 1992.
137.29    (b) Effective for services rendered on or after January 1, 2000, payment rates for
137.30physician and professional services shall be increased by three percent over the rates
137.31in effect on December 31, 1999, except for home health agency and family planning
137.32agency services. The increases in this paragraph shall be implemented January 1, 2000,
137.33for managed care.
137.34(c) Effective for services rendered on or after July 1, 2009, payment rates for
137.35physician and professional services shall be reduced by five percent, except that for the
138.1period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
138.2for the medical assistance and general assistance medical care programs, over the rates in
138.3effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
138.4to office or other outpatient visits, preventive medicine visits and family planning visits
138.5billed by physicians, advanced practice nurses, or physician assistants in a family planning
138.6agency or in one of the following primary care practices: general practice, general internal
138.7medicine, general pediatrics, general geriatrics, and family medicine. This reduction
138.8and the reductions in paragraph (d) do not apply to federally qualified health centers,
138.9rural health centers, and Indian health services. Effective October 1, 2009, payments
138.10made to managed care plans and county-based purchasing plans under sections 256B.69,
138.11256B.692 , and 256L.12 shall reflect the payment reduction described in this paragraph.
138.12(d) Effective for services rendered on or after July 1, 2010, payment rates for
138.13physician and professional services shall be reduced an additional seven percent over
138.14the five percent reduction in rates described in paragraph (c). This additional reduction
138.15does not apply to physical therapy services, occupational therapy services, and speech
138.16pathology and related services provided on or after July 1, 2010. This additional reduction
138.17does not apply to physician services billed by a psychiatrist or an advanced practice nurse
138.18with a specialty in mental health. Effective October 1, 2010, payments made to managed
138.19care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
138.20256L.12 shall reflect the payment reduction described in this paragraph.
138.21(e) Effective for services rendered on or after September 1, 2011, through June 30,
138.222013, payment rates for physician and professional services shall be reduced three percent
138.23from the rates in effect on August 31, 2011. This reduction does not apply to physical
138.24therapy services, occupational therapy services, and speech pathology and related services.

138.25    Sec. 67. Minnesota Statutes 2010, section 256B.76, subdivision 2, is amended to read:
138.26    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
138.27October 1, 1992, the commissioner shall make payments for dental services as follows:
138.28    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
138.29percent above the rate in effect on June 30, 1992; and
138.30    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
138.31percentile of 1989, less the percent in aggregate necessary to equal the above increases.
138.32    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
138.33shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
139.1    (c) Effective for services rendered on or after January 1, 2000, payment rates for
139.2dental services shall be increased by three percent over the rates in effect on December
139.331, 1999.
139.4    (d) Effective for services provided on or after January 1, 2002, payment for
139.5diagnostic examinations and dental x-rays provided to children under age 21 shall be the
139.6lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
139.7    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
139.82000, for managed care.
139.9(f) Effective for dental services rendered on or after October 1, 2010, by a
139.10state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
139.11on the Medicare principles of reimbursement. This payment shall be effective for services
139.12rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
139.13county-based purchasing plans.
139.14(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
139.15in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
139.16year, a supplemental state payment equal to the difference between the total payments
139.17in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
139.18services for the operation of the dental clinics.
139.19(h) If the cost-based payment system for state-operated dental clinics described in
139.20paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
139.21designated as critical access dental providers under subdivision 4, paragraph (b), and shall
139.22receive the critical access dental reimbursement rate as described under subdivision 4,
139.23paragraph (a).
139.24(i) Effective for services rendered on or after September 1, 2011, through June 30,
139.252013, payment rates for dental services shall be reduced by three percent. This reduction
139.26does not apply to state-operated dental clinics in paragraph (f).

139.27    Sec. 68. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
139.28    Subd. 4. Critical access dental providers. (a) Effective for dental services
139.29rendered on or after January 1, 2002, the commissioner shall increase reimbursements
139.30to dentists and dental clinics deemed by the commissioner to be critical access dental
139.31providers. For dental services rendered on or after July 1, 2007, the commissioner shall
139.32increase reimbursement by 30 percent above the reimbursement rate that would otherwise
139.33be paid to the critical access dental provider. The commissioner shall pay the managed
139.34care plans and county-based purchasing plans in amounts sufficient to reflect increased
139.35reimbursements to critical access dental providers as approved by the commissioner.
140.1(b) The commissioner shall designate the following dentists and dental clinics as
140.2critical access dental providers:
140.3    (1) nonprofit community clinics that:
140.4(i) have nonprofit status in accordance with chapter 317A;
140.5(ii) have tax exempt status in accordance with the Internal Revenue Code, section
140.6501(c)(3);
140.7(iii) are established to provide oral health services to patients who are low income,
140.8uninsured, have special needs, and are underserved;
140.9(iv) have professional staff familiar with the cultural background of the clinic's
140.10patients;
140.11(v) charge for services on a sliding fee scale designed to provide assistance to
140.12low-income patients based on current poverty income guidelines and family size;
140.13(vi) do not restrict access or services because of a patient's financial limitations
140.14or public assistance status; and
140.15(vii) have free care available as needed;
140.16    (2) federally qualified health centers, rural health clinics, and public health clinics;
140.17    (3) county owned and operated hospital-based dental clinics;
140.18(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
140.19accordance with chapter 317A with more than 10,000 patient encounters per year with
140.20patients who are uninsured or covered by medical assistance, general assistance medical
140.21care, or MinnesotaCare; and
140.22(5) a dental clinic associated with an oral health or dental education program owned
140.23and operated by the University of Minnesota or an institution within the Minnesota State
140.24Colleges and Universities system.
140.25     (c) The commissioner may designate a dentist or dental clinic as a critical access
140.26dental provider if the dentist or dental clinic is willing to provide care to patients covered
140.27by medical assistance, general assistance medical care, or MinnesotaCare at a level which
140.28significantly increases access to dental care in the service area.
140.29(d) Notwithstanding paragraph (a), critical access payments must not be made for
140.30dental services provided from April 1, 2010, through June 30, 2010.
140.31EFFECTIVE DATE.This section is effective September 1, 2011.

140.32    Sec. 69. Minnesota Statutes 2010, section 256B.766, is amended to read:
140.33256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
141.1(a) Effective for services provided on or after July 1, 2009, total payments for basic
141.2care services, shall be reduced by three percent, except that for the period July 1, 2009,
141.3through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
141.4assistance and general assistance medical care programs, prior to third-party liability and
141.5spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
141.6therapy services, occupational therapy services, and speech-language pathology and
141.7related services as basic care services. The reduction in this paragraph shall apply to
141.8physical therapy services, occupational therapy services, and speech-language pathology
141.9and related services provided on or after July 1, 2010.
141.10(b) Payments made to managed care plans and county-based purchasing plans shall
141.11be reduced for services provided on or after October 1, 2009, to reflect the reduction
141.12effective July 1, 2009, and payments made to the plans shall be reduced effective October
141.131, 2010, to reflect the reduction effective July 1, 2010.
141.14(c) Effective for services provided on or after September 1, 2011, through June 30,
141.152013, total payments for outpatient hospital facility fees shall be reduced by five percent
141.16from the rates in effect on August 31, 2011.
141.17(d) Effective for services provided on or after September 1, 2011, through June
141.1830, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
141.19and durable medical equipment not subject to a volume purchase contract, prosthetics
141.20and orthotics, renal dialysis services, laboratory services, public health nursing services,
141.21physical therapy services, occupational therapy services, speech therapy services,
141.22eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
141.23purchase contract, anesthesia services, and hospice services shall be reduced by three
141.24percent from the rates in effect on August 31, 2011.
141.25(e) This section does not apply to physician and professional services, inpatient
141.26hospital services, family planning services, mental health services, dental services,
141.27prescription drugs, medical transportation, federally qualified health centers, rural health
141.28centers, Indian health services, and Medicare cost-sharing.

141.29    Sec. 70. [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE
141.30DEMONSTRATION PROJECT.
141.31    Subdivision 1. Establishment and implementation. The commissioner of human
141.32services shall contract with a Minnesota-based academic or clinical research institution or
141.33institutions specializing in providing complementary and alternative medicine education
141.34and clinical services to establish and implement a five-year demonstration project in
141.35conjunction with federally qualified health centers or federally qualified health center
142.1"look-alikes" as defined in section 145.9269, to improve the quality and cost-effectiveness
142.2of care provided under medical assistance to enrollees with neck and back problems.
142.3The demonstration project must maximize the use of complementary and alternative
142.4medicine-oriented primary care providers, including but not limited to physicians and
142.5chiropractors. The demonstration project must be designed to significantly improve
142.6physical and mental health for enrollees who present with neck and back problems
142.7while decreasing medical treatment costs. The commissioner, in consultation with the
142.8commissioner of health, shall deliver services through the demonstration project beginning
142.9January 1, 2012, or upon federal approval, whichever is later.
142.10    Subd. 2. RFP and project criteria. The commissioner shall develop and issue a
142.11request for proposal (RFP) for the demonstration project. The RFP must require the
142.12academic or clinical research institution or institutions selected to demonstrate a proven
142.13track record over at least five years of conducting high-quality, federally funded clinical
142.14research. The RFP shall specify the state costs directly related to the requirements of this
142.15section and shall require that the selected institution pay those costs to the state. The
142.16institution and the federally qualified health centers and federally qualified health center
142.17"look-alikes" shall also:
142.18(1) provide patient education, provider education, and enrollment training
142.19components on health and lifestyle issues in order to promote enrollee responsibility for
142.20health care decisions, enhance productivity, prepare enrollees to reenter the workforce,
142.21and reduce future health care expenditures;
142.22(2) use high-quality and cost-effective integrated disease management that includes
142.23the best practices of traditional and complementary and alternative medicine;
142.24(3) incorporate holistic medical care, appropriate nutrition, exercise, medications,
142.25and conflict resolution techniques;
142.26(4) include a provider education component that makes use of professional
142.27organizations representing chiropractors, nurses, and other primary care providers
142.28and provides appropriate educational materials and activities in order to improve the
142.29integration of traditional medical care with licensed chiropractic services and other
142.30alternative health care services and achieve program enrollment objectives; and
142.31(5) provide to the commissioner the information and data necessary for the
142.32commissioner to prepare the annual reports required under subdivision 6.
142.33    Subd. 3. Enrollment. Enrollees from the program shall be selected by the
142.34commissioner from current enrollees in the prepaid medical assistance program who
142.35have, or are determined to be at significant risk of developing, neck and back problems.
142.36Participation in the demonstration project shall be voluntary. The commissioner shall
143.1seek to enroll, over the term of the demonstration project, ten percent of current and
143.2future medical assistance enrollees who have, or are determined to be at significant risk
143.3of developing, neck and back problems.
143.4    Subd. 4. Federal approval. The commissioner shall seek any federal waivers and
143.5approvals necessary to implement the demonstration project.
143.6    Subd. 5. Project costs. The commissioner shall require the academic or clinical
143.7research institution or institutions selected, federally qualified health centers, and federally
143.8qualified health center "look-alikes" to fund all costs of the demonstration project.
143.9Amounts received under subdivision 2 are appropriated to the commissioner for the
143.10purposes of this section.
143.11    Subd. 6. Annual reports. The commissioner, beginning December 15, 2012, and
143.12each December 15 thereafter through December 15, 2015, shall report annually to the
143.13legislature on the functional and mental improvements of the populations served by the
143.14demonstration project, patient satisfaction, and the cost-effectiveness of the program. The
143.15reports must also include data on hospital admissions, days in hospital, rates of outpatient
143.16surgery and other services, and drug utilization. The report, due December 15, 2015, must
143.17include recommendations on whether the demonstration project should be continued
143.18and expanded.

143.19    Sec. 71. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:
143.20    Subd. 3. Financial management. (a) The commissioner shall manage spending for
143.21the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
143.22each state revenue and expenditure forecast, the commissioner must make an assessment
143.23of the expected expenditures for the covered services for the remainder of the current
143.24biennium and for the following biennium. The estimated expenditure, including the
143.25reserve, shall be compared to an estimate of the revenues that will be available in the health
143.26care access fund. Based on this comparison, and after consulting with the chairs of the
143.27house of representatives Ways and Means Committee and the senate Finance Committee,
143.28and the Legislative Commission on Health Care Access, the commissioner shall, as
143.29necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
143.30remain within the limits of available revenues for the remainder of the current biennium
143.31and for the following biennium. The commissioner shall not hire additional staff using
143.32appropriations from the health care access fund until the commissioner of management
143.33and budget makes a determination that the adjustments implemented under paragraph (b)
143.34are sufficient to allow MinnesotaCare expenditures to remain within the limits of available
143.35revenues for the remainder of the current biennium and for the following biennium.
144.1(b) The adjustments the commissioner shall use must be implemented in this order:
144.2first, stop enrollment of single adults and households without children; second, upon 45
144.3days' notice, stop coverage of single adults and households without children already
144.4enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium
144.5subsidy amounts by ten percent for families with gross annual income above 200 percent
144.6of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium
144.7subsidy amounts by ten percent for families with gross annual income at or below 200
144.8percent; and fifth, require applicants to be uninsured for at least six months prior to
144.9eligibility in the MinnesotaCare program. If these measures are insufficient to limit the
144.10expenditures to the estimated amount of revenue, the commissioner shall further limit
144.11enrollment or decrease premium subsidies.

144.12    Sec. 72. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:
144.13    Subd. 5. Co-payments and coinsurance Cost-sharing. (a) Except as provided
144.14in paragraphs (b) and (c), the MinnesotaCare benefit plan shall include the following
144.15co-payments and coinsurance cost-sharing requirements for all enrollees:
144.16    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
144.17subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
144.18    (2) $3 per prescription for adult enrollees;
144.19    (3) $25 for eyeglasses for adult enrollees;
144.20    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
144.21episode of service which is required because of a recipient's symptoms, diagnosis, or
144.22established illness, and which is delivered in an ambulatory setting by a physician or
144.23physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
144.24audiologist, optician, or optometrist; and
144.25    (5) $6 for nonemergency visits to a hospital-based emergency room for services
144.26provided through December 31, 2010, and $3.50 effective January 1, 2011; and
144.27(6) a family deductible equal to the maximum amount allowed under Code of
144.28Federal Regulations, title 42, part 447.54.
144.29    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
144.30children under the age of 21.
144.31    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
144.32    (d) Paragraph (a), clause (4), does not apply to mental health services.
144.33    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
144.34poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
145.1and who are not pregnant shall be financially responsible for the coinsurance amount, if
145.2applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
145.3    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
145.4or changes from one prepaid health plan to another during a calendar year, any charges
145.5submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
145.6expenses incurred by the enrollee for inpatient services, that were submitted or incurred
145.7prior to enrollment, or prior to the change in health plans, shall be disregarded.
145.8(g) MinnesotaCare reimbursements to fee-for-service providers and payments to
145.9managed care plans or county-based purchasing plans shall not be increased as a result of
145.10the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
145.11EFFECTIVE DATE.This section is effective January 1, 2012.

145.12    Sec. 73. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
145.13    Subdivision 1. Defined contributions to enrollees. (a) Beginning July 1, 2012, the
145.14commissioner shall provide each MinnesotaCare enrollee eligible under section 256L.04,
145.15subdivision 7, with family income equal to or greater than 200 percent of the federal
145.16poverty guidelines with a monthly defined contribution to purchase health coverage under
145.17a health plan as defined in section 62A.011, subdivision 3.
145.18(b) Enrollees eligible under this section shall not be charged premiums under
145.19section 256L.15 and are exempt from the managed care enrollment requirement of section
145.20256L.12.
145.21(c) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
145.22eligible under this section unless otherwise provided in this section. Covered services, cost
145.23sharing, disenrollment for nonpayment of premium, enrollee appeal rights and complaint
145.24procedures, and the effective date of coverage for enrollees eligible under this section shall
145.25be as provided under the terms of the health plan purchased by the enrollee.
145.26(d) Unless otherwise provided in this section, all MinnesotaCare requirements
145.27related to eligibility, income and asset methodology, income reporting, and program
145.28administration, continue to apply to enrollees obtaining coverage under this section.
145.29    Subd. 2. Use of defined contribution; health plan requirements. (a) An enrollee
145.30may use up to the monthly defined contribution to pay premiums for coverage under a
145.31health plan as defined in section 62A.011, subdivision 3.
145.32(b) An enrollee must select a health plan within three calendar months of approval of
145.33MinnesotaCare eligibility. If a health plan is not selected and purchased within this time
145.34period, the enrollee must reapply and must meet all eligibility criteria.
145.35(c) A health plan purchased under this section must:
146.1(1) provide coverage for mental health and chemical dependency treatment services;
146.2and
146.3(2) comply with the coverage limitations specified in section 256L.03, subdivision
146.41, the second paragraph.
146.5    Subd. 3. Determination of defined contribution amount. (a) The commissioner
146.6shall determine the defined contribution sliding scale using the base contribution specified
146.7in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
146.8for defined contributions that provides:
146.9(1) persons with household incomes equal to 200 percent of the federal poverty
146.10guidelines with a defined contribution of 93 percent of the base contribution;
146.11(2) persons with household incomes equal to 250 percent of the federal poverty
146.12guidelines with a defined contribution of 80 percent of the base contribution; and
146.13(3) persons with household incomes in evenly spaced increments between the
146.14percentages of the federal poverty guideline or income level specified in clauses (1) and
146.15(2) with a base contribution that is a percentage interpolated from the defined contribution
146.16percentages specified in clauses (1) and (2).
146.17
19-29
$125
146.18
30-34
$135
146.19
35-39
$140
146.20
40-44
$175
146.21
45-49
$215
146.22
50-54
$295
146.23
55-59
$345
146.24
60+
$360
146.25(b) The commissioner shall multiply the defined contribution amounts developed
146.26under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
146.27health plan by a health plan company and who purchase coverage through the Minnesota
146.28Comprehensive Health Association.
146.29    Subd. 4. Administration by commissioner. (a) The commissioner shall administer
146.30the defined contributions. The commissioner shall:
146.31    (1) calculate and process defined contributions for enrollees; and
146.32    (2) pay the defined contribution amount to health plan companies or the Minnesota
146.33Comprehensive Health Association, as applicable, for enrollee health plan coverage.
146.34(b) Nonpayment of a health plan premium shall result in disenrollment from
146.35MinnesotaCare effective the first day of the calendar month following the calendar month
146.36for which the premium was due. Persons disenrolled for nonpayment or who voluntarily
146.37terminate coverage may not reenroll until four calendar months have elapsed.
147.1    Subd. 5. Assistance to enrollees. The commissioner of human services, in
147.2consultation with the commissioner of commerce, shall develop an efficient and
147.3cost-effective method of referring eligible applicants to professional insurance agent
147.4associations.
147.5    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
147.6July 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual health
147.7market by a health plan company in accordance with section 62A.65 are eligible
147.8for coverage through a health plan offered by the Minnesota Comprehensive Health
147.9Association and may enroll in MCHA in accordance with section 62E.14. Any difference
147.10between the revenue and actual covered losses to MCHA related to the implementation of
147.11this section are appropriated annually to the commissioner of human services from the
147.12health care access fund and shall be paid to MCHA.
147.13    Subd. 7. Federal approval. The commissioner shall seek federal financial
147.14participation for the adult enrollees eligible under this section.

147.15    Sec. 74. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:
147.16    Subdivision 1. Families with children. (a) Families with children with family
147.17income equal to or less than 275 percent of the federal poverty guidelines for the
147.18applicable family size shall be eligible for MinnesotaCare according to this section. All
147.19other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
147.20to enrollment under section 256L.07, shall apply unless otherwise specified.
147.21    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
147.22if the children are eligible. Children may be enrolled separately without enrollment by
147.23parents. However, if one parent in the household enrolls, both parents must enroll, unless
147.24other insurance is available. If one child from a family is enrolled, all children must
147.25be enrolled, unless other insurance is available. If one spouse in a household enrolls,
147.26the other spouse in the household must also enroll, unless other insurance is available.
147.27Families cannot choose to enroll only certain uninsured members.
147.28    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
147.29to the MinnesotaCare program. These persons are no longer counted in the parental
147.30household and may apply as a separate household.
147.31    (d) Beginning July 1, 2010, or upon federal approval, whichever is later, Parents are
147.32not eligible for MinnesotaCare if their gross income exceeds $57,500.
147.33    (e) Children formerly enrolled in medical assistance and automatically deemed
147.34eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
147.35from the requirements of this section until renewal.
148.1(f) [Reserved.]

148.2    Sec. 75. Minnesota Statutes 2010, section 256L.04, subdivision 10, is amended to read:
148.3    Subd. 10. Citizenship requirements. Eligibility for MinnesotaCare is limited
148.4to citizens or nationals of the United States, qualified noncitizens, and other persons
148.5residing lawfully in the United States as described in section 256B.06, subdivision 4,
148.6paragraphs (a) to (e) and (j) defined in Code of Federal Regulations, title 8, section 103.12.
148.7Undocumented noncitizens and nonimmigrants are ineligible for MinnesotaCare. For
148.8purposes of this subdivision, a nonimmigrant is an individual in one or more of the classes
148.9listed in United States Code, title 8, section 1101(a)(15), and an undocumented noncitizen
148.10is an individual who resides in the United States without the approval or acquiescence
148.11of the United States Citizenship and Immigration Services. Families with children who
148.12are citizens or nationals of the United States must cooperate in obtaining satisfactory
148.13documentary evidence of citizenship or nationality according to the requirements of the
148.14federal Deficit Reduction Act of 2005, Public Law 109-171.
148.15EFFECTIVE DATE.This section is effective January 1, 2012.

148.16    Sec. 76. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:
148.17    Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility
148.18must be renewed every 12 months. The 12-month period begins in the month after the
148.19month the application is approved.
148.20    (b) Each new period of eligibility must take into account any changes in
148.21circumstances that impact eligibility and premium amount. An enrollee must provide all
148.22the information needed to redetermine eligibility by the first day of the month that ends
148.23the eligibility period. If there is no change in circumstances, the enrollee may renew
148.24eligibility at designated locations that include community clinics and health care providers'
148.25offices. The designated sites shall forward the renewal forms to the commissioner. The
148.26commissioner may establish criteria and timelines for sites to forward applications to the
148.27commissioner or county agencies. The premium for the new period of eligibility must be
148.28received as provided in section 256L.06 in order for eligibility to continue.
148.29    (c) An enrollee who fails to submit renewal forms and related documentation
148.30necessary for verification of continued eligibility in a timely manner shall remain eligible
148.31for one additional month beyond the end of the current eligibility period before being
148.32disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
148.33additional month.
149.1(d) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8,
149.2the first period of renewal begins the month the enrollee turns 21 years of age.
149.3EFFECTIVE DATE.This section is effective the day following final enactment.

149.4    Sec. 77. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
149.5to read:
149.6    Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants
149.7for MinnesotaCare who identify themselves as veterans are referred to a county veterans
149.8service officer for assistance in applying to the United States Department of Veterans
149.9Affairs for any veterans benefits for which they may be eligible.

149.10    Sec. 78. Minnesota Statutes 2010, section 256L.09, subdivision 2, is amended to read:
149.11    Subd. 2. Residency requirement. (a) To be eligible for health coverage under
149.12the MinnesotaCare program, adults without children must be permanent residents of
149.13Minnesota.
149.14(b) To be eligible for health coverage under the MinnesotaCare program, pregnant
149.15women, individuals, and families, and with children must meet the residency requirements
149.16as provided by Code of Federal Regulations, title 42, section 435.403, except that the
149.17provisions of section 256B.056, subdivision 1, shall apply upon receipt of federal approval.
149.18EFFECTIVE DATE.This section is effective the day following final enactment
149.19or upon federal approval of federal financial participation for adults without children,
149.20whichever is later. The commissioner shall notify the revisor of statutes when federal
149.21approval is obtained.

149.22    Sec. 79. Minnesota Statutes 2010, section 256L.11, subdivision 6, is amended to read:
149.23    Subd. 6. Enrollees 18 or older. Payment by the MinnesotaCare program for
149.24inpatient hospital services provided to MinnesotaCare enrollees eligible under section
149.25256L.04, subdivision 7 , or who qualify under section 256L.04, subdivisions 1 and 2,
149.26with family gross income that exceeds 175 percent of the federal poverty guidelines
149.27and who are not pregnant, who are 18 years old or older on the date of admission to the
149.28inpatient hospital must be in accordance with paragraphs (a) and (b). Payment for adults
149.29who are not pregnant and are eligible under section 256L.04, subdivisions 1 and 2, and
149.30whose incomes are equal to or less than 175 percent of the federal poverty guidelines,
149.31shall be as provided for under paragraph (c).
150.1(a) If the medical assistance rate minus any co-payment required under section
150.2256L.03, subdivision 4 , is less than or equal to the amount remaining in the enrollee's
150.3benefit limit under section 256L.03, subdivision 3, payment must be the medical
150.4assistance rate minus any co-payment required under section 256L.03, subdivision 4. The
150.5hospital must not seek payment from the enrollee in addition to the co-payment. The
150.6MinnesotaCare payment plus the co-payment must be treated as payment in full.
150.7(b) If the medical assistance rate minus any co-payment required under section
150.8256L.03, subdivision 4 , is greater than the amount remaining in the enrollee's benefit limit
150.9under section 256L.03, subdivision 3, payment must be the lesser of:
150.10(1) the amount remaining in the enrollee's benefit limit; or
150.11(2) charges submitted for the inpatient hospital services less any co-payment
150.12established under section 256L.03, subdivision 4.
150.13The hospital may seek payment from the enrollee for the amount by which usual and
150.14customary charges exceed the payment under this paragraph. If payment is reduced under
150.15section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the
150.16enrollee for the amount of the reduction.
150.17(c) For admissions occurring on or after July 1, 2011, for single adults and
150.18households without children who are eligible under section 256L.04, subdivision 7, the
150.19commissioner shall pay hospitals directly, up to the medical assistance payment rate,
150.20for inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus
150.21any co-payment required under section 256L.03, subdivision 5. Inpatient services paid
150.22directly by the commissioner under this paragraph do not include chemical dependency
150.23hospital-based and residential treatment.

150.24    Sec. 80. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
150.25    Subd. 7. Critical access dental providers. Effective for dental services provided
150.26to MinnesotaCare enrollees on or after January 1, 2007, through August 31, 2011, the
150.27commissioner shall increase payment rates to dentists and dental clinics deemed by the
150.28commissioner to be critical access providers under section 256B.76, subdivision 4, by 50
150.29percent above the payment rate that would otherwise be paid to the provider. Effective for
150.30dental services provided on or after September 1, 2011, the commissioner shall increase
150.31the payment rate by 30 percent above the payment rate that would otherwise be paid to
150.32the provider. The commissioner shall pay the prepaid health plans under contract with
150.33the commissioner amounts sufficient to reflect this rate increase. The prepaid health plan
150.34must pass this rate increase to providers who have been identified by the commissioner as
150.35critical access dental providers under section 256B.76, subdivision 4.

151.1    Sec. 81. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
151.2    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
151.3per capita, where possible. The commissioner may allow health plans to arrange for
151.4inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
151.5an independent actuary to determine appropriate rates.
151.6    (b) For services rendered on or after January 1, 2004, the commissioner shall
151.7withhold five percent of managed care plan payments and county-based purchasing
151.8plan payments under this section pending completion of performance targets. Each
151.9performance target must be quantifiable, objective, measurable, and reasonably attainable,
151.10except in the case of a performance target based on a federal or state law or rule. Criteria
151.11for assessment of each performance target must be outlined in writing prior to the
151.12contract effective date. The managed care plan must demonstrate, to the commissioner's
151.13satisfaction, that the data submitted regarding attainment of the performance target is
151.14accurate. The commissioner shall periodically change the administrative measures used
151.15as performance targets in order to improve plan performance across a broader range of
151.16administrative services. The performance targets must include measurement of plan
151.17efforts to contain spending on health care services and administrative activities. The
151.18commissioner may adopt plan-specific performance targets that take into account factors
151.19affecting only one plan, such as characteristics of the plan's enrollee population. The
151.20withheld funds must be returned no sooner than July 1 and no later than July 31 of the
151.21following calendar year if performance targets in the contract are achieved.
151.22(c) For services rendered on or after January 1, 2011, the commissioner shall
151.23withhold an additional three percent of managed care plan or county-based purchasing
151.24plan payments under this section. The withheld funds must be returned no sooner than
151.25July 1 and no later than July 31 of the following calendar year. The return of the withhold
151.26under this paragraph is not subject to the requirements of paragraph (b).
151.27(d) Effective for services rendered on or after January 1, 2011, through December
151.2831, 2011, the commissioner shall include as part of the performance targets described in
151.29paragraph (b) a reduction in the plan's emergency room utilization rate for state health care
151.30program enrollees by a measurable rate of five percent from the plan's utilization rate for
151.31the previous calendar year. Effective for services rendered on or after January 1, 2012, the
151.32commissioner shall include as part of the performance targets described in paragraph (b) a
151.33reduction in the health plan's emergency department utilization rate for medical assistance
151.34and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
151.35the withhold each year, the managed care plan or county-based purchasing plan must
151.36achieve a qualifying reduction of no less than ten percent of the plan's utilization rate for
152.1medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared
152.2to the previous calendar year, until the final performance target is reached.
152.3The withheld funds must be returned no sooner than July 1 and no later than July
152.431 of the following calendar year if the managed care plan or county-based purchasing
152.5plan demonstrates to the satisfaction of the commissioner that a reduction in the utilization
152.6rate was achieved.
152.7The withhold described in this paragraph shall continue for each consecutive
152.8contract period until the plan's emergency room utilization rate for state health care
152.9program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
152.10for state health care program enrollees for calendar year 2009 medical assistance and
152.11MinnesotaCare enrollees for calendar year 2011. Hospitals shall cooperate with the health
152.12plans in meeting this performance target and shall accept payment withholds that may
152.13be returned to the hospitals if the performance target is achieved. The commissioner
152.14shall structure the withhold so that the commissioner returns a portion of the withheld
152.15funds in amounts commensurate with achieved reductions in utilization less than the
152.16targeted amount. The withhold described in this paragraph does not apply to county-based
152.17purchasing plans.
152.18(e) Effective for services rendered on or after January 1, 2012, the commissioner
152.19shall include as part of the performance targets described in paragraph (b) a reduction
152.20in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
152.21enrollees, as determined by the commissioner. To earn the return of the withhold each
152.22year, the managed care plan or county-based purchasing plan must achieve a qualifying
152.23reduction of no less than five percent of the plan's hospital admission rate for medical
152.24assistance and MinnesotaCare enrollees, excluding Medicare enrollees, compared to the
152.25previous calendar year, until the final performance target is reached.
152.26The withheld funds must be returned no sooner than July 1 and no later than July
152.2731 of the following calendar year if the managed care plan or county-based purchasing
152.28plan demonstrates to the satisfaction of the commissioner that this reduction in the
152.29hospitalization rate was achieved.
152.30The withhold described in this paragraph shall continue until there is a 25 percent
152.31reduction in the hospitals admission rate compared to the hospital admission rate for
152.32calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the
152.33plans in meeting this performance target and shall accept payment withholds that may be
152.34returned to the hospitals if the performance target is achieved. The hospital admissions
152.35in this performance target do not include the admissions applicable to the subsequent
152.36hospital admission performance target under paragraph (f).
153.1(f) Effective for services provided on or after January 1, 2012, the commissioner
153.2shall include as part of the performance targets described in paragraph (b) a reduction
153.3in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a
153.4previous hospitalization of a patient regardless of the reason, for medical assistance and
153.5MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
153.6withhold each year, the managed care plan or county-based purchasing plan must achieve
153.7a qualifying reduction of the subsequent hospital admissions rate for medical assistance
153.8and MinnesotaCare enrollees, excluding Medicare enrollees, of no less than five percent
153.9compared to the previous calendar year until the final performance target is reached.
153.10The withheld funds must be returned no sooner than July 1 and no later than July 31
153.11of the following calendar year if the managed care plan or county-based purchasing plan
153.12demonstrates to the satisfaction of the commissioner that a reduction in the subsequent
153.13hospitalization rate was achieved.
153.14The withhold described in this paragraph must continue for each consecutive
153.15contract period until the plan's subsequent hospitalization rate for medical assistance and
153.16MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization
153.17rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
153.18performance target and shall accept payment withholds that must be returned to the
153.19hospitals if the performance target is achieved.
153.20(g) A managed care plan or a county-based purchasing plan under section 256B.692
153.21may include as admitted assets under section 62D.044 any amount withheld under this
153.22section that is reasonably expected to be returned.

153.23    Sec. 82. Minnesota Statutes 2010, section 256L.15, subdivision 1, is amended to read:
153.24    Subdivision 1. Premium determination. (a) Families with children and individuals
153.25shall pay a premium determined according to subdivision 2.
153.26    (b) Pregnant women and children under age two are exempt from the provisions
153.27of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
153.28for failure to pay premiums. For pregnant women, this exemption continues until the
153.29first day of the month following the 60th day postpartum. Women who remain enrolled
153.30during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
153.31disenrolled on the first of the month following the 60th day postpartum for the penalty
153.32period that otherwise applies under section 256L.06, unless they begin paying premiums.
153.33    (c) Members of the military and their families who meet the eligibility criteria
153.34for MinnesotaCare upon eligibility approval made within 24 months following the end
153.35of the member's tour of active duty shall have their premiums paid by the commissioner.
154.1The effective date of coverage for an individual or family who meets the criteria of this
154.2paragraph shall be the first day of the month following the month in which eligibility is
154.3approved. This exemption applies for 12 months. This paragraph expires June 30, 2010.
154.4If the expiration of this provision is in violation of section 5001 of Public Law 111-5, this
154.5provision will expire on the date when it is no longer subject to section 5001 of Public Law
154.6111-5. The commissioner of human services shall notify the revisor of statutes of that date.

154.7    Sec. 83. Minnesota Statutes 2010, section 295.52, is amended by adding a subdivision
154.8to read:
154.9    Subd. 8. Contingent reduction in tax rate. (a) By December 1 of each year,
154.10beginning in 2011, the commissioner of management and budget shall determine the
154.11projected balance in the health care access fund for the biennium.
154.12(b) If the commissioner of management and budget determines that the projected
154.13balance in the health care access fund for the biennium reflects a ratio of revenues to
154.14expenditures and transfers greater than 125 percent, and if the actual cash balance in the
154.15fund is adequate, as determined by the commissioner of management and budget, the
154.16commissioner, in consultation with the commissioner of revenue, shall reduce the tax rates
154.17levied under subdivisions 1, 1a, 2, 3, and 4, for the subsequent calendar year sufficient
154.18to reduce the structural balance in the fund. The rate may be reduced to the extent that
154.19the projected revenues for the biennium do not exceed 125 percent of expenditures and
154.20transfers. The new rate shall be rounded to the nearest one-tenth of one percent. The rate
154.21reduction under this paragraph expires at the end of each calendar year and is subject to an
154.22annual redetermination by the commissioner of management and budget.
154.23(c) For purposes of the analysis defined in paragraph (b), the commissioner of
154.24management and budget shall include projected revenues, notwithstanding the repeal of
154.25the tax imposed under this section effective January 1, 2020.

154.26    Sec. 84. Laws 2009, chapter 79, article 5, section 17, the effective date, as amended by
154.27Laws 2010, First Special Session chapter 1, article 24, section 9, is amended to read:
154.28EFFECTIVE DATE.This section is effective January 1, 2011 October 1, 2019, or
154.29upon federal approval and on the date when it is no longer subject to the maintenance of
154.30effort requirements of section 5001 of Public Law 111-5 the date it is no longer subject
154.31to the maintenance of effort requirement in Public Law 111-148. The commissioner of
154.32human services shall notify the revisor of statutes of that date.

155.1    Sec. 85. Laws 2009, chapter 79, article 5, section 18, the effective date, as amended by
155.2Laws 2010, First Special Session chapter 1, article 24, section 10, is amended to read:
155.3EFFECTIVE DATE.This section is effective upon federal approval and on the
155.4date when it is no longer subject to the maintenance of effort requirements of section
155.55001 of Public Law 111-5 January 1, 2014, or upon the date it is no longer subject to the
155.6maintenance of effort requirement in Public Law 111-148. The commissioner of human
155.7services shall notify the revisor of statutes when federal approval is obtained.

155.8    Sec. 86. Laws 2009, chapter 79, article 5, section 22, the effective date, as amended by
155.9Laws 2010, First Special Session chapter 1, article 24, section 11, is amended to read:
155.10EFFECTIVE DATE.This section is effective for periods of ineligibility established
155.11on or after January 1, 2011 2014, unless it is in violation of section 5001 of Public Law
155.12111-5. If it is in violation of that section, then it shall be effective on the date when it is
155.13no longer subject to maintenance of effort requirements of section 5001 of Public Law
155.14111-5 or upon the date it is no longer subject to the maintenance of effort requirement
155.15in Public Law 111-148. The commissioner of human services shall notify the revisor of
155.16statutes of that date.

155.17    Sec. 87. Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by
155.18Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read:
155.19EFFECTIVE DATE.The section is effective July 1, 2011 January 1, 2014, or
155.20upon the date it is no longer subject to the maintenance effort requirement in Public Law
155.21111-148.

155.22    Sec. 88. Laws 2009, chapter 173, article 1, section 17, the effective date, as amended
155.23by Laws 2010, First Special Session chapter 1, article 24, section 13, is amended to read:
155.24EFFECTIVE DATE.This section is effective for pooled trust accounts established
155.25on or after January 1, 2011 2014, unless it is in violation of section 5001 of Public Law
155.26111-5 or upon the date it is no longer subject to the maintenance of effort requirement in
155.27Public Law 111-148. If it is in violation of that section, then it shall be effective on the
155.28date when it is no longer subject to maintenance of effort requirements of section 5001
155.29of Public Law 111-5. The commissioner of human services shall notify the revisor of
155.30statutes of that date.

156.1    Sec. 89. PLAN TO COORDINATE CARE FOR CHILDREN WITH HIGH-COST
156.2MENTAL HEALTH CONDITIONS.
156.3The commissioner of human services shall develop and submit to the legislature
156.4by January 15, 2012, a plan to provide care coordination to medical assistance and
156.5MinnesotaCare enrollees who are children with high-cost mental health conditions. For
156.6purposes of this section, a child has a "high-cost mental health condition" if mental health
156.7and medical expenses over the past year totalled $100,000 or more. For purposes of this
156.8section, "care coordination" means collaboration between an advanced practice nurse and
156.9primary care physicians and specialists to manage care; development of mental health
156.10management plans for recurrent mental health issues; oversight and coordination of all
156.11aspects of care in partnership with families; organization of medical, treatment, and
156.12therapy information into a summary of critical information; coordination and appropriate
156.13sequencing of evaluations and multiple appointments; information and assistance with
156.14accessing resources; and telephone triage for behavior or other problems.

156.15    Sec. 90. REGULATORY SIMPLIFICATION AND REDUCTION OF
156.16PROVIDER REPORTING AND DATA SUBMITTAL REQUIREMENTS.
156.17    Subdivision 1. Regulatory simplification and report reduction work group. The
156.18commissioner of management and budget shall convene a regulatory simplification and
156.19report reduction work group of persons designated by the commissioners of health, human
156.20services, and commerce to eliminate redundant, unnecessary, and obsolete state mandated
156.21reporting or data submittal requirements for health care providers or group purchasers
156.22related to health care costs, quality, utilization, access, or patient encounters or related to
156.23provider or group purchaser, monitoring, finances, and regulation. For purposes of this
156.24section, the term "health care providers or group purchasers" has the meaning provided
156.25in Minnesota Statutes, section 62J.03, subdivisions 6 and 8, except that it also includes
156.26nursing homes.
156.27    Subd. 2. Plan development and other duties. (a) The commissioner of
156.28management and budget, in consultation with the work group, shall develop a plan for
156.29regulatory simplification and report reduction activities of the commissioners of health,
156.30human services, and commerce that considers collection and regulation of the following
156.31in a coordinated manner:
156.32(1) encounter data;
156.33(2) group purchaser provider network data;
156.34(3) financial reporting;
157.1(4) reporting and documentation requirements relating to member communications
157.2and marketing materials;
157.3(5) state regulation and oversight of group purchasers;
157.4(6) requirements and procedures for denial, termination, or reduction of services
157.5and member appeals and grievances; and
157.6(7) state performance improvement projects, requirements, and procedures.
157.7(b) The commissioners of health, human services, and commerce, following
157.8consultation with the work group, shall present to the legislature by February 15, 2012,
157.9proposals to implement their recommendations.
157.10    Subd. 3. New reporting and other duties. (a) The commissioner of management
157.11and budget, in consultation with the work group and the commissioners of health, human
157.12services, and commerce, shall develop criteria to be used by the commissioners in
157.13determining whether to establish new reporting and data submittal requirements. These
157.14criteria must support the establishment of new reporting and data submittal requirements
157.15only:
157.16(1) if required by a federal agency or state statute;
157.17(2) if needed for a state regulatory audit or corrective action plan;
157.18(3) if needed to monitor or protect public health;
157.19(4) if needed to manage the cost and quality of Minnesota's public health insurance
157.20programs; or
157.21(5) if a review and analysis by the commissioner of the relevant agency has
157.22documented the necessity, importance, and administrative cost of the requirement, and
157.23has determined that the information sought cannot be efficiently obtained through another
157.24state or federal report.
157.25(b) The commissioners of health, human services, and commerce, following
157.26consultation with the work group, may propose to the legislature new provider and group
157.27purchaser reporting and data submittal requirements to take effect on or after July 1, 2012.
157.28These proposals shall include an analysis of the extent to which the requirements meet
157.29the criteria developed under paragraph (a).

157.30    Sec. 91. SPECIALIZED MAINTENANCE THERAPY.
157.31The commissioner of human services shall evaluate whether providing medical
157.32assistance coverage for specialized maintenance therapy for enrollees with serious and
157.33persistent mental illness who are at risk of hospitalization will improve the quality of
157.34care and lower medical assistance spending by reducing rates of hospitalization. The
157.35commissioner shall present findings and recommendations to the chairs and ranking
158.1minority members of the legislative committees with jurisdiction over health and human
158.2services finance and policy by December 15, 2011.

158.3    Sec. 92. REDUCING HOSPITALIZATION RATES.
158.4The commissioner of human services, by January 15, 2012, shall present
158.5recommendations to the legislature to reduce hospitalization rates for state health care
158.6program enrollees who are children with high-cost medical conditions.

158.7    Sec. 93. MEDICAID FRAUD PREVENTION AND DETECTION.
158.8    Subdivision 1. Request for proposals. By December 31, 2011, the commissioner
158.9of human services shall issue a request for proposals to prevent and detect Medicaid
158.10fraud and mispayment. The request for proposals shall require the vendor to provide
158.11data analytics capabilities, including, but not limited to, predictive modeling techniques
158.12and other forms of advanced analytics, technical assistance, claims review, and medical
158.13record and documentation investigations, to detect and investigate improper payments
158.14both before and after payments are made.
158.15    Subd. 2. Proof of concept phase. The selected vendor, at no cost to the state, shall
158.16be required to apply its analytics and investigations on a subset of data provided by the
158.17commissioner to demonstrate the direct recoveries of the solution.
158.18    Subd. 3. Data confidentiality. Data provided by the commissioner to the vendor
158.19under this section must maintain the confidentiality of the information.
158.20    Subd. 4. Full implementation phase. The request for proposal must require the
158.21commissioner to implement the recommendations provided by the vendor if the work
158.22done under the requirements of subdivision 2 provides recoveries directly related to the
158.23investigations to the state. After full implementation, the vendor shall be paid from
158.24recoveries directly attributable to the work done by the vendor, according to the terms and
158.25performance measures negotiated in the contract.
158.26    Subd. 5. Selection of vendor. The commissioner of human services shall select a
158.27vendor from the responses to the request for proposal by January 31, 2012.
158.28    Subd. 6. Progress report. The commissioner shall provide a report describing the
158.29progress made under this section to the governor and the chairs and ranking minority
158.30members of the legislative committees with jurisdiction over the Department of Human
158.31Services by June 15, 2012. The report shall provide a dynamic scoring analysis of the
158.32work described in the report.

158.33    Sec. 94. CAPITATION PAYMENT DELAY.
159.1The commissioner shall delay $135,000,000 of the medical assistance and
159.2MinnesotaCare capitation payment to managed care plans and county-based purchasing
159.3plans due in May 2013 and the payment due in April 2013 for special needs basic care
159.4until July 1, 2013. The payment shall be made no earlier than July 1, 2013, and no later
159.5than July 31, 2013.
159.6The commissioner shall delay $135,000,000 of the medical assistance and
159.7MinnesotaCare capitation payment to managed care plans and county-based purchasing
159.8plans due in the second quarter of calendar year 2015 and the April 2015 payment for
159.9special needs basic care until July 1, 2015. The payment shall be made no earlier than July
159.101, 2015, and no later than July 31, 2015.

159.11    Sec. 95. MINNESOTA AUTISM SPECTRUM DISORDER TASK FORCE.
159.12    Subdivision 1. Members. (a) The Autism Spectrum Disorder Task Force is
159.13composed of 19 members, appointed as follows:
159.14(1) two members of the senate, one appointed by the majority leader and one
159.15appointed by the minority leader;
159.16(2) two members of the house of representatives, one from the majority party,
159.17appointed by the speaker of the house, and one from the minority party, appointed by
159.18the minority leader;
159.19(3) two members who are family members of individuals with autism spectrum
159.20disorder (ASD), one of whom shall be appointed by the majority leader of the senate, and
159.21one of whom shall be appointed by the speaker of the house;
159.22(4) one member appointed by the Minnesota chapter of the American Academy of
159.23Pediatrics who is a developmental behavioral pediatrician;
159.24(5) one member appointed by the Minnesota Academy of Family Physicians who is
159.25a family practice physician;
159.26(6) one member appointed by the Minnesota Psychological Association who is a
159.27neuropsychologist;
159.28(7) one member appointed by the majority leader of the senate who represents a
159.29minority autism community;
159.30(8) one member representing the directors of public school student support services;
159.31(9) one member appointed by the Minnesota Council of Health Plans;
159.32(10) three members who represent autism advocacy groups, two of whom shall be
159.33appointed by the speaker of the house and one of whom shall be appointed by the majority
159.34leader of the senate; and
160.1(11) one member appointed by each of the respective commissioners of the
160.2following departments: education, employment and economic development, health, and
160.3human services.
160.4    (b) Appointments must be made by September 1, 2011. The senate member
160.5appointed by the majority leader of the senate shall convene the first meeting of the
160.6task force no later than October 1, 2011. The task force shall elect a chair from among
160.7members at the first meeting. The task force shall meet at least six times per year.
160.8    Subd. 2. Duties. (a) The task force shall develop an autism spectrum disorder
160.9statewide strategic plan that focuses on improving awareness, early diagnosis, and
160.10intervention and on ensuring delivery of treatment and services for individuals diagnosed
160.11with an autism spectrum disorder, including the coordination and accessibility of
160.12cost-effective treatments and services throughout the individual's lifetime.
160.13(b) The task force shall coordinate with existing efforts relating to autism spectrum
160.14disorders at the Departments of Education, Employment and Economic Development,
160.15Health, and Human Services and at the University of Minnesota and other agencies and
160.16organizations as the task force deems appropriate.
160.17    Subd. 3. Report. The task force shall submit its strategic plan to the legislature
160.18by January 15, 2013. The task force shall continue to provide assistance with the
160.19implementation of the strategic plan, as approved by the legislature, and shall submit
160.20a progress report by January 15, 2014, and by January 15, 2015, on the status of
160.21implementation of the strategic plan, including any draft legislation necessary for
160.22implementation.
160.23    Subd. 4. Expiration. The task force expires June 30, 2015, unless extended by law.

160.24    Sec. 96. COMPETITIVE BIDDING PILOT.
160.25For managed care contracts effective January 1, 2012, the commissioner of
160.26human services is required to establish a competitive price bidding pilot for nonelderly,
160.27nondisabled adults and children in medical assistance and MinnesotaCare in the
160.28seven-county metropolitan area. The pilot must allow a minimum of two managed care
160.29organizations to serve the metropolitan area. The pilot shall expire after two full calendar
160.30years on December 31, 2013. The commissioner of human service shall conduct an
160.31evaluation of the pilot to determine the cost-effectiveness and impacts to provider access
160.32at the end of the two-year period.

160.33    Sec. 97. REPEALER.
161.1    Subdivision 1. Legislative Oversight Commission. Minnesota Statutes 2010,
161.2section 62J.07, subdivisions 1, 2, and 3, are repealed.
161.3    Subd. 2. Children formally under medical assistance. Minnesota Statutes 2010,
161.4section 256L.07, subdivision 7, exempting eligibility for children formally under
161.5medical assistance, is repealed retroactively from October 1, 2008, and federal approval
161.6is no longer necessary.
161.7    Subd. 3. Extending medical assistance. Minnesota Statutes 2010, section
161.8256B.057, subdivision 2c, (extended medical assistance for certain children) is
161.9repealed.
161.10    Subd. 4. Minnesota Statutes 2010, section 256B.69, subdivision 9b, is repealed.
161.11    Subd. 5. The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9,
161.12(renewal rolling month and premium grace month) are repealed.
161.13    Subd. 6. MinnesotaCare provider taxes. Minnesota Statutes 2010, sections
161.1413.4967, subdivision 3; 295.50, subdivisions 1, 1a, 2, 2a, 3, 4, 6, 6a, 7, 9b, 9c, 10a, 10b,
161.1512b, 13, 14, and 15; 295.51, subdivisions 1 and 1a; 295.52, subdivisions 1, 1a, 2, 3, 4,
161.164a, 5, 6, and 7; 295.53, subdivisions 1, 2, 3, and 4a; 295.54; 295.55; 295.56; 295.57;
161.17295.58; 295.581; 295.582; and 295.59, are repealed effective for gross revenues received
161.18after December 31, 2019.
161.19    Subd. 7. Renewal of medical assistance eligibility. The amendment in Laws 2009,
161.20chapter 79, article 5, section 62, is repealed retroactively from July 1, 2009.

161.21    Sec. 98. EFFECTIVE DATE.
161.22This article is effective the day following final enactment unless another effective
161.23date is specified in this article.

161.24ARTICLE 7
161.25CONTINUING CARE

161.26    Section 1. Minnesota Statutes 2010, section 245A.03, subdivision 7, as amended by
161.27Laws 2011, chapter 86, section 4, is amended to read:
161.28    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
161.29initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
161.302960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
161.319555.6265, under this chapter for a physical location that will not be the primary residence
161.32of the license holder for the entire period of licensure. If a license is issued during this
161.33moratorium, and the license holder changes the license holder's primary residence away
162.1from the physical location of the foster care license, the commissioner shall revoke the
162.2license according to section 245A.07. Exceptions to the moratorium include:
162.3(1) foster care settings that are required to be registered under chapter 144D;
162.4(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
162.5and determined to be needed by the commissioner under paragraph (b);
162.6(3) new foster care licenses determined to be needed by the commissioner under
162.7paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
162.8restructuring of state-operated services that limits the capacity of state-operated facilities;
162.9(4) new foster care licenses determined to be needed by the commissioner under
162.10paragraph (b) for persons requiring hospital level care; or
162.11(5) new foster care licenses determined to be needed by the commissioner for the
162.12transition of people from personal care assistance to the home and community-based
162.13services.
162.14(b) The commissioner shall determine the need for newly licensed foster care homes
162.15as defined under this subdivision. As part of the determination, the commissioner shall
162.16consider the availability of foster care capacity in the area in which the licensee seeks to
162.17operate, and the recommendation of the local county board. The determination by the
162.18commissioner must be final. A determination of need is not required for a change in
162.19ownership at the same address.
162.20    (c) Residential settings that would otherwise be subject to the moratorium established
162.21in paragraph (a), that are in the process of receiving an adult or child foster care license as
162.22of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
162.23or child foster care license. For this paragraph, all of the following conditions must be met
162.24to be considered in the process of receiving an adult or child foster care license:
162.25    (1) participants have made decisions to move into the residential setting, including
162.26documentation in each participant's care plan;
162.27    (2) the provider has purchased housing or has made a financial investment in the
162.28property;
162.29    (3) the lead agency has approved the plans, including costs for the residential setting
162.30for each individual;
162.31    (4) the completion of the licensing process, including all necessary inspections, is
162.32the only remaining component prior to being able to provide services; and
162.33    (5) the needs of the individuals cannot be met within the existing capacity in that
162.34county.
163.1To qualify for the process under this paragraph, the lead agency must submit
163.2documentation to the commissioner by August 1, 2009, that all of the above criteria are
163.3met.
163.4(d) The commissioner shall study the effects of the license moratorium under this
163.5subdivision and shall report back to the legislature by January 15, 2011. This study shall
163.6include, but is not limited to the following:
163.7(1) the overall capacity and utilization of foster care beds where the physical location
163.8is not the primary residence of the license holder prior to and after implementation
163.9of the moratorium;
163.10(2) the overall capacity and utilization of foster care beds where the physical
163.11location is the primary residence of the license holder prior to and after implementation
163.12of the moratorium; and
163.13(3) the number of licensed and occupied ICF/MR beds prior to and after
163.14implementation of the moratorium.
163.15(e) When a foster care recipient moves out of a foster home that is not the primary
163.16residence of the license holder according to section 256B.49, subdivision 15, paragraph
163.17(f), the county shall immediately inform the Department of Human Services Licensing
163.18Division, and the department shall immediately decrease the licensed capacity for the
163.19home. A decreased licensed capacity according to this paragraph is not subject to appeal
163.20under this chapter.

163.21    Sec. 2. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
163.22    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
163.23Linkage Line, a to serve as Minnesota's neutral access point for statewide consumer
163.24disability information, referral, and assistance system for people with disabilities and
163.25chronic illnesses that. The Disability Linkage Line shall:
163.26(1) deliver information and assistance based on national and state standards;
163.27    (1) provides (2) provide information about state and federal eligibility requirements,
163.28benefits, and service options;
163.29(3) provide benefits and options counseling;
163.30    (2) makes (4) make referrals to appropriate support entities;
163.31    (3) delivers information and assistance based on national and state standards;
163.32    (4) assists (5) educate people to on their options so they can make well-informed
163.33decisions choices; and
163.34    (5) supports (6) help support the timely resolution of service access and benefit
163.35issues.;
164.1(7) inform people of their long-term community services and supports;
164.2(8) provide necessary resources and supports that can lead to employment and
164.3increased economic stability of people with disabilities; and
164.4(9) serve as the technical assistance and help center for the Web-based tool,
164.5Minnesota's Disability Benefits 101.org.

164.6    Sec. 3. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
164.7    Subd. 29. State medical review team. (a) To ensure the timely processing of
164.8determinations of disability by the commissioner's state medical review team under
164.9sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
164.10(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence
164.11submitted by county agencies with a referral and seek additional information from
164.12providers, applicants, and enrollees to support the determination of disability where
164.13necessary. Disability shall be determined according to the rules of title XVI and title
164.14XIX of the Social Security Act and pertinent rules and policies of the Social Security
164.15Administration.
164.16    (b) Prior to a denial or withdrawal of a requested determination of disability due
164.17to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
164.18necessary and appropriate to a determination of disability, and (2) assist applicants and
164.19enrollees to obtain the evidence, including, but not limited to, medical examinations
164.20and electronic medical records.
164.21(c) The commissioner shall provide the chairs of the legislative committees with
164.22jurisdiction over health and human services finance and budget the following information
164.23on the activities of the state medical review team by February 1 of each year:
164.24(1) the number of applications to the state medical review team that were denied,
164.25approved, or withdrawn;
164.26(2) the average length of time from receipt of the application to a decision;
164.27(3) the number of appeals, appeal results, and the length of time taken from the date
164.28the person involved requested an appeal for a written decision to be made on each appeal;
164.29(4) for applicants, their age, health coverage at the time of application, hospitalization
164.30history within three months of application, and whether an application for Social Security
164.31or Supplemental Security Income benefits is pending; and
164.32(5) specific information on the medical certification, licensure, or other credentials
164.33of the person or persons performing the medical review determinations and length of
164.34time in that position.
165.1(d) Any appeal made under section 256.045, subdivision 3, of a disability
165.2determination made by the state medical review team must be decided according to the
165.3timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is
165.4not issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the
165.5appeal must be immediately reviewed by the chief appeals referee.

165.6    Sec. 4. Minnesota Statutes 2010, section 256B.04, is amended by adding a subdivision
165.7to read:
165.8    Subd. 20. Money Follows the Person Rebalancing demonstration project. In
165.9accordance with federal law governing Money Follows the Person Rebalancing funds,
165.10amounts equal to the value of enhanced federal funding resulting from the operation of the
165.11demonstration project grant must be transferred from the medical assistance account in
165.12the general fund to an account in the special revenue fund. Funds in the special revenue
165.13fund account do not cancel and are appropriated to the commissioner to carry out the
165.14goals of the Money Follows the Person Rebalancing demonstration project as required
165.15under the approved federal plan for the use of the funds, and may be transferred to the
165.16medical assistance account if applicable.

165.17    Sec. 5. Minnesota Statutes 2010, section 256B.05, is amended by adding a subdivision
165.18to read:
165.19    Subd. 5. Obligation of local agency to process medical assistance applications
165.20within established timelines. The local agency must act on an application for medical
165.21assistance within ten working days of receipt of all information needed to act on the
165.22application but no later than required under Minnesota Rules, part 9505.0090, subparts
165.232 and 3.

165.24    Sec. 6. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
165.25    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
165.26medical assistance, a person must not individually own more than $3,000 in assets, or if a
165.27member of a household with two family members, husband and wife, or parent and child,
165.28the household must not own more than $6,000 in assets, plus $200 for each additional
165.29legal dependent. In addition to these maximum amounts, an eligible individual or family
165.30may accrue interest on these amounts, but they must be reduced to the maximum at the
165.31time of an eligibility redetermination. The accumulation of the clothing and personal
165.32needs allowance according to section 256B.35 must also be reduced to the maximum at
165.33the time of the eligibility redetermination. The value of assets that are not considered in
166.1determining eligibility for medical assistance is the value of those assets excluded under
166.2the supplemental security income program for aged, blind, and disabled persons, with
166.3the following exceptions:
166.4(1) household goods and personal effects are not considered;
166.5(2) capital and operating assets of a trade or business that the local agency determines
166.6are necessary to the person's ability to earn an income are not considered;
166.7(3) motor vehicles are excluded to the same extent excluded by the supplemental
166.8security income program;
166.9(4) assets designated as burial expenses are excluded to the same extent excluded by
166.10the supplemental security income program. Burial expenses funded by annuity contracts
166.11or life insurance policies must irrevocably designate the individual's estate as contingent
166.12beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
166.13(5) effective upon federal approval, for a person who no longer qualifies as an
166.14employed person with a disability due to loss of earnings, assets allowed while eligible
166.15for medical assistance under section 256B.057, subdivision 9, are not considered for 12
166.16months, beginning with the first month of ineligibility as an employed person with a
166.17disability, to the extent that the person's total assets remain within the allowed limits of
166.18section 256B.057, subdivision 9, paragraph (c) (d).
166.19(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
166.2015.
166.21EFFECTIVE DATE.This section is effective January 1, 2014.

166.22    Sec. 7. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
166.23    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
166.24for a person who is employed and who:
166.25(1) but for excess earnings or assets, meets the definition of disabled under the
166.26Supplemental Security Income program;
166.27(2) is at least 16 but less than 65 years of age;
166.28(3) meets the asset limits in paragraph (c) (d); and
166.29(4) pays a premium and other obligations under paragraph (e).
166.30    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
166.31for medical assistance under this subdivision, a person must have more than $65 of earned
166.32income. Earned income must have Medicare, Social Security, and applicable state and
166.33federal taxes withheld. The person must document earned income tax withholding. Any
166.34spousal income or assets shall be disregarded for purposes of eligibility and premium
166.35determinations.
167.1(b) (c) After the month of enrollment, a person enrolled in medical assistance under
167.2this subdivision who:
167.3(1) is temporarily unable to work and without receipt of earned income due to a
167.4medical condition, as verified by a physician, may retain eligibility for up to four calendar
167.5months; or
167.6(2) effective January 1, 2004, loses employment for reasons not attributable to the
167.7enrollee, and is without receipt of earned income may retain eligibility for up to four
167.8consecutive months after the month of job loss. To receive a four-month extension,
167.9enrollees must verify the medical condition or provide notification of job loss. All other
167.10eligibility requirements must be met and the enrollee must pay all calculated premium
167.11costs for continued eligibility.
167.12(c) (d) For purposes of determining eligibility under this subdivision, a person's
167.13assets must not exceed $20,000, excluding:
167.14(1) all assets excluded under section 256B.056;
167.15(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
167.16Keogh plans, and pension plans; and
167.17(3) medical expense accounts set up through the person's employer.; and
167.18(4) spousal assets, including spouse's share of jointly held assets.
167.19(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
167.20earned income disregard. To be eligible, a person applying for medical assistance under
167.21this subdivision must have earned income above the disregard level.
167.22(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
167.23Security, and applicable state and federal income taxes must be withheld. To be eligible,
167.24a person must document earned income tax withholding.
167.25(e)(1) A person whose earned and unearned income is equal to or greater than 100
167.26percent of federal poverty guidelines for the applicable family size must pay a premium
167.27to be eligible for medical assistance under this subdivision. (e) All enrollees must pay a
167.28premium to be eligible for medical assistance under this subdivision, except as provided
167.29under section 256.01, subdivision 18b.
167.30(1) An enrollee must pay the greater of a $65 premium or the premium shall be
167.31calculated based on the person's gross earned and unearned income and the applicable
167.32family size using a sliding fee scale established by the commissioner, which begins at
167.33one percent of income at 100 percent of the federal poverty guidelines and increases
167.34to 7.5 percent of income for those with incomes at or above 300 percent of the federal
167.35poverty guidelines.
168.1(2) Annual adjustments in the premium schedule based upon changes in the federal
168.2poverty guidelines shall be effective for premiums due in July of each year.
168.3(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
168.4medical assistance under this subdivision. An enrollee shall pay the greater of a $35
168.5premium or the premium calculated in clause (1).
168.6(3) Effective November 1, 2003, All enrollees who receive unearned income must
168.7pay one-half of one five percent of unearned income in addition to the premium amount,
168.8except as provided under section 256.01, subdivision 18b.
168.9(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
168.10percent of the federal poverty guidelines and who are also enrolled in Medicare, the
168.11commissioner must reimburse the enrollee for Medicare Part B premiums under section
168.12256B.0625, subdivision 15, paragraph (a).
168.13(5) (4) Increases in benefits under title II of the Social Security Act shall not be
168.14counted as income for purposes of this subdivision until July 1 of each year.
168.15(f) A person's eligibility and premium shall be determined by the local county
168.16agency. Premiums must be paid to the commissioner. All premiums are dedicated to
168.17the commissioner.
168.18(g) Any required premium shall be determined at application and redetermined at
168.19the enrollee's six-month income review or when a change in income or household size is
168.20reported. Enrollees must report any change in income or household size within ten days
168.21of when the change occurs. A decreased premium resulting from a reported change in
168.22income or household size shall be effective the first day of the next available billing month
168.23after the change is reported. Except for changes occurring from annual cost-of-living
168.24increases, a change resulting in an increased premium shall not affect the premium amount
168.25until the next six-month review.
168.26(h) Premium payment is due upon notification from the commissioner of the
168.27premium amount required. Premiums may be paid in installments at the discretion of
168.28the commissioner.
168.29(i) Nonpayment of the premium shall result in denial or termination of medical
168.30assistance unless the person demonstrates good cause for nonpayment. Good cause exists
168.31if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
168.32D, are met. Except when an installment agreement is accepted by the commissioner,
168.33all persons disenrolled for nonpayment of a premium must pay any past due premiums
168.34as well as current premiums due prior to being reenrolled. Nonpayment shall include
168.35payment with a returned, refused, or dishonored instrument. The commissioner may
169.1require a guaranteed form of payment as the only means to replace a returned, refused,
169.2or dishonored instrument.
169.3(j) The commissioner shall notify enrollees annually beginning at least 24 months
169.4before the person's 65th birthday of the medical assistance eligibility rules affecting
169.5income, assets, and treatment of a spouse's income and assets that will be applied upon
169.6reaching age 65.
169.7(k) For enrollees whose income does not exceed 200 percent of the federal poverty
169.8guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
169.9the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
169.10paragraph (a).
169.11EFFECTIVE DATE.This section is effective January 1, 2014, for adults age 21 or
169.12older, and October 1, 2019, for children age 16 to before the child's 21st birthday.

169.13    Sec. 8. Minnesota Statutes 2010, section 256B.0625, subdivision 19a, is amended to
169.14read:
169.15    Subd. 19a. Personal care assistance services. Medical assistance covers personal
169.16care assistance services in a recipient's home. Effective January 1, 2010, to qualify for
169.17personal care assistance services, a recipient must require assistance and be determined
169.18dependent in one activity of daily living as defined in section 256B.0659, subdivision 1,
169.19paragraph (b), or in a Level I behavior as defined in section 256B.0659, subdivision 1,
169.20paragraph (c). Beginning July 1, 2011, to qualify for personal care assistance services, a
169.21recipient must require assistance and be determined dependent in at least two activities
169.22of daily living as defined in section 256B.0659. Recipients or responsible parties must
169.23be able to identify the recipient's needs, direct and evaluate task accomplishment, and
169.24provide for health and safety. Approved hours may be used outside the home when normal
169.25life activities take them outside the home. To use personal care assistance services at
169.26school, the recipient or responsible party must provide written authorization in the care
169.27plan identifying the chosen provider and the daily amount of services to be used at school.
169.28Total hours for services, whether actually performed inside or outside the recipient's
169.29home, cannot exceed that which is otherwise allowed for personal care assistance services
169.30in an in-home setting according to sections 256B.0651 to 256B.0656. Medical assistance
169.31does not cover personal care assistance services for residents of a hospital, nursing facility,
169.32intermediate care facility, health care facility licensed by the commissioner of health, or
169.33unless a resident who is otherwise eligible is on leave from the facility and the facility
169.34either pays for the personal care assistance services or forgoes the facility per diem for the
169.35leave days that personal care assistance services are used. All personal care assistance
170.1services must be provided according to sections 256B.0651 to 256B.0656. Personal care
170.2assistance services may not be reimbursed if the personal care assistant is the spouse or
170.3paid guardian of the recipient or the parent of a recipient under age 18, or the responsible
170.4party or the family foster care provider of a recipient who cannot direct the recipient's own
170.5care unless, in the case of a foster care provider, a county or state case manager visits
170.6the recipient as needed, but not less than every six months, to monitor the health and
170.7safety of the recipient and to ensure the goals of the care plan are met. Notwithstanding
170.8the provisions of section 256B.0659, the unpaid guardian or conservator of an adult,
170.9who is not the responsible party and not the personal care provider organization, may be
170.10reimbursed to provide personal care assistance services to the recipient if the guardian or
170.11conservator meets all criteria for a personal care assistant according to section 256B.0659,
170.12and shall not be considered to have a service provider interest for purposes of participation
170.13on the screening team under section 256B.092, subdivision 7.

170.14    Sec. 9. Minnesota Statutes 2010, section 256B.0652, subdivision 6, is amended to read:
170.15    Subd. 6. Authorization; personal care assistance and qualified professional.
170.16    (a) All personal care assistance services, supervision by a qualified professional, and
170.17additional services beyond the limits established in subdivision 11, must be authorized
170.18by the commissioner or the commissioner's designee before services begin except for the
170.19assessments established in subdivision 11 and section 256B.0911. The authorization for
170.20personal care assistance and qualified professional services under section 256B.0659 must
170.21be completed within 30 days after receiving a complete request.
170.22    (b) The amount of personal care assistance services authorized must be based
170.23on the recipient's home care rating. The home care rating shall be determined by the
170.24commissioner or the commissioner's designee based on information submitted to the
170.25commissioner identifying the following for recipients with dependencies in two or more
170.26activities of daily living:
170.27    (1) total number of dependencies of activities of daily living as defined in section
170.28256B.0659 ;
170.29    (2) presence of complex health-related needs as defined in section 256B.0659; and
170.30    (3) presence of Level I behavior as defined in section 256B.0659.
170.31    (c) For purposes meeting the criteria in paragraph (b), the methodology to determine
170.32total time for personal care assistance services for each home care rating is based on
170.33the median paid units per day for each home care rating from fiscal year 2007 data for
170.34the personal care assistance program. Each home care rating has a base level of hours
171.1assigned. Additional time is added through the assessment and identification of the
171.2following:
171.3    (1) 30 additional minutes per day for a dependency in each critical activity of daily
171.4living as defined in section 256B.0659;
171.5    (2) 30 additional minutes per day for each complex health-related function as
171.6defined in section 256B.0659; and
171.7    (3) 30 additional minutes per day for each behavior issue as defined in section
171.8256B.0659 , subdivision 4, paragraph (d).
171.9    (d) Effective July 1, 2011, the home care rating for recipients who have a dependency
171.10in one activity of daily living or Level I behavior shall equal no more than two units per
171.11day. Recipients with this home care rating are not subject to the methodology in paragraph
171.12(c) and are not eligible for more than two units per day.
171.13(e) A limit of 96 units of qualified professional supervision may be authorized for
171.14each recipient receiving personal care assistance services. A request to the commissioner
171.15to exceed this total in a calendar year must be requested by the personal care provider
171.16agency on a form approved by the commissioner.

171.17    Sec. 10. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to
171.18read:
171.19    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
171.20must meet the following requirements:
171.21    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years
171.22of age with these additional requirements:
171.23    (i) supervision by a qualified professional every 60 days; and
171.24    (ii) employment by only one personal care assistance provider agency responsible
171.25for compliance with current labor laws;
171.26    (2) be employed by a personal care assistance provider agency;
171.27    (3) enroll with the department as a personal care assistant after clearing a background
171.28study. Except as provided in subdivision 11a, before a personal care assistant provides
171.29services, the personal care assistance provider agency must initiate a background study on
171.30the personal care assistant under chapter 245C, and the personal care assistance provider
171.31agency must have received a notice from the commissioner that the personal care assistant
171.32is:
171.33    (i) not disqualified under section 245C.14; or
171.34    (ii) is disqualified, but the personal care assistant has received a set aside of the
171.35disqualification under section 245C.22;
172.1    (4) be able to effectively communicate with the recipient and personal care
172.2assistance provider agency;
172.3    (5) be able to provide covered personal care assistance services according to the
172.4recipient's personal care assistance care plan, respond appropriately to recipient needs,
172.5and report changes in the recipient's condition to the supervising qualified professional
172.6or physician;
172.7    (6) not be a consumer of personal care assistance services;
172.8    (7) maintain daily written records including, but not limited to, time sheets under
172.9subdivision 12;
172.10    (8) effective January 1, 2010, complete standardized training as determined
172.11by the commissioner before completing enrollment. The training must be available
172.12in languages other than English and to those who need accommodations due to
172.13disabilities. Personal care assistant training must include successful completion of the
172.14following training components: basic first aid, vulnerable adult, child maltreatment,
172.15OSHA universal precautions, basic roles and responsibilities of personal care assistants
172.16including information about assistance with lifting and transfers for recipients, emergency
172.17preparedness, orientation to positive behavioral practices, fraud issues, and completion of
172.18time sheets. Upon completion of the training components, the personal care assistant must
172.19demonstrate the competency to provide assistance to recipients;
172.20    (9) complete training and orientation on the needs of the recipient within the first
172.21seven days after the services begin; and
172.22    (10) be limited to providing and being paid for up to 275 hours per month, except
172.23that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
172.242011, of personal care assistance services regardless of the number of recipients being
172.25served or the number of personal care assistance provider agencies enrolled with. The
172.26number of hours worked per day shall not be disallowed by the department unless in
172.27violation of the law.
172.28    (b) A legal guardian may be a personal care assistant if the guardian is not being paid
172.29for the guardian services and meets the criteria for personal care assistants in paragraph (a).
172.30    (c) Effective January 1, 2010, Persons who do not qualify as a personal care assistant
172.31include parents and stepparents of minors, spouses, paid legal guardians, family foster
172.32care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or
172.33staff of a residential setting. When the personal care assistant is a relative of the recipient,
172.34the commissioner shall pay 80 percent of the provider rate. For purposes of this section,
172.35relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or
172.36older, an adult child, a grandparent, or a grandchild.
173.1EFFECTIVE DATE.This section is effective October 1, 2011.

173.2    Sec. 11. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to
173.3read:
173.4    Subd. 28. Personal care assistance provider agency; required documentation.
173.5(a) Required documentation must be completed and kept in the personal care assistance
173.6provider agency file or the recipient's home residence. The required documentation
173.7consists of:
173.8(1) employee files, including:
173.9(i) applications for employment;
173.10(ii) background study requests and results;
173.11(iii) orientation records about the agency policies;
173.12(iv) trainings completed with demonstration of competence;
173.13(v) supervisory visits;
173.14(vi) evaluations of employment; and
173.15(vii) signature on fraud statement;
173.16(2) recipient files, including:
173.17(i) demographics;
173.18(ii) emergency contact information and emergency backup plan;
173.19(iii) personal care assistance service plan;
173.20(iv) personal care assistance care plan;
173.21(v) month-to-month service use plan;
173.22(vi) all communication records;
173.23(vii) start of service information, including the written agreement with recipient; and
173.24(viii) date the home care bill of rights was given to the recipient;
173.25(3) agency policy manual, including:
173.26(i) policies for employment and termination;
173.27(ii) grievance policies with resolution of consumer grievances;
173.28(iii) staff and consumer safety;
173.29(iv) staff misconduct; and
173.30(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
173.31resolution of consumer grievances;
173.32(4) time sheets for each personal care assistant along with completed activity sheets
173.33for each recipient served; and
173.34(5) agency marketing and advertising materials and documentation of marketing
173.35activities and costs; and
174.1(6) for each personal care assistant, whether or not the personal care assistant is
174.2providing care to a relative as defined in subdivision 11.
174.3(b) The commissioner may assess a fine of up to $500 on provider agencies that do
174.4not consistently comply with the requirements of this subdivision.

174.5    Sec. 12. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to
174.6read:
174.7    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
174.8    (a) "Long-term care consultation services" means:
174.9    (1) assistance in identifying services needed to maintain an individual in the most
174.10inclusive environment;
174.11    (2) providing recommendations on cost-effective community services that are
174.12available to the individual;
174.13    (3) development of an individual's person-centered community support plan;
174.14    (4) providing information regarding eligibility for Minnesota health care programs;
174.15    (5) face-to-face long-term care consultation assessments, which may be completed
174.16in a hospital, nursing facility, intermediate care facility for persons with developmental
174.17disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
174.18residence;
174.19    (6) federally mandated screening to determine the need for an institutional level of
174.20care under subdivision 4a;
174.21    (7) determination of home and community-based waiver service eligibility including
174.22level of care determination for individuals who need an institutional level of care as
174.23defined under section 144.0724, subdivision 11, determined under section 256B.0911,
174.24subdivision 4a, paragraph (d), or 256B.092, service eligibility including state plan home
174.25care services identified in sections 256B.0625, subdivisions 6, 7, and 19, paragraphs
174.26(a) and (c), and 256B.0657, based on assessment and support plan development with
174.27appropriate referrals, including the option for consumer-directed community supports;
174.28    (8) providing recommendations for nursing facility placement when there are no
174.29cost-effective community services available; and
174.30    (9) assistance to transition people back to community settings after facility
174.31admission.
174.32    (b) "Long-term care options counseling" means the services provided by the linkage
174.33lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
174.34telephone assistance and follow up once a long-term care consultation assessment has
174.35been completed.
175.1    (c) "Minnesota health care programs" means the medical assistance program under
175.2chapter 256B and the alternative care program under section 256B.0913.
175.3    (d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
175.4plans administering long-term care consultation assessment and support planning services.

175.5    Sec. 13. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to
175.6read:
175.7    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
175.8services planning, or other assistance intended to support community-based living,
175.9including persons who need assessment in order to determine waiver or alternative care
175.10program eligibility, must be visited by a long-term care consultation team within 15
175.11calendar days after the date on which an assessment was requested or recommended. After
175.12January 1, 2011, these requirements also apply to personal care assistance services, private
175.13duty nursing, and home health agency services, on timelines established in subdivision 5.
175.14Face-to-face assessments must be conducted according to paragraphs (b) to (i).
175.15    (b) The county may utilize a team of either the social worker or public health nurse,
175.16or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
175.17assessment in a face-to-face interview. The consultation team members must confer
175.18regarding the most appropriate care for each individual screened or assessed.
175.19    (c) The assessment must be comprehensive and include a person-centered
175.20assessment of the health, psychological, functional, environmental, and social needs of
175.21referred individuals and provide information necessary to develop a support plan that
175.22meets the consumers needs, using an assessment form provided by the commissioner.
175.23    (d) The assessment must be conducted in a face-to-face interview with the person
175.24being assessed and the person's legal representative, as required by legally executed
175.25documents, and other individuals as requested by the person, who can provide information
175.26on the needs, strengths, and preferences of the person necessary to develop a support plan
175.27that ensures the person's health and safety, but who is not a provider of service or has any
175.28financial interest in the provision of services.
175.29    (e) The person, or the person's legal representative, must be provided with written
175.30recommendations for community-based services, including consumer-directed options,
175.31or institutional care that include documentation that the most cost-effective alternatives
175.32available were offered to the individual, and alternatives to residential settings, including,
175.33but not limited to, foster care settings that are not the primary residence of the license
175.34holder. For purposes of this requirement, "cost-effective alternatives" means community
175.35services and living arrangements that cost the same as or less than institutional care.
176.1    (f) If the person chooses to use community-based services, the person or the person's
176.2legal representative must be provided with a written community support plan, regardless
176.3of whether the individual is eligible for Minnesota health care programs. A person may
176.4request assistance in identifying community supports without participating in a complete
176.5assessment. Upon a request for assistance identifying community support, the person must
176.6be transferred or referred to the services available under sections 256.975, subdivision 7,
176.7and 256.01, subdivision 24, for telephone assistance and follow up.
176.8    (g) The person has the right to make the final decision between institutional
176.9placement and community placement after the recommendations have been provided,
176.10except as provided in subdivision 4a, paragraph (c).
176.11    (h) The team must give the person receiving assessment or support planning, or
176.12the person's legal representative, materials, and forms supplied by the commissioner
176.13containing the following information:
176.14    (1) the need for and purpose of preadmission screening if the person selects nursing
176.15facility placement;
176.16    (2) the role of the long-term care consultation assessment and support planning in
176.17waiver and alternative care program eligibility determination;
176.18    (3) information about Minnesota health care programs;
176.19    (4) the person's freedom to accept or reject the recommendations of the team;
176.20    (5) the person's right to confidentiality under the Minnesota Government Data
176.21Practices Act, chapter 13;
176.22    (6) the long-term care consultant's decision regarding the person's need for
176.23institutional level of care as determined under criteria established in section 144.0724,
176.24subdivision 11
, or 256B.092; and
176.25    (7) the person's right to appeal the decision regarding the need for nursing facility
176.26level of care or the county's final decisions regarding public programs eligibility according
176.27to section 256.045, subdivision 3.
176.28    (i) Face-to-face assessment completed as part of eligibility determination for
176.29the alternative care, elderly waiver, community alternatives for disabled individuals,
176.30community alternative care, and traumatic brain injury waiver programs under sections
176.31256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more
176.32than 60 calendar days after the date of assessment. The effective eligibility start date
176.33for these programs can never be prior to the date of assessment. If an assessment was
176.34completed more than 60 days before the effective waiver or alternative care program
176.35eligibility start date, assessment and support plan information must be updated in a
176.36face-to-face visit and documented in the department's Medicaid Management Information
177.1System (MMIS). The effective date of program eligibility in this case cannot be prior to
177.2the date the updated assessment is completed.

177.3    Sec. 14. Minnesota Statutes 2010, section 256B.0911, subdivision 3c, is amended to
177.4read:
177.5    Subd. 3c. Transition to Consultation for housing with services. (a) Housing
177.6with services establishments offering or providing assisted living under chapter 144G
177.7shall inform all prospective residents of the availability of and contact information
177.8for transitional consultation services under this subdivision prior to executing a lease
177.9or contract with the prospective resident. The purpose of transitional long-term care
177.10consultation for registered housing with services is to support persons with current or
177.11anticipated long-term care needs in making informed choices among options that include
177.12the most cost-effective and least restrictive settings, and to delay spenddown to eligibility
177.13for publicly funded programs by connecting people to alternative services in their homes
177.14before transition to housing with services. Regardless of the consultation,. Prospective
177.15residents maintain the right to choose housing with services or assisted living if that
177.16option is their preference.
177.17    (b) Transitional consultation Registered housing with services establishments
177.18shall inform all prospective residents of the availability of long-term care consultation
177.19and the need to receive and verify the consultation prior to signing a lease or contract.
177.20Long-term care consultation for registered housing with services are is provided as
177.21determined by the commissioner of human services in partnership with county long-term
177.22care consultation units, and the Area Agencies on Aging, and are a combination of
177.23telephone-based and in-person assistance provided under models developed by the
177.24commissioner. The consultation shall be performed in a manner that provides objective
177.25and complete information. Transitional consultation. The service is delivered under a
177.26partnership between lead agencies as defined in subdivision 1a, paragraph (d), and the
177.27Area Agencies on Aging, and is a point of entry to a combination of telephone-based
177.28long-term care options counseling provided by Senior LinkAge Line and in-person
177.29long-term care consultation provided by lead agencies. The point of entry service must be
177.30provided within five working days of the request of the prospective resident as follows:
177.31    (1) the consultation must be provided by a qualified professional as determined by
177.32the commissioner shall be performed in a manner that provides objective and complete
177.33information;
177.34    (2) the consultation must include a review of the prospective resident's reasons for
177.35considering assisted living housing with services, the prospective resident's personal
178.1goals, a discussion of the prospective resident's immediate and projected long-term care
178.2needs, and alternative community services or assisted living housing with services settings
178.3that may meet the prospective resident's needs; and
178.4    (3) the prospective resident shall be informed of the availability of long-term care
178.5consultation services described in subdivision 3a that are available a face-to-face visit at
178.6no charge to the prospective resident to assist the prospective resident in assessment and
178.7planning to meet the prospective resident's long-term care needs. The Senior LinkAge Line
178.8and long-term care consultation team shall give the highest priority to referrals who are at
178.9highest risk of nursing facility placement or as needed for determining eligibility.; and
178.10(4) verification of counseling shall be generated and provided to the prospective
178.11resident by Senior LinkAge Line upon completion of the telephone-based counseling.
178.12(c) Housing with services establishments registered under chapter 144D shall:
178.13(1) inform all prospective residents of the availability of and contact information for
178.14consultation services under this subdivision;
178.15(2) except for individuals seeking lease-only arrangements in subsidized housing
178.16settings, receive a copy of the verification of counseling prior to executing a lease or
178.17service contract with the prospective resident, and prior to executing a service contract
178.18with individuals who have previously entered into lease-only arrangements; and
178.19(3) retain a copy of the verification of counseling as part of the resident's file.
178.20EFFECTIVE DATE.This section is effective October 1, 2011.

178.21    Sec. 15. Minnesota Statutes 2010, section 256B.0911, subdivision 4a, is amended to
178.22read:
178.23    Subd. 4a. Preadmission screening activities related to nursing facility
178.24admissions. (a) All applicants to Medicaid certified nursing facilities, including certified
178.25boarding care facilities, must be screened prior to admission regardless of income, assets,
178.26or funding sources for nursing facility care, except as described in subdivision 4b. The
178.27purpose of the screening is to determine the need for nursing facility level of care as
178.28described in paragraph (d) and to complete activities required under federal law related to
178.29mental illness and developmental disability as outlined in paragraph (b).
178.30(b) A person who has a diagnosis or possible diagnosis of mental illness or
178.31developmental disability must receive a preadmission screening before admission
178.32regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need
178.33for further evaluation and specialized services, unless the admission prior to screening is
178.34authorized by the local mental health authority or the local developmental disabilities case
178.35manager, or unless authorized by the county agency according to Public Law 101-508.
179.1The following criteria apply to the preadmission screening:
179.2(1) the county must use forms and criteria developed by the commissioner to identify
179.3persons who require referral for further evaluation and determination of the need for
179.4specialized services; and
179.5(2) the evaluation and determination of the need for specialized services must be
179.6done by:
179.7(i) a qualified independent mental health professional, for persons with a primary or
179.8secondary diagnosis of a serious mental illness; or
179.9(ii) a qualified developmental disability professional, for persons with a primary or
179.10secondary diagnosis of developmental disability. For purposes of this requirement, a
179.11qualified developmental disability professional must meet the standards for a qualified
179.12developmental disability professional under Code of Federal Regulations, title 42, section
179.13483.430.
179.14(c) The local county mental health authority or the state developmental disability
179.15authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
179.16nursing facility if the individual does not meet the nursing facility level of care criteria or
179.17needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
179.18purposes of this section, "specialized services" for a person with developmental disability
179.19means active treatment as that term is defined under Code of Federal Regulations, title
179.2042, section 483.440 (a)(1).
179.21(d) The determination of the need for nursing facility level of care must be made
179.22according to criteria established developed by the commissioner, and in section 144.0724,
179.23subdivision 11
, and 256B.092, using forms developed by the commissioner. Effective no
179.24sooner than on or after July 1, 2012, for individuals age 21 and older, and on or after
179.25October 1, 2019, for individuals under age 21, the determination of need for nursing
179.26facility level of care shall be based on criteria in section 144.0724, subdivision 11. In
179.27assessing a person's needs, consultation team members shall have a physician available for
179.28consultation and shall consider the assessment of the individual's attending physician, if
179.29any. The individual's physician must be included if the physician chooses to participate.
179.30Other personnel may be included on the team as deemed appropriate by the county.

179.31    Sec. 16. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to
179.32read:
179.33    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
179.34    (a) Funding for services under the alternative care program is available to persons who
179.35meet the following criteria:
180.1    (1) the person has been determined by a community assessment under section
180.2256B.0911 to be a person who would require the level of care provided in a nursing
180.3facility, as determined under section 256B.0911, subdivision 4a, paragraph (d), but for
180.4the provision of services under the alternative care program. Effective January 1, 2011,
180.5this determination must be made according to the criteria established in section 144.0724,
180.6subdivision 11
;
180.7    (2) the person is age 65 or older;
180.8    (3) the person would be eligible for medical assistance within 135 days of admission
180.9to a nursing facility;
180.10    (4) the person is not ineligible for the payment of long-term care services by the
180.11medical assistance program due to an asset transfer penalty under section 256B.0595 or
180.12equity interest in the home exceeding $500,000 as stated in section 256B.056;
180.13    (5) the person needs long-term care services that are not funded through other
180.14state or federal funding, or other health insurance or other third-party insurance such as
180.15long-term care insurance;
180.16    (6) except for individuals described in clause (7), the monthly cost of the alternative
180.17care services funded by the program for this person does not exceed 75 percent of the
180.18monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
180.19does not prohibit the alternative care client from payment for additional services, but in no
180.20case may the cost of additional services purchased under this section exceed the difference
180.21between the client's monthly service limit defined under section 256B.0915, subdivision
180.223
, and the alternative care program monthly service limit defined in this paragraph. If
180.23care-related supplies and equipment or environmental modifications and adaptations are or
180.24will be purchased for an alternative care services recipient, the costs may be prorated on a
180.25monthly basis for up to 12 consecutive months beginning with the month of purchase.
180.26If the monthly cost of a recipient's other alternative care services exceeds the monthly
180.27limit established in this paragraph, the annual cost of the alternative care services shall be
180.28determined. In this event, the annual cost of alternative care services shall not exceed 12
180.29times the monthly limit described in this paragraph;
180.30    (7) for individuals assigned a case mix classification A as described under section
180.31256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
180.32living, or (ii) only one dependency up to two dependencies in bathing, dressing, grooming,
180.33or walking, or (iii) a dependency score of less than three if eating is the only dependency
180.34and eating when the dependency score in eating is three or greater as determined by
180.35an assessment performed under section 256B.0911, the monthly cost of alternative
180.36care services funded by the program cannot exceed $600 $593 per month for all new
181.1participants enrolled in the program on or after July 1, 2009 2011. This monthly limit
181.2shall be applied to all other participants who meet this criteria at reassessment. This
181.3monthly limit shall be increased annually as described in section 256B.0915, subdivision
181.43a
, paragraph (a). This monthly limit does not prohibit the alternative care client from
181.5payment for additional services, but in no case may the cost of additional services
181.6purchased exceed the difference between the client's monthly service limit defined in this
181.7clause and the limit described in clause (6) for case mix classification A; and
181.8(8) the person is making timely payments of the assessed monthly fee.
181.9A person is ineligible if payment of the fee is over 60 days past due, unless the person
181.10agrees to:
181.11    (i) the appointment of a representative payee;
181.12    (ii) automatic payment from a financial account;
181.13    (iii) the establishment of greater family involvement in the financial management of
181.14payments; or
181.15    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
181.16    The lead agency may extend the client's eligibility as necessary while making
181.17arrangements to facilitate payment of past-due amounts and future premium payments.
181.18Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
181.19reinstated for a period of 30 days.
181.20    (b) Alternative care funding under this subdivision is not available for a person
181.21who is a medical assistance recipient or who would be eligible for medical assistance
181.22without a spenddown or waiver obligation. A person whose initial application for medical
181.23assistance and the elderly waiver program is being processed may be served under the
181.24alternative care program for a period up to 60 days. If the individual is found to be eligible
181.25for medical assistance, medical assistance must be billed for services payable under the
181.26federally approved elderly waiver plan and delivered from the date the individual was
181.27found eligible for the federally approved elderly waiver plan. Notwithstanding this
181.28provision, alternative care funds may not be used to pay for any service the cost of which:
181.29(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
181.30or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
181.31to participate in the federally approved elderly waiver program under the special income
181.32standard provision.
181.33    (c) Alternative care funding is not available for a person who resides in a licensed
181.34nursing home, certified boarding care home, hospital, or intermediate care facility, except
181.35for case management services which are provided in support of the discharge planning
182.1process for a nursing home resident or certified boarding care home resident to assist with
182.2a relocation process to a community-based setting.
182.3    (d) Alternative care funding is not available for a person whose income is greater
182.4than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
182.5to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
182.6year for which alternative care eligibility is determined, who would be eligible for the
182.7elderly waiver with a waiver obligation.

182.8    Sec. 17. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to
182.9read:
182.10    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
182.11waivered services to an individual elderly waiver client except for individuals described
182.12in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
182.13mix resident class to which the elderly waiver client would be assigned under Minnesota
182.14Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
182.15as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
182.16which the resident assessment system as described in section 256B.438 for nursing home
182.17rate determination is implemented. Effective on the first day of the state fiscal year in
182.18which the resident assessment system as described in section 256B.438 for nursing home
182.19rate determination is implemented and the first day of each subsequent state fiscal year, the
182.20monthly limit for the cost of waivered services to an individual elderly waiver client shall
182.21be the rate of the case mix resident class to which the waiver client would be assigned
182.22under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
182.23previous state fiscal year, adjusted by the greater of any legislatively adopted home and
182.24community-based services percentage rate increase or the average statewide percentage
182.25increase in nursing facility payment rates adjustment.
182.26    (b) The monthly limit for the cost of waivered services to an individual elderly
182.27waiver client assigned to a case mix classification A under paragraph (a) with:
182.28(1) no dependencies in activities of daily living,; or
182.29(2) only one dependency up to two dependencies in bathing, dressing, grooming, or
182.30walking, or (3) a dependency score of less than three if eating is the only dependency,
182.31and eating when the dependency score in eating is three or greater as determined by an
182.32assessment performed under section 256B.0911
182.33 shall be the lower of the case mix classification amount for case mix A as determined
182.34under paragraph (a) or the case mix classification amount for case mix A $1,750 per
182.35month effective on October July 1, 2008 2011, per month for all new participants enrolled
183.1in the program on or after July 1, 2009 2011. This monthly limit shall be applied to all
183.2other participants who meet this criteria at reassessment. This monthly limit shall be
183.3increased annually as described in paragraph (a).
183.4(c) If extended medical supplies and equipment or environmental modifications are
183.5or will be purchased for an elderly waiver client, the costs may be prorated for up to
183.612 consecutive months beginning with the month of purchase. If the monthly cost of a
183.7recipient's waivered services exceeds the monthly limit established in paragraph (a) or
183.8(b), the annual cost of all waivered services shall be determined. In this event, the annual
183.9cost of all waivered services shall not exceed 12 times the monthly limit of waivered
183.10services as described in paragraph (a) or (b).

183.11    Sec. 18. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to
183.12read:
183.13    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
183.14facility. (a) For a person who is a nursing facility resident at the time of requesting a
183.15determination of eligibility for elderly waivered services, a monthly conversion budget
183.16limit for the cost of elderly waivered services may be requested. The monthly conversion
183.17budget limit for the cost of elderly waiver services shall be the resident class assigned
183.18under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing
183.19facility where the resident currently resides until July 1 of the state fiscal year in which
183.20the resident assessment system as described in section 256B.438 for nursing home rate
183.21determination is implemented. Effective on July 1 of the state fiscal year in which the
183.22resident assessment system as described in section 256B.438 for nursing home rate
183.23determination is implemented, the monthly conversion budget limit for the cost of elderly
183.24waiver services shall be based on the per diem nursing facility rate as determined by the
183.25resident assessment system as described in section 256B.438 for that resident residents
183.26in the nursing facility where the resident elderly waiver applicant currently resides
183.27multiplied. The monthly conversion budget limit shall be calculated by multiplying the
183.28per diem by 365 and, divided by 12, less and reduced by the recipient's maintenance needs
183.29allowance as described in subdivision 1d. The initially approved monthly conversion rate
183.30may budget limit shall be adjusted by the greater of any subsequent legislatively adopted
183.31home and community-based services percentage rate increase or the average statewide
183.32percentage increase in nursing facility payment rates annually as described in subdivision
183.333a, paragraph (a). The limit under this subdivision only applies to persons discharged from
183.34a nursing facility after a minimum 30-day stay and found eligible for waivered services
183.35on or after July 1, 1997. For conversions from the nursing home to the elderly waiver
184.1with consumer directed community support services, the conversion rate limit is equal to
184.2the nursing facility rate per diem used to calculate the monthly conversion budget limit
184.3must be reduced by a percentage equal to the percentage difference between the consumer
184.4directed services budget limit that would be assigned according to the federally approved
184.5waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
184.6    (b) The following costs must be included in determining the total monthly costs
184.7for the waiver client:
184.8    (1) cost of all waivered services, including extended medical specialized supplies
184.9and equipment and environmental modifications and accessibility adaptations; and
184.10    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
184.11by medical assistance.

184.12    Sec. 19. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to
184.13read:
184.14    Subd. 3e. Customized living service rate. (a) Payment for customized living
184.15services shall be a monthly rate authorized by the lead agency within the parameters
184.16established by the commissioner. The payment agreement must delineate the amount of
184.17each component service included in the recipient's customized living service plan. The
184.18lead agency shall ensure that there is a documented need within the parameters established
184.19by the commissioner for all component customized living services authorized.
184.20(b) The payment rate must be based on the amount of component services to be
184.21provided utilizing component rates established by the commissioner. Counties and tribes
184.22shall use tools issued by the commissioner to develop and document customized living
184.23service plans and rates.
184.24(c) Component service rates must not exceed payment rates for comparable elderly
184.25waiver or medical assistance services and must reflect economies of scale. Customized
184.26living services must not include rent or raw food costs.
184.27    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
184.28individualized monthly authorized payment for the customized living service plan shall
184.29not exceed 50 percent of the greater of either the statewide or any of the geographic
184.30groups' weighted average monthly nursing facility rate of the case mix resident class
184.31to which the elderly waiver eligible client would be assigned under Minnesota Rules,
184.32parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
184.33in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
184.34resident assessment system as described in section 256B.438 for nursing home rate
184.35determination is implemented. Effective on July 1 of the state fiscal year in which
185.1the resident assessment system as described in section 256B.438 for nursing home
185.2rate determination is implemented and July 1 of each subsequent state fiscal year, the
185.3individualized monthly authorized payment for the services described in this clause shall
185.4not exceed the limit which was in effect on June 30 of the previous state fiscal year
185.5updated annually based on legislatively adopted changes to all service rate maximums for
185.6home and community-based service providers.
185.7(e) Effective July 1, 2011, the individualized monthly payment for the customized
185.8living service plan for individuals described in subdivision 3a, paragraph (b), must be the
185.9monthly authorized payment limit for customized living for individuals classified as case
185.10mix A, reduced by 25 percent. This rate limit must be applied to all new participants
185.11enrolled in the program on or after July 1, 2011, who meet the criteria described in
185.12subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
185.13meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
185.14    (e) (f) Customized living services are delivered by a provider licensed by the
185.15Department of Health as a class A or class F home care provider and provided in a
185.16building that is registered as a housing with services establishment under chapter 144D.
185.17Licensed home care providers are subject to section 256B.0651, subdivision 14.
185.18(g) A provider may not bill or otherwise charge an elderly waiver participant or their
185.19family for additional units of any allowable component service beyond those available
185.20under the service rate limits described in paragraph (d), nor for additional units of any
185.21allowable component service beyond those approved in the service plan by the lead agency.

185.22    Sec. 20. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to
185.23read:
185.24    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
185.25payment rate for 24-hour customized living services is a monthly rate authorized by the
185.26lead agency within the parameters established by the commissioner of human services.
185.27The payment agreement must delineate the amount of each component service included in
185.28each recipient's customized living service plan. The lead agency shall ensure that there is a
185.29documented need within the parameters established by the commissioner for all component
185.30customized living services authorized. The lead agency shall not authorize 24-hour
185.31customized living services unless there is a documented need for 24-hour supervision.
185.32(b) For purposes of this section, "24-hour supervision" means that the recipient
185.33requires assistance due to needs related to one or more of the following:
185.34    (1) intermittent assistance with toileting, positioning, or transferring;
185.35    (2) cognitive or behavioral issues;
186.1    (3) a medical condition that requires clinical monitoring; or
186.2    (4) for all new participants enrolled in the program on or after January July 1, 2011,
186.3and all other participants at their first reassessment after January July 1, 2011, dependency
186.4in at least two three of the following activities of daily living as determined by assessment
186.5under section 256B.0911: bathing; dressing; grooming; walking; or eating when the
186.6dependency score in eating is three or greater; and needs medication management and at
186.7least 50 hours of service per month. The lead agency shall ensure that the frequency and
186.8mode of supervision of the recipient and the qualifications of staff providing supervision
186.9are described and meet the needs of the recipient.
186.10(c) The payment rate for 24-hour customized living services must be based on the
186.11amount of component services to be provided utilizing component rates established by the
186.12commissioner. Counties and tribes will use tools issued by the commissioner to develop
186.13and document customized living plans and authorize rates.
186.14(d) Component service rates must not exceed payment rates for comparable elderly
186.15waiver or medical assistance services and must reflect economies of scale.
186.16(e) The individually authorized 24-hour customized living payments, in combination
186.17with the payment for other elderly waiver services, including case management, must not
186.18exceed the recipient's community budget cap specified in subdivision 3a. Customized
186.19living services must not include rent or raw food costs.
186.20(f) The individually authorized 24-hour customized living payment rates shall not
186.21exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
186.22living services in effect and in the Medicaid management information systems on March
186.2331, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
186.24to 9549.0059, to which elderly waiver service clients are assigned. When there are
186.25fewer than 50 authorizations in effect in the case mix resident class, the commissioner
186.26shall multiply the calculated service payment rate maximum for the A classification by
186.27the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
186.289549.0059, to determine the applicable payment rate maximum. Service payment rate
186.29maximums shall be updated annually based on legislatively adopted changes to all service
186.30rates for home and community-based service providers.
186.31    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
186.32may establish alternative payment rate systems for 24-hour customized living services in
186.33housing with services establishments which are freestanding buildings with a capacity of
186.3416 or fewer, by applying a single hourly rate for covered component services provided
186.35in either:
186.36    (1) licensed corporate adult foster homes; or
187.1    (2) specialized dementia care units which meet the requirements of section 144D.065
187.2and in which:
187.3    (i) each resident is offered the option of having their own apartment; or
187.4    (ii) the units are licensed as board and lodge establishments with maximum capacity
187.5of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
187.6subparts 1, 2, 3, and 4, item A.
187.7(h) A provider may not bill or otherwise charge an elderly waiver participant or their
187.8family for additional units of any allowable component service beyond those available
187.9under the service rate limits described in paragraph (e), nor for additional units of any
187.10allowable component service beyond those approved in the service plan by the lead agency.

187.11    Sec. 21. Minnesota Statutes 2010, section 256B.0915, subdivision 5, is amended to
187.12read:
187.13    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
187.14shall receive an initial assessment of strengths, informal supports, and need for services
187.15in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
187.16client served under the elderly waiver must be conducted at least every 12 months and
187.17at other times when the case manager determines that there has been significant change
187.18in the client's functioning. This may include instances where the client is discharged
187.19from the hospital. There must be a determination that the client requires nursing facility
187.20level of care as defined in section 144.0724, subdivision 11 256B.0911, subdivision 4a,
187.21paragraph (d), at initial and subsequent assessments to initiate and maintain participation
187.22in the waiver program.
187.23(b) Regardless of other assessments identified in section 144.0724, subdivision
187.244, as appropriate to determine nursing facility level of care for purposes of medical
187.25assistance payment for nursing facility services, only face-to-face assessments conducted
187.26according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
187.27level of care determination will be accepted for purposes of initial and ongoing access to
187.28waiver service payment.

187.29    Sec. 22. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to
187.30read:
187.31    Subd. 10. Waiver payment rates; managed care organizations. The
187.32commissioner shall adjust the elderly waiver capitation payment rates for managed care
187.33organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
187.34service rate limits for customized living services and 24-hour customized living services
188.1under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical
188.2assistance rates paid to customized living providers by managed care organizations under
188.3this section shall not exceed the maximum service rate limits and component rates as
188.4determined by the commissioner under subdivisions 3e and 3h.

188.5    Sec. 23. [256B.0961] STATE QUALITY ASSURANCE, QUALITY
188.6IMPROVEMENT, AND LICENSING SYSTEM.
188.7    Subdivision 1. Scope. (a) In order to improve the quality of services provided to
188.8Minnesotans with disabilities and to meet the requirements of the federally approved
188.9home and community-based waivers under section 1915c of the Social Security Act, a
188.10State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans
188.11receiving disability services is enacted. This system is a partnership between the
188.12Department of Human Services and the State Quality Council established under
188.13subdivision 3.
188.14    (b) This system is a result of the recommendations from the Department of Human
188.15Services' licensing and alternative quality assurance study mandated under Laws 2005,
188.16First Special Session chapter 4, article 7, section 57, and presented to the legislature
188.17in February 2007.
188.18    (c) The disability services eligible under this section include:
188.19    (1) the home and community-based services waiver programs for persons with
188.20developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
188.21including traumatic brain injuries and services for those who qualify for nursing facility
188.22level of care or hospital facility level of care;
188.23    (2) home care services under section 256B.0651;
188.24    (3) family support grants under section 252.32;
188.25    (4) consumer support grants under section 256.476;
188.26    (5) semi-independent living services under section 252.275; and
188.27    (6) services provided through an intermediate care facility for the developmentally
188.28disabled.
188.29    (d) For purposes of this section, the following definitions apply:
188.30    (1) "commissioner" means the commissioner of human services;
188.31    (2) "council" means the State Quality Council under subdivision 3;
188.32    (3) "Quality Assurance Commission" means the commission under section
188.33256B.0951; and
188.34    (4) "system" means the State Quality Assurance, Quality Improvement and
188.35Licensing System under this section.
189.1    Subd. 2. Duties of the commissioner of human services. (a) The commissioner of
189.2human services shall establish the State Quality Council under subdivision 3.
189.3    (b) The commissioner shall initially delegate authority to perform licensing
189.4functions and activities according to section 245A.16 to a host county in Region 10. The
189.5commissioner must not license or reimburse a participating facility, program, or service
189.6located in Region 10 if the commissioner has received notification from the host county
189.7that the facility, program, or service has failed to qualify for licensure.
189.8    (c) The commissioner may conduct random licensing inspections based on outcomes
189.9adopted under section 256B.0951, subdivision 3, at facilities or programs, and of services
189.10eligible under this section. The role of the random inspections is to verify that the system
189.11protects the safety and well-being of persons served and maintains the availability of
189.12high-quality services for persons with disabilities.
189.13    (d) The commissioner shall ensure that the federal home and community-based
189.14waiver requirements are met and that incidents that may have jeopardized safety and health
189.15or violated services-related assurances, civil and human rights, and other protections
189.16designed to prevent abuse, neglect, and exploitation, are reviewed, investigated, and
189.17acted upon in a timely manner.
189.18    (e) The commissioner shall seek a federal waiver by July 1, 2012 to allow
189.19intermediate care facilities for persons with developmental disabilities to participate in
189.20this system.
189.21    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
189.22Council which must define regional quality councils, and carry out a community-based,
189.23person-directed quality review component, and a comprehensive system for effective
189.24incident reporting, investigation, analysis, and follow-up.
189.25    (b) By August 1, 2011, the commissioner of human services shall appoint the
189.26members of the initial State Quality Council. Members shall include representatives
189.27from the following groups:
189.28    (1) disability service recipients and their family members;
189.29    (2) during the first two years of the State Quality Council, there must be at least three
189.30members from the Region 10 stakeholders. As regional quality councils are formed under
189.31subdivision 4, each regional quality council shall appoint one member;
189.32    (3) disability service providers;
189.33    (4) disability advocacy groups; and
189.34    (5) county human services agencies and staff from the Department of Human
189.35Services and Ombudsman for Mental Health and Developmental Disabilities.
190.1    (c) Members of the council who do not receive a salary or wages from an employer
190.2for time spent on council duties may receive a per diem payment when performing council
190.3duties and functions.
190.4    (d) The State Quality Council shall:
190.5    (1) assist the Department of Human Services in fulfilling federally mandated
190.6obligations by monitoring disability service quality and quality assurance and
190.7improvement practices in Minnesota; and
190.8    (2) establish state quality improvement priorities with methods for achieving results
190.9and provide an annual report to the legislative committees with jurisdiction over policy
190.10and funding of disability services on the outcomes, improvement priorities, and activities
190.11undertaken by the commission during the previous state fiscal year.
190.12    (e) The State Quality Council, in partnership with the commissioner, shall:
190.13    (1) approve and direct implementation of the community-based, person-directed
190.14system established in this section;
190.15    (2) recommend an appropriate method of funding this system, and determine the
190.16feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
190.17    (3) approve measurable outcomes in the areas of health and safety, consumer
190.18evaluation, education and training, providers, and systems;
190.19    (4) establish variable licensure periods not to exceed three years based on outcomes
190.20achieved; and
190.21    (5) in cooperation with the Quality Assurance Commission, design a transition plan
190.22for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
190.23    (f) The State Quality Council shall notify the commissioner of human services that a
190.24facility, program, or service has been reviewed by quality assurance team members under
190.25subdivision 4, paragraph (b), clause (13), and qualifies for a license.
190.26    (g) The State Quality Council, in partnership with the commissioner, shall establish
190.27an ongoing review process for the system. The review shall take into account the
190.28comprehensive nature of the system which is designed to evaluate the broad spectrum of
190.29licensed and unlicensed entities that provide services to persons with disabilities. The
190.30review shall address efficiencies and effectiveness of the system.
190.31    (h) The State Quality Council may recommend to the commissioner certain
190.32variances from the standards governing licensure of programs for persons with disabilities
190.33in order to improve the quality of services so long as the recommended variances do
190.34not adversely affect the health or safety of persons being served or compromise the
190.35qualifications of staff to provide services.
191.1    (i) The safety standards, rights, or procedural protections referenced under
191.2subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
191.3recommendations to the commissioner or to the legislature in the report required under
191.4paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
191.5procedural protections referenced under subdivision 2, paragraph (c).
191.6    (j) The State Quality Council may hire staff to perform the duties assigned in this
191.7subdivision.
191.8    Subd. 4. Regional quality councils. (a) The commissioner shall establish, as
191.9selected by the State Quality Council, regional quality councils of key stakeholders,
191.10including regional representatives of:
191.11    (1) disability service recipients and their family members;
191.12    (2) disability service providers;
191.13    (3) disability advocacy groups; and
191.14    (4) county human services agencies and staff from the Department of Human
191.15Services and Ombudsman for Mental Health and Developmental Disabilities.
191.16    (b) Each regional quality council shall:
191.17    (1) direct and monitor the community-based, person-directed quality assurance
191.18system in this section;
191.19    (2) approve a training program for quality assurance team members under clause
191.20(13);
191.21    (3) review summary reports from quality assurance team reviews and make
191.22recommendations to the State Quality Council regarding program licensure;
191.23    (4) make recommendations to the State Quality Council regarding the system;
191.24    (5) resolve complaints between the quality assurance teams, counties, providers,
191.25persons receiving services, their families, and legal representatives;
191.26    (6) analyze and review quality outcomes and critical incident data reporting
191.27incidents of life safety concerns immediately to the Department of Human Services
191.28licensing division;
191.29    (7) provide information and training programs for persons with disabilities and their
191.30families and legal representatives on service options and quality expectations;
191.31    (8) disseminate information and resources developed to other regional quality
191.32councils;
191.33    (9) respond to state-level priorities;
191.34    (10) establish regional priorities for quality improvement;
191.35    (11) submit an annual report to the State Quality Council on the status, outcomes,
191.36improvement priorities, and activities in the region;
192.1    (12) choose a representative to participate on the State Quality Council and assume
192.2other responsibilities consistent with the priorities of the State Quality Council; and
192.3    (13) recruit, train, and assign duties to members of quality assurance teams, taking
192.4into account the size of the service provider, the number of services to be reviewed,
192.5the skills necessary for the team members to complete the process, and ensure that no
192.6team member has a financial, personal, or family relationship with the facility, program,
192.7or service being reviewed or with anyone served at the facility, program, or service.
192.8Quality assurance teams must be comprised of county staff, persons receiving services
192.9or the person's families, legal representatives, members of advocacy organizations,
192.10providers, and other involved community members. Team members must complete
192.11the training program approved by the regional quality council and must demonstrate
192.12performance-based competency. Team members may be paid a per diem and reimbursed
192.13for expenses related to their participation in the quality assurance process.
192.14    (c) The commissioner shall monitor the safety standards, rights, and procedural
192.15protections for the monitoring of psychotropic medications and those identified under
192.16sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2)
192.17and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause
192.18(7); 626.556; and 626.557.
192.19    (d) The regional quality councils may hire staff to perform the duties assigned in
192.20this subdivision.
192.21    (e) The regional quality councils may charge fees for their services.
192.22    (f) The quality assurance process undertaken by a regional quality council consists of
192.23an evaluation by a quality assurance team of the facility, program, or service. The process
192.24must include an evaluation of a random sample of persons served. The sample must be
192.25representative of each service provided. The sample size must be at least five percent but
192.26not less than two persons served. All persons must be given the opportunity to be included
192.27in the quality assurance process in addition to those chosen for the random sample.
192.28    (g) A facility, program, or service may contest a licensing decision of the regional
192.29quality council as permitted under chapter 245A.
192.30    Subd. 5. Annual survey of service recipients. The commissioner, in consultation
192.31with the State Quality Council, shall conduct an annual independent statewide survey
192.32of service recipients, randomly selected, to determine the effectiveness and quality
192.33of disability services. The survey must be consistent with the system performance
192.34expectations of the Centers for Medicare and Medicaid Services (CMS) Quality
192.35Framework. The survey must analyze whether desired outcomes for persons with different
192.36demographic, diagnostic, health, and functional needs, who are receiving different types
193.1of services in different settings and with different costs, have been achieved. Annual
193.2statewide and regional reports of the results must be published and used to assist regions,
193.3counties, and providers to plan and measure the impact of quality improvement activities.
193.4    Subd. 6. Mandated reporters. Members of the State Quality Council under
193.5subdivision 3, the regional quality councils under subdivision 4, and quality assurance
193.6team members under subdivision 4, paragraph (b), clause (13), are mandated reporters as
193.7defined in sections 626.556, subdivision 3, and 626.5572, subdivision 16.
193.8EFFECTIVE DATE.(a) Subdivisions 1 to 6 are effective July 1, 2011.
193.9(b) The jurisdictions of the regional quality councils in subdivision 4 must be
193.10defined, with implementation dates, by July 1, 2012. During the biennium beginning July
193.111, 2011, the Quality Assurance Commission shall continue to implement the alternative
193.12licensing system under this section.

193.13    Sec. 24. Minnesota Statutes 2010, section 256B.19, subdivision 1e, is amended to read:
193.14    Subd. 1e. Additional local share of certain nursing facility costs. Beginning
193.15January October 1, 2011, participating local government governmental entities that own
193.16the physical plant or are the license holders of nursing facilities receiving rate adjustments
193.17under section 256B.441, subdivision 55a, shall be responsible for paying the portion of
193.18nonfederal costs calculated under section 256B.441, subdivision 55a, paragraph (d) (e).
193.19Payments of the nonfederal share shall be made monthly submitted to the commissioner in
193.20amounts determined in accordance with section 256B.441, subdivision 55a, paragraph (d).
193.21Payments for each month beginning in January 2011 through September 2015 shall be due
193.22by the 15th day of the following month prior to payment to the nursing facility for that
193.23month's services. If any provider participating governmental entity obligated to pay an
193.24amount under this subdivision is more than two months delinquent in the does not make
193.25 timely payment of the monthly installment, the commissioner may withhold payments,
193.26penalties, and interest in accordance with the methods outlined in section 256.9657,
193.27subdivision 7a. shall revoke participation under this subdivision and end payments
193.28determined under section 256B.441, subdivision 55a, to the participating nursing facility
193.29effective on the first day of the month for which timely payment was not received. In the
193.30event of revocation, the nursing facility may not bill, collect, or retain the amount allowed
193.31in section 256B.441, subdivision 55a, from private-pay residents for days of service on or
193.32after the first day of the month following the month in which the revocation occurred.

193.33    Sec. 25. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to
193.34read:
194.1    Subd. 2r. Payment restrictions on leave days. (a) Effective July 1, 1993, the
194.2commissioner shall limit payment for leave days in a nursing facility to 79 percent of that
194.3nursing facility's total payment rate for the involved resident.
194.4(b) For services rendered on or after July 1, 2003, for facilities reimbursed under this
194.5section or section 256B.434, the commissioner shall limit payment for leave days in a
194.6nursing facility to 60 percent of that nursing facility's total payment rate for the involved
194.7resident.
194.8(c) For services rendered on or after July 1, 2011, for facilities reimbursed under
194.9this chapter, the commissioner shall limit payment for leave days in a nursing facility
194.10to 30 percent of that nursing facility's total payment rate for the involved resident, and
194.11shall allow this payment only when the occupancy of the nursing facility, inclusive of
194.12bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules,
194.13part 9505.0415.

194.14    Sec. 26. Minnesota Statutes 2010, section 256B.431, subdivision 2t, is amended to
194.15read:
194.16    Subd. 2t. Payment limitation. For services rendered on or after July 1, 2003,
194.17for facilities reimbursed under this section or section 256B.434 chapter, the Medicaid
194.18program shall only pay a co-payment during a Medicare-covered skilled nursing facility
194.19stay if the Medicare rate less the resident's co-payment responsibility is less than the
194.20Medicaid RUG-III case-mix payment rate, or, beginning January 1, 2012, the Medicaid
194.21RUG-IV case-mix payment rate. The amount that shall be paid by the Medicaid program
194.22is equal to the amount by which the Medicaid RUG-III or RUG-IV case-mix payment
194.23rate exceeds the Medicare rate less the co-payment responsibility. Health plans paying
194.24for nursing home services under section 256B.69, subdivision 6a, may limit payments as
194.25allowed under this subdivision.

194.26    Sec. 27. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to
194.27read:
194.28    Subd. 32. Payment during first 90 30 days. (a) For rate years beginning on or after
194.29July 1, 2001, the total payment rate for a facility reimbursed under this section, section
194.30256B.434, or any other section for the first 90 paid days after admission shall be:
194.31(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical
194.32assistance rate for each case mix class;
194.33(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent
194.34of the facility's medical assistance rate for each case mix class;
195.1(3) beginning with the 91st paid day after admission, the payment rate shall be the
195.2rate otherwise determined under this section, section 256B.434, or any other section; and
195.3(4) payments under this paragraph apply to admissions occurring on or after July 1,
195.42001, and before July 1, 2003, and to resident days occurring before July 30, 2003.
195.5(b) For rate years beginning on or after July 1, 2003 2011, the total payment rate for
195.6a facility reimbursed under this section, section 256B.434, or any other section shall be:
195.7(1) for the first 30 calendar days after admission, the rate shall be 120 percent of
195.8the facility's medical assistance rate for each RUG class;
195.9(2) beginning with the 31st calendar day after admission, the payment rate shall be
195.10the rate otherwise determined under this section, section 256B.434, or any other section;
195.11and
195.12(3) payments under this paragraph apply to admissions occurring on or after July
195.131, 2003 2011.
195.14(c) Effective January 1, 2004, (b) The enhanced rates under this subdivision shall not
195.15be allowed if a resident has resided during the previous 30 calendar days in:
195.16(1) the same nursing facility;
195.17(2) a nursing facility owned or operated by a related party; or
195.18(3) a nursing facility or part of a facility that closed or was in the process of closing.

195.19    Sec. 28. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:
195.20    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
195.21have their payment rates determined under this section rather than section 256B.431, the
195.22commissioner shall establish a rate under this subdivision. The nursing facility must enter
195.23into a written contract with the commissioner.
195.24    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
195.25contract under this section is the payment rate the facility would have received under
195.26section 256B.431.
195.27    (c) A nursing facility's case mix payment rates for the second and subsequent years
195.28of a facility's contract under this section are the previous rate year's contract payment
195.29rates plus an inflation adjustment and, for facilities reimbursed under this section or
195.30section 256B.431, an adjustment to include the cost of any increase in Health Department
195.31licensing fees for the facility taking effect on or after July 1, 2001. The index for the
195.32inflation adjustment must be based on the change in the Consumer Price Index-All Items
195.33(United States City average) (CPI-U) forecasted by the commissioner of management and
195.34budget's national economic consultant, as forecasted in the fourth quarter of the calendar
195.35year preceding the rate year. The inflation adjustment must be based on the 12-month
196.1period from the midpoint of the previous rate year to the midpoint of the rate year for
196.2which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
196.32000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
196.4July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, October 1, 2011, and
196.5October 1, 2012. this paragraph shall apply only to the property-related payment rate,
196.6except that adjustments to include the cost of any increase in Health Department licensing
196.7fees taking effect on or after July 1, 2001, shall be provided. For the rate years beginning
196.8on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall
196.9be suspended. Beginning in 2005, adjustment to the property payment rate under this
196.10section and section 256B.431 shall be effective on October 1. In determining the amount
196.11of the property-related payment rate adjustment under this paragraph, the commissioner
196.12shall determine the proportion of the facility's rates that are property-related based on the
196.13facility's most recent cost report.
196.14    (d) The commissioner shall develop additional incentive-based payments of up to
196.15five percent above a facility's operating payment rate for achieving outcomes specified
196.16in a contract. The commissioner may solicit contract amendments and implement those
196.17which, on a competitive basis, best meet the state's policy objectives. The commissioner
196.18shall limit the amount of any incentive payment and the number of contract amendments
196.19under this paragraph to operate the incentive payments within funds appropriated for this
196.20purpose. The contract amendments may specify various levels of payment for various
196.21levels of performance. Incentive payments to facilities under this paragraph may be in the
196.22form of time-limited rate adjustments or onetime supplemental payments. In establishing
196.23the specified outcomes and related criteria, the commissioner shall consider the following
196.24state policy objectives:
196.25    (1) successful diversion or discharge of residents to the residents' prior home or other
196.26community-based alternatives;
196.27    (2) adoption of new technology to improve quality or efficiency;
196.28    (3) improved quality as measured in the Nursing Home Report Card;
196.29    (4) reduced acute care costs; and
196.30    (5) any additional outcomes proposed by a nursing facility that the commissioner
196.31finds desirable.
196.32    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
196.33take action to come into compliance with existing or pending requirements of the life
196.34safety code provisions or federal regulations governing sprinkler systems must receive
196.35reimbursement for the costs associated with compliance if all of the following conditions
196.36are met:
197.1    (1) the expenses associated with compliance occurred on or after January 1, 2005,
197.2and before December 31, 2008;
197.3    (2) the costs were not otherwise reimbursed under subdivision 4f or section
197.4144A.071 or 144A.073; and
197.5    (3) the total allowable costs reported under this paragraph are less than the minimum
197.6threshold established under section 256B.431, subdivision 15, paragraph (e), and
197.7subdivision 16.
197.8The commissioner shall use money appropriated for this purpose to provide to qualifying
197.9nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
197.102008. Nursing facilities that have spent money or anticipate the need to spend money
197.11to satisfy the most recent life safety code requirements by (1) installing a sprinkler
197.12system or (2) replacing all or portions of an existing sprinkler system may submit to the
197.13commissioner by June 30, 2007, on a form provided by the commissioner the actual
197.14costs of a completed project or the estimated costs, based on a project bid, of a planned
197.15project. The commissioner shall calculate a rate adjustment equal to the allowable
197.16costs of the project divided by the resident days reported for the report year ending
197.17September 30, 2006. If the costs from all projects exceed the appropriation for this
197.18purpose, the commissioner shall allocate the money appropriated on a pro rata basis
197.19to the qualifying facilities by reducing the rate adjustment determined for each facility
197.20by an equal percentage. Facilities that used estimated costs when requesting the rate
197.21adjustment shall report to the commissioner by January 31, 2009, on the use of this
197.22money on a form provided by the commissioner. If the nursing facility fails to provide
197.23the report, the commissioner shall recoup the money paid to the facility for this purpose.
197.24If the facility reports expenditures allowable under this subdivision that are less than
197.25the amount received in the facility's annualized rate adjustment, the commissioner shall
197.26recoup the difference.

197.27    Sec. 29. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
197.28    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
197.29services shall calculate the amount of the planned closure rate adjustment available under
197.30subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
197.31(1) the amount available is the net reduction of nursing facility beds multiplied
197.32by $2,080;
197.33(2) the total number of beds in the nursing facility or facilities receiving the planned
197.34closure rate adjustment must be identified;
198.1(3) capacity days are determined by multiplying the number determined under
198.2clause (2) by 365; and
198.3(4) the planned closure rate adjustment is the amount available in clause (1), divided
198.4by capacity days determined under clause (3).
198.5(b) A planned closure rate adjustment under this section is effective on the first day
198.6of the month following completion of closure of the facility designated for closure in the
198.7application and becomes part of the nursing facility's total operating payment rate.
198.8(c) Applicants may use the planned closure rate adjustment to allow for a property
198.9payment for a new nursing facility or an addition to an existing nursing facility or as an
198.10operating payment rate adjustment. Applications approved under this subdivision are
198.11exempt from other requirements for moratorium exceptions under section 144A.073,
198.12subdivisions 2 and 3.
198.13(d) Upon the request of a closing facility, the commissioner must allow the facility a
198.14closure rate adjustment as provided under section 144A.161, subdivision 10.
198.15(e) A facility that has received a planned closure rate adjustment may reassign it
198.16to another facility that is under the same ownership at any time within three years of its
198.17effective date. The amount of the adjustment shall be computed according to paragraph (a).
198.18(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
198.19the commissioner shall recalculate planned closure rate adjustments for facilities that
198.20delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
198.21bed dollar amount. The recalculated planned closure rate adjustment shall be effective
198.22from the date the per bed dollar amount is increased.
198.23(g) For planned closures approved after June 30, 2009, the commissioner of human
198.24services shall calculate the amount of the planned closure rate adjustment available under
198.25subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
198.26(h) Beginning July 16, 2011, the commissioner shall no longer accept applications
198.27for planned closure rate adjustments under subdivision 3.

198.28    Sec. 30. Minnesota Statutes 2010, section 256B.438, subdivision 1, is amended to read:
198.29    Subdivision 1. Scope. This section establishes the method and criteria used to
198.30determine resident reimbursement classifications based upon the assessments of residents
198.31of nursing homes and boarding care homes whose payment rates are established under
198.32section 256B.431, 256B.434, or 256B.435 256B.441 or any other section. Resident
198.33reimbursement classifications shall be established according to the 34 group, resource
198.34utilization groups, version III or RUG-III model as described in section 144.0724.
198.35Reimbursement classifications established under this section shall be implemented
199.1after June 30, 2002, but no later than January 1, 2003. Reimbursement classifications
199.2established under this section shall be implemented no earlier than six weeks after the
199.3commissioner mails notices of payment rates to the facilities. Effective January 1, 2012,
199.4resident reimbursement classifications shall be established according to the 48 group,
199.5resource utilization groups, RUG-IV model under section 144.0724.

199.6    Sec. 31. Minnesota Statutes 2010, section 256B.438, subdivision 3, is amended to read:
199.7    Subd. 3. Case mix indices. (a) The commissioner of human services shall assign a
199.8case mix index to each resident class based on the Centers for Medicare and Medicaid
199.9Services staff time measurement study and adjusted for Minnesota-specific wage indices.
199.10The case mix indices assigned to each resident class shall be published in the Minnesota
199.11State Register at least 120 days prior to the implementation of the 34 group, RUG-III
199.12resident classification system.
199.13(b) An index maximization approach shall be used to classify residents.
199.14(c) After implementation of the revised case mix system, the commissioner of
199.15human services may annually rebase case mix indices and base rates using more current
199.16data on average wage rates and staff time measurement studies. This rebasing shall be
199.17calculated under subdivision 7, paragraph (b). The commissioner shall publish in the
199.18Minnesota State Register adjusted case mix indices at least 45 days prior to the effective
199.19date of the adjusted case mix indices.
199.20(d) Upon implementation of the 48-group RUG-IV resident classification system, the
199.21commissioner of human services shall assign a case mix index to each resident class based
199.22on the Centers for Medicare and Medicaid Services staff time measurement study. The
199.23case mix indices assigned to each resident class shall be published in the State Register at
199.24least 120 days prior to the implementation of the RUG-IV resident classification system.

199.25    Sec. 32. Minnesota Statutes 2010, section 256B.438, subdivision 4, is amended to read:
199.26    Subd. 4. Resident assessment schedule. (a) Nursing facilities shall conduct and
199.27submit case mix assessments according to the schedule established by the commissioner
199.28of health under section 144.0724, subdivisions 4 and 5.
199.29(b) The resident reimbursement classifications established under section 144.0724,
199.30subdivision 3
, shall be effective the day of admission for new admission assessments.
199.31The effective date for significant change assessments shall be the assessment reference
199.32date. The effective date for annual and quarterly assessments shall be the first day of the
199.33month following assessment reference date.
200.1(c) Effective October 1, 2006, the commissioner shall rebase payment rates
200.2to account for the change in the resident assessment schedule in section 144.0724,
200.3subdivision 4, paragraph (b), clause (4), in a facility specific budget neutral manner,
200.4according to subdivision 7, paragraph (b).
200.5(d) Effective January 1, 2012, the commissioner shall determine payment rates
200.6to account for the transition to RUG-IV, in a facility-specific, revenue-neutral manner,
200.7according to subdivision 8, paragraph (b).

200.8    Sec. 33. Minnesota Statutes 2010, section 256B.438, is amended by adding a
200.9subdivision to read:
200.10    Subd. 8. Rate determination upon transition to RUG-IV payment rates. (a) The
200.11commissioner of human services shall determine payment rates at the time of transition
200.12to the RUG-IV-based payment model in a facility-specific, revenue-neutral manner. To
200.13transition from the current calculation methodology to the RUG-IV-based methodology,
200.14nursing facilities shall report to the commissioner of human services the private pay
200.15and Medicaid resident days classified according to the categories defined in subdivision
200.163, paragraphs (a) and (d), for the six-month reporting period ending June 30, 2011. This
200.17report must be submitted to the commissioner, in a form prescribed by the commissioner,
200.18by August 15, 2011. The commissioner of human services shall use this data to compute
200.19the standardized days for the RUG-III and RUG-IV classification systems.
200.20(b) The commissioner of human services shall determine the case mix adjusted
200.21component for the January 1, 2012, rate as follows:
200.22(1) using the September 30, 2010, cost report, determine the case mix portion of the
200.23operating cost for each facility;
200.24(2) multiply the 36 operating payment rates in effect on December 31, 2011, by the
200.25number of private pay and Medicaid resident days assigned to each group for the reporting
200.26period ending June 30, 2011, and compute the total;
200.27(3) compute the product of the amounts in clauses (1) and (2);
200.28(4) determine the private pay and Medicaid RUG standardized days for the reporting
200.29period ending June 30, 2011, using the new indices calculated under subdivision 3,
200.30paragraph (d);
200.31(5) divide the amount determined in clause (3) by the amount in clause (4), which
200.32shall be the default rate (DDF) unadjusted case mix component of the rate under the
200.33RUG-IV method; and
201.1(6) determine the case mix adjusted component of each operating rate by multiplying
201.2the default rate (DDF) unadjusted case mix component by the case mix weight in
201.3subdivision 3, paragraph (d), for each RUG-IV group.
201.4(c) The noncase mix components will be allocated to each RUG group as a constant
201.5amount to determine the operating payment rate.

201.6    Sec. 34. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to
201.7read:
201.8    Subd. 50a. Determination of proximity adjustments. (a) For a nursing facility
201.9located in close proximity to another nursing facility of the same facility group type but in
201.10a different peer group and that has higher limits for care-related or other operating costs,
201.11the commissioner shall adjust the limits in accordance with clauses (1) to (4):
201.12    (1) determine the difference between the limits;
201.13    (2) determine the distance between the two facilities, by the shortest driving route. If
201.14the distance exceeds 20 miles, no adjustment shall be made;
201.15    (3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a
201.16percentage; and
201.17    (4) increase the limits for the nursing facility with the lower limits by the value
201.18determined in clause (1) multiplied by the value determined in clause (3).
201.19(b) Effective October 1, 2011, nursing facilities located no more than one-quarter
201.20mile from a peer group with higher limits under either subdivision 50 or 51, may receive
201.21an operating rate adjustment. The operating payment rates of a lower-limit peer group
201.22facility must be adjusted to be equal to those of the nearest facility in a higher-limit peer
201.23group if that facility's RUG rate with a weight of 1.00 is higher than the lower-limit peer
201.24group facility. Peer groups are those defined in subdivision 30. The nearest facility must
201.25be determined by the most direct driving route.

201.26    Sec. 35. Minnesota Statutes 2010, section 256B.441, subdivision 55a, is amended to
201.27read:
201.28    Subd. 55a. Alternative to phase-in for publicly owned nursing facilities. (a) For
201.29operating payment rates implemented between January October 1, 2011, and September
201.3030, 2015 the day before the phase-in under subdivision 55 is complete, the commissioner
201.31shall allow nursing facilities whose physical plant is owned or whose license is held by a
201.32city, county, or hospital district to apply for a higher payment rate under this section if the
201.33local government governmental entity agrees to pay a specified portion of the nonfederal
201.34share of medical assistance costs. Nursing facilities that apply shall be eligible to select an
202.1operating payment rate, with a weight of 1.00, up to the rate calculated in subdivision 54,
202.2without application of the phase-in under subdivision 55. The rates for the other RUG's
202.3levels RUGs shall be computed as provided under subdivision 54.
202.4(b) For operating payment rates implemented beginning the day when the phase-in
202.5under subdivision 55 is complete, the commissioner shall allow nursing facilities whose
202.6physical plant is owned or whose license is held by a city, county, or hospital district to
202.7apply for a higher payment rate under this section if the local governmental entity agrees
202.8to pay a specified portion of the nonfederal share of medical assistance costs. Nursing
202.9facilities that apply are eligible to select an operating payment rate with a weight of 1.00,
202.10up to an amount determined by the commissioner to be allowable under the Medicare upper
202.11payment limit test. The rates for the other RUGs shall be computed under subdivision 54.
202.12The rate increase allowed in this paragraph shall take effect only upon federal approval.
202.13(c) Rates determined under this subdivision shall take effect beginning January
202.14October 1, 2011, based on cost reports for the rate reporting year ending September 30,
202.152009 2010, and in future rate years, rates determined for nursing facilities participating
202.16under this subdivision shall take effect on October 1 of each year, based on the most
202.17recent available cost report.
202.18(c) (d) Eligible nursing facilities that wish to participate under this subdivision shall
202.19make an application to the commissioner by September 30, 2010. Participation under this
202.20subdivision is irrevocable. If paragraph (a) does not result in a rate greater than what
202.21would have been provided without application of this subdivision, a facility's rates shall be
202.22calculated as otherwise provided and no payment by the local government entity shall be
202.23required under paragraph (d) August 31, 2011, or by June 30 of any subsequent year.
202.24(d) (e) For each participating nursing facility, the public entity that owns the physical
202.25plant or is the license holder of the nursing facility shall pay to the state the entire
202.26nonfederal share of medical assistance payments received as a result of the difference
202.27between the nursing facility's payment rate under subdivision 54, paragraph (a) or (b),
202.28and the rates that the nursing facility would otherwise be paid without application of this
202.29subdivision under subdivision 54 or 55 as determined by the commissioner.
202.30(e) (f) The commissioner may, at any time, reduce the payments under this
202.31subdivision based on the commissioner's determination that the payments shall cause
202.32nursing facility rates to exceed the state's Medicare upper payment limit or any other
202.33federal limitation. If the commissioner determines a reduction is necessary, the
202.34commissioner shall reduce all payment rates for participating nursing facilities by a
202.35percentage applied to the amount of increase they would otherwise receive under this
202.36subdivision and shall notify participating facilities of the reductions. If payments to a
203.1nursing facility are reduced, payments under section 256B.19, subdivision 1e, shall be
203.2reduced accordingly.

203.3    Sec. 36. Minnesota Statutes 2010, section 256B.441, is amended by adding a
203.4subdivision to read:
203.5    Subd. 61. Rate increase for low-rate facilities. Effective October 1, 2011,
203.6operating payment rates of all nursing facilities that are reimbursed under this section or
203.7section 256B.434 shall be increased for a resource utilization group rate with a weight
203.8of 1.00 by up to 2.45 percent, but not to exceed for the same resource utilization group
203.9weight the rate of the facility at the 18th percentile of all nursing facilities in the state. The
203.10percentage of the operating payment rate for each facility to be case-mix adjusted shall be
203.11equal to the percentage that is case-mix adjusted in that facility's operating payment rate
203.12on the preceding September 30.

203.13    Sec. 37. Minnesota Statutes 2010, section 256B.441, is amended by adding a
203.14subdivision to read:
203.15    Subd. 62. Repeal of rebased operating payment rates. Notwithstanding
203.16subdivision 54 or 55, no further steps toward phase-in of rebased operating payment
203.17rates shall be taken.

203.18    Sec. 38. Minnesota Statutes 2010, section 256B.49, subdivision 12, is amended to read:
203.19    Subd. 12. Informed choice. Persons who are determined likely to require the
203.20level of care provided in a nursing facility as determined under sections 144.0724,
203.21subdivision 11, and section 256B.0911, or a hospital shall be informed of the home and
203.22community-based support alternatives to the provision of inpatient hospital services or
203.23nursing facility services. Each person must be given the choice of either institutional or
203.24home and community-based services using the provisions described in section 256B.77,
203.25subdivision 2
, paragraph (p).

203.26    Sec. 39. Minnesota Statutes 2010, section 256B.49, subdivision 14, is amended to read:
203.27    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
203.28strengths, informal support systems, and need for services shall be completed within 20
203.29working days of the recipient's request as provided in section 256B.0911. Reassessment
203.30of each recipient's strengths, support systems, and need for services shall be conducted
203.31at least every 12 months and at other times when there has been a significant change in
203.32the recipient's functioning.
204.1(b) There must be a determination that the client requires a hospital level of care or a
204.2nursing facility level of care as defined in section 144.0724, subdivision 11 256B.0911,
204.3subdivision 4a, paragraph (d), at initial and subsequent assessments to initiate and
204.4maintain participation in the waiver program.
204.5(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
204.6appropriate to determine nursing facility level of care for purposes of medical assistance
204.7payment for nursing facility services, only face-to-face assessments conducted according
204.8to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
204.9determination or a nursing facility level of care determination must be accepted for
204.10purposes of initial and ongoing access to waiver services payment.
204.11(d) Persons with developmental disabilities who apply for services under the nursing
204.12facility level waiver programs shall be screened for the appropriate level of care according
204.13to section 256B.092.
204.14(e) Recipients who are found eligible for home and community-based services under
204.15this section before their 65th birthday may remain eligible for these services after their
204.1665th birthday if they continue to meet all other eligibility factors.
204.17(f) The commissioner shall develop criteria to identify recipients whose level of
204.18functioning is reasonably expected to improve and reassess these recipients to establish
204.19a baseline assessment. Recipients who meet these criteria must have a comprehensive
204.20transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
204.21reassessed every six months until there has been no significant change in the recipient's
204.22functioning for at least 12 months. After there has been no significant change in the
204.23recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
204.24informal support systems, and need for services shall be conducted at least every 12
204.25months and at other times when there has been a significant change in the recipient's
204.26functioning. Counties, case managers, and service providers are responsible for conducting
204.27these reassessments and shall complete the reassessments out of existing funds.
204.28EFFECTIVE DATE.Paragraph (f) is effective July 1, 2013.

204.29    Sec. 40. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:
204.30    Subd. 15. Individualized service plan; comprehensive transitional service plan;
204.31maintenance service plan. (a) Each recipient of home and community-based waivered
204.32services shall be provided a copy of the written service plan which:
204.33(1) is developed and signed by the recipient within ten working days of the
204.34completion of the assessment;
204.35(2) meets the assessed needs of the recipient;
205.1(3) reasonably ensures the health and safety of the recipient;
205.2(4) promotes independence;
205.3(5) allows for services to be provided in the most integrated settings; and
205.4(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
205.5paragraph (p), of service and support providers.
205.6(b) In developing the comprehensive transitional service plan, the individual
205.7receiving services, the case manager, and the guardian, if applicable, will identify
205.8the transitional service plan fundamental service outcome and anticipated timeline to
205.9achieve this outcome. Within the first 20 days following a recipient's request for an
205.10assessment or reassessment, the transitional service planning team must be identified. A
205.11team leader must be identified who will be responsible for assigning responsibility and
205.12communicating with team members to ensure implementation of the transition plan and
205.13ongoing assessment and communication process. The team leader should be an individual,
205.14such as the case manager or guardian, who has the opportunity to follow the recipient to
205.15the next level of service.
205.16Within ten days following an assessment, a comprehensive transitional service plan
205.17must be developed incorporating elements of a comprehensive functional assessment and
205.18including short-term measurable outcomes and timelines for achievement of and reporting
205.19on these outcomes. Functional milestones must also be identified and reported according
205.20to the timelines agreed upon by the transitional service planning team. In addition, the
205.21comprehensive transitional service plan must identify additional supports that may assist
205.22in the achievement of the fundamental service outcome such as the development of greater
205.23natural community support, increased collaboration among agencies, and technological
205.24supports.
205.25The timelines for reporting on functional milestones will prompt a reassessment of
205.26services provided, the units of services, rates, and appropriate service providers. It is
205.27the responsibility of the transitional service planning team leader to review functional
205.28milestone reporting to determine if the milestones are consistent with observable skills
205.29and that milestone achievement prompts any needed changes to the comprehensive
205.30transitional service plan.
205.31For those whose fundamental transitional service outcome involves the need to
205.32procure housing, a plan for the recipient to seek the resources necessary to secure the least
205.33restrictive housing possible should be incorporated into the plan, including employment
205.34and public supports such as housing access and shelter needy funding.
205.35(c) Counties and other agencies responsible for funding community placement and
205.36ongoing community supportive services are responsible for the implementation of the
206.1comprehensive transitional service plans. Oversight responsibilities include both ensuring
206.2effective transitional service delivery and efficient utilization of funding resources.
206.3(d) Following one year of transitional services, the transitional services planning
206.4team will make a determination as to whether or not the individual receiving services
206.5requires the current level of continuous and consistent support in order to maintain the
206.6recipient's current level of functioning. Recipients who are determined to have not had
206.7a significant change in functioning for 12 months must move from a transitional to a
206.8maintenance service plan. Recipients on a maintenance service plan must be reassessed
206.9to determine if the recipient would benefit from a transitional service plan at least every
206.1012 months and at other times when there has been a significant change in the recipient's
206.11functioning. This assessment should consider any changes to technological or natural
206.12community supports.
206.13(b) (e) When a county is evaluating denials, reductions, or terminations of home
206.14and community-based services under section 256B.49 for an individual, the case manager
206.15shall offer to meet with the individual or the individual's guardian in order to discuss the
206.16prioritization of service needs within the individualized service plan, comprehensive
206.17transitional service plan, or maintenance service plan. The reduction in the authorized
206.18services for an individual due to changes in funding for waivered services may not exceed
206.19the amount needed to ensure medically necessary services to meet the individual's health,
206.20safety, and welfare.
206.21(f) At the time of reassessment, local agency case managers shall assess each
206.22recipient of community alternatives for disabled individuals or traumatic brain injury
206.23waivered services currently residing in a licensed adult foster home that is not the primary
206.24residence of the license holder, or in which the license holder is not the primary caregiver,
206.25to determine if that recipient could appropriately be served in a community-living setting.
206.26If appropriate for the recipient, the case manager shall offer the recipient, through a
206.27person-centered planning process, the option to receive alternative housing and service
206.28options. In the event that the recipient chooses to transfer from the adult foster home,
206.29the vacated bed shall not be filled with another recipient of waiver services and group
206.30residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a),
206.31clauses (3) and (4), and the licensed capacity shall be reduced accordingly. If the adult
206.32foster home becomes no longer viable due to these transfers, the county agency, with the
206.33assistance of the department, shall facilitate a consolidation of settings or closure. This
206.34reassessment process shall be completed by June 30, 2012.
206.35EFFECTIVE DATE.Paragraphs (b), (c), and (d) are effective July 1, 2013.

207.1    Sec. 41. Minnesota Statutes 2010, section 256B.49, is amended by adding a
207.2subdivision to read:
207.3    Subd. 23. Community-living settings. "Community-living settings" means a
207.4single-family home or apartment where the service recipient or their family owns or rents,
207.5as demonstrated by a lease agreement, and maintains control over the individual unit.
207.6Community-living settings are subject to the following:
207.7(1) individuals are not required to receive services;
207.8(2) individuals are not required to have a disability or specific diagnosis to live
207.9in the community-living setting;
207.10(3) individuals may hire service providers of their choice;
207.11(4) individuals may choose whether to share their household and with whom;
207.12(5) the home or apartment must include living, sleeping, bathing, and cooking areas;
207.13(6) individuals must have lockable access and egress;
207.14(7) individuals must be free to receive visitors and leave the settings at times and for
207.15durations of their own choosing;
207.16(8) leases must not reserve the right to assign units or change unit assignments; and
207.17(9) access to the greater community must be easily facilitated based on the
207.18individual's needs and preferences.

207.19    Sec. 42. Minnesota Statutes 2010, section 256B.5012, is amended by adding a
207.20subdivision to read:
207.21    Subd. 9. ICF/DD rate increase. Effective July 1, 2011, the commissioner shall
207.22increase the daily rate to $138.23 at an intermediate care facility for the developmentally
207.23disabled located in Clearwater County and classified as a class A facility with 15 beds.

207.24    Sec. 43. Minnesota Statutes 2010, section 256B.5012, is amended by adding a
207.25subdivision to read:
207.26    Subd. 10. ICF/DD rate adjustment. For each facility reimbursed under this section,
207.27except for a facility located in Clearwater County and classified as a class A facility with
207.2815 beds, the commissioner shall decrease operating payment rates equal to 0.095 percent of
207.29the operating payment rates in effect on June 30, 2011. For each facility, the commissioner
207.30shall apply the rate reduction, based on occupied beds, using the percentage specified
207.31in this subdivision multiplied by the total payment rate, including the variable rate but
207.32excluding the property-related payment rate, in effect on the preceding date. The total rate
207.33reduction shall include the adjustment provided in section 256B.501, subdivision 12.

208.1    Sec. 44. Minnesota Statutes 2010, section 256B.5012, is amended by adding a
208.2subdivision to read:
208.3    Subd. 11. ICF/DD rate decrease effective July 1, 2011. For each facility
208.4reimbursed under this section, the commissioner shall decrease operating payments equal
208.5to 1.5 percent of the operating payment rates in effect on June 30, 2011. For each facility,
208.6the commissioner shall apply the rate reduction, based on occupied beds, using the
208.7percentage specified in this subdivision multiplied by the total payment rate, including the
208.8variable rate but excluding the property-related payment rate, in effect on the preceding
208.9date. The total rate reduction shall include the adjustment provided in section 256B.501,
208.10subdivision 12.

208.11    Sec. 45. Minnesota Statutes 2010, section 256B.5012, is amended by adding a
208.12subdivision to read:
208.13    Subd. 12. ICF/DD rate increase effective July 1, 2013. For each facility
208.14reimbursed under this section, the commissioner shall increase operating payments equal
208.15to one-half percent of the operating payment rates in effect on June 30, 2013. For each
208.16facility, the commissioner shall apply the rate increase, based on occupied beds, using the
208.17percentage specified in this subdivision multiplied by the total payment rate, including the
208.18variable rate but excluding the property-related payment rate, in effect on the preceding
208.19date. The total rate increase shall include the adjustment provided in section 256B.501,
208.20subdivision 12.

208.21    Sec. 46. Minnesota Statutes 2010, section 256B.5012, is amended by adding a
208.22subdivision to read:
208.23    Subd. 13. ICF/DD rate decrease effective July 1, 2012. Notwithstanding
208.24subdivision 12, for each facility reimbursed under this section, the commissioner shall
208.25decrease operating payments equal to 1.67 percent of the operating payment rates in effect
208.26on June 30, 2012. For each facility, the commissioner shall apply the rate reduction based
208.27on occupied beds, using the percentage specified in this subdivision multiplied by the total
208.28payment rate, including the variable rate but excluding the property-related payment rate,
208.29in effect on the preceding date. The total rate reduction shall include the adjustment
208.30provided in section 256B.501, subdivision 12.
208.31EFFECTIVE DATE.This section is effective July 1, 2012, if the federal approval
208.32required under section 52 has not been obtained by June 30, 2012.

209.1    Sec. 47. Laws 2009, chapter 79, article 8, section 4, the effective date, as amended by
209.2Laws 2010, First Special Session chapter 1, article 24, section 12, is amended to read:
209.3EFFECTIVE DATE.The section is effective July 1, 2011 on or after January 1,
209.42014, for individuals age 21 and older, and on or after October 1, 2019, for individuals
209.5under age 21.

209.6    Sec. 48. Laws 2009, chapter 79, article 8, section 51, the effective date, as amended by
209.7Laws 2010, First Special Session chapter 1, article 17, section 14, is amended to read:
209.8EFFECTIVE DATE.This section is effective July 1, 2011 2012, or upon federal
209.9approval, whichever is later.

209.10    Sec. 49. Laws 2009, chapter 79, article 13, section 3, subdivision 8, as amended by
209.11Laws 2009, chapter 173, article 2, section 1, subdivision 8, and Laws 2010, First Special
209.12Session chapter 1, article 15, section 5, and article 25, section 16, is amended to read:
209.13
Subd. 8.Continuing Care Grants
209.14The amounts that may be spent from the
209.15appropriation for each purpose are as follows:
209.16
(a) Aging and Adult Services Grants
13,499,000
15,805,000
209.17Base Adjustment. The general fund base is
209.18increased by $5,751,000 in fiscal year 2012
209.19and $6,705,000 in fiscal year 2013.
209.20Information and Assistance
209.21Reimbursement. Federal administrative
209.22reimbursement obtained from information
209.23and assistance services provided by the
209.24Senior LinkAge or Disability Linkage lines
209.25to people who are identified as eligible for
209.26medical assistance shall be appropriated to
209.27the commissioner for this activity.
209.28Community Service Development Grant
209.29Reduction. Funding for community service
209.30development grants must be reduced by
209.31$260,000 for fiscal year 2010; $284,000 in
209.32fiscal year 2011; $43,000 in fiscal year 2012;
210.1and $43,000 in fiscal year 2013. Base level
210.2funding shall be restored in fiscal year 2014.
210.3Community Service Development Grant
210.4Community Initiative. Funding for
210.5community service development grants shall
210.6be used to offset the cost of aging support
210.7grants. Base level funding shall be restored
210.8in fiscal year 2014.
210.9Senior Nutrition Use of Federal Funds.
210.10For fiscal year 2010, general fund grants
210.11for home-delivered meals and congregate
210.12dining shall be reduced by $500,000. The
210.13commissioner must replace these general
210.14fund reductions with equal amounts from
210.15federal funding for senior nutrition from the
210.16American Recovery and Reinvestment Act
210.17of 2009.
210.18
(b) Alternative Care Grants
50,234,000
48,576,000
210.19Base Adjustment. The general fund base is
210.20decreased by $3,598,000 in fiscal year 2012
210.21and $3,470,000 in fiscal year 2013.
210.22Alternative Care Transfer. Any money
210.23allocated to the alternative care program that
210.24is not spent for the purposes indicated does
210.25not cancel but must be transferred to the
210.26medical assistance account.
210.27
210.28
(c) Medical Assistance Grants; Long-Term
Care Facilities.
367,444,000
419,749,000
210.29
210.30
(d) Medical Assistance Long-Term Care
Waivers and Home Care Grants
853,567,000
1,039,517,000
210.31Manage Growth in TBI and CADI
210.32Waivers. During the fiscal years beginning
210.33on July 1, 2009, and July 1, 2010, the
210.34commissioner shall allocate money for home
210.35and community-based waiver programs
211.1under Minnesota Statutes, section 256B.49,
211.2to ensure a reduction in state spending that is
211.3equivalent to limiting the caseload growth of
211.4the TBI waiver to 12.5 allocations per month
211.5each year of the biennium and the CADI
211.6waiver to 95 allocations per month each year
211.7of the biennium. Limits do not apply: (1)
211.8when there is an approved plan for nursing
211.9facility bed closures for individuals under
211.10age 65 who require relocation due to the
211.11bed closure; (2) to fiscal year 2009 waiver
211.12allocations delayed due to unallotment; or (3)
211.13to transfers authorized by the commissioner
211.14from the personal care assistance program
211.15of individuals having a home care rating
211.16of "CS," "MT," or "HL." Priorities for the
211.17allocation of funds must be for individuals
211.18anticipated to be discharged from institutional
211.19settings or who are at imminent risk of a
211.20placement in an institutional setting.
211.21Manage Growth in DD Waiver. The
211.22commissioner shall manage the growth in
211.23the DD waiver by limiting the allocations
211.24included in the February 2009 forecast to 15
211.25additional diversion allocations each month
211.26for the calendar years that begin on January
211.271, 2010, and January 1, 2011. Additional
211.28allocations must be made available for
211.29transfers authorized by the commissioner
211.30from the personal care program of individuals
211.31having a home care rating of "CS," "MT,"
211.32or "HL."
211.33Adjustment to Lead Agency Waiver
211.34Allocations. Prior to the availability of the
211.35alternative license defined in Minnesota
211.36Statutes, section 245A.11, subdivision 8,
212.1the com