S.F. No. 760, Conference Committee Report - 87th Legislative Session (2011-2012)
Posted 05/14/11 07:43 PM [ccrsf0760]
1.1CONFERENCE COMMITTEE REPORT ON S.F. No. 760
1.3relating to state government; establishing the health and human services budget;
1.4modifying provisions related to continuing care, chemical and mental health,
1.5children and family services, human services licensing, health care programs,
1.6the Department of Health, and health licensing boards; appropriating money to
1.7the departments of health and human services and other health-related boards
1.8and councils; making forecast adjustments; requiring reports; imposing fees;
1.9imposing criminal penalties;amending Minnesota Statutes 2010, sections 8.31,
1.10subdivisions 1, 3a; 62E.14, by adding a subdivision; 62J.04, subdivision 3;
1.1162J.17, subdivision 4a; 62J.692, subdivisions 4, 7; 103I.005, subdivisions
1.122, 8, 12, by adding a subdivision; 103I.101, subdivisions 2, 5; 103I.105;
1.13103I.111, subdivision 8; 103I.205, subdivision 4; 103I.208, subdivision 2;
1.14103I.501; 103I.531, subdivision 5; 103I.535, subdivision 6; 103I.641; 103I.711,
1.15subdivision 1; 103I.715, subdivision 2; 119B.011, subdivision 13; 119B.09,
1.16subdivision 10, by adding subdivisions; 119B.125, by adding a subdivision;
1.17119B.13, subdivisions 1, 1a, 7; 144.125, subdivisions 1, 3; 144.128; 144.396,
1.18subdivisions 5, 6; 145.925, subdivision 1; 145.928, subdivisions 7, 8; 148.108, by
1.19adding a subdivision; 148.191, subdivision 2; 148.212, subdivision 1; 148.231;
1.20151.07; 151.101; 151.102, by adding a subdivision; 151.12; 151.13, subdivision
1.211; 151.19; 151.25; 151.47, subdivision 1; 151.48; 152.12, subdivision 3;
1.22245A.10, subdivisions 1, 3, 4, by adding subdivisions; 245A.11, subdivision
1.232b; 245A.143, subdivision 1; 245C.10, by adding a subdivision; 254B.03,
1.24subdivision 4; 254B.04, by adding a subdivision; 254B.06, subdivision 2; 256.01,
1.25subdivisions 14, 24, 29, by adding a subdivision; 256.969, subdivision 2b;
1.26256B.04, subdivision 18; 256B.056, subdivisions 1a, 3; 256B.057, subdivision
1.279; 256B.06, subdivision 4; 256B.0625, subdivisions 8, 8a, 8b, 8c, 12, 13e,
1.2817, 17a, 18, 19a, 25, 31a, by adding subdivisions; 256B.0651, subdivision 1;
1.29256B.0652, subdivision 6; 256B.0653, subdivisions 2, 6; 256B.0911, subdivision
1.303a; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3b, 3e, 3h, 6,
1.3110; 256B.14, by adding a subdivision; 256B.431, subdivisions 2r, 32, 42, by
1.32adding a subdivision; 256B.437, subdivision 6; 256B.441, subdivisions 50a,
1.3359; 256B.48, subdivision 1; 256B.49, subdivision 16a; 256B.69, subdivisions
1.344, 5a, by adding a subdivision; 256B.76, subdivision 4; 256D.02, subdivision
1.3512a; 256D.031, subdivisions 6, 7, 9; 256D.44, subdivision 5; 256D.47; 256D.49,
1.36subdivision 3; 256E.30, subdivision 2; 256E.35, subdivisions 5, 6; 256J.12,
1.37subdivisions 1a, 2; 256J.37, by adding a subdivision; 256J.38, subdivision 1;
1.38256L.04, subdivision 7; 256L.05, by adding a subdivision; 256L.11, subdivision
1.397; 256L.12, subdivision 9; 297F.10, subdivision 1; 393.07, subdivision 10;
1.40402A.10, subdivisions 4, 5; 402A.15; 518A.51; Laws 2008, chapter 363, article
1.4118, section 3, subdivision 5; Laws 2010, First Special Session chapter 1, article
1.4215, section 3, subdivision 6; article 25, section 3, subdivision 6; proposing
1.43coding for new law in Minnesota Statutes, chapters 1; 145; 148; 151; 214; 256;
2.1256B; 256L; proposing coding for new law as Minnesota Statutes, chapter
2.2256N; repealing Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a,
2.36a, 8; 62J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1, 2; 103I.005,
2.4subdivision 20; 144.1464; 144.147; 144.1487; 144.1488, subdivisions 1, 3,
2.54; 144.1489; 144.1490; 144.1491; 144.1499; 144.1501; 144.6062; 145.925;
2.6145A.14, subdivisions 1, 2a; 245A.10, subdivision 5; 256.979, subdivisions
2.75, 6, 7, 10; 256.9791; 256B.055, subdivision 15; 256B.0625, subdivision 8e;
2.8256B.0653, subdivision 5; 256B.0756; 256D.01, subdivisions 1, 1a, 1b, 1e,
2.92; 256D.03, subdivisions 1, 2, 2a; 256D.031, subdivisions 5, 8; 256D.05,
2.10subdivisions 1, 2, 4, 5, 6, 7, 8; 256D.0513; 256D.053, subdivisions 1, 2, 3;
2.11256D.06, subdivisions 1, 1b, 2, 5, 7, 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, 6;
2.12256D.10; 256D.13; 256D.15; 256D.16; 256D.35, subdivision 8b; 256D.46; Laws
2.132010, First Special Session chapter 1, article 16, sections 6; 7; Minnesota Rules,
2.14parts 3400.0130, subpart 8; 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11,
2.1512, 14, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, 23; 4651.0110, subparts 2, 2a, 3, 4, 5;
2.164651.0120; 4651.0130; 4651.0140; 4651.0150; 9500.1243, subpart 3.
2.17May 14, 2011
2.18The Honorable Michelle L. Fischbach
2.19President of the Senate
2.20The Honorable Kurt Zellers
2.21Speaker of the House of Representatives
2.22We, the undersigned conferees for S.F. No. 760 report that we have agreed upon the
2.23items in dispute and recommend as follows:
2.24That the House recede from its amendments and that S.F. No. 760 be further
2.25amended as follows:
2.26Delete everything after the enacting clause and insert:
2.29 Section 1. Minnesota Statutes 2010, section 119B.011, subdivision 13, is amended to
2.31 Subd. 13. Family. "Family" means parents, stepparents, guardians and their spouses,
2.32or other eligible relative caregivers and their spouses, and their blood related dependent
2.33children and adoptive siblings under the age of 18 years living in the same home including
2.34children temporarily absent from the household in settings such as schools, foster care, and
2.35residential treatment facilities or parents, stepparents, guardians and their spouses, or other
2.36relative caregivers and their spouses temporarily absent from the household in settings
2.37such as schools, military service, or rehabilitation programs. An adult family member who
2.38is not in an authorized activity under this chapter may be temporarily absent for up to 60
2.39days. When a minor parent or parents and his, her, or their child or children are living with
2.40other relatives, and the minor parent or parents apply for a child care subsidy, "family"
2.41means only the minor parent or parents and their child or children. An adult age 18 or
2.42older who meets this definition of family and is a full-time high school or postsecondary
3.1student may be considered a dependent member of the family unit if 50 percent or more of
3.2the adult's support is provided by the parents, stepparents, guardians, and their spouses or
3.3eligible relative caregivers and their spouses residing in the same household.
3.4EFFECTIVE DATE.This section is effective April 16, 2012.
3.5 Sec. 2. Minnesota Statutes 2010, section 119B.035, subdivision 4, is amended to read:
3.6 Subd. 4. Assistance. (a) A family is limited to a lifetime total of 12 months of
3.7assistance under subdivision 2. The maximum rate of assistance is equal to
3.8of the rate established under section
3.9care in the applicant's county of residence.
3.10(b) A participating family must report income and other family changes as specified
3.11in the county's plan under section
3.12(c) Persons who are admitted to the at-home infant child care program retain their
3.13position in any basic sliding fee program. Persons leaving the at-home infant child care
3.14program reenter the basic sliding fee program at the position they would have occupied.
3.15(d) Assistance under this section does not establish an employer-employee
3.16relationship between any member of the assisted family and the county or state.
3.17EFFECTIVE DATE.This section is effective October 31, 2011.
3.18 Sec. 3. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
3.20 Subd. 9a. Child care centers; assistance. (a) For the purposes of this subdivision,
3.21"qualifying child" means a child who satisfies both of the following:
3.22(1) is not a child or dependent of an employee of the child care provider; and
3.23(2) does not reside with an employee of the child care provider.
3.24(b) Funds distributed under this chapter must not be paid for child care services
3.25that are provided for a child by a child care provider who employs either the parent of
3.26the child or a person who resides with the child, unless at all times at least 50 percent of
3.27the children for whom the child care provider is providing care are qualifying children
3.28under paragraph (a).
3.29(c) If a child care provider satisfies the requirements for payment under paragraph
3.30(b), but the percentage of qualifying children under paragraph (a) for whom the provider
3.31is providing care falls below 50 percent, the provider shall have four weeks to raise the
3.32percentage of qualifying children for whom the provider is providing care to at least 50
4.1percent before payments to the provider are discontinued for child care services provided
4.2for a child who is not a qualifying child.
4.3EFFECTIVE DATE.This section is effective January 1, 2013.
4.4 Sec. 4. Minnesota Statutes 2010, section 119B.09, subdivision 10, is amended to read:
4.5 Subd. 10. Payment of funds. All federal, state, and local child care funds must
4.6be paid directly to the parent when a provider cares for children in the children's own
4.7home. In all other cases, all federal, state, and local child care funds must be paid directly
4.8to the child care provider, either licensed or legal nonlicensed, on behalf of the eligible
4.9family. Funds distributed under this chapter must not be used for child care services that
4.10are provided for a child by a child care provider who resides in the same household or
4.11occupies the same residence as the child.
4.12EFFECTIVE DATE.This section is effective March 5, 2012.
4.13 Sec. 5. Minnesota Statutes 2010, section 119B.09, is amended by adding a subdivision
4.15 Subd. 13. Child care in the child's home. Child care assistance must only be
4.16authorized in the child's home if the child's parents have authorized activities outside of
4.17the home and if one or more of the following circumstances are met:
4.18(1) the parents' qualifying activity occurs during times when out-of-home care is
4.19not available. If child care is needed during any period when out-of-home care is not
4.20available, in-home care can be approved for the entire time care is needed;
4.21(2) the family lives in an area where out-of-home care is not available; or
4.22(3) a child has a verified illness or disability that would place the child or other
4.23children in an out-of-home facility at risk or creates a hardship for the child and the family
4.24to take the child out of the home to a child care home or center.
4.25EFFECTIVE DATE.This section is effective March 5, 2012.
4.26 Sec. 6. Minnesota Statutes 2010, section 119B.125, is amended by adding a subdivision
4.28 Subd. 1b. Training required. (a) Effective November 1, 2011, prior to initial
4.29authorization as required in subdivision 1, a legal nonlicensed family child care provider
4.30must complete first aid and CPR training and provide the verification of first aid and CPR
4.31training to the county. The training documentation must have valid effective dates as of
5.1the date the registration request is submitted to the county and the training must have been
5.2provided by an individual approved to provide first aid and CPR instruction.
5.3(b) Legal nonlicensed family child care providers with an authorization effective
5.4before November 1, 2011, must be notified of the requirements before October 1, 2011, or
5.5at authorization, and must meet the requirements upon renewal of an authorization that
5.6occurs on or after January 1, 2012.
5.7(c) Upon each reauthorization after the authorization period when the initial first aid
5.8and CPR training requirements are met, a legal nonlicensed family child care provider
5.9must provide verification of at least eight hours of additional training listed in the
5.10Minnesota Center for Professional Development Registry.
5.11(d) This subdivision only applies to legal nonlicensed family child care providers.
5.12 Sec. 7. Minnesota Statutes 2010, section 119B.13, subdivision 1, is amended to read:
5.13 Subdivision 1. Subsidy restrictions. (a) Beginning
5.14the maximum rate paid for child care assistance in any county or multicounty region under
5.15the child care fund shall be the rate for like-care arrangements in the county effective
5.25providers in Minnesota to determine the 75th percentile for like-care arrangements in
5.26counties. When the commissioner determines that, using the commissioner's established
5.27protocol, the number of providers responding to the survey is too small to determine
5.28the 75th percentile rate for like-care arrangements in a county or multicounty region,
5.29the commissioner may establish the 75th percentile maximum rate based on like-care
5.30arrangements in a county, region, or category that the commissioner deems to be similar.
5.32school readiness service agreement paid under section 119B.231, may be in excess of the
5.33maximum rate allowed under this subdivision.
5.35The county shall pay the provider's full charges for every child in care up to the maximum
6.1established. The commissioner shall determine the maximum rate for each type of care
6.2on an hourly, full-day, and weekly basis, including special needs and disability care. The
6.3maximum payment to a provider for one day of care must not exceed the daily rate. The
6.4maximum payment to a provider for one week of care must not exceed the weekly rate.
6.5(e) Child care providers receiving reimbursement under this chapter must not be
6.6paid activity fees or an additional amount above the maximum rates for care provided
6.7during nonstandard hours for families receiving assistance.
6.8 (f) When the provider charge is greater than the maximum provider rate allowed,
6.9the parent is responsible for payment of the difference in the rates in addition to any
6.10family co-payment fee.
6.11 (g) All maximum provider rates changes shall be implemented on the Monday
6.12following the effective date of the maximum provider rate.
6.13EFFECTIVE DATE.Paragraph (d) is effective April 16, 2012. Paragraph (e)
6.14is effective September 3, 2012.
6.15 Sec. 8. Minnesota Statutes 2010, section 119B.13, subdivision 1a, is amended to read:
6.16 Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal
6.17nonlicensed family child care providers receiving reimbursement under this chapter must
6.18be paid on an hourly basis for care provided to families receiving assistance.
6.19(b) The maximum rate paid to legal nonlicensed family child care providers must be
6.21In counties where the maximum hourly rate for licensed family child care providers is
6.22higher than the maximum weekly rate for those providers divided by 50, the maximum
6.23hourly rate that may be paid to legal nonlicensed family child care providers is the rate
6.24equal to the maximum weekly rate for licensed family child care providers divided by 50
6.25and then multiplied by
6.26must not exceed the maximum hourly rate times ten. The maximum payment to a provider
6.27for one week of care must not exceed the maximum hourly rate times 50.
6.28(c) A rate which includes a special needs rate paid under subdivision 3 may be in
6.29excess of the maximum rate allowed under this subdivision.
6.30(d) Legal nonlicensed family child care providers receiving reimbursement under
6.31this chapter may not be paid registration fees for families receiving assistance.
6.32EFFECTIVE DATE.This section is effective April 16, 2012, except the
6.33amendment changing 80 to 68 and 0.80 to 0.68 is effective October 31, 2011.
7.1 Sec. 9. Minnesota Statutes 2010, section 119B.13, subdivision 7, is amended to read:
7.2 Subd. 7. Absent days. (a) Licensed child care providers
7.3centers must not be reimbursed for more than
7.4excluding holidays, in a fiscal year
7.14must not be reimbursed for absent days. If a child attends for part of the time authorized to
7.15be in care in a day, but is absent for part of the time authorized to be in care in that same
7.16day, the absent time
7.25absent days if the provider has a written policy for child absences and charges all other
7.26families in care for similar absences.
7.27 (b) Child care providers must be reimbursed for up to ten federal or state holidays
7.28or designated holidays per year when the provider charges all families for these days
7.29and the holiday or designated holiday falls on a day when the child is authorized to be
7.30in attendance. Parents may substitute other cultural or religious holidays for the ten
7.31recognized state and federal holidays. Holidays do not count toward the ten
7.33 (c) A family or child care provider
7.34absent day payment unless (1) there was an error in the amount of care authorized for the
7.35family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
7.36the family or provider did not timely report a change as required under law.
8.1 (d) The
8.5absent days used upon initial provider authorization for a family and ongoing notification
8.6of the number of absent days used as of the date of the notification.
8.12EFFECTIVE DATE.This section is effective January 1, 2013.
8.13 Sec. 10. [256.987] ELECTRONIC BENEFIT TRANSFER CARD.
8.14 Subdivision 1. Electronic benefit transfer (EBT) card. Beginning July 1, 2011,
8.15cash benefits for the general assistance and Minnesota supplemental aid programs under
8.16chapter 256D and programs under chapter 256J must be issued on a separate EBT card
8.17with the name of the head of household printed on the card. The card must include the
8.18following statement: "It is unlawful to use this card to purchase tobacco products or
8.19alcoholic beverages." This card must be issued within 30 calendar days of an eligibility
8.20determination. During the initial 30 calendar days of eligibility, a recipient may have
8.21cash benefits issued on an EBT card without a name printed on the card. This card may
8.22be the same card on which food support benefits are issued and does not need to meet
8.23the requirements of this section.
8.24 Subd. 2. EBT card use restricted to Minnesota vendors. EBT cardholders
8.25receiving cash benefits under the general assistance and Minnesota supplemental aid
8.26programs under chapter 256D or programs under chapter 256J are prohibited from using
8.27their EBT cards at vendors located outside of Minnesota. This subdivision does not apply
8.28to food support benefits.
8.29 Subd. 3. Prohibited purchases. EBT debit cardholders in programs listed under
8.30subdivision 1 are prohibited from using the EBT debit card to purchase tobacco products
8.31and alcoholic beverages, as defined in section 340A.101, subdivision 2. It is unlawful for
8.32an EBT cardholder to purchase or attempt to purchase tobacco products or alcoholic
8.33beverages with the cardholder's EBT card. Violation of this subdivision is a petty
8.34misdemeanor. A retailer must not be held liable for the crime of another under section
8.35609.05, for actions taken under this subdivision.
9.1EFFECTIVE DATE.Subdivisions 1 and 2 of this section are effective June 1, 2012.
9.2 Sec. 11. Minnesota Statutes 2010, section 256D.02, subdivision 12a, is amended to
9.4 Subd. 12a. Resident; general assistance medical care. (a) For purposes of
9.6resident of this state.
9.7(b) A "resident" is a person living in the state for at least 30 days with the intention of
9.8making the person's home here and not for any temporary purpose. Time spent in a shelter
9.9for battered women shall count toward satisfying the 30-day residency requirement. All
9.10applicants for these programs are required to demonstrate the requisite intent and can do
9.11so in any of the following ways:
9.12(1) by showing that the applicant maintains a residence at a verified address, other
9.13than a place of public accommodation. An applicant may verify a residence address by
9.14presenting a valid state driver's license
9.16verifying that the individual is residing at the address
9.17approved by the commissioner; or
9.18(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
9.193, item C.
9.20(c) For general assistance medical care, a county agency shall waive the 30-day
9.21residency requirement in cases of medical emergencies.
9.25The county agency must report to the commissioner within 30 days on any waiver
9.26granted under this section. The county shall not deny an application solely because the
9.27applicant does not meet at least one of the criteria in this subdivision, but shall continue to
9.28process the application and leave the application pending until the residency requirement
9.29is met or until eligibility or ineligibility is established.
10.2immediate families are exempt from the residency requirements of this section, provided
10.3the migrant worker provides verification that the migrant family worked in this state
10.4within the last 12 months and earned at least $1,000 in gross wages during the time the
10.5migrant worker worked in this state.
10.9unconstitutional by any court of competent jurisdiction, the remaining provisions shall
10.10remain valid and shall be given full effect.
10.11EFFECTIVE DATE.This section is effective October 1, 2012.
10.12 Sec. 12. Minnesota Statutes 2010, section 256D.05, subdivision 1, is amended to read:
10.13 Subdivision 1. Eligibility. (a) Each assistance unit with income and resources
10.14less than the standard of assistance established by the commissioner and with a member
10.15who is a resident of the state shall be eligible for and entitled to general assistance if
10.16the assistance unit is:
10.17(1) a person who is suffering from a professionally certified permanent or temporary
10.18illness, injury, or incapacity which is expected to continue for more than
10.19which prevents the person from obtaining or retaining employment;
10.24facility for purposes of physical or mental health or rehabilitation, or in an approved
10.25chemical dependency domiciliary facility, if the placement is based on illness or incapacity
10.26and is according to a plan developed or approved by the county agency through its
10.27director or designated representative;
10.30physician, psychological practitioner, or other qualified professional, as developmentally
10.31disabled or mentally ill, and that condition prevents the person from obtaining or retaining
11.7with the county agency, has been determined to be unemployable for purposes of this
11.8clause; a person is considered employable if there exist positions of employment in the
11.9local labor market, regardless of the current availability of openings for those positions,
11.10that the person is capable of performing. The person's eligibility under this category must
11.11be reassessed at least annually. The county agency must provide notice to the person not
11.12later than 30 days before annual eligibility under this item ends, informing the person of the
11.13date annual eligibility will end and the need for vocational assessment if the person wishes
11.14to continue eligibility under this clause. For purposes of establishing eligibility under this
11.15clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
11.17rules adopted by the commissioner, to
11.18under Minnesota's special education rules as a specific learning disability, provided that
11.19a rehabilitation plan for the person is developed or approved by the county agency, and
11.20the person is following the plan;
11.22legal custodian, and only if: the child is legally emancipated or living with an adult with
11.23the consent of an agency acting as a legal custodian; the child is at least 16 years of age
11.24and the general assistance grant is approved by the director of the county agency or a
11.25designated representative as a component of a social services case plan for the child; or the
11.26child is living with an adult with the consent of the child's legal custodian and the county
11.27agency. For purposes of this clause, "legally emancipated" means a person under the age
11.28of 18 years who: (i) has been married; (ii) is on active duty in the uniformed services of
11.29the United States; (iii) has been emancipated by a court of competent jurisdiction; or (iv)
11.30is otherwise considered emancipated under Minnesota law, and for whom county social
11.31services has not determined that a social services case plan is necessary, for reasons other
11.32than the child has failed or refuses to cooperate with the county agency in developing
11.35assistance under section
12.4prevent the applicant or recipient from working at least four hours per day; or
12.8contributes to the person's disability; applicants who assert this clause as a basis for
12.9eligibility must be assessed by the county agency to determine if they are amenable
12.10to treatment; if the applicant is determined to be not amenable to treatment, but is
12.11otherwise eligible for benefits, then general assistance must be paid in vendor form, for
12.12the individual's shelter costs up to the limit of the grant amount, with the residual, if
12.13any, paid according to section
12.14to be amenable to treatment, then in order to receive benefits, the applicant must be in
12.15a treatment program or on a waiting list and the benefits must be paid in vendor form,
12.16for the individual's shelter costs, up to the limit of the grant amount, with the residual, if
12.17any, paid according to section
12.18(b) As a condition of eligibility under paragraph (a), clauses (1),
12.20must apply for other maintenance benefits as specified in section
12.23(c) As a condition of eligibility under this section, the recipient must complete
12.24at least 20 hours per month of volunteer or paid work. The county of residence shall
12.25determine what may be included as volunteer work. Recipients must provide monthly
12.26proof of volunteer work on the forms established by the county. A person who is unable
12.27to obtain or retain 20 hours per month of volunteer or paid work due to a professionally
12.28certified illness, injury, disability, or incapacity must not be made ineligible for general
12.29assistance under this section.
12.31eligibility for general assistance or for exemption from the food stamp employment
12.32and training program is upon the applicant or recipient. The county agency shall use
12.33documents already in its possession to verify eligibility, and shall help the applicant or
12.34recipient obtain other existing verification necessary to determine eligibility which the
12.35applicant or recipient does not have and is unable to obtain.
12.36EFFECTIVE DATE.This section is effective May 1, 2012.
13.1 Sec. 13. Minnesota Statutes 2010, section 256D.06, subdivision 2, is amended to read:
13.2 Subd. 2. Emergency need. (a) Notwithstanding the provisions of subdivision 1, a
13.3grant of emergency general assistance shall, to the extent funds are available, be made to
13.4an eligible single adult, married couple, or family for an emergency need
13.6not exceeding 30 days if an emergency situation appears to exist
13.8written criteria adopted by the county agency. If an applicant or recipient relates facts
13.9to the county agency which may be sufficient to constitute an emergency situation, the
13.10county agency shall, to the extent funds are available, advise the person of the procedure
13.11for applying for assistance according to this subdivision.
13.12 (b) The applicant must be ineligible for assistance under chapter 256J, must have
13.13annual net income no greater than 200 percent of the federal poverty guidelines for the
13.14previous calendar year, and may receive an emergency
13.16 (c) Funding for an emergency general assistance program is limited to the
13.17appropriation. Each fiscal year, the commissioner shall allocate to counties the money
13.18appropriated for emergency general assistance grants based on each county agency's
13.19average share of state's emergency general expenditures for the immediate past three fiscal
13.20years as determined by the commissioner, and may reallocate any unspent amounts to
13.21other counties. No county shall be allocated less than $1,000 for a fiscal year.
13.22 (d) Any emergency general assistance expenditures by a county above the amount of
13.23the commissioner's allocation to the county must be made from county funds.
13.24EFFECTIVE DATE.This section is effective November 1, 2011.
13.25 Sec. 14. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
13.26 Subd. 5. Special needs. In addition to the state standards of assistance established in
13.27subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
13.28Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
13.29center, or a group residential housing facility.
14.36maximum allotment authorized by the federal Food Stamp Program for a single individual
15.1which is in effect on the first day of July of each year will be added to the standards of
15.2assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
15.3as shelter needy and are: (i) relocating from an institution, or an adult mental health
15.4residential treatment program under section
15.5supports option as defined under section
15.6community-based waiver recipients living in their own home or rented or leased apartment
15.7which is not owned, operated, or controlled by a provider of service not related by blood
15.8or marriage, unless allowed under paragraph
15.9 (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
15.10shelter needy benefit under this paragraph is considered a household of one. An eligible
15.11individual who receives this benefit prior to age 65 may continue to receive the benefit
15.12after the age of 65.
15.13 (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
15.14exceed 40 percent of the assistance unit's gross income before the application of this
15.15special needs standard. "Gross income" for the purposes of this section is the applicant's or
15.16recipient's income as defined in section
15.17in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
15.18state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
15.19considered shelter needy for purposes of this paragraph.
15.22controlled by the recipient's service provider. In a multifamily building of four or more
15.23units, the maximum number of apartments that may be used by recipients of this program
15.24shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012.
15.25EFFECTIVE DATE.This section is effective October 1, 2012.
15.26 Sec. 15. Minnesota Statutes 2010, section 256D.46, subdivision 1, is amended to read:
15.27 Subdivision 1. Eligibility.
15.32Applicants for or recipients of SSI or Minnesota supplemental aid who have emergency
15.33need may apply for emergency general assistance under section 256D.06, subdivision 2.
15.34EFFECTIVE DATE.This section is effective November 1, 2011.
16.1 Sec. 16. Minnesota Statutes 2010, section 256D.47, is amended to read:
16.2256D.47 PAYMENT METHODS.
16.3Minnesota supplemental aid payments must be issued to the recipient, a protective
16.4payee, or a conservator or guardian of the recipient's estate in the form of county warrants
16.5immediately redeemable in cash, electronic benefits transfer, or by direct deposit into the
16.6recipient's account in a financial institution. Minnesota supplemental aid payments must
16.7be issued regularly on the first day of the month. The supplemental aid warrants must be
16.8mailed only to the address at which the recipient resides, unless another address has been
16.9approved in advance by the county agency. Vendor payments must not be issued by the
16.10county agency except for nonrecurring emergency need payments; at the request of the
16.12need for protective payments exist.
16.13EFFECTIVE DATE.This section is effective October 1, 2012.
16.14 Sec. 17. Minnesota Statutes 2010, section 256E.35, subdivision 5, is amended to read:
16.15 Subd. 5. Household eligibility; participation. (a) To be eligible for
16.16matching funds in the family assets for independence initiative, a household must meet the
16.17eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
16.18in Title IV, section 408 of that act.
16.19(b) Each participating household must sign a family asset agreement that includes
16.20the amount of scheduled deposits into its savings account, the proposed use, and the
16.21proposed savings goal. A participating household must agree to complete an economic
16.22literacy training program.
16.23Participating households may only deposit money that is derived from household
16.24earned income or from state and federal income tax credits.
16.25 Sec. 18. Minnesota Statutes 2010, section 256E.35, subdivision 6, is amended to read:
16.26 Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a
16.27participating household must transfer funds withdrawn from a family asset account to its
16.28matching fund custodial account held by the fiscal agent, according to the family asset
16.29agreement. The fiscal agent must determine if the match request is for a permissible use
16.30consistent with the household's family asset agreement.
16.31The fiscal agent must ensure the household's custodial account contains the
16.32applicable matching funds to match the balance in the household's account, including
17.1interest, on at least a quarterly basis and at the time of an approved withdrawal.
17.9(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
17.10direct payment to the vendor of the goods or services for the permissible use.
17.11 Sec. 19. Minnesota Statutes 2010, section 256I.03, is amended by adding a subdivision
17.13 Subd. 8. Supplementary services. "Supplementary services" means services
17.14provided to residents of group residential housing providers in addition to room and
17.15board including, but not limited to, oversight and up to 24-hour supervision, medication
17.16reminders, assistance with transportation, arranging for meetings and appointments, and
17.17arranging for medical and social services.
17.18 Sec. 20. Minnesota Statutes 2010, section 256I.04, subdivision 1, is amended to read:
17.19 Subdivision 1. Individual eligibility requirements. An individual is eligible for
17.20and entitled to a group residential housing payment to be made on the individual's behalf
17.21if the county agency has approved the individual's residence in a group residential housing
17.22setting and the individual meets the requirements in
17.23(a) The individual is aged, blind, or is over 18 years of age and disabled as
17.24determined under the criteria used by the title II program of the Social Security Act,
17.25and meets the resource restrictions and standards of the supplemental security income
17.26program, and the individual's countable income after deducting the (1) exclusions and
17.27disregards of the SSI program, (2) the medical assistance personal needs allowance
17.29to a community spouse by an elderly waiver recipient under the provisions of sections
17.31monthly rate specified in the county agency's agreement with the provider of group
17.32residential housing in which the individual resides.
18.5(b) Each individual with income and resources less than the standard of assistance
18.6established by the commissioner and who is a resident of the state shall be eligible for and
18.7entitled to group residential housing if the assistance unit is:
18.8(1) a person who is suffering from a professionally certified permanent or temporary
18.9illness, injury, or incapacity which is expected to continue for more than 90 days and
18.10which prevents the person from obtaining or retaining employment;
18.11(2) a person who has been placed in, and is residing in, a licensed or certified facility
18.12for purposes of physical or mental health or rehabilitation, or in an approved chemical
18.13dependency domiciliary facility, if the placement is based on illness or incapacity and is
18.14according to a plan developed or approved by the county agency through its director or
18.16(3) a person not described in clause (1) or (2) who is diagnosed by a licensed
18.17physician, psychological practitioner, or other qualified professional, as developmentally
18.18disabled or mentally ill, and that condition prevents the person from obtaining or retaining
18.20(4) a person who has been assessed by a vocational specialist and, in consultation
18.21with the county agency, has been determined to be unemployable for purposes of this
18.22clause; a person is considered employable if there exist positions of employment in the
18.23local labor market, regardless of the current availability of openings for those positions,
18.24that the person is capable of performing. The person's eligibility under this category must
18.25be reassessed at least annually. The county agency must provide notice to the person not
18.26later than 30 days before annual eligibility under this item ends, informing the person of the
18.27date annual eligibility will end and the need for vocational assessment if the person wishes
18.28to continue eligibility under this clause. For purposes of establishing eligibility under this
18.29clause, it is the applicant's or recipient's duty to obtain any needed vocational assessment;
18.30(5) a person who is determined by the county agency, according to permanent rules
18.31adopted by the commissioner, to have a condition that qualifies under Minnesota's special
18.32education rules as a specific learning disability, provided that a rehabilitation plan for
18.33the person is developed or approved by the county agency, and the person is following
18.34the plan; or
18.35(6) a person whose alcohol and drug addiction is a material factor that contributes
18.36to the person's disability.
19.1(c) As a condition of eligibility under paragraph (b), the recipient must complete an
19.2interim assistance agreement and must apply for other maintenance benefits as specified in
19.3section 256N.35, and must comply with efforts to determine the recipient's eligibility for
19.4those other maintenance benefits.
19.5(d) As a condition of eligibility under this section, the recipient must complete
19.6at least 20 hours per month of volunteer or paid work. The county of residence shall
19.7determine what may be included as volunteer work. Recipients must provide monthly
19.8proof of volunteer work on the forms established by the county. A person who is unable
19.9to obtain or retain 20 hours per month of volunteer or paid work due to a professionally
19.10certified illness, injury, disability, or incapacity must not be made ineligible for group
19.11residential housing under this section.
19.12(e) The burden of providing documentation for a county agency to use to verify
19.13eligibility under this section is upon the applicant or recipient. The county agency shall
19.14use documents already in its possession to verify eligibility, and shall help the applicant or
19.15recipient obtain other existing verification necessary to determine eligibility which the
19.16applicant or recipient does not have and is unable to obtain.
19.17EFFECTIVE DATE.This section is effective October 1, 2012.
19.18 Sec. 21. Minnesota Statutes 2010, section 256I.04, subdivision 2b, is amended to read:
19.19 Subd. 2b. Group residential housing agreements. (a) Agreements between county
19.20agencies and providers of group residential housing must be in writing and must specify
19.21the name and address under which the establishment subject to the agreement does
19.22business and under which the establishment, or service provider, if different from the
19.23group residential housing establishment, is licensed by the Department of Health or the
19.24Department of Human Services; the specific license or registration from the Department
19.25of Health or the Department of Human Services held by the provider and the number
19.26of beds subject to that license; the address of the location or locations at which group
19.27residential housing is provided under this agreement; the per diem and monthly rates that
19.28are to be paid from group residential housing funds for each eligible resident at each
19.29location; the number of beds at each location which are subject to the group residential
19.30housing agreement; whether the license holder is a not-for-profit corporation under section
19.31501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to
19.32the provisions of sections
19.33Group residential housing agreements may be terminated with or without cause by either
19.34the county or the provider with two calendar months prior notice.
20.1(b) Beginning July 1, 2011, counties must not enter into agreements with providers
20.2of group residential housing that are licensed as board and lodging with special services
20.3and that do not include a residency requirement of at least 20 hours per month of volunteer
20.4or paid work. A person who is unable to obtain or retain 20 hours per month of volunteer
20.5or paid work due to a professionally certified illness, injury, disability, or incapacity must
20.6not be made ineligible for group residential housing under this section. This paragraph
20.7does not apply to group residential housing providers who serve people aged 21 or
20.8younger if the residents are required to attend school or improve independent living skills.
20.9EFFECTIVE DATE.This section is effective May 1, 2012.
20.10 Sec. 22. Minnesota Statutes 2010, section 256I.05, subdivision 1a, is amended to read:
20.11 Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
20.13for other services necessary to provide room and board provided by the group residence
20.14if the residence is licensed by or registered by the Department of Health, or licensed by
20.15the Department of Human Services to provide services in addition to room and board,
20.16and if the provider of services is not also concurrently receiving funding for services for
20.17a recipient under a home and community-based waiver under title XIX of the Social
20.18Security Act; or funding from the medical assistance program under section
20.19for personal care services for residents in the setting; or residing in a setting which
20.20receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is
20.21available for other necessary services through a home and community-based waiver, or
20.22personal care services under section
20.23set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary
20.24service rate exceed $426.37. The registration and licensure requirement does not apply to
20.25establishments which are exempt from state licensure because they are located on Indian
20.26reservations and for which the tribe has prescribed health and safety requirements. Service
20.27payments under this section may be prohibited under rules to prevent the supplanting of
20.28federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
20.29the approval of the Secretary of Health and Human Services to provide home and
20.30community-based waiver services under title XIX of the Social Security Act for residents
20.31who are not eligible for an existing home and community-based waiver due to a primary
20.32diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is
20.33determined to be cost-effective.
20.34(b) The commissioner is authorized to make cost-neutral transfers from the GRH
20.35fund for beds under this section to other funding programs administered by the department
21.1after consultation with the county or counties in which the affected beds are located.
21.2The commissioner may also make cost-neutral transfers from the GRH fund to county
21.3human service agencies for beds permanently removed from the GRH census under a plan
21.4submitted by the county agency and approved by the commissioner. The commissioner
21.5shall report the amount of any transfers under this provision annually to the legislature.
21.6(c) The provisions of paragraph (b) do not apply to a facility that has its
21.7reimbursement rate established under section
21.8 (d) Beginning July 1, 2011, counties must not negotiate supplementary service rates
21.9with providers of group residential housing that are licensed as board and lodging with
21.10special services and that do not encourage a policy of sobriety on their premises.
21.11EFFECTIVE DATE.This section is effective May 1, 2012.
21.12 Sec. 23. Minnesota Statutes 2010, section 256J.12, subdivision 1a, is amended to read:
21.13 Subd. 1a.
21.14to have established residency in this state only when a child or caregiver has resided in this
21.15state for at least
21.16here and not for any temporary purpose. The birth of a child in Minnesota to a member
21.17of the assistance unit does not automatically establish the residency in this state under
21.18this subdivision of the other members of the assistance unit. Time spent in a shelter for
21.19battered women shall count toward satisfying the
21.20 Sec. 24. Minnesota Statutes 2010, section 256J.12, subdivision 2, is amended to read:
21.21 Subd. 2. Exceptions. (a)
21.331a if they once resided in Minnesota and:
22.1(1) joined the United States armed services, returned to Minnesota within 30 days of
22.2leaving the armed services, and intend to remain in Minnesota; or
22.3(2) left to attend school in another state, paid nonresident tuition or Minnesota
22.4tuition rates under a reciprocity agreement, and returned to Minnesota within 30 days of
22.5graduation with the intent to remain in Minnesota.
22.7(1) a minor child or a minor caregiver moves from another state to the residence of
22.8a relative caregiver; and
22.9(2) the relative caregiver has resided in Minnesota for at least
22.11(i) the minor caregiver applies for and receives MFIP; or
22.12(ii) the relative caregiver applies for assistance for the minor child but does not
22.13choose to be a member of the MFIP assistance unit.
22.14 Sec. 25. Minnesota Statutes 2010, section 256J.20, subdivision 3, is amended to read:
22.15 Subd. 3. Other property limitations. To be eligible for MFIP, the equity value of
22.16all nonexcluded real and personal property of the assistance unit must not exceed $2,000
22.17for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
22.18(19) must be excluded when determining the equity value of real and personal property:
22.19 (1) a licensed vehicle up to a loan value of less than or equal to
22.20the assistance unit owns more than one licensed vehicle, the county agency shall determine
22.21the loan value of all additional vehicles and exclude the combined loan value of less than
22.22or equal to $7,500. The county agency shall apply any excess loan value as if it were
22.23equity value to the asset limit described in this section, excluding: (i) the value of one
22.24vehicle per physically disabled person when the vehicle is needed to transport the disabled
22.25unit member; this exclusion does not apply to mentally disabled people; (ii) the value of
22.26special equipment for a disabled member of the assistance unit; and (iii) any vehicle used
22.27for long-distance travel, other than daily commuting, for the employment of a unit member.
22.28 To establish the loan value of vehicles, a county agency must use the N.A.D.A.
22.29Official Used Car Guide, Midwest Edition, for newer model cars. When a vehicle is not
22.30listed in the guidebook, or when the applicant or participant disputes the loan value listed
22.31in the guidebook as unreasonable given the condition of the particular vehicle, the county
22.32agency may require the applicant or participant document the loan value by securing a
22.33written statement from a motor vehicle dealer licensed under section
22.34the amount that the dealer would pay to purchase the vehicle. The county agency shall
23.1reimburse the applicant or participant for the cost of a written statement that documents
23.2a lower loan value;
23.3 (2) the value of life insurance policies for members of the assistance unit;
23.4 (3) one burial plot per member of an assistance unit;
23.5 (4) the value of personal property needed to produce earned income, including
23.6tools, implements, farm animals, inventory, business loans, business checking and
23.7savings accounts used at least annually and used exclusively for the operation of a
23.8self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
23.9is to produce income and if the vehicles are essential for the self-employment business;
23.10 (5) the value of personal property not otherwise specified which is commonly
23.11used by household members in day-to-day living such as clothing, necessary household
23.12furniture, equipment, and other basic maintenance items essential for daily living;
23.13 (6) the value of real and personal property owned by a recipient of Supplemental
23.14Security Income or Minnesota supplemental aid;
23.15 (7) the value of corrective payments, but only for the month in which the payment
23.16is received and for the following month;
23.17 (8) a mobile home or other vehicle used by an applicant or participant as the
23.18applicant's or participant's home;
23.19 (9) money in a separate escrow account that is needed to pay real estate taxes or
23.20insurance and that is used for this purpose;
23.21 (10) money held in escrow to cover employee FICA, employee tax withholding,
23.22sales tax withholding, employee worker compensation, business insurance, property rental,
23.23property taxes, and other costs that are paid at least annually, but less often than monthly;
23.24 (11) monthly assistance payments for the current month's or short-term emergency
23.25needs under section
23.26 (12) the value of school loans, grants, or scholarships for the period they are
23.27intended to cover;
23.28 (13) payments listed in section
23.29in escrow for a period not to exceed three months to replace or repair personal or real
23.31 (14) income received in a budget month through the end of the payment month;
23.32 (15) savings from earned income of a minor child or a minor parent that are set aside
23.33in a separate account designated specifically for future education or employment costs;
23.34 (16) the federal earned income credit, Minnesota working family credit, state and
23.35federal income tax refunds, state homeowners and renters credits under chapter 290A,
24.1property tax rebates and other federal or state tax rebates in the month received and the
24.3 (17) payments excluded under federal law as long as those payments are held in a
24.4separate account from any nonexcluded funds;
24.5 (18) the assets of children ineligible to receive MFIP benefits because foster care or
24.6adoption assistance payments are made on their behalf; and
24.7 (19) the assets of persons whose income is excluded under section
24.9EFFECTIVE DATE.This section is effective October 1, 2011.
24.10 Sec. 26. Minnesota Statutes 2010, section 256J.37, is amended by adding a subdivision
24.12 Subd. 3c. Treatment of Supplemental Security Income. Effective July 1, 2011, the
24.13county shall reduce the cash portion of the MFIP grant by $50 per adult SSI recipient who
24.14resides in the household, and who would otherwise be included in the MFIP assistance
24.15unit under section 256J.24, subdivision 2, but is excluded solely due to the SSI recipient
24.16status under section 256J.24, subdivision 3, paragraph (a), clause (1). If the SSI recipient
24.17receives less than $150 of SSI, only the amount received shall be used in calculating the
24.18MFIP cash assistance payment. This provision does not apply to relative caregivers who
24.19could elect to be included in the MFIP assistance unit under section 256J.24, subdivision
24.204, unless the caregiver's children or stepchildren are included in the MFIP assistance unit.
24.21EFFECTIVE DATE.This section is effective November 1, 2011.
24.22 Sec. 27. Minnesota Statutes 2010, section 256J.49, subdivision 13, is amended to read:
24.23 Subd. 13. Work activity. (a) "Work activity" means any activity in a participant's
24.24approved employment plan that leads to employment. For purposes of the MFIP program,
24.25this includes activities that meet the definition of work activity under the participation
24.26requirements of TANF. Work activity includes:
24.27 (1) unsubsidized employment, including work study and paid apprenticeships or
24.29 (2) subsidized private sector or public sector employment, including grant diversion
24.30as specified in section
24.31work experience, and supported work when a wage subsidy is provided;
24.32 (3) unpaid work experience, including community service, volunteer work,
24.33the community work experience program as specified in section
25.1apprenticeships or internships, and supported work when a wage subsidy is not provided.
25.2Unpaid work experience is only an option if the participant has been unable to obtain or
25.3maintain paid employment in the competitive labor market, and no paid work experience
25.4programs are available to the participant. Prior to placing a participant in unpaid work,
25.5the county must inform the participant that the participant will be notified if a paid work
25.6experience or supported work position becomes available. Unless a participant consents in
25.7writing to participate in unpaid work experience, the participant's employment plan may
25.8only include unpaid work experience if including the unpaid work experience in the plan
25.9will meet the following criteria:
25.10 (i) the unpaid work experience will provide the participant specific skills or
25.11experience that cannot be obtained through other work activity options where the
25.12participant resides or is willing to reside; and
25.13 (ii) the skills or experience gained through the unpaid work experience will result
25.14in higher wages for the participant than the participant could earn without the unpaid
25.16 (4) job search including job readiness assistance, job clubs, job placement,
25.17job-related counseling, and job retention services;
25.18 (5) job readiness education, including English as a second language (ESL) or
25.19functional work literacy classes as limited by the provisions of section
25.21completion, and adult basic education as limited by the provisions of section
25.23 (6) job skills training directly related to employment, including education and
25.24training that can reasonably be expected to lead to employment, as limited by the
25.25provisions of section
25.26 (7) providing child care services to a participant who is working in a community
25.28 (8) activities included in the employment plan that is developed under section
25.30 (9) preemployment activities including chemical and mental health assessments,
25.31treatment, and services; learning disabilities services; child protective services; family
25.32stabilization services; or other programs designed to enhance employability.
25.33(b) "Work activity" does not include activities done for political purposes as defined
25.34in section 211B.01, subdivision 6.
25.35 Sec. 28. Minnesota Statutes 2010, section 256J.53, subdivision 2, is amended to read:
26.1 Subd. 2. Approval of postsecondary education or training. (a) In order for a
26.2postsecondary education or training program to be an approved activity in an employment
26.6must be working in unsubsidized employment at least 10 hours per week.
26.7 (b) Participants seeking approval of a postsecondary education or training plan
26.8must provide documentation that:
26.9 (1) the employment goal can only be met with the additional education or training;
26.10 (2) there are suitable employment opportunities that require the specific education or
26.11training in the area in which the participant resides or is willing to reside;
26.12 (3) the education or training will result in significantly higher wages for the
26.13participant than the participant could earn without the education or training;
26.14 (4) the participant can meet the requirements for admission into the program; and
26.15 (5) there is a reasonable expectation that the participant will complete the training
26.16program based on such factors as the participant's MFIP assessment, previous education,
26.17training, and work history; current motivation; and changes in previous circumstances.
26.18(c) The hourly unsubsidized employment requirement does not apply for intensive
26.19education or training programs lasting 12 weeks or less when full-time attendance is
26.21 Sec. 29. [256N.10] ADULT ASSISTANCE GRANT PROGRAM.
26.22The adult assistance grant program is a capped allocation to counties that can be
26.23spent in a flexible manner, to the extent funds are available, for adult assistance.
26.24EFFECTIVE DATE.This section is effective October 1, 2012.
26.25 Sec. 30. [256N.20] DEFINITIONS.
26.26 Subdivision 1. Scope. For the purposes of sections
26.27defined in this section have the meanings given them.
26.28 Subd. 2. Adult assistance. "Adult assistance" means a capped allocation provided
26.29or arranged for by county boards for ongoing emergency needs, special diets, or special
26.30needs as determined by the county.
26.31 Subd. 3. Commissioner. "Commissioner" means the commissioner of human
26.33 Subd. 4. County board. "County board" means the board of county commissioners
26.34in each county.
27.1 Subd. 5. Eligible participant. "Eligible participant" means low-income adults who
27.2meet the residency requirements under section 256N.22, and who were previously eligible
27.3for programs under subdivision 6 are eligible for adult assistance. The commissioner may
27.4develop more specific eligibility criteria.
27.5 Subd. 6. Former programs. "Former programs" means funding for:
27.6(1) general assistance;
27.7(2) emergency general assistance;
27.8(3) emergency supplemental aid; and
27.9(4) Minnesota supplemental aid special needs and special diets.
27.10EFFECTIVE DATE.This section is effective October 1, 2012.
27.11 Sec. 31. [256N.22] RESIDENCY.
27.12(a) For purposes of eligibility for adult assistance, a person must be a resident of
27.14(b) A "resident" is a person living in the state for at least 60 days with the intention of
27.15making the person's home here and not for any temporary purpose. Time spent in a shelter
27.16for battered women shall count toward satisfying the 60-day residency requirement. All
27.17applicants for these programs are required to demonstrate the requisite intent and may do
27.18so in any of the following ways:
27.19(1) by showing that the applicant maintains a residence at a verified address, other
27.20than a place of public accommodation. An applicant may verify a residence address by
27.21presenting a valid state driver's license, a state identification card, a voter registration
27.22card, or a rent receipt; or
27.23(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart
27.243, item C.
27.25(c) The county shall not deny an application solely because the applicant does not
27.26meet at least one of the criteria in this subdivision, but shall continue to process the
27.27application and leave the application pending until the residency requirement is met or
27.28until eligibility or ineligibility is established.
27.29(d) If any provision of this subdivision is enjoined from implementation or found
27.30unconstitutional by any court of competent jurisdiction, the remaining provisions shall
27.31remain valid and shall be given full effect.
27.32EFFECTIVE DATE.This section is effective October 1, 2012.
27.33 Sec. 32. [256N.25] PROGRAM EVALUATION.
28.1 Subdivision 1. County evaluation. Each county shall submit to the commissioner
28.2data from the past calendar year on the outcomes and performance indicators, and
28.3information as to how grant funds are being spent on the target population. The
28.4commissioner shall prescribe standard methods to be used by the counties in providing
28.5the data. The data shall be submitted no later than March 1 of each year, beginning with
28.6March 1, 2013. The commissioner shall define outcomes and performance indicators.
28.7 Subd. 2. Statewide evaluation. Six months after the end of the first full calendar
28.8year and biennially thereafter, the commissioner shall prepare a report on the counties'
28.9progress in improving the outcomes of adults related to safety and well-being. This report
28.10shall be disseminated electronically throughout the state.
28.11EFFECTIVE DATE.This section is effective October 1, 2012.
28.12 Sec. 33. [256N.30] FUNDING.
28.13 Subdivision 1. Assistance. (a) Counties may use the capped allocation for adult
28.14assistance for individuals under section 256N.20, subdivision 2.
28.15(b) The county agency shall, within available appropriations, provide a personal
28.16needs allowance to individuals eligible for group residential housing under section
28.17256I.04, subdivision 1, paragraph (b), and to other individuals who reside in licensed
28.18residential facilities other than group residential housing. The county may determine the
28.19amount of the personal needs allowance based on the individual's net income and need.
28.20(c) In determining the amount of assistance, the county shall disregard the first
28.21$150 of earned income per month. In addition, the county shall disregard additional
28.22earned income up to a maximum of $500 per month for individuals residing in facilities or
28.23group residential housing for whom the county agency has approved a discharge plan that
28.24includes work. The additional amount disregarded must be placed in a separate savings
28.25account by the eligible individual, to be used upon discharge from the residential facility
28.26into the community, up to a maximum of $2,000.
28.27(d) The county shall give priority to eligible individuals who are enrolled in a
28.2812-month residential chemical dependency treatment program.
28.29 Subd. 2. Allocation. Funding for the adult assistance grant program is limited to the
28.30appropriation. The commissioner shall allocate to counties the money appropriated for the
28.31program based on each county agency's average share of the state's former programs under
28.32section 256N.20, subdivision 6. The commissioner may reallocate any unspent amounts
28.33to other counties. No county shall be allocated less than $1,000 for the fiscal year. Any
28.34adult assistance aid expenditures by a county above the amount of the commissioner's
28.35allocation to the county must be made from county funds.
29.1EFFECTIVE DATE.This section is effective October 1, 2012.
29.2 Sec. 34. [256N.35] APPLICANT REQUIREMENTS.
29.3(a) Any applicant, otherwise eligible for adult assistance and possibly eligible for
29.4federal maintenance benefits from any other source shall: (1) make application for those
29.5benefits within 30 days of the adult assistance application; and (2) execute an interim
29.6assistance authorization on a form as directed by the commissioner.
29.7(b) The commissioner shall review a denial of an application for other federal
29.8maintenance benefits and may require a recipient of adult assistance to file an appeal of
29.9the denial if appropriate.
29.10(c) If found eligible for maintenance benefits, and maintenance benefits were
29.11received during the period in which adult assistance was also being received, the recipient
29.12shall be required to reimburse the county for the interim assistance paid. Reimbursement
29.13shall not exceed the amount of adult assistance paid during the time period to which the
29.14other maintenance benefits apply.
29.15(d) The commissioner may contract with the county agencies, qualified agencies,
29.16organizations, or persons to provide advocacy and support services to process claims for
29.17federal disability benefits for applicants or recipients of services or benefits supervised by
29.18the commissioner using money retained under this section.
29.19(e) The commissioner may provide methods by which county agencies shall identify,
29.20refer, and assist recipients who may be eligible for benefits under federal programs for the
29.22(f) The total amount of interim assistance recoveries retained under this section
29.23for advocacy, support, and claim processing services shall not exceed 35 percent of the
29.24interim assistance recoveries in the prior fiscal year.
29.25EFFECTIVE DATE.This section is effective October 1, 2012.
29.26 Sec. 35. Minnesota Statutes 2010, section 260C.157, subdivision 3, is amended to read:
29.27 Subd. 3. Juvenile treatment screening team. (a) The responsible social services
29.28agency shall establish a juvenile treatment screening team to conduct screenings and
29.29prepare case plans under
29.30260C and 260D. Screenings shall be conducted within 15 days of a request for a screening.
29.31The team, which may be the team constituted under section
29.32Minnesota Rules, parts 9530.6600 to 9530.6655, shall consist of social workers, juvenile
29.33justice professionals, and persons with expertise in the treatment of juveniles who are
29.34emotionally disabled, chemically dependent, or have a developmental disability
30.2parent, guardian, or permanent legal custodian under section 260C.201, subdivision 11.
30.3The team may be the same team as defined in section
30.4(b) The social services agency shall determine whether a child brought to its
30.5attention for the purposes described in this section is an Indian child, as defined in section
30.7defined in section
30.8the team provided in paragraph (a) shall include a designated representative of the Indian
30.9child's tribe, unless the child's tribal authority declines to appoint a representative. The
30.10Indian child's tribe may delegate its authority to represent the child to any other federally
30.11recognized Indian tribe, as defined in section
30.12(c) If the court, prior to, or as part of, a final disposition, proposes to place a child:
30.13(1) for the primary purpose of treatment for an emotional disturbance, a
30.14developmental disability, or chemical dependency in a residential treatment facility out
30.15of state or in one which is within the state and licensed by the commissioner of human
30.16services under chapter 245A; or
30.17(2) in any out-of-home setting potentially exceeding 30 days in duration, including a
30.18postdispositional placement in a facility licensed by the commissioner of corrections or
30.19human services, the court shall ascertain whether the child is an Indian child and shall
30.20notify the county welfare agency and, if the child is an Indian child, shall notify the Indian
30.21child's tribe. The county's juvenile treatment screening team must either: (i) screen and
30.22evaluate the child and file its recommendations with the court within 14 days of receipt
30.23of the notice; or (ii) elect not to screen a given case and notify the court of that decision
30.24within three working days.
30.26may not be placed for the primary purpose of treatment for an emotional disturbance, a
30.27developmental disability, or chemical dependency, in a residential treatment facility out of
30.28state nor in a residential treatment facility within the state that is licensed under chapter
30.29245A, unless one of the following conditions applies:
30.30(1) a treatment professional certifies that an emergency requires the placement
30.31of the child in a facility within the state;
30.32(2) the screening team has evaluated the child and recommended that a residential
30.33placement is necessary to meet the child's treatment needs and the safety needs of the
30.34community, that it is a cost-effective means of meeting the treatment needs, and that it
30.35will be of therapeutic value to the child; or
31.1(3) the court, having reviewed a screening team recommendation against placement,
31.2determines to the contrary that a residential placement is necessary. The court shall state
31.3the reasons for its determination in writing, on the record, and shall respond specifically
31.4to the findings and recommendation of the screening team in explaining why the
31.5recommendation was rejected. The attorney representing the child and the prosecuting
31.6attorney shall be afforded an opportunity to be heard on the matter.
31.7(e) When the county's juvenile treatment screening team has elected to screen and
31.8evaluate a child determined to be an Indian child, the team shall provide notice to the
31.9tribe or tribes that accept jurisdiction for the Indian child or that recognize the child as a
31.10member of the tribe or as a person eligible for membership in the tribe, and permit the
31.11tribe's representative to participate in the screening team.
31.12(f) When the Indian child's tribe or tribal health care services provider or Indian
31.13Health Services provider proposes to place a child for the primary purpose of treatment
31.14for an emotional disturbance, a developmental disability, or co-occurring emotional
31.15disturbance and chemical dependency, the Indian child's tribe or the tribe delegated by
31.16the child's tribe shall submit necessary documentation to the county juvenile treatment
31.17screening team, which must invite the Indian child's tribe to designate a representative to
31.18the screening team.
31.19 Sec. 36. Minnesota Statutes 2010, section 260D.01, is amended to read:
31.20260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
31.21 (a) Sections
31.22for treatment" provisions of the Juvenile Court Act.
31.23 (b) The juvenile court has original and exclusive jurisdiction over a child in
31.24voluntary foster care for treatment upon the filing of a report or petition required under
31.25this chapter. All obligations of the agency to a child and family in foster care contained in
31.26chapter 260C not inconsistent with this chapter are also obligations of the agency with
31.27regard to a child in foster care for treatment under this chapter.
31.28 (c) This chapter shall be construed consistently with the mission of the children's
31.29mental health service system as set out in section
31.30of an agency under section
31.31to 9525.0016, to meet the needs of a child with a developmental disability or related
31.32condition. This chapter:
31.33 (1) establishes voluntary foster care through a voluntary foster care agreement as the
31.34means for an agency and a parent to provide needed treatment when the child must be in
32.1foster care to receive necessary treatment for an emotional disturbance or developmental
32.2disability or related condition;
32.3 (2) establishes court review requirements for a child in voluntary foster care for
32.4treatment due to emotional disturbance or developmental disability or a related condition;
32.5 (3) establishes the ongoing responsibility of the parent as legal custodian to visit the
32.6child, to plan together with the agency for the child's treatment needs, to be available and
32.7accessible to the agency to make treatment decisions, and to obtain necessary medical,
32.8dental, and other care for the child; and
32.9 (4) applies to voluntary foster care when the child's parent and the agency agree that
32.10the child's treatment needs require foster care either:
32.11 (i) due to a level of care determination by the agency's screening team informed by
32.12the diagnostic and functional assessment under section
32.13 (ii) due to a determination regarding the level of services needed by the responsible
32.14social services' screening team under section
32.159525.0004 to 9525.0016.
32.16 (d) This chapter does not apply when there is a current determination under section
32.18for any reason other than treatment for the child's emotional disturbance or developmental
32.19disability or related condition. When there is a determination under section
32.20the child requires child protective services based on an assessment that there are safety
32.21and risk issues for the child that have not been mitigated through the parent's engagement
32.22in services or otherwise, or when the child is in foster care for any reason other than
32.23the child's emotional disturbance or developmental disability or related condition, the
32.24provisions of chapter 260C apply.
32.25 (e) The paramount consideration in all proceedings concerning a child in voluntary
32.26foster care for treatment is the safety, health, and the best interests of the child. The
32.27purpose of this chapter is:
32.28 (1) to ensure a child with a disability is provided the services necessary to treat or
32.29ameliorate the symptoms of the child's disability;
32.30 (2) to preserve and strengthen the child's family ties whenever possible and in the
32.31child's best interests, approving the child's placement away from the child's parents only
32.32when the child's need for care or treatment requires it and the child cannot be maintained
32.33in the home of the parent; and
32.34 (3) to ensure the child's parent retains legal custody of the child and associated
32.35decision-making authority unless the child's parent willfully fails or is unable to make
32.36decisions that meet the child's safety, health, and best interests. The court may not find
33.1that the parent willfully fails or is unable to make decisions that meet the child's needs
33.2solely because the parent disagrees with the agency's choice of foster care facility, unless
33.3the agency files a petition under chapter 260C, and establishes by clear and convincing
33.4evidence that the child is in need of protection or services.
33.5 (f) The legal parent-child relationship shall be supported under this chapter by
33.6maintaining the parent's legal authority and responsibility for ongoing planning for the
33.7child and by the agency's assisting the parent, where necessary, to exercise the parent's
33.8ongoing right and obligation to visit or to have reasonable contact with the child. Ongoing
33.10 (1) actively participating in the planning and provision of educational services,
33.11medical, and dental care for the child;
33.12 (2) actively planning and participating with the agency and the foster care facility
33.13for the child's treatment needs; and
33.14 (3) planning to meet the child's need for safety, stability, and permanency, and the
33.15child's need to stay connected to the child's family and community.
33.16 (g) The provisions of section
33.17reunification, and all active and reasonable effort requirements of that section apply. This
33.18chapter shall be construed consistently with the requirements of the Indian Child Welfare
33.19Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the
33.20Minnesota Indian Family Preservation Act, sections
33.21 Sec. 37. Minnesota Statutes 2010, section 393.07, subdivision 10a, is amended to read:
33.22 Subd. 10a. Expedited issuance of food stamps. The commissioner of human
33.23services shall continually monitor the expedited issuance of food stamp benefits to ensure
33.24that each county complies with federal regulations and that households eligible for
33.25expedited issuance of food stamps are identified, processed, and certified within the time
33.26frames prescribed in federal regulations.
33.27County food stamp offices shall screen
33.28day of application. Applicants who meet the federal criteria for expedited issuance and
33.29have an immediate need for food assistance shall receive
33.32The local food stamp agency shall conspicuously post in each food stamp office a
33.33notice of the availability of and the procedure for applying for expedited issuance and
33.34verbally advise each applicant of the availability of the expedited process.
34.1 Sec. 38. REQUIREMENT FOR LIQUOR STORES, TOBACCO STORES,
34.2GAMBLING ESTABLISHMENTS, AND TATTOO PARLORS.
34.3Liquor stores, tobacco stores, gambling establishments, and tattoo parlors must
34.4negotiate with their third-party processors to block EBT card cash transactions at their
34.5places of business and withdrawals of cash at automatic teller machines located in their
34.6places of business.
34.7 Sec. 39. MINNESOTA EBT BUSINESS TASK FORCE.
34.8 Subdivision 1. Members. The Minnesota EBT Business Task Force includes seven
34.9members, appointed as follows:
34.10(1) two members of the Minnesota house of representatives appointed by the speaker
34.11of the house;
34.12(2) two members of the Minnesota senate appointed by the senate majority leader;
34.13(3) the commissioner of human services, or designee;
34.14(4) an appointee of the Minnesota Grocers Association; and
34.15(5) a credit card processor, appointed by the commissioner of human services.
34.16 Subd. 2. Duties. The Minnesota EBT Business Task Force shall create a workable
34.17strategy to eliminate the purchase of tobacco and alcoholic beverages by recipients of the
34.18general assistance program and Minnesota supplemental aid program under Minnesota
34.19Statutes, chapter 256D, and programs under Minnesota Statutes, chapter 256J, using EBT
34.20cards. The task force will consider cost to the state, feasibility of execution at retail, and
34.21ease of use and privacy for EBT cardholders.
34.22 Subd. 3. Report. The task force will report back to the legislative committees with
34.23jurisdiction over health and human services policy and finance by April 1, 2012, with
34.24recommendations related to the task force duties under subdivision 2.
34.25 Subd. 4. Expiration. The task force expires on June 30, 2012.
34.26 Sec. 40. STREAMLINING CHILDREN AND COMMUNITY SERVICES ACT
34.28 The commissioner of human services and county human services representatives, in
34.29consultation with other interested parties, shall develop a streamlined alternative to current
34.30reporting requirements related to the Children and Community Services Act service plan.
34.31The commissioner shall submit recommendations and draft legislation to the chairs and
35.1ranking minority members of the committees having jurisdiction over human services no
35.2later than November 15, 2012.
35.3 Sec. 41. REVISOR'S INSTRUCTION.
35.4The revisor of statutes shall make conforming amendments and correct statutory
35.5cross-references as necessitated by the creation of Minnesota Statutes, chapter 256N, and
35.6related repealers in this article.
35.7 Sec. 42. REPEALER.
35.8(a) Minnesota Statutes 2010, section 256.9862, subdivision 2, is repealed effective
35.9February 1, 2012.
35.10(b) Minnesota Statutes 2010, sections 256.979, subdivisions 5, 6, 7, and 10;
35.11256.9791; 256D.01, subdivisions 1, 1a, 1b, 1e, and 2; 256D.03, subdivisions 1, 2, and 2a;
35.12256D.05, subdivisions 1, 2, 4, 5, 6, 7, and 8; 256D.0513; 256D.06, subdivisions 1, 1b, 2,
35.135, 7, and 8; 256D.09, subdivisions 1, 2, 2a, 2b, 5, and 6; 256D.10; 256D.13; 256D.15;
35.14256D.16; 256D.35, subdivision 8b; and 256D.46, are repealed effective October 1, 2012.
35.15(c) Minnesota Rules, part 3400.0130, subpart 8, is repealed effective September
35.17(d) Minnesota Rules, part 9500.1261, subparts 3, items D and E, 4, and 5, are
35.18repealed effective November 1, 2011.
35.21 Section 1. Minnesota Statutes 2010, section 62D.08, subdivision 7, is amended to read:
35.22 Subd. 7. Consistent administrative expenses and investment income reporting.
35.23(a) Every health maintenance organization must directly allocate administrative expenses
35.24to specific lines of business or products when such information is available. The definition
35.25of administrative expenses must be consistent with that of the National Association of
35.26Insurance Commissioners (NAIC) as provided in the most current NAIC blank. Remaining
35.27expenses that cannot be directly allocated must be allocated based on other methods, as
35.28recommended by the Advisory Group on Administrative Expenses. Health maintenance
35.29organizations must submit this information, including administrative expenses for dental
35.30services, using the reporting template provided by the commissioner of health.
35.31(b) Every health maintenance organization must allocate investment income based
35.32on cumulative net income over time by business line or product and must submit this
36.1information, including investment income for dental services, using the reporting template
36.2provided by the commissioner of health.
36.3 Sec. 2. Minnesota Statutes 2010, section 62J.04, subdivision 3, is amended to read:
36.4 Subd. 3. Cost containment duties. The commissioner shall:
36.5(1) establish statewide and regional cost containment goals for total health care
36.6spending under this section and collect data as described in sections
36.762J.40 to monitor statewide achievement of the cost containment goals;
36.8(2) divide the state into no fewer than four regions, with one of those regions being
36.9the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
36.10Wright, and Sherburne Counties, for purposes of fostering the development of regional
36.11health planning and coordination of health care delivery among regional health care
36.12systems and working to achieve the cost containment goals;
36.13(3) monitor the quality of health care throughout the state and take action as
36.14necessary to ensure an appropriate level of quality;
36.15(4) issue recommendations regarding uniform billing forms, uniform electronic
36.16billing procedures and data interchanges, patient identification cards, and other uniform
36.17claims and administrative procedures for health care providers and private and public
36.18sector payers. In developing the recommendations, the commissioner shall review the
36.19work of the work group on electronic data interchange (WEDI) and the American National
36.20Standards Institute (ANSI) at the national level, and the work being done at the state and
36.21local level. The commissioner may adopt rules requiring the use of the Uniform Bill
36.2282/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
36.23version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
36.24forms or procedures;
36.25(5) undertake health planning responsibilities;
36.26(6) authorize, fund, or promote research and experimentation on new technologies
36.27and health care procedures;
36.28(7) within the limits of appropriations for these purposes, administer or contract for
36.29statewide consumer education and wellness programs that will improve the health of
36.30Minnesotans and increase individual responsibility relating to personal health and the
36.31delivery of health care services, undertake prevention programs including initiatives to
36.32improve birth outcomes, expand childhood immunization efforts, and provide start-up
36.33grants for worksite wellness programs;
37.1(8) undertake other activities to monitor and oversee the delivery of health care
37.2services in Minnesota with the goal of improving affordability, quality, and accessibility of
37.3health care for all Minnesotans; and
37.4(9) make the cost containment goal data available to the public in a
37.6EFFECTIVE DATE.This section is effective July 1, 2011.
37.7 Sec. 3. Minnesota Statutes 2010, section 62J.17, subdivision 4a, is amended to read:
37.8 Subd. 4a. Expenditure reporting. Each hospital, outpatient surgical center,
37.9diagnostic imaging center, and physician clinic shall report annually to the commissioner
37.10on all major spending commitments, in the form and manner specified by the
37.11commissioner. The report shall include the following information:
37.12 (a) a description of major spending commitments made during the previous year,
37.13including the total dollar amount of major spending commitments and purpose of the
37.15 (b) the cost of land acquisition, construction of new facilities, and renovation of
37.17 (c) the cost of purchased or leased medical equipment, by type of equipment;
37.18 (d) expenditures by type for specialty care and new specialized services;
37.19 (e) information on the amount and types of added capacity for diagnostic imaging
37.20services, outpatient surgical services, and new specialized services; and
37.21 (f) information on investments in electronic medical records systems.
37.22For hospitals and outpatient surgical centers, this information shall be included in reports
37.23to the commissioner that are required under section
37.24centers, this information shall be included in reports to the commissioner that are required
37.27providers that are subject to this reporting requirement, reports must be submitted to the
37.28commissioner by March 1 each year for the preceding calendar year.
37.29EFFECTIVE DATE.This section is effective July 1, 2011.
37.30 Sec. 4. Minnesota Statutes 2010, section 62J.495, is amended by adding a subdivision
37.32 Subd. 7. Exemption. Any clinical practice with a total annual net revenue of less
37.33than $500,000, and that has not received a state or federal grant for implementation
38.1of electronic health records, is exempt from the requirements of subdivision 1. This
38.2subdivision expires December 31, 2020.
38.3 Sec. 5. Minnesota Statutes 2010, section 62J.692, is amended to read:
38.462J.692 MEDICAL EDUCATION.
38.5 Subdivision 1. Definitions. For purposes of this section, the following definitions
38.7 (a) "Accredited clinical training" means the clinical training provided by a
38.8medical education program that is accredited through an organization recognized by the
38.9Department of Education, the Centers for Medicare and Medicaid Services, or another
38.10national body who reviews the accrediting organizations for multiple disciplines and
38.11whose standards for recognizing accrediting organizations are reviewed and approved by
38.12the commissioner of health in consultation with the Medical Education and Research
38.14 (b) "Commissioner" means the commissioner of health.
38.15 (c) "Clinical medical education program" means the accredited clinical training of
38.16physicians (medical students and residents), doctor of pharmacy practitioners, doctors
38.17of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
38.18registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
38.20 (d) "Sponsoring institution" means a hospital, school, or consortium located in
38.21Minnesota that sponsors and maintains primary organizational and financial responsibility
38.22for a clinical medical education program in Minnesota and which is accountable to the
38.24 (e) "Teaching institution" means a hospital, medical center, clinic, or other
38.25organization that conducts a clinical medical education program in Minnesota.
38.26 (f) "Trainee" means a student or resident involved in a clinical medical education
38.28 (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
38.29equivalent counts, that are at training sites located in Minnesota with currently active
38.30medical assistance enrollment status and a National Provider Identification (NPI) number
38.31where training occurs in either an inpatient or ambulatory patient care setting and where
38.32the training is funded, in part, by patient care revenues. Training that occurs in nursing
38.33facility settings is not eligible for funding under this section.
38.34 Subd. 3. Application process. (a) A clinical medical education program
38.35conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy
39.1practitioners, dentists, chiropractors, or physician assistants is eligible for funds under
39.2subdivision 4 or 11, as appropriate, if the program:
39.3(1) is funded, in part, by patient care revenues;
39.4(2) occurs in patient care settings that face increased financial pressure as a result
39.5of competition with nonteaching patient care entities; and
39.6(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
39.10(b) A clinical medical education program for advanced practice nursing is eligible
39.11for funds under subdivision 4 or 11, as appropriate, if the program meets the eligibility
39.12requirements in paragraph (a), clauses (1) to (3), and is sponsored by the University of
39.13Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part
39.14of the Minnesota State Colleges and Universities system or members of the Minnesota
39.15Private College Council.
39.16(c) Applications must be submitted to the commissioner by a sponsoring institution
39.17on behalf of an eligible clinical medical education program and must be received by
39.18October 31 of each year for distribution in the following year. An application for funds
39.19must contain the following information:
39.20(1) the official name and address of the sponsoring institution and the official
39.21name and site address of the clinical medical education programs on whose behalf the
39.22sponsoring institution is applying;
39.23(2) the name, title, and business address of those persons responsible for
39.24administering the funds;
39.25(3) for each clinical medical education program for which funds are being sought;
39.26the type and specialty orientation of trainees in the program; the name, site address, and
39.27medical assistance provider number and national provider identification number of each
39.28training site used in the program; the federal tax identification number of each training site
39.29used in the program, where available; the total number of trainees at each training site; and
39.30the total number of eligible trainee FTEs at each site; and
39.31(4) other supporting information the commissioner deems necessary to determine
39.32program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
39.33equitable distribution of funds.
39.34(d) An application must include the information specified in clauses (1) to (3) for
39.35each clinical medical education program on an annual basis for three consecutive years.
40.1After that time, an application must include the information specified in clauses (1) to (3)
40.2when requested, at the discretion of the commissioner:
40.3(1) audited clinical training costs per trainee for each clinical medical education
40.4program when available or estimates of clinical training costs based on audited financial
40.6(2) a description of current sources of funding for clinical medical education costs,
40.7including a description and dollar amount of all state and federal financial support,
40.8including Medicare direct and indirect payments; and
40.9(3) other revenue received for the purposes of clinical training.
40.10(e) An applicant that does not provide information requested by the commissioner
40.11shall not be eligible for funds for the current funding cycle.
40.12 Subd. 4. Distribution of funds. (a) Following the distribution described under
40.13paragraph (b), the commissioner shall annually distribute the available medical education
40.14funds to all qualifying applicants based on a distribution formula that reflects a summation
40.15of two factors:
40.16 (1) a public program volume factor, which is determined by the total volume of
40.17public program revenue received by each training site as a percentage of all public
40.18program revenue received by all training sites in the fund pool; and
40.19 (2) a supplemental public program volume factor, which is determined by providing
40.20a supplemental payment of 20 percent of each training site's grant to training sites whose
40.21public program revenue accounted for at least 0.98 percent of the total public program
40.22revenue received by all eligible training sites. Grants to training sites whose public
40.23program revenue accounted for less than 0.98 percent of the total public program revenue
40.24received by all eligible training sites shall be reduced by an amount equal to the total
40.25value of the supplemental payment.
40.26 Public program revenue for the distribution formula includes revenue from medical
40.27assistance, prepaid medical assistance, general assistance medical care, and prepaid
40.28general assistance medical care. Training sites that receive no public program revenue
40.29are ineligible for funds available under this subdivision. For purposes of determining
40.30training-site level grants to be distributed under paragraph (a), total statewide average
40.31costs per trainee for medical residents is based on audited clinical training costs per trainee
40.32in primary care clinical medical education programs for medical residents. Total statewide
40.33average costs per trainee for dental residents is based on audited clinical training costs
40.34per trainee in clinical medical education programs for dental students. Total statewide
40.35average costs per trainee for pharmacy residents is based on audited clinical training costs
40.36per trainee in clinical medical education programs for pharmacy students. Training sites
41.1whose training site level grant is less than $1,000, based on the formula described in this
41.2paragraph, are ineligible for funds available under this subdivision.
41.4distributed as follows:
41.8distributed to the Academic Health Center under this paragraph shall be used for a
41.9program to assist internationally trained physicians who are legal residents and who
41.10commit to serving underserved Minnesota communities in a health professional shortage
41.11area to successfully compete for family medicine residency programs at the University
41.13 (c) Funds distributed shall not be used to displace current funding appropriations
41.14from federal or state sources.
41.15 (d) Funds shall be distributed to the sponsoring institutions indicating the amount
41.16to be distributed to each of the sponsor's clinical medical education programs based on
41.17the criteria in this subdivision and in accordance with the commissioner's approval letter.
41.18Each clinical medical education program must distribute funds allocated under paragraph
41.19(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
41.20institutions, which are accredited through an organization recognized by the Department
41.21of Education or the Centers for Medicare and Medicaid Services, may contract directly
41.22with training sites to provide clinical training. To ensure the quality of clinical training,
41.23those accredited sponsoring institutions must:
41.24 (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
41.25training conducted at sites; and
41.26 (2) take necessary action if the contract requirements are not met. Action may
41.27include the withholding of payments under this section or the removal of students from
41.29 (e) Any funds not distributed in accordance with the commissioner's approval letter
41.30must be returned to the medical education and research fund within 30 days of receiving
41.31notice from the commissioner. The commissioner shall distribute returned funds to the
41.32appropriate training sites in accordance with the commissioner's approval letter.
41.33 (f) A maximum of $150,000 of the funds dedicated to the commissioner under
41.35administrative expenses associated with implementing this section.
42.1 Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section
42.2must sign and submit a medical education grant verification report (GVR) to verify that
42.3the correct grant amount was forwarded to each eligible training site. If the sponsoring
42.4institution fails to submit the GVR by the stated deadline, or to request and meet
42.5the deadline for an extension, the sponsoring institution is required to return the full
42.6amount of funds received to the commissioner within 30 days of receiving notice from
42.7the commissioner. The commissioner shall distribute returned funds to the appropriate
42.8training sites in accordance with the commissioner's approval letter.
42.9 (b) The reports must provide verification of the distribution of the funds and must
42.11 (1) the total number of eligible trainee FTEs in each clinical medical education
42.13 (2) the name of each funded program and, for each program, the dollar amount
42.14distributed to each training site;
42.15 (3) documentation of any discrepancies between the initial grant distribution notice
42.16included in the commissioner's approval letter and the actual distribution;
42.17 (4) a statement by the sponsoring institution stating that the completed grant
42.18verification report is valid and accurate; and
42.19 (5) other information the commissioner, with advice from the advisory committee,
42.20deems appropriate to evaluate the effectiveness of the use of funds for medical education.
42.21 (c) By February 15 of each year, the commissioner, with advice from the
42.22advisory committee, shall provide an annual summary report to the legislature on the
42.23implementation of this section.
42.24 Subd. 6. Other available funds. The commissioner is authorized to distribute, in
42.25accordance with subdivision 4 or 11, as appropriate, funds made available through:
42.26(1) voluntary contributions by employers or other entities;
42.27(2) allocations for the commissioner of human services to support medical education
42.28and research; and
42.29(3) other sources as identified and deemed appropriate by the legislature for
42.30inclusion in the fund.
42.31 Subd. 7. Transfers from the commissioner of human services. Of the amount
42.32transferred according to section
42.33$21,714,000 shall be distributed as follows:
42.34(1) $2,157,000 shall be distributed by the commissioner to the University of
42.35Minnesota Board of Regents for the purposes described in sections
43.1(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
43.2Medical Center for clinical medical education;
43.3(3) $17,400,000 shall be distributed by the commissioner to the University of
43.4Minnesota Board of Regents for purposes of medical education;
43.5(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
43.6dental innovation grants in accordance with subdivision 7a; and
43.7(5) the remainder of the amount transferred according to section
43.8subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
43.9clinical medical education programs that meet the qualifications of subdivision 3 based on
43.10the formula in subdivision 4, paragraph (a), or 11, as appropriate.
43.11 Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
43.12shall award grants to teaching institutions and clinical training sites for projects that
43.13increase dental access for underserved populations and promote innovative clinical
43.14training of dental professionals. In awarding the grants, the commissioner, in consultation
43.15with the commissioner of human services, shall consider the following:
43.16(1) potential to successfully increase access to an underserved population;
43.17(2) the long-term viability of the project to improve access beyond the period
43.18of initial funding;
43.19(3) evidence of collaboration between the applicant and local communities;
43.20(4) the efficiency in the use of the funding; and
43.21(5) the priority level of the project in relation to state clinical education, access,
43.22and workforce goals.
43.23(b) The commissioner shall periodically evaluate the priorities in awarding the
43.24innovations grants in order to ensure that the priorities meet the changing workforce
43.25needs of the state.
43.26 Subd. 8. Federal financial participation. The commissioner of human services
43.27shall seek to maximize federal financial participation in payments for medical education
43.28and research costs.
43.29 The commissioner shall use physician clinic rates where possible to maximize
43.30federal financial participation. Any additional funds that become available must be
43.31distributed under subdivision 4, paragraph (a), or 11, as appropriate.
43.32 Subd. 9. Review of eligible providers. The commissioner and the Medical
43.33Education and Research Costs Advisory Committee may review provider groups included
43.34in the definition of a clinical medical education program to assure that the distribution of
43.35the funds continue to be consistent with the purpose of this section. The results of any
43.36such reviews must be reported to the Legislative Commission on Health Care Access.
44.1 Subd. 11. Distribution of funds. (a) Upon receiving federal approval, the
44.2commissioner shall annually distribute the available medical education funds to all
44.3qualifying applicants based on the distribution formula provided in this subdivision, which
44.4supersedes the formula described in subdivision 4, paragraph (a).
44.5(1) Following the distribution of funds described under subdivision 4, paragraph
44.6(b), the commissioner shall annually distribute the available medical education funds
44.7to all qualifying applicants based on a distribution formula that reflects a summation
44.8of two factors:
44.9(i) a public program volume factor, which is determined by the total volume of
44.10public program revenue received by each training site as a percentage of all public
44.11program revenue received by all training sites in the fund pool; and
44.12(ii) a supplemental public program volume factor, which is determined by providing
44.13a supplemental payment of 20 percent of each training site's grant to training sites whose
44.14public program revenue accounted for at least 0.98 percent of the total public program
44.15revenue received by all eligible training sites. Grants to training sites whose public
44.16program revenue accounted for less than 0.98 percent of the total public program revenue
44.17received by all eligible training sites shall be reduced by an amount equal to the total
44.18value of the supplemental payment.
44.19Public program revenue for the distribution formula includes revenue from medical
44.20assistance, prepaid medical assistance, general assistance medical care, and prepaid
44.21general assistance medical care. Training sites that receive no public program revenue are
44.22ineligible for funds available under this subdivision. For purposes of determining training
44.23site level grants to be distributed under paragraph (a), total statewide average costs per
44.24trainee for medical residents is based on audited clinical training costs per trainee in
44.25primary care clinical medical education programs for medical residents. Total statewide
44.26average costs per trainee for dental residents is based on audited clinical training costs
44.27per trainee in clinical medical education programs for dental students. Total statewide
44.28average costs per trainee for pharmacy residents is based on audited clinical training costs
44.29per trainee in clinical medical education programs for pharmacy students.
44.30(2) Ten percent of available medical education funds shall be used to create a primary
44.31care bonus pool. Grants to eligible training sites under this clause shall be determined by
44.32dividing the total number of eligible FTE trainees from primary care medicine, advanced
44.33practice nursing, or physician assistant programs at all eligible training sites by the amount
44.34of funds available in the primary care bonus pool to determine a grant per primary care
44.35FTE; each eligible training site shall receive a grant equal to the grant per primary care
44.36FTE multiplied by the number of eligible primary care FTE's at the training site.
45.1(3) After determining the grant amount for each training site under clause (1), items
45.2(i) and (ii), and clause (2), the commissioner shall calculate a grant per eligible trainee for
45.3each training site. Any training site whose grant per eligible trainee is greater than the
45.495th percentile grant per eligible trainee shall have the grant amount reduced to the 95th
45.5percentile grant per eligible trainee. Grants in excess of this amount for any training site
45.6shall be redistributed based on the criteria in clause (4).
45.7Any training site with fewer than 0.1 FTE eligible trainees from all programs or a
45.8calculated grant less than $1,000 based on the formula described in clauses (1) and (2)
45.9shall be eliminated from the distribution; the calculated grants for these training sites shall
45.10be redistributed based on the criteria in clause (4).
45.11(4) The commissioner shall award from available funds appropriated for this purpose
45.12and equally divided between the following programs:
45.13(i) the community mental health center grants program under section 145.9272; and
45.14(ii) the community health centers development grants program under section
45.16If federal approval for this funding mechanism is not received for either of the grant
45.17programs described in this paragraph, available funds will be provided to the remaining
45.18grant program described in this paragraph. If none of the grant programs described in this
45.19paragraph receive federal approval, available funds will be distributed to eligible training
45.20sites based on the formula in clauses (1) to (3).
45.21(b) Funds distributed shall not be used to displace current funding appropriations
45.22from federal or state sources.
45.23(c) Funds shall be distributed to the sponsoring institutions indicating the amount
45.24to be distributed to each of the sponsor's clinical medical education programs based on
45.25the criteria in this subdivision and according to the commissioner's approval letter. Each
45.26clinical medical education program must distribute funds allocated under paragraph
45.27(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
45.28institutions, which are accredited through an organization recognized by the Department
45.29of Education or the Centers for Medicare and Medicaid Services, may contract directly
45.30with training sites to provide clinical training. To ensure the quality of clinical training,
45.31those accredited sponsoring institutions must:
45.32(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
45.33training conducted at sites; and
45.34(2) take necessary action if the contract requirements are not met. Action may
45.35include the withholding of payments under this section or the removal of students from
46.1(d) Any funds not distributed according to the commissioner's approval letter must
46.2be returned to the medical education and research fund within 30 days of receiving
46.3notice from the commissioner. The commissioner shall distribute returned funds to the
46.4appropriate training sites according to the commissioner's approval letter.
46.5(e) A maximum of $150,000 of the funds dedicated to the commissioner under
46.6section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
46.7administrative expenses associated with implementing this section.
46.8 Sec. 6. [62U.15] ALZHEIMER'S DISEASE; PREVALENCE AND SCREENING
46.10 Subdivision 1. Data from providers. (a) By July 1, 2012, the commissioner
46.11shall review currently available quality measures and make recommendations for future
46.12measurement aimed at improving assessment and care related to Alzheimer's disease and
46.13other dementia diagnoses, including improved rates and results of cognitive screening,
46.14rates of Alzheimer's and other dementia diagnoses, and prescribed care and treatment
46.16(b) The commissioner may contract with a private entity to complete the
46.17requirements in this subdivision. If the commissioner contracts with a private entity
46.18already under contract through section 62U.02, then the commissioner may use a sole
46.19source contract and is exempt from competitive procurement processes.
46.20 Subd. 2. Learning collaborative. By July 1, 2012, the commissioner shall
46.21develop a health care home learning collaborative curriculum that includes screening and
46.22education on best practices regarding identification and management of Alzheimer's and
46.23other dementia patients under section 256B.0751, subdivision 5, for providers, clinics,
46.24care coordinators, clinic administrators, patient partners and families, and community
46.25resources including public health.
46.26 Subd. 3. Comparison data. The commissioner, with the commissioner of human
46.27services, the Minnesota Board on Aging, and other appropriate state offices, shall jointly
46.28review existing and forthcoming literature in order to estimate differences in the outcomes
46.29and costs of current practices for caring for those with Alzheimer's disease and other
46.30dementias, compared to the outcomes and costs resulting from:
46.31(1) earlier identification of Alzheimer's and other dementias;
46.32(2) improved support of family caregivers; and
46.33(3) improved collaboration between medical care management and community-based
47.1 Subd. 4. Reporting. By January 15, 2013, the commissioner must report to the
47.2legislature on progress toward establishment and collection of quality measures required
47.3under this section.
47.4 Sec. 7. Minnesota Statutes 2010, section 144.1501, subdivision 1, is amended to read:
47.5 Subdivision 1. Definitions. (a) For purposes of this section, the following definitions
47.7(b) "Dentist" means an individual who is licensed to practice dentistry.
47.8(c) "Designated rural area" means
47.14an area defined as a small rural area or isolated rural area according to the four category
47.15classifications of the Rural Urban Commuting Area system developed for the United
47.16States Health Resources and Services Administration.
47.17(d) "Emergency circumstances" means those conditions that make it impossible for
47.18the participant to fulfill the service commitment, including death, total and permanent
47.19disability, or temporary disability lasting more than two years.
47.20(e) "Medical resident" means an individual participating in a medical residency in
47.21family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
47.22(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
47.23anesthetist, advanced clinical nurse specialist, or physician assistant.
47.24(g) "Nurse" means an individual who has completed training and received all
47.25licensing or certification necessary to perform duties as a licensed practical nurse or
47.27(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
47.28study designed to prepare registered nurses for advanced practice as nurse-midwives.
47.29(i) "Nurse practitioner" means a registered nurse who has graduated from a program
47.30of study designed to prepare registered nurses for advanced practice as nurse practitioners.
47.31(j) "Pharmacist" means an individual with a valid license issued under chapter 151.
47.32(k) "Physician" means an individual who is licensed to practice medicine in the areas
47.33of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
47.34(l) "Physician assistant" means a person licensed under chapter 147A.
48.1(m) "Qualified educational loan" means a government, commercial, or foundation
48.2loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
48.3expenses related to the graduate or undergraduate education of a health care professional.
48.4(n) "Underserved urban community" means a Minnesota urban area or population
48.5included in the list of designated primary medical care health professional shortage areas
48.6(HPSAs), medically underserved areas (MUAs), or medically underserved populations
48.7(MUPs) maintained and updated by the United States Department of Health and Human
48.9 Sec. 8. Minnesota Statutes 2010, section 144.396, subdivision 5, is amended to read:
48.10 Subd. 5. Statewide tobacco prevention grants. (a) To the extent funds are
48.11appropriated for the purposes of this subdivision, the commissioner of health shall, within
48.12available appropriations, award competitive grants to eligible applicants for projects and
48.13initiatives directed at the prevention of tobacco use. The project areas for grants include:
48.14(1) statewide public education and information campaigns which include
48.15implementation at the local level; and
48.16(2) coordinated special projects, including training and technical assistance, a
48.17resource clearinghouse, and contracts with ethnic and minority communities.
48.18(b) Eligible applicants may include, but are not limited to, nonprofit organizations,
48.19colleges and universities, professional health associations, community health boards, and
48.20other health care organizations. Applicants must submit proposals to the commissioner.
48.21The proposals must specify the strategies to be implemented to target tobacco use among
48.22youth, and must take into account the need for a coordinated statewide tobacco prevention
48.24(c) The commissioner must give priority to applicants who demonstrate that the
48.26(1) is research based or based on proven effective strategies;
48.27(2) is designed to coordinate with other activities and education messages related
48.28to other health initiatives;
48.29(3) utilizes and enhances existing prevention activities and resources; or
48.30(4) involves innovative approaches preventing tobacco use among youth.
48.31 Sec. 9. Minnesota Statutes 2010, section 144.396, subdivision 6, is amended to read:
48.32 Subd. 6. Local tobacco prevention grants. (a) The commissioner shall award
48.33grants, within available appropriations, to eligible applicants for local and regional
48.34projects and initiatives directed at tobacco prevention in coordination with other health
49.1areas aimed at reducing high-risk behaviors in youth that lead to adverse health-related
49.2problems. The project areas for grants include:
49.3(1) school-based tobacco prevention programs aimed at youth and parents;
49.4(2) local public awareness and education projects aimed at tobacco prevention in
49.5coordination with locally assessed community public health needs pursuant to chapter
49.7(3) local initiatives aimed at reducing high-risk behavior in youth associated with
49.8tobacco use and the health consequences of these behaviors.
49.9(b) Eligible applicants may include, but are not limited to, community health boards,
49.10school districts, community clinics, Indian tribes, nonprofit organizations, and other health
49.11care organizations. Applicants must submit proposals to the commissioner. The proposals
49.12must specify the strategies to be implemented to target tobacco use among youth, and must
49.13be targeted to achieve the outcomes established in subdivision 2.
49.14(c) The commissioner must give priority to applicants who demonstrate that the
49.15proposed project or initiative is:
49.16(1) supported by the community in which the applicant serves;
49.17(2) is based on research or on proven effective strategies;
49.18(3) is designed to coordinate with other community activities related to other health
49.20(4) incorporates an understanding of the role of community in influencing behavioral
49.21changes among youth regarding tobacco use and other high-risk health-related behaviors;
49.23(5) addresses disparities among populations of color related to tobacco use and
49.24other high-risk health-related behaviors.
49.25(d) The commissioner shall divide the state into specific geographic regions and
49.26allocate a percentage of the money available for distribution to projects or initiatives
49.27aimed at that geographic region. If the commissioner does not receive a sufficient number
49.28of grant proposals from applicants that serve a particular region or the proposals submitted
49.29do not meet the criteria developed by the commissioner, the commissioner shall provide
49.30technical assistance and expertise to ensure the development of adequate proposals
49.31aimed at addressing the public health needs of that region. In awarding the grants, the
49.32commissioner shall consider locally assessed community public health needs pursuant to
49.34 Sec. 10. Minnesota Statutes 2010, section 144.98, subdivision 2a, is amended to read:
50.1 Subd. 2a. Standards. Notwithstanding the exemptions in subdivisions 8 and 9, the
50.2commissioner shall accredit laboratories according to the most current environmental
50.3laboratory accreditation standards under subdivision 1 and as accepted by the accreditation
50.4bodies recognized by the National Environmental Laboratory Accreditation Program
50.5(NELAP) of the NELAC Institute.
50.6 Sec. 11. Minnesota Statutes 2010, section 144.98, subdivision 7, is amended to read:
50.7 Subd. 7. Initial accreditation and annual accreditation renewal. (a) The
50.8commissioner shall issue or renew accreditation after receipt of the completed application
50.9and documentation required in this section, provided the laboratory maintains compliance
50.10with the standards specified in subdivision 2a, notwithstanding any exemptions under
50.11subdivisions 8 and 9, and attests to the compliance on the application form.
50.12(b) The commissioner shall prorate the fees in subdivision 3 for laboratories
50.13applying for accreditation after December 31. The fees are prorated on a quarterly basis
50.14beginning with the quarter in which the commissioner receives the completed application
50.15from the laboratory.
50.16(c) Applications for renewal of accreditation must be received by November 1 and
50.17no earlier than October 1 of each year. The commissioner shall send annual renewal
50.18notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
50.19not exempt laboratories from meeting the annual November 1 renewal date.
50.20(d) The commissioner shall issue all accreditations for the calendar year for which
50.21the application is made, and the accreditation shall expire on December 31 of that year.
50.22(e) The accreditation of any laboratory that fails to submit a renewal application
50.23and fees to the commissioner expires automatically on December 31 without notice or
50.24further proceeding. Any person who operates a laboratory as accredited after expiration of
50.25accreditation or without having submitted an application and paid the fees is in violation
50.26of the provisions of this section and is subject to enforcement action under sections
50.28accreditation may reapply under subdivision 6.
50.29 Sec. 12. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
50.31 Subd. 8. Exemption from national standards for quality control and personnel
50.32requirements. Effective January 1, 2012, a laboratory that analyzes samples for
50.33compliance with a permit issued under section 115.03, subdivision 5, may request
50.34exemption from the personnel requirements and specific quality control provisions for
51.1microbiology and chemistry stated in the national standards as incorporated by reference
51.2in subdivision 2a. The commissioner shall grant the exemption if the laboratory:
51.3(1) complies with the methodology and quality control requirements, where
51.4available, in the most recent, approved edition of the Standard Methods for the
51.5Examination of Water and Wastewater as published by the Water Environment Federation;
51.7(2) supplies the name of the person meeting the requirements in section 115.73, or
51.8the personnel requirements in the national standard pursuant to subdivision 2a.
51.9A laboratory applying for this exemption shall not apply for simultaneous
51.10accreditation under the national standard.
51.11 Sec. 13. Minnesota Statutes 2010, section 144.98, is amended by adding a subdivision
51.13 Subd. 9. Exemption from national standards for proficiency testing frequency.
51.14(a) Effective January 1, 2012, a laboratory applying for or requesting accreditation under
51.15the exemption in subdivision 8 must obtain an acceptable proficiency test result for each
51.16of the laboratory's accredited or requested fields of testing. The laboratory must analyze
51.17proficiency samples selected from one of two annual proficiency testing studies scheduled
51.18by the commissioner.
51.19(b) If a laboratory fails to successfully complete the first scheduled proficiency
51.20study, the laboratory shall:
51.21(1) obtain and analyze a supplemental test sample within 15 days of receiving the
51.22test report for the initial failed attempt; and
51.23(2) participate in the second annual study as scheduled by the commissioner.
51.24(c) If a laboratory does not submit results or fails two consecutive proficiency
51.25samples, the commissioner will revoke the laboratory's accreditation for the affected
51.26fields of testing.
51.27(d) The commissioner may require a laboratory to analyze additional proficiency
51.28testing samples beyond what is required in this subdivision if information available to
51.29the commissioner indicates that the laboratory's analysis for the field of testing does not
51.30meet the requirements for accreditation.
51.31(e) The commissioner may collect from laboratories accredited under the exemption
51.32in subdivision 8 any additional costs required to administer this subdivision and
51.34 Sec. 14. Minnesota Statutes 2010, section 144A.102, is amended to read:
52.1144A.102 WAIVER FROM FEDERAL RULES AND REGULATIONS;
52.3(a) By January 2000, the commissioner of health shall work with providers to
52.4examine state and federal rules and regulations governing the provision of care in licensed
52.5nursing facilities and apply for federal waivers and identify necessary changes in state
52.7(1) allow the use of civil money penalties imposed upon nursing facilities to abate
52.8any deficiencies identified in a nursing facility's plan of correction; and
52.9(2) stop the accrual of any fine imposed by the Health Department when a follow-up
52.10inspection survey is not conducted by the department within the regulatory deadline.
52.11(b) By January 2012, the commissioner of health shall work with providers and
52.12the ombudsman for long-term care to examine state and federal rules and regulations
52.13governing the provision of care in licensed nursing facilities and apply for federal waivers
52.14and identify necessary changes in state law to:
52.15(1) eliminate the requirement for written plans of correction from nursing homes for
52.16federal deficiencies issued at a scope and severity that is not widespread, harmful, or in
52.17immediate jeopardy; and
52.18(2) issue the federal survey form electronically to nursing homes.
52.19The commissioner shall issue a report to the legislative chairs of the committees
52.20with jurisdiction over health and human services by January 31, 2012, on the status of
52.21implementation of this paragraph.
52.22 Sec. 15. Minnesota Statutes 2010, section 144A.61, is amended by adding a
52.23subdivision to read:
52.24 Subd. 9. Electronic transmission. The commissioner of health must accept
52.25electronic transmission of applications and supporting documentation for interstate
52.26endorsement for the nursing assistant registry.
52.27 Sec. 16. Minnesota Statutes 2010, section 144E.123, is amended to read:
52.28144E.123 PREHOSPITAL CARE DATA.
52.29 Subdivision 1. Collection and maintenance. A licensee shall collect and provide
52.30prehospital care data to the board in a manner prescribed by the board. At a minimum,
52.31the data must include items identified by the board that are part of the National Uniform
52.32Emergency Medical Services Data Set. A licensee shall maintain prehospital care data
52.33for every response.
53.1 Subd. 2. Copy to receiving hospital. If a patient is transported to a hospital, a copy
53.2of the ambulance report delineating prehospital medical care given shall be provided
53.3to the receiving hospital.
53.4 Subd. 3. Review. Prehospital care data may be reviewed by the board or its
53.5designees. The data shall be classified as private data on individuals under chapter 13, the
53.6Minnesota Government Data Practices Act.
53.9 Subd. 5. Working group. By October 1, 2011, the board must convene a working
53.10group composed of six members, three of which must be appointed by the board and three
53.11of which must be appointed by the Minnesota Ambulance Association, to redesign the
53.12board's policies related to collection of data from licenses. The issues to be considered
53.13include, but are not limited to, the following: user-friendly reporting requirements; data
53.14sets; improved accuracy of reported information; appropriate use of information gathered
53.15through the reporting system; and methods for minimizing the financial impact of data
53.16reporting on licenses, particularly for rural volunteer services. The working group must
53.17report its findings and recommendations to the board no later than July 1, 2012.
53.18EFFECTIVE DATE.This section is effective the day following final enactment.
53.19 Sec. 17. [145.4221] HUMAN CLONING PROHIBITED.
53.20 Subdivision 1. Definitions. (a) For purposes of this section, the following terms
53.21have the meanings given.
53.22(b) "Human cloning" means human asexual reproduction accomplished by
53.23introducing nuclear material from one or more human somatic cells into a fertilized
53.24or unfertilized oocyte whose nuclear material has been removed or inactivated so as
53.25to produce a living organism at any stage of development that is genetically virtually
53.26identical to an existing or previously existing human organism.
53.27(c) "Somatic cell" means a diploid cell, having a complete set of chromosomes,
53.28obtained or derived from a living or deceased human body at any stage of development.
53.29 Subd. 2. Prohibition on cloning. No person or entity, whether public or private,
53.31(1) perform or attempt to perform human cloning;
53.32(2) participate in an attempt to perform human cloning;
53.33(3) ship, import, or receive for any purpose an embryo produced by human cloning
53.34or any product derived from such an embryo; or
54.1(4) ship or receive, in whole or in part, any oocyte, embryo, fetus, or human somatic
54.2cell, for the purpose of human cloning.
54.3 Subd. 3. Scientific research. Nothing in this section shall restrict areas of scientific
54.4research not specifically prohibited by this section, including research in the use of nuclear
54.5transfer or other cloning techniques to produce molecules, DNA, cells other than human
54.6embryos, tissues, organs, plants, or animals other than humans. In addition, nothing in this
54.7section shall restrict, inhibit, or make unlawful the scientific field of stem cell research,
54.8unless explicitly prohibited.
54.9 Subd. 4. Penalties. Any person or entity that knowingly or recklessly violates
54.10subdivision 2 is guilty of a misdemeanor.
54.11 Subd. 5. Severability. If any provision, section, subdivision, sentence, clause,
54.12phrase, or word in this section or the application thereof to any person or circumstance is
54.13found to be unconstitutional, the same is hereby declared to be severable and the remainder
54.14of this section shall remain effective notwithstanding such unconstitutional provision. The
54.15legislature declares that it would have passed this section and each provision, subdivision,
54.16sentence, clause, phrase, or word thereof, regardless of the fact that any provision, section,
54.17subdivision, sentence, clause, phrase, or word is declared unconstitutional.
54.18EFFECTIVE DATE.This section is effective August 1, 2011, and applies to crimes
54.19committed on or after that date.
54.20 Sec. 18. Minnesota Statutes 2010, section 145.925, subdivision 1, is amended to read:
54.21 Subdivision 1. Eligible organizations; purpose. The commissioner of health may,
54.22within available appropriations, make special grants to cities, counties, groups of cities or
54.23counties, or nonprofit corporations to provide prepregnancy family planning services.
54.24 Sec. 19. Minnesota Statutes 2010, section 145.925, subdivision 2, is amended to read:
54.25 Subd. 2. Prohibition. The commissioner shall not make special grants pursuant to
54.26this section to any
54.27that performs abortions or provides referrals for abortion services. No state funds shall be
54.28used under contract from a grantee to any
54.31that performs abortions or provides referrals for abortion services.
54.32 Sec. 20. [145.9271] WHITE EARTH BAND URBAN CLINIC.
55.1 Subdivision 1. Establish urban clinic. The White Earth Band of Ojibwe Indians
55.2shall establish and operate one or more health care clinics in the Minneapolis area or
55.3greater Minnesota to serve members of the White Earth Tribe and may use funds received
55.4under this section for application to qualify as a federally qualified health center.
55.5 Subd. 2. Grant agreements. Before receiving the funds under this section, the
55.6White Earth Band of Ojibwe Indians is requested to submit to the commissioner of health
55.7a work plan and budget that describes its annual plan for the funds. The commissioner will
55.8incorporate the work plan and budget into a grant agreement between the commissioner
55.9and the White Earth Band of Ojibwe Indians. Before each successive disbursement, the
55.10White Earth Band of Ojibwe Indians is requested to submit a narrative progress report and
55.11an expenditure report to the commissioner.
55.12 Sec. 21. [145.9272] COMMUNITY MENTAL HEALTH CENTER GRANTS.
55.13 Subdivision 1. Definitions. For purposes of this section, "community mental
55.14health center" means an entity that is eligible for payment under section 256B.0625,
55.16 Subd. 2. Allocation of subsidies. The commissioner of health shall distribute, from
55.17money appropriated for this purpose, grants to community mental health centers operating
55.18in the state on July 1 of the year 2011 and each subsequent year for community mental
55.19health center services to low-income consumers and patients with mental illness. The
55.20amount of each grant shall be in proportion to each community mental health center's
55.21revenues received from state health care programs in the most recent calendar year for
55.22which data is available.
55.23EFFECTIVE DATE.This section is effective July 1, 2011, or upon federal
55.24approval of the funding mechanism set out in Minnesota Statutes, section 62J.692,
55.25subdivision 11, whichever is later.
55.26 Sec. 22. Minnesota Statutes 2010, section 145.928, subdivision 7, is amended to read:
55.27 Subd. 7. Community grant program; immunization rates and infant mortality
55.28rates. (a) The commissioner shall, within available appropriations, award grants to
55.29eligible applicants for local or regional projects and initiatives directed at reducing health
55.30disparities in one or both of the following priority areas:
55.31(1) decreasing racial and ethnic disparities in infant mortality rates; or
55.32(2) increasing adult and child immunization rates in nonwhite racial and ethnic
56.1(b) The commissioner may award up to 20 percent of the funds available as planning
56.2grants. Planning grants must be used to address such areas as community assessment,
56.3coordination activities, and development of community supported strategies.
56.4(c) Eligible applicants may include, but are not limited to, faith-based organizations,
56.5social service organizations, community nonprofit organizations, community health
56.6boards, tribal governments, and community clinics. Applicants must submit proposals to
56.7the commissioner. A proposal must specify the strategies to be implemented to address
56.8one or both of the priority areas listed in paragraph (a) and must be targeted to achieve the
56.9outcomes established according to subdivision 3.
56.10(d) The commissioner shall give priority to applicants who demonstrate that their
56.11proposed project or initiative:
56.12(1) is supported by the community the applicant will serve;
56.13(2) is research-based or based on promising strategies;
56.14(3) is designed to complement other related community activities;
56.15(4) utilizes strategies that positively impact both priority areas;
56.16(5) reflects racially and ethnically appropriate approaches; and
56.17(6) will be implemented through or with community-based organizations that reflect
56.18the race or ethnicity of the population to be reached.
56.19 Sec. 23. Minnesota Statutes 2010, section 145.928, subdivision 8, is amended to read:
56.20 Subd. 8. Community grant program; other health disparities. (a) The
56.21commissioner shall, within available appropriations, award grants to eligible applicants
56.22for local or regional projects and initiatives directed at reducing health disparities in
56.23one or more of the following priority areas:
56.24(1) decreasing racial and ethnic disparities in morbidity and mortality rates from
56.25breast and cervical cancer;
56.26(2) decreasing racial and ethnic disparities in morbidity and mortality rates from
56.27HIV/AIDS and sexually transmitted infections;
56.28(3) decreasing racial and ethnic disparities in morbidity and mortality rates from
56.30(4) decreasing racial and ethnic disparities in morbidity and mortality rates from
56.32(5) decreasing racial and ethnic disparities in morbidity and mortality rates from
56.33accidental injuries or violence.
56.34(b) The commissioner may award up to 20 percent of the funds available as planning
56.35grants. Planning grants must be used to address such areas as community assessment,
57.1determining community priority areas, coordination activities, and development of
57.2community supported strategies.
57.3(c) Eligible applicants may include, but are not limited to, faith-based organizations,
57.4social service organizations, community nonprofit organizations, community health
57.5boards, and community clinics. Applicants shall submit proposals to the commissioner.
57.6A proposal must specify the strategies to be implemented to address one or more of
57.7the priority areas listed in paragraph (a) and must be targeted to achieve the outcomes
57.8established according to subdivision 3.
57.9(d) The commissioner shall give priority to applicants who demonstrate that their
57.10proposed project or initiative:
57.11(1) is supported by the community the applicant will serve;
57.12(2) is research-based or based on promising strategies;
57.13(3) is designed to complement other related community activities;
57.14(4) utilizes strategies that positively impact more than one priority area;
57.15(5) reflects racially and ethnically appropriate approaches; and
57.16(6) will be implemented through or with community-based organizations that reflect
57.17the race or ethnicity of the population to be reached.
57.18 Sec. 24. [145.987] COMMUNITY HEALTH CENTERS DEVELOPMENT
57.20(a) The commissioner of health shall award grants from money appropriated for this
57.21purpose to expand community health centers, as defined in section 145.9269, subdivision
57.221, in the state through the establishment of new community health centers or sites in
57.23areas defined as small rural areas or isolated rural areas according to the four category
57.24classification of the Rural Urban Commuting Area system developed for the United States
57.25Health Resources and Services Administration or serving underserved patient populations.
57.26(b) Grant funds may be used to pay for:
57.27(1) costs for an organization to develop and submit a proposal to the federal
57.28government for the designation of a new community health center or site; and
57.29(2) costs of planning, designing, remodeling, constructing, or purchasing equipment
57.30for a new center or site.
57.31Funds may not be used for operating costs.
57.32(c) The commissioner shall award grants on a competitive basis.
57.33EFFECTIVE DATE.This section is effective July 1, 2011, or upon federal
57.34approval of the funding mechanism set out in Minnesota Statutes, section 62J.692,
57.35subdivision 11, whichever is later.
58.1 Sec. 25. Minnesota Statutes 2010, section 145A.17, subdivision 3, is amended to read:
58.2 Subd. 3. Requirements for programs; process. (a) Community health boards
58.3and tribal governments that receive funding under this section must submit a plan to
58.4the commissioner describing a multidisciplinary approach to targeted home visiting for
58.5families. The plan must be submitted on forms provided by the commissioner. At a
58.6minimum, the plan must include the following:
58.7 (1) a description of outreach strategies to families prenatally or at birth;
58.8 (2) provisions for the seamless delivery of health, safety, and early learning services;
58.9 (3) methods to promote continuity of services when families move within the state;
58.10 (4) a description of the community demographics;
58.11 (5) a plan for meeting outcome measures; and
58.12 (6) a proposed work plan that includes:
58.13 (i) coordination to ensure nonduplication of services for children and families;
58.14 (ii) a description of the strategies to ensure that children and families at greatest risk
58.15receive appropriate services; and
58.16 (iii) collaboration with multidisciplinary partners including public health,
58.17ECFE, Head Start, community health workers, social workers, community home
58.18visiting programs, school districts, and other relevant partners. Letters of intent from
58.19multidisciplinary partners must be submitted with the plan.
58.20 (b) Each program that receives funds must accomplish the following program
58.22 (1) use a community-based strategy to provide preventive and early intervention
58.23home visiting services;
58.24 (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
58.25home visit must occur prenatally or as soon after birth as possible and must include a
58.26public health nursing assessment by a public health nurse;
58.27 (3) offer, at a minimum, information on infant care, child growth and development,
58.28positive parenting, preventing diseases, preventing exposure to environmental hazards,
58.29and support services available in the community;
58.30 (4) provide information on and referrals to health care services, if needed, including
58.31information on and assistance in applying for health care coverage for which the child or
58.32family may be eligible; and provide information on preventive services, developmental
58.33assessments, and the availability of public assistance programs as appropriate;
58.34 (5) provide youth development programs when appropriate;
58.35 (6) recruit home visitors who will represent, to the extent possible, the races,
58.36cultures, and languages spoken by families that may be served;
59.1 (7) train and supervise home visitors in accordance with the requirements established
59.2under subdivision 4;
59.3 (8) maximize resources and minimize duplication by coordinating or contracting
59.4with local social and human services organizations, education organizations, and other
59.5appropriate governmental entities and community-based organizations and agencies;
59.6 (9) utilize appropriate racial and ethnic approaches to providing home visiting
59.8 (10) connect eligible families, as needed, to additional resources available in the
59.9community, including, but not limited to, early care and education programs, health or
59.10mental health services, family literacy programs, employment agencies, social services,
59.11and child care resources and referral agencies.
59.12 (c) When available, programs that receive funds under this section must offer or
59.13provide the family with a referral to center-based or group meetings that meet at least
59.14once per month for those families identified with additional needs. The meetings must
59.15focus on further enhancing the information, activities, and skill-building addressed during
59.16home visitation; offering opportunities for parents to meet with and support each other;
59.17and offering infants and toddlers a safe, nurturing, and stimulating environment for
59.18socialization and supervised play with qualified teachers.
59.19 (d) Funds available under this section shall not be used for medical services. The
59.20commissioner shall establish an administrative cost limit for recipients of funds. The
59.21outcome measures established under subdivision 6 must be specified to recipients of
59.22funds at the time the funds are distributed.
59.23 (e) Data collected on individuals served by the home visiting programs must remain
59.24confidential and must not be disclosed by providers of home visiting services without a
59.25specific informed written consent that identifies disclosures to be made. Upon request,
59.26agencies providing home visiting services must provide recipients with information on
59.27disclosures, including the names of entities and individuals receiving the information and
59.28the general purpose of the disclosure. Prospective and current recipients of home visiting
59.29services must be told and informed in writing that written consent for disclosure of data is
59.30not required for access to home visiting services.
59.31(f) Upon initial contact with a family, programs that receive funding under this
59.32section must receive permission from the family to share with other family service
59.33providers information about services the family is receiving and unmet needs of the family
59.34in order to select a lead agency for the family and coordinate available resources. For
59.35purposes of this paragraph, the term "family service providers" includes local public
60.1health, social services, school districts, Head Start programs, health care providers, and
60.2other public agencies.
60.3 Sec. 26. Minnesota Statutes 2010, section 157.15, is amended by adding a subdivision
60.5 Subd. 7a. Limited food establishment. "Limited food establishment" means a food
60.6and beverage service establishment that primarily provides beverages that consist of
60.7combining dry mixes and water or ice for immediate service to the consumer. Limited
60.8food establishments must use equipment and utensils that are nontoxic, durable, and retain
60.9their characteristic qualities under normal use conditions and may request a variance for
60.10plumbing requirements from the commissioner.
60.11EFFECTIVE DATE.This section is effective July 1, 2011, and applies to
60.12applications for licensure submitted on or after that date.
60.13 Sec. 27. Minnesota Statutes 2010, section 157.20, is amended by adding a subdivision
60.15 Subd. 5. Variance requests. (a) A person may request a variance from all parts of
60.16Minnesota Rules, chapter 4626, except as provided in paragraph (b) or Minnesota Rules,
60.17chapter 4626. At the time of application for plan review, the person, operator, or submitter
60.18must be notified of the right to request variances.
60.19(b) No variance may be requested or approved for the following parts of Minnesota
60.20Rules, chapter 4626:
60.21(1) Minnesota Rules, part 4626.0020, subpart 35;
60.22(2) Minnesota Rules, parts 4626.0040 to 4626.0060;
60.23(3) Minnesota Rules, parts 4626.0065 to 4626.0100;
60.24(4) Minnesota Rules, parts 4626.0105 to 4626.0120;
60.25(5) Minnesota Rules, part 4626.1565;
60.26(6) Minnesota Rules, parts 4626.1590 and 4626.1595; and
60.27(7) Minnesota Rules, parts 4626.1600 to 4626.1675.
60.28 Sec. 28. Minnesota Statutes 2010, section 297F.10, subdivision 1, is amended to read:
60.29 Subdivision 1. Tax and use tax on cigarettes. Revenue received from cigarette
60.30taxes, as well as related penalties, interest, license fees, and miscellaneous sources of
60.31revenue shall be deposited by the commissioner in the state treasury and credited as
61.1(1) $22,220,000 for fiscal year 2006 and $22,250,000 for fiscal year 2007 and each
61.2year thereafter must be credited to the Academic Health Center special revenue fund
61.3hereby created and is annually appropriated to the Board of Regents at the University of
61.4Minnesota for Academic Health Center funding at the University of Minnesota; and
61.7must be credited to the medical education and research costs account hereby created in
61.8the special revenue fund and is annually appropriated to the commissioner of health for
61.9distribution under section
61.10(3) the balance of the revenues derived from taxes, penalties, and interest (under
61.11this chapter) and from license fees and miscellaneous sources of revenue shall be credited
61.12to the general fund.
61.13 Sec. 29. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
61.15(a) The commissioner of health, in consultation with the commissioner of human
61.16services, shall evaluate and recommend options for reorganizing health and human
61.17services regulatory responsibilities in both agencies to provide better efficiency and
61.18operational cost savings while maintaining the protection of the health, safety, and welfare
61.19of the public. Regulatory responsibilities that are to be evaluated are those found in
61.20Minnesota Statutes, chapters 62D, 62N, 62R, 62T, 144A, 144D, 144G, 146A, 146B,
61.21149A, 153A, 245A, 245B, and 245C, and sections 62Q.19, 144.058, 144.0722, 144.50,
61.22144.651, 148.511, 148.6401, 148.995, 256B.692, 626.556, and 626.557.
61.23(b) The evaluation and recommendations shall be submitted in a report to the
61.24legislative committees with jurisdiction over health and human services no later than
61.25February 15, 2012, and shall include, at a minimum, the following:
61.26(1) whether the regulatory responsibilities of each agency should be combined into
61.27a separate agency;
61.28(2) whether the regulatory responsibilities of each agency should be merged into
61.29an existing agency;
61.30(3) what cost savings would result by merging the activities regardless of where
61.31they are located;
61.32(4) what additional costs would result if the activities were merged;
61.33(5) whether there are additional regulatory responsibilities in both agencies that
61.34should be considered in any reorganization; and
62.1(6) for each option recommended, projected cost and a timetable and identification
62.2of the necessary steps and requirements for a successful transition period.
62.3 Sec. 30. STUDY OF FOR-PROFIT HEALTH MAINTENANCE
62.5The commissioner of health shall contract with an entity with expertise in health
62.6economics and health care delivery and quality to study the efficiency, costs, service
62.7quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to
62.8not-for-profit health maintenance organizations operating in Minnesota and other states.
62.9The study findings must address whether the state of Minnesota could: (1) reduce medical
62.10assistance and MinnesotaCare costs and costs of providing coverage to state employees;
62.11and (2) maintain or improve the quality of care provided to state health care program
62.12enrollees and state employees if for-profit health maintenance organizations were allowed
62.13to operate in the state. The commissioner shall require the entity under contract to report
62.14study findings to the commissioner and the legislature by January 15, 2012.
62.15 Sec. 31. MINNESOTA TASK FORCE ON PREMATURITY.
62.16 Subdivision 1. Establishment. The Minnesota Task Force on Prematurity is
62.17established to evaluate and make recommendations on methods for reducing prematurity
62.18and improving premature infant health care in the state.
62.19 Subd. 2. Membership; meetings; staff. (a) The task force shall be composed of at
62.20least the following members, who serve at the pleasure of their appointing authority:
62.21(1) 15 representatives of the Minnesota Prematurity Coalition including, but not
62.22limited to, health care providers who treat pregnant women or neonates, organizations
62.23focused on preterm births, early childhood education and development professionals, and
62.24families affected by prematurity;
62.25(2) one representative appointed by the commissioner of human services;
62.26(3) two representatives appointed by the commissioner of health;
62.27(4) one representative appointed by the commissioner of education;
62.28(5) two members of the house of representatives, one appointed by the speaker of
62.29the house and one appointed by the minority leader; and
62.30(6) two members of the senate, appointed according to the rules of the senate.
62.31(b) Members of the task force serve without compensation or payment of expenses.
62.32(c) The commissioner of health must convene the first meeting of the Minnesota
62.33Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
63.1least quarterly. Staffing and technical assistance shall be provided by the Minnesota
63.3 Subd. 3. Duties. The task force must report the current state of prematurity in
63.4Minnesota and develop recommendations on strategies for reducing prematurity and
63.5improving premature infant health care in the state by considering the following:
63.6(1) standards of care for premature infants born less than 37 weeks gestational age,
63.7including recommendations to improve hospital discharge and follow-up care procedures;
63.8(2) coordination of information among appropriate professional and advocacy
63.9organizations on measures to improve health care for infants born prematurely;
63.10(3) identification and centralization of available resources to improve access and
63.11awareness for caregivers of premature infants;
63.12(4) development and dissemination of evidence-based practices through networking
63.13and educational opportunities;
63.14(5) a review of relevant evidence-based research regarding the causes and effects of
63.15premature births in Minnesota;
63.16(6) a review of relevant evidence-based research regarding premature infant health
63.17care, including methods for improving quality of and access to care for premature infants;
63.18(7) a review of the potential improvements in health status related to the use of
63.19health care homes to provide and coordinate pregnancy-related services; and
63.20(8) identification of gaps in public reporting measures and possible effects of these
63.21measures on prematurity rates.
63.22 Subd. 4. Report; expiration. (a) By November 30, 2011, the task force must submit
63.23a report on the current state of prematurity in Minnesota to the chairs of the legislative
63.24policy committees on health and human services.
63.25(b) By January 15, 2013, the task force must report its final recommendations,
63.26including any draft legislation necessary for implementation, to the chairs of the legislative
63.27policy committees on health and human services.
63.28(c) This task force expires on January 31, 2013, or upon submission of the final
63.29report required in paragraph (b), whichever is earlier.
63.30 Sec. 32. NURSING HOME REGULATORY EFFICIENCY.
63.31The commissioner of health must work with long-term care providers, provider
63.32associations, and consumer advocates to clarify for the benefit of providers, survey
63.33teams, and investigators from the office of health facility complaints all of the situations
63.34that providers must report and are required to report to the department under federal
64.1certification regulations and to the common entry point under the Minnesota Vulnerable
64.2Adults Act. The commissioner must produce decision trees, flow sheets, or other
64.3reproducible materials to guide the parties and to reduce the number of unnecessary
64.5 Sec. 33. REPEALER.
64.6(a) Minnesota Statutes 2010, sections 62J.17, subdivisions 1, 3, 5a, 6a, and 8;
64.762J.321, subdivision 5a; 62J.381; 62J.41, subdivisions 1 and 2; 144.1464; 144.147; and
64.8144.1499, are repealed.
64.9(b) Minnesota Rules, parts 4651.0100, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12,
64.1014, 15, 16, 16a, 18, 19, 20, 20a, 21, 22, and 23; 4651.0110, subparts 2, 2a, 3, 4, and 5;
64.114651.0120; 4651.0130; 4651.0140; and 4651.0150, are repealed effective July 1, 2011.
64.14 Section 1. Minnesota Statutes 2010, section 245A.14, subdivision 4, is amended to
64.16 Subd. 4. Special family day care homes. Nonresidential child care programs
64.17serving 14 or fewer children that are conducted at a location other than the license holder's
64.18own residence shall be licensed under this section and the rules governing family day
64.19care or group family day care if:
64.20(a) the license holder is the primary provider of care and the nonresidential child
64.21care program is conducted in a dwelling that is located on a residential lot;
64.22(b) the license holder is an employer who may or may not be the primary provider
64.23of care, and the purpose for the child care program is to provide child care services to
64.24children of the license holder's employees;
64.25(c) the license holder is a church or religious organization;
64.26(d) the license holder is a community collaborative child care provider. For
64.27purposes of this subdivision, a community collaborative child care provider is a provider
64.28participating in a cooperative agreement with a community action agency as defined in
64.30(e) the license holder is a not-for-profit agency that provides child care in a dwelling
64.31located on a residential lot and the license holder maintains two or more contracts with
64.32community employers or other community organizations to provide child care services.
64.33The county licensing agency may grant a capacity variance to a license holder licensed
64.34under this paragraph to exceed the licensed capacity of 14 children by no more than five
65.1children during transition periods related to the work schedules of parents, if the license
65.2holder meets the following requirements:
65.3(1) the program does not exceed a capacity of 14 children more than a cumulative
65.4total of four hours per day;
65.5(2) the program meets a one to seven staff-to-child ratio during the variance period;
65.6(3) all employees receive at least an extra four hours of training per year than
65.7required in the rules governing family child care each year;
65.8(4) the facility has square footage required per child under Minnesota Rules, part
65.10(5) the program is in compliance with local zoning regulations;
65.11(6) the program is in compliance with the applicable fire code as follows:
65.12(i) if the program serves more than five children older than 2-1/2 years of age,
65.13but no more than five children 2-1/2 years of age or less, the applicable fire code is
65.14educational occupancy, as provided in Group E Occupancy under the Minnesota State
65.15Fire Code 2003, Section 202; or
65.16(ii) if the program serves more than five children 2-1/2 years of age or less, the
65.17applicable fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire
65.18Code 2003, Section 202; and
65.19(7) any age and capacity limitations required by the fire code inspection and square
65.20footage determinations shall be printed on the license
65.21(f) the license holder is the primary provider of care and has located the licensed
65.22child care program in a commercial space, if the license holder meets the following
65.24(1) the program is in compliance with local zoning regulations;
65.25(2) the program is in compliance with the applicable fire code as follows:
65.26(i) if the program serves more than five children older than 2-1/2 years of age,
65.27but no more than five children 2-1/2 years of age or less, the applicable fire code is
65.28educational occupancy, as provided in Group E Occupancy under the Minnesota State
65.29Fire Code 2003, Section 202; or
65.30(ii) if the program serves more than five children 2-1/2 years of age or less, the
65.31applicable fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire
65.32Code 2003, Section 202;
65.33(3) any age and capacity limitations required by the fire code inspection and square
65.34footage determinations are printed on the license; and
66.1(4) the license holder prominently displays the license issued by the commissioner
66.2which contains the statement "This special family child care provider is not licensed as a
66.3child care center."
66.4 Sec. 2. Minnesota Statutes 2010, section 245C.03, is amended by adding a subdivision
66.6 Subd. 7. Children's therapeutic services and supports providers. The
66.7commissioner shall conduct background studies according to this chapter when initiated
66.8by a children's therapeutic services and supports provider under section 256B.0943.
66.9 Sec. 3. Minnesota Statutes 2010, section 245C.10, is amended by adding a subdivision
66.11 Subd. 8. Children's therapeutic services and supports providers. The
66.12commissioner shall recover the cost of background studies required under section
66.13245C.03, subdivision 7, for the purposes of children's therapeutic services and supports
66.14under section 256B.0943, through a fee of no more than $20 per study charged to
66.15the license holder. The fees collected under this subdivision are appropriated to the
66.16commissioner for the purpose of conducting background studies.
66.17 Sec. 4. Minnesota Statutes 2010, section 256B.04, subdivision 14a, is amended to read:
66.18 Subd. 14a. Level of need determination. Nonemergency medical transportation
66.19level of need determinations must be performed by a physician, a registered nurse working
66.20under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
66.21licensed practical nurse, or a discharge planner.
66.22 Nonemergency medical transportation level of need determinations must not be
66.23performed more than annually on any individual, unless the individual's circumstances
66.24have sufficiently changed so as to require a new level of need determination. No entity
66.25shall charge, and the commissioner shall pay, no more than $25 for performing a level of
66.26need determination regarding any person receiving nonemergency medical transportation,
66.27including special transportation.
66.28Special transportation services to eligible persons who need a stretcher-accessible
66.29vehicle from an inpatient or outpatient hospital are exempt from a level of need
66.30determination if the special transportation services have been ordered by the eligible
66.31person's physician, registered nurse working under direct supervision of a physician,
66.32physician's assistant, nurse practitioner, licensed practical nurse, or discharge planner
66.33pursuant to Medicare guidelines.
67.1 Individuals transported to or residing in licensed nursing facilities are exempt from a
67.2level of need determination and are eligible for special transportation services until the
67.3individual no longer resides in a licensed nursing facility. If a person authorized by this
67.4subdivision to perform a level of need determination determines that an individual requires
67.5stretcher transportation, the individual is presumed to maintain that level of need until
67.6otherwise determined by a person authorized to perform a level of need determination, or
67.7for six months, whichever is sooner.
67.8 Sec. 5. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
67.10 Subd. 17. Transportation costs. (a) Medical assistance covers medical
67.11transportation costs incurred solely for obtaining emergency medical care or transportation
67.12costs incurred by eligible persons in obtaining emergency or nonemergency medical
67.13care when paid directly to an ambulance company, common carrier, or other recognized
67.14providers of transportation services. Medical transportation must be provided by:
67.15(1) an ambulance, as defined in section
67.16(2) special transportation; or
67.17(3) common carrier including, but not limited to, bus, taxicab, other commercial
67.18carrier, or private automobile.
67.19(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
67.20part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
67.21would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
67.22transportation, or private automobile.
67.23The commissioner may use an order by the recipient's attending physician to certify that
67.24the recipient requires special transportation services. Special transportation providers
67.25shall perform driver-assisted services for eligible individuals. Driver-assisted service
67.26includes passenger pickup at and return to the individual's residence or place of business,
67.27assistance with admittance of the individual to the medical facility, and assistance in
67.28passenger securement or in securing of wheelchairs or stretchers in the vehicle. Special
67.29transportation providers must obtain written documentation from the health care service
67.30provider who is serving the recipient being transported, identifying the time that the
67.31recipient arrived. Special transportation providers may not bill for separate base rates for
67.32the continuation of a trip beyond the original destination. Special transportation providers
67.33must take recipients to the nearest appropriate health care provider, using the most direct
67.34route as determined by a commercially available mileage software program approved by
68.1the commissioner. The minimum medical assistance reimbursement rates for special
68.2transportation services are:
68.3(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
68.4eligible persons who need a wheelchair-accessible van;
68.5(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
68.6eligible persons who do not need a wheelchair-accessible van; and
68.7(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
68.8special transportation services to eligible persons who need a stretcher-accessible vehicle;
68.9(2) the base rates for special transportation services in areas defined under RUCA
68.10to be super rural shall be equal to the reimbursement rate established in clause (1) plus
68.1111.3 percent; and
68.12(3) for special transportation services in areas defined under RUCA to be rural
68.13or super rural areas:
68.14(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
68.15percent of the respective mileage rate in clause (1); and
68.16(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
68.17112.5 percent of the respective mileage rate in clause (1).
68.18(c) For purposes of reimbursement rates for special transportation services under
68.19paragraph (b), the zip code of the recipient's place of residence shall determine whether
68.20the urban, rural, or super rural reimbursement rate applies.
68.21(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
68.22means a census-tract based classification system under which a geographical area is
68.23determined to be urban, rural, or super rural.
68.24 Sec. 6. Minnesota Statutes 2010, section 256B.0943, is amended by adding a
68.25subdivision to read:
68.26 Subd. 5a. Background studies. The requirements for background studies under
68.27this section may be met by a children's therapeutic services and supports services agency
68.28through the commissioner's NETStudy system as provided under sections 245C.03,
68.29subdivision 7, and 245C.10, subdivision 8.
68.30 Sec. 7. Minnesota Statutes 2010, section 256B.14, is amended by adding a subdivision
68.32 Subd. 3a. Spousal contribution. (a) For purposes of this subdivision, the following
68.33terms have the meanings given:
68.34(1) "commissioner" means the commissioner of human services;
69.1(2) "community spouse" means the spouse, who lives in the community, of an
69.2individual receiving long-term care services in a long-term care facility or home care
69.3services pursuant to the Medicaid waiver for elderly services under section 256B.0915
69.4or the alternative care program under section 256B.0913. A community spouse does not
69.5include a spouse living in the community who receives a monthly income allowance under
69.6section 256B.058, subdivision 2, or who receives home and community-based services
69.7under section 256B.0915, 256B.092, or 256B.49, or the alternative care program under
69.9(3) "cost of care" means the actual fee-for-service costs or capitated payments for
69.10the long-term care spouse;
69.11(4) "department" means the Department of Human Services;
69.12(5) "disabled child" means a blind or permanently and totally disabled son or
69.13daughter of any age based on the Social Security Administration disability standards;
69.14(6) "income" means earned and unearned income, attributable to the community
69.15spouse, used to calculate the adjusted gross income on the prior year's income tax return.
69.16Evidence of income includes, but is not limited to, W-2 and 1099 forms; and
69.17(7) "long-term care spouse" means the spouse who is receiving long-term care
69.18services in a long-term care facility or home and community based services pursuant
69.19to the Medicaid waiver for elderly services under section 256B.0915 or the alternative
69.20care program under section 256B.0913.
69.21(b) The community spouse of a long-term care spouse who receives medical
69.22assistance or alternative care services has an obligation to contribute to the cost of care.
69.23The community spouse must pay a monthly fee on a sliding fee scale based on the
69.24community spouse's income. If a minor or disabled child resides with and receives care
69.25from the community spouse, then no fee shall be assessed.
69.26(c) For a community spouse with an income equal to or greater than 250 percent of
69.27the federal poverty guidelines for a family of two and less than 545 percent of the federal
69.28poverty guidelines for a family of two, the spousal contribution shall be determined using
69.29a sliding fee scale established by the commissioner that begins at 7.5 percent of the
69.30community spouse's income and increases to 15 percent for those with an income of up to
69.31545 percent of the federal poverty guidelines for a family of two.
69.32(d) For a community spouse with an income equal to or greater than 545 percent of
69.33the federal poverty guidelines for a family of two and less than 750 percent of the federal
69.34poverty guidelines for a family of two, the spousal contribution shall be determined using
69.35a sliding fee scale established by the commissioner that begins at 15 percent of the
70.1community spouse's income and increases to 25 percent for those with an income of up to
70.2750 percent of the federal poverty guidelines for a family of two.
70.3(e) For a community spouse with an income equal to or greater than 750 percent of
70.4the federal poverty guidelines for a family of two and less than 975 percent of the federal
70.5poverty guidelines for a family of two, the spousal contribution shall be determined using
70.6a sliding fee scale established by the commissioner that begins at 25 percent of the
70.7community spouse's income and increases to 33 percent for those with an income of up to
70.8975 percent of the federal poverty guidelines for a family of two.
70.9(f) For a community spouse with an income equal to or greater than 975 percent of
70.10the federal poverty guidelines for a family of two, the spousal contribution shall be 33
70.11percent of the community spouse's income.
70.12(g) The spousal contribution shall be explained in writing at the time eligibility
70.13for medical assistance or alternative care is being determined. In addition to explaining
70.14the formula used to determine the fee, the county or tribal agency shall provide written
70.15information describing how to request a variance for undue hardship, how a contribution
70.16may be reviewed or redetermined, the right to appeal a contribution determination, and
70.17that the consequences for not complying with a request to provide information shall be
70.18an assessment against the community spouse for the full cost of care for the long-term
70.20(h) The contribution shall be assessed for each month the long-term care spouse
70.21has a community spouse and is eligible for medical assistance payment of long-term
70.22care services or alternative care.
70.23(i) The spousal contribution shall be reviewed at least once every 12 months and
70.24when there is a loss or gain in income in excess of ten percent. Thirty days prior to a
70.25review or redetermination, written notice must be provided to the community spouse
70.26and must contain the amount the spouse is required to contribute, notice of the right to
70.27redetermination and appeal, and the telephone number of the division at the agency that is
70.28responsible for redetermination and review. If, after review, the contribution amount is to
70.29be adjusted, the county or tribal agency shall mail a written notice to the community spouse
70.3030 days in advance of the effective date of the change in the amount of the contribution.
70.31(1) The spouse shall notify the county or tribal agency within 30 days of a gain or
70.32loss in income in excess of ten percent and provide the agency supporting documentation
70.33to verify the need for redetermination of the fee.
70.34(2) When a spouse requests a review or redetermination of the contribution amount,
70.35a request for information shall be sent to the spouse within ten calendar days after the
70.36county or tribal agency receives the request for review.
71.1(3) No action shall be taken on a review or redetermination until the required
71.2information is received by the county or tribal agency.
71.3(4) The review of the spousal contribution shall be completed within ten days after
71.4the county or tribal agency receives completed information that verifies a loss or gain in
71.5income in excess of ten percent.
71.6(5) An increase in the contribution amount is effective in the month in which the
71.7increase in income occurs.
71.8(6) A decrease in the contribution amount is effective in the month the spouse
71.9verifies the reduction in income, retroactive to no longer than six months.
71.10(j) In no case shall the spousal contribution exceed the amount of medical assistance
71.11expended or the cost of alternative care services for the care of the long-term care spouse.
71.12Annually, upon redetermination, or at termination of eligibility, the total amount of
71.13medical assistance paid or costs of alternative care for the care of the long-term care spouse
71.14and the total amount of the spousal contribution shall be compared. If the total amount
71.15of the spousal contribution exceeds the total amount of medical assistance expended or
71.16cost of alternative care, then the agency shall reimburse the community spouse the excess
71.17amount if the long-term care spouse is no longer receiving services, or apply the excess
71.18amount to the spousal contribution due until the excess amount is exhausted.
71.19(k) A community spouse may request a variance by submitting a written request
71.20and supporting documentation that payment of the calculated contribution would cause
71.21an undue hardship. An undue hardship is defined as the inability to pay the calculated
71.22contribution due to medical expenses incurred by the community spouse. Documentation
71.23must include proof of medical expenses incurred by the community spouse since the last
71.24annual redetermination of the contribution amount that are not reimbursable by any public
71.25or private source, and are a type, regardless of amount, that would be allowable as a
71.26federal tax deduction under the Internal Revenue Code.
71.27(1) A spouse who requests a variance from a notice of an increase in the amount
71.28of spousal contribution shall continue to make monthly payments at the lower amount
71.29pending determination of the variance request. A spouse who requests a variance from
71.30the initial determination shall not be required to make a payment pending determination
71.31of the variance request. Payments made pending outcome of the variance request that
71.32result in overpayment must be returned to the spouse, if the long-term care spouse is no
71.33longer receiving services, or applied to the spousal contribution in the current year. If the
71.34variance is denied, the spouse shall pay the additional amount due from the effective date
71.35of the increase or the total amount due from the effective date of the original notice of
71.36determination of the spousal contribution.
72.1(2) A spouse who is granted a variance shall sign a written agreement in which the
72.2spouse agrees to report to the county or tribal agency any changes in circumstances that
72.3gave rise to the undue hardship variance.
72.4(3) When the county or tribal agency receives a request for a variance, written notice
72.5of a grant or denial of the variance shall be mailed to the spouse within 30 calendar days
72.6after the county or tribal agency receives the financial information required in this clause.
72.7The granting of a variance will necessitate a written agreement between the spouse and the
72.8county or tribal agency with regard to the specific terms of the variance. The variance
72.9will not become effective until the written agreement is signed by the spouse. If the
72.10county or tribal agency denies in whole or in part the request for a variance, the denial
72.11notice shall set forth in writing the reasons for the denial that address the specific hardship
72.12and right to appeal.
72.13(4) If a variance is granted, the term of the variance shall not exceed 12 months
72.14unless otherwise determined by the county or tribal agency.
72.15(5) Undue hardship does not include action taken by a spouse which divested or
72.16diverted income in order to avoid being assessed a spousal contribution.
72.17(l) A spouse aggrieved by an action under this subdivision has the right to appeal
72.18under subdivision 4. If the spouse appeals on or before the effective date of an increase
72.19in the spousal fee, the spouse shall continue to make payments to the county or tribal
72.20agency in the lower amount while the appeal is pending. A spouse appealing an initial
72.21determination of a spousal contribution shall not be required to make monthly payments
72.22pending an appeal decision. Payments made that result in an overpayment shall be
72.23reimbursed to the spouse if the long-term care spouse is no longer receiving services, or
72.24applied to the spousal contribution remaining in the current year. If the county or tribal
72.25agency's determination is affirmed, the community spouse shall pay within 90 calendar
72.26days of the order the total amount due from the effective date of the original notice of
72.27determination of the spousal contribution. The commissioner's order is binding on the
72.28spouse and the agency and shall be implemented subject to section 256.045, subdivision 7.
72.29No additional notice is required to enforce the commissioner's order.
72.30(m) If the county or tribal agency finds that notice of the payment obligation was
72.31given to the community spouse and the spouse was determined to be able to pay, but that
72.32the spouse failed or refused to pay, a cause of action exists against the community spouse
72.33for that portion of medical assistance payment of long-term care services or alternative
72.34care services granted after notice was given to the community spouse. The action may be
72.35brought by the county or tribal agency in the county where assistance was granted for the
72.36assistance together with the costs of disbursements incurred due to the action. In addition
73.1to granting the county or tribal agency a money judgment, the court may, upon a motion or
73.2order to show cause, order continuing contributions by a community spouse found able to
73.3repay the county or tribal agency. The order shall be effective only for the period of time
73.4during which a contribution shall be assessed.
73.5 (n) Counties and tribes are entitled to one-half of the nonfederal share of
73.6contributions made under this section for long-term care spouses on medical assistance
73.7that are directly attributed to county or tribal efforts. Counties and tribes are entitled to
73.825 percent of the contributions made under this section for long-term care spouses on
73.9alternative care directly attributed to county or tribal efforts.
73.10EFFECTIVE DATE.This section is effective July 1, 2012.
73.11 Sec. 8. Minnesota Statutes 2010, section 326B.175, is amended to read:
73.12326B.175 ELEVATORS, ENTRANCES SEALED.
73.13 Except as provided in section 326B.188, it shall be the duty of the department and
73.14the licensing authority of any municipality which adopts any such ordinance whenever
73.15it finds any such elevator under its jurisdiction in use in violation of any provision of
73.17forbidding the use of such elevator until the provisions thereof are complied with.
73.18 Sec. 9. [326B.188] COMPLIANCE WITH ELEVATOR CODE CHANGES.
73.19(a) This section applies to code requirements for existing elevators and related
73.20devices under Minnesota Rules, chapter 1307, where the deadline set by law for meeting
73.21the code requirements is January 29, 2012, or later.
73.22(b) If the department or municipality conducting elevator inspections within its
73.23jurisdiction notifies the owner of an existing elevator or related device of the code
73.24requirements before the effective date of this section, the owner may submit a compliance
73.25plan by December 30, 2011. If the department or municipality does not notify the owner
73.26of an existing elevator or related device of the code requirements before the effective
73.27date of this section, the department or municipality shall notify the owner of the code
73.28requirements and permit the owner to submit a compliance plan by December 30, 2011, or
73.29within 60 days after the date of notification, whichever is later.
73.30(c) Any compliance plan submitted under this section must result in compliance with
73.31the code requirements by the later of January 29, 2012, or three years after submission of
73.32the compliance plan. Elevators and related devices that are not in compliance with the
74.1code requirements by the later of January 29, 2012, or three years after the submission of
74.2the compliance plan may be taken out of service as provided in section 326B.175.
74.3 Sec. 10. NONEMERGENCY MEDICAL TRANSPORTATION SINGLE
74.4ADMINISTRATIVE STRUCTURE PROPOSAL.
74.5(a) The commissioner of human services shall develop a proposal to create a single
74.6administrative structure for providing nonemergency medical transportation services to
74.7fee-for-service medical assistance recipients. This proposal must consolidate access and
74.8special transportation into one administrative structure with the goal of standardizing
74.9eligibility determination processes, scheduling arrangements, billing procedures, data
74.10collection, and oversight mechanisms in order to enhance coordination, improve
74.11accountability, and lessen confusion.
74.12(b) In developing the proposal, the commissioner shall:
74.13(1) examine the current responsibilities performed by the counties and the
74.14Department of Human Services and consider the shift in costs if these responsibilities are
74.16(2) identify key performance measures to assess the cost effectiveness of
74.17nonemergency medical transportation statewide, including a process to collect, audit,
74.18and report data;
74.19(3) develop a statewide complaint system for medical assistance recipients using
74.21(4) establish a standardized billing process;
74.22(5) establish a process that provides public input from interested parties before
74.23special transportation eligibility policies are implemented or significantly changed;
74.24(6) establish specific eligibility criteria that include the frequency of eligibility
74.25assessments and the length of time a recipient remains eligible for special transportation;
74.26(7) develop a reimbursement method to compensate volunteers for no-load miles
74.27when transporting recipients to or from health-related appointments; and
74.28(8) establish specific eligibility criteria to maximize the use of public transportation
74.29by recipients who are without a physical, mental, or other impairment that would prohibit
74.30safely accessing and using public transportation.
74.31(c) In developing the proposal, the commissioner shall consult with the
74.32nonemergency medical transportation advisory council established under paragraph (d).
74.33(d) The commissioner shall establish the nonemergency medical transportation
74.34advisory council to assist the commissioner in developing a single administrative structure
75.1for providing nonemergency medical transportation services. The council shall be
75.3(1) one representative each from the departments of human services and
75.5(2) one representative each from the following organizations: the Minnesota State
75.6Council on Disability, the Minnesota Consortium for Citizens with Disabilities, ARC
75.7of Minnesota, the Association of Minnesota Counties, the Metropolitan Inter-County
75.8Association, the R-80 Medical Transportation Coalition, the Minnesota Paratransit
75.9Association, legal aid, the Minnesota Ambulance Association, the National Alliance on
75.10Mental Illness, Medical Transportation Management, and other transportation providers;
75.12(3) four members from the house of representatives, two from the majority party
75.13and two from the minority party, appointed by the speaker, and four members from the
75.14senate, two from the majority party and two from the minority party, appointed by the
75.15Subcommittee on Committees of the Committee on Rules and Administration.
75.16The council is governed by Minnesota Statutes, section 15.509, except that members
75.17shall not receive per diems. The commissioner of human services shall fund all costs
75.18related to the council from existing resources.
75.19(e) The commissioner shall submit the proposal and draft legislation necessary for
75.20implementation to the chairs and ranking minority members of the senate and house of
75.21representatives committees or divisions with jurisdiction over health care policy and
75.22finance by January 15, 2012.
75.25 Section 1. Minnesota Statutes 2010, section 148.07, subdivision 1, is amended to read:
75.26 Subdivision 1. Renewal fees. All persons practicing chiropractic within this state,
75.27or licensed so to do, shall pay, on or before the date of expiration of their licenses, to the
75.28Board of Chiropractic Examiners a renewal fee set
75.2916A.1283, with a penalty
75.30license fee is in arrears and upon payment of the renewal and upon compliance with all the
75.31rules of the board, shall be entitled to renewal of their license.
75.32 Sec. 2. Minnesota Statutes 2010, section 148.108, is amended by adding a subdivision
75.34 Subd. 4. Animal chiropractic. (a) Animal chiropractic registration fee is $125.
76.1(b) Animal chiropractic registration renewal fee is $75.
76.2(c) Animal chiropractic inactive renewal fee is $25.
76.3 Sec. 3. Minnesota Statutes 2010, section 148.191, subdivision 2, is amended to read:
76.4 Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise
76.5rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
76.6provisions of sections
76.7and standards for schools and courses preparing persons for licensure under sections
76.9at such times as it may deem necessary. It shall approve such schools and courses as
76.10meet the requirements of sections
76.11license, and renew the license of duly qualified applicants. It shall hold examinations
76.12at least once in each year at such time and place as it may determine. It shall by rule
76.13adopt, evaluate, and periodically revise, as necessary, requirements for licensure and for
76.14registration and renewal of registration as defined in section
76.15record of all persons licensed by the board to practice professional or practical nursing and
76.16all registered nurses who hold Minnesota licensure and registration and are certified as
76.17advanced practice registered nurses. It shall cause the prosecution of all persons violating
76.19It shall register public health nurses who meet educational and other requirements
76.20established by the board by rule, including payment of a fee.
76.23witnesses and the production of all necessary documents and other evidentiary material.
76.24Any board member may administer oaths to witnesses, or take their affirmation. It shall
76.25keep a record of all its proceedings.
76.26(b) The board shall have access to hospital, nursing home, and other medical records
76.27of a patient cared for by a nurse under review. If the board does not have a written consent
76.28from a patient permitting access to the patient's records, the nurse or facility shall delete
76.29any data in the record that identifies the patient before providing it to the board. The board
76.30shall have access to such other records as reasonably requested by the board to assist the
76.31board in its investigation. Nothing herein may be construed to allow access to any records
76.32protected by section
76.33this paragraph as investigative data under chapter 13.
77.1(c) The board may accept and expend grants or gifts of money or in-kind services
77.2from a person, a public or private entity, or any other source for purposes consistent with
77.3the board's role and within the scope of its statutory authority.
77.4(d) The board may accept registration fees for meetings and conferences conducted
77.5for the purposes of board activities that are within the scope of its authority.
77.6 Sec. 4. Minnesota Statutes 2010, section 148.212, subdivision 1, is amended to read:
77.7 Subdivision 1. Issuance. Upon receipt of the applicable licensure or reregistration
77.8fee and permit fee, and in accordance with rules of the board, the board may issue
77.9a nonrenewable temporary permit to practice professional or practical nursing to an
77.10applicant for licensure or reregistration who is not the subject of a pending investigation
77.11or disciplinary action, nor disqualified for any other reason, under the following
77.21is currently licensed to practice professional or practical nursing in another state, territory,
77.22or Canadian province. The permit is valid
77.23date of board action on the application or for 60 days, whichever comes first.
77.26registered in a formal, structured refresher course or its equivalent for nurses that includes
78.1 Sec. 5. Minnesota Statutes 2010, section 148.231, is amended to read:
78.2148.231 REGISTRATION; FAILURE TO REGISTER; REREGISTRATION;
78.4 Subdivision 1. Registration. Every person licensed to practice professional or
78.5practical nursing must maintain with the board a current registration for practice as a
78.6registered nurse or licensed practical nurse which must be renewed at regular intervals
78.7established by the board by rule. No
78.8to a nurse until the nurse has submitted satisfactory evidence of compliance with the
78.9procedures and minimum requirements established by the board.
78.10The fee for periodic registration for practice as a nurse shall be determined by the
78.13required fees, the board shall verify the application and the evidence of completion of
78.14continuing education requirements in effect, and thereupon issue to the nurse
78.16 Subd. 4. Failure to register. Any person licensed under the provisions of sections
78.18practice nursing in this state as a registered nurse or licensed practical nurse.
78.19 Subd. 5. Reregistration. A person whose registration has lapsed desiring to
78.20resume practice shall make application for reregistration, submit satisfactory evidence of
78.21compliance with the procedures and requirements established by the board, and pay the
78.23required from a person who practiced nursing without current registration. Thereupon,
78.25the practicing list as a registered nurse or licensed practical nurse.
78.26 Subd. 6. Verification. A person licensed under the provisions of sections
78.28or country or to an agency, facility, school, or institution shall pay a fee
78.29for each verification.
78.30 Sec. 6. [148.242] FEES.
78.31The fees specified in section 148.243 are nonrefundable and must be deposited in
78.32the state government special revenue fund.
78.33 Sec. 7. [148.243] FEE AMOUNTS.
79.1 Subdivision 1. Licensure by examination. The fee for licensure by examination is
79.3 Subd. 2. Reexamination fee. The reexamination fee is $60.
79.4 Subd. 3. Licensure by endorsement. The fee for licensure by endorsement is $105.
79.5 Subd. 4. Registration renewal. The fee for registration renewal is $85.
79.6 Subd. 5. Reregistration. The fee for reregistration is $105.
79.7 Subd. 6. Replacement license. The fee for a replacement license is $20.
79.8 Subd. 7. Public health nurse certification. The fee for public health nurse
79.9certification is $30.
79.10 Subd. 8. Drug Enforcement Administration verification for Advanced Practice
79.11Registered Nurse (APRN). The Drug Enforcement Administration verification for
79.12APRN is $50.
79.13 Subd. 9. Licensure verification other than through Nursys. The fee for
79.14verification of licensure status other than through Nursys verification is $20.
79.15 Subd. 10. Verification of examination scores. The fee for verification of
79.16examination scores is $20.
79.17 Subd. 11. Microfilmed licensure application materials. The fee for a copy of
79.18microfilmed licensure application materials is $20.
79.19 Subd. 12. Nursing business registration; initial application. The fee for the initial
79.20application for nursing business registration is $100.
79.21 Subd. 13. Nursing business registration; annual application. The fee for the
79.22annual application for nursing business registration is $25.
79.23 Subd. 14. Practicing without current registration. The fee for practicing without
79.24current registration is two times the amount of the current registration renewal fee for any
79.25part of the first calendar month, plus the current registration renewal fee for any part of
79.26any subsequent month up to 24 months.
79.27 Subd. 15. Practicing without current APRN certification. The fee for practicing
79.28without current APRN certification is $200 for the first month or any part thereof, plus
79.29$100 for each subsequent month or part thereof.
79.30 Subd. 16. Dishonored check fee. The service fee for a dishonored check is as
79.31provided in section 604.113.
79.32 Subd. 17. Border state registry fee. The initial application fee for border state
79.33registration is $50. Any subsequent notice of employment change to remain or be
79.34reinstated on the registry is $50.
79.35 Sec. 8. [148.2855] NURSE LICENSURE COMPACT.
80.1The Nurse Licensure Compact is enacted into law and entered into with all other
80.2jurisdictions legally joining in it, in the form substantially as follows:
80.5As used in this compact:
80.6(a) "Adverse action" means a home or remote state action.
80.7(b) "Alternative program" means a voluntary, nondisciplinary monitoring program
80.8approved by a nurse licensing board.
80.9(c) "Coordinated licensure information system" means an integrated process for
80.10collecting, storing, and sharing information on nurse licensure and enforcement activities
80.11related to nurse licensure laws, which is administered by a nonprofit organization
80.12composed of and controlled by state nurse licensing boards.
80.13(d) "Current significant investigative information" means:
80.14(1) investigative information that a licensing board, after a preliminary inquiry that
80.15includes notification and an opportunity for the nurse to respond if required by state law,
80.16has reason to believe is not groundless and, if proved true, would indicate more than a
80.17minor infraction; or
80.18(2) investigative information that indicates that the nurse represents an immediate
80.19threat to public health and safety regardless of whether the nurse has been notified and
80.20had an opportunity to respond.
80.21(e) "Home state" means the party state which is the nurse's primary state of residence.
80.22(f) "Home state action" means any administrative, civil, equitable, or criminal
80.23action permitted by the home state's laws which are imposed on a nurse by the home
80.24state's licensing board or other authority including actions against an individual's license
80.25such as revocation, suspension, probation, or any other action which affects a nurse's
80.26authorization to practice.
80.27(g) "Licensing board" means a party state's regulatory body responsible for issuing
80.29(h) "Multistate licensure privilege" means current, official authority from a
80.30remote state permitting the practice of nursing as either a registered nurse or a licensed
80.31practical/vocational nurse in the party state. All party states have the authority, according
80.32to existing state due process law, to take actions against the nurse's privilege such as
80.33revocation, suspension, probation, or any other action which affects a nurse's authorization
80.35(i) "Nurse" means a registered nurse or licensed practical/vocational nurse as those
80.36terms are defined by each party state's practice laws.
81.1(j) "Party state" means any state that has adopted this compact.
81.2(k) "Remote state" means a party state other than the home state:
81.3(1) where the patient is located at the time nursing care is provided; or
81.4(2) in the case of the practice of nursing not involving a patient, in the party state
81.5where the recipient of nursing practice is located.
81.6(l) "Remote state action" means:
81.7(1) any administrative, civil, equitable, or criminal action permitted by a remote
81.8state's laws which are imposed on a nurse by the remote state's licensing board or other
81.9authority including actions against an individual's multistate licensure privilege to practice
81.10in the remote state; and
81.11(2) cease and desist and other injunctive or equitable orders issued by remote states
81.12or the licensing boards of those states.
81.13(m) "State" means a state, territory, or possession of the United States, the District of
81.14Columbia, or the Commonwealth of Puerto Rico.
81.15(n) "State practice laws" means individual party state laws and regulations that
81.16govern the practice of nursing, define the scope of nursing practice, and create the
81.17methods and grounds for imposing discipline. State practice laws does not include the
81.18initial qualifications for licensure or requirements necessary to obtain and retain a license,
81.19except for qualifications or requirements of the home state.
81.22(a) A license to practice registered nursing issued by a home state to a resident in
81.23that state will be recognized by each party state as authorizing a multistate licensure
81.24privilege to practice as a registered nurse in the party state. A license to practice licensed
81.25practical/vocational nursing issued by a home state to a resident in that state will be
81.26recognized by each party state as authorizing a multistate licensure privilege to practice
81.27as a licensed practical/vocational nurse in the party state. In order to obtain or retain a
81.28license, an applicant must meet the home state's qualifications for licensure and license
81.29renewal as well as all other applicable state laws.
81.30(b) Party states may, according to state due process laws, limit or revoke the
81.31multistate licensure privilege of any nurse to practice in their state and may take any other
81.32actions under their applicable state laws necessary to protect the health and safety of
81.33their citizens. If a party state takes such action, it shall promptly notify the administrator
81.34of the coordinated licensure information system. The administrator of the coordinated
81.35licensure information system shall promptly notify the home state of any such actions by
82.1(c) Every nurse practicing in a party state must comply with the state practice laws of
82.2the state in which the patient is located at the time care is rendered. In addition, the practice
82.3of nursing is not limited to patient care, but shall include all nursing practice as defined by
82.4the state practice laws of the party state. The practice of nursing will subject a nurse to the
82.5jurisdiction of the nurse licensing board, the courts, and the laws in the party state.
82.6(d) This compact does not affect additional requirements imposed by states for
82.7advanced practice registered nursing. However, a multistate licensure privilege to practice
82.8registered nursing granted by a party state shall be recognized by other party states as a
82.9license to practice registered nursing if one is required by state law as a precondition for
82.10qualifying for advanced practice registered nurse authorization.
82.11(e) Individuals not residing in a party state shall continue to be able to apply for
82.12nurse licensure as provided for under the laws of each party state. However, the license
82.13granted to these individuals will not be recognized as granting the privilege to practice
82.14nursing in any other party state unless explicitly agreed to by that party state.
82.17(a) Upon application for a license, the licensing board in a party state shall ascertain,
82.18through the coordinated licensure information system, whether the applicant has ever held
82.19or is the holder of a license issued by any other state, whether there are any restrictions
82.20on the multistate licensure privilege, and whether any other adverse action by a state
82.21has been taken against the license.
82.22(b) A nurse in a party state shall hold licensure in only one party state at a time,
82.23issued by the home state.
82.24(c) A nurse who intends to change primary state of residence may apply for licensure
82.25in the new home state in advance of the change. However, new licenses will not be
82.26issued by a party state until after a nurse provides evidence of change in primary state of
82.27residence satisfactory to the new home state's licensing board.
82.28(d) When a nurse changes primary state of residence by:
82.29(1) moving between two party states, and obtains a license from the new home state,
82.30the license from the former home state is no longer valid;
82.31(2) moving from a nonparty state to a party state, and obtains a license from the new
82.32home state, the individual state license issued by the nonparty state is not affected and will
82.33remain in full force if so provided by the laws of the nonparty state; or
82.34(3) moving from a party state to a nonparty state, the license issued by the prior
82.35home state converts to an individual state license, valid only in the former home state,
82.36without the multistate licensure privilege to practice in other party states.
83.3In addition to the general provisions described in article 2, the provisions in this
83.5(a) The licensing board of a remote state shall promptly report to the administrator
83.6of the coordinated licensure information system any remote state actions including the
83.7factual and legal basis for the action, if known. The licensing board of a remote state shall
83.8also promptly report any significant current investigative information yet to result in a
83.9remote state action. The administrator of the coordinated licensure information system
83.10shall promptly notify the home state of any reports.
83.11(b) The licensing board of a party state shall have the authority to complete any
83.12pending investigation for a nurse who changes primary state of residence during the
83.13course of the investigation. The board shall also have the authority to take appropriate
83.14action, and shall promptly report the conclusion of the investigation to the administrator
83.15of the coordinated licensure information system. The administrator of the coordinated
83.16licensure information system shall promptly notify the new home state of any action.
83.17(c) A remote state may take adverse action affecting the multistate licensure
83.18privilege to practice within that party state. However, only the home state shall have the
83.19power to impose adverse action against the license issued by the home state.
83.20(d) For purposes of imposing adverse actions, the licensing board of the home state
83.21shall give the same priority and effect to reported conduct received from a remote state as
83.22it would if the conduct had occurred within the home state. In so doing, it shall apply its
83.23own state laws to determine appropriate action.
83.24(e) The home state may take adverse action based on the factual findings of the
83.25remote state, provided each state follows its own procedures for imposing the adverse
83.27(f) Nothing in this compact shall override a party state's decision that participation
83.28in an alternative program may be used in lieu of licensure action and that participation
83.29shall remain nonpublic if required by the party state's laws.
83.30Party states must require nurses who enter any alternative programs to agree not to
83.31practice in any other party state during the term of the alternative program without prior
83.32authorization from the other party state.
84.1Notwithstanding any other laws, party state nurse licensing boards shall have the
84.3(1) if otherwise permitted by state law, recover from the affected nurse the costs of
84.4investigation and disposition of cases resulting from any adverse action taken against
84.6(2) issue subpoenas for both hearings and investigations which require the attendance
84.7and testimony of witnesses, and the production of evidence. Subpoenas issued by a nurse
84.8licensing board in a party state for the attendance and testimony of witnesses, and the
84.9production of evidence from another party state, shall be enforced in the latter state by
84.10any court of competent jurisdiction according to the practice and procedure of that court
84.11applicable to subpoenas issued in proceedings pending before it. The issuing authority
84.12shall pay any witness fees, travel expenses, mileage, and other fees required by the service
84.13statutes of the state where the witnesses and evidence are located;
84.14(3) issue cease and desist orders to limit or revoke a nurse's authority to practice
84.15in the nurse's state; and
84.16(4) adopt uniform rules and regulations as provided for in article 7, paragraph (c).
84.19(a) All party states shall participate in a cooperative effort to create a coordinated
84.20database of all licensed registered nurses and licensed practical/vocational nurses. This
84.21system shall include information on the licensure and disciplinary history of each
84.22nurse, as contributed by party states, to assist in the coordination of nurse licensure and
84.24(b) Notwithstanding any other provision of law, all party states' licensing boards shall
84.25promptly report adverse actions, actions against multistate licensure privileges, any current
84.26significant investigative information yet to result in adverse action, denials of applications,
84.27and the reasons for the denials to the coordinated licensure information system.
84.28(c) Current significant investigative information shall be transmitted through the
84.29coordinated licensure information system only to party state licensing boards.
84.30(d) Notwithstanding any other provision of law, all party states' licensing boards
84.31contributing information to the coordinated licensure information system may designate
84.32information that may not be shared with nonparty states or disclosed to other entities or
84.33individuals without the express permission of the contributing state.
84.34(e) Any personally identifiable information obtained by a party state's licensing
84.35board from the coordinated licensure information system may not be shared with nonparty
85.1states or disclosed to other entities or individuals except to the extent permitted by the
85.2laws of the party state contributing the information.
85.3(f) Any information contributed to the coordinated licensure information system that
85.4is subsequently required to be expunged by the laws of the party state contributing that
85.5information shall also be expunged from the coordinated licensure information system.
85.6(g) The compact administrators, acting jointly with each other and in consultation
85.7with the administrator of the coordinated licensure information system, shall formulate
85.8necessary and proper procedures for the identification, collection, and exchange of
85.9information under this compact.
85.13(a) The head or designee of the nurse licensing board of each party state shall be the
85.14administrator of this compact for that state.
85.15(b) The compact administrator of each party state shall furnish to the compact
85.16administrator of each other party state any information and documents including, but not
85.17limited to, a uniform data set of investigations, identifying information, licensure data, and
85.18disclosable alternative program participation information to facilitate the administration of
85.20(c) Compact administrators shall have the authority to develop uniform rules to
85.21facilitate and coordinate implementation of this compact. These uniform rules shall be
85.22adopted by party states under the authority in article 5, clause (4).
85.25A party state or the officers, employees, or agents of a party state's nurse licensing
85.26board who acts in good faith according to the provisions of this compact shall not be
85.27liable for any act or omission while engaged in the performance of their duties under
85.28this compact. Good faith shall not include willful misconduct, gross negligence, or
85.32(a) This compact shall become effective for each state when it has been enacted by
85.33that state. Any party state may withdraw from this compact by repealing the nurse licensure
85.34compact, but no withdrawal shall take effect until six months after the withdrawing state
85.35has given notice of the withdrawal to the executive heads of all other party states.
86.1(b) No withdrawal shall affect the validity or applicability by the licensing boards
86.2of states remaining party to the compact of any report of adverse action occurring prior
86.3to the withdrawal.
86.4(c) Nothing contained in this compact shall be construed to invalidate or prevent any
86.5nurse licensure agreement or other cooperative arrangement between a party state and a
86.6nonparty state that is made according to the other provisions of this compact.
86.7(d) This compact may be amended by the party states. No amendment to this
86.8compact shall become effective and binding upon the party states until it is enacted into
86.9the laws of all party states.
86.12(a) This compact shall be liberally construed to effectuate the purposes of the
86.13compact. The provisions of this compact shall be severable and if any phrase, clause,
86.14sentence, or provision of this compact is declared to be contrary to the constitution of any
86.15party state or of the United States or the applicability thereof to any government, agency,
86.16person, or circumstance is held invalid, the validity of the remainder of this compact and
86.17the applicability of it to any government, agency, person, or circumstance shall not be
86.18affected by it. If this compact is held contrary to the constitution of any party state, the
86.19compact shall remain in full force and effect for the remaining party states and in full force
86.20and effect for the party state affected as to all severable matters.
86.21(b) In the event party states find a need for settling disputes arising under this
86.23(1) the party states may submit the issues in dispute to an arbitration panel which
86.24shall be comprised of an individual appointed by the compact administrator in the home
86.25state, an individual appointed by the compact administrator in the remote states involved,
86.26and an individual mutually agreed upon by the compact administrators of the party states
86.27involved in the dispute; and
86.28(2) the decision of a majority of the arbitrators shall be final and binding.
86.29 Sec. 9. [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
86.31(a) A nurse practicing professional or practical nursing in Minnesota under the
86.32authority of section 148.2855 shall have the same obligations, privileges, and rights as if
86.33the nurse was licensed in Minnesota. Notwithstanding any contrary provisions in section
86.34148.2855, the Board of Nursing shall comply with and follow all laws and rules with
86.35respect to registered and licensed practical nurses practicing professional or practical
87.1nursing in Minnesota under the authority of section 148.2855, and all such individuals
87.2shall be governed and regulated as if they were licensed by the board.
87.3(b) Section 148.2855 does not relieve employers of nurses from complying with
87.4statutorily imposed obligations.
87.5(c) Section 148.2855 does not supersede existing state labor laws.
87.6(d) For purposes of the Minnesota Government Data Practices Act, chapter 13,
87.7an individual not licensed as a nurse under sections 148.171 to 148.285 who practices
87.8professional or practical nursing in Minnesota under the authority of section 148.2855 is
87.9considered to be a licensee of the board.
87.10(e) Uniform rules developed by the compact administrators shall not be subject
87.11to the provisions of sections 14.05 to 14.389, except for sections 14.07, 14.08, 14.101,
87.1214.131, 14.18, 14.22, 14.23, 14.27, 14.28, 14.365, 14.366, 14.37, and 14.38.
87.13(f) Proceedings brought against an individual's multistate privilege shall be
87.14adjudicated following the procedures listed in sections 14.50 to 14.62 and shall be subject
87.15to judicial review as provided for in sections 14.63 to 14.69.
87.16(g) For purposes of sections 62M.09, subdivision 2; 121A.22, subdivision 4;
87.17144.051; 144.052; 145A.02, subdivision 18; 148.975; 151.37; 152.12; 154.04; 256B.0917,
87.18subdivision 8; 595.02, subdivision 1, paragraph (g); 604.20, subdivision 5; and 631.40,
87.19subdivision 2; and chapters 319B and 364, holders of a multistate privilege who are
87.20licensed as registered or licensed practical nurses in the home state shall be considered
87.21to be licensees in Minnesota. If any of the statutes listed in this paragraph are limited to
87.22registered nurses or the practice of professional nursing, then only holders of a multistate
87.23privilege who are licensed as registered nurses in the home state shall be considered
87.25(h) The reporting requirements of sections 144.4175, 148.263, 626.52, and 626.557
87.26apply to individuals not licensed as registered or licensed practical nurses under sections
87.27148.171 to 148.285 who practice professional or practical nursing in Minnesota under
87.28the authority of section 148.2855.
87.29(i) The board may take action against an individual's multistate privilege based on
87.30the grounds listed in section 148.261, subdivision 1, and any other statute authorizing or
87.31requiring the board to take corrective or disciplinary action.
87.32(j) The board may take all forms of disciplinary action provided for in section
87.33148.262, subdivision 1, and corrective action provided for in section 214.103, subdivision
87.346, against an individual's multistate privilege.
88.1(k) The immunity provisions of section 148.264, subdivision 1, apply to individuals
88.2who practice professional or practical nursing in Minnesota under the authority of section
88.4(l) The cooperation requirements of section 148.265 apply to individuals who
88.5practice professional or practical nursing in Minnesota under the authority of section
88.7(m) The provisions of section 148.283 shall not apply to individuals who practice
88.8professional or practical nursing in Minnesota under the authority of section 148.2855.
88.9(n) Complaints against individuals who practice professional or practical nursing
88.10in Minnesota under the authority of section 148.2855 shall be handled as provided in
88.11sections 214.10 and 214.103.
88.12(o) All provisions of section 148.2855 authorizing or requiring the board to provide
88.13data to party states are authorized by section 214.10, subdivision 8, paragraph (d).
88.14(p) Except as provided in section 13.41, subdivision 6, the board shall not report to a
88.15remote state any active investigative data regarding a complaint investigation against a
88.16nurse licensed under sections 148.171 to 148.285, unless the board obtains reasonable
88.17assurances from the remote state that the data will be maintained with the same protections
88.18as provided in Minnesota law.
88.19(q) The provisions of sections 214.17 to 214.25 apply to individuals who practice
88.20professional or practical nursing in Minnesota under the authority of section 148.2855
88.21when the practice involves direct physical contact between the nurse and a patient.
88.22(r) A nurse practicing professional or practical nursing in Minnesota under the
88.23authority of section 148.2855 must comply with any criminal background check required
88.24under Minnesota law.
88.25 Sec. 10. [148.2857] WITHDRAWAL FROM COMPACT.
88.26The governor may withdraw the state from the compact in section 148.2855 if
88.27the Board of Nursing notifies the governor that a party state to the compact changed
88.28the party state's requirements for nurse licensure after July 1, 2009, and that the party
88.29state's requirements, as changed, are substantially lower than the requirements for nurse
88.30licensure in this state.
88.31 Sec. 11. [148.2858] MISCELLANEOUS PROVISIONS.
88.32(a) For the purposes of section 148.2855, "head of the Nurse Licensing Board"
88.33means the executive director of the board.
89.1(b) The Board of Nursing shall have the authority to recover from a nurse practicing
89.2professional or practical nursing in Minnesota under the authority of section 148.2855
89.3the costs of investigation and disposition of cases resulting from any adverse action
89.4taken against the nurse.
89.5(c) The board may implement a system of identifying individuals who practice
89.6professional or practical nursing in Minnesota under the authority of section 148.2855.
89.7 Sec. 12. [148.2859] NURSE LICENSURE COMPACT ADVISORY
89.9 Subdivision 1. Establishment; membership. A Nurse Licensure Compact Advisory
89.10Committee is established to advise the compact administrator in the implementation of
89.11section 148.2855. Members of the advisory committee shall be appointed by the board
89.12and shall be composed of representatives of Minnesota nursing organizations, Minnesota
89.13licensed nurses who practice in nursing facilities or hospitals, Minnesota licensed nurses
89.14who provide home care, Minnesota licensed advanced practice registered nurses, and
89.15public members as defined in section 214.02.
89.16 Subd. 2. Duties. The advisory committee shall advise the compact administrator in
89.17the implementation of section 148.2855.
89.18 Subd. 3. Organization. The advisory committee shall be organized and
89.19administered under section 15.059.
89.20 Sec. 13. Minnesota Statutes 2010, section 148B.17, is amended to read:
89.22 Subdivision. 1. Fees; Board of Marriage and Family Therapy.
89.24established so that the total fees collected by the board will as closely as possible equal
89.25anticipated expenditures during the fiscal biennium, as provided in section
89.26Fees must be credited to
89.28 Subd. 2. Licensure and application fees. Nonrefundable licensure and application
89.29fees charged by the board are as follows:
89.30(1) application fee for national examination is $220;
89.31(2) application fee for Licensed Marriage and Family Therapist (LMFT) state
89.32examination is $110;
89.33(3) initial LMFT license fee is prorated, but cannot exceed $125;
89.34(4) annual renewal fee for LMFT license is $125;
90.1(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
90.2license renewal is $50;
90.3(6) application fee for LMFT licensure by reciprocity is $340;
90.4(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
90.5license is $75;
90.6(8) annual renewal fee for LAMFT license is $75;
90.7(9) late fee for LAMFT renewal is $50;
90.8(10) fee for reinstatement of license is $150; and
90.9(11) fee for emeritus status is $125.
90.10 Subd. 3. Other fees. Other fees charged by the board are as follows:
90.11(1) sponsor application fee for approval of a continuing education course is $60;
90.12(2) fee for license verification by mail is $10;
90.13(3) duplicate license fee is $25;
90.14(4) duplicate renewal card fee is $10;
90.15(5) fee for licensee mailing list is $60;
90.16(6) fee for a rule book is $10; and
90.17(7) fees as authorized by section 148B.175, subdivision 6, clause (7).
90.18 Sec. 14. Minnesota Statutes 2010, section 148B.33, subdivision 2, is amended to read:
90.19 Subd. 2. Fee. Each applicant shall pay a nonrefundable application fee
90.21 Sec. 15. Minnesota Statutes 2010, section 148B.52, is amended to read:
90.22148B.52 DUTIES OF THE BOARD.
90.23(a) The Board of Behavioral Health and Therapy shall:
90.24(1) establish by rule appropriate techniques, including examinations and other
90.25methods, for determining whether applicants and licensees are qualified under sections
90.27(2) establish by rule standards for professional conduct, including adoption of a
90.28Code of Professional Ethics and requirements for continuing education and supervision;
90.29(3) issue licenses to individuals qualified under sections
90.30(4) establish by rule standards for initial education including coursework for
90.31licensure and content of professional education;
90.32(5) establish, maintain, and publish annually a register of current licensees and
91.1(6) establish initial and renewal application and examination fees sufficient to cover
91.2operating expenses of the board and its agents in accordance with section 16A.1283;
91.3(7) educate the public about the existence and content of the laws and rules for
91.4licensed professional counselors to enable consumers to file complaints against licensees
91.5who may have violated the rules; and
91.6(8) periodically evaluate its rules in order to refine the standards for licensing
91.7professional counselors and to improve the methods used to enforce the board's standards.
91.8(b) The board may appoint a professional discipline committee for each occupational
91.9licensure regulated by the board, and may appoint a board member as chair. The
91.10professional discipline committee shall consist of five members representative of the
91.11licensed occupation and shall provide recommendations to the board with regard to rule
91.12techniques, standards, procedures, and related issues specific to the licensed occupation.
91.13 Sec. 16. Minnesota Statutes 2010, section 150A.091, subdivision 2, is amended to read:
91.14 Subd. 2. Application fees. Each applicant shall submit with a license, advanced
91.15dental therapist certificate, or permit application a nonrefundable fee in the following
91.16amounts in order to administratively process an application:
91.17(1) dentist, $140;
91.18(2) full faculty dentist, $140;
91.21(5) advanced dental therapist, $100;
91.263100.8500, subpart 3, $15.
91.27 Sec. 17. Minnesota Statutes 2010, section 150A.091, subdivision 3, is amended to read:
91.28 Subd. 3. Initial license or permit fees. Along with the application fee, each of the
91.29following applicants shall submit a separate prorated initial license or permit fee. The
91.30prorated initial fee shall be established by the board based on the number of months of the
91.31applicant's initial term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to
91.32exceed the following monthly fee amounts:
91.33(1) dentist or full faculty dentist, $14 times the number of months of the initial term;
91.34(2) dental therapist, $10 times the number of months of the initial term;
92.1(3) dental hygienist, $5 times the number of months of the initial term;
92.2(4) licensed dental assistant, $3 times the number of months of the initial term; and
92.3(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
92.4subpart 3, $1 times the number of months of the initial term.
92.5 Sec. 18. Minnesota Statutes 2010, section 150A.091, subdivision 4, is amended to read:
92.6 Subd. 4. Annual license fees. Each limited faculty or resident dentist shall submit
92.7with an annual license renewal application a fee established by the board not to exceed
92.8the following amounts:
92.9(1) limited faculty dentist, $168; and
92.10(2) resident dentist or dental provider, $59.
92.11 Sec. 19. Minnesota Statutes 2010, section 150A.091, subdivision 5, is amended to read:
92.12 Subd. 5. Biennial license or permit fees. Each of the following applicants shall
92.13submit with a biennial license or permit renewal application a fee as established by the
92.14board, not to exceed the following amounts:
92.15(1) dentist or full faculty dentist, $336;
92.16(2) dental therapist, $180;
92.17(3) dental hygienist, $118;
92.18(4) licensed dental assistant, $80; and
92.19(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500,
92.20subpart 3, $24.
92.21 Sec. 20. Minnesota Statutes 2010, section 150A.091, subdivision 8, is amended to read:
92.22 Subd. 8. Duplicate license or certificate fee. Each applicant shall submit, with
92.23a request for issuance of a duplicate of the original license, or of an annual or biennial
92.24renewal certificate for a license or permit, a fee in the following amounts:
92.25(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental
92.26assistant license, $35; and
92.27(2) annual or biennial renewal certificates, $10.
92.28 Sec. 21. Minnesota Statutes 2010, section 150A.091, is amended by adding a
92.29subdivision to read:
92.30 Subd. 16. Failure of professional development portfolio audit. A licensee shall
92.31submit a fee as established by the board not to exceed the amount of $250 after failing
93.1two consecutive professional development portfolio audits and, thereafter, for each failed
93.2professional development portfolio audit under Minnesota Rules, part 3100.5300.
93.3 Sec. 22. [151.065] FEE AMOUNTS.
93.4 Subdivision 1. Application fees. Application fees for licensure and registration
93.5are as follows:
93.6(1) pharmacist licensed by examination, $130;
93.7(2) pharmacist licensed by reciprocity, $225;
93.8(3) pharmacy intern, $30;
93.9(4) pharmacy technician, $30;
93.10(5) pharmacy, $190;
93.11(6) drug wholesaler, legend drugs only, $200;
93.12(7) drug wholesaler, legend and nonlegend drugs, $200;
93.13(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
93.14(9) drug wholesaler, medical gases, $150;
93.15(10) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
93.16(11) drug manufacturer, legend drugs only, $200;
93.17(12) drug manufacturer, legend and nonlegend drugs, $200;
93.18(13) drug manufacturer, nonlegend or veterinary legend drugs, $175;
93.19(14) drug manufacturer, medical gases, $150;
93.20(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
93.21(16) medical gas distributor, $75;
93.22(17) controlled substance researcher, $50; and
93.23(18) pharmacy professional corporation, $100.
93.24 Subd. 2. Original license fee. The pharmacist original licensure fee, $130.
93.25 Subd. 3. Annual renewal fees. Annual licensure and registration renewal fees
93.26are as follows:
93.27(1) pharmacist, $130;
93.28(2) pharmacy technician, $30;
93.29(3) pharmacy, $190;
93.30(4) drug wholesaler, legend drugs only, $200;
93.31(5) drug wholesaler, legend and nonlegend drugs, $200;
93.32(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $175;
93.33(7) drug wholesaler, medical gases, $150;
93.34(8) drug wholesaler, also licensed as a pharmacy in Minnesota, $125;
93.35(9) drug manufacturer, legend drugs only, $200;
94.1(10) drug manufacturer, legend and nonlegend drugs, $200;
94.2(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $175;
94.3(12) drug manufacturer, medical gases, $150;
94.4(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $125;
94.5(14) medical gas distributor, $75;
94.6(15) controlled substance researcher, $50; and
94.7(16) pharmacy professional corporation, $45.
94.8 Subd. 4. Miscellaneous fees. Fees for issuance of affidavits and duplicate licenses
94.9and certificates are as follows:
94.10(1) intern affidavit, $15;
94.11(2) duplicate small license, $15; and
94.12(3) duplicate large certificate, $25.
94.13 Subd. 5. Late fees. All annual renewal fees are subject to a 50 percent late fee if
94.14the renewal fee and application are not received by the board prior to the date specified
94.15by the board.
94.16 Subd. 6. Reinstatement fees. (a) A pharmacist who has allowed the pharmacist's
94.17license to lapse may reinstate the license with board approval and upon payment of any
94.18fees and late fees in arrears, up to a maximum of $1,000.
94.19(b) A pharmacy technician who has allowed the technician's registration to lapse
94.20may reinstate the registration with board approval and upon payment of any fees and late
94.21fees in arrears, up to a maximum of $90.
94.22(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, or a medical
94.23gas distributor who has allowed the license of the establishment to lapse may reinstate the
94.24license with board approval and upon payment of any fees and late fees in arrears.
94.25(d) A controlled substance researcher who has allowed the researcher's registration
94.26to lapse may reinstate the registration with board approval and upon payment of any fees
94.27and late fees in arrears.
94.28(e) A pharmacist owner of a professional corporation who has allowed the
94.29corporation's registration to lapse may reinstate the registration with board approval and
94.30upon payment of any fees and late fees in arrears.
94.31 Sec. 23. Minnesota Statutes 2010, section 151.07, is amended to read:
94.32151.07 MEETINGS; EXAMINATION FEE.
94.33The board shall meet at times as may be necessary and as it may determine to
94.34examine applicants for licensure and to transact its other business, giving reasonable
94.35notice of all examinations by mail to known applicants therefor. The secretary shall record
95.1the names of all persons licensed by the board, together with the grounds upon which
95.2the right of each to licensure was claimed. The fee for examination shall be in
95.4discretion of the board be returned to applicants not taking the examination.
95.5 Sec. 24. Minnesota Statutes 2010, section 151.101, is amended to read:
95.7Upon payment of the fee specified in section 151.065, the board may
95.8as an intern any natural persons who have satisfied the board that they are of good moral
95.9character, not physically or mentally unfit, and who have successfully completed the
95.10educational requirements for intern
95.11board shall prescribe standards and requirements for interns, pharmacist-preceptors, and
95.12internship training but may not require more than one year of such training.
95.13The board in its discretion may accept internship experience obtained in another
95.14state provided the internship requirements in such other state are in the opinion of the
95.15board equivalent to those herein provided.
95.16 Sec. 25. Minnesota Statutes 2010, section 151.102, is amended by adding a subdivision
95.18 Subd. 3. Registration fee. The board shall not register an individual as a pharmacy
95.19technician unless all applicable fees specified in section 151.065 have been paid.
95.20 Sec. 26. Minnesota Statutes 2010, section 151.12, is amended to read:
95.21151.12 RECIPROCITY; LICENSURE.
95.22The board may in its discretion grant licensure without examination to any
95.23pharmacist licensed by the Board of Pharmacy or a similar board of another state which
95.24accords similar recognition to licensees of this state; provided, the requirements for
95.25licensure in such other state are in the opinion of the board equivalent to those herein
95.26provided. The fee for licensure shall be in
95.28 Sec. 27. Minnesota Statutes 2010, section 151.13, subdivision 1, is amended to read:
95.29 Subdivision 1. Renewal fee. Every person licensed by the board as a pharmacist
95.30shall pay to the board
95.31151.065. The board may
96.1application are not received by the board prior to the date specified by the board. It shall
96.2be unlawful for any person licensed as a pharmacist who refuses or fails to pay
96.3applicable renewal or late fee to practice pharmacy in this state. Every certificate and
96.4license shall expire at the time therein prescribed.
96.5 Sec. 28. Minnesota Statutes 2010, section 151.19, is amended to read:
96.6151.19 REGISTRATION; FEES.
96.7 Subdivision 1. Pharmacy registration. The board shall require and provide for the
96.8annual registration of every pharmacy now or hereafter doing business within this state.
96.9Upon the payment of
96.10151.065, the board shall issue a registration certificate in such form as it may prescribe to
96.11such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be
96.12displayed in a conspicuous place in the pharmacy for which it is issued and expire on the
96.1330th day of June following the date of issue. It shall be unlawful for any person to conduct
96.14a pharmacy unless such certificate has been issued to the person by the board.
96.15 Subd. 2. Nonresident pharmacies. The board shall require and provide for an
96.16annual nonresident special pharmacy registration for all pharmacies located outside of this
96.17state that regularly dispense medications for Minnesota residents and mail, ship, or deliver
96.18prescription medications into this state. Nonresident special pharmacy registration shall
96.19be granted by the board upon payment of any applicable fee specified in section 151.065
96.20and the disclosure and certification by a pharmacy:
96.21 (1) that it is licensed in the state in which the dispensing facility is located and from
96.22which the drugs are dispensed;
96.23 (2) the location, names, and titles of all principal corporate officers and all
96.24pharmacists who are dispensing drugs to residents of this state;
96.25 (3) that it complies with all lawful directions and requests for information from
96.26the Board of Pharmacy of all states in which it is licensed or registered, except that it
96.27shall respond directly to all communications from the board concerning emergency
96.28circumstances arising from the dispensing of drugs to residents of this state;
96.29 (4) that it maintains its records of drugs dispensed to residents of this state so that the
96.30records are readily retrievable from the records of other drugs dispensed;
96.31 (5) that it cooperates with the board in providing information to the Board of
96.32Pharmacy of the state in which it is licensed concerning matters related to the dispensing
96.33of drugs to residents of this state;
96.34 (6) that during its regular hours of operation, but not less than six days per week, for
96.35a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
97.1communication between patients in this state and a pharmacist at the pharmacy who has
97.2access to the patients' records; the toll-free number must be disclosed on the label affixed
97.3to each container of drugs dispensed to residents of this state; and
97.4 (7) that, upon request of a resident of a long-term care facility located within the
97.5state of Minnesota, the resident's authorized representative, or a contract pharmacy or
97.6licensed health care facility acting on behalf of the resident, the pharmacy will dispense
97.7medications prescribed for the resident in unit-dose packaging or, alternatively, comply
97.8with the provisions of section
97.9 Subd. 3. Sale of federally restricted medical gases. The board shall require and
97.10provide for the annual registration of every person or establishment not licensed as a
97.11pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
97.12medical gases. Upon the payment of
97.13in section 151.065, the board shall issue a registration certificate in such form as it may
97.14prescribe to those persons or places that may be qualified to sell or distribute federally
97.15restricted medical gases. The certificate shall be displayed in a conspicuous place in the
97.16business for which it is issued and expire on the date set by the board. It is unlawful for
97.17a person to sell or distribute federally restricted medical gases unless a certificate has
97.18been issued to that person by the board.
97.19 Sec. 29. Minnesota Statutes 2010, section 151.25, is amended to read:
97.20151.25 REGISTRATION OF MANUFACTURERS; FEE; PROHIBITIONS.
97.21The board shall require and provide for the annual registration of every person
97.22engaged in manufacturing drugs, medicines, chemicals, or poisons for medicinal purposes,
97.23now or hereafter doing business with accounts in this state. Upon a payment of
97.25registration certificate in such form as it may prescribe to such manufacturer. Such
97.26registration certificate shall be displayed in a conspicuous place in such manufacturer's
97.27or wholesaler's place of business for which it is issued and expire on the date set by the
97.28board. It shall be unlawful for any person to manufacture drugs, medicines, chemicals,
97.29or poisons for medicinal purposes unless such a certificate has been issued to the person
97.30by the board. It shall be unlawful for any person engaged in the manufacture of drugs,
97.31medicines, chemicals, or poisons for medicinal purposes, or the person's agent, to sell
97.32legend drugs to other than a pharmacy, except as provided in this chapter.
97.33 Sec. 30. Minnesota Statutes 2010, section 151.47, subdivision 1, is amended to read:
98.1 Subdivision 1. Requirements. All wholesale drug distributors are subject to the
98.2requirements in paragraphs (a) to (f).
98.3(a) No person or distribution outlet shall act as a wholesale drug distributor without
98.4first obtaining a license from the board and paying
98.5specified in section 151.065.
98.6(b) No license shall be issued or renewed for a wholesale drug distributor to operate
98.7unless the applicant agrees to operate in a manner prescribed by federal and state law and
98.8according to the rules adopted by the board.
98.9(c) The board may require a separate license for each facility directly or indirectly
98.10owned or operated by the same business entity within the state, or for a parent entity
98.11with divisions, subsidiaries, or affiliate companies within the state, when operations
98.12are conducted at more than one location and joint ownership and control exists among
98.13all the entities.
98.14(d) As a condition for receiving and retaining a wholesale drug distributor license
98.15issued under sections
98.16and will continuously maintain:
98.17(1) adequate storage conditions and facilities;
98.18(2) minimum liability and other insurance as may be required under any applicable
98.19federal or state law;
98.20(3) a viable security system that includes an after hours central alarm, or comparable
98.21entry detection capability; restricted access to the premises; comprehensive employment
98.22applicant screening; and safeguards against all forms of employee theft;
98.23(4) a system of records describing all wholesale drug distributor activities set forth
98.25accessible as defined by board regulations in any inspection authorized by the board;
98.26(5) principals and persons, including officers, directors, primary shareholders,
98.27and key management executives, who must at all times demonstrate and maintain their
98.28capability of conducting business in conformity with sound financial practices as well
98.29as state and federal law;
98.30(6) complete, updated information, to be provided to the board as a condition for
98.31obtaining and retaining a license, about each wholesale drug distributor to be licensed,
98.32including all pertinent corporate licensee information, if applicable, or other ownership,
98.33principal, key personnel, and facilities information found to be necessary by the board;
98.34(7) written policies and procedures that assure reasonable wholesale drug distributor
98.35preparation for, protection against, and handling of any facility security or operation
98.36problems, including, but not limited to, those caused by natural disaster or government
99.1emergency, inventory inaccuracies or product shipping and receiving, outdated product
99.2or other unauthorized product control, appropriate disposition of returned goods, and
99.4(8) sufficient inspection procedures for all incoming and outgoing product
99.6(9) operations in compliance with all federal requirements applicable to wholesale
99.8(e) An agent or employee of any licensed wholesale drug distributor need not seek
99.9licensure under this section.
99.10(f) A wholesale drug distributor shall file with the board an annual report, in a
99.11form and on the date prescribed by the board, identifying all payments, honoraria,
99.12reimbursement or other compensation authorized under section
99.13(5), paid to practitioners in Minnesota during the preceding calendar year. The report
99.14shall identify the nature and value of any payments totaling $100 or more, to a particular
99.15practitioner during the year, and shall identify the practitioner. Reports filed under this
99.16provision are public data.
99.17 Sec. 31. Minnesota Statutes 2010, section 151.48, is amended to read:
99.18151.48 OUT-OF-STATE WHOLESALE DRUG DISTRIBUTOR LICENSING.
99.19(a) It is unlawful for an out-of-state wholesale drug distributor to conduct business
99.20in the state without first obtaining a license from the board and paying
99.21applicable fee specified in section 151.065.
99.22(b) Application for an out-of-state wholesale drug distributor license under this
99.23section shall be made on a form furnished by the board.
99.24(c) No person acting as principal or agent for any out-of-state wholesale drug
99.25distributor may sell or distribute drugs in the state unless the distributor has obtained
99.27(d) The board may adopt regulations that permit out-of-state wholesale drug
99.28distributors to obtain a license on the basis of reciprocity to the extent that an out-of-state
99.29wholesale drug distributor:
99.30(1) possesses a valid license granted by another state under legal standards
99.31comparable to those that must be met by a wholesale drug distributor of this state as
99.32prerequisites for obtaining a license under the laws of this state; and
99.33(2) can show that the other state would extend reciprocal treatment under its own
99.34laws to a wholesale drug distributor of this state.
100.1 Sec. 32. Minnesota Statutes 2010, section 152.12, subdivision 3, is amended to read:
100.2 Subd. 3. Research project use of controlled substances. Any qualified person
100.3may use controlled substances in the course of a bona fide research project but cannot
100.4administer or dispense such drugs to human beings unless such drugs are prescribed,
100.5dispensed and administered by a person lawfully authorized to do so. Every person
100.6who engages in research involving the use of such substances shall apply annually for
100.7registration by the state Board of Pharmacy and shall pay any applicable fee specified in
100.8section 151.065, provided that such registration shall not be required if the person is
100.9covered by and has complied with federal laws covering such research projects.
100.10 Sec. 33. [214.107] HEALTH-RELATED LICENSING BOARDS
100.11ADMINISTRATIVE SERVICES UNIT.
100.12 Subdivision 1. Establishment. An administrative services unit is established
100.13for the health-related licensing boards in section 214.01, subdivision 2, to perform
100.14administrative, financial, and management functions common to all the boards in a manner
100.15that streamlines services, reduces expenditures, targets the use of state resources, and
100.16meets the mission of public protection.
100.17 Subd. 2. Authority. The administrative services unit shall act as an agent of the
100.19 Subd. 3. Funding. (a) The administrative service unit shall apportion among the
100.20health-related licensing boards an amount to be allocated to each health-related licensing
100.21board. The amount apportioned to each board shall equal each board's share of the annual
100.22operating costs for the unit and shall be deposited into the state government special
100.24(b) The administrative services unit may receive and expend reimbursements for
100.25services performed for other agencies.
100.26 Sec. 34. EFFECTIVE DATE.
100.27Sections 8 to 12 are effective upon implementation of the coordinated licensure
100.28information system defined in Minnesota Statutes, section 148.2855, but no sooner than
100.29July 1, 2012.
100.32 Section 1. [1.06] FREEDOM OF CHOICE IN HEALTH CARE ACT.
101.1 Subdivision 1. Citation. This section shall be known as and may be cited as the
101.2"Freedom of Choice in Health Care Act."
101.3 Subd. 2. Definitions. (a) For purposes of this section, the following terms have
101.4the meaning given them.
101.5(b) "Health care service" means any service, treatment, or provision of a product for
101.6the care of a physical or mental disease, illness, injury, defect, or condition, or to otherwise
101.7maintain or improve physical or mental health, subject to all laws and rules regulating
101.8health service providers and products within the state of Minnesota.
101.9(c) "Mode of securing" means to purchase directly or on credit or by trade, or to
101.10contract for third-party payment by insurance or other legal means as authorized by the
101.11state of Minnesota, or to apply for or accept employer-sponsored or government-sponsored
101.12health care benefits under such conditions as may legally be required as a condition of
101.13such benefits, or any combination of the same.
101.14(d) "Penalty" means any civil or criminal fine, tax, salary or wage withholding,
101.15surcharge, fee, or any other imposed consequence established by law or rule of a
101.16government or its subdivision or agency that is used to punish or discourage the exercise
101.17of rights protected under this section.
101.18 Subd. 3. Statement of public policy. (a) The power to require or regulate a person's
101.19choice in the mode of securing health care services, or to impose a penalty related to that
101.20choice, is not found in the Constitution of the United States of America, and is therefore a
101.21power reserved to the people pursuant to the Ninth Amendment, and to the several states
101.22pursuant to the Tenth Amendment. The state of Minnesota hereby exercises its sovereign
101.23power to declare the public policy of the state of Minnesota regarding the right of all
101.24persons residing in the state in choosing the mode of securing health care services.
101.25(b) It is hereby declared that the public policy of the state of Minnesota, consistent
101.26with our constitutionally recognized and inalienable rights of liberty, is that every person
101.27within the state of Minnesota is and shall be free to choose or decline to choose any mode
101.28of securing health care services without penalty or threat of penalty.
101.29(c) The policy stated under this section shall not be applied to impair any right of
101.30contract related to the provision of health care services to any person or group.
101.31 Subd. 4. Enforcement. (a) No public official, employee, or agent of the state of
101.32Minnesota or any of its political subdivisions shall act to impose, collect, enforce, or
101.33effectuate any penalty in the state of Minnesota that violates the public policy set forth
101.34in this section.
101.35(b) The attorney general shall take any action as is provided in this section or section
101.368.31 in the defense or prosecution of rights protected under this section.
102.1 Sec. 2. Minnesota Statutes 2010, section 8.31, subdivision 1, is amended to read:
102.2 Subdivision 1. Investigate offenses against provisions of certain designated
102.3sections; assist in enforcement. (a) The attorney general shall investigate violations of the
102.4law of this state respecting unfair, discriminatory, and other unlawful practices in business,
102.5commerce, or trade, and specifically, but not exclusively, the Nonprofit Corporation Act
102.8325D.16), the Antitrust Act (sections
102.9laws against false or fraudulent advertising, the antidiscrimination acts contained in
102.11the act regulating telephone advertising services (section 325E.39), the Prevention of
102.12Consumer Fraud Act (sections
102.13exchanges and assist in the enforcement of those laws as in this section provided.
102.14(b) The attorney general shall seek injunctive and any other appropriate relief as
102.15expeditiously as possible to preserve the rights and property of the residents of Minnesota,
102.16and to defend as necessary the state of Minnesota, its officials, employees, and agents in
102.17the event that any law or regulation violating the public policy set forth in the Freedom
102.18of Choice in Health Care Act in this section is enacted by any government, subdivision,
102.19or agency thereof.
102.20(c) The attorney general shall seek injunctive and any other appropriate relief
102.21as expeditiously as possible in the event that any law or regulation violating the public
102.22policy set forth in the Freedom of Choice in Health Care Act in this section is enacted
102.23without adequate federal funding to the state to ensure affordable health care coverage
102.24is available to the residents of Minnesota.
102.25 Sec. 3. Minnesota Statutes 2010, section 8.31, subdivision 3a, is amended to read:
102.26 Subd. 3a. Private remedies. In addition to the remedies otherwise provided by law,
102.27any person injured by a violation of any of the laws referred to in subdivision 1 or a
102.28violation of the public policy in section 1.06 may bring a civil action and recover damages,
102.29together with costs and disbursements, including costs of investigation and reasonable
102.30attorney's fees, and receive other equitable relief as determined by the court. The court
102.31may, as appropriate, enter a consent judgment or decree without the finding of illegality.
102.32In any action brought by the attorney general pursuant to this section, the court may award
102.33any of the remedies allowable under this subdivision. An action under this subdivision
102.34for any violation of section 1.06 is in the public interest.
103.1 Sec. 4. Minnesota Statutes 2010, section 62E.08, subdivision 1, is amended to read:
103.2 Subdivision 1. Establishment. The association shall establish the following
103.3maximum premiums to be charged for membership in the comprehensive health insurance
103.5(a) the premium for the number one qualified plan shall range from a minimum of
103.6101 percent to a maximum of 125 percent of the weighted average of rates charged by
103.7those insurers and health maintenance organizations with individuals enrolled in:
103.8(1) $1,000 annual deductible individual plans of insurance in force in Minnesota;
103.9(2) individual health maintenance organization contracts of coverage with a $1,000
103.10annual deductible which are in force in Minnesota; and
103.11(3) other plans of coverage similar to plans offered by the association based on
103.12generally accepted actuarial principles;
103.13(b) the premium for the number two qualified plan shall range from a minimum of
103.14101 percent to a maximum of 125 percent of the weighted average of rates charged by
103.15those insurers and health maintenance organizations with individuals enrolled in:
103.16(1) $500 annual deductible individual plans of insurance in force in Minnesota;
103.17(2) individual health maintenance organization contracts of coverage with a $500
103.18annual deductible which are in force in Minnesota; and
103.19(3) other plans of coverage similar to plans offered by the association based on
103.20generally accepted actuarial principles;
103.21(c) the premiums for the plans with a $2,000, $5,000, or $10,000 annual deductible
103.22shall range from a minimum of 101 percent to a maximum of 125 percent of the weighted
103.23average of rates charged by those insurers and health maintenance organizations with
103.24individuals enrolled in:
103.25(1) $2,000, $5,000, or $10,000 annual deductible individual plans, respectively, in
103.26force in Minnesota; and
103.27(2) individual health maintenance organization contracts of coverage with a $2,000,
103.28$5,000, or $10,000 annual deductible, respectively, which are in force in Minnesota; or
103.29(3) other plans of coverage similar to plans offered by the association based on
103.30generally accepted actuarial principles;
103.31(d) the premium for each type of Medicare supplement plan required to be offered
103.32by the association pursuant to section
103.33to a maximum of 125 percent of the weighted average of rates charged by those insurers
103.34and health maintenance organizations with individuals enrolled in:
103.35(1) Medicare supplement plans in force in Minnesota;
104.1(2) health maintenance organization Medicare supplement contracts of coverage
104.2which are in force in Minnesota; and
104.3(3) other plans of coverage similar to plans offered by the association based on
104.4generally accepted actuarial principles;
104.5(e) the charge for health maintenance organization coverage shall be based on
104.6generally accepted actuarial principles
104.7(f) the premium for a high-deductible, basic plan offered under section 62E.121 shall
104.8range from a minimum of 101 percent to a maximum of 125 percent of the weighted
104.9average of rates charged by those insurers and health maintenance organizations offering
104.10comparable plans outside of the Minnesota Comprehensive Health Association.
104.11The list of insurers and health maintenance organizations whose rates are used to
104.12establish the premium for coverage offered by the association pursuant to paragraphs (a)
104.13to (d) and (f) shall be established by the commissioner on the basis of information which
104.14shall be provided to the association by all insurers and health maintenance organizations
104.15annually at the commissioner's request. This information shall include the number of
104.16individuals covered by each type of plan or contract specified in paragraphs (a) to (d) and
104.17(f) that is sold, issued, and renewed by the insurers and health maintenance organizations,
104.18including those plans or contracts available only on a renewal basis. The information shall
104.19also include the rates charged for each type of plan or contract.
104.20In establishing premiums pursuant to this section, the association shall utilize
104.21generally accepted actuarial principles, provided that the association shall not discriminate
104.22in charging premiums based upon sex. In order to compute a weighted average for each
104.23type of plan or contract specified under paragraphs (a) to (d) and (f), the association
104.24shall, using the information collected pursuant to this subdivision, list insurers and health
104.25maintenance organizations in rank order of the total number of individuals covered by
104.26each insurer or health maintenance organization. The association shall then compute
104.27a weighted average of the rates charged for coverage by all the insurers and health
104.28maintenance organizations by:
104.29(1) multiplying the numbers of individuals covered by each insurer or health
104.30maintenance organization by the rates charged for coverage;
104.31(2) separately summing both the number of individuals covered by all the insurers
104.32and health maintenance organizations and all the products computed under clause (1); and
104.33(3) dividing the total of the products computed under clause (1) by the total number
104.34of individuals covered.
104.35The association may elect to use a sample of information from the insurers and
104.36health maintenance organizations for purposes of computing a weighted average. In no
105.1case, however, may a sample used by the association to compute a weighted average
105.2include information from fewer than the two insurers or health maintenance organizations
105.3highest in rank order.
105.4 Sec. 5. [62E.121] HIGH-DEDUCTIBLE, BASIC PLAN.
105.5 Subdivision 1. Required offering. The Minnesota Comprehensive Health
105.6Association shall offer a high-deductible, basic plan that meets the requirements specified
105.7in this section. The high-deductible, basic plan is a one-person plan. Any dependents
105.8must be covered separately.
105.9 Subd. 2. Annual deductible; out-of-pocket maximum. (a) The plan shall provide
105.10the following in-network annual deductible options: $3,000, $6,000, $9,000, and $12,000.
105.11The in-network annual out-of-pocket maximum for each annual deductible option shall be
105.12$1,000 greater than the amount of the annual deductible.
105.13(b) The deductible is subject to an annual increase based on the change in the
105.14Consumer Price Index (CPI).
105.15 Subd. 3. Office visits for nonpreventive care. The following co-payments shall
105.16apply for each of the first three office visits per calendar year for nonpreventive care:
105.17(1) $30 per visit for the $3,000 annual deductible option;
105.18(2) $40 per visit for the $6,000 annual deductible option;
105.19(3) $50 per visit for the $9,000 annual deductible option; and
105.20(4) $60 per visit for the $12,000 annual deductible option.
105.21For the fourth and subsequent visits during the calendar year, 80 percent coverage is
105.22provided under all deductible options, after the deductible is met.
105.23 Subd. 4. Preventive care. One hundred percent coverage is provided for preventive
105.24care, and no co-payment, coinsurance, or deductible requirements apply.
105.25 Subd. 5. Prescription drugs. A $10 co-payment applies to preferred generic drugs.
105.26Preferred brand-name drugs require an enrollee payment of 100 percent of the health
105.27plan's discounted rate.
105.28 Subd. 6. Convenience care center visits. A $20 co-payment applies for the first
105.29three convenience care center visits during a calendar year. For the fourth and subsequent
105.30visits during a calendar year, 80 percent coverage is provided after the deductible is met.
105.31 Subd. 7. Urgent care center visits. A $100 co-payment applies for the first urgent
105.32care center visit during a calendar year. For the second and subsequent visits during a
105.33calendar year, 80 percent coverage is provided after the deductible is met.
106.1 Subd. 8. Emergency room visits. A $200 co-payment applies for the first
106.2emergency room visit during a calendar year. For the second and subsequent visits during
106.3a calendar year, 80 percent coverage is provided after the deductible is met.
106.4 Subd. 9. Lab and x-ray; hospital services; ambulance; surgery. Lab and x-ray
106.5services, hospital services, ambulance services, and surgery are covered at 80 percent
106.6after the deductible is met.
106.7 Subd. 10. Eyewear. The health plan pays up to $50 per calendar year for eyewear.
106.8 Subd. 11. Maternity. Maternity, labor and delivery, and postpartum care are not
106.9covered. One hundred percent coverage is provided for prenatal care and no deductible
106.11 Subd. 12. Other eligible health care services. Other eligible health care services
106.12are covered at 80 percent after the deductible is met.
106.13 Subd. 13. Option to remove mental health and substance abuse coverage.
106.14Enrollees have the option of removing mental health and substance abuse coverage in
106.15exchange for a reduced premium.
106.16 Subd. 14. Option to upgrade prescription drug coverage. Enrollees have
106.17the option to upgrade prescription drug coverage to include coverage for preferred
106.18brand-name drugs with a $50 co-payment and coverage for nonpreferred drugs with a
106.19$100 co-payment in exchange for an increased premium.
106.20 Subd. 15. Out-of-network services. (a) The out-of-network annual deductible is
106.21double the in-network annual deductible.
106.22(b) There is no out-of-pocket maximum for out-of-network services.
106.23(c) Benefits for out-of-network services are covered at 60 percent after the deductible
106.25(d) The lifetime maximum benefit for out-of-network services is $1,000,000.
106.26 Subd. 16. Services not covered. Services not covered include: custodial care
106.27or rest care; most dental services; cosmetic services; refractive eye surgery; infertility
106.28services; and services that are investigational, not medically necessary, or received while
106.29on military duty.
106.30 Sec. 6. Minnesota Statutes 2010, section 62E.14, is amended by adding a subdivision
106.32 Subd. 4f. Waiver of preexisting conditions for persons covered by healthy
106.33Minnesota contribution program. A person may enroll in the comprehensive plan with
106.34a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
107.1the healthy Minnesota contribution program, and has been denied coverage as described
107.2under section 256L.031, subdivision 6.
107.3 Sec. 7. Minnesota Statutes 2010, section 62J.04, subdivision 9, is amended to read:
107.4 Subd. 9. Growth limits; federal programs. The commissioners of health and
107.5human services shall establish a rate methodology for Medicare and Medicaid risk-based
107.6contracting with health plan companies that is consistent with statewide growth limits.
107.11 Sec. 8. Minnesota Statutes 2010, section 62J.692, subdivision 7, is amended to read:
107.12 Subd. 7. Transfers from the commissioner of human services. Of the amount
107.13transferred according to section
107.14$21,714,000 shall be distributed as follows:
107.15(1) $2,157,000 shall be distributed by the commissioner to the University of
107.16Minnesota Board of Regents for the purposes described in sections
107.17(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
107.18Medical Center for clinical medical education;
107.19(3) $17,400,000 shall be distributed by the commissioner to the University of
107.20Minnesota Board of Regents for purposes of medical education;
107.21(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
107.22dental innovation grants in accordance with subdivision 7a; and
107.23(5) the remainder of the amount transferred according to section
107.24subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
107.25clinical medical education programs that meet the qualifications of subdivision 3 based on
107.26the formula in subdivision 4, paragraph (a), or subdivision 11, as appropriate.
107.27 Sec. 9. Minnesota Statutes 2010, section 62J.692, subdivision 9, is amended to read:
107.28 Subd. 9. Review of eligible providers. The commissioner and the Medical
107.29Education and Research Costs Advisory Committee may review provider groups included
107.30in the definition of a clinical medical education program to assure that the distribution of
107.31the funds continue to be consistent with the purpose of this section. The results of any
107.32such reviews must be reported to the
108.1chairs and ranking minority members of the legislative committees with jurisdiction over
108.2health care policy and finance.
108.3 Sec. 10. [62J.824] BILLING FOR PROCEDURES TO CORRECT MEDICAL
108.5A health care provider shall not bill a patient, and shall not be reimbursed, for
108.6any operation, treatment, or other care that is provided to reverse, correct, or otherwise
108.7minimize the affects of an adverse health care event, as described in section 144.7065,
108.8subdivisions 2 to 7, for which that health care provider is responsible.
108.9 Sec. 11. Minnesota Statutes 2010, section 62Q.32, is amended to read:
108.1062Q.32 LOCAL OMBUDSPERSON.
108.11County board or community health service agencies may establish an office of
108.12ombudsperson to provide a system of consumer advocacy for persons receiving health
108.13care services through a health plan company. The ombudsperson's functions may include,
108.14but are not limited to:
108.15(a) mediation or advocacy on behalf of a person accessing the complaint and appeal
108.16procedures to ensure that necessary medical services are provided by the health plan
108.18(b) investigation of the quality of services provided to a person and determine the
108.19extent to which quality assurance mechanisms are needed or any other system change
108.20may be needed.
108.24 Sec. 12. Minnesota Statutes 2010, section 62U.04, subdivision 3, is amended to read:
108.25 Subd. 3. Provider peer grouping. (a) The commissioner shall develop a peer
108.26grouping system for providers based on a combined measure that incorporates both
108.27provider risk-adjusted cost of care and quality of care, and for specific conditions as
108.28determined by the commissioner. In developing this system, the commissioner shall
108.29consult and coordinate with health care providers, health plan companies, state agencies,
108.30and organizations that work to improve health care quality in Minnesota. For purposes of
108.31the final establishment of the peer grouping system, the commissioner shall not contract
108.32with any private entity, organization, or consortium of entities that has or will have a direct
108.33financial interest in the outcome of the system.
109.1 (b) By no later than October 15, 2010, the commissioner shall disseminate
109.2information to providers on their total cost of care, total resource use, total quality of care,
109.3and the total care results of the grouping developed under this subdivision in comparison
109.4to an appropriate peer group. Any analyses or reports that identify providers may only be
109.5published after the provider has been provided the opportunity by the commissioner to
109.6review the underlying data and submit comments. Providers may be given any data for
109.7which they are the subject of the data. The provider shall have 30 days to review the data
109.8for accuracy and initiate an appeal as specified in paragraph (d).
109.9 (c) By no later than January 1, 2011, the commissioner shall disseminate information
109.10to providers on their condition-specific cost of care, condition-specific resource use,
109.11condition-specific quality of care, and the condition-specific results of the grouping
109.12developed under this subdivision in comparison to an appropriate peer group. Any
109.13analyses or reports that identify providers may only be published after the provider has
109.14been provided the opportunity by the commissioner to review the underlying data and
109.15submit comments. Providers may be given any data for which they are the subject of the
109.16data. The provider shall have 30 days to review the data for accuracy and initiate an
109.17appeal as specified in paragraph (d).
109.18(d) The commissioner shall establish an appeals process to resolve disputes from
109.19providers regarding the accuracy of the data used to develop analyses or reports. When
109.20a provider appeals the accuracy of the data used to calculate the peer grouping system
109.21results, the provider shall:
109.22(1) clearly indicate the reason they believe the data used to calculate the peer group
109.23system results are not accurate;
109.24(2) provide evidence and documentation to support the reason that data was not
109.26(3) cooperate with the commissioner, including allowing the commissioner access to
109.27data necessary and relevant to resolving the dispute.
109.28If a provider does not meet the requirements of this paragraph, a provider's appeal shall be
109.29considered withdrawn. The commissioner shall not publish results for a specific provider
109.30under paragraph (e) or (f) while that provider has an unresolved appeal.
109.31 (e) Beginning January 1, 2011, the commissioner shall, no less than annually,
109.32publish information on providers' total cost, total resource use, total quality, and the results
109.33of the total care portion of the peer grouping process. The results that are published must
109.34be on a risk-adjusted basis.
109.35(f) Beginning March 30, 2011, the commissioner shall no less than annually publish
109.36information on providers' condition-specific cost, condition-specific resource use, and
110.1condition-specific quality, and the results of the condition-specific portion of the peer
110.2grouping process. The results that are published must be on a risk-adjusted basis.
110.3(g) Prior to disseminating data to providers under paragraph (b) or (c) or publishing
110.4information under paragraph (e) or (f), the commissioner shall ensure the scientific
110.5validity and reliability of the results according to the standards described in paragraph (h).
110.6If additional time is needed to establish the scientific validity and reliability of the results,
110.7the commissioner may delay the dissemination of data to providers under paragraph (b)
110.8or (c), or the publication of information under paragraph (e) or (f). If the delay is more
110.9than 60 days, the commissioner shall report in writing to the
110.11with jurisdiction over health care policy and finance the following information:
110.12(1) the reason for the delay;
110.13(2) the actions being taken to resolve the delay and establish the scientific validity
110.14and reliability of the results; and
110.15(3) the new dates by which the results shall be disseminated.
110.16If there is a delay under this paragraph, the commissioner must disseminate the
110.17information to providers under paragraph (b) or (c) at least 90 days before publishing
110.18results under paragraph (e) or (f).
110.19(h) The commissioner's assurance of valid and reliable clinic and hospital peer
110.20grouping performance results shall include, at a minimum, the following:
110.21(1) use of the best available evidence, research, and methodologies; and
110.22(2) establishment of an explicit minimum reliability threshold developed in
110.23collaboration with the subjects of the data and the users of the data, at a level not below
110.24nationally accepted standards where such standards exist.
110.25In achieving these thresholds, the commissioner shall not aggregate clinics that are not
110.26part of the same system or practice group. The commissioner shall consult with and solicit
110.27feedback from representatives of physician clinics and hospitals during the peer grouping
110.28data analysis process to obtain input on the methodological options prior to final analysis
110.29and on the design, development, and testing of provider reports.
110.30 Sec. 13. Minnesota Statutes 2010, section 62U.04, subdivision 9, is amended to read:
110.31 Subd. 9. Uses of information. (a)
110.33new products that are offered, after 12 months have elapsed from publication by the
110.34commissioner of the information in subdivision 3, paragraph (e):
111.1 (1) the commissioner of management and budget shall use the information and
111.2methods developed under subdivision 3 to strengthen incentives for members of the state
111.3employee group insurance program to use high-quality, low-cost providers;
111.4 (2) all political subdivisions, as defined in section
111.5health benefits to their employees must offer plans that differentiate providers on their
111.6cost and quality performance and create incentives for members to use better-performing
111.8 (3) all health plan companies shall use the information and methods developed
111.9under subdivision 3 to develop products that encourage consumers to use high-quality,
111.10low-cost providers; and
111.11 (4) health plan companies that issue health plans in the individual market or the
111.12small employer market must offer at least one health plan that uses the information
111.13developed under subdivision 3 to establish financial incentives for consumers to choose
111.14higher-quality, lower-cost providers through enrollee cost-sharing or selective provider
111.16 (b) By January 1, 2011, the commissioner of health shall report to the governor
111.17and the legislature on recommendations to encourage health plan companies to promote
111.18widespread adoption of products that encourage the use of high-quality, low-cost providers.
111.19The commissioner's recommendations may include tax incentives, public reporting of
111.20health plan performance, regulatory incentives or changes, and other strategies.
111.21 Sec. 14. Minnesota Statutes 2010, section 62U.06, subdivision 2, is amended to read:
111.22 Subd. 2. Legislative oversight. Beginning January 15, 2009, the commissioner
111.23of health shall submit to the
111.24ranking minority members of the legislative committees with jurisdiction over health care
111.25policy and finance periodic progress reports on the implementation of this chapter and
111.27 Sec. 15. Minnesota Statutes 2010, section 256.01, subdivision 2b, is amended to read:
111.28 Subd. 2b. Performance payments.
111.33money that is made available through the medical assistance program for managed care
111.34oversight contracted through vendors, including consumer surveys, studies, and external
112.1quality reviews as required by the federal Balanced Budget Act of 1997, Code of Federal
112.2Regulations, title 42, part 438-managed care, subpart E-external quality review. Any
112.3federal money received for managed care oversight is appropriated to the commissioner
112.4for this purpose. The commissioner may expend the federal money received in either
112.5year of the biennium.
112.6 Sec. 16. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
112.8 Subd. 33. Contingency contract fees. (a) When the commissioner enters into
112.9a contingency-based contract for the purpose of recovering medical assistance or
112.10MinnesotaCare funds, the commissioner may retain that portion of the recovered funds
112.11equal to the amount of the contingency fee.
112.12(b) Amounts attributed to new recoveries under this subdivision are appropriated
112.13to the commissioner to the extent they fulfill the payment terms of the contract with the
112.14vendor and shall be deposited into an account in a fund other than the general fund for
112.15purposes of fulfilling the terms of the vendor contract.
112.16 Sec. 17. Minnesota Statutes 2010, section 256.969, subdivision 2b, is amended to read:
112.17 Subd. 2b. Operating payment rates. In determining operating payment rates for
112.18admissions occurring on or after the rate year beginning January 1, 1991, and every two
112.19years after, or more frequently as determined by the commissioner, the commissioner
112.20shall obtain operating data from an updated base year and establish operating payment
112.21rates per admission for each hospital based on the cost-finding methods and allowable
112.22costs of the Medicare program in effect during the base year. Rates under the general
112.23assistance medical care, medical assistance, and MinnesotaCare programs shall not be
112.24rebased to more current data on January 1, 1997, January 1, 2005, for the first 24 months
112.25of the rebased period beginning January 1, 2009. For the first 24 months of the rebased
112.26period beginning January 1, 2011, rates shall not be rebased, except that a Minnesota
112.27long-term hospital shall be rebased effective January 1, 2011, based on its most recent
112.28Medicare cost report ending on or before September 1, 2008, with the provisions under
112.29subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For subsequent
112.30rate setting periods in which the base years are updated, a Minnesota long-term hospital's
112.31base year shall remain within the same period as other hospitals.
112.33for the first six months of the rebased period beginning January 1, 2013. The base year
112.34operating payment rate per admission is standardized by the case mix index and adjusted
113.1by the hospital cost index, relative values, and disproportionate population adjustment.
113.2The cost and charge data used to establish operating rates shall only reflect inpatient
113.3services covered by medical assistance and shall not include property cost information
113.4and costs recognized in outlier payments.
113.5 Sec. 18. Minnesota Statutes 2010, section 256B.04, subdivision 18, is amended to read:
113.6 Subd. 18. Applications for medical assistance. (a) The state agency may
113.7take applications for medical assistance and conduct eligibility determinations for
113.9 (b) The commissioner of human services shall modify the Minnesota health care
113.10programs application form to add a question asking applicants whether they have ever
113.11served in the United States military.
113.12EFFECTIVE DATE.This section is effective August 1, 2011.
113.13 Sec. 19. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
113.14 Subd. 3. Asset limitations for individuals and families.
113.15medical assistance, a person must not individually own more than $3,000 in assets, or if a
113.16member of a household with two family members, husband and wife, or parent and child,
113.17the household must not own more than $6,000 in assets, plus $200 for each additional
113.18legal dependent. In addition to these maximum amounts, an eligible individual or family
113.19may accrue interest on these amounts, but they must be reduced to the maximum at the
113.20time of an eligibility redetermination. The accumulation of the clothing and personal
113.21needs allowance according to section
113.22the time of the eligibility redetermination. The value of assets that are not considered in
113.23determining eligibility for medical assistance is the value of those assets excluded under
113.24the supplemental security income program for aged, blind, and disabled persons, with
113.25the following exceptions:
113.26 (1) household goods and personal effects are not considered;
113.27 (2) capital and operating assets of a trade or business that the local agency determines
113.28are necessary to the person's ability to earn an income are not considered;
113.29 (3) motor vehicles are excluded to the same extent excluded by the supplemental
113.30security income program;
113.31 (4) assets designated as burial expenses are excluded to the same extent excluded by
113.32the supplemental security income program. Burial expenses funded by annuity contracts
113.33or life insurance policies must irrevocably designate the individual's estate as contingent
113.34beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
114.1 (5) effective upon federal approval, for a person who no longer qualifies as an
114.2employed person with a disability due to loss of earnings, assets allowed while eligible
114.3for medical assistance under section
114.4months, beginning with the first month of ineligibility as an employed person with a
114.5disability, to the extent that the person's total assets remain within the allowed limits of
114.9EFFECTIVE DATE.This section is effective October 1, 2011.
114.10 Sec. 20. Minnesota Statutes 2010, section 256B.056, subdivision 4, is amended to read:
114.11 Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
114.13the federal poverty guidelines. Effective January 1, 2000, and each successive January,
114.14recipients of supplemental security income may have an income up to the supplemental
114.15security income standard in effect on that date.
114.16 (b) To be eligible for medical assistance, families and children may have an income
114.17up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
114.18AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
114.191996, shall be increased by three percent.
114.20 (c) Effective July 1, 2002, to be eligible for medical assistance, families and children
114.21may have an income up to 100 percent of the federal poverty guidelines for the family size.
114.27disregard increases in income as required by Public Law Numbers 94-566, section 503;
114.2899-272; and 99-509. Veterans aid and attendance benefits and Veterans Administration
114.29unusual medical expense payments are considered income to the recipient.
114.30EFFECTIVE DATE.This section is effective October 1, 2011.
114.31 Sec. 21. Minnesota Statutes 2010, section 256B.06, subdivision 4, is amended to read:
114.32 Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
114.33to citizens of the United States, qualified noncitizens as defined in this subdivision, and
115.1other persons residing lawfully in the United States. Citizens or nationals of the United
115.2States must cooperate in obtaining satisfactory documentary evidence of citizenship or
115.3nationality according to the requirements of the federal Deficit Reduction Act of 2005,
115.4Public Law 109-171.
115.5(b) "Qualified noncitizen" means a person who meets one of the following
115.7(1) admitted for lawful permanent residence according to United States Code, title 8;
115.8(2) admitted to the United States as a refugee according to United States Code,
115.9title 8, section 1157;
115.10(3) granted asylum according to United States Code, title 8, section 1158;
115.11(4) granted withholding of deportation according to United States Code, title 8,
115.13(5) paroled for a period of at least one year according to United States Code, title 8,
115.15(6) granted conditional entrant status according to United States Code, title 8,
115.17(7) determined to be a battered noncitizen by the United States Attorney General
115.18according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
115.19title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
115.20(8) is a child of a noncitizen determined to be a battered noncitizen by the United
115.21States Attorney General according to the Illegal Immigration Reform and Immigrant
115.22Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
115.23Public Law 104-200; or
115.24(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
115.25Law 96-422, the Refugee Education Assistance Act of 1980.
115.26(c) All qualified noncitizens who were residing in the United States before August
115.2722, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
115.28medical assistance with federal financial participation.
115.32Beginning December 1, 1996, qualified noncitizens who entered the United States
115.33on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
115.34chapter are eligible for medical assistance with federal participation for five years if they
115.35meet one of the following criteria:
116.1(i) refugees admitted to the United States according to United States Code, title 8,
116.3(ii) persons granted asylum according to United States Code, title 8, section 1158;
116.4(iii) persons granted withholding of deportation according to United States Code,
116.5title 8, section 1253(h);
116.6(iv) veterans of the United States armed forces with an honorable discharge for
116.7a reason other than noncitizen status, their spouses and unmarried minor dependent
116.9(v) persons on active duty in the United States armed forces, other than for training,
116.10their spouses and unmarried minor dependent children.
116.15women who are noncitizens described in paragraph (b) or
116.16United States as defined in Code of Federal Regulations, title 8, section 103.12, and who
116.17otherwise meet eligibility requirements of this chapter, are eligible for medical assistance
116.18with federal financial participation as provided by the federal Children's Health Insurance
116.19Program Reauthorization Act of 2009, Public Law 111-3.
116.36chapter are eligible for the benefits as provided in paragraphs
117.1of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United
117.2States Code, title 8, section 1101(a)(15).
117.4noncitizens, regardless of immigration status, who otherwise meet the eligibility
117.5requirements of this chapter, if such care and services are necessary for the treatment of an
117.6emergency medical condition
117.9means a medical condition that meets the requirements of United States Code, title 42,
117.11(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
117.12of an emergency medical condition are limited to the following:
117.13(i) services delivered in an emergency room or by an ambulance service licensed
117.14under chapter 144E that are directly related to the treatment of an emergency medical
117.16(ii) services delivered in an inpatient hospital setting following admission from an
117.17emergency room or clinic for an acute emergency condition; and
117.18(iii) follow-up services that are directly related to the original service provided
117.19to treat the emergency medical condition and are covered by the global payment made
117.20to the provider.
117.21 (2) Services for the treatment of emergency medical conditions do not include:
117.22(i) services delivered in an emergency room or inpatient setting to treat a
117.24(ii) organ transplants and related care;
117.25(iii) services for routine prenatal care;
117.26(iv) continuing care, including long-term care, nursing facility services, home health
117.27care, adult day care, day training, or supportive living services;
117.28(v) elective surgery;
117.29(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
117.30part of an emergency room visit;
117.31(vii) preventative health care and family planning services;
117.33(ix) chemotherapy or therapeutic radiation services;
117.34(x) rehabilitation services;
117.35(xi) physical, occupational, or speech therapy;
117.36(xii) transportation services;
118.1(xiii) case management;
118.2(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
118.3(xv) dental services;
118.4(xvi) hospice care;
118.5(xvii) audiology services and hearing aids;
118.6(xviii) podiatry services;
118.7(xix) chiropractic services;
118.9(xxi) vision services and eyeglasses;
118.10(xxii) waiver services;
118.11(xxiii) individualized education programs; or
118.12(xxiv) chemical dependency treatment.
118.13(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
118.14nonimmigrants, or lawfully present
118.15States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by
118.16a group health plan or health insurance coverage according to Code of Federal Regulations,
118.17title 42, section 457.310, and who otherwise meet the eligibility requirements of this
118.18chapter, are eligible for medical assistance through the period of pregnancy, including
118.19labor and delivery, and 60 days postpartum, to the extent federal funds are available under
118.20title XXI of the Social Security Act, and the state children's health insurance program.
118.29services from a nonprofit center established to serve victims of torture and are otherwise
118.30ineligible for medical assistance under this chapter are eligible for medical assistance
118.31without federal financial participation. These individuals are eligible only for the period
118.32during which they are receiving services from the center. Individuals eligible under this
118.33paragraph shall not be required to participate in prepaid medical assistance.
118.34 Sec. 22. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
118.35subdivision to read:
119.1 Subd. 3q. Evidence-based childbirth program. (a) The commissioner shall
119.2implement a program to reduce the number of elective inductions of labor prior to 39
119.3weeks' gestation. In this subdivision, the term "elective induction of labor" means the
119.4use of artificial means to stimulate labor in a woman without the presence of a medical
119.5condition affecting the woman or the child that makes the onset of labor a medical
119.6necessity. The program must promote the implementation of policies within hospitals
119.7providing services to recipients of medical assistance or MinnesotaCare that prohibit the
119.8use of elective inductions prior to 39 weeks' gestation, and adherence to such policies by
119.9the attending providers.
119.10(b) For all births covered by medical assistance or MinnesotaCare on or after
119.11January 1, 2012, a payment for professional services associated with the delivery of a
119.12child in a hospital must not be made unless the provider has submitted information about
119.13the nature of the labor and delivery including any induction of labor that was performed
119.14in conjunction with that specific birth. The information must be on a form prescribed by
119.16(c) The requirements in paragraph (b) must not apply to deliveries performed
119.17at a hospital that has policies and processes in place that have been approved by the
119.18commissioner which prohibit elective inductions prior to 39 weeks' gestation. A process
119.19for review of hospital induction policies must be established by the commissioner and
119.20review of policies must occur at the discretion of the commissioner. The commissioner's
119.21decision to approve or rescind approval must include verification and review of items
119.22including, but not limited to:
119.23(1) policies that prohibit use of elective inductions for gestation less than 39 weeks;
119.24(2) policies that encourage providers to document and communicate with patients a
119.25final expected date of delivery by 20 weeks' gestation that includes data from ultrasound
119.26measurements as applicable;
119.27(3) policies that encourage patient education regarding elective inductions, and
119.28requires documentation of the processes used to educate patients;
119.29(4) ongoing quality improvement review as determined by the commissioner; and
119.30(5) any data that has been collected by the commissioner.
119.31(d) All hospitals must report annually to the commissioner induction information
119.32for all births that were covered by medical assistance or MinnesotaCare in a format and
119.33manner to be established by the commissioner.
119.34(e) The commissioner at any time may choose not to implement or may discontinue
119.35any or all aspects of the program if the commissioner is able to determine that hospitals
120.1representing at least 90 percent of births covered by medical assistance or MinnesotaCare
120.2have approved policies in place.
120.3EFFECTIVE DATE.This section is effective January 1, 2012.
120.4 Sec. 23. Minnesota Statutes 2010, section 256B.0625, subdivision 8, is amended to
120.6 Subd. 8. Physical therapy. (a) Medical assistance covers physical therapy and
120.8therapy is covered for recipients age 20 and under.
120.9(b) Authorization by the commissioner is required to provide medically necessary
120.10services to a recipient beyond any of the following onetime service thresholds, or a lower
120.11threshold where one has been established by the commissioner for a specified service: (1)
120.1280 units of any approved CPT code other than modalities; (2) 20 modality sessions; and
120.13(3) three evaluations or reevaluations. Services provided by a physical therapy assistant
120.14shall be reimbursed at the same rate as services performed by a physical therapist when
120.15the services of the physical therapy assistant are provided under the direction of a physical
120.16therapist who is on the premises. Services provided by a physical therapy assistant that
120.17are provided under the direction of a physical therapist who is not on the premises shall
120.18be reimbursed at 65 percent of the physical therapist rate.
120.19EFFECTIVE DATE.This section is effective July 1, 2011, for services provided
120.20on a fee-for-service basis, and January 1, 2012, for services provided by a managed care
120.21plan or county-based purchasing plan.
120.22 Sec. 24. Minnesota Statutes 2010, section 256B.0625, subdivision 8a, is amended to
120.24 Subd. 8a. Occupational therapy. (a) Medical assistance covers occupational
120.25therapy and related services
120.26maintenance therapy is covered for recipients age 20 and under.
120.27(b) Authorization by the commissioner is required to provide medically necessary
120.28services to a recipient beyond any of the following onetime service thresholds, or a lower
120.29threshold where one has been established by the commissioner for a specified service:
120.30(1) 120 units of any combination of approved CPT codes; and (2) two evaluations or
120.31reevaluations. Services provided by an occupational therapy assistant shall be reimbursed
120.32at the same rate as services performed by an occupational therapist when the services of
120.33the occupational therapy assistant are provided under the direction of the occupational
121.1therapist who is on the premises. Services provided by an occupational therapy assistant
121.2that are provided under the direction of an occupational therapist who is not on the
121.3premises shall be reimbursed at 65 percent of the occupational therapist rate.
121.4EFFECTIVE DATE.This section is effective July 1, 2011, for services provided
121.5on a fee-for-service basis, and January 1, 2012, for services provided by a managed care
121.6plan or county-based purchasing plan.
121.7 Sec. 25. Minnesota Statutes 2010, section 256B.0625, subdivision 8b, is amended to
121.9 Subd. 8b. Speech-language pathology and audiology services. (a) Medical
121.10assistance covers speech-language pathology and related services
121.1220 and under.
121.13(b) Authorization by the commissioner is required to provide medically necessary
121.14speech-language pathology services to a recipient beyond any of the following
121.15onetime service thresholds, or a lower threshold where one has been established by the
121.16commissioner for a specified service: (1) 50 treatment sessions with any combination of
121.17approved CPT codes; and (2) one evaluation.
121.18(c) Medical assistance covers audiology services and related services. Services
121.19provided by a person who has been issued a temporary registration under section
121.21pathologist or audiologist as long as the requirements of section
121.23EFFECTIVE DATE.This section is effective July 1, 2011, for services provided
121.24on a fee-for-service basis, and January 1, 2012, for services provided by a managed care
121.25plan or county-based purchasing plan.
121.26 Sec. 26. Minnesota Statutes 2010, section 256B.0625, subdivision 8c, is amended to
121.28 Subd. 8c. Care management; rehabilitation services. (a) Effective July 1, 1999,
121.29onetime thresholds shall replace annual thresholds for provision of rehabilitation services
121.30described in subdivisions 8, 8a, and 8b. The onetime thresholds will be the same in
121.31amount and description as the thresholds prescribed by the Department of Human Services
121.32health care programs provider manual for calendar year 1997, except they will not be
121.33renewed annually, and they will include sensory skills and cognitive training skills.
122.1(b) A care management approach for authorization of rehabilitation services beyond
122.2the threshold described in subdivisions 8, 8a, and 8b shall be instituted in conjunction
122.3with the onetime thresholds. The care management approach shall require the provider
122.4and the department rehabilitation reviewer to work together directly through written
122.5communication, or telephone communication when appropriate, to establish a medically
122.6necessary care management plan. Authorization for rehabilitation services shall include
122.7approval for up to 12 months of services at a time without additional documentation from
122.8the provider during the extended period, when the rehabilitation services are medically
122.9necessary due to an ongoing health condition.
122.10(c) The commissioner shall implement an expedited five-day turnaround time to
122.11review authorization requests for recipients who need emergency rehabilitation services
122.12and who have exhausted their onetime threshold limit for those services.
122.13EFFECTIVE DATE.This section is effective July 1, 2011.
122.14 Sec. 27. Minnesota Statutes 2010, section 256B.0625, subdivision 8e, is amended to
122.16 Subd. 8e. Chiropractic services. Payment for chiropractic services is limited to
122.17one annual evaluation and
122.18number of visits is obtained.
122.19 Sec. 28. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
122.20subdivision to read:
122.21 Subd. 8f. Acupuncture services. Medical assistance covers acupuncture, as defined
122.22in section 147B.01, subdivision 3, only when provided by a licensed acupuncturist or by
122.23another Minnesota licensed practitioner for whom acupuncture is within the practitioner's
122.24scope of practice and who has specific acupuncture training or credentialing.
122.25 Sec. 29. Minnesota Statutes 2010, section 256B.0625, subdivision 13e, is amended to
122.27 Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
122.28shall be the lower of the actual acquisition costs of the drugs
122.29or the maximum allowable cost
122.30plus the fixed dispensing fee; or the usual and customary price charged to the public. The
122.31amount of payment basis must be reduced to reflect all discount amounts applied to the
122.32charge by any provider/insurer agreement or contract for submitted charges to medical
122.33assistance programs. The net submitted charge may not be greater than the patient liability
123.1for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
123.2for intravenous solutions which must be compounded by the pharmacist shall be $8 per
123.3bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
123.4nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
123.5nutritional products dispensed in quantities greater than one liter. Actual acquisition cost
123.6includes quantity and other special discounts except time and cash discounts.
123.10acquisition cost plus four percent for independently owned pharmacies located in a
123.11designated rural area within Minnesota, and at wholesale acquisition cost plus two percent
123.12for all other pharmacies. A pharmacy is "independently owned" if it is one of four or
123.13fewer pharmacies under the same ownership nationally. A "designated rural area" means
123.14an area defined as a small rural area or isolated rural area according to the four-category
123.15classification of the Rural Urban Commuting Area system developed for the United States
123.16Health Resources and Services Administration. Wholesale acquisition cost is defined as
123.17the manufacturer's list price for a drug or biological to wholesalers or direct purchasers
123.18in the United States, not including prompt pay or other discounts, rebates, or reductions
123.19in price, for the most recent month for which information is available, as reported in
123.20wholesale price guides or other publications of drug or biological pricing data. The
123.21maximum allowable cost of a multisource drug may be set by the commissioner and it
123.22shall be comparable to, but no higher than, the maximum amount paid by other third-party
123.23payors in this state who have maximum allowable cost programs. Establishment of the
123.24amount of payment for drugs shall not be subject to the requirements of the Administrative
123.26 (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
123.27to pharmacists for legend drug prescriptions dispensed to residents of long-term care
123.28facilities when a unit dose blister card system, approved by the department, is used. Under
123.29this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
123.30The National Drug Code (NDC) from the drug container used to fill the blister card must
123.31be identified on the claim to the department. The unit dose blister card containing the
123.32drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
123.33that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
123.34will be required to credit the department for the actual acquisition cost of all unused
123.35drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
124.1manufacturer's unopened package. The commissioner may permit the drug clozapine to be
124.2dispensed in a quantity that is less than a 30-day supply.
124.3 (c) Whenever a maximum allowable cost has been set for a multisource drug,
124.4payment shall be
124.5to the public or the maximum allowable cost established by the commissioner unless
124.6prior authorization for the brand name product has been granted according to the criteria
124.7established by the Drug Formulary Committee as required by subdivision 13f, paragraph
124.8(a), and the prescriber has indicated "dispense as written" on the prescription in a manner
124.9consistent with section
124.10 (d) The basis for determining the amount of payment for drugs administered in an
124.11outpatient setting shall be the lower of the usual and customary cost submitted by the
124.13price as determined by the United States Department of Health and Human Services
124.14pursuant to title XVIII, section 1847a of the federal Social Security Act. If average sales
124.15price is unavailable, the amount of payment must be lower of the usual and customary cost
124.16submitted by the provider or the wholesale acquisition cost.
124.17 (e) The commissioner may negotiate lower reimbursement rates for specialty
124.18pharmacy products than the rates specified in paragraph (a). The commissioner may
124.19require individuals enrolled in the health care programs administered by the department
124.20to obtain specialty pharmacy products from providers with whom the commissioner has
124.21negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
124.22used by a small number of recipients or recipients with complex and chronic diseases
124.23that require expensive and challenging drug regimens. Examples of these conditions
124.24include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
124.25C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
124.26of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
124.27biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
124.28that require complex care. The commissioner shall consult with the formulary committee
124.29to develop a list of specialty pharmacy products subject to this paragraph. In consulting
124.30with the formulary committee in developing this list, the commissioner shall take into
124.31consideration the population served by specialty pharmacy products, the current delivery
124.32system and standard of care in the state, and access to care issues. The commissioner shall
124.33have the discretion to adjust the reimbursement rate to prevent access to care issues.
124.34(f) Home infusion therapy services provided by home infusion therapy pharmacies
124.35must be paid at rates according to subdivision 8d.
125.1EFFECTIVE DATE.This section is effective July 1, 2011, or upon federal
125.2approval, whichever is later.
125.3 Sec. 30. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended to
125.5 Subd. 13h. Medication therapy management services. (a) Medical assistance
125.6and general assistance medical care cover medication therapy management services for
125.7a recipient taking
125.8chronic medical conditions
125.9by the commissioner or identified by a pharmacist and approved by the commissioner; or
125.10prior authorized by the commissioner that has resulted or is likely to result in significant
125.11nondrug program costs. The commissioner may cover medical therapy management
125.12services under MinnesotaCare if the commissioner determines this is cost-effective. For
125.13purposes of this subdivision, "medication therapy management" means the provision
125.14of the following pharmaceutical care services by a licensed pharmacist to optimize the
125.15therapeutic outcomes of the patient's medications:
125.16 (1) performing or obtaining necessary assessments of the patient's health status;
125.17 (2) formulating a medication treatment plan;
125.18 (3) monitoring and evaluating the patient's response to therapy, including safety
125.20 (4) performing a comprehensive medication review to identify, resolve, and prevent
125.21medication-related problems, including adverse drug events;
125.22 (5) documenting the care delivered and communicating essential information to
125.23the patient's other primary care providers;
125.24 (6) providing verbal education and training designed to enhance patient
125.25understanding and appropriate use of the patient's medications;
125.26 (7) providing information, support services, and resources designed to enhance
125.27patient adherence with the patient's therapeutic regimens; and
125.28 (8) coordinating and integrating medication therapy management services within the
125.29broader health care management services being provided to the patient.
125.30Nothing in this subdivision shall be construed to expand or modify the scope of practice of
125.31the pharmacist as defined in section
125.32 (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
125.33must meet the following requirements:
125.34 (1) have a valid license issued under chapter 151;
126.1 (2) have graduated from an accredited college of pharmacy on or after May 1996, or
126.2completed a structured and comprehensive education program approved by the Board of
126.3Pharmacy and the American Council of Pharmaceutical Education for the provision and
126.4documentation of pharmaceutical care management services that has both clinical and
126.6 (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
126.7have developed a structured patient care process that is offered in a private or semiprivate
126.8patient care area that is separate from the commercial business that also occurs in the
126.9setting, or in home settings,
126.11providing assisted living services, but excluding skilled nursing facilities; and
126.12 (4) make use of an electronic patient record system that meets state standards.
126.13 (c) For purposes of reimbursement for medication therapy management services,
126.14the commissioner may enroll individual pharmacists as medical assistance and general
126.15assistance medical care providers. The commissioner may also establish contact
126.16requirements between the pharmacist and recipient, including limiting the number of
126.17reimbursable consultations per recipient.
126.18(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
126.19within a reasonable geographic distance of the patient, a pharmacist who meets the
126.20requirements may provide the services via two-way interactive video. Reimbursement
126.21shall be at the same rates and under the same conditions that would otherwise apply to
126.22the services provided. To qualify for reimbursement under this paragraph, the pharmacist
126.23providing the services must meet the requirements of paragraph (b), and must be located
126.24within an ambulatory care setting approved by the commissioner. The patient must also
126.25be located within an ambulatory care setting approved by the commissioner. Services
126.26provided under this paragraph may not be transmitted into the patient's residence.
126.27(e) The commissioner shall establish a pilot project for an intensive medication
126.28therapy management program for patients identified by the commissioner with multiple
126.29chronic conditions and a high number of medications who are at high risk of preventable
126.30hospitalizations, emergency room use, medication complications, and suboptimal
126.31treatment outcomes due to medication-related problems. For purposes of the pilot
126.32project, medication therapy management services may be provided in a patient's home
126.33or community setting, in addition to other authorized settings. The commissioner may
126.34waive existing payment policies and establish special payment rates for the pilot project.
126.35The pilot project must be designed to produce a net savings to the state compared to the
127.1estimated costs that would otherwise be incurred for similar patients without the program.
127.2The pilot project must begin by January 1, 2010, and end June 30, 2012.
127.3EFFECTIVE DATE.This section is effective July 1, 2011.
127.4 Sec. 31. Minnesota Statutes 2010, section 256B.0625, subdivision 17, is amended to
127.6 Subd. 17. Transportation costs. (a) Medical assistance covers medical
127.7transportation costs incurred solely for obtaining emergency medical care or transportation
127.8costs incurred by eligible persons in obtaining emergency or nonemergency medical
127.9care when paid directly to an ambulance company, common carrier, or other recognized
127.10providers of transportation services. Medical transportation must be provided by:
127.11(1) an ambulance, as defined in section
127.12(2) special transportation; or
127.13(3) common carrier including, but not limited to, bus, taxicab, other commercial
127.14carrier, or private automobile.
127.15(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
127.16part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
127.17would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
127.18transportation, or private automobile.
127.19The commissioner may use an order by the recipient's attending physician to certify that
127.20the recipient requires special transportation services. Special transportation providers shall
127.21perform driver-assisted services for eligible individuals. Driver-assisted service includes
127.22passenger pickup at and return to the individual's residence or place of business, assistance
127.23with admittance of the individual to the medical facility, and assistance in passenger
127.24securement or in securing of wheelchairs or stretchers in the vehicle. Special transportation
127.25providers must obtain written documentation from the health care service provider who
127.26is serving the recipient being transported, identifying the time that the recipient arrived.
127.27Special transportation providers may not bill for separate base rates for the continuation of
127.28a trip beyond the original destination. Special transportation providers must take recipients
127.29to the nearest appropriate health care provider, using the most direct route. The minimum
127.30medical assistance reimbursement rates for special transportation services are:
127.31(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
127.32eligible persons who need a wheelchair-accessible van;
127.33(ii) $11.50 for the base rate and $1.30 per mile for special transportation services to
127.34eligible persons who do not need a wheelchair-accessible van; and
128.1(iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
128.2special transportation services to eligible persons who need a stretcher-accessible vehicle;
128.3(2) the base rates for special transportation services in areas defined under RUCA
128.4to be super rural shall be equal to the reimbursement rate established in clause (1) plus
128.511.3 percent; and
128.6(3) for special transportation services in areas defined under RUCA to be rural
128.7or super rural areas:
128.8(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
128.9percent of the respective mileage rate in clause (1); and
128.10(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
128.11112.5 percent of the respective mileage rate in clause (1).
128.12(c) For purposes of reimbursement rates for special transportation services under
128.13paragraph (b), the zip code of the recipient's place of residence shall determine whether
128.14the urban, rural, or super rural reimbursement rate applies.
128.15(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
128.16means a census-tract based classification system under which a geographical area is
128.17determined to be urban, rural, or super rural.
128.18(e) Effective for services provided on or after July 1, 2011, nonemergency
128.19transportation rates, including special transportation, taxi, and other commercial carriers,
128.20are reduced 4.5 percent. Payments made to managed care plans and county-based
128.21purchasing plans must be reduced for services provided on or after January 1, 2012,
128.22to reflect this reduction.
128.23 Sec. 32. Minnesota Statutes 2010, section 256B.0625, subdivision 17a, is amended to
128.25 Subd. 17a. Payment for ambulance services. (a) Medical assistance covers
128.26ambulance services. Providers shall bill ambulance services according to Medicare
128.27criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
128.28for services rendered on or after July 1, 2001, medical assistance payments for ambulance
128.29services shall be paid at the Medicare reimbursement rate or at the medical assistance
128.30payment rate in effect on July 1, 2000, whichever is greater.
128.31(b) Effective for services provided on or after July 1, 2011, ambulance services
128.32payment rates are reduced 4.5 percent. Payments made to managed care plans and
128.33county-based purchasing plans must be reduced for services provided on or after January
128.341, 2012, to reflect this reduction.
129.1 Sec. 33. Minnesota Statutes 2010, section 256B.0625, subdivision 18, is amended to
129.3 Subd. 18. Bus or taxicab transportation. To the extent authorized by rule of the
129.4state agency, medical assistance covers
129.5form of transportation incurred by any ambulatory eligible person for obtaining
129.6nonemergency medical care.
129.7 Sec. 34. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
129.8subdivision to read:
129.9 Subd. 25b. Authorization with third-party liability. (a) Except as otherwise
129.10allowed under this subdivision or required under federal or state regulations, the
129.11commissioner must not consider a request for authorization of a service when the recipient
129.12has coverage from a third-party payer unless the provider requesting authorization has
129.13made a good faith effort to receive payment or authorization from the third-party payer.
129.14A good faith effort is established by supplying with the authorization request to the
129.15commissioner the following:
129.16(1) a determination of payment for the service from the third-party payer, a
129.17determination of authorization for the service from the third-party payer, or a verification
129.18of noncoverage of the service by the third-party payer; and
129.19(2) the information or records required by the department to document the reason for
129.20the determination or to validate noncoverage from the third-party payer.
129.21(b) A provider requesting authorization for services covered by Medicare is not
129.22required to bill Medicare before requesting authorization from the commissioner if the
129.23provider has reason to believe that a service covered by Medicare is not eligible for
129.24payment. The provider must document that, because of recent claim experiences with
129.25Medicare or because of written communication from Medicare, coverage is not available
129.26for the service.
129.27(c) Authorization is not required if a third-party payer has made payment that is
129.28equal to or greater than 60 percent of the maximum payment amount for the service
129.29allowed under medical assistance.
129.30 Sec. 35. Minnesota Statutes 2010, section 256B.0625, subdivision 31a, is amended to
129.32 Subd. 31a. Augmentative and alternative communication systems. (a) Medical
129.33assistance covers augmentative and alternative communication systems consisting of
129.34electronic or nonelectronic devices and the related components necessary to enable a
130.1person with severe expressive communication limitations to produce or transmit messages
130.2or symbols in a manner that compensates for that disability.
130.11(1) submitted charge; or
130.12(2)(i) manufacturer's suggested retail price minus 20 percent for providers that are
130.13manufacturers of augmentative and alternative communication systems; or
130.14(ii) manufacturer's invoice charge plus 20 percent for providers that are not
130.15manufacturers of augmentative and alternative communication systems.
130.16(c) Reimbursement rates established by this purchasing program are not subject to
130.17Minnesota Rules, part 9505.0445, item S or T.
130.18 Sec. 36. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
130.19subdivision to read:
130.20 Subd. 55. Payment for noncovered services. (a) Except when specifically
130.21prohibited by the commissioner or federal law, a provider may seek payment from the
130.22recipient for services not eligible for payment under the medical assistance program when
130.23the provider, prior to delivering the service, reviews and considers all other available
130.24covered alternatives with the recipient and obtains a signed acknowledgment from the
130.25recipient of the potential of the recipient's liability. The signed acknowledgment must be
130.26in a form approved by the commissioner.
130.27(b) Conditions under which a provider must not request payment from the recipient
130.28include, but are not limited to:
130.29(1) a service that requires prior authorization, unless authorization has been denied
130.30as not medically necessary and all other therapeutic alternatives have been reviewed;
130.31(2) a service for which payment has been denied for reasons relating to billing
130.33(3) standard shipping or delivery and setup of medical equipment or medical
130.35(4) services that are included in the recipient's long term care per diem;
131.1(5) the recipient is enrolled in the Restricted Recipient Program and the provider is
131.2one of a provider type designated for the recipient's health care services; and
131.3(6) the noncovered service is a prescriptive drug identified by the commissioner as
131.4having the potential for abuse and overuse, except where payment by the recipient is
131.5specifically approved by the commissioner on the date of service based upon compelling
131.6evidence supplied by the prescribing provider that establishes medical necessity for that
131.8(c) The payment requested from recipients for noncovered services under this
131.9subdivision must not exceed the provider's usual and customary charge for the actual
131.10service received by the recipient. A recipient must not be billed for the difference between
131.11what medical assistance paid for the service or would pay for a less costly alternative
131.13 Sec. 37. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
131.14subdivision to read:
131.15 Subd. 56. Medical service coordination. (a) Medical assistance covers in-reach
131.16community-based service coordination that is performed in a hospital emergency
131.17department as an eligible procedure under a state healthcare program or private insurance
131.18for a frequent user. A frequent user is defined as an individual who has frequented the
131.19hospital emergency department for services three or more times in the previous four
131.20consecutive months. In-reach community-based service coordination includes navigating
131.21services to address a client's mental health, chemical health, social, economic, and housing
131.22needs, or any other activity targeted at reducing the incidence of emergency room and
131.23other nonmedically necessary health care utilization.
131.24(b) Reimbursement must be made in 15-minute increments under current Medicaid
131.25mental health social work reimbursement methodology and allowed for up to 60 days
131.26posthospital discharge based upon the specific identified emergency department visit or
131.27inpatient admitting event. A frequent user who is participating in care coordination within
131.28a health care home framework is ineligible for reimbursement under this subdivision.
131.29Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in
131.30social work, public health, corrections, or a related field. The commissioner shall submit
131.31any necessary application for waivers to the Centers for Medicare and Medicaid Services
131.32to implement this subdivision.
131.33(c) For the purposes of this subdivision, "in-reach community-based service
131.34coordination" means the practice of a community-based worker with training, knowledge,
131.35skills, and ability to access a continuum of services, including housing, transportation,
132.1chemical and mental health treatment, employment, and peer support services, by working
132.2with an organization's staff to transition an individual back into the individual's living
132.3environment. In-reach community-based service coordination includes working with the
132.4individual during their discharge and for up to a defined amount of time in the individual's
132.5living environment, reducing the individual's need for readmittance.
132.6 Sec. 38. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
132.7subdivision to read:
132.8 Subd. 57. Payment for Part B Medicare crossover claims. Effective for services
132.9provided on or after January 1, 2012, medical assistance payment for an enrollee's cost
132.10sharing associated with Medicare Part B is limited to an amount up to the medical
132.11assistance total allowed, when the medical assistance rate exceeds the amount paid by
132.13EFFECTIVE DATE.This section is effective January 1, 2012.
132.14 Sec. 39. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
132.15subdivision to read:
132.16 Subd. 58. Early and periodic screening, diagnosis, and treatment services.
132.17Medical assistance covers early and periodic screening, diagnosis, and treatment services
132.18(EPSDT). The payment amount for a complete EPSDT screening shall not exceed the rate
132.19established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.
132.20 Sec. 40. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
132.21subdivision to read:
132.22 Subd. 59. Services provided by advanced dental therapists and dental
132.23therapists. Medical assistance covers services provided by advanced dental therapists
132.24and dental therapists when provided within the scope of practice identified in sections
132.25150A.105 and 150A.106.
132.26 Sec. 41. Minnesota Statutes 2010, section 256B.0631, subdivision 1, is amended to
132.28 Subdivision 1.
132.292, the medical assistance benefit plan shall include the following
132.30for all recipients, effective for services provided on or after
133.1 (1) $3 per nonpreventive visit, except as provided in paragraph (c). For purposes
133.2of this subdivision, a visit means an episode of service which is required because of
133.3a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
133.4ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
133.5midwife, advanced practice nurse, audiologist, optician, or optometrist;
133.6 (2) $3 for eyeglasses;
133.8that this co-payment shall be increased to $20 upon federal approval;
133.9 (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
133.10subject to a $12 per month maximum for prescription drug co-payments. No co-payments
133.11shall apply to antipsychotic drugs when used for the treatment of mental illness
133.12(5) a family deductible equal to the maximum amount allowed under Code of
133.13Federal Regulations, title 42, part 447.54; and
133.22percent of the federal poverty guidelines, total monthly
133.23not exceed five percent of family income. For purposes of this paragraph, family income
133.24is the total earned and unearned income of the individual and the individual's spouse, if
133.25the spouse is enrolled in medical assistance and also subject to the five percent limit on
133.28deductibles in this subdivision.
133.29(c) Effective January 1, 2012, or upon federal approval, whichever is later, the
133.30following co-payments for nonpreventive visits shall apply to providers included in
133.31provider peer grouping:
133.32(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of
133.33care per medical assistance enrollee is at the 60th percentile or lower for providers of
133.34the same type;
134.1(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care
134.2per medical assistance enrollee is greater than the 60th percentile but does not exceed the
134.380th percentile for providers of the same type; and
134.4(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of
134.5care per medical assistance enrollee is greater than the 80th percentile for providers of
134.6the same type.
134.7Each managed care and county-based purchasing plan shall calculate the average,
134.8risk-adjusted, total annual cost of care for providers under this paragraph using a
134.9methodology approved by the commissioner. The commissioner shall develop a
134.10methodology for calculating the average, risk-adjusted, total annual cost of care for
134.12(d) The commissioner shall seek any federal waivers and approvals necessary to
134.13increase the co-payment for nonemergency visits to a hospital-based emergency room
134.14under paragraph (a), clause (3), and to implement paragraph (c).
134.15 Sec. 42. Minnesota Statutes 2010, section 256B.0631, subdivision 2, is amended to
134.17 Subd. 2. Exceptions. Co-payments and deductibles shall be subject to the following
134.19(1) children under the age of 21;
134.20(2) pregnant women for services that relate to the pregnancy or any other medical
134.21condition that may complicate the pregnancy;
134.22(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
134.23intermediate care facility for the developmentally disabled;
134.24(4) recipients receiving hospice care;
134.25(5) 100 percent federally funded services provided by an Indian health service;
134.26(6) emergency services;
134.27(7) family planning services;
134.28(8) services that are paid by Medicare, resulting in the medical assistance program
134.29paying for the coinsurance and deductible; and
134.30(9) co-payments that exceed one per day per provider for nonpreventive visits,
134.31eyeglasses, and nonemergency visits to a hospital-based emergency room.
134.32 Sec. 43. Minnesota Statutes 2010, section 256B.0631, subdivision 3, is amended to
135.1 Subd. 3. Collection. (a) The medical assistance reimbursement to the provider shall
135.2be reduced by the amount of the co-payment or deductible, except that reimbursements
135.3shall not be reduced:
135.4 (1) once a recipient has reached the $12 per month maximum
135.6 (2) for a recipient identified by the commissioner under 100 percent of the federal
135.7poverty guidelines who has met their monthly five percent
135.8 (b) The provider collects the co-payment or deductible from the recipient. Providers
135.9may not deny services to recipients who are unable to pay the co-payment or deductible.
135.10 (c) Medical assistance reimbursement to fee-for-service providers and payments to
135.11managed care plans shall not be increased as a result of the removal of co-payments or
135.12deductibles effective on or after January 1, 2009.
135.13 Sec. 44. Minnesota Statutes 2010, section 256B.0644, is amended to read:
135.14256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
135.16 (a) A vendor of medical care, as defined in section
135.17health maintenance organization, as defined in chapter 62D, must participate as a provider
135.18or contractor in the medical assistance program, general assistance medical care program,
135.19and MinnesotaCare as a condition of participating as a provider in health insurance plans
135.20and programs or contractor for state employees established under section
135.21public employees insurance program under section
135.22offered to local statutory or home rule charter city, county, and school district employees,
135.23the workers' compensation system under section
135.24through the Minnesota Comprehensive Health Association under sections
135.26not be applicable in geographic areas where provider participation is limited by managed
135.27care contracts with the Department of Human Services.
135.28 (b) For providers other than health maintenance organizations, participation in the
135.29medical assistance program means that:
135.30 (1) the provider accepts new medical assistance, general assistance medical care,
135.31and MinnesotaCare patients;
135.32 (2) for providers other than dental service providers, at least 20 percent of the
135.33provider's patients are covered by medical assistance, general assistance medical care,
135.34and MinnesotaCare as their primary source of coverage; or
136.1 (3) for dental service providers, at least ten percent of the provider's patients are
136.2covered by medical assistance, general assistance medical care, and MinnesotaCare as
136.3their primary source of coverage, or the provider accepts new medical assistance and
136.4MinnesotaCare patients who are children with special health care needs. For purposes
136.5of this section, "children with special health care needs" means children up to age 18
136.6who: (i) require health and related services beyond that required by children generally;
136.7and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
136.8condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
136.9cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
136.10neurological diseases; visual impairment or deafness; Down syndrome and other genetic
136.11disorders; autism; fetal alcohol syndrome; and other conditions designated by the
136.12commissioner after consultation with representatives of pediatric dental providers and
136.14 (c) Patients seen on a volunteer basis by the provider at a location other than
136.15the provider's usual place of practice may be considered in meeting the participation
136.16requirement in this section. The commissioner shall establish participation requirements
136.17for health maintenance organizations. The commissioner shall provide lists of participating
136.18medical assistance providers on a quarterly basis to the commissioner of management and
136.19budget, the commissioner of labor and industry, and the commissioner of commerce. Each
136.20of the commissioners shall develop and implement procedures to exclude as participating
136.21providers in the program or programs under their jurisdiction those providers who do
136.22not participate in the medical assistance program. The commissioner of management
136.23and budget shall implement this section through contracts with participating health and
136.25 (d) For purposes of paragraphs (a) and (b), participation in the general assistance
136.26medical care program applies only to pharmacy providers.
136.27 (e) A provider described in section 256B.76, subdivision 5, may limit the eligibility
136.28of new medical assistance, general assistance medical care, and MinnesotaCare patients
136.29for specific categories of rehabilitative services, if medical assistance, general assistance
136.30medical care, and MinnesotaCare patients served by the provider in the aggregate exceed
136.3130 percent of the provider's overall patient population.
136.32 Sec. 45. Minnesota Statutes 2010, section 256B.0751, subdivision 4, is amended to
136.34 Subd. 4. Alternative models and waivers of requirements. (a) Nothing in this
136.35section shall preclude the continued development of existing medical or health care
137.1home projects currently operating or under development by the commissioner of human
137.2services or preclude the commissioner from establishing alternative models and payment
137.3mechanisms for persons who are enrolled in integrated Medicare and Medicaid programs
137.5care programs under section
137.6medical assistance, are in the waiting period for Medicare, or who have other primary
137.8(b) The commissioner of health shall waive health care home certification
137.9requirements if an applicant demonstrates that compliance with a certification requirement
137.10will create a major financial hardship or is not feasible, and the applicant establishes an
137.11alternative way to accomplish the objectives of the certification requirement.
137.12 Sec. 46. Minnesota Statutes 2010, section 256B.0751, is amended by adding a
137.13subdivision to read:
137.14 Subd. 8. Coordination with local services. The health care home and the county
137.15shall coordinate care and services provided to patients enrolled with a health care home
137.16who have complex medical needs or a disability, and who need and are eligible for
137.17additional local services administered by counties, including but not limited to waivered
137.18services, mental health services, social services, public health services, transportation, and
137.19housing. The coordination of care and services must be as provided in the plan established
137.20by the patient and health care home.
137.21 Sec. 47. Minnesota Statutes 2010, section 256B.69, subdivision 5a, is amended to read:
137.22 Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
137.24January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
137.25renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
137.2631, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
137.27issue separate contracts with requirements specific to services to medical assistance
137.28recipients age 65 and older.
137.29 (b) A prepaid health plan providing covered health services for eligible persons
137.30pursuant to chapters 256B and 256L is responsible for complying with the terms of its
137.31contract with the commissioner. Requirements applicable to managed care programs
137.32under chapters 256B and 256L established after the effective date of a contract with the
137.33commissioner take effect when the contract is next issued or renewed.
138.1 (c) Effective for services rendered on or after January 1, 2003, the commissioner
138.2shall withhold five percent of managed care plan payments under this section and
138.3county-based purchasing plan payments under section
138.4assistance program pending completion of performance targets. Each performance target
138.5must be quantifiable, objective, measurable, and reasonably attainable, except in the case
138.6of a performance target based on a federal or state law or rule. Criteria for assessment
138.7of each performance target must be outlined in writing prior to the contract effective
138.8date. The managed care plan must demonstrate, to the commissioner's satisfaction,
138.9that the data submitted regarding attainment of the performance target is accurate. The
138.10commissioner shall periodically change the administrative measures used as performance
138.11targets in order to improve plan performance across a broader range of administrative
138.12services. The performance targets must include measurement of plan efforts to contain
138.13spending on health care services and administrative activities. The commissioner may
138.14adopt plan-specific performance targets that take into account factors affecting only one
138.15plan, including characteristics of the plan's enrollee population. The withheld funds
138.16must be returned no sooner than July of the following year if performance targets in the
138.17contract are achieved. The commissioner may exclude special demonstration projects
138.18under subdivision 23.
138.19 (d) Effective for services rendered on or after January 1, 2009, through December
138.2031, 2009, the commissioner shall withhold three percent of managed care plan payments
138.21under this section and county-based purchasing plan payments under section
138.23sooner than July 1 and no later than July 31 of the following year. The commissioner may
138.24exclude special demonstration projects under subdivision 23.
138.25(e) Effective for services provided on or after January 1, 2010, the commissioner
138.26shall require that managed care plans use the assessment and authorization processes,
138.27forms, timelines, standards, documentation, and data reporting requirements, protocols,
138.28billing processes, and policies consistent with medical assistance fee-for-service or the
138.29Department of Human Services contract requirements consistent with medical assistance
138.30fee-for-service or the Department of Human Services contract requirements for all
138.31personal care assistance services under section
138.32(f) Effective for services rendered on or after January 1, 2010, through December
138.3331, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
138.34under this section and county-based purchasing plan payments under section
139.1sooner than July 1 and no later than July 31 of the following year. The commissioner may
139.2exclude special demonstration projects under subdivision 23.
139.3(g) Effective for services rendered on or after January 1, 2011, the commissioner
139.4shall include as part of the performance targets described in paragraph (c) a reduction in
139.5the health plan's emergency room utilization rate for state health care program enrollees
139.6by a measurable rate of five percent from the plan's utilization rate for state health care
139.7program enrollees for the previous calendar year.
139.8The withheld funds must be returned no sooner than July 1 and no later than July 31
139.9of the following calendar year if the managed care plan demonstrates to the satisfaction of
139.10the commissioner that a reduction in the utilization rate was achieved.
139.11The withhold described in this paragraph shall continue for each consecutive
139.12contract period until the plan's emergency room utilization rate for state health care
139.13program enrollees is reduced by 25 percent of the plan's emergency room utilization
139.14rate for state health care program enrollees for calendar year 2009. Hospitals shall
139.15cooperate with the health plans in meeting this performance target and shall accept
139.16payment withholds that may be returned to the hospitals if the performance target is
139.17achieved. The commissioner shall structure the withhold so that the commissioner returns
139.18a portion of the withheld funds in amounts commensurate with achieved reductions in
139.19utilization less than the targeted amount. The withhold in this paragraph does not apply to
139.20county-based purchasing plans.
139.21(h) Effective for services rendered on or after January 1, 2012, the commissioner
139.22shall include as part of the performance targets described in paragraph (c) a reduction in
139.23the plan's hospitalization rates or subsequent hospitalizations within 30 days of a previous
139.24hospitalization of a patient regardless of the reason for the hospitalization for state health
139.25care program enrollees by a measurable rate of five percent from the plan's utilization rate
139.26for state health care program enrollees for the previous calendar year.
139.27The withheld funds must be returned no sooner than July 1 and no later than July 31
139.28of the following calendar year if the managed care plan or county-based purchasing plan
139.29demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
139.30rate was achieved.
139.31The withhold described in this paragraph must continue for each consecutive
139.32contract period until the plan's subsequent hospitalization rate for state health care
139.33program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
139.34for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
139.35with the plans in meeting this performance target and shall accept payment withholds that
139.36must be returned to the hospitals if the performance target is achieved. The commissioner
140.1shall structure the withhold so that the commissioner returns a portion of the withheld
140.2funds in amounts commensurate with achieved reductions in utilization less than the
140.531, 2011, the commissioner shall withhold 4.5 percent of managed care plan payments
140.6under this section and county-based purchasing plan payments under section
140.8sooner than July 1 and no later than July 31 of the following year. The commissioner may
140.9exclude special demonstration projects under subdivision 23.
140.1131, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
140.12under this section and county-based purchasing plan payments under section
140.14sooner than July 1 and no later than July 31 of the following year. The commissioner may
140.15exclude special demonstration projects under subdivision 23.
140.1731, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
140.18under this section and county-based purchasing plan payments under section
140.20sooner than July 1 and no later than July 31 of the following year. The commissioner may
140.21exclude special demonstration projects under subdivision 23.
140.23shall withhold three percent of managed care plan payments under this section and
140.24county-based purchasing plan payments under section
140.25assistance program. The withheld funds must be returned no sooner than July 1 and
140.26no later than July 31 of the following year. The commissioner may exclude special
140.27demonstration projects under subdivision 23.
140.30under this section that is reasonably expected to be returned.
140.32from the set-aside and preference provisions of section
140.33(a), and 7.
140.35subject to the requirements of paragraph (c).
141.1 Sec. 48. Minnesota Statutes 2010, section 256B.69, subdivision 5c, is amended to read:
141.2 Subd. 5c. Medical education and research fund. (a) The commissioner of human
141.3services shall transfer each year to the medical education and research fund established
141.5calculate the following:
141.6(1) an amount equal to the reduction in the prepaid medical assistance payments as
141.7specified in this clause. Until January 1, 2002, the county medical assistance capitation
141.8base rate prior to plan specific adjustments and after the regional rate adjustments under
141.9subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
141.10metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
141.11January 1, 2002, the county medical assistance capitation base rate prior to plan specific
141.12adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
141.13metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
141.14facility and elderly waiver payments and demonstration project payments operating
141.15under subdivision 23 are excluded from this reduction. The amount calculated under
141.16this clause shall not be adjusted for periods already paid due to subsequent changes to
141.17the capitation payments;
141.18(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
141.20(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
141.21paid under this section; and
141.22(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
141.23under this section.
141.24(b) This subdivision shall be effective upon approval of a federal waiver which
141.25allows federal financial participation in the medical education and research fund.
141.27(a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009.
141.28Any excess shall first reduce the amounts
141.29under paragraph (a), clauses (2) to (4). Any excess following this reduction shall
141.30proportionally reduce the
141.31(c) Beginning July 1,
141.32commissioner shall transfer $21,714,000 each fiscal year to the medical education and
142.1(d) Beginning July 1, 2011, of the amount in paragraph (a), following the transfer
142.2under paragraph (c), the commissioner shall transfer to the medical education research
142.3fund $4,024,000 in fiscal year 2012 and $4,626,000 in fiscal year 2013 and thereafter.
142.4 Sec. 49. Minnesota Statutes 2010, section 256B.69, subdivision 28, is amended to read:
142.5 Subd. 28. Medicare special needs plans; medical assistance basic health care.
142.6 (a) The commissioner may contract with qualified Medicare-approved special needs
142.7plans to provide medical assistance basic health care services to persons with disabilities,
142.8including those with developmental disabilities. Basic health care services include:
142.9 (1) those services covered by the medical assistance state plan except for ICF/MR
142.10services, home and community-based waiver services, case management for persons with
142.11developmental disabilities under section
142.12and certain home care services defined by the commissioner in consultation with the
142.13stakeholder group established under paragraph (d); and
142.14 (2) basic health care services may also include risk for up to 100 days of nursing
142.15facility services for persons who reside in a noninstitutional setting and home health
142.16services related to rehabilitation as defined by the commissioner after consultation with
142.17the stakeholder group.
142.18 The commissioner may exclude other medical assistance services from the basic
142.19health care benefit set. Enrollees in these plans can access any excluded services on the
142.20same basis as other medical assistance recipients who have not enrolled.
142.24 (b) Beginning January 1, 2007, the commissioner may contract with qualified
142.25Medicare special needs plans to provide basic health care services under medical
142.26assistance to persons who are dually eligible for both Medicare and Medicaid and those
142.27Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
142.28The commissioner shall consult with the stakeholder group under paragraph (d) in
142.29developing program specifications for these services. The commissioner shall report to
142.30the chairs of the house of representatives and senate committees with jurisdiction over
142.31health and human services policy and finance by February 1, 2007, on implementation
142.32of these programs and the need for increased funding for the ombudsman for managed
142.33care and other consumer assistance and protections needed due to enrollment in managed
142.34care of persons with disabilities. Payment for Medicaid services provided under this
143.1subdivision for the months of May and June will be made no earlier than July 1 of the
143.2same calendar year.
143.3 (c) Notwithstanding subdivision 4, beginning January 1,
143.6unless the individual chooses to opt out of enrollment. The commissioner shall establish
143.7enrollment and opt out procedures consistent with applicable enrollment procedures under
143.9 (d) The commissioner shall establish a state-level stakeholder group to provide
143.10advice on managed care programs for persons with disabilities, including both MnDHO
143.11and contracts with special needs plans that provide basic health care services as described
143.12in paragraphs (a) and (b). The stakeholder group shall provide advice on program
143.13expansions under this subdivision and subdivision 23, including:
143.14 (1) implementation efforts;
143.15 (2) consumer protections; and
143.16 (3) program specifications such as quality assurance measures, data collection and
143.17reporting, and evaluation of costs, quality, and results.
143.18 (e) Each plan under contract to provide medical assistance basic health care services
143.19shall establish a local or regional stakeholder group, including representatives of the
143.20counties covered by the plan, members, consumer advocates, and providers, for advice on
143.21issues that arise in the local or regional area.
143.22 (f) The commissioner is prohibited from providing the names of potential enrollees
143.23to health plans for marketing purposes. The commissioner
143.24two sets of marketing materials per contract year to potential enrollees on behalf of health
143.26by the commissioner within 30 days of receipt of these materials from the health plan. The
143.27health plans shall cover any costs incurred by the commissioner for mailing marketing
143.29 Sec. 50. Minnesota Statutes 2010, section 256B.69, is amended by adding a
143.30subdivision to read:
143.31 Subd. 30. Provider payment rates. (a) Each managed care and county-based plan
143.32shall, by October 1, 2011, array all providers within each provider type, employed by or
143.33under contract with the plan, by their average total annual cost of care for serving medical
143.34assistance and MinnesotaCare enrollees for the most recent reporting year for which data
143.35is available, risk-adjusted for enrollee demographics and health status.
144.1(b) Beginning January 1, 2012, and each contract year thereafter, each managed
144.2care and county-based purchasing plan shall implement a progressive payment withhold
144.3methodology for each provider type, under which the withhold for a provider increases
144.4proportionally as the provider's risk-adjusted total annual cost increases, relative to other
144.5providers of the same type. For purposes of this paragraph, the risk-adjusted total annual
144.6cost of care is the dollar amount calculated under paragraph (a).
144.7(c) At the end of each contract year, each plan shall array all providers within each
144.8provider type by their average total annual cost of care for serving medical assistance and
144.9MinnesotaCare enrollees for that contract year, risk-adjusted for enrollee demographics
144.10and health status. For each provider whose risk-adjusted total annual cost of care is at or
144.11below the 70th percentile of providers of the same type or specialty, the plan shall return
144.12the full amount of any withhold. For each provider whose risk-adjusted total annual cost
144.13of care is above the 70th percentile, the plan shall return only the portion of the withhold
144.14sufficient to bring the provider's payment rate to the average for providers within the
144.15provider type whose risk-adjusted total annual cost of care is at the 70th percentile. Each
144.16plan shall reduce provider payments only as allowed under paragraph (f).
144.17(d) Each managed care and county-based purchasing plan must establish an appeals
144.18process to allow providers to appeal determinations of risk-adjusted total annual cost of
144.19care. Each plan's appeals process must be approved by the commissioner.
144.20(e) The commissioner shall require each plan to submit to the commissioner, in
144.21the form and manner specified by the commissioner, all provider payment data and
144.22information on the withhold methodology that the commissioner determines is necessary
144.23to verify compliance with this subdivision.
144.24(f) The commissioner, for the contract year beginning January 1, 2012, shall reduce
144.25plan capitation rates by ten percent from the rates that would otherwise apply, absent
144.26application of this subdivision. The reduced rate shall be the historical base rate for
144.27negotiating capitation rates for future contract years. The commissioner may recommend
144.28additional reductions in capitation rates for future contract years to the legislature, if the
144.29commissioner determines this is necessary to ensure that health care providers under
144.30contract with managed care and county-based purchasing plans practice in an efficient
144.31manner. Effective for services rendered on or after January 1, 2012, managed care plans
144.32and county-based purchasing plans contracted with the state to administer the health
144.33care programs provided under sections 256B.69, 256B.692, and 256L.12, may reduce
144.34payments made to providers employed or under contract with the plan. However, a
144.35managed care or county-based purchasing plan is prohibited from: (1) reducing payments
144.36made to providers whose risk-adjusted total annual cost of care is at or below the 70th
145.1percentile of providers of the same type or specialty, or at or below the 80th percentile
145.2for provider types or specialties currently subject to plan care management requirements
145.3that in the aggregate are more extensive than those that apply to other provider types or
145.4specialties, or for which a majority of services are currently subject to prior authorization
145.5by the plan and (2) reducing payments to hospitals described under the Social Security
145.6Act, title 18, section 1886, subsection (d), paragraph (l), and subparagraph (B), clause (iii).
145.7(g) The commissioner of human services, in consultation with the commissioner of
145.8health, shall develop and provide to managed care and county-based purchasing plans, by
145.9September 1, 2011, standard criteria and definitions necessary for consistent calculation
145.10of the total annual risk-adjusted cost of care across plans. The commissioner may use
145.11encounter data to implement this subdivision, and may provide encounter data or analyses
145.13(h) For purposes of this subdivision, "provider" means a vendor of medical care
145.14as defined in section 256B.02, subdivision 7, for which sufficient encounter data on
145.15utilization and costs is available to implement this subdivision.
145.16(i) A managed care or county-based purchasing plan must use the methodology
145.17described in paragraphs (a) to (e), unless the plan develops an alternative model consistent
145.18with the purpose of this subdivision.
145.19EFFECTIVE DATE.This section is effective the day following final enactment.
145.20 Sec. 51. Minnesota Statutes 2010, section 256B.69, is amended by adding a
145.21subdivision to read:
145.22 Subd. 32. Health education. The commissioner shall require managed care and
145.23county-based purchasing plans, as a condition of contract, to provide health education,
145.24wellness training, and information about the availability and benefits of preventive
145.25services to all medical assistance and MinnesotaCare enrollees, beginning January 1,
145.262012. Plan initiatives developed or implemented to comply with this requirement must be
145.27approved by the commissioner.
145.28 Sec. 52. Minnesota Statutes 2010, section 256B.76, subdivision 4, is amended to read:
145.29 Subd. 4. Critical access dental providers. (a) Effective for dental services
145.30rendered on or after January 1, 2002, the commissioner shall increase reimbursements
145.31to dentists and dental clinics deemed by the commissioner to be critical access dental
145.32providers. For dental services rendered on or after July 1, 2007, the commissioner shall
145.33increase reimbursement by 30 percent above the reimbursement rate that would otherwise
145.34be paid to the critical access dental provider. The commissioner shall pay the managed
146.1care plans and county-based purchasing plans in amounts sufficient to reflect increased
146.2reimbursements to critical access dental providers as approved by the commissioner.
146.3(b) The commissioner shall designate the following dentists and dental clinics as
146.4critical access dental providers:
146.5 (1) nonprofit community clinics that:
146.6(i) have nonprofit status in accordance with chapter 317A;
146.7(ii) have tax exempt status in accordance with the Internal Revenue Code, section
146.9(iii) are established to provide oral health services to patients who are low income,
146.10uninsured, have special needs, and are underserved;
146.11(iv) have professional staff familiar with the cultural background of the clinic's
146.13(v) charge for services on a sliding fee scale designed to provide assistance to
146.14low-income patients based on current poverty income guidelines and family size;
146.15(vi) do not restrict access or services because of a patient's financial limitations
146.16or public assistance status; and
146.17(vii) have free care available as needed;
146.18 (2) federally qualified health centers, rural health clinics, and public health clinics;
146.19 (3) county owned and operated hospital-based dental clinics;
146.20(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
146.21accordance with chapter 317A with more than 10,000 patient encounters per year with
146.22patients who are uninsured or covered by medical assistance, general assistance medical
146.23care, or MinnesotaCare; and
146.24(5) a dental clinic
146.25and operated by the University of Minnesota or
146.26Colleges and Universities system.
146.27 (c) The commissioner may designate a dentist or dental clinic as a critical access
146.28dental provider if the dentist or dental clinic is willing to provide care to patients covered
146.29by medical assistance, general assistance medical care, or MinnesotaCare at a level which
146.30significantly increases access to dental care in the service area.
146.31(d) Notwithstanding paragraph (a), critical access payments must not be made for
146.32dental services provided from April 1, 2010, through June 30, 2010.
146.33(e) Notwithstanding section 256B.04, subdivision 2, the commissioner of human
146.34services shall not adopt rules governing this section or section 256L.11, subdivision 7.
146.35EFFECTIVE DATE.This section is effective July 1, 2011.
147.1 Sec. 53. [256B.771] COMPLEMENTARY AND ALTERNATIVE MEDICINE
147.3 Subdivision 1. Establishment and implementation. The commissioner of
147.4human services, in consultation with the commissioner of health, shall contract
147.5with a Minnesota-based academic and research institution specializing in providing
147.6complementary and alternative medicine education and clinical services to establish and
147.7implement a five-year demonstration project in conjunction with federally qualified health
147.8centers and federally qualified health center look-alikes as defined in section 145.9269, to
147.9improve the quality and cost-effectiveness of care provided under medical assistance to
147.10enrollees with neck and back problems. The demonstration project must maximize the use
147.11of complementary and alternative medicine-oriented primary care providers, including but
147.12not limited to physicians and chiropractors. The demonstration project must be designed
147.13to significantly improve physical and mental health for enrollees who present with
147.14neck and back problems while decreasing medical treatment costs. The commissioner,
147.15in consultation with the commissioner of health, shall deliver services through the
147.16demonstration project beginning July 1, 2011, or upon federal approval, whichever is later.
147.17 Subd. 2. RFP and project criteria. The commissioner, in consultation with the
147.18commissioner of health, shall develop and issue a request for proposal (RFP) for the
147.19demonstration project. The RFP must require the academic and research institution
147.20selected to demonstrate a proven track record over at least five years of conducting
147.21high-quality, federally funded clinical research. The RFP shall specify the state costs
147.22directly related to the requirements of this section and shall require that the selected
147.23institution pay those costs to the state. The institution and the federally qualified health
147.24centers and federally qualified health center look-alikes shall also:
147.25(1) provide patient education, provider education, and enrollment training
147.26components on health and lifestyle issues in order to promote enrollee responsibility for
147.27health care decisions, enhance productivity, prepare enrollees to reenter the workforce,
147.28and reduce future health care expenditures;
147.29(2) use high-quality and cost-effective integrated disease management that includes
147.30the best practices of traditional and complementary and alternative medicine;
147.31(3) incorporate holistic medical care, appropriate nutrition, exercise, medications,
147.32and conflict resolution techniques;
147.33(4) include a provider education component that makes use of professional
147.34organizations representing chiropractors, nurses, and other primary care providers
147.35and provides appropriate educational materials and activities in order to improve the
148.1integration of traditional medical care with licensed chiropractic services and other
148.2alternative health care services and achieve program enrollment objectives; and
148.3(5) provide to the commissioner the information and data necessary for the
148.4commissioner to prepare the annual reports required under subdivision 6.
148.5 Subd. 3. Enrollment. Enrollees from the program shall be selected by the
148.6commissioner from current enrollees in the prepaid medical assistance program who
148.7have, or are determined to be at significant risk of developing, neck and back problems.
148.8Participation in the demonstration project shall be voluntary. The commissioner shall
148.9seek to enroll, over the term of the demonstration project, ten percent of current and
148.10future medical assistance enrollees who have, or are determined to be at significant risk
148.11of developing, neck and back problems.
148.12 Subd. 4. Federal approval. The commissioner shall seek any federal waivers and
148.13approvals necessary to implement the demonstration project.
148.14 Subd. 5. Project costs. The commissioner shall require the academic and research
148.15institution selected, federally qualified health centers, and federally qualified health center
148.16look-alikes to fund all costs of the demonstration project. Amounts received under
148.17subdivision 2 are appropriated to the commissioner for the purposes of this section.
148.18 Subd. 6. Annual reports. The commissioner, in consultation with the commissioner
148.19of health, beginning December 15, 2011, and each December 15 thereafter through
148.20December 15, 2015, shall report annually to the legislature on the functional and mental
148.21improvements of the populations served by the demonstration project, patient satisfaction,
148.22and the cost-effectiveness of the program. The reports must also include data on hospital
148.23admissions, days in hospital, rates of outpatient surgery and other services, and drug
148.24utilization. The report, due December 15, 2015, must include recommendations on
148.25whether the demonstration project should be continued and expanded.
148.26 Sec. 54. [256B.841] MINNESOTA CHOICE WAIVER APPLICATION AND
148.28 Subdivision 1. Intent. It is the intent of the legislature that medical assistance be:
148.29(1) a sustainable, cost-effective, person-centered, and opportunity-driven program
148.30utilizing competitive and value-based purchasing to maximize available service options;
148.32(2) a results-oriented system of coordinated care that focuses on independence
148.33and choice, promotes accountability and transparency, encourages and rewards healthy
148.34outcomes and responsible choices, and promotes efficiency.
149.1 Subd. 2. Waiver application. (a) By September 1, 2011, the commissioner of
149.2human services shall apply for a waiver and any necessary state plan amendments from
149.3the secretary of the United States Department of Health and Human Services, including,
149.4but not limited to, a waiver of the appropriate sections of title XIX of the federal Social
149.5Security Act, United States Code, title 42, section 1396 et seq., or other provisions of
149.6federal law that provide program flexibility and under which Minnesota will operate
149.7all facets of the state's medical assistance program. For purposes of this section, and
149.8256B.842, and 256B.843, this waiver shall be known as the Minnesota Consumer Health
149.9Opportunities and Innovative Care Excellence (CHOICE) waiver.
149.10(b) The commissioner of human services shall provide the legislative committees
149.11with jurisdiction over health and human services finance and policy with the CHOICE
149.12waiver application and financial and other related materials, at least ten days prior to
149.13submitting the application and materials to the federal Centers for Medicare and Medicaid
149.15(c) If the state's CHOICE waiver application is approved, the commissioner of
149.16human services shall:
149.17(1) notify the chairs of the legislative committees with jurisdiction over health and
149.18human services finance and policy and allow the legislative committees with jurisdiction
149.19over health and human services finance and policy to review the terms of the CHOICE
149.21(2) not implement the CHOICE waiver until ten legislative days have passed
149.22following notification of the chairs.
149.23 Subd. 3. Rulemaking; legislative proposals. Upon acceptance of the terms of the
149.24CHOICE waiver, the commissioner of human services shall:
149.25(1) adopt rules to implement the CHOICE waiver; and
149.26(2) propose any legislative changes necessary to implement the terms of the
149.28 Subd. 4. Joint commission on waiver implementation. (a) After acceptance of the
149.29terms of the CHOICE waiver, the governor shall establish a joint commission on CHOICE
149.30waiver implementation. The commission shall consist of eight members; four of whom
149.31shall be members of the senate, not more than three from the same political party, to be
149.32appointed by the Subcommittee on Committees of the senate Committee on Rules and
149.33Administration, and four of whom shall be members of the house of representatives, not
149.34more than three from the same political party, to be appointed by the speaker of the house.
149.35(b) The commission shall:
149.36(1) oversee implementation of the CHOICE waiver;
150.1(2) confer as necessary with state agency commissioners;
150.2(3) make recommendations on services covered under the medical assistance
150.4(4) monitor and make recommendations on quality and access to care under the
150.5CHOICE waiver; and
150.6(5) make recommendations for the efficient and cost-effective administration of the
150.7medical assistance program under the terms of the CHOICE waiver.
150.8 Sec. 55. [256B.842] PRINCIPLES AND GOALS FOR MEDICAL ASSISTANCE
150.10 Subdivision 1. Goals for reform. In developing the CHOICE waiver application
150.11and implementing the CHOICE waiver, the commissioner of human services shall ensure
150.12that the reformed medical assistance program is a person-centered, financially sustainable,
150.13and cost-effective program.
150.14 Subd. 2. Reformed medical assistance criteria. The reformed medical assistance
150.15program established through the CHOICE waiver must:
150.16(1) empower consumers to make informed and cost-effective choices about their
150.17health and offer consumers rewards for healthy decisions;
150.18(2) ensure adequate access to needed services;
150.19(3) enable consumers to receive individualized health care that is outcome-oriented
150.20and focused on prevention, disease management, recovery, and maintaining independence;
150.21(4) promote competition between health care providers to ensure best value
150.22purchasing, leverage resources, and to create opportunities for improving service quality
150.24(5) redesign purchasing and payment methods and encourage and reward
150.25high-quality and cost-effective care by incorporating and expanding upon current payment
150.26reform and quality of care initiatives including, but not limited to, those initiatives
150.27authorized under chapter 62U; and
150.28(6) continually improve technology to take advantage of recent innovations and
150.29advances that help decision makers, consumers, and providers make informed and
150.30cost-effective decisions regarding health care.
150.31 Subd. 3. Annual report. The commissioner of human services shall annually
150.32submit a report to the governor and the legislature, beginning December 1, 2012, and each
150.33December 1 thereafter, describing the status of the administration and implementation
150.34of the CHOICE waiver.
151.1 Sec. 56. [256B.843] CHOICE WAIVER APPLICATION REQUIREMENTS.
151.2 Subdivision 1. Requirements for CHOICE waiver request. The commissioner
151.3shall seek federal approval to:
151.4(1) enter into a five-year agreement with the United States Department of Health and
151.5Human Services and Centers for Medicaid and Medicare Services (CMS) under section
151.61115a to waive, as part of the CHOICE waiver, provisions of title XIX of the federal
151.7Social Security Act, United States Code, title 42, section 1396 et seq., requiring:
151.8(i) statewideness to allow for the provision of different services in different areas or
151.9regions of the state;
151.10(ii) comparability of services to allow for the provision of different services to
151.11members of the same or different coverage groups;
151.12(iii) no prohibitions restricting the amount, duration, and scope of services included
151.13in the medical assistance state plan;
151.14(iv) no prohibitions limiting freedom of choice of providers; and
151.15(v) retroactive payment for medical assistance, at the state's discretion;
151.16(2) waive the applicable provisions of title XIX of the federal Social Security Act,
151.17United States Code, title 42, section 1396 et seq., in order to:
151.18(i) expand cost sharing requirements above the five percent of income threshold for
151.19beneficiaries in certain populations;
151.20(ii) establish health savings or power accounts that encourage and reward
151.21beneficiaries who reach certain prevention and wellness targets; and
151.22(iii) implement a tiered set of parameters to use as the basis for determining
151.23long-term service care and setting needs;
151.24(3) modify income and resource rules in a manner consistent with the goals of the
151.26(4) provide enrollees with a choice of appropriate private sector health coverage
151.27options, with full federal financial participation;
151.28(5) treat payments made toward the cost of care as a monthly premium for
151.29beneficiaries receiving home and community-based services when applicable;
151.30(6) provide health coverage and services to individuals over the age of 65 that are
151.31limited in scope and are available only in the home and community-based setting;
151.32(7) consolidate all home and community-based services currently provided under
151.33title XIX of the federal Social Security Act, United States Code, title 42, section 1915(c),
151.34into a single program of home and community-based services that include options for
151.35consumer direction and shared living;
152.1(8) expand disease management, care coordination, and wellness programs for all
152.2medical assistance recipients; and
152.3(9) empower and encourage able-bodied medical assistance recipients to work,
152.5 Subd. 2. Agency coordination. The commissioner shall establish an intraagency
152.6assessment and coordination unit to ensure that decision making and program planning for
152.7recipients who may need long-term care, residential placement, and community support
152.8services are coordinated. The assessment and coordination unit shall determine level of
152.9care, develop service plans and a service budget, make referrals to appropriate settings,
152.10provide education and choice counseling to consumers and providers, track utilization,
152.11and monitor outcomes.
152.12 Sec. 57. Minnesota Statutes 2010, section 256D.03, subdivision 3, is amended to read:
152.13 Subd. 3. General assistance medical care; eligibility. (a) Beginning
152.15according to section
152.16drug coverage, which shall continue to be administered under this section and funded
152.18 (b) Outpatient prescription drug coverage under general assistance medical care is
152.19limited to prescription drugs that:
152.20 (1) are covered under the medical assistance program as described in section
152.22 (2) are provided by manufacturers that have fully executed general assistance
152.23medical care rebate agreements with the commissioner and comply with the agreements.
152.24Outpatient prescription drug coverage under general assistance medical care must conform
152.25to coverage under the medical assistance program according to section
152.27 (c) Outpatient prescription drug coverage does not include drugs administered in a
152.28clinic or other outpatient setting.
152.31EFFECTIVE DATE.This section is effective October 1, 2011.
152.32 Sec. 58. Minnesota Statutes 2010, section 256D.031, subdivision 1, is amended to read:
152.33 Subdivision 1. Eligibility. (a) Except as provided under subdivision 2, general
152.34assistance medical care may be paid for any individual who is not eligible for medical
153.1assistance under chapter 256B, including eligibility for medical assistance based on a
153.2spenddown of excess income according to section
153.3(1) is receiving assistance under section
153.4who are eligible under the Minnesota family investment program (MFIP), or who is
153.5having a payment made on the person's behalf under sections
153.9(2) is a resident of Minnesota and has gross countable income that is equal to or less
153.10than 125 percent of the federal poverty guidelines for the family size, using a six-month
153.11budget period, and who meets the asset limit specified in section 256L.17, subdivision 2.
153.12Exempt assets, the reduction of excess assets, and the waiver of excess assets must
153.13conform to the medical assistance program in section
153.14except that the maximum amount of undistributed funds in a trust that could be distributed
153.15to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's
153.16discretion under the terms of the trust, must be applied toward the asset maximum.
153.17(b) The commissioner shall adjust the income standards under this section each July
153.181 by the annual update of the federal poverty guidelines following publication by the
153.19United States Department of Health and Human Services.
153.20 Sec. 59. Minnesota Statutes 2010, section 256D.031, subdivision 6, is amended to read:
153.21 Subd. 6. Coordinated care delivery systems. (a) Effective
153.221, 2011, the commissioner shall contract with hospitals or groups of hospitals, or
153.23county-based purchasing plans, that qualify under paragraph (b) and agree to deliver
153.24services according to this subdivision. Contracting hospitals or plans shall develop
153.25and implement a coordinated care delivery system to provide health care services to
153.26individuals who are eligible for general assistance medical care under this section and who
153.27either choose to receive services through the coordinated care delivery system or who are
153.28enrolled by the commissioner under paragraph (c). The health care services provided by
153.29the system must include: (1) the services described in subdivision 4 with the exception
153.30of outpatient prescription drug coverage but shall include drugs administered in a clinic
153.31or other outpatient setting; or (2) a set of comprehensive and medically necessary health
153.32services that the recipients might reasonably require to be maintained in good health and
153.33that has been approved by the commissioner, including at a minimum, but not limited
153.34to, emergency care, medical transportation services, inpatient hospital and physician
153.35care, outpatient health services, preventive health services, mental health services,
154.1and prescription drugs administered in a clinic or other outpatient setting. Outpatient
154.2prescription drug coverage is covered on a fee-for-service basis in accordance with section
154.4coordinated care delivery system under this subdivision must ensure that the requirements
154.5of this subdivision are met.
154.6 (b) A hospital or group of hospitals, or a county-based purchasing plan established
154.7under section 256B.692, may contract with the commissioner to develop and implement a
154.8coordinated care delivery system
154.9agrees to satisfy the requirements of this subdivision.
154.19Participation by hospitals or plans shall become effective quarterly on
154.21participation is effective for a period of 12 months and may be renewed for successive
154.23 (c) Applicants and recipients may enroll in any available coordinated care delivery
154.24system statewide. If more than one coordinated care delivery system is available, the
154.25applicant or recipient shall be allowed to choose among the systems. The commissioner
154.26may assign an applicant or recipient to a coordinated care delivery system if no choice
154.27is made by the applicant or recipient. The commissioner shall consider a recipient's zip
154.28code, city of residence, county of residence, or distance from a participating coordinated
154.29care delivery system when determining default assignment. An applicant or recipient
154.30may decline enrollment in a coordinated care delivery system but services excluding
154.31outpatient prescription drug coverage are only available through a coordinated care
154.32delivery system. Upon enrollment into a coordinated care delivery system, the recipient
154.33must agree to receive all nonemergency services through the coordinated care delivery
154.34system. Enrollment in a coordinated care delivery system is for six months and may be
154.35renewed for additional six-month periods, except that initial enrollment is for six months
154.36or until the end of a recipient's period of general assistance medical care eligibility,
155.1whichever occurs first.
155.8 (d) The hospital or plan may contract and coordinate with providers and clinics
155.9for the delivery of services and shall contract with essential community providers as
155.10defined under section
155.11extent practicable. When contracting with providers and clinics, the hospital or plan
155.12shall give preference to providers and clinics certified as health care homes under section
155.13256B.0751. The hospital or plan must contract with federally qualified health centers or
155.14federally qualified health center look-alikes, as defined in section 145.9269, subdivision 1,
155.15and essential community providers as defined in section 62Q.19, that agree to accept the
155.16terms, conditions, and payment rates offered by the hospital or plan to similarly situated
155.17providers, except that reimbursement to federally qualified health centers and federally
155.18qualified health center look-alikes must comply with federal law. If a provider or clinic or
155.19health center contracts with a hospital or plan to provide services through the coordinated
155.20care delivery system, the provider may not refuse to provide services to any recipient
155.21enrolled in the system, and payment for services shall be negotiated with the hospital or
155.22plan and paid by the hospital or plan from the system's allocation under subdivision 7.
155.23 (e) A coordinated care delivery system must:
155.24 (1) provide the covered services required under paragraph (a) to recipients enrolled
155.25in the coordinated care delivery system, and comply with the requirements of subdivision
155.264, paragraphs (b) to (g);
155.27 (2) establish a process to monitor enrollment and ensure the quality of care provided;
155.28 (3) in cooperation with counties, coordinate the delivery of health care services with
155.29existing homeless prevention, supportive housing, and rent subsidy programs and funding
155.30administered by the Minnesota Housing Finance Agency under chapter 462A; and
155.31 (4) adopt innovative and cost-effective methods of care delivery and coordination,
155.32which may include the use of allied health professionals, telemedicine, patient educators,
155.33care coordinators, and community health workers.
155.34 (f) The hospital or plan may require a recipient to designate a primary care provider
155.35or a primary care clinic. The hospital or plan may limit the delivery of services to a
155.36network of providers who have contracted with the hospital or plan to deliver services in
156.1accordance with this subdivision, and require a recipient to seek services only within this
156.2network. The hospital or plan may also require a referral to a provider before the service
156.3is eligible for payment. A coordinated care delivery system is not required to provide
156.4payment to a provider who is not employed by or under contract with the system for
156.5services provided to a recipient enrolled in the system, except in cases of an emergency.
156.6For purposes of this section, emergency services are defined in accordance with Code of
156.7Federal Regulations, title 42, section 438.114 (a).
156.8 (g) A recipient enrolled in a coordinated care delivery system has the right to appeal
156.9to the commissioner according to section
156.10 (h) The state shall not be liable for the payment of any cost or obligation incurred
156.11by the coordinated care delivery system.
156.12 (i) The hospital or plan must provide the commissioner with data necessary for
156.13assessing enrollment, quality of care, cost, and utilization of services. Each hospital or
156.14plan must provide, on a quarterly basis on a form prescribed by the commissioner for each
156.15recipient served by the coordinated care delivery system, the services provided, the cost of
156.16services provided, and the actual payment amount for the services provided and any other
156.17information the commissioner deems necessary to claim federal Medicaid match. The
156.18commissioner must provide this data to the legislature on a quarterly basis.
156.20paragraph (b), do not apply to general assistance medical care provided under this section.
156.21 (k) Notwithstanding any other provision in this section to the contrary,
156.25to develop and implement a coordinated care delivery system
156.29EFFECTIVE DATE.This section is effective October 1, 2011.
156.30 Sec. 60. Minnesota Statutes 2010, section 256D.031, subdivision 7, is amended to read:
156.31 Subd. 7. Payments; rate setting for the
156.32system. (a) Effective for general assistance medical care services, with the exception
156.33of outpatient prescription drug coverage
156.34coordinated care delivery system, the commissioner shall allocate the annual appropriation
156.35for the coordinated care delivery system to hospitals or plans participating under
157.1subdivision 6 in quarterly payments, beginning on the first scheduled warrant on or after
157.3plans qualified to participate on the allocation date
157.4thresholds negotiated with the commissioner.
157.15 The commissioner may prospectively reallocate payments to participating hospitals
157.16or plans on a biannual basis to ensure that final allocations reflect actual coordinated
157.17care delivery system enrollment.
157.24care services shall contract with one or more hospitals or plans described in paragraph (a)
157.25to provide services to general assistance medical care recipients through the coordinated
157.26care delivery system established by the hospital or plan. The hospital or plan shall
157.27reimburse bills submitted by nonhospital providers participating under this paragraph at a
157.28rate negotiated between the hospital or plan and the nonhospital provider.
157.33EFFECTIVE DATE.This section is effective October 1, 2011.
157.34 Sec. 61. Minnesota Statutes 2010, section 256D.031, subdivision 9, is amended to read:
158.1 Subd. 9. Prescription drug pool. (a) The commissioner shall establish an outpatient
158.2prescription drug pool, effective
158.3be used to reimburse pharmacies and other pharmacy service providers as defined in
158.4Minnesota Rules, part 9505.0340, for the covered outpatient prescription drugs dispensed
158.5to recipients. Payment for drugs shall be on a fee-for-service basis according to the rates
158.6established in section
158.7is subject to the availability of funds in the pool. If the commissioner forecasts that
158.8expenditures under this subdivision will exceed the appropriation for this purpose, the
158.9commissioner may bring recommendations to the Legislative Advisory Commission on
158.10methods to resolve the shortfall.
158.12established under subdivision 6 shall pay to the commissioner, on a quarterly basis, an
158.13assessment equal to 20 percent of payments for the prescribed drugs for recipients of
158.14services through that coordinated care delivery system, as calculated by the commissioner
158.15based on the most recent available data.
158.16 Sec. 62. Minnesota Statutes 2010, section 256D.031, subdivision 10, is amended to
158.18 Subd. 10. Assistance for veterans. Hospitals and plans participating in the
158.19coordinated care delivery system under subdivision 6 shall consult with counties, county
158.20veterans service officers, and the Veterans Administration to identify other programs for
158.21which general assistance medical care recipients enrolled in their system are qualified.
158.22 Sec. 63. Minnesota Statutes 2010, section 256L.01, subdivision 4a, is amended to read:
158.23 Subd. 4a. Gross individual or gross family income. (a) "Gross individual or gross
158.24family income" for nonfarm self-employed means income calculated for the
158.25six-month period of eligibility using as a baseline the adjusted gross income reported
158.26on the applicant's federal income tax form for the previous year and adding back in
158.27depreciation, and carryover net operating loss amounts that apply to the business in which
158.28the family is currently engaged.
158.29(b) "Gross individual or gross family income" for farm self-employed means
158.30income calculated for the
158.31the adjusted gross income reported on the applicant's federal income tax form for the
158.33(c) "Gross individual or gross family income" means the total income for all family
158.34members, calculated for the
159.1 Sec. 64. Minnesota Statutes 2010, section 256L.02, subdivision 3, is amended to read:
159.2 Subd. 3. Financial management. (a) The commissioner shall manage spending for
159.3the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
159.4each state revenue and expenditure forecast, the commissioner must make an assessment
159.5of the expected expenditures for the covered services for the remainder of the current
159.6biennium and for the following biennium. The estimated expenditure, including the
159.7reserve, shall be compared to an estimate of the revenues that will be available in the health
159.8care access fund. Based on this comparison, and after consulting with the chairs of the
159.9house of representatives Ways and Means Committee and the senate Finance Committee,
159.11necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
159.12remain within the limits of available revenues for the remainder of the current biennium
159.13and for the following biennium. The commissioner shall not hire additional staff using
159.14appropriations from the health care access fund until the commissioner of management
159.15and budget makes a determination that the adjustments implemented under paragraph (b)
159.16are sufficient to allow MinnesotaCare expenditures to remain within the limits of available
159.17revenues for the remainder of the current biennium and for the following biennium.
159.18(b) The adjustments the commissioner shall use must be implemented in this order:
159.19first, stop enrollment of single adults and households without children; second, upon 45
159.20days' notice, stop coverage of single adults and households without children already
159.21enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium
159.22subsidy amounts by ten percent for families with gross annual income above 200 percent
159.23of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium
159.24subsidy amounts by ten percent for families with gross annual income at or below 200
159.25percent; and fifth, require applicants to be uninsured for at least six months prior to
159.26eligibility in the MinnesotaCare program. If these measures are insufficient to limit the
159.27expenditures to the estimated amount of revenue, the commissioner shall further limit
159.28enrollment or decrease premium subsidies.
159.29 Sec. 65. Minnesota Statutes 2010, section 256L.03, subdivision 5, is amended to read:
159.30 Subd. 5.
159.33 (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
159.34subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
159.35 (2) $3 per prescription for adult enrollees;
160.1 (3) $25 for eyeglasses for adult enrollees;
160.2 (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
160.3episode of service which is required because of a recipient's symptoms, diagnosis, or
160.4established illness, and which is delivered in an ambulatory setting by a physician or
160.5physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
160.6audiologist, optician, or optometrist;
160.7 (5) $6 for nonemergency visits to a hospital-based emergency room for services
160.8provided through December 31, 2010, and $3.50 effective January 1, 2011; and
160.9(6) a family deductible equal to the maximum amount allowed under Code of
160.10Federal Regulations, title 42, part 447.54.
160.11 (b) Paragraph (a), clause (1),
160.12relative caretakers of children under the age of 21.
160.13 (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
160.14 (d) Paragraph (a), clause (4), does not apply to mental health services.
160.15 (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
160.16poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
160.17and who are not pregnant shall be financially responsible for the coinsurance amount, if
160.18applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
160.19 (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
160.20or changes from one prepaid health plan to another during a calendar year, any charges
160.21submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
160.22expenses incurred by the enrollee for inpatient services, that were submitted or incurred
160.23prior to enrollment, or prior to the change in health plans, shall be disregarded.
160.24(g) MinnesotaCare reimbursements to fee-for-service providers and payments to
160.25managed care plans or county-based purchasing plans shall not be increased as a result of
160.26the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
160.27(h) Effective January 1, 2012, the following co-payments for nonpreventive visits
160.28shall apply to enrollees who are adults without children eligible under section 256L.04,
160.30(1) $3 for visits to providers whose average, risk-adjusted, total annual cost of care
160.31per MinnesotaCare enrollee is at the 60th percentile or lower for providers of the same
160.33(2) $6 for visits to providers whose average, risk-adjusted, total annual cost of care
160.34per MinnesotaCare enrollee is greater than the 60th percentile but does not exceed the
160.3580th percentile for providers of the same type; and
161.1(3) $10 for visits to providers whose average, risk-adjusted, total annual cost of
161.2care per MinnesotaCare enrollee is greater than the 80th percentile for providers of the
161.4Each managed care and county-based purchasing plan shall calculate the average,
161.5risk-adjusted, total annual cost of care for providers under this paragraph using a
161.6methodology that has been approved by the commissioner.
161.7 Sec. 66. [256L.031] HEALTHY MINNESOTA CONTRIBUTION PROGRAM.
161.8 Subdivision 1. Defined contributions to enrollees. (a) Beginning January 1, 2012,
161.9the commissioner shall provide each MinnesotaCare enrollee eligible under section
161.10256L.04, subdivision 7, with family income greater than 125 percent of the federal poverty
161.11guidelines with a monthly defined contribution to purchase health coverage under a health
161.12plan as defined in section 62A.011, subdivision 3.
161.13(b) Beginning January 1, 2012, the commissioner shall provide each MinnesotaCare
161.14adult enrollee eligible under section 256L.04, subdivision 1, with family income greater
161.15than 133 percent of the federal poverty guidelines with a monthly defined contribution to
161.16purchase health coverage under a health plan as defined in section 62A.011, subdivision 3,
161.17offered by a health plan company as defined in section 62Q.01, subdivision 4.
161.18(c) Enrollees eligible under paragraph (a) or (b) shall not be charged premiums
161.19under section 256L.15 and are exempt from the managed care enrollment requirement
161.20of section 256L.12.
161.21(d) Sections 256L.03; 256L.05, subdivision 3; and 256L.11 do not apply to enrollees
161.22eligible under paragraph (a) or (b) unless otherwise provided in this section. Covered
161.23services, cost sharing, disenrollment for nonpayment of premium, enrollee appeal rights
161.24and complaint procedures, and the effective date of coverage for enrollees eligible under
161.25paragraph (a) shall be as provided under the terms of the health plan purchased by the
161.27(e) Unless otherwise provided in this section, all MinnesotaCare requirements
161.28related to eligibility, income and asset methodology, income reporting, and program
161.29administration, continue to apply to enrollees obtaining coverage under this section.
161.30 Subd. 2. Use of defined contribution; health plan requirements. (a) An enrollee
161.31may use up to the monthly defined contribution to pay premiums for coverage under a
161.32health plan as defined in section 62A.011, subdivision 3.
161.33(b) An enrollee must select a health plan within three calendar months of approval of
161.34MinnesotaCare eligibility. If a health plan is not selected and purchased within this time
161.35period, the enrollee must reapply and must meet all eligibility criteria.
162.1(c) A health plan purchased under this section must:
162.2(1) provide coverage for mental health and chemical dependency treatment services;
162.4(2) comply with the coverage limitations specified in section 256L.03, subdivision
162.51, the second paragraph.
162.6 Subd. 3. Determination of defined contribution amount. (a) The commissioner
162.7shall determine the defined contribution sliding scale using the base contribution specified
162.8in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
162.9for defined contributions that provides:
162.10(1) persons with the lowest eligible household income with a defined contribution
162.11of 110 percent of the base contribution;
162.12(2) persons with household incomes equal to 175 percent of the federal poverty
162.13guidelines with a defined contribution of 100 percent of the base contribution;
162.14(3) persons with household incomes equal to or greater than 250 percent of
162.15the federal poverty guidelines with a defined contribution of 80 percent of the base
162.17(4) persons with household incomes in evenly spaced increments between the
162.18percentages of the federal poverty guideline or income level specified in clauses (1) to (3)
162.19with a base contribution that is a percentage interpolated from the defined contribution
162.20percentages specified in clauses (1) to (3).
162.31under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
162.32health plan by a health plan company and who purchase coverage through the Minnesota
162.33Comprehensive Health Association.
162.34 Subd. 4. Administration by commissioner. (a) The commissioner shall administer
162.35the defined contributions. The commissioner shall:
162.36 (1) calculate and process defined contributions for enrollees; and
163.1 (2) pay the defined contribution amount to health plan companies or the Minnesota
163.2Comprehensive Health Association, as applicable, for enrollee health plan coverage.
163.3(b) Nonpayment of a health plan premium shall result in disenrollment from
163.4MinnesotaCare effective the first day of the calendar month following the calendar month
163.5for which the premium was due. Persons disenrolled for nonpayment or who voluntarily
163.6terminate coverage may not reenroll until four calendar months have elapsed.
163.7 Subd. 5. Assistance to enrollees. The commissioner of human services, in
163.8consultation with the commissioner of commerce, shall develop an efficient and
163.9cost-effective method of referring eligible applicants to professional insurance agent
163.11 Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
163.12January 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual
163.13health market by a health plan company in accordance with section 62A.65 are eligible
163.14for coverage through a health plan offered by the Minnesota Comprehensive Health
163.15Association and may enroll in MCHA in accordance with section 62E.14. Any difference
163.16between the revenue and covered losses to the MCHA related to implementation of this
163.17section shall be paid to the MCHA from the health care access fund.
163.18 Subd. 7. Federal approval. The commissioner shall seek all federal waivers and
163.19approvals necessary to implement coverage under this section for MinnesotaCare enrollees
163.20eligible under subdivision 1. The commissioner shall seek the continuation of federal
163.21financial participation for the adult enrollees eligible under section 256L.04, subdivision 1.
163.22 Sec. 67. Minnesota Statutes 2010, section 256L.04, subdivision 1, is amended to read:
163.23 Subdivision 1. Families with children. (a) Families with children with family
163.24income equal to or less than 275 percent of the federal poverty guidelines for the
163.25applicable family size shall be eligible for MinnesotaCare according to this section. All
163.26other provisions of sections
163.27to enrollment under section
163.28 (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
163.29if the children are eligible. Children may be enrolled separately without enrollment by
163.30parents. However, if one parent in the household enrolls, both parents must enroll, unless
163.31other insurance is available. If one child from a family is enrolled, all children must
163.32be enrolled, unless other insurance is available. If one spouse in a household enrolls,
163.33the other spouse in the household must also enroll, unless other insurance is available.
163.34Families cannot choose to enroll only certain uninsured members.
164.1 (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
164.2to the MinnesotaCare program. These persons are no longer counted in the parental
164.3household and may apply as a separate household.
164.5not eligible for MinnesotaCare if their gross income exceeds
164.10 Sec. 68. Minnesota Statutes 2010, section 256L.04, subdivision 7, is amended to read:
164.11 Subd. 7. Single adults and households with no children. (a) The definition of
164.12eligible persons, through September 30, 2011, includes all individuals and households
164.13with no children who have gross family incomes that are equal to or less than
164.14percent of the federal poverty guidelines.
164.15 (b) Effective
164.16all individuals and households with no children who have gross family incomes that are
164.17greater than 125 percent of the federal poverty guidelines and equal to or less than 250
164.18percent of the federal poverty guidelines.
164.19EFFECTIVE DATE.This section is effective October 1, 2011.
164.20 Sec. 69. Minnesota Statutes 2010, section 256L.04, subdivision 10, is amended to read:
164.21 Subd. 10. Citizenship requirements. Eligibility for MinnesotaCare is limited to
164.22citizens or nationals of the United States, qualified noncitizens
164.25according to United States Code, title 8, section 1612. Undocumented noncitizens and
164.26nonimmigrants are ineligible for MinnesotaCare. For purposes of this subdivision, a
164.27nonimmigrant is an individual in one or more of the classes listed in United States Code,
164.28title 8, section 1101(a)(15), and an undocumented noncitizen is an individual who resides
164.29in the United States without the approval or acquiescence of the United States Citizenship
164.30and Immigration Services. Families with children who are citizens or nationals of
164.31the United States must cooperate in obtaining satisfactory documentary evidence of
164.32citizenship or nationality according to the requirements of the federal Deficit Reduction
164.33Act of 2005, Public Law 109-171.
165.1EFFECTIVE DATE.This section is effective January 1, 2012.
165.2 Sec. 70. Minnesota Statutes 2010, section 256L.05, subdivision 2, is amended to read:
165.3 Subd. 2. Commissioner's duties. (a) The commissioner or county agency shall
165.4use electronic verification as the primary method of income verification. If there is a
165.5discrepancy between reported income and electronically verified income, an individual
165.6may be required to submit additional verification. In addition, the commissioner shall
165.7perform random audits to verify reported income and eligibility. The commissioner
165.8may execute data sharing arrangements with the Department of Revenue and any other
165.9governmental agency in order to perform income verification related to eligibility and
165.10premium payment under the MinnesotaCare program.
165.11(b) In determining eligibility for MinnesotaCare, the commissioner shall require
165.12applicants and enrollees seeking renewal of eligibility to verify both earned and unearned
165.13income. The commissioner shall also require applicants and enrollees , and their spouses
165.14or parents, who are age 21 and over and employed 20 or more hours per week by any one
165.15employer, to verify that they do not have access to employer-subsidized coverage as
165.16described in section 256L.07, subdivision 2. Data collected is nonpublic data as defined
165.17in section 13.02, subdivision 9.
165.18 Sec. 71. Minnesota Statutes 2010, section 256L.05, subdivision 3a, is amended to read:
165.19 Subd. 3a. Renewal of eligibility. (a) Beginning July 1,
165.20eligibility must be renewed every
165.22 (b) Each new period of eligibility must take into account any changes in
165.23circumstances that impact eligibility and premium amount. An enrollee must provide all
165.24the information needed to redetermine eligibility by the first day of the month that ends
165.25the eligibility period. If there is no change in circumstances, the enrollee may renew
165.26eligibility at designated locations that include community clinics and health care providers'
165.27offices. The designated sites shall forward the renewal forms to the commissioner. The
165.28commissioner may establish criteria and timelines for sites to forward applications to the
165.29commissioner or county agencies. The premium for the new period of eligibility must be
165.30received as provided in section
165.31 (c) An enrollee who fails to submit renewal forms and related documentation
165.32necessary for verification of continued eligibility in a timely manner shall remain eligible
165.33for one additional month beyond the end of the current eligibility period before being
166.1disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
166.3 Sec. 72. Minnesota Statutes 2010, section 256L.05, is amended by adding a subdivision
166.5 Subd. 6. Referral of veterans. The commissioner shall ensure that all applicants
166.6for MinnesotaCare who identify themselves as veterans are referred to a county veterans
166.7service officer for assistance in applying to the United States Department of Veterans
166.8Affairs for any veterans benefits for which they may be eligible.
166.9 Sec. 73. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:
166.10 Subdivision 1. General requirements. (a) Children enrolled in the original
166.11children's health plan as of September 30, 1992, children who enrolled in the
166.12MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
166.13article 4, section 17, and children who have family gross incomes that are equal to or
166.14less than 150 percent of the federal poverty guidelines are eligible without meeting
166.15the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
166.16long as they maintain continuous coverage in the MinnesotaCare program or medical
166.17assistance. Children who apply for MinnesotaCare on or after the implementation date
166.18of the employer-subsidized health coverage program as described in Laws 1998, chapter
166.19407, article 5, section 45, who have family gross incomes that are equal to or less than 150
166.20percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
166.21be eligible for MinnesotaCare.
166.22 (b) Families enrolled in MinnesotaCare under section
166.23income increases above
166.24in section 256L.04, subdivision 1, are no longer eligible for the program and shall be
166.25disenrolled by the commissioner.
166.26(c) Individuals enrolled in MinnesotaCare under section
166.27whose income increases above 200 percent of the federal poverty guidelines or 250
166.28percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
166.29the program and shall be disenrolled by the commissioner.
166.30(d) For persons disenrolled under this subdivision, MinnesotaCare coverage
166.31terminates the last day of the calendar month following the month in which the
166.32commissioner determines that the income of a family or individual exceeds program
167.2MinnesotaCare if ten percent of their gross individual or gross family income as defined
167.4policy with a $500 deductible available through the Minnesota Comprehensive Health
167.5Association. Children who are no longer eligible for MinnesotaCare under this clause shall
167.6be given a 12-month notice period from the date that ineligibility is determined before
167.7disenrollment. The premium for children remaining eligible under this clause shall be the
167.8maximum premium determined under section
167.10MinnesotaCare if gross household income exceeds
167.11the six-month period of eligibility.
167.12 Sec. 74. Minnesota Statutes 2010, section 256L.07, subdivision 1, is amended to read:
167.13 Subdivision 1. General requirements. (a) Children enrolled in the original
167.14children's health plan as of September 30, 1992, children who enrolled in the
167.15MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
167.16article 4, section 17, and children who have family gross incomes that are equal to or
167.17less than 150 percent of the federal poverty guidelines are eligible without meeting
167.18the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
167.19long as they maintain continuous coverage in the MinnesotaCare program or medical
167.20assistance. Children who apply for MinnesotaCare on or after the implementation date
167.21of the employer-subsidized health coverage program as described in Laws 1998, chapter
167.22407, article 5, section 45, who have family gross incomes that are equal to or less than 150
167.23percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
167.24be eligible for MinnesotaCare.
167.25 (b) Families enrolled in MinnesotaCare under section
167.26income increases above 275 percent of the federal poverty guidelines, are no longer
167.27eligible for the program and shall be disenrolled by the commissioner.
167.28(c) Beginning January 1, 2008, individuals enrolled in MinnesotaCare under section
167.30guidelines or 250 percent of the federal poverty guidelines on or after July 1, 2009, are no
167.31longer eligible for the program and shall be disenrolled by the commissioner.
167.32(d) For persons disenrolled under this subdivision, MinnesotaCare coverage
167.33terminates the last day of the calendar month following the month in which the
167.34commissioner determines that the income of a family or individual exceeds program
168.2MinnesotaCare if ten percent of their gross individual or gross family income as defined in
168.4deductible available through the Minnesota Comprehensive Health Association. Children
168.5who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month
168.6notice period from the date that ineligibility is determined before disenrollment. The
168.7premium for children remaining eligible under this clause shall be the maximum premium
168.8determined under section
168.10MinnesotaCare if gross household income exceeds
168.11six-month period of eligibility.
168.12 Sec. 75. Minnesota Statutes 2010, section 256L.11, subdivision 7, is amended to read:
168.13 Subd. 7. Critical access dental providers. Effective for dental services provided to
168.14MinnesotaCare enrollees on or after
168.15increase payment rates to dentists and dental clinics deemed by the commissioner to be
168.16critical access providers under section
168.17the payment rate that would otherwise be paid to the provider. The commissioner shall
168.18pay the prepaid health plans under contract with the commissioner amounts sufficient to
168.19reflect this rate increase. The prepaid health plan must pass this rate increase to providers
168.20who have been identified by the commissioner as critical access dental providers under
168.22 Sec. 76. Minnesota Statutes 2010, section 256L.12, subdivision 9, is amended to read:
168.23 Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
168.24per capita, where possible. The commissioner may allow health plans to arrange for
168.25inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
168.26an independent actuary to determine appropriate rates.
168.27 (b) For services rendered on or after January 1, 2004, the commissioner shall
168.28withhold five percent of managed care plan payments and county-based purchasing
168.29plan payments under this section pending completion of performance targets. Each
168.30performance target must be quantifiable, objective, measurable, and reasonably attainable,
168.31except in the case of a performance target based on a federal or state law or rule. Criteria
168.32for assessment of each performance target must be outlined in writing prior to the
168.33contract effective date. The managed care plan must demonstrate, to the commissioner's
168.34satisfaction, that the data submitted regarding attainment of the performance target is
169.1accurate. The commissioner shall periodically change the administrative measures used
169.2as performance targets in order to improve plan performance across a broader range of
169.3administrative services. The performance targets must include measurement of plan
169.4efforts to contain spending on health care services and administrative activities. The
169.5commissioner may adopt plan-specific performance targets that take into account factors
169.6affecting only one plan, such as characteristics of the plan's enrollee population. The
169.7withheld funds must be returned no sooner than July 1 and no later than July 31 of the
169.8following calendar year if performance targets in the contract are achieved.
169.9(c) For services rendered on or after January 1, 2011, the commissioner shall
169.10withhold an additional three percent of managed care plan or county-based purchasing
169.11plan payments under this section. The withheld funds must be returned no sooner than
169.12July 1 and no later than July 31 of the following calendar year. The return of the withhold
169.13under this paragraph is not subject to the requirements of paragraph (b).
169.14(d) Effective for services rendered on or after January 1, 2011, the commissioner
169.15shall include as part of the performance targets described in paragraph (b) a reduction in
169.16the plan's emergency room utilization rate for state health care program enrollees by a
169.17measurable rate of five percent from the plan's utilization rate for the previous calendar
169.19The withheld funds must be returned no sooner than July 1 and no later than July 31
169.20of the following calendar year if the managed care plan demonstrates to the satisfaction of
169.21the commissioner that a reduction in the utilization rate was achieved.
169.22The withhold described in this paragraph shall continue for each consecutive
169.23contract period until the plan's emergency room utilization rate for state health care
169.24program enrollees is reduced by 25 percent of the plan's emergency room utilization rate
169.25for state health care program enrollees for calendar year 2009. Hospitals shall cooperate
169.26with the health plans in meeting this performance target and shall accept payment
169.27withholds that may be returned to the hospitals if the performance target is achieved. The
169.28commissioner shall structure the withhold so that the commissioner returns a portion of
169.29the withheld funds in amounts commensurate with achieved reductions in utilization less
169.30than the targeted amount. The withhold described in this paragraph does not apply to
169.31county-based purchasing plans.
169.32(e) Effective for services provided on or after January 1, 2012, the commissioner
169.33shall include as part of the performance targets described in paragraph (b) a reduction in
169.34the plan's hospitalization rate for a subsequent hospitalization within 30 days of a previous
169.35hospitalization of a patient regardless of the reason for the hospitalization for state health
170.1care program enrollees by a measurable rate of five percent from the plan's hospitalization
170.2rate for the previous calendar year.
170.3The withheld funds must be returned no sooner than July 1 and no later than July 31
170.4of the following calendar year if the managed care plan or county-based purchasing plan
170.5demonstrates to the satisfaction of the commissioner that a reduction in the hospitalization
170.6rate was achieved.
170.7The withhold described in this paragraph must continue for each consecutive
170.8contract period until the plan's subsequent hospitalization rate for state health care
170.9program enrollees is reduced by 25 percent of the plan's subsequent hospitalization rate
170.10for state health care program enrollees for calendar year 2010. Hospitals shall cooperate
170.11with the plans in meeting this performance target and shall accept payment withholds that
170.12must be returned to the hospitals if the performance target is achieved. The commissioner
170.13shall structure the withhold so that the commissioner returns a portion of the withheld
170.14funds in amounts commensurate with achieved reductions in utilizations less than the
170.15targeted amount. The withhold described in this paragraph does not apply to county-based
170.19under this section that is reasonably expected to be returned.
170.20 Sec. 77. Minnesota Statutes 2010, section 256L.15, subdivision 1a, is amended to read:
170.21 Subd. 1a. Payment options. The commissioner may offer the following payment
170.22options to an enrollee:
170.23(1) payment by check;
170.24(2) payment by credit card;
170.25(3) payment by recurring automatic checking withdrawal;
170.26(4) payment by onetime electronic transfer of funds;
170.27(5) payment by wage withholding with the consent of the employer and the
170.29(6) payment by using state tax refund payments.
170.30The commissioner shall include information about the payment options on each
170.31premium notice. At application or reapplication, a MinnesotaCare applicant or enrollee
170.32may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to
170.33collect funds from the applicant's or enrollee's refund for the purposes of meeting all or
170.34part of the applicant's or enrollee's MinnesotaCare premium obligation. The applicant or
170.35enrollee may authorize the commissioner to apply for the state working family tax credit
171.1on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be
171.2subject to the $10 fee under section
171.3 Sec. 78. Laws 2010, First Special Session chapter 1, article 25, section 3, subdivision
171.46, is amended to read:
171.9Health Care Access Fund Transfer to
171.10General Fund. The commissioner of
171.11management and budget shall transfer the
171.12following amounts in the following years
171.13from the health care access fund to the
171.16year 2011; $141,041,000 in fiscal year 2012;
171.17and $286,150,000 in fiscal year 2013. If at
171.18any time the governor issues an executive
171.19order not to participate in early medical
171.20assistance expansion, no funds shall be
171.21transferred from the health care access
171.22fund to the general fund until early medical
171.23assistance expansion takes effect. This
171.24paragraph is effective the day following final
171.26MinnesotaCare Ratable Reduction.
171.27Effective for services rendered on or after
171.28July 1, 2010, to December 31, 2013,
171.29MinnesotaCare payments to managed care
171.30plans under Minnesota Statutes, section
171.32without children whose income is greater
171.33than 75 percent of federal poverty guidelines
171.34shall be reduced by 15 percent. Effective
172.1for services provided from July 1, 2010, to
172.2June 30, 2011, this reduction shall apply to
172.3all services. Effective for services provided
172.4from July 1, 2011, to December 31, 2013, this
172.5reduction shall apply to all services except
172.6inpatient hospital services. Notwithstanding
172.7any contrary provision of this article, this
172.8paragraph shall expire on December 31,
172.13fund appropriation, $731,000 in fiscal year
172.142011 is to the commissioner for critical
172.15access dental provider reimbursement
172.16payments under Minnesota Statutes, section
172.19Nonadministrative Rate Reduction. For
172.20services rendered on or after July 1, 2010,
172.21to December 31, 2013, the commissioner
172.22shall reduce contract rates paid to managed
172.23care plans under Minnesota Statutes,
172.25county-based purchasing plans under
172.26Minnesota Statutes, section
172.27three percent of the contract rate attributable
172.28to nonadministrative services in effect on
172.29June 30, 2010. Notwithstanding any contrary
172.30provision in this article, this rider expires on
172.31December 31, 2013.
173.2care grants is contingent upon the effective
173.3date in Laws 2010, First Special Session
173.4chapter 1, article 16, section 48. The
173.5reduction shall be reestimated based upon
173.6the actual effective date of the law. The
173.7commissioner of management and budget
173.8shall make adjustments in fiscal year
173.92011 to general assistance medical care
173.10appropriations to conform to the total
173.11expected expenditure reductions specified in
173.15appropriated in fiscal year 2010 for COBRA
173.16grants under Laws 2009, chapter 79, article
173.175, section 78, do not cancel and are available
173.18to the commissioner for fiscal year 2011
173.19COBRA grant expenditures. Up to $111,000
173.20of the fiscal year 2011 appropriation for
173.21COBRA grants provided in Laws 2009,
173.22chapter 79, article 13, section 3, subdivision
173.236, may be used by the commissioner for costs
173.24related to administration of the COBRA
173.26 Sec. 79. PLAN TO COORDINATE CARE FOR CHILDREN WITH HIGH-COST
173.27MENTAL HEALTH CONDITIONS.
173.28The commissioner of human services shall develop and submit to the legislature
173.29by December 15, 2011, a plan to provide care coordination to medical assistance and
173.30MinnesotaCare enrollees who are children with high-cost mental health conditions. For
173.31purposes of this section, a child has a "high-cost mental health condition" if mental health
173.32and medical expenses over the past year totalled $100,000 or more. For purposes of this
173.33section, "care coordination" means collaboration between an advanced practice nurse and
173.34primary care physicians and specialists to manage care; development of mental health
173.35management plans for recurrent mental health issues; oversight and coordination of all
174.1aspects of care in partnership with families; organization of medical, treatment, and
174.2therapy information into a summary of critical information; coordination and appropriate
174.3sequencing of evaluations and multiple appointments; information and assistance with
174.4accessing resources; and telephone triage for behavior or other problems.
174.5 Sec. 80. REGULATORY SIMPLIFICATION AND REDUCTION OF
174.6PROVIDER REPORTING AND DATA SUBMITTAL REQUIREMENTS.
174.7 Subdivision 1. Regulatory simplification and report reduction work group. The
174.8commissioner of management and budget shall convene a regulatory simplification and
174.9report reduction work group of persons designated by the commissioners of health, human
174.10services, and commerce to eliminate redundant, unnecessary, and obsolete state mandated
174.11reporting or data submittal requirements for health care providers or group purchasers
174.12related to health care costs, quality, utilization, access, or patient encounters or related to
174.13provider or group purchaser, monitoring, finances, and regulation. For purposes of this
174.14section, the term "health care providers or group purchasers" has the meaning provided
174.15in Minnesota Statutes, section 62J.03, subdivisions 6 and 8, except that it also includes
174.17 Subd. 2. Plan development and other duties. (a) The commissioner of
174.18management and budget, in consultation with the work group, shall develop a plan for
174.19regulatory simplification and report reduction activities of the commissioners of health,
174.20human services, and commerce that considers collection and regulation of the following
174.21in a coordinated manner:
174.22(1) encounter data;
174.23(2) group purchaser provider network data;
174.24(3) financial reporting;
174.25(4) reporting and documentation requirements relating to member communications
174.26and marketing materials;
174.27(5) state regulation and oversight of group purchasers;
174.28(6) requirements and procedures for denial, termination, or reduction of services
174.29and member appeals and grievances; and
174.30(7) state performance improvement projects, requirements, and procedures.
174.31(b) The commissioners of health, human services, and commerce, following
174.32consultation with the work group, shall present to the legislature by January 1, 2012,
174.33proposals to implement their recommendations.
175.1 Subd. 3. New reporting and other duties. (a) The commissioner of management
175.2and budget, in consultation with the work group and the commissioners of health, human
175.3services, and commerce, shall develop criteria to be used by the commissioners in
175.4determining whether to establish new reporting and data submittal requirements. These
175.5criteria must support the establishment of new reporting and data submittal requirements
175.7(1) if required by a federal agency or state statute;
175.8(2) if needed for a state regulatory audit or corrective action plan;
175.9(3) if needed to monitor or protect public health;
175.10(4) if needed to manage the cost and quality of Minnesota's public health insurance
175.12(5) if a review and analysis by the commissioner of the relevant agency has
175.13documented the necessity, importance, and administrative cost of the requirement, and
175.14has determined that the information sought cannot be efficiently obtained through another
175.15state or federal report.
175.16(b) The commissioners of health, human services, and commerce, following
175.17consultation with the work group, may propose to the legislature new provider and group
175.18purchaser reporting and data submittal requirements to take effect on or after July 1, 2012.
175.19These proposals shall include an analysis of the extent to which the requirements meet
175.20the criteria developed under paragraph (a).
175.21 Sec. 81. MEDICAID FRAUD PREVENTION AND DETECTION.
175.22 Subdivision 1. Request for proposals. By October 31, 2011, the commissioner
175.23of human services shall issue a request for proposals to prevent and detect Medicaid
175.24fraud and mispayment. The request for proposals shall require the vendor to provide
175.25data analytics capabilities, including, but not limited to, predictive modeling techniques
175.26and other forms of advanced analytics, technical assistance, claims review, and medical
175.27record and documentation investigations, to detect and investigate improper payments
175.28both before and after payments are made.
175.29 Subd. 2. Proof of concept phase. The selected vendor, at no cost to the state, shall
175.30be required to apply its analytics and investigations on a subset of data provided by the
175.31commissioner to demonstrate the direct recoveries of the solution.
175.32 Subd. 3. Data confidentiality. Data provided by the commissioner to the vendor
175.33under this section must maintain the confidentiality of the information.
176.1 Subd. 4. Full implementation phase. The request for proposal must require the
176.2commissioner to implement the recommendations provided by the vendor if the work
176.3done under the requirements of subdivision 2 provides recoveries directly related to the
176.4investigations to the state. After full implementation, the vendor shall be paid from
176.5recoveries directly attributable to the work done by the vendor, according to the terms and
176.6performance measures negotiated in the contract.
176.7 Subd. 5. Selection of vendor. The commissioner of human services shall select a
176.8vendor from the responses to the request for proposal by January 31, 2012.
176.9 Subd. 6. Progress report. The commissioner shall provide a report describing the
176.10progress made under this section to the governor and the chairs and ranking minority
176.11members of the legislative committees with jurisdiction over the Department of Human
176.12Services by June 15, 2012. The report shall provide a dynamic scoring analysis of the
176.13work described in the report.
176.14 Sec. 82. SPECIALIZED MAINTENANCE THERAPY.
176.15The commissioner of human services shall evaluate whether providing medical
176.16assistance coverage for specialized maintenance therapy for enrollees with serious and
176.17persistent mental illness who are at risk of hospitalization will improve the quality of
176.18care and lower medical assistance spending by reducing rates of hospitalization. The
176.19commissioner shall present findings and recommendations to the chairs and ranking
176.20minority members of the legislative committees with jurisdiction over health and human
176.21services finance and policy by December 15, 2011.
176.22 Sec. 83. BENEFIT SET OPTIONS.
176.23The commissioner of human services shall analyze and provide recommendations
176.24for state plan amendments that would provide different benefits for different demographic
176.25populations under the medical assistance program as permitted under federal law, with the
176.26goal of tailoring more cost-effective coverage based on unique needs of the demographic
176.27population. The commissioner shall report these recommendations to the chairs and
176.28ranking minority members of the senate and house health and human services committees
176.29by January 15, 2012.
176.30 Sec. 84. REDUCING HOSPITALIZATION RATES.
177.1The commissioner of human services, by January 15, 2012, shall present
177.2recommendations to the legislature to reduce hospitalization rates for state health care
177.3program enrollees who are children with high-cost medical conditions.
177.4 Sec. 85. MEDICAID FRAUD PREVENTION AND DETECTION.
177.5 Subdivision 1. Request for proposals. By July 1, 2011, the commissioner of human
177.6services shall issue a request for proposals to prevent and detect Medicaid fraud and
177.7mispayment. The request for proposals shall require the vendor to provide data analytics
177.8capabilities, including, but not limited to, predictive modeling techniques and other forms
177.9of advanced analytics that will integrate into the current claim processing system to detect
177.10improper payments both before and after payments are made.
177.11 Subd. 2. Proof of concept phase. The selected vendor, at no cost to the state,
177.12shall be required to implement its recommendations on a subset of data provided by the
177.13commissioner to demonstrate the cost-savings potential of the solution.
177.14 Subd. 3. Data. Data provided by the commissioner to the vendor under this section
177.15must not include not public data, as defined in section 13.02, subdivision 8a.
177.16 Subd. 4. Full implementation phase. The request for proposals must require the
177.17commissioner to implement the recommendations provided by the vendor if the work done
177.18under the requirements of subdivision 2 provides material savings to the state. After the
177.19full implementation of the system provided by the vendor, the vendor shall be paid by
177.20the state from the savings attributable to the work done by the vendor, according to the
177.21terms and performance measures negotiated in the contract.
177.22 Subd. 5. Selection of vendor. The commissioner of human services shall select a
177.23vendor from the responses to the request for proposals by September 1, 2011.
177.24 Subd. 6. Progress report. The commissioner shall provide a report describing the
177.25progress made under this section to the governor and the chairs and ranking minority
177.26members of the legislative committees with jurisdiction over the Department of Human
177.27Services and data practices by January 15, 2012. The report shall provide a dynamic
177.28scoring analysis of the work described in the report and address data access and privacy
177.29issues involved in implementation of the system.
177.30 Sec. 86. PROHIBITION OF STATE FUNDS TO IMPLEMENT CERTAIN
177.31FEDERAL HEALTH CARE REFORMS.
178.1State funds must not be expended in the planning or implementation of the Patient
178.2Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care
178.3and Education Affordability and Reconciliation Act of 2010, Public Law 111-152, and no
178.4provisions of the act may be implemented, until the constitutionality of the act has been
178.5affirmed by the United States Supreme Court.
178.6EFFECTIVE DATE.This section is effective the day following final enactment.
178.7 Sec. 87. COMMISSIONER'S ACTIONS; REPEAL OF EARLY MEDICAL
178.9 (a) Effective October 1, 2011, the commissioner of human services shall suspend
178.10implementation and administration of Minnesota Statutes 2010, sections 256B.055,
178.11subdivision 15; 256B.056, subdivision 3, paragraph (b); and 256B.056, subdivision 4,
178.12paragraph (d). The commissioner shall refer persons enrolled under these provisions, and
178.13applicants for coverage under these provisions, to the general assistance medical care
178.14program established under Minnesota Statutes, section 256D.031.
178.15(b) The commissioner shall seek all federal approvals and waivers necessary
178.16to implement Minnesota Statutes, section 256D.031, and to ensure federal financial
178.17participation for the population covered under Minnesota Statutes, section 256D.031.
178.18 Sec. 88. GENERAL ASSISTANCE MEDICAL CARE PROGRAM;
178.20 Notwithstanding their contingent repeal in Laws 2010, First Special Session chapter
178.211, article 16, section 47, the following statutes are revived and have the force of law
178.22effective October 1, 2011:
178.23 (1) Minnesota Statutes 2010, section 256D.03, subdivisions 3, 3a, 6, 7, and 8;
178.24 (2) Minnesota Statutes 2010, section 256D.031, subdivisions 1, 2, 3, 4, 6, 7, 9,
178.25and 10; and
178.26 (3) Laws 2010, chapter 200, article 1, section 18.
178.27 Sec. 89. REPEALER.
178.28(a) Minnesota Statutes 2010, section 62J.07, subdivisions 1, 2, and 3, () are repealed.
178.29(b) Minnesota Statutes 2010, section 256L.07, subdivision 7, exempting eligibility
178.30for children formally under medical assistance, is repealed retroactively from October
178.311, 2008, and federal approval is no longer necessary.
178.32(c) The amendment in Laws 2009, chapter 79, article 5, section 55, as amended by
178.33Laws 2009, chapter 173, article 1, section 36, (256L.04, subdivision 1, children deemed
179.1eligible are exempt from eligibility requirements) is repealed retroactively from January
179.21, 2009, and federal approval is no longer necessary.
179.3(d) Laws 2009, chapter 79, article 5, section 56, (256L.04, subdivision 1b,
179.4exemption from income limit for children) is repealed retroactively from July 1, 2009,
179.5and federal approval is no longer necessary.
179.6(e) Laws 2009, chapter 79, article 5, section 60, (256L.05, subdivision 1c, open
179.7enrollment and streamlined application) is repealed retroactively from July 1, 2009,
179.8and federal approval is no longer necessary.
179.9(f) Laws 2009, chapter 79, article 5, section 66, (256L.07, subdivision 8, automatic
179.10eligibility certain children) is repealed retroactively from July 1, 2009, and federal
179.11approval is no longer necessary.
179.12(g) The amendment in Laws 2009, chapter 79, article 5, section 57, (256L.04,
179.13subdivision 7a, ineligibility for adults with certain income) is repealed retroactively
179.14from July 1, 2009, and federal approval is no longer necessary.
179.15(h) The amendment in Laws 2009, chapter 79, article 5, section 61, (256L.05,
179.16subdivision 3, children eligibility following termination from foster care) is repealed
179.17retroactively from July 1, 2009, and federal approval is no longer necessary.
179.18(i) The amendment in Laws 2009, chapter 79, article 5, section 62, (256L.05,
179.19subdivision 3a, exemption from cancellation for nonrenewal for children) is repealed
179.20retroactively from July 1, 2009, and federal approval is no longer necessary.
179.21(j) The amendment in Laws 2009, chapter 79, article 5, section 63, (256L.07,
179.22subdivision 1, children whose gross family income is greater than 275 percent FPG
179.23may remain enrolled) is repealed retroactively from July 1, 2009, and federal approval is
179.24no longer necessary.
179.25(k) The amendment in Laws 2009, chapter 79, article 5, section 64, (256L.07,
179.26subdivision 2, exempts children from requirement not to have employer-subsidized
179.27coverage) is repealed retroactively from July 1, 2009, and federal approval is no longer
179.29(l) The amendment in Laws 2009, chapter 79, article 5, section 65, (256L.07,
179.30subdivision 3, requires children with family gross income over 200 percent of FPG
179.31to have had no health coverage for four months prior to application) is repealed
179.32retroactively from July 1, 2009, and federal approval is no longer necessary.
179.33(m) The amendment in Laws 2009, chapter 79, article 5, section 68, (256L.15,
179.34subdivision 2, children in families with income less than 200 percent FPG pay no
179.35premium) is repealed retroactively from July 1, 2009, and federal approval is no longer
180.1(n) The amendment in Laws 2009, chapter 79, article 5, section 69, (256L.15,
180.2subdivision 3, exempts children with family income below 200 percent FPG from
180.3sliding fee scale) is repealed retroactively from July 1, 2009, and federal approval is
180.4no longer necessary.
180.5(o) Laws 2009, chapter 79, article 5, section 79, (uncoded federal approval) is
180.6repealed the day following final enactment.
180.7(p) Minnesota Statutes 2010, section 256B.057, subdivision 2c, (extended medical
180.8assistance for certain children) is repealed.
180.9(q) The amendments in Laws 2008, chapter 358, article 3, sections 8; and 9,
180.10(renewal rolling month and premium grace month) are repealed.
180.11 Sec. 90. REPEALER.
180.12Minnesota Statutes 2010, sections 256B.055, subdivision 15; and 256B.0756, are
180.13repealed effective October 1, 2011.
180.16 Section 1. [15.996] PERFORMANCE-BASED ORGANIZATIONS.
180.17 Subdivision 1. Designation. The governor may designate one or more programs
180.18within the Department of Human Services and within up to two other executive branch
180.19state agencies whose missions involve people with disabilities as performance-based
180.20organizations. The goal of the performance-based organization designation is to provide
180.21the best services in the most cost-effective manner to people with disabilities. For a
180.22program that is designated as a performance-based organization, the agency providing
180.23services or another governmental or private organization under contract with the agency
180.24may enter into a performance-based agreement that allows the agency or the entity under
180.25contract with the agency more flexibility in its operations in exchange for a greater level of
180.26accountability. With any required legislative approval, a performance-based organization
180.27agreement may exempt an agency or an outside entity providing services from one or
180.28more procedural laws, rules, or policies that otherwise would govern the program.
180.29 Subd. 2. Performance-based organization agreement. Designation of a
180.30performance-based organization must be implemented through a performance-based
180.31organization agreement. A performance-based organization agreement may be between
180.32the governor and an agency, if an agency is to provide services under the agreement, or
180.33between an agency and an outside entity, if the outside entity is to provide the services. A
180.34performance-based organization agreement must:
181.1(1) describe the programs subject to the agreement;
181.2(2) specify the procedural laws, rules, or policies that will not apply to the
181.3performance-based organization, why waiver or variance from these laws, rules, or
181.4policies is necessary to achieve desired outcomes, and a description of alternative means
181.5of accomplishing the purposes of those laws, rules, or policies;
181.6(3) contain procedures for oversight of the performance-based organization,
181.7including requirements and procedures for program and financial audits;
181.8(4) if the performance-based organization involves a nonstate entity, contain
181.9provisions governing assumption of liability, and types and amounts of insurance coverage
181.10to be obtained;
181.11(5) specify the duration of the agreement; and
181.12(6) specify measurable performance-based outcomes for achieving program
181.13goals, time periods during which these outcomes will be measured and reported, and
181.14consequences for not meeting the performance-based outcomes.
181.15 Subd. 3. Duration; legislative approval; reporting. (a) A performance-based
181.16organization agreement may be up to three years and may be renewed.
181.17 (b) The chief executive of the state agency whose program is subject to a
181.18performance-based organization must report to the chairs and ranking minority members
181.19of legislative policy and finance committees with jurisdiction over the program on the
181.20proposed content of the performance-based organization, and specifically describing
181.21any procedural laws, rules, and policies that will not apply. The legislature must
181.22approve a performance-based organization before the state agency may enter into a
181.24 Sec. 2. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:
181.25 Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
181.26child, including a child determined eligible for medical assistance without consideration of
181.27parental income, must contribute to the cost of services used by making monthly payments
181.28on a sliding scale based on income, unless the child is married or has been married,
181.29parental rights have been terminated, or the child's adoption is subsidized according to
181.31is a partial or full payment for medical services provided for diagnostic, therapeutic,
181.32curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
181.33defined in United States Code, title 26, section 213, needed by the child with a chronic
181.34illness or disability.
182.1 (b) For households with adjusted gross income equal to or greater than 100 percent
182.2of federal poverty guidelines, the parental contribution shall be computed by applying the
182.3following schedule of rates to the adjusted gross income of the natural or adoptive parents:
182.4 (1) if the adjusted gross income is equal to or greater than 100 percent of federal
182.5poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
182.6contribution is $4 per month;
182.7 (2) if the adjusted gross income is equal to or greater than 175 percent of federal
182.8poverty guidelines and less than or equal to
182.9the parental contribution shall be determined using a sliding fee scale established by the
182.10commissioner of human services which begins at one percent of adjusted gross income at
182.11175 percent of federal poverty guidelines and increases to
182.12gross income for those with adjusted gross income up to
182.14 (3) if the adjusted gross income is greater than
182.15poverty guidelines and less than 675 percent of federal poverty guidelines, the parental
182.16contribution shall be
182.17 (4) if the adjusted gross income is equal to or greater than 675 percent of federal
182.18poverty guidelines and less than
182.19contribution shall be determined using a sliding fee scale established by the commissioner
182.20of human services which begins at
182.21of federal poverty guidelines and increases to
182.22those with adjusted gross income up to
182.23 (5) if the adjusted gross income is equal to or greater than
182.24federal poverty guidelines, the parental contribution shall be
182.26 If the child lives with the parent, the annual adjusted gross income is reduced by
182.27$2,400 prior to calculating the parental contribution. If the child resides in an institution
182.28specified in section
182.29specified under that section in addition to the parental contribution determined under this
182.30section. The parental contribution is reduced by any amount required to be paid directly to
182.31the child pursuant to a court order, but only if actually paid.
182.32 (c) The household size to be used in determining the amount of contribution under
182.33paragraph (b) includes natural and adoptive parents and their dependents, including the
182.34child receiving services. Adjustments in the contribution amount due to annual changes
182.35in the federal poverty guidelines shall be implemented on the first day of July following
182.36publication of the changes.
183.1 (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
183.2natural or adoptive parents determined according to the previous year's federal tax form,
183.3except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
183.4have been used to purchase a home shall not be counted as income.
183.5 (e) The contribution shall be explained in writing to the parents at the time eligibility
183.6for services is being determined. The contribution shall be made on a monthly basis
183.7effective with the first month in which the child receives services. Annually upon
183.8redetermination or at termination of eligibility, if the contribution exceeded the cost of
183.9services provided, the local agency or the state shall reimburse that excess amount to
183.10the parents, either by direct reimbursement if the parent is no longer required to pay a
183.11contribution, or by a reduction in or waiver of parental fees until the excess amount is
183.12exhausted. All reimbursements must include a notice that the amount reimbursed may be
183.13taxable income if the parent paid for the parent's fees through an employer's health care
183.14flexible spending account under the Internal Revenue Code, section 125, and that the
183.15parent is responsible for paying the taxes owed on the amount reimbursed.
183.16 (f) The monthly contribution amount must be reviewed at least every 12 months;
183.17when there is a change in household size; and when there is a loss of or gain in income
183.18from one month to another in excess of ten percent. The local agency shall mail a written
183.19notice 30 days in advance of the effective date of a change in the contribution amount.
183.20A decrease in the contribution amount is effective in the month that the parent verifies a
183.21reduction in income or change in household size.
183.22 (g) Parents of a minor child who do not live with each other shall each pay the
183.23contribution required under paragraph (a). An amount equal to the annual court-ordered
183.24child support payment actually paid on behalf of the child receiving services shall be
183.25deducted from the adjusted gross income of the parent making the payment prior to
183.26calculating the parental contribution under paragraph (b).
183.27 (h) The contribution under paragraph (b) shall be increased by an additional five
183.28percent if the local agency determines that insurance coverage is available but not
183.29obtained for the child. For purposes of this section, "available" means the insurance is a
183.30benefit of employment for a family member at an annual cost of no more than five percent
183.31of the family's annual income. For purposes of this section, "insurance" means health
183.32and accident insurance coverage, enrollment in a nonprofit health service plan, health
183.33maintenance organization, self-insured plan, or preferred provider organization.
183.34 Parents who have more than one child receiving services shall not be required
183.35to pay more than the amount for the child with the highest expenditures. There shall
183.36be no resource contribution from the parents. The parent shall not be required to pay
184.1a contribution in excess of the cost of the services provided to the child, not counting
184.2payments made to school districts for education-related services. Notice of an increase in
184.3fee payment must be given at least 30 days before the increased fee is due.
184.4 (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
184.5in the 12 months prior to July 1:
184.6 (1) the parent applied for insurance for the child;
184.7 (2) the insurer denied insurance;
184.8 (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
184.9a complaint or appeal, in writing, to the commissioner of health or the commissioner of
184.10commerce, or litigated the complaint or appeal; and
184.11 (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
184.12 For purposes of this section, "insurance" has the meaning given in paragraph (h).
184.13 A parent who has requested a reduction in the contribution amount under this
184.14paragraph shall submit proof in the form and manner prescribed by the commissioner or
184.15county agency, including, but not limited to, the insurer's denial of insurance, the written
184.16letter or complaint of the parents, court documents, and the written response of the insurer
184.17approving insurance. The determinations of the commissioner or county agency under this
184.18paragraph are not rules subject to chapter 14.
185.13 Sec. 3. Minnesota Statutes 2010, section 256.01, subdivision 24, is amended to read:
185.14 Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
185.18(1) deliver information and assistance based on national and state standards;
185.20benefits, and service options;
185.21(3) provide benefits and options counseling;
185.28(7) inform people of their long-term community services and supports;
185.29(8) provide necessary resources and supports that can lead to employment and
185.30increased economic stability of people with disabilities; and
185.31(9) serve as the technical assistance and help center for the Web-based tool,
185.32Minnesota's Disability Benefits 101.org.
185.33EFFECTIVE DATE.This section is effective July 1, 2011.
185.34 Sec. 4. Minnesota Statutes 2010, section 256.01, subdivision 29, is amended to read:
186.1 Subd. 29. State medical review team. (a) To ensure the timely processing of
186.2determinations of disability by the commissioner's state medical review team under
186.5submitted by county agencies with a referral and seek additional information from
186.6providers, applicants, and enrollees to support the determination of disability where
186.7necessary. Disability shall be determined according to the rules of title XVI and title
186.8XIX of the Social Security Act and pertinent rules and policies of the Social Security
186.10 (b) Prior to a denial or withdrawal of a requested determination of disability due
186.11to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
186.12necessary and appropriate to a determination of disability, and (2) assist applicants and
186.13enrollees to obtain the evidence, including, but not limited to, medical examinations
186.14and electronic medical records.
186.15(c) The commissioner shall provide the chairs of the legislative committees with
186.16jurisdiction over health and human services finance and budget the following information
186.17on the activities of the state medical review team by February 1 of each year:
186.18(1) the number of applications to the state medical review team that were denied,
186.19approved, or withdrawn;
186.20(2) the average length of time from receipt of the application to a decision;
186.21(3) the number of appeals, appeal results, and the length of time taken from the date
186.22the person involved requested an appeal for a written decision to be made on each appeal;
186.23(4) for applicants, their age, health coverage at the time of application, hospitalization
186.24history within three months of application, and whether an application for Social Security
186.25or Supplemental Security Income benefits is pending; and
186.26(5) specific information on the medical certification, licensure, or other credentials
186.27of the person or persons performing the medical review determinations and length of
186.28time in that position.
186.29(d) Any appeal made under section
186.30determination made by the state medical review team must be decided according to the
186.31timelines under section
186.32not issued within the timelines under section
186.33appeal must be immediately reviewed by the chief appeals referee.
186.34EFFECTIVE DATE.This section is effective July 1, 2011.
187.1 Sec. 5. Minnesota Statutes 2010, section 256B.04, is amended by adding a subdivision
187.3 Subd. 20. Money Follows the Person Rebalancing demonstration project. In
187.4accordance with federal law governing Money Follows the Person Rebalancing funds,
187.5amounts equal to the value of enhanced federal funding resulting from the operation of the
187.6demonstration project grant must be transferred from the medical assistance account in
187.7the general fund to an account in the special revenue fund. Funds in the special revenue
187.8fund account do not cancel and are appropriated to the commissioner to carry out the
187.9goals of the Money Follows the Person Rebalancing demonstration project as required
187.10under the approved federal plan for the use of the funds, and may be transferred to the
187.11medical assistance account if applicable.
187.12 Sec. 6. Minnesota Statutes 2010, section 256B.05, is amended by adding a subdivision
187.14 Subd. 5. Obligation of local agency to process medical assistance applications
187.15within established timelines. The local agency must act on an application for medical
187.16assistance within ten working days of receipt of all information needed to act on the
187.17application but no later than required under Minnesota Rules, part 9505.0090, subparts
187.182 and 3.
187.19 Sec. 7. Minnesota Statutes 2010, section 256B.056, subdivision 3, is amended to read:
187.20 Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
187.21medical assistance, a person must not individually own more than $3,000 in assets, or if a
187.22member of a household with two family members, husband and wife, or parent and child,
187.23the household must not own more than $6,000 in assets, plus $200 for each additional
187.24legal dependent. In addition to these maximum amounts, an eligible individual or family
187.25may accrue interest on these amounts, but they must be reduced to the maximum at the
187.26time of an eligibility redetermination. The accumulation of the clothing and personal
187.27needs allowance according to section
187.28the time of the eligibility redetermination. The value of assets that are not considered in
187.29determining eligibility for medical assistance is the value of those assets excluded under
187.30the supplemental security income program for aged, blind, and disabled persons, with
187.31the following exceptions:
187.32(1) household goods and personal effects are not considered;
187.33(2) capital and operating assets of a trade or business that the local agency determines
187.34are necessary to the person's ability to earn an income are not considered;
188.1(3) motor vehicles are excluded to the same extent excluded by the supplemental
188.2security income program;
188.3(4) assets designated as burial expenses are excluded to the same extent excluded by
188.4the supplemental security income program. Burial expenses funded by annuity contracts
188.5or life insurance policies must irrevocably designate the individual's estate as contingent
188.6beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
188.8employed person with a disability due to loss of earnings, assets allowed while eligible
188.9for medical assistance under section
188.10months, beginning with the first month of ineligibility as an employed person with a
188.11disability, to the extent that the person's total assets remain within the allowed limits of
188.13(b) No asset limit shall apply to persons eligible under section
188.15EFFECTIVE DATE.This section is effective January 1, 2014.
188.16 Sec. 8. Minnesota Statutes 2010, section 256B.057, subdivision 9, is amended to read:
188.17 Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
188.18for a person who is employed and who:
188.19(1) but for excess earnings or assets, meets the definition of disabled under the
188.20Supplemental Security Income program;
188.21(2) is at least 16 but less than 65 years of age;
188.22(3) meets the asset limits in paragraph
188.23(4) pays a premium and other obligations under paragraph (e).
188.24 (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
188.25for medical assistance under this subdivision, a person must have more than $65 of earned
188.26income. Earned income must have Medicare, Social Security, and applicable state and
188.27federal taxes withheld. The person must document earned income tax withholding. Any
188.28spousal income or assets shall be disregarded for purposes of eligibility and premium
188.31this subdivision who:
188.32(1) is temporarily unable to work and without receipt of earned income due to a
188.33medical condition, as verified by a physician
189.2enrollee, and is without receipt of earned income may retain eligibility for up to four
189.3consecutive months after the month of job loss. To receive a four-month extension,
189.4enrollees must verify the medical condition or provide notification of job loss. All other
189.5eligibility requirements must be met and the enrollee must pay all calculated premium
189.6costs for continued eligibility.
189.8assets must not exceed $20,000, excluding:
189.9(1) all assets excluded under section
189.10(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
189.11Keogh plans, and pension plans;
189.12(3) medical expense accounts set up through the person's employer
189.13(4) spousal assets, including spouse's share of jointly held assets.
189.23premium to be eligible for medical assistance under this subdivision, except as provided
189.24under section 256.01, subdivision 18b.
189.25(1) An enrollee must pay the greater of a $65 premium or the premium
189.26calculated based on the person's gross earned and unearned income and the applicable
189.27family size using a sliding fee scale established by the commissioner, which begins at
189.28one percent of income at 100 percent of the federal poverty guidelines and increases
189.29to 7.5 percent of income for those with incomes at or above 300 percent of the federal
189.31(2) Annual adjustments in the premium schedule based upon changes in the federal
189.32poverty guidelines shall be effective for premiums due in July of each year.
190.3except as provided under section 256.01, subdivision 18b.
190.9counted as income for purposes of this subdivision until July 1 of each year.
190.10(f) A person's eligibility and premium shall be determined by the local county
190.11agency. Premiums must be paid to the commissioner. All premiums are dedicated to
190.13(g) Any required premium shall be determined at application and redetermined at
190.14the enrollee's six-month income review or when a change in income or household size is
190.15reported. Enrollees must report any change in income or household size within ten days
190.16of when the change occurs. A decreased premium resulting from a reported change in
190.17income or household size shall be effective the first day of the next available billing month
190.18after the change is reported. Except for changes occurring from annual cost-of-living
190.19increases, a change resulting in an increased premium shall not affect the premium amount
190.20until the next six-month review.
190.21(h) Premium payment is due upon notification from the commissioner of the
190.22premium amount required. Premiums may be paid in installments at the discretion of
190.24(i) Nonpayment of the premium shall result in denial or termination of medical
190.25assistance unless the person demonstrates good cause for nonpayment. Good cause exists
190.26if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
190.27D, are met. Except when an installment agreement is accepted by the commissioner,
190.28all persons disenrolled for nonpayment of a premium must pay any past due premiums
190.29as well as current premiums due prior to being reenrolled. Nonpayment shall include
190.30payment with a returned, refused, or dishonored instrument. The commissioner may
190.31require a guaranteed form of payment as the only means to replace a returned, refused,
190.32or dishonored instrument.
190.33(j) The commissioner shall notify enrollees annually beginning at least 24 months
190.34before the person's 65th birthday of the medical assistance eligibility rules affecting
190.35income, assets, and treatment of a spouse's income and assets that will be applied upon
190.36reaching age 65.
191.1(k) For enrollees whose income does not exceed 200 percent of the federal poverty
191.2guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
191.3the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
191.5EFFECTIVE DATE.This section is effective January 1, 2014, for adults age 21 or
191.6older, and October 1, 2019, for children age 16 to before the child's 21st birthday.
191.7 Sec. 9. Minnesota Statutes 2010, section 256B.0659, subdivision 11, is amended to
191.9 Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
191.10must meet the following requirements:
191.11 (1) be at least 18 years of age with the exception of persons who are 16 or 17 years
191.12of age with these additional requirements:
191.13 (i) supervision by a qualified professional every 60 days; and
191.14 (ii) employment by only one personal care assistance provider agency responsible
191.15for compliance with current labor laws;
191.16 (2) be employed by a personal care assistance provider agency;
191.17 (3) enroll with the department as a personal care assistant after clearing a background
191.18study. Except as provided in subdivision 11a, before a personal care assistant provides
191.19services, the personal care assistance provider agency must initiate a background study on
191.20the personal care assistant under chapter 245C, and the personal care assistance provider
191.21agency must have received a notice from the commissioner that the personal care assistant
191.23 (i) not disqualified under section
191.24 (ii) is disqualified, but the personal care assistant has received a set aside of the
191.25disqualification under section
191.26 (4) be able to effectively communicate with the recipient and personal care
191.27assistance provider agency;
191.28 (5) be able to provide covered personal care assistance services according to the
191.29recipient's personal care assistance care plan, respond appropriately to recipient needs,
191.30and report changes in the recipient's condition to the supervising qualified professional
191.32 (6) not be a consumer of personal care assistance services;
191.33 (7) maintain daily written records including, but not limited to, time sheets under
192.1 (8) effective January 1, 2010, complete standardized training as determined
192.2by the commissioner before completing enrollment. The training must be available
192.3in languages other than English and to those who need accommodations due to
192.4disabilities. Personal care assistant training must include successful completion of the
192.5following training components: basic first aid, vulnerable adult, child maltreatment,
192.6OSHA universal precautions, basic roles and responsibilities of personal care assistants
192.7including information about assistance with lifting and transfers for recipients, emergency
192.8preparedness, orientation to positive behavioral practices, fraud issues, and completion of
192.9time sheets. Upon completion of the training components, the personal care assistant must
192.10demonstrate the competency to provide assistance to recipients;
192.11 (9) complete training and orientation on the needs of the recipient within the first
192.12seven days after the services begin; and
192.13 (10) be limited to providing and being paid for up to 275 hours per month, except
192.14that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
192.152011, of personal care assistance services regardless of the number of recipients being
192.16served or the number of personal care assistance provider agencies enrolled with. The
192.17number of hours worked per day shall not be disallowed by the department unless in
192.18violation of the law.
192.19 (b) A legal guardian may be a personal care assistant if the guardian is not being paid
192.20for the guardian services and meets the criteria for personal care assistants in paragraph (a).
192.21 (c) Effective January 1, 2010, persons who do not qualify as a personal care assistant
192.22include parents and stepparents of minors, spouses, paid legal guardians, family foster
192.23care providers, except as otherwise allowed in section
192.24staff of a residential setting. When the personal care assistant is a relative of the recipient,
192.25the commissioner shall pay 80 percent of the provider rate. For purposes of this section,
192.26relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or
192.27older, an adult child, a grandparent, or a grandchild.
192.28 Sec. 10. Minnesota Statutes 2010, section 256B.0659, subdivision 28, is amended to
192.30 Subd. 28. Personal care assistance provider agency; required documentation.
192.31(a) Required documentation must be completed and kept in the personal care assistance
192.32provider agency file or the recipient's home residence. The required documentation
192.34(1) employee files, including:
192.35(i) applications for employment;
193.1(ii) background study requests and results;
193.2(iii) orientation records about the agency policies;
193.3(iv) trainings completed with demonstration of competence;
193.4(v) supervisory visits;
193.5(vi) evaluations of employment; and
193.6(vii) signature on fraud statement;
193.7(2) recipient files, including:
193.9(ii) emergency contact information and emergency backup plan;
193.10(iii) personal care assistance service plan;
193.11(iv) personal care assistance care plan;
193.12(v) month-to-month service use plan;
193.13(vi) all communication records;
193.14(vii) start of service information, including the written agreement with recipient; and
193.15(viii) date the home care bill of rights was given to the recipient;
193.16(3) agency policy manual, including:
193.17(i) policies for employment and termination;
193.18(ii) grievance policies with resolution of consumer grievances;
193.19(iii) staff and consumer safety;
193.20(iv) staff misconduct; and
193.21(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
193.22resolution of consumer grievances;
193.23(4) time sheets for each personal care assistant along with completed activity sheets
193.24for each recipient served;
193.25(5) agency marketing and advertising materials and documentation of marketing
193.26activities and costs; and
193.27(6) for each personal care assistant, whether or not the personal care assistant is
193.28providing care to a relative as defined in subdivision 11.
193.29(b) The commissioner may assess a fine of up to $500 on provider agencies that do
193.30not consistently comply with the requirements of this subdivision.
193.31 Sec. 11. Minnesota Statutes 2010, section 256B.0911, subdivision 1a, is amended to
193.33 Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
193.34 (a) "Long-term care consultation services" means:
194.1 (1) assistance in identifying services needed to maintain an individual in the most
194.3 (2) providing recommendations on cost-effective community services that are
194.4available to the individual;
194.5 (3) development of an individual's person-centered community support plan;
194.6 (4) providing information regarding eligibility for Minnesota health care programs;
194.7 (5) face-to-face long-term care consultation assessments, which may be completed
194.8in a hospital, nursing facility, intermediate care facility for persons with developmental
194.9disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
194.11 (6) federally mandated screening to determine the need for an institutional level of
194.12care under subdivision 4a;
194.13 (7) determination of home and community-based waiver service eligibility
194.14including level of care determination for individuals who need an institutional level of
194.15care as defined under section
194.16including state plan home care services identified in sections
194.18plan development with appropriate referrals, including the option for
194.20 (8) providing recommendations for nursing facility placement when there are no
194.21cost-effective community services available;
194.22 (9) assistance to transition people back to community settings after facility
194.24(10) providing notice to the individual or legal representative of the annual and
194.25monthly average authorized amount for traditional agency services and self-directed
194.26services under section 256B.0657 for which the recipient is found eligible.
194.27 (b) "Long-term care options counseling" means the services provided by the linkage
194.28lines as mandated by sections
194.29telephone assistance and follow up once a long-term care consultation assessment has
194.31 (c) "Minnesota health care programs" means the medical assistance program under
194.32chapter 256B and the alternative care program under section
194.33 (d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
194.34plans administering long-term care consultation assessment and support planning services.
194.35EFFECTIVE DATE.This section is effective January 1, 2012.
195.1 Sec. 12. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, is amended to
195.3 Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
195.4services planning, or other assistance intended to support community-based living,
195.5including persons who need assessment in order to determine waiver or alternative
195.6care program eligibility, must be visited by a long-term care consultation team within
195.8recommended. After January 1, 2011, these requirements also apply to personal care
195.9assistance services, private duty nursing, and home health agency services, on timelines
195.10established in subdivision 5. Face-to-face assessments must be conducted according
195.11to paragraphs (b) to (i).
195.12 (b) The county may utilize a team of either the social worker or public health nurse,
195.13or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
195.14assessment in a face-to-face interview. The consultation team members must confer
195.15regarding the most appropriate care for each individual screened or assessed.
195.16 (c) The assessment must be comprehensive and include a person-centered
195.17assessment of the health, psychological, functional, environmental, and social needs of
195.18referred individuals and provide information necessary to develop a support plan that
195.19meets the consumers needs, using an assessment form provided by the commissioner.
195.20 (d) The assessment must be conducted in a face-to-face interview with the person
195.21being assessed and the person's legal representative, as required by legally executed
195.22documents, and other individuals as requested by the person, who can provide information
195.23on the needs, strengths, and preferences of the person necessary to develop a support
195.24plan that ensures the person's health and safety, but who is not a provider of service or
195.25has any financial interest in the provision of services. For persons who are to be assessed
195.26for elderly waiver customized living services under section 256B.0915, and with the
195.27permission of the person being assessed or the persons' designated or legal representative,
195.28the client's current or proposed provider of services may submit a copy of the provider's
195.29nursing assessment or written report outlining their recommendations regarding the
195.30client's care needs. The person conducting the assessment will notify the provider of the
195.31date by which this information is to be submitted. This information shall be provided to
195.32the person conducting the assessment prior to the assessment.
195.33 (e) The person, or the person's legal representative, must be provided with
195.34written recommendations for community-based services, including
195.35self-directed options, or institutional care that include documentation that the most
195.36cost-effective alternatives available were offered to the individual. For purposes of
196.1this requirement, "cost-effective alternatives" means community services and living
196.2arrangements that cost the same as or less than institutional care. For persons determined
196.3eligible for services defined under subdivision 1a, paragraph (a), clauses (7) to (9), the
196.4community support plan must also include the estimated annual and monthly average
196.5authorized budget amount for those services.
196.6 (f)(1) If the person chooses to use community-based services, the person or the
196.7person's legal representative must be provided with a written community support plan,
196.8regardless of whether the individual is eligible for Minnesota health care programs. The
196.9written community support plan must include:
196.10 (i) a summary of assessed needs as defined in paragraphs (c) and (d);
196.11 (ii) the individual's options and choices to meet identified needs, including all
196.12available options for case management services and providers;
196.13 (iii) identification of health and safety risks and how those risks will be addressed,
196.14including personal risk management strategies;
196.15 (iv) referral information; and
196.16 (v) informal caregiver supports, if applicable.
196.17 (2) For persons determined eligible for services defined under subdivision 1a,
196.18paragraph (a), clauses (7) to (10), the community support plan must also include:
196.19 (i) identification of individual goals;
196.20 (ii) identification of short-term and long-term service outcomes. Short-term service
196.21outcomes are defined as achievable within six months;
196.22 (iii) a recommended schedule for case management visits. When achievement of
196.23short-term service outcomes may affect the amount of service required, the schedule must
196.24be at least every six months and must reflect evaluation and progress toward identified
196.25short-term service outcomes; and
196.26 (iv) the estimated annual and monthly budget amount for services.
196.27 (3) In addition, for persons determined eligible for state plan home care under
196.28subdivision 1a, paragraph (a), clause (8), the person or person's representative must also
196.29receive a copy of the home care service plan developed by a certified assessor.
196.30(4) A person may request assistance in identifying community supports without
196.31participating in a complete assessment. Upon a request for assistance identifying
196.32community support, the person must be transferred or referred to the services available
196.34assistance and follow up.
197.1 (g) The person has the right to make the final decision between institutional
197.2placement and community placement after the recommendations have been provided,
197.3except as provided in subdivision 4a, paragraph (c).
197.4 (h) The team must give the person receiving assessment or support planning, or
197.5the person's legal representative, materials, and forms supplied by the commissioner
197.6containing the following information:
197.7 (1) the need for and purpose of preadmission screening if the person selects nursing
197.9 (2) the role of the long-term care consultation assessment and support planning in
197.10waiver and alternative care program eligibility determination;
197.11 (3) information about Minnesota health care programs;
197.12 (4) the person's freedom to accept or reject the recommendations of the team;
197.13 (5) the person's right to confidentiality under the Minnesota Government Data
197.14Practices Act, chapter 13;
197.15 (6) the long-term care consultant's decision regarding the person's need for
197.16institutional level of care as determined under criteria established in section
197.18(7) the person's right to appeal the decision regarding the need for nursing facility
197.19level of care or the county's final decisions regarding public programs eligibility according
197.21 (i) Face-to-face assessment completed as part of eligibility determination for
197.22the alternative care, elderly waiver, community alternatives for disabled individuals,
197.23community alternative care, and traumatic brain injury waiver programs under sections
197.25than 60 calendar days after the date of assessment. The effective eligibility start date
197.26for these programs can never be prior to the date of assessment. If an assessment was
197.27completed more than 60 days before the effective waiver or alternative care program
197.28eligibility start date, assessment and support plan information must be updated
197.30System (MMIS). The updated assessment may be completed by face-to-face visit, written
197.31communication, or telephone as determined by the commissioner to establish statewide
197.32consistency. The effective date of program eligibility in this case cannot be prior to the
197.33date the updated assessment is completed.
197.34EFFECTIVE DATE.This section is effective January 1, 2012.
198.1 Sec. 13. Minnesota Statutes 2010, section 256B.0913, subdivision 4, is amended to
198.3 Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
198.4 (a) Funding for services under the alternative care program is available to persons who
198.5meet the following criteria:
198.6 (1) the person has been determined by a community assessment under section
198.8facility, but for the provision of services under the alternative care program. Effective
198.9January 1, 2011, this determination must be made according to the criteria established in
198.11 (2) the person is age 65 or older;
198.12 (3) the person would be eligible for medical assistance within 135 days of admission
198.13to a nursing facility;
198.14 (4) the person is not ineligible for the payment of long-term care services by the
198.15medical assistance program due to an asset transfer penalty under section
198.16equity interest in the home exceeding $500,000 as stated in section
198.17 (5) the person needs long-term care services that are not funded through other
198.18state or federal funding, or other health insurance or other third-party insurance such as
198.19long-term care insurance;
198.20 (6) except for individuals described in clause (7), the monthly cost of the alternative
198.21care services funded by the program for this person does not exceed 75 percent of the
198.22monthly limit described under section
198.23does not prohibit the alternative care client from payment for additional services, but in no
198.24case may the cost of additional services purchased under this section exceed the difference
198.25between the client's monthly service limit defined under section
198.27care-related supplies and equipment or environmental modifications and adaptations are or
198.28will be purchased for an alternative care services recipient, the costs may be prorated on a
198.29monthly basis for up to 12 consecutive months beginning with the month of purchase.
198.30If the monthly cost of a recipient's other alternative care services exceeds the monthly
198.31limit established in this paragraph, the annual cost of the alternative care services shall be
198.32determined. In this event, the annual cost of alternative care services shall not exceed 12
198.33times the monthly limit described in this paragraph;
198.34 (7) for individuals assigned a case mix classification A as described under section
198.36living, or (ii)
199.2and eating when the dependency score in eating is three or greater as determined by
199.3an assessment performed under section
199.4care services funded by the program cannot exceed
199.5participants enrolled in the program on or after July 1,
199.6shall be applied to all other participants who meet this criteria at reassessment. This
199.7monthly limit shall be increased annually as described in section
199.9payment for additional services, but in no case may the cost of additional services
199.10purchased exceed the difference between the client's monthly service limit defined in this
199.11clause and the limit described in clause (6) for case mix classification A; and
199.12(8) the person is making timely payments of the assessed monthly fee.
199.13A person is ineligible if payment of the fee is over 60 days past due, unless the person
199.15 (i) the appointment of a representative payee;
199.16 (ii) automatic payment from a financial account;
199.17 (iii) the establishment of greater family involvement in the financial management of
199.19 (iv) another method acceptable to the lead agency to ensure prompt fee payments.
199.20 The lead agency may extend the client's eligibility as necessary while making
199.21arrangements to facilitate payment of past-due amounts and future premium payments.
199.22Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
199.23reinstated for a period of 30 days.
199.24 (b) Alternative care funding under this subdivision is not available for a person
199.25who is a medical assistance recipient or who would be eligible for medical assistance
199.26without a spenddown or waiver obligation. A person whose initial application for medical
199.27assistance and the elderly waiver program is being processed may be served under the
199.28alternative care program for a period up to 60 days. If the individual is found to be eligible
199.29for medical assistance, medical assistance must be billed for services payable under the
199.30federally approved elderly waiver plan and delivered from the date the individual was
199.31found eligible for the federally approved elderly waiver plan. Notwithstanding this
199.32provision, alternative care funds may not be used to pay for any service the cost of which:
199.33(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
199.34or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
199.35to participate in the federally approved elderly waiver program under the special income
200.1 (c) Alternative care funding is not available for a person who resides in a licensed
200.2nursing home, certified boarding care home, hospital, or intermediate care facility, except
200.3for case management services which are provided in support of the discharge planning
200.4process for a nursing home resident or certified boarding care home resident to assist with
200.5a relocation process to a community-based setting.
200.6 (d) Alternative care funding is not available for a person whose income is greater
200.7than the maintenance needs allowance under section
200.8to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
200.9year for which alternative care eligibility is determined, who would be eligible for the
200.10elderly waiver with a waiver obligation.
200.11 Sec. 14. Minnesota Statutes 2010, section 256B.0915, subdivision 3a, is amended to
200.13 Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
200.14waivered services to an individual elderly waiver client except for individuals described
200.15in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
200.16mix resident class to which the elderly waiver client would be assigned under Minnesota
200.17Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
200.18as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
200.19which the resident assessment system as described in section
200.20rate determination is implemented. Effective on the first day of the state fiscal year in
200.21which the resident assessment system as described in section
200.22rate determination is implemented and the first day of each subsequent state fiscal year, the
200.23monthly limit for the cost of waivered services to an individual elderly waiver client shall
200.24be the rate of the case mix resident class to which the waiver client would be assigned
200.25under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
200.26previous state fiscal year, adjusted by
200.27community-based services percentage rate
200.29 (b) The monthly limit for the cost of waivered services to an individual elderly
200.30waiver client assigned to a case mix classification A under paragraph (a) with:
200.31(1) no dependencies in activities of daily living
200.34and eating when the dependency score in eating is three or greater as determined by an
200.35assessment performed under section 256B.0911
201.1 shall be
201.3month effective on
201.4in the program on or after July 1,
201.5other participants who meet this criteria at reassessment. This monthly limit shall be
201.6increased annually as described in paragraph (a).
201.7(c) If extended medical supplies and equipment or environmental modifications are
201.8or will be purchased for an elderly waiver client, the costs may be prorated for up to
201.912 consecutive months beginning with the month of purchase. If the monthly cost of a
201.10recipient's waivered services exceeds the monthly limit established in paragraph (a) or
201.11(b), the annual cost of all waivered services shall be determined. In this event, the annual
201.12cost of all waivered services shall not exceed 12 times the monthly limit of waivered
201.13services as described in paragraph (a) or (b).
201.14 Sec. 15. Minnesota Statutes 2010, section 256B.0915, subdivision 3b, is amended to
201.16 Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
201.17facility. (a) For a person who is a nursing facility resident at the time of requesting a
201.18determination of eligibility for elderly waivered services, a monthly conversion budget
201.19limit for the cost of elderly waivered services may be requested. The monthly conversion
201.20budget limit for the cost of elderly waiver services shall be the resident class assigned
201.21under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing
201.22facility where the resident currently resides until July 1 of the state fiscal year in which
201.23the resident assessment system as described in section
201.24determination is implemented. Effective on July 1 of the state fiscal year in which the
201.25resident assessment system as described in section
201.26determination is implemented, the monthly conversion budget limit for the cost of elderly
201.27waiver services shall be based on the per diem nursing facility rate as determined by the
201.28resident assessment system as described in section
201.29in the nursing facility where the
201.31per diem by 365
201.32allowance as described in subdivision 1d. The initially approved monthly conversion
202.13a, paragraph (a). The limit under this subdivision only applies to persons discharged from
202.2a nursing facility after a minimum 30-day stay and found eligible for waivered services
202.3on or after July 1, 1997. For conversions from the nursing home to the elderly waiver
202.4with consumer directed community support services, the
202.6must be reduced by a percentage equal to the percentage difference between the consumer
202.7directed services budget limit that would be assigned according to the federally approved
202.8waiver plan and the corresponding community case mix cap, but not to exceed 50 percent.
202.9 (b) The following costs must be included in determining the total monthly costs
202.10for the waiver client:
202.11 (1) cost of all waivered services, including
202.12and equipment and environmental
202.13 (2) cost of skilled nursing, home health aide, and personal care services reimbursable
202.14by medical assistance.
202.15 Sec. 16. Minnesota Statutes 2010, section 256B.0915, subdivision 3e, is amended to
202.17 Subd. 3e. Customized living service rate. (a) Payment for customized living
202.18services shall be a monthly rate authorized by the lead agency within the parameters
202.19established by the commissioner. The payment agreement must delineate the amount of
202.20each component service included in the recipient's customized living service plan. The
202.21lead agency shall ensure that there is a documented need within the parameters established
202.22by the commissioner for all component customized living services authorized.
202.23(b) The payment rate must be based on the amount of component services to be
202.24provided utilizing component rates established by the commissioner. Counties and tribes
202.25shall use tools issued by the commissioner to develop and document customized living
202.26service plans and rates.
202.27(c) Component service rates must not exceed payment rates for comparable elderly
202.28waiver or medical assistance services and must reflect economies of scale. Customized
202.29living services must not include rent or raw food costs.
202.30 (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
202.31individualized monthly authorized payment for the customized living service plan shall
202.32not exceed 50 percent of the greater of either the statewide or any of the geographic
202.33groups' weighted average monthly nursing facility rate of the case mix resident class
202.34to which the elderly waiver eligible client would be assigned under Minnesota Rules,
202.35parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
203.1in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
203.2resident assessment system as described in section
203.3determination is implemented. Effective on July 1 of the state fiscal year in which
203.4the resident assessment system as described in section
203.5rate determination is implemented and July 1 of each subsequent state fiscal year, the
203.6individualized monthly authorized payment for the services described in this clause shall
203.7not exceed the limit which was in effect on June 30 of the previous state fiscal year
203.8updated annually based on legislatively adopted changes to all service rate maximums for
203.9home and community-based service providers.
203.10(e) Effective July 1, 2011, the individualized monthly payment for the customized
203.11living service plan for individuals described in subdivision 3a, paragraph (b), must be the
203.12monthly authorized payment limit for customized living for individuals classified as case
203.13mix A, reduced by 25 percent. This rate limit must be applied to all new participants
203.14enrolled in the program on or after July 1, 2011, who meet the criteria described in
203.15subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
203.16meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
203.18Department of Health as a class A or class F home care provider and provided in a
203.19building that is registered as a housing with services establishment under chapter 144D.
203.20Licensed home care providers are subject to section 256B.0651, subdivision 14.
203.21(g) A provider may not bill or otherwise charge an elderly waiver participant or their
203.22family for additional units of any allowable component service beyond those available
203.23under the service rate limits described in paragraph (d), nor for additional units of any
203.24allowable component service beyond those approved in the service plan by the lead agency.
203.25 Sec. 17. Minnesota Statutes 2010, section 256B.0915, subdivision 3h, is amended to
203.27 Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
203.28payment rate for 24-hour customized living services is a monthly rate authorized by the
203.29lead agency within the parameters established by the commissioner of human services.
203.30The payment agreement must delineate the amount of each component service included in
203.31each recipient's customized living service plan. The lead agency shall ensure that there is a
203.32documented need within the parameters established by the commissioner for all component
203.33customized living services authorized. The lead agency shall not authorize 24-hour
203.34customized living services unless there is a documented need for 24-hour supervision.
204.1(b) For purposes of this section, "24-hour supervision" means that the recipient
204.2requires assistance due to needs related to one or more of the following:
204.3 (1) intermittent assistance with toileting, positioning, or transferring;
204.4 (2) cognitive or behavioral issues;
204.5 (3) a medical condition that requires clinical monitoring; or
204.6 (4) for all new participants enrolled in the program on or after
204.7and all other participants at their first reassessment after
204.8in at least
204.10dependency score in eating is three or greater; and needs medication management and at
204.11least 50 hours of service per month. The lead agency shall ensure that the frequency and
204.12mode of supervision of the recipient and the qualifications of staff providing supervision
204.13are described and meet the needs of the recipient.
204.14(c) The payment rate for 24-hour customized living services must be based on the
204.15amount of component services to be provided utilizing component rates established by the
204.16commissioner. Counties and tribes will use tools issued by the commissioner to develop
204.17and document customized living plans and authorize rates.
204.18(d) Component service rates must not exceed payment rates for comparable elderly
204.19waiver or medical assistance services and must reflect economies of scale.
204.20(e) The individually authorized 24-hour customized living payments, in combination
204.21with the payment for other elderly waiver services, including case management, must not
204.22exceed the recipient's community budget cap specified in subdivision 3a. Customized
204.23living services must not include rent or raw food costs.
204.24(f) The individually authorized 24-hour customized living payment rates shall not
204.25exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
204.26living services in effect and in the Medicaid management information systems on March
204.2731, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
204.28to 9549.0059, to which elderly waiver service clients are assigned. When there are
204.29fewer than 50 authorizations in effect in the case mix resident class, the commissioner
204.30shall multiply the calculated service payment rate maximum for the A classification by
204.31the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
204.329549.0059, to determine the applicable payment rate maximum. Service payment rate
204.33maximums shall be updated annually based on legislatively adopted changes to all service
204.34rates for home and community-based service providers.
204.35 (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
204.36may establish alternative payment rate systems for 24-hour customized living services in
205.1housing with services establishments which are freestanding buildings with a capacity of
205.216 or fewer, by applying a single hourly rate for covered component services provided
205.4 (1) licensed corporate adult foster homes; or
205.5 (2) specialized dementia care units which meet the requirements of section
205.7 (i) each resident is offered the option of having their own apartment; or
205.8 (ii) the units are licensed as board and lodge establishments with maximum capacity
205.9of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
205.10subparts 1, 2, 3, and 4, item A.
205.11(h) A provider may not bill or otherwise charge an elderly waiver participant or their
205.12family for additional units of any allowable component service beyond those available
205.13under the service rate limits described in paragraph (e), nor for additional units of any
205.14allowable component service beyond those approved in the service plan by the lead agency.
205.15 Sec. 18. Minnesota Statutes 2010, section 256B.0915, subdivision 10, is amended to
205.17 Subd. 10. Waiver payment rates; managed care organizations. The
205.18commissioner shall adjust the elderly waiver capitation payment rates for managed care
205.19organizations paid under section
205.20service rate limits for customized living services and 24-hour customized living services
205.21under subdivisions 3e and 3h
205.22assistance rates paid to customized living providers by managed care organizations under
205.23this section shall not exceed the maximum service rate limits and component rates as
205.24determined by the commissioner under subdivisions 3e and 3h.
205.25 Sec. 19. Minnesota Statutes 2010, section 256B.0916, subdivision 6a, is amended to
205.27 Subd. 6a. Statewide availability of
205.28 support services. (a) The commissioner shall submit to the federal Health Care Financing
205.29Administration by August 1, 2001, an amendment to the home and community-based
205.312005, for waivers under sections 256B.0915 and 256B.49, to make
206.1(b) Until the waiver amendment for self-directed community supports is effective, if
206.2a county declines to meet the requirements for provision of
206.3self-directed supports, the commissioner shall contract with another county, a group of
206.4counties, or a private agency to plan for and administer
206.5self-directed supports in that county.
206.6(c) The state of Minnesota, county agencies, tribal governments, or administrative
206.7entities under contract to participate in the implementation and administration of the home
206.8and community-based waiver for persons with developmental disabilities, shall not be
206.9liable for damages, injuries, or liabilities sustained through the purchase of support by the
206.10individual, the individual's family, legal representative, or the authorized representative
206.11with funds received through the
206.12service under this section. Liabilities include but are not limited to: workers' compensation
206.13liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment
206.14Tax Act (FUTA).
206.15EFFECTIVE DATE.This section is effective July 1, 2011.
206.16 Sec. 20. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to
206.18 Subd. 1b.
206.19recipient of case management services and any legal representative shall be provided a
206.20written copy of the coordinated service and support plan
206.22receives the community support plan from the certified assessor under section 256B.0911;
206.23(2) includes the results of the assessment information on the person's need for
206.24service, including identification of service needs that will be or that are met by the person's
206.25relatives, friends, and others, as well as community services used by the general public;
206.26(3) reasonably assures the health, safety, and welfare of the recipient;
206.28the person's legal guardian or conservator, or the parent if the person is a minor;
206.29(5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
206.30paragraph (o), of service and support providers;
206.33services to be provided to the person based on assessed needs, preferences,
207.1individual coordinated service and support plan shall also specify service outcomes and
207.2the provider's responsibility to monitor the achievement of the service outcomes;
207.4plan to be developed by the provider according to the respective state and federal licensing
207.5and certification standards, and additional assessments to be completed or arranged by the
207.6provider after service initiation;
207.8recommendations for modification to the
207.10service plans developed within specified time periods, the right to appeal action or
207.11inaction, and the right to request
207.14or conservator, or the parent if the person is a minor, and the authorized county
207.17needs that impact the delivery of services.
207.21EFFECTIVE DATE.This section is effective January 1, 2013.
207.22 Sec. 21. Minnesota Statutes 2010, section 256B.092, subdivision 1e, is amended to
207.24 Subd. 1e. Case management service monitoring, coordination, and evaluation
207.26plan identifies the need for individual
207.28individual provider plans are developed by the providers according to clauses (2) to (5).
207.29The providers shall assure that the individual
207.30(1) are developed according to the respective state and federal licensing and
207.32(2) are designed to achieve the goals of the individual service plan;
207.33(3) are consistent with other aspects of the
207.35(4) assure the health and safety of the person; and
208.1(5) are developed with consistent and coordinated approaches to services and service
208.2outcomes among the various service providers.
208.3(b) The case
208.5(1) to assure that the individual service plan is being followed according to
208.7(2) to identify any changes or modifications that might be needed in the individual
208.8service plan, including changes resulting from recommendations of current service
208.10(3) to determine if the person's legal rights are protected, and if not, notify the
208.11person's legal guardian or conservator, or the parent if the person is a minor, protection
208.12services, or licensing agencies as appropriate; and
208.13(4) to determine if the person, the person's legal guardian or conservator, or the
208.14parent if the person is a minor, is satisfied with the services provided.
208.15(c) If the provider fails to develop or carry out the individual
208.16according to paragraph (a), the case manager shall notify the person's legal guardian or
208.17conservator, or the parent if the person is a minor, the provider, the respective licensing
208.18and certification agencies, and the county board where the services are being provided. In
208.19addition, the case manager shall identify other steps needed to assure the person receives
208.20the services identified in the
208.21EFFECTIVE DATE.This section is effective January 1, 2012.
208.22 Sec. 22. Minnesota Statutes 2010, section 256B.092, subdivision 1g, is amended to
208.24 Subd. 1g. Conditions not requiring development of
208.25service and support plan. Unless otherwise required by federal law, the county agency is
208.26not required to complete
208.27subdivision 1b for:
208.28(1) persons whose families are requesting respite care for their family member who
208.29resides with them, or whose families are requesting a family support grant and are not
208.30requesting purchase or arrangement of habilitative services; and
208.31(2) persons with developmental disabilities, living independently without authorized
208.32services or receiving funding for services at a rehabilitation facility as defined in section
208.34EFFECTIVE DATE.This section is effective January 1, 2012.
209.1 Sec. 23. Minnesota Statutes 2010, section 256B.092, subdivision 3, is amended to read:
209.2 Subd. 3. Authorization and termination of services.
209.4services of community and regional treatment center providers according to
209.5coordinated service and support plans. Services provided to persons with developmental
209.6disabilities may only be authorized and terminated
209.7rules of the commissioner and (2) the
209.8defined in subdivision 1b. Medical assistance services not needed shall not be authorized
209.9by county agencies or funded by the commissioner. When purchasing or arranging for
209.10unlicensed respite care services for persons with overriding health needs, the county
209.11agency shall seek the advice of a health care professional in assessing provider staff
209.12training needs and skills necessary to meet the medical needs of the person.
209.13EFFECTIVE DATE.This section is effective January 1, 2012.
209.14 Sec. 24. Minnesota Statutes 2010, section 256B.092, subdivision 8, is amended to read:
209.15 Subd. 8.
209.16certified assessor shall:
209.17(1) review diagnostic data;
209.18(2) review health, social, and developmental assessment data using a
209.20(3) identify the level of services appropriate to maintain the person in the most
209.21normal and least restrictive setting that is consistent with the person's treatment needs;
209.22(4) identify other noninstitutional public assistance or social service that may prevent
209.23or delay long-term residential placement;
209.24(5) assess whether a person is in need of long-term residential care;
209.25(6) make recommendations regarding
209.26service or public assistance support, or both, to maintain a person in the person's own home
209.27or other place of residence; (ii) training and habilitation service, vocational rehabilitation,
209.28and employment training activities; (iii) community residential
209.30alternative to community residential placement or regional treatment center placement;
209.31(7) evaluate the availability, location, and quality of the services listed in clause
209.32(6), including the impact of
209.33person's ability to maintain or improve existing patterns of contact and involvement with
209.34parents and other family members;
210.1(8) identify the cost implications of recommendations in clause (6) and provide
210.2written notice of the annual and monthly average authorized amount to be spent for
210.3services for the recipient;
210.4(9) make recommendations to a court as may be needed to assist the court in making
210.5decisions regarding commitment of persons with developmental disabilities; and
210.6(10) inform the person and the person's legal guardian or conservator, or the parent if
210.7the person is a minor, that appeal may be made to the commissioner pursuant to section
210.9EFFECTIVE DATE.This section is effective January 1, 2012.
210.10 Sec. 25. Minnesota Statutes 2010, section 256B.431, subdivision 2r, is amended to
210.12 Subd. 2r. Payment restrictions on leave days. (a) Effective July 1, 1993, the
210.13commissioner shall limit payment for leave days in a nursing facility to 79 percent of that
210.14nursing facility's total payment rate for the involved resident.
210.15(b) For services rendered on or after July 1, 2003, for facilities reimbursed under this
210.16section or section
210.17nursing facility to 60 percent of that nursing facility's total payment rate for the involved
210.19(c) For services rendered on or after July 1, 2011, for facilities reimbursed under
210.20this chapter, the commissioner shall limit payment for leave days in a nursing facility
210.21to 30 percent of that nursing facility's total payment rate for the involved resident, and
210.22shall allow this payment only when the occupancy of the nursing facility, inclusive of
210.23bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules,
210.25 Sec. 26. Minnesota Statutes 2010, section 256B.431, subdivision 32, is amended to
210.27 Subd. 32. Payment during first
211.6a facility reimbursed under this section, section
211.7(1) for the first 30 calendar days after admission, the rate shall be 120 percent of
211.8the facility's medical assistance rate for each RUG class;
211.9(2) beginning with the 31st calendar day after admission, the payment rate shall be
211.10the rate otherwise determined under this section, section
211.12(3) payments under this paragraph apply to admissions occurring on or after July
211.15be allowed if a resident has resided during the previous 30 calendar days in:
211.16(1) the same nursing facility;
211.17(2) a nursing facility owned or operated by a related party; or
211.18(3) a nursing facility or part of a facility that closed or was in the process of closing.
211.19 Sec. 27. Minnesota Statutes 2010, section 256B.434, subdivision 4, is amended to read:
211.20 Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
211.21have their payment rates determined under this section rather than section
211.22commissioner shall establish a rate under this subdivision. The nursing facility must enter
211.23into a written contract with the commissioner.
211.24 (b) A nursing facility's case mix payment rate for the first rate year of a facility's
211.25contract under this section is the payment rate the facility would have received under
211.27 (c) A nursing facility's case mix payment rates for the second and subsequent years
211.28of a facility's contract under this section are the previous rate year's contract payment
211.29rates plus an inflation adjustment and, for facilities reimbursed under this section or
211.31licensing fees for the facility taking effect on or after July 1, 2001. The index for the
211.32inflation adjustment must be based on the change in the Consumer Price Index-All Items
211.33(United States City average) (CPI-U) forecasted by the commissioner of management and
211.34budget's national economic consultant, as forecasted in the fourth quarter of the calendar
211.35year preceding the rate year. The inflation adjustment must be based on the 12-month
212.1period from the midpoint of the previous rate year to the midpoint of the rate year for
212.2which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
212.32000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
212.4July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010,
212.8on October 1, 2011, and October 1, 2012, the rate adjustment under this paragraph shall
212.9be suspended. Beginning in 2005, adjustment to the property payment rate under this
212.10section and section
212.11of the property-related payment rate adjustment under this paragraph, the commissioner
212.12shall determine the proportion of the facility's rates that are property-related based on the
212.13facility's most recent cost report.
212.14 (d) The commissioner shall develop additional incentive-based payments of up to
212.15five percent above a facility's operating payment rate for achieving outcomes specified
212.16in a contract. The commissioner may solicit contract amendments and implement those
212.17which, on a competitive basis, best meet the state's policy objectives. The commissioner
212.18shall limit the amount of any incentive payment and the number of contract amendments
212.19under this paragraph to operate the incentive payments within funds appropriated for this
212.20purpose. The contract amendments may specify various levels of payment for various
212.21levels of performance. Incentive payments to facilities under this paragraph may be in the
212.22form of time-limited rate adjustments or onetime supplemental payments. In establishing
212.23the specified outcomes and related criteria, the commissioner shall consider the following
212.24state policy objectives:
212.25 (1) successful diversion or discharge of residents to the residents' prior home or other
212.27 (2) adoption of new technology to improve quality or efficiency;
212.28 (3) improved quality as measured in the Nursing Home Report Card;
212.29 (4) reduced acute care costs; and
212.30 (5) any additional outcomes proposed by a nursing facility that the commissioner
212.32 (e) Notwithstanding the threshold in section
212.33take action to come into compliance with existing or pending requirements of the life
212.34safety code provisions or federal regulations governing sprinkler systems must receive
212.35reimbursement for the costs associated with compliance if all of the following conditions
213.1 (1) the expenses associated with compliance occurred on or after January 1, 2005,
213.2and before December 31, 2008;
213.3 (2) the costs were not otherwise reimbursed under subdivision 4f or section
213.5 (3) the total allowable costs reported under this paragraph are less than the minimum
213.6threshold established under section
213.8The commissioner shall use money appropriated for this purpose to provide to qualifying
213.9nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
213.102008. Nursing facilities that have spent money or anticipate the need to spend money
213.11to satisfy the most recent life safety code requirements by (1) installing a sprinkler
213.12system or (2) replacing all or portions of an existing sprinkler system may submit to the
213.13commissioner by June 30, 2007, on a form provided by the commissioner the actual
213.14costs of a completed project or the estimated costs, based on a project bid, of a planned
213.15project. The commissioner shall calculate a rate adjustment equal to the allowable
213.16costs of the project divided by the resident days reported for the report year ending
213.17September 30, 2006. If the costs from all projects exceed the appropriation for this
213.18purpose, the commissioner shall allocate the money appropriated on a pro rata basis
213.19to the qualifying facilities by reducing the rate adjustment determined for each facility
213.20by an equal percentage. Facilities that used estimated costs when requesting the rate
213.21adjustment shall report to the commissioner by January 31, 2009, on the use of this
213.22money on a form provided by the commissioner. If the nursing facility fails to provide
213.23the report, the commissioner shall recoup the money paid to the facility for this purpose.
213.24If the facility reports expenditures allowable under this subdivision that are less than
213.25the amount received in the facility's annualized rate adjustment, the commissioner shall
213.26recoup the difference.
213.27 Sec. 28. Minnesota Statutes 2010, section 256B.437, subdivision 6, is amended to read:
213.28 Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
213.29services shall calculate the amount of the planned closure rate adjustment available under
213.30subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
213.31(1) the amount available is the net reduction of nursing facility beds multiplied
213.33(2) the total number of beds in the nursing facility or facilities receiving the planned
213.34closure rate adjustment must be identified;
214.1(3) capacity days are determined by multiplying the number determined under
214.2clause (2) by 365; and
214.3(4) the planned closure rate adjustment is the amount available in clause (1), divided
214.4by capacity days determined under clause (3).
214.5(b) A planned closure rate adjustment under this section is effective on the first day
214.6of the month following completion of closure of the facility designated for closure in the
214.7application and becomes part of the nursing facility's total operating payment rate.
214.8(c) Applicants may use the planned closure rate adjustment to allow for a property
214.9payment for a new nursing facility or an addition to an existing nursing facility or as an
214.10operating payment rate adjustment. Applications approved under this subdivision are
214.11exempt from other requirements for moratorium exceptions under section
214.12subdivisions 2 and 3.
214.13(d) Upon the request of a closing facility, the commissioner must allow the facility a
214.14closure rate adjustment as provided under section
214.15(e) A facility that has received a planned closure rate adjustment may reassign it
214.16to another facility that is under the same ownership at any time within three years of its
214.17effective date. The amount of the adjustment shall be computed according to paragraph (a).
214.18(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
214.19the commissioner shall recalculate planned closure rate adjustments for facilities that
214.20delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
214.21bed dollar amount. The recalculated planned closure rate adjustment shall be effective
214.22from the date the per bed dollar amount is increased.
214.23(g) For planned closures approved after June 30, 2009, the commissioner of human
214.24services shall calculate the amount of the planned closure rate adjustment available under
214.25subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
214.26(h) Beginning July 16, 2011, the commissioner shall no longer approve planned
214.27closure rate adjustments under this subdivision.
214.28 Sec. 29. Minnesota Statutes 2010, section 256B.441, subdivision 50a, is amended to
214.30 Subd. 50a. Determination of proximity adjustments. (a) For a nursing facility
214.31located in close proximity to another nursing facility of the same facility group type but in
214.32a different peer group and that has higher limits for care-related or other operating costs,
214.33the commissioner shall adjust the limits in accordance with clauses (1) to (4):
214.34 (1) determine the difference between the limits;
215.1 (2) determine the distance between the two facilities, by the shortest driving route. If
215.2the distance exceeds 20 miles, no adjustment shall be made;
215.3 (3) subtract the value in clause (2) from 20 miles, divide by 20, and convert to a
215.5 (4) increase the limits for the nursing facility with the lower limits by the value
215.6determined in clause (1) multiplied by the value determined in clause (3).
215.7(b) Effective October 1, 2011, nursing facilities located no more than one-quarter
215.8mile from a peer group with higher limits und