HF 2294

2nd Engrossment - 87th Legislature (2011 - 2012) Posted on 03/28/2012 01:25pm

A bill for an act
relating to state government; making adjustments to health and human
services appropriations; making changes to provisions related to health care,
the Department of Health, children and family services, continuing care,
chemical dependency, child support, background studies, homelessness,
and vulnerable children and adults; providing for data sharing; requiring
eligibility determinations; requiring the University of Minnesota to request
funding for rural primary care training; providing for the release of medical
assistance liens; providing appointments; providing grants; requiring studies
and reports; appropriating money; amending Minnesota Statutes 2010, sections
62D.02, subdivision 3; 62D.05, subdivision 6; 62D.12, subdivision 1; 62J.496,
subdivision 2; 62Q.80; 62U.04, subdivisions 1, 2, 4, 5; 119B.13, subdivision 3a;
144.1222, by adding a subdivision; 144.292, subdivision 6; 144.293, subdivision
2; 144A.351; 144D.04, subdivision 2; 145.906; 245.697, subdivision 1; 245A.03,
by adding a subdivision; 245A.11, subdivision 7; 245B.07, subdivision 1;
245C.04, subdivision 6; 245C.05, subdivision 7; 252.27, subdivision 2a;
254A.19, by adding a subdivision; 256.01, by adding subdivisions; 256B.056,
subdivision 1a; 256B.0625, subdivisions 9, 28a, by adding subdivisions;
256B.0659, by adding a subdivision; 256B.0751, by adding a subdivision;
256B.0754, subdivision 2; 256B.0915, subdivision 3g; 256B.092, subdivisions
1b, 7, by adding subdivisions; 256B.0943, subdivision 9; 256B.431, subdivision
17e, by adding a subdivision; 256B.441, by adding a subdivision; 256B.49, by
adding a subdivision; 256B.69, subdivision 9, by adding subdivisions; 256D.06,
subdivision 1b; 256D.44, subdivision 5; 256E.37, subdivision 1; 256I.05,
subdivision 1e; 256J.08, by adding a subdivision; 256J.26, subdivision 1, by
adding a subdivision; 256J.45, subdivision 2; 256J.50, by adding a subdivision;
256J.521, subdivision 2; 462A.29; 518A.40, subdivision 4; Minnesota Statutes
2011 Supplement, sections 62U.04, subdivisions 3, 9; 119B.13, subdivision
7; 245A.03, subdivision 7; 256.045, subdivision 3; 256.987, subdivisions 1,
2, by adding subdivisions; 256B.056, subdivision 3; 256B.057, subdivision
9; 256B.0625, subdivision 38; 256B.0911, subdivisions 3a, 3c; 256B.0915,
subdivisions 3e, 3h; 256B.097, subdivision 3; 256B.49, subdivisions 14, 15, 23;
256B.5012, subdivision 13; 256B.69, subdivisions 5a, 5c; 256E.35, subdivisions
5, 6; 256I.05, subdivision 1a; 256J.49, subdivision 13; 256L.12, subdivision 9;
256M.40, subdivision 1; Laws 2010, chapter 374, section 1; Laws 2011, First
Special Session chapter 9, article 7, sections 52; 54; article 9, section 18; article
10, section 3, subdivisions 1, 3, 4; proposing coding for new law in Minnesota
Statutes, chapters 144; 256B.

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

ARTICLE 1

HEALTH CARE

Section 1.

Minnesota Statutes 2010, section 256B.0625, subdivision 9, is amended to
read:

Subd. 9.

Dental services.

(a) Medical assistance covers dental services.

(b) Medical assistance dental coverage for nonpregnant adults is limited to the
following services:

(1) comprehensive exams, limited to once every five years;

(2) periodic exams, limited to one per year;

(3) limited exams;

(4) bitewing x-rays, limited to one per year;

(5) periapical x-rays;

(6) panoramic x-rays, limited to one every five years except (1) when medically
necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma
or (2) once every two years for patients who cannot cooperate for intraoral film due to
a developmental disability or medical condition that does not allow for intraoral film
placement;

(7) prophylaxis, limited to one per year;

(8) application of fluoride varnish, limited to one per year;

(9) posterior fillings, all at the amalgam rate;

(10) anterior fillings;

(11) endodontics, limited to root canals on the anterior and premolars only;

(12) removable prostheses, each dental arch limited to one every six years;

(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
abscesses;

(14) palliative treatment and sedative fillings for relief of pain; and

(15) full-mouth debridement, limited to one every five years.

(c) In addition to the services specified in paragraph (b), medical assistance
covers the following services for adults, if provided in an outpatient hospital setting or
freestanding ambulatory surgical center as part of outpatient dental surgery:

(1) periodontics, limited to periodontal scaling and root planing once every two
years;

(2) general anesthesia; and

(3) full-mouth survey once every five years.

(d) Medical assistance covers medically necessary dental services for children and
pregnant women. The following guidelines apply:

(1) posterior fillings are paid at the amalgam rate;

(2) application of sealants are covered once every five years per permanent molar for
children only;

(3) application of fluoride varnish is covered once every six months; and

(4) orthodontia is eligible for coverage for children only.

new text begin (e) In addition to the services specified in paragraphs (b) and (c), medical assistance
covers the following services for developmentally disabled adults:
new text end

new text begin (1) house calls or extended care facility calls for on-site delivery of covered services;
new text end

new text begin (2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used; and
new text end

new text begin (3) oral or IV conscious sedation, if the covered dental service cannot be performed
safely without it or would otherwise require the service to be performed under general
anesthesia in a hospital or surgical center.
new text end

Sec. 2.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 18c. new text end

new text begin Nonemergency Medical Transportation Advisory Committee.
new text end

new text begin (a) The Nonemergency Medical Transportation Advisory Committee shall advise the
commissioner on the administration of nonemergency medical transportation covered
under medical assistance. The advisory committee shall meet at least quarterly and may
meet more frequently as required by the commissioner. The advisory committee shall
annually elect a chair from among its members, who shall work with the commissioner or
the commissioner's designee to establish the agenda for each meeting.
new text end

new text begin (b) The Nonemergency Medical Transportation Advisory Committee shall advise
and make recommendations to the commissioner on:
new text end

new text begin (1) the development of, and periodic updates to, a policy manual for nonemergency
medical transportation services;
new text end

new text begin (2) policies and a funding source for reimbursing no-load miles;
new text end

new text begin (3) policies to prevent waste, fraud, and abuse, and to improve the efficiency of the
nonemergency medical transportation system;
new text end

new text begin (4) other issues identified in the 2011 evaluation report by the Office of the
Legislative Auditor on medical nonemergency transportation; and
new text end

new text begin (5) other aspects of the nonemergency medical transportation system, as requested
by the commissioner.
new text end

new text begin (c) The Nonemergency Medical Transportation Advisory Committee shall
coordinate its activities with the Minnesota Council on Transportation Access established
under section 174.285.
new text end

new text begin (d) The Nonemergency Medical Transportation Advisory Committee shall expire
December 1, 2014.
new text end

Sec. 3.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 18d. new text end

new text begin Advisory committee members. new text end

new text begin (a) The Nonemergency Medical
Transportation Advisory Committee consists of:
new text end

new text begin (1) two voting members who represent counties, at least one of whom must represent
a county or counties other than Anoka, Carver, Chisago, Dakota, Hennepin, Isanti,
Ramsey, Scott, Sherburne, Washington, and Wright;
new text end

new text begin (2) four voting members who represent medical assistance recipients, including
persons with physical and developmental disabilities, persons with mental illness, seniors,
children, and low-income individuals;
new text end

new text begin (3) four voting members who represent providers that deliver nonemergency medical
transportation services to medical assistance enrollees;
new text end

new text begin (4) two voting members of the house of representatives, one from the majority
party and one from the minority party, appointed by the speaker of the house, and two
voting members from the senate, one from the majority party and one from the minority
party, appointed by the Subcommittee on Committees of the Committee on Rules and
Administration;
new text end

new text begin (5) one voting member who represents demonstration providers as defined in section
256B.69, subdivision 2;
new text end

new text begin (6) one voting member who represents an organization that contracts with state or
local governments to coordinate transportation services for medical assistance enrollees;
and
new text end

new text begin (7) the commissioner of transportation or the commissioner's designee, who shall
serve as a voting member.
new text end

new text begin (b) Members of the advisory committee shall not be employed by the Department
of Human Services.
new text end

Sec. 4.

Minnesota Statutes 2010, section 256B.0625, subdivision 28a, is amended to
read:

Subd. 28a.

Licensed physician assistant services.

new text begin (a) new text end Medical assistance covers
services performed by a licensed physician assistant if the service is otherwise covered
under this chapter as a physician service and if the service is within the scope of practice
of a licensed physician assistant as defined in section 147A.09.

new text begin (b) Licensed physician assistants, who are supervised by a physician certified by
the American Board of Psychiatry and Neurology or eligible for board certification in
psychiatry, may bill for medication management and evaluation and management services
provided to medical assistance enrollees in inpatient hospital settings, consistent with
their authorized scope of practice, as defined in section 147A.09, with the exception of
performing psychotherapy, diagnostic assessments, or providing clinical supervision.
new text end

Sec. 5.

Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 38,
is amended to read:

Subd. 38.

Payments for mental health services.

Payments for mental
health services covered under the medical assistance program that are provided by
masters-prepared mental health professionals shall be 80 percent of the rate paid to
doctoral-prepared professionals. Payments for mental health services covered under
the medical assistance program that are provided by masters-prepared mental health
professionals employed by community mental health centers shall be 100 percent of the
rate paid to doctoral-prepared professionals. new text begin Payments for mental health services covered
under the medical assistance program that are provided by physician assistants shall be 65
percent of the rate paid to psychiatrists.
new text end

Sec. 6.

Minnesota Statutes 2010, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 60. new text end

new text begin Community paramedic services. new text end

new text begin (a) Medical assistance covers services
provided by community paramedics who are certified under section 144E.28, subdivision
9, when the services are provided in accordance with this subdivision to an eligible
recipient as defined in paragraph (b).
new text end

new text begin (b) For purposes of this subdivision, an eligible recipient is defined as an individual
who has received hospital emergency department services three or more times in a period
of four consecutive months in the past 12 months, or an individual who has been identified
by the individual's primary health care provider for whom community paramedic services
identified in paragraph (c) would likely prevent admission to or would allow discharge
from a nursing facility, or would likely prevent readmission to a hospital or nursing facility.
new text end

new text begin (c) Payment for services provided by a community paramedic under this subdivision
must be a part of a care plan ordered by a primary health care provider in consultation with
the medical director of an ambulance service and must be billed by an eligible provider
enrolled in medical assistance that employs or contracts with the community paramedic.
The care plan must ensure that the services provided by a community paramedic are
coordinated with other community health providers and local public health agencies and
that community paramedic services do not duplicate services already provided to the
patient, including home health and waiver services. Community paramedic services
shall include health assessment, chronic disease monitoring and education, medication
compliance, immunizations and vaccinations, laboratory specimen collection, hospital
discharge follow-up care, and minor medical procedures approved by the ambulance
medical director.
new text end

new text begin (d) Services provided by a community paramedic to an eligible recipient who is
also receiving care coordination services must be in consultation with the providers of
the recipient's care coordination services.
new text end

new text begin (e) The commissioner shall seek the necessary federal approval to implement this
subdivision.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, or upon federal
approval, whichever is later.
new text end

Sec. 7.

Minnesota Statutes 2010, section 256B.0751, is amended by adding a
subdivision to read:

new text begin Subd. 9. new text end

new text begin Pediatric care coordination. new text end

new text begin The commissioner shall implement a
pediatric care coordination service for children with high-cost medical or high-cost
psychiatric conditions who are at risk of recurrent hospitalization or emergency room use
for acute, chronic, or psychiatric illness, who receive medical assistance services. Care
coordination services must be targeted to children not already receiving care coordination
through another service and may include but are not limited to the provision of health
care home services to children admitted to hospitals that do not currently provide care
coordination. Care coordination services must be provided by care coordinators who
are directly linked to provider teams in the care delivery setting, but who may be part
of a community care team shared by multiple primary care providers or practices. For
purposes of this subdivision, the commissioner shall, to the extent possible, use the
existing health care home certification and payment structure established under this
section and section 256B.0753.
new text end

Sec. 8.

Minnesota Statutes 2010, section 256B.441, is amended by adding a
subdivision to read:

new text begin Subd. 63. new text end

new text begin Special needs nursing facility rate adjustment. new text end

new text begin The commissioner may
increase the medical assistance payment rate for a nursing facility that is participating
in a health care delivery system demonstration project under sections 256B.0755 or
256B.0756, or another care coordination project, if the nursing facility has agreed to
accept patients enrolled in the project in order to reduce hospital or emergency room
admissions or readmissions, shorten the length of inpatient hospital stays, or prevent a
medical emergency that would require more costly treatment. The higher rate must reflect
the higher costs of participating in the care coordination demonstration project and the
higher costs of serving patients with more complex medical, dental, mental health, and
socioeconomic conditions.
new text end

Sec. 9.

Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a, is
amended to read:

Subd. 5a.

Managed care contracts.

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

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

(c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program pending completion of performance targets. Each performance target
must be quantifiable, objective, measurable, and reasonably attainable, except in the case
of a performance target based on a federal or state law or rule. Criteria for assessment
of each performance target must be outlined in writing prior to the contract effective
date. new text begin Clinical or utilization performance targets and their related criteria must consider
evidence-based research and reasonable interventions when available or applicable to
the population served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans and providers. new text end The managed care plan
must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
attainment of the performance target is accurate. The commissioner shall periodically
change the administrative measures used as performance targets in order to improve plan
performance across a broader range of administrative services. The performance targets
must include measurement of plan efforts to contain spending on health care services and
administrative activities. The commissioner may adopt plan-specific performance targets
that take into account factors affecting only one plan, including characteristics of the
plan's enrollee population. The withheld funds must be returned no sooner than July of the
following year if performance targets in the contract are achieved. The commissioner may
exclude special demonstration projects under subdivision 23.

(d) Effective for services rendered on or after January 1, 2009, through December
31, 2009, the commissioner shall withhold three percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.

(e) Effective for services provided on or after January 1, 2010, the commissioner
shall require that managed care plans use the assessment and authorization processes,
forms, timelines, standards, documentation, and data reporting requirements, protocols,
billing processes, and policies consistent with medical assistance fee-for-service or the
Department of Human Services contract requirements consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all
personal care assistance services under section 256B.0659.

(f) Effective for services rendered on or after January 1, 2010, through December
31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.

(g) Effective for services rendered on or after January 1, 2011, through December
31, 2011, the commissioner shall include as part of the performance targets described
in paragraph (c) a reduction in the health plan's emergency room utilization rate for
state health care program enrollees by a measurable rate of five percent from the plan's
utilization rate for state health care program enrollees for the previous calendar year.
Effective for services rendered on or after January 1, 2012, the commissioner shall include
as part of the performance targets described in paragraph (c) a reduction in the health plan's
emergency department utilization rate for medical assistance and MinnesotaCare enrollees,
as determined by the commissioner. new text begin For 2012, the reduction shall be based on the health
plan's utilization in 2009. new text end To earn the return of the withhold each new text begin subsequent new text end year, the
managed care plan or county-based purchasing plan must achieve a qualifying reduction
of no less than ten percent of the plan's emergency department utilization rate for medical
assistance and MinnesotaCare enrollees, excluding deleted text begin Medicare deleted text end enrollees new text begin in programs
described in subdivisions 23 and 28 new text end , compared to the previous deleted text begin calendar deleted text end new text begin measurement new text end
year new text begin , new text end until the final performance target is reached. new text begin When measuring performance, the
commissioner must consider the difference in health risk in a plan's membership in the
baseline year compared to the measurement year and work with the managed care or
county-based purchasing plan to account for differences that they agree are significant.
new text end

The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. new text begin The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
new text end

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization
rate for medical assistance and MinnesotaCare enrollees for calendar year deleted text begin 2011 deleted text end new text begin 2009 new text end .
Hospitals shall cooperate with the health plans in meeting this performance target and
shall accept payment withholds that may be returned to the hospitals if the performance
target is achieved.

(h) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction
in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than five percent of the plan's hospital admission rate for medical
assistance and MinnesotaCare enrollees, excluding deleted text begin Medicare deleted text end enrollees new text begin in programs
described in subdivisions 23 and 28 new text end , compared to the previous calendar year until the final
performance target is reached. new text begin When measuring performance, the commissioner must
consider the difference in health risk in a plan's membership in the baseline year compared
to the measurement year, and work with the managed care or county-based purchasing
plan to account for differences that they agree are significant.
new text end

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved. new text begin The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
new text end

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in
calendar year 2011, as determined by the commissioner. The hospital admissions in this
performance target do not include the admissions applicable to the subsequent hospital
admission performance target under paragraph (i). Hospitals shall cooperate with the
plans in meeting this performance target and shall accept payment withholds that may be
returned to the hospitals if the performance target is achieved.

(i) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the plan's hospitalization admission rates for subsequent hospitalizations within 30 days
of a previous hospitalization of a patient regardless of the reason, for medical assistance
and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
the withhold each year, the managed care plan or county-based purchasing plan must
achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance
and MinnesotaCare enrollees, excluding deleted text begin Medicare deleted text end enrollees new text begin in programs described in
subdivisions 23 and 28 new text end , of no less than five percent compared to the previous calendar
year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
the subsequent hospitalization rate was achieved. new text begin The commissioner shall structure the
withhold so that the commissioner returns a portion of the withheld funds in amounts
commensurate with achieved reductions in utilization less than the targeted amount.
new text end

The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for medical assistance
and MinnesotaCare enrollees, excluding deleted text begin Medicare deleted text end enrollees new text begin in programs described in
subdivisions 23 and 28 new text end , is reduced by 25 percent of the plan's subsequent hospitalization
rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
performance target and shall accept payment withholds that must be returned to the
hospitals if the performance target is achieved.

(j) Effective for services rendered on or after January 1, 2011, through December 31,
2011, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(k) Effective for services rendered on or after January 1, 2012, through December
31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.

(l) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(m) Effective for services rendered on or after January 1, 2014, the commissioner
shall withhold three percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. The withheld funds must be returned no sooner than July 1 and
no later than July 31 of the following year. The commissioner may exclude special
demonstration projects under subdivision 23.

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

(o) Contracts between the commissioner and a prepaid health plan are exempt from
the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
(a), and 7.

(p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject
to the requirements of paragraph (c).

Sec. 10.

Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5c,
is amended to read:

Subd. 5c.

Medical education and research fund.

(a) The commissioner of human
services shall transfer each year to the medical education and research fund established
under section 62J.692, an amount specified in this subdivision. The commissioner shall
calculate the following:

(1) an amount equal to the reduction in the prepaid medical assistance payments as
specified in this clause. Until January 1, 2002, the county medical assistance capitation
base rate prior to plan specific adjustments and after the regional rate adjustments under
subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
January 1, 2002, the county medical assistance capitation base rate prior to plan specific
adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
facility and elderly waiver payments and demonstration project payments operating
under subdivision 23 are excluded from this reduction. The amount calculated under
this clause shall not be adjusted for periods already paid due to subsequent changes to
the capitation payments;

(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
section;

(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
paid under this section; and

(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
under this section.

(b) This subdivision shall be effective upon approval of a federal waiver which
allows federal financial participation in the medical education and research fund. The
amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount
transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under
paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally
reduce the amount specified under paragraph (a), clause (1).

(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner
shall transfer $21,714,000 each fiscal year to the medical education and research fund.

(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
transfer under paragraph (c), the commissioner shall transfer to the medical education
research fund $23,936,000 in fiscal deleted text begin years deleted text end new text begin year new text end 2012 deleted text begin and deleted text end new text begin , $24,936,000 in fiscal year new text end 2013 new text begin , new text end
and deleted text begin $36,744,000 deleted text end new text begin $37,744,000 new text end in fiscal year 2014 and thereafter.

Sec. 11.

Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:

Subd. 9.

Reporting.

(a) Each demonstration provider shall submit information as
required by the commissioner, including data required for assessing client satisfaction,
quality of care, cost, and utilization of services for purposes of project evaluation. The
commissioner shall also develop methods of data reporting and collection in order to
provide aggregate enrollee information on encounters and outcomes to determine access
and quality assurance. Required information shall be specified before the commissioner
contracts with a demonstration provider.

(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
spending data for major categories of service as reported to the commissioners of
health and commerce under section 62D.08, subdivision 3, clause (a), and criteria for
service authorization and service use are public data that the commissioner shall make
available and use in public reports. The commissioner shall require each health plan and
county-based purchasing plan to provide:

(1) encounter data for each service provided, using standard codes and unit of
service definitions set by the commissioner, in a form that the commissioner can report by
age, eligibility groups, and health plan; and

(2) criteria, written policies, and procedures required to be disclosed under section
62M.10, subdivision 7, and Code of Federal Regulations, title 42, part 438.210(b)(1), used
for each type of service for which authorization is required.

new text begin (c) Each demonstration provider shall report to the commissioner on the extent to
which providers employed by or under contract with the demonstration provider use
patient-centered decision-making tools or procedures designed to engage patients early
in the decision-making process and the steps taken by the demonstration provider to
encourage their use.
new text end

Sec. 12.

Minnesota Statutes 2010, section 256B.69, is amended by adding a
subdivision to read:

new text begin Subd. 32. new text end

new text begin Initiatives to reduce incidence of low birth weight. new text end

new text begin The commissioner
shall require managed care and county-based purchasing plans, as a condition of contract,
to implement strategies to reduce the incidence of low birth weight in geographic areas
identified by the commissioner as having a higher than average incidence of low birth
weight. The strategies must coordinate health care with social services and the local
public health system. Each plan shall develop and report to the commissioner outcome
measures related to reducing the incidence of low birth weight. The commissioner shall
consider the outcomes reported when considering plan participation in the competitive
bidding program established under subdivision 33.
new text end

Sec. 13.

Minnesota Statutes 2010, section 256B.69, is amended by adding a
subdivision to read:

new text begin Subd. 33. new text end

new text begin Competitive bidding. new text end

new text begin (a) For managed care contracts effective on or
after January 1, 2014, the commissioner may utilize a competitive price bidding program
for nonelderly, nondisabled adults and children in medical assistance and MinnesotaCare
in the seven-county metropolitan area. The program must allow a minimum of two
managed care plans to serve the metropolitan area.
new text end

new text begin (b) In designing the competitive bid program, the commissioner shall consider, and
incorporate where appropriate, the procedures and criteria used in the competitive bidding
pilot authorized under Laws 2011, First Special Session chapter 9, article 6, section 96.
The pilot program operating in Hennepin County under the authority of section 256B.0756
shall continue to be exempt from competitive bid.
new text end

new text begin (c) The commissioner shall use past performance data as a factor in selecting vendors
and shall consider this information, along with competitive bid and other information, in
determining whether to contract with a managed care plan under this subdivision. Where
possible, the assessment of past performance in serving persons on public programs shall
be based on encounter data submitted to the commissioner. The commissioner shall
evaluate past performance based on both the health outcomes of care and success rates
in securing participation in recommended preventive and early diagnostic care. Data
provided by managed care plans must be provided in a uniform manner as specified by
the commissioner and must include only data on medical assistance and MinnesotaCare
enrollees. The data submitted must include health outcome measures on reducing the
incidence of low birth weight established by the managed care plan under subdivision 32.
new text end

Sec. 14.

Minnesota Statutes 2011 Supplement, section 256L.12, subdivision 9, is
amended to read:

Subd. 9.

Rate setting; performance withholds.

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

(b) For services rendered on or after January 1, 2004, the commissioner shall
withhold five percent of managed care plan payments and county-based purchasing
plan payments under this section pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. new text begin Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions, when available or
applicable to the populations served, and must be developed with input from external
clinical experts and stakeholders, including managed care plans and providers. new text end The
managed care plan must demonstrate, to the commissioner's satisfaction, that the data
submitted regarding attainment of the performance target is accurate. The commissioner
shall periodically change the administrative measures used as performance targets in
order to improve plan performance across a broader range of administrative services.
The performance targets must include measurement of plan efforts to contain spending
on health care services and administrative activities. The commissioner may adopt
plan-specific performance targets that take into account factors affecting only one plan,
such as characteristics of the plan's enrollee population. The withheld funds must be
returned no sooner than July 1 and no later than July 31 of the following calendar year if
performance targets in the contract are achieved.

(c) For services rendered on or after January 1, 2011, the commissioner shall
withhold an additional three percent of managed care plan or county-based purchasing
plan payments under this section. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following calendar year. The return of the withhold
under this paragraph is not subject to the requirements of paragraph (b).

(d) Effective for services rendered on or after January 1, 2011, through December
31, 2011, the commissioner shall include as part of the performance targets described in
paragraph (b) a reduction in the plan's emergency room utilization rate for state health
care program enrollees by a measurable rate of five percent from the plan's utilization
rate for the previous calendar year. Effective for services rendered on or after January
1, 2012, the commissioner shall include as part of the performance targets described in
paragraph (b) a reduction in the health plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, as determined by the commissioner. new text begin
For 2012, the reduction shall be based on the health plan's utilization in 2009. new text end To earn
the return of the withhold each new text begin subsequent new text end year, the managed care plan or county-based
purchasing plan must achieve a qualifying reduction of no less than ten percent of the
plan's utilization rate for medical assistance and MinnesotaCare enrollees, excluding
deleted text begin Medicare deleted text end enrollees new text begin in programs described in section 256B.69, subdivisions 23 and 28 new text end ,
compared to the previous deleted text begin calendar deleted text end new text begin measurement new text end year, until the final performance target is
reached. new text begin When measuring performance, the commissioner must consider the difference
in health risk in a plan's membership in the baseline year compared to the measurement
year, and work with the managed care or county-based purchasing plan to account for
differences that they agree are significant.
new text end

The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. new text begin The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
new text end

The withhold described in this paragraph shall continue for each consecutive
contract period until the plan's emergency room utilization rate for state health care
program enrollees is reduced by 25 percent of the plan's emergency room utilization
rate for medical assistance and MinnesotaCare enrollees for calendar year deleted text begin 2011 deleted text end new text begin 2009 new text end .
Hospitals shall cooperate with the health plans in meeting this performance target and
shall accept payment withholds that may be returned to the hospitals if the performance
target is achieved.

(e) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction
in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than five percent of the plan's hospital admission rate for medical
assistance and MinnesotaCare enrollees, excluding deleted text begin Medicare deleted text end enrollees new text begin in programs
described in section 256B.69, subdivisions 23 and 28 new text end , compared to the previous calendar
year, until the final performance target is reached. new text begin When measuring performance, the
commissioner must consider the difference in health risk in a plan's membership in the
baseline year compared to the measurement year, and work with the managed care or
county-based purchasing plan to account for differences that they agree are significant.
new text end

The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved. new text begin The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
new text end

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospitals admission rate compared to the hospital admission rate for
calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the
plans in meeting this performance target and shall accept payment withholds that may be
returned to the hospitals if the performance target is achieved. The hospital admissions
in this performance target do not include the admissions applicable to the subsequent
hospital admission performance target under paragraph (f).

(f) Effective for services provided on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (b) a reduction
in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a
previous hospitalization of a patient regardless of the reason, for medical assistance and
MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
withhold each year, the managed care plan or county-based purchasing plan must achieve
a qualifying reduction of the subsequent hospital admissions rate for medical assistance
and MinnesotaCare enrollees, excluding deleted text begin Medicare deleted text end enrollees new text begin in programs described in
section 256B.69, subdivisions 23 and 28 new text end , of no less than five percent compared to the
previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the subsequent
hospitalization rate was achieved. new text begin The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
new text end

The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization
rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
performance target and shall accept payment withholds that must be returned to the
hospitals if the performance target is achieved.

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

Sec. 15. new text begin DATA ON CLAIMS AND UTILIZATION.
new text end

new text begin The commissioner of human services shall develop and provide to the legislature
by December 15, 2012, a methodology and any draft legislation necessary to allow for
the release, upon request, of summary data as defined in Minnesota Statutes, section
13.02, subdivision 19, on claims and utilization for medical assistance and MinnesotaCare
enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical
School, Northwestern Health Sciences University, the Institute for Clinical Systems
Improvement, and other research institutions in Minnesota to conduct analyses of health
care outcomes and treatment effectiveness, provided:
new text end

new text begin (1) a data-sharing agreement is in place that ensures compliance with the Minnesota
Government Data Practices Act;
new text end

new text begin (2) the commissioner of human services determines that the work would produce
analyses useful in the administration of the medical assistance or MinnesotaCare
programs; and
new text end

new text begin (3) the research institutions do not release private or nonpublic data or data for
which dissemination is prohibited by law.
new text end

Sec. 16. new text begin MANAGING MEDICAL ASSISTANCE FEE-FOR-SERVICE CARE
DELIVERY.
new text end

new text begin The commissioner of human services may issue a request for proposals to develop
and administer a care delivery management system for medical assistance enrollees
served under fee-for-service. The care delivery management system must improve health
care quality and reduce unnecessary health care costs through the: (1) use of predictive
modeling tools and comprehensive patient encounter data to identify missed preventive
care and other gaps in health care delivery and to identify chronically ill and high-cost
enrollees for targeted interventions and care management; (2) use of claims data to
evaluate health care providers for overall quality and cost-effectiveness and make this
information available to enrollees; and (3) establishment of a program integrity initiative
to reduce fraudulent or improper billing. The commissioner shall award a contract
under any request for proposals to a Minnesota-based organization by October 1, 2012.
The contract must require the organization to implement the care delivery management
system by July 1, 2013.
new text end

Sec. 17. new text begin PHYSICIAN ASSISTANTS AND OUTPATIENT MENTAL HEALTH.
new text end

new text begin The commissioner of human services shall convene a group of interested
stakeholders to assist the commissioner in developing recommendations on how to
improve access to, and the quality of, outpatient mental health services for medical
assistance enrollees through the use of physician assistants. The commissioner shall report
these recommendations to the chairs and ranking minority members of the legislative
committees with jurisdiction over health care policy and financing by January 15, 2013.
new text end

ARTICLE 2

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:

Subd. 3.

Commissioner of deleted text begin health deleted text end new text begin commerce new text end or commissioner.

"Commissioner of
deleted text begin health deleted text end new text begin commerce new text end " or "commissioner" means the state commissioner of deleted text begin health deleted text end new text begin commerce new text end
or a designee.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2012.
new text end

Sec. 2.

Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:

Subd. 6.

Supplemental benefits.

(a) A health maintenance organization may, as
a supplemental benefit, provide coverage to its enrollees for health care services and
supplies received from providers who are not employed by, under contract with, or
otherwise affiliated with the health maintenance organization. Supplemental benefits may
be provided if the following conditions are met:

(1) a health maintenance organization desiring to offer supplemental benefits must at
all times comply with the requirements of sections 62D.041 and 62D.042;

(2) a health maintenance organization offering supplemental benefits must maintain
an additional surplus in the first year supplemental benefits are offered equal to the
lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of
the second year supplemental benefits are offered, the health maintenance organization
must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the
supplemental benefit expenses. At the end of the third year benefits are offered and every
year after that, the health maintenance organization must maintain an additional surplus
equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses.
When in the judgment of the commissioner the health maintenance organization's surplus
is inadequate, the commissioner may require the health maintenance organization to
maintain additional surplus;

(3) claims relating to supplemental benefits must be processed in accordance with
the requirements of section 72A.201; and

(4) in marketing supplemental benefits, the health maintenance organization shall
fully disclose and describe to enrollees and potential enrollees the nature and extent of the
supplemental coverage, and any claims filing and other administrative responsibilities in
regard to supplemental benefits.

(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer
rules relating to this subdivision, including: rules insuring that these benefits are
supplementary and not substitutes for comprehensive health maintenance services by
addressing percentage of out-of-plan coverage; rules relating to the establishment of
necessary financial reserves; rules relating to marketing practices; and other rules necessary
for the effective and efficient administration of this subdivision. deleted text begin The commissioner, in
adopting rules, shall give consideration to existing laws and rules administered and
enforced by the Department of Commerce relating to health insurance plans.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2012.
new text end

Sec. 3.

Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:

Subdivision 1.

False representations.

No health maintenance organization or
representative thereof may cause or knowingly permit the use of advertising or solicitation
which is untrue or misleading, or any form of evidence of coverage which is deceptive.
Each health maintenance organization shall be subject to sections 72A.17 to 72A.32,
relating to the regulation of trade practices, except deleted text begin (a) deleted text end to the extent that the nature of a
health maintenance organization renders such sections clearly inappropriate deleted text begin and (b) that
enforcement shall be by the commissioner of health and not by the commissioner of
commerce deleted text end . Every health maintenance organization shall be subject to sections 8.31 and
325F.69.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2012.
new text end

Sec. 4.

Minnesota Statutes 2010, section 62Q.80, is amended to read:

62Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM.

Subdivision 1.

Scope.

(a) Any community-based health care initiative may develop
and operate community-based health care coverage programs that offer to eligible
individuals and their dependents the option of purchasing through their employer health
care coverage on a fixed prepaid basis without meeting the requirements of chapter 60A,
62A, 62C, 62D, 62M, 62N, 62Q, 62T, or 62U, or any other law or rule that applies to
entities licensed under these chapters.

(b) Each initiative shall establish health outcomes to be achieved through the
programs and performance measurements in order to determine whether these outcomes
have been met. The outcomes must include, but are not limited to:

(1) a reduction in uncompensated care provided by providers participating in the
community-based health network;

(2) an increase in the delivery of preventive health care services; and

(3) health improvement for enrollees with chronic health conditions through the
management of these conditions.

In establishing performance measurements, the initiative shall use measures that are
consistent with measures published by nonprofit Minnesota or national organizations that
produce and disseminate health care quality measures.

(c) Any program established under this section shall not constitute a financial
liability for the state, in that any financial risk involved in the operation or termination
of the program shall be borne by the community-based initiative and the participating
health care providers.

deleted text begin Subd. 1a. deleted text end

deleted text begin Demonstration project. deleted text end

deleted text begin The commissioner of health and the
commissioner of human services shall award demonstration project grants to
community-based health care initiatives to develop and operate community-based health
care coverage programs in Minnesota. The demonstration projects shall extend for five
years and must comply with the requirements of this section.
deleted text end

Subd. 2.

Definitions.

For purposes of this section, the following definitions apply:

(a) "Community-based" means located in or primarily relating to the community,
as determined by the board of a community-based health initiative that is served by the
community-based health care coverage program.

(b) "Community-based health care coverage program" or "program" means a
program administered by a community-based health initiative that provides health care
services through provider members of a community-based health network or combination
of networks to eligible individuals and their dependents who are enrolled in the program.

(c) "Community-based health initiative" or "initiative" means a nonprofit corporation
that is governed by a board that has at least 80 percent of its members residing in the
community and includes representatives of the participating network providers and
employers, or a county-based purchasing organization as defined in section 256B.692.

(d) "Community-based health network" means a contract-based network of health
care providers organized by the community-based health initiative to provide or support
the delivery of health care services to enrollees of the community-based health care
coverage program on a risk-sharing or nonrisk-sharing basis.

(e) "Dependent" means an eligible employee's spouse or unmarried child who is
under the age of 19 years.

Subd. 3.

Approval.

(a) Prior to the operation of a community-based health
care coverage program, a community-based health initiative, defined in subdivision
2, paragraph (c), deleted text begin and receiving funds from the Department of Health, deleted text end shall submit to
the commissioner of health for approval the community-based health care coverage
program developed by the initiative. deleted text begin Each community-based health initiative as defined
in subdivision 2, paragraph (c), and receiving State Health Access Program (SHAP)
grant funding shall submit to the commissioner of human services for approval prior
to its operation the community-based health care coverage programs developed by the
initiatives. deleted text end The deleted text begin commissioners deleted text end new text begin commissioner new text end shall ensure that each program meets
deleted text begin the federal grant requirements and any deleted text end requirements described in this section and is
actuarially sound based on a review of appropriate records and methods utilized by the
community-based health initiative in establishing premium rates for the community-based
health care coverage programs.

(b) Prior to approval, the commissioner shall also ensure that:

(1) the benefits offered comply with subdivision 8 and that there are adequate
numbers of health care providers participating in the community-based health network to
deliver the benefits offered under the program;

(2) the activities of the program are limited to activities that are exempt under this
section or otherwise from regulation by the commissioner of commerce;

(3) the complaint resolution process meets the requirements of subdivision 10; and

(4) the data privacy policies and procedures comply with state and federal law.

Subd. 4.

Establishment.

The initiative shall establish and operate upon approval
by the deleted text begin commissioners deleted text end new text begin commissioner new text end of health deleted text begin and human services deleted text end community-based
health care coverage programs. The operational structure established by the initiative
shall include, but is not limited to:

(1) establishing a process for enrolling eligible individuals and their dependents;

(2) collecting and coordinating premiums from enrollees and employers of enrollees;

(3) providing payment to participating providers;

(4) establishing a benefit set according to subdivision 8 and establishing premium
rates and cost-sharing requirements;

(5) creating incentives to encourage primary care and wellness services; and

(6) initiating disease management services, as appropriate.

Subd. 5.

Qualifying employees.

To be eligible for the community-based health
care coverage program, an individual must:

(1) reside in or work within the designated community-based geographic area
served by the program;

(2) be employed by a qualifying employer, be an employee's dependent, or be
self-employed on a full-time basis;

(3) not be enrolled in or have currently available health coverage, except for
catastrophic health care coverage; and

(4) not be eligible for or enrolled in medical assistance or general assistance medical
care, and not be enrolled in MinnesotaCare or Medicare.

Subd. 6.

Qualifying employers.

(a) To qualify for participation in the
community-based health care coverage program, an employer must:

(1) employ at least one but no more than 50 employees at the time of initial
enrollment in the program;

(2) pay its employees a median wage that equals 350 percent of the federal poverty
guidelines or less for an individual; and

(3) not have offered employer-subsidized health coverage to its employees for
at least 12 months prior to the initial enrollment in the program. For purposes of this
section, "employer-subsidized health coverage" means health care coverage for which the
employer pays at least 50 percent of the cost of coverage for the employee.

(b) To participate in the program, a qualifying employer agrees to:

(1) offer health care coverage through the program to all eligible employees and
their dependents regardless of health status;

(2) participate in the program for an initial term of at least one year;

(3) pay a percentage of the premium established by the initiative for the employee;
and

(4) provide the initiative with any employee information deemed necessary by the
initiative to determine eligibility and premium payments.

Subd. 7.

Participating providers.

Any health care provider participating in the
community-based health network must accept as payment in full the payment rate
established by the initiatives and may not charge to or collect from an enrollee any amount
in access of this amount for any service covered under the program.

Subd. 8.

Coverage.

(a) The initiatives shall establish the health care benefits offered
through the community-based health care coverage programs. The benefits established
shall include, at a minimum:

(1) child health supervision services up to age 18, as defined under section 62A.047;
and

(2) preventive services, including:

(i) health education and wellness services;

(ii) health supervision, evaluation, and follow-up;

(iii) immunizations; and

(iv) early disease detection.

(b) Coverage of health care services offered by the program may be limited to
participating health care providers or health networks. All services covered under the
programs must be services that are offered within the scope of practice of the participating
health care providers.

(c) The initiatives may establish cost-sharing requirements. Any co-payment or
deductible provisions established may not discriminate on the basis of age, sex, race,
disability, economic status, or length of enrollment in the programs.

(d) If any of the initiatives amends or alters the benefits offered through the program
from the initial offering, that initiative must notify the deleted text begin commissioners deleted text end new text begin commissioner new text end of
health deleted text begin and human services deleted text end and all enrollees of the benefit change.

Subd. 9.

Enrollee information.

(a) The initiatives must provide an individual or
family who enrolls in the program a clear and concise written statement that includes
the following information:

(1) health care services that are covered under the program;

(2) any exclusions or limitations on the health care services covered, including any
cost-sharing arrangements or prior authorization requirements;

(3) a list of where the health care services can be obtained and that all health
care services must be provided by or through a participating health care provider or
community-based health network;

(4) a description of the program's complaint resolution process, including how to
submit a complaint; how to file a complaint with the commissioner of health; and how to
obtain an external review of any adverse decisions as provided under subdivision 10;

(5) the conditions under which the program or coverage under the program may
be canceled or terminated; and

(6) a precise statement specifying that this program is not an insurance product and,
as such, is exempt from state regulation of insurance products.

(b) The deleted text begin commissioners deleted text end new text begin commissioner new text end of health deleted text begin and human services deleted text end must approve a
copy of the written statement prior to the operation of the program.

Subd. 10.

Complaint resolution process.

(a) The initiatives must establish
a complaint resolution process. The process must make reasonable efforts to resolve
complaints and to inform complainants in writing of the initiative's decision within 60
days of receiving the complaint. Any decision that is adverse to the enrollee shall include
a description of the right to an external review as provided in paragraph (c) and how to
exercise this right.

(b) The initiatives must report any complaint that is not resolved within 60 days to
the commissioner of health.

(c) The initiatives must include in the complaint resolution process the ability of an
enrollee to pursue the external review process provided under section 62Q.73 with any
decision rendered under this external review process binding on the initiatives.

Subd. 11.

Data privacy.

The initiatives shall establish data privacy policies and
procedures for the program that comply with state and federal data privacy laws.

Subd. 12.

Limitations on enrollment.

(a) The initiatives may limit enrollment in
the program. If enrollment is limited, a waiting list must be established.

(b) The initiatives shall not restrict or deny enrollment in the program except for
nonpayment of premiums, fraud or misrepresentation, or as otherwise permitted under
this section.

(c) The initiatives may require a certain percentage of participation from eligible
employees of a qualifying employer before coverage can be offered through the program.

Subd. 13.

Report.

Each initiative shall submit deleted text begin quarterly deleted text end new text begin an annual new text end status deleted text begin reports deleted text end new text begin
report new text end to the commissioner of health on January 15, deleted text begin April 15, July 15, and October 15 deleted text end of
each year, with the first report due January 15, 2008. deleted text begin Each initiative receiving funding
from the Department of Human Services shall submit status reports to the commissioner
of human services as defined in the terms of the contract with the Department of Human
Services. deleted text end Each status report shall include:

(1) the financial status of the program, including the premium rates, cost per member
per month, claims paid out, premiums received, and administrative expenses;

(2) a description of the health care benefits offered and the services utilized;

(3) the number of employers participating, the number of employees and dependents
covered under the program, and the number of health care providers participating;

(4) a description of the health outcomes to be achieved by the program and a status
report on the performance measurements to be used and collected; and

(5) any other information requested by the deleted text begin commissioners deleted text end new text begin commissioner new text end of health deleted text begin ,
human services, deleted text end or commerce or the legislature.

deleted text begin Subd. 14. deleted text end

deleted text begin Sunset. deleted text end

deleted text begin This section expires August 31, 2014.
deleted text end

Sec. 5.

Minnesota Statutes 2010, section 62U.04, subdivision 1, is amended to read:

Subdivision 1.

Development of tools to improve costs and quality outcomes.

The commissioner of health shall develop a plan to create transparent prices, encourage
greater provider innovation and collaboration across points on the health continuum
in cost-effective, high-quality care delivery, reduce the administrative burden on
providers and health plans associated with submitting and processing claims, and provide
comparative information to consumers on variation in health care cost and quality across
providers. deleted text begin The development must be complete by January 1, 2010.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012.
new text end

Sec. 6.

Minnesota Statutes 2010, section 62U.04, subdivision 2, is amended to read:

Subd. 2.

Calculation of health care costs and quality.

The commissioner of health
shall develop a uniform method of calculating providers' relative cost of care, defined as a
measure of health care spending including resource use and unit prices, and relative quality
of care. In developing this method, the commissioner must address the following issues:

(1) provider attribution of costs and quality;

(2) appropriate adjustment for outlier or catastrophic cases;

(3) appropriate risk adjustment to reflect differences in the demographics and health
status across provider patient populations, using generally accepted and transparent risk
adjustment methodologies new text begin and case mix adjustment new text end ;

(4) specific types of providers that should be included in the calculation;

(5) specific types of services that should be included in the calculation;

(6) appropriate adjustment for variation in payment rates;

(7) the appropriate provider level for analysis;

(8) payer mix adjustments, including variation across providers in the percentage of
revenue received from government programs; and

(9) other factors that the commissioner deleted text begin determines deleted text end new text begin and the advisory committee,
established under subdivision 3, determine new text end are needed to ensure validity and comparability
of the analysis.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, and applies to all
information provided or released to the public or to health care providers, pursuant to
Minnesota Statutes, section 62U.04, on or after that date.
new text end

Sec. 7.

Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 3, is
amended to read:

Subd. 3.

Provider peer grouping new text begin ; system development; advisory committee new text end .

(a) The commissioner shall develop a peer grouping system for providers deleted text begin based on a
combined measure deleted text end that incorporates both provider risk-adjusted cost of care and quality of
care, and for specific conditions as determined by the commissioner. deleted text begin In developing this
system, the commissioner shall consult and coordinate with health care providers, health
plan companies, state agencies, and organizations that work to improve health care quality
in Minnesota. deleted text end For purposes of the final establishment of the peer grouping system, the
commissioner shall not contract with any private entity, organization, or consortium of
entities that has or will have a direct financial interest in the outcome of the system.

new text begin (b) The commissioner shall establish an advisory committee comprised of
representatives of health care providers, health plan companies, consumers, state agencies,
employers, academic researchers, and organizations that work to improve health care
quality in Minnesota. The advisory committee shall meet no fewer than three times
per year. The commissioner shall consult with the advisory committee in developing
and administering the peer grouping system, including but not limited to the following
activities:
new text end

new text begin (1) establishing peer groups;
new text end

new text begin (2) selecting quality measures;
new text end

new text begin (3) recommending thresholds for completeness of data and statistical significance
for the purposes of public release of provider peer grouping results;
new text end

new text begin (4) considering whether adjustments are necessary for facilities that provide medical
education, level 1 trauma services, neonatal intensive care, or inpatient psychiatric care;
new text end

new text begin (5) recommending inclusion or exclusion of other costs; and
new text end

new text begin (6) adopting patient attribution and quality and cost-scoring methodologies.
new text end

new text begin Subd. 3a. new text end

new text begin Provider peer grouping; dissemination of data to providers. new text end

deleted text begin (b) By
no later than October 15, 2010, deleted text end new text begin (a) new text end The commissioner shall disseminate information
to providers on their total cost of care, total resource use, total quality of care, and the
total care results of the grouping developed under deleted text begin this deleted text end subdivision new text begin 3 new text end in comparison to an
appropriate peer group. new text begin Data used for this analysis must be the most recent data available.
new text end Any analyses or reports that identify providers may only be published after the provider
has been provided the opportunity by the commissioner to review the underlying data new text begin in
order to verify, consistent with the findings specified in subdivision 3c, paragraph (d), the
accuracy and representativeness of any analyses or reports new text end and submit comments new text begin to the
commissioner or initiate an appeal under subdivision 3b new text end . deleted text begin Providers may deleted text end new text begin Upon request,
providers shall new text end be given any data for which they are the subject of the data. The provider
shall have deleted text begin 30 deleted text end new text begin 60 new text end days to review the data for accuracy and initiate an appeal as specified
in deleted text begin paragraph (d) deleted text end new text begin subdivision 3b new text end .

deleted text begin (c) By no later than January 1, 2011, deleted text end new text begin (b) new text end The commissioner shall disseminate
information to providers on their condition-specific cost of care, condition-specific
resource use, condition-specific quality of care, and the condition-specific results of the
grouping developed under deleted text begin this deleted text end subdivision new text begin 3 new text end in comparison to an appropriate peer group. new text begin
Data used for this analysis must be the most recent data available. new text end Any analyses or
reports that identify providers may only be published after the provider has been provided
the opportunity by the commissioner to review the underlying data new text begin in order to verify,
consistent with the findings specified in subdivision 3c, paragraph (d), the accuracy and
representativeness of any analyses or reports new text end and submit comments new text begin to the commissioner
or initiate an appeal under subdivision 3b new text end . deleted text begin Providers may deleted text end new text begin Upon request, providers shall new text end
be given any data for which they are the subject of the data. The provider shall have deleted text begin 30 deleted text end new text begin
60 new text end days to review the data for accuracy and initiate an appeal as specified in deleted text begin paragraph
(d) deleted text end new text begin subdivision 3b new text end .

new text begin Subd. 3b. new text end

new text begin Provider peer grouping; appeals process. new text end

deleted text begin (d) deleted text end The commissioner shall
establish deleted text begin an appeals deleted text end new text begin a new text end process to resolve disputes from providers regarding the accuracy
of the data used to develop analyses or reports new text begin or errors in the application of standards
or methodology established by the commissioner in consultation with the advisory
committee new text end . When a provider deleted text begin appeals the accuracy of the data used to calculate the peer
grouping system results deleted text end new text begin submits an appeal new text end , the provider shall:

(1) clearly indicate the reason deleted text begin they believe the data used to calculate the peer group
system results are not accurate deleted text end new text begin or reasons for the appeal new text end ;

(2) provide new text begin any new text end evidence deleted text begin and deleted text end new text begin , calculations, or new text end documentation to support the reason
deleted text begin that data was not accurate deleted text end new text begin for the appeal new text end ; and

(3) cooperate with the commissioner, including allowing the commissioner access to
data necessary and relevant to resolving the dispute.

new text begin The commissioner shall cooperate with the provider during the data review period
specified in subdivisions 3a and 3c by giving the provider information necessary for the
preparation of an appeal.
new text end

If a provider does not meet the requirements of this deleted text begin paragraph deleted text end new text begin subdivision new text end , a provider's
appeal shall be considered withdrawn. The commissioner shall not publish new text begin peer grouping new text end
results for a deleted text begin specific deleted text end provider deleted text begin under paragraph (e) or (f) while that provider has an
unresolved appeal deleted text end new text begin until the appeal has been resolved new text end .

new text begin Subd. 3c. new text end

new text begin Provider peer grouping; publication of information for the public.
new text end

deleted text begin (e) Beginning January 1, 2011, the commissioner shall, no less than annually, publish
information on providers' total cost, total resource use, total quality, and the results of
the total care portion of the peer grouping process. The results that are published must
be on a risk-adjusted basis. deleted text end new text begin (a) The commissioner may publicly release summary data
related to the peer grouping system as long as the data do not contain information or
descriptions from which the identity of individual hospitals, clinics, or other providers
may be discerned.
new text end

deleted text begin (f) Beginning March 30, 2011, the commissioner shall no less than annually publish
information on providers' condition-specific cost, condition-specific resource use, and
condition-specific quality, and the results of the condition-specific portion of the peer
grouping process. The results that are published must be on a risk-adjusted basis. deleted text end new text begin (b) The
commissioner may publicly release analyses or results related to the peer grouping system
that identify hospitals, clinics, or other providers only if the following criteria are met:
new text end

new text begin (1) the results, data, and summaries, including any graphical depictions of provider
performance, have been distributed to providers at least 120 days prior to publication;
new text end

new text begin (2) the commissioner has provided an opportunity for providers to verify and
review data for which the provider is the subject consistent with the findings specified
in subdivision 3c, paragraph (d);
new text end

new text begin (3) the results meet thresholds of validity, reliability, statistical significance,
representativeness, and other standards that reflect the recommendations of the advisory
committee, established under subdivision 3; and
new text end

new text begin (4) any public report or other usage of the analyses, report, or data used by the
state clearly notifies consumers about how to use and interpret the results, including
any limitations of the data and analysis.
new text end

deleted text begin (g) deleted text end new text begin (c) After publishing the first public report, the commissioner shall, no less
frequently than annually, publish information on providers' total cost, total resource use,
total quality, and the results of the total care portion of the peer grouping process, as well
as information on providers' condition-specific cost, condition-specific resource use,
and condition-specific quality, and the results of the condition-specific portion of the
peer grouping process. The results that are published must be on a risk-adjusted basis,
including case mix adjustments. new text end

new text begin (d) The commissioner shall convene a work group comprised of representatives
of physician clinics, hospitals, their respective statewide associations, and other
relevant stakeholder organizations to make recommendations on data to be made
available to hospitals and physician clinics to allow for verification of the accuracy and
representativeness of the provider peer grouping results.
new text end

new text begin Subd. 3d. new text end

new text begin Provider peer grouping; standards for dissemination and publication.
new text end

new text begin (a) new text end Prior to disseminating data to providers under deleted text begin paragraph (b) or (c) deleted text end new text begin subdivision 3a new text end or
publishing information under deleted text begin paragraph (e) or (f) deleted text end new text begin subdivision 3c new text end , the commissioner new text begin , in
consultation with the advisory committee, new text end shall ensure the scientific new text begin and statistical new text end validity
and reliability of the results according to the standards described in paragraph deleted text begin (h) deleted text end new text begin (b) new text end .
If additional time is needed to establish the scientific validity new text begin , statistical significance, new text end
and reliability of the results, the commissioner may delay the dissemination of data to
providers under deleted text begin paragraph (b) or (c) deleted text end new text begin subdivision 3a new text end , or the publication of information under
deleted text begin paragraph (e) or (f) deleted text end new text begin subdivision 3c new text end . deleted text begin If the delay is more than 60 days, the commissioner
shall report in writing to the chairs and ranking minority members of the legislative
committees with jurisdiction over health care policy and finance the following information:
deleted text end

deleted text begin (1) the reason for the delay;
deleted text end

deleted text begin (2) the actions being taken to resolve the delay and establish the scientific validity
and reliability of the results; and
deleted text end

deleted text begin (3) the new dates by which the results shall be disseminated.
deleted text end

deleted text begin If there is a delay under this paragraph, deleted text end The commissioner must disseminate the
information to providers under deleted text begin paragraph (b) or (c) deleted text end new text begin subdivision 3a new text end at least deleted text begin 90 deleted text end new text begin 120 new text end days
before publishing results under deleted text begin paragraph (e) or (f) deleted text end new text begin subdivision 3c new text end .

deleted text begin (h) deleted text end new text begin (b) new text end The commissioner's assurance of valid new text begin , timely, new text end and reliable clinic and hospital
peer grouping performance results shall include, at a minimum, the following:

(1) use of the best available evidence, research, and methodologies; and

(2) establishment of deleted text begin an deleted text end explicit minimum reliability deleted text begin threshold deleted text end new text begin thresholds for both
quality and costs new text end developed in collaboration with the subjects of the data and the users of
the data, at a level not below nationally accepted standards where such standards exist.

In achieving these thresholds, the commissioner shall not aggregate clinics that are not
part of the same system or practice group. The commissioner shall consult with and
solicit feedback from new text begin the advisory committee and new text end representatives of physician clinics
and hospitals during the peer grouping data analysis process to obtain input on the
methodological options prior to final analysis and on the design, development, and testing
of provider reports.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, shall be implemented
within available resources, and applies to all information provided or released to the
public or to health care providers, pursuant to Minnesota Statutes, section 64U.04, on or
after that date.
new text end

Sec. 8.

Minnesota Statutes 2010, section 62U.04, subdivision 4, is amended to read:

Subd. 4.

Encounter data.

(a) Beginning July 1, 2009, and every six months
thereafter, all health plan companies and third-party administrators shall submit encounter
data to a private entity designated by the commissioner of health. The data shall be
submitted in a form and manner specified by the commissioner subject to the following
requirements:

(1) the data must be de-identified data as described under the Code of Federal
Regulations, title 45, section 164.514;

(2) the data for each encounter must include an identifier for the patient's health care
home if the patient has selected a health care home; and

(3) except for the identifier described in clause (2), the data must not include
information that is not included in a health care claim or equivalent encounter information
transaction that is required under section 62J.536.

(b) The commissioner or the commissioner's designee shall only use the data
submitted under paragraph (a) deleted text begin for the purpose of carrying out its responsibilities in this
section, and must maintain the data that it receives according to the provisions of this
section deleted text end new text begin to carry out its responsibilities in this section, including supplying the data to
providers so they can verify their results of the peer grouping process consistent with the
findings specified under subdivision 3c, paragraph (d), and, if necessary, submit comments
to the commissioner or initiate an appeal new text end .

(c) Data on providers collected under this subdivision are private data on individuals
or nonpublic data, as defined in section 13.02. Notwithstanding the definition of summary
data in section 13.02, subdivision 19, summary data prepared under this subdivision
may be derived from nonpublic data. The commissioner or the commissioner's designee
shall establish procedures and safeguards to protect the integrity and confidentiality of
any data that it maintains.

(d) The commissioner or the commissioner's designee shall not publish analyses or
reports that identify, or could potentially identify, individual patients.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, and applies to all
information provided or released to the public or to health care providers pursuant to
Minnesota Statutes, section 62U.04, on or after that date.
new text end

Sec. 9.

Minnesota Statutes 2010, section 62U.04, subdivision 5, is amended to read:

Subd. 5.

Pricing data.

(a) Beginning July 1, 2009, and annually on January 1
thereafter, all health plan companies and third-party administrators shall submit data
on their contracted prices with health care providers to a private entity designated by
the commissioner of health for the purposes of performing the analyses required under
this subdivision. The data shall be submitted in the form and manner specified by the
commissioner of health.

(b) The commissioner or the commissioner's designee shall only use the data
submitted under this subdivision deleted text begin for the purpose of carrying out its responsibilities under
this section deleted text end new text begin to carry out its responsibilities under this section, including supplying the
data to providers so they can verify their results of the peer grouping process consistent
with the findings specified under subdivision 3c, paragraph (d), and, if necessary, submit
comments to the commissioner or initiate an appeal new text end .

(c) Data collected under this subdivision are nonpublic data as defined in section
13.02. Notwithstanding the definition of summary data in section 13.02, subdivision 19,
summary data prepared under this section may be derived from nonpublic data. The
commissioner shall establish procedures and safeguards to protect the integrity and
confidentiality of any data that it maintains.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012, and applies to all
information provided or released to the public or to health care providers pursuant to
Minnesota Statutes, section 62U.04, on or after that date.
new text end

Sec. 10.

Minnesota Statutes 2011 Supplement, section 62U.04, subdivision 9, is
amended to read:

Subd. 9.

Uses of information.

deleted text begin (a) deleted text end For product renewals or for new products that
are offered deleted text begin , after 12 months have elapsed from publication by the commissioner of the
information in subdivision 3, paragraph (e) deleted text end :

(1) the commissioner of management and budget deleted text begin shall deleted text end new text begin may new text end use the information and
methods developed under deleted text begin subdivision 3 deleted text end new text begin subdivisions 3 to 3d new text end to strengthen incentives for
members of the state employee group insurance program to use high-quality, low-cost
providers;

(2) deleted text begin all deleted text end political subdivisions, as defined in section 13.02, subdivision 11, that offer
health benefits to their employees deleted text begin must deleted text end new text begin may new text end offer plans that differentiate providers on their
cost and quality performance and create incentives for members to use better-performing
providers;

(3) deleted text begin all deleted text end health plan companies deleted text begin shall deleted text end new text begin may new text end use the information and methods developed
under deleted text begin subdivision 3 deleted text end new text begin subdivisions 3 to 3d new text end to develop products that encourage consumers to
use high-quality, low-cost providers; and

(4) health plan companies that issue health plans in the individual market or the
small employer market deleted text begin must deleted text end new text begin may new text end offer at least one health plan that uses the information
developed under deleted text begin subdivision 3 deleted text end new text begin subdivisions 3 to 3d new text end to establish financial incentives for
consumers to choose higher-quality, lower-cost providers through enrollee cost-sharing
or selective provider networks.

deleted text begin (b) By January 1, 2011, the commissioner of health shall report to the governor
and the legislature on recommendations to encourage health plan companies to promote
widespread adoption of products that encourage the use of high-quality, low-cost providers.
The commissioner's recommendations may include tax incentives, public reporting of
health plan performance, regulatory incentives or changes, and other strategies.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012.
new text end

Sec. 11.

Minnesota Statutes 2010, section 144.1222, is amended by adding a
subdivision to read:

new text begin Subd. 6. new text end

new text begin Exemption. new text end

new text begin The natural swimming pond project known as Webber Lake
in the city of Minneapolis is exempt from this chapter and Minnesota Rules, chapter
4717, for the purpose of allowing a swimming pool that uses an alternative, nonchemical
filtration system to eliminate pathogens through natural processes. If the commissioner
determines that this project is unable to provide a safe swimming environment, the
commissioner shall rescind this exemption.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day the governing body of the
city of Minneapolis and its chief clerical officer timely complete their compliance with
Minnesota Statutes, section 645.021, subdivisions 2 and 3.
new text end

Sec. 12.

new text begin [144.1225] ADVANCED DIAGNOSTIC IMAGING SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "advanced diagnostic
imaging services" means services entailing the use of diagnostic magnetic resonance
imaging (MRI) equipment, except that it does not include MRI equipment owned or
operated by a hospital licensed under sections 144.50 to 144.56 or any facility affiliated
with or owned by such hospital.
new text end

new text begin Subd. 2. new text end

new text begin Accreditation required. new text end

new text begin (a) Except as otherwise provided in paragraph
(b), advanced diagnostic imaging services eligible for reimbursement from any source
including, but not limited to, the individual receiving such services and any individual
or group insurance contract, plan, or policy delivered in this state including, but not
limited to, private health insurance plans, workers' compensation insurance, motor vehicle
insurance, the State Employee Group Insurance Program (SEGIP), and other state health
care programs shall be reimbursed only if the facility at which the service has been
conducted and processed is accredited by one of the following entities:
new text end

new text begin (1) American College of Radiology (ACR);
new text end

new text begin (2) Intersocietal Accreditation Commission (IAC); or
new text end

new text begin (3) the joint commission.
new text end

new text begin (b) Any facility that performs advanced diagnostic imaging services and is eligible
to receive reimbursement for such services from any source in paragraph (a) must obtain
accreditation by August 1, 2013. Thereafter, all facilities that provide advanced diagnostic
imaging services in the state must obtain accreditation prior to commencing operations
and must, at all times, maintain accreditation with an accrediting organization as provided
in paragraph (a).
new text end

new text begin Subd. 3. new text end

new text begin Reporting. new text end

new text begin (a) Advanced diagnostic imaging facilities and providers
of advanced diagnostic imaging services must annually report to the commissioner
demonstration of accreditation as required under this section.
new text end

new text begin (b) The commissioner may promulgate any rules necessary to administer the
reporting required under paragraph (a).
new text end

Sec. 13.

Minnesota Statutes 2010, section 144.292, subdivision 6, is amended to read:

Subd. 6.

Cost.

(a) When a patient requests a copy of the patient's record for
purposes of reviewing current medical care, the provider must not charge a fee.

(b) When a provider or its representative makes copies of patient records upon a
patient's request under this section, the provider or its representative may charge the
patient or the patient's representative no more than 75 cents per page, plus $10 for time
spent retrieving and copying the records, unless other law or a rule or contract provide for
a lower maximum charge. This limitation does not apply to x-rays. The provider may
charge a patient no more than the actual cost of reproducing x-rays, plus no more than
$10 for the time spent retrieving and copying the x-rays.

(c) The respective maximum charges of 75 cents per page and $10 for time provided
in this subdivision are in effect for calendar year 1992 and may be adjusted annually each
calendar year as provided in this subdivision. The permissible maximum charges shall
change each year by an amount that reflects the change, as compared to the previous year,
in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
published by the Department of Labor.

(d) A provider or its representative new text begin may charge the $10 retrieval fee, but new text end must not
charge a new text begin per page new text end fee to provide copies of records requested by a patient or the patient's
authorized representative if the request for copies of records is for purposes of appealing
a denial of Social Security disability income or Social Security disability benefits under
title II or title XVI of the Social Security Act new text begin ; except that no fee shall be charged to a
person who is receiving public assistance, who is represented by an attorney on behalf of
a civil legal services program or a volunteer attorney program based on indigency new text end . For
the purpose of further appeals, a patient may receive no more than two medical record
updates without charge, but only for medical record information previously not provided.
For purposes of this paragraph, a patient's authorized representative does not include units
of state government engaged in the adjudication of Social Security disability claims.

Sec. 14.

Minnesota Statutes 2010, section 144.293, subdivision 2, is amended to read:

Subd. 2.

Patient consent to release of records.

A provider, or a person who
receives health records from a provider, may not release a patient's health records to a
person without:

(1) a signed and dated consent from the patient or the patient's legally authorized
representative authorizing the release;

(2) specific authorization in law; or

(3) new text begin in the case of a medical emergency, new text end a representation from a provider that holds a
signed and dated consent from the patient authorizing the release.

Sec. 15.

Minnesota Statutes 2010, section 145.906, is amended to read:

145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.

(a) The commissioner of health shall work with health care facilities, licensed health
and mental health care professionals, new text begin the women, infants, and children (WIC) program,
new text end mental health advocates, consumers, and families in the state to develop materials and
information about postpartum depression, including treatment resources, and develop
policies and procedures to comply with this section.

(b) Physicians, traditional midwives, and other licensed health care professionals
providing prenatal care to women must have available to women and their families
information about postpartum depression.

(c) Hospitals and other health care facilities in the state must provide departing new
mothers and fathers and other family members, as appropriate, with written information
about postpartum depression, including its symptoms, methods of coping with the illness,
and treatment resources.

new text begin (d) Information about postpartum depression, including its symptoms, potential
impact on families, and treatment resources, must be available at WIC sites.
new text end

Sec. 16.

Minnesota Statutes 2010, section 256B.0754, subdivision 2, is amended to
read:

Subd. 2.

Payment reform.

By no later than 12 months after the commissioner of
health publishes the information in section deleted text begin 62U.04, subdivision 3, paragraph (e) deleted text end new text begin 62U.04,
subdivision 3c, paragraph (b) new text end , the commissioner of human services deleted text begin shall deleted text end new text begin may new text end use the
information and methods developed under section 62U.04 to establish a payment system
that:

(1) rewards high-quality, low-cost providers;

(2) creates enrollee incentives to receive care from high-quality, low-cost providers;
and

(3) fosters collaboration among providers to reduce cost shifting from one part of
the health continuum to another.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012.
new text end

Sec. 17. new text begin EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
RESPONSIBILITIES.
new text end

new text begin Relating to the evaluations and legislative report completed pursuant to Laws
2011, First Special Session chapter 9, article 2, section 26, the following activities must
be completed:
new text end

new text begin (1) the commissioners of health and human services must update, revise, and
link the contents of their Web sites related to supervised living facilities, intermediate
care facilities for the developmentally disabled, nursing facilities, board and lodging
establishments, and human services licensed programs so that consumers and providers
can access consistent clear information about the regulations affecting these facilities; and
new text end

new text begin (2) the commissioner of management and budget, in consultation with the
commissioners of health and human services, must evaluate and recommend options
for administering health and human services regulations. The evaluation and
recommendations must be submitted in a report to the legislative committees with
jurisdiction over health and human services no later than August 1, 2013, and shall at a
minimum: (i) identify and evaluate the regulatory responsibilities of the Departments
of Health and Human Services to determine whether to reorganize these regulatory
responsibilities to improve how the state administers health and human services
regulatory functions, or whether there are ways to improve these regulatory activities
without reorganizing; (ii) describe and evaluate the multiple roles of the Department of
Human Services as a direct provider of care services, a regulator, and a payor for state
program services; and (iii) for long-term care regulated in both departments, evaluate and
make recommendations for reasonable client risk assessments, planning for client risk
reductions, and determining reasonable assumptions of client risks in relation to directing
health care, client health care rights, provider liabilities, and provider responsibilities to
provide minimum standards of care.
new text end

Sec. 18. new text begin STUDY OF FOR-PROFIT HEALTH MAINTENANCE
ORGANIZATIONS.
new text end

new text begin The commissioner of health shall contract with an entity with expertise in health
economics and health care delivery and quality to study the efficiency, costs, service
quality, and enrollee satisfaction of for-profit health maintenance organizations, relative to
not-for-profit health maintenance organizations operating in Minnesota and other states.
The study findings must address whether the state could: (1) reduce medical assistance
and MinnesotaCare costs and costs of providing coverage to state employees; and (2)
maintain or improve the quality of care provided to state health care program enrollees and
state employees if for-profit health maintenance organizations were allowed to operate in
the state. The commissioner shall require the entity under contract to report study findings
to the commissioner and the legislature by January 15, 2013.
new text end

Sec. 19. new text begin REPORTING PREVALENCE OF SEXUAL VIOLENCE.
new text end

new text begin The commissioner of health must routinely report to the public and to the legislature
data on the prevalence and incidence of sexual violence in Minnesota. The commissioner
must use existing data provided by the Centers for Disease Control and Prevention, or
other source as identified by commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 20. new text begin LICENSED HOME CARE PROVIDERS.
new text end

new text begin By February 1, 2013, the commissioner of health must report recommendations to
the legislature as to development of a comprehensive home care plan to increase inspection
and oversight of licensed home care providers under Minnesota Statutes, chapter 144A.
new text end

ARTICLE 3

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2010, section 119B.13, subdivision 3a, is amended to
read:

Subd. 3a.

Provider rate differential for accreditation.

A family child care
provider or child care center shall be paid a deleted text begin 15 deleted text end new text begin 16 new text end percent differential above the maximum
rate established in subdivision 1, up to the actual provider rate, if the provider or center
holds a current early childhood development credential or is accredited. For a family
child care provider, early childhood development credential and accreditation includes
an individual who has earned a child development associate degree, a child development
associate credential, a diploma in child development from a Minnesota state technical
college, or a bachelor's or post baccalaureate degree in early childhood education from
an accredited college or university, or who is accredited by the National Association
for Family Child Care or the Competency Based Training and Assessment Program.
For a child care center, accreditation includes accreditation deleted text begin by deleted text end new text begin that meets the following
criteria: the accrediting organization must demonstrate the use of standards that promote
the physical, social, emotional, and cognitive development of children. The accreditation
standards shall include, but are not limited to, positive interactions between adults and
children, age-appropriate learning activities, a system of tracking children's learning,
use of assessment to meet children's needs, specific qualifications for staff, a learning
environment that supports developmentally appropriate experiences for children, health
and safety requirements, and family engagement strategies. The commissioner of human
services, in conjunction with the commissioners of education and health, will develop an
application and approval process based on the criteria in this section and any additional
criteria. The process developed by the commissioner of human services must address
periodic reassessment of approved accreditations. The commissioner of human services
must report the criteria developed, the application, approval, and reassessment processes,
and any additional recommendations by February 15, 2013, to the chairs and ranking
minority members of the legislative committees having jurisdiction over early childhood
issues. The following accreditations shall be recognized for the provider rate differential
until an approval process is implemented: new text end the National Association for the Education of
Young Children, the Council on Accreditation, the National Early Childhood Program
Accreditation, the National School-Age Care Association, or the National Head Start
Association Program of Excellence. For Montessori programs, accreditation includes
the American Montessori Society, Association of Montessori International-USA, or the
National Center for Montessori Education.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 3, 2012.
new text end

Sec. 2.

Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is
amended to read:

Subd. 7.

Absent days.

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

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

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

(d) The provider and family shall receive notification of the number of absent days
used upon initial provider authorization for a family and ongoing notification of the
number of absent days used as of the date of the notification.

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:

new text begin Subd. 18c. new text end

new text begin Drug convictions. new text end

new text begin (a) The state court administrator shall report every
six months by electronic means to the commissioner of human services the name, address,
date of birth, and, if available, driver's license or state identification card number, date
of sentence, effective date of the sentence, and county in which the conviction occurred
of each individual who has been convicted of a felony under chapter 152 during the
previous six months.
new text end

new text begin (b) The commissioner shall determine whether the individuals who are the subject of
the data reported under paragraph (a) are receiving public assistance under chapter 256D
or 256J, and if any individual is receiving assistance under chapter 256D or 256J, the
commissioner shall instruct the county to proceed under section 256D.024 or 256J.26,
whichever is applicable, for this individual.
new text end

new text begin (c) The commissioner shall not retain any data received under paragraph (a) that
does not relate to an individual receiving publicly funded assistance under chapter 256D
or 256J.
new text end

new text begin (d) In addition to the routine data transfer under paragraph (a), the state court
administrator shall provide a onetime report of the data fields under paragraph (a) for
individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until
the date of the data transfer. The commissioner shall perform the tasks identified under
paragraph (b) related to this data and shall retain the data according to paragraph (c).
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:

new text begin Subd. 18d. new text end

new text begin Data sharing with Department of Human Services; multiple
identification cards. new text end

new text begin (a) The commissioner of public safety shall, on a monthly basis,
provide the commissioner of human services with the first, middle, and last name,
the address, date of birth, and driver's license or state identification card number of all
applicants and holders whose drivers' licenses and state identification cards have been
canceled under section 171.14, paragraph (a), clause (2) or (3), by the commissioner of
public safety. After the initial data report has been provided by the commissioner of
public safety to the commissioner of human services under this paragraph, subsequent
reports shall only include cancellations that occurred after the end date of the cancellations
represented in the previous data report.
new text end

new text begin (b) The commissioner of human services shall compare the information provided
under paragraph (a) with the commissioner's data regarding recipients of all public
assistance programs managed by the Department of Human Services to determine whether
any individual with multiple identification cards issued by the Department of Public
Safety has illegally or improperly enrolled in any public assistance program managed by
the Department of Human Services.
new text end

new text begin (c) If the commissioner of human services determines that an applicant or recipient
has illegally or improperly enrolled in any public assistance program, the commissioner
shall provide all due process protections to the individual before terminating the individual
from the program according to applicable statute and notifying the county attorney.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 5.

Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
to read:

new text begin Subd. 18e. new text end

new text begin Data sharing with Department of Human Services; legal presence
status. new text end

new text begin (a) The commissioner of public safety shall, on a monthly basis, provide the
commissioner of human services with the first, middle, and last name, address, date of
birth, and driver's license or state identification number of all applicants and holders of
drivers' licenses and state identification cards whose temporary legal presence status has
expired and whose driver's license or identification card has been canceled under section
171.14 by the commissioner of public safety.
new text end

new text begin (b) The commissioner of human services shall use the information provided under
paragraph (a) to determine whether the eligibility of any recipients of public assistance
programs managed by the Department of Human Services has changed as a result of the
status change in the Department of Public Safety data.
new text end

new text begin (c) If the commissioner of human services determines that a recipient has illegally or
improperly received benefits from any public assistance program, the commissioner shall
provide all due process protections to the individual before terminating the individual from
the program according to applicable statute and notifying the county attorney.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is
amended to read:

Subdivision 1.

Electronic benefit transfer (EBT) card.

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

Sec. 7.

Minnesota Statutes 2011 Supplement, section 256.987, subdivision 2, is
amended to read:

Subd. 2.

Prohibited purchases.

new text begin An individual with an new text end EBT deleted text begin debit cardholders in deleted text end new text begin
card issued for one of the new text end programs listed under subdivision 1 deleted text begin are deleted text end new text begin is new text end prohibited from using
the EBT debit card to purchase tobacco products and alcoholic beverages, as defined in
section 340A.101, subdivision 2. deleted text begin It is unlawful for an EBT cardholder to purchase or
attempt to purchase tobacco products or alcoholic beverages with the cardholder's EBT
card. deleted text end Any deleted text begin unlawful use deleted text end new text begin prohibited purchases made new text end under this subdivision shall constitute
deleted text begin fraud deleted text end new text begin unlawful use new text end and result in disqualification new text begin of the cardholder new text end from the program deleted text begin under
section 256.98, subdivision 8 deleted text end new text begin as provided in subdivision 4 new text end .

Sec. 8.

Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a
subdivision to read:

new text begin Subd. 3. new text end

new text begin EBT use restricted to certain states. new text end

new text begin EBT debit cardholders in programs
listed under subdivision 1 are prohibited from using the cash portion of the EBT card at
vendors and automatic teller machines located outside of Minnesota, Iowa, North Dakota,
South Dakota, or Wisconsin. This subdivision does not apply to the food portion.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a
subdivision to read:

new text begin Subd. 4. new text end

new text begin Disqualification. new text end

new text begin (a) Any person found to be guilty of purchasing tobacco
products or alcoholic beverages with their EBT debit card by a federal or state court or
by an administrative hearing determination, or waiver thereof, through a disqualification
consent agreement, or as part of any approved diversion plan under section 401.065, or
any court-ordered stay which carries with it any probationary or other conditions, in
the: (1) Minnesota family investment program and any affiliated program to include the
diversionary work program and the work participation cash benefit program under chapter
256J; (2) general assistance program under chapter 256D; or (3) Minnesota supplemental
aid program under chapter 256D, shall be disqualified from all of the listed programs.
new text end

new text begin (b) The needs of the disqualified individual shall not be taken into consideration
in determining the grant level for that assistance unit: (1) for one year after the first
offense; (2) for two years after the second offense; and (3) permanently after the third or
subsequent offense.
new text end

new text begin (c) The period of program disqualification shall begin on the date stipulated on the
advance notice of disqualification without possibility for postponement for administrative
stay or administrative hearing and shall continue through completion unless and until the
findings upon which the sanctions were imposed are reversed by a court of competent
jurisdiction. The period for which sanctions are imposed is not subject to review.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2012.
new text end

Sec. 10.

Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:

Subd. 1b.

Earned income savings account.

In addition to the $50 disregard
required under subdivision 1, the county agency shall disregard an additional earned
income up to a maximum of deleted text begin $150 deleted text end new text begin $500 new text end per month for: (1) persons residing in facilities
licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to
9530.4000, and for whom discharge and work are part of a treatment plan; (2) persons
living in supervised apartments with services funded under Minnesota Rules, parts
9535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan;
and (3) persons residing in group residential housing, as that term is defined in section
256I.03, subdivision 3, for whom the county agency has approved a discharge plan
which includes work. The additional amount disregarded must be placed in a separate
savings account by the eligible individual, to be used upon discharge from the residential
facility into the community. For individuals residing in a chemical dependency program
licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from
the savings account require the signature of the individual and for those individuals with
an authorized representative payee, the signature of the payee. A maximum of deleted text begin $1,000 deleted text end new text begin
$2,000 new text end , including interest, of the money in the savings account must be excluded from
the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in
that account in excess of deleted text begin $1,000 deleted text end new text begin $2,000 new text end must be applied to the resident's cost of care. If
excluded money is removed from the savings account by the eligible individual at any
time before the individual is discharged from the facility into the community, the money is
income to the individual in the month of receipt and a resource in subsequent months. If
an eligible individual moves from a community facility to an inpatient hospital setting,
the separate savings account is an excluded asset for up to 18 months. During that time,
amounts that accumulate in excess of the deleted text begin $1,000 deleted text end new text begin $2,000 new text end savings limit must be applied to
the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the
18-month period, the entire account must be applied to the patient's cost of care.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2012.
new text end

Sec. 11.

Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 5, is
amended to read:

Subd. 5.

Household eligibility; participation.

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

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

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

Sec. 12.

Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 6, is
amended to read:

Subd. 6.

Withdrawal; matching; permissible uses.

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

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

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

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

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

Sec. 13.

Minnesota Statutes 2010, section 256E.37, subdivision 1, is amended to read:

Subdivision 1.

Grant authority.

The commissioner may make grants to state
agencies and political subdivisions to construct or rehabilitate facilities for early childhood
programs, crisis nurseries, or parenting time centers. The following requirements apply:

(1) The facilities must be owned by the state or a political subdivision, but may
be leased under section 16A.695 to organizations that operate the programs. The
commissioner must prescribe the terms and conditions of the leases.

(2) A grant for an individual facility must not exceed $500,000 for each program
that is housed in the facility, up to a maximum of $2,000,000 for a facility that houses
three programs or more. Programs include Head Start, School Readiness, Early Childhood
Family Education, licensed child care, and other early childhood intervention programs.

(3) State appropriations must be matched on a 50 percent basis with nonstate funds.
The matching requirement must apply program wide and not to individual grants.

new text begin (4) At least 80 percent of grant funds must be distributed to facilities located in
counties not included in the definition under section 473.121, subdivision 4.
new text end

Sec. 14.

Minnesota Statutes 2011 Supplement, section 256I.05, subdivision 1a, is
amended to read:

Subd. 1a.

Supplementary service rates.

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

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

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

(d) Counties must not negotiate supplementary service rates with providers of group
residential housing that are licensed as board and lodging with special services and that
do not encourage a policy of sobriety on their premises new text begin and make referrals to available
community services for volunteer and employment opportunities for residents new text end .

Sec. 15.

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

Subd. 1e.

Supplementary rate for certain facilities.

new text begin (a) new text end Notwithstanding the
provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
exceed $700 per month, including any legislatively authorized inflationary adjustments,
for a group residential housing provider that:

(1) is located in Hennepin County and has had a group residential housing contract
with the county since June 1996;

(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
26-bed facility; and

(3) serves a chemically dependent clientele, providing 24 hours per day supervision
and limiting a resident's maximum length of stay to 13 months out of a consecutive
24-month period.

new text begin (b) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county
agency shall negotiate a supplementary rate in addition to the rate specified in subdivision
1, not to exceed $700 per month, including any legislatively authorized inflationary
adjustments, for the group residential provider described under paragraph (a), not to
exceed an additional 175 beds.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2010, section 256J.26, subdivision 1, is amended to read:

Subdivision 1.

Person convicted of drug offenses.

(a) deleted text begin Applicants or participants deleted text end new text begin
An individual new text end who deleted text begin have deleted text end new text begin has new text end been convicted of a new text begin felony level new text end drug offense committed deleted text begin after
July 1, 1997, may, if otherwise eligible, receive MFIP benefits subject to the following
conditions: deleted text end new text begin during the previous ten years from the date of application or recertification is
subject to the following:
new text end

(1) Benefits for the entire assistance unit must be paid in vendor form for shelter and
utilities during any time the applicant is part of the assistance unit.

(2) The convicted applicant or participant shall be subject to random drug testing as
a condition of continued eligibility and following any positive test for an illegal controlled
substance is subject to the following sanctions:

(i) for failing a drug test the first time, the residual amount of the participant's grant
after making vendor payments for shelter and utility costs, if any, must be reduced by an
amount equal to 30 percent of the MFIP standard of need for an assistance unit of the same
size. When a sanction under this subdivision is in effect, the job counselor must attempt
to meet with the person face-to-face. During the face-to-face meeting, the job counselor
must explain the consequences of a subsequent drug test failure and inform the participant
of the right to appeal the sanction under section 256J.40. If a face-to-face meeting is
not possible, the county agency must send the participant a notice of adverse action as
provided in section 256J.31, subdivisions 4 and 5, and must include the information
required in the face-to-face meeting; or

(ii) for failing a drug test two times, the participant is permanently disqualified from
receiving MFIP assistance, both the cash and food portions. The assistance unit's MFIP
grant must be reduced by the amount which would have otherwise been made available to
the disqualified participant. Disqualification under this item does not make a participant
ineligible for food stamps or food support. Before a disqualification under this provision is
imposed, the job counselor must attempt to meet with the participant face-to-face. During
the face-to-face meeting, the job counselor must identify other resources that may be
available to the participant to meet the needs of the family and inform the participant of
the right to appeal the disqualification under section 256J.40. If a face-to-face meeting is
not possible, the county agency must send the participant a notice of adverse action as
provided in section 256J.31, subdivisions 4 and 5, and must include the information
required in the face-to-face meeting.

(3) A participant who fails a drug test the first time and is under a sanction due to
other MFIP program requirements is considered to have more than one occurrence of
noncompliance and is subject to the applicable level of sanction as specified under section
256J.46, subdivision 1, paragraph (d).

(b) Applicants requesting only food stamps or food support or participants receiving
only food stamps or food support, who have been convicted of a drug offense that
occurred after July 1, 1997, may, if otherwise eligible, receive food stamps or food support
if the convicted applicant or participant is subject to random drug testing as a condition
of continued eligibility. Following a positive test for an illegal controlled substance, the
applicant is subject to the following sanctions:

(1) for failing a drug test the first time, food stamps or food support shall be reduced
by an amount equal to 30 percent of the applicable food stamp or food support allotment.
When a sanction under this clause is in effect, a job counselor must attempt to meet with
the person face-to-face. During the face-to-face meeting, a job counselor must explain
the consequences of a subsequent drug test failure and inform the participant of the right
to appeal the sanction under section 256J.40. If a face-to-face meeting is not possible,
a county agency must send the participant a notice of adverse action as provided in
section 256J.31, subdivisions 4 and 5, and must include the information required in the
face-to-face meeting; and

(2) for failing a drug test two times, the participant is permanently disqualified from
receiving food stamps or food support. Before a disqualification under this provision is
imposed, a job counselor must attempt to meet with the participant face-to-face. During
the face-to-face meeting, the job counselor must identify other resources that may be
available to the participant to meet the needs of the family and inform the participant of
the right to appeal the disqualification under section 256J.40. If a face-to-face meeting
is not possible, a county agency must send the participant a notice of adverse action as
provided in section 256J.31, subdivisions 4 and 5, and must include the information
required in the face-to-face meeting.

deleted text begin (c) deleted text end new text begin (b) new text end For the purposes of this subdivision, "drug offense" means an offense that
occurred deleted text begin after July 1, 1997, deleted text end new text begin during the previous ten years from the date of application
or recertification new text end of sections 152.021 to 152.025, 152.0261, 152.0262, deleted text begin or deleted text end 152.096 new text begin , or
152.137 new text end . Drug offense also means a conviction in another jurisdiction of the possession,
use, or distribution of a controlled substance, or conspiracy to commit any of these
offenses, if the offense occurred deleted text begin after July 1, 1997, deleted text end new text begin during the previous ten years from
the date of application or recertification new text end and the conviction is a felony offense in that
jurisdiction, or in the case of New Jersey, a high misdemeanor.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2012, for all new MFIP
applicants who apply on or after that date and for all recertifications occurring on or
after that date.
new text end

Sec. 17.

Minnesota Statutes 2010, section 256J.26, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Vendor payment; uninhabitable units. new text end

new text begin Upon discovery by the county
that a unit has been deemed uninhabitable under section 504B.131, the county shall
immediately notify the landlord to return the vendor paid rent under this section for the
month in which the discovery occurred. The county shall cease future rent payments for
the uninhabitable housing units until the landlord demonstrates the premises are fit for
the intended use. A landlord who is required to return vendor paid rent or is prohibited
from receiving future rent under this subdivision may not take an eviction action against
anyone in the assistance unit.
new text end

Sec. 18.

Laws 2010, chapter 374, section 1, is amended to read:

Section 1. deleted text begin LADDER OUT OF POVERTY deleted text end new text begin ASSET DEVELOPMENT AND
FINANCIAL LITERACY new text end TASK FORCE.

Subdivision 1.

Creation.

(a) The task force consists of the following members:

(1) four senators, including two members of the majority party and two members of
the minority party, appointed by the Subcommittee on Committees of the Committee on
Rules and Administration of the senate;

(2) four members of the house of representatives, including two members of the
majority party, appointed by the speaker of the house, and two members of the minority
party, appointed by the minority leader; new text begin and
new text end

(3) the commissioner of the Minnesota Department of Commerce or the
commissioner's designee deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (4) the attorney general or the attorney general's designee.
deleted text end

(b) The task force shall ensure that representatives of the following have the
opportunity to meet with and present views to the task force: new text begin the attorney general; new text end credit
unions; independent community banks; state and federal financial institutions; community
action agencies; faith-based financial counseling agencies; faith-based social justice
organizations; legal services organizations representing low-income persons; nonprofit
organizations providing free tax preparation services as part of the volunteer income tax
assistance program; relevant state and local agencies; University of Minnesota faculty
involved in personal and family financial education; philanthropic organizations that have
as one of their missions combating predatory lending; organizations representing older
Minnesotans; and organizations representing the interests of women, Latinos and Latinas,
African-Americans, Asian-Americans, American Indians, and immigrants.

Subd. 2.

Duties.

(a) At a minimum, the task force must identify specific policies,
strategies, and actions to deleted text begin : deleted text end new text begin reduce asset poverty and increase household financial security
by improving opportunities for households to earn, learn, save, invest, and protect
assets through expansion of such asset building opportunities as the Family Assets for
Independence in Minnesota (FAIM) program and Earned Income Tax Credit (EITC)
program.
new text end

deleted text begin (1) increase opportunities for poor and near-poor families and individuals to acquire
assets and create and build wealth;
deleted text end

deleted text begin (2) expand the utilization of Family Assets for Independence in Minnesota (FAIM)
or other culturally specific individual development account programs;
deleted text end

deleted text begin (3) reduce or eliminate predatory financial practices in Minnesota through regulatory
actions, legislative enactments, and the development and deployment of alternative,
nonpredatory financial products;
deleted text end

deleted text begin (4) provide incentives or assistance to private sector financial institutions to
offer additional programs and services that provide alternatives to and education about
predatory financial products;
deleted text end

deleted text begin (5) provide financial literacy information to low-income families and individuals at
the time the recipient has the ability, opportunity, and motivation to receive, understand,
and act on the information provided; and
deleted text end

deleted text begin (6) identify incentives and mechanisms to increase community engagement in
combating poverty and helping poor and near-poor families and individuals to acquire
assets and create and build wealth.
deleted text end

new text begin For purposes of this section, "asset poverty" means an individual's or family's
inability to meet fixed financial obligations and other financial requirements of daily living
with existing assets for a three-month period in the event of a disruption in income or
extraordinary economic emergency.
new text end

(b) deleted text begin By June 1, 2012 deleted text end new text begin During the 2013 and 2014 legislative sessions new text end , the task force
must provide new text begin the legislature with new text end written recommendations deleted text begin and any draft legislation deleted text end
necessary to deleted text begin implement the recommendations to the chairs and ranking minority members
of the legislative committees and divisions with jurisdiction over commerce and consumer
protection deleted text end new text begin fulfill the duties enumerated in paragraph (a) new text end . new text begin The recommendations may
include draft legislation.
new text end

Subd. 3.

Administrative provisions.

(a) The director of the Legislative
Coordinating Commission, or a designee of the director, must convene the initial meeting
of the task force by September 15, 2010. The members of the task force must elect a chair
or cochairs from the legislative members at the initial meeting.

(b) Members of the task force serve without compensation or payment of expenses
except as provided in this paragraph. To the extent possible, meetings of the task force
shall be scheduled on dates when legislative members of the task force are able to
attend legislative meetings that would make them eligible to receive legislative per diem
payments.

(c) The task force expires June 1, deleted text begin 2012, or upon the submission of the report required
under subdivision 3, whichever is earlier deleted text end new text begin 2014 new text end .

(d) The task force may accept gifts and grants, which are accepted on behalf of the
state and constitute donations to the state. The funds must be deposited in an account in
the special revenue fund and are appropriated to the Legislative Coordinating Commission
for purposes of the task force.

(e) The Legislative Coordinating Commission shall provide fiscal services to the
task force as needed under this subdivision.

Subd. 4.

Deadline for appointments and designations.

The appointments and
designations authorized under this section must be completed no later than August 15,
deleted text begin 2010 deleted text end new text begin 2012 new text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 19.

Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
1, is amended to read:

Subdivision 1. Total Appropriation

$

6,259,280,000

$

6,212,085,000

Appropriations by Fund
	2012	2013
General	5,657,737,000	5,584,471,000
State Government Special Revenue	3,565,000	3,565,000
Health Care Access	330,435,000	353,283,000
Federal TANF	265,378,000	268,101,000
Lottery Prize	1,665,000	1,665,000
Special Revenue	500,000	1,000,000

Receipts for Systems Projects.
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state systems account authorized in
Minnesota Statutes, section 256.014. Money
appropriated for computer projects approved
by the Minnesota Office of Enterprise
Technology, funded by the legislature,
and approved by the commissioner
of management and budget, may be
transferred from one project to another
and from development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in
the appropriation for these projects does
not cancel but is available for ongoing
development and operations.

Nonfederal Share Transfers. The
nonfederal share of activities for which
federal administrative reimbursement is
appropriated to the commissioner may be
transferred to the special revenue fund.

TANF Maintenance of Effort.

(a) In order to meet the basic maintenance
of effort (MOE) requirements of the TANF
block grant specified under Code of Federal
Regulations, title 45, section 263.1, the
commissioner may only report nonfederal
money expended for allowable activities
listed in the following clauses as TANF/MOE
expenditures:

(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;

(2) the child care assistance programs
under Minnesota Statutes, sections 119B.03
and 119B.05, and county child care
administrative costs under Minnesota
Statutes, section 119B.15;

(3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;

(4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;

(5) expenditures made on behalf of legal
noncitizen MFIP recipients who qualify for
the MinnesotaCare program under Minnesota
Statutes, chapter 256L;

(6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671; and

(7) qualifying Minnesota education credit
expenditures under Minnesota Statutes,
section 290.0674.

(b) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
TANF/MOE requirements. For the activities
listed in paragraph (a), clauses (2) to
(7), the commissioner may only report
expenditures that are excluded from the
definition of assistance under Code of
Federal Regulations, title 45, section 260.31.

(c) For fiscal years beginning with state fiscal
year 2003, the commissioner shall assure
that the maintenance of effort used by the
commissioner of management and budget
for the February and November forecasts
required under Minnesota Statutes, section
16A.103, contains expenditures under
paragraph (a), clause (1), equal to at least 16
percent of the total required under Code of
Federal Regulations, title 45, section 263.1.

(d) Minnesota Statutes, section 256.011,
subdivision 3, which requires that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, do not apply
if the grants or aids are federal TANF funds.

(e) For the federal fiscal years beginning on
or after October 1, 2007, the commissioner
may not claim an amount of TANF/MOE in
excess of the 75 percent standard in Code
of Federal Regulations, title 45, section
263.1(a)(2), except:

(1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1),
if it is determined by the commissioner
that the state will not meet the TANF work
participation target rate for the current year;

(2) to provide any additional amounts
under Code of Federal Regulations, title 45,
section 264.5, that relate to replacement of
TANF funds due to the operation of TANF
penalties; and

(3) to provide any additional amounts that
may contribute to avoiding or reducing
TANF work participation penalties through
the operation of the excess MOE provisions
of Code of Federal Regulations, title 45,
section 261.43 (a)(2).

For the purposes of clauses (1) to (3),
the commissioner may supplement the
MOE claim with working family credit
expenditures or other qualified expenditures
to the extent such expenditures are otherwise
available after considering the expenditures
allowed in this subdivision.

(f) Notwithstanding any contrary provision
in this article, paragraphs (a) to (e) expire
June 30, 2015.

Working Family Credit Expenditures
as TANF/MOE. The commissioner may
claim as TANF maintenance of effort up to
$6,707,000 per year of working family credit
expenditures for fiscal years 2012 and 2013.

Working Family Credit Expenditures
to be Claimed for TANF/MOE. The
commissioner may count the following
amounts of working family credit
expenditures as TANF/MOE:

(1) fiscal year 2012, $23,692,000;

(2) fiscal year 2013, $44,969,000;

(3) fiscal year 2014, $32,579,000; and

(4) fiscal year 2015, $32,476,000.

Notwithstanding any contrary provision in
this article, this rider expires June 30, 2015.

TANF Transfer to Federal Child Care
and Development Fund. (a) The following
TANF fund amounts are appropriated
to the commissioner for purposes of
MFIP/Transition Year Child Care Assistance
under Minnesota Statutes, section 119B.05:

(1) fiscal year 2012, $10,020,000;

(2) fiscal year 2013, deleted text begin $28,020,000 deleted text end new text begin
$28,599,000 new text end ;

(3) fiscal year 2014, deleted text begin $14,020,000 deleted text end new text begin
$15,488,000 new text end ; and

(4) fiscal year 2015, deleted text begin $14,020,000 deleted text end new text begin
$15,479,000 new text end .

(b) The commissioner shall authorize the
transfer of sufficient TANF funds to the
federal child care and development fund to
meet this appropriation and shall ensure that
all transferred funds are expended according
to federal child care and development fund
regulations.

Food Stamps Employment and Training
Funds. (a) Notwithstanding Minnesota
Statutes, sections 256D.051, subdivisions 1a,
6b, and 6c, and 256J.626, federal food stamps
employment and training funds received
as reimbursement for child care assistance
program expenditures must be deposited in
the general fund. The amount of funds must
be limited to $500,000 per year in fiscal
years 2012 through 2015, contingent upon
approval by the federal Food and Nutrition
Service.

(b) Consistent with the receipt of these
federal funds, the commissioner may
adjust the level of working family credit
expenditures claimed as TANF maintenance
of effort. Notwithstanding any contrary
provision in this article, this rider expires
June 30, 2015.

ARRA Food Support Benefit Increases.
The funds provided for food support benefit
increases under the Supplemental Nutrition
Assistance Program provisions of the
American Recovery and Reinvestment Act
(ARRA) of 2009 must be used for benefit
increases beginning July 1, 2009.

Supplemental Security Interim Assistance
Reimbursement Funds. $2,800,000 of
uncommitted revenue available to the
commissioner of human services for SSI
advocacy and outreach services must be
transferred to and deposited into the general
fund by October 1, 2011.

Sec. 20. new text begin GRANT PROGRAM TO PROMOTE HEALTHY COMMUNITY
INITIATIVES.
new text end

new text begin (a) The commissioner of human services must contract with the Search Institute to
help local communities develop, expand, and maintain the tools, training, and resources
needed to foster positive community development and effectively engage people in their
community. The Search Institute must: (1) provide training in community mobilization,
youth development, and assets getting to outcomes; (2) provide ongoing technical
assistance to communities receiving grants under this section; (3) use best practices to
promote community development; (4) share best program practices with other interested
communities; (5) create electronic and other opportunities for communities to share
experiences in and resources for promoting healthy community development; and (6)
provide an annual report of the strong communities project.
new text end

new text begin (b) Specifically, the Search Institute must use a competitive grant process to select
four interested communities throughout Minnesota to undertake strong community
mobilization initiatives to support communities wishing to catalyze multiple sectors to
create or strengthen a community collaboration to address issues of poverty in their
communities. The Search Institute must provide the selected communities with the
tools, training, and resources they need for successfully implementing initiatives focused
on strengthening the community. The Search Institute also must use a competitive
grant process to provide four strong community innovation grants to encourage current
community initiatives to bring new innovative approaches to their work to reduce poverty.
Finally, the Search Institute must work to strengthen networking and information sharing
activities among all healthy community initiatives throughout Minnesota, including
sharing best program practices and providing personal and electronic opportunities for
peer learning and ongoing program support.
new text end

new text begin (c) In order to receive a grant under paragraph (b), a community must show
involvement of at least three sectors of their community and the active leadership of both
youth and adults. Sectors may include, but are not limited to, local government, schools,
community action agencies, faith communities, businesses, higher education institutions,
and the medical community. In addition, communities must agree to: (1) attend training
on community mobilization processes and strength-based approaches; (2) apply the assets
getting to outcomes process in their initiative; (3) meet at least two times during the
grant period to share successes and challenges with other grantees; (4) participate on an
electronic listserv to share information throughout the period on their work; and (5) all
communication requirements and reporting processes.
new text end

new text begin (d) The commissioner of human services must evaluate the effectiveness of this
program and must recommend to the committees of the legislature with jurisdiction over
health and human services reform and finance by February 15, 2013, whether or not
to make the program available statewide. The Search Institute annually must report to
the commissioner of human services on the services it provided and the grant money
it expended under this section.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 21. new text begin CIRCLES OF SUPPORT GRANTS.
new text end

new text begin The commissioner of human services must provide grants to community action
agencies to help local communities develop, expand, and maintain the tools, training, and
resources needed to foster social assets to assist people out of poverty through circles of
support. The circles of support model must provide a framework for a community to build
relationships across class and race lines so that people can work together to advocate for
change in their communities and move individuals toward self-sufficiency.
new text end

new text begin Specifically, circles of support initiatives must focus on increasing social capital,
income, educational attainment, and individual accountability, while reducing debt,
service dependency, and addressing systemic disparities that hold poverty in place. The
effort must support the development of local guiding coalitions as the link between the
community and circles of support for resource development and funding leverage.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2012.
new text end

Sec. 22. new text begin MINNESOTA VISIBLE CHILD WORK GROUP.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin The Minnesota visible child work group is established to
identify and recommend issues that should be addressed in a statewide, comprehensive
plan to improve the well-being of children who are homeless or have experienced
homelessness.
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin The members of the Minnesota visible child work group
include: (1) two members of the Minnesota house of representatives appointed by
the speaker of the house, one member from the majority party and one member from
the minority party; (2) two members of the Minnesota senate appointed by the senate
Subcommittee on Committees of the Committee on Rules and Administration, one
member from the majority party and one member from the minority party; (3) three
representatives from family shelter, transitional housing, and supportive housing providers
appointed by the governor; (4) two individuals appointed by the governor who have
experienced homelessness; (5) three housing and child advocates appointed by the
governor; (6) three representatives from the business or philanthropic community; and (7)
children's cabinet members, or their designees. Work group membership should include
people from rural, suburban, and urban areas of the state.
new text end

new text begin Subd. 3. new text end

new text begin Duties. new text end

new text begin The work group shall: (1) recommend goals and objectives for a
comprehensive, statewide plan to improve the well-being of children who are homeless or
who have experienced homelessness; (2) recommend a definition of "child well-being";
(3) identify evidence-based interventions and best practices improving the well-being
of young children; (4) plan implementation timelines and ways to measure progress,
including measures of child well-being from birth through adolescence; (5) identify ways
to address issues of collaboration and coordination across systems, including education,
health, human services, and housing; (6) recommend the type of data and information
necessary to develop, effectively implement, and monitor a strategic plan; (7) examine and
make recommendations regarding funding to implement an effective plan; and (8) provide
recommendations for ongoing reports on the well-being of children, monitoring progress
in implementing the statewide comprehensive plan, and any other issues determined to be
relevant to achieving the goals of this section.
new text end

new text begin Subd. 4. new text end

new text begin Work group convening and facilitation. new text end

new text begin The work group must be
organized, scheduled, and facilitated by the staff of a nonprofit child advocacy, outreach,
research, and youth development organization focusing on a wide range of issues
affecting children who are vulnerable, and a nonprofit organization working to provide
safe, affordable, and sustainable homes for children and families in the seven-county
metropolitan area through partnerships with the public and private sector. These two
organizations will also be responsible for preparing and submitting the work group's
recommendations.
new text end

new text begin Subd. 5. new text end

new text begin Report. new text end

new text begin The work group shall make recommendations under subdivision
3 to the legislative committees with jurisdiction over education, housing, health, and
human services policy and finance by December 15, 2012. The recommendations must
also be submitted to the children's cabinet to provide the foundation for a statewide
visible child plan.
new text end

new text begin Subd. 6. new text end

new text begin Expiration. new text end

new text begin The Minnesota visible child work group expires on June
30, 2013.
new text end

Sec. 23. new text begin UNIFORM ASSET LIMIT REQUIREMENTS.
new text end

new text begin The commissioner of human services, in consultation with county human
services representatives, shall analyze the differences in asset limit requirements across
human services assistance programs, including group residential housing, Minnesota
supplemental aid, general assistance, Minnesota family investment program, diversionary
work program, the federal Supplemental Nutrition Assistance Program, state food
assistance programs, and child care programs. The goal of the analysis is to establish a
consistent asset limit across human services programs and minimize the administrative
burdens on counties in implementing asset tests. The commissioner shall report its
findings and conclusions to the legislative committees with jurisdiction over health and
human services policy and finance by January 15, 2013, and include draft legislation
establishing a uniform asset limit for human services assistance programs.
new text end

Sec. 24. new text begin DIRECTION TO THE COMMISSIONER.
new text end

new text begin The commissioner of human services, in consultation with the commissioner of
public safety, shall report to the legislative committees with jurisdiction over health and
human services policy and finance regarding the implementations of Minnesota Statutes,
section 256.01, subdivisions 18c, 18d, and 18e, and the number of persons affected and
fiscal impact by program by April 1, 2013.
new text end

Sec. 25. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the term "assistance transaction card" or
similar terms to "electronic benefit transaction" or similar terms wherever they appear in
Minnesota Statutes, chapter 256. The revisor may make changes necessary to correct the
punctuation, grammar, or structure of the remaining text and preserve its meaning.
new text end

ARTICLE 4

CONTINUING CARE

Section 1.

Minnesota Statutes 2010, section 62J.496, subdivision 2, is amended to read:

Subd. 2.

Eligibility.

(a) "Eligible borrower" means one of the following:

(1) federally qualified health centers;

(2) community clinics, as defined under section 145.9268;

(3) nonprofit or local unit of government hospitals licensed under sections 144.50
to 144.56;

(4) individual or small group physician practices that are focused primarily on
primary care;

(5) nursing facilities licensed under sections 144A.01 to 144A.27;

(6) local public health departments as defined in chapter 145A; and

(7) other providers of health or health care services approved by the commissioner
for which interoperable electronic health record capability would improve quality of
care, patient safety, or community health.

(b) The commissioner shall administer the loan fund to prioritize support and
assistance to:

(1) critical access hospitals;

(2) federally qualified health centers;

(3) entities that serve uninsured, underinsured, and medically underserved
individuals, regardless of whether such area is urban or rural; deleted text begin and
deleted text end

(4) individual or small group practices that are primarily focused on primary care deleted text begin . deleted text end new text begin ;
new text end

new text begin (5) nursing facilities certified to participate in the medical assistance program; and
new text end

new text begin (6) providers enrolled in the elderly waiver program of customized living or 24-hour
customized living of the medical assistance program, if at least half of their annual
operating revenue is paid under the medical assistance program.
new text end

(c) An eligible applicant must submit a loan application to the commissioner of
health on forms prescribed by the commissioner. The application must include, at a
minimum:

(1) the amount of the loan requested and a description of the purpose or project
for which the loan proceeds will be used;

(2) a quote from a vendor;

(3) a description of the health care entities and other groups participating in the
project;

(4) evidence of financial stability and a demonstrated ability to repay the loan; and

(5) a description of how the system to be financed interoperates or plans in the
future to interoperate with other health care entities and provider groups located in the
same geographical area;

(6) a plan on how the certified electronic health record technology will be maintained
and supported over time; and

(7) any other requirements for applications included or developed pursuant to
section 3014 of the HITECH Act.

Sec. 2.

Minnesota Statutes 2010, section 144A.351, is amended to read:

144A.351 BALANCING LONG-TERM CARE new text begin SERVICES AND SUPPORTS new text end :
REPORT REQUIRED.

The commissioners of health and human services, new text begin in consultation new text end with deleted text begin the
cooperation of counties and deleted text end new text begin stakeholders, including persons who need or are using
long-term care services and supports, lead agencies, new text end regional entities, new text begin senior, disability,
and mental health organization representatives, service providers, community members,
including local businesses, and faith-based representatives new text end shall prepare a report to the
legislature by August 15, deleted text begin 2004 deleted text end new text begin 2013 new text end , and biennially thereafter, regarding the status of the
full range of long-term care services new text begin and supports new text end for the elderly new text begin and children and adults
with disabilities new text end in Minnesota. The report shall address:

(1) demographics and need for long-term care new text begin services and supports new text end in Minnesota;

(2) summary of county and regional reports on long-term care gaps, surpluses,
imbalances, and corrective action plans;

(3) status of long-term care services new text begin and mental illnesses new text end by county and region
including:

(i) changes in availability of the range of long-term care services and housing
options;

(ii) access problems regarding long-term care new text begin services new text end ; and

(iii) comparative measures of long-term care new text begin services new text end availability and deleted text begin progress deleted text end new text begin
changes new text end over time; and

(4) recommendations regarding goals for the future of long-term care services new text begin and
supports new text end , policy new text begin and fiscal new text end changes, and resource needs.

Sec. 3.

Minnesota Statutes 2010, section 144D.04, subdivision 2, is amended to read:

Subd. 2.

Contents of contract.

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

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

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

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

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

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

(6) the term of the contract;

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

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

(9) a description of the process through which the contract may be modified,
amended, or terminated new text begin , including whether a move to a different room or sharing a room
would be required in the event that the tenant can no longer pay the current rent new text end ;

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

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

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

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

(14) billing and payment procedures and requirements;

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

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

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

Sec. 4.

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

new text begin Subd. 6a. new text end

new text begin Adult foster care homes serving people with mental illness;
certification. new text end

new text begin (a) The commissioner of human services shall issue a mental health
certification for adult foster care homes licensed under this chapter and Minnesota Rules,
parts 9555.5105 to 9555.6265, that serve people with mental illness where the home is not
the primary residence of the license holder when a provider is determined to have met
the requirements under paragraph (b). This certification is voluntary for license holders.
The certification shall be printed on the license, and identified on the commissioner's
public Web site.
new text end

new text begin (b) The requirements for certification are:
new text end

new text begin (1) all staff working in the adult foster care home have received at least seven hours
of annual training covering all of the following topics:
new text end

new text begin (i) mental health diagnoses;
new text end

new text begin (ii) mental health crisis response and de-escalation techniques;
new text end

new text begin (iii) recovery from mental illness;
new text end

new text begin (iv) treatment options including evidence-based practices;
new text end

new text begin (v) medications and their side effects;
new text end

new text begin (vi) co-occurring substance abuse and health conditions; and
new text end

new text begin (vii) community resources; and
new text end

new text begin (2) a mental health professional, as defined in section 245.462, subdivision 18, or
a mental health practitioner as defined in section 245.462, subdivision 17, are available
for consultation and assistance;
new text end

new text begin (3) there is a plan and protocol in place to address a mental health crisis; and
new text end

new text begin (4) each individual's individual placement agreement identifies who is providing
clinical services and their contact information, and includes an individual crisis prevention
and management plan developed with the individual.
new text end

new text begin (c) License holders seeking certification under this subdivision must request this
certification on forms provided by the commissioner and must submit the request to the
county licensing agency in which the home is located. The county licensing agency must
forward the request to the commissioner with a county recommendation regarding whether
the commissioner should issue the certification.
new text end

new text begin (d) Ongoing compliance with the certification requirements under paragraph (b)
shall be reviewed by the county licensing agency at each licensing review. When a county
licensing agency determines that the requirements of paragraph (b) are not met, the county
shall inform the commissioner, and the commissioner will remove the certification.
new text end

new text begin (e) A denial of the certification or the removal of the certification based on a
determination that the requirements under paragraph (b) have not been met by the adult
foster care license holder are not subject to appeal. A license holder that has been denied a
certification or that has had a certification removed may again request certification when
the license holder is in compliance with the requirements of paragraph (b).
new text end

Sec. 5.

Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is
amended to read:

Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an
initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
9555.6265, under this chapter for a physical location that will not be the primary residence
of the license holder for the entire period of licensure. If a license is issued during this
moratorium, and the license holder changes the license holder's primary residence away
from the physical location of the foster care license, the commissioner shall revoke the
license according to section 245A.07. Exceptions to the moratorium include:

(1) foster care settings that are required to be registered under chapter 144D;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
and determined to be needed by the commissioner under paragraph (b);

(3) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
restructuring of state-operated services that limits the capacity of state-operated facilities;

(4) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for persons requiring hospital level care; or

(5) new foster care licenses determined to be needed by the commissioner for the
transition of people from personal care assistance to the home and community-based
services.

(b) The commissioner shall determine the need for newly licensed foster care homes
as defined under this subdivision new text begin using the resource need determination process described
in paragraph (f) new text end . As part of the determination, the commissioner shall consider the
availability of foster care capacity in the area in which the licensee seeks to operate, deleted text begin and
the recommendation of the local county board. The determination by the commissioner
must be final. A determination of need is not required for a change in ownership at
the same address deleted text end new text begin and other data and information, including the report on the status of
long-term care services required under section 144A.351 new text end .

(c) Residential settings that would otherwise be subject to the moratorium established
in paragraph (a), that are in the process of receiving an adult or child foster care license as
of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
or child foster care license. For this paragraph, all of the following conditions must be met
to be considered in the process of receiving an adult or child foster care license:

(1) participants have made decisions to move into the residential setting, including
documentation in each participant's care plan;

(2) the provider has purchased housing or has made a financial investment in the
property;

(3) the lead agency has approved the plans, including costs for the residential setting
for each individual;

(4) the completion of the licensing process, including all necessary inspections, is
the only remaining component prior to being able to provide services; and

(5) the needs of the individuals cannot be met within the existing capacity in that
county.

To qualify for the process under this paragraph, the lead agency must submit
documentation to the commissioner by August 1, 2009, that all of the above criteria are
met.

(d) The commissioner shall study the effects of the license moratorium under this
subdivision and shall report back to the legislature by January 15, 2011. This study shall
include, but is not limited to the following:

(1) the overall capacity and utilization of foster care beds where the physical location
is not the primary residence of the license holder prior to and after implementation
of the moratorium;

(2) the overall capacity and utilization of foster care beds where the physical
location is the primary residence of the license holder prior to and after implementation
of the moratorium; and

(3) the number of licensed and occupied ICF/MR beds prior to and after
implementation of the moratorium.

(e) When a foster care recipient moves out of a foster home that is not the
primary residence of the license holder according to section new text begin 256B.092, subdivision 1e,
paragraph (d), or new text end 256B.49, subdivision 15, paragraph (f), the county shall immediately
inform the Department of Human Services Licensing Division deleted text begin , and deleted text end new text begin . new text end The department
shall deleted text begin immediately deleted text end decrease the licensed capacity for the home new text begin . If the voluntary changes
described in paragraph (f) are not sufficient to meet the savings required by 2011
reductions in licensed bed capacity and maintain statewide long-term care residential
services capacity within budgetary limits, the commissioner shall delicense ... beds
by June 30, 2013, using the needs determination process. Under this paragraph, the
commissioner has the authority to reduce unused licensed capacity of a current foster care
program to accomplish the consolidation or closure of settings new text end . A decreased licensed
capacity according to this paragraph is not subject to appeal under this chapter.

new text begin (f) A resource need determination process, managed at the state level, using the
available reports required by section 144A.351, and other data and information shall be
used to determine where the reduced capacity required under Laws 2011, First Special
Session chapter 9, article 7, sections 1 and 40 will occur. The commissioner shall consult
with the stakeholders described in section 144A.351, and employ a variety of methods to
improve the state's capacity to meet long-term care service needs within budgetary limits,
including seeking proposals from service providers or lead agencies to change service type,
capacity, or location to improve services, increase the independence of residents, allow for
payment to hold a person's bed open from permanent reassignment up to 60 days while
the person tries living in a more independent setting, and better meet needs identified by
the long-term care services reports and statewide data and information. By February 1 of
each year, the commissioner shall provide information and data on the overall capacity of
licensed long-term care services, actions taken under this subdivision to manage statewide
long-term care services and supports resources, and any recommendations for change to
the legislative committees with jurisdiction over the health and human services budget.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:

Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home during normal sleeping
hours to allow for alternative methods of overnight supervision. The commissioner may
grant the variance if the local county licensing agency recommends the variance and the
county recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of
providing overnight supervision and determined the plan protects the residents' health,
safety, and rights;

(2) the license holder has obtained written and signed informed consent from
each resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include
the use of technology, is specified for each resident in the resident's: (i) individualized
plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
required; or (iii) individual resident placement agreement under Minnesota Rules, part
9555.5105, subpart 19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster care license
holder must not have had a deleted text begin licensing action deleted text end new text begin conditional license issued new text end under section
245A.06 or new text begin any other licensing sanction issued under section new text end 245A.07 during the prior 24
months based on failure to provide adequate supervision, health care services, or resident
safety in the adult foster care home.

(c) A license holder requesting a variance under this subdivision to utilize
technology as a component of a plan for alternative overnight supervision may request
the commissioner's review in the absence of a county recommendation. Upon receipt of
such a request from a license holder, the commissioner shall review the variance request
with the county.

Sec. 7.

Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:

Subdivision 1.

Consumer data file.

The license holder must maintain the following
information for each consumer:

(1) identifying information that includes date of birth, medications, legal
representative, history, medical, and other individual-specific information, and names and
telephone numbers of contacts;

(2) consumer health information, including individual medication administration
and monitoring information;

(3) the consumer's individual service plan. When a consumer's case manager does
not provide a current individual service plan, the license holder shall make a written
request to the case manager to provide a copy of the individual service plan and inform
the consumer or the consumer's legal representative of the right to an individual service
plan and the right to appeal under section 256.045 new text begin . In the event the case manager fails
to provide an individual service plan after a written request from the license holder, the
license holder shall not be sanctioned or penalized financially for not having a current
individual service plan in the consumer's data file new text end ;

(4) copies of assessments, analyses, summaries, and recommendations;

(5) progress review reports;

(6) incidents involving the consumer;

(7) reports required under section 245B.05, subdivision 7;

(8) discharge summary, when applicable;

(9) record of other license holders serving the consumer that includes a contact
person and telephone numbers, services being provided, services that require coordination
between two license holders, and name of staff responsible for coordination;

(10) information about verbal aggression directed at the consumer by another
consumer; and

(11) information about self-abuse.

Sec. 8.

Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:

Subd. 6.

Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.

(a) Providers required to initiate background
studies under section 256B.4912 must initiate a study before the individual begins in a
position allowing direct contact with persons served by the provider.

(b) deleted text begin The commissioner shall conduct deleted text end new text begin Except as provided in paragraph (c), the
providers must initiate new text end a background study annually of an individual required to be studied
under section 245C.03, subdivision 6.

new text begin (c) After an initial background study under this subdivision is initiated on an
individual by a provider of both services licensed by the commissioner and the unlicensed
services under this subdivision, a repeat annual background study is not required if:
new text end

new text begin (1) the provider maintains compliance with the requirements of section 245C.07,
paragraph (a), regarding one individual with one address and telephone number as the
person to receive sensitive background study information for the multiple programs that
depend on the same background study, and that the individual who is designated to receive
the sensitive background information is capable of determining, upon the request of the
commissioner, whether a background study subject is providing direct contact services
in one or more of the provider's programs or services and, if so, at which location or
locations; and
new text end

new text begin (2) the individual who is the subject of the background study provides direct
contact services under the provider's licensed program for at least 40 hours per year so
the individual will be recognized by a probation officer or corrections agent to prompt
a report to the commissioner regarding criminal convictions as required under section
245C.05, subdivision 7.
new text end

Sec. 9.

Minnesota Statutes 2010, section 245C.05, subdivision 7, is amended to read:

Subd. 7.

Probation officer and corrections agent.

(a) A probation officer or
corrections agent shall notify the commissioner of an individual's conviction if the
individual deleted text begin is deleted text end :

(1) new text begin has been new text end affiliated with a program or facility regulated by the Department of
Human Services or Department of Health, a facility serving children or youth licensed by
the Department of Corrections, or any type of home care agency or provider of personal
care assistance services new text begin within the preceding year new text end ; and

(2) new text begin has been new text end convicted of a crime constituting a disqualification under section
245C.14.

(b) For the purpose of this subdivision, "conviction" has the meaning given it
in section 609.02, subdivision 5.

(c) The commissioner, in consultation with the commissioner of corrections, shall
develop forms and information necessary to implement this subdivision and shall provide
the forms and information to the commissioner of corrections for distribution to local
probation officers and corrections agents.

(d) The commissioner shall inform individuals subject to a background study that
criminal convictions for disqualifying crimes will be reported to the commissioner by the
corrections system.

(e) A probation officer, corrections agent, or corrections agency is not civilly or
criminally liable for disclosing or failing to disclose the information required by this
subdivision.

(f) Upon receipt of disqualifying information, the commissioner shall provide the
notice required under section 245C.17, as appropriate, to agencies on record as having
initiated a background study or making a request for documentation of the background
study status of the individual.

(g) This subdivision does not apply to family child care programs.

Sec. 10.

Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:

Subd. 2a.

Contribution amount.

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

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

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

(2) if the adjusted gross income is equal to or greater than 175 percent of federal
poverty guidelines and less than or equal to deleted text begin 545 deleted text end new text begin 525 new text end percent of federal poverty guidelines,
the parental contribution shall be determined using a sliding fee scale established by the
commissioner of human services which begins at one percent of adjusted gross income at
175 percent of federal poverty guidelines and increases to deleted text begin 7.5 deleted text end new text begin eight new text end percent of adjusted
gross income for those with adjusted gross income up to deleted text begin 545 deleted text end new text begin 525 new text end percent of federal
poverty guidelines;

(3) if the adjusted gross income is greater than deleted text begin 545 deleted text end new text begin 525 new text end percent of federal
poverty guidelines and less than 675 percent of federal poverty guidelines, the parental
contribution shall be deleted text begin 7.5 deleted text end new text begin 9.5 new text end percent of adjusted gross income;

(4) if the adjusted gross income is equal to or greater than 675 percent of federal
poverty guidelines and less than deleted text begin 975 deleted text end new text begin 900 new text end percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at deleted text begin 7.5 deleted text end new text begin 9.5 new text end percent of adjusted gross income at 675 percent
of federal poverty guidelines and increases to deleted text begin ten deleted text end new text begin 12 new text end percent of adjusted gross income for
those with adjusted gross income up to deleted text begin 975 deleted text end new text begin 900 new text end percent of federal poverty guidelines; and

(5) if the adjusted gross income is equal to or greater than deleted text begin 975 deleted text end new text begin 900 new text end percent of
federal poverty guidelines, the parental contribution shall be deleted text begin 12.5 deleted text end new text begin 13.5 new text end percent of adjusted
gross income.

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

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

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

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

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

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

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

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

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

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

(2) the insurer denied insurance;

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

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

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

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

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

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

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

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

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

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

Sec. 11.

Minnesota Statutes 2011 Supplement, section 256.045, subdivision 3, is
amended to read:

Subd. 3.

State agency hearings.

(a) State agency hearings are available for the
following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or
the federal Food Stamp Act whose application for assistance is denied, not acted upon
with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
claimed to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section 626.556 is denied or not
acted upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship
waiver under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined
to have maltreated a minor under section 626.556, after the individual or facility has
exercised the right to administrative reconsideration under section 626.556;

(10) except as provided under chapter 245C, an individual disqualified under
sections 245C.14 and 245C.15, following a reconsideration decision issued under section
245C.23, on the basis of serious or recurring maltreatment; a preponderance of the
evidence that the individual has committed an act or acts that meet the definition of any of
the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make reports
required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings
regarding a maltreatment determination under clause (4) or (9) and a disqualification under
this clause in which the basis for a disqualification is serious or recurring maltreatment,
shall be consolidated into a single fair hearing. In such cases, the scope of review by
the human services referee shall include both the maltreatment determination and the
disqualification. The failure to exercise the right to an administrative reconsideration shall
not be a bar to a hearing under this section if federal law provides an individual the right to
a hearing to dispute a finding of maltreatment. Individuals and organizations specified in
this section may contest the specified action, decision, or final disposition before the state
agency by submitting a written request for a hearing to the state agency within 30 days
after receiving written notice of the action, decision, or final disposition, or within 90 days
of such written notice if the applicant, recipient, patient, or relative shows good cause why
the request was not submitted within the 30-day time limit; or

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A
against the debt.

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
(10), is the only administrative appeal to the final agency determination specifically,
including a challenge to the accuracy and completeness of data under section 13.04.
Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
contested case proceeding under the provisions of chapter 14. Hearings requested under
paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
only available when there is no juvenile court or adult criminal action pending. If such
action is filed in either court while an administrative review is pending, the administrative
review must be suspended until the judicial actions are completed. If the juvenile court
action or criminal charge is dismissed or the criminal action overturned, the matter may be
considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph
(a), clause (5), shall be limited to the issue of whether the county is legally responsible
for a child's placement under court order or voluntary placement agreement and, if so,
the correct amount of foster care payment to be made on the child's behalf and shall not
include review of the propriety of the county's child protection determination or child
placement decision.

(e) new text begin The scope of hearings involving appeals related to the reduction, suspension,
denial, or termination of personal care assistance services under section 256B.0659, or
home and community-based services waivers under sections 256B.092 and 256B.49, shall
be limited to the specific issues under written appeal.
new text end

new text begin (f) new text end A vendor of medical care as defined in section 256B.02, subdivision 7, or a
vendor under contract with a county agency to provide social services is not a party and
may not request a hearing under this section, except if assisting a recipient as provided in
subdivision 4.

deleted text begin (f) deleted text end new text begin (g) new text end An applicant or recipient is not entitled to receive social services beyond the
services prescribed under chapter 256M or other social services the person is eligible
for under state law.

deleted text begin (g) deleted text end new text begin (h) new text end The commissioner may summarily affirm the county or state agency's
proposed action without a hearing when the sole issue is an automatic change due to
a change in state or federal law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for all notices of action dated on or
after July 1, 2012.
new text end

Sec. 12.

Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to
read:

Subd. 1a.

Income and assets generally.

Unless specifically required by state
law or rule or federal law or regulation, the methodologies used in counting income
and assets to determine eligibility for medical assistance for persons whose eligibility
category is based on blindness, disability, or age of 65 or more years, the methodologies
for the supplemental security income program shall be used new text begin , except as provided under
subdivision 3, paragraph (a), clause (6) new text end . Increases in benefits under title II of the Social
Security Act shall not be counted as income for purposes of this subdivision until July 1 of
each year. Effective upon federal approval, for children eligible under section 256B.055,
subdivision 12, or for home and community-based waiver services whose eligibility
for medical assistance is determined without regard to parental income, child support
payments, including any payments made by an obligor in satisfaction of or in addition
to a temporary or permanent order for child support, and Social Security payments are
not counted as income. For families and children, which includes all other eligibility
categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as
required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the
earned income disregards and deductions are limited to those in subdivision 1c. For these
purposes, a "methodology" does not include an asset or income standard, or accounting
method, or method of determining effective dates.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2012.
new text end

Sec. 13.

Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3,
is amended to read:

Subd. 3.

Asset limitations for individuals and families.

(a) To be eligible for
medical assistance, a person must not individually own more than $3,000 in assets, or if a
member of a household with two family members, husband and wife, or parent and child,
the household must not own more than $6,000 in assets, plus $200 for each additional
legal dependent. In addition to these maximum amounts, an eligible individual or family
may accrue interest on these amounts, but they must be reduced to the maximum at the
time of an eligibility redetermination. The accumulation of the clothing and personal
needs allowance according to section 256B.35 must also be reduced to the maximum at
the time of the eligibility redetermination. The value of assets that are not considered in
determining eligibility for medical assistance is the value of those assets excluded under
the supplemental security income program for aged, blind, and disabled persons, with
the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the supplemental
security income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by
the supplemental security income program. Burial expenses funded by annuity contracts
or life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses; deleted text begin and
deleted text end

(5) for a person who no longer qualifies as an employed person with a disability due
to loss of earnings, assets allowed while eligible for medical assistance under section
256B.057, subdivision 9, are not considered for 12 months, beginning with the first month
of ineligibility as an employed person with a disability, to the extent that the person's total
assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph
(d) deleted text begin . deleted text end new text begin ; and
new text end

new text begin (6) when a person enrolled in medical assistance under section 256B.057, subdivision
9, is age 65 or older and has been enrolled during each of the 24 consecutive months
before the person's 65th birthday, the assets owned by the person and the person's spouse
must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
when determining eligibility for medical assistance under section 256B.055, subdivision
7. The income of a spouse of a person enrolled in medical assistance under section
256B.057, subdivision 9, during each of the 24 consecutive months before the person's
65th birthday must be disregarded when determining eligibility for medical assistance
under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
is required to have qualified for medical assistance under section 256B.057, subdivision 9,
prior to age 65 for at least 20 months in the 24 months prior to reaching age 65.
new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2012.
new text end

Sec. 14.

Minnesota Statutes 2011 Supplement, section 256B.057, subdivision 9,
is amended to read:

Subd. 9.

Employed persons with disabilities.

(a) Medical assistance may be paid
for a person who is employed and who:

(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;

(2) deleted text begin is at least 16 but less than 65 years of age;
deleted text end

deleted text begin (3) deleted text end meets the asset limits in paragraph (d); and

deleted text begin (4) deleted text end new text begin (3) new text end pays a premium and other obligations under paragraph (e).

(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. Any
spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.

(c) After the month of enrollment, a person enrolled in medical assistance under
this subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a
medical condition, as verified by a physician; or

(2) loses employment for reasons not attributable to the enrollee, and is without
receipt of earned income may retain eligibility for up to four consecutive months after the
month of job loss. To receive a four-month extension, enrollees must verify the medical
condition or provide notification of job loss. All other eligibility requirements must be met
and the enrollee must pay all calculated premium costs for continued eligibility.

(d) For purposes of determining eligibility under this subdivision, a person's assets
must not exceed $20,000, excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
Keogh plans, and pension plans;

(3) medical expense accounts set up through the person's employer; and

(4) spousal assets, including spouse's share of jointly held assets.

(e) All enrollees must pay a premium to be eligible for medical assistance under this
subdivision, except as provided under section 256.01, subdivision 18b.

(1) An enrollee must pay the greater of a $65 premium or the premium calculated
based on the person's gross earned and unearned income and the applicable family size
using a sliding fee scale established by the commissioner, which begins at one percent of
income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of
income for those with incomes at or above 300 percent of the federal poverty guidelines.

(2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.

(3) All enrollees who receive unearned income must pay five percent of unearned
income in addition to the premium amount, except as provided under section 256.01,
subdivision 18b.

(4) Increases in benefits under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each year.

(f) A person's eligibility and premium shall be determined by the local county
agency. Premiums must be paid to the commissioner. All premiums are dedicated to
the commissioner.

(g) Any required premium shall be determined at application and redetermined at
the enrollee's six-month income review or when a change in income or household size is
reported. Enrollees must report any change in income or household size within ten days
of when the change occurs. A decreased premium resulting from a reported change in
income or household size shall be effective the first day of the next available billing month
after the change is reported. Except for changes occurring from annual cost-of-living
increases, a change resulting in an increased premium shall not affect the premium amount
until the next six-month review.

(h) Premium payment is due upon notification from the commissioner of the
premium amount required. Premiums may be paid in installments at the discretion of
the commissioner.

(i) Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. Good cause exists
if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
D, are met. Except when an installment agreement is accepted by the commissioner,
all persons disenrolled for nonpayment of a premium must pay any past due premiums
as well as current premiums due prior to being reenrolled. Nonpayment shall include
payment with a returned, refused, or dishonored instrument. The commissioner may
require a guaranteed form of payment as the only means to replace a returned, refused,
or dishonored instrument.

(j) The commissioner shall notify enrollees annually beginning at least 24 months
before the person's 65th birthday of the medical assistance eligibility rules affecting
income, assets, and treatment of a spouse's income and assets that will be applied upon
reaching age 65.

(k) For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
paragraph (a).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2012.
new text end

Sec. 15.

Minnesota Statutes 2010, section 256B.0659, is amended by adding a
subdivision to read:

new text begin Subd. 31. new text end

new text begin Appeals. new text end

new text begin (a) A recipient who is adversely affected by the reduction,
suspension, denial, or termination of services under this section may appeal the decision
according to section 256.045. The notice of the reduction, suspension, denial, or
termination of services from the lead agency to the applicant or recipient must be made
in plain language and must include a form for written appeal. The commissioner may
provide lead agencies with a model form for written appeal. The appeal must be in
writing and identify the specific issues the recipient would like to have considered in the
appeal hearing and a summary of the basis, with supporting professional documentation
if available, for contesting the decision.
new text end

new text begin (b) If a recipient has a change in condition or new information after the date of
the assessment, temporary services may be authorized according to section 256B.0652,
subdivision 9, until a new assessment is completed.
new text end

Sec. 16.

Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3a,
is amended to read:

Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment,
services planning, or other assistance intended to support community-based living,
including persons who need assessment in order to determine waiver or alternative care
program eligibility, must be visited by a long-term care consultation team within 15
calendar days after the date on which an assessment was requested or recommended. After
January 1, 2011, these requirements also apply to personal care assistance services, private
duty nursing, and home health agency services, on timelines established in subdivision 5.
Face-to-face assessments must be conducted according to paragraphs (b) to (i).

(b) The county may utilize a team of either the social worker or public health nurse,
or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
assessment in a face-to-face interview. The consultation team members must confer
regarding the most appropriate care for each individual screened or assessed.

(c) The assessment must be comprehensive and include a person-centered
assessment of the health, psychological, functional, environmental, and social needs of
referred individuals and provide information necessary to develop a support plan that
meets the consumers needs, using an assessment form provided by the commissioner.

(d) The assessment must be conducted in a face-to-face interview with the person
being assessed and the person's legal representative, as required by legally executed
documents, and other individuals as requested by the person, who can provide information
on the needs, strengths, and preferences of the person necessary to develop a support plan
that ensures the person's health and safety, but who is not a provider of service or has any
financial interest in the provision of services. new text begin For persons who are to be assessed for
elderly waiver customized living services under section 256B.0915, with the permission
of the person being assessed or the person's designated or legal representative, the client's
current or proposed provider of services may submit a copy of the provider's nursing
assessment or written report outlining their recommendations regarding the client's care
needs. The person conducting the assessment will notify the provider of the date by
which this information is to be submitted. This information shall be provided to the
person conducting the assessment and must be considered prior to the finalization of
the assessment.
new text end

(e) The person, or the person's legal representative, must be provided with written
recommendations for community-based services, including consumer-directed options,
or institutional care that include documentation that the most cost-effective alternatives
available were offered to the individual, and alternatives to residential settings, including,
but not limited to, foster care settings that are not the primary residence of the license
holder. For purposes of this requirement, "cost-effective alternatives" means community
services and living arrangements that cost the same as or less than institutional care.

(f) If the person chooses to use community-based services, the person or the person's
legal representative must be provided with a written community support plan, regardless
of whether the individual is eligible for Minnesota health care programs. A person may
request assistance in identifying community supports without participating in a complete
assessment. Upon a request for assistance identifying community support, the person must
be transferred or referred to the services available under sections 256.975, subdivision 7,
and 256.01, subdivision 24, for telephone assistance and follow up.

(g) The person has the right to make the final decision between institutional
placement and community placement after the recommendations have been provided,
except as provided in subdivision 4a, paragraph (c).

(h) The team must give the person receiving assessment or support planning, or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) the need for and purpose of preadmission screening if the person selects nursing
facility placement;

(2) the role of the long-term care consultation assessment and support planning in
waiver and alternative care program eligibility determination;

(3) information about Minnesota health care programs;

(4) the person's freedom to accept or reject the recommendations of the team;

(5) the person's right to confidentiality under the Minnesota Government Data
Practices Act, chapter 13;

(6) the long-term care consultant's decision regarding the person's need for
institutional level of care as determined under criteria established in section 144.0724,
subdivision 11, or 256B.092; and

(7) the person's right to appeal the decision regarding the need for nursing facility
level of care or the county's final decisions regarding public programs eligibility according
to section 256.045, subdivision 3.

(i) Face-to-face assessment completed as part of eligibility determination for
the alternative care, elderly waiver, community alternatives for disabled individuals,
community alternative care, and traumatic brain injury waiver programs under sections
256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
than 60 calendar days after the date of assessment. The effective eligibility start date
for these programs can never be prior to the date of assessment. If an assessment was
completed more than 60 days before the effective waiver or alternative care program
eligibility start date, assessment and support plan information must be updated in a
face-to-face visit and documented in the department's Medicaid Management Information
System (MMIS). The effective date of program eligibility in this case cannot be prior to
the date the updated assessment is completed.

Sec. 17.

Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c,
is amended to read:

Subd. 3c.

Consultation for housing with services.

(a) The purpose of long-term
care consultation for registered housing with services is to support persons with current or
anticipated long-term care needs in making informed choices among options that include
the most cost-effective and least restrictive settings. Prospective residents maintain the
right to choose housing with services or assisted living if that option is their preference.

(b) Registered housing with services establishments shall inform all prospective
residents of the availability of long-term care consultation and the need to receive and
verify the consultation prior to signing a lease or contract. Long-term care consultation
for registered housing with services is provided as determined by the commissioner of
human services. The service is delivered under a partnership between lead agencies as
defined in subdivision 1a, paragraph (d), and the Area Agencies on Aging, and is a point
of entry to a combination of telephone-based long-term care options counseling provided
by Senior LinkAge Line and in-person long-term care consultation provided by lead
agencies. The point of entry service must be provided within five working days of the
request of the prospective resident as follows:

(1) the consultation shall be performed in a manner that provides objective and
complete information;

(2) the consultation must include a review of the prospective resident's reasons for
considering housing with services, the prospective resident's personal goals, a discussion
of the prospective resident's immediate and projected long-term care needs, and alternative
community services or housing with services settings that may meet the prospective
resident's needs;

(3) the prospective resident shall be informed of the availability of a face-to-face
visit at no charge to the prospective resident to assist the prospective resident in assessment
and planning to meet the prospective resident's long-term care needs; and

(4) verification of counseling shall be generated and provided to the prospective
resident by Senior LinkAge Line upon completion of the telephone-based counseling.

(c) Housing with services establishments registered under chapter 144D shall:

(1) inform all prospective residents of the availability of and contact information for
consultation services under this subdivision;

(2) except for individuals seeking lease-only arrangements in subsidized housing
settings, receive a copy of the verification of counseling prior to executing a lease or
service contract with the prospective resident, and prior to executing a service contract
with individuals who have previously entered into lease-only arrangements; and

(3) retain a copy of the verification of counseling as part of the resident's file.

new text begin (d) Exemptions from the consultation requirement under paragraph (b) and
emergency admissions to registered housing with services establishments prior to
consultation under paragraph (b) are permitted according to policies established by the
commissioner.
new text end

new text begin (e) Prospective residents who have used financial planning services and created a
long-term care plan in the 12 months prior to signing a lease or contract with a registered
housing with services or assisted living establishment are exempt from the long-term care
consultation requirements under this subdivision. Housing with services establishments
registered under chapter 144D are exempt from the requirements of paragraph (c),
clauses (2) and (3), for prospective residents who are exempt from the requirements
of this subdivision.
new text end

Sec. 18.

Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3e,
is amended to read:

Subd. 3e.

Customized living service rate.

(a) Payment for customized living
services shall be a monthly rate authorized by the lead agency within the parameters
established by the commissioner. The payment agreement must delineate the amount of
each component service included in the recipient's customized living service plan. The
lead agency new text begin , with input from the provider of customized living services, new text end shall ensure that
there is a documented need within the parameters established by the commissioner for all
component customized living services authorized.

(b) The payment rate must be based on the amount of component services to be
provided utilizing component rates established by the commissioner. Counties and tribes
shall use tools issued by the commissioner to develop and document customized living
service plans and rates.

(c) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale. Customized
living services must not include rent or raw food costs.

(d) With the exception of individuals described in subdivision 3a, paragraph (b), the
individualized monthly authorized payment for the customized living service plan shall
not exceed 50 percent of the greater of either the statewide or any of the geographic
groups' weighted average monthly nursing facility rate of the case mix resident class
to which the elderly waiver eligible client would be assigned under Minnesota Rules,
parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
resident assessment system as described in section 256B.438 for nursing home rate
determination is implemented. Effective on July 1 of the state fiscal year in which
the resident assessment system as described in section 256B.438 for nursing home
rate determination is implemented and July 1 of each subsequent state fiscal year, the
individualized monthly authorized payment for the services described in this clause shall
not exceed the limit which was in effect on June 30 of the previous state fiscal year
updated annually based on legislatively adopted changes to all service rate maximums for
home and community-based service providers.

(e) Effective July 1, 2011, the individualized monthly payment for the customized
living service plan for individuals described in subdivision 3a, paragraph (b), must be the
monthly authorized payment limit for customized living for individuals classified as case
mix A, reduced by 25 percent. This rate limit must be applied to all new participants
enrolled in the program on or after July 1, 2011, who meet the criteria described in
subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
meet the criteria described in subdivision 3a, paragraph (b), at reassessment.

(f) Customized living services are delivered by a provider licensed by the
Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.
Licensed home care providers are subject to section 256B.0651, subdivision 14.

(g) A provider may not bill or otherwise charge an elderly waiver participant or their
family for additional units of any allowable component service beyond those available
under the service rate limits described in paragraph (d), nor for additional units of any
allowable component service beyond those approved in the service plan by the lead agency.

Sec. 19.

Minnesota Statutes 2010, section 256B.0915, subdivision 3g, is amended to
read:

Subd. 3g.

Service rate limits; state assumption of costs.

(a) To improve access
to community services and eliminate payment disparities between the alternative care
program and the elderly waiver, the commissioner shall establish statewide maximum
service rate limits and eliminate lead agency-specific service rate limits.

(b) Effective July 1, 2001, for service rate limits, except those described or defined in
subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative
care statewide maximum rate or the elderly waiver statewide maximum rate.

(c) Lead agencies may negotiate individual service rates with vendors for actual
costs up to the statewide maximum service rate limit.

new text begin (d) Notwithstanding the requirements of paragraphs (a) through (c), or the
requirements in subdivisions 3e and 3h, and as part of waiver reform proposals
developed under authority in section 256B.021, subdivision 4, paragraphs (f) and (g),
the commissioner may develop proposals for alternative or enhanced service payment
rate systems for purposes of ensuring reasonable and adequate access to home and
community-based services for elderly waiver participants throughout the state based
on criteria established to designate areas as critical access home and community-based
service areas. These proposals, to be submitted to the legislature no later than February
15, 2013, must be based on an evaluation of statewide capacity and the determination of
critical access home and community-based services areas. Alternative or enhanced service
payment rate systems will be limited to providers delivering services to individuals
residing in communities, counties, or groups of counties designated as critical access
areas for home and community-based services. The commissioner shall consult with
stakeholders who authorize and provide elderly waiver services as well as with consumer
advocates and the ombudsman for long-term care.
new text end

new text begin (1) Alternative or enhanced payment rate systems may be developed in designated
areas for elderly waiver services providers that may include:
new text end

new text begin (i) licensed home care providers qualified to enroll in Minnesota health care
programs that are delivering services in housing with services establishments in critical
access areas of the state;
new text end

new text begin (ii) providers as described in subdivision 3h, paragraph (g). Any calculation of
an enhanced or alternative service rate under this clause or clause (i), must be limited
to services only and cannot include rent, utilities, raw food, or nonallowable service
component costs or charges; and
new text end

new text begin (iii) other nonresidential elderly waiver services.
new text end

new text begin (2) In order to develop critical access criteria and alternative or enhanced payment
systems for critical access home and community-based services areas, the commissioner
shall utilize information available from existing sources whenever possible.
new text end

new text begin (3) Providers applying for alternative or enhanced rates in critical access areas may
be required to provide additional information as recommended by the commissioner
and approved by the legislature.
new text end

Sec. 20.

Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3h,
is amended to read:

Subd. 3h.

Service rate limits; 24-hour customized living services.

(a) The
payment rate for 24-hour customized living services is a monthly rate authorized by the
lead agency within the parameters established by the commissioner of human services.
The payment agreement must delineate the amount of each component service included
in each recipient's customized living service plan. The lead agency new text begin , with input from
the provider of customized living services, new text end shall ensure that there is a documented need
within the parameters established by the commissioner for all component customized
living services authorized. The lead agency shall not authorize 24-hour customized living
services unless there is a documented need for 24-hour supervision.

(b) For purposes of this section, "24-hour supervision" means that the recipient
requires assistance due to needs related to one or more of the following:

(1) intermittent assistance with toileting, positioning, or transferring;

(2) cognitive or behavioral issues;

(3) a medical condition that requires clinical monitoring; or

(4) for all new participants enrolled in the program on or after July 1, 2011, and
all other participants at their first reassessment after July 1, 2011, dependency in at
least three of the following activities of daily living as determined by assessment under
section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency
score in eating is three or greater; and needs medication management and at least 50
hours of service per month. The lead agency shall ensure that the frequency and mode
of supervision of the recipient and the qualifications of staff providing supervision are
described and meet the needs of the recipient.

(c) The payment rate for 24-hour customized living services must be based on the
amount of component services to be provided utilizing component rates established by the
commissioner. Counties and tribes will use tools issued by the commissioner to develop
and document customized living plans and authorize rates.

(d) Component service rates must not exceed payment rates for comparable elderly
waiver or medical assistance services and must reflect economies of scale.

(e) The individually authorized 24-hour customized living payments, in combination
with the payment for other elderly waiver services, including case management, must not
exceed the recipient's community budget cap specified in subdivision 3a. Customized
living services must not include rent or raw food costs.

(f) The individually authorized 24-hour customized living payment rates shall not
exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
living services in effect and in the Medicaid management information systems on March
31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
to 9549.0059, to which elderly waiver service clients are assigned. When there are
fewer than 50 authorizations in effect in the case mix resident class, the commissioner
shall multiply the calculated service payment rate maximum for the A classification by
the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
9549.0059, to determine the applicable payment rate maximum. Service payment rate
maximums shall be updated annually based on legislatively adopted changes to all service
rates for home and community-based service providers.

(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
may establish alternative payment rate systems for 24-hour customized living services in
housing with services establishments which are freestanding buildings with a capacity of
16 or fewer, by applying a single hourly rate for covered component services provided
in either:

(1) licensed corporate adult foster homes; or

(2) specialized dementia care units which meet the requirements of section 144D.065
and in which:

(i) each resident is offered the option of having their own apartment; or

(ii) the units are licensed as board and lodge establishments with maximum capacity
of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
subparts 1, 2, 3, and 4, item A.

new text begin (h) 24-hour customized living services are delivered by a provider licensed by
the Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.
Licensed home care providers are subject to section 256B.0651, subdivision 14.
new text end

deleted text begin (h) deleted text end new text begin (i) new text end A provider may not bill or otherwise charge an elderly waiver participant
or their family for additional units of any allowable component service beyond those
available under the service rate limits described in paragraph (e), nor for additional
units of any allowable component service beyond those approved in the service plan
by the lead agency.

Sec. 21.

Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to
read:

Subd. 1b.

Individual service plan.

new text begin (a) new text end The individual service plan must:

(1) include the results of the assessment information on the person's need for service,
including identification of service needs that will be or that are met by the person's
relatives, friends, and others, as well as community services used by the general public;

(2) identify the person's preferences for services as stated by the person, the person's
legal guardian or conservator, or the parent if the person is a minor;

(3) identify long- and short-range goals for the person;

(4) identify specific services and the amount and frequency of the services to be
provided to the person based on assessed needs, preferences, and available resources.
The individual service plan shall also specify other services the person needs that are
not available;

(5) identify the need for an individual program plan to be developed by the provider
according to the respective state and federal licensing and certification standards, and
additional assessments to be completed or arranged by the provider after service initiation;

(6) identify provider responsibilities to implement and make recommendations for
modification to the individual service plan;

(7) include notice of the right to request a conciliation conference or a hearing
under section 256.045;

(8) be agreed upon and signed by the person, the person's legal guardian
or conservator, or the parent if the person is a minor, and the authorized county
representative; and

(9) be reviewed by a health professional if the person has overriding medical needs
that impact the delivery of services.

new text begin (b) new text end Service planning formats developed for interagency planning such as transition,
vocational, and individual family service plans may be substituted for service planning
formats developed by county agencies.

new text begin (c) Approved, written, and signed changes to a consumer's services that meet the
criteria in this subdivision shall be an addendum to that consumer's individual service plan.
new text end

Sec. 22.

Minnesota Statutes 2010, section 256B.092, is amended by adding a
subdivision to read:

new text begin Subd. 1h. new text end

new text begin Commissioner's authority to reduce licensed capacity of adult foster
care. new text end

new text begin At the time of reassessment, lead agency case managers shall assess each recipient
of home and community-based services waivers for individuals with developmental
disabilities currently residing in a licensed adult foster care home that is not the primary
residence of the license holder, or in which the license holder is not the primary caregiver,
to determine if that resident could appropriately be served in a community-living setting.
If appropriate for the recipient, the case manager shall offer the recipient, through a
person-centered planning process, the option to receive alternative housing and service
options. In the event that the recipient chooses to transfer from the adult foster care home,
the vacated bed shall not be filled with another recipient of waiver services and group
residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a),
clauses (3) and (4), and the licensed capacity shall be reduced accordingly. If the adult
foster care home becomes no longer viable due to these transfers, the county agency, with
the assistance of the commissioner, shall facilitate a consolidation of settings or closure.
This reassessment process shall be completed by July 1, 2013.
new text end

Sec. 23.

Minnesota Statutes 2010, section 256B.092, subdivision 7, is amended to read:

Subd. 7.

Screening teams.

new text begin (a) new text end For persons with developmental disabilities,
screening teams shall be established which shall evaluate the need for the level of care
provided by residential-based habilitation services, residential services, training and
habilitation services, and nursing facility services. The evaluation shall address whether
home and community-based services are appropriate for persons who are at risk of
placement in an intermediate care facility for persons with developmental disabilities, or
for whom there is reasonable indication that they might require this level of care. The
screening team shall make an evaluation of need within 60 working days of a request for
service by a person with a developmental disability, and within five working days of
an emergency admission of a person to an intermediate care facility for persons with
developmental disabilities.

new text begin (b) new text end The screening team shall consist of the case manager for persons with
developmental disabilities, the person, the person's legal guardian or conservator, or the
parent if the person is a minor, and a qualified developmental disability professional, as
defined in the Code of Federal Regulations, title 42, section 483.430, as amended through
June 3, 1988. The case manager may also act as the qualified developmental disability
professional if the case manager meets the federal definition.

new text begin (c) new text end County social service agencies may contract with a public or private agency
or individual who is not a service provider for the person for the public guardianship
representation required by the screening or individual service planning process. The
contract shall be limited to public guardianship representation for the screening and
individual service planning activities. The contract shall require compliance with the
commissioner's instructions and may be for paid or voluntary services.

new text begin (d) new text end For persons determined to have overriding health care needs and are
seeking admission to a nursing facility or an ICF/MR, or seeking access to home and
community-based waivered services, a registered nurse must be designated as either the
case manager or the qualified developmental disability professional.

new text begin (e) new text end For persons under the jurisdiction of a correctional agency, the case manager
must consult with the corrections administrator regarding additional health, safety, and
supervision needs.

new text begin (f) new text end The case manager, with the concurrence of the person, the person's legal guardian
or conservator, or the parent if the person is a minor, may invite other individuals to
attend meetings of the screening team. new text begin With the permission of the person being screened
or the person's designated legal representative, the person's current provider of services
may submit a written report outlining their recommendations regarding the person's care
needs prepared by a direct service employee with at least 20 hours of service to that client.
The screening team must notify the provider of the date by which this information is to
be submitted. This information must be provided to the screening team and the person
or the person's legal representative and must be considered prior to the finalization of
the screening.
new text end

new text begin (g) new text end No member of the screening team shall have any direct or indirect service
provider interest in the case.

new text begin (h) new text end Nothing in this section shall be construed as requiring the screening team
meeting to be separate from the service planning meeting.

Sec. 24.

Minnesota Statutes 2010, section 256B.092, is amended by adding a
subdivision to read:

new text begin Subd. 13. new text end

new text begin Appeals. new text end

new text begin A recipient who is adversely affected by the reduction,
suspension, denial, or termination of services under this section may appeal the decision
according to section 256.045. The notice of the reduction, suspension, denial, or
termination of services from the lead agency to the applicant or recipient must be made
in plain language and must include a form for written appeal. The commissioner may
provide lead agencies with a model form for written appeal. The appeal must be in
writing and identify the specific issues the recipient would like to have considered in the
appeal hearing and a summary of the basis, with supporting professional documentation
if available, for contesting the decision.
new text end

Sec. 25.

Minnesota Statutes 2011 Supplement, section 256B.097, subdivision 3,
is amended to read:

Subd. 3.

State Quality Council.

(a) There is hereby created a State Quality
Council which must define regional quality councils, and carry out a community-based,
person-directed quality review component, and a comprehensive system for effective
incident reporting, investigation, analysis, and follow-up.

(b) By August 1, 2011, the commissioner of human services shall appoint the
members of the initial State Quality Council. Members shall include representatives
from the following groups:

(1) disability service recipients and their family members;

(2) during the first two years of the State Quality Council, there must be at least three
members from the Region 10 stakeholders. As regional quality councils are formed under
subdivision 4, each regional quality council shall appoint one member;

(3) disability service providers;

(4) disability advocacy groups; and

(5) county human services agencies and staff from the Department of Human
Services and Ombudsman for Mental Health and Developmental Disabilities.

(c) Members of the council who do not receive a salary or wages from an employer
for time spent on council duties may receive a per diem payment when performing council
duties and functions.

(d) The State Quality Council shall:

(1) assist the Department of Human Services in fulfilling federally mandated
obligations by monitoring disability service quality and quality assurance and
improvement practices in Minnesota; deleted text begin and
deleted text end

(2) establish state quality improvement priorities with methods for achieving results
and provide an annual report to the legislative committees with jurisdiction over policy
and funding of disability services on the outcomes, improvement priorities, and activities
undertaken by the commission during the previous state fiscal year deleted text begin . deleted text end new text begin ;
new text end

new text begin (3) identify issues pertaining to financial and personal risk that impede Minnesotans
with disabilities from optimizing choice of community-based services; and
new text end

new text begin (4) recommend to the chairs of the legislative committees with jurisdiction over
human services and civil law by January 15, 2013, statutory and rule changes related to
the findings under clause (3) that promote individualized service and housing choices
balanced with appropriate individualized protection.
new text end

(e) The State Quality Council, in partnership with the commissioner, shall:

(1) approve and direct implementation of the community-based, person-directed
system established in this section;

(2) recommend an appropriate method of funding this system, and determine the
feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;

(3) approve measurable outcomes in the areas of health and safety, consumer
evaluation, education and training, providers, and systems;

(4) establish variable licensure periods not to exceed three years based on outcomes
achieved; and

(5) in cooperation with the Quality Assurance Commission, design a transition plan
for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.

(f) The State Quality Council shall notify the commissioner of human services that a
facility, program, or service has been reviewed by quality assurance team members under
subdivision 4, paragraph (b), clause (13), and qualifies for a license.

(g) The State Quality Council, in partnership with the commissioner, shall establish
an ongoing review process for the system. The review shall take into account the
comprehensive nature of the system which is designed to evaluate the broad spectrum of
licensed and unlicensed entities that provide services to persons with disabilities. The
review shall address efficiencies and effectiveness of the system.

(h) The State Quality Council may recommend to the commissioner certain
variances from the standards governing licensure of programs for persons with disabilities
in order to improve the quality of services so long as the recommended variances do
not adversely affect the health or safety of persons being served or compromise the
qualifications of staff to provide services.

(i) The safety standards, rights, or procedural protections referenced under
subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
recommendations to the commissioner or to the legislature in the report required under
paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
procedural protections referenced under subdivision 2, paragraph (c).

(j) The State Quality Council may hire staff to perform the duties assigned in this
subdivision.

Sec. 26.

Minnesota Statutes 2010, section 256B.431, subdivision 17e, is amended to
read:

Subd. 17e.

Replacement-costs-new per bed limit effective October 1, 2007.

Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2),
for a total replacement, as defined in subdivision 17d, authorized under section
144A.071 or 144A.073 after July 1, 1999, any building project that is a relocation,
renovation, upgrading, or conversion completed on or after July 1, 2001, or any
building project eligible for reimbursement under section 256B.434, subdivision 4f, the
replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
9549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1,
2000. new text begin These amounts must be increased annually as specified in subdivision 3f, paragraph
(a), beginning October 1, 2012.
new text end

Sec. 27.

Minnesota Statutes 2010, section 256B.431, is amended by adding a
subdivision to read:

new text begin Subd. 45. new text end

new text begin Rate adjustments for some moratorium exception projects.
new text end

new text begin Notwithstanding any other law to the contrary, money available for moratorium exception
projects under section 144A.073, subdivisions 2 and 11, shall be used to fund the
incremental rate increases resulting from this section for any nursing facility with a
moratorium exception project approved under section 144A.073, and completed after
August 30, 2010, where the replacement-costs-new limits under subdivision 17e were
higher at any time after project approval than at the time of project completion. The
commissioner shall calculate the property rate increase for these facilities using the highest
set of limits; however, any rate increase under this section shall not be effective until on
or after the effective date of this section, contingent upon federal approval. No property
rate decrease shall result from this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval.
new text end

Sec. 28.

Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 14,
is amended to read:

Subd. 14.

Assessment and reassessment.

(a) Assessments of each recipient's
strengths, informal support systems, and need for services shall be completed within 20
working days of the recipient's request as provided in section 256B.0911. Reassessment of
each recipient's strengths, support systems, and need for services shall be conducted at
least every 12 months and at other times when there has been a significant change in the
recipient's functioning. new text begin With the permission of the recipient or the recipient's designated
legal representative, the recipient's current provider of services may submit a written
report outlining their recommendations regarding the recipient's care needs prepared by
a direct service employee with at least 20 hours of service to that client. The person
conducting the assessment or reassessment must notify the provider of the date by which
this information is to be submitted. This information shall be provided to the person
conducting the assessment and the person or the person's legal representative and must be
considered prior to the finalization of the assessment or reassessment.
new text end

(b) There must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
(d), at initial and subsequent assessments to initiate and maintain participation in the
waiver program.

(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only face-to-face assessments conducted according
to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
determination or a nursing facility level of care determination must be accepted for
purposes of initial and ongoing access to waiver services payment.

(d) Persons with developmental disabilities who apply for services under the nursing
facility level waiver programs shall be screened for the appropriate level of care according
to section 256B.092.

(e) Recipients who are found eligible for home and community-based services under
this section before their 65th birthday may remain eligible for these services after their
65th birthday if they continue to meet all other eligibility factors.

(f) The commissioner shall develop criteria to identify recipients whose level of
functioning is reasonably expected to improve and reassess these recipients to establish
a baseline assessment. Recipients who meet these criteria must have a comprehensive
transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
reassessed every six months until there has been no significant change in the recipient's
functioning for at least 12 months. After there has been no significant change in the
recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
informal support systems, and need for services shall be conducted at least every 12
months and at other times when there has been a significant change in the recipient's
functioning. Counties, case managers, and service providers are responsible for
conducting these reassessments and shall complete the reassessments out of existing funds.

Sec. 29.

Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15,
is amended to read:

Subd. 15.

Individualized service plan; comprehensive transitional service plan;
maintenance service plan.

(a) Each recipient of home and community-based waivered
services shall be provided a copy of the written service plan which:

(1) is developed and signed by the recipient within ten working days of the
completion of the assessment;

(2) meets the assessed needs of the recipient;

(3) reasonably ensures the health and safety of the recipient;

(4) promotes independence;

(5) allows for services to be provided in the most integrated settings; and

(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (p), of service and support providers.

(b) In developing the comprehensive transitional service plan, the individual
receiving services, the case manager, and the guardian, if applicable, will identify
the transitional service plan fundamental service outcome and anticipated timeline to
achieve this outcome. Within the first 20 days following a recipient's request for an
assessment or reassessment, the transitional service planning team must be identified. A
team leader must be identified who will be responsible for assigning responsibility and
communicating with team members to ensure implementation of the transition plan and
ongoing assessment and communication process. The team leader should be an individual,
such as the case manager or guardian, who has the opportunity to follow the recipient to
the next level of service.

Within ten days following an assessment, a comprehensive transitional service plan
must be developed incorporating elements of a comprehensive functional assessment and
including short-term measurable outcomes and timelines for achievement of and reporting
on these outcomes. Functional milestones must also be identified and reported according
to the timelines agreed upon by the transitional service planning team. In addition, the
comprehensive transitional service plan must identify additional supports that may assist
in the achievement of the fundamental service outcome such as the development of greater
natural community support, increased collaboration among agencies, and technological
supports.

The timelines for reporting on functional milestones will prompt a reassessment of
services provided, the units of services, rates, and appropriate service providers. It is
the responsibility of the transitional service planning team leader to review functional
milestone reporting to determine if the milestones are consistent with observable skills
and that milestone achievement prompts any needed changes to the comprehensive
transitional service plan.

For those whose fundamental transitional service outcome involves the need to
procure housing, a plan for the recipient to seek the resources necessary to secure the least
restrictive housing possible should be incorporated into the plan, including employment
and public supports such as housing access and shelter needy funding.

(c) Counties and other agencies responsible for funding community placement and
ongoing community supportive services are responsible for the implementation of the
comprehensive transitional service plans. Oversight responsibilities include both ensuring
effective transitional service delivery and efficient utilization of funding resources.

(d) Following one year of transitional services, the transitional services planning
team will make a determination as to whether or not the individual receiving services
requires the current level of continuous and consistent support in order to maintain the
recipient's current level of functioning. Recipients who are determined to have not had
a significant change in functioning for 12 months must move from a transitional to a
maintenance service plan. Recipients on a maintenance service plan must be reassessed
to determine if the recipient would benefit from a transitional service plan at least every
12 months and at other times when there has been a significant change in the recipient's
functioning. This assessment should consider any changes to technological or natural
community supports.

(e) When a county is evaluating denials, reductions, or terminations of home and
community-based services under section 256B.49 for an individual, the case manager
shall offer to meet with the individual or the individual's guardian in order to discuss the
prioritization of service needs within the individualized service plan, comprehensive
transitional service plan, or maintenance service plan. The reduction in the authorized
services for an individual due to changes in funding for waivered services may not exceed
the amount needed to ensure medically necessary services to meet the individual's health,
safety, and welfare.

(f) At the time of reassessment, local agency case managers shall assess each
recipient of community alternatives for disabled individuals or traumatic brain injury
waivered services currently residing in a licensed adult foster home that is not the primary
residence of the license holder, or in which the license holder is not the primary caregiver,
to determine if that recipient could appropriately be served in a community-living setting.
If appropriate for the recipient, the case manager shall offer the recipient, through a
person-centered planning process, the option to receive alternative housing and service
options. deleted text begin In the event that the recipient chooses to transfer from the adult foster home,
deleted text end deleted text begin the vacated bed shall not be filled with another recipient of waiver services and group
deleted text end deleted text begin residential housing , unless deleted text end new text begin The licensed capacity shall be reduced accordingly, unless the
savings required by the 2011 licensed bed closure reductions for foster care settings where
the physical location is not the primary residence of the license holder are met through
voluntary changes described in section 245A.03, subdivision 7, paragraph (f), or as
new text end provided under section 245A.03, subdivision 7, paragraph (a), clauses (3) and (4) deleted text begin , and the
licensed capacity shall be reduced accordingly. If the adult foster home becomes no longer
viable due to these transfers, the county agency, with the assistance of the department,
shall facilitate a consolidation of settings or closure deleted text end . This reassessment process shall be
completed by deleted text begin June 30, 2012 deleted text end new text begin July 1, 2013 new text end .

Sec. 30.

Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 23,
is amended to read:

Subd. 23.

Community-living settings.

"Community-living settings" means a
single-family home or apartment where the service recipient or their family owns or rents,
deleted text begin as demonstrated by a lease agreement, deleted text end and maintains control over the individual unit deleted text begin . deleted text end new text begin as
demonstrated by the lease agreement, or has a plan for transition of a lease from a service
provider to the individual. Within two years of signing the initial lease, the service provider
shall transfer the lease to the individual. In the event the landlord denies the transfer, the
commissioner may approve an exception within sufficient time to ensure the continued
occupancy by the individual. new text end Community-living settings are subject to the following:

(1) individuals are not required to receive services;

(2) individuals are not required to have a disability or specific diagnosis to live in the
community-living setting new text begin unless state or federal funding for housing requires it new text end ;

(3) individuals may hire service providers of their choice;

(4) individuals may choose whether to share their household and with whom;

(5) the home or apartment must include living, sleeping, bathing, and cooking areas;

(6) individuals must have lockable access and egress;

(7) individuals must be free to receive visitors and leave the settings at times and for
durations of their own choosing;

(8) leases must not reserve the right to assign units or change unit assignments; and

(9) access to the greater community must be easily facilitated based on the
individual's needs and preferences.

Sec. 31.

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

new text begin Subd. 24. new text end

new text begin Appeals. new text end

new text begin A recipient who is adversely affected by the reduction,
suspension, denial, or termination of services under this section may appeal the decision
according to section 256.045. The notice of the reduction, suspension, denial, or
termination of services from the lead agency to the applicant or recipient must be made
in plain language and must include a form for written appeal. The commissioner may
provide lead agencies with a model form for written appeal. The appeal must be in
writing and identify the specific issues the recipient would like to have considered in the
appeal hearing and a summary of the basis, with supporting professional documentation
if available, for contesting the decision.
new text end

Sec. 32.

new text begin [256B.492] HOME AND COMMUNITY-BASED SETTINGS.
new text end

new text begin (a) For purposes of the home and community-based waiver programs under sections
256B.092 and 256B.49, home and community-based settings include:
new text end

new text begin (1) licensed adult or child foster care settings of four or five, if emergency exception
criteria are met; and
new text end

new text begin (2) other settings that meet the definition of "community-living settings" under
section 256B.49, subdivision 23:
new text end

new text begin (i) in addition to this definition, if a single corporation or entity provides both
housing and services, there must be a distinct separation between the housing and services;
new text end

new text begin (ii) individuals may choose a service provider separate from the housing provider
without being required to move; and
new text end

new text begin (iii) for settings that meet this definition, individuals with disabilities may reside in
up to four units plus 25 percent of the remaining units in the building unless an exception
is granted under paragraph (c).
new text end

new text begin (b) For purposes of the home and community-based waiver programs under sections
256B.092 and 256B.49, home and community-based settings must not:
new text end

new text begin (1) be located in a building that is also a publicly or privately operated facility that
provides institutional treatment or custodial care;
new text end

new text begin (2) be located in a building on the grounds of, or immediately adjacent to, a public or
private institution;
new text end

new text begin (3) be a housing complex designed expressly around an individual's diagnosis or
disability;
new text end

new text begin (4) be segregated based on disability, either physically or because of setting
characteristics, from the larger community; or
new text end

new text begin (5) have the qualities of an institution which include, but are not limited to:
regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
agreed to and documented in the person's individual service plan shall not result in a
residence having the qualities of an institution as long as the restrictions for the person are
not imposed upon others in the same residence and are the least restrictive alternative,
imposed for the shortest possible time to meet the person's needs.
new text end

new text begin (c) The provisions of this section do not apply to any setting in which residents
receive services under a home and community-based waiver as of June 30, 2013, and
which have been delivering those services for at least one year.
new text end

new text begin (d) Notwithstanding paragraph (c), a program in Hennepin County established as
part of a Hennepin County demonstration project by January 1, 2013, is qualified for
the exception allowed under paragraph (c).
new text end

Sec. 33.

Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13,
is amended to read:

Subd. 13.

ICF/DD rate decrease effective July 1, deleted text begin 2012 deleted text end new text begin 2013 new text end .

Notwithstanding
subdivision 12, new text begin and if the commissioner has not received federal approval before July 1,
2013, of the Long-Term Care Realignment Waiver application submitted under Laws
2011, First Special Session chapter 9, article 7, section 52, new text end for each facility reimbursed
under this section new text begin for services provided from July 1, 2013, through December 31, 2013 new text end ,
the commissioner shall decrease operating payments equal to 1.67 percent of the operating
payment rates in effect on June 30, deleted text begin 2012 deleted text end new text begin 2013 new text end . For each facility, the commissioner shall
apply the rate reduction based on occupied beds, using the percentage specified in this
subdivision multiplied by the total payment rate, including the variable rate but excluding
the property-related payment rate, in effect on the preceding date. The total rate reduction
shall include the adjustment provided in section 256B.501, subdivision 12.

Sec. 34.

Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:

Subd. 5.

Special needs.

In addition to the state standards of assistance established in
subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a group residential housing facility.

(a) The county agency shall pay a monthly allowance for medically prescribed
diets if the cost of those additional dietary needs cannot be met through some other
maintenance benefit. The need for special diets or dietary items must be prescribed by
a licensed physician. Costs for special diets shall be determined as percentages of the
allotment for a one-person household under the thrifty food plan as defined by the United
States Department of Agriculture. The types of diets and the percentages of the thrifty
food plan that are covered are as follows:

(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;

(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
of thrifty food plan;

(3) controlled protein diet, less than 40 grams and requires special products, 125
percent of thrifty food plan;

(4) low cholesterol diet, 25 percent of thrifty food plan;

(5) high residue diet, 20 percent of thrifty food plan;

(6) pregnancy and lactation diet, 35 percent of thrifty food plan;

(7) gluten-free diet, 25 percent of thrifty food plan;

(8) lactose-free diet, 25 percent of thrifty food plan;

(9) antidumping diet, 15 percent of thrifty food plan;

(10) hypoglycemic diet, 15 percent of thrifty food plan; or

(11) ketogenic diet, 25 percent of thrifty food plan.

(b) Payment for nonrecurring special needs must be allowed for necessary home
repairs or necessary repairs or replacement of household furniture and appliances using
the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
as long as other funding sources are not available.

(c) A fee for guardian or conservator service is allowed at a reasonable rate
negotiated by the county or approved by the court. This rate shall not exceed five percent
of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
guardian or conservator is a member of the county agency staff, no fee is allowed.

(d) The county agency shall continue to pay a monthly allowance of $68 for
restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
1990, and who eats two or more meals in a restaurant daily. The allowance must continue
until the person has not received Minnesota supplemental aid for one full calendar month
or until the person's living arrangement changes and the person no longer meets the criteria
for the restaurant meal allowance, whichever occurs first.

(e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
is allowed for representative payee services provided by an agency that meets the
requirements under SSI regulations to charge a fee for representative payee services. This
special need is available to all recipients of Minnesota supplemental aid regardless of
their living arrangement.

(f)(1) Notwithstanding the language in this subdivision, an amount equal to the
maximum allotment authorized by the federal Food Stamp Program for a single individual
which is in effect on the first day of July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
as shelter needy and are: (i) relocating from an institution, or an adult mental health
residential treatment program under section 256B.0622; (ii) eligible for the self-directed
supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
community-based waiver recipients living in their own home or rented or leased apartment
which is not owned, operated, or controlled by a provider of service not related by blood
or marriage, unless allowed under paragraph (g).

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
shelter needy benefit under this paragraph is considered a household of one. An eligible
individual who receives this benefit prior to age 65 may continue to receive the benefit
after the age of 65.

(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this
special needs standard. "Gross income" for the purposes of this section is the applicant's or
recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
considered shelter needy for purposes of this paragraph.

(g) Notwithstanding this subdivision, to access housing and services as provided
in paragraph (f), the recipient may choose housing that may be owned, operated, or
controlled by the recipient's service provider. In a multifamily building deleted text begin of four or more
units, the maximum number of apartments that may be used by recipients of this program
shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. deleted text end new text begin of
more than four units, the maximum number of units that may be used by recipients of this
program shall be 50 percent of the units in the building. When housing is controlled by
the service provider, the individual may choose the individual's own service provider as
provided in section 256B.49, subdivision 23, clause (3). When the housing is controlled
by the service provider, the service provider shall implement a plan with the recipient to
transition the lease to the recipient's name. Within two years of signing the initial lease,
the service provider shall transfer the lease entered into under this subdivision to the
recipient. In the event the landlord denies this transfer, the commissioner may approve an
exception within sufficient time to ensure the continued occupancy by the recipient. This
paragraph expires June 30, 2016.
new text end

Sec. 35.

Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to
read:

Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.

The commissioner shall seek any necessary federal approval in order to implement
the changes to the level of care criteria in Minnesota Statutes, section 144.0724,
subdivision 11, on new text begin or after new text end July 1, 2012 new text begin , for adults and children new text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 36.

Laws 2011, First Special Session chapter 9, article 7, section 54, is amended to
read:

Sec. 54. CONTINGENCY PROVIDER RATE AND GRANT REDUCTIONS.

(a) Notwithstanding any other rate reduction in this article, new text begin if the commissioner of
human services has not received federal approval before July 1, 2013, of the long-term
care realignment waiver application submitted under Laws 2011, First Special Session
chapter 9, article 7, section 52, new text end the commissioner deleted text begin of deleted text end deleted text begin human services deleted text end shall decrease grants,
allocations, reimbursement rates, individual limits, and rate limits, as applicable, by 1.67
percent effective July 1, deleted text begin 2012 deleted text end new text begin 2013 new text end , for services rendered deleted text begin on or after those dates deleted text end new text begin from July
1, 2013, through December 31, 2013 new text end . County or tribal contracts for services specified in
this section must be amended to pass through these rate reductions within 60 days of
the effective date of the decrease, and must be retroactive from the effective date of the
rate decrease.

(b) The rate changes described in this section must be provided to:

(1) home and community-based waivered services for persons with developmental
disabilities or related conditions, including consumer-directed community supports, under
Minnesota Statutes, section 256B.501;

(2) home and community-based waivered services for the elderly, including
consumer-directed community supports, under Minnesota Statutes, section 256B.0915;

(3) waivered services under community alternatives for disabled individuals,
including consumer-directed community supports, under Minnesota Statutes, section
256B.49;

(4) community alternative care waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;

(5) traumatic brain injury waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;

(6) nursing services and home health services under Minnesota Statutes, section
256B.0625, subdivision 6a;

(7) personal care services and qualified professional supervision of personal care
services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;

(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
subdivision 7;

(9) day training and habilitation services for adults with developmental disabilities
or related conditions, under Minnesota Statutes, sections 252.40 to 252.46, including the
additional cost of rate adjustments on day training and habilitation services, provided as a
social service under Minnesota Statutes, section 256M.60; and

(10) alternative care services under Minnesota Statutes, section 256B.0913.

(c) A managed care plan receiving state payments for the services in this section
must include these decreases in their payments to providers. To implement the rate
reductions in this section, capitation rates paid by the commissioner to managed care
organizations under Minnesota Statutes, section 256B.69, shall reflect a deleted text begin 2.34 deleted text end new text begin 1.67 new text end percent
reduction for the specified services for the period of deleted text begin January 1, 2013, through June 30,
deleted text end deleted text begin 2013, and a 1.67 percent reduction for those services on and after July 1 deleted text end new text begin July 1, 2013,
through December 31 new text end , 2013.

The above payment rate reduction, allocation rates, and rate limits shall expire for
services rendered on December 31, 2013.

Sec. 37.

Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
3, is amended to read:

Subd. 3. Forecasted Programs

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

(a) MFIP/DWP Grants

Appropriations by Fund
General	84,680,000	91,978,000
Federal TANF	84,425,000	75,417,000

(b) MFIP Child Care Assistance Grants

55,456,000

30,923,000

(c) General Assistance Grants

49,192,000

46,938,000

General Assistance Standard. The
commissioner shall set the monthly standard
of assistance for general assistance units
consisting of an adult recipient who is
childless and unmarried or living apart
from parents or a legal guardian at $203.
The commissioner may reduce this amount
according to Laws 1997, chapter 85, article
3, section 54.

Emergency General Assistance. The
amount appropriated for emergency general
assistance funds is limited to no more
than $6,689,812 in fiscal year 2012 and
$6,729,812 in fiscal year 2013. Funds
to counties shall be allocated by the
commissioner using the allocation method
specified in Minnesota Statutes, section
256D.06.

(d) Minnesota Supplemental Aid Grants

38,095,000

39,120,000

(e) Group Residential Housing Grants

121,080,000

129,238,000

(f) MinnesotaCare Grants

295,046,000

317,272,000

This appropriation is from the health care
access fund.

(g) Medical Assistance Grants

4,501,582,000

4,437,282,000

Managed Care Incentive Payments. The
commissioner shall not make managed care
incentive payments for expanding preventive
services during fiscal years beginning July 1,
2011, and July 1, 2012.

Reduction of Rates for Congregate
Living for Individuals with Lower Needs.
Beginning October 1, 2011, new text begin through June
30, 2012, new text end lead agencies must reduce rates in
effect on January 1, 2011, by ten percent for
individuals with lower needs living in foster
care settings where the license holder does
not share the residence with recipients on
the CADI and DD waivers and customized
living settings for CADI. new text begin Beginning July
1, 2012, lead agencies must reduce rates in
effect on January 1, 2011, by ten percent,
for individuals living in foster care settings
where the license holder does not share the
residence with recipients on the CADI and
DD waivers and customized living settings
for CADI, in a manner that ensures that:
(1) an identical percentage of recipients
receiving services under each waiver receive
a reduction; and (2) the projected savings
for this provision for fiscal year 2013 are
achieved, notwithstanding whether or not a
recipient is an individual with lower needs. new text end
Lead agencies must adjust contracts within
60 days of the effective date.

Reduction of Lead Agency Waiver
Allocations to Implement Rate Reductions
for Congregate Living for Individuals
with Lower Needs. Beginning October 1,
2011, the commissioner shall reduce lead
agency waiver allocations to implement the
reduction of rates for individuals with lower
needs living in foster care settings where the
license holder does not share the residence
with recipients on the CADI and DD waivers
and customized living settings for CADI.

Reduce customized living and 24-hour
customized living component rates.
Effective July 1, 2011, the commissioner
shall reduce elderly waiver customized living
and 24-hour customized living component
service spending by five percent through
reductions in component rates and service
rate limits. The commissioner shall adjust
the elderly waiver capitation payment
rates for managed care organizations paid
under Minnesota Statutes, section 256B.69,
subdivisions 6a and 23, to reflect reductions
in component spending for customized living
services and 24-hour customized living
services under Minnesota Statutes, section
256B.0915, subdivisions 3e and 3h, for the
contract period beginning January 1, 2012.
To implement the reduction specified in
this provision, capitation rates paid by the
commissioner to managed care organizations
under Minnesota Statutes, section 256B.69,
shall reflect a ten percent reduction for the
specified services for the period January 1,
2012, to June 30, 2012, and a five percent
reduction for those services on or after July
1, 2012.

Limit Growth in the Developmental
Disability Waiver. The commissioner
shall limit growth in the developmental
disability waiver to six diversion allocations
per month beginning July 1, 2011, through
June 30, 2013, and 15 diversion allocations
per month beginning July 1, 2013, through
June 30, 2015. Waiver allocations shall
be targeted to individuals who meet the
priorities for accessing waiver services
identified in Minnesota Statutes, 256B.092,
subdivision 12. The limits do not include
conversions from intermediate care facilities
for persons with developmental disabilities.
Notwithstanding any contrary provisions in
this article, this paragraph expires June 30,
2015.

Limit Growth in the Community
Alternatives for Disabled Individuals
Waiver. The commissioner shall limit
growth in the community alternatives for
disabled individuals waiver to 60 allocations
per month beginning July 1, 2011, through
June 30, 2013, and 85 allocations per
month beginning July 1, 2013, through
June 30, 2015. Waiver allocations must
be targeted to individuals who meet the
priorities for accessing waiver services
identified in Minnesota Statutes, section
256B.49, subdivision 11a. The limits include
conversions and diversions, unless the
commissioner has approved a plan to convert
funding due to the closure or downsizing
of a residential facility or nursing facility
to serve directly affected individuals on
the community alternatives for disabled
individuals waiver. Notwithstanding any
contrary provisions in this article, this
paragraph expires June 30, 2015.

Personal Care Assistance Relative
Care. The commissioner shall adjust the
capitation payment rates for managed care
organizations paid under Minnesota Statutes,
section 256B.69, to reflect the rate reductions
for personal care assistance provided by
a relative pursuant to Minnesota Statutes,
section 256B.0659, subdivision 11.

(h) Alternative Care Grants

46,421,000

46,035,000

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

(i) Chemical Dependency Entitlement Grants

94,675,000

93,298,000

Sec. 38.

Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
4, is amended to read:

Subd. 4. Grant Programs

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

(a) Support Services Grants

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

MFIP Consolidated Fund Grants. The
TANF fund base is reduced by $10,000,000
each year beginning in fiscal year 2012.

Subsidized Employment Funding Through
ARRA. The commissioner is authorized to
apply for TANF emergency fund grants for
subsidized employment activities. Growth
in expenditures for subsidized employment
within the supported work program and the
MFIP consolidated fund over the amount
expended in the calendar year quarters in
the TANF emergency fund base year shall
be used to leverage the TANF emergency
fund grants for subsidized employment and
to fund supported work. The commissioner
shall develop procedures to maximize
reimbursement of these expenditures over the
TANF emergency fund base year quarters,
and may contract directly with employers
and providers to maximize these TANF
emergency fund grants.

(b) Basic Sliding Fee Child Care Assistance Grants

37,144,000

38,678,000

Base Adjustment. The general fund base is
decreased by $990,000 in fiscal year 2014
and $979,000 in fiscal year 2015.

Child Care and Development Fund
Unexpended Balance. In addition to
the amount provided in this section, the
commissioner shall expend $5,000,000
in fiscal year 2012 from the federal child
care and development fund unexpended
balance for basic sliding fee child care under
Minnesota Statutes, section 119B.03. The
commissioner shall ensure that all child
care and development funds are expended
according to the federal child care and
development fund regulations.

(c) Child Care Development Grants

774,000

774,000

Base Adjustment. The general fund base is
increased by $713,000 in fiscal years 2014
and 2015.

(d) Child Support Enforcement Grants

50,000

50,000

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

(e) Children's Services Grants

Appropriations by Fund
General	47,949,000	48,507,000
Federal TANF	140,000	140,000

Adoption Assistance and Relative Custody
Assistance Transfer. The commissioner
may transfer unencumbered appropriation
balances for adoption assistance and relative
custody assistance between fiscal years and
between programs.

Privatized Adoption Grants. Federal
reimbursement for privatized adoption grant
and foster care recruitment grant expenditures
is appropriated to the commissioner for
adoption grants and foster care and adoption
administrative purposes.

Adoption Assistance Incentive Grants.
Federal funds available during fiscal year
2012 and fiscal year 2013 for adoption
incentive grants are appropriated to the
commissioner for these purposes.

(f) Children and Community Services Grants

53,301,000

53,301,000

(g) Children and Economic Support Grants

Appropriations by Fund
General	16,103,000	16,180,000
Federal TANF	700,000	0

Long-Term Homeless Services. $700,000
is appropriated from the federal TANF
fund for the biennium beginning July
1, 2011, to the commissioner of human
services for long-term homeless services
for low-income homeless families under
Minnesota Statutes, section 256K.26. This
is a onetime appropriation and is not added
to the base.

Base Adjustment. The general fund base is
increased by $42,000 in fiscal year 2014 and
$43,000 in fiscal year 2015.

Minnesota Food Assistance Program.
$333,000 in fiscal year 2012 and $408,000 in
fiscal year 2013 are to increase the general
fund base for the Minnesota food assistance
program. Unexpended funds for fiscal year
2012 do not cancel but are available to the
commissioner for this purpose in fiscal year
2013.

(h) Health Care Grants

Appropriations by Fund
General	26,000	66,000
Health Care Access	190,000	190,000

Base Adjustment. The general fund base is
increased by $24,000 in each of fiscal years
2014 and 2015.

(i) Aging and Adult Services Grants

12,154,000

11,456,000

Aging Grants Reduction. Effective July
1, 2011, funding for grants made under
Minnesota Statutes, sections 256.9754 and
256B.0917, subdivision 13, is reduced by
$3,600,000 for each year of the biennium.
These reductions are onetime and do
not affect base funding for the 2014-2015
biennium. Grants made during the 2012-2013
biennium under Minnesota Statutes, section
256B.9754, must not be used for new
construction or building renovation.

Essential Community Support Grant
Delay. Upon federal approval to implement
the nursing facility level of care on July
1, 2013, essential community supports
grants under Minnesota Statutes, section
256B.0917, subdivision 14, are reduced by
$6,410,000 in fiscal year 2013. Base level
funding is increased by $5,541,000 in fiscal
year 2014 and $6,410,000 in fiscal year 2015.

Base Level Adjustment. The general fund
base is increased by $10,035,000 in fiscal
year 2014 and increased by $10,901,000 in
fiscal year 2015.

(j) Deaf and Hard-of-Hearing Grants

1,936,000

1,767,000

(k) Disabilities Grants

15,945,000

18,284,000

Grants for Housing Access Services. In
fiscal year 2012, the commissioner shall
make available a total of $161,000 in housing
access services grants to individuals who
relocate from an adult foster care home to
a community living setting for assistance
with completion of rental applications or
lease agreements; assistance with publicly
financed housing options; development of
household budgets; and assistance with
funding affordable furnishings and related
household matters.

HIV Grants. The general fund appropriation
for the HIV drug and insurance grant
program shall be reduced by $2,425,000 in
fiscal year 2012 and increased by $2,425,000
in fiscal year 2014. These adjustments are
onetime and shall not be applied to the base.
Notwithstanding any contrary provision, this
provision expires June 30, 2014.

Region 10. Of this appropriation, $100,000
each year is for a grant provided under
Minnesota Statutes, section 256B.097.

Base Level Adjustment. The general fund
base is increased by $2,944,000 in fiscal year
2014 and $653,000 in fiscal year 2015.

Local Planning Grants for Creating
Alternatives to Congregate Living for
Individuals with Lower Needs. new text begin Of this
appropriation, $100,000 in fiscal year 2013
is for administrative functions related to the
need determination and planning process
required under Minnesota Statutes, sections
144A.351 and 245A.03, subdivision 7,
paragraphs (e) and (f). new text end The commissioner
shall make available a total of deleted text begin $250,000 per
year deleted text end new text begin $400,000, $250,000 of which carries
forward from fiscal year 2012, new text end in local new text begin
and regional new text end planning grants, beginning
July 1, deleted text begin 2011 deleted text end new text begin 2012 new text end , to assist lead agencies
and provider organizations in developing
alternatives to congregate living within the
available level of resources for the home
and community-based services waivers for
persons with disabilities.

Disability Linkage Line. Of this
appropriation, $125,000 in fiscal year 2012
and $300,000 in fiscal year 2013 are for
assistance to people with disabilities who are
considering enrolling in managed care.

(l) Adult Mental Health Grants

Appropriations by Fund
General	70,570,000	70,570,000
Health Care Access	750,000	750,000
Lottery Prize	1,508,000	1,508,000

Funding Usage. Up to 75 percent of a fiscal
year's appropriation for adult mental health
grants may be used to fund allocations in that
portion of the fiscal year ending December
31.

Base Adjustment. The general fund base is
increased by $200,000 in fiscal years 2014
and 2015.

(m) Children's Mental Health Grants

16,457,000

16,457,000

Funding Usage. Up to 75 percent of a fiscal
year's appropriation for children's mental
health grants may be used to fund allocations
in that portion of the fiscal year ending
December 31.

Base Adjustment. The general fund base is
increased by $225,000 in fiscal years 2014
and 2015.

(n) Chemical Dependency Nonentitlement Grants

1,336,000

1,336,000

Sec. 39. new text begin INDEPENDENT LIVING SERVICES BILLING.
new text end

new text begin The commissioner shall allow for daily rate and 15-minute increment billing for
independent living services under the brain injury (BI) and CADI waivers. If necessary to
comply with this requirement, the commissioner shall submit a waiver amendment to the
state plan no later than December 31, 2012.
new text end

Sec. 40. new text begin COMMUNITY FIRST CHOICE OPTION.
new text end

new text begin (a) If the final federal regulations under Community First Choice Option are
determined by the commissioner, after consultation with interested stakeholders in
paragraph (d), to be compatible with Minnesota's fiscal neutrality and policy requirements
for redesigning and simplifying the personal care assistance program, assistance at home
and in the community provided through the home and community-based services with
waivers, state-funded grants, and medical assistance-funded services and programs, the
commissioner shall develop and request a state plan amendment to establish services,
including self-directed options, under section 1915k of the Social Security Act by January
15, 2013, for implementation on July 1, 2013.
new text end

new text begin (b) The commissioner shall develop and provide to the chairs of the health and
human services policy and finance committees, legislation needed to reform and simplify
home care, home and community-based services waivers, and other community support
services under the Community First Choice Option by February 15, 2013.
new text end

new text begin (c) Any savings generated by this option shall accrue to the commissioner for
development and implementation of community support services under the Community
First Choice Option.
new text end

new text begin (d) The commissioner shall consult with stakeholders, including persons with
disabilities and seniors, who represent a range of disabilities, ages, cultures, and
geographic locations, their families and guardians, as well as representatives of advocacy
organizations, lead agencies, direct support staff, labor unions, and a variety of service
provider groups.
new text end

Sec. 41. new text begin COMMISSIONER AUTHORITY TO REDUCE 2011 CONGREGATE
CARE LOW NEED RATE CUT.
new text end

new text begin During fiscal years 2013 and 2014, the commissioner shall reduce the 2011 reduction
of rates for congregate living for individuals with lower needs to the extent actions taken
under Minnesota Statutes, section 245A.03, subdivision 7, paragraph (f), produce savings
beyond the amount needed to meet the licensed bed closure savings requirements of
Minnesota Statutes, section 245A.03, subdivision 7, paragraph (e). Each February 1, the
commissioner shall report to the chairs of the legislative committees with jurisdiction over
health and human services finance on any reductions provided under this section. This
section is effective on July 1, 2012, and expires on June 30, 2014.
new text end

Sec. 42. new text begin HOME AND COMMUNITY-BASED SERVICES WAIVERS
AMENDMENT FOR EXCEPTION.
new text end

new text begin By September 1, 2012, the commissioner of human services shall submit
amendments to the home and community-based waiver plans consistent with the definition
of home and community-based settings under Minnesota Statutes, section 256B.492,
including a request to allow an exception for those settings that serve persons with
disabilities under a home and community-based service waiver in more than 25 percent
of the units in a building as of January 1, 2012, but otherwise meet the definition under
Minnesota Statutes, section 256B.492.
new text end

Sec. 43. new text begin COMMISSIONER TO SEEK AMENDMENT FOR EXCEPTION
TO CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
METHODOLOGY.
new text end

new text begin By July 1, 2012, the commissioner shall request an amendment to the home and
community-based services waivers authorized under Minnesota Statutes, sections
256B.092 and 256B.49, to establish an exception to the consumer-directed community
supports budget methodology to provide up to 20 percent more funds for those
participants who have their 21st birthday and graduate from high school during 2013 and
are authorized for more services under consumer-directed community supports prior to
graduation than what they are eligible to receive under the current consumer-directed
community supports budget methodology. The exception is limited to those who can
demonstrate that they will have to leave consumer-directed community supports and use
other waiver services because their need for day or employment supports cannot be met
within the consumer-directed community supports budget limits. The commissioner
shall consult with the stakeholder group authorized under Minnesota Statutes, section
256B.0657, subdivision 11, to implement this provision. The exception process shall be
effective upon federal approval for persons eligible during 2013 and 2014.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 44. new text begin DIRECTION TO OMBUDSMAN FOR LONG-TERM CARE.
new text end

new text begin The ombudsman for long-term care shall:
new text end

new text begin (1) research the existence of differential treatment based on source of payment in
assisted living settings;
new text end

new text begin (2) convene stakeholders to provide technical assistance and expertise in studying
and addressing these issues, including but not limited to consumers, health care and
housing providers, advocates representing seniors and younger persons with disabilities or
mental health challenges, county representatives, and representatives of the Departments
of Health and Human Services; and
new text end

new text begin (3) submit a report of findings to the legislature no later than January 31, 2013,
with recommendations for the development of policies and procedures to prevent and
remedy instances of discrimination based on participation in or potential eligibility for
medical assistance.
new text end

ARTICLE 5

MINNESOTA CHILDREN AND FAMILY INVESTMENT PROGRAM

Section 1. new text begin CITATION.
new text end

new text begin Sections 2 to 8 may be cited as the "Minnesota Children and Family Investment
Program Act."
new text end

Sec. 2.

Minnesota Statutes 2010, section 256J.08, is amended by adding a subdivision
to read:

new text begin Subd. 11b. new text end

new text begin Child well-being. new text end

new text begin "Child well-being" means a child's developmental
progress relative to the child's age, including cognitive, physical, emotional, and social
development as measured through developmental screening tools, school achievement,
health status, and other relevant standardized measures of development.
new text end

Sec. 3.

Minnesota Statutes 2010, section 256J.45, subdivision 2, is amended to read:

Subd. 2.

General information.

new text begin (a) new text end The MFIP orientation must consist of a
presentation that informs caregivers of:

(1) the necessity to obtain immediate employment;

(2) the work incentives under MFIP, including the availability of the federal earned
income tax credit and the Minnesota working family tax credit;

(3) the requirement to comply with the employment plan and other requirements
of the employment and training services component of MFIP, including a description
of the range of work and training activities that are allowable under MFIP to meet the
individual needs of participants;

(4) the consequences for failing to comply with the employment plan and other
program requirements, and that the county agency may not impose a sanction when failure
to comply is due to the unavailability of child care or other circumstances where the
participant has good cause under subdivision 3;

(5) the rights, responsibilities, and obligations of participants;

(6) the types and locations of child care services available through the county agency;

(7) the availability and the benefits of the early childhood health and developmental
screening under sections 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10;

(8) the caregiver's eligibility for transition year child care assistance under section
119B.05;

(9) the availability of all health care programs, including transitional medical
assistance;

(10) the caregiver's option to choose an employment and training provider and
information about each provider, including but not limited to, services offered, program
components, job placement rates, job placement wages, and job retention rates;

(11) the caregiver's option to request approval of an education and training plan
according to section 256J.53;

(12) the work study programs available under the higher education system; deleted text begin and
deleted text end

(13) information about the 60-month time limit exemptions under the family
violence waiver and referral information about shelters and programs for victims of family
violence deleted text begin . deleted text end new text begin ; and
new text end

new text begin (14) the availability and benefits of early childhood health and developmental
screening and other early childhood resources and programs.
new text end

new text begin (b) For MFIP caregivers who are exempt from attending the orientation under
subdivision 1, the county agency must provide the information required under paragraph
(a), clause (14), via other means.
new text end

Sec. 4.

Minnesota Statutes 2011 Supplement, section 256J.49, subdivision 13, is
amended to read:

Subd. 13.

Work activity.

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

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

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

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

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

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

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

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

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

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

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

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

new text begin (10) attending a child's early childhood activities, including developmental
screenings and subsequent referral and follow-up services. MFIP employment and training
providers must coordinate with county social service agencies and health plans to assist
recipients in arranging referrals indicated by screening results.
new text end

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

Sec. 5.

Minnesota Statutes 2010, section 256J.50, is amended by adding a subdivision
to read:

new text begin Subd. 13. new text end

new text begin Child development information. new text end

new text begin MFIP employment and training
providers and county agencies shall post information regarding child development in areas
easily accessible to families participating in MFIP.
new text end

Sec. 6.

Minnesota Statutes 2010, section 256J.521, subdivision 2, is amended to read:

Subd. 2.

Employment plan; contents.

(a) Based on the assessment under
subdivision 1, the job counselor and the participant must develop an employment plan
that includes participation in activities and hours that meet the requirements of section
256J.55, subdivision 1. The purpose of the employment plan is to identify for each
participant the most direct path to unsubsidized employment and any subsequent steps that
support long-term economic stability. The employment plan should be developed using
the highest level of activity appropriate for the participant. Activities must be chosen from
clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of
preference for activities, priority must be given for activities related to a family violence
waiver when developing the employment plan. The employment plan must also list the
specific steps the participant will take to obtain employment, including steps necessary
for the participant to progress from one level of activity to another, and a timetable for
completion of each step. Levels of activity include:

(1) unsubsidized employment;

(2) job search;

(3) subsidized employment or unpaid work experience;

(4) unsubsidized employment and job readiness education or job skills training;

(5) unsubsidized employment or unpaid work experience and activities related to
a family violence waiver or preemployment needs; and

(6) activities related to a family violence waiver or preemployment needs.

(b) Participants who are determined to possess sufficient skills such that the
participant is likely to succeed in obtaining unsubsidized employment must job search at
least 30 hours per week for up to six weeks and accept any offer of suitable employment.
The remaining hours necessary to meet the requirements of section 256J.55, subdivision
1, may be met through participation in other work activities under section 256J.49,
subdivision 13. The participant's employment plan must specify, at a minimum: (1)
whether the job search is supervised or unsupervised; (2) support services that will
be provided; and (3) how frequently the participant must report to the job counselor.
Participants who are unable to find suitable employment after six weeks must meet
with the job counselor to determine whether other activities in paragraph (a) should be
incorporated into the employment plan. Job search activities which are continued after six
weeks must be structured and supervised.

(c) Participants who are determined to have barriers to obtaining or maintaining
suitable employment that will not be overcome during six weeks of job search under
paragraph (b) must work with the job counselor to develop an employment plan that
addresses those barriers by incorporating appropriate activities from paragraph (a), clauses
(1) to (6). The employment plan must include enough hours to meet the participation
requirements in section 256J.55, subdivision 1, unless a compelling reason to require
fewer hours is noted in the participant's file.

(d) The job counselor and the participant must sign the employment plan to indicate
agreement on the contents.

(e) Except as provided under paragraph (f), failure to develop or comply with
activities in the plan, or voluntarily quitting suitable employment without good cause, will
result in the imposition of a sanction under section 256J.46.

(f) When a participant fails to meet the agreed-upon hours of participation in paid
employment because the participant is not eligible for holiday pay and the participant's
place of employment is closed for a holiday, the job counselor shall not impose a sanction
or increase the hours of participation in any other activity, including paid employment, to
offset the hours that were missed due to the holiday.

(g) Employment plans must be reviewed at least every three months to determine
whether activities and hourly requirements should be revised. new text begin At the time of the
employment plan review, the job counselor must provide information to participants
regarding early childhood development and resources for families. new text end The job counselor
is encouraged to allow participants who are participating in at least 20 hours of work
activities to also participate in education and training activities in order to meet the federal
hourly participation rates.

Sec. 7. new text begin DIRECTION TO COMMISSIONER.
new text end

new text begin The commissioner of human services may phase in the change in terminology from
"Minnesota Family Investment Program" to "Minnesota Children and Family Investment
Program" as the commissioner exhausts supplies of printed materials.
new text end

Sec. 8. new text begin REVISOR INSTRUCTION.
new text end

new text begin In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall substitute
the terms "Minnesota Children and Family Investment Program" for "Minnesota Family
Investment Program" and "MCFIP" for "MFIP" wherever they appear.
new text end

ARTICLE 6

MISCELLANEOUS

Section 1.

Minnesota Statutes 2010, section 245.697, subdivision 1, is amended to read:

Subdivision 1.

Creation.

(a) A State Advisory Council on Mental Health is created.
The council must have deleted text begin 30 deleted text end new text begin 31 new text end members appointed by the governor in accordance with
federal requirements. In making the appointments, the governor shall consider appropriate
representation of communities of color. The council must be composed of:

(1) the assistant commissioner of mental health for the department of human services;

(2) a representative of the Department of Human Services responsible for the
medical assistance program;

(3) one member of each of the deleted text begin four deleted text end new text begin five new text end core mental health professional disciplines
(psychiatry, psychology, social work, nursing new text begin , and marriage and family therapy new text end );

(4) one representative from each of the following advocacy groups: Mental Health
Association of Minnesota, NAMI-MN, Mental Health Consumer/Survivor Network of
Minnesota, and Minnesota Disability Law Center;

(5) providers of mental health services;

(6) consumers of mental health services;

(7) family members of persons with mental illnesses;

(8) legislators;

(9) social service agency directors;

(10) county commissioners; and

(11) other members reflecting a broad range of community interests, including
family physicians, or members as the United States Secretary of Health and Human
Services may prescribe by regulation or as may be selected by the governor.

(b) The council shall select a chair. Terms, compensation, and removal of members
and filling of vacancies are governed by section 15.059. Notwithstanding provisions
of section 15.059, the council and its subcommittee on children's mental health do not
expire. The commissioner of human services shall provide staff support and supplies
to the council.

Sec. 2.

Minnesota Statutes 2010, section 254A.19, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Civil commitments. new text end

new text begin A Rule 25 assessment, under Minnesota Rules,
part 9530.6615, does not need to be completed for an individual being committed as a
chemically dependent person, as defined in section 253B.02, and for the duration of a civil
commitment under section 253B.065, 253B.09, or 253B.095 in order for a county to
access consolidated chemical dependency treatment funds under section 254B.04. The
county must determine if the individual meets the financial eligibility requirements for
the consolidated chemical dependency treatment funds under section 254B.04. Nothing
in this subdivision shall prohibit placement in a treatment facility or treatment program
governed under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.
new text end

Sec. 3.

Minnesota Statutes 2010, section 256B.0943, subdivision 9, is amended to read:

Subd. 9.

Service delivery criteria.

(a) In delivering services under this section, a
certified provider entity must ensure that:

(1) each individual provider's caseload size permits the provider to deliver services
to both clients with severe, complex needs and clients with less intensive needs. The
provider's caseload size should reasonably enable the provider to play an active role in
service planning, monitoring, and delivering services to meet the client's and client's
family's needs, as specified in each client's individual treatment plan;

(2) site-based programs, including day treatment and preschool programs, provide
staffing and facilities to ensure the client's health, safety, and protection of rights, and that
the programs are able to implement each client's individual treatment plan;

(3) a day treatment program is provided to a group of clients by a multidisciplinary
team under the clinical supervision of a mental health professional. The day treatment
program must be provided in and by: (i) an outpatient hospital accredited by the Joint
Commission on Accreditation of Health Organizations and licensed under sections 144.50
to 144.55; (ii) a community mental health center under section 245.62; or (iii) an entity
that is deleted text begin under contract with the county board deleted text end new text begin certified under subdivision 4 new text end to operate a
program that meets the requirements of deleted text begin section 245.4712, subdivision 2, or 245.4884,
subdivision 2, and deleted text end Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment
program must stabilize the client's mental health status while developing and improving
the client's independent living and socialization skills. The goal of the day treatment
program must be to reduce or relieve the effects of mental illness and provide training to
enable the client to live in the community. The program must be available at least one day
a week for a two-hour time block. The two-hour time block must include at least one hour
of individual or group psychotherapy. The remainder of the structured treatment program
may include individual or group psychotherapy, and individual or group skills training, if
included in the client's individual treatment plan. Day treatment programs are not part of
inpatient or residential treatment services. A day treatment program may provide fewer
than the minimally required hours for a particular child during a billing period in which
the child is transitioning into, or out of, the program; and

(4) a therapeutic preschool program is a structured treatment program offered
to a child who is at least 33 months old, but who has not yet reached the first day of
kindergarten, by a preschool multidisciplinary team in a day program licensed under
Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available two
hours per day, five days per week, and 12 months of each calendar year. The structured
treatment program may include individual or group psychotherapy and individual or
group skills training, if included in the client's individual treatment plan. A therapeutic
preschool program may provide fewer than the minimally required hours for a particular
child during a billing period in which the child is transitioning into, or out of, the program.

(b) A provider entity must deliver the service components of children's therapeutic
services and supports in compliance with the following requirements:

(1) individual, family, and group psychotherapy must be delivered as specified in
Minnesota Rules, part 9505.0323;

(2) individual, family, or group skills training must be provided by a mental health
professional or a mental health practitioner who has a consulting relationship with a
mental health professional who accepts full professional responsibility for the training;

(3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
through arrangements for direct intervention and support services to the child and the
child's family. Crisis assistance must utilize resources designed to address abrupt or
substantial changes in the functioning of the child or the child's family as evidenced by
a sudden change in behavior with negative consequences for well being, a loss of usual
coping mechanisms, or the presentation of danger to self or others;

(4) mental health behavioral aide services must be medically necessary treatment
services, identified in the child's individual treatment plan and individual behavior plan,
which are performed minimally by a paraprofessional qualified according to subdivision
7, paragraph (b), clause (3), and which are designed to improve the functioning of the
child in the progressive use of developmentally appropriate psychosocial skills. Activities
involve working directly with the child, child-peer groupings, or child-family groupings
to practice, repeat, reintroduce, and master the skills defined in subdivision 1, paragraph
(p), as previously taught by a mental health professional or mental health practitioner
including:

(i) providing cues or prompts in skill-building peer-to-peer or parent-child
interactions so that the child progressively recognizes and responds to the cues
independently;

(ii) performing as a practice partner or role-play partner;

(iii) reinforcing the child's accomplishments;

(iv) generalizing skill-building activities in the child's multiple natural settings;

(v) assigning further practice activities; and

(vi) intervening as necessary to redirect the child's target behavior and to de-escalate
behavior that puts the child or other person at risk of injury.

A mental health behavioral aide must document the delivery of services in written
progress notes. The mental health behavioral aide must implement treatment strategies
in the individual treatment plan and the individual behavior plan. The mental health
behavioral aide must document the delivery of services in written progress notes. Progress
notes must reflect implementation of the treatment strategies, as performed by the mental
health behavioral aide and the child's responses to the treatment strategies; and

(5) direction of a mental health behavioral aide must include the following:

(i) a clinical supervision plan approved by the responsible mental health professional;

(ii) ongoing on-site observation by a mental health professional or mental health
practitioner for at least a total of one hour during every 40 hours of service provided
to a child; and

(iii) immediate accessibility of the mental health professional or mental health
practitioner to the mental health behavioral aide during service provision.

Sec. 4.

Minnesota Statutes 2011 Supplement, section 256M.40, subdivision 1, is
amended to read:

Subdivision 1.

Formula.

The commissioner shall allocate state funds appropriated
under this chapter to each county board on a calendar year basis in an amount determined
according to the formula in paragraphs (a) to deleted text begin (e) deleted text end new text begin (f) new text end .

(a) For calendar years 2011 deleted text begin and deleted text end new text begin , new text end 2012, new text begin and 2013, new text end the commissioner shall allocate
available funds to each county in proportion to that county's share in calendar year 2010.

(b) For calendar year deleted text begin 2013 deleted text end new text begin 2014 new text end , the commissioner shall allocate available funds to
each county as follows:

(1) deleted text begin 75 deleted text end new text begin 80 new text end percent must be distributed on the basis of the county share in calendar
year deleted text begin 2012 deleted text end new text begin 2013 new text end ;

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

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

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

new text begin (2) 20 percent must be distributed as follows:
new text end

new text begin (i) 25 percent must be allocated to cover infrastructure costs for grant implementation
which includes a guaranteed floor and an amount based on the county's population size
as determined by the commissioner; and
new text end

new text begin (ii) 75 percent must be allocated based on the need for vulnerable children and
adult services as follows:
new text end

new text begin (A) 70 percent shall be allocated to counties based on the county's average three-year
count of vulnerable children who are subjects of family assessments or subjects of
accepted reports under sections 626.556 and 626.5561 per 1,000 county child population
as determined by the most recent data of the commissioner; and
new text end

new text begin (B) 30 percent shall be allocated to counties based on the county's average three-year
count of vulnerable adults who are subjects of reports accepted for county investigation or
emergency protective services under section 626.557 per 1,000 county adult population
determined by the most recent data of the commissioner.
new text end

(c) For calendar year deleted text begin 2014 deleted text end new text begin 2015 new text end , the commissioner shall allocate available funds to
each county as follows:

(1) deleted text begin 50 deleted text end new text begin 60 new text end percent must be distributed on the basis of the county share in calendar
year deleted text begin 2012 deleted text end new text begin 2013 new text end ; new text begin and
new text end

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

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

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

new text begin (2) 40 percent must be distributed as follows:
new text end

new text begin (i) 25 percent must be allocated to cover infrastructure costs for grant implementation
which includes a guaranteed floor and an amount based on the county's population size
as determined by the commissioner; and
new text end

new text begin (ii) 75 percent must be allocated based on the need for vulnerable children and
adult services as follows:
new text end

new text begin (A) 70 percent shall be allocated to counties based on the county's average three-year
count of vulnerable children who are subjects of family assessments or subjects of
accepted reports under sections 626.556 and 626.5561 per 1,000 county child population
as determined by the most recent data of the commissioner; and
new text end

new text begin (B) 30 percent shall be allocated to counties based on the county's average three-year
count of vulnerable adults who are subjects of reports accepted for county investigation or
emergency protective services under section 626.557 per 1,000 county adult population
determined by the most recent data of the commissioner.
new text end

(d) For calendar year deleted text begin 2015 deleted text end new text begin 2016 new text end , the commissioner shall allocate available funds to
each county as follows:

(1) deleted text begin 25 deleted text end new text begin 40 new text end percent must be distributed on the basis of the county share in calendar
year deleted text begin 2012 deleted text end new text begin 2013 new text end ; new text begin and
new text end

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

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

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

new text begin (2) 60 percent must be distributed as follows:
new text end

new text begin (i) 25 percent must be allocated to cover infrastructure costs for grant implementation
which includes a guaranteed floor and an amount based on the county's population size
as determined by the commissioner; and
new text end

new text begin (ii) 75 percent must be allocated based on the need for vulnerable children and
adult services as follows:
new text end

new text begin (A) 70 percent shall be allocated to counties based on the county's average three-year
count of vulnerable children who are subjects of family assessments or subjects of
accepted reports under sections 626.556 and 626.5561 per 1,000 county child population
as determined by the most recent data of the commissioner; and
new text end

new text begin (B) 30 percent shall be allocated to counties based on the county's average three-year
count of vulnerable adults who are subjects of reports accepted for county investigation or
emergency protective services under section 626.557 per 1,000 county adult population
determined by the most recent data of the commissioner.
new text end

(e) For calendar year deleted text begin 2016 and each calendar year thereafter deleted text end new text begin 2017 new text end , the commissioner
shall allocate available funds to each county as follows:

(1) 20 percent must be distributed on the basis of the deleted text begin number of persons residing
in the county as determined by the most recent data of the state demographer deleted text end new text begin county
share in calendar year 2013 new text end ; new text begin and
new text end

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

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

new text begin (2) 80 percent must be distributed as follows:
new text end

new text begin (i) 25 percent must be allocated to cover infrastructure costs for grant implementation
which includes a guaranteed floor and an amount based on the county's population size
as determined by the commissioner; and
new text end

new text begin (ii) 75 percent must be allocated based on the need for vulnerable children and
adult services as follows:
new text end

new text begin (A) 70 percent shall be allocated to counties based on the county's average three-year
count of vulnerable children who are subjects of family assessments or subjects of
accepted reports under sections 626.556 and 626.5561 per 1,000 county child population
as determined by the most recent data of the commissioner; and
new text end

new text begin (B) 30 percent shall be allocated to counties based on the county's average three-year
count of vulnerable adults who are subjects of reports accepted for county investigation or
emergency protective services under section 626.557 per 1,000 county adult population
determined by the most recent data of the commissioner.
new text end

new text begin (f) For calendar year 2018 and each calendar year thereafter, the commissioner shall
allocate available funds to each county as follows:
new text end

new text begin (1) 25 percent must be allocated to cover infrastructure costs for grant
implementation which includes a guaranteed floor and an amount based on the county's
population size as determined by the commissioner; and
new text end

new text begin (2) 75 percent must be allocated based on the need for vulnerable children and
adult services as follows:
new text end

new text begin (i) 70 percent shall be allocated to counties based on the county's average three-year
count of vulnerable children that are subject of family assessments or subjects of accepted
reports under sections 626.556 and 626.5561 per 1,000 county child population as
determined by the most recent data of the commissioner; and
new text end

new text begin (ii) 30 percent shall be allocated to counties based on the county's average three-year
count of vulnerable adults that are subjects of reports accepted for county investigation or
emergency protective services under section 626.557 per 1,000 county adult population
determined by the most recent data of the commissioner.
new text end

Sec. 5.

Minnesota Statutes 2010, section 462A.29, is amended to read:

462A.29 INTERAGENCY COORDINATION ON HOMELESSNESS.

new text begin (a) new text end The agency shall coordinate services and activities of all state agencies relating
to homelessness. The agency shall coordinate an investigation and review of the current
system of service delivery to the homeless. The agency may request assistance from other
agencies of state government as needed for the execution of the responsibilities under this
section and the other agencies shall furnish the assistance upon request.

new text begin (b) The Interagency Council on Homelessness established to assist with the
execution of the duties of this section shall give priority to improving the coordination
of services and activities that reduce the number of children and military veterans who
experience homelessness and improve the economic, health, social, and education
outcomes for children and military veterans who experience homelessness.
new text end

Sec. 6.

Minnesota Statutes 2010, section 518A.40, subdivision 4, is amended to read:

Subd. 4.

Change in child care.

(a) When a court order provides for child care
expenses, and child care support is not assigned under section 256.741, the public
authority, if the public authority provides child support enforcement services, deleted text begin must deleted text end new text begin may new text end
suspend collecting the amount allocated for child care expenses when deleted text begin :
deleted text end

deleted text begin (1) deleted text end either party informs the public authority that no child care costs are being
incurred deleted text begin ; deleted text end and new text begin :
new text end

deleted text begin (2) deleted text end new text begin (1) new text end the public authority verifies the accuracy of the information with the obligee deleted text begin . deleted text end new text begin ;
or
new text end

new text begin (2) the obligee fails to respond within 30 days of the date of a written request
from the public authority for information regarding child care costs. A written or oral
response from the obligee that child care costs are being incurred is sufficient for the
public authority to continue collecting child care expenses.
new text end

The suspension is effective as of the first day of the month following the date that the
public authority deleted text begin received the verification deleted text end new text begin either verified the information with the obligee
or the obligee failed to respond new text end . The public authority will resume collecting child care
expenses when either party provides information that child care costs deleted text begin have resumed deleted text end new text begin are
incurred new text end , or when a child care support assignment takes effect under section 256.741,
subdivision 4. The resumption is effective as of the first day of the month after the date
that the public authority received the information.

(b) If the parties provide conflicting information to the public authority regarding
whether child care expenses are being incurred, deleted text begin or if the public authority is unable to
verify with the obligee that no child care costs are being incurred, deleted text end the public authority will
continue or resume collecting child care expenses. Either party, by motion to the court,
may challenge the suspension, continuation, or resumption of the collection of child care
expenses under this subdivision. If the public authority suspends collection activities
for the amount allocated for child care expenses, all other provisions of the court order
remain in effect.

(c) In cases where there is a substantial increase or decrease in child care expenses,
the parties may modify the order under section 518A.39.

Sec. 7.

Laws 2011, First Special Session chapter 9, article 9, section 18, is amended to
read:

Sec. 18. WHITE EARTH BAND OF OJIBWE HUMAN SERVICES
PROJECT.

(a) The commissioner of human services, in consultation with the White Earth Band
of Ojibwe, shall transfer legal responsibility to the tribe for providing human services to
tribal members and their families who reside on or off the reservation in Mahnomen
County. The transfer shall include:

(1) financing, including federal and state funds, grants, and foundation funds; and

(2) services to eligible tribal members and families defined as it applies to state
programs being transferred to the tribe.

(b) The determination as to which programs will be transferred to the tribe and
the timing of the transfer of the programs shall be made by a consensus decision of the
governing body of the tribe and the commissioner. The commissioner shall waive existing
rules and seek all federal approvals and waivers as needed to carry out the transfer.

(c) When the commissioner approves transfer of programs and the tribe assumes
responsibility under this section, Mahnomen County is relieved of responsibility for
providing program services to tribal members and their families who live on or off the
reservation while the tribal project is in effect and funded, except that a family member
who is not a White Earth member may choose to receive services through the tribe or the
county. The commissioner shall have authority to redirect funds provided to Mahnomen
County for these services, including administrative expenses, to the White Earth Band
of Ojibwe Indians.

(d) Upon the successful transfer of legal responsibility for providing human services
for tribal members and their families who reside on and off the reservation in Mahnomen
County, the commissioner and the White Earth Band of Ojibwe shall develop a plan to
transfer legal responsibility for providing human services for tribal members and their
families who reside on or off reservation in Clearwater and Becker Counties.

(e) No later than January 15, 2012, the commissioner shall submit a written
report detailing the transfer progress to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services. If legislation is
needed to fully complete the transfer of legal responsibility for providing human services,
the commissioner shall submit proposed legislation along with the written report.

new text begin (f) Upon receipt of 100 percent match for health care costs from the Indian Health
Service, the first $500,000 of savings to the state in tribal health care costs shall be
distributed to the White Earth Band of Ojibwe to offset the band's cost of implementing
the human services project. The remainder of the state savings shall be distributed to the
White Earth Band of Ojibwe to supplement services to off-reservation tribal members.
new text end

Sec. 8. new text begin FOSTER CARE FOR INDIVIDUALS WITH AUTISM.
new text end

new text begin The commissioner of human services shall identify and coordinate with one or more
counties that agree to issue a foster care license and authorize funding for people with
autism who are currently receiving home and community-based services under Minnesota
Statutes, section 256B.092 or 256B.49. Children eligible under this section must be in an
out-of-home placement approved by the lead agency that has legal responsibility for the
placement. Nothing in this section must be construed as restricting an individual's choice
of provider. The commissioner will assist the interested county or counties with obtaining
necessary capacity within the moratorium under Minnesota Statutes, section 245A.03,
subdivision 7. The commissioner shall coordinate with the interested counties and issue a
request for information to identify providers who have the training and skills to meet the
needs of the individuals identified in this section.
new text end

Sec. 9. new text begin DIRECTION TO COMMISSIONER.
new text end

new text begin The commissioner shall develop an optional certification for providers of home
and community-based services waivers under Minnesota Statutes, section 256B.092
or 256B.49, that demonstrates competency in working with individuals with autism.
Recommended language and an implementation plan will be provided to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services policy and finance by February 15, 2013, as part of the Quality Outcome
Standards required under Laws 2010, chapter 352, article 1, section 24.
new text end

Sec. 10. new text begin CHEMICAL HEALTH NAVIGATOR PROGRAM.
new text end

new text begin (a) The commissioner of human services, in partnership with the counties, tribes,
and stakeholders, shall develop a community-based integrated model of care to improve
the effectiveness and efficiency of the service continuum for chemically dependent
individuals. The plan shall identify methods to reduce duplication of efforts, promote
scientifically supported practices, and improve efficiency. This plan shall consider the
potential for geographically or demographically disparate impact on individuals who need
chemical dependency services.
new text end

new text begin (b) The commissioner shall provide the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services a report detailing
necessary statutory and rule changes and a proposed pilot project to implement the plan no
later than March 15, 2013.
new text end

Sec. 11. new text begin BIENNIAL BUDGET REQUEST; UNIVERSITY OF MINNESOTA.
new text end

new text begin Beginning in 2013, as part of the biennial budget request submitted to the Office
of Management and Budget, the Board of Regents of the University of Minnesota must
include a request for funding for an investment in rural primary care training to be
delivered by family practice residence programs to prepare doctors for the practice of
primary care medicine in rural areas of the state. The funding request must provide for
ongoing support of rural primary care training through the University of Minnesota's
general operation and maintenance funding or through dedicated health science funding.
new text end

Sec. 12. new text begin RELEASE OF MEDICAL ASSISTANCE LIEN.
new text end

new text begin Notwithstanding Minnesota Statutes, section 514.981, the commissioner of human
services shall release and discharge the medical assistance lien in full, pursuant to
Minnesota Statutes, section 514.981, subdivision 5, for any person who:
new text end

new text begin (1) purchased a home in St. Louis County that was subject to a medical assistance
lien;
new text end

new text begin (2) hired Scenic Title and Abstract, Inc. in Duluth to handle the closing on the home;
new text end

new text begin (3) satisfied the purchase price of the home by securing a mortgage; and
new text end

new text begin (4) obtained a warranty deed for the home that was signed and notarized on
December 3, 2007, and recorded in St. Louis County on December 28, 2007.
new text end

ARTICLE 7

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1. new text begin SUMMARY OF APPROPRIATIONS. new text end

new text begin The amounts shown in this section summarize direct appropriations, by fund, made
in this article.
new text end

		new text begin 2012 new text end		new text begin 2013 new text end		new text begin Total new text end
new text begin General new text end	new text begin $ new text end	new text begin 301,000 new text end	new text begin $ new text end	new text begin (301,000) new text end	new text begin $ new text end	new text begin -0- new text end
new text begin Federal TANF new text end		new text begin -0- new text end		new text begin 3,996,000 new text end		new text begin 3,996,000 new text end
new text begin State Government Special Revenue new text end		new text begin -0- new text end		new text begin -0- new text end		new text begin -0- new text end
new text begin Total new text end	new text begin $ new text end	new text begin 301,000 new text end	new text begin $ new text end	new text begin 3,695,000 new text end	new text begin $ new text end	new text begin 3,996,000 new text end

Sec. 2. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS. new text end

new text begin The sums shown in the columns marked "Appropriations" are added to or, if shown
in parentheses, subtracted from the appropriations in Laws 2011, First Special Session
chapter 9, article 10, to the agencies and for the purposes specified in this article. The
appropriations are from the general fund or other named fund and are available for the
fiscal years indicated for each purpose. The figures "2012" and "2013" used in this
article mean that the addition to or subtraction from the appropriation listed under them
is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively.
Supplemental appropriations and reductions to appropriations for the fiscal year ending
June 30, 2012, are effective the day following final enactment unless a different effective
date is explicit.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2012 new text end		new text begin 2013 new text end

Sec. 3. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin 301,000 new text end

new text begin $ new text end

new text begin 3,484,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2012 new text end	new text begin 2013 new text end
new text begin General new text end	new text begin 301,000 new text end	new text begin (512,000) new text end
new text begin Federal TANF new text end	new text begin -0- new text end	new text begin 3,996,000 new text end

new text begin Subd. 2. new text end new text begin Central Office Operations new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 1,049,000 new text end
new text begin Federal TANF new text end	new text begin -0- new text end	new text begin 81,000 new text end

new text begin Return On Taxpayer Investment
Implementation Study. $64,000 is
appropriated in fiscal year 2013 from the
general fund to the commissioner of human
services for a grant to the commissioner
of management and budget to develop
recommendations for implementing a
return on taxpayer investment (ROTI)
methodology and practice related to
human services and corrections programs
administered and funded by state and county
government. The scope of the study shall
include assessments of ROTI initiatives
in other states, design implications for
Minnesota, and identification of one or
more Minnesota institutions of higher
education capable of providing rigorous
and consistent nonpartisan institutional
support for ROTI. The commissioner
shall consult with representatives of other
state agencies, counties, legislative staff,
Minnesota institutions of higher education,
and other stakeholders in developing
recommendations. The commissioner shall
report findings and recommendations to the
governor and legislature by November 30,
2012. This appropriation is added to the base.
new text end

new text begin Minnesota Specialty Health Services -
Willmar. $549,000 in fiscal year 2012
and $2,713,000 in fiscal year 2013 is
appropriated from the account established
under Minnesota Statutes, section 246.18,
subdivision 8, for continued operation of
the Minnesota Specialty Health Services -
Willmar. These appropriations are onetime.
Closure of the facility shall not occur prior
to June 30, 2013.
new text end

new text begin Subd. 3. new text end new text begin Forecasted Programs new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 301,000 new text end	new text begin (1,821,000) new text end
new text begin Federal TANF new text end	new text begin -0- new text end	new text begin -0- new text end

new text begin (a) Group Residential Housing Grants new text end

new text begin Managing Residential Settings. If
the commissioner's efforts to implement
Minnesota Statutes, section 256B.492, results
in general fund savings as compared to base
level costs in the February 2012 Department
of Management and Budget forecast of
revenues and expenditures, the savings
shall be applied to reduce the reductions
to congregate care rates for low-needs
individuals specified in Laws 2011, First
Special Session chapter 9, effective July 1,
2013.
new text end

new text begin (b) Medical Assistance Grants new text end

new text begin PCA Relative Care Payment Recovery.
Notwithstanding any law to the contrary, and
if, at the conclusion of the HealthStar Home
Health, Inc et al v. Commissioner of Human
Services litigation, the PCA relative rate
reduction under Minnesota Statutes, section
256B.0659, subdivision 11, paragraph (c),
is upheld, the commissioner is prohibited
from recovering the difference between the
100 percent rate paid to providers and the
80 percent rate, during the period of the
temporary injunction issued on October 26,
2011. This section does not prohibit the
commissioner from recovering any other
overpayments from providers.
new text end

new text begin Long-Term Care Realignment Waiver
Conformity. Notwithstanding Minnesota
Statutes, section 256B.0916, subdivision 14,
and upon federal approval of the long-term
care realignment waiver application,
essential community support grants must be
made available in a manner that is consistent
with the state's long-term care realignment
waiver application submitted on February
13, 2012. The commissioner is authorized
to use increased federal matching funds
resulting from approval of the long-term care
realignment waiver as necessary to meet
the fiscal year 2013 demand for essential
community support grants administered in a
manner that is consistent with the terms and
conditions of the long-term care realignment
waiver, and that amount of federal funds is
appropriated to the commissioner for this
purpose.
new text end

new text begin new text begin Managing Corporate Foster Care. new text end The
commissioner of human services shall
manage foster care beds under Minnesota
Statutes, section 245A.03, subdivision 7,
in order to reduce costs by $4,149,000 in
fiscal year 2013 as compared to base level
costs in the February 2012 Department of
Management and Budget forecast of revenues
and expenditures. If the department's efforts
to implement this provision results in savings
greater than $4,149,000 in fiscal year 2014,
the additional savings shall be applied to
reduce the reductions to congregate care
rates for low-needs individuals specified in
Laws 2011, First Special Session chapter 9,
effective July 1, 2013.
new text end

new text begin Continuing Care Provider Payment
Delay. The commissioner of human services
shall delay the last payment or payments
in fiscal year 2013 to providers listed in
Minnesota Statutes 2011 Supplement,
section 256B.5012, subdivision 13, and
Laws 2011, First Special Session chapter
9, article 7, section 54, paragraph (b),
by up to $22,854,000. In calculating the
actual payment amounts to be delayed, the
commissioner must reduce the $22,854,000
figure by any cash basis state share
savings to be realized in fiscal year 2013
from implementing the long-term care
realignment waiver before July 1, 2013.
The commissioner shall make the delayed
payments in July 2013. Notwithstanding
any contrary provision in this article, this
provision expires on August 1, 2013.
new text end

new text begin Contingent Managed Care Provider
Payment Increases. Any money received
by the state as a result of the cap on
earnings in the 2011 contract or 2011
contract amendments for services provided
under Minnesota Statutes, sections
256B.69 and 256L.12, shall be used to
retroactively increase medical assistance
and MinnesotaCare capitation payments to
managed care plans for calendar year 2011.
The commissioner of human services shall
require managed care plans to use the entire
amount of any increase in capitation rates
provided under this provision to retroactively
increase calendar year 2011 payment rates for
health care providers employed by or under
contract with the plan, including nursing
facilities that provide services to emergency
medical assistance recipients, but excluding
payments to hospitals and other institutional
providers for facility, administrative, and
other operating costs not related to direct
patient care. Increased payments must be
distributed in proportion to each provider's
share of total plan payments received for
services provided to medical assistance and
MinnesotaCare enrollees. Any increase in
provider payment rates under this provision
is onetime and shall not increase base
provider payment rates.
new text end

new text begin Subd. 4. new text end new text begin Grant Programs new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin 260,000 new text end
new text begin Federal TANF new text end	new text begin -0- new text end	new text begin 2,900,000 new text end

new text begin (a) Support Services Grants new text end

new text begin Northern Connections. $300,000 is
appropriated from the TANF fund in fiscal
year 2013 to the commissioner of human
services for a grant to Northern Connections
in Perham for a workforce program that
provides one-stop supportive services
to individuals as they transition into the
workforce. This appropriation must be used
for families with incomes below 200 percent
of the federal poverty guidelines and with
minor children in the household. This is a
onetime appropriation and is available until
expended.
new text end

new text begin (b) Children and Economic Support Grants new text end

new text begin Long-Term Homeless Supportive Services.
$500,000 is appropriated in fiscal year 2013
from the TANF fund for long-term homeless
supportive services for low-income families
under Minnesota Statutes, section 256K.26.
This is a onetime appropriation and is not
added to the base.
new text end

new text begin Healthy Community Initiatives. $300,000
in fiscal year 2013 is appropriated from the
TANF fund to the commissioner of human
services for contracting with the Search
Institute to promote healthy community
initiatives. The commissioner may expend
up to five percent of the appropriation
to provide for the program evaluation.
This appropriation must be used to serve
families with incomes below 200 percent
of the federal poverty guidelines and minor
children in the household. This is a onetime
appropriation and is available until expended.
new text end

new text begin Circles of Support. $400,000 in fiscal year
2013 is appropriated from the TANF fund
to the commissioner of human services for
the purpose of providing grants to three
community action agencies for circles of
support initiatives. This appropriation must
be used to serve families with incomes below
200 percent of the federal poverty guidelines
and minor children in the household. This
is a onetime appropriation and is available
until expended.
new text end

new text begin Transitional Housing Services. $1,000,000
is appropriated in fiscal year 2013 to the
commissioner of human services from the
TANF fund for transitional housing services,
including the provision of up to four months
of rental assistance under Minnesota Statutes,
section 256E.33. This appropriation must be
used for homeless families with children with
incomes below 115 percent of the federal
poverty guidelines, and must be coordinated
with family stabilization services under
Minnesota Statutes, section 256J.575.
new text end

new text begin Community Action Agencies. new text end new text begin $250,000
is appropriated in fiscal year 2013 from the
TANF fund for grants to community action
agencies under Minnesota Statutes, section
256E.30. This appropriation must be used
to serve families with income below 200
percent of the federal poverty guidelines and
minor children in the household. This is a
onetime appropriation and is available until
expended.
new text end

new text begin new text begin MFIP Mentoring Pilot Program. new text end $150,000
is appropriated to the commissioner of
human services from the TANF fund in
fiscal year 2013 for the purpose of providing
grants to help five local communities to
train and support volunteers mentoring
families receiving MFIP. Each pilot program
may receive a grant of up to $30,000.
Organizations must apply for grant funds
according to the timelines and on the
forms prescribed by the commissioner.
Organizations receiving grant funding must
model their project on the circles of support
model. Projects must focus on reducing
parents' and their children's isolation and
supporting families in making connections
within their local communities.
new text end

new text begin (c) Basic Sliding Fee Child Care Grants new text end

new text begin TANF Transfer to Federal Child Care
and Development Fund. (a) In addition
to the amount provided in this section, the
commissioner shall transfer TANF funds to
basic sliding fee child care assistance under
Minnesota Statutes, section 119B.03:
new text end

new text begin (1) fiscal year 2013, $436,000; and
new text end

new text begin (2) fiscal year 2014 and ongoing, $1,135,000.
new text end

new text begin (b) The commissioner shall authorize the
transfer of sufficient TANF funds to the
federal child care and development fund to
meet this appropriation and shall ensure that
all transferred funds are expended according
to federal child care and development fund
regulations.
new text end

new text begin (d) Disabilities Grants new text end

new text begin Living Skills Training for Persons
with Intractable Epilepsy. $65,000 is
appropriated in fiscal year 2013 from the
general fund to the commissioner of human
services for living skills training programs
for persons with intractable epilepsy
who need assistance in the transition to
independent living under Laws 1988, chapter
689, article 2, section 251. This is a onetime
appropriation and is available until expended.
new text end

new text begin Self-advocacy Network for Persons with
Disabilities.
new text end

new text begin (1) $95,000 is appropriated from the general
fund in fiscal year 2013 to the commissioner
of human services to establish and maintain
a statewide self-advocacy network for
persons with intellectual and developmental
disabilities. This is a onetime appropriation
and is available until expended.
new text end

new text begin (2) The self-advocacy network must focus on
ensuring that persons with disabilities are:
new text end

new text begin (i) informed of and educated about their legal
rights in the areas of education, employment,
housing, transportation, and voting; and
new text end

new text begin (ii) educated and trained to self-advocate for
their rights under law.
new text end

new text begin (3) Self-advocacy network activities under
this section include but are not limited to:
new text end

new text begin (i) education and training, including
preemployment and workplace skills;
new text end

new text begin (ii) establishment and maintenance of a
communication and information exchange
system for self-advocacy groups; and
new text end

new text begin (iii) financial and technical assistance to
self-advocacy groups.
new text end

new text begin Aliveness Project. $100,000 in fiscal year
2013 is for a grant to the Aliveness Project,
a statewide nonprofit, for providing the
health and wellness services it has provided
to individuals throughout Minnesota since
its inception in 1985. The activities and
proposed outcomes supported by this
onetime appropriation must further the
comprehensive plan of the Department of
Human Services, HIV/AIDS program. This
is a onetime appropriation and is available
until expended.
new text end

Sec. 4. new text begin COMMISSIONER OF HEALTH new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 423,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2012 new text end	new text begin 2013 new text end
new text begin General new text end	new text begin -0- new text end	new text begin -0- new text end

new text begin Subd. 2. new text end new text begin Community and Family Health Promotions new text end

new text begin new text begin Autism Study. new text end $200,000 is for the
commissioner of health, in partnership with
the University of Minnesota, to conduct a
qualitative study focused on cultural and
resource-based aspects of autism spectrum
disorders (ASD) that are unique to the
Somali community. By February 15,
2014, the commissioner shall report the
findings of this study to the legislature. The
report must include recommendations as to
establishment of a population-based public
health surveillance system for ASD. This
appropriation is available until June 30, 2014.
new text end

new text begin Subd. 3. new text end new text begin Policy Quality and Compliance new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin -0- new text end	new text begin -0- new text end

new text begin Web Site Changes. $36,000 from the
general fund is for Web site changes required
in article 2, section 17. This is a onetime
appropriation and must be shared with the
Department of Human Services through an
interagency agreement.
new text end

new text begin Management and Budget. $100,000 from
the general fund is for the commissioner to
transfer to the commissioner of management
and budget for the evaluation and report
required in article 2, section 17. This is a
onetime appropriation.
new text end

new text begin For-Profit HMO Study. $79,000 is for
a study of for-profit health maintenance
organizations. This is onetime and available
until expended.
new text end

new text begin Nursing Facility Moratorium Exceptions.
(a) Beginning in fiscal year 2013, the
commissioner of health may approve
moratorium exception projects under
Minnesota Statutes, section 144A.073, for
which the full annualized state share of
medical assistance costs does not exceed
$1,500,000.
new text end

new text begin (b) In fiscal year 2013, $8,000 is for
administrative costs related to review of
moratorium exception projects.
new text end

Sec. 5. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2013, unless a
different expiration date is explicit.
new text end

Sec. 6. new text begin EFFECTIVE DATE.
new text end

new text begin The provisions in this article are effective July 1, 2012, unless a different effective
date is explicit.
new text end