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HF 2294A

Conference Committee Report - 87th Legislature (2011 - 2012) Posted on 01/15/2013 08:26pm

KEY: stricken = removed, old language.
underscored = added, new language.
1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 2294
1.2A bill for an act
1.3relating to state government; making adjustments to health and human
1.4services appropriations; making changes to provisions related to health care,
1.5the Department of Health, children and family services, continuing care,
1.6chemical dependency, child support, background studies, homelessness, and
1.7vulnerable children and adults; providing for data sharing; requiring eligibility
1.8determinations; requiring the University of Minnesota to request funding for
1.9rural primary care training; providing for the release of medical assistance liens;
1.10requiring reporting of potential welfare fraud; providing penalties; providing
1.11appointments; providing grants; requiring studies and reports; appropriating
1.12money;amending Minnesota Statutes 2010, sections 62D.02, subdivision 3;
1.1362D.05, subdivision 6; 62D.12, subdivision 1; 62J.496, subdivision 2; 62Q.80;
1.1462U.04, subdivisions 1, 2, 4, 5; 119B.13, subdivision 3a; 144.1222, by adding
1.15a subdivision; 144.292, subdivision 6; 144.293, subdivision 2; 144.298,
1.16subdivision 2; 144A.351; 144D.04, subdivision 2; 145.906; 245.697, subdivision
1.171; 245A.03, by adding a subdivision; 245A.10, by adding a subdivision; 245A.11,
1.18subdivision 7; 245B.07, subdivision 1; 245C.04, subdivision 6; 245C.05,
1.19subdivision 7; 252.27, subdivision 2a; 254A.19, by adding a subdivision;
1.20256.01, by adding subdivisions; 256.9831, subdivision 2; 256B.056, subdivision
1.211a; 256B.0625, subdivisions 9, 28a, by adding subdivisions; 256B.0659,
1.22by adding a subdivision; 256B.0751, by adding a subdivision; 256B.0754,
1.23subdivision 2; 256B.0915, subdivision 3g; 256B.092, subdivisions 1b, 7, by
1.24adding subdivisions; 256B.0943, subdivision 9; 256B.431, subdivision 17e,
1.25by adding a subdivision; 256B.441, by adding a subdivision; 256B.49, by
1.26adding a subdivision; 256B.69, subdivision 9, by adding subdivisions; 256D.06,
1.27subdivision 1b; 256D.44, subdivision 5; 256E.37, subdivision 1; 256I.05,
1.28subdivision 1e; 256J.08, by adding a subdivision; 256J.26, subdivision 1, by
1.29adding a subdivision; 256J.45, subdivision 2; 256J.50, by adding a subdivision;
1.30256J.521, subdivision 2; 256L.07, subdivision 3; 462A.29; 514.981, subdivision
1.315; 518A.40, subdivision 4; Minnesota Statutes 2011 Supplement, sections
1.3262E.14, subdivision 4g; 62U.04, subdivisions 3, 9; 119B.13, subdivision 7;
1.33245A.03, subdivision 7; 256.045, subdivision 3; 256.987, subdivisions 1,
1.342, by adding subdivisions; 256B.056, subdivision 3; 256B.057, subdivision
1.359; 256B.0625, subdivisions 8, 8a, 8b, 38; 256B.0911, subdivisions 3a, 3c;
1.36256B.0915, subdivisions 3e, 3h; 256B.097, subdivision 3; 256B.49, subdivisions
1.3714, 15, 23; 256B.5012, subdivision 13; 256B.69, subdivisions 5a, 5c; 256E.35,
1.38subdivisions 5, 6; 256I.05, subdivision 1a; 256J.49, subdivision 13; 256L.031,
1.39subdivisions 2, 3, 6; 256L.12, subdivision 9; 256M.40, subdivision 1; Laws
1.402010, chapter 374, section 1; Laws 2011, First Special Session chapter 9, article
1.417, sections 52; 54; article 9, section 18; article 10, section 3, subdivisions 1, 3, 4;
1.42proposing coding for new law in Minnesota Statutes, chapters 144; 256B; 626.
2.1April 23, 2012
2.2The Honorable Kurt Zellers
2.3Speaker of the House of Representatives
2.4The Honorable Michelle L. Fischbach
2.5President of the Senate
2.6We, the undersigned conferees for H. F. No. 2294 report that we have agreed upon
2.7the items in dispute and recommend as follows:
2.8That the Senate recede from its amendments and that H. F. No. 2294 be further
2.9amended as follows:
2.10Delete everything after the enacting clause and insert:

2.11"ARTICLE 1
2.12HEALTH CARE

2.13    Section 1. Minnesota Statutes 2011 Supplement, section 62E.14, subdivision 4g, is
2.14amended to read:
2.15    Subd. 4g. Waiver of preexisting conditions for persons covered by healthy
2.16Minnesota contribution program. A person may enroll in the comprehensive plan with
2.17a waiver of the preexisting condition limitation in subdivision 3 if the person is eligible for
2.18the healthy Minnesota contribution program, and has been denied coverage as described
2.19under section 256L.031, subdivision 6. The six-month durational residency requirement
2.20specified in section 62E.02, subdivision 13, does not apply to individuals enrolled in the
2.21healthy Minnesota contribution program.

2.22    Sec. 2. Minnesota Statutes 2010, section 72A.201, subdivision 8, is amended to read:
2.23    Subd. 8. Standards for claim denial. The following acts by an insurer, adjuster, or
2.24self-insured, or self-insurance administrator constitute unfair settlement practices:
2.25(1) denying a claim or any element of a claim on the grounds of a specific policy
2.26provision, condition, or exclusion, without informing the insured of the policy provision,
2.27condition, or exclusion on which the denial is based;
2.28(2) denying a claim without having made a reasonable investigation of the claim;
2.29(3) denying a liability claim because the insured has requested that the claim be
2.30denied;
2.31(4) denying a liability claim because the insured has failed or refused to report the
2.32claim, unless an independent evaluation of available information indicates there is no
2.33liability;
2.34(5) denying a claim without including the following information:
2.35(i) the basis for the denial;
3.1(ii) the name, address, and telephone number of the insurer's claim service office
3.2or the claim representative of the insurer to whom the insured or claimant may take any
3.3questions or complaints about the denial;
3.4(iii) the claim number and the policy number of the insured; and
3.5(iv) if the denied claim is a fire claim, the insured's right to file with the Department
3.6of Commerce a complaint regarding the denial, and the address and telephone number
3.7of the Department of Commerce;
3.8(6) denying a claim because the insured or claimant failed to exhibit the damaged
3.9property unless:
3.10(i) the insurer, within a reasonable time period, made a written demand upon the
3.11insured or claimant to exhibit the property; and
3.12(ii) the demand was reasonable under the circumstances in which it was made;
3.13(7) denying a claim by an insured or claimant based on the evaluation of a chemical
3.14dependency claim reviewer selected by the insurer unless the reviewer meets the
3.15qualifications specified under subdivision 8a. An insurer that selects chemical dependency
3.16reviewers to conduct claim evaluations must annually file with the commissioner of
3.17commerce a report containing the specific evaluation standards and criteria used in these
3.18evaluations. The report must be filed at the same time its annual statement is submitted
3.19under section 60A.13. The report must also include the number of evaluations performed
3.20on behalf of the insurer during the reporting period, the types of evaluations performed,
3.21the results, the number of appeals of denials based on these evaluations, the results of
3.22these appeals, and the number of complaints filed in a court of competent jurisdiction.
3.23EFFECTIVE DATE.This section is effective the day following final enactment.

3.24    Sec. 3. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
3.25subdivision to read:
3.26    Subd. 18c. Nonemergency Medical Transportation Advisory Committee.
3.27(a) The Nonemergency Medical Transportation Advisory Committee shall advise the
3.28commissioner on the administration of nonemergency medical transportation covered
3.29under medical assistance. The advisory committee shall meet at least quarterly and may
3.30meet more frequently as required by the commissioner. The advisory committee shall
3.31annually elect a chair from among its members, who shall work with the commissioner or
3.32the commissioner's designee to establish the agenda for each meeting. The commissioner,
3.33or the commissioner's designee, shall attend all advisory committee meetings.
3.34(b) The Nonemergency Medical Transportation Advisory Committee shall advise
3.35and make recommendations to the commissioner on:
4.1(1) the development of, and periodic updates to, a policy manual for nonemergency
4.2medical transportation services;
4.3(2) policies and a funding source for reimbursing no-load miles;
4.4(3) policies to prevent waste, fraud, and abuse, and to improve the efficiency of the
4.5nonemergency medical transportation system;
4.6(4) other issues identified in the 2011 evaluation report by the Office of the
4.7Legislative Auditor on medical nonemergency transportation; and
4.8(5) other aspects of the nonemergency medical transportation system, as requested
4.9by the commissioner.
4.10(c) The Nonemergency Medical Transportation Advisory Committee shall
4.11coordinate its activities with the Minnesota Council on Transportation Access established
4.12under section 174.285. The chair of the advisory committee, or the chair's designee, shall
4.13attend all meetings of the Minnesota Council on Transportation Access.
4.14(d) The Nonemergency Medical Transportation Advisory Committee shall expire
4.15December 1, 2014.

4.16    Sec. 4. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
4.17subdivision to read:
4.18    Subd. 18d. Advisory committee members. (a) The Nonemergency Medical
4.19Transportation Advisory Committee consists of:
4.20(1) two voting members who represent counties, at least one of whom must represent
4.21a county or counties other than Anoka, Carver, Chisago, Dakota, Hennepin, Isanti,
4.22Ramsey, Scott, Sherburne, Washington, and Wright;
4.23(2) four voting members who represent medical assistance recipients, including
4.24persons with physical and developmental disabilities, persons with mental illness, seniors,
4.25children, and low-income individuals;
4.26(3) four voting members who represent providers that deliver nonemergency medical
4.27transportation services to medical assistance enrollees;
4.28(4) two voting members of the house of representatives, one from the majority
4.29party and one from the minority party, appointed by the speaker of the house, and two
4.30voting members from the senate, one from the majority party and one from the minority
4.31party, appointed by the Subcommittee on Committees of the Committee on Rules and
4.32Administration;
4.33(5) one voting member who represents demonstration providers as defined in section
4.34256B.69, subdivision 2;
5.1(6) one voting member who represents an organization that contracts with state or
5.2local governments to coordinate transportation services for medical assistance enrollees;
5.3and
5.4(7) the commissioner of transportation or the commissioner's designee, who shall
5.5serve as a voting member.
5.6(b) Members of the advisory committee shall not be employed by the Department of
5.7Human Services. Members of the advisory committee shall receive no compensation.

5.8    Sec. 5. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
5.9subdivision to read:
5.10    Subd. 18e. Single administrative structure and delivery system. (a) The
5.11commissioner shall implement a single administrative structure and delivery system for
5.12nonemergency medical transportation, beginning July 1, 2013. The single administrative
5.13structure and delivery system must:
5.14(1) eliminate the distinction between access transportation services and special
5.15transportation services;
5.16(2) enable all medical assistance recipients to follow the same process to obtain
5.17nonemergency medical transportation, regardless of their level of need;
5.18(3) provide a single oversight framework for all providers of nonemergency medical
5.19transportation; and
5.20(4) provide flexibility in service delivery, recognizing that clients fall along a
5.21continuum of needs and resources.
5.22(b) The commissioner shall present to the legislature, by January 15, 2013, any draft
5.23legislation necessary to implement the single administrative structure and delivery system
5.24for nonemergency medical transportation.
5.25(c) In developing the single administrative structure and delivery system and
5.26the draft legislation, the commissioner shall consult with the Nonemergency Medical
5.27Transportation Advisory Committee.

5.28    Sec. 6. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
5.29subdivision to read:
5.30    Subd. 18f. Enrollee assessment process. (a) The commissioner, in consultation
5.31with the Nonemergency Medical Transportation Advisory Committee, shall develop and
5.32implement, by July 1, 2013, a comprehensive, statewide, standard assessment process
5.33for medical assistance enrollees seeking nonemergency medical transportation services.
5.34The assessment process must identify a client's level of needs, abilities, and resources,
6.1and match the client with the mode of transportation in the client's service area that best
6.2meets those needs.
6.3(b) The assessment process must:
6.4(1) address mental health diagnoses when determining the most appropriate mode of
6.5transportation;
6.6(2) base decisions on clearly defined criteria that are available to clients, providers,
6.7and counties;
6.8(3) be standardized across the state and be aligned with other similar existing
6.9processes;
6.10(4) allow for extended periods of eligibility for certain types of nonemergency
6.11transportation, when a client's condition is unlikely to change; and
6.12(5) increase the use of public transportation when appropriate and cost-effective,
6.13including offering monthly bus passes to clients.

6.14    Sec. 7. Minnesota Statutes 2010, section 256B.0625, is amended by adding a
6.15subdivision to read:
6.16    Subd. 18g. Use of standardized measures. The commissioner, in consultation
6.17with the Nonemergency Medical Transportation Advisory Committee, shall establish
6.18performance measures to assess the cost-effectiveness and quality of nonemergency
6.19medical transportation. At a minimum, performance measures should include the number
6.20of unique participants served by type of transportation provider, number of trips provided
6.21by type of transportation provider, and cost per trip by type of transportation provider. The
6.22commissioner must also consider the measures identified in the January 2012 Department
6.23of Human Services report to the legislature on nonemergency medical transportation.
6.24Beginning in calendar year 2013, the commissioner shall collect, audit, and analyze
6.25performance data on nonemergency medical transportation annually and report this
6.26information on the agency's Web site. The commissioner shall periodically supplement
6.27this information with the results of consumer surveys of the quality of services, and shall
6.28make these survey findings available to the public on the agency Web site.

6.29    Sec. 8. Minnesota Statutes 2010, section 256B.0625, subdivision 28a, is amended to
6.30read:
6.31    Subd. 28a. Licensed physician assistant services. (a) Medical assistance covers
6.32services performed by a licensed physician assistant if the service is otherwise covered
6.33under this chapter as a physician service and if the service is within the scope of practice
6.34of a licensed physician assistant as defined in section 147A.09.
7.1(b) Licensed physician assistants, who are supervised by a physician certified by
7.2the American Board of Psychiatry and Neurology or eligible for board certification in
7.3psychiatry, may bill for medication management and evaluation and management services
7.4provided to medical assistance enrollees in inpatient hospital settings, consistent with
7.5their authorized scope of practice, as defined in section 147A.09, with the exception of
7.6performing psychotherapy, diagnostic assessments, or providing clinical supervision.

7.7    Sec. 9. Minnesota Statutes 2011 Supplement, section 256B.0625, subdivision 38,
7.8is amended to read:
7.9    Subd. 38. Payments for mental health services. Payments for mental
7.10health services covered under the medical assistance program that are provided by
7.11masters-prepared mental health professionals shall be 80 percent of the rate paid to
7.12doctoral-prepared professionals. Payments for mental health services covered under
7.13the medical assistance program that are provided by masters-prepared mental health
7.14professionals employed by community mental health centers shall be 100 percent of the
7.15rate paid to doctoral-prepared professionals. Payments for mental health services covered
7.16under the medical assistance program that are provided by physician assistants shall be
7.1780.4 percent of the base rate paid to psychiatrists.

7.18    Sec. 10. Minnesota Statutes 2011 Supplement, section 256B.0631, subdivision 1,
7.19is amended to read:
7.20    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
7.21assistance benefit plan shall include the following cost-sharing for all recipients, effective
7.22for services provided on or after September 1, 2011:
7.23    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
7.24of this subdivision, a visit means an episode of service which is required because of
7.25a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
7.26ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
7.27midwife, advanced practice nurse, audiologist, optician, or optometrist;
7.28    (2) $3 for eyeglasses;
7.29    (3) $3.50 for nonemergency visits to a hospital-based emergency room, except that
7.30this co-payment shall be increased to $20 upon federal approval;
7.31    (4) $3 per brand-name drug prescription and $1 per generic drug prescription,
7.32subject to a $12 per month maximum for prescription drug co-payments. No co-payments
7.33shall apply to antipsychotic drugs when used for the treatment of mental illness;
8.1(5) effective January 1, 2012, a family deductible equal to the maximum amount
8.2allowed under Code of Federal Regulations, title 42, part 447.54; and
8.3    (6) for individuals identified by the commissioner with income at or below 100
8.4percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
8.5percent of family income. For purposes of this paragraph, family income is the total
8.6earned and unearned income of the individual and the individual's spouse, if the spouse is
8.7enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
8.8    (b) Recipients of medical assistance are responsible for all co-payments and
8.9deductibles in this subdivision.
8.10(c) Notwithstanding paragraph (b), the commissioner, through the contracting
8.11process under sections 256B.69 and 256B.692, may allow managed care plans and
8.12county-based purchasing plans to waive the family deductible under paragraph (a),
8.13clause (5). The value of the family deductible shall not be included in the capitation
8.14payment to managed care plans and county-based purchasing plans. Managed care plans
8.15and county-based purchasing plans shall certify annually to the commissioner the dollar
8.16value of the family deductible.
8.17(d) Notwithstanding paragraph (b), the commissioner may waive the collection of
8.18the family deductible described under paragraph (a), clause (5), from individuals and
8.19allow long-term care and waivered service providers to assume responsibility for payment.
8.20EFFECTIVE DATE.Paragraph (c) is effective January 1, 2012. Paragraph (d)
8.21is effective July 1, 2012.

8.22    Sec. 11. Minnesota Statutes 2010, section 256B.0751, is amended by adding a
8.23subdivision to read:
8.24    Subd. 9. Pediatric care coordination. The commissioner shall implement a
8.25pediatric care coordination service for children with high-cost medical or high-cost
8.26psychiatric conditions who are at risk of recurrent hospitalization or emergency room use
8.27for acute, chronic, or psychiatric illness, who receive medical assistance services. Care
8.28coordination services must be targeted to children not already receiving care coordination
8.29through another service and may include but are not limited to the provision of health
8.30care home services to children admitted to hospitals that do not currently provide care
8.31coordination. Care coordination services must be provided by care coordinators who
8.32are directly linked to provider teams in the care delivery setting, but who may be part
8.33of a community care team shared by multiple primary care providers or practices. For
8.34purposes of this subdivision, the commissioner shall, to the extent possible, use the
9.1existing health care home certification and payment structure established under this
9.2section and section 256B.0753.

9.3    Sec. 12. Minnesota Statutes 2011 Supplement, section 256B.69, subdivision 5a,
9.4is amended to read:
9.5    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
9.6and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
9.7January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
9.8renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
9.931, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
9.10issue separate contracts with requirements specific to services to medical assistance
9.11recipients age 65 and older.
9.12    (b) A prepaid health plan providing covered health services for eligible persons
9.13pursuant to chapters 256B and 256L is responsible for complying with the terms of its
9.14contract with the commissioner. Requirements applicable to managed care programs
9.15under chapters 256B and 256L established after the effective date of a contract with the
9.16commissioner take effect when the contract is next issued or renewed.
9.17    (c) Effective for services rendered on or after January 1, 2003, the commissioner
9.18shall withhold five percent of managed care plan payments under this section and
9.19county-based purchasing plan payments under section 256B.692 for the prepaid medical
9.20assistance program pending completion of performance targets. Each performance target
9.21must be quantifiable, objective, measurable, and reasonably attainable, except in the case
9.22of a performance target based on a federal or state law or rule. Criteria for assessment
9.23of each performance target must be outlined in writing prior to the contract effective
9.24date. Clinical or utilization performance targets and their related criteria must consider
9.25evidence-based research and reasonable interventions when available or applicable to the
9.26populations served, and must be developed with input from external clinical experts
9.27and stakeholders, including managed care plans, county-based purchasing plans, and
9.28providers. The managed care or county-based purchasing plan must demonstrate,
9.29to the commissioner's satisfaction, that the data submitted regarding attainment of
9.30the performance target is accurate. The commissioner shall periodically change the
9.31administrative measures used as performance targets in order to improve plan performance
9.32across a broader range of administrative services. The performance targets must include
9.33measurement of plan efforts to contain spending on health care services and administrative
9.34activities. The commissioner may adopt plan-specific performance targets that take into
9.35account factors affecting only one plan, including characteristics of the plan's enrollee
10.1population. The withheld funds must be returned no sooner than July of the following
10.2year if performance targets in the contract are achieved. The commissioner may exclude
10.3special demonstration projects under subdivision 23.
10.4    (d) Effective for services rendered on or after January 1, 2009, through December
10.531, 2009, the commissioner shall withhold three percent of managed care plan payments
10.6under this section and county-based purchasing plan payments under section 256B.692
10.7for the prepaid medical assistance program. The withheld funds must be returned no
10.8sooner than July 1 and no later than July 31 of the following year. The commissioner may
10.9exclude special demonstration projects under subdivision 23.
10.10(e) Effective for services provided on or after January 1, 2010, the commissioner
10.11shall require that managed care plans use the assessment and authorization processes,
10.12forms, timelines, standards, documentation, and data reporting requirements, protocols,
10.13billing processes, and policies consistent with medical assistance fee-for-service or the
10.14Department of Human Services contract requirements consistent with medical assistance
10.15fee-for-service or the Department of Human Services contract requirements for all
10.16personal care assistance services under section 256B.0659.
10.17(f) Effective for services rendered on or after January 1, 2010, through December
10.1831, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
10.19under this section and county-based purchasing plan payments under section 256B.692
10.20for the prepaid medical assistance program. The withheld funds must be returned no
10.21sooner than July 1 and no later than July 31 of the following year. The commissioner may
10.22exclude special demonstration projects under subdivision 23.
10.23(g) Effective for services rendered on or after January 1, 2011, through December
10.2431, 2011, the commissioner shall include as part of the performance targets described
10.25in paragraph (c) a reduction in the health plan's emergency room utilization rate for
10.26state health care program enrollees by a measurable rate of five percent from the plan's
10.27utilization rate for state health care program enrollees for the previous calendar year.
10.28Effective for services rendered on or after January 1, 2012, the commissioner shall include
10.29as part of the performance targets described in paragraph (c) a reduction in the health
10.30plan's emergency department utilization rate for medical assistance and MinnesotaCare
10.31enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
10.32the health plan's utilization in 2009. To earn the return of the withhold each subsequent
10.33year, the managed care plan or county-based purchasing plan must achieve a qualifying
10.34reduction of no less than ten percent of the plan's emergency department utilization
10.35rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees
10.36in programs described in subdivisions 23 and 28, compared to the previous calendar
11.1measurement year until the final performance target is reached. When measuring
11.2performance, the commissioner must consider the difference in health risk in a managed
11.3care or county-based purchasing plan's membership in the baseline year compared to the
11.4measurement year, and work with the managed care or county-based purchasing plan to
11.5account for differences that they agree are significant.
11.6The withheld funds must be returned no sooner than July 1 and no later than July 31
11.7of the following calendar year if the managed care plan or county-based purchasing plan
11.8demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
11.9was achieved. The commissioner shall structure the withhold so that the commissioner
11.10returns a portion of the withheld funds in amounts commensurate with achieved reductions
11.11in utilization less than the target amount.
11.12The withhold described in this paragraph shall continue for each consecutive
11.13contract period until the plan's emergency room utilization rate for state health care
11.14program enrollees is reduced by 25 percent of the plan's emergency room utilization
11.15rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009.
11.16Hospitals shall cooperate with the health plans in meeting this performance target and
11.17shall accept payment withholds that may be returned to the hospitals if the performance
11.18target is achieved.
11.19(h) Effective for services rendered on or after January 1, 2012, the commissioner
11.20shall include as part of the performance targets described in paragraph (c) a reduction in the
11.21plan's hospitalization admission rate for medical assistance and MinnesotaCare enrollees,
11.22as determined by the commissioner. To earn the return of the withhold each year, the
11.23managed care plan or county-based purchasing plan must achieve a qualifying reduction
11.24of no less than five percent of the plan's hospital admission rate for medical assistance
11.25and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
11.26subdivisions 23 and 28, compared to the previous calendar year until the final performance
11.27target is reached. When measuring performance, the commissioner must consider the
11.28difference in health risk in a managed care or county-based purchasing plan's membership
11.29in the baseline year compared to the measurement year, and work with the managed care
11.30or county-based purchasing plan to account for differences that they agree are significant.
11.31The withheld funds must be returned no sooner than July 1 and no later than July
11.3231 of the following calendar year if the managed care plan or county-based purchasing
11.33plan demonstrates to the satisfaction of the commissioner that this reduction in the
11.34hospitalization rate was achieved. The commissioner shall structure the withhold so that
11.35the commissioner returns a portion of the withheld funds in amounts commensurate with
11.36achieved reductions in utilization less than the targeted amount.
12.1The withhold described in this paragraph shall continue until there is a 25 percent
12.2reduction in the hospital admission rate compared to the hospital admission rates in
12.3calendar year 2011, as determined by the commissioner. The hospital admissions in this
12.4performance target do not include the admissions applicable to the subsequent hospital
12.5admission performance target under paragraph (i). Hospitals shall cooperate with the
12.6plans in meeting this performance target and shall accept payment withholds that may be
12.7returned to the hospitals if the performance target is achieved.
12.8(i) Effective for services rendered on or after January 1, 2012, the commissioner
12.9shall include as part of the performance targets described in paragraph (c) a reduction in
12.10the plan's hospitalization admission rates for subsequent hospitalizations within 30 days
12.11of a previous hospitalization of a patient regardless of the reason, for medical assistance
12.12and MinnesotaCare enrollees, as determined by the commissioner. To earn the return of
12.13the withhold each year, the managed care plan or county-based purchasing plan must
12.14achieve a qualifying reduction of the subsequent hospitalization rate for medical assistance
12.15and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
12.16subdivisions 23 and 28, of no less than five percent compared to the previous calendar
12.17year until the final performance target is reached.
12.18The withheld funds must be returned no sooner than July 1 and no later than July
12.1931 of the following calendar year if the managed care plan or county-based purchasing
12.20plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
12.21the subsequent hospitalization rate was achieved. The commissioner shall structure the
12.22withhold so that the commissioner returns a portion of the withheld funds in amounts
12.23commensurate with achieved reductions in utilization less that the targeted amount.
12.24The withhold described in this paragraph must continue for each consecutive
12.25contract period until the plan's subsequent hospitalization rate for medical assistance
12.26and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
12.27subdivisions 23 and 28, is reduced by 25 percent of the plan's subsequent hospitalization
12.28rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
12.29performance target and shall accept payment withholds that must be returned to the
12.30hospitals if the performance target is achieved.
12.31(j) Effective for services rendered on or after January 1, 2011, through December 31,
12.322011, the commissioner shall withhold 4.5 percent of managed care plan payments under
12.33this section and county-based purchasing plan payments under section 256B.692 for the
12.34prepaid medical assistance program. The withheld funds must be returned no sooner than
12.35July 1 and no later than July 31 of the following year. The commissioner may exclude
12.36special demonstration projects under subdivision 23.
13.1(k) Effective for services rendered on or after January 1, 2012, through December
13.231, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
13.3under this section and county-based purchasing plan payments under section 256B.692
13.4for the prepaid medical assistance program. The withheld funds must be returned no
13.5sooner than July 1 and no later than July 31 of the following year. The commissioner may
13.6exclude special demonstration projects under subdivision 23.
13.7(l) Effective for services rendered on or after January 1, 2013, through December 31,
13.82013, the commissioner shall withhold 4.5 percent of managed care plan payments under
13.9this section and county-based purchasing plan payments under section 256B.692 for the
13.10prepaid medical assistance program. The withheld funds must be returned no sooner than
13.11July 1 and no later than July 31 of the following year. The commissioner may exclude
13.12special demonstration projects under subdivision 23.
13.13(m) Effective for services rendered on or after January 1, 2014, the commissioner
13.14shall withhold three percent of managed care plan payments under this section and
13.15county-based purchasing plan payments under section 256B.692 for the prepaid medical
13.16assistance program. The withheld funds must be returned no sooner than July 1 and
13.17no later than July 31 of the following year. The commissioner may exclude special
13.18demonstration projects under subdivision 23.
13.19(n) A managed care plan or a county-based purchasing plan under section 256B.692
13.20may include as admitted assets under section 62D.044 any amount withheld under this
13.21section that is reasonably expected to be returned.
13.22(o) Contracts between the commissioner and a prepaid health plan are exempt from
13.23the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
13.24(a), and 7.
13.25(p) The return of the withhold under paragraphs (d), (f), and (j) to (m) is not subject
13.26to the requirements of paragraph (c).

13.27    Sec. 13. Minnesota Statutes 2010, section 256B.69, subdivision 9, is amended to read:
13.28    Subd. 9. Reporting. (a) Each demonstration provider shall submit information as
13.29required by the commissioner, including data required for assessing client satisfaction,
13.30quality of care, cost, and utilization of services for purposes of project evaluation. The
13.31commissioner shall also develop methods of data reporting and collection in order to
13.32provide aggregate enrollee information on encounters and outcomes to determine access
13.33and quality assurance. Required information shall be specified before the commissioner
13.34contracts with a demonstration provider.
14.1(b) Aggregate nonpersonally identifiable health plan encounter data, aggregate
14.2spending data for major categories of service as reported to the commissioners of
14.3health and commerce under section 62D.08, subdivision 3, clause (a), and criteria for
14.4service authorization and service use are public data that the commissioner shall make
14.5available and use in public reports. The commissioner shall require each health plan and
14.6county-based purchasing plan to provide:
14.7(1) encounter data for each service provided, using standard codes and unit of
14.8service definitions set by the commissioner, in a form that the commissioner can report by
14.9age, eligibility groups, and health plan; and
14.10(2) criteria, written policies, and procedures required to be disclosed under section
14.1162M.10 , subdivision 7, and Code of Federal Regulations, title 42, part 438.210(b)(1), used
14.12for each type of service for which authorization is required.
14.13(c) Each demonstration provider shall report to the commissioner on the extent to
14.14which providers employed by or under contract with the demonstration provider use
14.15patient-centered decision-making tools or procedures designed to engage patients early
14.16in the decision-making process and the steps taken by the demonstration provider to
14.17encourage their use.

14.18    Sec. 14. Minnesota Statutes 2010, section 256B.69, is amended by adding a
14.19subdivision to read:
14.20    Subd. 9d. Financial audit. (a) The legislative auditor shall contract with an audit
14.21firm to conduct a biennial independent third-party financial audit of the information
14.22required to be provided by managed care plans and county-based purchasing plans under
14.23subdivision 9c, paragraph (b). The audit shall be conducted in accordance with generally
14.24accepted government auditing standards issued by the United States Government
14.25Accountability Office. The contract with the audit firm shall be designed and administered
14.26so as to render the independent third-party audit eligible for a federal subsidy, if available.
14.27The contract shall require the audit to include a determination of compliance with
14.28the federal Medicaid rate certification process. The contract shall require the audit to
14.29determine if the administrative expenses and investment income reported by the managed
14.30care plans and county-based purchasing plans are compliant with state and federal law.
14.31(b) For purposes of this subdivision, "independent third-party" means an audit firm
14.32that is independent in accordance with government auditing standards issued by the United
14.33States Government Accountability Office and licensed in accordance with chapter 326A.
14.34An audit firm under contract to provide services in accordance with this subdivision must
15.1not have provided services to a managed care plan or county-based purchasing plan during
15.2the period for which the audit is being conducted.
15.3(c) The commissioner shall require in the request for bids and resulting contracts
15.4with managed care plans and county-based purchasing plans under this section and section
15.5256B.692, that each managed care plan and county-based purchasing plan submit to
15.6and fully cooperate with the independent third-party financial audit of the information
15.7required under subdivision 9c, paragraph (b). Each contract with a managed care plan
15.8or county-based purchasing plan under this section or section 256B.692, must provide
15.9the commissioner and the audit firm contracting with the legislative auditor access to all
15.10data required to complete the audit. For purposes of this subdivision, the contracting
15.11audit firm shall have the same investigative power as the legislative auditor under section
15.123.978, subdivision 2.
15.13(d) Each managed care plan and county-based purchasing plan providing services
15.14under this section shall provide to the commissioner biweekly encounter data and claims
15.15data for state public health care programs and shall participate in a quality assurance
15.16program that verifies the timeliness, completeness, accuracy, and consistency of the data
15.17provided. The commissioner shall develop written protocols for the quality assurance
15.18program and shall make the protocols publicly available. The commissioner shall contract
15.19for an independent third-party audit to evaluate the quality assurance protocols as to
15.20the capacity of the protocols to ensure complete and accurate data and to evaluate the
15.21commissioner's implementation of the protocols. The audit firm under contract to provide
15.22this evaluation must meet the requirements in paragraph (b).
15.23(e) Upon completion of the audit under paragraph (a) and receipt by the legislative
15.24auditor, the legislative auditor shall provide copies of the audit report to the commissioner,
15.25the state auditor, the attorney general, and the chairs and ranking minority members of the
15.26health and human services finance committees of the legislature. Upon completion of the
15.27evaluation under paragraph (d), the commissioner shall provide copies of the report to
15.28the legislative auditor and the chairs and ranking minority members of the health finance
15.29committees of the legislature.
15.30(f) Any actuary under contract with the commissioner to provide actuarial services
15.31must meet the independence requirements under the professional code for fellows in the
15.32Society of Actuaries and must not have provided actuarial services to a managed care plan
15.33or county-based purchasing plan that is under contract with the commissioner pursuant to
15.34this section and section 256B.692 during the period in which the actuarial services are
15.35being provided. An actuary or actuarial firm meeting the requirements of this paragraph
15.36must certify and attest to the rates paid to the managed care plans and county-based
16.1purchasing plans under this section and section 256B.692, and the certification and
16.2attestation must be auditable.
16.3(g) Nothing in this subdivision shall allow the release of information that is
16.4nonpublic data pursuant to section 13.02.
16.5EFFECTIVE DATE.This section is effective the day following final enactment
16.6and applies to the managed care and county-based purchasing plan contracts that are
16.7effective January 1, 2014, and biennially thereafter.

16.8    Sec. 15. Minnesota Statutes 2010, section 256B.69, is amended by adding a
16.9subdivision to read:
16.10    Subd. 32. Initiatives to reduce incidence of low birth weight. The commissioner
16.11shall require managed care and county-based purchasing plans, as a condition of contract,
16.12to implement strategies to reduce the incidence of low birth weight in geographic areas
16.13identified by the commissioner as having a higher than average incidence of low birth
16.14weight. The strategies must coordinate health care with social services and the local
16.15public health system. Each plan shall develop and report to the commissioner outcome
16.16measures related to reducing the incidence of low birth weight. The commissioner shall
16.17consider the outcomes reported when considering plan participation in the competitive
16.18bidding program established under subdivision 33.

16.19    Sec. 16. Minnesota Statutes 2010, section 256B.69, is amended by adding a
16.20subdivision to read:
16.21    Subd. 33. Competitive bidding. (a) For managed care contracts effective on or
16.22after January 1, 2014, the commissioner may utilize a competitive price bidding program
16.23for nonelderly, nondisabled adults and children in medical assistance and MinnesotaCare
16.24in the seven-county metropolitan area. The program must allow a minimum of two
16.25managed care plans to serve the metropolitan area.
16.26(b) In designing the competitive bid program, the commissioner shall consider, and
16.27incorporate where appropriate, the procedures and criteria used in the competitive bidding
16.28pilot authorized under Laws 2011, First Special Session chapter 9, article 6, section 96.
16.29The pilot program operating in Hennepin County under the authority of section 256B.0756
16.30shall continue to be exempt from competitive bid.
16.31(c) The commissioner shall use past performance data as a factor in selecting vendors
16.32and shall consider this information, along with competitive bid and other information, in
16.33determining whether to contract with a managed care plan under this subdivision. Where
16.34possible, the assessment of past performance in serving persons on public programs shall
17.1be based on encounter data submitted to the commissioner. The commissioner shall
17.2evaluate past performance based on both the health outcomes of care and success rates
17.3in securing participation in recommended preventive and early diagnostic care. Data
17.4provided by managed care plans must be provided in a uniform manner as specified by
17.5the commissioner and must include only data on medical assistance and MinnesotaCare
17.6enrollees. The data submitted must include health outcome measures on reducing the
17.7incidence of low birth weight established by the managed care plan under subdivision 32.

17.8    Sec. 17. Minnesota Statutes 2011 Supplement, section 256B.76, subdivision 4, is
17.9amended to read:
17.10    Subd. 4. Critical access dental providers. (a) Effective for dental services
17.11rendered on or after January 1, 2002, the commissioner shall increase reimbursements
17.12to dentists and dental clinics deemed by the commissioner to be critical access dental
17.13providers. For dental services rendered on or after July 1, 2007, the commissioner shall
17.14increase reimbursement by 30 percent above the reimbursement rate that would otherwise
17.15be paid to the critical access dental provider. The commissioner shall pay the managed
17.16care plans and county-based purchasing plans in amounts sufficient to reflect increased
17.17reimbursements to critical access dental providers as approved by the commissioner.
17.18(b) The commissioner shall designate the following dentists and dental clinics as
17.19critical access dental providers:
17.20    (1) nonprofit community clinics that:
17.21(i) have nonprofit status in accordance with chapter 317A;
17.22(ii) have tax exempt status in accordance with the Internal Revenue Code, section
17.23501(c)(3);
17.24(iii) are established to provide oral health services to patients who are low income,
17.25uninsured, have special needs, and are underserved;
17.26(iv) have professional staff familiar with the cultural background of the clinic's
17.27patients;
17.28(v) charge for services on a sliding fee scale designed to provide assistance to
17.29low-income patients based on current poverty income guidelines and family size;
17.30(vi) do not restrict access or services because of a patient's financial limitations
17.31or public assistance status; and
17.32(vii) have free care available as needed;
17.33    (2) federally qualified health centers, rural health clinics, and public health clinics;
17.34    (3) county owned and operated hospital-based dental clinics;
18.1(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
18.2accordance with chapter 317A with more than 10,000 patient encounters per year with
18.3patients who are uninsured or covered by medical assistance, general assistance medical
18.4care, or MinnesotaCare; and
18.5(5) a dental clinic owned and operated by the University of Minnesota or the
18.6Minnesota State Colleges and Universities system.
18.7     (c) The commissioner may designate a dentist or dental clinic as a critical access
18.8dental provider if the dentist or dental clinic is willing to provide care to patients covered
18.9by medical assistance, general assistance medical care, or MinnesotaCare at a level which
18.10significantly increases access to dental care in the service area.
18.11(d) Notwithstanding paragraph (a), critical access payments must not be made for
18.12dental services provided from April 1, 2010, through June 30, 2010. A designated critical
18.13access clinic shall receive the reimbursement rate specified in paragraph (a) for dental
18.14services provided off-site at a private dental office if the following requirements are met:
18.15(1) the designated critical access dental clinic is located within a health professional
18.16shortage area as defined under the Code of Federal Regulations, title 42, part 5, and
18.17the United States Code, title 42, section 254E, and is located outside the seven-county
18.18metropolitan area;
18.19(2) the designated critical access dental clinic is not able to provide the service
18.20and refers the patient to the off-site dentist;
18.21(3) the service, if provided at the critical access dental clinic, would be reimbursed
18.22at the critical access reimbursement rate;
18.23(4) the dentist and allied dental professionals providing the services off-site are
18.24licensed and in good standing under chapter 150A;
18.25(5) the dentist providing the services is enrolled as a medical assistance provider;
18.26(6) the critical access dental clinic submits the claim for services provided off-site
18.27and receives the payment for the services; and
18.28(7) the critical access dental clinic maintains dental records for each claim submitted
18.29under this paragraph, including the name of the dentist, the off-site location, and the
18.30license number of the dentist and allied dental professionals providing the services.
18.31EFFECTIVE DATE.This section is effective July 1, 2012, or upon federal
18.32approval, whichever is later.

18.33    Sec. 18. Minnesota Statutes 2011 Supplement, section 256L.03, subdivision 5, is
18.34amended to read:
19.1    Subd. 5. Cost-sharing. (a) Except as provided in paragraphs (b) and (c), the
19.2MinnesotaCare benefit plan shall include the following cost-sharing requirements for all
19.3enrollees:
19.4    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
19.5subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
19.6    (2) $3 per prescription for adult enrollees;
19.7    (3) $25 for eyeglasses for adult enrollees;
19.8    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
19.9episode of service which is required because of a recipient's symptoms, diagnosis, or
19.10established illness, and which is delivered in an ambulatory setting by a physician or
19.11physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
19.12audiologist, optician, or optometrist;
19.13    (5) $6 for nonemergency visits to a hospital-based emergency room for services
19.14provided through December 31, 2010, and $3.50 effective January 1, 2011; and
19.15(6) a family deductible equal to the maximum amount allowed under Code of
19.16Federal Regulations, title 42, part 447.54.
19.17    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
19.18children under the age of 21.
19.19    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
19.20    (d) Paragraph (a), clause (4), does not apply to mental health services.
19.21    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
19.22poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
19.23and who are not pregnant shall be financially responsible for the coinsurance amount, if
19.24applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
19.25    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
19.26or changes from one prepaid health plan to another during a calendar year, any charges
19.27submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
19.28expenses incurred by the enrollee for inpatient services, that were submitted or incurred
19.29prior to enrollment, or prior to the change in health plans, shall be disregarded.
19.30(g) MinnesotaCare reimbursements to fee-for-service providers and payments to
19.31managed care plans or county-based purchasing plans shall not be increased as a result of
19.32the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
19.33(h) The commissioner, through the contracting process under section 256L.12,
19.34may allow managed care plans and county-based purchasing plans to waive the family
19.35deductible under paragraph (a), clause (6). The value of the family deductible shall not be
19.36included in the capitation payment to managed care plans and county-based purchasing
20.1plans. Managed care plans and county-based purchasing plans shall certify annually to the
20.2commissioner the dollar value of the family deductible.
20.3EFFECTIVE DATE.This section is effective January 1, 2012.

20.4    Sec. 19. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 2,
20.5is amended to read:
20.6    Subd. 2. Use of defined contribution; health plan requirements. (a) An enrollee
20.7may use up to the monthly defined contribution to pay premiums for coverage under
20.8a health plan as defined in section 62A.011, subdivision 3, or as provided in section
20.9256L.031, subdivision 6.
20.10    (b) An enrollee must select a health plan within three four calendar months of
20.11approval of MinnesotaCare eligibility. If a health plan is not selected and purchased
20.12within this time period, the enrollee must reapply and must meet all eligibility criteria.
20.13The commissioner may determine criteria under which an enrollee has more than four
20.14calendar months to select a health plan.
20.15    (c) A health plan Coverage purchased under this section must:
20.16    (1) provide coverage for include mental health and chemical dependency treatment
20.17services; and
20.18    (2) comply with the coverage limitations specified in section 256L.03, subdivision
20.191, the second paragraph.

20.20    Sec. 20. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 3,
20.21is amended to read:
20.22    Subd. 3. Determination of defined contribution amount. (a) The commissioner
20.23shall determine the defined contribution sliding scale using the base contribution specified
20.24in paragraph (b) this paragraph for the specified age ranges. The commissioner shall use a
20.25sliding scale for defined contributions that provides:
20.26    (1) persons with household incomes equal to 200 percent of the federal poverty
20.27guidelines with a defined contribution of 93 percent of the base contribution;
20.28    (2) persons with household incomes equal to 250 percent of the federal poverty
20.29guidelines with a defined contribution of 80 percent of the base contribution; and
20.30    (3) persons with household incomes in evenly spaced increments between the
20.31percentages of the federal poverty guideline or income level specified in clauses (1) and
20.32(2) with a base contribution that is a percentage interpolated from the defined contribution
20.33percentages specified in clauses (1) and (2).
21.1
19-29
$125
21.2
30-34
$135
21.3
35-39
$140
21.4
40-44
$175
21.5
45-49
$215
21.6
50-54
$295
21.7
55-59
$345
21.8
60+
$360
21.9    (b) The commissioner shall multiply the defined contribution amounts developed
21.10under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
21.11health plan by a health plan company and who purchase coverage through the Minnesota
21.12Comprehensive Health Association.

21.13    Sec. 21. Minnesota Statutes 2011 Supplement, section 256L.031, subdivision 6,
21.14is amended to read:
21.15    Subd. 6. Minnesota Comprehensive Health Association (MCHA). Beginning
21.16July 1, 2012, MinnesotaCare enrollees who are denied coverage in the individual
21.17health market by a health plan company in accordance with section 62A.65 are eligible
21.18for coverage through a health plan offered by the Minnesota Comprehensive Health
21.19Association and may enroll in MCHA in accordance with section 62E.14. Any difference
21.20between the revenue and actual covered losses to MCHA related to the implementation of
21.21this section are appropriated annually to the commissioner of human services from the
21.22health care access fund and shall be paid to MCHA.

21.23    Sec. 22. Minnesota Statutes 2010, section 256L.07, subdivision 3, is amended to read:
21.24    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
21.25MinnesotaCare program must have no health coverage while enrolled or for at least four
21.26months prior to application and renewal. Children enrolled in the original children's health
21.27plan and children in families with income equal to or less than 150 percent of the federal
21.28poverty guidelines, who have other health insurance, are eligible if the coverage:
21.29    (1) lacks two or more of the following:
21.30    (i) basic hospital insurance;
21.31    (ii) medical-surgical insurance;
21.32    (iii) prescription drug coverage;
21.33    (iv) dental coverage; or
21.34    (v) vision coverage;
21.35    (2) requires a deductible of $100 or more per person per year; or
22.1    (3) lacks coverage because the child has exceeded the maximum coverage for a
22.2particular diagnosis or the policy excludes a particular diagnosis.
22.3    The commissioner may change this eligibility criterion for sliding scale premiums
22.4in order to remain within the limits of available appropriations. The requirement of no
22.5health coverage does not apply to newborns.
22.6    (b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
22.7assistance, general assistance medical care, and the Civilian Health and Medical Program
22.8of the Uniformed Service, CHAMPUS, or other coverage provided under United States
22.9Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health
22.10coverage for purposes of the four-month requirement described in this subdivision.
22.11    (c) For purposes of this subdivision, an applicant or enrollee who is entitled to
22.12Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
22.13Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
22.14have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
22.15Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
22.16for MinnesotaCare.
22.17    (d) Applicants who were recipients of medical assistance or general assistance
22.18medical care within one month of application must meet the provisions of this subdivision
22.19and subdivision 2.
22.20    (e) Cost-effective health insurance that was paid for by medical assistance is not
22.21considered health coverage for purposes of the four-month requirement under this
22.22section, except if the insurance continued after medical assistance no longer considered it
22.23cost-effective or after medical assistance closed.

22.24    Sec. 23. Minnesota Statutes 2011 Supplement, section 256L.12, subdivision 9, is
22.25amended to read:
22.26    Subd. 9. Rate setting; performance withholds. (a) Rates will be prospective,
22.27per capita, where possible. The commissioner may allow health plans to arrange for
22.28inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
22.29an independent actuary to determine appropriate rates.
22.30    (b) For services rendered on or after January 1, 2004, the commissioner shall
22.31withhold five percent of managed care plan payments and county-based purchasing
22.32plan payments under this section pending completion of performance targets. Each
22.33performance target must be quantifiable, objective, measurable, and reasonably attainable,
22.34except in the case of a performance target based on a federal or state law or rule. Criteria
22.35for assessment of each performance target must be outlined in writing prior to the contract
23.1effective date. Clinical or utilization performance targets and their related criteria must
23.2consider evidence-based research and reasonable interventions, when available or
23.3applicable to the populations served, and must be developed with input from external
23.4clinical experts and stakeholders, including managed care plans, county-based purchasing
23.5plans, and providers. The managed care plan must demonstrate, to the commissioner's
23.6satisfaction, that the data submitted regarding attainment of the performance target is
23.7accurate. The commissioner shall periodically change the administrative measures used
23.8as performance targets in order to improve plan performance across a broader range of
23.9administrative services. The performance targets must include measurement of plan
23.10efforts to contain spending on health care services and administrative activities. The
23.11commissioner may adopt plan-specific performance targets that take into account factors
23.12affecting only one plan, such as characteristics of the plan's enrollee population. The
23.13withheld funds must be returned no sooner than July 1 and no later than July 31 of the
23.14following calendar year if performance targets in the contract are achieved.
23.15(c) For services rendered on or after January 1, 2011, the commissioner shall
23.16withhold an additional three percent of managed care plan or county-based purchasing
23.17plan payments under this section. The withheld funds must be returned no sooner than
23.18July 1 and no later than July 31 of the following calendar year. The return of the withhold
23.19under this paragraph is not subject to the requirements of paragraph (b).
23.20(d) Effective for services rendered on or after January 1, 2011, through December
23.2131, 2011, the commissioner shall include as part of the performance targets described in
23.22paragraph (b) a reduction in the plan's emergency room utilization rate for state health care
23.23program enrollees by a measurable rate of five percent from the plan's utilization rate for
23.24the previous calendar year. Effective for services rendered on or after January 1, 2012,
23.25the commissioner shall include as part of the performance targets described in paragraph
23.26(b) a reduction in the health plan's emergency department utilization rate for medical
23.27assistance and MinnesotaCare enrollees, as determined by the commissioner. For 2012,
23.28the reductions shall be based on the health plan's utilization in 2009. To earn the return of
23.29the withhold each subsequent year, the managed care plan or county-based purchasing
23.30plan must achieve a qualifying reduction of no less than ten percent of the plan's utilization
23.31rate for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees in
23.32programs described in section 256B.69, subdivisions 23 and 28, compared to the previous
23.33calendar measurement year, until the final performance target is reached. When measuring
23.34performance, the commissioner must consider the difference in health risk in a managed
23.35care or county-based purchasing plan's membership in the baseline year compared to the
24.1measurement year, and work with the managed care or county-based purchasing plan to
24.2account for differences that they agree are significant.
24.3The withheld funds must be returned no sooner than July 1 and no later than July 31
24.4of the following calendar year if the managed care plan or county-based purchasing plan
24.5demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
24.6was achieved. The commissioner shall structure the withhold so that the commissioner
24.7returns a portion of the withheld funds in amounts commensurate with achieved reductions
24.8in utilization less than the targeted amount.
24.9The withhold described in this paragraph shall continue for each consecutive
24.10contract period until the plan's emergency room utilization rate for state health care
24.11program enrollees is reduced by 25 percent of the plan's emergency room utilization
24.12rate for medical assistance and MinnesotaCare enrollees for calendar year 2011 2009.
24.13Hospitals shall cooperate with the health plans in meeting this performance target and
24.14shall accept payment withholds that may be returned to the hospitals if the performance
24.15target is achieved.
24.16(e) Effective for services rendered on or after January 1, 2012, the commissioner
24.17shall include as part of the performance targets described in paragraph (b) a reduction
24.18in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
24.19enrollees, as determined by the commissioner. To earn the return of the withhold
24.20each year, the managed care plan or county-based purchasing plan must achieve a
24.21qualifying reduction of no less than five percent of the plan's hospital admission rate
24.22for medical assistance and MinnesotaCare enrollees, excluding Medicare enrollees
24.23in programs described in section 256B.69, subdivisions 23 and 28, compared to the
24.24previous calendar year, until the final performance target is reached. When measuring
24.25performance, the commissioner must consider the difference in health risk in a managed
24.26care or county-based purchasing plan's membership in the baseline year compared to the
24.27measurement year, and work with the managed care or county-based purchasing plan to
24.28account for differences that they agree are significant.
24.29The withheld funds must be returned no sooner than July 1 and no later than July
24.3031 of the following calendar year if the managed care plan or county-based purchasing
24.31plan demonstrates to the satisfaction of the commissioner that this reduction in the
24.32hospitalization rate was achieved. The commissioner shall structure the withhold so that
24.33the commissioner returns a portion of the withheld funds in amounts commensurate with
24.34achieved reductions in utilization less than the targeted amount.
24.35The withhold described in this paragraph shall continue until there is a 25 percent
24.36reduction in the hospitals admission rate compared to the hospital admission rate for
25.1calendar year 2011 as determined by the commissioner. Hospitals shall cooperate with the
25.2plans in meeting this performance target and shall accept payment withholds that may be
25.3returned to the hospitals if the performance target is achieved. The hospital admissions
25.4in this performance target do not include the admissions applicable to the subsequent
25.5hospital admission performance target under paragraph (f).
25.6(f) Effective for services provided on or after January 1, 2012, the commissioner
25.7shall include as part of the performance targets described in paragraph (b) a reduction
25.8in the plan's hospitalization rate for a subsequent hospitalization within 30 days of a
25.9previous hospitalization of a patient regardless of the reason, for medical assistance and
25.10MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
25.11withhold each year, the managed care plan or county-based purchasing plan must achieve
25.12a qualifying reduction of the subsequent hospital admissions rate for medical assistance
25.13and MinnesotaCare enrollees, excluding Medicare enrollees in programs described in
25.14section 256B.69, subdivisions 23 and 28, of no less than five percent compared to the
25.15previous calendar year until the final performance target is reached.
25.16The withheld funds must be returned no sooner than July 1 and no later than July 31
25.17of the following calendar year if the managed care plan or county-based purchasing plan
25.18demonstrates to the satisfaction of the commissioner that a reduction in the subsequent
25.19hospitalization rate was achieved. The commissioner shall structure the withhold so that
25.20the commissioner returns a portion of the withheld funds in amounts commensurate with
25.21achieved reductions in utilization less than the targeted amount.
25.22The withhold described in this paragraph must continue for each consecutive
25.23contract period until the plan's subsequent hospitalization rate for medical assistance and
25.24MinnesotaCare enrollees is reduced by 25 percent of the plan's subsequent hospitalization
25.25rate for calendar year 2011. Hospitals shall cooperate with the plans in meeting this
25.26performance target and shall accept payment withholds that must be returned to the
25.27hospitals if the performance target is achieved.
25.28(g) A managed care plan or a county-based purchasing plan under section 256B.692
25.29may include as admitted assets under section 62D.044 any amount withheld under this
25.30section that is reasonably expected to be returned.

25.31    Sec. 24. NONEMERGENCY MEDICAL TRANSPORTATION SERVICES
25.32REQUEST FOR INFORMATION.
25.33(a) The commissioner of human services shall issue a request for information
25.34from vendors about potential solutions for the management of nonemergency medical
25.35transportation (NEMT) services provided to recipients of Minnesota health care programs.
26.1The request for information must require vendors to submit responses by November 1,
26.22012. The request for information shall seek information from vendors, including but not
26.3limited to, the following aspects:
26.4(1) administration of the NEMT program within a single administrative structure,
26.5that may include a statewide or regionalized solution;
26.6(2) oversight of transportation services;
26.7(3) a process for assessing an individual's level of need;
26.8(4) methods that promote the appropriate use of public transportation; and
26.9(5) an electronic system that assists providers in managing services to clients and is
26.10consistent with the recommendations in the 2011 evaluation report by the Office of the
26.11Legislative Auditor on NEMT, related to the use of data to inform decision-making and
26.12reduce waste and fraud.
26.13(b) The commissioner shall provide the information obtained from the request for
26.14information to the chairs and ranking minority members of the legislative committees with
26.15jurisdiction over health and human services policy and financing by November 15, 2012.

26.16    Sec. 25. PHYSICIAN ASSISTANTS AND OUTPATIENT MENTAL HEALTH.
26.17The commissioner of human services shall convene a group of interested
26.18stakeholders to assist the commissioner in developing recommendations on how to
26.19improve access to, and the quality of, outpatient mental health services for medical
26.20assistance enrollees through the use of physician assistants. The commissioner shall report
26.21these recommendations to the chairs and ranking minority members of the legislative
26.22committees with jurisdiction over health care policy and financing by January 15, 2013.

26.23    Sec. 26. HEALTH SERVICES ADVISORY COUNCIL.
26.24The Health Services Advisory Council shall review currently available literature
26.25regarding the efficacy of various treatments for autism spectrum disorder, including
26.26an evaluation of age-based variation in the appropriateness of existing medical and
26.27behavioral interventions. The council shall recommend to the commissioner of human
26.28services authorization criteria for services based on existing evidence. The council may
26.29recommend coverage with ongoing collection of outcomes evidence in circumstances
26.30where evidence is currently unavailable, or where the strength of the evidence is low. The
26.31council shall make this recommendation by December 31, 2012.

26.32    Sec. 27. REPORTING REQUIREMENTS.
27.1    Subdivision 1. Evidence-based childbirth program. The commissioner of human
27.2services may discontinue the evidence-based childbirth program and shall discontinue all
27.3affiliated reporting requirements established under Minnesota Statutes, section 256B.0625,
27.4subdivision 3g, once the commissioner determines that hospitals representing at least 90
27.5percent of births covered by medical assistance or MinnesotaCare have approved policies
27.6and processes in place that prohibit elective inductions prior to 39 weeks' gestation.
27.7    Subd. 2. Provider networks. The commissioner of health, the commissioner of
27.8commerce, and the commissioner of human services shall merge reporting requirements
27.9for health maintenance organizations and county-based purchasing plans related to
27.10Minnesota Department of Health oversight of network adequacy under Minnesota
27.11Statutes, section 62D.124, and the provider network list reported to the Department of
27.12Human Services under Minnesota Rules, part 4685.2100. The commissioners shall work
27.13with health maintenance organizations and county-based purchasing plans to ensure that
27.14the report merger is done in a manner that simplifies health maintenance organization and
27.15county-based purchasing plan reporting processes.
27.16EFFECTIVE DATE.This section is effective the day following final enactment.

27.17    Sec. 28. EMERGENCY MEDICAL ASSISTANCE STUDY.
27.18(a) The commissioner of human services shall develop a plan to provide coordinated
27.19and cost-effective health care and coverage for individuals who meet eligibility standards
27.20for emergency medical assistance and who are ineligible for other state public programs.
27.21The commissioner shall consult with relevant stakeholders in the development of the plan.
27.22The commissioner shall consider the following elements:
27.23(1) strategies to provide individuals with the most appropriate care in the appropriate
27.24setting, utilizing higher quality and lower cost providers;
27.25(2) payment mechanisms to encourage providers to manage the care of these
27.26populations, and to produce lower cost of care and better patient outcomes;
27.27(3) ensure coverage and payment options that address the unique needs of those
27.28needing episodic care, chronic care, and long-term care services;
27.29(4) strategies for coordinating health care and nonhealth care services, and
27.30integrating with existing coverage; and
27.31(5) other issues and strategies to ensure cost-effective and coordinated delivery
27.32of coverage and services.
28.1(b) The commissioner shall submit the plan to the chairs and ranking minority
28.2members of the legislative committees with jurisdiction over health and human services
28.3policy and financing by January 15, 2013.

28.4    Sec. 29. EMERGENCY MEDICAL CONDITION COVERAGE EXCEPTIONS.
28.5(a) Notwithstanding Minnesota Statutes, section 256B.06, subdivision 4, paragraph
28.6(h), clause (2), the following services are covered as emergency medical conditions under
28.7Minnesota Statutes, section 256B.06, subdivision 4, paragraph (f):
28.8(1) dialysis services provided in a hospital or free-standing dialysis facility; and
28.9(2) surgery and the administration of chemotherapy, radiation, and related services
28.10necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission
28.11and requires surgery, chemotherapy, or radiation treatment.
28.12(b) Coverage under paragraph (a) is effective May 1, 2012, until June 30, 2013.

28.13    Sec. 30. COST-SHARING REQUIREMENTS STUDY.
28.14The commissioner of human services, in consultation with managed care
28.15plans, county-based purchasing plans, and other relevant stakeholders, shall develop
28.16recommendations to implement a revised cost-sharing structure for state public health
28.17care programs that ensures application of meaningful cost-sharing requirements within
28.18the limits of title 42, Code of Federal Regulations, section 447.54, for enrollees in these
28.19programs. The commissioner shall report to the chairs and ranking minority members of
28.20the legislative committees with jurisdiction over these issues by January 15, 2013, with
28.21draft legislation to implement these recommendations effective January 1, 2014.

28.22    Sec. 31. STUDY OF MANAGED CARE.
28.23(a) The commissioner of human services must contract with an independent
28.24vendor with demonstrated expertise in evaluating Medicaid managed care programs to
28.25evaluate the value of managed care for state public health care programs provided under
28.26Minnesota Statutes, sections 256B.69, 256B.692, and 256L.12. Determination of the
28.27value of managed care must include consideration of the following, as compared to a
28.28fee-for-service program:
28.29(1) the satisfaction of state public health care program recipients and providers;
28.30(2) the ability to measure and improve health outcomes of recipients;
28.31(3) the access to health services for recipients;
28.32(4) the availability of additional services such as care coordination, case
28.33management, disease management, transportation, and after-hours nurse lines;
29.1(5) actual and potential cost savings to the state;
29.2(6) the level of alignment with state and federal health reform policies, including a
29.3health benefit exchange for individuals not enrolled in state public health care programs;
29.4and
29.5(7) the ability to use different provider payment models that provide incentives for
29.6cost-effective health care.
29.7(b) The evaluation described in paragraph (a) must also consider the need to continue
29.8the requirement for health maintenance organizations to participate in the medical
29.9assistance and MinnesotaCare programs as a condition of licensure under Minnesota
29.10Statutes, section 62D.04, subdivision 5, and under Minnesota Statutes, section 256B.0644,
29.11in terms of continued stability and access to services for enrollees of these programs.
29.12(c) A preliminary report of the evaluation must be submitted to the chairs and
29.13ranking minority members of the health and human services legislative committees by
29.14February 15, 2013, and the final report must be submitted by July 1, 2013.

29.15    Sec. 32. REPEALER.
29.16    Subdivision 1. Summary of complaints and grievances. (a) Minnesota Rules, part
29.174685.2000, is repealed effective the day following final enactment.
29.18    Subd. 2. Medical necessity denials and appeals. Minnesota Statutes 2010, section
29.1962M.09, subdivision 9, is repealed effective the day following final enactment.
29.20    Subd. 3. Salary reports. Minnesota Statutes 2010, section 62Q.64, is repealed
29.21effective the day following final enactment.

29.22ARTICLE 2
29.23DEPARTMENT OF HEALTH

29.24    Section 1. Minnesota Statutes 2010, section 62Q.80, is amended to read:
29.2562Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM.
29.26    Subdivision 1. Scope. (a) Any community-based health care initiative may develop
29.27and operate community-based health care coverage programs that offer to eligible
29.28individuals and their dependents the option of purchasing through their employer health
29.29care coverage on a fixed prepaid basis without meeting the requirements of chapter 60A,
29.3062A, 62C, 62D, 62M, 62N, 62Q, 62T, or 62U, or any other law or rule that applies to
29.31entities licensed under these chapters.
29.32(b) Each initiative shall establish health outcomes to be achieved through the
29.33programs and performance measurements in order to determine whether these outcomes
29.34have been met. The outcomes must include, but are not limited to:
30.1(1) a reduction in uncompensated care provided by providers participating in the
30.2community-based health network;
30.3(2) an increase in the delivery of preventive health care services; and
30.4(3) health improvement for enrollees with chronic health conditions through the
30.5management of these conditions.
30.6In establishing performance measurements, the initiative shall use measures that are
30.7consistent with measures published by nonprofit Minnesota or national organizations that
30.8produce and disseminate health care quality measures.
30.9(c) Any program established under this section shall not constitute a financial
30.10liability for the state, in that any financial risk involved in the operation or termination
30.11of the program shall be borne by the community-based initiative and the participating
30.12health care providers.
30.13    Subd. 1a. Demonstration project. The commissioner of health and the
30.14commissioner of human services shall award demonstration project grants to
30.15community-based health care initiatives to develop and operate community-based health
30.16care coverage programs in Minnesota. The demonstration projects shall extend for five
30.17years and must comply with the requirements of this section.
30.18    Subd. 2. Definitions. For purposes of this section, the following definitions apply:
30.19(a) "Community-based" means located in or primarily relating to the community,
30.20as determined by the board of a community-based health initiative that is served by the
30.21community-based health care coverage program.
30.22(b) "Community-based health care coverage program" or "program" means a
30.23program administered by a community-based health initiative that provides health care
30.24services through provider members of a community-based health network or combination
30.25of networks to eligible individuals and their dependents who are enrolled in the program.
30.26(c) "Community-based health initiative" or "initiative" means a nonprofit corporation
30.27that is governed by a board that has at least 80 percent of its members residing in the
30.28community and includes representatives of the participating network providers and
30.29employers, or a county-based purchasing organization as defined in section 256B.692.
30.30(d) "Community-based health network" means a contract-based network of health
30.31care providers organized by the community-based health initiative to provide or support
30.32the delivery of health care services to enrollees of the community-based health care
30.33coverage program on a risk-sharing or nonrisk-sharing basis.
30.34(e) "Dependent" means an eligible employee's spouse or unmarried child who is
30.35under the age of 19 years.
31.1    Subd. 3. Approval. (a) Prior to the operation of a community-based health
31.2care coverage program, a community-based health initiative, defined in subdivision
31.32, paragraph (c), and receiving funds from the Department of Health, shall submit to
31.4the commissioner of health for approval the community-based health care coverage
31.5program developed by the initiative. Each community-based health initiative as defined
31.6in subdivision 2, paragraph (c), and receiving State Health Access Program (SHAP)
31.7grant funding shall submit to the commissioner of human services for approval prior
31.8to its operation the community-based health care coverage programs developed by the
31.9initiatives. The commissioners commissioner shall ensure that each program meets
31.10the federal grant requirements and any requirements described in this section and is
31.11actuarially sound based on a review of appropriate records and methods utilized by the
31.12community-based health initiative in establishing premium rates for the community-based
31.13health care coverage programs.
31.14    (b) Prior to approval, the commissioner shall also ensure that:
31.15    (1) the benefits offered comply with subdivision 8 and that there are adequate
31.16numbers of health care providers participating in the community-based health network to
31.17deliver the benefits offered under the program;
31.18    (2) the activities of the program are limited to activities that are exempt under this
31.19section or otherwise from regulation by the commissioner of commerce;
31.20    (3) the complaint resolution process meets the requirements of subdivision 10; and
31.21    (4) the data privacy policies and procedures comply with state and federal law.
31.22    Subd. 4. Establishment. The initiative shall establish and operate upon approval
31.23by the commissioners commissioner of health and human services community-based
31.24health care coverage programs. The operational structure established by the initiative
31.25shall include, but is not limited to:
31.26    (1) establishing a process for enrolling eligible individuals and their dependents;
31.27    (2) collecting and coordinating premiums from enrollees and employers of enrollees;
31.28    (3) providing payment to participating providers;
31.29    (4) establishing a benefit set according to subdivision 8 and establishing premium
31.30rates and cost-sharing requirements;
31.31    (5) creating incentives to encourage primary care and wellness services; and
31.32    (6) initiating disease management services, as appropriate.
31.33    Subd. 5. Qualifying employees. To be eligible for the community-based health
31.34care coverage program, an individual must:
31.35(1) reside in or work within the designated community-based geographic area
31.36served by the program;
32.1(2) be employed by a qualifying employer, be an employee's dependent, or be
32.2self-employed on a full-time basis;
32.3(3) not be enrolled in or have currently available health coverage, except for
32.4catastrophic health care coverage; and
32.5(4) not be eligible for or enrolled in medical assistance or general assistance medical
32.6care, and not be enrolled in MinnesotaCare or Medicare.
32.7    Subd. 6. Qualifying employers. (a) To qualify for participation in the
32.8community-based health care coverage program, an employer must:
32.9(1) employ at least one but no more than 50 employees at the time of initial
32.10enrollment in the program;
32.11(2) pay its employees a median wage that equals 350 percent of the federal poverty
32.12guidelines or less for an individual; and
32.13(3) not have offered employer-subsidized health coverage to its employees for
32.14at least 12 months prior to the initial enrollment in the program. For purposes of this
32.15section, "employer-subsidized health coverage" means health care coverage for which the
32.16employer pays at least 50 percent of the cost of coverage for the employee.
32.17(b) To participate in the program, a qualifying employer agrees to:
32.18(1) offer health care coverage through the program to all eligible employees and
32.19their dependents regardless of health status;
32.20(2) participate in the program for an initial term of at least one year;
32.21(3) pay a percentage of the premium established by the initiative for the employee;
32.22and
32.23(4) provide the initiative with any employee information deemed necessary by the
32.24initiative to determine eligibility and premium payments.
32.25    Subd. 7. Participating providers. Any health care provider participating in the
32.26community-based health network must accept as payment in full the payment rate
32.27established by the initiatives and may not charge to or collect from an enrollee any amount
32.28in access of this amount for any service covered under the program.
32.29    Subd. 8. Coverage. (a) The initiatives shall establish the health care benefits offered
32.30through the community-based health care coverage programs. The benefits established
32.31shall include, at a minimum:
32.32(1) child health supervision services up to age 18, as defined under section 62A.047;
32.33and
32.34(2) preventive services, including:
32.35(i) health education and wellness services;
32.36(ii) health supervision, evaluation, and follow-up;
33.1(iii) immunizations; and
33.2(iv) early disease detection.
33.3(b) Coverage of health care services offered by the program may be limited to
33.4participating health care providers or health networks. All services covered under the
33.5programs must be services that are offered within the scope of practice of the participating
33.6health care providers.
33.7(c) The initiatives may establish cost-sharing requirements. Any co-payment or
33.8deductible provisions established may not discriminate on the basis of age, sex, race,
33.9disability, economic status, or length of enrollment in the programs.
33.10(d) If any of the initiatives amends or alters the benefits offered through the program
33.11from the initial offering, that initiative must notify the commissioners commissioner of
33.12health and human services and all enrollees of the benefit change.
33.13    Subd. 9. Enrollee information. (a) The initiatives must provide an individual or
33.14family who enrolls in the program a clear and concise written statement that includes
33.15the following information:
33.16(1) health care services that are covered under the program;
33.17(2) any exclusions or limitations on the health care services covered, including any
33.18cost-sharing arrangements or prior authorization requirements;
33.19(3) a list of where the health care services can be obtained and that all health
33.20care services must be provided by or through a participating health care provider or
33.21community-based health network;
33.22(4) a description of the program's complaint resolution process, including how to
33.23submit a complaint; how to file a complaint with the commissioner of health; and how to
33.24obtain an external review of any adverse decisions as provided under subdivision 10;
33.25(5) the conditions under which the program or coverage under the program may
33.26be canceled or terminated; and
33.27(6) a precise statement specifying that this program is not an insurance product and,
33.28as such, is exempt from state regulation of insurance products.
33.29(b) The commissioners commissioner of health and human services must approve a
33.30copy of the written statement prior to the operation of the program.
33.31    Subd. 10. Complaint resolution process. (a) The initiatives must establish
33.32a complaint resolution process. The process must make reasonable efforts to resolve
33.33complaints and to inform complainants in writing of the initiative's decision within 60
33.34days of receiving the complaint. Any decision that is adverse to the enrollee shall include
33.35a description of the right to an external review as provided in paragraph (c) and how to
33.36exercise this right.
34.1(b) The initiatives must report any complaint that is not resolved within 60 days to
34.2the commissioner of health.
34.3(c) The initiatives must include in the complaint resolution process the ability of an
34.4enrollee to pursue the external review process provided under section 62Q.73 with any
34.5decision rendered under this external review process binding on the initiatives.
34.6    Subd. 11. Data privacy. The initiatives shall establish data privacy policies and
34.7procedures for the program that comply with state and federal data privacy laws.
34.8    Subd. 12. Limitations on enrollment. (a) The initiatives may limit enrollment in
34.9the program. If enrollment is limited, a waiting list must be established.
34.10(b) The initiatives shall not restrict or deny enrollment in the program except for
34.11nonpayment of premiums, fraud or misrepresentation, or as otherwise permitted under
34.12this section.
34.13(c) The initiatives may require a certain percentage of participation from eligible
34.14employees of a qualifying employer before coverage can be offered through the program.
34.15    Subd. 13. Report. Each initiative shall submit quarterly an annual status reports
34.16report to the commissioner of health on January 15, April 15, July 15, and October 15 of
34.17each year, with the first report due January 15, 2008. Each initiative receiving funding
34.18from the Department of Human Services shall submit status reports to the commissioner
34.19of human services as defined in the terms of the contract with the Department of Human
34.20Services. Each status report shall include:
34.21    (1) the financial status of the program, including the premium rates, cost per member
34.22per month, claims paid out, premiums received, and administrative expenses;
34.23    (2) a description of the health care benefits offered and the services utilized;
34.24    (3) the number of employers participating, the number of employees and dependents
34.25covered under the program, and the number of health care providers participating;
34.26    (4) a description of the health outcomes to be achieved by the program and a status
34.27report on the performance measurements to be used and collected; and
34.28    (5) any other information requested by the commissioners commissioner of health,
34.29human services, or commerce or the legislature.
34.30    Subd. 14. Sunset. This section expires August 31, 2014.

34.31    Sec. 2. Minnesota Statutes 2011 Supplement, section 144.1222, subdivision 5, is
34.32amended to read:
34.33    Subd. 5. Swimming pond exemption Exemptions. (a) A public swimming pond
34.34in existence before January 1, 2008, is not a public pool for purposes of this section and
35.1section 157.16, and is exempt from the requirements for public swimming pools under
35.2Minnesota Rules, chapter 4717.
35.3(b) A naturally treated swimming pool located in the city of Minneapolis is not
35.4a public pool for purposes of this section and section 157.16, and is exempt from the
35.5requirements for public swimming pools under Minnesota Rules, chapter 4717.
35.6    (b) (c) Notwithstanding paragraph paragraphs (a) and (b), a public swimming pond
35.7and a naturally treated swimming pool must meet the requirements for public pools
35.8described in subdivisions 1c and 1d.
35.9    (c) (d) For purposes of this subdivision, a "public swimming pond" means an
35.10artificial body of water contained within a lined, sand-bottom basin, intended for public
35.11swimming, relaxation, or recreational use that includes a water circulation system for
35.12maintaining water quality and does not include any portion of a naturally occurring lake
35.13or stream.
35.14(e) For purposes of this subdivision, a "naturally treated swimming pool" means an
35.15artificial body of water contained in a basin, intended for public swimming, relaxation, or
35.16recreational use that uses a chemical free filtration system for maintaining water quality
35.17through natural processes, including the use of plants, beneficial bacteria, and microbes.
35.18EFFECTIVE DATE.This section is effective the day following final enactment.

35.19    Sec. 3. [144.1225] ADVANCED DIAGNOSTIC IMAGING SERVICES.
35.20    Subdivision 1. Definition. For purposes of this section, "advanced diagnostic
35.21imaging services" has the meaning given in United States Code, title 42, section 1395M,
35.22except that it does not include x-ray, ultrasound, or fluoroscopy.
35.23    Subd. 2. Accreditation required. (a)(1) Except as otherwise provided in paragraph
35.24(b), advanced diagnostic imaging services eligible for reimbursement from any source,
35.25including, but not limited to, the individual receiving such services and any individual
35.26or group insurance contract, plan, or policy delivered in this state, including, but not
35.27limited to, private health insurance plans, workers' compensation insurance, motor vehicle
35.28insurance, the State Employee Group Insurance Program (SEGIP), and other state health
35.29care programs, shall be reimbursed only if the facility at which the service has been
35.30conducted and processed is accredited by one of the following entities:
35.31(i) American College of Radiology (ACR);
35.32(ii) Intersocietal Accreditation Commission (IAC);
35.33(iii) the Joint Commission; or
36.1(iv) other relevant accreditation organization designated by the secretary of the
36.2United States Department of Health and Human Services pursuant to United States Code,
36.3title 42, section 1395M.
36.4(2) All accreditation standards recognized under this section must include, but are
36.5not limited to:
36.6(i) provisions establishing qualifications of the physician;
36.7(ii) standards for quality control and routine performance monitoring by a medical
36.8physicist;
36.9(iii) qualifications of the technologist, including minimum standards of supervised
36.10clinical experience;
36.11(iv) guidelines for personnel and patient safety; and
36.12(v) standards for initial and ongoing quality control using clinical image review
36.13and quantitative testing.
36.14(b) Any facility that performs advanced diagnostic imaging services and is eligible
36.15to receive reimbursement for such services from any source in paragraph (a)(1) must
36.16obtain accreditation by August 1, 2013. Thereafter, all facilities that provide advanced
36.17diagnostic imaging services in the state must obtain accreditation prior to commencing
36.18operations and must, at all times, maintain accreditation with an accrediting organization
36.19as provided in paragraph (a).
36.20    Subd. 3. Reporting. (a) Advanced diagnostic imaging facilities and providers
36.21of advanced diagnostic imaging services must annually report to the commissioner
36.22demonstration of accreditation as required under this section.
36.23(b) The commissioner may promulgate any rules necessary to administer the
36.24reporting required under paragraph (a).

36.25    Sec. 4. Minnesota Statutes 2010, section 144.292, subdivision 6, is amended to read:
36.26    Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for
36.27purposes of reviewing current medical care, the provider must not charge a fee.
36.28    (b) When a provider or its representative makes copies of patient records upon a
36.29patient's request under this section, the provider or its representative may charge the
36.30patient or the patient's representative no more than 75 cents per page, plus $10 for time
36.31spent retrieving and copying the records, unless other law or a rule or contract provide for
36.32a lower maximum charge. This limitation does not apply to x-rays. The provider may
36.33charge a patient no more than the actual cost of reproducing x-rays, plus no more than
36.34$10 for the time spent retrieving and copying the x-rays.
37.1    (c) The respective maximum charges of 75 cents per page and $10 for time provided
37.2in this subdivision are in effect for calendar year 1992 and may be adjusted annually each
37.3calendar year as provided in this subdivision. The permissible maximum charges shall
37.4change each year by an amount that reflects the change, as compared to the previous year,
37.5in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
37.6published by the Department of Labor.
37.7    (d) A provider or its representative may charge the $10 retrieval fee, but must not
37.8charge a per page fee to provide copies of records requested by a patient or the patient's
37.9authorized representative if the request for copies of records is for purposes of appealing
37.10a denial of Social Security disability income or Social Security disability benefits under
37.11title II or title XVI of the Social Security Act; except that no fee shall be charged to a
37.12person who is receiving public assistance, who is represented by an attorney on behalf of
37.13a civil legal services program or a volunteer attorney program based on indigency. For
37.14the purpose of further appeals, a patient may receive no more than two medical record
37.15updates without charge, but only for medical record information previously not provided.
37.16For purposes of this paragraph, a patient's authorized representative does not include units
37.17of state government engaged in the adjudication of Social Security disability claims.

37.18    Sec. 5. Minnesota Statutes 2010, section 144.298, subdivision 2, is amended to read:
37.19    Subd. 2. Liability of provider or other person. A person who does any of the
37.20following is liable to the patient for compensatory damages caused by an unauthorized
37.21release or an intentional, unauthorized access, plus costs and reasonable attorney fees:
37.22    (1) negligently or intentionally requests or releases a health record in violation
37.23of sections 144.291 to 144.297;
37.24    (2) forges a signature on a consent form or materially alters the consent form of
37.25another person without the person's consent; or
37.26    (3) obtains a consent form or the health records of another person under false
37.27pretenses; or
37.28(4) intentionally violates sections 144.291 to 144.297 by intentionally accessing a
37.29record locator service without authorization.

37.30    Sec. 6. Minnesota Statutes 2010, section 144.5509, is amended to read:
37.31144.5509 RADIATION THERAPY FACILITY CONSTRUCTION.
37.32    (a) A radiation therapy facility may be constructed only by an entity owned,
37.33operated, or controlled by a hospital licensed according to sections 144.50 to 144.56 either
37.34alone or in cooperation with another entity.
38.1    (b) Notwithstanding paragraph (a), there shall be a moratorium on the construction
38.2of any radiation therapy facility located in the following counties: Hennepin, Ramsey,
38.3Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns,
38.4Chisago, Isanti, and Wright. This paragraph does not apply to the relocation or
38.5reconstruction of an existing facility owned by a hospital if the relocation or reconstruction
38.6is within one mile of the existing facility. This paragraph does not apply to a radiation
38.7therapy facility that is being built attached to a community hospital in Wright County and
38.8meets the following conditions prior to August 1, 2007: the capital expenditure report
38.9required under Minnesota Statutes, section 62J.17, has been filed with the commissioner
38.10of health; a timely construction schedule is developed, stipulating dates for beginning,
38.11achieving various stages, and completing construction; and all zoning and building permits
38.12applied for. Beginning January 1, 2013, this paragraph does not apply to any construction
38.13necessary to relocate a radiation therapy machine from a community hospital-owned
38.14radiation therapy facility located in the city of Maplewood to a community hospital
38.15campus in the city of Woodbury within the same health system. This paragraph expires
38.16August 1, 2014.
38.17(c) Notwithstanding paragraph (a), after August 1, 2014, the construction of a
38.18radiation therapy facility located in any of the following counties: Hennepin, Ramsey,
38.19Dakota, Washington, Anoka, Carver, Scott, St. Louis, Sherburne, Benton, Stearns,
38.20Chisago, Isanti, and Wright, may occur only if the following requirements are met:
38.21(1) the entity constructing the radiation therapy facility is controlled by or is under
38.22common control with a hospital licensed under sections 144.50 to 144.56; and
38.23(2) the new radiation therapy facility is located at least seven miles from an existing
38.24radiation therapy facility.
38.25(d) Any referring physician located within a county identified in paragraph (c) must
38.26provide each patient who is in need of radiation therapy services with a list of all radiation
38.27therapy facilities located within the counties identified in paragraph (c). Physicians
38.28with a financial interest in any radiation therapy facility must disclose to the patient the
38.29existence of the interest.
38.30(e) For purposes of this section, "controlled by" or "under common control with"
38.31means the possession, direct or indirect, of the power to direct or cause the direction of the
38.32policies, operations, or activities of an entity, through the ownership of, or right to vote
38.33or to direct the disposition of shares, membership interests, or ownership interests of
38.34the entity.
39.1(f) For purposes of this section, "financial interest in any radiation therapy facility"
39.2means a direct or indirect ownership or investment interest in a radiation therapy facility
39.3or a compensation arrangement with a radiation therapy facility.
39.4(g) This section does not apply to the relocation or reconstruction of an existing
39.5radiation therapy facility if:
39.6(1) the relocation or reconstruction of the facility remains owned by the same entity;
39.7(2) the relocation or reconstruction is located within one mile of the existing facility;
39.8and
39.9(3) the period in which the existing facility is closed and the relocated or
39.10reconstructed facility begins providing services does not exceed 12 months.

39.11    Sec. 7. [145.8811] MATERNAL AND CHILD HEALTH ADVISORY TASK
39.12FORCE.
39.13    Subdivision 1. Composition of task force. The commissioner shall establish and
39.14appoint a Maternal and Child Health Advisory Task Force consisting of 15 members
39.15who will provide equal representation from:
39.16(1) professionals with expertise in maternal and child health services;
39.17(2) representatives of community health boards as defined in section 145A.02,
39.18subdivision 5; and
39.19(3) consumer representatives interested in the health of mothers and children.
39.20No members shall be employees of the Minnesota Department of Health. Section
39.2115.059 governs the Maternal and Child Health Advisory Task Force. Notwithstanding
39.22section 15.059, the Maternal and Child Health Advisory Task Force expires June 30, 2015.
39.23    Subd. 2. Duties. The advisory task force shall meet on a regular basis to perform
39.24the following duties:
39.25(1) review and report on the health care needs of mothers and children throughout
39.26the state of Minnesota;
39.27(2) review and report on the type, frequency, and impact of maternal and child health
39.28care services provided to mothers and children under existing maternal and child health
39.29care programs, including programs administered by the commissioner of health;
39.30(3) establish, review, and report to the commissioner a list of program guidelines
39.31and criteria which the advisory task force considers essential to providing an effective
39.32maternal and child health care program to low-income populations and high-risk persons
39.33and fulfilling the purposes defined in section 145.88;
39.34(4) make recommendations to the commissioner for the use of other federal and state
39.35funds available to meet maternal and child health needs;
40.1(5) make recommendations to the commissioner of health on priorities for funding
40.2the following maternal and child health services:
40.3(i) prenatal, delivery, and postpartum care;
40.4(ii) comprehensive health care for children, especially from birth through five
40.5years of age;
40.6(iii) adolescent health services;
40.7(iv) family planning services;
40.8(v) preventive dental care;
40.9(vi) special services for chronically ill and disabled children; and
40.10(vii) any other services that promote the health of mothers and children; and
40.11(6) establish, in consultation with the commissioner and the State Community Health
40.12Advisory Committee established under section 145A.10, subdivision 10, paragraph (a),
40.13statewide outcomes that will improve the health status of mothers and children as required
40.14in section 145A.12, subdivision 7.

40.15    Sec. 8. Minnesota Statutes 2010, section 145.906, is amended to read:
40.16145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
40.17(a) The commissioner of health shall work with health care facilities, licensed health
40.18and mental health care professionals, the women, infants, and children (WIC) program,
40.19mental health advocates, consumers, and families in the state to develop materials and
40.20information about postpartum depression, including treatment resources, and develop
40.21policies and procedures to comply with this section.
40.22(b) Physicians, traditional midwives, and other licensed health care professionals
40.23providing prenatal care to women must have available to women and their families
40.24information about postpartum depression.
40.25(c) Hospitals and other health care facilities in the state must provide departing new
40.26mothers and fathers and other family members, as appropriate, with written information
40.27about postpartum depression, including its symptoms, methods of coping with the illness,
40.28and treatment resources.
40.29(d) Information about postpartum depression, including its symptoms, potential
40.30impact on families, and treatment resources, must be available at WIC sites.

40.31    Sec. 9. EVALUATION OF HEALTH AND HUMAN SERVICES REGULATORY
40.32RESPONSIBILITIES.
41.1Relating to the evaluations and legislative report completed pursuant to Laws
41.22011, First Special Session chapter 9, article 2, section 26, the following activities must
41.3be completed:
41.4(1) the commissioners of health and human services must update, revise, and
41.5link the contents of their Web sites related to supervised living facilities, intermediate
41.6care facilities for the developmentally disabled, nursing facilities, board and lodging
41.7establishments, and human services licensed programs so that consumers and providers
41.8can access consistent clear information about the regulations affecting these facilities; and
41.9(2) the commissioner of management and budget, in consultation with the
41.10commissioners of health and human services, must evaluate and recommend options
41.11for administering health and human services regulations. The evaluation and
41.12recommendations must be submitted in a report to the chairs and ranking minority
41.13members of the health and human services legislative committees no later than August 1,
41.142013, and shall at a minimum: (i) identify and evaluate the regulatory responsibilities of
41.15the Departments of Health and Human Services to determine whether to reorganize these
41.16regulatory responsibilities to improve how the state administers health and human services
41.17regulatory functions, or whether there are ways to improve these regulatory activities
41.18without reorganizing; (ii) describe and evaluate the multiple roles of the Department of
41.19Human Services as a direct provider of care services, a regulator, and a payor for state
41.20program services; and (iii) for long-term care regulated in both departments, evaluate and
41.21make recommendations for reasonable client risk assessments, planning for client risk
41.22reductions, and determining reasonable assumptions of client risks in relation to directing
41.23health care, client health care rights, provider liabilities, and provider responsibilities to
41.24provide minimum standards of care.

41.25    Sec. 10. HEALTH RECORD ACCESS STUDY.
41.26The commissioner of health, in consultation with the Minnesota e-Health Advisory
41.27Committee, shall study the following:
41.28(1) the extent to which providers have audit procedures in place to monitor use of
41.29representation of consent and unauthorized access to a patient's health records in violation
41.30of Minnesota Statutes, sections 144.291 to 144.297;
41.31(2) the feasibility of informing patients if an intentional, unauthorized access of
41.32their health records occurs; and
41.33(3) the feasibility of providing patients with a copy of a provider's audit log showing
41.34who has accessed their health records.
42.1The commissioner shall report study findings and any relevant patient privacy and
42.2other recommendations to the legislature by February 15, 2013.

42.3    Sec. 11. REPORTING PREVALENCE OF SEXUAL VIOLENCE.
42.4The commissioner of health must routinely report to the public and to the legislature
42.5data on the prevalence and incidence of sexual violence in Minnesota, to the extent
42.6federal funding is available for this purpose. The commissioner must use existing data
42.7provided by the Centers for Disease Control and Prevention, or other source as identified
42.8by commissioner.
42.9EFFECTIVE DATE.This section is effective the day following final enactment.

42.10    Sec. 12. LICENSED HOME CARE PROVIDERS.
42.11By February 1, 2013, the commissioner of health must report recommendations to
42.12the legislature as to development of a comprehensive home care plan to increase inspection
42.13and oversight of licensed home care providers under Minnesota Statutes, chapter 144A.

42.14    Sec. 13. EVALUATION OF HEALTH AND COMMERCE REGULATORY
42.15RESPONSIBILITIES.
42.16The commissioner of health, in consultation with the commissioner of commerce,
42.17shall report to the legislature by February 15, 2013, on recommendations to maximize
42.18administrative efficiency in the regulation of health maintenance organizations,
42.19county-based purchasers, insurance carriers, and related entities while maintaining quality
42.20health outcomes, regulatory stability, and price stability.

42.21    Sec. 14. STUDY OF RADIATION THERAPY FACILITIES CAPACITY.
42.22(a) To the extent of available appropriations, the commissioner of health shall
42.23conduct a study of the following: (1) current treatment capacity of the existing radiation
42.24therapy facilities within the state; (2) the present need for radiation therapy services based
42.25on population demographics and new cancer cases; and (3) the projected need in the next
42.26ten years for radiation therapy services and whether the current facilities can sustain
42.27this projected need.
42.28(b) The commissioner may contract with a qualified entity to conduct the study. The
42.29study shall be completed by March 15, 2013, and the results shall be submitted to the
42.30chairs and ranking minority members of the health and human services committees of
42.31the legislature.

43.1    Sec. 15. MERC DISTRIBUTION.
43.2(a) For the distribution of funds for fiscal year 2013, as required under Minnesota
43.3Statutes, section 62J.692, subdivision 4, the commissioner of health shall distribute
43.4$300,000 to Gillette Children's Specialty Healthcare before following the distribution
43.5described under Minnesota Statutes, section 62J.692, subdivision 4, paragraph (a).
43.6(b) This section is effective upon federal approval.

43.7ARTICLE 3
43.8CHILDREN AND FAMILY SERVICES

43.9    Section 1. Minnesota Statutes 2011 Supplement, section 119B.13, subdivision 7, is
43.10amended to read:
43.11    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
43.12must not be reimbursed for more than ten full-day absent days per child, excluding
43.13holidays, in a fiscal year. Legal nonlicensed family child care providers must not be
43.14reimbursed for absent days. If a child attends for part of the time authorized to be in care in
43.15a day, but is absent for part of the time authorized to be in care in that same day, the absent
43.16time must be reimbursed but the time must not count toward the ten absent day limit.
43.17Child care providers must only be reimbursed for absent days if the provider has a written
43.18policy for child absences and charges all other families in care for similar absences.
43.19(b) Notwithstanding paragraph (a), children in families may exceed the ten absent
43.20days limit if at least one parent is: (1) under the age of 21; (2) does not have a high school
43.21or general equivalency diploma; and (3) is a student in a school district or another similar
43.22program that provides or arranges for child care, parenting support, social services, career
43.23and employment supports, and academic support to achieve high school graduation, upon
43.24request of the program and approval of the county. If a child attends part of an authorized
43.25day, payment to the provider must be for the full amount of care authorized for that day.
43.26    (b) (c) Child care providers must be reimbursed for up to ten federal or state
43.27holidays or designated holidays per year when the provider charges all families for these
43.28days and the holiday or designated holiday falls on a day when the child is authorized to
43.29be in attendance. Parents may substitute other cultural or religious holidays for the ten
43.30recognized state and federal holidays. Holidays do not count toward the ten absent day
43.31limit.
43.32    (c) (d) A family or child care provider must not be assessed an overpayment for an
43.33absent day payment unless (1) there was an error in the amount of care authorized for the
43.34family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
43.35the family or provider did not timely report a change as required under law.
44.1    (d) (e) The provider and family shall receive notification of the number of absent
44.2days used upon initial provider authorization for a family and ongoing notification of the
44.3number of absent days used as of the date of the notification.
44.4EFFECTIVE DATE.This section is effective January 1, 2013.

44.5    Sec. 2. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
44.6to read:
44.7    Subd. 18c. Drug convictions. (a) The state court administrator shall provide a
44.8report every six months by electronic means to the commissioner of human services,
44.9including the name, address, date of birth, and, if available, driver's license or state
44.10identification card number, date of sentence, effective date of the sentence, and county in
44.11which the conviction occurred of each person convicted of a felony under chapter 152
44.12during the previous six months.
44.13(b) The commissioner shall determine whether the individuals who are the subject of
44.14the data reported under paragraph (a) are receiving public assistance under chapter 256D
44.15or 256J, and if the individual is receiving assistance under chapter 256D or 256J, the
44.16commissioner shall instruct the county to proceed under section 256D.024 or 256J.26,
44.17whichever is applicable, for this individual.
44.18(c) The commissioner shall not retain any data received under paragraph (a) or (d)
44.19that does not relate to an individual receiving publicly funded assistance under chapter
44.20256D or 256J.
44.21(d) In addition to the routine data transfer under paragraph (a), the state court
44.22administrator shall provide a onetime report of the data fields under paragraph (a) for
44.23individuals with a felony drug conviction under chapter 152 dated from July 1, 1997, until
44.24the date of the data transfer. The commissioner shall perform the tasks identified under
44.25paragraph (b) related to this data and shall retain the data according to paragraph (c).
44.26EFFECTIVE DATE.This section is effective July 1, 2013.

44.27    Sec. 3. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
44.28to read:
44.29    Subd. 18d. Data sharing with the Department of Human Services; multiple
44.30identification cards. (a) The commissioner of public safety shall, on a monthly basis,
44.31provide the commissioner of human services with the first, middle, and last name,
44.32the address, date of birth, and driver's license or state identification card number of all
44.33applicants and holders whose drivers' licenses and state identification cards have been
45.1canceled under section 171.14, paragraph (a), clauses (2) or (3), by the commissioner of
45.2public safety. After the initial data report has been provided by the commissioner of
45.3public safety to the commissioner of human services under this paragraph, subsequent
45.4reports shall only include cancellations that occurred after the end date of the cancellations
45.5represented in the previous data report.
45.6(b) The commissioner of human services shall compare the information provided
45.7under paragraph (a) with the commissioner's data regarding recipients of all public
45.8assistance programs managed by the Department of Human Services to determine whether
45.9any individual with multiple identification cards issued by the Department of Public
45.10Safety has illegally or improperly enrolled in any public assistance program managed by
45.11the Department of Human Services.
45.12(c) If the commissioner of human services determines that an applicant or recipient
45.13has illegally or improperly enrolled in any public assistance program, the commissioner
45.14shall provide all due process protections to the individual before terminating the individual
45.15from the program according to applicable statute and notifying the county attorney.
45.16EFFECTIVE DATE.This section is effective July 1, 2013.

45.17    Sec. 4. Minnesota Statutes 2010, section 256.01, is amended by adding a subdivision
45.18to read:
45.19    Subd. 18e. Data sharing with the Department of Human Services; legal
45.20presence date. (a) The commissioner of public safety shall, on a monthly basis, provide
45.21the commissioner of human services with the first, middle, and last name, address, date of
45.22birth, and driver's license or state identification number of all applicants and holders of
45.23drivers' licenses and state identification cards whose temporary legal presence date has
45.24expired and as a result the driver's license or identification card has been accordingly
45.25canceled under section 171.14 by the commissioner of public safety.
45.26(b) The commissioner of human services shall use the information provided under
45.27paragraph (a) to determine whether the eligibility of any recipients of public assistance
45.28programs managed by the Department of Human Services has changed as a result of the
45.29status change in the Department of Public Safety data.
45.30(c) If the commissioner of human services determines that a recipient has illegally or
45.31improperly received benefits from any public assistance program, the commissioner shall
45.32provide all due process protections to the individual before terminating the individual from
45.33the program according to applicable statute and notifying the county attorney.
45.34EFFECTIVE DATE.This section is effective July 1, 2013.

46.1    Sec. 5. Minnesota Statutes 2010, section 256.9831, subdivision 2, is amended to read:
46.2    Subd. 2. Financial transaction cards. The commissioner shall take all actions
46.3necessary to ensure that no person may obtain benefits under chapter 256 or, 256D, or 256J
46.4through the use of a financial transaction card, as defined in section 609.821, subdivision
46.51
, paragraph (a), at a terminal located in or attached to a gambling establishment, liquor
46.6store, tobacco store, or tattoo parlor.

46.7    Sec. 6. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 1, is
46.8amended to read:
46.9    Subdivision 1. Electronic benefit transfer (EBT) card. Cash benefits for the
46.10general assistance and Minnesota supplemental aid programs under chapter 256D and
46.11programs under chapter 256J must be issued on a separate an EBT card with the name of
46.12the head of household printed on the card. The card must include the following statement:
46.13"It is unlawful to use this card to purchase tobacco products or alcoholic beverages." This
46.14card must be issued within 30 calendar days of an eligibility determination. During the
46.15initial 30 calendar days of eligibility, a recipient may have cash benefits issued on an EBT
46.16card without a name printed on the card. This card may be the same card on which food
46.17support benefits are issued and does not need to meet the requirements of this section.

46.18    Sec. 7. Minnesota Statutes 2011 Supplement, section 256.987, subdivision 2, is
46.19amended to read:
46.20    Subd. 2. Prohibited purchases. An individual with an EBT debit cardholders in
46.21card issued for one of the programs listed under subdivision 1 are is prohibited from using
46.22the EBT debit card to purchase tobacco products and alcoholic beverages, as defined in
46.23section 340A.101, subdivision 2. It is unlawful for an EBT cardholder to purchase or
46.24attempt to purchase tobacco products or alcoholic beverages with the cardholder's EBT
46.25card. Any unlawful use prohibited purchases made under this subdivision shall constitute
46.26fraud unlawful use and result in disqualification of the cardholder from the program under
46.27section 256.98, subdivision 8 as provided in subdivision 4.

46.28    Sec. 8. Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a
46.29subdivision to read:
46.30    Subd. 3. EBT use restricted to certain states. EBT debit cardholders in programs
46.31listed under subdivision 1 are prohibited from using the cash portion of the EBT card at
46.32vendors and automatic teller machines located outside of Minnesota, Iowa, North Dakota,
46.33South Dakota, or Wisconsin. This subdivision does not apply to the food portion.
47.1EFFECTIVE DATE.This section is effective March 1, 2013.

47.2    Sec. 9. Minnesota Statutes 2011 Supplement, section 256.987, is amended by adding a
47.3subdivision to read:
47.4    Subd. 4. Disqualification. (a) Any person found to be guilty of purchasing tobacco
47.5products or alcoholic beverages with their EBT debit card by a federal or state court or
47.6by an administrative hearing determination, or waiver thereof, through a disqualification
47.7consent agreement, or as part of any approved diversion plan under section 401.065, or
47.8any court-ordered stay which carries with it any probationary or other conditions, in
47.9the: (1) Minnesota family investment program and any affiliated program to include the
47.10diversionary work program and the work participation cash benefit program under chapter
47.11256J; (2) general assistance program under chapter 256D; or (3) Minnesota supplemental
47.12aid program under chapter 256D, shall be disqualified from all of the listed programs.
47.13(b) The needs of the disqualified individual shall not be taken into consideration
47.14in determining the grant level for that assistance unit: (1) for one year after the first
47.15offense; (2) for two years after the second offense; and (3) permanently after the third or
47.16subsequent offense.
47.17(c) The period of program disqualification shall begin on the date stipulated on the
47.18advance notice of disqualification without possibility for postponement for administrative
47.19stay or administrative hearing and shall continue through completion unless and until the
47.20findings upon which the sanctions were imposed are reversed by a court of competent
47.21jurisdiction. The period for which sanctions are imposed is not subject to review.
47.22EFFECTIVE DATE.This section is effective June 1, 2012.

47.23    Sec. 10. Minnesota Statutes 2010, section 256D.06, subdivision 1b, is amended to read:
47.24    Subd. 1b. Earned income savings account. In addition to the $50 disregard
47.25required under subdivision 1, the county agency shall disregard an additional earned
47.26income up to a maximum of $150 $500 per month for: (1) persons residing in facilities
47.27licensed under Minnesota Rules, parts 9520.0500 to 9520.0690 and 9530.2500 to
47.289530.4000, and for whom discharge and work are part of a treatment plan; (2) persons
47.29living in supervised apartments with services funded under Minnesota Rules, parts
47.309535.0100 to 9535.1600, and for whom discharge and work are part of a treatment plan;
47.31and (3) persons residing in group residential housing, as that term is defined in section
47.32256I.03, subdivision 3 , for whom the county agency has approved a discharge plan
47.33which includes work. The additional amount disregarded must be placed in a separate
47.34savings account by the eligible individual, to be used upon discharge from the residential
48.1facility into the community. For individuals residing in a chemical dependency program
48.2licensed under Minnesota Rules, part 9530.4100, subpart 22, item D, withdrawals from
48.3the savings account require the signature of the individual and for those individuals with
48.4an authorized representative payee, the signature of the payee. A maximum of $1,000
48.5$2,000, including interest, of the money in the savings account must be excluded from
48.6the resource limits established by section 256D.08, subdivision 1, clause (1). Amounts in
48.7that account in excess of $1,000 $2,000 must be applied to the resident's cost of care. If
48.8excluded money is removed from the savings account by the eligible individual at any
48.9time before the individual is discharged from the facility into the community, the money is
48.10income to the individual in the month of receipt and a resource in subsequent months. If
48.11an eligible individual moves from a community facility to an inpatient hospital setting,
48.12the separate savings account is an excluded asset for up to 18 months. During that time,
48.13amounts that accumulate in excess of the $1,000 $2,000 savings limit must be applied to
48.14the patient's cost of care. If the patient continues to be hospitalized at the conclusion of the
48.1518-month period, the entire account must be applied to the patient's cost of care.
48.16EFFECTIVE DATE.This section is effective October 1, 2012.

48.17    Sec. 11. Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 5, is
48.18amended to read:
48.19    Subd. 5. Household eligibility; participation. (a) To be eligible for state or TANF
48.20matching funds in the family assets for independence initiative, a household must meet the
48.21eligibility requirements of the federal Assets for Independence Act, Public Law 105-285,
48.22in Title IV, section 408 of that act.
48.23(b) Each participating household must sign a family asset agreement that includes
48.24the amount of scheduled deposits into its savings account, the proposed use, and the
48.25proposed savings goal. A participating household must agree to complete an economic
48.26literacy training program.
48.27Participating households may only deposit money that is derived from household
48.28earned income or from state and federal income tax credits.

48.29    Sec. 12. Minnesota Statutes 2011 Supplement, section 256E.35, subdivision 6, is
48.30amended to read:
48.31    Subd. 6. Withdrawal; matching; permissible uses. (a) To receive a match, a
48.32participating household must transfer funds withdrawn from a family asset account to its
48.33matching fund custodial account held by the fiscal agent, according to the family asset
49.1agreement. The fiscal agent must determine if the match request is for a permissible use
49.2consistent with the household's family asset agreement.
49.3The fiscal agent must ensure the household's custodial account contains the
49.4applicable matching funds to match the balance in the household's account, including
49.5interest, on at least a quarterly basis and at the time of an approved withdrawal. Matches
49.6must be provided as follows:
49.7(1) from state grant and TANF funds, a matching contribution of $1.50 for every
49.8$1 of funds withdrawn from the family asset account equal to the lesser of $720 per
49.9year or a $3,000 lifetime limit; and
49.10(2) from nonstate funds, a matching contribution of no less than $1.50 for every $1
49.11of funds withdrawn from the family asset account equal to the lesser of $720 per year or
49.12a $3,000 lifetime limit.
49.13(b) Upon receipt of transferred custodial account funds, the fiscal agent must make a
49.14direct payment to the vendor of the goods or services for the permissible use.

49.15    Sec. 13. Minnesota Statutes 2010, section 256E.37, subdivision 1, is amended to read:
49.16    Subdivision 1. Grant authority. The commissioner may make grants to state
49.17agencies and political subdivisions to construct or rehabilitate facilities for early childhood
49.18programs, crisis nurseries, or parenting time centers. The following requirements apply:
49.19    (1) The facilities must be owned by the state or a political subdivision, but may
49.20be leased under section 16A.695 to organizations that operate the programs. The
49.21commissioner must prescribe the terms and conditions of the leases.
49.22    (2) A grant for an individual facility must not exceed $500,000 for each program
49.23that is housed in the facility, up to a maximum of $2,000,000 for a facility that houses
49.24three programs or more. Programs include Head Start, School Readiness, Early Childhood
49.25Family Education, licensed child care, and other early childhood intervention programs.
49.26    (3) State appropriations must be matched on a 50 percent basis with nonstate funds.
49.27The matching requirement must apply program wide and not to individual grants.
49.28(4) At least 80 percent of grant funds must be distributed to facilities located in
49.29counties not included in the definition under section 473.121, subdivision 4.

49.30    Sec. 14. Minnesota Statutes 2011 Supplement, section 256I.05, subdivision 1a, is
49.31amended to read:
49.32    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
49.33256I.04, subdivision 3 , the county agency may negotiate a payment not to exceed $426.37
49.34for other services necessary to provide room and board provided by the group residence
50.1if the residence is licensed by or registered by the Department of Health, or licensed by
50.2the Department of Human Services to provide services in addition to room and board,
50.3and if the provider of services is not also concurrently receiving funding for services for
50.4a recipient under a home and community-based waiver under title XIX of the Social
50.5Security Act; or funding from the medical assistance program under section 256B.0659,
50.6for personal care services for residents in the setting; or residing in a setting which
50.7receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is
50.8available for other necessary services through a home and community-based waiver, or
50.9personal care services under section 256B.0659, then the GRH rate is limited to the rate
50.10set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary
50.11service rate exceed $426.37. The registration and licensure requirement does not apply to
50.12establishments which are exempt from state licensure because they are located on Indian
50.13reservations and for which the tribe has prescribed health and safety requirements. Service
50.14payments under this section may be prohibited under rules to prevent the supplanting of
50.15federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
50.16the approval of the Secretary of Health and Human Services to provide home and
50.17community-based waiver services under title XIX of the Social Security Act for residents
50.18who are not eligible for an existing home and community-based waiver due to a primary
50.19diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is
50.20determined to be cost-effective.
50.21(b) The commissioner is authorized to make cost-neutral transfers from the GRH
50.22fund for beds under this section to other funding programs administered by the department
50.23after consultation with the county or counties in which the affected beds are located.
50.24The commissioner may also make cost-neutral transfers from the GRH fund to county
50.25human service agencies for beds permanently removed from the GRH census under a plan
50.26submitted by the county agency and approved by the commissioner. The commissioner
50.27shall report the amount of any transfers under this provision annually to the legislature.
50.28(c) The provisions of paragraph (b) do not apply to a facility that has its
50.29reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).
50.30    (d) Counties must not negotiate supplementary service rates with providers of group
50.31residential housing that are licensed as board and lodging with special services and that
50.32do not encourage a policy of sobriety on their premises and make referrals to available
50.33community services for volunteer and employment opportunities for residents.

50.34    Sec. 15. Minnesota Statutes 2010, section 256I.05, subdivision 1e, is amended to read:
51.1    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
51.2provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
51.3negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
51.4exceed $700 per month, including any legislatively authorized inflationary adjustments,
51.5for a group residential housing provider that:
51.6(1) is located in Hennepin County and has had a group residential housing contract
51.7with the county since June 1996;
51.8(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
51.926-bed facility; and
51.10(3) serves a chemically dependent clientele, providing 24 hours per day supervision
51.11and limiting a resident's maximum length of stay to 13 months out of a consecutive
51.1224-month period.
51.13(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
51.14supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
51.15per month, including any legislatively authorized inflationary adjustments, of a group
51.16residential provider that:
51.17(1) is located in St. Louis County and has had a group residential housing contract
51.18with the county since 2006;
51.19(2) operates a 62-bed facility; and
51.20(3) serves a chemically dependent adult male clientele, providing 24 hours per
51.21day supervision and limiting a resident's maximum length of stay to 13 months out of
51.22a consecutive 24-month period.
51.23(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
51.24shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
51.25to exceed $700 per month, including any legislatively authorized inflationary adjustments,
51.26for the group residential provider described under paragraphs (a) and (b), not to exceed
51.27an additional 115 beds.
51.28EFFECTIVE DATE.This section is effective July 1, 2013.

51.29    Sec. 16. Minnesota Statutes 2010, section 256J.26, subdivision 1, is amended to read:
51.30    Subdivision 1. Person convicted of drug offenses. (a) Applicants or participants
51.31An individual who have has been convicted of a felony level drug offense committed after
51.32July 1, 1997, may, if otherwise eligible, receive MFIP benefits subject to the following
51.33conditions: during the previous ten years from the date of application or recertification is
51.34subject to the following:
52.1(1) Benefits for the entire assistance unit must be paid in vendor form for shelter and
52.2utilities during any time the applicant is part of the assistance unit.
52.3(2) The convicted applicant or participant shall be subject to random drug testing as
52.4a condition of continued eligibility and following any positive test for an illegal controlled
52.5substance is subject to the following sanctions:
52.6(i) for failing a drug test the first time, the residual amount of the participant's grant
52.7after making vendor payments for shelter and utility costs, if any, must be reduced by an
52.8amount equal to 30 percent of the MFIP standard of need for an assistance unit of the same
52.9size. When a sanction under this subdivision is in effect, the job counselor must attempt
52.10to meet with the person face-to-face. During the face-to-face meeting, the job counselor
52.11must explain the consequences of a subsequent drug test failure and inform the participant
52.12of the right to appeal the sanction under section 256J.40. If a face-to-face meeting is
52.13not possible, the county agency must send the participant a notice of adverse action as
52.14provided in section 256J.31, subdivisions 4 and 5, and must include the information
52.15required in the face-to-face meeting; or
52.16(ii) for failing a drug test two times, the participant is permanently disqualified from
52.17receiving MFIP assistance, both the cash and food portions. The assistance unit's MFIP
52.18grant must be reduced by the amount which would have otherwise been made available to
52.19the disqualified participant. Disqualification under this item does not make a participant
52.20ineligible for food stamps or food support. Before a disqualification under this provision is
52.21imposed, the job counselor must attempt to meet with the participant face-to-face. During
52.22the face-to-face meeting, the job counselor must identify other resources that may be
52.23available to the participant to meet the needs of the family and inform the participant of
52.24the right to appeal the disqualification under section 256J.40. If a face-to-face meeting is
52.25not possible, the county agency must send the participant a notice of adverse action as
52.26provided in section 256J.31, subdivisions 4 and 5, and must include the information
52.27required in the face-to-face meeting.
52.28(3) A participant who fails a drug test the first time and is under a sanction due to
52.29other MFIP program requirements is considered to have more than one occurrence of
52.30noncompliance and is subject to the applicable level of sanction as specified under section
52.31256J.46, subdivision 1 , paragraph (d).
52.32(b) Applicants requesting only food stamps or food support or participants receiving
52.33only food stamps or food support, who have been convicted of a drug offense that
52.34occurred after July 1, 1997, may, if otherwise eligible, receive food stamps or food support
52.35if the convicted applicant or participant is subject to random drug testing as a condition
53.1of continued eligibility. Following a positive test for an illegal controlled substance, the
53.2applicant is subject to the following sanctions:
53.3(1) for failing a drug test the first time, food stamps or food support shall be reduced
53.4by an amount equal to 30 percent of the applicable food stamp or food support allotment.
53.5When a sanction under this clause is in effect, a job counselor must attempt to meet with
53.6the person face-to-face. During the face-to-face meeting, a job counselor must explain
53.7the consequences of a subsequent drug test failure and inform the participant of the right
53.8to appeal the sanction under section 256J.40. If a face-to-face meeting is not possible,
53.9a county agency must send the participant a notice of adverse action as provided in
53.10section 256J.31, subdivisions 4 and 5, and must include the information required in the
53.11face-to-face meeting; and
53.12(2) for failing a drug test two times, the participant is permanently disqualified from
53.13receiving food stamps or food support. Before a disqualification under this provision is
53.14imposed, a job counselor must attempt to meet with the participant face-to-face. During
53.15the face-to-face meeting, the job counselor must identify other resources that may be
53.16available to the participant to meet the needs of the family and inform the participant of
53.17the right to appeal the disqualification under section 256J.40. If a face-to-face meeting
53.18is not possible, a county agency must send the participant a notice of adverse action as
53.19provided in section 256J.31, subdivisions 4 and 5, and must include the information
53.20required in the face-to-face meeting.
53.21(c) (b) For the purposes of this subdivision, "drug offense" means an offense that
53.22occurred after July 1, 1997, during the previous ten years from the date of application
53.23or recertification of sections 152.021 to 152.025, 152.0261, 152.0262, or 152.096, or
53.24152.137
. Drug offense also means a conviction in another jurisdiction of the possession,
53.25use, or distribution of a controlled substance, or conspiracy to commit any of these
53.26offenses, if the offense occurred after July 1, 1997, during the previous ten years from
53.27the date of application or recertification and the conviction is a felony offense in that
53.28jurisdiction, or in the case of New Jersey, a high misdemeanor.
53.29EFFECTIVE DATE.This section is effective October 1, 2012, for all new MFIP
53.30applicants who apply on or after that date and for all recertifications occurring on or
53.31after that date.

53.32    Sec. 17. Minnesota Statutes 2010, section 256J.26, is amended by adding a subdivision
53.33to read:
53.34    Subd. 5. Vendor payment; uninhabitable units. Upon discovery by the county
53.35that a unit has been deemed uninhabitable under section 504B.131, the county shall
54.1immediately notify the landlord to return the vendor paid rent under this section for the
54.2month in which the discovery occurred. The county shall cease future rent payments for
54.3the uninhabitable housing units until the landlord demonstrates the premises are fit for
54.4the intended use. A landlord who is required to return vendor paid rent or is prohibited
54.5from receiving future rent under this subdivision may not take an eviction action against
54.6anyone in the assistance unit.

54.7    Sec. 18. Minnesota Statutes 2010, section 256J.575, subdivision 1, is amended to read:
54.8    Subdivision 1. Purpose. (a) The Family stabilization services serve families who
54.9are not making significant progress within the regular employment and training services
54.10track of the Minnesota family investment program (MFIP) due to a variety of barriers to
54.11employment.
54.12    (b) The goal of the services is to stabilize and improve the lives of families at risk
54.13of long-term welfare dependency or family instability due to employment barriers such
54.14as physical disability, mental disability, age, or providing care for a disabled household
54.15member. These services promote and support families to achieve the greatest possible
54.16degree of self-sufficiency.

54.17    Sec. 19. Minnesota Statutes 2010, section 256J.575, subdivision 2, is amended to read:
54.18    Subd. 2. Definitions. The terms used in this section have the meanings given them
54.19in paragraphs (a) to (d) and (b).
54.20    (a) "Case manager" means the county-designated staff person or employment
54.21services counselor.
54.22    (b) "Case management" "Family stabilization services" means the services
54.23programs, activities, and services provided by or through the county agency or through the
54.24employment services agency to participating families, including. Services include, but
54.25are not limited to, assessment as defined in section 256J.521, subdivision 1, information,
54.26referrals, and assistance in the preparation and implementation of a family stabilization
54.27plan under subdivision 5.
54.28    (c) (b) "Family stabilization plan" means a plan developed by a case manager
54.29and with the participant, which identifies the participant's most appropriate path to
54.30unsubsidized employment, family stability, and barrier reduction, taking into account the
54.31family's circumstances.
54.32    (d) "Family stabilization services" means programs, activities, and services in this
54.33section that provide participants and their family members with assistance regarding,
54.34but not limited to:
55.1    (1) obtaining and retaining unsubsidized employment;
55.2    (2) family stability;
55.3    (3) economic stability; and
55.4    (4) barrier reduction.
55.5    The goal of the services is to achieve the greatest degree of economic self-sufficiency
55.6and family well-being possible for the family under the circumstances.

55.7    Sec. 20. Minnesota Statutes 2010, section 256J.575, subdivision 5, is amended to read:
55.8    Subd. 5. Case management; Family stabilization plans; coordinated services.
55.9    (a) The county agency or employment services provider shall provide family stabilization
55.10services to families through a case management model. A case manager shall be assigned
55.11to each participating family within 30 days after the family is determined to be eligible
55.12for family stabilization services. The case manager, with the full involvement of the
55.13participant, shall recommend, and the county agency shall establish and modify as
55.14necessary, a family stabilization plan for each participating family. Once a participant
55.15has been determined eligible for family stabilization services, the county agency or
55.16employment services provider must attempt to meet with the participant to develop a
55.17plan within 30 days.
55.18(b) If a participant is already assigned to a county case manager or a
55.19county-designated case manager in social services, disability services, or housing services
55.20that case manager already assigned may be the case manager for purposes of these services.
55.21    (b) The family stabilization plan must include:
55.22    (1) each participant's plan for long-term self-sufficiency, including an employment
55.23goal where applicable;
55.24    (2) an assessment of each participant's strengths and barriers, and any special
55.25circumstances of the participant's family that impact, or are likely to impact, the
55.26participant's progress towards the goals in the plan; and
55.27    (3) an identification of the services, supports, education, training, and
55.28accommodations needed to reduce or overcome any barriers to enable the family to
55.29achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.
55.30    (c) The case manager and the participant shall meet within 30 days of the family's
55.31referral to the case manager. The initial family stabilization plan must be completed within
55.3230 days of the first meeting with the case manager. The case manager shall establish a
55.33schedule for periodic review of the family stabilization plan that includes personal contact
55.34with the participant at least once per month. In addition, the case manager shall review
55.35and, if necessary, modify the plan under the following circumstances:
56.1    (1) there is a lack of satisfactory progress in achieving the goals of the plan;
56.2    (2) the participant has lost unsubsidized or subsidized employment;
56.3    (3) a family member has failed or is unable to comply with a family stabilization
56.4plan requirement;
56.5    (4) services, supports, or other activities required by the plan are unavailable;
56.6    (5) changes to the plan are needed to promote the well-being of the children; or
56.7    (6) the participant and case manager determine that the plan is no longer appropriate
56.8for any other reason.
56.9(c) Participants determined eligible for family stabilization services must have
56.10access to employment and training services under sections 256J.515 to 256J.575, to the
56.11extent these services are available to other MFIP participants.

56.12    Sec. 21. Minnesota Statutes 2010, section 256J.575, subdivision 6, is amended to read:
56.13    Subd. 6. Cooperation with services requirements. (a) A participant who is eligible
56.14for family stabilization services under this section shall comply with paragraphs (b) to (d).
56.15    (b) Participants shall engage in family stabilization plan services for the appropriate
56.16number of hours per week that the activities are scheduled and available, based on the
56.17needs of the participant and the participant's family, unless good cause exists for not
56.18doing so, as defined in section 256J.57, subdivision 1. The appropriate number of hours
56.19must be based on the participant's plan.
56.20    (c) The case manager county agency or employment services agency shall review
56.21the participant's progress toward the goals in the family stabilization plan every six
56.22months to determine whether conditions have changed, including whether revisions to
56.23the plan are needed.
56.24    (d) A participant's requirement to comply with any or all family stabilization plan
56.25requirements under this subdivision is excused when the case management services,
56.26training and educational services, or family support services identified in the participant's
56.27family stabilization plan are unavailable for reasons beyond the control of the participant,
56.28including when money appropriated is not sufficient to provide the services.

56.29    Sec. 22. Minnesota Statutes 2010, section 256J.575, subdivision 8, is amended to read:
56.30    Subd. 8. Funding. (a) The commissioner of human services shall treat MFIP
56.31expenditures made to or on behalf of any minor child under this section, who is part of a
56.32household that meets criteria in subdivision 3, as expenditures under a separately funded
56.33state program. These expenditures shall not count toward the state's maintenance of effort
56.34requirements under the federal TANF program.
57.1    (b) A family is no longer part of a separately funded program under this section if
57.2the caregiver no longer meets the criteria for family stabilization services in subdivision
57.33, or if it is determined at recertification that a caregiver with a child under the age of six
57.4is working at least 87 hours per month in paid or unpaid employment, or a caregiver
57.5without a child under the age of six is working at least 130 hours per month in paid or
57.6unpaid employment, whichever occurs sooner.

57.7    Sec. 23. [626.5533] REPORTING POTENTIAL WELFARE FRAUD.
57.8    Subdivision 1. Reports required. A peace officer must report to the head of the
57.9officer's department every arrest where the person arrested possesses more than one
57.10welfare electronic benefit transfer card. Each report must include all of the following:
57.11(1) the name of the suspect;
57.12(2) the suspect's drivers license or state identification card number, where available;
57.13(3) the suspect's home address;
57.14(4) the number on each card;
57.15(5) the name on each electronic benefit card in the possession of the suspect, in cases
57.16where the card has a name printed on it;
57.17(6) the date of the alleged offense;
57.18(7) the location of the alleged offense;
57.19(8) the alleged offense; and
57.20(9) any other information the commissioner of human services deems necessary.
57.21    Subd. 2. Use of information collected. The head of a local law enforcement agency
57.22or state law enforcement department that employs peace officers licensed under section
57.23626.843 must forward the report required under subdivision 1 to the commissioner of
57.24human services within 30 days of receiving the report. The commissioner of human
57.25services shall use the report to determine whether the suspect is authorized to possess any
57.26of the electronic benefit cards found in the suspect's possession.
57.27    Subd. 3. Reporting forms. The commissioner of human services, in consultation
57.28with the superintendent of the Bureau of Criminal Apprehension, shall adopt reporting
57.29forms to be used by law enforcement agencies in making the reports required under this
57.30section.

57.31    Sec. 24. Minnesota Statutes 2010, section 626.556, is amended by adding a subdivision
57.32to read:
57.33    Subd. 10n. Required referral to early intervention services. A child under
57.34age three who is involved in a substantiated case of maltreatment shall be referred for
58.1screening under the Individuals with Disabilities Education Act, part C. Parents must be
58.2informed that the evaluation and acceptance of services are voluntary. The commissioner
58.3of human services shall monitor referral rates by county and annually report the
58.4information to the legislature beginning March 15, 2014. Refusal to have a child screened
58.5is not a basis for a child in need of protection or services petition under chapter 260C.

58.6    Sec. 25. Laws 2010, chapter 374, section 1, is amended to read:
58.7    Section 1. LADDER OUT OF POVERTY ASSET DEVELOPMENT AND
58.8FINANCIAL LITERACY TASK FORCE.
58.9    Subdivision 1. Creation. (a) The task force consists of the following members:
58.10(1) four senators, including two members of the majority party and two members of
58.11the minority party, appointed by the Subcommittee on Committees of the Committee on
58.12Rules and Administration of the senate;
58.13(2) four members of the house of representatives, including two members of the
58.14majority party, appointed by the speaker of the house, and two members of the minority
58.15party, appointed by the minority leader; and
58.16(3) the commissioner of the Minnesota Department of Commerce or the
58.17commissioner's designee; and.
58.18(4) the attorney general or the attorney general's designee.
58.19(b) The task force shall ensure that representatives of the following have the
58.20opportunity to meet with and present views to the task force: the attorney general; credit
58.21unions; independent community banks; state and federal financial institutions; community
58.22action agencies; faith-based financial counseling agencies; faith-based social justice
58.23organizations; legal services organizations representing low-income persons; nonprofit
58.24organizations providing free tax preparation services as part of the volunteer income tax
58.25assistance program; relevant state and local agencies; University of Minnesota faculty
58.26involved in personal and family financial education; philanthropic organizations that have
58.27as one of their missions combating predatory lending; organizations representing older
58.28Minnesotans; and organizations representing the interests of women, Latinos and Latinas,
58.29African-Americans, Asian-Americans, American Indians, and immigrants.
58.30    Subd. 2. Duties. (a) At a minimum, the task force must identify specific policies,
58.31strategies, and actions to: reduce asset poverty and increase household financial security
58.32by improving opportunities for households to earn, learn, save, invest, and protect
58.33assets through expansion of such asset building opportunities as the Family Assets for
58.34Independence in Minnesota (FAIM) program and Earned Income Tax Credit (EITC)
58.35program.
59.1(1) increase opportunities for poor and near-poor families and individuals to acquire
59.2assets and create and build wealth;
59.3(2) expand the utilization of Family Assets for Independence in Minnesota (FAIM)
59.4or other culturally specific individual development account programs;
59.5(3) reduce or eliminate predatory financial practices in Minnesota through regulatory
59.6actions, legislative enactments, and the development and deployment of alternative,
59.7nonpredatory financial products;
59.8(4) provide incentives or assistance to private sector financial institutions to
59.9offer additional programs and services that provide alternatives to and education about
59.10predatory financial products;
59.11(5) provide financial literacy information to low-income families and individuals at
59.12the time the recipient has the ability, opportunity, and motivation to receive, understand,
59.13and act on the information provided; and
59.14(6) identify incentives and mechanisms to increase community engagement in
59.15combating poverty and helping poor and near-poor families and individuals to acquire
59.16assets and create and build wealth.
59.17For purposes of this section, "asset poverty" means an individual's or family's
59.18inability to meet fixed financial obligations and other financial requirements of daily living
59.19with existing assets for a three-month period in the event of a disruption in income or
59.20extraordinary economic emergency.
59.21(b) By June 1, 2012 During the 2013 and 2014 legislative sessions, the task force
59.22must provide the legislature with written recommendations and any draft legislation
59.23necessary to implement the recommendations to the chairs and ranking minority members
59.24of the legislative committees and divisions with jurisdiction over commerce and consumer
59.25protection fulfill the duties enumerated in paragraph (a). The recommendations may
59.26include draft legislation.
59.27    Subd. 3. Administrative provisions. (a) The director of the Legislative
59.28Coordinating Commission, or a designee of the director, must convene the initial meeting
59.29of the task force by September 15, 2010. The members of the task force must elect a chair
59.30or cochairs from the legislative members at the initial meeting.
59.31(b) Members of the task force serve without compensation or payment of expenses
59.32except as provided in this paragraph. To the extent possible, meetings of the task force
59.33shall be scheduled on dates when legislative members of the task force are able to
59.34attend legislative meetings that would make them eligible to receive legislative per diem
59.35payments.
60.1(c) The task force expires June 1, 2012, or upon the submission of the report required
60.2under subdivision 3, whichever is earlier 2014.
60.3(d) The task force may accept gifts and grants, which are accepted on behalf of the
60.4state and constitute donations to the state. The funds must be deposited in an account in
60.5the special revenue fund and are appropriated to the Legislative Coordinating Commission
60.6for purposes of the task force.
60.7(e) The Legislative Coordinating Commission shall provide fiscal services to the
60.8task force as needed under this subdivision.
60.9    Subd. 4. Deadline for appointments and designations. The appointments and
60.10designations authorized under this section must be completed no later than August 15,
60.112010 2012.
60.12EFFECTIVE DATE.This section is effective the day following final enactment.

60.13    Sec. 26. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
60.141, is amended to read:
60.15
Subdivision 1.Total Appropriation
$
6,259,280,000
$
6,212,085,000
60.16
Appropriations by Fund
60.17
2012
2013
60.18
General
5,657,737,000
5,584,471,000
60.19
60.20
State Government
Special Revenue
3,565,000
3,565,000
60.21
Health Care Access
330,435,000
353,283,000
60.22
Federal TANF
265,378,000
268,101,000
60.23
Lottery Prize
1,665,000
1,665,000
60.24
Special Revenue
500,000
1,000,000
60.25Receipts for Systems Projects.
60.26Appropriations and federal receipts for
60.27information systems projects for MAXIS,
60.28PRISM, MMIS, and SSIS must be deposited
60.29in the state systems account authorized in
60.30Minnesota Statutes, section 256.014. Money
60.31appropriated for computer projects approved
60.32by the Minnesota Office of Enterprise
60.33Technology, funded by the legislature,
60.34and approved by the commissioner
60.35of management and budget, may be
61.1transferred from one project to another
61.2and from development to operations as the
61.3commissioner of human services considers
61.4necessary. Any unexpended balance in
61.5the appropriation for these projects does
61.6not cancel but is available for ongoing
61.7development and operations.
61.8Nonfederal Share Transfers. The
61.9nonfederal share of activities for which
61.10federal administrative reimbursement is
61.11appropriated to the commissioner may be
61.12transferred to the special revenue fund.
61.13TANF Maintenance of Effort.
61.14(a) In order to meet the basic maintenance
61.15of effort (MOE) requirements of the TANF
61.16block grant specified under Code of Federal
61.17Regulations, title 45, section 263.1, the
61.18commissioner may only report nonfederal
61.19money expended for allowable activities
61.20listed in the following clauses as TANF/MOE
61.21expenditures:
61.22(1) MFIP cash, diversionary work program,
61.23and food assistance benefits under Minnesota
61.24Statutes, chapter 256J;
61.25(2) the child care assistance programs
61.26under Minnesota Statutes, sections 119B.03
61.27and 119B.05, and county child care
61.28administrative costs under Minnesota
61.29Statutes, section 119B.15;
61.30(3) state and county MFIP administrative
61.31costs under Minnesota Statutes, chapters
61.32256J and 256K;
62.1(4) state, county, and tribal MFIP
62.2employment services under Minnesota
62.3Statutes, chapters 256J and 256K;
62.4(5) expenditures made on behalf of legal
62.5noncitizen MFIP recipients who qualify for
62.6the MinnesotaCare program under Minnesota
62.7Statutes, chapter 256L;
62.8(6) qualifying working family credit
62.9expenditures under Minnesota Statutes,
62.10section 290.0671; and
62.11(7) qualifying Minnesota education credit
62.12expenditures under Minnesota Statutes,
62.13section 290.0674.
62.14(b) The commissioner shall ensure that
62.15sufficient qualified nonfederal expenditures
62.16are made each year to meet the state's
62.17TANF/MOE requirements. For the activities
62.18listed in paragraph (a), clauses (2) to
62.19(7), the commissioner may only report
62.20expenditures that are excluded from the
62.21definition of assistance under Code of
62.22Federal Regulations, title 45, section 260.31.
62.23(c) For fiscal years beginning with state fiscal
62.24year 2003, the commissioner shall assure
62.25that the maintenance of effort used by the
62.26commissioner of management and budget
62.27for the February and November forecasts
62.28required under Minnesota Statutes, section
62.2916A.103 , contains expenditures under
62.30paragraph (a), clause (1), equal to at least 16
62.31percent of the total required under Code of
62.32Federal Regulations, title 45, section 263.1.
62.33(d) Minnesota Statutes, section 256.011,
62.34subdivision 3
, which requires that federal
63.1grants or aids secured or obtained under that
63.2subdivision be used to reduce any direct
63.3appropriations provided by law, do not apply
63.4if the grants or aids are federal TANF funds.
63.5(e) For the federal fiscal years beginning on
63.6or after October 1, 2007, the commissioner
63.7may not claim an amount of TANF/MOE in
63.8excess of the 75 percent standard in Code
63.9of Federal Regulations, title 45, section
63.10263.1(a)(2), except:
63.11(1) to the extent necessary to meet the 80
63.12percent standard under Code of Federal
63.13Regulations, title 45, section 263.1(a)(1),
63.14if it is determined by the commissioner
63.15that the state will not meet the TANF work
63.16participation target rate for the current year;
63.17(2) to provide any additional amounts
63.18under Code of Federal Regulations, title 45,
63.19section 264.5, that relate to replacement of
63.20TANF funds due to the operation of TANF
63.21penalties; and
63.22(3) to provide any additional amounts that
63.23may contribute to avoiding or reducing
63.24TANF work participation penalties through
63.25the operation of the excess MOE provisions
63.26of Code of Federal Regulations, title 45,
63.27section 261.43 (a)(2).
63.28For the purposes of clauses (1) to (3),
63.29the commissioner may supplement the
63.30MOE claim with working family credit
63.31expenditures or other qualified expenditures
63.32to the extent such expenditures are otherwise
63.33available after considering the expenditures
63.34allowed in this subdivision.
64.1(f) Notwithstanding any contrary provision
64.2in this article, paragraphs (a) to (e) expire
64.3June 30, 2015.
64.4Working Family Credit Expenditures
64.5as TANF/MOE. The commissioner may
64.6claim as TANF maintenance of effort up to
64.7$6,707,000 per year of working family credit
64.8expenditures for fiscal years 2012 and 2013.
64.9Working Family Credit Expenditures
64.10to be Claimed for TANF/MOE. The
64.11commissioner may count the following
64.12amounts of working family credit
64.13expenditures as TANF/MOE:
64.14(1) fiscal year 2012, $23,692,000;
64.15(2) fiscal year 2013, $44,969,000
64.16$51,978,000;
64.17(3) fiscal year 2014, $32,579,000
64.18$43,576,000; and
64.19(4) fiscal year 2015, $32,476,000
64.20$43,548,000.
64.21Notwithstanding any contrary provision in
64.22this article, this rider expires June 30, 2015.
64.23TANF Transfer to Federal Child Care
64.24and Development Fund. (a) The following
64.25TANF fund amounts are appropriated
64.26to the commissioner for purposes of
64.27MFIP/Transition Year Child Care Assistance
64.28under Minnesota Statutes, section 119B.05:
64.29(1) fiscal year 2012, $10,020,000;
64.30(2) fiscal year 2013, $28,020,000
64.31$28,022,000;
64.32(3) fiscal year 2014, $14,020,000
64.33$14,030,000; and
65.1(4) fiscal year 2015, $14,020,000
65.2$14,030,000.
65.3(b) The commissioner shall authorize the
65.4transfer of sufficient TANF funds to the
65.5federal child care and development fund to
65.6meet this appropriation and shall ensure that
65.7all transferred funds are expended according
65.8to federal child care and development fund
65.9regulations.
65.10Food Stamps Employment and Training
65.11Funds. (a) Notwithstanding Minnesota
65.12Statutes, sections 256D.051, subdivisions 1a,
65.136b, and 6c, and 256J.626, federal food stamps
65.14employment and training funds received
65.15as reimbursement for child care assistance
65.16program expenditures must be deposited in
65.17the general fund. The amount of funds must
65.18be limited to $500,000 per year in fiscal
65.19years 2012 through 2015, contingent upon
65.20approval by the federal Food and Nutrition
65.21Service.
65.22(b) Consistent with the receipt of these
65.23federal funds, the commissioner may
65.24adjust the level of working family credit
65.25expenditures claimed as TANF maintenance
65.26of effort. Notwithstanding any contrary
65.27provision in this article, this rider expires
65.28June 30, 2015.
65.29ARRA Food Support Benefit Increases.
65.30The funds provided for food support benefit
65.31increases under the Supplemental Nutrition
65.32Assistance Program provisions of the
65.33American Recovery and Reinvestment Act
65.34(ARRA) of 2009 must be used for benefit
65.35increases beginning July 1, 2009.
66.1Supplemental Security Interim Assistance
66.2Reimbursement Funds. $2,800,000 of
66.3uncommitted revenue available to the
66.4commissioner of human services for SSI
66.5advocacy and outreach services must be
66.6transferred to and deposited into the general
66.7fund by October 1, 2011.

66.8    Sec. 27. MINNESOTA VISIBLE CHILD WORK GROUP.
66.9    Subdivision 1. Purpose. The Minnesota visible child work group is established to
66.10identify and recommend issues that should be addressed in a statewide, comprehensive
66.11plan to improve the well-being of children who are homeless or have experienced
66.12homelessness.
66.13    Subd. 2. Membership. The members of the Minnesota visible child work group
66.14include: (1) two members of the Minnesota house of representatives appointed by
66.15the speaker of the house, one member from the majority party and one member from
66.16the minority party; (2) two members of the Minnesota senate appointed by the senate
66.17Subcommittee on Committees of the Committee on Rules and Administration, one
66.18member from the majority party and one member from the minority party; (3) three
66.19representatives from family shelter, transitional housing, and supportive housing providers
66.20appointed by the governor; (4) two individuals appointed by the governor who have
66.21experienced homelessness; (5) three housing and child advocates appointed by the
66.22governor; (6) three representatives from the business or philanthropic community; and (7)
66.23children's cabinet members, or their designees. Work group membership should include
66.24people from rural, suburban, and urban areas of the state.
66.25    Subd. 3. Duties. The work group shall: (1) recommend goals and objectives for a
66.26comprehensive, statewide plan to improve the well-being of children who are homeless or
66.27who have experienced homelessness; (2) recommend a definition of "child well-being";
66.28(3) identify evidence-based interventions and best practices improving the well-being
66.29of young children; (4) plan implementation timelines and ways to measure progress,
66.30including measures of child well-being from birth through adolescence; (5) identify ways
66.31to address issues of collaboration and coordination across systems, including education,
66.32health, human services, and housing; (6) recommend the type of data and information
66.33necessary to develop, effectively implement, and monitor a strategic plan; (7) examine and
66.34make recommendations regarding funding to implement an effective plan; and (8) provide
67.1recommendations for ongoing reports on the well-being of children, monitoring progress
67.2in implementing the statewide comprehensive plan, and any other issues determined to be
67.3relevant to achieving the goals of this section.
67.4    Subd. 4. Work group convening and facilitation. The work group must be
67.5organized, scheduled, and facilitated by the staff of a nonprofit child advocacy, outreach,
67.6research, and youth development organization focusing on a wide range of issues
67.7affecting children who are vulnerable, and a nonprofit organization working to provide
67.8safe, affordable, and sustainable homes for children and families in the seven-county
67.9metropolitan area through partnerships with the public and private sector. These two
67.10organizations will also be responsible for preparing and submitting the work group's
67.11recommendations.
67.12    Subd. 5. Report. The work group shall make recommendations under subdivision
67.133 to the legislative committees with jurisdiction over education, housing, health, and
67.14human services policy and finance by December 15, 2012. The recommendations must
67.15also be submitted to the children's cabinet to provide the foundation for a statewide
67.16visible child plan.
67.17    Subd. 6. Expiration. The Minnesota visible child work group expires on June
67.1830, 2013.

67.19    Sec. 28. UNIFORM ASSET LIMIT REQUIREMENTS.
67.20The commissioner of human services, in consultation with county human
67.21services representatives, shall analyze the differences in asset limit requirements across
67.22human services assistance programs, including group residential housing, Minnesota
67.23supplemental aid, general assistance, Minnesota family investment program, diversionary
67.24work program, the federal Supplemental Nutrition Assistance Program, state food
67.25assistance programs, and child care programs. The goal of the analysis is to establish a
67.26consistent asset limit across human services programs and minimize the administrative
67.27burdens on counties in implementing asset tests. The commissioner shall report its
67.28findings and conclusions to the legislative committees with jurisdiction over health and
67.29human services policy and finance by January 15, 2013, and include draft legislation
67.30establishing a uniform asset limit for human services assistance programs.

67.31    Sec. 29. DIRECTIONS TO THE COMMISSIONER.
67.32The commissioner of human services, in consultation with the commissioner of
67.33public safety, shall report to the chairs and ranking minority members of the legislative
68.1committees with jurisdiction over health and human services policy and finance regarding
68.2the implementation of Minnesota Statutes, section 256.01, subdivisions 18c, 18d, and 18e,
68.3the number of persons affected, and fiscal impact by program by December 1, 2013.
68.4EFFECTIVE DATE.This section is effective July 1, 2013.

68.5    Sec. 30. REVISOR INSTRUCTION.
68.6The revisor of statutes shall change the term "assistance transaction card" or
68.7similar terms to "electronic benefit transaction" or similar terms wherever they appear in
68.8Minnesota Statutes, chapter 256. The revisor may make changes necessary to correct the
68.9punctuation, grammar, or structure of the remaining text and preserve its meaning.

68.10ARTICLE 4
68.11CONTINUING CARE

68.12    Section 1. Minnesota Statutes 2010, section 62J.496, subdivision 2, is amended to read:
68.13    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
68.14(1) federally qualified health centers;
68.15    (2) community clinics, as defined under section 145.9268;
68.16    (3) nonprofit or local unit of government hospitals licensed under sections 144.50
68.17to 144.56;
68.18(4) individual or small group physician practices that are focused primarily on
68.19primary care;
68.20    (5) nursing facilities licensed under sections 144A.01 to 144A.27;
68.21(6) local public health departments as defined in chapter 145A; and
68.22    (7) other providers of health or health care services approved by the commissioner
68.23for which interoperable electronic health record capability would improve quality of
68.24care, patient safety, or community health.
68.25(b) The commissioner shall administer the loan fund to prioritize support and
68.26assistance to:
68.27(1) critical access hospitals;
68.28(2) federally qualified health centers;
68.29(3) entities that serve uninsured, underinsured, and medically underserved
68.30individuals, regardless of whether such area is urban or rural; and
68.31(4) individual or small group practices that are primarily focused on primary care.;
68.32(5) nursing facilities certified to participate in the medical assistance program; and
69.1(6) providers enrolled in the elderly waiver program of customized living or 24-hour
69.2customized living of the medical assistance program, if at least half of their annual
69.3operating revenue is paid under the medical assistance program.
69.4    (c) An eligible applicant must submit a loan application to the commissioner of
69.5health on forms prescribed by the commissioner. The application must include, at a
69.6minimum:
69.7    (1) the amount of the loan requested and a description of the purpose or project
69.8for which the loan proceeds will be used;
69.9    (2) a quote from a vendor;
69.10    (3) a description of the health care entities and other groups participating in the
69.11project;
69.12    (4) evidence of financial stability and a demonstrated ability to repay the loan; and
69.13    (5) a description of how the system to be financed interoperates or plans in the
69.14future to interoperate with other health care entities and provider groups located in the
69.15same geographical area;
69.16(6) a plan on how the certified electronic health record technology will be maintained
69.17and supported over time; and
69.18(7) any other requirements for applications included or developed pursuant to
69.19section 3014 of the HITECH Act.

69.20    Sec. 2. Minnesota Statutes 2010, section 144A.073, is amended by adding a
69.21subdivision to read:
69.22    Subd. 13. Moratorium exception funding. In fiscal year 2013, the commissioner
69.23of health may approve moratorium exception projects under this section for which the full
69.24annualized state share of medical assistance costs does not exceed $1,000,000.

69.25    Sec. 3. Minnesota Statutes 2010, section 144A.351, is amended to read:
69.26144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
69.27REPORT REQUIRED.
69.28    The commissioners of health and human services, with the cooperation of counties
69.29and in consultation with stakeholders, including persons who need or are using long-term
69.30care services and supports, lead agencies, regional entities, senior, disability, and mental
69.31health organization representatives, service providers, and community members shall
69.32prepare a report to the legislature by August 15, 2004 2013, and biennially thereafter,
69.33regarding the status of the full range of long-term care services and supports for the
70.1elderly and children and adults with disabilities and mental illnesses in Minnesota. The
70.2report shall address:
70.3    (1) demographics and need for long-term care services and supports in Minnesota;
70.4    (2) summary of county and regional reports on long-term care gaps, surpluses,
70.5imbalances, and corrective action plans;
70.6    (3) status of long-term care services and mental illnesses, housing options, and
70.7supports by county and region including:
70.8    (i) changes in availability of the range of long-term care services and housing
70.9options;
70.10    (ii) access problems, including access to the least restrictive and most integrated
70.11services and settings, regarding long-term care services; and
70.12    (iii) comparative measures of long-term care services availability, including serving
70.13people in their home areas near family, and progress changes over time; and
70.14    (4) recommendations regarding goals for the future of long-term care services and
70.15supports, policy and fiscal changes, and resource development and transition needs.

70.16    Sec. 4. Minnesota Statutes 2010, section 144D.04, subdivision 2, is amended to read:
70.17    Subd. 2. Contents of contract. A housing with services contract, which need not be
70.18entitled as such to comply with this section, shall include at least the following elements
70.19in itself or through supporting documents or attachments:
70.20(1) the name, street address, and mailing address of the establishment;
70.21(2) the name and mailing address of the owner or owners of the establishment and, if
70.22the owner or owners is not a natural person, identification of the type of business entity
70.23of the owner or owners;
70.24(3) the name and mailing address of the managing agent, through management
70.25agreement or lease agreement, of the establishment, if different from the owner or owners;
70.26(4) the name and address of at least one natural person who is authorized to accept
70.27service of process on behalf of the owner or owners and managing agent;
70.28(5) a statement describing the registration and licensure status of the establishment
70.29and any provider providing health-related or supportive services under an arrangement
70.30with the establishment;
70.31(6) the term of the contract;
70.32(7) a description of the services to be provided to the resident in the base rate to be
70.33paid by resident, including a delineation of the portion of the base rate that constitutes rent
70.34and a delineation of charges for each service included in the base rate;
71.1(8) a description of any additional services, including home care services, available
71.2for an additional fee from the establishment directly or through arrangements with the
71.3establishment, and a schedule of fees charged for these services;
71.4(9) a description of the process through which the contract may be modified,
71.5amended, or terminated, including whether a move to a different room or sharing a room
71.6would be required in the event that the tenant can no longer pay the current rent;
71.7(10) a description of the establishment's complaint resolution process available
71.8to residents including the toll-free complaint line for the Office of Ombudsman for
71.9Long-Term Care;
71.10(11) the resident's designated representative, if any;
71.11(12) the establishment's referral procedures if the contract is terminated;
71.12(13) requirements of residency used by the establishment to determine who may
71.13reside or continue to reside in the housing with services establishment;
71.14(14) billing and payment procedures and requirements;
71.15(15) a statement regarding the ability of residents to receive services from service
71.16providers with whom the establishment does not have an arrangement;
71.17(16) a statement regarding the availability of public funds for payment for residence
71.18or services in the establishment; and
71.19(17) a statement regarding the availability of and contact information for
71.20long-term care consultation services under section 256B.0911 in the county in which the
71.21establishment is located.

71.22    Sec. 5. Minnesota Statutes 2010, section 245A.03, is amended by adding a subdivision
71.23to read:
71.24    Subd. 6a. Adult foster care homes serving people with mental illness;
71.25certification. (a) The commissioner of human services shall issue a mental health
71.26certification for adult foster care homes licensed under this chapter and Minnesota Rules,
71.27parts 9555.5105 to 9555.6265, that serve people with mental illness where the home is not
71.28the primary residence of the license holder when a provider is determined to have met
71.29the requirements under paragraph (b). This certification is voluntary for license holders.
71.30The certification shall be printed on the license, and identified on the commissioner's
71.31public Web site.
71.32(b) The requirements for certification are:
71.33(1) all staff working in the adult foster care home have received at least seven hours
71.34of annual training covering all of the following topics:
71.35(i) mental health diagnoses;
72.1(ii) mental health crisis response and de-escalation techniques;
72.2(iii) recovery from mental illness;
72.3(iv) treatment options including evidence-based practices;
72.4(v) medications and their side effects;
72.5(vi) co-occurring substance abuse and health conditions; and
72.6(vii) community resources;
72.7(2) a mental health professional, as defined in section 245.462, subdivision 18, or
72.8a mental health practitioner as defined in section 245.462, subdivision 17, are available
72.9for consultation and assistance;
72.10(3) there is a plan and protocol in place to address a mental health crisis; and
72.11(4) each individual's Individual Placement Agreement identifies who is providing
72.12clinical services and their contact information, and includes an individual crisis prevention
72.13and management plan developed with the individual.
72.14(c) License holders seeking certification under this subdivision must request this
72.15certification on forms provided by the commissioner and must submit the request to the
72.16county licensing agency in which the home is located. The county licensing agency must
72.17forward the request to the commissioner with a county recommendation regarding whether
72.18the commissioner should issue the certification.
72.19(d) Ongoing compliance with the certification requirements under paragraph (b)
72.20shall be reviewed by the county licensing agency at each licensing review. When a county
72.21licensing agency determines that the requirements of paragraph (b) are not met, the county
72.22shall inform the commissioner, and the commissioner will remove the certification.
72.23(e) A denial of the certification or the removal of the certification based on a
72.24determination that the requirements under paragraph (b) have not been met by the adult
72.25foster care license holder are not subject to appeal. A license holder that has been denied a
72.26certification or that has had a certification removed may again request certification when
72.27the license holder is in compliance with the requirements of paragraph (b).

72.28    Sec. 6. Minnesota Statutes 2011 Supplement, section 245A.03, subdivision 7, is
72.29amended to read:
72.30    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
72.31initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
72.322960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
72.339555.6265, under this chapter for a physical location that will not be the primary residence
72.34of the license holder for the entire period of licensure. If a license is issued during this
72.35moratorium, and the license holder changes the license holder's primary residence away
73.1from the physical location of the foster care license, the commissioner shall revoke the
73.2license according to section 245A.07. Exceptions to the moratorium include:
73.3(1) foster care settings that are required to be registered under chapter 144D;
73.4(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
73.5and determined to be needed by the commissioner under paragraph (b);
73.6(3) new foster care licenses determined to be needed by the commissioner under
73.7paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
73.8restructuring of state-operated services that limits the capacity of state-operated facilities;
73.9(4) new foster care licenses determined to be needed by the commissioner under
73.10paragraph (b) for persons requiring hospital level care; or
73.11(5) new foster care licenses determined to be needed by the commissioner for the
73.12transition of people from personal care assistance to the home and community-based
73.13services.
73.14(b) The commissioner shall determine the need for newly licensed foster care homes
73.15as defined under this subdivision. As part of the determination, the commissioner shall
73.16consider the availability of foster care capacity in the area in which the licensee seeks to
73.17operate, and the recommendation of the local county board. The determination by the
73.18commissioner must be final. A determination of need is not required for a change in
73.19ownership at the same address.
73.20    (c) Residential settings that would otherwise be subject to the moratorium established
73.21in paragraph (a), that are in the process of receiving an adult or child foster care license as
73.22of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
73.23or child foster care license. For this paragraph, all of the following conditions must be met
73.24to be considered in the process of receiving an adult or child foster care license:
73.25    (1) participants have made decisions to move into the residential setting, including
73.26documentation in each participant's care plan;
73.27    (2) the provider has purchased housing or has made a financial investment in the
73.28property;
73.29    (3) the lead agency has approved the plans, including costs for the residential setting
73.30for each individual;
73.31    (4) the completion of the licensing process, including all necessary inspections, is
73.32the only remaining component prior to being able to provide services; and
73.33    (5) the needs of the individuals cannot be met within the existing capacity in that
73.34county.
74.1To qualify for the process under this paragraph, the lead agency must submit
74.2documentation to the commissioner by August 1, 2009, that all of the above criteria are
74.3met.
74.4(d) The commissioner shall study the effects of the license moratorium under this
74.5subdivision and shall report back to the legislature by January 15, 2011. This study shall
74.6include, but is not limited to the following:
74.7(1) the overall capacity and utilization of foster care beds where the physical location
74.8is not the primary residence of the license holder prior to and after implementation
74.9of the moratorium;
74.10(2) the overall capacity and utilization of foster care beds where the physical
74.11location is the primary residence of the license holder prior to and after implementation
74.12of the moratorium; and
74.13(3) the number of licensed and occupied ICF/MR beds prior to and after
74.14implementation of the moratorium.
74.15(e) When a foster care recipient moves out of a foster home that is not the primary
74.16residence of the license holder according to section 256B.49, subdivision 15, paragraph
74.17(f), the county shall immediately inform the Department of Human Services Licensing
74.18Division, and. The department shall immediately decrease the statewide licensed
74.19capacity for the home foster care settings where the physical location is not the primary
74.20residence of the license holder, if the voluntary changes described in paragraph (g) are
74.21not sufficient to meet the savings required by reductions in licensed bed capacity under
74.22Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
74.23and maintain statewide long-term care residential services capacity within budgetary
74.24limits. Implementation of the statewide licensed capacity reduction shall begin on July 1,
74.252013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the needs
74.26determination process. Under this paragraph, the commissioner has the authority to reduce
74.27unused licensed capacity of a current foster care program to accomplish the consolidation
74.28or closure of settings. A decreased licensed capacity according to this paragraph is not
74.29subject to appeal under this chapter.
74.30(f) Residential settings that would otherwise be subject to the decreased license
74.31capacity established in paragraph (e) shall be exempt under the following circumstances:
74.32(1) until August 1, 2013, the license holder's beds occupied by residents whose
74.33primary diagnosis is mental illness and the license holder is:
74.34(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
74.35health services (ARMHS) as defined in section 256B.0623;
75.1(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
75.29520.0870;
75.3(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
75.49520.0870; or
75.5(iv) a provider of intensive residential treatment services (IRTS) licensed under
75.6Minnesota Rules, parts 9520.0500 to 9520.0670; or
75.7(2) the license holder is certified under the requirements in subdivision 6a.
75.8(g) A resource need determination process, managed at the state level, using the
75.9available reports required by section 144A.351, and other data and information shall
75.10be used to determine where the reduced capacity required under paragraph (e) will be
75.11implemented. The commissioner shall consult with the stakeholders described in section
75.12144A.351, and employ a variety of methods to improve the state's capacity to meet
75.13long-term care service needs within budgetary limits, including seeking proposals from
75.14service providers or lead agencies to change service type, capacity, or location to improve
75.15services, increase the independence of residents, and better meet needs identified by the
75.16long-term care services reports and statewide data and information. By February 1 of each
75.17year, the commissioner shall provide information and data on the overall capacity of
75.18licensed long-term care services, actions taken under this subdivision to manage statewide
75.19long-term care services and supports resources, and any recommendations for change to
75.20the legislative committees with jurisdiction over health and human services budget.

75.21    Sec. 7. Minnesota Statutes 2010, section 245A.11, subdivision 2a, is amended to read:
75.22    Subd. 2a. Adult foster care license capacity. (a) The commissioner shall issue
75.23adult foster care licenses with a maximum licensed capacity of four beds, including
75.24nonstaff roomers and boarders, except that the commissioner may issue a license with a
75.25capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).
75.26(b) An adult foster care license holder may have a maximum license capacity of five
75.27if all persons in care are age 55 or over and do not have a serious and persistent mental
75.28illness or a developmental disability.
75.29(c) The commissioner may grant variances to paragraph (b) to allow a foster care
75.30provider with a licensed capacity of five persons to admit an individual under the age of 55
75.31if the variance complies with section 245A.04, subdivision 9, and approval of the variance
75.32is recommended by the county in which the licensed foster care provider is located.
75.33(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
75.34bed for emergency crisis services for a person with serious and persistent mental illness
75.35or a developmental disability, regardless of age, if the variance complies with section
76.1245A.04, subdivision 9 , and approval of the variance is recommended by the county in
76.2which the licensed foster care provider is located.
76.3(e) The commissioner may grant a variance to paragraph (b) to allow for the
76.4use of a fifth bed for respite services, as defined in section 245A.02, for persons with
76.5disabilities, regardless of age, if the variance complies with section 245A.03, subdivision
76.67, and section 245A.04, subdivision 9, and approval of the variance is recommended by
76.7the county in which the licensed foster care provider is licensed. Respite care may be
76.8provided under the following conditions:
76.9(1) staffing ratios cannot be reduced below the approved level for the individuals
76.10being served in the home on a permanent basis;
76.11(2) no more than two different individuals can be accepted for respite services in
76.12any calendar month and the total respite days may not exceed 120 days per program in
76.13any calendar year;
76.14(3) the person receiving respite services must have his or her own bedroom, which
76.15could be used for alternative purposes when not used as a respite bedroom, and cannot be
76.16the room of another person who lives in the foster care home; and
76.17(4) individuals living in the foster care home must be notified when the variance
76.18is approved. The provider must give 60 days' notice in writing to the residents and their
76.19legal representatives prior to accepting the first respite placement. Notice must be given to
76.20residents at least two days prior to service initiation, or as soon as the license holder is
76.21able if they receive notice of the need for respite less than two days prior to initiation,
76.22each time a respite client will be served, unless the requirement for this notice is waived
76.23by the resident or legal guardian.
76.24(e) If the 2009 legislature adopts a rate reduction that impacts providers of adult
76.25foster care services, (f) The commissioner may issue an adult foster care license with a
76.26capacity of five adults if the fifth bed does not increase the overall statewide capacity of
76.27licensed adult foster care beds in homes that are not the primary residence of the license
76.28holder, over the licensed capacity in such homes on July 1, 2009, as identified in a plan
76.29submitted to the commissioner by the county, when the capacity is recommended by
76.30the county licensing agency of the county in which the facility is located and if the
76.31recommendation verifies that:
76.32(1) the facility meets the physical environment requirements in the adult foster
76.33care licensing rule;
76.34(2) the five-bed living arrangement is specified for each resident in the resident's:
76.35(i) individualized plan of care;
76.36(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
77.1(iii) individual resident placement agreement under Minnesota Rules, part
77.29555.5105, subpart 19, if required;
77.3(3) the license holder obtains written and signed informed consent from each
77.4resident or resident's legal representative documenting the resident's informed choice
77.5to remain living in the home and that the resident's refusal to consent would not have
77.6resulted in service termination; and
77.7(4) the facility was licensed for adult foster care before March 1, 2009 2011.
77.8(f) (g) The commissioner shall not issue a new adult foster care license under
77.9paragraph (e) (f) after June 30, 2011 2016. The commissioner shall allow a facility with
77.10an adult foster care license issued under paragraph (e) (f) before June 30, 2011 2016, to
77.11continue with a capacity of five adults if the license holder continues to comply with the
77.12requirements in paragraph (e) (f).

77.13    Sec. 8. Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:
77.14    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The
77.15commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
77.16requiring a caregiver to be present in an adult foster care home during normal sleeping
77.17hours to allow for alternative methods of overnight supervision. The commissioner may
77.18grant the variance if the local county licensing agency recommends the variance and the
77.19county recommendation includes documentation verifying that:
77.20    (1) the county has approved the license holder's plan for alternative methods of
77.21providing overnight supervision and determined the plan protects the residents' health,
77.22safety, and rights;
77.23    (2) the license holder has obtained written and signed informed consent from
77.24each resident or each resident's legal representative documenting the resident's or legal
77.25representative's agreement with the alternative method of overnight supervision; and
77.26    (3) the alternative method of providing overnight supervision, which may include
77.27the use of technology, is specified for each resident in the resident's: (i) individualized
77.28plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
77.29required; or (iii) individual resident placement agreement under Minnesota Rules, part
77.309555.5105, subpart 19, if required.
77.31    (b) To be eligible for a variance under paragraph (a), the adult foster care license
77.32holder must not have had a licensing action conditional license issued under section
77.33245A.06 , or any other licensing sanction issued under section 245A.07 during the prior 24
77.34months based on failure to provide adequate supervision, health care services, or resident
77.35safety in the adult foster care home.
78.1    (c) A license holder requesting a variance under this subdivision to utilize
78.2technology as a component of a plan for alternative overnight supervision may request
78.3the commissioner's review in the absence of a county recommendation. Upon receipt of
78.4such a request from a license holder, the commissioner shall review the variance request
78.5with the county.

78.6    Sec. 9. Minnesota Statutes 2010, section 245A.11, subdivision 7a, is amended to read:
78.7    Subd. 7a. Alternate overnight supervision technology; adult foster care license.
78.8    (a) The commissioner may grant an applicant or license holder an adult foster care license
78.9for a residence that does not have a caregiver in the residence during normal sleeping
78.10hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
78.11monitoring technology to alert the license holder when an incident occurs that may
78.12jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
78.13holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
78.14to 9555.6265, and the requirements under this subdivision. The license printed by the
78.15commissioner must state in bold and large font:
78.16    (1) that the facility is under electronic monitoring; and
78.17    (2) the telephone number of the county's common entry point for making reports of
78.18suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
78.19(b) Applications for a license under this section must be submitted directly to
78.20the Department of Human Services licensing division. The licensing division must
78.21immediately notify the host county and lead county contract agency and the host county
78.22licensing agency. The licensing division must collaborate with the county licensing
78.23agency in the review of the application and the licensing of the program.
78.24    (c) Before a license is issued by the commissioner, and for the duration of the
78.25license, the applicant or license holder must establish, maintain, and document the
78.26implementation of written policies and procedures addressing the requirements in
78.27paragraphs (d) through (f).
78.28    (d) The applicant or license holder must have policies and procedures that:
78.29    (1) establish characteristics of target populations that will be admitted into the home,
78.30and characteristics of populations that will not be accepted into the home;
78.31    (2) explain the discharge process when a foster care recipient requires overnight
78.32supervision or other services that cannot be provided by the license holder due to the
78.33limited hours that the license holder is on site;
78.34    (3) describe the types of events to which the program will respond with a physical
78.35presence when those events occur in the home during time when staff are not on site, and
79.1how the license holder's response plan meets the requirements in paragraph (e), clause
79.2(1) or (2);
79.3    (4) establish a process for documenting a review of the implementation and
79.4effectiveness of the response protocol for the response required under paragraph (e),
79.5clause (1) or (2). The documentation must include:
79.6    (i) a description of the triggering incident;
79.7    (ii) the date and time of the triggering incident;
79.8    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
79.9    (iv) whether the response met the resident's needs;
79.10    (v) whether the existing policies and response protocols were followed; and
79.11    (vi) whether the existing policies and protocols are adequate or need modification.
79.12    When no physical presence response is completed for a three-month period, the
79.13license holder's written policies and procedures must require a physical presence response
79.14drill to be conducted for which the effectiveness of the response protocol under paragraph
79.15(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
79.16    (5) establish that emergency and nonemergency phone numbers are posted in a
79.17prominent location in a common area of the home where they can be easily observed by a
79.18person responding to an incident who is not otherwise affiliated with the home.
79.19    (e) The license holder must document and include in the license application which
79.20response alternative under clause (1) or (2) is in place for responding to situations that
79.21present a serious risk to the health, safety, or rights of people receiving foster care services
79.22in the home:
79.23    (1) response alternative (1) requires only the technology to provide an electronic
79.24notification or alert to the license holder that an event is underway that requires a response.
79.25Under this alternative, no more than ten minutes will pass before the license holder will be
79.26physically present on site to respond to the situation; or
79.27    (2) response alternative (2) requires the electronic notification and alert system
79.28under alternative (1), but more than ten minutes may pass before the license holder is
79.29present on site to respond to the situation. Under alternative (2), all of the following
79.30conditions are met:
79.31    (i) the license holder has a written description of the interactive technological
79.32applications that will assist the license holder in communicating with and assessing the
79.33needs related to the care, health, and safety of the foster care recipients. This interactive
79.34technology must permit the license holder to remotely assess the well being of the foster
79.35care recipient without requiring the initiation of the foster care recipient. Requiring the
79.36foster care recipient to initiate a telephone call does not meet this requirement;
80.1(ii) the license holder documents how the remote license holder is qualified and
80.2capable of meeting the needs of the foster care recipients and assessing foster care
80.3recipients' needs under item (i) during the absence of the license holder on site;
80.4(iii) the license holder maintains written procedures to dispatch emergency response
80.5personnel to the site in the event of an identified emergency; and
80.6    (iv) each foster care recipient's individualized plan of care, individual service plan
80.7under section 256B.092, subdivision 1b, if required, or individual resident placement
80.8agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
80.9maximum response time, which may be greater than ten minutes, for the license holder
80.10to be on site for that foster care recipient.
80.11    (f) All Each foster care recipient's placement agreements agreement, individual
80.12service agreements, and plans applicable to the foster care recipient agreement, and plan
80.13must clearly state that the adult foster care license category is a program without the
80.14presence of a caregiver in the residence during normal sleeping hours; the protocols in
80.15place for responding to situations that present a serious risk to the health, safety, or rights
80.16of foster care recipients under paragraph (e), clause (1) or (2); and a signed informed
80.17consent from each foster care recipient or the person's legal representative documenting
80.18the person's or legal representative's agreement with placement in the program. If
80.19electronic monitoring technology is used in the home, the informed consent form must
80.20also explain the following:
80.21    (1) how any electronic monitoring is incorporated into the alternative supervision
80.22system;
80.23    (2) the backup system for any electronic monitoring in times of electrical outages or
80.24other equipment malfunctions;
80.25    (3) how the license holder is caregivers are trained on the use of the technology;
80.26    (4) the event types and license holder response times established under paragraph (e);
80.27    (5) how the license holder protects the foster care recipient's privacy related to
80.28electronic monitoring and related to any electronically recorded data generated by the
80.29monitoring system. A foster care recipient may not be removed from a program under
80.30this subdivision for failure to consent to electronic monitoring. The consent form must
80.31explain where and how the electronically recorded data is stored, with whom it will be
80.32shared, and how long it is retained; and
80.33    (6) the risks and benefits of the alternative overnight supervision system.
80.34    The written explanations under clauses (1) to (6) may be accomplished through
80.35cross-references to other policies and procedures as long as they are explained to the
80.36person giving consent, and the person giving consent is offered a copy.
81.1(g) Nothing in this section requires the applicant or license holder to develop or
81.2maintain separate or duplicative policies, procedures, documentation, consent forms, or
81.3individual plans that may be required for other licensing standards, if the requirements of
81.4this section are incorporated into those documents.
81.5(h) The commissioner may grant variances to the requirements of this section
81.6according to section 245A.04, subdivision 9.
81.7(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
81.8under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
81.9contractors affiliated with the license holder.
81.10(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
81.11remotely determine what action the license holder needs to take to protect the well-being
81.12of the foster care recipient.
81.13(k) The commissioner shall evaluate license applications using the requirements
81.14in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
81.15including a checklist of criteria needed for approval.
81.16(l) To be eligible for a license under paragraph (a), the adult foster care license holder
81.17must not have had a conditional license issued under section 245A.06 or any licensing
81.18sanction under section 245A.07 during the prior 24 months based on failure to provide
81.19adequate supervision, health care services, or resident safety in the adult foster care home.
81.20(m) The commissioner shall review an application for an alternative overnight
81.21supervision license within 60 days of receipt of the application. When the commissioner
81.22receives an application that is incomplete because the applicant failed to submit required
81.23documents or that is substantially deficient because the documents submitted do not meet
81.24licensing requirements, the commissioner shall provide the applicant written notice
81.25that the application is incomplete or substantially deficient. In the written notice to the
81.26applicant, the commissioner shall identify documents that are missing or deficient and
81.27give the applicant 45 days to resubmit a second application that is substantially complete.
81.28An applicant's failure to submit a substantially complete application after receiving
81.29notice from the commissioner is a basis for license denial under section 245A.05. The
81.30commissioner shall complete subsequent review within 30 days.
81.31(n) Once the application is considered complete under paragraph (m), the
81.32commissioner will approve or deny an application for an alternative overnight supervision
81.33license within 60 days.
81.34(o) For the purposes of this subdivision, "supervision" means:
81.35(1) oversight by a caregiver as specified in the individual resident's place agreement
81.36and awareness of the resident's needs and activities; and
82.1(2) the presence of a caregiver in a residence during normal sleeping hours, unless a
82.2determination has been made and documented in the individual's support plan that the
82.3individual does not require the presence of a caregiver during normal sleeping hours.

82.4    Sec. 10. Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:
82.5    Subdivision 1. Consumer data file. The license holder must maintain the following
82.6information for each consumer:
82.7(1) identifying information that includes date of birth, medications, legal
82.8representative, history, medical, and other individual-specific information, and names and
82.9telephone numbers of contacts;
82.10(2) consumer health information, including individual medication administration
82.11and monitoring information;
82.12(3) the consumer's individual service plan. When a consumer's case manager does
82.13not provide a current individual service plan, the license holder shall make a written
82.14request to the case manager to provide a copy of the individual service plan and inform
82.15the consumer or the consumer's legal representative of the right to an individual service
82.16plan and the right to appeal under section 256.045. In the event the case manager fails
82.17to provide an individual service plan after a written request from the license holder, the
82.18license holder shall not be sanctioned or penalized financially for not having a current
82.19individual service plan in the consumer's data file;
82.20(4) copies of assessments, analyses, summaries, and recommendations;
82.21(5) progress review reports;
82.22(6) incidents involving the consumer;
82.23(7) reports required under section 245B.05, subdivision 7;
82.24(8) discharge summary, when applicable;
82.25(9) record of other license holders serving the consumer that includes a contact
82.26person and telephone numbers, services being provided, services that require coordination
82.27between two license holders, and name of staff responsible for coordination;
82.28(10) information about verbal aggression directed at the consumer by another
82.29consumer; and
82.30(11) information about self-abuse.

82.31    Sec. 11. Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:
82.32    Subd. 6. Unlicensed home and community-based waiver providers of service to
82.33seniors and individuals with disabilities. (a) Providers required to initiate background
83.1studies under section 256B.4912 must initiate a study before the individual begins in a
83.2position allowing direct contact with persons served by the provider.
83.3(b) The commissioner shall conduct Except as provided in paragraph (c), the
83.4providers must initiate a background study annually of an individual required to be studied
83.5under section 245C.03, subdivision 6.
83.6(c) After an initial background study under this subdivision is initiated on an
83.7individual by a provider of both services licensed by the commissioner and the unlicensed
83.8services under this subdivision, a repeat annual background study is not required if:
83.9(1) the provider maintains compliance with the requirements of section 245C.07,
83.10paragraph (a), regarding one individual with one address and telephone number as the
83.11person to receive sensitive background study information for the multiple programs that
83.12depend on the same background study, and that the individual who is designated to receive
83.13the sensitive background information is capable of determining, upon the request of the
83.14commissioner, whether a background study subject is providing direct contact services
83.15in one or more of the provider's programs or services and, if so, at which location or
83.16locations; and
83.17(2) the individual who is the subject of the background study provides direct
83.18contact services under the provider's licensed program for at least 40 hours per year so
83.19the individual will be recognized by a probation officer or corrections agent to prompt
83.20a report to the commissioner regarding criminal convictions as required under section
83.21245C.05, subdivision 7.

83.22    Sec. 12. Minnesota Statutes 2010, section 245C.05, subdivision 7, is amended to read:
83.23    Subd. 7. Probation officer and corrections agent. (a) A probation officer or
83.24corrections agent shall notify the commissioner of an individual's conviction if the
83.25individual is:
83.26    (1) has been affiliated with a program or facility regulated by the Department of
83.27Human Services or Department of Health, a facility serving children or youth licensed by
83.28the Department of Corrections, or any type of home care agency or provider of personal
83.29care assistance services within the preceding year; and
83.30    (2) has been convicted of a crime constituting a disqualification under section
83.31245C.14 .
83.32    (b) For the purpose of this subdivision, "conviction" has the meaning given it
83.33in section 609.02, subdivision 5.
83.34    (c) The commissioner, in consultation with the commissioner of corrections, shall
83.35develop forms and information necessary to implement this subdivision and shall provide
84.1the forms and information to the commissioner of corrections for distribution to local
84.2probation officers and corrections agents.
84.3    (d) The commissioner shall inform individuals subject to a background study that
84.4criminal convictions for disqualifying crimes will be reported to the commissioner by the
84.5corrections system.
84.6    (e) A probation officer, corrections agent, or corrections agency is not civilly or
84.7criminally liable for disclosing or failing to disclose the information required by this
84.8subdivision.
84.9    (f) Upon receipt of disqualifying information, the commissioner shall provide the
84.10notice required under section 245C.17, as appropriate, to agencies on record as having
84.11initiated a background study or making a request for documentation of the background
84.12study status of the individual.
84.13    (g) This subdivision does not apply to family child care programs.

84.14    Sec. 13. Minnesota Statutes 2010, section 252.27, subdivision 2a, is amended to read:
84.15    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
84.16child, including a child determined eligible for medical assistance without consideration of
84.17parental income, must contribute to the cost of services used by making monthly payments
84.18on a sliding scale based on income, unless the child is married or has been married,
84.19parental rights have been terminated, or the child's adoption is subsidized according to
84.20section 259.67 or through title IV-E of the Social Security Act. The parental contribution
84.21is a partial or full payment for medical services provided for diagnostic, therapeutic,
84.22curing, treating, mitigating, rehabilitation, maintenance, and personal care services as
84.23defined in United States Code, title 26, section 213, needed by the child with a chronic
84.24illness or disability.
84.25    (b) For households with adjusted gross income equal to or greater than 100 percent
84.26of federal poverty guidelines, the parental contribution shall be computed by applying the
84.27following schedule of rates to the adjusted gross income of the natural or adoptive parents:
84.28    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
84.29poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
84.30contribution is $4 per month;
84.31    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
84.32poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
84.33the parental contribution shall be determined using a sliding fee scale established by the
84.34commissioner of human services which begins at one percent of adjusted gross income
84.35at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
85.1gross income for those with adjusted gross income up to 545 percent of federal poverty
85.2guidelines;
85.3    (3) if the adjusted gross income is greater than 545 percent of federal poverty
85.4guidelines and less than 675 percent of federal poverty guidelines, the parental
85.5contribution shall be 7.5 percent of adjusted gross income;
85.6    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
85.7poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
85.8contribution shall be determined using a sliding fee scale established by the commissioner
85.9of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
85.10federal poverty guidelines and increases to ten percent of adjusted gross income for those
85.11with adjusted gross income up to 975 percent of federal poverty guidelines; and
85.12    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
85.13poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
85.14income.
85.15    If the child lives with the parent, the annual adjusted gross income is reduced by
85.16$2,400 prior to calculating the parental contribution. If the child resides in an institution
85.17specified in section 256B.35, the parent is responsible for the personal needs allowance
85.18specified under that section in addition to the parental contribution determined under this
85.19section. The parental contribution is reduced by any amount required to be paid directly to
85.20the child pursuant to a court order, but only if actually paid.
85.21    (c) The household size to be used in determining the amount of contribution under
85.22paragraph (b) includes natural and adoptive parents and their dependents, including the
85.23child receiving services. Adjustments in the contribution amount due to annual changes
85.24in the federal poverty guidelines shall be implemented on the first day of July following
85.25publication of the changes.
85.26    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
85.27natural or adoptive parents determined according to the previous year's federal tax form,
85.28except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
85.29have been used to purchase a home shall not be counted as income.
85.30    (e) The contribution shall be explained in writing to the parents at the time eligibility
85.31for services is being determined. The contribution shall be made on a monthly basis
85.32effective with the first month in which the child receives services. Annually upon
85.33redetermination or at termination of eligibility, if the contribution exceeded the cost of
85.34services provided, the local agency or the state shall reimburse that excess amount to
85.35the parents, either by direct reimbursement if the parent is no longer required to pay a
85.36contribution, or by a reduction in or waiver of parental fees until the excess amount is
86.1exhausted. All reimbursements must include a notice that the amount reimbursed may be
86.2taxable income if the parent paid for the parent's fees through an employer's health care
86.3flexible spending account under the Internal Revenue Code, section 125, and that the
86.4parent is responsible for paying the taxes owed on the amount reimbursed.
86.5    (f) The monthly contribution amount must be reviewed at least every 12 months;
86.6when there is a change in household size; and when there is a loss of or gain in income
86.7from one month to another in excess of ten percent. The local agency shall mail a written
86.8notice 30 days in advance of the effective date of a change in the contribution amount.
86.9A decrease in the contribution amount is effective in the month that the parent verifies a
86.10reduction in income or change in household size.
86.11    (g) Parents of a minor child who do not live with each other shall each pay the
86.12contribution required under paragraph (a). An amount equal to the annual court-ordered
86.13child support payment actually paid on behalf of the child receiving services shall be
86.14deducted from the adjusted gross income of the parent making the payment prior to
86.15calculating the parental contribution under paragraph (b).
86.16    (h) The contribution under paragraph (b) shall be increased by an additional five
86.17percent if the local agency determines that insurance coverage is available but not
86.18obtained for the child. For purposes of this section, "available" means the insurance is a
86.19benefit of employment for a family member at an annual cost of no more than five percent
86.20of the family's annual income. For purposes of this section, "insurance" means health
86.21and accident insurance coverage, enrollment in a nonprofit health service plan, health
86.22maintenance organization, self-insured plan, or preferred provider organization.
86.23    Parents who have more than one child receiving services shall not be required
86.24to pay more than the amount for the child with the highest expenditures. There shall
86.25be no resource contribution from the parents. The parent shall not be required to pay
86.26a contribution in excess of the cost of the services provided to the child, not counting
86.27payments made to school districts for education-related services. Notice of an increase in
86.28fee payment must be given at least 30 days before the increased fee is due.
86.29    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
86.30in the 12 months prior to July 1:
86.31    (1) the parent applied for insurance for the child;
86.32    (2) the insurer denied insurance;
86.33    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
86.34a complaint or appeal, in writing, to the commissioner of health or the commissioner of
86.35commerce, or litigated the complaint or appeal; and
86.36    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
87.1    For purposes of this section, "insurance" has the meaning given in paragraph (h).
87.2    A parent who has requested a reduction in the contribution amount under this
87.3paragraph shall submit proof in the form and manner prescribed by the commissioner or
87.4county agency, including, but not limited to, the insurer's denial of insurance, the written
87.5letter or complaint of the parents, court documents, and the written response of the insurer
87.6approving insurance. The determinations of the commissioner or county agency under this
87.7paragraph are not rules subject to chapter 14.
87.8(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 2013
87.92015, the parental contribution shall be computed by applying the following contribution
87.10schedule to the adjusted gross income of the natural or adoptive parents:
87.11(1) if the adjusted gross income is equal to or greater than 100 percent of federal
87.12poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
87.13contribution is $4 per month;
87.14(2) if the adjusted gross income is equal to or greater than 175 percent of federal
87.15poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
87.16the parental contribution shall be determined using a sliding fee scale established by the
87.17commissioner of human services which begins at one percent of adjusted gross income
87.18at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
87.19gross income for those with adjusted gross income up to 525 percent of federal poverty
87.20guidelines;
87.21(3) if the adjusted gross income is greater than 525 percent of federal poverty
87.22guidelines and less than 675 percent of federal poverty guidelines, the parental
87.23contribution shall be 9.5 percent of adjusted gross income;
87.24(4) if the adjusted gross income is equal to or greater than 675 percent of federal
87.25poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
87.26contribution shall be determined using a sliding fee scale established by the commissioner
87.27of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
87.28federal poverty guidelines and increases to 12 percent of adjusted gross income for those
87.29with adjusted gross income up to 900 percent of federal poverty guidelines; and
87.30(5) if the adjusted gross income is equal to or greater than 900 percent of federal
87.31poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
87.32income. If the child lives with the parent, the annual adjusted gross income is reduced by
87.33$2,400 prior to calculating the parental contribution. If the child resides in an institution
87.34specified in section 256B.35, the parent is responsible for the personal needs allowance
87.35specified under that section in addition to the parental contribution determined under this
88.1section. The parental contribution is reduced by any amount required to be paid directly to
88.2the child pursuant to a court order, but only if actually paid.

88.3    Sec. 14. Minnesota Statutes 2010, section 256.975, subdivision 7, is amended to read:
88.4    Subd. 7. Consumer information and assistance and long-term care options
88.5counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
88.6statewide service to aid older Minnesotans and their families in making informed choices
88.7about long-term care options and health care benefits. Language services to persons with
88.8limited English language skills may be made available. The service, known as Senior
88.9LinkAge Line, must be available during business hours through a statewide toll-free
88.10number and must also be available through the Internet.
88.11    (b) The service must provide long-term care options counseling by assisting older
88.12adults, caregivers, and providers in accessing information and options counseling about
88.13choices in long-term care services that are purchased through private providers or available
88.14through public options. The service must:
88.15    (1) develop a comprehensive database that includes detailed listings in both
88.16consumer- and provider-oriented formats;
88.17    (2) make the database accessible on the Internet and through other telecommunication
88.18and media-related tools;
88.19    (3) link callers to interactive long-term care screening tools and make these tools
88.20available through the Internet by integrating the tools with the database;
88.21    (4) develop community education materials with a focus on planning for long-term
88.22care and evaluating independent living, housing, and service options;
88.23    (5) conduct an outreach campaign to assist older adults and their caregivers in
88.24finding information on the Internet and through other means of communication;
88.25    (6) implement a messaging system for overflow callers and respond to these callers
88.26by the next business day;
88.27    (7) link callers with county human services and other providers to receive more
88.28in-depth assistance and consultation related to long-term care options;
88.29    (8) link callers with quality profiles for nursing facilities and other providers
88.30developed by the commissioner of health;
88.31    (9) incorporate information about the availability of housing options, as well as
88.32registered housing with services and consumer rights within the MinnesotaHelp.info
88.33network long-term care database to facilitate consumer comparison of services and costs
88.34among housing with services establishments and with other in-home services and to
88.35support financial self-sufficiency as long as possible. Housing with services establishments
89.1and their arranged home care providers shall provide information that will facilitate price
89.2comparisons, including delineation of charges for rent and for services available. The
89.3commissioners of health and human services shall align the data elements required by
89.4section 144G.06, the Uniform Consumer Information Guide, and this section to provide
89.5consumers standardized information and ease of comparison of long-term care options.
89.6The commissioner of human services shall provide the data to the Minnesota Board on
89.7Aging for inclusion in the MinnesotaHelp.info network long-term care database;
89.8(10) provide long-term care options counseling. Long-term care options counselors
89.9shall:
89.10(i) for individuals not eligible for case management under a public program or public
89.11funding source, provide interactive decision support under which consumers, family
89.12members, or other helpers are supported in their deliberations to determine appropriate
89.13long-term care choices in the context of the consumer's needs, preferences, values, and
89.14individual circumstances, including implementing a community support plan;
89.15(ii) provide Web-based educational information and collateral written materials to
89.16familiarize consumers, family members, or other helpers with the long-term care basics,
89.17issues to be considered, and the range of options available in the community;
89.18(iii) provide long-term care futures planning, which means providing assistance to
89.19individuals who anticipate having long-term care needs to develop a plan for the more
89.20distant future; and
89.21(iv) provide expertise in benefits and financing options for long-term care, including
89.22Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
89.23private pay options, and ways to access low or no-cost services or benefits through
89.24volunteer-based or charitable programs; and
89.25(11) using risk management and support planning protocols, provide long-term care
89.26options counseling to current residents of nursing homes deemed appropriate for discharge
89.27by the commissioner. In order to meet this requirement, the commissioner shall provide
89.28designated Senior LinkAge Line contact centers with a list of nursing home residents
89.29appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
89.30provide these residents, if they indicate a preference to receive long-term care options
89.31counseling, with initial assessment, review of risk factors, independent living support
89.32consultation, or referral to:
89.33(i) long-term care consultation services under section 256B.0911;
89.34(ii) designated care coordinators of contracted entities under section 256B.035 for
89.35persons who are enrolled in a managed care plan; or
90.1(iii) the long-term care consultation team for those who are appropriate for relocation
90.2service coordination due to high-risk factors or psychological or physical disability.; and
90.3(12) develop referral protocols and processes that will assist certified health care
90.4homes and hospitals to identify at-risk older adults and determine when to refer these
90.5individuals to the Senior LinkAge Line for long-term care options counseling under this
90.6section. The commissioner is directed to work with the commissioner of health to develop
90.7protocols that would comply with the health care home designation criteria and protocols
90.8available at the time of hospital discharge. The commissioner shall keep a record of the
90.9number of people who choose long-term care options counseling as a result of this section.

90.10    Sec. 15. Minnesota Statutes 2010, section 256B.056, subdivision 1a, is amended to
90.11read:
90.12    Subd. 1a. Income and assets generally. Unless specifically required by state
90.13law or rule or federal law or regulation, the methodologies used in counting income
90.14and assets to determine eligibility for medical assistance for persons whose eligibility
90.15category is based on blindness, disability, or age of 65 or more years, the methodologies
90.16for the supplemental security income program shall be used, except as provided under
90.17subdivision 3, paragraph (a), clause (6). Increases in benefits under title II of the Social
90.18Security Act shall not be counted as income for purposes of this subdivision until July 1 of
90.19each year. Effective upon federal approval, for children eligible under section 256B.055,
90.20subdivision 12
, or for home and community-based waiver services whose eligibility
90.21for medical assistance is determined without regard to parental income, child support
90.22payments, including any payments made by an obligor in satisfaction of or in addition
90.23to a temporary or permanent order for child support, and Social Security payments are
90.24not counted as income. For families and children, which includes all other eligibility
90.25categories, the methodologies under the state's AFDC plan in effect as of July 16, 1996, as
90.26required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
90.27(PRWORA), Public Law 104-193, shall be used, except that effective October 1, 2003, the
90.28earned income disregards and deductions are limited to those in subdivision 1c. For these
90.29purposes, a "methodology" does not include an asset or income standard, or accounting
90.30method, or method of determining effective dates.
90.31EFFECTIVE DATE.This section is effective April 1, 2012.

90.32    Sec. 16. Minnesota Statutes 2011 Supplement, section 256B.056, subdivision 3,
90.33is amended to read:
91.1    Subd. 3. Asset limitations for individuals and families. (a) To be eligible for
91.2medical assistance, a person must not individually own more than $3,000 in assets, or if a
91.3member of a household with two family members, husband and wife, or parent and child,
91.4the household must not own more than $6,000 in assets, plus $200 for each additional
91.5legal dependent. In addition to these maximum amounts, an eligible individual or family
91.6may accrue interest on these amounts, but they must be reduced to the maximum at the
91.7time of an eligibility redetermination. The accumulation of the clothing and personal
91.8needs allowance according to section 256B.35 must also be reduced to the maximum at
91.9the time of the eligibility redetermination. The value of assets that are not considered in
91.10determining eligibility for medical assistance is the value of those assets excluded under
91.11the supplemental security income program for aged, blind, and disabled persons, with
91.12the following exceptions:
91.13(1) household goods and personal effects are not considered;
91.14(2) capital and operating assets of a trade or business that the local agency determines
91.15are necessary to the person's ability to earn an income are not considered;
91.16(3) motor vehicles are excluded to the same extent excluded by the supplemental
91.17security income program;
91.18(4) assets designated as burial expenses are excluded to the same extent excluded by
91.19the supplemental security income program. Burial expenses funded by annuity contracts
91.20or life insurance policies must irrevocably designate the individual's estate as contingent
91.21beneficiary to the extent proceeds are not used for payment of selected burial expenses; and
91.22(5) for a person who no longer qualifies as an employed person with a disability due
91.23to loss of earnings, assets allowed while eligible for medical assistance under section
91.24256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
91.25of ineligibility as an employed person with a disability, to the extent that the person's total
91.26assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph
91.27(d).; and
91.28    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
91.299, is age 65 or older and has been enrolled during each of the 24 consecutive months
91.30before the person's 65th birthday, the assets owned by the person and the person's spouse
91.31must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
91.32when determining eligibility for medical assistance under section 256B.055, subdivision
91.337. The income of a spouse of a person enrolled in medical assistance under section
91.34256B.057, subdivision 9, during each of the 24 consecutive months before the person's
91.3565th birthday must be disregarded when determining eligibility for medical assistance
91.36under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
92.1the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
92.2is required to have qualified for medical assistance under section 256B.057, subdivision 9,
92.3prior to age 65 for at least 20 months in the 24 months prior to reaching age 65.
92.4(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
92.515.
92.6EFFECTIVE DATE.This section is effective April 1, 2012.

92.7    Sec. 17. Minnesota Statutes 2011 Supplement, section 256B.057, subdivision 9,
92.8is amended to read:
92.9    Subd. 9. Employed persons with disabilities. (a) Medical assistance may be paid
92.10for a person who is employed and who:
92.11    (1) but for excess earnings or assets, meets the definition of disabled under the
92.12Supplemental Security Income program;
92.13    (2) is at least 16 but less than 65 years of age;
92.14    (3) meets the asset limits in paragraph (d); and
92.15    (4) (3) pays a premium and other obligations under paragraph (e).
92.16    (b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
92.17for medical assistance under this subdivision, a person must have more than $65 of earned
92.18income. Earned income must have Medicare, Social Security, and applicable state and
92.19federal taxes withheld. The person must document earned income tax withholding. Any
92.20spousal income or assets shall be disregarded for purposes of eligibility and premium
92.21determinations.
92.22    (c) After the month of enrollment, a person enrolled in medical assistance under
92.23this subdivision who:
92.24    (1) is temporarily unable to work and without receipt of earned income due to a
92.25medical condition, as verified by a physician; or
92.26    (2) loses employment for reasons not attributable to the enrollee, and is without
92.27receipt of earned income may retain eligibility for up to four consecutive months after the
92.28month of job loss. To receive a four-month extension, enrollees must verify the medical
92.29condition or provide notification of job loss. All other eligibility requirements must be met
92.30and the enrollee must pay all calculated premium costs for continued eligibility.
92.31    (d) For purposes of determining eligibility under this subdivision, a person's assets
92.32must not exceed $20,000, excluding:
92.33    (1) all assets excluded under section 256B.056;
92.34    (2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
92.35Keogh plans, and pension plans;
93.1    (3) medical expense accounts set up through the person's employer; and
93.2    (4) spousal assets, including spouse's share of jointly held assets.
93.3    (e) All enrollees must pay a premium to be eligible for medical assistance under this
93.4subdivision, except as provided under section 256.01, subdivision 18b.
93.5    (1) An enrollee must pay the greater of a $65 premium or the premium calculated
93.6based on the person's gross earned and unearned income and the applicable family size
93.7using a sliding fee scale established by the commissioner, which begins at one percent of
93.8income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of
93.9income for those with incomes at or above 300 percent of the federal poverty guidelines.
93.10    (2) Annual adjustments in the premium schedule based upon changes in the federal
93.11poverty guidelines shall be effective for premiums due in July of each year.
93.12    (3) All enrollees who receive unearned income must pay five percent of unearned
93.13income in addition to the premium amount, except as provided under section 256.01,
93.14subdivision 18b
.
93.15    (4) Increases in benefits under title II of the Social Security Act shall not be counted
93.16as income for purposes of this subdivision until July 1 of each year.
93.17    (f) A person's eligibility and premium shall be determined by the local county
93.18agency. Premiums must be paid to the commissioner. All premiums are dedicated to
93.19the commissioner.
93.20    (g) Any required premium shall be determined at application and redetermined at
93.21the enrollee's six-month income review or when a change in income or household size is
93.22reported. Enrollees must report any change in income or household size within ten days
93.23of when the change occurs. A decreased premium resulting from a reported change in
93.24income or household size shall be effective the first day of the next available billing month
93.25after the change is reported. Except for changes occurring from annual cost-of-living
93.26increases, a change resulting in an increased premium shall not affect the premium amount
93.27until the next six-month review.
93.28    (h) Premium payment is due upon notification from the commissioner of the
93.29premium amount required. Premiums may be paid in installments at the discretion of
93.30the commissioner.
93.31    (i) Nonpayment of the premium shall result in denial or termination of medical
93.32assistance unless the person demonstrates good cause for nonpayment. Good cause exists
93.33if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
93.34D, are met. Except when an installment agreement is accepted by the commissioner,
93.35all persons disenrolled for nonpayment of a premium must pay any past due premiums
93.36as well as current premiums due prior to being reenrolled. Nonpayment shall include
94.1payment with a returned, refused, or dishonored instrument. The commissioner may
94.2require a guaranteed form of payment as the only means to replace a returned, refused,
94.3or dishonored instrument.
94.4    (j) The commissioner shall notify enrollees annually beginning at least 24 months
94.5before the person's 65th birthday of the medical assistance eligibility rules affecting
94.6income, assets, and treatment of a spouse's income and assets that will be applied upon
94.7reaching age 65.
94.8    (k) For enrollees whose income does not exceed 200 percent of the federal poverty
94.9guidelines and who are also enrolled in Medicare, the commissioner shall reimburse
94.10the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15,
94.11paragraph (a).
94.12EFFECTIVE DATE.This section is effective April 1, 2012.

94.13    Sec. 18. Minnesota Statutes 2011 Supplement, section 256B.0659, subdivision 11,
94.14is amended to read:
94.15    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
94.16must meet the following requirements:
94.17    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years
94.18of age with these additional requirements:
94.19    (i) supervision by a qualified professional every 60 days; and
94.20    (ii) employment by only one personal care assistance provider agency responsible
94.21for compliance with current labor laws;
94.22    (2) be employed by a personal care assistance provider agency;
94.23    (3) enroll with the department as a personal care assistant after clearing a background
94.24study. Except as provided in subdivision 11a, before a personal care assistant provides
94.25services, the personal care assistance provider agency must initiate a background study on
94.26the personal care assistant under chapter 245C, and the personal care assistance provider
94.27agency must have received a notice from the commissioner that the personal care assistant
94.28is:
94.29    (i) not disqualified under section 245C.14; or
94.30    (ii) is disqualified, but the personal care assistant has received a set aside of the
94.31disqualification under section 245C.22;
94.32    (4) be able to effectively communicate with the recipient and personal care
94.33assistance provider agency;
94.34    (5) be able to provide covered personal care assistance services according to the
94.35recipient's personal care assistance care plan, respond appropriately to recipient needs,
95.1and report changes in the recipient's condition to the supervising qualified professional
95.2or physician;
95.3    (6) not be a consumer of personal care assistance services;
95.4    (7) maintain daily written records including, but not limited to, time sheets under
95.5subdivision 12;
95.6    (8) effective January 1, 2010, complete standardized training as determined
95.7by the commissioner before completing enrollment. The training must be available
95.8in languages other than English and to those who need accommodations due to
95.9disabilities. Personal care assistant training must include successful completion of the
95.10following training components: basic first aid, vulnerable adult, child maltreatment,
95.11OSHA universal precautions, basic roles and responsibilities of personal care assistants
95.12including information about assistance with lifting and transfers for recipients, emergency
95.13preparedness, orientation to positive behavioral practices, fraud issues, and completion of
95.14time sheets. Upon completion of the training components, the personal care assistant must
95.15demonstrate the competency to provide assistance to recipients;
95.16    (9) complete training and orientation on the needs of the recipient within the first
95.17seven days after the services begin; and
95.18    (10) be limited to providing and being paid for up to 275 hours per month, except
95.19that this limit shall be 275 hours per month for the period July 1, 2009, through June 30,
95.202011, of personal care assistance services regardless of the number of recipients being
95.21served or the number of personal care assistance provider agencies enrolled with. The
95.22number of hours worked per day shall not be disallowed by the department unless in
95.23violation of the law.
95.24    (b) A legal guardian may be a personal care assistant if the guardian is not being paid
95.25for the guardian services and meets the criteria for personal care assistants in paragraph (a).
95.26    (c) Persons who do not qualify as a personal care assistant include parents and
95.27stepparents of minors, spouses, paid legal guardians, family foster care providers, except
95.28as otherwise allowed in section 256B.0625, subdivision 19a, or staff of a residential
95.29setting. When the personal care assistant is a relative of the recipient, the commissioner
95.30shall pay 80 percent of the provider rate. This rate reduction is effective July 1, 2013. For
95.31purposes of this section, relative means the parent or adoptive parent of an adult child, a
95.32sibling aged 16 years or older, an adult child, a grandparent, or a grandchild.

95.33    Sec. 19. Minnesota Statutes 2010, section 256B.0659, is amended by adding a
95.34subdivision to read:
96.1    Subd. 31. Commissioner's access. When the commissioner is investigating a
96.2possible overpayment of Medicaid funds, the commissioner must be given immediate
96.3access without prior notice to the office during regular business hours and to
96.4documentation and records related to services provided and submission of claims for
96.5services provided. Denying the commissioner access to records is cause for immediate
96.6suspension of payment and/or terminating the personal care provider organization's
96.7enrollment according to section 256B.064.

96.8    Sec. 20. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3a,
96.9is amended to read:
96.10    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
96.11services planning, or other assistance intended to support community-based living,
96.12including persons who need assessment in order to determine waiver or alternative care
96.13program eligibility, must be visited by a long-term care consultation team within 15
96.14calendar days after the date on which an assessment was requested or recommended. After
96.15January 1, 2011, these requirements also apply to personal care assistance services, private
96.16duty nursing, and home health agency services, on timelines established in subdivision 5.
96.17Face-to-face assessments must be conducted according to paragraphs (b) to (i).
96.18    (b) The county may utilize a team of either the social worker or public health nurse,
96.19or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
96.20assessment in a face-to-face interview. The consultation team members must confer
96.21regarding the most appropriate care for each individual screened or assessed.
96.22    (c) The assessment must be comprehensive and include a person-centered
96.23assessment of the health, psychological, functional, environmental, and social needs of
96.24referred individuals and provide information necessary to develop a support plan that
96.25meets the consumers needs, using an assessment form provided by the commissioner.
96.26    (d) The assessment must be conducted in a face-to-face interview with the person
96.27being assessed and the person's legal representative, as required by legally executed
96.28documents, and other individuals as requested by the person, who can provide information
96.29on the needs, strengths, and preferences of the person necessary to develop a support plan
96.30that ensures the person's health and safety, but who is not a provider of service or has any
96.31financial interest in the provision of services. For persons who are to be assessed for
96.32elderly waiver customized living services under section 256B.0915, with the permission
96.33of the person being assessed or the person's designated or legal representative, the client's
96.34current or proposed provider of services may submit a copy of the provider's nursing
96.35assessment or written report outlining their recommendations regarding the client's care
97.1needs. The person conducting the assessment will notify the provider of the date by which
97.2this information is to be submitted. This information shall be provided to the person
97.3conducting the assessment prior to the assessment.
97.4    (e) The person, or the person's legal representative, must be provided with written
97.5recommendations for community-based services, including consumer-directed options,
97.6or institutional care that include documentation that the most cost-effective alternatives
97.7available were offered to the individual, and alternatives to residential settings, including,
97.8but not limited to, foster care settings that are not the primary residence of the license
97.9holder. For purposes of this requirement, "cost-effective alternatives" means community
97.10services and living arrangements that cost the same as or less than institutional care.
97.11    (f) If the person chooses to use community-based services, the person or the person's
97.12legal representative must be provided with a written community support plan, regardless
97.13of whether the individual is eligible for Minnesota health care programs. A person may
97.14request assistance in identifying community supports without participating in a complete
97.15assessment. Upon a request for assistance identifying community support, the person must
97.16be transferred or referred to the services available under sections 256.975, subdivision 7,
97.17and 256.01, subdivision 24, for telephone assistance and follow up.
97.18    (g) The person has the right to make the final decision between institutional
97.19placement and community placement after the recommendations have been provided,
97.20except as provided in subdivision 4a, paragraph (c).
97.21    (h) The team must give the person receiving assessment or support planning, or
97.22the person's legal representative, materials, and forms supplied by the commissioner
97.23containing the following information:
97.24    (1) the need for and purpose of preadmission screening if the person selects nursing
97.25facility placement;
97.26    (2) the role of the long-term care consultation assessment and support planning in
97.27waiver and alternative care program eligibility determination;
97.28    (3) information about Minnesota health care programs;
97.29    (4) the person's freedom to accept or reject the recommendations of the team;
97.30    (5) the person's right to confidentiality under the Minnesota Government Data
97.31Practices Act, chapter 13;
97.32    (6) the long-term care consultant's decision regarding the person's need for
97.33institutional level of care as determined under criteria established in section 144.0724,
97.34subdivision 11
, or 256B.092; and
98.1    (7) the person's right to appeal the decision regarding the need for nursing facility
98.2level of care or the county's final decisions regarding public programs eligibility according
98.3to section 256.045, subdivision 3.
98.4    (i) Face-to-face assessment completed as part of eligibility determination for
98.5the alternative care, elderly waiver, community alternatives for disabled individuals,
98.6community alternative care, and traumatic brain injury waiver programs under sections
98.7256B.0915 , 256B.0917, and 256B.49 is valid to establish service eligibility for no more
98.8than 60 calendar days after the date of assessment. The effective eligibility start date
98.9for these programs can never be prior to the date of assessment. If an assessment was
98.10completed more than 60 days before the effective waiver or alternative care program
98.11eligibility start date, assessment and support plan information must be updated in a
98.12face-to-face visit and documented in the department's Medicaid Management Information
98.13System (MMIS). The effective date of program eligibility in this case cannot be prior to
98.14the date the updated assessment is completed.

98.15    Sec. 21. Minnesota Statutes 2011 Supplement, section 256B.0911, subdivision 3c,
98.16is amended to read:
98.17    Subd. 3c. Consultation for housing with services. (a) The purpose of long-term
98.18care consultation for registered housing with services is to support persons with current or
98.19anticipated long-term care needs in making informed choices among options that include
98.20the most cost-effective and least restrictive settings. Prospective residents maintain the
98.21right to choose housing with services or assisted living if that option is their preference.
98.22    (b) Registered housing with services establishments shall inform all prospective
98.23residents or the prospective resident's designated or legal representative of the availability
98.24of long-term care consultation and the need to receive and verify the consultation prior
98.25to signing a lease or contract. Long-term care consultation for registered housing with
98.26services is provided as determined by the commissioner of human services. The service
98.27is delivered under a partnership between lead agencies as defined in subdivision 1a,
98.28paragraph (d), and the Area Agencies on Aging, and is a point of entry to a combination
98.29of telephone-based long-term care options counseling provided by Senior LinkAge Line
98.30and in-person long-term care consultation provided by lead agencies. The point of entry
98.31service must be provided within five working days of the request of the prospective
98.32resident as follows:
98.33    (1) the consultation shall be conducted with the prospective resident, or in the
98.34alternative, the resident's designated or legal representative, if:
98.35(i) the resident verbally requests; or
99.1(ii) the registered housing with services provider has documentation of the
99.2designated or legal representative's authority to enter into a lease or contract on behalf of
99.3the prospective resident and accepts the documentation in good faith;
99.4(2) the consultation shall be performed in a manner that provides objective and
99.5complete information;
99.6    (2) (3) the consultation must include a review of the prospective resident's reasons
99.7for considering housing with services, the prospective resident's personal goals, a
99.8discussion of the prospective resident's immediate and projected long-term care needs,
99.9and alternative community services or housing with services settings that may meet the
99.10prospective resident's needs;
99.11    (3) (4) the prospective resident shall be informed of the availability of a face-to-face
99.12visit at no charge to the prospective resident to assist the prospective resident in assessment
99.13and planning to meet the prospective resident's long-term care needs; and
99.14(4) (5) verification of counseling shall be generated and provided to the prospective
99.15resident by Senior LinkAge Line upon completion of the telephone-based counseling.
99.16(c) Housing with services establishments registered under chapter 144D shall:
99.17(1) inform all prospective residents or the prospective resident's designated or legal
99.18representative of the availability of and contact information for consultation services
99.19under this subdivision;
99.20(2) except for individuals seeking lease-only arrangements in subsidized housing
99.21settings, receive a copy of the verification of counseling prior to executing a lease or
99.22service contract with the prospective resident, and prior to executing a service contract
99.23with individuals who have previously entered into lease-only arrangements; and
99.24(3) retain a copy of the verification of counseling as part of the resident's file.
99.25(d) Emergency admissions to registered housing with services establishments prior
99.26to consultation under paragraph (b) are permitted according to policies established by
99.27the commissioner.

99.28    Sec. 22. Minnesota Statutes 2010, section 256B.0911, is amended by adding a
99.29subdivision to read:
99.30    Subd. 3d. Exemptions. Individuals shall be exempt from the requirements outlined
99.31in subdivision 3c in the following circumstances:
99.32(1) the individual is seeking a lease-only arrangement in a subsidized housing setting;
99.33(2) the individual has previously received a long-term care consultation assessment
99.34under this section. In this instance, the assessor who completes the long-term care
99.35consultation will issue a verification code and provide it to the individual;
100.1(3) the individual is receiving or is being evaluated for hospice services from a
100.2hospice provider licensed under sections 144A.75 to 144A.755; or
100.3(4) the individual has used financial planning services and created a long-term care
100.4plan as defined by the commissioner in the 12 months prior to signing a lease or contract
100.5with a registered housing with services establishment.

100.6    Sec. 23. Minnesota Statutes 2010, section 256B.0911, is amended by adding a
100.7subdivision to read:
100.8    Subd. 3e. Consultation at hospital discharge. (a) Hospitals shall refer all
100.9individuals described in paragraph (b) prior to discharge from an inpatient hospital stay
100.10to the Senior LinkAge Line for long-term care options counseling. Hospitals shall make
100.11these referrals using referral protocols and processes developed under section 256.975,
100.12subdivision 7. The purpose of the counseling is to support persons with current or
100.13anticipated long-term care needs in making informed choices among options that include
100.14the most cost-effective and least restrictive setting.
100.15(b) The individuals who shall be referred under paragraph (a) include older adults
100.16who are at risk of nursing home placement. Protocols for identifying at-risk individuals
100.17shall be developed under section 256.975, subdivision 7, paragraph (b), clause (12).
100.18(c) Counseling provided under this subdivision shall meet the requirements for the
100.19consultation required under section 256B.0911, subdivision 3c.
100.20EFFECTIVE DATE.This section is effective October 1, 2012.

100.21    Sec. 24. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3e,
100.22is amended to read:
100.23    Subd. 3e. Customized living service rate. (a) Payment for customized living
100.24services shall be a monthly rate authorized by the lead agency within the parameters
100.25established by the commissioner. The payment agreement must delineate the amount of
100.26each component service included in the recipient's customized living service plan. The
100.27lead agency, with input from the provider of customized living services, shall ensure that
100.28there is a documented need within the parameters established by the commissioner for all
100.29component customized living services authorized.
100.30(b) The payment rate must be based on the amount of component services to be
100.31provided utilizing component rates established by the commissioner. Counties and tribes
100.32shall use tools issued by the commissioner to develop and document customized living
100.33service plans and rates.
101.1(c) Component service rates must not exceed payment rates for comparable elderly
101.2waiver or medical assistance services and must reflect economies of scale. Customized
101.3living services must not include rent or raw food costs.
101.4    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
101.5individualized monthly authorized payment for the customized living service plan shall
101.6not exceed 50 percent of the greater of either the statewide or any of the geographic
101.7groups' weighted average monthly nursing facility rate of the case mix resident class
101.8to which the elderly waiver eligible client would be assigned under Minnesota Rules,
101.9parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described
101.10in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the
101.11resident assessment system as described in section 256B.438 for nursing home rate
101.12determination is implemented. Effective on July 1 of the state fiscal year in which
101.13the resident assessment system as described in section 256B.438 for nursing home
101.14rate determination is implemented and July 1 of each subsequent state fiscal year, the
101.15individualized monthly authorized payment for the services described in this clause shall
101.16not exceed the limit which was in effect on June 30 of the previous state fiscal year
101.17updated annually based on legislatively adopted changes to all service rate maximums for
101.18home and community-based service providers.
101.19(e) Effective July 1, 2011, the individualized monthly payment for the customized
101.20living service plan for individuals described in subdivision 3a, paragraph (b), must be the
101.21monthly authorized payment limit for customized living for individuals classified as case
101.22mix A, reduced by 25 percent. This rate limit must be applied to all new participants
101.23enrolled in the program on or after July 1, 2011, who meet the criteria described in
101.24subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who
101.25meet the criteria described in subdivision 3a, paragraph (b), at reassessment.
101.26    (f) Customized living services are delivered by a provider licensed by the
101.27Department of Health as a class A or class F home care provider and provided in a
101.28building that is registered as a housing with services establishment under chapter 144D.
101.29Licensed home care providers are subject to section 256B.0651, subdivision 14.
101.30(g) A provider may not bill or otherwise charge an elderly waiver participant or their
101.31family for additional units of any allowable component service beyond those available
101.32under the service rate limits described in paragraph (d), nor for additional units of any
101.33allowable component service beyond those approved in the service plan by the lead agency.

101.34    Sec. 25. Minnesota Statutes 2011 Supplement, section 256B.0915, subdivision 3h,
101.35is amended to read:
102.1    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
102.2payment rate for 24-hour customized living services is a monthly rate authorized by the
102.3lead agency within the parameters established by the commissioner of human services.
102.4The payment agreement must delineate the amount of each component service included
102.5in each recipient's customized living service plan. The lead agency, with input from
102.6the provider of customized living services, shall ensure that there is a documented need
102.7within the parameters established by the commissioner for all component customized
102.8living services authorized. The lead agency shall not authorize 24-hour customized living
102.9services unless there is a documented need for 24-hour supervision.
102.10(b) For purposes of this section, "24-hour supervision" means that the recipient
102.11requires assistance due to needs related to one or more of the following:
102.12    (1) intermittent assistance with toileting, positioning, or transferring;
102.13    (2) cognitive or behavioral issues;
102.14    (3) a medical condition that requires clinical monitoring; or
102.15    (4) for all new participants enrolled in the program on or after July 1, 2011, and
102.16all other participants at their first reassessment after July 1, 2011, dependency in at
102.17least three of the following activities of daily living as determined by assessment under
102.18section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency
102.19score in eating is three or greater; and needs medication management and at least 50
102.20hours of service per month. The lead agency shall ensure that the frequency and mode
102.21of supervision of the recipient and the qualifications of staff providing supervision are
102.22described and meet the needs of the recipient.
102.23(c) The payment rate for 24-hour customized living services must be based on the
102.24amount of component services to be provided utilizing component rates established by the
102.25commissioner. Counties and tribes will use tools issued by the commissioner to develop
102.26and document customized living plans and authorize rates.
102.27(d) Component service rates must not exceed payment rates for comparable elderly
102.28waiver or medical assistance services and must reflect economies of scale.
102.29(e) The individually authorized 24-hour customized living payments, in combination
102.30with the payment for other elderly waiver services, including case management, must not
102.31exceed the recipient's community budget cap specified in subdivision 3a. Customized
102.32living services must not include rent or raw food costs.
102.33(f) The individually authorized 24-hour customized living payment rates shall not
102.34exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
102.35living services in effect and in the Medicaid management information systems on March
102.3631, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
103.1to 9549.0059, to which elderly waiver service clients are assigned. When there are
103.2fewer than 50 authorizations in effect in the case mix resident class, the commissioner
103.3shall multiply the calculated service payment rate maximum for the A classification by
103.4the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
103.59549.0059, to determine the applicable payment rate maximum. Service payment rate
103.6maximums shall be updated annually based on legislatively adopted changes to all service
103.7rates for home and community-based service providers.
103.8    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
103.9may establish alternative payment rate systems for 24-hour customized living services in
103.10housing with services establishments which are freestanding buildings with a capacity of
103.1116 or fewer, by applying a single hourly rate for covered component services provided
103.12in either:
103.13    (1) licensed corporate adult foster homes; or
103.14    (2) specialized dementia care units which meet the requirements of section 144D.065
103.15and in which:
103.16    (i) each resident is offered the option of having their own apartment; or
103.17    (ii) the units are licensed as board and lodge establishments with maximum capacity
103.18of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
103.19subparts 1, 2, 3, and 4, item A.
103.20(h) 24-hour customized living services are delivered by a provider licensed by
103.21the Department of Health as a class A or class F home care provider and provided in a
103.22building that is registered as a housing with services establishment under chapter 144D.
103.23Licensed home care providers are subject to section 256B.0651, subdivision 14.
103.24(h) (i) A provider may not bill or otherwise charge an elderly waiver participant
103.25or their family for additional units of any allowable component service beyond those
103.26available under the service rate limits described in paragraph (e), nor for additional
103.27units of any allowable component service beyond those approved in the service plan
103.28by the lead agency.

103.29    Sec. 26. Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to
103.30read:
103.31    Subd. 1b. Individual service plan. (a) The individual service plan must:
103.32(1) include the results of the assessment information on the person's need for service,
103.33including identification of service needs that will be or that are met by the person's
103.34relatives, friends, and others, as well as community services used by the general public;
104.1(2) identify the person's preferences for services as stated by the person, the person's
104.2legal guardian or conservator, or the parent if the person is a minor;
104.3(3) identify long- and short-range goals for the person;
104.4(4) identify specific services and the amount and frequency of the services to be
104.5provided to the person based on assessed needs, preferences, and available resources.
104.6The individual service plan shall also specify other services the person needs that are
104.7not available;
104.8(5) identify the need for an individual program plan to be developed by the provider
104.9according to the respective state and federal licensing and certification standards, and
104.10additional assessments to be completed or arranged by the provider after service initiation;
104.11(6) identify provider responsibilities to implement and make recommendations for
104.12modification to the individual service plan;
104.13(7) include notice of the right to request a conciliation conference or a hearing
104.14under section 256.045;
104.15(8) be agreed upon and signed by the person, the person's legal guardian
104.16or conservator, or the parent if the person is a minor, and the authorized county
104.17representative; and
104.18(9) be reviewed by a health professional if the person has overriding medical needs
104.19that impact the delivery of services.
104.20(b) Service planning formats developed for interagency planning such as transition,
104.21vocational, and individual family service plans may be substituted for service planning
104.22formats developed by county agencies.
104.23(c) Approved, written, and signed changes to a consumer's services that meet the
104.24criteria in this subdivision shall be an addendum to that consumer's individual service plan.

104.25    Sec. 27. Minnesota Statutes 2010, section 256B.092, subdivision 7, is amended to read:
104.26    Subd. 7. Screening teams. (a) For persons with developmental disabilities,
104.27screening teams shall be established which shall evaluate the need for the level of care
104.28provided by residential-based habilitation services, residential services, training and
104.29habilitation services, and nursing facility services. The evaluation shall address whether
104.30home and community-based services are appropriate for persons who are at risk of
104.31placement in an intermediate care facility for persons with developmental disabilities, or
104.32for whom there is reasonable indication that they might require this level of care. The
104.33screening team shall make an evaluation of need within 60 working days of a request for
104.34service by a person with a developmental disability, and within five working days of
105.1an emergency admission of a person to an intermediate care facility for persons with
105.2developmental disabilities.
105.3(b) The screening team shall consist of the case manager for persons with
105.4developmental disabilities, the person, the person's legal guardian or conservator, or the
105.5parent if the person is a minor, and a qualified developmental disability professional, as
105.6defined in the Code of Federal Regulations, title 42, section 483.430, as amended through
105.7June 3, 1988. The case manager may also act as the qualified developmental disability
105.8professional if the case manager meets the federal definition.
105.9(c) County social service agencies may contract with a public or private agency
105.10or individual who is not a service provider for the person for the public guardianship
105.11representation required by the screening or individual service planning process. The
105.12contract shall be limited to public guardianship representation for the screening and
105.13individual service planning activities. The contract shall require compliance with the
105.14commissioner's instructions and may be for paid or voluntary services.
105.15(d) For persons determined to have overriding health care needs and are
105.16seeking admission to a nursing facility or an ICF/MR, or seeking access to home and
105.17community-based waivered services, a registered nurse must be designated as either the
105.18case manager or the qualified developmental disability professional.
105.19(e) For persons under the jurisdiction of a correctional agency, the case manager
105.20must consult with the corrections administrator regarding additional health, safety, and
105.21supervision needs.
105.22(f) The case manager, with the concurrence of the person, the person's legal guardian
105.23or conservator, or the parent if the person is a minor, may invite other individuals to
105.24attend meetings of the screening team. With the permission of the person being screened
105.25or the person's designated legal representative, the person's current provider of services
105.26may submit a written report outlining their recommendations regarding the person's care
105.27needs prepared by a direct service employee with at least 20 hours of service to that client.
105.28The screening team must notify the provider of the date by which this information is to
105.29be submitted. This information must be provided to the screening team and the person
105.30or the person's legal representative and must be considered prior to the finalization of
105.31the screening.
105.32(g) No member of the screening team shall have any direct or indirect service
105.33provider interest in the case.
105.34(h) Nothing in this section shall be construed as requiring the screening team
105.35meeting to be separate from the service planning meeting.

106.1    Sec. 28. Minnesota Statutes 2011 Supplement, section 256B.097, subdivision 3,
106.2is amended to read:
106.3    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
106.4Council which must define regional quality councils, and carry out a community-based,
106.5person-directed quality review component, and a comprehensive system for effective
106.6incident reporting, investigation, analysis, and follow-up.
106.7    (b) By August 1, 2011, the commissioner of human services shall appoint the
106.8members of the initial State Quality Council. Members shall include representatives
106.9from the following groups:
106.10    (1) disability service recipients and their family members;
106.11    (2) during the first two years of the State Quality Council, there must be at least three
106.12members from the Region 10 stakeholders. As regional quality councils are formed under
106.13subdivision 4, each regional quality council shall appoint one member;
106.14    (3) disability service providers;
106.15    (4) disability advocacy groups; and
106.16    (5) county human services agencies and staff from the Department of Human
106.17Services and Ombudsman for Mental Health and Developmental Disabilities.
106.18    (c) Members of the council who do not receive a salary or wages from an employer
106.19for time spent on council duties may receive a per diem payment when performing council
106.20duties and functions.
106.21    (d) The State Quality Council shall:
106.22    (1) assist the Department of Human Services in fulfilling federally mandated
106.23obligations by monitoring disability service quality and quality assurance and
106.24improvement practices in Minnesota; and
106.25    (2) establish state quality improvement priorities with methods for achieving results
106.26and provide an annual report to the legislative committees with jurisdiction over policy
106.27and funding of disability services on the outcomes, improvement priorities, and activities
106.28undertaken by the commission during the previous state fiscal year;
106.29(3) identify issues pertaining to financial and personal risk that impede Minnesotans
106.30with disabilities from optimizing choice of community-based services; and
106.31(4) recommend to the chairs and ranking minority members of the legislative
106.32committees with jurisdiction over human services and civil law by January 15, 2013,
106.33statutory and rule changes related to the findings under clause (3) that promote
106.34individualized service and housing choices balanced with appropriate individualized
106.35protection.
106.36    (e) The State Quality Council, in partnership with the commissioner, shall:
107.1    (1) approve and direct implementation of the community-based, person-directed
107.2system established in this section;
107.3    (2) recommend an appropriate method of funding this system, and determine the
107.4feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
107.5    (3) approve measurable outcomes in the areas of health and safety, consumer
107.6evaluation, education and training, providers, and systems;
107.7    (4) establish variable licensure periods not to exceed three years based on outcomes
107.8achieved; and
107.9    (5) in cooperation with the Quality Assurance Commission, design a transition plan
107.10for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
107.11    (f) The State Quality Council shall notify the commissioner of human services that a
107.12facility, program, or service has been reviewed by quality assurance team members under
107.13subdivision 4, paragraph (b), clause (13), and qualifies for a license.
107.14    (g) The State Quality Council, in partnership with the commissioner, shall establish
107.15an ongoing review process for the system. The review shall take into account the
107.16comprehensive nature of the system which is designed to evaluate the broad spectrum of
107.17licensed and unlicensed entities that provide services to persons with disabilities. The
107.18review shall address efficiencies and effectiveness of the system.
107.19    (h) The State Quality Council may recommend to the commissioner certain
107.20variances from the standards governing licensure of programs for persons with disabilities
107.21in order to improve the quality of services so long as the recommended variances do
107.22not adversely affect the health or safety of persons being served or compromise the
107.23qualifications of staff to provide services.
107.24    (i) The safety standards, rights, or procedural protections referenced under
107.25subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
107.26recommendations to the commissioner or to the legislature in the report required under
107.27paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
107.28procedural protections referenced under subdivision 2, paragraph (c).
107.29    (j) The State Quality Council may hire staff to perform the duties assigned in this
107.30subdivision.

107.31    Sec. 29. Minnesota Statutes 2010, section 256B.431, subdivision 17e, is amended to
107.32read:
107.33    Subd. 17e. Replacement-costs-new per bed limit effective October 1, 2007.
107.34    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2),
107.35for a total replacement, as defined in subdivision 17d, authorized under section
108.1144A.071 or 144A.073 after July 1, 1999, any building project that is a relocation,
108.2renovation, upgrading, or conversion completed on or after July 1, 2001, or any
108.3building project eligible for reimbursement under section 256B.434, subdivision 4f, the
108.4replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
108.5rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
108.6the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
108.79549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
108.8adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1,
108.92000. These amounts must be increased annually as specified in subdivision 3f, paragraph
108.10(a), beginning October 1, 2012.

108.11    Sec. 30. Minnesota Statutes 2010, section 256B.431, is amended by adding a
108.12subdivision to read:
108.13    Subd. 45. Rate adjustments for some moratorium exception projects.
108.14Notwithstanding any other law to the contrary, money available for moratorium exception
108.15projects under section 144A.073, subdivisions 2 and 11, shall be used to fund the
108.16incremental rate increases resulting from this section for any nursing facility with a
108.17moratorium exception project approved under section 144A.073, and completed after
108.18August 30, 2010, where the replacement-costs-new limits under subdivision 17e were
108.19higher at any time after project approval than at the time of project completion. The
108.20commissioner shall calculate the property rate increase for these facilities using the highest
108.21set of limits; however, any rate increase under this section shall not be effective until on
108.22or after the effective date of this section, contingent upon federal approval. No property
108.23rate decrease shall result from this section.
108.24EFFECTIVE DATE.This section is effective upon federal approval.

108.25    Sec. 31. Minnesota Statutes 2010, section 256B.434, subdivision 10, is amended to
108.26read:
108.27    Subd. 10. Exemptions. (a) To the extent permitted by federal law, (1) a facility that
108.28has entered into a contract under this section is not required to file a cost report, as defined
108.29in Minnesota Rules, part 9549.0020, subpart 13, for any year after the base year that is the
108.30basis for the calculation of the contract payment rate for the first rate year of the alternative
108.31payment demonstration project contract; and (2) a facility under contract is not subject
108.32to audits of historical costs or revenues, or paybacks or retroactive adjustments based on
108.33these costs or revenues, except audits, paybacks, or adjustments relating to the cost report
108.34that is the basis for calculation of the first rate year under the contract.
109.1(b) A facility that is under contract with the commissioner under this section is
109.2not subject to the moratorium on licensure or certification of new nursing home beds in
109.3section 144A.071, unless the project results in a net increase in bed capacity or involves
109.4relocation of beds from one site to another. Contract payment rates must not be adjusted
109.5to reflect any additional costs that a nursing facility incurs as a result of a construction
109.6project undertaken under this paragraph. In addition, as a condition of entering into a
109.7contract under this section, a nursing facility must agree that any future medical assistance
109.8payments for nursing facility services will not reflect any additional costs attributable to
109.9the sale of a nursing facility under this section and to construction undertaken under
109.10this paragraph that otherwise would not be authorized under the moratorium in section
109.11144A.073 . Nothing in this section prevents a nursing facility participating in the
109.12alternative payment demonstration project under this section from seeking approval of
109.13an exception to the moratorium through the process established in section 144A.073,
109.14and if approved the facility's rates shall be adjusted to reflect the cost of the project.
109.15Nothing in this section prevents a nursing facility participating in the alternative payment
109.16demonstration project from seeking legislative approval of an exception to the moratorium
109.17under section 144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the
109.18cost of the project.
109.19(c) Notwithstanding section 256B.48, subdivision 6, paragraphs (c), (d), and (e),
109.20and pursuant to any terms and conditions contained in the facility's contract, a nursing
109.21facility that is under contract with the commissioner under this section is in compliance
109.22with section 256B.48, subdivision 6, paragraph (b), if the facility is Medicare certified.
109.23(d) (c) Notwithstanding paragraph (a), if by April 1, 1996, the health care financing
109.24administration has not approved a required waiver, or the Centers for Medicare and
109.25Medicaid Services otherwise requires cost reports to be filed prior to the waiver's approval,
109.26the commissioner shall require a cost report for the rate year.
109.27(e) (d) A facility that is under contract with the commissioner under this section
109.28shall be allowed to change therapy arrangements from an unrelated vendor to a related
109.29vendor during the term of the contract. The commissioner may develop reasonable
109.30requirements designed to prevent an increase in therapy utilization for residents enrolled
109.31in the medical assistance program.
109.32(f) (e) Nursing facilities participating in the alternative payment system
109.33demonstration project must either participate in the alternative payment system quality
109.34improvement program established by the commissioner or submit information on their
109.35own quality improvement process to the commissioner for approval. Nursing facilities
109.36that have had their own quality improvement process approved by the commissioner
110.1must report results for at least one key area of quality improvement annually to the
110.2commissioner.

110.3    Sec. 32. Minnesota Statutes 2010, section 256B.441, is amended by adding a
110.4subdivision to read:
110.5    Subd. 63. Critical access nursing facilities. (a) The commissioner, in consultation
110.6with the commissioner of health, may designate certain nursing facilities as critical access
110.7nursing facilities. The designation shall be granted on a competitive basis, within the
110.8limits of funds appropriated for this purpose.
110.9(b) The commissioner shall request proposals from nursing facilities every two years.
110.10Proposals must be submitted in the form and according to the timelines established by
110.11the commissioner. In selecting applicants to designate, the commissioner, in consultation
110.12with the commissioner of health, and with input from stakeholders, shall develop criteria
110.13designed to preserve access to nursing facility services in isolated areas, rebalance
110.14long-term care, and improve quality.
110.15(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing
110.16facilities designated as critical access nursing facilities:
110.17(1) partial rebasing, with operating payment rates being the sum of 60 percent of the
110.18operating payment rate determined in accordance with subdivision 54 and 40 percent of the
110.19operating payment rate that would have been allowed had the facility not been designated;
110.20(2) enhanced payments for leave days. Notwithstanding section 256B.431,
110.21subdivision 2r, upon designation as a critical access nursing facility, the commissioner
110.22shall limit payment for leave days to 60 percent of that nursing facility's total payment rate
110.23for the involved resident, and shall allow this payment only when the occupancy of the
110.24nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;
110.25(3) two designated critical access nursing facilities, with up to 100 beds in active
110.26service, may jointly apply to the commissioner of health for a waiver of Minnesota
110.27Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The
110.28commissioner of health will consider each waiver request independently based on the
110.29criteria under Minnesota Rules, part 4658.0040;
110.30(4) the minimum threshold under section 256B.431, subdivisions 3f, paragraph (a),
110.31and 17e, shall be 40 percent of the amount that would otherwise apply; and
110.32(5) notwithstanding subdivision 58, beginning October 1, 2014, the quality-based
110.33rate limits under subdivision 50 shall apply to designated critical access nursing facilities.
111.1(d) Designation of a critical access nursing facility shall be for a period of two
111.2years, after which the benefits allowed under paragraph (c) shall be removed. Designated
111.3facilities may apply for continued designation.
111.4EFFECTIVE DATE.This section is effective the day following final enactment.

111.5    Sec. 33. Minnesota Statutes 2010, section 256B.48, is amended by adding a
111.6subdivision to read:
111.7    Subd. 6a. Referrals to Medicare providers required. Notwithstanding subdivision
111.81, nursing facility providers that do not participate in or accept Medicare assignment
111.9must refer and document the referral of dual eligible recipients for whom placement is
111.10requested and for whom the resident would be qualified for a Medicare-covered stay to
111.11Medicare providers. The commissioner shall audit nursing facilities that do not accept
111.12Medicare and determine if dual eligible individuals with Medicare qualifying stays have
111.13been admitted. If such a determination is made, the commissioner shall deny Medicaid
111.14payment for the first 20 days of that resident's stay.

111.15    Sec. 34. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 14,
111.16is amended to read:
111.17    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
111.18strengths, informal support systems, and need for services shall be completed within 20
111.19working days of the recipient's request as provided in section 256B.0911. Reassessment of
111.20each recipient's strengths, support systems, and need for services shall be conducted at
111.21least every 12 months and at other times when there has been a significant change in the
111.22recipient's functioning. With the permission of the recipient or the recipient's designated
111.23legal representative, the recipient's current provider of services may submit a written
111.24report outlining their recommendations regarding the recipient's care needs prepared by
111.25a direct service employee with at least 20 hours of service to that client. The person
111.26conducting the assessment or reassessment must notify the provider of the date by which
111.27this information is to be submitted. This information shall be provided to the person
111.28conducting the assessment and the person or the person's legal representative and must be
111.29considered prior to the finalization of the assessment or reassessment.
111.30(b) There must be a determination that the client requires a hospital level of care or a
111.31nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
111.32(d), at initial and subsequent assessments to initiate and maintain participation in the
111.33waiver program.
112.1(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
112.2appropriate to determine nursing facility level of care for purposes of medical assistance
112.3payment for nursing facility services, only face-to-face assessments conducted according
112.4to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
112.5determination or a nursing facility level of care determination must be accepted for
112.6purposes of initial and ongoing access to waiver services payment.
112.7(d) Persons with developmental disabilities who apply for services under the nursing
112.8facility level waiver programs shall be screened for the appropriate level of care according
112.9to section 256B.092.
112.10(e) Recipients who are found eligible for home and community-based services under
112.11this section before their 65th birthday may remain eligible for these services after their
112.1265th birthday if they continue to meet all other eligibility factors.
112.13(f) The commissioner shall develop criteria to identify recipients whose level of
112.14functioning is reasonably expected to improve and reassess these recipients to establish
112.15a baseline assessment. Recipients who meet these criteria must have a comprehensive
112.16transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
112.17reassessed every six months until there has been no significant change in the recipient's
112.18functioning for at least 12 months. After there has been no significant change in the
112.19recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
112.20informal support systems, and need for services shall be conducted at least every 12
112.21months and at other times when there has been a significant change in the recipient's
112.22functioning. Counties, case managers, and service providers are responsible for
112.23conducting these reassessments and shall complete the reassessments out of existing funds.

112.24    Sec. 35. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15,
112.25is amended to read:
112.26    Subd. 15. Individualized service plan; comprehensive transitional service plan;
112.27maintenance service plan. (a) Each recipient of home and community-based waivered
112.28services shall be provided a copy of the written service plan which:
112.29(1) is developed and signed by the recipient within ten working days of the
112.30completion of the assessment;
112.31(2) meets the assessed needs of the recipient;
112.32(3) reasonably ensures the health and safety of the recipient;
112.33(4) promotes independence;
112.34(5) allows for services to be provided in the most integrated settings; and
113.1(6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
113.2paragraph (p), of service and support providers.
113.3(b) In developing the comprehensive transitional service plan, the individual
113.4receiving services, the case manager, and the guardian, if applicable, will identify
113.5the transitional service plan fundamental service outcome and anticipated timeline to
113.6achieve this outcome. Within the first 20 days following a recipient's request for an
113.7assessment or reassessment, the transitional service planning team must be identified. A
113.8team leader must be identified who will be responsible for assigning responsibility and
113.9communicating with team members to ensure implementation of the transition plan and
113.10ongoing assessment and communication process. The team leader should be an individual,
113.11such as the case manager or guardian, who has the opportunity to follow the recipient to
113.12the next level of service.
113.13Within ten days following an assessment, a comprehensive transitional service plan
113.14must be developed incorporating elements of a comprehensive functional assessment and
113.15including short-term measurable outcomes and timelines for achievement of and reporting
113.16on these outcomes. Functional milestones must also be identified and reported according
113.17to the timelines agreed upon by the transitional service planning team. In addition, the
113.18comprehensive transitional service plan must identify additional supports that may assist
113.19in the achievement of the fundamental service outcome such as the development of greater
113.20natural community support, increased collaboration among agencies, and technological
113.21supports.
113.22The timelines for reporting on functional milestones will prompt a reassessment of
113.23services provided, the units of services, rates, and appropriate service providers. It is
113.24the responsibility of the transitional service planning team leader to review functional
113.25milestone reporting to determine if the milestones are consistent with observable skills
113.26and that milestone achievement prompts any needed changes to the comprehensive
113.27transitional service plan.
113.28For those whose fundamental transitional service outcome involves the need to
113.29procure housing, a plan for the recipient to seek the resources necessary to secure the least
113.30restrictive housing possible should be incorporated into the plan, including employment
113.31and public supports such as housing access and shelter needy funding.
113.32(c) Counties and other agencies responsible for funding community placement and
113.33ongoing community supportive services are responsible for the implementation of the
113.34comprehensive transitional service plans. Oversight responsibilities include both ensuring
113.35effective transitional service delivery and efficient utilization of funding resources.
114.1(d) Following one year of transitional services, the transitional services planning
114.2team will make a determination as to whether or not the individual receiving services
114.3requires the current level of continuous and consistent support in order to maintain the
114.4recipient's current level of functioning. Recipients who are determined to have not had
114.5a significant change in functioning for 12 months must move from a transitional to a
114.6maintenance service plan. Recipients on a maintenance service plan must be reassessed
114.7to determine if the recipient would benefit from a transitional service plan at least every
114.812 months and at other times when there has been a significant change in the recipient's
114.9functioning. This assessment should consider any changes to technological or natural
114.10community supports.
114.11(e) When a county is evaluating denials, reductions, or terminations of home and
114.12community-based services under section 256B.49 for an individual, the case manager
114.13shall offer to meet with the individual or the individual's guardian in order to discuss the
114.14prioritization of service needs within the individualized service plan, comprehensive
114.15transitional service plan, or maintenance service plan. The reduction in the authorized
114.16services for an individual due to changes in funding for waivered services may not exceed
114.17the amount needed to ensure medically necessary services to meet the individual's health,
114.18safety, and welfare.
114.19(f) At the time of reassessment, local agency case managers shall assess each
114.20recipient of community alternatives for disabled individuals or traumatic brain injury
114.21waivered services currently residing in a licensed adult foster home that is not the primary
114.22residence of the license holder, or in which the license holder is not the primary caregiver,
114.23to determine if that recipient could appropriately be served in a community-living setting.
114.24If appropriate for the recipient, the case manager shall offer the recipient, through a
114.25person-centered planning process, the option to receive alternative housing and service
114.26options. In the event that the recipient chooses to transfer from the adult foster home,
114.27the vacated bed shall not be filled with another recipient of waiver services and group
114.28residential housing, unless and the licensed capacity shall be reduced accordingly, unless
114.29the savings required by the licensed bed closure reductions under Laws 2011, First Special
114.30Session chapter 9, article 7, sections 1 and 40, paragraph (f), for foster care settings where
114.31the physical location is not the primary residence of the license holder are met through
114.32voluntary changes described in section 245A.03, subdivision 7, paragraph (g), or as
114.33provided under section 245A.03, subdivision 7, paragraph (a), clauses (3) and (4), and the
114.34licensed capacity shall be reduced accordingly. If the adult foster home becomes no longer
114.35viable due to these transfers, the county agency, with the assistance of the department,
115.1shall facilitate a consolidation of settings or closure. This reassessment process shall be
115.2completed by June 30, 2012 July 1, 2013.

115.3    Sec. 36. Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 23,
115.4is amended to read:
115.5    Subd. 23. Community-living settings. "Community-living settings" means a
115.6single-family home or apartment where the service recipient or their family owns or rents,
115.7as demonstrated by a lease agreement, and maintains control over the individual unit as
115.8demonstrated by the lease agreement, or has a plan for transition of a lease from a service
115.9provider to the individual. Within two years of signing the initial lease, the service provider
115.10shall transfer the lease to the individual. In the event the landlord denies the transfer, the
115.11commissioner may approve an exception within sufficient time to ensure the continued
115.12occupancy by the individual. Community-living settings are subject to the following:
115.13(1) individuals are not required to receive services;
115.14(2) individuals are not required to have a disability or specific diagnosis to live
115.15in the community-living setting;
115.16(3) individuals may hire service providers of their choice;
115.17(4) individuals may choose whether to share their household and with whom;
115.18(5) the home or apartment must include living, sleeping, bathing, and cooking areas;
115.19(6) individuals must have lockable access and egress;
115.20(7) individuals must be free to receive visitors and leave the settings at times and for
115.21durations of their own choosing;
115.22(8) leases must not reserve the right to assign units or change unit assignments; and
115.23(9) access to the greater community must be easily facilitated based on the
115.24individual's needs and preferences.

115.25    Sec. 37. [256B.492] HOME AND COMMUNITY-BASED SETTINGS FOR
115.26PEOPLE WITH DISABILITIES.
115.27(a) Individuals receiving services under a home and community-based waiver under
115.28Minnesota Statutes, section 256B.092 or 256B.49, may receive services in the following
115.29settings:
115.30(1) an individual's own home or family home;
115.31(2) a licensed adult foster care setting of up to five people; and
115.32(3) community living settings as defined in Minnesota Statutes, section 256B.49,
115.33subdivision 23, where individuals with disabilities may reside in all of the units in a
116.1building of four or fewer units, and no more than the greater of four or 25 percent of the
116.2units in a multifamily building of more than four units.
116.3(b) The settings in paragraph (a) must not:
116.4(1) be located in a building that is a publicly or privately operated facility that
116.5provides institutional treatment or custodial care;
116.6(2) be located in a building on the grounds of or adjacent to a public or private
116.7institution;
116.8(3) be a housing complex designed expressly around an individual's diagnosis or
116.9disability;
116.10(4) be segregated based on a disability, either physically or because of setting
116.11characteristics, from the larger community; and
116.12(5) have the qualities of an institution which include, but are not limited to:
116.13regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
116.14agreed to and documented in the person's individual service plan shall not result in a
116.15residence having the qualities of an institution as long as the restrictions for the person are
116.16not imposed upon others in the same residence and are the least restrictive alternative,
116.17imposed for the shortest possible time to meet the person's needs.
116.18(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
116.19individuals receive services under a home and community-based waiver as of the effective
116.20date of this section and the setting does not meet the criteria of this section.
116.21(d) Notwithstanding paragraph (c), a program in Hennepin County established as
116.22part of a Hennepin County demonstration project is qualified for the exception allowed
116.23under paragraph (c).
116.24(e) The commissioner shall submit an amendment to the waiver plan no later than
116.25December 31, 2012.

116.26    Sec. 38. [256B.493] ADULT FOSTER CARE PLANNED CLOSURE.
116.27    Subdivision 1. Commissioner's duties; report. The commissioner of human
116.28services shall solicit proposals for the conversion of services provided for persons with
116.29disabilities in settings licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, to
116.30other types of community settings in conjunction with the closure of identified licensed
116.31adult foster care settings.
116.32    Subd. 2. Planned closure process needs determination. The commissioner shall
116.33announce and implement a program for planned closure of adult foster care homes.
116.34Planned closure shall be the preferred method for achieving necessary budgetary savings
116.35required by the licensed bed closure budget reduction in section 245A.03, subdivision 7,
117.1paragraph (e). If additional closures are required to achieve the necessary savings, the
117.2commissioner shall use the process and priorities in section 245A.03, subdivision 7,
117.3paragraph (e).
117.4    Subd. 3. Application process. (a) The commissioner shall establish a process for
117.5the application, review, and approval of proposals from license holders for the closure of
117.6adult foster care settings.
117.7(b) When an application for a planned closure rate adjustment is submitted, the
117.8license holder shall provide written notification within five working days to the lead
117.9agencies responsible for authorizing the licensed services for the residents of the affected
117.10adult foster care settings. This notification shall be deemed confidential until the license
117.11holder has received approval of the application by the commissioner.
117.12    Subd. 4. Review and approval process. (a) To be considered for approval, an
117.13application must include:
117.14(1) a description of the proposed closure plan, which must identify the home or
117.15homes, and occupied beds for which a planned closure rate adjustment is requested;
117.16(2) the proposed timetable for any proposed closure, including the proposed dates
117.17for notification to residents and the affected lead agencies, commencement of closure,
117.18and completion of closure;
117.19(3) the proposed relocation plan jointly developed by the counties of financial
117.20responsibility, the residents and their legal representatives, if any, who wish to continue to
117.21receive services from the provider, and the providers for current residents of any adult
117.22foster care home designated for closure; and
117.23(4) documentation in a format approved by the commissioner that all the adult foster
117.24care homes receiving a planned closure rate adjustment under the plan have accepted joint
117.25and several liability for recovery of overpayments under section 256B.0641, subdivision
117.262, for the facilities designated for closure under this plan.
117.27(b) In reviewing and approving closure proposals, the commissioner shall give first
117.28priority to proposals that:
117.29(1) target counties and geographic areas which have:
117.30(i) need for other types of services;
117.31(ii) need for specialized services;
117.32(iii) higher than average per capita use of foster care settings where the license
117.33holder does not reside; or
117.34(iv) residents not living in the geographic area of their choice;
117.35(2) demonstrate savings of medical assistance expenditures; and
118.1(3) demonstrate that alternative services are based on the recipient's choice of
118.2provider and are consistent with federal law, state law, and federally approved waiver
118.3plans.
118.4The commissioner shall also consider any information provided by service
118.5recipients, their legal representatives, family members, or the lead agency on the impact of
118.6the planned closure on the recipients and the services they need.
118.7(c) The commissioner shall select proposals that best meet the criteria established in
118.8this subdivision for planned closure of adult foster care settings. The commissioner shall
118.9notify license holders of the selections approved by the commissioner.
118.10(d) For each proposal approved by the commissioner, a contract must be established
118.11between the commissioner, the counties of financial responsibility, and the participating
118.12license holder.
118.13    Subd. 5. Notification of approved proposal. (a) Once the license holder receives
118.14notification from the commissioner that the proposal has been approved, the license holder
118.15shall provide written notification within five working days to:
118.16(1) the lead agencies responsible for authorizing the licensed services for the
118.17residents of the affected adult foster care settings; and
118.18(2) current and prospective residents, any legal representatives, and family members
118.19involved.
118.20(b) This notification must occur at least 45 days prior to the implementation of
118.21the closure proposal.
118.22    Subd. 6. Adjustment to rates. (a) For purposes of this section, the commissioner
118.23shall establish enhanced medical assistance payment rates under sections 256B.092 and
118.24256B.49, to facilitate an orderly transition for persons with disabilities from adult foster
118.25care to other community-based settings.
118.26(b) The enhanced payment rate shall be effective the day after the first resident has
118.27moved until the day the last resident has moved, not to exceed six months.

118.28    Sec. 39. Minnesota Statutes 2011 Supplement, section 256B.5012, subdivision 13,
118.29is amended to read:
118.30    Subd. 13. ICF/DD rate decrease effective July 1, 2012 2013. Notwithstanding
118.31subdivision 12, and if the commissioner has not received federal approval before July 1,
118.322013, of the Long-Term Care Realignment Waiver application submitted under Laws
118.332011, First Special Session chapter 9, article 7, section 52, or only receives approval to
118.34implement portions of the waiver request, for each facility reimbursed under this section
118.35for services provided from July 1, 2013, through December 31, 2013, the commissioner
119.1shall decrease operating payments equal up to 1.67 percent of the operating payment rates
119.2in effect on June 30, 2012 2013. The commissioner shall prorate the reduction in the
119.3event that only portions of the waiver request are approved and after application of the
119.4continuing care provider payment delay provision in article 6, section 2, subdivision 4,
119.5paragraph (f). For each facility, the commissioner shall apply the rate reduction based on
119.6occupied beds, using the percentage specified in this subdivision multiplied by the total
119.7payment rate, including the variable rate but excluding the property-related payment rate,
119.8in effect on the preceding date. The total rate reduction shall include the adjustment
119.9provided in section 256B.501, subdivision 12.

119.10    Sec. 40. Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:
119.11    Subd. 5. Special needs. In addition to the state standards of assistance established in
119.12subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
119.13Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
119.14center, or a group residential housing facility.
119.15    (a) The county agency shall pay a monthly allowance for medically prescribed
119.16diets if the cost of those additional dietary needs cannot be met through some other
119.17maintenance benefit. The need for special diets or dietary items must be prescribed by
119.18a licensed physician. Costs for special diets shall be determined as percentages of the
119.19allotment for a one-person household under the thrifty food plan as defined by the United
119.20States Department of Agriculture. The types of diets and the percentages of the thrifty
119.21food plan that are covered are as follows:
119.22    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
119.23    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
119.24of thrifty food plan;
119.25    (3) controlled protein diet, less than 40 grams and requires special products, 125
119.26percent of thrifty food plan;
119.27    (4) low cholesterol diet, 25 percent of thrifty food plan;
119.28    (5) high residue diet, 20 percent of thrifty food plan;
119.29    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
119.30    (7) gluten-free diet, 25 percent of thrifty food plan;
119.31    (8) lactose-free diet, 25 percent of thrifty food plan;
119.32    (9) antidumping diet, 15 percent of thrifty food plan;
119.33    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
119.34    (11) ketogenic diet, 25 percent of thrifty food plan.
120.1    (b) Payment for nonrecurring special needs must be allowed for necessary home
120.2repairs or necessary repairs or replacement of household furniture and appliances using
120.3the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
120.4as long as other funding sources are not available.
120.5    (c) A fee for guardian or conservator service is allowed at a reasonable rate
120.6negotiated by the county or approved by the court. This rate shall not exceed five percent
120.7of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
120.8guardian or conservator is a member of the county agency staff, no fee is allowed.
120.9    (d) The county agency shall continue to pay a monthly allowance of $68 for
120.10restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
120.111990, and who eats two or more meals in a restaurant daily. The allowance must continue
120.12until the person has not received Minnesota supplemental aid for one full calendar month
120.13or until the person's living arrangement changes and the person no longer meets the criteria
120.14for the restaurant meal allowance, whichever occurs first.
120.15    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
120.16is allowed for representative payee services provided by an agency that meets the
120.17requirements under SSI regulations to charge a fee for representative payee services. This
120.18special need is available to all recipients of Minnesota supplemental aid regardless of
120.19their living arrangement.
120.20    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
120.21maximum allotment authorized by the federal Food Stamp Program for a single individual
120.22which is in effect on the first day of July of each year will be added to the standards of
120.23assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
120.24as shelter needy and are: (i) relocating from an institution, or an adult mental health
120.25residential treatment program under section 256B.0622; (ii) eligible for the self-directed
120.26supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
120.27community-based waiver recipients living in their own home or rented or leased apartment
120.28which is not owned, operated, or controlled by a provider of service not related by blood
120.29or marriage, unless allowed under paragraph (g).
120.30    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
120.31shelter needy benefit under this paragraph is considered a household of one. An eligible
120.32individual who receives this benefit prior to age 65 may continue to receive the benefit
120.33after the age of 65.
120.34    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
120.35exceed 40 percent of the assistance unit's gross income before the application of this
120.36special needs standard. "Gross income" for the purposes of this section is the applicant's or
121.1recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
121.2in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
121.3state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
121.4considered shelter needy for purposes of this paragraph.
121.5(g) Notwithstanding this subdivision, to access housing and services as provided
121.6in paragraph (f), the recipient may choose housing that may be owned, operated, or
121.7controlled by the recipient's service provider. In a multifamily building of four or more
121.8units, the maximum number of apartments that may be used by recipients of this program
121.9shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. of
121.10more than four units, the maximum number of units that may be used by recipients of this
121.11program shall be the greater of four units of 25 percent of the units in the building. In
121.12multifamily buildings of four or fewer units, all of the units may be used by recipients
121.13of this program. When housing is controlled by the service provider, the individual may
121.14choose their own service provider as provided in section 256B.49, subdivision 23, clause
121.15(3). When the housing is controlled by the service provider, the service provider shall
121.16implement a plan with the recipient to transition the lease to the recipient's name. Within
121.17two years of signing the initial lease, the service provider shall transfer the lease entered
121.18into under this subdivision to the recipient. In the event the landlord denies this transfer,
121.19the commissioner may approve an exception within sufficient time to ensure the continued
121.20occupancy by the recipient. This paragraph expires June 30, 2016.

121.21    Sec. 41. Laws 2011, First Special Session chapter 9, article 7, section 52, is amended to
121.22read:
121.23    Sec. 52. IMPLEMENT NURSING HOME LEVEL OF CARE CRITERIA.
121.24The commissioner shall seek any necessary federal approval in order to implement
121.25the changes to the level of care criteria in Minnesota Statutes, section 144.0724,
121.26subdivision 11
, on or after July 1, 2012, for adults and children.
121.27EFFECTIVE DATE.This section is effective the day following final enactment.

121.28    Sec. 42. Laws 2011, First Special Session chapter 9, article 7, section 54, is amended to
121.29read:
121.30    Sec. 54. CONTINGENCY PROVIDER RATE AND GRANT REDUCTIONS.
121.31(a) Notwithstanding any other rate reduction in this article, if the commissioner of
121.32human services has not received federal approval before July 1, 2013, of the long-term
121.33care realignment waiver application submitted under Laws 2011, First Special Session
121.34chapter 9, article 7, section 52, or only receives approval to implement portions of the
122.1waiver request, the commissioner of human services shall decrease grants, allocations,
122.2reimbursement rates, individual limits, and rate limits, as applicable, by 1.67 percent
122.3effective July 1, 2012 2013, for services rendered on or after those dates from July 1,
122.42013, through December 31, 2013. The commissioner shall prorate the reduction in the
122.5event that only portions of the waiver request are approved and after application of the
122.6continuing care provider payment delay provision in article 6, section 2, subdivision 4,
122.7paragraph (f). County or tribal contracts for services specified in this section must be
122.8amended to pass through these rate reductions within 60 days of the effective date of the
122.9decrease, and must be retroactive from the effective date of the rate decrease.
122.10(b) The rate changes described in this section must be provided to:
122.11(1) home and community-based waivered services for persons with developmental
122.12disabilities or related conditions, including consumer-directed community supports, under
122.13Minnesota Statutes, section 256B.501;
122.14(2) home and community-based waivered services for the elderly, including
122.15consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
122.16(3) waivered services under community alternatives for disabled individuals,
122.17including consumer-directed community supports, under Minnesota Statutes, section
122.18256B.49 ;
122.19(4) community alternative care waivered services, including consumer-directed
122.20community supports, under Minnesota Statutes, section 256B.49;
122.21(5) traumatic brain injury waivered services, including consumer-directed
122.22community supports, under Minnesota Statutes, section 256B.49;
122.23(6) nursing services and home health services under Minnesota Statutes, section
122.24256B.0625, subdivision 6a ;
122.25(7) personal care services and qualified professional supervision of personal care
122.26services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
122.27(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
122.28subdivision 7
;
122.29(9) day training and habilitation services for adults with developmental disabilities
122.30or related conditions, under Minnesota Statutes, sections 252.40 to 252.46, including the
122.31additional cost of rate adjustments on day training and habilitation services, provided as a
122.32social service under Minnesota Statutes, section 256M.60; and
122.33(10) alternative care services under Minnesota Statutes, section 256B.0913.
122.34(c) A managed care plan receiving state payments for the services in this section
122.35must include these decreases in their payments to providers. To implement the rate
122.36reductions in this section, capitation rates paid by the commissioner to managed care
123.1organizations under Minnesota Statutes, section 256B.69, shall reflect up to a 2.34 1.67
123.2percent reduction for the specified services for the period of January 1, 2013, through
123.3June 30, 2013, and a 1.67 percent reduction for those services on and after July 1 July 1,
123.42013, through December 31, 2013.
123.5The above payment rate reduction, allocation rates, and rate limits shall expire for
123.6services rendered on December 31, 2013.

123.7    Sec. 43. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
123.83, is amended to read:
123.9
Subd. 3.Forecasted Programs
123.10The amounts that may be spent from this
123.11appropriation for each purpose are as follows:
123.12
(a) MFIP/DWP Grants
123.13
Appropriations by Fund
123.14
General
84,680,000
91,978,000
123.15
Federal TANF
84,425,000
75,417,000
123.16
(b) MFIP Child Care Assistance Grants
55,456,000
30,923,000
123.17
(c) General Assistance Grants
49,192,000
46,938,000
123.18General Assistance Standard. The
123.19commissioner shall set the monthly standard
123.20of assistance for general assistance units
123.21consisting of an adult recipient who is
123.22childless and unmarried or living apart
123.23from parents or a legal guardian at $203.
123.24The commissioner may reduce this amount
123.25according to Laws 1997, chapter 85, article
123.263, section 54.
123.27Emergency General Assistance. The
123.28amount appropriated for emergency general
123.29assistance funds is limited to no more
123.30than $6,689,812 in fiscal year 2012 and
123.31$6,729,812 in fiscal year 2013. Funds
123.32to counties shall be allocated by the
123.33commissioner using the allocation method
124.1specified in Minnesota Statutes, section
124.2256D.06 .
124.3
(d) Minnesota Supplemental Aid Grants
38,095,000
39,120,000
124.4
(e) Group Residential Housing Grants
121,080,000
129,238,000
124.5
(f) MinnesotaCare Grants
295,046,000
317,272,000
124.6This appropriation is from the health care
124.7access fund.
124.8
(g) Medical Assistance Grants
4,501,582,000
4,437,282,000
124.9Managed Care Incentive Payments. The
124.10commissioner shall not make managed care
124.11incentive payments for expanding preventive
124.12services during fiscal years beginning July 1,
124.132011, and July 1, 2012.
124.14Reduction of Rates for Congregate
124.15Living for Individuals with Lower Needs.
124.16Beginning October 1, 2011, lead agencies
124.17must reduce rates in effect on January 1,
124.182011, by ten percent for individuals with
124.19lower needs living in foster care settings
124.20where the license holder does not share the
124.21residence with recipients on the CADI and
124.22DD waivers and customized living settings
124.23for CADI. Lead agencies shall consult
124.24with providers to review individual service
124.25plans and identify changes or modifications
124.26to reduce the utilization of services while
124.27maintaining the health and safety of the
124.28individual receiving services. Lead agencies
124.29must adjust contracts within 60 days of the
124.30effective date. If federal waiver approval
124.31is obtained under the long-term care
124.32realignment waiver application submitted
124.33on February 13, 2012, and federal financial
124.34participation is authorized for the alternative
125.1care program, the commissioner shall adjust
125.2this payment rate reduction from ten to five
125.3percent for services rendered on or after
125.4July 1, 2012, or the first day of the month
125.5following federal approval, whichever is
125.6later.
125.7Reduction of Lead Agency Waiver
125.8Allocations to Implement Rate Reductions
125.9for Congregate Living for Individuals
125.10with Lower Needs. Beginning October 1,
125.112011, the commissioner shall reduce lead
125.12agency waiver allocations to implement the
125.13reduction of rates for individuals with lower
125.14needs living in foster care settings where the
125.15license holder does not share the residence
125.16with recipients on the CADI and DD waivers
125.17and customized living settings for CADI.
125.18Reduce customized living and 24-hour
125.19customized living component rates.
125.20Effective July 1, 2011, the commissioner
125.21shall reduce elderly waiver customized living
125.22and 24-hour customized living component
125.23service spending by five percent through
125.24reductions in component rates and service
125.25rate limits. The commissioner shall adjust
125.26the elderly waiver capitation payment
125.27rates for managed care organizations paid
125.28under Minnesota Statutes, section 256B.69,
125.29subdivisions 6a
and 23, to reflect reductions
125.30in component spending for customized living
125.31services and 24-hour customized living
125.32services under Minnesota Statutes, section
125.33256B.0915, subdivisions 3e and 3h, for the
125.34contract period beginning January 1, 2012.
125.35To implement the reduction specified in
125.36this provision, capitation rates paid by the
126.1commissioner to managed care organizations
126.2under Minnesota Statutes, section 256B.69,
126.3shall reflect a ten percent reduction for the
126.4specified services for the period January 1,
126.52012, to June 30, 2012, and a five percent
126.6reduction for those services on or after July
126.71, 2012.
126.8Limit Growth in the Developmental
126.9Disability Waiver. The commissioner
126.10shall limit growth in the developmental
126.11disability waiver to six diversion allocations
126.12per month beginning July 1, 2011, through
126.13June 30, 2013, and 15 diversion allocations
126.14per month beginning July 1, 2013, through
126.15June 30, 2015. Waiver allocations shall
126.16be targeted to individuals who meet the
126.17priorities for accessing waiver services
126.18identified in Minnesota Statutes, 256B.092,
126.19subdivision 12
. The limits do not include
126.20conversions from intermediate care facilities
126.21for persons with developmental disabilities.
126.22Notwithstanding any contrary provisions in
126.23this article, this paragraph expires June 30,
126.242015.
126.25Limit Growth in the Community
126.26Alternatives for Disabled Individuals
126.27Waiver. The commissioner shall limit
126.28growth in the community alternatives for
126.29disabled individuals waiver to 60 allocations
126.30per month beginning July 1, 2011, through
126.31June 30, 2013, and 85 allocations per
126.32month beginning July 1, 2013, through
126.33June 30, 2015. Waiver allocations must
126.34be targeted to individuals who meet the
126.35priorities for accessing waiver services
126.36identified in Minnesota Statutes, section
127.1256B.49, subdivision 11a . The limits include
127.2conversions and diversions, unless the
127.3commissioner has approved a plan to convert
127.4funding due to the closure or downsizing
127.5of a residential facility or nursing facility
127.6to serve directly affected individuals on
127.7the community alternatives for disabled
127.8individuals waiver. Notwithstanding any
127.9contrary provisions in this article, this
127.10paragraph expires June 30, 2015.
127.11Personal Care Assistance Relative
127.12Care. The commissioner shall adjust the
127.13capitation payment rates for managed care
127.14organizations paid under Minnesota Statutes,
127.15section 256B.69, to reflect the rate reductions
127.16for personal care assistance provided by
127.17a relative pursuant to Minnesota Statutes,
127.18section 256B.0659, subdivision 11. This rate
127.19reduction is effective July 1, 2013.
127.20
(h) Alternative Care Grants
46,421,000
46,035,000
127.21Alternative Care Transfer. Any money
127.22allocated to the alternative care program that
127.23is not spent for the purposes indicated does
127.24not cancel but shall be transferred to the
127.25medical assistance account.
127.26
(i) Chemical Dependency Entitlement Grants
94,675,000
93,298,000

127.27    Sec. 44. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
127.284, is amended to read:
127.29
Subd. 4.Grant Programs
127.30The amounts that may be spent from this
127.31appropriation for each purpose are as follows:
127.32
(a) Support Services Grants
128.1
Appropriations by Fund
128.2
General
8,715,000
8,715,000
128.3
Federal TANF
100,525,000
94,611,000
128.4MFIP Consolidated Fund Grants. The
128.5TANF fund base is reduced by $10,000,000
128.6each year beginning in fiscal year 2012.
128.7Subsidized Employment Funding Through
128.8ARRA. The commissioner is authorized to
128.9apply for TANF emergency fund grants for
128.10subsidized employment activities. Growth
128.11in expenditures for subsidized employment
128.12within the supported work program and the
128.13MFIP consolidated fund over the amount
128.14expended in the calendar year quarters in
128.15the TANF emergency fund base year shall
128.16be used to leverage the TANF emergency
128.17fund grants for subsidized employment and
128.18to fund supported work. The commissioner
128.19shall develop procedures to maximize
128.20reimbursement of these expenditures over the
128.21TANF emergency fund base year quarters,
128.22and may contract directly with employers
128.23and providers to maximize these TANF
128.24emergency fund grants.
128.25
128.26
(b) Basic Sliding Fee Child Care Assistance
Grants
37,144,000
38,678,000
128.27Base Adjustment. The general fund base is
128.28decreased by $990,000 in fiscal year 2014
128.29and $979,000 in fiscal year 2015.
128.30Child Care and Development Fund
128.31Unexpended Balance. In addition to
128.32the amount provided in this section, the
128.33commissioner shall expend $5,000,000
128.34in fiscal year 2012 from the federal child
128.35care and development fund unexpended
129.1balance for basic sliding fee child care under
129.2Minnesota Statutes, section 119B.03. The
129.3commissioner shall ensure that all child
129.4care and development funds are expended
129.5according to the federal child care and
129.6development fund regulations.
129.7
(c) Child Care Development Grants
774,000
774,000
129.8Base Adjustment. The general fund base is
129.9increased by $713,000 in fiscal years 2014
129.10and 2015.
129.11
(d) Child Support Enforcement Grants
50,000
50,000
129.12Federal Child Support Demonstration
129.13Grants. Federal administrative
129.14reimbursement resulting from the federal
129.15child support grant expenditures authorized
129.16under section 1115a of the Social Security
129.17Act is appropriated to the commissioner for
129.18this activity.
129.19
(e) Children's Services Grants
129.20
Appropriations by Fund
129.21
General
47,949,000
48,507,000
129.22
Federal TANF
140,000
140,000
129.23Adoption Assistance and Relative Custody
129.24Assistance Transfer. The commissioner
129.25may transfer unencumbered appropriation
129.26balances for adoption assistance and relative
129.27custody assistance between fiscal years and
129.28between programs.
129.29Privatized Adoption Grants. Federal
129.30reimbursement for privatized adoption grant
129.31and foster care recruitment grant expenditures
129.32is appropriated to the commissioner for
129.33adoption grants and foster care and adoption
129.34administrative purposes.
130.1Adoption Assistance Incentive Grants.
130.2Federal funds available during fiscal year
130.32012 and fiscal year 2013 for adoption
130.4incentive grants are appropriated to the
130.5commissioner for these purposes.
130.6
(f) Children and Community Services Grants
53,301,000
53,301,000
130.7
(g) Children and Economic Support Grants
130.8
Appropriations by Fund
130.9
General
16,103,000
16,180,000
130.10
Federal TANF
700,000
0
130.11Long-Term Homeless Services. $700,000
130.12is appropriated from the federal TANF
130.13fund for the biennium beginning July
130.141, 2011, to the commissioner of human
130.15services for long-term homeless services
130.16for low-income homeless families under
130.17Minnesota Statutes, section 256K.26. This
130.18is a onetime appropriation and is not added
130.19to the base.
130.20Base Adjustment. The general fund base is
130.21increased by $42,000 in fiscal year 2014 and
130.22$43,000 in fiscal year 2015.
130.23Minnesota Food Assistance Program.
130.24$333,000 in fiscal year 2012 and $408,000 in
130.25fiscal year 2013 are to increase the general
130.26fund base for the Minnesota food assistance
130.27program. Unexpended funds for fiscal year
130.282012 do not cancel but are available to the
130.29commissioner for this purpose in fiscal year
130.302013.
130.31
(h) Health Care Grants
130.32
Appropriations by Fund
130.33
General
26,000
66,000
130.34
Health Care Access
190,000
190,000
131.1Base Adjustment. The general fund base is
131.2increased by $24,000 in each of fiscal years
131.32014 and 2015.
131.4
(i) Aging and Adult Services Grants
12,154,000
11,456,000
131.5Aging Grants Reduction. Effective July
131.61, 2011, funding for grants made under
131.7Minnesota Statutes, sections 256.9754 and
131.8256B.0917, subdivision 13 , is reduced by
131.9$3,600,000 for each year of the biennium.
131.10These reductions are onetime and do
131.11not affect base funding for the 2014-2015
131.12biennium. Grants made during the 2012-2013
131.13biennium under Minnesota Statutes, section
131.14256B.9754 , must not be used for new
131.15construction or building renovation.
131.16Essential Community Support Grant
131.17Delay. Upon federal approval to implement
131.18the nursing facility level of care on July
131.191, 2013, essential community supports
131.20grants under Minnesota Statutes, section
131.21256B.0917, subdivision 14 , are reduced by
131.22$6,410,000 in fiscal year 2013. Base level
131.23funding is increased by $5,541,000 in fiscal
131.24year 2014 and $6,410,000 in fiscal year 2015.
131.25Base Level Adjustment. The general fund
131.26base is increased by $10,035,000 in fiscal
131.27year 2014 and increased by $10,901,000 in
131.28fiscal year 2015.
131.29
(j) Deaf and Hard-of-Hearing Grants
1,936,000
1,767,000
131.30
(k) Disabilities Grants
15,945,000
18,284,000
131.31Grants for Housing Access Services. In
131.32fiscal year 2012, the commissioner shall
131.33make available a total of $161,000 in housing
131.34access services grants to individuals who
132.1relocate from an adult foster care home to
132.2a community living setting for assistance
132.3with completion of rental applications or
132.4lease agreements; assistance with publicly
132.5financed housing options; development of
132.6household budgets; and assistance with
132.7funding affordable furnishings and related
132.8household matters.
132.9HIV Grants. The general fund appropriation
132.10for the HIV drug and insurance grant
132.11program shall be reduced by $2,425,000 in
132.12fiscal year 2012 and increased by $2,425,000
132.13in fiscal year 2014. These adjustments are
132.14onetime and shall not be applied to the base.
132.15Notwithstanding any contrary provision, this
132.16provision expires June 30, 2014.
132.17Region 10. Of this appropriation, $100,000
132.18each year is for a grant provided under
132.19Minnesota Statutes, section 256B.097.
132.20Base Level Adjustment. The general fund
132.21base is increased by $2,944,000 in fiscal year
132.222014 and $653,000 in fiscal year 2015.
132.23Local Planning Grants for Creating
132.24Alternatives to Congregate Living for
132.25Individuals with Lower Needs. (1) The
132.26commissioner shall make available a total
132.27of $250,000 per year in local planning
132.28grants, beginning July 1, 2011, to assist
132.29lead agencies and provider organizations in
132.30developing alternatives to congregate living
132.31within the available level of resources for the
132.32home and community-based services waivers
132.33for persons with disabilities.
132.34(2) Notwithstanding clause (1), for fiscal
132.35years 2012 and 2013 only, the appropriation
133.1of $250,000 for fiscal year 2012 carries
133.2forward to fiscal year 2013, effective the day
133.3following final enactment.
133.4Of the appropriations available for fiscal
133.5year 2013, $100,000 is for administrative
133.6functions related to the planning process
133.7required under Minnesota Statutes, sections
133.8144A.351 and 245A.03, subdivision 7,
133.9paragraphs (e) and (g), and $400,000 is for
133.10grants required to accomplish that planning
133.11process.
133.12(3) Base funding for the grants under clause
133.13(1) is not affected by the appropriations
133.14under clause (2).
133.15Disability Linkage Line. Of this
133.16appropriation, $125,000 in fiscal year 2012
133.17and $300,000 in fiscal year 2013 are for
133.18assistance to people with disabilities who are
133.19considering enrolling in managed care.
133.20
(l) Adult Mental Health Grants
133.21
Appropriations by Fund
133.22
General
70,570,000
70,570,000
133.23
Health Care Access
750,000
750,000
133.24
Lottery Prize
1,508,000
1,508,000
133.25Funding Usage. Up to 75 percent of a fiscal
133.26year's appropriation for adult mental health
133.27grants may be used to fund allocations in that
133.28portion of the fiscal year ending December
133.2931.
133.30Base Adjustment. The general fund base is
133.31increased by $200,000 in fiscal years 2014
133.32and 2015.
133.33
(m) Children's Mental Health Grants
16,457,000
16,457,000
134.1Funding Usage. Up to 75 percent of a fiscal
134.2year's appropriation for children's mental
134.3health grants may be used to fund allocations
134.4in that portion of the fiscal year ending
134.5December 31.
134.6Base Adjustment. The general fund base is
134.7increased by $225,000 in fiscal years 2014
134.8and 2015.
134.9
134.10
(n) Chemical Dependency Nonentitlement
Grants
1,336,000
1,336,000

134.11    Sec. 45. INDEPENDENT LIVING SERVICES BILLING.
134.12The commissioner shall allow for daily rate and 15-minute increment billing for
134.13independent living services under the brain injury (BI) and CADI waivers. If necessary to
134.14comply with this requirement, the commissioner shall submit a waiver amendment to the
134.15state plan no later than December 31, 2012.

134.16    Sec. 46. HOME AND COMMUNITY-BASED SERVICES WAIVERS
134.17AMENDMENT FOR EXCEPTION.
134.18    By September 1, 2012, the commissioner of human services shall submit
134.19amendments to the home and community-based waiver plans consistent with the definition
134.20of home and community-based settings under Minnesota Statutes, section 256B.492,
134.21including a request to allow an exception for those settings that serve persons with
134.22disabilities under a home and community-based service waiver in more than 25 percent
134.23of the units in a building as of January 1, 2012, but otherwise meet the definition under
134.24Minnesota Statutes, section 256B.492.

134.25    Sec. 47. COMMISSIONER TO SEEK AMENDMENT FOR EXCEPTION
134.26TO CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
134.27METHODOLOGY.
134.28By July 1, 2012, the commissioner shall request an amendment to the home and
134.29community-based services waivers authorized under Minnesota Statutes, sections
134.30256B.092 and 256B.49, to establish an exception to the consumer-directed community
134.31supports budget methodology to provide up to 20 percent more funds for those
134.32participants who have their 21st birthday and graduate from high school during 2013 and
134.33are authorized for more services under consumer-directed community supports prior to
135.1graduation than what they are eligible to receive under the current consumer-directed
135.2community supports budget methodology. The exception is limited to those who can
135.3demonstrate that they will have to leave consumer-directed community supports and use
135.4other waiver services because their need for day or employment supports cannot be met
135.5within the consumer-directed community supports budget limits. The commissioner
135.6shall consult with the stakeholder group authorized under Minnesota Statutes, section
135.7256B.0657, subdivision 11, to implement this provision. The exception process shall be
135.8effective upon federal approval for persons eligible during 2013 and 2014.
135.9EFFECTIVE DATE.This section is effective the day following final enactment.

135.10    Sec. 48. DIRECTION TO OMBUDSMAN FOR LONG-TERM CARE.
135.11The ombudsman for long-term care shall:
135.12(1) research the existence of differential treatment based on source of payment in
135.13assisted living settings;
135.14(2) convene stakeholders to provide technical assistance and expertise in studying
135.15and addressing these issues, including but not limited to consumers, health care and
135.16housing providers, advocates representing seniors and younger persons with disabilities or
135.17mental health challenges, county representatives, and representatives of the Departments
135.18of Health and Human Services; and
135.19(3) submit a report of findings to the legislature no later than January 31, 2013,
135.20with recommendations for the development of policies and procedures to prevent and
135.21remedy instances of discrimination based on participation in or potential eligibility for
135.22medical assistance.

135.23    Sec. 49. LICENSING PERSONAL CARE ATTENDANT SERVICES.
135.24    The commissioner of human services shall study the feasibility of licensing personal
135.25care attendant services and issue a report to the legislature no later than January 15, 2013,
135.26that includes recommendations and proposed legislation for licensure and oversight of
135.27these services.

135.28    Sec. 50. AUTISM HOUSING WITH SUPPORTS STUDY.
135.29The commissioner of human services, in consultation with the commissioners of
135.30education, health, and employment and economic development, shall complete a study
135.31to determine one or more models of housing with supports that involve coordination or
135.32integration across the human services, educational, and vocational systems for children
135.33with a diagnosis of autistic disorder as defined by diagnostic code 299.0 in the Diagnostic
136.1and Statistical Manual of Mental Disorders (DSM-IV). This study must include research
136.2on recent efforts undertaken or under consideration in other states to address the housing
136.3and long-term support needs of children with severe autism, including a campus model.
136.4The study shall result in an implementation plan that responds to the housing and service
136.5needs of persons with autism. The study is due to the chairs and ranking minority
136.6members of the legislative committees with jurisdiction over health and human services
136.7by January 15, 2013.

136.8    Sec. 51. REPEALER.
136.9(a) Minnesota Statutes 2010, sections 144A.073, subdivision 9; and 256B.48,
136.10subdivision 6, are repealed.
136.11(b) Minnesota Rules, part 4640.0800, subpart 4, is repealed.

136.12ARTICLE 5
136.13MISCELLANEOUS

136.14    Section 1. Minnesota Statutes 2010, section 62A.047, is amended to read:
136.1562A.047 CHILDREN'S HEALTH SUPERVISION SERVICES AND
136.16PRENATAL CARE SERVICES.
136.17A policy of individual or group health and accident insurance regulated under this
136.18chapter, or individual or group subscriber contract regulated under chapter 62C, health
136.19maintenance contract regulated under chapter 62D, or health benefit certificate regulated
136.20under chapter 64B, issued, renewed, or continued to provide coverage to a Minnesota
136.21resident, must provide coverage for child health supervision services and prenatal care
136.22services. The policy, contract, or certificate must specifically exempt reasonable and
136.23customary charges for child health supervision services and prenatal care services from a
136.24deductible, co-payment, or other coinsurance or dollar limitation requirement. Nothing
136.25in this section prohibits a health carrier that has a network of providers from imposing
136.26a deductible, co-payment, or other coinsurance or dollar limitation requirement for
136.27child health supervision services and prenatal care services that are delivered by an
136.28out-of-network provider. This section does not prohibit the use of policy waiting periods
136.29or preexisting condition limitations for these services. Minimum benefits may be limited
136.30to one visit payable to one provider for all of the services provided at each visit cited in
136.31this section subject to the schedule set forth in this section. Nothing in this section applies
136.32to a commercial health insurance policy issued as a companion to a health maintenance
136.33organization contract, a policy designed primarily to provide coverage payable on a per
136.34diem, fixed indemnity, or nonexpense incurred basis, or a policy that provides only
137.1accident coverage Nothing in this section applies to a policy designed primarily to provide
137.2coverage payable on a per diem, fixed indemnity, or non-expense-incurred basis, or a
137.3policy that provides only accident coverage.
137.4"Child health supervision services" means pediatric preventive services, appropriate
137.5immunizations, developmental assessments, and laboratory services appropriate to the age
137.6of a child from birth to age six, and appropriate immunizations from ages six to 18, as
137.7defined by Standards of Child Health Care issued by the American Academy of Pediatrics.
137.8Reimbursement must be made for at least five child health supervision visits from birth
137.9to 12 months, three child health supervision visits from 12 months to 24 months, once a
137.10year from 24 months to 72 months.
137.11"Prenatal care services" means the comprehensive package of medical and
137.12psychosocial support provided throughout the pregnancy, including risk assessment,
137.13serial surveillance, prenatal education, and use of specialized skills and technology,
137.14when needed, as defined by Standards for Obstetric-Gynecologic Services issued by the
137.15American College of Obstetricians and Gynecologists.
137.16EFFECTIVE DATE.The amendments to this section are effective for policies
137.17issued on or after August 1, 2012, and expire June 30, 2013.

137.18    Sec. 2. Minnesota Statutes 2010, section 245.697, subdivision 1, is amended to read:
137.19    Subdivision 1. Creation. (a) A State Advisory Council on Mental Health is created.
137.20The council must have 30 members appointed by the governor in accordance with federal
137.21requirements. In making the appointments, the governor shall consider appropriate
137.22representation of communities of color. The council must be composed of:
137.23(1) the assistant commissioner of mental health for the department of human services;
137.24(2) a representative of the Department of Human Services responsible for the
137.25medical assistance program;
137.26(3) one member of each of the four core mental health professional disciplines
137.27(psychiatry, psychology, social work, nursing); following professions:
137.28(i) psychiatry;
137.29(ii) psychology;
137.30(iii) social work;
137.31(iv) nursing;
137.32(v) marriage and family therapy; and
137.33(vi) professional clinical counseling;
138.1(4) one representative from each of the following advocacy groups: Mental Health
138.2Association of Minnesota, NAMI-MN, Mental Health Consumer/Survivor Network of
138.3Minnesota, and Minnesota Disability Law Center;
138.4(5) providers of mental health services;
138.5(6) consumers of mental health services;
138.6(7) family members of persons with mental illnesses;
138.7(8) legislators;
138.8(9) social service agency directors;
138.9(10) county commissioners; and
138.10(11) other members reflecting a broad range of community interests, including
138.11family physicians, or members as the United States Secretary of Health and Human
138.12Services may prescribe by regulation or as may be selected by the governor.
138.13(b) The council shall select a chair. Terms, compensation, and removal of members
138.14and filling of vacancies are governed by section 15.059. Notwithstanding provisions
138.15of section 15.059, the council and its subcommittee on children's mental health do not
138.16expire. The commissioner of human services shall provide staff support and supplies
138.17to the council.

138.18    Sec. 3. Minnesota Statutes 2010, section 254A.19, is amended by adding a subdivision
138.19to read:
138.20    Subd. 4. Civil commitments. A Rule 25 assessment, under Minnesota Rules,
138.21part 9530.6615, does not need to be completed for an individual being committed as a
138.22chemically dependent person, as defined in section 253B.02, and for the duration of a civil
138.23commitment under section 253B.065, 253B.09, or 253B.095 in order for a county to
138.24access consolidated chemical dependency treatment funds under section 254B.04. The
138.25county must determine if the individual meets the financial eligibility requirements for the
138.26consolidated chemical dependency treatment funds under section 254B.04. Nothing in
138.27this subdivision prohibits placement in a treatment facility or treatment program governed
138.28under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.

138.29    Sec. 4. Minnesota Statutes 2010, section 256B.0943, subdivision 9, is amended to read:
138.30    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a
138.31certified provider entity must ensure that:
138.32    (1) each individual provider's caseload size permits the provider to deliver services
138.33to both clients with severe, complex needs and clients with less intensive needs. The
138.34provider's caseload size should reasonably enable the provider to play an active role in
139.1service planning, monitoring, and delivering services to meet the client's and client's
139.2family's needs, as specified in each client's individual treatment plan;
139.3    (2) site-based programs, including day treatment and preschool programs, provide
139.4staffing and facilities to ensure the client's health, safety, and protection of rights, and that
139.5the programs are able to implement each client's individual treatment plan;
139.6    (3) a day treatment program is provided to a group of clients by a multidisciplinary
139.7team under the clinical supervision of a mental health professional. The day treatment
139.8program must be provided in and by: (i) an outpatient hospital accredited by the Joint
139.9Commission on Accreditation of Health Organizations and licensed under sections 144.50
139.10to 144.55; (ii) a community mental health center under section 245.62; or (iii) an entity
139.11that is under contract with the county board certified under subdivision 4 to operate a
139.12program that meets the requirements of section 245.4712, subdivision 2, or 245.4884,
139.13subdivision 2
, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment
139.14program must stabilize the client's mental health status while developing and improving
139.15the client's independent living and socialization skills. The goal of the day treatment
139.16program must be to reduce or relieve the effects of mental illness and provide training to
139.17enable the client to live in the community. The program must be available at least one day
139.18a week for a two-hour time block. The two-hour time block must include at least one hour
139.19of individual or group psychotherapy. The remainder of the structured treatment program
139.20may include individual or group psychotherapy, and individual or group skills training, if
139.21included in the client's individual treatment plan. Day treatment programs are not part of
139.22inpatient or residential treatment services. A day treatment program may provide fewer
139.23than the minimally required hours for a particular child during a billing period in which
139.24the child is transitioning into, or out of, the program; and
139.25    (4) a therapeutic preschool program is a structured treatment program offered
139.26to a child who is at least 33 months old, but who has not yet reached the first day of
139.27kindergarten, by a preschool multidisciplinary team in a day program licensed under
139.28Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available two
139.29hours per day, five days per week, and 12 months of each calendar year. The structured
139.30treatment program may include individual or group psychotherapy and individual or
139.31group skills training, if included in the client's individual treatment plan. A therapeutic
139.32preschool program may provide fewer than the minimally required hours for a particular
139.33child during a billing period in which the child is transitioning into, or out of, the program.
139.34    (b) A provider entity must deliver the service components of children's therapeutic
139.35services and supports in compliance with the following requirements:
140.1    (1) individual, family, and group psychotherapy must be delivered as specified in
140.2Minnesota Rules, part 9505.0323;
140.3    (2) individual, family, or group skills training must be provided by a mental health
140.4professional or a mental health practitioner who has a consulting relationship with a
140.5mental health professional who accepts full professional responsibility for the training;
140.6    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
140.7through arrangements for direct intervention and support services to the child and the
140.8child's family. Crisis assistance must utilize resources designed to address abrupt or
140.9substantial changes in the functioning of the child or the child's family as evidenced by
140.10a sudden change in behavior with negative consequences for well being, a loss of usual
140.11coping mechanisms, or the presentation of danger to self or others;
140.12    (4) mental health behavioral aide services must be medically necessary treatment
140.13services, identified in the child's individual treatment plan and individual behavior plan,
140.14which are performed minimally by a paraprofessional qualified according to subdivision
140.157, paragraph (b), clause (3), and which are designed to improve the functioning of the
140.16child in the progressive use of developmentally appropriate psychosocial skills. Activities
140.17involve working directly with the child, child-peer groupings, or child-family groupings
140.18to practice, repeat, reintroduce, and master the skills defined in subdivision 1, paragraph
140.19(p), as previously taught by a mental health professional or mental health practitioner
140.20including:
140.21(i) providing cues or prompts in skill-building peer-to-peer or parent-child
140.22interactions so that the child progressively recognizes and responds to the cues
140.23independently;
140.24(ii) performing as a practice partner or role-play partner;
140.25(iii) reinforcing the child's accomplishments;
140.26(iv) generalizing skill-building activities in the child's multiple natural settings;
140.27(v) assigning further practice activities; and
140.28(vi) intervening as necessary to redirect the child's target behavior and to de-escalate
140.29behavior that puts the child or other person at risk of injury.
140.30A mental health behavioral aide must document the delivery of services in written
140.31progress notes. The mental health behavioral aide must implement treatment strategies
140.32in the individual treatment plan and the individual behavior plan. The mental health
140.33behavioral aide must document the delivery of services in written progress notes. Progress
140.34notes must reflect implementation of the treatment strategies, as performed by the mental
140.35health behavioral aide and the child's responses to the treatment strategies; and
140.36    (5) direction of a mental health behavioral aide must include the following:
141.1    (i) a clinical supervision plan approved by the responsible mental health professional;
141.2    (ii) ongoing on-site observation by a mental health professional or mental health
141.3practitioner for at least a total of one hour during every 40 hours of service provided
141.4to a child; and
141.5    (iii) immediate accessibility of the mental health professional or mental health
141.6practitioner to the mental health behavioral aide during service provision.

141.7    Sec. 5. Minnesota Statutes 2010, section 518A.40, subdivision 4, is amended to read:
141.8    Subd. 4. Change in child care. (a) When a court order provides for child care
141.9expenses, and child care support is not assigned under section 256.741, the public
141.10authority, if the public authority provides child support enforcement services, must may
141.11suspend collecting the amount allocated for child care expenses when:
141.12    (1) either party informs the public authority that no child care costs are being
141.13incurred; and:
141.14    (2) (1) the public authority verifies the accuracy of the information with the obligee.;
141.15or
141.16(2) the obligee fails to respond within 30 days of the date of a written request
141.17from the public authority for information regarding child care costs. A written or oral
141.18response from the obligee that child care costs are being incurred is sufficient for the
141.19public authority to continue collecting child care expenses.
141.20The suspension is effective as of the first day of the month following the date that the
141.21public authority received the verification either verified the information with the obligee
141.22or the obligee failed to respond. The public authority will resume collecting child care
141.23expenses when either party provides information that child care costs have resumed are
141.24incurred, or when a child care support assignment takes effect under section 256.741,
141.25subdivision 4. The resumption is effective as of the first day of the month after the date
141.26that the public authority received the information.
141.27    (b) If the parties provide conflicting information to the public authority regarding
141.28whether child care expenses are being incurred, or if the public authority is unable to
141.29verify with the obligee that no child care costs are being incurred, the public authority will
141.30continue or resume collecting child care expenses. Either party, by motion to the court,
141.31may challenge the suspension, continuation, or resumption of the collection of child care
141.32expenses under this subdivision. If the public authority suspends collection activities
141.33for the amount allocated for child care expenses, all other provisions of the court order
141.34remain in effect.
142.1    (c) In cases where there is a substantial increase or decrease in child care expenses,
142.2the parties may modify the order under section 518A.39.

142.3    Sec. 6. Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 8,
142.4is amended to read:
142.5
142.6
Subd. 8.Board of Nursing Home
Administrators
2,153,000
2,145,000
142.7Rulemaking. Of this appropriation, $44,000
142.8in fiscal year 2012 is for rulemaking. This is
142.9a onetime appropriation.
142.10Electronic Licensing System Adaptors.
142.11Of this appropriation, $761,000 in fiscal
142.12year 2013 from the state government special
142.13revenue fund is to the administrative services
142.14unit to cover the costs to connect to the
142.15e-licensing system. Minnesota Statutes,
142.16section 16E.22. Base level funding for this
142.17activity in fiscal year 2014 shall be $100,000.
142.18Base level funding for this activity in fiscal
142.19year 2015 shall be $50,000.
142.20Development and Implementation of a
142.21Disciplinary, Regulatory, Licensing and
142.22Information Management System. Of this
142.23appropriation, $800,000 in fiscal year 2012
142.24and $300,000 in fiscal year 2013 are for the
142.25development of a shared system. Base level
142.26funding for this activity in fiscal year 2014
142.27shall be $50,000.
142.28Administrative Services Unit - Operating
142.29Costs. Of this appropriation, $526,000
142.30in fiscal year 2012 and $526,000 in
142.31fiscal year 2013 are for operating costs
142.32of the administrative services unit. The
142.33administrative services unit may receive
143.1and expend reimbursements for services
143.2performed by other agencies.
143.3Administrative Services Unit - Retirement
143.4Costs. Of this appropriation in fiscal year
143.52012, $225,000 is for onetime retirement
143.6costs in the health-related boards. This
143.7funding may be transferred to the health
143.8boards incurring those costs for their
143.9payment. These funds are available either
143.10year of the biennium.
143.11Administrative Services Unit - Volunteer
143.12Health Care Provider Program. Of this
143.13appropriation, $150,000 in fiscal year 2012
143.14and $150,000 in fiscal year 2013 are to pay
143.15for medical professional liability coverage
143.16required under Minnesota Statutes, section
143.17214.40 .
143.18Administrative Services Unit - Contested
143.19Cases and Other Legal Proceedings. Of
143.20this appropriation, $200,000 in fiscal year
143.212012 and $200,000 in fiscal year 2013 are
143.22for costs of contested case hearings and other
143.23unanticipated costs of legal proceedings
143.24involving health-related boards funded
143.25under this section. Upon certification of a
143.26health-related board to the administrative
143.27services unit that the costs will be incurred
143.28and that there is insufficient money available
143.29to pay for the costs out of money currently
143.30available to that board, the administrative
143.31services unit is authorized to transfer money
143.32from this appropriation to the board for
143.33payment of those costs with the approval
143.34of the commissioner of management and
143.35budget. This appropriation does not cancel.
144.1Any unencumbered and unspent balances
144.2remain available for these expenditures in
144.3subsequent fiscal years.
144.4Base Adjustment. The State Government
144.5Special Revenue Fund base is decreased by
144.6$911,000 in fiscal year 2014 and $1,011,000
144.7$961,000 in fiscal year 2015.

144.8    Sec. 7. FOSTER CARE FOR INDIVIDUALS WITH AUTISM.
144.9The commissioner of human services shall identify and coordinate with one or more
144.10counties that agree to issue a foster care license and authorize funding for people with
144.11autism who are currently receiving home and community-based services under Minnesota
144.12Statutes, section 256B.092 or 256B.49. Children eligible under this section must be in an
144.13out-of-home placement approved by the lead agency that has legal responsibility for the
144.14placement. Nothing in this section must be construed as restricting an individual's choice
144.15of provider. The commissioner will assist the interested county or counties with obtaining
144.16necessary capacity within the moratorium under Minnesota Statutes, section 245A.03,
144.17subdivision 7. The commissioner shall coordinate with the interested counties and issue a
144.18request for information to identify providers who have the training and skills to meet the
144.19needs of the individuals identified in this section.

144.20    Sec. 8. CHEMICAL HEALTH INTEGRATED MODEL OF CARE
144.21DEVELOPMENT.
144.22(a) The commissioner of human services, in partnership with the counties, tribes,
144.23and stakeholders, shall develop a community-based integrated model of care to improve
144.24the effectiveness and efficiency of the service continuum for chemically dependent
144.25individuals. The plan shall identify methods to reduce duplication of efforts, promote
144.26scientifically supported practices, and improve efficiency. This plan shall consider the
144.27potential for geographically or demographically disparate impact on individuals who need
144.28chemical dependency services.
144.29(b) The commissioner shall provide the chairs and ranking minority members of the
144.30legislative committees with jurisdiction over health and human services a report detailing
144.31necessary statutory and rule changes and a proposed pilot project to implement the plan no
144.32later than March 15, 2013.

144.33    Sec. 9. BIENNIAL BUDGET REQUEST; UNIVERSITY OF MINNESOTA.
145.1Beginning in 2013, as part of the biennial budget request submitted to the
145.2Department of Management and Budget and the legislature, the Board of Regents of the
145.3University of Minnesota is encouraged to include a request for funding for rural primary
145.4care training by family practice residence programs to prepare doctors for the practice
145.5of primary care medicine in rural areas of the state. The funding request should provide
145.6for ongoing support of rural primary care training through the University of Minnesota's
145.7general operation and maintenance funding or through dedicated health science funding.

145.8ARTICLE 6
145.9HEALTH AND HUMAN SERVICES APPROPRIATIONS

145.10
Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
145.11The sums shown in the columns marked "Appropriations" are added to or, if shown
145.12in parentheses, subtracted from the appropriations in Laws 2011, First Special Session
145.13chapter 9, article 10, to the agencies and for the purposes specified in this article. The
145.14appropriations are from the general fund or other named fund and are available for the
145.15fiscal years indicated for each purpose. The figures "2012" and "2013" used in this
145.16article mean that the addition to or subtraction from the appropriation listed under them
145.17is available for the fiscal year ending June 30, 2012, or June 30, 2013, respectively.
145.18Supplemental appropriations and reductions to appropriations for the fiscal year ending
145.19June 30, 2012, are effective the day following final enactment unless a different effective
145.20date is explicit.
145.21
APPROPRIATIONS
145.22
Available for the Year
145.23
Ending June 30
145.24
2012
2013

145.25
145.26
Sec. 2. COMMISSIONER OF HUMAN
SERVICES
145.27
Subdivision 1.Total Appropriation
$
1,352,000
$
19,849,000
145.28
Appropriations by Fund
145.29
2012
2013
145.30
General
803,000
9,680,000
145.31
Health Care Access
-0-
3,000
145.32
Federal TANF
-0-
7,453,000
145.33
Special Revenue
549,000
2,713,000
145.34
Subd. 2.Central Office Operations
145.35
(a) Operations
118,000
356,000
146.1Base Level Adjustment. The general fund
146.2base is increased by $91,000 in fiscal year
146.32014 and $44,000 in fiscal year 2015.
146.4
(b) Health Care
24,000
346,000
146.5This is a onetime appropriation.
146.6Managed Care Audit Activities. In fiscal
146.7year 2014, and in each even-numbered year
146.8thereafter, the commissioner shall transfer
146.9from the health care access fund $1,740,000
146.10to the legislative auditor for managed care
146.11audit services under Minnesota Statutes,
146.12section 256B.69, subdivision 9d. This is
146.13a biennial appropriation. The health care
146.14access fund base is increased by $1,842,000
146.15in fiscal year 2014. Notwithstanding any
146.16contrary provision in this article, this
146.17paragraph does not expire.
146.18
(c) Continuing Care
19,000
375,000
146.19Base Level Adjustment. The general fund
146.20base is decreased by $159,000 in fiscal years
146.212014 and 2015.
146.22
Subd. 3.Chemical and Mental Health
19,000
68,000
146.23Base Level Adjustment. The general fund
146.24base is decreased by $68,000 in fiscal years
146.252014 and 2015.
146.26
Subd. 4.Forecasted Programs
146.27
(a) MFIP/DWP Grants
146.28
Appropriations by Fund
146.29
2012
2013
146.30
General
-0-
(7,009,000)
146.31
Federal TANF
-0-
7,000,000
146.32
(b) General Assistance Grants
-0-
(8,000)
146.33
(c) Minnesota Supplemental Aid Grants
-0-
152,000
147.1
(d) MinnesotaCare Grants
-0-
3,000
147.2This appropriation is from the health care
147.3access fund.
147.4
(e) Group Residential Housing Grants
-0-
(202,000)
147.5
(f) Medical Assistance Grants
623,000
14,303,000
147.6PCA Relative Care Payment Recovery.
147.7Notwithstanding any law to the contrary, and
147.8if, at the conclusion of the HealthStar Home
147.9Health, Inc et al v. Commissioner of Human
147.10Services litigation, the PCA relative rate
147.11reduction under Minnesota Statutes, section
147.12256B.0659, subdivision 11, paragraph (c),
147.13is upheld, the commissioner is prohibited
147.14from recovering the difference between the
147.15100 percent rate paid to providers and the
147.1680 percent rate, during the period of the
147.17temporary injunction issued on October 26,
147.182011. This section does not prohibit the
147.19commissioner from recovering any other
147.20overpayments from providers.
147.21Long-Term Care Realignment Waiver
147.22Conformity. Notwithstanding Minnesota
147.23Statutes, section 256B.0916, subdivision 14,
147.24and upon federal approval of the long-term
147.25care realignment waiver application,
147.26essential community support grants must be
147.27made available in a manner that is consistent
147.28with the state's long-term care realignment
147.29waiver application submitted on February
147.3013, 2012. The commissioner is authorized
147.31to use increased federal matching funds
147.32resulting from approval of the long-term care
147.33realignment waiver as necessary to meet
147.34the fiscal year 2013 demand for essential
148.1community support grants administered in a
148.2manner that is consistent with the terms and
148.3conditions of the long-term care realignment
148.4waiver, and that amount of federal funds is
148.5appropriated to the commissioner for this
148.6purpose.
148.7Continuing Care Provider Payment
148.8Delay. The commissioner of human services
148.9shall delay the last payment or payments
148.10in fiscal year 2013 to providers listed in
148.11Minnesota Statutes 2011 Supplement,
148.12section 256B.5012, subdivision 13, and
148.13Laws 2011, First Special Session chapter
148.149, article 7, section 54, paragraph (b),
148.15by up to $20,688,000. In calculating the
148.16actual payment amounts to be delayed, the
148.17commissioner must reduce the $20,688,000
148.18amount by any cash basis state share
148.19savings to be realized in fiscal year 2013
148.20from implementing the long-term care
148.21realignment waiver before July 1, 2013.
148.22The commissioner shall make the delayed
148.23payments in July 2013. Notwithstanding
148.24any contrary provision in this article, this
148.25provision expires on August 1, 2013.
148.26Critical Access Nursing Facilities
148.27Designation. $500,000 is appropriated in
148.28fiscal year 2013 for critical access nursing
148.29facilities under Minnesota Statutes, section
148.30256B.441, subdivision 63. This is a onetime
148.31appropriation and is available until expended.
148.32
Subd. 5.Grant Programs
148.33
(a) Children and Economic Support Grants
-0-
450,000
148.34Long-Term Homeless Supportive Services.
148.35$200,000 in fiscal year 2013 from the TANF
149.1fund is for long-term homeless supportive
149.2services for low-income families under
149.3Minnesota Statutes, section 256K.26. This is
149.4a onetime appropriation.
149.5Family Assets for Independence Program.
149.6$250,000 in fiscal year 2013 from the
149.7TANF fund is for grants for the family
149.8assets for independence program under
149.9Minnesota Statutes, section 256E.35. This
149.10appropriation must be used to serve families
149.11with income below 200 percent of the federal
149.12poverty guidelines and minor children in the
149.13household. This is a onetime appropriation
149.14and is available until June 30, 2014.
149.15TANF Transfer to Federal Child Care
149.16and Development Fund. (1) In addition
149.17to the amount provided in this section, the
149.18commissioner shall transfer TANF funds to
149.19basic sliding fee child care assistance under
149.20Minnesota Statutes, section 119B.03:
149.21(i) fiscal year 2013, $1,000; and
149.22(ii) fiscal year 2014 and ongoing, $6,000.
149.23(2) The commissioner shall authorize the
149.24transfer of sufficient TANF funds to the
149.25federal child care and development fund to
149.26meet this appropriation and shall ensure that
149.27all transferred funds are expended according
149.28to federal child care and development fund
149.29regulations.
149.30
(b) Aging and Adult Services Grants
-0-
999,000
149.31In fiscal year 2013, upon federal approval
149.32to implement the nursing facility level
149.33of care under Minnesota Statutes, section
149.34144.0724, subdivision 11, $999,000 is for
150.1essential community supports grants. This is
150.2a onetime appropriation.
150.3
(c) Disabilities Grants
-0-
300,000
150.4Intractable Epilepsy. This appropriation
150.5includes $65,000 for living skills training
150.6programs for persons with intractable
150.7epilepsy who need assistance in the transition
150.8to independent living under Laws 1988,
150.9chapter 689, article 2, section 251. This
150.10appropriation is ongoing.
150.11Self-advocacy Network for Persons with
150.12Disabilities.
150.13(1) $50,000 is appropriated in fiscal year
150.142013 to establish and maintain a statewide
150.15self-advocacy network for persons with
150.16intellectual and developmental disabilities.
150.17This is a onetime appropriation and is
150.18available until expended.
150.19(2) The self-advocacy network must focus on
150.20ensuring that persons with disabilities are:
150.21(i) informed of and educated about their legal
150.22rights in the areas of education, employment,
150.23housing, transportation, and voting; and
150.24(ii) educated and trained to self-advocate for
150.25their rights under law.
150.26(3) Self-advocacy network activities under
150.27this section include but are not limited to:
150.28(i) education and training, including
150.29preemployment and workplace skills;
150.30(ii) establishment and maintenance of a
150.31communication and information exchange
150.32system for self-advocacy groups; and
151.1(iii) financial and technical assistance to
151.2self-advocacy groups.
151.3Base Level Adjustment. The general fund
151.4base is increased by $23,000 in fiscal year
151.52014 and decreased by $235,000 in fiscal
151.6year 2015.
151.7
Subd. 6.State-Operated Services
549,000
2,713,000
151.8Minnesota Specialty Health Services -
151.9Willmar. $549,000 in fiscal year 2012
151.10and $2,713,000 in fiscal year 2013 from
151.11the account established under Minnesota
151.12Statutes, section 246.18, subdivision 8, is
151.13for continued operation of the Minnesota
151.14Specialty Health Services - Willmar. These
151.15appropriations are onetime from the special
151.16revenue fund. Closure of the facility shall
151.17not occur prior to June 30, 2013.
151.18
Subd. 7.Technical Activities
-0-
3,000
151.19This appropriation is from the TANF fund.
151.20Base Level Adjustment. The TANF fund
151.21base is increased by $13,000 in fiscal years
151.222014 and 2015.

151.23
Sec. 3. COMMISSIONER OF HEALTH
151.24
Subdivision 1.Total Appropriation
$
-0-
$
501,000
151.25
Appropriations by Fund
151.26
2012
2013
151.27
General
-0-
364,000
151.28
Health Care Access
-0-
137,000
151.29
151.30
Subd. 2.Community and Family Health
Promotions
-0-
200,000
151.31Autism Study. $200,000 is for the
151.32commissioner of health, in partnership with
151.33the University of Minnesota, to conduct a
152.1qualitative study focused on cultural and
152.2resource-based aspects of autism spectrum
152.3disorders (ASD) that are unique to the
152.4Somali community. By February 15,
152.52014, the commissioner shall report the
152.6findings of this study to the legislature. The
152.7report must include recommendations as to
152.8establishment of a population-based public
152.9health surveillance system for ASD. This is a
152.10onetime appropriation and is available until
152.11June 30, 2014.
152.12
Subd. 3.Policy Quality and Compliance
152.13
Appropriations by Fund
152.14
2012
2013
152.15
General
-0-
164,000
152.16
Health Care Access
-0-
137,000
152.17Web Site Changes. $36,000 is for
152.18Web site changes required as part of the
152.19evaluation of health and human services
152.20regulatory responsibilities. This is a onetime
152.21appropriation and must be shared with the
152.22Department of Human Services through an
152.23interagency agreement.
152.24Management and Budget. $100,000 is for
152.25transfer to the commissioner of management
152.26and budget for the evaluation of health and
152.27human services regulatory responsibilities.
152.28This is a onetime appropriation.
152.29Nursing Facility Moratorium Exceptions.
152.30In fiscal year 2013, $8,000 is for
152.31administrative costs related to review
152.32of moratorium exception projects under
152.33Minnesota Statutes, section 144A.073,
152.34subdivision 13. This is a onetime
152.35appropriation.
153.1Health Record Access Study. $20,000
153.2in fiscal year 2013 is for the health record
153.3access study. This is a onetime appropriation.
153.4Radiation Therapy Facilities Study. In
153.5fiscal year 2013, $137,000 from the health
153.6care access fund is for a study of radiation
153.7therapy facilities capacity. This is a onetime
153.8appropriation.

153.9
153.10
Sec. 4. BOARD OF NURSING HOME
ADMINISTRATORS
$
-0-
$
10,000
153.11Administrative Services Unit. This
153.12appropriation is to provide a grant to the
153.13Minnesota Ambulance Association to
153.14coordinate and prepare an assessment of
153.15the extent and costs of uncompensated care
153.16as a direct result of emergency responses
153.17on interstate highways in Minnesota.
153.18The study will collect appropriate
153.19information from medical response units
153.20and ambulance services regulated under
153.21Minnesota Statutes, chapter 144E, and to
153.22the extent possible, firefighting agencies.
153.23In preparing the assessment, the Minnesota
153.24Ambulance Association shall consult with
153.25its membership, the Minnesota Fire Chiefs
153.26Association, the Office of the State Fire
153.27Marshal, and the Emergency Medical
153.28Services Regulatory Board. The findings
153.29of the assessment will be reported to the
153.30chairs and ranking minority members of the
153.31legislative committees with jurisdiction over
153.32health and public safety by January 1, 2013.

153.33    Sec. 5. MANAGED CARE ORGANIZATION EXCESS PROFITS.
154.1Excess profits of managed care organizations paid to the commissioner of human
154.2services in fiscal year 2013 shall be deposited in the funds from which the payments
154.3originated. These amounts are estimated to be $27,740,000 for the general fund and
154.4$7,300,000 for the health care access fund.

154.5    Sec. 6. EXPIRATION OF UNCODIFIED LANGUAGE.
154.6All uncodified language contained in this article expires on June 30, 2013, unless a
154.7different expiration date is explicit.

154.8    Sec. 7. EFFECTIVE DATE.
154.9The provisions in this article are effective July 1, 2012, unless a different effective
154.10date is explicit."
154.11Delete the title and insert:
154.12"A bill for an act
154.13relating to state government; making adjustments to health and human services
154.14appropriations; making changes to provisions related to health care, the
154.15Department of Health, children and family services, continuing care, background
154.16studies, chemical dependency, and child support; requiring reporting of potential
154.17welfare fraud; providing for data sharing; requiring eligibility determinations;
154.18providing rulemaking authority; providing penalties; encouraging the University
154.19of Minnesota to request funding for rural primary care training; requiring studies
154.20and reports; providing appointments; appropriating money;amending Minnesota
154.21Statutes 2010, sections 62A.047; 62J.496, subdivision 2; 62Q.80; 72A.201,
154.22subdivision 8; 144.292, subdivision 6; 144.298, subdivision 2; 144.5509;
154.23144A.073, by adding a subdivision; 144A.351; 144D.04, subdivision 2; 145.906;
154.24245.697, subdivision 1; 245A.03, by adding a subdivision; 245A.11, subdivisions
154.252a, 7, 7a; 245B.07, subdivision 1; 245C.04, subdivision 6; 245C.05, subdivision
154.267; 252.27, subdivision 2a; 254A.19, by adding a subdivision; 256.01, by adding
154.27subdivisions; 256.975, subdivision 7; 256.9831, subdivision 2; 256B.056,
154.28subdivision 1a; 256B.0625, subdivision 28a, by adding subdivisions; 256B.0659,
154.29by adding a subdivision; 256B.0751, by adding a subdivision; 256B.0911, by
154.30adding subdivisions; 256B.092, subdivisions 1b, 7; 256B.0943, subdivision 9;
154.31256B.431, subdivision 17e, by adding a subdivision; 256B.434, subdivision
154.3210; 256B.441, by adding a subdivision; 256B.48, by adding a subdivision;
154.33256B.69, subdivision 9, by adding subdivisions; 256D.06, subdivision 1b;
154.34256D.44, subdivision 5; 256E.37, subdivision 1; 256I.05, subdivision 1e;
154.35256J.26, subdivision 1, by adding a subdivision; 256J.575, subdivisions 1, 2, 5,
154.366, 8; 256L.07, subdivision 3; 518A.40, subdivision 4; 626.556, by adding a
154.37subdivision; Minnesota Statutes 2011 Supplement, sections 62E.14, subdivision
154.384g; 119B.13, subdivision 7; 144.1222, subdivision 5; 245A.03, subdivision 7;
154.39256.987, subdivisions 1, 2, by adding subdivisions; 256B.056, subdivision 3;
154.40256B.057, subdivision 9; 256B.0625, subdivision 38; 256B.0631, subdivision
154.411; 256B.0659, subdivision 11; 256B.0911, subdivisions 3a, 3c; 256B.0915,
154.42subdivisions 3e, 3h; 256B.097, subdivision 3; 256B.49, subdivisions 14, 15, 23;
154.43256B.5012, subdivision 13; 256B.69, subdivision 5a; 256B.76, subdivision 4;
154.44256E.35, subdivisions 5, 6; 256I.05, subdivision 1a; 256L.03, subdivision 5;
154.45256L.031, subdivisions 2, 3, 6; 256L.12, subdivision 9; Laws 2010, chapter 374,
154.46section 1; Laws 2011, First Special Session chapter 9, article 7, sections 52; 54;
154.47article 10, sections 3, subdivisions 1, 3, 4; 8, subdivision 8; proposing coding
154.48for new law in Minnesota Statutes, chapters 144; 145; 256B; 626; repealing
155.1Minnesota Statutes 2010, sections 62M.09, subdivision 9; 62Q.64; 144A.073,
155.2subdivision 9; 256B.48, subdivision 6; Minnesota Rules, parts 4640.0800,
155.3subpart 4; 4685.2000."
156.1
We request the adoption of this report and repassage of the bill.
156.2
House Conferees:
156.3
.....
.....
156.4
Jim Abeler
Steve Gottwalt
156.5
.....
.....
156.6
Mary Kiffmeyer
Joe Schomacker
156.7
.....
156.8
Thomas Huntley
156.9
Senate Conferees:
156.10
.....
.....
156.11
David W. Hann
Julie A. Rosen
156.12
.....
.....
156.13
Michelle R. Benson
Sean Nienow
156.14
.....
156.15
Tony Lourey